Psychometric properties of observational tools for identifying motor difficulties - a systematic review

Brain imaging of a gamified cognitive flexibility task in young and older adults

The study aimed to develop and validate a gamified cognitive flexibility task through brain imaging, and to investigate behavioral and brain activation differences between young and older adults during task performance. Thirty-one young adults (aged 18-35) and 31 older adults (aged 60-80) were included in the present study. All participants underwent fMRI scans while completing the gamified cognitive flexibility task. Results showed that young adults outperformed older adults on the task. The left inferior frontal junction (IFJ), a key region of cognitive flexibility, was significantly activated during the task in both older and young adults. Comparatively, the percent signal change in the left IFJ was stronger in older adults than in young adults. Moreover, older adults demonstrated more precise representations during the task in the left IFJ. Additionally, the left inferior parietal lobule (IPL) and superior parietal lobule in older adults and the left middle frontal gyrus (MFG) and inferior frontal gyrus in young adults were also activated during the task. Psychophysiological interaction analyses showed significant functional connectivity between the left IFJ and the left IPL, as well as the right precuneus in older adults. In young adults, significant functional connectivity was found between the left IFJ and the left MFG, as well as the right angular. The current study provides preliminary evidence for the validity of the gamified cognitive flexibility task through brain imaging. The findings suggest that this task could serve as a reliable tool for assessing cognitive flexibility and for exploring age-related differences of cognitive flexibility in both brain and behavior.

An assessment of the content and properties of extended and instrumental activities of daily living scales: a systematic review

PURPOSE

We performed a systematic review to assess the psychometric properties of extended Activities of Daily Living (eADL) scales.

MATERIALS AND METHODS

Articles assessing eADL scales' properties were retrieved by searching multidisciplinary databases, and reference screening. Data on the following properties were extracted: validity, reliability, responsiveness, and internal consistency. The COSMIN (Consensus-based Standards for the selection of health status Measurement Instruments) risk of bias checklists are used to assess the quality of included articles. All aspects were performed by two independent researchers.

RESULTS

Of 245 titles, 26 articles were eligible, comprising 15 different eADL scales. The Lawton scale had the most papers describing properties, while the Performance-based Instrumental Activities of Daily Living received the highest COSMIN rating. Properties most often assessed were convergent validity and reliability, no articles assessed all COSMIN properties. The COSMIN assessment rated 43% of the properties as 'positive', 31% 'doubtful' and 26% 'inadequate'. Only Lawton was assessed in more than one paper, available data suggest that this scale has excellent reliability, construct validity, internal consistency, and medium criterion validity.

CONCLUSION

Despite their common use, there are limited data on the properties of eADL scales. Where data are available there are potential methodological issues in the studies.

Association between motor skills and executive function of children with autism spectrum disorder in Taiwan and the United States

Objective

The purpose of this study was to examine the relationship between parent ratings of motor skills and executive function (EF) in children with autism spectrum disorder (ASD) in the United States and Taiwan.

Materials and method

One hundred and seventy-two parents/legal guardians of children (4-6 years and 11 months old) with ASD were recruited from two countries, Taiwan (n = 100) and the United States (n = 72). The parents or guardians of the child with ASD completed a questionnaire including demographic information, child's motor skills (using Children Activity Scale - Parents, ChAS-P), and child's EF (using Childhood Executive Functioning Inventory, CHEXI). A series of hierarchical multiple regressions were conducted to determine whether ChAS-P (total motor score, fine motor skills, and gross motor skill) was associated with CHEXI (total EF score, working memory, and inhibition), after controlling for covariates (i.e., age, gender, race, body mass index, whether children received physical activity or cognitive training, parental education level).

Results

Total motor skills, fine motor skills, and gross motor skills were significantly associated with EF in both working memory and inhibition as rated by parents in both countries (β = 0.21-0.57, p < 0.01), with the exception of a non-significant association between parent-rated total motor skills, fine motor skills, and gross motor skills, and inhibition among Taiwanese children with ASD. In addition, the associations between parent ratings of motor skills (i.e., fine motor and gross motor skills) and EF (i.e., working memory and inhibition) were similar between the two countries.

