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Coburn SL, Crossley KM, Kemp JL, Gassert F, Luitjens J, Warden SJ, Culvenor AG, Scholes MJ, King MG, Lawrenson P, Link TM, Heerey JJ. Association between hip muscle strength/function and hip cartilage defects in sub-elite football players with hip/groin pain. Osteoarthritis Cartilage 2024; 32:943-951. [PMID: 38648877 DOI: 10.1016/j.joca.2024.03.121] [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: 09/19/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To explore associations between hip muscle strength and cartilage defects (presence and severity) on magnetic resonance imaging (MRI) in young adults with hip/groin pain participating in sub-elite football. DESIGN Sub-elite football players with hip/groin pain (>6 months) completed assessments of isometric hip strength and functional task performance. Hip cartilage defects were assessed using the Scoring Hip Osteoarthritis with MRI tool. This exploratory, cross-sectional study used logistic and negative binomial models to assess the relationships between hip muscle strength or functional task performance and hip cartilage defects, controlling for body mass index, age, testing site and cam morphology, incorporating sex-specific interaction terms. RESULTS One hundred and eighty-two (37 women) sub-elite (soccer or Australian football) players with hip/groin pain (age 26 ± 7 years) were included. Greater hip extension strength was associated with higher cartilage total score (adjusted incidence rate ratio [aIRR] 1.01, 95%CI: 1.0 to 1.02, p = 0.013) and superolateral cartilage score (adjusted odds ratio (aOR) 1.03, 95% confidence interval (CI): 1.01 to 1.06, p < 0.01). In female sub-elite football players, greater hip external rotation strength was associated with lateral cartilage defects (aOR 1.61, 95%CI: 1.05 to 2.48, p = 0.03) and higher cartilage total score (aIRR 1.25, 95%CI: 1.01 to 1.66, p = 0.042). A one-repetition increase in one-leg rise performance was related to lower odds of superomedial cartilage defects (aOR 0.96, 95%CI: 0.94 to 0.99, p < 0.01). CONCLUSIONS Overall, there were few associations between peak isometric hip muscle strength and overall hip cartilage defects. It is possible that other factors may have relevance in sub-elite football players. Additional studies are needed to support or refute our findings that higher one leg rise performance was associated with reduced superomedial cartilage defect severity and greater hip extension strength was related to higher cartilage defect severity scores.
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Affiliation(s)
- S L Coburn
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.
| | - K M Crossley
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - J L Kemp
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - F Gassert
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - J Luitjens
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - S J Warden
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Department of Physical Therapy, School of Health & Human Sciences, Indiana 15 University, Indianapolis, IN, USA
| | - A G Culvenor
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - M J Scholes
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - M G King
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - P Lawrenson
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Australia
| | - T M Link
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - J J Heerey
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
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Gregory MA, Schaeffer MJ, Reeves JTH, Griffith LE, Wolfson C, Basta NE, McMillan JM, Kirkland S, Raina P, Paterson TSE. The Effects of Cognitive Ability, Mental Health, and Self-Quarantining on Functional Ability of Older Adults During the COVID-19 Pandemic: Results From the Canadian Longitudinal Study on Aging. J Geriatr Psychiatry Neurol 2024; 37:307-317. [PMID: 38116645 PMCID: PMC11089823 DOI: 10.1177/08919887231218755] [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] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Determine whether levels of anxiety and depression, cognitive ability, and self-quarantining during and prior to the pandemic predict decreases in perceived functional ability. DESIGN AND SETTING Longitudinal data collected from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study (2020) and core CLSA study (Follow-Up 1; 2014-2018). PARTICIPANTS 17 541 CLSA participants. MEASUREMENTS Self-quarantining behaviours from questionnaires administered at Baseline (April 2020), Monthly, and Exit (December 2020) time points of the CLSA COVID-19 Questionnaire Study, levels of anxiety and depression at Baseline, perceived change in functional ability at Exit, and performance on neuropsychological tests (Rey Auditory Verbal Learning Task, Mental Alternation Task, Animal Fluency Test) and functional ability (Older Americans Resources and Services [OARS] Multidimensional Assessment Questionnaire) from the core CLSA study. RESULTS Greater cognitive ability pre-pandemic (B = -.003, P < .01), higher levels of anxiety (B = -.024, P < .01) and depressive symptoms (B = -.110, P < .01) at Baseline, and higher frequency of engaging in self-quarantining throughout the COVID-19 survey period (B = -.098, P < .01) were associated with perceived loss in functional ability at Exit. Self-quarantining behaviour was associated with perceived loss in functional ability only at average and high levels of depressive symptoms (B = -.013, P < .01). CONCLUSIONS Older adults with higher cognitive and lower functional ability prior to the pandemic were at greater risk of decreased perceived functional ability during the first year of the pandemic, as were those who experienced greater levels of anxiety and depressive symptoms during the pandemic. Strategies/interventions to preserve functional ability in older adults with cognitive independence prior to future pandemics are warranted.
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Affiliation(s)
| | | | | | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada
| | - Christina Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, QC, Canada
| | - Nicole E Basta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, QC, Canada
| | - Jacqueline M McMillan
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Susan Kirkland
- Department of Community Health & Epidemiology and Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada
| | - Theone S E Paterson
- Department of Psychology, University of Victoria, Victoria, BC, Canada
- Neuropsychology and Cognitive Health, Baycrest Health Sciences Centre, Toronto, ON, Canada
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Aily JB, da Silva AC, de Noronha M, White DK, Mattiello SM. Concurrent Validity and Reliability of Video-Based Approach to Assess Physical Function in Adults With Knee Osteoarthritis. Phys Ther 2024; 104:pzae039. [PMID: 38537274 DOI: 10.1093/ptj/pzae039] [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: 02/05/2023] [Revised: 11/04/2023] [Accepted: 02/08/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES The aim of this study was to determine the concurrent validity and reliability of the Osteoarthritis Research Society International recommended performance-based tests delivered by video-based in adults with knee osteoarthritis. METHODS Thirty-two participants (aged 40-70 years; 15 men) undertook assessments of 4 performance-based tests via both video-based (real-time and recorded) and face-to-face approaches, on the same day. Outcome measures were performance-based test and the number of technical issues encountered. The performance-based tests included the 40-Meter Fast-Paced Walk Test (velocity, m/s), the 30-Second Chair Stand Test (number of repetitions), the Stair Climb Test (time, seconds), and the Timed "Up & Go" Test (time, seconds). The Bland-Altman limit of agreement measures, standard error of measurement (SEM), coefficient of variation (CV), minimal detectable changes, and bias (mean difference) were employed to analyze the concurrent validity between video-based and face-to-face approaches of the performance-based tests. Reliability was measured using intraclass correlation coefficients, CV, and SEM. RESULTS A high degree of concurrent validity for the Timed "Up & Go" Test (bias = -0.22), the 30-Second Chair Stand Test (bias = -0.22), the Stair Climb Test (bias = -0.31), and the 40-Meter Fast-Paced Walk Test (bias = -0.06) was found. SEM and CV values were within the acceptable level for concurrent validity. There was a high degree of reliability demonstrated for all tests analyzed. Intraclass correlation coefficient measures ranged from 0.95 to 1.00 for intrarater reliability, and from 0.95 to 0.99 for interrater reliability. CONCLUSIONS Video-based assessment of physical performance tests is a valid and reliable tool for measuring physical function among adults with knee osteoarthritis via Microsoft Teams (Microsoft Corp, Redmond, WA, USA). IMPACT Video-based assessment is a promising public health tool to measure physical function in adults with knee osteoarthritis.
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Affiliation(s)
- Jéssica B Aily
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Alyssa Conte da Silva
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Marcos de Noronha
- Department of Physiotherapy, Community and Allied Health, La Trobe University Bendigo Campus, Bendigo, Victoria, Australia
| | - Daniel K White
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Stela M Mattiello
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Vatandoost S, Kowalski K, Lanting B, Ng KCG, Soltanabadi S, Rushton A. Association between physical measures of spinopelvic alignment and physical functioning with patient reported outcome measures (PROMs) after total hip arthroplasty: Protocol for systematic review and meta-analysis. PLoS One 2024; 19:e0304382. [PMID: 38787884 PMCID: PMC11125517 DOI: 10.1371/journal.pone.0304382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Prevalence of total hip arthroplasty (THA) has trended upwards over past decades and is projected to increase further. Optimizing outcomes after surgery is essential to avoid surgical revision and maximize outcomes. Low back pain is reported as a problem post THA. Patient-reported outcome measures (PROMs) are commonly used to evaluate THA outcomes but have limitations (e.g., ceiling effects). It is therefore important to assess a comprehensive range of outcomes. Physical outcome measures of spinopelvic alignment and physical functioning demonstrate potential value, but no evidence synthesis has investigated their association with PROMs. The objectives of this systematic review are to evaluate the association between spinopelvic alignment and physical outcome measures of physical functioning with PROMs and characteristics of low back pain after THA. METHODS AND ANALYSIS This protocol is aligned with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Cross-sectional and longitudinal cohort studies evaluating the association between the physical outcome measures and PROMs (any outcome measures reported) following THA by any approach/implant will be included except surface replacement and revision THA. Studies investigating THA for developmental pathology and inflammatory conditions will be excluded. A systematic search in MEDLINE (Ovid), Embase (Ovid), Scopus, Web of Science, CINAHL, and the grey literature will be carried out from inception to July 31, 2023. Two independent reviewers will evaluate eligibility of retrieved articles, extract data and assess risk of bias (NIH quality assessment tool) of included studies. A third reviewer will mediate disagreements. Random-effects meta-analyses will be conducted if studies are sufficiently homogeneous in design, population, physical measures and PROMs; reporting odds ratios and 95% confidence intervals. Where meta-analyses are not possible, a narrative synthesis will be conducted. Confidence in cumulative evidence will be assessed using a modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation). PROSPERO REGISTRATION NUMBER PROSPERO Registration number CRD42023412744.
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Affiliation(s)
- Sima Vatandoost
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Katie Kowalski
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Brent Lanting
- Department of Surgery, Division of Orthopaedic Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - K. C. Geoffrey Ng
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | | | - Alison Rushton
- School of Physical Therapy, Western University, London, Ontario, Canada
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Slade CAJ, Kruger MC, Miller MR, Mazahery H, Beck KL, Conlon CA, von Hurst PR. The Effects of GreenShell Mussel Powder (Brand-Named PERNAULTRA) on Physical Performance and Subjective Pain, Symptoms, and Function Measures in Knee Osteoarthritis: A 6-Mo Randomized, Double-Blind, Placebo-Controlled Trial. Curr Dev Nutr 2024; 8:102148. [PMID: 38645882 PMCID: PMC11026721 DOI: 10.1016/j.cdnut.2024.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/06/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Background Osteoarthritis (OA) can cause disability and reduce quality of life (QoL). Objectives This study aimed to determine whether GreenShell mussel (GSM) powder (PERNAULTRA) consumption was more effective than placebo at improving physical performance and subjective measures of symptoms and function in adults with early signs of knee OA. Methods The Researching Osteoarthritis and GSM study was a 6-mo randomized, double-blind, placebo-controlled trial in adults aged 55-80 y, screened for signs of OA (n = 120, 65.9 ± 6.43 y, 63% female). Participants consumed either 3 g of powdered whole GSM or placebo (pea protein) daily. Baseline and end data collection included 30-s chair stand, stair test, 40-m fast-paced walk test, Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire categorized into 5 subscales [pain (P), symptoms except pain (S), function in activities of daily living (ADL), function in sports/recreation (SP), and QoL], a measure of Intermittent and Constant Osteoarthritis Pain, and visual analog scale of pain and symptoms. Results Visual analog scale symptoms showed a significantly greater reduction in percentage change for GSM than that for placebo [-28.1 (-59.2, 43.2) compared with 0.00 (-28.6, 100); P = 0.03]. Further, a trend for improvement in percentage change for GSM compared with placebo was seen in 40m fast-paced walk [2.51 (-3.55, 8.12) compared with 0.20 (-6.58, 4.92); P = 0.09], KOOS-SP [11.4 (-4.48, 27.0) compared with 0.00 (-11.1, 17.7); P = 0.09], and Intermittent and Constant Osteoarthritis Pain intermittent pain scale [-27.7 (-77.3, 0.00) compared with -14.6 (-50.0, 36.4); P = 0.08]. In those with body mass index (BMI; in kg/m2) <25, GSM consumption significantly improved KOOS-S compared with placebo [6.35 (3.49, 12.7) compared with 0.00 (-4.65, 4.49); P = 0.03] and showed a trend for improvement in KOOS-ADL [3.29 (1.01, 8.79) compared with 1.01 (-5.75, 4.30); P = 0.07]. Those with BMI of ≥25, consuming GSM showed a trend for improvement in KOOS-SP [13.6 (-4.76, 33.3) compared with 0.00 (-12.5, 20.0); P = 0.07]. Conclusions This research suggests consumption of GSM has potential to alleviate symptoms and improve functionality in OA.This trial was registered at Clinical Trial Registry as ACTRN12620001112954p (https://www.anzctr.org.au/ACTRN12620001112954p.aspx).
