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Heide M, Mørk M, Fenne Hoksrud A, Brox JI, Røe C. Responsiveness of specific and generic patient-reported outcome measures in patients with plantar fasciopathy. Disabil Rehabil 2024; 46:4300-4306. [PMID: 37855657 DOI: 10.1080/09638288.2023.2267438] [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: 03/31/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE To evaluate and compare responsiveness characteristics for the Foot Function Index revised short form (FFI-RS), RAND-12 Health Status Inventory (RAND-12), and Numeric Rating Scale (NRS), in patients with plantar fasciopathy receiving non-surgical treatment. MATERIALS AND METHODS This study was conducted on a sub-group of patients from an ongoing randomised controlled trial. One-hundred fifteen patients were included. The patient-reported outcome measures (PROMs) were applied at baseline and after 6 months. Responsiveness was calculated using standardised response mean and area under the receiver operating characteristic (ROC) curve. ROC curves were used to compute the minimal important change (MIC) for the outcome measures. RESULTS The region specific FFI-RS had best responsiveness and the NRS at rest had lowest responsiveness. CONCLUSION FFI-RS were marginally more responsive than the other PROMs. Responsiveness and MIC estimates should be regarded as indicative rather than fixed estimates.
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Affiliation(s)
- Marte Heide
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Nydalen, Norway
| | - Marianne Mørk
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Nydalen, Norway
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Aasne Fenne Hoksrud
- Norwegian Olympic and Paralympics Committee and Confederation of Sports, Oslo, Norway
| | - Jens Ivar Brox
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Nydalen, Norway
| | - Cecilie Røe
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Nydalen, Norway
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Kanzler CM, Armand T, Simovic L, Sylvester R, Domnik N, Eilfort AM, Rohner C, Gassert R, Gonzenbach R, Lambercy O. Influence of virtual reality and task complexity on digital health metrics assessing upper limb function. J Neuroeng Rehabil 2024; 21:125. [PMID: 39068424 PMCID: PMC11282591 DOI: 10.1186/s12984-024-01413-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Technology-based assessments using 2D virtual reality (VR) environments and goal-directed instrumented tasks can deliver digital health metrics describing upper limb sensorimotor function that are expected to provide sensitive endpoints for clinical studies. Open questions remain about the influence of the VR environment and task complexity on such metrics and their clinimetric properties. METHODS We aim to investigate the influence of VR and task complexity on the clinimetric properties of digital health metrics describing upper limb function. We relied on the Virtual Peg Insertion Test (VPIT), a haptic VR-based assessment with a virtual manipulation task. To evaluate the influence of VR and task complexity, we designed two novel tasks derived from the VPIT, the VPIT-2H (VR environment with reduced task complexity) and the PPIT (physical task with reduced task complexity). These were administered in an observational longitudinal study with 27 able-bodied participants and 31 participants with multiple sclerosis (pwMS, VPIT and PPIT only) and the value of kinematic and kinetic metrics, their clinimetric properties, and the usability of the assessment tasks were compared. RESULTS Intra-participant variability strongly increased with increasing task complexity (coefficient of variation + 56%) and was higher in the VR compared to the physical environment (+ 27%). Surprisingly, this did not translate into significant differences in the metrics' measurement error and test-retest reliability across task conditions (p > 0.05). Responsiveness to longitudinal changes in pwMS was even significantly higher (effect size + 0.35, p < 0.05) for the VR task with high task complexity compared to the physical instrumented task with low task complexity. Increased inter-participant variability might have compensated for the increased intra-participant variability to maintain good clinimetric properties. No significant influence of task condition on concurrent validity was present in pwMS. Lastly, pwMS rated the PPIT with higher usability than the VPIT (System Usability Scale + 7.5, p < 0.05). CONCLUSION The metrics of both the VR haptic- and physical task-based instrumented assessments showed adequate clinimetric properties. The VR haptic-based assessment may be superior when longitudinally assessing pwMS due to its increased responsiveness. The physical instrumented task may be advantageous for regular clinical use due to its higher usability. These findings highlight that both assessments should be further validated for their ideal use-cases.
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Affiliation(s)
- Christoph M Kanzler
- Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
- Campus for Research Excellence And Technological Enterprise (CREATE), Future Health Technologies, Singapore-ETH Centre, Singapore, Singapore.
| | - Tom Armand
- Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Leonardo Simovic
- Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | | | - Nadine Domnik
- Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Antonia M Eilfort
- Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Carola Rohner
- Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Roger Gassert
- Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Campus for Research Excellence And Technological Enterprise (CREATE), Future Health Technologies, Singapore-ETH Centre, Singapore, Singapore
| | | | - Olivier Lambercy
- Rehabilitation Engineering Laboratory, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Campus for Research Excellence And Technological Enterprise (CREATE), Future Health Technologies, Singapore-ETH Centre, Singapore, Singapore
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Plümer L, Jung E, Krause L, Fischer M. Quality of recovery after major noncardiac surgery in a high-acuity postoperative unit: A prospective validation study to evaluate the QoR-15GE during advanced recovery room care. Eur J Anaesthesiol 2024:00003643-990000000-00205. [PMID: 39034890 DOI: 10.1097/eja.0000000000002036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Affiliation(s)
- Lili Plümer
- From the Department of Anesthesiology (LP, EJ, MF), Institute of Medical Biometry and Epidemiology (LK) and Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (MF)
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Klukowska AM, Vandertop WP, Schröder ML, Staartjes VE. Calculation of the minimum clinically important difference (MCID) using different methodologies: case study and practical guide. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024:10.1007/s00586-024-08369-5. [PMID: 38940854 DOI: 10.1007/s00586-024-08369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/17/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Establishing thresholds of change that are actually meaningful for the patient in an outcome measurement instrument is paramount. This concept is called the minimum clinically important difference (MCID). We summarize available MCID calculation methods relevant to spine surgery, and outline key considerations, followed by a step-by-step working example of how MCID can be calculated, using publicly available data, to enable the readers to follow the calculations themselves. METHODS Thirteen MCID calculations methods were summarized, including anchor-based methods, distribution-based methods, Reliable Change Index, 30% Reduction from Baseline, Social Comparison Approach and the Delphi method. All methods, except the latter two, were used to calculate MCID for improvement of Zurich Claudication Questionnaire (ZCQ) Symptom Severity of patients with lumbar spinal stenosis. Numeric Rating Scale for Leg Pain and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire Walking Ability domain were used as anchors. RESULTS The MCID for improvement of ZCQ Symptom Severity ranged from 0.8 to 5.1. On average, distribution-based methods yielded lower MCID values, than anchor-based methods. The percentage of patients who achieved the calculated MCID threshold ranged from 9.5% to 61.9%. CONCLUSIONS MCID calculations are encouraged in spinal research to evaluate treatment success. Anchor-based methods, relying on scales assessing patient preferences, continue to be the "gold-standard" with receiver operating characteristic curve approach being optimal. In their absence, the minimum detectable change approach is acceptable. The provided explanation and step-by-step example of MCID calculations with statistical code and publicly available data can act as guidance in planning future MCID calculation studies.