Conclusion

Positive associations with specific aspects of parent ratings of fine motor and gross motor skills and working memory and inhibition were found in children with ASD from both countries. These findings have implications for future interventions and programs focused on improving early motor skills and EF development for young children with ASD from Taiwan and the United States.

Cultural Adaptation of the MABC-2 Checklist as a Screening Tool for Developmental Coordination Disorder in Schools

The purpose of this study was to adapt the MABC-2 Checklist to Czech primary schools by examining of its content validity and feasibility. The content validity achieved the satisfactory level in the second round of panels of experts on child motor development. The evidence on feasibility was obtained from classroom teachers who described this tool as clear, objective and having logical structure and its administration as comprehensible and fast. The MABC-2 Checklist is applicable instrument for the Czech school environment, but its adaptation to various countries should consider the items representing the common motor skills in local children.

The Ten-Item Personality Inventory (TIPI): a scoping review of versions, translations and psychometric properties

Background

The Ten-Item Personality Inventory (TIPI) is a brief instrument designed to assess the five-factor model (FFM) personality dimensions. It was specifically developed to provide a brief assessment option in situations where using more comprehensive FFM instruments would be unfeasible. The TIPI enjoys widespread use and has been translated into several different languages.

Objective

The aim of this scoping review was to generate an overview of different versions of the TIPI, and their psychometric properties in terms of two aspects of validity (convergent and structural) and two aspects of reliability (internal consistency and test-retest reliability).

Methods

Four databases (PsycINFO, PubPsych, Medline, and Web of Science) were searched for studies exploring psychometric properties of the TIPI (original and/or translated or revised versions), published in English as full-text original research articles. Additionally, manual searches were conducted on the official TIPI website and in reference lists. Studies who utilized the TIPI simply as a measure, without an aim of testing its psychometric properties, were excluded. A descriptive-analytical approach was utilized to generate overviews of available TIPI versions and their psychometric properties.

Results

In a total of 29 studies, 27 versions of the TIPI were identified, covering 18 different languages. Across versions, and evaluated against conventions of acceptable psychometric properties, the TIPI demonstrated acceptable test-retest reliability, somewhat mixed results for convergent and structural validity, and inappropriate internal consistency.

Conclusion

Being a brief instrument, the TIPI is unsurprisingly characterized by certain psychometric shortcomings. However, the TIPI may represent a feasible compromise in instances where it is necessary to strike a balance between maximizing psychometric properties and minimizing survey length.

Motor and cognitive skills implicated in the Motor Observation Questionnaire for Teachers (MOQ-T): A multidisciplinary approach

This study was designed to determine the relationship between an observational measure of motor skills for teachers (i.e., MOQ-T), age, and some objectively assessed cognitive and motor indices. Two further goals were to examine which motor and cognitive factors predicted MOQ-T scores and to explore whether pupils with very low motor skills identified through MOQ-T also exhibited lower scores on objectively assessed motor and visuo-spatial tasks. A sample of 156 pupils aged 8.4 years-11.3 years and attending Italian primary school completed a battery of tests assessing writing speed, visuo-spatial abstract reasoning, fluency, and static balance abilities objectively assessed by measuring postural sway. Small to medium associations were found between MOQ-T scores and age, motor, and cognitive parameters, respectively. Moreover, approximately 26% of the variance in MOQ-T was predicted by sway area in the eyes-open condition, visuo-spatial fluency, and writing speed. Finally, pupils at risk of developmental coordination disorder exhibited poorer writing speed, and motor and higher-order visuo-spatial deficits. In conclusion, the synergistic use of objective measures of motor and cognitive functioning and observational screening questionnaires such as MOQ-T should be encouraged at school to identify pupils at risk of developmental coordination disorder.

The feasibility of using the Körperkoordinationstest fur Kinder (KTK) in a U.S. elementary physical education setting to assess gross motor skills specific to postural balance

Introduction

For the past ten years, falls have been the leading cause of nonfatal injuries for all age groups less than 15 years old. A significant rise in childhood sedentary behavior in schools and limited opportunities to be outside has led to motor coordination deficits which have contributed to fall injuries.