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Affiliation(s)
| | - Marlena C Kruger
- College of Health, Massey University, Palmerston North, New Zealand
| | | | - Hajar Mazahery
- College of Health, Massey University, Auckland, New Zealand
| | - Kathryn L Beck
- College of Health, Massey University, Auckland, New Zealand
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Mehra S, Kumar P, Soni A. Physical Functional Impairment in Breast Cancer Patients: A Cross-Sectional Expert Survey. Cureus 2024; 16:e57364. [PMID: 38694423 PMCID: PMC11061580 DOI: 10.7759/cureus.57364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/04/2024] Open
Abstract
INTRODUCTION AND AIM Anti-cancer treatment imparts a variety of physical impairments that cause limitations in physical functioning among women with breast cancer. The aim of the study was to explore the opinions of healthcare professionals (HCPs) working with breast cancer patients on various aspects of physical functional impairments in breast cancer patients and survivors (BCP&S). METHODOLOGY The study was a cross-sectional survey. Taking into consideration the literature definition of 'physical function', its determinants, and literature published on relevant clinical factors in breast cancer, a survey questionnaire containing 29 questions was constructed. Thirty-seven HCPs, including physiotherapists, occupational therapists, and medical cancer experts, participated in the study. The participant's responses were obtained using a 5-point 'Agreement' Likert scale. Data analysis included a frequency table and the reliability test (Cronbach's alpha). RESULTS The reliability of the questionnaire used in the survey was found to be acceptable (Cronbach's alpha = 0.891). The majority of the participants were of the opinion that various parameters and determinants of 'physical function' get adversely affected in BCP&S, leading to limitations in the performance of activities of daily living (e.g., dressing and bathing), particularly in elderly and frail women. Participants agreed that such impairments in physical functioning affect social and role functioning and the overall quality of life (QoL) of women with breast cancer negatively. CONCLUSION This study found that various parameters and determinants of physical functioning are adversely affected in BCP&S, and physical functional impairments are prevalent in women with breast cancer, affecting their QoL negatively. Implications for breast cancer patients: This study points out the need for long-term surveillance of BCP&S for physical functional limitations and a proactive treatment approach to prevent such limitations.
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Affiliation(s)
- Suman Mehra
- Department of Physiotherapy, Amity Institute of Health Allied Sciences, Amity University, Noida, Noida, IND
- College of Physiotherapy, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, IND
| | - Pragya Kumar
- Department of Physiotherapy, Amity Institute of Health Allied Sciences, Amity University, Noida, Noida, IND
| | - Abhishek Soni
- Department of Radiation Oncology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, IND
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Alamrani S, Gardner A, Falla D, Russell E, Rushton AB, Heneghan NR. Outcome measures for young people with adolescent idiopathic scoliosis: A qualitative exploration of healthcare professionals' perceptions and practices. PLoS One 2024; 19:e0297339. [PMID: 38277344 PMCID: PMC10817127 DOI: 10.1371/journal.pone.0297339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/03/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Limited knowledge exists on current use of patient reported outcome measures (PROMs) and performance measures for adolescents with idiopathic scoliosis (AIS), as well as health care professionals' (HCPs) perceived barriers and facilitators towards their use. This study's objectives were: 1) to explore current practice of HCPs when assessing outcomes for AIS 2) to understand perceived barriers and facilitators of HCPs to use PROMs 3) to understand perceived barriers and facilitators of HCPs to use performance measures. METHODS A qualitative study recruited a purposive sample of HCPs from a tertiary hospital in the United Kingdom. Mean years of experience managing individuals with AIS was 11.8 years; and included surgeons, physiotherapists and nurses, educated at Bachelor, Masters and Doctoral level. Consent to participate and demographic information were collected in advance of the interviews. In-depth, virtual semi-structured interviews were informed by a topic guide based on current evidence. Interviews of approximately 45 minutes were audio and video recorded and transcribed verbatim alongside written field notes. Data were coded and analysed using inductive thematic analysis, involving researchers with topic and methodological expertise and input from a patient representative. RESULTS Two themes emerged regarding current practice of using PROMs routine practice and personal evaluations. Four themes emerged as barriers to using PROMs for individuals with AIS: priority and support (e.g., HCPs focus on providing care), practical challenges (e.g., inadequate PROMs), patient-related challenges (e.g., patient preferences) and knowledge, education, and perceived value. Two themes emerged as facilitators: quality existing measure (e.g., sufficient psychometric properties), and priority and support (e.g., research department/culture). Themes for barriers to use performance measures were practicality (e.g., need physical space) and perceived value and knowledge (e.g., PROMs are more important), while the one theme for facilitators was practical consideration (e.g., acceptability). CONCLUSIONS Although HCPs perceived the value of using outcome measures, current practice indicates limited use for individuals with AIS. The findings revealed different barriers and facilitators to implement PROMs in practice. Adopting performance measure are limited due to lack of knowledge and perceived value alongside the practicality, while considering practical factors can improve the use of these measures in practice.
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Affiliation(s)
- Samia Alamrani
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Physical Therapy Department, College of Applied Medical Science, University of Tabuk, Tabuk, Saudi Arabia
| | - Adrian Gardner
- Spine Unit, The Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, United Kingdom
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Emily Russell
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Alison B. Rushton
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Nicola R. Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Buckinx F, Rezoulat M, Lefranc C, Reginster JY, Bruyere O. Comparing remote and face-to-face assessments of physical performance in older adults: A reliability study. Geriatr Nurs 2024; 55:71-78. [PMID: 37976558 DOI: 10.1016/j.gerinurse.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Older people often experience a decline in their physical performance. Tests have been approved to evaluate this performance in person. Yet, the constraints associated with in-person assessments (e.g. lack of medical facilities, pandemic lockdown, and contagion risk) are making us contemplate setting up assessments remotely. OBJECTIVES To determine whether remote physical performance measurements of older adults are reliable and valid compared to face-to-face measurements. METHODS Forty-five subjects aged 65 and over completed the normal/fast speed test (NWT/FWT), the unipodal balance test (UBT), the normal/fast timed up and go test (NTUG/FTUG), the 5 and 10 rep sit to stand test (5STS and 10STS), the 30 sec chair stand (30CS), the 2 minute step test (2MST) and the flexibility before standing (SAD) once face-to-face and twice remotely, by two different observers. The intraclass correlation coefficients (ICC), the standard errors of measurement (SEM%) and minimum detectable changes (MDC%) were calculated for both intra- and inter-observer conditions, to assess the relative and the absolute reliability. An ICC value exceeding 0.90 indicates a very high reliability, while an ICC between 0.70 and 0.89 signifies a high reliability. In clinical practice, a SEM % of less than 10% is considered acceptable. A smaller MDC % indicates a measurement that is more sensitive to detecting changes. RESULTS Intra-observer relative reliability was very high (ICC>0.9) for the UBT, NWT, NTUG, FTUG, 5STS, 10STS, 30CS and the SAD; and high (ICC>0.7) for the 2MST and FWS. SEM% values ranged from 0% to 24.03% and MDC from 0% to 9.93%. Inter-observer relative reliability was considered very high (ICC>0.9) for all tests. SEM% values ranged from 0% to 17.68% and MDC from 0% to 7.32%. CONCLUSION Our findings demonstrate that remote assessments exhibited consistently high to very high levels of intra- and inter-observer relative reliability when compared to face-to-face assessments. Additionally, certain remote evaluations showed acceptable absolute reliability, making them viable alternatives for healthcare professionals when in-person assessments are not feasible in clinical practice.
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Affiliation(s)
- Fanny Buckinx
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium.
| | - Marvin Rezoulat
- Department of physical activity and rehabilitation sciences, University of Liège, Belgium
| | - César Lefranc
- Department of physical activity and rehabilitation sciences, University of Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | - Olivier Bruyere
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium; Department of physical activity and rehabilitation sciences, University of Liège, Belgium
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Rashed R, Kowalski K, Walton D, Niazigharemakhe A, Rushton A. Physical measures of physical functioning as prognostic factors to predict outcomes in low back pain: Protocol for a systematic review. PLoS One 2023; 18:e0295761. [PMID: 38079434 PMCID: PMC10712879 DOI: 10.1371/journal.pone.0295761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a highly prevalent condition that substantially impairs individuals' physical functioning. This highlights the need for effective management strategies to improve patient outcomes. It is, therefore, crucial to have knowledge of physical functioning prognostic factors that can predict outcomes to facilitate the development of targeted treatment plans aiming to achieve better patient outcomes. There is no synthesis of evidence for physical functioning measures as prognostic factors in the LBP population. The objective of this systematic review is to synthesize evidence for physical measures of physical functioning as prognostic factors to predict outcomes in LBP. METHODS The protocol is registered in the International Prospective Register of Systematic Reviews and reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Prospective longitudinal observational studies investigating potential physical prognostic factors in LBP and/or low back-related leg pain population will be included, with no restriction on outcome. Searches will be performed in MEDLINE, EMBASE, Scopus, CINAHL databases, grey literature search using Open Grey System and ProQuest Dissertations and Theses, hand-searching journals, and reference lists of included studies. Two independent reviewers will evaluate the eligibility of studies, extract data, assess risk of bias and quality of evidence. Risk of bias will be assessed using the Quality in Prognostic Studies (QUIPS) tool. Adequacy of clinical, methodological, and statistical homogeneity among included studies will decide quantitative (meta-analysis) or qualitative analysis (narrative synthesis) focused on prognostic factors and strength of association with outcomes. Quality of cumulative evidence will be evaluated using a modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE). DISCUSSION Information about prognostic factors can be used to predict outcomes in LBP. Accurate outcome prediction is essential for identifying high-risk patients that allows targeted allocation of healthcare resources, ultimately reducing the healthcare burden. REGISTRATION PROSPERO, CRD42023406796.
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Affiliation(s)
- Rameeza Rashed
- School of Physiotherapy, Western University, London, Ontario, Canada
| | - Katie Kowalski
- School of Physiotherapy, Western University, London, Ontario, Canada
| | - David Walton
- School of Physiotherapy, Western University, London, Ontario, Canada
| | | | - Alison Rushton
- School of Physiotherapy, Western University, London, Ontario, Canada
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10
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Martin RL, Takla A, Disantis A, Kohlrieser D, Enseki K, Lifshitz L, Grant L, Bizzini M, Voight M, Ryan M, McGovern R, Tyler T, Steinfeld-Mass Y, Campbell A, Zhang Y. Evaluating Functional Performance Tests in those with Non-arthritic Intra-articular Hip Pain: An International Consensus Statement. Int J Sports Phys Ther 2023; 18:1346-1355. [PMID: 38050542 PMCID: PMC10693491 DOI: 10.26603/001c.89269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/25/2023] [Indexed: 12/06/2023] Open
Abstract
Background Non-arthritic intra-articular hip pain, caused by various pathologies, leads to impairments in range of motion, strength, balance, and neuromuscular control. Although functional performance tests offer valuable insights in evaluating these patients, no clear consensus exists regarding the optimal tests for this patient population. Purpose This study aimed to establish expert consensus on the application and selection of functional performance tests in individuals presenting with non-arthritic intra-articular hip pain. Study Design A modified Delphi technique was used with fourteen physical therapy experts, all members of the International Society for Hip Arthroscopy (ISHA). The panelists participated in three rounds of questions and related discussions to reach full consensus on the application and selection of functional performance tests. Results The panel agreed that functional performance tests should be utilized at initial evaluation, re-evaluations, and discharge, as well as criterion for assessing readiness for returning to sports. Tests should be as part of a multimodal assessment of neuromuscular control, strength, range of motion, and balance, applied in a graded fashion depending on the patient's characteristics. Clinicians should select functional performance tests with objective scoring criteria and prioritize the use of tests with supporting psychometric evidence. A list of recommended functional performance tests with varying intensity levels is provided. Low-intensity functional performance tests encompass controlled speed in a single plane with no impact. Medium-intensity functional performance tests involve controlled speed in multiple planes with low impact. High-intensity functional performance tests include higher speeds in multiple planes with higher impact and agility requirements. Sport-specific movement tests should mimic the patient's particular activity or sport. Conclusion This international consensus statement provides recommendations for clinicians regarding selection and utilization of functional performance tests for those with non-arthritic intra-articular hip pain. These recommendations will encourage greater consistency and standardization among clinicians during a physical therapy assessment.
