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Hansen A, Mortensen OS, Escorpizo R, Søgaard K, Søndergaard J, Schiøttz-Christensen B, Lauridsen HH. Assessing Work Functioning in Patients with Persistent Low Back Pain: Exploring the Structural Validity of the Work Rehabilitation Questionnaire. JOURNAL OF OCCUPATIONAL REHABILITATION 2023:10.1007/s10926-023-10157-9. [PMID: 38102368 DOI: 10.1007/s10926-023-10157-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/05/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Assessing work functioning in patients with persistent low back pain (LBP) is important for understanding their ability to engage in work-related activities. This study aims to evaluate the item characteristics, factor structure, and internal consistency of the Work Rehabilitation Questionnaire (WORQ) in patients with persistent LBP. METHODS Four hundred and twenty-five individuals with LBP completed the WORQ. Item characteristics, exploratory factor analysis (EFA), and consistency were performed to identify the underlying factors. RESULTS Missing responses were < 2% for each item. The analysis revealed three factors: psychological wellbeing, physical functioning, and cognitive ability. The factors demonstrated strong internal consistency, with Cronbach's alpha values ranging from 0.88 to 0.93 and McDonald's Omega from 0.92 to 0.96. Fifteen items did not fit into any identified factors, suggesting their potential value in screening functioning levels beyond the factors. CONCLUSIONS The WORQ is a valid instrument for evaluating work limitations in individuals with persistent LBP. Further research should assess its responsiveness to changes from interventions that target workability. Advancing this knowledge has the potential to promote work rehabilitation and improve the quality of life for patients with persistent LBP.
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Affiliation(s)
- Anders Hansen
- Medical Research, Spine Centre of Southern Denmark, Lillebaelt Hospital, University Hospital of Southern Denmark, Østre Houghvej 55, 5500, Middelfart, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Holbæk Hospital, Part of Copenhagen University Hospital, Holbæk, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, USA
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jens Søndergaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Berit Schiøttz-Christensen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Henrik Hein Lauridsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Berger M, Bertrand AM, Robert T, Chèze L. Measuring objective physical activity in people with chronic low back pain using accelerometers: a scoping review. Front Sports Act Living 2023; 5:1236143. [PMID: 38022769 PMCID: PMC10646390 DOI: 10.3389/fspor.2023.1236143] [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: 06/14/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Accelerometers can be used to objectively measure physical activity. They could be offered to people with chronic low back pain (CLBP) who are encouraged to maintain an active lifestyle. The aim of this study was to examine the use of accelerometers in studies of people with CLBP and to synthesize the main results regarding the measurement of objective physical activity. Methods A scoping review was conducted following Arksey and O'Malley's framework. Relevant studies were collected from 4 electronic databases (PubMed, Embase, CINHAL, Web of Science) between January 2000 and July 2023. Two reviewers independently screened all studies and extracted data. Results 40 publications out of 810 citations were included for analysis. The use of accelerometers in people with CLBP differed across studies; the duration of measurement, physical activity outcomes and models varied, and several limitations of accelerometry were reported. The main results of objective physical activity measures varied and were sometimes contradictory. Thus, they question the validity of measurement methods and provide the opportunity to discuss the objective physical activity of people with CLBP. Conclusions Accelerometers have the potential to monitor physical performance in people with CLBP; however, important technical limitations must be overcome.
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Affiliation(s)
- Mathilde Berger
- Occupational Therapy Department (HETSL | HES-SO), University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Université de Lyon, Université Claude Bernard Lyon 1, Univ Eiffel, LBMC UMR_T 9406, Lyon, France
| | - Anne Martine Bertrand
- Occupational Therapy Department (HETSL | HES-SO), University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Thomas Robert
- Université de Lyon, Université Claude Bernard Lyon 1, Univ Eiffel, LBMC UMR_T 9406, Lyon, France
| | - Laurence Chèze
- Université de Lyon, Université Claude Bernard Lyon 1, Univ Eiffel, LBMC UMR_T 9406, Lyon, France
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Sheehan RC, Fain AC, Wilson JB, Wilken JM, Rábago CA. Inclusion of a Military-specific, Virtual Reality-based Rehabilitation Intervention Improved Measured Function, but Not Perceived Function, in Individuals with Lower Limb Trauma. Mil Med 2021; 186:e777-e783. [PMID: 33201245 DOI: 10.1093/milmed/usaa483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/12/2020] [Accepted: 10/28/2020] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Lower extremity injury is common in the military and can lead to instability, pain, and decreased function. Military service also places high physical demands on service members (SMs). Standard treatment interventions often fail to align with these unique demands. Thus, the goal of the study was to evaluate the effectiveness of a military-specific virtual reality-based rehabilitation (VR) intervention supplemental to standard care (SC) in improving military performance in SMs with lower extremity injuries. MATERIALS AND METHODS As part of an institutional review board-approved randomized control trial, SMs receiving care at an advanced rehabilitation center were randomized to receive either SC or VR in addition to SC (VR+SC). Participants were evaluated before treatment and ∼3 weeks later using a previously developed and validated military-specific assessment. Perceived improvement in physical function was measured using a Global Rating of Change (GROC) questionnaire. A repeated measures ANOVA was used to evaluate the effects of adding VR on the military-specific assessment measures. Linear regression was used to determine the relationship between perceived improvement, measured improvement, and VR volume. RESULTS The VR+SC group was able to traverse a greater distance in the assessment following the VR intervention. There was no significant difference in GROC between groups. For the VR+SC group, change in distance completed was not correlated with GROC, but GROC was correlated with VR volume. CONCLUSION VR improved the distance that participants were able to traverse in the assessment. However, the VR+SC group demonstrated a disconnect between their perceived functional improvement as measured by the GROC and functional improvement as measured by the change in the distance completed. Rather, the perceived improvement appears to be more correlated with the volume of VR received. The way in which the treatment progression is structured and communicated may influence how patients perceive their change in physical function.