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Affiliation(s)
- Anita M Klukowska
- Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Department of Neurosurgery, University Clinical Hospital of Bialystok, Bialystok, Poland
| | - W Peter Vandertop
- Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Marc L Schröder
- Department of Neurosurgery, Park Medical Center, Rotterdam, The Netherlands
| | - Victor E Staartjes
- Machine Intelligence in Clinical Neuroscience and Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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Schmidt J, Düvel JA, Elkenkamp S, Greiner W. Comparing the EQ-5D-5L and stroke impact scale 2.0 in stroke patients: an analysis of measurement properties. Health Qual Life Outcomes 2024; 22:45. [PMID: 38835023 DOI: 10.1186/s12955-024-02252-z] [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: 10/10/2023] [Accepted: 04/20/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Stroke has evolved to become a chronic disease and a major public health challenge. To adequately capture the full disease burden of stroke patients, the assessment of health-related quality of life (HRQoL) and thus the performance of respective measures is increasingly relevant. The aim of this analysis was to compare the measurement properties of two self-report instruments, the EQ-5D-5L and the Stroke Impact Scale 2.0. METHODS The data used for the analysis was derived from a quasi-experimental case management study for mildly to moderately affected incident stroke and transient ischemic attack (TIA) patients aged ≥ 18 in Germany. Data was collected patient-individually at 3, 6 and 12 months after initial stroke. The EQ-5D-5L and SIS 2.0 were compared in terms of feasibility, ceiling and floor effects, responsiveness and known-groups validity (Kruskal-Wallis H and Wilcoxon rank-sum test). RESULTS A response for all three follow-ups is available for n = 855 patients. The feasibility of the EQ-5D-5L is determined as good (completion rate: 96.4-96.6%, ≥ one item missing: 3.2 - 3.3%), whereas the SIS 2.0 is moderately feasible (overall completion rate: 44.9-46.1%, ≥ one item missing in domains: 4.7 - 28.7%). The SIS 2.0 shows substantial ceiling effects in comparable domains (physical function: 10.4 - 13%, others: 3.5-31.3%) which are mainly larger than ceiling effects in the EQ-5D-5L index (17.1-21.5%). In terms of responsiveness, the EQ-5D-5L shows small to moderate change while the SIS 2.0 presents with moderate to large responsiveness. The EQ-5D-5L index, mobility, usual activities and Visual Analogue Scale show known-groups validity (p < 0.05). Content-related domains of the SIS 2.0 show known-groups validity as well (p < 0.05). However, it is compromised in the emotion domain in both measures (p > 0.05). CONCLUSIONS The EQ-5D-5L seems to be slightly more suitable for this cohort. Nonetheless, the results of both measures indicate limited suitability for TIA patients. Large-scale studies concerning responsiveness and known-groups validity are encouraged. TRIAL REGISTRATION The study was registered in the German Clinical Trials Register, retrospective registration on 21.09.2022. REGISTRATION ID DRKS00030297.
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Affiliation(s)
- Juliana Schmidt
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany.
| | - Juliane Andrea Düvel
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Svenja Elkenkamp
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
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Waddell LM, Musbahi O, Collins JE, Jones MH, Selzer F, Losina E, Katz JN. Responsiveness of Subjective and Objective Measures of Pain and Function Following Operative Interventions for Musculoskeletal Conditions: A Narrative Review. Arthritis Care Res (Hoboken) 2024; 76:882-888. [PMID: 38221714 PMCID: PMC11132946 DOI: 10.1002/acr.25298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/16/2023] [Accepted: 01/10/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVE Musculoskeletal (MSK) disorders affect ~50% of US adults and 75% of those over the age of 65, representing a sizable economic and disability burden. Outcome measures, both objective and subjective, help clinicians and investigators determine whether interventions to treat MSK conditions are effective. This narrative review qualitatively compared the responsiveness of different types of outcome measures, a key measurement characteristic that assesses an outcome measure's ability to detect change in patient status. METHODS We evaluated elective orthopedic interventions as a model for assessing responsiveness because the great majority of patients improves following surgery. We searched for articles reporting responsiveness (quantified as effect size [ES]) of subjective and objective outcome measures after orthopedic surgery and included 16 articles reporting 17 interventions in this review. RESULTS In 14 of 17 interventions, subjective function measures had an ES 10% greater than that of objective function measures. Two reported a difference in ES of <10%. The sole intervention that demonstrated higher ES of objective function used a composite measure. Sixteen interventions reported measures of subjective pain and/or mixed measures and subjective function. In nine interventions, subjective pain had a higher ES than subjective function by >10%, in three, subjective function had a higher ES than subjective pain by >10%, and in the remaining four, the difference between pain and function was <10%. CONCLUSION These findings reinforce the clinical observation that subjective pain generally changes more than function following elective orthopedic surgery. They also suggest that subjective function measures are more responsive than objective function measures, and composite scores may be more responsive than individual performance tests.