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Affiliation(s)
| | - Amir Takla
- Swinburne University of Technology
- Australian Sports Physiotherapy
- Hip Arthroscopy Australia
| | | | | | | | | | | | | | - Mike Voight
- Nashville Hip Institute at TOA
- School of Physical Therapy Belmont University
| | - Mark Ryan
- The Steadman Clinic Steadman Philippon Research Institute
| | | | | | | | - Ashley Campbell
- Nashville Hip Institute at TOA
- School of Physical Therapy Belmont University
| | - Yongni Zhang
- Duquesne University
- Duquesne - China Health Institute
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11
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Moore M, Northey JM, Crispin P, Semple S, Toohey K. Effects of Exercise Rehabilitation on Physical Function in Adults With Hematological Cancer Receiving Active Treatment: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151504. [PMID: 37743111 DOI: 10.1016/j.soncn.2023.151504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/27/2023] [Accepted: 08/26/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE Evaluate the efficacy of exercise rehabilitation at improving physical function during active treatment for adults diagnosed with a hematological malignancy. DATA SOURCE Systematic review with a multilevel meta-analysis of randomized trails was conducted. Four electronic databases, MEDLINE (EBSCOhost), CINAHL, Scopus, and CENTRAL, were searched using key words and medical subject headings. Articles were screened and assessed against the predetermined eligibility criteria. Data extracted were appraised using the Cochrane risk of bias tool for randomized trials and the GRADE guidelines. A meta-analysis examined four key clinical objectives. CONCLUSION Twelve studies representing a total of 812 participants were included. Analysis of 36 dependent effect sizes from nine studies revealed structured and prescribed exercise interventions improved physical function (SMD = 0.39; 95% CI 0.21-0.57) compared to usual care or an active control. Exercise interventions with a multimodal design consisting of both aerobic and resistance exercise had a statistically significant effect on physical function (P < .001). Exercise intensity also had a statistically significant effect on physical function when prescribed at a moderate (P = .003) and vigorous (P < .001) intensity during active treatment in patients with leukemia or lymphoma. IMPLICATIONS FOR NURSING PRACTICE This review suggests individuals diagnosed with leukemia or lymphoma can optimize physical function during and immediately post-treatment by attending exercise rehabilitation 3-5 times per weeks performing moderate-vigorous aerobic and resistance exercise. While further research is needed to identify optimal prescription guidelines throughout the treatment continuum, this review underscores the importance for hematology nurses to support patient referrals to exercise oncology professionals to gain positive improvements in physical function.
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Affiliation(s)
- Melanie Moore
- Faculty of Health and Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Australia.
| | - Joseph M Northey
- Faculty of Health and Research Institute for Sport and Exercise, University of Canberra, Australia
| | - Philip Crispin
- Haematology Department, Canberra Hospital, Australian and Australian National University Medical School, Canberra, Australia
| | - Stuart Semple
- Faculty of Health, University of Canberra, Australia
| | - Kellie Toohey
- Faculty of Health and Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Australia; Faculty of Health and Research Institute for Sport and Exercise, University of Canberra, Australia; Faculty of Health, Southern Cross University, Queensland, Australia
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12
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Adriani M, Becker R, Milano G, Lachowski K, Prill R. High variation among clinical studies in the assessment of physical function after knee replacement: a systematic review. Knee Surg Sports Traumatol Arthrosc 2023; 31:3854-3860. [PMID: 36907938 PMCID: PMC10435639 DOI: 10.1007/s00167-023-07375-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE The purpose of this study was to summarise the current use of outcome measures for the assessment of physical function after knee joint replacement. METHODS A systematic approach following the PRISMA guidelines was used. Literature search was performed on MEDLINE database via PubMed and on Epistemonikos. Clinical trials (level of evidence I-II) on knee joint replacement reporting data on the 'physical function' domain published between January 2017 and June 2022 were included. Descriptive statistics were used to summarise the evidence. RESULTS In the 181 articles that met the inclusion criteria, 49 different outcome measurements were used to evaluate clinical outcomes after knee joint replacement. The most frequently adopted patient-reported outcome measures (PROMs) were the Knee Society Score (KSS) (78 studies; 43.1%), the Western Ontario and McMaster Universities (WOMAC) Arthritis Index (62 studies; 34.3%), the Oxford Knee Score (OKS) (51 studies; 28.2%) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) (36 studies; 20%). The most frequently used performance-based outcome measures (PBOMs) were the Timed-Up-and-Go (TUG) test (30 studies; 16.6%) and the 6-min-walk test (6MWT) (21 studies; 11.6%). Among impairment-based outcome measures (IBOMs), range of motion (ROM) was the most used (74 studies; 40.9%). CONCLUSION There is considerable variation among clinical studies regarding the assessment of the physical function of patients after knee joint replacement. PROMs were found to be the most commonly adopted outcome measures; however, no single PROM was used in more than half of the papers analysed. LEVEL OF EVIDENCE Level II, systematic review of level I-II studies.
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Affiliation(s)
- Marco Adriani
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Krzysztof Lachowski
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
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13
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Alkhathami K, Alshehre Y, Brizzolara K, Weber M, Wang-Price S. Effectiveness of Spinal Stabilization Exercises on Movement Performance in Adults with Chronic Low Back Pain. Int J Sports Phys Ther 2023; 18:169-172. [PMID: 36793568 PMCID: PMC9897033 DOI: 10.26603/001c.68024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/23/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Low back pain (LBP) is a musculoskeletal disorder that affects more than 80% of people in the United States at least once in their lifetime. LBP is one of the most common complaints prompting individuals to seek medical care. The purpose of this study was to determine the effects of spinal stabilization exercises (SSEs) on movement performance, pain intensity, and disability level in adults with chronic low back pain (CLBP). Methods Forty participants, 20 in each group, with CLBP were recruited and randomly allocated into one of two interventions: SSEs and general exercises (GEs). All participants received their assigned intervention under supervision one to two times per week for the first four weeks and then were asked to continue their program at home for another four weeks. Outcome measures were collected at baseline, two weeks, four weeks, and eight weeks, including the Functional Movement ScreenTM (FMSTM), Numeric Pain Rating Scale (NPRS), and Modified Oswestry Low Back Pain Disability Questionnaire (OSW) scores. Results There was a significant interaction for the FMSTM scores (p = 0.016), but not for the NPRS and OSW scores. Post hoc analysis showed significant between-group differences between baseline and four weeks (p = 0.005) and between baseline and eight weeks (p = 0.026) favor SSEs over GEs. Further, the results demonstrated that all participants, regardless of group, had significant improvements in movement performance, pain intensity, and disability level over time. Conclusion The results of the study favor SSEs over GEs in improving movement performance for individuals with CLBP, specifically after four weeks of the supervised SSE program.
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Affiliation(s)
| | | | | | - Mark Weber
- School of Physical Therapy Texas Woman's University
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14
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Mardan-Dezfouli S, Reid OG, Fliss MD, Stevenson J, Harris D, Lyon MR, Koehle MS, Mitchell CJ. The Impact of Abdominal Body Contouring Surgery on Physical Function After Massive Weight Loss: A Pilot Prospective Matched Comparison. Aesthet Surg J 2023; 43:NP28-NP37. [PMID: 35946751 DOI: 10.1093/asj/sjac220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Many individuals develop excess skin (ES) following massive weight loss (MWL). Patient-reported outcomes demonstrate that abdominal ES negatively impacts perceived physical function which is improved by abdominal body contouring surgery (ABCS). However, the effect of ABCS on objective measures of physical function is unknown. OBJECTIVES The aim of this study was to examine the impact of ABCS on objective measures of physical function in individuals who have undergone MWL. METHODS Patients who have undergone MWL with abdominal ES (grade, ≥2) underwent the following physical function assessments: 9-item modified physical performance test (mPPT), chair stand, star excursion balance test (SEBT), timed up and go (TUG), modified agility T test, and 6-minute walk test (6-MWT). Perception of physical exertion and BODY-Q questionnaire scales were also collected. Nonsurgical controls (n = 21) and those who had undergone ABCS (n = 6) after the first visit performed a second physical function assessment 8 to 12 weeks later to allow for postoperative healing. RESULTS No ceiling or floor effect was detected for any physical function measure. The intraclass correlation coefficient was 0.78 (95% CI, 0.44, 0.91) for the mPPT and >0.80 for all other measures. The effect sizes were 0.74 (75% CI, 0.19, 1.28) for the mPPT, 0.54 (75% CI, 0.00, 1.08) for the SEBT, -0.63 (75% CI, -1.17, -0.09) for the modified agility T test, and 0.79 (75% CI, 0.24, 0.13) for the 6-MWT. CONCLUSIONS The mPPT and tests involving dynamic balance, agility, and walking were reliable and showed medium to large effect sizes, suggesting that these tests may be sensitive to change following ABCS. LEVEL OF EVIDENCE: 2
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Affiliation(s)
| | - Owen G Reid
- Division of Plastic Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Matthew D Fliss
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Jordan Stevenson
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - David Harris
- Richmond Metabolic and Bariatric Surgery, Vancouver, BC, Canada
| | - Michael R Lyon
- Obesity Medicine and Diabetes Institute, Coquitlam, BC, Canada
| | - Michael S Koehle
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Cameron J Mitchell
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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15
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Santana A, Mediano M, Kasal D. Physical performance tests and in-hospital outcomes in elective open chest heart surgery. IJC HEART & VASCULATURE 2022; 44:101164. [PMID: 36578300 PMCID: PMC9791027 DOI: 10.1016/j.ijcha.2022.101164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
Background Physical performance tests are essential for a comprehensive health assessment, and have been described as predictors of disability and muscle mass decline after open chest heart surgery (OHS). We evaluated the association between physical performance tests with clinical outcomes after OHS in younger and older patients. Moreover, the ability of physical performance tests and European System for Cardiac Operative Risk Evaluation (Euroscore II) to predict death was assessed. Methods Elective OHS patients were evaluated before surgery with handgrip strength (HGS), 30-s Chair-Stand Test (30sCST), and timed up and go test (TUGT). The outcomes were post-surgical complications, total length of stay (LOS), time to walk (TW), time in invasive mechanical ventilation (TIMV), and in-hospital mortality. Data were stratified between patients < 60 (younger) and ≥ 60 years old (older). Results A total of 166 patients were included in the study (older, n = 89). The only physical test associated with mortality in the adjusted models was HGS in older patients (p = 0.03). Among older patients, both Euroscore II (AUC = 0.77) and HGS (AUC = 0.80) demonstrated good ability to predict death. Combining HGS and Euroscore II did not increase accuracy for mortality prediction (AUC = 0.83). Conclusion HGS performance was comparable to a well-established surgical risk score in evaluating in-hospital mortality after OHS, only in older patients. Functional testing before OHS could be a tool to improve risk stratification in these patients. Future intervention studies aiming to improve functional capacity before elective OHS can further clarify the impact of physical fitness in surgical recovery.
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Affiliation(s)
- Abisai Santana
- National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil
| | - Mauro Mediano
- National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil
| | - Daniel Kasal
- National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil,State University of Rio de Janeiro, Internal Medicine Department, Brazil,Corresponding author at: Rua das Laranjeiras 374, 22240-006 Rio de Janeiro, Brazil.
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16
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Guo CC, Chiesa PA, de Moor C, Fazeli MS, Schofield T, Hofer K, Belachew S, Scotland A. Digital Devices for Assessing Motor Functions in Mobility-Impaired and Healthy Populations: Systematic Literature Review. J Med Internet Res 2022; 24:e37683. [DOI: 10.2196/37683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/18/2022] [Accepted: 10/11/2022] [Indexed: 11/22/2022] Open
Abstract
Background
With the advent of smart sensing technology, mobile and wearable devices can provide continuous and objective monitoring and assessment of motor function outcomes.
Objective
We aimed to describe the existing scientific literature on wearable and mobile technologies that are being used or tested for assessing motor functions in mobility-impaired and healthy adults and to evaluate the degree to which these devices provide clinically valid measures of motor function in these populations.
Methods
A systematic literature review was conducted by searching Embase, MEDLINE, CENTRAL (January 1, 2015, to June 24, 2020), the United States and European Union clinical trial registries, and the United States Food and Drug Administration website using predefined study selection criteria. Study selection, data extraction, and quality assessment were performed by 2 independent reviewers.
Results
A total of 91 publications representing 87 unique studies were included. The most represented clinical conditions were Parkinson disease (n=51 studies), followed by stroke (n=5), Huntington disease (n=5), and multiple sclerosis (n=2). A total of 42 motion-detecting devices were identified, and the majority (n=27, 64%) were created for the purpose of health care–related data collection, although approximately 25% were personal electronic devices (eg, smartphones and watches) and 11% were entertainment consoles (eg, Microsoft Kinect or Xbox and Nintendo Wii). The primary motion outcomes were related to gait (n=30), gross motor movements (n=25), and fine motor movements (n=23). As a group, sensor-derived motion data showed a mean sensitivity of 0.83 (SD 7.27), a mean specificity of 0.84 (SD 15.40), a mean accuracy of 0.90 (SD 5.87) in discriminating between diseased individuals and healthy controls, and a mean Pearson r validity coefficient of 0.52 (SD 0.22) relative to clinical measures. We did not find significant differences in the degree of validity between in-laboratory and at-home sensor-based assessments nor between device class (ie, health care–related device, personal electronic devices, and entertainment consoles).
