The psychosocial impact of assistive device scale: Italian validation in a cohort of nonambulant people with neuromotor disorders

Translation and validation of the Persian version of "The Psychosocial Impact of Assistive Devices Scale" in patients with neurological disorders

Neurological disorders are a heterogeneous group of central or peripheral nervous disorders of which the main symptoms include impaired walking and balance. One of the main interventions for neurological disorders is the use of assistive devices, and it is necessary to consider the psychosocial effects of these devices on users. The psychometric properties of the Persian version of the Psychosocial Impact of Assistive Devices Scale (PIADS) were evaluated in patients with neurological disorders. After translating the scale into Persian based on IQULA, face and content validity were determined. The divergent validity of the scale was examined through its relationship with the Orthotics and Prosthetics Users' Survey (OPUS). Reliability of the tool was evaluated using an internal consistency and test-retest method over two weeks with 50 patients with neurological disorders and a history of using assistive devices for at least six months. The face and content validity of the PIADS was confirmed. The ICC for all subscales was higher than 0.78, which indicates a good correlation. However, the divergent validity of the scale with the OPUS scale was not confirmed. The Persian version of PIADS is a valid and reliable measure for patients with neurological disorders in Iran.

Cultural adaptation and validation in Italian of the Seated Postural Control Measure for Adults 2.0

OBJECTIVE

The aim of this study was to assess the cultural adaptation and validation in Italian of the Seated Postural Control Measure for Adults 2.0 (SPCMA 2.0).

METHODS

The original scale was translated and culturally adapted from French to Italian using the "Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice" guidelines. Its internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Italian version of the Wheelchair use Confidence Scale and Wheelchair Skills Test 4.2.

RESULTS

Fifty-nine people were evaluated and re-evaluated after 48 h. Most of the items and subscale totals were stable in the 2 evaluations as they reported an intraclass correlation coefficient value of >0.77. The test-retest analysis of the dynamic evaluation was performed on the same patients 48 h apart. The analysis for construct validity showed statistically significant correlations with Wheelchair use Confidence Scale and Wheelchair Skills Test 4.2.

CONCLUSIONS

Seated Postural Control Measure for Adults 2.0 is one of the few tools that allow researchers to perform a quantitative and standardized posture assessment in a cost-effective and time-saving way. Furthermore, it has been demonstrated that it is an easy-to-administer scale and requires readily available tools. The limitations of this study highlighted above and the need to use quantitative and qualitative tools in clinical practice imply the need to conduct future studies.

Evaluation of test-retest reliability and concurrent validity of the Italian version of the pediatric evaluation of disability inventory in children with down syndrome: A cross-sectional study

PURPOSE

Down Syndrome (DS) is a common genetic disorder caused by trisomy 21. Due to cognitive challenges associated with DS, individuals often experience difficulty performing activities of daily living (ADLs), at levels that can range from mild to significant. This study aimed to measure psychometric properties of the Italian version of the Pediatric Evaluation of Disability Inventory (PEDI-I) in the DS population.

METHODS

The PEDI-I was administered to children with DS. The internal consistency was examined using Cronbach's Alpha. Test-retest reliability was demonstrated by intraclass correlation coefficient (ICC) and Bland-Altman plots. The concurrent validity was evaluated with the Italian version of the Barthel Index.

RESULTS

The PEDI-I was administered to 54 children with DS. Cronbach's Alpha showed statistically significant values (0.899 -0.986). The ICC confirmed the reproducibility of the scale with a range of (0.988 -1), while Bland-Altman plots showed a smallest detectable change of (0.18-1.63). The Pearson Correlation Coefficient with the Barthel Index showed statistically significant values for all PEDI-I subscales (range 0.75-0.95).

CONCLUSION

The study provides evidence of good test-retest reliability and convergent validity when used in children with DS. Other psychometric proprieties need to be investigated in future studies.

Seated postural control measure: Italian translation and validation in children with cerebral palsy

BACKGROUND

Seating interventions are part of the postural management program recommended for children with Cerebral Palsy (CP) who are nonambulatory or have difficulty in walking. The lack of validated outcome measures for assessing seating interventions limits access to obtain valid and comparable data internationally.

OBJECTIVE

To translate the Seated Postural Control Measure (SPCM) into Italian and assess reliability and validity of the translated measure in a population of children with CP.