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Affiliation(s)
- Riley C Sheehan
- Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, Sam Houston, TX 78234, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
- Department of Rehabilitation Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - AuraLea C Fain
- Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, Sam Houston, TX 78234, USA
- Extremity Trauma and Amputation Center of Excellence, Sam Houston, TX 78234, USA
| | - Jonathan B Wilson
- Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, Sam Houston, TX 78234, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
- Department of Rehabilitation Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Jason M Wilken
- Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, Sam Houston, TX 78234, USA
- Extremity Trauma and Amputation Center of Excellence, Sam Houston, TX 78234, USA
| | - Christopher A Rábago
- Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, Sam Houston, TX 78234, USA
- Department of Rehabilitation Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Extremity Trauma and Amputation Center of Excellence, Sam Houston, TX 78234, USA
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Jelsma J, Schotanus MG, Senden R, Heyligers IC, Grimm B. Metal ion concentrations after metal-on-metal hip arthroplasty are not correlated with habitual physical activity levels. Hip Int 2019; 29:638-646. [PMID: 30479165 DOI: 10.1177/1120700018814225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Metal-on-metal (MoM) hip arthroplasties have shown high clinical failure rates with many patients at risk for a revision and under surveillance for high metal ion concentrations. Implant wear releasing such ions is assumed to be a function of use, i.e. the patient's physical activity. This study aimed to assess whether habitual physical activity levels of MoM patients are correlated with metal ion concentrations and are higher in patients with high (at risk) than in patients with low (safe) metal ion concentrations. METHODS A cohort study was conducted of patients with any type of MoM hip prosthesis. Metal ion concentrations were determined using ICP-MS. Habitual physical activity of subjects was measured in daily living using an acceleration-based activity monitor. Outcome consisted of quantitative and qualitative activity parameters. RESULTS In total, 62 patients were included. Mean age at surgery was 60.8 ± 9.3 years and follow-up was 6.3 ± 1.4 years. Cobalt concentrations were highly elevated overall (112.4 ± 137.9 nmol/L) and significantly more in bilateral (184.8 ± 106.5 nmol/L) than in unilateral cases (87.8 ± 139.4 nmol/L). No correlations were found between physical activity parameters and metal ion concentrations. Subgroup analysis of patients with low versus high cobalt concentration showed no significant differences in habitual physical activity. DISCUSSION No correlation was found between physical activity levels and metal ion concentrations. Implant use by normal habitual activities of daily living seems not to influence metal ion concentrations.
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Affiliation(s)
- Jetse Jelsma
- Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, The Netherlands
| | - Martijn Gm Schotanus
- Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, The Netherlands
| | - Rachel Senden
- Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, The Netherlands
| | - Ide C Heyligers
- Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, The Netherlands
| | - Bernd Grimm
- Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, The Netherlands
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Kierkegaard S, Lund B, Dalgas U, Sørensen H, Søballe K, Mechlenburg I. The Horsens-Aarhus Femoro Acetabular Impingement (HAFAI) cohort: outcome of arthroscopic treatment for femoroacetabular impingement. Protocol for a prospective cohort study. BMJ Open 2015; 5:e008952. [PMID: 26346877 PMCID: PMC4563276 DOI: 10.1136/bmjopen-2015-008952] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION During the past decade, it has become increasingly more common to offer hip arthroscopic surgery when treating people with femoroacetabular impingement (FAI). Nevertheless, the latest reviews conclude that it still remains to be properly investigated how surgery affects the patients. Specifically, detailed information on the functional, muscular and mechanical impact of surgery in larger groups is lacking. Furthermore, the long-term outcome of the surgery is still to be investigated. METHODS AND ANALYSIS In this prospective cohort study, a total of 60 patients with FAI scheduled for arthroscopic surgery will be followed and tested preoperatively, and again after 3, 6, 9 and 12 months. Assessment includes isokinetic dynamometry evaluating hip flexion and extension; evaluation of functional capacity in a three-dimensional motion laboratory; pain assessment; self-reported function, quality of life, expectation and satisfaction with the surgery; recording of previous and present sporting activities and accelerometry. In addition, data on surgical procedure, rehabilitation progress, adverse events and failure will be recorded. Patients will be compared with an age-matched and gender-matched reference group of 30 persons with no hip, knee, ankle or back problems. Long-term follow-up of this cohort may evaluate possible reoperations and development of hip osteoarthritis. Furthermore, analysis on how subgroups respond to the treatment could be performed together with identification of possible "non-responders". ETHICS AND DISSEMINATION The study is approved by the Central Denmark Region Committee on Biomedical Research Ethics (Journal No 1-10-72-239-14). The results from this study will be presented at national and international congresses and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02306525.
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Affiliation(s)
- Signe Kierkegaard
- Department of Orthopaedic Surgery, Horsens Hospital, Horsens, Denmark
| | - Bent Lund
- Department of Orthopaedic Surgery, Horsens Hospital, Horsens, Denmark
| | - Ulrik Dalgas
- Section of Sports, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Henrik Sørensen
- Section of Sports, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Kjeld Søballe
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
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