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Lopes ERDC, Macêdo FPF, Fifolato TRIM, Nardim HCB, Suzuki KAK, Fonseca MDCR. Physical, functional and personal variables affecting shoulder complaints in healthcare workers. Work 2024:WOR230373. [PMID: 38427524 DOI: 10.3233/wor-230373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Work related shoulder disorders adversely affect the quality of life and lead to increased costs related to decreased productivity and injury treatment. Therefore, understanding the relationship between strength, upper extremity function and work ability contributes to the development of interventions aimed to improve the well-being of healthcare workers. OBJECTIVE Correlate shoulder abduction and handgrip strength with upper extremity function and work ability in healthcare workers with shoulder complaints. METHODS 67 workers with shoulder pain in the last year were assessed by Disability of Arm, Shoulder and Hand (QuickDASH), Work Ability Index (WAI), isokinetic shoulder strength and isometric handgrip strength dynamometers. Data were analysed with Spearman's Correlation Coefficient (ρ= 0.05), SPSS 20.0 ®. RESULTS 52% males, mean age 48.4 years, 42% physically active, most administrative and general services workers. Low correlation between handgrip strength and QuickDASH (r=-0.359; p = 0.004); low correlation between handgrip strength and WAI (r = 0.359; p = 0.003) and between shoulder abduction strength and the QuickDASH (r = -0.267; p = 0.049); no significant correlation between shoulder abduction strength and WAI (r = 0.001; p = 0.997). CONCLUSIONS Handgrip and shoulder abduction strength were inversely associated with upper extremity dysfunction. Shoulder abduction strength was associated with work ability. The inclusion of strength assessment in workers is important to guide strategies to prevent musculoskeletal disorders.
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Affiliation(s)
| | - Flávia Pessoni Faleiros Macêdo
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Tha Rsquo Is Marques Fifolato
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Heloisa Correa Bueno Nardim
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Karen Ayumi Kawano Suzuki
- Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av 3900, Ribeirão Preto, SP14049-900, Brazil
| | - Marisa de Cássia Registro Fonseca
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av 3900, Ribeirão Preto, SP 14049-900, Brazil
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av 3900, Ribeirão Preto, SP 14049-900, Brazil
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Pyörny J, Sletten IN, Jokihaara J. Concurrent validity study of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation. BMC Musculoskelet Disord 2024; 25:86. [PMID: 38263085 PMCID: PMC10804815 DOI: 10.1186/s12891-024-07183-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The Disability of the Arm, Shoulder and Hand Outcome Measure (DASH) is a validated patient-reported outcome measure (PROM) for many upper extremity musculoskeletal disorders. In patients with severe traumatic conditions, limited evidence exists regarding the equivalence between DASH and its shortened version, QuickDASH, which is more feasible in clinical practice. The rationale of this study was to analyze the concurrent validity of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation. METHODS This study is based on a consecutive cohort of traumatic upper extremity amputation patients treated with replantation or revision (completion) amputation at Tampere University Hospital between 2009 and 2019. We estimated the concurrent validity of QuickDASH with respect to DASH by correlation coefficients, mean score differences, Bland-Altman plots, and distribution density. Additionally, we assessed internal reliability with Cronbach's alpha coefficients and item-total correlations. RESULTS We found a very strong linear correlation between DASH and QuickDASH scores (r = 0.97 [CI 95% 0.97-0.98], p < 0.001). The mean difference between DASH and QuickDASH was minor (MD = -1, SD 4 [CI95% from -1 to 0] p = 0.02). The mean sub-score for the activity domain was higher for QuickDASH than DASH (MD = -3 [CI95% from -4 to -3] p < 0.000) and lower for the symptom domain (MD = 7 [CI95% from 6 to 9] p < 0.000). The Bland and Altman plot showed good agreement between DASH and QuickDASH scores, but there was measurement error in QuickDASH with high scores (r = -0.20, [CI95% from -0.31 to -0.09], p = 0.001). CONCLUSION QuickDASH demonstrates higher total scores than the full DASH and emphasizes rating of activity over symptoms. Still, on average the differences in total scores are likely less than the MCID of DASH, and consequently, this study shows that QuickDASH can be recommended instead of the full DASH when assessing a traumatic condition. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Joonas Pyörny
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Jarkko Jokihaara
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
- Center for Musculoskeletal Diseases, Tampere University Hospital, Tampere, Finland.