STUDY DESIGN

Cross-sectional and repeated measures study.

METHODS

The original version of the SPCM was translated and culturally adapted by a multidisciplinary team according to international guidelines. Internal consistency was examined with Cronbach's alpha. Both inter- and intrarater reliabilities were estimated using intraclass correlation coefficients with 95% confidence intervals. Intrarater reliability was estimated over a 1-week period. Convergent construct validity was investigated by comparing SPCM values with the Level of Sitting Scale, the Gross Motor Function Classification System, and the Manual Ability Classification System using Pearson's correlation coefficients.

RESULTS

The Italian version of the SPCM (IT-SPCM) was evaluated on 72 children with CP aged 4-18 years. Cronbach's alpha was 0.83, 0.95, and 0.93 for IT-SPCM alignment subscale, IT-SPCM functioning subscale, and total score, respectively. Reliability for IT-SPCM total score was high for both inter- and intrarater reliabilities (0.95 and 0.93). The IT-SPCM total score was moderately correlated with the Level of Sitting Scale (0.37), Gross Motor Function Classification System (-0.41), and Manual Ability Classification System (-0.56).

CONCLUSION

Preliminary evidence supports the reliability and validity of using IT-SPCM with a population of children with CP.

Psychometric Properties of the Spanish Version of Psychosocial Impact of Assistive Devices Scale in a Large Sample of People With Neuromuscular, Neurological, or Hearing Disabilities

Assistive technology (AT) is any device, software, or equipment designed for and used by individuals with disabilities to engage in everyday activities and achieve independence. However, the usefulness of those technology-based or supported treatments is a complex issue that has led to the development of various conceptual models for assistive technology outcomes research and practice as well as different assessment tools that help to explore the effect of technology on people's lives. One of those instruments is the Psychosocial Impact of Assistive Device Scale (PIADS), a 26-item questionnaire that measures the psychosocial impact of interventions, using assistive devices in three quality-of-life domains: competence, adaptability, and self-esteem. PIADS scale has been translated and adapted to several languages, and it has been successfully used to measure AT outcomes in different disability profiles to predict abandonment or even as a relevant determinant of future adoption of eHealth. Quinteiro (2010) adapted PIADS to Spanish for the first time, although no studies have yet been published to systematically study its psychometric properties. Therefore, the purpose of this study was to evaluate measurement properties of the Spanish version of PIADS scale by means of a dataset obtained from its application to a large sample (n = 417) of people with neuromuscular, neurological, or hearing disabilities that used different assistive devices. The results will provide valuable indicators about the measurement quality of the Spanish PIADS scale and will help to promote the use of reliable and valid AT outcome assessment tools for research and clinical purposes.

Athletes with disability' satisfaction with sport wheelchairs: an Italian cross sectional study

PURPOSE

Physical activity is essential for health and well-being. People with physical disability often experience barriers in performing sports due to the lack of appropriate assistive technologies. The present research aimed to investigate athletes with disability satisfaction when using sports wheelchairs and to explore clinometric properties of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

MATERIALS AND METHODS

One hundred and twenty-eight athletes were involved in the present study. Data on sport discipline and wheelchair provision were collected with qualitative approach. Internal consistency and reliability of QUEST were respectively analyzed with Cronbach's Alpha and Intraclass Correlation Coefficient. Validity was investigated with the correlation of the Wheelchair Use Confidence Scale for Manual users.

RESULTS

Results revealed good internal consistency (.858) and moderate inter-rater reliability for service subscale (.664) and for the total score (.675), while for device subscale (.802) reliability was high. Validity revealed moderate correlation (.300) with a p < 0.05. Qualitative analysis highlighted economic barriers as primary social determinant who affect participation in sport activities.

CONCLUSIONS

The present study confirms preliminary evidence of the QUEST for athletes with disability. The research group also recommends an international effort to promote a comprehensive evaluation of sports wheelchair involving rehabilitation professionals, sport technicians and people with disability.Implications for rehabilitationEconomic factors linked to the purchase of a wheelchair seem being the main barrier for practising sportThe Quebec User Evaluation of Satisfaction with Assistive Technology is a useful tool to measure athletes' satisfaction using a wheelchairRehabilitation professionals and sport technicians should collaborate together with people with disability in determining how choose appropriate sport wheelchairs.