Method

A German assessment tool, the Körperkoordinationstest fur Kinder (KTK), which has been used for decades in Western European countries, allows researchers and physical education teachers to evaluate typical and atypical children's motor coordination competencies related to dynamic postural balance successfully. No research has been published on the use of this assessment tool in the United States. If its use were found to be feasible in this country for identifying motor coordination deficits in typical and atypical children, it would close the gap in determining motor coordination. Therefore, this study sought in Phase 1 to determine the feasibility of using the KTK assessment in U.S. children and Phase 2 sought to determine the adaptability of the scoring protocol from use in other countries to the United States.

Results

The Phase 1 results revealed the KTK assessment was feasible to administer in U.S. physical education class by addressing three challenges for U.S. schools: 1) KTK implementation, 2) time to assess each skill, and 3) the equipment availability and cost to implement the test in a physical education setting. In Phase 2, the researchers were able to determine the raw scores and motor quotient scores in this population and then were able to show similar scoring trends between U.S. children and Flemish children from a previous study.

Conclusion

This assessment tool was deemed feasible and adaptable which is the first step to use the KTK in U.S. physical education elementary school settings.

Measurement is the foundation of research and theory on children's eating behaviours: Current issues and directions for progress

Eating behaviours affect food intakes and are involved in the aetiology of obesity. There has been impetus to translate findings about children's eating behaviour into intervention and policy programs. However, measurement limitations have hindered our capacity to understand and influence children's eating behaviours. In the present paper we provide an overview of some of the key methodological and measurement issues facing the field of children's eating behaviours and highlight implications for research and health promotion. Drawing on insight from parallel issues that occur in the measurement of early social and emotional development, we examine two overlapping themes in children's (aged 0-∼12 years) eating behaviours (Somaraki et al., 2021) measurement issues related to validity and reliability, and (Steinsbekk & Wichstrøm, 2015) associated methodological challenges, such as contextual influences and the importance of designing studies that use multiple informants and multiple methods. We then suggest insights and strategies aimed at advancing approaches to measurement of children's eating behaviours. To progress our understanding of children's eating behaviours, we conclude that a range of psychometrically sound, fit-for-purpose measurement instruments and procedures are needed for use in multi-trait, multi-method, multi-informant studies in a range of populations and contexts.

Comparison of Psychometric Properties of Patient-Reported Outcomes Measurement Information System With Traditional Outcome Metrics in Spine Surgery

OBJECTIVE

Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to address certain shortcomings of traditional, or legacy patient-reported outcome measures (PROMs). Because the use of PROMIS across orthopedic populations continues to increase, the purpose of this study was to provide a comprehensive overview of the use and validation of PROMIS in spine surgery.

METHODS

PubMed and Google Scholar were searched for relevant articles reporting on the use and validation of PROMIS in spine surgery. The PROMIS formats and individual domains used by investigators were noted. Additionally, psychometric properties reported in validation studies were evaluated.

RESULTS

Both individual studies and systematic reviews have demonstrated the convergent validity of PROMIS domains, reporting moderate-to-strong correlations with legacy measures in a variety of spine patient populations. Across spine surgery patient populations, PROMIS instruments are consistently efficient, demonstrating decreased question burden compared with legacy PROMs. PROMIS domains overall exhibit responsiveness comparable with legacy measures, and the normalization of PROMIS scores to a general population allows for broad coverage, resulting in acceptable floor and ceiling effects. Despite the many strengths of PROMIS, there remain some populations where PROMIS is not suited to be used in isolation.

CONCLUSIONS

PROMIS is widely used as an outcome measure in spine surgery and has been validated in a range of patient populations. Although PROMIS domains cannot fully replace legacy measures in spine patients, they can be used in certain settings to provide an efficient and psychometrically sound PROM.

Physiotherapist performed Point of Care Ultrasonography (POCUS): a scoping review of 209 studies

BACKGROUND

Point of care ultrasonography (POCUS) is a non-ionizing imaging technique that is emerging in physiotherapy practice.