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3
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Macedo FPF, McKee P, Semedo ACG, Parisi M, Scarpa I, Santiago PRP, Fonseca MDCR. Exploration of outcome measures for assessing orthotic intervention in upper extremity peripheral nerve injuries: 2 case reports. Prosthet Orthot Int 2024; 48:76-82. [PMID: 38334503 DOI: 10.1097/pxr.0000000000000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 08/17/2023] [Indexed: 02/10/2024]
Abstract
In upper extremity peripheral nerve injuries, orthotic intervention has been used as a valuable device to restore function. However, there is lacking evidence to support it. The purpose of this study was to explore the application of body function's outcome measures for orthotic intervention evaluation in patients with peripheral nerve injury. Two participants sustaining a peripheral nerve injury who underwent orthotic intervention were assessed: subject 1 was a 25-year-old man with ulnar and median nerve injury presenting with a composite claw; subject 2, a 28-year-old man with radial nerve injury presenting with a dropped wrist. Strength, range of motion, and electromyography were measured in 2 conditions: wearing the orthosis and without it. The Jamar, Pinch Gauge, a 3D motion capture system (Optitrack-NaturalPoint), and surface electromyography (Trigno Wireless System, Delsys) were the chosen instruments. Both subjects presented differences in grip and pinch strength. In both tasks, subject 1 reached higher wrist extension while wearing the orthosis. Subject 2 reached higher wrist extension and radial deviation while wearing the orthosis. There were marked differences in both tasks for subject 2, especially the maintenance of wrist extension when wearing the orthosis. Electromyographic assessment showed higher root-mean-square values for all muscles, in both tasks for subject 1. For subject 2, a higher root-mean-square value was found for flexor carpi ulnaris during the execution of task 1 wearing the orthosis. Outcome measures of body function can quantify the impact of orthotic intervention in patients sustaining peripheral nerve injury, and therefore, they are feasible for evaluating it.
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Affiliation(s)
- Flávia Pessoni F Macedo
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Pat McKee
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Ana Carolina Grillo Semedo
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Maitê Parisi
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Isadora Scarpa
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Paulo Roberto Pereira Santiago
- Laboratory of Biomechanics and Motor Control, School of Physical Education and Sport of Ribeirao Preto, University of São Paulo, São Paulo, Brazil
| | - Marisa de Cássia Registro Fonseca
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Aldaihan MM, Alnahdi AH. Responsiveness of the Arabic Quick Disabilities of the Arm, Shoulder and Hand in Patients with Upper Extremity Musculoskeletal Disorders. Healthcare (Basel) 2023; 11:2507. [PMID: 37761704 PMCID: PMC10530924 DOI: 10.3390/healthcare11182507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/31/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to examine the responsiveness of the Arabic Disabilities of the Arm, Shoulder and Hand short version (Quick-DASH) in patients with upper extremity musculoskeletal disorders. Participants with upper extremity musculoskeletal disorders (N = 88) under physical therapy care were assessed at initial visit and later at a follow-up visit, and they completed the Arabic Quick-DASH, DASH, Numeric Pain Rating Scale (NPRS), Global Assessment of Function (GAF), and the Global Rating of Change Scale (GRC). Responsiveness of the Arabic Quick-DASH was assessed by examining six pre-defined hypotheses. Consistent with the pre-defined hypotheses, the Arabic Quick-DASH changes scores exhibited significant positive correlation with the change in DASH (r = 0.98), GAF (r = 0.67), NPRS (r = 0.72), and the GRC (r = 0.78). As hypothesized, the Arabic Quick-DASH showed a large effect size above the pre-determined level (ES = 1.61, SRM = 1.49) in patients who reported improved upper extremity function. The Arabic Quick-DASH change score discriminated between patients who reported improvement versus no improvement in upper extremity function (area under the receiver operating characteristic curve = 0.90). The results supported 100% (six out of six) of the pre-defined hypotheses. The Arabic Quick-DASH demonstrated sufficient responsiveness where all the pre-defined hypotheses were supported, leading to the established validity of the Arabic Quick-DASH change score as a measure of change in upper extremity function and symptoms. The minimal importance change in the Arabic Quick-DASH needs to be determined in future studies.