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Affiliation(s)
- Lily M. Waddell
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women’s Hospital
- Department of Orthopedic Surgery, Brigham and Women’s Hospital
| | - Omar Musbahi
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women’s Hospital
- MSk Lab, Imperial College London, London
| | - Jamie E. Collins
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women’s Hospital
- Harvard Medical School
- Department of Orthopedic Surgery, Brigham and Women’s Hospital
| | - Morgan H. Jones
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women’s Hospital
- Harvard Medical School
- Department of Orthopedic Surgery, Brigham and Women’s Hospital
| | - Faith Selzer
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women’s Hospital
- Harvard Medical School
| | - Elena Losina
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women’s Hospital
- Harvard Medical School
- Department of Orthopedic Surgery, Brigham and Women’s Hospital
- Department of Biostatistics, Boston University School of Public Health
| | - Jeffrey N. Katz
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women’s Hospital
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital
- Harvard Medical School
- Department of Orthopedic Surgery, Brigham and Women’s Hospital
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Jalali O, Smith JS, Bess S, Hostin R, Lafage R, Lafage V, Shaffrey CI, Ames CP, Lenke LG, Kelly MP. Validation of the Oswestry Disability Index in Adult Spinal Deformity. Spine (Phila Pa 1976) 2024; 49:682-688. [PMID: 38356276 DOI: 10.1097/brs.0000000000004960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/03/2024] [Indexed: 02/16/2024]
Abstract
STUDY DESIGN Retrospective cohort. OBJECTIVE To examine the validity of the Oswestry Disability Index (ODI) in patients with adult spinal deformity (ASD) treated with surgery. BACKGROUND The ODI is a patient-reported outcome measure of low back pain and disability. Although nearly ubiquitous in ASD research, the measure has not been validated in this patient population. PATIENTS AND METHODS A registry of patients with ASD was queried for baseline and 1-year PROM data, including the ODI, the Scoliosis Research Society-22r (SRS-22r), and the Patient Reported Outcomes Measurement Information System-Pain Interference (PI) and Physical Function (PF) CATs. Internal reliability was assessed with Cronbach alpha, where values ≥0.7 are considered reliable. Validity was assessed with Spearman correlation coefficients calculated for the ODI against validated Patient-Reported Outcomes Measurement Information System (PROMIS)-PI and PF, and legacy measures SRS-Pain and SRS-Activity. Responsiveness to change was measured with the adjusted effect size. RESULTS A total of 325 patients were enrolled, with 208 completing baseline and 1-year patient-reported outcome measures. The majority (149, 72%) were females and White (193, 93%), median Charlson Comorbidity Index 0 (interquartile range: 0-2). The majority of cases included sagittal plane deformity [mean T1PA: 24.2° (13.9)]. Cronbach alpha showed excellent internal reliability (baseline = 0.89, 1 yr = 0.90). ODI was valid, with strong correlations between PROMIS-PI, PROMIS-PF, SRS-Pain, and SRS-Activity at baseline and 1-year follow-up. All measures were responsive to change, with the ODI showing greater responsiveness than PROMIS-PI, PROMIS-PF, and SRS-Activity. CONCLUSIONS The ODI is a valid measure of disability as measured by pain and function in patients with ASD. It is responsive to change in a manner not different from validated PROMIS-CAT or the SRS-22r legacy measure. It is multidimensional, however, as it assesses both pain and function simultaneously. It does not measure disability related to self-image and may not account for all disease-related disability in patients with ASD.
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Affiliation(s)
- Omid Jalali
- Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA
| | - Justin S Smith
- Department of Neurosurgery, University of Virginia, Charlottesville, VA
| | - Shay Bess
- Denver International Spine Center, Presbyterian St. Luke's/Rocky Mountain Hospital for Children, Denver, CO
| | - Richard Hostin
- Department of Orthopaedic Surgery, Baylor Scoliosis Center, Plano, TX
| | - Renaud Lafage
- Department of Orthopedic Surgery, Lennox Hill Hospital, New York, NY
| | - Virginie Lafage
- Department of Orthopedic Surgery, Lennox Hill Hospital, New York, NY
| | | | - Christopher P Ames
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA
| | | | - Michael P Kelly
- Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA
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Schnitzer TJ, Conaghan PG, Berenbaum F, Abraham L, Cappelleri JC, Bushmakin AG, Viktrup L, Yang R, Brown MT. Effect size varies based on calculation method and may affect interpretation of treatment effect: an illustration using randomised clinical trials in osteoarthritis. Adv Rheumatol 2024; 64:31. [PMID: 38650049 DOI: 10.1186/s42358-024-00358-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 02/14/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND To illustrate how (standardised) effect sizes (ES) vary based on calculation method and to provide considerations for improved reporting. METHODS Data from three trials of tanezumab in subjects with osteoarthritis were analyzed. ES of tanezumab versus comparator for WOMAC Pain (outcome) was defined as least squares difference between means (mixed model for repeated measures analysis) divided by a pooled standard deviation (SD) of outcome scores. Three approaches to computing the SD were evaluated: Baseline (the pooled SD of WOMAC Pain values at baseline [pooled across treatments]); Endpoint (the pooled SD of these values at the time primary endpoints were assessed); and Median (the median pooled SD of these values based on the pooled SDs across available timepoints). Bootstrap analyses were used to compute 95% confidence intervals (CI). RESULTS ES (95% CI) of tanezumab 2.5 mg based on Baseline, Endpoint, and Median SDs in one study were - 0.416 (- 0.796, - 0.060), - 0.195 (- 0.371, - 0.028), and - 0.196 (- 0.373, - 0.028), respectively; negative values indicate pain improvement. This pattern of ES differences (largest with Baseline SD, smallest with Endpoint SD, Median SD similar to Endpoint SD) was consistent across all studies and doses of tanezumab. CONCLUSION Differences in ES affect interpretation of treatment effect. Therefore, we advocate clearly reporting individual elements of ES in addition to its overall calculation. This is particularly important when ES estimates are used to determine sample sizes for clinical trials, as larger ES will lead to smaller sample sizes and potentially underpowered studies. TRIAL REGISTRATION Clinicaltrials.gov NCT02697773, NCT02709486, and NCT02528188.
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Affiliation(s)
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, National Institute for Health Research, Leeds Biomedical Research Centre-University of Leeds, Leeds, UK
| | - Francis Berenbaum
- Sorbonne University, INSERM CRSA, AP-HP Saint-Antoine hospital, Paris, France
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Christopher M, Bowen S, Witkiewitz K, Grupe D, Goerling R, Hunsinger M, Oken B, Korecki T, Rosenbaum N. A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers. BMC Complement Med Ther 2024; 24:142. [PMID: 38575888 PMCID: PMC10993469 DOI: 10.1186/s12906-024-04452-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Law enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs. METHODS This multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes. RESULTS We observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures. CONCLUSIONS Results of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve. TRIAL REGISTRATION ClinicalTrials.gov, NCT03784846 . Registered on December 24th, 2018.
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Affiliation(s)
- Michael Christopher
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA.