Conclusions
Sensor-derived motion data can be leveraged to classify and quantify disease status for a variety of neurological conditions. However, most of the recent research on digital clinical measures is derived from proof-of-concept studies with considerable variation in methodological approaches, and much of the reviewed literature has focused on clinical validation, with less than one-quarter of the studies performing analytical validation. Overall, future research is crucially needed to further consolidate that sensor-derived motion data may lead to the development of robust and transformative digital measurements intended to predict, diagnose, and quantify neurological disease state and its longitudinal change.
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Marques-Sule E, Arnal-Gómez A, Monzani L, Deka P, López-Bueno JP, Saavedra-Hernández M, Suso-Martí L, Espí-López GV. Canoe polo Athletes' Anthropometric, Physical, Nutritional, and Functional Characteristics and Performance in a Rowing Task: Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13518. [PMID: 36294099 PMCID: PMC9602600 DOI: 10.3390/ijerph192013518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Understanding the physical, functional, mental, and nutritional attributes of canoe polo athletes is essential for training and development. Forty-three canoe polo athletes (mean age: 21.54 ± 6.03) participated in the study and were assessed for: anthropometric measurements, exercise motivation, eating habits, adherence to the Mediterranean Diet, and physical and functional abilities. Correlation and multivariate analysis were conducted. Individual performance in a rowing task showed body mass index (β = 0.41) and female gender (β = 0.34) to be the strongest anthropometric predictors, whereas body fat (β = -0.35) and triceps brachii skinfold fatty tissue (β = -0.35) were the strongest negative predictors. Pushing strength (β = 0.37) and range of motion with internal rotation (β = 0.30) were the strongest physical predictors. The physical dimension of the Exercise Motivation Index was a significant psychosocial predictor (β = 0.27). Senior participants had a higher waist-hip ratio (p = 0.04, d = 0.66), arm circumference (p = 0.03, d = 0.68), handgrip strength (p < 0.01, d = 1.27), and push strength (p < 0.01, d = 1.42) than under 21-year-olds. Understanding the highlighted sport-specific characteristics of canoe polo athletes can help trainers to design programs at all levels to optimize performance.
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Affiliation(s)
- Elena Marques-Sule
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
- Physiotherapy in Motion, Multispecialty Research Group (PTinMOTION), C/Gascó Oliag, 5, 46010 Valencia, Spain
| | - Anna Arnal-Gómez
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
- Physiotherapy in Motion, Multispecialty Research Group (PTinMOTION), C/Gascó Oliag, 5, 46010 Valencia, Spain
| | - Lucas Monzani
- Ivey Business School, Western University, 1255 Western Rd, London, ON N6G 0N1, Canada
| | - Pallav Deka
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Jairo P. López-Bueno
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
| | - Manuel Saavedra-Hernández
- Department of Physical Therapy, University of Almeria, Carretera Sacramento s/n, 04120 Almería, Spain
| | - Luis Suso-Martí
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
- Exercise Intervention for Health (EXINH), C/Gascó Oliag, 5, 46010 Valencia, Spain
| | - Gemma V. Espí-López
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
- Exercise Intervention for Health (EXINH), C/Gascó Oliag, 5, 46010 Valencia, Spain
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de Clercq H, Naudé A, Bornman J. Development and Utility of an International Classification of Functioning, Disability and Health Code Set for Younger-Old Adults With Fall Risk: Implications for Audiologists. Am J Audiol 2022; 31:1116-1132. [DOI: 10.1044/2022_aja-21-00269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose:
Falling is a multifactorial condition that can cause severe injury and even death in older adults. Early identification of fall risk factors, as the first step of preventive health care, can assist in reducing the negative and often debilitating effects of falls in older adults. By using the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to develop an ICF code set to identify fall risk factors in older adults, health care practitioners could obtain health information in a multidimensional way.
Method:
This study describes the final phase of a comprehensive, three-phase, mixed-methods sequential study. For this third phase, a pre–post group design that focused on the audiologist's perceptions of the clinical utility of a newly developed ICF code set was employed. The questionnaire that was used for this purpose consisted of two distinct sections: clinical application and clinical utility (viz., appropriateness, accessibility, practicability, acceptability, and professional utility). Thirty practicing audiologists participated in the study. Data were analyzed for each of the two sections of the questionnaire.
Results:
Results related to clinical application indicated that regardless of the audiologists' experience in routine fall risk assessment or fall risk factor identification, the use of the developed ICF code set increased their ability to correctly identify relevant clinical aspects. Results related to clinical utility showed high scores across all five measure components, with the highest clinical utility component being acceptability, closely followed by appropriateness and professional utility, and the lowest being accessibility.
Conclusion:
Several clinical implications have emerged from this study, including the usefulness of the ICF code set to identify and document fall risk factors in older adults, the code set's ability to guide audiologists to determine individualized assessment needs either by themselves or by other health care disciplines, and that the code set could be used by audiologists regardless of their experience in vestibular assessments.
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Affiliation(s)
- Hendrika de Clercq
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, South Africa
| | - Alida Naudé
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, South Africa
| | - Juan Bornman
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, South Africa
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Berg B, Urhausen AP, Øiestad BE, Whittaker JL, Culvenor AG, Roos EM, Crossley KM, Juhl CB, Risberg MA. What tests should be used to assess functional performance in youth and young adults following anterior cruciate ligament or meniscal injury? A systematic review of measurement properties for the OPTIKNEE consensus. Br J Sports Med 2022; 56:1454-1464. [PMID: 35697502 DOI: 10.1136/bjsports-2022-105510] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To critically appraise and summarise measurement properties of functional performance tests in individuals following anterior cruciate ligament (ACL) or meniscal injury. DESIGN Systematic review. DATA SOURCES Systematic searches were performed in Medline (Ovid), Embase (Ovid), CINAHL (EBSCO) and SPORTSDiscus (EBSCO) on 7 July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies evaluating at least one measurement property of a functional performance test including individuals following an ACL tear or meniscal injury with a mean injury age of ≤30 years. The COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias checklist was used to assess methodological quality. A modified Grading of Recommendations Assessment, Development and Evaluation assessed evidence quality. RESULTS Thirty studies evaluating 26 functional performance tests following ACL injury were included. No studies were found in individuals with an isolated meniscal injury. Included studies evaluated reliability (n=5), measurement error (n=3), construct validity (n=26), structural validity (n=1) and responsiveness (n=1). The Single Leg Hop and Crossover Hop tests showed sufficient intrarater reliability (high and moderate quality evidence, respectively), construct validity (low-quality and moderate-quality evidence, respectively) and responsiveness (low-quality evidence). CONCLUSION Frequently used functional performance tests for individuals with ACL or meniscal injury lack evidence supporting their measurement properties. The Single Leg Hop and Crossover Hop are currently the most promising tests following ACL injury. High-quality studies are required to facilitate stronger recommendations of performance-based outcomes following ACL or meniscal injury.
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Affiliation(s)
- Bjørnar Berg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Centre for Intelligent Musculoskeletal Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anouk P Urhausen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Centre, Vancouver, Vancouver, Canada
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Bundoora, Victoria, Australia
| | - Ewa M Roos
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Bundoora, Victoria, Australia
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Kobenhavn, Denmark
| | - May Arna Risberg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Kowalski KL, Lukacs MJ, Mistry J, Goodman M, Rushton AB. Physical functioning outcome measures in the lumbar spinal surgery population and measurement properties of the physical outcome measures: protocol for a systematic review. BMJ Open 2022; 12:e060950. [PMID: 35667717 PMCID: PMC9171219 DOI: 10.1136/bmjopen-2022-060950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Low back pain can lead to substantial decline in physical functioning. For disabling pain not responsive to conservative management, surgical intervention can enhance physical functioning. Measurements of physical functioning include patient-reported outcome measures and physical outcome measures using evaluations of impairments, performance on a standardised task or activity in a natural environment. Selecting outcome measures with adequate measurement properties is fundamental to evaluating effectiveness of interventions. The purpose of this systematic review is to identify outcome measures (patient reported and physical) used to evaluate physical functioning (stage 1) and assess the measurement properties of physical outcome measures of physical functioning (stage 2) in the lumbar spinal surgery population. METHODS AND ANALYSIS This protocol aligns with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Using a two-staged approach, searches will be performed in MEDLINE, EMBASE, Health and Psychosocial Instruments, CINAHL, Web of Science, Scopus, PEDro and the grey literature from inception until 15 December 2021. Stage 1 will identify studies evaluating physical functioning with patient-reported or physical outcome measures in the lumbar spinal surgery population. Stage 2 will search for studies evaluating measurement properties (validity, reliability, responsiveness) of the physical outcome measures identified in stage 1 in the lumbar spinal surgery population. Two independent reviewers will evaluate studies for inclusion, extract data, assess risk of bias (COSMIN risk of bias tool and checklist) and quality of evidence (modified Grading of Recommendations Assessment, Development and Evaluation approach). Results for each measurement property per physical outcome measure will be quantitatively pooled if there is adequate clinical and methodological homogeneity or qualitatively synthesised if there is high heterogeneity in studies. ETHICS AND DISSEMINATION Ethics approval is not required. Results will be disseminated through peer-reviewed journal publication and conference presentation. PROSPERO REGISTRATION NUMBER CRD42021293880.
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Affiliation(s)
- Katie L Kowalski
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Michael J Lukacs
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Jai Mistry
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Physiotherapy, St George's Hospital, London, UK
| | - Maren Goodman
- Western Libraries, Western University, London, Ontario, Canada
| | - Alison B Rushton
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
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21
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van Helvoort EM, Hodgins D, Mastbergen SC, Marijnissen ACA, Kloppenburg M, Blanco FJ, Haugen IK, Berenbaum F, Lafeber FPJG, Welsing PMJ. GaitSmart motion analysis compared to commonly used function outcome measures in the IMI-APPROACH knee osteoarthritis cohort. PLoS One 2022; 17:e0265883. [PMID: 35320321 PMCID: PMC8942249 DOI: 10.1371/journal.pone.0265883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/09/2022] [Indexed: 11/19/2022] Open
Abstract
Background There are multiple measures for assessment of physical function in knee osteoarthritis (OA), but each has its strengths and limitations. The GaitSmart® system, which uses inertial measurement units (IMUs), might be a user-friendly and objective method to assess function. This study evaluates the validity and responsiveness of GaitSmart® motion analysis as a function measurement in knee OA and compares this to Knee Injury and Osteoarthritis Outcome Score (KOOS), Short Form 36 Health Survey (SF-36), 30s chair stand test, and 40m self-paced walk test. Methods The 2-year Innovative Medicines Initiative—Applied Public-Private Research enabling OsteoArthritis Clinical Headway (IMI-APPROACH) knee OA cohort was conducted between January 2018 and April 2021. For this study, available baseline and 6 months follow-up data (n = 262) was used. Principal component analysis was used to investigate whether above mentioned function instruments could represent one or more function domains. Subsequently, linear regression was used to explore the association between GaitSmart® parameters and those function domains. In addition, standardized response means, effect sizes and t-tests were calculated to evaluate the ability of GaitSmart® to differentiate between good and poor general health (based on SF-36). Lastly, the responsiveness of GaitSmart® to detect changes in function was determined. Results KOOS, SF-36, 30s chair test and 40m self-paced walk test were first combined into one function domain (total function). Thereafter, two function domains were substracted related to either performance based (objective function) or self-reported (subjective function) function. Linear regression resulted in the highest R2 for the total function domain: 0.314 (R2 for objective and subjective function were 0.252 and 0.142, respectively.). Furthermore, GaitSmart® was able to distinguish a difference in general health status, and is responsive to changes in the different aspects of objective function (Standardized response mean (SRMs) up to 0.74). Conclusion GaitSmart® analysis can reflect performance based and self-reported function and may be of value in the evaluation of function in knee OA. Future studies are warranted to validate whether GaitSmart® can be used as clinical outcome measure in OA research and clinical practice.