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Affiliation(s)
| | - Ali H. Alnahdi
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
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True neurogenic thoracic outlet syndrome: late outcomes from a surgical series. Acta Neurochir (Wien) 2022; 164:2673-2681. [PMID: 35906353 DOI: 10.1007/s00701-022-05319-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/14/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND True neurogenic thoracic outlet syndrome (TNTOS) is rare, and evaluation of surgical treatment is limited to a few studies in the literature. The purpose of this study is to present the results from a surgical series of 21 patients with TNTOS. METHODS Retrospective analysis on 21 patients diagnosed with TNTOS who underwent surgery. Demographic data and neurological status were characterized, and patients were classified in accordance with a pre-established scale for assessing the severity of hand impairment before and after surgery. Neuropathic pain was assessed using a visual analogue scale (VAS) and functional disability was quantified using the QuickDASH questionnaire. The results from before and after surgery were compared using the Wilcoxon test, and the significance level was taken to be 5%. RESULTS There was a significant difference in VAS values from before to after the operation (Wilcoxon test: p = 0.0001; r = 0.86). Most patients (90%) improved after surgery, and in 85% of these patients, the VAS improvement was greater than 50%. Improvement in hand function occurred in seven patients (33.3%), and in most of these cases (28.6%), this improvement was classified as mild. Most patients (93.3%) showed moderate to very severe functional disability at the end of the follow-up. CONCLUSION After surgery, only one-third of the cases showed improvement in motor function and most patients had significant functional disability. However, the improvement regarding pain was significant. Surgery to control this symptom should be recommended, even in cases of late presentation and severe motor impairment.
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Pinho AB, Freitas MMD, Fontes CJF. Validação de um instrumento simples e de aplicação rápida para rastrear incapacidade em pacientes com hanseníase. Rev Bras Ortop 2022; 58:101-107. [PMID: 36969776 PMCID: PMC10038715 DOI: 10.1055/s-0042-1742342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/14/2021] [Indexed: 10/17/2022] Open
Abstract
Resumo
Objetivo Avaliar um instrumento diagnóstico simples e rápido a ser utilizado por qualquer profissional da saúde para rastrear a incapacidade apresentada por pacientes com hanseníase.
Método Estudo de validação de teste de diagnóstico realizado em uma amostra de 156 pacientes com hanseníase para rastrear incapacidade funcional, por meio do questionário abreviado disabilities of arm, shoulder, and hand (QuickDASH). A avaliação neurológica simplificada proposta pela Organização Mundial da Saúde foi utilizada como referência. Construiu-se a curva de características operacionais do receptor (ROC) para determinação do ponto de corte do QuickDASH que melhor discriminou pacientes com incapacidade funcional provocada pela hanseníase.
Resultados Foram identificados 86 (55,5%) pacientes com incapacidade funcional pela avaliação neurológica simplificada. O desempenho do QuickDASH mostrou que, em ponto de corte de 30 pontos, a sensibilidade e a especificidade foram de 72,1% e 68,1% (acurácia de 70,3%), respectivamente, para identificar incapacidade funcional, com um valor preditivo positivo de 73,8%.
Conclusão O instrumento QuickDASH mostrou boa acurácia para rastrear incapacidade funcional no paciente com hanseníase, podendo ser útil na prática clínica da atenção básica e ambulatorial geral, com o objetivo de identificar pacientes que necessitam de referência especializada para sua prevenção e tratamento.