OBJECTIVE

To systematically map the research literature on physiotherapist performed POCUS.

DATA SOURCES

Following PRISMA-ScR guidelines, OVID Medline, CINAHL, AMED, and EMBASE were searched.

ELIGIBILITY CRITERIA

Peer-reviewed publications of physiotherapist performed POCUS were included.

DATA EXTRACTION AND DATA SYNTHESIS

Data collected included: title, author(s), journal, year of publication, design of included studies, sample size, age category of the sample, anatomical area of POCUS, geographical location of research, study setting, and disease condition/patient population. Data analysis consisted of descriptive statistics for the key characteristics of each research question.

RESULTS

A total of 18 217 titles and abstracts and 1 372 full-text citations were screened, with 209 studies included. Most included studies were measurement studies that assessed the psychometric properties of POCUS in adult patients, were published in the United States of America and imaged the abdominal lumbo-pelvic region. Eighty-two percent of studies were published in the last 10 years.

LIMITATIONS

Non-English language, review articles and grey literature were excluded for feasibility. Studies were excluded if it was not clearly reported that a physiotherapist performed the POCUS.

CONCLUSION

This review identified a wide variety of practice settings and a diverse number of patient conditions in which physiotherapists are performing POCUS. This breadth and depth of this review highlighted the need for improved reporting of study methodology and key areas of future research in physiotherapy performed POCUS. CONTRIBUTION OF THE PAPER.

Reliability and validity of specific quality of life assessment questionnaires related to chronic venous insufficiency: a systematic review

This systematic review aimed to discuss the main findings regarding the reliability and validity of health-related quality of life questionnaires for chronic venous insufficiency. Searches were performed on the MEDLINE, CINAHL, Web of Science, LILACS, and Scopus databases. The search terms used were related to "venous insufficiency", and "quality of life". The CIVIQ-20 and CIVIQ-14 instruments had adequate internal consistency and both were able to discriminate disease severity. The VEINES-QoL showed adequate internal consistency but was not able to discriminate disease severity. Most studies did not demonstrate a correlation between VEINES-QoL and the mental component of the SF-36. The AVVQ had inadequate reliability but its validity was also doubtful when compared to the SF-36. The VARIShort demonstrated good internal consistency, reproducibility, and validity, but only the original study was included. For venous leg ulcers, the CCVUQ showed adequate reliability and validity when compared to VLU-QoL.

Assessment of Viscoelastic Parameters of Muscles in Children Aged 4-9 Months with Minor Qualitative Impairment of the Motor Pattern after Vojta Therapy Implementation

The aim of this study was to assess if there are any objective changes in the viscoelastic parameters of the erector spinae muscle after Vojta stimulation. The study involved 22 healthy children at an average age of 7 months and with an Apgar score of 8-10 points, who were referred for rehabilitation due to a slight delay in the phases of psychomotor development. The first group consisted of 11 children with increased muscle tone (IMT) and the second group consisted of 11 children with non-increased muscle tone (nonIMT). All study participants received a one-time Vojta therapy session, which was continued for 4 weeks by parents at home. The viscoelastic parameters of the dorsal extensor muscle were measured three times. In the first study group, changes in the viscoelastic parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination, whereas changes in the supporting and extensor function of the limbs occurred in both groups at the second examination. Analysis featuring an objective assessment allows physiotherapists to diagnose local changes in the viscoelastic parameters after the implementation of therapy. These studies are the first pilot studies to be continued with a 30- or 60-day follow-up.