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Affiliation(s)
- Eefje M. van Helvoort
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- * E-mail:
| | - D. Hodgins
- Dynamic Metrics Limited, Codicote, United Kingdom
| | - Simon C. Mastbergen
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anne C. A. Marijnissen
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - M. Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Fransisco J. Blanco
- Servicio de Reumatología, INIBIC-Hospital Universitario A Coruña, Grupo de Investigación Reumatologia, Agrupación CICA-INIBIC, Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidad de A Coruña, A Coruña, Spain
| | - Ida K. Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - F. Berenbaum
- Sorbonne Université, Institut National de la Santé et de la Recherché Médicale (INSERM), APHP hôpital Saint-Antoine, Paris, France
| | - Floris P. J. G. Lafeber
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Paco M. J. Welsing
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Alamrani S, Gardner A, Falla D, Russell E, Rushton AB, Heneghan NR. Content validity of Scoliosis Research Society questionnaire-22 revised (SRS-22r) for adolescents with idiopathic scoliosis: protocol for a qualitative study exploring patient's and practitioner's perspectives. BMJ Open 2021; 11:e053911. [PMID: 34907066 PMCID: PMC8672051 DOI: 10.1136/bmjopen-2021-053911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Content validity is the most important measurement property for any patient-reported outcome measure (PROM). It being the extent that the PROM measures important concepts that are relevant to the population of interest. Adolescent with idiopathic scoliosis (AIS) is the most common spinal deformity in paediatric populations, with the Scoliosis Research Society questionnaire-22 revised (SRS-22r) a commonly used PROMof quality of life. In the absence of existing evidence, a content validity study for SRS-22r is needed to confirm its suitability for AIS. Thus, this study aims to investigate the content validity of SRS-22r for AIS. A secondary aim is to explore healthcare professional (HCP) perspectives of the barriers and facilitators to using outcome measures in AIS. METHODS AND ANALYSIS Qualitative study reported according to COnsolidated criteria for Reporting Qualitative Studies. A purposive sample of AIS (n=10-15, Cobb angle >25°, aged 10-18 years) will be recruited for online semi-structured interviews. A convenience sample (n=10-12) of HCP with clinical and/or research experience in AIS will be recruited for a focus group discussion. Topic guides and age-relevant documents are informed by existing evidence and developed using a framework of concept elicitation and cognitive debriefing. Audio-recordings will be transcribed verbatim, coded, analysed and synthesised using interpretive phenomenology analysis. Themes that generated from the analysis will be used as codes that will then be mapped to the SRS-22r contents. ETHICS AND DISSEMINATION The Health Research Authority and Health and Care Research Wales approval have been granted (IRAS 289888). Study findings will be disseminated through publications in peer-reviewed journals and conference presentations.
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Affiliation(s)
- Samia Alamrani
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Physical Therapy Department,Faculty of Applied Medical Science, University of Tabuk, Tabuk, Saudi Arabia
| | - Adrian Gardner
- Spinal Unit, The Royal Orthopaedic Hospital, Birmingham, UK
| | - Deborah Falla
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Emily Russell
- Department of Acute General Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alison B Rushton
- School of Physical Therapy, Faculty of Health Sciences,Western University, London, Ontario, Canada
| | - Nicola R Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Assessment of Dysfunctional Movements and Asymmetries in Children and Adolescents Using the Functional Movement Screen-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312501. [PMID: 34886227 PMCID: PMC8657295 DOI: 10.3390/ijerph182312501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/24/2022]
Abstract
The Functional Movement Screen (FMS) is a screening tool that identifies dysfunctional movements in seven test items requiring an interplay of cognitive, perceptual, proprioceptive, and motor functions that involve muscular strength/endurance, flexibility, mobility, coordination, and balance. The results of the FMS include an overall composite score, scores on the individual test items, and identification of compensatory movement patterns and left-right asymmetries on 5 bilateral test items. Although there is a plethora of literature on the use of the FMS in adults, there is a growing body of evidence indicating its use in children. The available research in children involves school children and young athletes in at least 20 different sports in over 20 countries and comparisons between pre- and post-pubescent children, and normal weight, overweight, and obese children. Studies that include measures of adiposity and physical activity levels, or report prevalence of asymmetries and dysfunctional movement patterns are not well represented in the children’s literature. The purpose of this paper is to synthesize the currently available literature in children and suggest potential uses of the FMS by coaches, physical educators, and other health/fitness professionals, appropriate interpretation of results, and future research in children.
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24
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Spasticity, Pain, and Fatigue. Rehabil Nurs 2021; 47:60-71. [DOI: 10.1097/rnj.0000000000000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Physical Functioning in Adolescents with Idiopathic Scoliosis: A Systematic Review of Outcome Measures and Their Measurement Properties. Spine (Phila Pa 1976) 2021; 46:E985-E997. [PMID: 33496543 DOI: 10.1097/brs.0000000000003969] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A systematic review. OBJECTIVE To summarize evidence on measurement properties of Outcome Measures (OM) used to assess physical functioning in adolescents with idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA The AIS is a common spine deformity in those aged 10 to 18 years old. Associated health problems (e.g., back pain) significantly impact the quality of life (QoL). One important domain in QoL is physical functioning, which can be measured with patient-reported outcome measures (PROM), performance-based outcome measures (PBOM), and body structure and function OM. Adequate measurement properties of OM are important for precision in research and practice. METHODS A two-staged search strategy was performed on electronic databases up to December 2019. Search one revealed a list of OM was used for physical functioning assessment in AIS. Search two identified studies that evaluated the measurement properties of OM in AIS; using the list identified in search one. Two independent reviewers determined study eligibility, risk of bias assessment (COnsensus-based Standards for the selection of health Measurement INstruments [COSMIN] checklist), and performed data extraction. The level of evidence was established using a modified GRADE approach. RESULTS Search one yielded: 28 PROM, 20 PBOM, and 10 body structure and function OM. Search two revealed: 16 measurement properties studies for PROM, one for PBOM, and three for body structure and function measures. Construct validity, reliability, and responsiveness of most PROM has been established in AIS, but not content validity or internal consistency (moderate evidence). Construct validity was sufficient for the Timed Up and Go test and body structure and function measures (very low to low evidence). CONCLUSION Currently, physical functioning is evaluated with a variety of measures in AIS. The majority of measurement properties studies evaluated PROM with a paucity of information on measurement properties of PBOM and body structure and function OM. Based on COSMIN methodology, none of the OM identified in this review can be recommended with confidence in individuals with AIS.Level of Evidence: 2.
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Obrusnikova I, Cavalier AR, Novak HM, Blair-McKinsey AE, Suminski RR. Effects of a Community-Based Familiarization Intervention on Independent Performance of Resistance-Training Exercise Tasks by Adults With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 59:239-255. [PMID: 34030178 DOI: 10.1352/1934-9556-59.3.239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/05/2020] [Indexed: 06/12/2023]
Abstract
Adults with intellectual disability (ID) have significantly lower levels of fitness compared to the general population. The study examined the effects of a multicomponent familiarization intervention, consisting of a visual activity schedule and a video-enhanced system of least-to-most prompting, both displayed via an iPad, on the acquisition of resistance-training exercise tasks by adults with ID, aged 18-44 years, in a community fitness center. Twelve participants were randomly allocated to an experimental group (EG) and 12 to an active control group (CG). ANOVA revealed EG correctly and independently performed a significantly greater number of steps of four resistance-training exercise tasks compared with CG, relative to preintervention levels (p < .01). The intervention was effective in promoting functional performance of resistance-training exercise tasks among adults with ID.
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Affiliation(s)
- Iva Obrusnikova
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
| | - Albert R Cavalier
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
| | - Haley M Novak
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
| | - Ashleigh E Blair-McKinsey
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
| | - Rick R Suminski
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
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27
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Resection of Anterior and Lateral Muscle Compartments Does Not Preclude Limb Salvage and Functions. Adv Skin Wound Care 2021; 34:268-272. [PMID: 33852463 DOI: 10.1097/01.asw.0000741520.63373.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Fasciotomy with resection of nonviable muscle is often necessary when there is a delay in compartment syndrome (CS) diagnosis after revascularization. The reported rate of major amputation following missed CS or delayed fasciotomy ranges from 12% to 35%. Herein, the authors present a series of critically ill patients who experienced delayed CS diagnosis and required complete resection of the anterior and/or lateral compartments but still achieved limb salvage and function. METHODS A retrospective chart review identified five patients from April 2018 to April 2019 within a single institution who met the inclusion criteria. Patient charts were reviewed for demographic data, risk factors, time to diagnosis following revascularization, muscle compartments resected, operative and wound care details, and functional outcome at follow-up. RESULTS All of the patients developed CS of the lower extremity following revascularization secondary to acute limb ischemia and required two-incision, four-compartment fasciotomies. Further, they all required serial operative debridements to achieve limb salvage; however, there were no major amputations, and all of the patients were walking at follow-up. CONCLUSIONS Delay in CS diagnosis can have devastating consequences, resulting in major amputation. In cases where myonecrosis is isolated to two or fewer compartments, complete compartment muscle resection can be safely performed, and limb preservation and function can be maintained with aggressive wound management and physical therapy.
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Fanning E, Daniels K, Cools A, Miles JJ, Falvey É. Biomechanical upper-extremity performance tests and isokinetic shoulder strength in collision and contact athletes. J Sports Sci 2021; 39:1873-1881. [PMID: 33874850 DOI: 10.1080/02640414.2021.1904694] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was threefold (1) to assess the reliability of three upper-extremity performance tests: a countermovement push up, press jump and drop box land, performed on a set of dual-force plates (2) to examine whether there was an association between isokinetic dynamometry and the performance tests in a non-injured cohort of collision/contact athletes and (3) to establish a normal descriptive profile of the vertical ground reaction forces from the performance tests, in a cohort of contact/collision athletes. The study was split into two sub-sections; the inter-day reliability of three upper-extremity performance tests (n = 21) and a descriptive, correlation study investigating the relationship between isokinetic dynamometry and performance tests metrics (n = 39). We used intraclass correlation coefficients (absolute agreement, 2-way mixed-effects model) with 95% confidence intervals to quantify inter-day reliability of all variables. We used Pearson correlation coefficients to investigate associations between isokinetic strength and vertical ground reaction force asymmetry variables. Inter-day reliability was moderate-to-excellent for the upper-extremity performance tests (ICC 0.67-0.97). There was no statistically significant correlation between external and internal rotational peak torque and the variables of CPMU, PJ and BDL (r range = .02-.24).These upper-extremity tests are reliable for use with male contact/collision athletes.
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Affiliation(s)
- Edel Fanning
- Sports Medicine, Sports Surgery Clinic, Dublin, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - Katherine Daniels
- Sports Medicine, Sports Surgery Clinic, Dublin, Ireland.,Queen's School of Engineering, University of Bristol, University Walk, Bristol, UK
| | - Ann Cools
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Gent, Belgium
| | - Josh J Miles
- Department for Health, University of Bath, Bath, UK
| | - Éanna Falvey
- Sports Medicine, Sports Surgery Clinic, Dublin, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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Andrasfay T. Changes in Physical Functioning as Short-Term Predictors of Mortality. J Gerontol B Psychol Sci Soc Sci 2020; 75:630-639. [PMID: 30388248 DOI: 10.1093/geronb/gby133] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Both performance-based and self-reported measures of physical functioning are predictors of mortality. There has been relatively little research examining whether their changes predict mortality. This study examines whether 5-year changes in performance-based and self-reported measures of functioning predict subsequent mortality. METHOD Data are from the 2006 wave of the Social Environment and Biomarkers of Aging Study, 2011 wave of the Taiwan Longitudinal Study of Aging, and mortality follow-up through 2015. Gompertz proportional hazard models predict mortality from changes in ability to complete performance-based tests and changes in performance-based and self-reported functioning. RESULTS Incident inability to complete at least one performance-based test of functioning is associated with twice the risk of subsequent 4-year mortality. Conditional on the baseline measurement, a one standard deviation (SD) decline in grip strength is associated with a 61% increased risk of 4-year mortality; a one-SD decline in walking speed and a one-SD increase in self-reported limitations are both associated with around a 40% increased risk of 4-year mortality. Conditional on the most recent measurement of functioning, prior change is not significantly associated with subsequent mortality. DISCUSSION Repeated measures of performance-based and self-reported functioning are valuable in that they provide an updated measurement of functioning.