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Affiliation(s)
- Adriano Bastos Pinho
- Hospital Universitário Júlio Müller da Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
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da Silva NC, Ricci FPFM, de Castro VR, de Lima ACR, do Carmo Lopes ER, de Salvo Mauad LD, Kawano Suzuki KA, de Oliveira Medeiros ME, de Santana JS, Rocha FLR, de Cássia Registro Fonseca M. Effects of workplace upper extremity resistance exercises on function and symptoms of workers at a tertiary hospital: a randomized controlled trial protocol. BMC Musculoskelet Disord 2022; 23:119. [PMID: 35123476 PMCID: PMC8818236 DOI: 10.1186/s12891-022-05059-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background Work-related musculoskeletal disorders (WRMDs) are often caused by inadequate use of the musculoskeletal system during work. Evidence suggests that multimodal intervention through exercises, massage, education, and ergonomic guidelines reduces pain and symptoms in the neck and upper extremities and help to prevent musculoskeletal disorders. The purpose of this study will be to assess the additive effectiveness of a specific and individualized workplace strengthening exercise program to an ergonomic guidance in reducing fatigue, pain and discomfort in the upper extremities and neck perceived by workers. Methods This trial was designed according to the Consolidated Standards of Reporting Trials - CONSORT guidelines. Participants will be employees of a tertiary hospital, with any complaints of pain or discomfort in the upper extremities during the past 12 months, without clinical musculoskeletal diagnosis. 166 participants will be randomized into parallels groups as control and workplace exercises. The primary outcomes will be Numerical Pain Scale, isokinetic muscle strength of abduction and isometric handgrip strength. Secondary outcomes on discomfort, fatigue, work capacity and dysfunction will be assessed by QuickDASH, Patient Specific Functional Scale, Neck Disability Index, Need for recovery, Work Ability Index self-report questionnaires and FIT-HANSA performance test. The Ergonomic Work Analysis will be done by Quick Expose Check, RULA, REBA, RARME, ROSA and HARM risk assessment ergonomic tools. We will analyze the difference between baseline and 12 weeks of intervention by T test of independent samples (95% confidence interval, p < 0.05). Clinical significance will be analyzed by the minimum clinically important difference and effect size by Cohen index. The association between the variables will be analyzed by construct validity with the hypothesis of correlations between pain and muscle strength, strength and functionality and strength and fatigue. Discussion Although studies have shown promise outcomes for workplace exercises as an available therapeutic resource used to minimize complaints of pain and discomfort related to work, the results of this study aim to bring evidence about the benefit of a specific resistance exercise as an effective modality to facilitate mechanisms of neuromuscular adaptations, with gradual and posterior hypertrophy in the later phases. Trial registration (NCT04047056, https://clinicaltrials.gov/ct2/show/NCT04047056?term=NCT04047056&draw=2&rank=1) on Dec 03, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05059-5.
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Takahasi HY, Fidelis-de-Paula-Gomes CA, Gabel CP, Dibai-Filho AV. Translation, cross-cultural adaptation and validation of the Upper Limb Functional Index (ULFI) into Brazilian Portuguese in patients with chronic upper limb musculoskeletal disorders. Musculoskelet Sci Pract 2021; 56:102452. [PMID: 34507047 DOI: 10.1016/j.msksp.2021.102452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The purpose of this study was to translate, cross-culturally adapt, and validate the Upper Limb Functional Index (ULFI) into Brazilian Portuguese (ULFI-Br). METHODS The translation and cross-cultural adaptation of the ULFI was performed according to international recommendations. The ULFI-Br was applied to 190 patients with chronic upper limb musculoskeletal disorders to verify structural validity. The QuickDASH, the SF-36 and a Numerical Pain Scale (NPS) were completed by 180 patients to assess construct validity using the Spearman correlation (ρ). The internal structure of the ULFI-Br was evaluated by exploratory and confirmatory factor analysis with fit indices chi-square/degrees of freedom (DF), Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI) and Tucker Lewis Index (TLI). A subsample of 51 patients was used to assess test-retest reliability using the intra-class correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change at the 90th percentile (MDC90). Internal consistency was assessed by Cronbach's alpha (α). Floor and ceiling effects were also assessed. RESULTS Factor analysis identified an uni-dimensional structure with acceptable fit indices (RMSEA = 0.063, CFI = 0.918, TLI = 0.910). The ULFI-Br showed excellent reliability (ICC = 0.909) and adequate internal consistency (α = 0.897). The SEM was 6.11% and the MDC90 was 14.26%. The ULFI-Br demonstrated high correlation with the QuickDASH (ρ = -0.721), and moderate to low correlation with other questionnaires. There were no floor or ceiling effects. CONCLUSION The ULFI-Br showed adequate measurement properties in patients with chronic upper limb musculoskeletal disorders indicating its suitability for use as a measure of upper limb functional status in Brazil.