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, 2001 Redondo S Dr, Albuquerque, NM, 87106, USA
| | - Daniel Grupe
- Center for Healthy Minds, University of Wisconsin Madison, 625 West Washington Ave, Madison, WI, 53703, USA
| | - Richard Goerling
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Matthew Hunsinger
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Barry Oken
- Department of Neurology, Oregon Center for Complementary and Alternative Medicine in Neurological Disorders, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Tyrus Korecki
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA
| | - Nils Rosenbaum
- Behavioral Sciences Department, Albuquerque Police Department, 400 Rome, NW, Albuquerque, NM, 87102, USA
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Shah R, Finlay AY, Salek MS, Allen H, Nixon SJ, Nixon M, Otwombe K, Ali FM, Ingram JR. Responsiveness and minimal important change of the Family Reported Outcome Measure (FROM-16). J Patient Rep Outcomes 2024; 8:38. [PMID: 38530614 PMCID: PMC10965873 DOI: 10.1186/s41687-024-00703-1] [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: 06/15/2023] [Accepted: 02/15/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The FROM-16 is a generic family quality of life (QoL) instrument that measures the QoL impact of patients' disease on their family members/partners. The study aimed to assess the responsiveness of FROM-16 to change and determine Minimal Important Change (MIC). METHODS Responsiveness and MIC for FROM-16 were assessed prospectively with patients and their family members recruited from outpatient departments of the University Hospital Wales and University Hospital Llandough, Cardiff, United Kingdom. Patients completed the EQ-5D-3L and a global severity question (GSQ) online at baseline and at 3-month follow-up. Family members completed FROM-16 at baseline and a Global Rating of Change (GRC) in addition to FROM-16 at follow-up. Responsiveness was assessed using the distribution-based (effect size-ES, standardized response mean -SRM) and anchor-based (area under the receiver operating characteristics curve ROC-AUC) approaches and by testing hypotheses on expected correlation strength between FROM-16 change score and patient assessment tools (GSQ and EQ-5D). Cohen's criteria were used for assessing ES. The AUC ≥ 0.7 was considered a good measure of responsiveness. MIC was calculated using anchor-based (ROC analysis and adjusted predictive modelling) and distribution methods based on standard deviation (SD) and standard error of the measurement (SEM). RESULTS Eighty-three patients with 15 different health conditions and their relatives completed baseline and follow-up questionnaires and were included in the responsiveness analysis. The mean FROM-16 change over 3 months = 1.43 (SD = 4.98). The mean patient EQ-5D change over 3 months = -0.059 (SD = 0.14). The responsiveness analysis showed that the FROM-16 was responsive to change (ES = 0.2, SRM = 0.3; p < 0.01). The ES and SRM of FROM-16 change score ranged from small (ES = 0.2; SRM = 0.3) for the distribution-based method to large (ES = 0.8, SRM = 0.85) for anchor-based methods. The AUC value was above 0.7, indicating good responsiveness. There was a significant positive correlation between the FROM-16 change scores and the patient's disease severity change scores (p < 0.001). The MIC analysis was based on data from 100 family members of 100 patients. The MIC value of 4 was suggested for FROM-16. CONCLUSIONS The results of this study confirm the longitudinal validity of FROM-16 which refers to the degree to which an instrument is able to measure change in the construct to be measured. The results yield a MIC value of 4 for FROM-16. These psychometric attributes of the FROM-16 instrument are useful in both clinical research as well as clinical practice.
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Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M S Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - M Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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11
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Kahl U, Boehm A, Krause L, Klinger R, Stoimenov K, Zöllner C, Plümer L, Fischer M. Psychometric evaluation of the modified quality of recovery score for the postanaesthesia care unit (QoR-PACU 2)-A prospective validation study. Anaesth Crit Care Pain Med 2024; 43:101380. [PMID: 38499247 DOI: 10.1016/j.accpm.2024.101380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/03/2024] [Accepted: 03/09/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND To date, there is no instrument to adequately assess self-reported quality of recovery (QoR) in the post-anesthesia care unit (PACU). We previously developed the QoR-PACU, a 13-item questionnaire specifically applicable to the PACU. The feasibility, acceptance, and validity of the QoR-PACU were promising. However, measures of reliability were slightly lower than expected. METHODS We modified the QoR-PACU and evaluated its psychometric properties in a cohort of adult patients scheduled for non-cardiac surgery with general anesthesia. The modified QoR-PACU (termed QoR-PACU2) was administered before surgery and postoperatively in the PACU at the time of the decision to discharge. RESULTS A total of 307 patients were included in the final analysis. Postoperative QoR-PACU2 sum scores differed across categories of sex, perioperative and surgical risk, and modes of airway management. The duration of anesthesia and surgery, maximum pain intensity and analgesic requirement in the PACU, and length of PACU stay were all inversely correlated with QoR in the PACU. Cronbach's alpha was 0.70 (95%CI: 0.66-0.75). The intra-class correlation coefficient was 0.86 (95%CI: 0.70-0.94, p < 0.001) for intra-rater reliability (n = 24) and 0.94 (95%CI 0.90 to 0.97, p < 0.001) for inter-rater reliability (n = 31). Cohen's effect size was 0.68 and the standardized response mean was 0.57. CONCLUSION The QoR-PACU2 assesses self-reported QoR after surgery in the PACU. Measures of feasibility, validity, and reliability were consistently high. Measures of responsiveness were moderate, which might be attributable to the heterogeneity of the study population. Future studies should include aspects of ethnicity and cross-cultural applicability.
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Affiliation(s)
- Ursula Kahl
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alena Boehm
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Linda Krause
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Regine Klinger
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kaloyan Stoimenov
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Zöllner
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lili Plümer
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marlene Fischer
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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12
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Larsen EN, Marsh N, Rickard CM, Mihala G, Walker RM, Byrnes J. Health-related quality of life and experience measures, to assess patients' experiences of peripheral intravenous catheters: a secondary data analysis. Health Qual Life Outcomes 2024; 22:1. [PMID: 38167165 PMCID: PMC10762939 DOI: 10.1186/s12955-023-02217-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Peripheral intravenous catheters (PIVCs) are essential for successful administration of intravenous treatments. However, insertion failure and PIVC complications are common and negatively impact patients' health-outcomes and experiences. We aimed to assess whether generic (not condition-specific) quality of life and experience measures were suitable for assessing outcomes and experiences of patients with PIVCs. METHODS We undertook a secondary analysis of data collected on three existing instruments within a large randomised controlled trial, conducted at two adult tertiary hospitals in Queensland, Australia. Instruments included the EuroQol Five Dimension - Five Level (EQ5D-5L), the Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - General measure (FACIT-TS-G, eight items), and the Australian Hospital Patient Experience Question Set (AHPEQS, 12 items). Responses were compared against two clinical PIVC outcomes of interest: all-cause failure and multiple insertion attempts. Classic descriptives were reported for ceiling and floor effects. Regression analyses examined validity (discrimination). Standardised response mean and effect size (ES) assessed responsiveness (EQ5D-5L, only). RESULTS In total, 685 participants completed the EQ5D-5L at insertion and 526 at removal. The FACIT-TS-G was completed by 264 and the AHPEQS by 262 participants. Two FACIT-TS-G items and one AHPEQS item demonstrated ceiling effect. Instruments overall demonstrated poor discrimination, however, all-cause PIVC failure was significantly associated with several individual items in the instruments (e.g., AHPEQS, 'unexpected physical and emotional harm'). EQ5D-5L demonstrated trivial (ES < 0.20) responsiveness. CONCLUSIONS Initial investigation of an existing health-related quality of life measure (EQ5D-5L) and two patient-reported experience measures (FACIT-TS-G; AHPEQS) suggest they are inadequate (as a summary measure) to assess outcomes and experiences for patients with PIVCs. Reliable instruments are urgently needed to inform quality improvement and benchmark standards of care.
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Affiliation(s)
- Emily N Larsen
- School of Nursing and Midwifery, Griffith University, Nathan, Australia.
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Building 34, Corner Bowen Bridge Rd and Butterfield St, Herston, QLD, 4029, Australia.