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Lorenzoni G, Azzolina D, Fraccaro C, Di Liberti A, D'Onofrio A, Cavalli C, Fabris T, D'Amico G, Cibin G, Nai Fovino L, Ocagli H, Gerosa G, Tarantini G, Gregori D. Using Wearable Devices to Monitor Physical Activity in Patients Undergoing Aortic Valve Replacement: Protocol for a Prospective Observational Study. JMIR Res Protoc 2020; 9:e20072. [PMID: 33180023 PMCID: PMC7691084 DOI: 10.2196/20072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 12/25/2022] Open
Abstract
Background In last few decades, several tools have been developed to measure physical function objectively; however, their use has not been well established in clinical practice. Objective This study aims to describe the preoperative physical function and to assess and compare 6-month postoperative changes in the physical function of patients undergoing treatment for aortic stenosis with either surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). The study also aims to evaluate the feasibility of wearable devices in assessing physical function in such patients. Methods This is a prospective observational study. The enrollment will be conducted 1 month before patients’ SAVR/TAVR. Patients will be provided with the wearable device at baseline (activity tracker device, Garmin vívoactive 3). They will be trained in the use of the device, and they will be requested to wear it on the wrist of their preferred hand until 12 months after SAVR/TAVR. After baseline assessment, they will undergo 4 follow-up assessments at 1, 3, 6, and 12 months after SAVR/TAVR. At baseline and each follow-up, they will undergo a set of standard and validated tests to assess physical function, health-related quality of life, and sleep quality. Results The ethics committee of Vicenza in Veneto Region in Italy approved the study (Protocol No. 943; January 4, 2019). As of October 2020, the enrollment of participants is ongoing. Conclusions The use of the wearable devices for real-time monitoring of physical activity of patients undergoing aortic valve replacement is a promising opportunity for improving the clinical management and consequently, the health outcomes of such patients. Trial Registration Clinicaltrials.gov NCT03843320; https://tinyurl.com/yyareu5y International Registered Report Identifier (IRRID) DERR1-10.2196/20072
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Affiliation(s)
- Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Chiara Fraccaro
- Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessandro Di Liberti
- Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Augusto D'Onofrio
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Chiara Cavalli
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Tommaso Fabris
- Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Gianpiero D'Amico
- Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Giorgia Cibin
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Luca Nai Fovino
- Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Honoria Ocagli
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Gino Gerosa
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Giuseppe Tarantini
- Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
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Baumann CW, Kwak D, Thompson LV. Phenotypic Frailty Assessment in Mice: Development, Discoveries, and Experimental Considerations. Physiology (Bethesda) 2020; 35:405-414. [PMID: 33052773 DOI: 10.1152/physiol.00016.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The underlying mechanisms contributing to the onset of frailty, its progression, and its mortality risk remain unknown. Recently, the two most common human frailty assessments were reverse-translated to mice. Here, we highlight the development of the mouse frailty phenotype, unique discoveries, experimental considerations, and future perspectives.
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Affiliation(s)
- Cory W Baumann
- Ohio Musculoskeletal and Neurological Institute (OMNI) and Department of Biomedical Sciences, Ohio University, Athens, Ohio
| | - Dongmin Kwak
- Division of Sport Science, Hanyang University, Ansan, South Korea.,Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts
| | - LaDora V Thompson
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts
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Lockwood CT, Duffy CJ. Hyperexcitability in Aging Is Lost in Alzheimer's: What Is All the Excitement About? Cereb Cortex 2020; 30:5874-5884. [PMID: 32548625 DOI: 10.1093/cercor/bhaa163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Neuronal hyperexcitability has emerged as a potential biomarker of late-onset early-stage Alzheimer's disease (LEAD). We hypothesize that the aging-related posterior cortical hyperexcitability anticipates the loss of excitability with the emergence of impairment in LEAD. To test this hypothesis, we compared the behavioral and neurophysiological responses of young and older (ON) normal adults, and LEAD patients during a visuospatial attentional control task. ONs show frontal cortical signal incoherence and posterior cortical hyper-responsiveness with preserved attentional control. LEADs lose the posterior hyper-responsiveness and fail in the attentional task. Our findings suggest that signal incoherence and cortical hyper-responsiveness in aging may contribute to the development of functional impairment in LEAD.
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Affiliation(s)
- Colin T Lockwood
- Departments of Neurology and Brain and Cognitive Sciences, University of Rochester Medical Center, Rochester 14642, NY, USA
| | - Charles J Duffy
- Departments of Neurology and Brain and Cognitive Sciences, University of Rochester Medical Center, Rochester 14642, NY, USA
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Fanning E, Maher N, Cools A, Falvey EC. Outcome Measures After Shoulder Stabilization in the Athletic Population: A Systematic Review of Clinical and Patient-Reported Metrics. Orthop J Sports Med 2020; 8:2325967120950040. [PMID: 32984424 PMCID: PMC7498977 DOI: 10.1177/2325967120950040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/07/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Athletic endeavor can require the “athletic shoulder” to tolerate significant
load through supraphysiological range and often under considerable
repetition. Outcome measures are valuable when determining an athlete’s safe
return to sport. Few data are available to guide a clinician’s choice from
the variety of measures available. Purpose: To describe the use of quantifiable objective outcome measures and
patient-reported outcome tools after glenohumeral joint stabilization,
specifically in an athletic population. The secondary aim of our study was
to assess whether the method of measurement used was clearly described and
standardized to aid clinical interpretation. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of MEDLINE, Scopus, SPORTDiscus, and Web of Science
databases was performed in December 2018 based on the PRISMA (Preferred
Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After
the application of selection criteria, a full review of identified papers,
and screening of reference lists, a total of 62 studies were included in the
review. All studies were independently appraised for quality, predefined
data fields were populated and cross-checked for accuracy, and results were
then summarized from these data fields. Results: Of the 62 included studies, 94% used a quantifiable objective clinical
outcome. A majority (85%) of the studies measured range of motion, 21%
recorded muscle strength, 5% measured electromyographic activity, 5%
examined shoulder kinematics, and 3% assessed joint proprioception after
surgery. However, only 18% of the studies clearly described a standardized
method of measuring the outcome. Nearly all (95%) of the studies used at
least 1 patient-reported outcome measure. The Rowe score was most commonly
used (35%). Conclusion: We must standardize and clearly describe the use of quantifiable objective
outcome measures to aid clinical interpretation. A concerted effort should
also be made to standardize the use of patient-reported outcome tools after
shoulder stabilization in the athletic population.
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Affiliation(s)
- Edel Fanning
- Sports Surgery Clinic, Sports Medicine, Dublin, Ireland.,University College Cork, Cork, Ireland
| | - Natasha Maher
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, West Yorkshire, UK
| | - Ann Cools
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Gent, Belgium
| | - Eanna C Falvey
- Sports Surgery Clinic, Sports Medicine, Dublin, Ireland.,University College Cork, Cork, Ireland
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Kyriazis M. Aging as “Time-Related Dysfunction”: A Perspective. Front Med (Lausanne) 2020; 7:371. [PMID: 32850891 PMCID: PMC7397818 DOI: 10.3389/fmed.2020.00371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/17/2020] [Indexed: 11/13/2022] Open
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Schliep ME, Kasparian L, Kaminski O, Tierney-Hendricks C, Ayuk E, Brady Wagner L, Koymen S, Vallila-Rohter S. Implementing a Standardized Language Evaluation in the Acute Phases of Aphasia: Linking Evidence-Based Practice and Practice-Based Evidence. Front Neurol 2020; 11:412. [PMID: 32547472 PMCID: PMC7278284 DOI: 10.3389/fneur.2020.00412] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/20/2020] [Indexed: 11/13/2022] Open
Abstract
The research to practice gap is a significant problem across all disciplines of healthcare. A major challenge associated with the adoption of evidence into routine clinical care is the disconnect between findings that are identified in a controlled research setting, and the needs and challenges of a real-world clinical practice setting. Implementation Science, which is the study of methods to promote research into clinical practice, provides frameworks to promote the translation of findings into practice. To begin to bridge the research-practice gap in assessing recovery in individuals with aphasia in the acute phases of recovery following stroke, clinicians in an acute care hospital and an inpatient rehabilitation hospital followed an implementation science framework to select and implement a standardized language assessment to evaluate early changes in language performance across multiple timepoints. Using a secure online database to track patient data and language metrics, clinically-accessible information was examined to identify predictors of recovery in the acute phases of stroke. We report on the feasibility of implementing such standardized assessments into routine clinical care via measures of adherence. We also report on initial analyses of the data within the database that provide insights into the opportunities to track change. This initiative highlights the feasibility of collecting clinical data using a standardized assessment measure across acute and inpatient rehabilitation care settings. Practice-based evidence may inform future research by contributing pilot data and systematic observations that may lead to the development of empirical studies, which can then feed back into clinical practice.
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Affiliation(s)
- Megan E Schliep
- MGH Institute of Health Professions, Boston, MA, United States.,Speech-Language Pathology Department, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Laura Kasparian
- Speech-Language and Swallow Department, Brigham and Women's Hospital, Boston, MA, United States
| | - Olga Kaminski
- Speech-Language and Swallow Department, Brigham and Women's Hospital, Boston, MA, United States
| | - Carla Tierney-Hendricks
- MGH Institute of Health Professions, Boston, MA, United States.,Speech-Language Pathology Department, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Esther Ayuk
- Speech-Language Pathology Department, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Lynne Brady Wagner
- Speech-Language Pathology Department, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Semra Koymen
- Speech-Language and Swallow Department, Brigham and Women's Hospital, Boston, MA, United States
| | - Sofia Vallila-Rohter
- MGH Institute of Health Professions, Boston, MA, United States.,Speech-Language and Swallow Department, Brigham and Women's Hospital, Boston, MA, United States
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Alamrani S, Rushton A, Gardner A, Falla D, Heneghan NR. Outcome measures evaluating physical functioning and their measurement properties in adolescent idiopathic scoliosis: a protocol for a systematic review. BMJ Open 2020; 10:e034286. [PMID: 32241788 PMCID: PMC7170637 DOI: 10.1136/bmjopen-2019-034286] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Physical functioning (PF) is the ability to carry out the physical activity of daily living. It is an important outcome that provides a meaningful evaluation of individuals' life. PF can be assessed using patient-reported outcome measures, performance-based outcome measures or body structure and function measure. Measures need to be valid, reliable and responsive to change to evaluate the effects of an intervention. Adolescent idiopathic scoliosis (AIS) is the most common deformity among the paediatric population and impacts on individuals' lives. This systematic review will appraise evidence on the measurement properties of PF tools in individuals with AIS. METHODS/ANALYSIS A protocol for systematic review and meta-analysis informed by Cochrane guidelines is reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis-P. MEDLINE, PsycINFO, EMBASE, CINAHL, SPORTdiscus, Web of Science and PubMed will be searched in two stages, from inception until December 2019. Search 1 will inventory all studies that assessed PF in participants with AIS, without any limitations. The search terms will be scoliosis, adolescent and PF-related terms. Search 2 will include studies which investigated instrument measurement properties in the same population for measures identified in search one. Two reviewers will independently perform study selection, data extraction, risk of bias and overall quality assessment. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias and a modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines will be used. A meta-analysis will be conducted if possible, or the evidence will be synthesised and summarised per measurement property per outcome measure per measurement type. ETHICS AND DISSEMINATION This review will provide recommendations for practice and future research, considering psychometric properties of outcome measures of PF in AIS. The results of this study will be disseminated through a peer-reviewed publication and conference presentation. PROSPERO REGISTRATION NUMBER CRD42019142335.
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Affiliation(s)
- Samia Alamrani
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Physical Therapy Department, College of Applied Medical Science, University of Tabouk, Tabouk, Saudi Arabia
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Adrian Gardner
- Spine Unit, The Royal Orthopaedic Hospital Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Tolk JJ, Janssen RPA, Prinsen CAC, Latijnhouwers DAJM, van der Steen MC, Bierma-Zeinstra SMA, Reijman M. The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive. Knee Surg Sports Traumatol Arthrosc 2019; 27:2898-2909. [PMID: 29128879 DOI: 10.1007/s00167-017-4789-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 10/27/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The Osteoarthritis Research Society International has identified a core set of performance-based tests of physical function for use in people with knee osteoarthritis (OA). The core set consists of the 30-second chair stand test (30-s CST), 4 × 10 m fast-paced walk test (40 m FPWT) and a stair climb test. The aim of this study was to evaluate the reliability, validity and responsiveness of these performance-based measures to assess the ability to measure physical function in knee OA patients. METHODS A prospective cohort study of 85 knee OA patients indicated for total knee arthroplasty (TKA) was performed. Construct validity and responsiveness were assessed by testing of predefined hypotheses. A subgroup (n = 30) underwent test-retest measurements for reliability analysis. The Oxford Knee Score, Knee injury and Osteoarthritis Outcome Score-Physical Function Short Form, pain during activity score and knee extensor strength were used as comparator instruments. Measurements were obtained at baseline and 12 months after TKA. RESULTS Appropriate test-retest reliability was found for all three tests. Intraclass correlation coefficient (ICC) for the 30-s CST was 0.90 (95% CI 0.68; 0.96), 40 m FPWT 0.93 (0.85; 0.96) and for the 10-step stair climb test (10-step SCT) 0.94 (0.89; 0.97). Adequate construct validity could not be confirmed for the three tests. For the 30-s CST, 42% of the predefined hypotheses were confirmed; for the 40 m FPWT, 27% and for the 10-step SCT 36% were confirmed. The 40 m FPWT was found to be responsive with 75% of predefined hypothesis confirmed, whereas the responsiveness for the other tests could not be confirmed. For the 30 s CST and 10-step SCT, only 50% of hypotheses were confirmed. CONCLUSIONS The three performance-based tests had good reliability, but poor construct validity and responsiveness in the assessment of function for the domains sit-to-stand movement, walking short distances and stair negotiation. The findings of the present study do not justify their use for clinical practice. LEVEL OF EVIDENCE Level 1. Diagnostic study.