The effect of aquatic physical therapy in patients with stroke: A systematic review and meta-analysis

Objective: The purpose of this study was to evaluate the literature reports of qualitative and quantitative results of physical therapy treatments in the alternative aquatic setting for individuals affected by strokes. Method: PRISMA guidelines were used to carry out the systematic review and meta-analysis. Three bibliographic databases were searched: MEDLINE, PEDro, and the Cochrane Library. Papers included in the study were required to: (a) have a randomized controlled trial (RCT) design of research; and (b) be published in English; (c) be published during the last 10 years (2008-2018). Only randomized controlled trials were employed in the study. The quality of the clinical trials to be included was evaluated according to the Jadad scale. The internal validity was assessed according to the PEDro scale. Results: Eleven RCTs were initially identified in the systematic review. Eight of these were involved in the meta-analysis comparing outcomes and follow-up. Eight studies received a Jadad score of three, indicating a high level of quality. The remaining three studies achieved a lower score which indicated lower qualitative level. Nearly all of the results of the quantitative analysis were statistically significant (P < 0,05) and most of them favored of the experimental group subject to aquatic treatment. Conclusion: Aquatic physical therapy may be a valid means for the rehabilitation of people affected by stroke. The integration of this methodological approach with conventional physical therapy should be considered. However, more studies; a larger number of participants; and varying lengths of follow-up times are necessary.

A study validating the Italian version of the Level of Sitting Scale in children with cerebral palsy

Objectives:

To assess measurement properties of the Italian version of the Level of Sitting Scale when classifying sitting ability of children with cerebral palsy.

Design:

Methodological study.

Setting:

Children’s hospital (inpatients and outpatients).

Subjects:

Children 18 years of age or younger with cerebral palsy.

Methods:

The original English version of the Level of Sitting Scale was translated and culturally adapted for the Italian culture following international guidelines. Examination of reliability and validity of the Italian Level of Sitting Scale was then undertaken. Inter-rater and one-week test–retest reliability were estimated using both intraclass correlation coefficients (ICCs) with 95% confidence intervals and Bland–Altman plots. Construct validity of the Italian Level of Sitting was evaluated using three approaches examining Pearson’s correlation coefficient ( r) and Mann–Whitney U test ( P-value < 0.05).

Main measures:

Italian Level of Sitting Scale and Gross Motor Function Classification System.

Results:

The Italian Level of Sitting Scale was administered to 109 subjects. Inter-rater reliability and one-week test–retest showed excellent value with ICCs of 0.99 for both. (1) The Pearson correlation coefficient comparing Italian Level of Sitting Scale with Gross Motor Function Classification System was −0.91 and (2) correlation with total amount of adaptive seating components was −0.90. Differences in sitting abilities and use/non-use of wheelchair were found. All reported a statistical significance of P < 0.01.

Conclusion:

Our findings provide evidence of reliability and validity when using the Italian Level of Sitting Scale to classify seated postural abilities in a sample of Italian children with cerebral palsy.

Exploring Validity, Reliability, and Factor Analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology in an Italian Population: A Cross-Sectional Study

This study explores validity, reliability, and factor analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology (IT-QUEST) for users of assistive technology devices in an Italian population. It was administered to 75 people to determine which of the 24 original items were relevant to the Italian context using exploratory and confirmatory factor analyses (EFAs and CFAs) were conducted with internal consistency and test-retest reproducibility also evaluated. The EFA and CFA showed that the 24-item survey may have limited relevance to the Italian context. We individuated 12 significative items, divided into two subscales, as well as the original validation. The test-retest showed high values of the Intraclass Correlation Coefficient (ICC) (0.7-0.9), with a 0.812 ICC for the total scale providing support and evidence for Italian professionals to evaluate user satisfaction with assistive technology devices. This research also lays the foundation for developing a validation study of the IT-QUEST 2.0 that is relevant to the Italian culture. Further research may investigate psychometric properties involving more participants and different users of assistive technology devices.

Physical Activity Scale for the Elderly: Translation, Cultural Adaptation, and Validation of the Italian Version

OBJECTIVE

The aim of the study was to translate and culturally adapt the Physical Activity Scale for the Elderly into Italian (PASE-I) and to evaluate its psychometric properties in the Italian older adults healthy population.