- Patient-Centred Health Services, Menzies Health Institute Queensland, NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Nathan, Australia.
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia.
- School of Nursing, Midwifery and Social Work, The University of Queensland Centre for Clinical Research, Herston, QLD, Australia.
| | - Nicole Marsh
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Building 34, Corner Bowen Bridge Rd and Butterfield St, Herston, QLD, 4029, Australia
- Patient-Centred Health Services, Menzies Health Institute Queensland, NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Nathan, Australia
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland Centre for Clinical Research, Herston, QLD, Australia
| | - Claire M Rickard
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Building 34, Corner Bowen Bridge Rd and Butterfield St, Herston, QLD, 4029, Australia
- Patient-Centred Health Services, Menzies Health Institute Queensland, NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Nathan, Australia
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland Centre for Clinical Research, Herston, QLD, Australia
- Herston Infectious Diseases Institute, Metro North Health, Herston, QLD, Australia
| | - Gabor Mihala
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, QLD, Australia
| | - Rachel M Walker
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Patient-Centred Health Services, Menzies Health Institute Queensland, NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Nathan, Australia
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- Division of Surgery, Princess Alexandra Hospital, Metro South Health, Brisbane, QLD, Australia
| | - Joshua Byrnes
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, QLD, Australia
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13
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Reed DE, Stump TE, Monahan PO, Kroenke K. Comparable Minimally Important Differences and Responsiveness of Brief Pain Inventory and PEG Pain Scales across 6 Trials. THE JOURNAL OF PAIN 2024; 25:142-152. [PMID: 37544394 PMCID: PMC10859144 DOI: 10.1016/j.jpain.2023.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/21/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
The 3-item pain intensity (P), interference with the enjoyment of life (E), and interference with general activity (G), or PEG, has become one of the most widely used measures of pain severity and interference. The minimally important differences (MID) and responsiveness of the PEG are essential metrics for solidifying its role in research and clinical care. The current study aims to establish the MID and responsiveness of the PEG by synthesizing data from 1,710 participants across 6 controlled trials. MIDs were estimated using absolute score changes among individuals reporting their pain was "a little better" on a retrospective global change anchor as well as distribution-based estimates using standard deviation thresholds and 1 and 2 standard errors of measurement. Responsiveness was assessed using standardized response means, area under the curve, and treatment effect sizes. MID estimates for the PEG ranged from 0.60 to 1.1 when using 0.35 SD, and 0.78 to 1.22 using 1 standard error of measurement. MID estimates using the global anchor had somewhat more variability but most estimates ranged from 1.0 to 1.75. Responsiveness effect sizes were generally large (>.80) for standardized response means and moderate (>.50) for treatment effect. Similarly, the most area under the curve values demonstrated an acceptable level of scale responsiveness (≥.70). Importantly, MID estimates and responsiveness of the PEG and BPI scales were largely comparable when aggregating data across trials. Our synthesis indicates that 1 point is a reasonable MID estimate on these 0- to 10-point pain scales, with 2 points being an upper bound. PERSPECTIVE: This article synthesizes data from 6 clinical trials to establish the minimally important difference (MID) and responsiveness of the 3-item PEG pain scale. The PEG demonstrated good responsiveness, and 1 to 2 points proved to be reasonable estimates for the lower and upper bounds of the MID.
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Affiliation(s)
- David E Reed
- Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care, Seattle, Washington; Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
| | - Timothy E Stump
- Department of Biostatistics and Health Data Science, Indiana University Fairbanks School of Public Health and School of Medicine, Indianapolis, Indiana
| | - Patrick O Monahan
- Department of Biostatistics and Health Data Science, Indiana University Fairbanks School of Public Health and School of Medicine, Indianapolis, Indiana
| | - Kurt Kroenke
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Regenstrief Institute, Inc., Indianapolis, Indiana
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Babazadeh-Zavieh SS, Ansari NN, Ghotbi N, Naghdi S, Jafar Haeri SM. Dry needling combined with exercise therapy: Effects on wrist flexors spasticity in post-stroke patients - A randomized controlled trial. NeuroRehabilitation 2024; 54:399-409. [PMID: 38393926 DOI: 10.3233/nre-230081] [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] [Indexed: 02/25/2024]
Abstract
BACKGROUND The positive contribution of dry needling (DN) in conjunction with exercise therapy for patients with stroke and spasticity remains uncertain. OBJECTIVE To examine the effects of DN combined with exercise therapy on wrist flexor spasticity and motor function in patients with stroke. METHODS Twenty-four participants with stroke were randomly assigned to either the DN and exercise therapy group or the DN alone group. Assessments were conducted at baseline, after the 4th treatment session, and 3 weeks post-treatment. RESULTS A significant Group×Time interaction was observed for wrist active range of motion (ROM) (P = 0.046), favoring the DN with exercise therapy group (∼10° at baseline, ∼15° immediately after the 4th session, and 15.4° at follow-up). The improvements in spasticity, passive ROM, and H-reflex latency were sustained during follow-up. However, there were no significant between-group differences in any outcome at any measurement time point. CONCLUSION The combined DN and exercise therapy did not exhibit superiority over DN alone concerning spasticity severity and motor function. However, it demonstrated additional advantages, particularly in improving motor neuron excitability and wrist passive extension.
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Affiliation(s)
- Seyedeh Saeideh Babazadeh-Zavieh
- Department of Physiotherapy, School of Rehabilitation Sciences, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Ghotbi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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15
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Rabbia M, Guridi Ormazabal M, Staunton H, Veenstra K, Eggenspieler D, Annoussamy M, Servais L, Strijbos P. Stride Velocity 95th Centile Detects Decline in Ambulatory Function Over Shorter Intervals than the 6-Minute Walk Test or North Star Ambulatory Assessment in Duchenne Muscular Dystrophy. J Neuromuscul Dis 2024; 11:701-714. [PMID: 38640165 PMCID: PMC11091611 DOI: 10.3233/jnd-230188] [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] [Accepted: 03/17/2024] [Indexed: 04/21/2024]
Abstract
Background Stride Velocity 95th Centile (SV95C) is the first wearable device-derived clinical outcome assessment (COA) to receive European Medicines Agency (EMA) qualification as a primary endpoint in ambulant patients with Duchenne muscular dystrophy (DMD) aged ≥4 years. Objective To compare SV95C-in its first-ever clinical trial application as a secondary endpoint-with established motor function COAs used in the trial (Four-Stair Climb [4SC] velocity, North Star Ambulatory Assessment [NSAA], and Six-Minute Walk Distance [6MWD]). Methods SV95C was a secondary endpoint in a subset (n = 47) of participants in the SPITFIRE/WN40227 trial of taldefgrobep alfa, which was discontinued due to lack of clinical benefit. Participants in the ≤48-week SV95C sub-study were 6-11 years old and received corticosteroids for ≥6 months pre-treatment. Pearson correlations were used to compare SV95C with the other COAs. Responsiveness and changes over time were respectively assessed via standardized response means (SRMs) based on absolute changes and mixed models for repeated measures. Results SV95C change at Week 24 was -0.07 m/s, with limited variability (standard deviation: 0.16, n = 27). The SRM for SV95C indicated moderate responsiveness to clinical change at the earliest timepoint (Week 12, n = 46), while those of the other COAs did not indicate moderate responsiveness until Week 36 (6MWD, n = 33) or Week 48 (4SC velocity, n = 20; NSAA total score, n = 20). Baseline correlations between SV95C and other COAs were strong (r = 0.611-0.695). Correlations between SV95C change from baseline to Week 48 and changes in other COAs were moderate to strong (r = 0.443-0.678).∥. Conclusions Overall, SV95C demonstrated sensitivity to ambulatory decline over short intervals, low variability, and correlation with established COAs. Although the negative trial precluded demonstration of SV95C's sensitivity to drug effect, these findings support the continued use of SV95C in DMD clinical trials.