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Affiliation(s)
- J J Tolk
- Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, The Netherlands.
| | - R P A Janssen
- Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, The Netherlands
| | - C A C Prinsen
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health (APH) Research Institute, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
| | - D A J M Latijnhouwers
- Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, The Netherlands
| | - M C van der Steen
- Department of Orthopedic Surgery, Catharina Hospital Eindhoven, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands
| | - S M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
| | - M Reijman
- Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, The Netherlands
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
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Glei DA, Goldman N, Ryff CD, Weinstein M. Physical Function in U.S. Older Adults Compared With Other Populations: A Multinational Study. J Aging Health 2019; 31:1067-1084. [PMID: 29466893 PMCID: PMC6070428 DOI: 10.1177/0898264318759378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: We compare physical performance from three U.S. national surveys and nationally representative surveys in England, Taiwan, and Costa Rica. Method: For each performance test, we use local mean smoothing to plot the age profiles by sex and survey wave and then fit a linear regression model to the pooled data, separately by sex, to test for significant differences across surveys controlling for age and height. Results: Age profiles of performance vary across U.S. surveys, but levels of lung function (peak expiratory flow) and handgrip strength in the United States are as high as they are in the other three countries. Americans also perform as well on the chair stand test as the English and Costa Ricans, if not better, but exhibit slower gait speed than the English at most ages. Discussion: With the exception of walking speed, we find little evidence that older Americans have worse physical performance than their peers.
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Affiliation(s)
- Dana A. Glei
- Center for Population and Health, Georgetown University
| | - Noreen Goldman
- Office of Population Research and Woodrow Wilson School of Public and International Affairs, Princeton University
| | - Carol D. Ryff
- Department of Psychology, University of Wisconsin-Madison
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Tolk JJ, Janssen RPA, Prinsen C(SAC, van der Steen M(MC, Bierma Zeinstra SMA, Reijman M. Measurement properties of the OARSI core set of performance-based measures for hip osteoarthritis: a prospective cohort study on reliability, construct validity and responsiveness in 90 hip osteo-arthritis patients. Acta Orthop 2019; 90:15-20. [PMID: 30451049 PMCID: PMC6366472 DOI: 10.1080/17453674.2018.1539567] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Improvement of physical function is one of the main treatment goals in severe hip osteoarthritis (OA) patients. The Osteoarthritis Research Society International (OARSI) has identified a core set of performance-based tests to assess the construct physical function: 30-s chair stand test (30-s CST), 4x10-meter fast-paced walk test (40 m FPWT), and a stair-climb test. Despite this recommendation, available evidence on the measurement properties is limited. We evaluated the reliability, validity, and responsiveness of these performance-based measures in patients with hip OA scheduled for total hip arthroplasty (THA). Patients and methods - Baseline and 12-month follow-up measurements were prospectively obtained in 90 end-stage hip OA patients who underwent THA. As there is no gold standard for comparison, the hypothesis testing method was used for construct validity and responsiveness analysis. A test can be assumed valid if ≥75% of predefined hypotheses are confirmed. A subgroup (n = 30) underwent test-retest measurements for reliability analysis. The Oxford Hip Score, Hip injury and Osteoarthritis Outcome Score-Physical Function Short Form, pain during activity score, and muscle strength were used as comparator instruments. Results - Test-retest reliability was appropriate; intraclass correlation coefficient values exceeded 0.70 for all 3 tests. None of the performance-based measures reached 75% hypothesis confirmation for the construct validity or responsiveness analysis. Interpretation - The performance-based tests have good reliability in the assessment of physical function. Construct validity and responsiveness, using patient-reported measures and muscle strength as comparator instruments, could not be confirmed. Therefore, our findings do not justify their use for clinical practice.
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Affiliation(s)
- Jaap J Tolk
- Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Eindhoven;; ,Correspondence:
| | - Rob P A Janssen
- Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Eindhoven;;
| | - C (Sanna) A C Prinsen
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health (APH) Research Institute, Amsterdam;
| | | | - Sita M A Bierma Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam;; ,Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Max Reijman
- Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Eindhoven;; ,Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Cluster analysis using physical performance and self-report measures to identify shoulder injury in overhead female athletes. J Sci Med Sport 2018; 22:269-274. [PMID: 30253926 DOI: 10.1016/j.jsams.2018.09.224] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/04/2018] [Accepted: 09/07/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To evaluate the diagnostic validity of the Kerlan-Jobe orthopedic clinic shoulder and elbow score (KJOC) and the Closed kinetic upper extremity stability test (CKCUEST) to assess functional impairments associated with shoulder injury in overhead female athletic populations. DESIGN Cross-sectional design. METHODS Thirty-four synchronized swimming and team handball female athletes completed the KJOC and the CKCUEST during their respective team selection trials. Unsupervised learning using k-means algorithm was used on collected data to perform group clustering and classify athletes as Injured or Not Injured. Odds ratios, likelihood ratios, sensitivity and specificity were computed based on the self-reported presence of shoulder injury at the time of testing or during the previous year. RESULTS Seven of the 34 athletes were injured or had suffered a time-loss injury in the previous year, representing a 20.5% prevalence rate. Clustering method using KJOC data resulted in a sensitivity of 86%, a specificity of 100% and a 229.67 diagnostic odds ratio. Clustering method using CKCUEST data resulted in a sensitivity of 86%, a specificity of 37% and a 3.53 diagnostic odds ratio. CONCLUSIONS KJOC had good diagnostic validity to assess shoulder function and differentiate between injured and non-injured elite synchronized swimming and team handball female athletes. The CKCUEST seemed to be a poor screening test but may be an interesting test to evaluate functional upper extremity strength and plyometric capacity. Unsupervised learning methods allow to make decisions based on numerous variables which is an advantage when considering the usually substantial overlap in screening test scores between high- and low-risk athletes.
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Sions JM, Beisheim EH, Manal TJ, Smith SC, Horne JR, Sarlo FB. Differences in Physical Performance Measures Among Patients With Unilateral Lower-Limb Amputations Classified as Functional Level K3 Versus K4. Arch Phys Med Rehabil 2018; 99:1333-1341. [PMID: 29410114 PMCID: PMC6019138 DOI: 10.1016/j.apmr.2017.12.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/27/2017] [Accepted: 12/19/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To determine whether differences in physical function, assessed via self-report questionnaires and physical performance tests, exist between individuals with lower-limb loss using a prosthetic device classified as a K3 versus a K4 functional level. DESIGN Cross-sectional study. SETTING A university physical therapy amputee clinic. PARTICIPANTS Participants (N=55) were included if they (1) were aged ≥18 years with a unilateral transfemoral or transtibial amputation; (2) were classified as K3 or K4 functional level; (3) completed all relevant outcome measures; and (4) were currently using a prosthesis. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Locomotor Capabilities Index (LCI), Prosthetic Evaluation Questionnaire-Mobility Section (PEQ-MS), Timed Up and Go (TUG), 10-Meter Walk Test (10MWT), Amputee Mobility Predictor (AMPPRO), and 6-Minute Walk Test (6MWT). K level was determined by group consensus based on a standardized clinical evaluation. RESULTS After controlling for covariates, patients classified as K3 had slower TUG times (P=.002) and self-selected and fast gait speeds (P<.001), lower AMPPRO scores (P<.001), and walked shorter distances during the 6MWT (P=.003) when compared with patients classified as K4. No significant between-group differences for the LCI or PEQ-MS were found. CONCLUSIONS Clinicians involved in prosthetic prescription may consider including the TUG, 10MWT, AMPPRO, and 6MWT during their clinical evaluations to help differentiate between individuals of higher functional mobility. The LCI and PEQ-MS may be less useful in classifying individuals as K3 versus K4 because of a ceiling effect.
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Affiliation(s)
| | | | - Tara Jo Manal
- Department of Physical Therapy, University of Delaware, Newark, DE
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Sheill G, Guinan EM, Peat N, Hussey J. Considerations for Exercise Prescription in Patients With Bone Metastases: A Comprehensive Narrative Review. PM R 2018; 10:843-864. [DOI: 10.1016/j.pmrj.2018.02.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/07/2018] [Accepted: 02/13/2018] [Indexed: 12/17/2022]
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Goes SM, Trask CM, Boden C, Bath B, Ribeiro DC, Hendrick P, Clay L, Zeng X, Milosavljevic S. Measurement properties of instruments assessing permanent functional impairment of the spine: a systematic review protocol. BMJ Open 2018; 8:e019276. [PMID: 29374671 PMCID: PMC5829857 DOI: 10.1136/bmjopen-2017-019276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Permanent functional impairment (PFI) of the spine is a rating system used by compensation authorities, such as workers compensation boards, to establish an appropriate level of financial compensation for persistent loss of function. Determination of PFI of the spine is commonly based on the assessment of spinal movement combined with other measures of physical and functional impairments; however, the reliability and validity of the measurement instruments used for these evaluations have yet to be established. The aim of this study is to systematically review and synthesise the literature concerning measurement properties of the various and different instruments used for assessing PFI of the spine. METHODS Three conceptual groups of terms (1) PFI, (2) spinal disorder and (3) measurement properties will be combined to search Medline, EMBASE, CINAHL, Web of Science, Scopus, PEDro, OTSeeker and Health and Safety Science Abstracts. We will examine peer-reviewed, full-text articles over the full available date range. Two reviewers will independently screen citations (title, abstract and full text) and perform data extraction. Included studies will be appraised as to their methodological quality using the COnsensus-based Standards for the selection of health Measurement INstruments criteria. Findings will be summarised and presented descriptively, with meta-analysis pursued as appropriate. ETHICS AND DISSEMINATION This review will summarise the current level of evidence of measurement properties of instruments used for assessing PFI of the spine. Findings of this review may be applicable to clinicians, policy-makers, workers' compensation boards, other insurers and health and safety organisations. The findings will likely provide a foundation and direction for future research priorities for assessing spinal PFI. PROSPERO REGISTRATION NUMBER CRD42017060390.
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Affiliation(s)
- Suelen Meira Goes
- School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Catherine M Trask
- Canadian Centre for Health and Safety in Agriculture (CCHSA), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Catherine Boden
- Leslie and Irene Dubé Health Sciences Library, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Brenna Bath
- School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Paul Hendrick
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Lynne Clay
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Xiaoke Zeng
- Canadian Centre for Health and Safety in Agriculture (CCHSA), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Stephan Milosavljevic
- School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Linkel A, Raudonytė I, Shippen J, May B, Daunoravičienė K, Sawicki A, Griškevičius J. Intrapersonal and interpersonal evaluation of upper extremity kinematics. Technol Health Care 2017; 25:939-948. [PMID: 29103062 DOI: 10.3233/thc-170927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The quality of upper extremity (UE) function can be evaluated by measuring the kinematic parameters of patient movements. OBJECTIVE This investigation focused on finding the angles and angular velocity amplitudes of UE motions in healthy participants to compare with the experimental results of patients with a UE disability who are trying to recover previous movement conditions. METHODS The UE motions of 23 healthy adult volunteers were tested using a three-dimensional motion capture system and measuring hand segment motions. A simplified 7 degrees of freedom (DOF) human arm kinematic model created within MATLAB and used to process the experimental data. RESULTS The interpersonal CV (coefficients of variability) of left-side motions showed that the lowest CV of linear velocity amplitudes was at elbow flexion (4.2%), but the highest was at wrist extension (48.3%). The lowest and highest CV of angular velocity amplitudes were 19.6% and 55.7%, during shoulder adduction and wrist extension, respectively. CONCLUSIONS High interpersonal CV may restrict the direct comparison of kinematic parameters of UE in different healthy and disabled persons.
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Affiliation(s)
- Artūras Linkel
- Department of Biomechanics, Faculty of Mechanics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Inga Raudonytė
- Department of PM&R, Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | | | | | - Kristina Daunoravičienė
- Department of Biomechanics, Faculty of Mechanics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Aleksander Sawicki
- Department of Theoretical Electrotechnics and Metrology, Bialystok University of Technology, Bialystok, Poland
| | - Julius Griškevičius
- Department of Biomechanics, Faculty of Mechanics, Vilnius Gediminas Technical University, Vilnius, Lithuania
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Abstract
PURPOSE OF REVIEW Because of the epidemiological incidence of anterior cruciate ligament (ACL) injuries, the high reinjury rates that occur when returning back to sports, the actual number of patients that return to the same premorbid level of competition, the high incidence of osteoarthritis at 5-10-year follow-ups, and the effects on the long-term health of the knee and the quality of life for the patient, individualizing the return to sports after ACL reconstruction (ACL-R) is critical. However, one of the challenging but unsolved dilemmas is what criteria and clinical decision making should be used to return an athlete back to sports following an ACL-R. This article describes an example of a functional testing algorithm (FTA) as one method for clinical decision making based on quantitative and qualitative testing and assessment utilized to make informed decisions to return an athlete to their sports safely and without compromised performance. The methods were a review of the best current evidence to support a FTA. RECENT FINDINGS In order to evaluate all the complicated domains of the clinical decision making for individualizing the return to sports after ACL-R, numerous assessments need to be performed including the biopsychosocial concepts, impairment testing, strength and power testing, functional testing, and patient-reported outcomes (PROs). The optimum criteria to use for individualizing the return to sports after ACL-R remain elusive. However, since this decision needs to be made on a regular basis with the safety and performance factors of the patient involved, this FTA provides one method of quantitatively and qualitatively making the decisions. Admittedly, there is no predictive validity of this system, but it does provide practical guidelines to facilitate the clinical decision making process for return to sports. The clinical decision to return an athlete back into competition has significant implications ranging from the safety of the athlete, to performance factors and actual litigation issues. By using a multifactorial FTA, such as the one described, provides quantitative and qualitatively criteria to make an informed decision in the best interests of the athlete.