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Affiliation(s)
- Henrique Yuji Takahasi
- Sarah Network of Rehabilitation Hospitals, São Luís, MA, Brazil; Postgraduation Program in Physical Education, Universidade Federal Do Maranhão, São Luís, MA, Brazil.
| | | | | | - Almir Vieira Dibai-Filho
- Postgraduation Program in Physical Education, Universidade Federal Do Maranhão, São Luís, MA, Brazil
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Measurement properties of the Nepali version of the Quick-DASH in patients with shoulder pain. Musculoskelet Sci Pract 2021; 56:102437. [PMID: 34416559 DOI: 10.1016/j.msksp.2021.102437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/07/2021] [Accepted: 07/31/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To examine the measurement properties of the Nepali version of the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH-NP). MATERIALS AND METHODS The Nepali DASH and Shoulder Pain and Disability Index (SPADI) were completed at baseline assessment, and again at follow-up with the Nepali Global Rating of Change (GROC-NP) score. The 11 items of the QuickDASH-NP were extracted from the DASH and tested for confirmatory factory analysis (CFA), exploratory factor analysis (EFA), internal consistency (α), item-total correlation (ITC), test-retest reliability (ICC), measurement errors, hypothesis testing (correlation with DASH and SPADI) and responsiveness (effect size-ES, standardised response mean-SRM). RESULTS A total of 156 participants completed questionnaires at baseline and 121 at follow-up with all questionnaires valid (no participant leaving more than one question blank). CFA suggested a poor fit for the single-factor model. The EFA demonstrated two factors with acceptable internal consistency (α = 0.79 and 0.75) for each factor. The test-retest reliability was excellent (ICC = 0.94; 95%CI:0.92-0.98), correlation was positive and very strong with the DASH-NP (r = 0.96) and strong with the SPADI-NP (r = 0.81). The Standard Error of Measurement was 2.83 and Smallest Detectable Change 7.84/100. The ES and SRM were moderate to high. CONCLUSIONS The QuickDASH-NP is reliable, valid, and able to detect change in shoulder symptoms among Nepali participants. It offers a short, easy to complete self-reporting tool for clinical use and research.
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Fifolato TM, Nardim HCB, do Carmo Lopes ER, Suzuki KAK, da Silva NC, de Souza Serenza F, Fonseca MCR. Association between muscle strength, upper extremity fatigue resistance, work ability and upper extremity dysfunction in a sample of workers at a tertiary hospital. BMC Musculoskelet Disord 2021; 22:508. [PMID: 34074292 PMCID: PMC8170978 DOI: 10.1186/s12891-021-04256-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background Upper extremity musculoskeletal disorders negatively affect ability to perform activities of daily living, self-care and work. Therefore, outcome measurements that address muscle strength, fatigue resistance, functionality and work physical capacity must be defined to assess and plan specific actions to minimize them. Objective To investigate the association of upper extremity muscle strength with upper extremity fatigue resistance, work ability and upper extremity dysfunction in a sample of workers from a tertiary hospital. Methods Shoulder and elbow isokinetic strength were assessed by Biodex System 4™, isometric hand grip by JAMAR™, upper extremity fatigue resistance by Functional Impairment Test Hand and Neck/Shoulder/Arm (FIT-HaNSA), ability to work by the Work Ability Index and upper extremity dysfunction by the Quick-Disabilities of the Arm, Shoulder and Hand QuickDASH-Br questionnaire. The Nordic questionnaire and Numeric Pain Rating Scale (NPRS) were used for pain description. The associations were analysed by Spearman’s correlation coefficient (rho) (p < 0.05). Results Twenty-seven participants: 59.2% women; mean age 46 years old; 70.3% obese/overweight; 62.9% active with predominantly dynamic muscle contraction work. Besides predominance of good to moderate work ability (81.4%) and comorbidities (37%), all participants had symptoms of the upper extremities for at least 12 months, with a predominance of low-intensity in the shoulder (55.5%). In addition, 88.8% reported pain in other segments. Muscle strength of abduction (rho = 0.49), adduction (rho = 0.40), internal rotation (rho = 0.44) and hand grip (rho = 0.68) presented moderate correlation with FIT-HaNSA. Hand grip (rho = − 0.52) showed moderate correlation with upper extremity dysfunction. Conclusions The results of this preliminary study suggested the association of shoulder strength with fatigue resistance. Also, hand grip strength was associated with upper extremity dysfunction and fatigue resistance. No association was found with the Work Ability Index in this sample. So, it is suggested that hand grip and shoulder strength could be outcome measurements used for future interventions focused on upper extremity preventive exercises to improve strength and fatigue resistance of workers at risk for the development of musculoskeletal disorders. Other individual, psychosocial and organizational risk factors must also be considered as influences on upper extremity function.