A scoping review of measures examining the environments of persons with neurodevelopmental disorders in a supported housing setting

Introduction: Having a neurodevelopmental disorder (NDD) can impact the abilities of an individual in many areas of life, including the ability to live independently. The environment of an individual impacts their day-to-day life throughout their lifespan. To improve supported housing experiences, it is important to map the evidence, especially relating to quality and satisfaction with the environment (as defined by the International Classification of Functioning, Disability and Health (ICF) framework). This has been exacerbated by COVID-19 pandemic restrictions, therefore more insight is needed in measuring this. Objective and methods: This scoping review searched 5 health and social science databases with the objective to identify and examine the outcome measures that integrate aspects of the environment that examine supported housing in individuals with NDD. Results and discussion: Fifteen studies met the inclusion criteria. We found that most measures targeted the satisfaction of individuals about their environment, with the ICF Support and Relationships factor of the environment assessed most. Measures were most often completed by a proxy through an interview. This work enhances our understanding of aspects of the environments of supported housing that are currently measured, laying an essential base for future research to improve the lives of individuals with NDDs.

The prevalence of the academic learning difficulties: An observation tool

This study seeks to develop an effective observation tool to determine the prevalence of various academic learning difficulties among school students at the primary level in Sana'a City, Yemen. A measure comprising of 34 items has been processed by the EFA and CFA for contriving ALD's psychometric properties. The study sample comprised 714 students between 6 - 14 years of age. The study's findings revealed that the observation tool under development could measure the prevalence of various academic learning difficulties to a great extent with accuracy. The learning difficulties were classified under five categories based on observation scores. The observed raw scores were standardised after taking the standard deviation from the sample's mean value into consideration. The study's findings suggested that the gender and grade of the subjects affected academic learning difficulties significantly. A brief discussion of the educational implications of these findings has also been presented.

Developing the first pan-Canadian survey on patient engagement in patient safety

BACKGROUND

Patient safety is a worldwide problem, and the patient contribution to mitigate the risk of patient harm is now recognized as a cornerstone to its solution. In order to understand the nature of integrating patients into patient safety and healthcare organizations and to monitor their integration, a Canadian survey tool has been co-constructed by patients, researchers and the Canadian Patient Safety Institute (CPSI). This questionnaire has been adapted from the French version of the patient engagement (PE) in patient safety (PS) questionnaire created for the province of Quebec, Canada.

METHODOLOGY

The pan-Canadian PE in PS survey tool was developed in a five-step process: (1) a literature review and revision of the initial tool developed in the province of Quebec; (2) translation of the French questionnaire into an English version tool; (3) creation of a Canadian expert advisory group; (4) adaptation of the English version tool based on feedback from the expert advisory group (assessment and development of the construct's dimensions, wording assessment and adaptation for pan-Canadian use, technical testing of the online platform for the survey); and (5) pilot testing and pre-validation of the tool before pan-Canadian use.

RESULTS AND CONCLUSION

Eight pan-Canadian PE in PS surveys were completed from five Canadian provinces by the expert advisory group and six surveys were completed during the pilot project by participants from different provinces in Canada. This survey tool comprises 5 sections: (1) demographic identification of the participants (Q1 to Q5); (2) general questions (Q6 to Q17); (3) the patient engagement process (experience level of participants and organizational incentives for PE in general) (Q18 to Q33); (4) PE in PS processes, such as current activities, strategies, structures, resources and factors (Q34 to Q67); and (5) the context and impact of PE in PS initiatives in Canadian healthcare organizations (CHOs) (Q68 to Q75), including outcome identification, improvement mechanisms and strategies, evaluation mechanisms, and indicators.

The psychometric properties of the Persian version of the MUSIC Model of Academic Motivation Inventory among nursing students

Aim

To determine the psychometric properties of the Persian version of the MUSIC Inventory in nursing students.

Design

Cross‐sectional psychometric study.

Methods

Transcultural adaptation of the MUSIC Model of Academic Motivation Inventory was carried out using translation to Persian and back‐translation. Then, the qualitative and quantitative face and content validity of the inventory were evaluated. Construct validity was assessed by exploratory factor analysis. To perform construct validity and reliability, a convenience sample of 360 undergraduate nursing students was recruited. Cronbach's alpha was used to assess internal consistency reliability.

Results

Cronbach's alpha for all items of the MUSIC inventory was .94, and each factor was between .72–.93. Exploratory factor analysis supported the 5‐factor structure of the MUSIC inventory. These 5 factors explain 66.59% of the overall extracted variance. Three items of the MUSIC inventory, which were related to the empowerment component, were deleted.