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Affiliation(s)
| | | | - Hannah Staunton
- Roche Products Ltd, Hexagon Place, Shire Park, 6 Falcon Way, Welwyn Garden City, UK
| | - Klaas Veenstra
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, Basel, Switzerland
| | | | | | - Laurent Servais
- MDUK Oxford Neuromuscular Centre and NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- Department of Pediatrics, Division of Child Neurology, Centre de Référence des Maladies Neuromusculaires, University Hospital Liège and University of Liège, Avenue de l’Hôpital 1, Liege, Belgium
| | - Paul Strijbos
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, Basel, Switzerland
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16
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Herbold J, O'Brien T, Peters K, Sanichar A, Babyar S. Responsiveness of Section GG Scores in Tracking Post-Stroke Functional Recovery From Inpatient Rehabilitation Admission to 90-Day Follow-Up. Arch Phys Med Rehabil 2023; 104:2002-2010. [PMID: 37541360 DOI: 10.1016/j.apmr.2023.07.013] [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: 03/28/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE To evaluate the responsiveness and scale-to-sample targeting of Section GG of the Inpatient Rehabilitation Facility-Patient Assessment Instrument in measuring the trajectory of functional recovery in patients with stroke from inpatient rehabilitation admission to 90 days after discharge. DESIGN Retrospective cohort study. SETTING 150-bed inpatient rehabilitation facility. PARTICIPANTS Patients with stroke (N=1087) discharged between December 2019 to April 2021. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Admission and discharge self-care and mobility scores from Section GG were analyzed for the Inpatient Only group (n= 817). Admission, discharge and 90-day post-discharge Section GG scores from telephone interviews with patients or caregivers were analyzed for the Follow-Up group (n=270). Standardized response means (SRM) determined responsiveness of the tool for each group and time interval. Score means, standard deviations, and floor/ceiling effects illustrated scale-to-sample targeting of the tool. RESULTS Self-care and mobility scores improved significantly from admission to discharge (P<.001) for both groups and from discharge to 90 days (P<.001) for the Follow-Up group. Large SRM existed from admission to discharge for self-care and mobility scores in both groups. A small-to-moderate SRM was seen from discharge to 90 days for self-care (0.46) and a moderate SRM was observed for mobility (0.68). Overall floor effects were minor at admission for self-care (9.8%) and mobility (7.2.%). Overall ceiling effects were minor at discharge for self-care (11.2%) and mobility (4.6%) and significant at follow-up for both self-care (45.2%) and mobility (32.2%). CONCLUSIONS Section GG is responsive to change and appropriately measures patients' functional ability during inpatient rehabilitation. More study is required for telephone follow-up after discharge from inpatient rehabilitation.
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Affiliation(s)
- Janet Herbold
- Post Acute Services, Burke Rehabilitation Hospital, White Plains, NY
| | - Theodore O'Brien
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Karrah Peters
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Andrea Sanichar
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Suzanne Babyar
- Post Acute Services, Burke Rehabilitation Hospital, White Plains, NY; Department of Physical Therapy, Hunter College, The City University of New York, New York, NY.
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Hsu CN, Tain YL, Lu PC, Lin HW. Comparisons of EQ-5D-Y and PedsQL in pediatric patients with mild-to-moderate chronic kidney disease in longitudinal analyses. Health Qual Life Outcomes 2023; 21:117. [PMID: 37891615 PMCID: PMC10605985 DOI: 10.1186/s12955-023-02197-9] [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: 11/14/2022] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE To characterize longitudinal changes and correlations between the measures of EQ-5D-Y and generic PedsQL and their associations with clinical changes in children and adolescents with mild-to-moderate chronic kidney disease (CKD). METHODS Participants were recruited from January 2017 to September 2021 in a medical center in Taiwan. Both instruments were administered in their initial visits and every 6-month subsequent visits. Spearman's Rho (ρ) was used to assess correlations between the scores of EQ-5D-Y and PedsQL measures in longitudinal changes. Cohen's effect size (ES) was used to evaluate the changes of scores/subscales over time. In addition, factors associated with longitudinal changes in the score/subscales were explored. RESULTS A total of 121 participants were enrolled, and 83 with ≥ 3 HRQOL measures during the 3.5 years follow-up were assessed their changes of HRQOL measures. The correlations (ρ > 0.3) appeared between the changes in the visual analog scale (VAS) of EQ-5D-Y and emotional and social subscales of PedsQL. ES was small (< 0.5) in the VAS and level-sum-score (LSS) of EQ-5D-Y scores for the clinical changes in comorbidities, while some PedsQL subscales were medium to high (0.5-0.8 or > 0.8). Hypertension, mineral bone disorder/anemia, and hyperuricemia associated with the changes in both HRQOL scores were varied by their various domains. CONCLUSION Both EQ-5D-Y and PedsQL of HRQOL measures were responsive to worsened childhood CKD-related comorbidities during the follow-up; however, convergent validity between them was limited in some domains. The LSS of EQ-5D-Y showed greater changes than the VAS by comorbidity status; further comparison with utility weight is needed to determine the better performance of EQ-5D-Y.
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Affiliation(s)
- Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - You-Lin Tain
- Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung, Taiwan
| | - Pei-Chen Lu
- Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung, Taiwan
| | - Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung City, 406040, Taiwan.
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan.