METHODS

For translation and cultural adaptation, the "Translation and Cultural Adaptation of Patient-Reported Outcomes Measures" guidelines have been followed. Participants included healthy individuals between 55 and 75 years old. The reliability and validity were assessed following the "Consensus-Based Standards for the Selection of Health Status Measurement Instruments" checklist. To evaluate internal consistency and test-retest reliability, Cronbach's α and Intraclass Correlation Coefficient (ICC) were, respectively, calculated. The Berg Balance Score (BBS) and the PASE-I were administered together, and Pearson's correlation coefficient was calculated for validity.

RESULTS

All the PASE-I items were identical or similar to the original version. The scale was administered twice within a week to 94 Italian healthy older people. The mean PASE-I score in this study was 159±77.88. Cronbach's α was 0.815 (p < 0.01) and ICC was 0.977 (p < 0.01). The correlation with the BBS was 0.817 (p < 0.01).

CONCLUSIONS

The PASE-I showed positive results for reliability and validity. This scale will be of great use to clinicians and researchers in evaluating and managing physical activities in the Italian older adults population.

Quality of life in Parkinson's disease: Italian validation of the Parkinson's Disease Questionnaire (PDQ-39-IT)

Translation and cross-cultural adaptation of the 39-item Parkinson's Disease Questionnaire (PDQ-39) to the Italian culture was performed by Oxford University Innovation in 2008, but this version has never been validated. Therefore, we performed the process of validation of the Italian version of the PDQ-39 (PDQ-39-IT) following the "Consensus-Based Standards for the Selection of Health Status Measurement Instruments" checklist. The translated PDQ-39-IT was tested with 104 patients diagnosed with Parkinson's disease (PD) who were recruited between June and October 2017. The mean age of the participants was 65.7 ± 10.2 years, and the mean duration of symptoms was 7.4 ± 5.3 years. The internal consistency of the PDQ-39-IT was assessed by Cronbach's alpha and ranged from 0.69 to 0.92. In an assessment of test-retest reliability in 35 of the 104 patients, the infraclass correlation coefficient (ICC) ranged from 0.85 to 0.96 for the various subitems of the PDQ-39-IT (all p < 0.01). Spearman's rank correlation coefficient for the validity of the PDQ-39-IT and the Italian version of the 36-Item Short Form (SF-36) was - 0.50 (p < 0.01). The results show that the PDQ-39-IT is a reliable and valid tool to assess the impact of PD on functioning and well-being. Thus, the PDQ-39-IT can be used in clinical and research practice to assess this construct and to evaluate the overall effect of different treatments in Italian PD patients.

Effectiveness of Integrated Neurocognitive Therapy on Cognitive Impairment and Functional Outcome for Schizophrenia Outpatients

Cognitive impairment is highly prevalent in patients with schizophrenia and schizoaffective disorder. Many interventions have been developed to treat cognitive deficit, since it has a strong impact on functional outcome; however, there are no integrated interventions targeting multiple neuro- and social-cognitive domains with a particular focus on the generalization of the effects of therapy on the functional outcome. Recently, a group of experts has developed a cognitive remediation group therapy approach called Integrated Neurocognitive Therapy (INT), which includes exercises to improve the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) neuro- and social-cognitive domains. This systematic review and meta-analysis aimed to assess the efficacy of this approach. We conducted a search of PubMed, Scopus, Web of Science, and PsycINFO to select primary studies evaluating INT in schizophrenic and schizoaffective patients. The primary outcomes of the meta-analysis included negative and positive symptoms and global functioning. Two randomized controlled trials met inclusion criteria. A total of 217 participants were included. Based on the results from the Positive and Negative Syndrome Scale (PANSS), a significant pooled effect size was observed for negative symptoms, which demonstrated not only an improvement in the patients treated immediately after therapy but also a permanence of positive results at a 9-12-month follow-up. On the other hand, no significant effect size was observed for positive symptoms. In addition, a significant pooled effect size was found for Global Assessment of Functioning (GAF), which shows how INT's integrated approach has lasting positive implications on patients' functional outcome. We concluded that INT might be an effective treatment for negative symptoms and global functioning in patients with schizophrenia, compared to treatment as usual (TAU).