Conclusion

Based on the findings of this study, the Persian version of the MUSIC Model of Academic Motivation Inventory is a valid and reliable tool for Persian language nursing students.

Validity and reliability of new instruments for measuring patient satisfaction with removable dentures, Arabic Version

BACKGROUND

The psychometric properties of self-administered instruments for measuring patient satisfaction with removable dentures should be tested before inviting patients to express their opinions. This study aimed to evaluate the validity and reliability of new instruments in the Arabic language that measure patient satisfaction with all types of removable dentures.

METHODS

A three-step methodology was used to translate and test the instruments. In step one, the instruments were translated from tested German instruments to develop the pilot questionnaires. In step two, the face validity of the pilot questionnaires was tested through three rounds of interviews. There were 15, 13, and 15 participants per round, respectively. At the end of every round, the results of the interviews were discussed with an expert panel. The expert panel confirmed the form and the type of questionnaires' adjustments before a new round of interviews began. At the end of step two, the final form of the questionnaires was reached. In step three, 235 questionnaires were distributed to 133 participants to estimate the construct validity of the upper jaw and the lower jaw questionnaires. After one week, the participants were asked to complete the questionnaires again. A total of 102 questionnaires were returned and used to assess the instruments' reliability. Factor analysis was used to assess the construct validity. The intraclass correlation coefficient and Cronbach's alpha were used to estimate the reliability and suitability of the items in the indexes.

RESULTS

The result of step one was two pilot questionnaires. The pilot questionnaires were adjusted in step two. At the end of step two, the questionnaires proved to have good face validity. Factor analyses in step three revealed that only one factor could be retained. The one-factor model explained 60.95% and 63.06 of the total variance of the upper jaw and lower jaw questionnaires, respectively. The items in every questionnaire shared the same cluster and could be summed to form an upper jaw index and lower jaw index that reflected patient satisfaction with removable dentures. Cronbach's alpha values indicated excellent internal consistency and reliability for the upper jaw questionnaire (α = 0.91) and the lower jaw questionnaire (α = 0.92). Intraclass correlation coefficient values ranged from 0.72 to 0.95, which can be considered "moderate" to "excellent".

CONCLUSIONS

The Arabic version of questionnaires and indexes assessing patient satisfaction with upper and lower removable dentures are reliable and valid self-administered instruments.

Development and Validation of a Malaysian Blood Donor's Satisfaction Questionnaire

Objective

To develop and validate a questionnaire which evaluates the blood donors’ satisfaction.

Background

In Malaysia, blood procurement relies mainly on voluntary non-remunerated donors. Hence, it is important to ensure the satisfaction of the blood donors in order to increase retention.

Methods

This study was conducted among blood donors who attended blood donation and understood the Malay language. Non-Malaysian and illiterate donors were excluded. The questionnaire was developed by the transfusion medicine team. Content validity was established by content reviewers, while face validity was examined in the cognitive debriefing stage. For the 18-item questionnaire, 90 respondents were required based on the 1:5 ratio. A retest was performed in two weeks’ time.

Results

One hundred and thirty-seven participants responded in the first phase, while 103 responded after two weeks. The five domains were: technical, interpersonal, accessibility/ convenience, physical experience and overall satisfaction. The Kaiser-Meyer-Olkin (KMO) value was 0.896, with significant Bartlett’s Test of Sphericity (P < 0.001). The factor loadings ranged from 0.729 to 0.953. The Cronbach alpha values of the five domains ranged from 0.814 to 0.955 and the intraclass correlation coefficient ranged from 0.663 to 0.847.

Conclusion

The Malaysian blood donor’s satisfaction (M-BDS) questionnaire is a reliable and valid tool suitable for the assessment of blood donor’s satisfaction in blood donation centres.