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
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Chen IC, Chuang IC, Chang KC, Chang CH, Wu CY. Dual task measures in older adults with and without cognitive impairment: response to simultaneous cognitive-exercise training and minimal clinically important difference estimates. BMC Geriatr 2023; 23:663. [PMID: 37845603 PMCID: PMC10580601 DOI: 10.1186/s12877-023-04390-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Responsiveness and minimal clinically important difference (MCID) are critical indices to understand whether observed improvement represents a meaningful improvement after intervention. Although simultaneous cognitive-exercise training (SCET; e.g., performing memory tasks while cycling) has been suggested to enhance the cognitive function of older adults, responsiveness and MCID have not been established. Hence, we aimed to estimate responsiveness and MCIDs of two dual task performance involving cognition and hand function in older adults with and without cognitive impairment and to compare the differences in responsiveness and MCIDs of the two dual task performance between older adults with and without cognitive impairment. METHODS A total of 106 older adults completed the Montreal Cognitive Assessment and two dual tasks before and after SCET. One dual task was a combination of Serial Sevens Test and Box and Block Test (BBT), and the other included frequency discrimination and BBT. We used effect size and standardized response mean to indicate responsiveness and used anchor- and distribution-based approaches to estimating MCID ranges. When conducting data analysis, all participants were classified into two cognitive groups, cognitively healthy (Montreal Cognitive Assessment ≥ 26) and cognitively impaired (Montreal Cognitive Assessment < 26) groups, based on the scores of the Montreal Cognitive Assessment before SCET. RESULTS In the cognitively healthy group, Serial Seven Test performance when tasked with BBT and BBT performance when tasked with Serial Seven Test were responsive to SCET (effect size = 0.18-0.29; standardized response mean = 0.25-0.37). MCIDs of Serial Seven Test performance when tasked with BBT ranged 2.09-2.36, and MCIDs of BBT performance when tasked with Serial Seven Test ranged 3.77-5.85. In the cognitively impaired group, only frequency discrimination performance when tasked with BBT was responsive to SCET (effect size = 0.37; standardized response mean = 0.47). MCIDs of frequency discrimination performance when tasked with BBT ranged 1.47-2.18, and MCIDs of BBT performance when tasked with frequency discrimination ranged 1.13-7.62. CONCLUSIONS Current findings suggest that a change in Serial Seven Test performance when tasked with BBT between 2.09 and 2.36 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively healthy, and a change in frequency discrimination performance when tasked with BBT between 1.47 and 2.18 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively impaired. Clinical practitioners may use these established MCIDs of dual tasks involving cognition and hand function to interpret changes following SCET for older adults with and without cognitive impairment. TRIAL REGISTRATION NCT04689776, 30/12/2020.
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Affiliation(s)
- I-Chen Chen
- Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan.
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Ku-Chou Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Hung Chang
- Program in Occupational Therapy, School of Medicine, Washington University , St. Louis, MO, USA
- Department of Medicine, School of Medicine, Washington University , St. Louis, MO, USA
- Department of Orthopedic Surgery, School of Medicine, Washington University , St. Louis, MO, USA
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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19
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Yu N, Peng C, Zhou J, Gu J, Xu J, Li X, Bi X, Deng H, Li X, Ding Y, Shi Y. Measurement properties of the patient global assessment numerical rating scale in moderate-to-severe psoriasis. Br J Dermatol 2023; 189:437-446. [PMID: 37310289 DOI: 10.1093/bjd/ljad188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/03/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Patient global assessment (PtGA) has been recommended as one of the core domains in psoriasis clinical trials. Among multiple versions of PtGA, the single-question, 11-point PtGA numeric rating scale (NRS) remains to be validated in patients with plaque psoriasis. OBJECTIVES To evaluate the psychometric characteristics of an 11-point PtGA NRS for disease severity in patients with moderate-to-severe plaque psoriasis. METHODS Data were analysed from 759 patients with moderate-to-severe psoriasis in the Shanghai Psoriasis Effectiveness Evaluation CoHort (SPEECH), a prospective, multicentre and observational registry assessing the comparative effectiveness and safety of biologics (adalimumab, ustekinumab, secukinumab or ixekizumab), conventional systemic therapies (acitretin or methotrexate) and phototherapy. RESULTS The test-retest reliability of the PtGA NRS showed good agreement (intraclass correlation coefficient range 0.79-0.83). No floor or ceiling effects of PtGA NRS were observed. The PtGA NRS was significantly correlated with the Psoriasis Area and Severity Index (PASI), static Physician Global Assessment (sPGA), body surface area, Dermatology Quality of Life Index (DLQI) and Hospital Anxiety and Depression Scale. Relatively large correlations of PtGA NRS with PASI and the DLQI 'symptoms and feelings' domain (all correlations ≥ 0.4 except at baseline) supported convergent validity. The presence of psoriatic arthritis or joint symptoms had no significant association with the PtGA NRS. In multivariate regression analyses, the PtGA NRS at baseline was predicted by age, lesion extent, lesion intensity, patients' symptoms and feelings, and impact on work or school. The PtGA NRS displayed known-groups validity with the PASI, sPGA and DLQI score bands. The PtGA NRS was responsive to change in PASI and DLQI after treatment. Anchor- and distribution-based approaches supported -3 as the minimal important difference for PtGA NRS. An absolute PtGA NRS ≤ 2 during follow-up was concordant with the state of minimal disease activity based on a 90% reduction in PASI (PASI 90) or PASI 90 plus a DLQI of 0/1. Sensitivity analysis using subgroup comparison and multiple imputation model yielded consistent conclusions. CONCLUSIONS The PtGA NRS showed good reliability, validity and responsiveness in patients with psoriasis, and was feasible in clinical trials and daily practice.