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Affiliation(s)
- George J Davies
- Physical Therapy Program, Armstrong State University, Savannah, GA, USA.
- Coastal Therapy, Savannah, GA, USA.
- Gundersen Health System, LaCrosse, WI, USA.
| | - Eric McCarty
- Sports Medicine and Performance Center, Colorado University, Boulder, CO, USA
| | - Matthew Provencher
- Steadman Clinic and Steadman Philippon Research Institute, Vail, CO, USA
| | - Robert C Manske
- Department of Physical Therapy, Wichita State University, Via Christi Health, Wichita, KS, USA
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Mitchell UH, Johnson AW, Vehrs PR, Feland JB, Hilton SC. Performance on the Functional Movement Screen in older active adults. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:119-125. [PMID: 30356515 PMCID: PMC6188618 DOI: 10.1016/j.jshs.2015.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 02/14/2015] [Accepted: 04/21/2015] [Indexed: 05/08/2023]
Abstract
BACKGROUND The Functional Movement Screen (FMS™) has become increasingly popular for identifying functional limitations in basic functional movements. This exploratory and descriptive study was undertaken to confirm feasibility of performing the FMS™ in older active adults, assess prevalence of asymmetries and to evaluate the relationship between functional movement ability, age, physical activity levels and body mass index (BMI). METHODS This is an observational study; 97 men (n = 53) and women (n = 44) between the ages of 52 and 83 participated. BMI was computed and self-reported physical activity levels were obtained. Subjects were grouped by age (5-year intervals), BMI (normal, over-weight, and obese) and sex. Each participant's performance on the FMS™ was digitally recorded for later analysis. RESULTS The youngest age group (50-54 years) scored highest in all seven tests and the oldest age group (75+) scored lowest in most of the tests compared to all other age groups. The subjects in the "normal weight" group performed no different than those who were in the "overweight" group; both groups performed better than the "obese" group. Of the 97 participants 54 had at least one asymmetry. The pairwise correlations between the total FMS™ score and age (r = -0.531), BMI (r = -0.270), and the measure of activity level (r = 0.287) were significant (p < 0.01 for all). CONCLUSION FMS™ scores decline with increased BMI, increased age, and decreased activity level. The screen identifies range of motion- and strength-related asymmetries. The FMS™ can be used to assess functional limitations and asymmetries. Future research should evaluate if a higher total FMS™ score is related to fewer falls or injuries in the older population.
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Affiliation(s)
- Ulrike H. Mitchell
- Department of Exercise Sciences, Brigham Young University, Provo, UT 84602, USA
- Corresponding author.
| | - A. Wayne Johnson
- Department of Exercise Sciences, Brigham Young University, Provo, UT 84602, USA
| | - Pat R. Vehrs
- Department of Exercise Sciences, Brigham Young University, Provo, UT 84602, USA
| | - J. Brent Feland
- Department of Exercise Sciences, Brigham Young University, Provo, UT 84602, USA
| | - Sterling C. Hilton
- Department of Educational Leadership and Foundations, David O. McKay School of Education, Brigham Young University, Provo, UT 84602, USA
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Tarara DT, Fogaca LK, Taylor JB, Hegedus EJ. Clinician-friendly physical performance tests in athletes part 3: a systematic review of measurement properties and correlations to injury for tests in the upper extremity. Br J Sports Med 2015; 50:545-51. [PMID: 26701926 DOI: 10.1136/bjsports-2015-095198] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVE In parts 1 and 2 of this systematic review, the methodological quality as well as the quality of the measurement properties of physical performance tests (PPTs) of the lower extremity in athletes was assessed. In this study, part 3, PPTs of the upper extremity in athletes are examined. METHODS Database and hand searches were conducted to identify primary literature addressing the use of upper extremity PPTs in athletes. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was used to critique the methodological quality of each paper. The Terwee Scale was used to analyse the quality of the measurement properties of each test. RESULTS 11 articles that examined 6 PPTs were identified. The 6 PPTs were: closed kinetic chain upper extremity stability test (CKCUEST), seated shot put (2 hands), unilateral seated shot put, medicine ball throw, modified push-up test and 1-arm hop test. Best evidence synthesis provided moderate positive evidence for the CKCUEST and unilateral seated shot put. Limited positive evidence was available for the medicine ball throw and 1-arm hop test. CONCLUSIONS There are a limited number of upper extremity PPTs used as part of musculoskeletal screening examinations, or as outcome measures in athletic populations. The CKCUEST and unilateral seated shot put are 2 promising PPTs based on moderate evidence. However, the utility of the PPTs in injured populations is unsubstantiated in literature and warrants further investigation.
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Affiliation(s)
- Daniel T Tarara
- Department of Exercise Science, High Point University, School of Health Sciences, High Point, North Carolina, USA
| | - Lucas K Fogaca
- Department of Biology, High Point University, High Point, North Carolina, USA
| | - Jeffrey B Taylor
- Department of Physical Therapy, High Point University, School of Health Sciences, High Point, North Carolina, USA
| | - Eric J Hegedus
- Department of Physical Therapy, High Point University, School of Health Sciences, High Point, North Carolina, USA
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Monti R. RETURN TO HITTING: AN INTERVAL HITTING PROGRESSION AND OVERVIEW OF HITTING MECHANICS FOLLOWING INJURY. Int J Sports Phys Ther 2015; 10:1059-1073. [PMID: 26672900 PMCID: PMC4675191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Participation in baseball is prevalent across all age groups. Baseball injuries are common and can impact a player's ability to participate. An injury to any region can influence the player's ability to swing the bat. As a part of the athlete's rehabilitation, a sports-specific program should be implemented re-introducing the hitting cycle that addresses proper biomechanics as well as providing a progressive atmosphere to return to hitting. Although there are several return to throwing progression programs in the literature, to the author's knowledge no published hitting progression programs exist. Thus, the purpose of this clinical commentary is to propose a progressive return to hitting program that emphasizes proper mechanics for ballplayers who have sustained an injury. DESCRIPTION OF TOPIC This return to hitting program describes in detail the phases of the baseball hitting cycle. Proper biomechanical information is provided on each phase that can be used to assist the clinician in injury prevention. This article gives the healthcare professional guidance for assessment for appropriate readiness for return to sport using impairment measures, patient-report measures, and physical performance measures. The purpose of this hitting progression is to provide a safe, gradual increase in hitting intensity by moving from a fixed position to soft toss and finally to increasing pitch velocity. DISCUSSION This interval hitting program guides the clinician from when the patient is ready to begin hitting through a full return to sport. Use of appropriate hitting mechanics must be ensured during rehabilitation to avoid compensation. Similar to the return to throwing programs that exist, this interval hitting progression program can provide a framework to quantify progression and reduce the chance of re-injury from occurring during the return to sport phase of rehab. LEVEL OF EVIDENCE Level 5.
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Affiliation(s)
- Ryan Monti
- Sports and Orthopedic Physical Therapy, Nationwide Children's Hospital, Columbus, Ohio, USA
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Sciascia A, Uhl T. RELIABILITY OF STRENGTH AND PERFORMANCE TESTING MEASURES AND THEIR ABILITY TO DIFFERENTIATE PERSONS WITH AND WITHOUT SHOULDER SYMPTOMS. Int J Sports Phys Ther 2015; 10:655-666. [PMID: 26491616 PMCID: PMC4595919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Upper extremity physical performance measures exist but none have been universally accepted as the primary means of gauging readiness to return to activity following rehabilitation. Few reports have described reliability and/or differences in outcome with physical performance measures between individuals with and without shoulder symptoms. HYPOTHESES/PURPOSE The purpose of this study was to establish the reliability of traditional upper extremity strength testing and the CKCUEST in persons with and without shoulder symptoms as well as to determine if the testing maneuvers could discriminate between individuals with and without shoulder symptoms. The authors hypothesized that strength and physical performance testing would have excellent test/re-test reliability for individuals with and without shoulder symptoms and that the physical performance maneuver would be able to discriminate between individuals with and without shoulder symptoms. METHODS Male and female subjects 18-50 years of age were recruited for testing. Subjects were screened and placed into groups based on the presence (Symptomatic Group) or absence of shoulder symptoms (Asymptomatic Group). Each subject performed an isometric strength task, a task designed to estimate 1-repetition maximum (RM) lifting in the plane of the scapula, and the closed kinetic chain upper extremity stability test (CKCUEST) during two sessions 7-10 days apart. Test/re-test reliability was calculated for all three tasks. Independent t-tests were utilized for between group comparisons to determine if a performance task could discriminate between persons with and without shoulder symptoms. RESULTS Thirty-six subjects (18/group) completed both sessions. Test/re-test reliability for each task was excellent for both groups (intraclass correlations ≥ .85 for all tasks). Neither strength task could discriminate between subjects in either group. Subjects with shoulder symptoms had 3% less touches per kilogram of body weight on the CKCUEST compared to subjects without shoulder symptoms but this was not statistically significantly different (p=.064). CONCLUSIONS The excellent test/re-test reliability has now been expanded to include individuals with various reasons for shoulder symptoms. Traditional strength testing does not appear to be the ideal assessment method for making discharge and/or return to activity decisions due to the inability to discriminate between the groups. The CKCUEST could be utilized to determine readiness for activity as it was trending towards being discriminatory between known groups. LEVEL OF EVIDENCE Basic Science Reliability Study, Level 3.
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Affiliation(s)
- Aaron Sciascia
- Lexington Clinic, Shoulder Center of Kentucky, Lexington, KY, USA
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50
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Tarara DT, Hegedus EJ, Taylor JB. Real-time test-retest and interrater reliability of select physical performance measures in physically active college-aged students. Int J Sports Phys Ther 2014; 9:874-887. [PMID: 25540703 PMCID: PMC4275192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND A new 16-item physical performance measure screening battery (16-PPM) was developed in order to expand on established movement based qualitatively scored functional screening batteries to encompass a broader spectrum of quantitatively scored functional constructs such as strength, endurance, and power. PURPOSE/HYPOTHESIS The purpose of this study was quantify the real-time tests-retest and expert versus novice interrater reliability of the 16-PPM screen on a group of physically active college-aged individuals. The authors' hypothesized that the test-retest and interrater reliability of quantitatively-scored performance measures would be highly correlated (ICC ≥ 0.75) and that qualitatively-scored movement screening tests would be moderately correlated (K w = 0.41-0.60). STUDY DESIGN Cohort reliability study. METHODS Nineteen (8 males, 11 females) healthy physically active college-aged students completed the 16-PPM on two days, one week apart. RESULTS The majority of the quantitatively scored components of the 16-PPMs demonstrated good expert-novice interrater reliability (ICC > 0.75), while qualitatively scored tests had moderate (K w = 0.41-0.60) to substantial (K w = 0.61-0.80) agreement. Test-retest reliability was consistent between raters, with most quantitatively scored PPMs exhibiting superior reliability to the qualitatively scored PPMs. CONCLUSIONS The 16-PPM test items showed good test-retest and interrater reliability. However, results indicate that expert raters may be more reliable than novice raters for qualitatively scored tests. The validity of this 16-PPM needs to be determined in future studies. CLINICAL RELEVANCE Physical performance screening batteries may be used to help identify individuals at risk for future athletic injury; however, current PPMs that rely on qualitatively scored movement screens have exhibited inconsistent and questionable injury prediction validity. The addition of reliable quantitatively scored PPMs may complement qualitatively scored PPMs to improve the battery's predictive ability. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Daniel T. Tarara
- Department of Exercise Science High Point University, School of Health Sciences, High Point, NC, USA
| | - Eric J. Hegedus
- Department of Physical Therapy High Point University, School of Health Sciences, High Point, NC, USA
| | - Jeffrey B. Taylor
- Department of Physical Therapy High Point University, School of Health Sciences, High Point, NC, USA
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