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Affiliation(s)
- Thaís Marques Fifolato
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.,Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Heloísa Correa Bueno Nardim
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.,Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ester Rodrigues do Carmo Lopes
- Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.,Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Karen A Kawano Suzuki
- Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.,Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Natalia Claro da Silva
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.,Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Felipe de Souza Serenza
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.,Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Marisa C Registro Fonseca
- Post Graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. .,Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil. .,Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av 3900, Ribeirão Preto, SP, 14049-900, Brazil.
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Alnahdi AH. Validity and reliability of the Arabic quick disabilities of the arm, Shoulder and Hand (QuickDASH-Arabic). Musculoskelet Sci Pract 2021; 53:102372. [PMID: 33780697 DOI: 10.1016/j.msksp.2021.102372] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 03/03/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The QuickDASH is a commonly used upper extremity region-specific outcome measure assessing activity limitation and symptoms. The Arabic version of QuickDASH is available in the official outcome measure website, but no prior studies have examined its psychometric properties. OBJECTIVE To examine the psychometric properties of the Arabic QuickDASH in patients with upper extremity musculoskeletal disorders. METHODS Participants with upper extremity musculoskeletal disorders were recruited (N = 109) using convenience sampling and completed the Arabic QuickDASH, Numeric Pain Rating Scale, Global Assessment of Function, and RAND 36-item Health Survey in two testing sessions (2-7 days apart). The Arabic QuickDASH structural validity, internal consistency, floor and ceiling effect, test-retest reliability, measurement error, and construct validity were examined. RESULTS Exploratory factor analysis indicated a one factor underlying the Arabic QuickDASH. The Arabic QuickDASH had Cronbach's alpha of 0.90 and ICC2.1 of 0.91 indicating excellent internal consistency and test-retest reliability. None of the participant reached the minimum or the maximum score. The scale's standard error of measurement and minimal detectable change were 7.0 and 16.3. Five out of the six construct validity predefined hypotheses were supported by the results. CONCLUSION The Arabic QuickDASH is a unidimensional scale with excellent internal consistency, test-retest reliability and acceptable measurement error. The Arabic Quick DASH is a valid and reliable outcome measure that can be used in Arabic speaking countries with Arabic patients suffering from various upper extremity activity limitations and symptoms.
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Affiliation(s)
- Ali H Alnahdi
- Rehabilitation Sciences Department, College of Applied Medical, Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia.
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Şavkın R, Büker N, Şimşek Ş. The Liverpool Elbow Score, patient-answered section: Cultural adaptation, validity and reliability of Turkish version. Musculoskelet Sci Pract 2020; 50:102256. [PMID: 33069940 DOI: 10.1016/j.msksp.2020.102256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The use of self-assessment questionnaires in addition to clinical evaluations is gradually increasing. Liverpool Elbow Scale (LES) is an elbow-specific outcome score that provides a comprehensive assessment of by both the clinicians and patients. However, it has not been adapted and validated to Turkish language. OBJECTIVE To conduct the translation, cross-cultural adaptation and validation of Liverpool Elbow Score-patient answered outcome (LES-PAQ) into Turkish for patients with elbow fracture. DESIGN Study of diagnostic accuracy/assessment scale. METHODS This study was carried out in three consecutive phases: translation, cross-cultural adaptation and validation. In the third phase, we used the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH), Mayo Elbow Performance Score (MEPS) and 12-Item Short Form Survey (SF-12) physical health score. RESULTS Sixty-one patients were included for the analysis. Neither a ceiling nor a floor effect was observed. Cronbach's α coefficient was 0.89. Intraclass correlation coefficient was 0.94 (95% CI 0.89 to 0.96; p < 0.001). SEM was 0.28 and MDC95 was 0.79. The LES-PAQ showed a high negative correlation with the Quick-DASH (r = -0.72, p < 0.001) and high positive correlation with MEPS (r = 0.77, p < 0.001), and with SF-12 physical health subscale (r = 0.73, p < 0.001). CONCLUSIONS The Turkish version of the LES-PAQ is a reliable and valid tool for the assessment of the patients with elbow fracture.
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Affiliation(s)
- Raziye Şavkın
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey.
| | - Nihal Büker
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Şule Şimşek
- Saraykoy Vocational School, Department of Therapy and Rehabilitation, Denizli, Turkey
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