Validity of the Developmental Coordination Disorder Questionnaire’ 07 and Its Association with Physical Activity in Young Children with Developmental Disabilities

OBJECTIVES The purposes of the current study were to examine the construct and predictive validity, and reliability of the developmental coordination disorder questionnaire’ 07 (DCDQ’ 07) for young children with developmental disabilities (DD).METHODS 135 parents of young children with DD completed an online questionnaire which consisted of demographic information, the DCDQ’ 07, and a physical activity behavior questionnaire. A one-way analysis of variance was conducted to evaluate motor difficulties across different types of young children with DD. Exploratory factor analysis and Cronbach’s alpha were used to examine construct validity and reliability of the DCDQ’ 07. Moreover, hierarchical multiple regression analysis was used to examine the association between the DCDQ’ 07 scores and physical activity behaviors in young children with DD.RESULTS The one-way analysis of variance indicated that the DCDQ’ 07 scores were significantly different across different types of young children with DD = 6.66, p <0.001). The exploratory factor analysis revealed a three-factor solution, accounting for 64.34% of the variance of the DCDQ’ 07. Internal consistencies of the three factors were acceptable. One factor, control during movement, was a significant predictor for physical activity behaviors in young children with DD (β = 0.37, p < 0.01).CONCLUSIONS The DCDQ’ 07 may be a reliable and valid measure in examining motor difficulties in young children with DD. To promote physical activity behaviors in young children with DD, teaching and reinforcing motor skills need to be encouraged.

Predictive validity of the 5-item Compliance Questionnaire for Rheumatology (CQR5) in detecting poor adherence of patients with rheumatoid arthritis to biological medication

Background

Adherence is a key factor for therapeutic success in patients with rheumatoid arthritis (RA). The aim of this study was to determine whether results from the 5-item Compliance Questionnaire for Rheumatology (CQR5) can predict future poor adherence to biological disease-modifying anti-rheumatic drugs (bDMARDs) in patients with RA, using medication possession ratio (MPR) as the gold standard comparator.

Methods

RA patients starting a bDMARD were prospectively followed for 12 months. At baseline, CQR5 was collected in relation to the prescribed bDMARD. Patients were dichotomised into good adherers and poor adherers, categories that were then used as the variable in a predictive function analysis of the CQR5 in order to determine the accuracy of the classification at the end of the study period in comparison with the MPR. The sensitivity, specificity, and likelihood ratio of detecting poor adherers were also determined because this is the clinically important purpose of the questionnaire. Satisfactory adherence was defined as > 80% compliance with the prescribed dose regimen.

Results

Of the 210 RA patients enrolled (147 women and 63 men; mean age 58.6 ± 12.8 years; mean disease duration 7.4 ± 2.5 years), at the end of the 12-month follow-up, 152 patients (72.4%) were good adherers and 58 (27.6%) were poor adherers according to MPR. Predictive analyses showed that the sensitivity and specificity of the CQR5 in detecting poor adherence were respectively 89.9% (95% CI 84.07–94.10%) and 80.8% (95% CI 67.46–90.37%). The accuracy of the CQR5 was 83.04% (95% CI 77.27–87.85%), the positive likelihood ratio (i.e. detecting ≤ 80% adherence) 4.67 (95% CI 2.58–8.18), and the area under curve 0.85 (95% CI 0.79–0.89).

Conclusion

Higher baseline CQR5 scores significantly predict the treatment adherence of RA patients. This suggests that this instrument could be used for screening purposes in order to identify patients who are poorly adherent to bDMARDs.

The contribution of motor functions to academic achievement in primary school: State of the art and future directions

This review is intended to point out the role played by motor skills proficiency in the academic achievement of typically and atypically developing pupils who are attending primary school. First, the interplay between motor and cognitive development will be presented. Next, the cognitive phenotype, not yet deeply investigated, of a neurodevelopmental condition associated with the atypical development of motor functions (known as Developmental Coordination Disorder) will be illustrated. Thus, the contribution of motor functions to academic learning and the impact of motor difficulties for pupils attending primary school will be discussed. In addition, the importance of developing observational tools to be used in educational settings and the need for effective interventions designed to empower motor functioning and academic achievement of atypically developing pupils with motor deficits will be highlighted. Finally, future directions within the educational agencies for the early detection of the atypically developing motor trajectories and their treatment will be traced.