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Affiliation(s)
- Ning Yu
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis
| | - Chen Peng
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis
| | - Jing Zhou
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis
| | - Jun Gu
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jinhua Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xia Li
- Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xinling Bi
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Hui Deng
- Department of Dermatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yangfeng Ding
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis
| | - Yuling Shi
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis
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Thumbeck SM, Webster J, Domahs F. Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire-German version. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:1588-1609. [PMID: 37077024 DOI: 10.1111/1460-6984.12884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/30/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Reading comprehension is frequently impaired in persons with aphasia (PWA). For goal-setting and outcome measurement, speech and language therapists (SLTs) need to determine an individual's perspective of their reading difficulties and everyday reading activities. The Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire provides a person-centred tool to find out the individual perception of reading functions, reading-related emotions and reading activities in PWA. It was developed and evaluated in English. So far, there is no equivalent instrument in German. AIMS To translate and adapt the CARA reading questionnaire into German language and culture, to evaluate its practicability and acceptance, and to provide the first psychometric properties of the German version. METHODS & PROCEDURES Based on translation and adaptation guidelines, we conducted two forward translations that were merged and then adapted. A back translation was prepared and compared with the original version. It was found to be semantically equivalent by one of the authors of the original version. We performed pilot testing with 12 PWA, and the pilot version was adapted according to the comments of these participants. We then collected data on self-reported perception of reading and on psychometric properties of the translated and adapted German version. A total of 22 German-speaking PWA completed the questionnaire at least five times during an intervention study. We analysed retest reliability with Spearman correlation, internal consistency with Cronbach's alpha, internal responsiveness with the standardized response mean, as well as the relationship between outcomes of the questionnaire and text comprehension measures using repeated measures correlations. OUTCOMES & RESULTS Our data suggest good practicability and acceptance of the German version of the CARA reading questionnaire as well as appropriate validity, reliability and sensitivity to measure therapy-induced change. We found moderate correlations between outcomes of the questionnaire and text-level reading speed. CONCLUSIONS & IMPLICATIONS The German version of the CARA reading questionnaire could be helpful in intervention planning and goal-setting with German-speaking PWA. By using the questionnaire, SLTs can find out about a person's individual perception of reading difficulties as well as individually relevant reading activities. The questionnaire provides a tool to measure change and is therefore valuable to demonstrate self-reported individual progress. As reading speed seems to be an indicator of personal perception of reading difficulty, it is important to consider reading speed in reading interventions and in reading comprehension assessments. WHAT THIS PAPER ADDS What is already known on the subject Reading comprehension is frequently impaired in PWA. Reading preferences, the perception of difficulties and the impact on everyday life reading activities are specific to the individual and thus need to be known for goal-setting, intervention planning and monitoring of change. As part of a comprehensive assessment of reading, Morris et al. developed a person-centred English language questionnaire for this purpose. So far, there is no equivalent tool in German. What this paper adds to the existing knowledge In this study, we translated and adapted the questionnaire to German language and culture, and analysed its validity and reliability with German-speaking PWA. We demonstrated that the German version is accessible for German-speaking PWA, and that it has appropriate validity, reliability and sensitivity to measure self-reported change. Outcomes of the questionnaire correlate with text level reading speed. What are the potential or actual clinical implications of this work? The German version of the questionnaire could be a valuable self-reported outcome measure to assess individual perceptions of reading and to measure progress (as perceived by an individual) as a consequence of recovery or intervention in either clinical or research settings. As reading speed might be an indicator of everyday life reading as perceived by an individual, it should be considered in reading assessments and interventions.
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Affiliation(s)
| | - Janet Webster
- Speech and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Frank Domahs
- Department of Linguistics, University of Erfurt, Erfurt, Germany
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Kahl U, Brodersen K, Kaiser S, Krause L, Klinger R, Plümer L, Zöllner C, Fischer M. Psychometric evaluation of a quality of recovery score for the postanesthesia care unit-A preliminary validation study. PLoS One 2023; 18:e0289685. [PMID: 37582085 PMCID: PMC10426991 DOI: 10.1371/journal.pone.0289685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/24/2023] [Indexed: 08/17/2023] Open
Abstract
INTRODUCTION Patients' perception of postoperative recovery is a key aspect of perioperative care. Self-reported quality of recovery (QoR) has evolved as a relevant endpoint in perioperative research. Several psychometric instruments have been introduced to assess self-reported recovery 24 hours after surgery. However, there is no questionnaire suitable for use in the postanesthesia care unit (PACU). We aimed to develop and psychometrically evaluate a QoR questionnaire for the PACU (QoR-PACU). METHODS The QoR-PACU was developed in German language based on the 40-item QoR-40 questionnaire. Between March and November 2020, adult patients scheduled for elective urologic surgery completed the QoR-PACU preoperatively and during the PACU stay. We evaluated feasibility, validity, reliability, and responsiveness. RESULTS We included 375 patients. After two piloting phases including 72 and 48 patients, respectively, we administered the final version of the QoR-PACU to 255 patients, with a completion rate of 96.5%. Patients completed the QoR-PACU at a median of 125.0 (83.0; 156.8) min after arrival in the PACU. Construct validity was good with postoperative QoR-PACU sum scores correlating with age (r = 0.23, 95% CI: 0.11 to 0.35, p < 0.001), length of PACU stay (r = -0.15, 95%CI: -0.27 to -0.03, p = 0.02), pain in the PACU (r = -0.48, 95% CI: -0.57 to -0.37, p < 0.001) and piritramide dose administered (r = -0.29, 95% CI: -0.40 to -0.17, p < 0.001). Cronbach's alpha was 0.67 (95% CI: 0.61-0.73) with moderate test-retest reliability (ICC of 0.67, 95% CI: 0.38 to 0.83). Cohen's effect size was 3.08 and the standardized response mean was 1.65 indicating adequate responsiveness. CONCLUSION The assessment of QoR in the early postoperative period is feasible. We found high acceptability, good validity, adequate responsiveness, and moderate reliability. Future studies should evaluate the psychometric properties of the QoR-PACU in more heterogeneous patient populations including female and gender-diverse patients with varying degress of perioperative risk.
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Affiliation(s)
- Ursula Kahl
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Brodersen
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Kaiser
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Linda Krause
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Regine Klinger
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lili Plümer
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Zöllner
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marlene Fischer
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Beaudart C, Reginster JY, Amuthavalli Thiyagarajan J, Bautmans I, Bauer J, Burlet N, Cesari M, Cherubini A, Cooper C, Cruz-Jentoft AJ, Dawson-Hughes B, Fielding RA, Harvey NC, Landi F, Laslop A, Maggi S, Montero-Errasquin B, Concepción PYM, Rolland Y, Rizzoli R, Visser M, Bruyère O. Measuring health-related quality of life in sarcopenia: summary of the SarQoL psychometric properties. Aging Clin Exp Res 2023; 35:1581-1593. [PMID: 37219755 PMCID: PMC10363087 DOI: 10.1007/s40520-023-02438-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023]
Abstract
Patient perspectives are now widely recognized as a key element in the evaluation of health interventions. Therefore, the provision of specific and validated Patient Reported Outcome Measures that emphasize the lived experience of patients suffering from specific diseases is very important. In the field of sarcopenia, the only validated specific health-related quality of life (HRQoL) instrument available is the Sarcopenia Quality of Life questionnaire (SarQoL). This self-administrated HRQoL questionnaire, developed in 2015, consists of 55 items arranged into 22 questions and has currently been translated into 35 languages. Nineteen validation studies performed on SarQoL have consensually confirmed the capacity of SarQoL to detect difference in HRQoL between older people with and without sarcopenia, its reliability and its validity. Two further observational studies have also indicated its responsiveness to change. A short form SarQoL, including only 14 items has further been developed and validated to reduce the potential burden of administration. Research on the psychometric properties of SarQoL questionnaire is still encouraged as the responsiveness to change of SarQoL has not yet been measured in the context of interventional studies, as limited prospective data currently exist and as there is still not cut-off score to define a low HRQoL. In addition, SarQoL has mainly been used in community-dwelling older individuals with sarcopenia and would benefit to be studied in other types of populations. This review aims to provide to researchers, clinicians, regulators, pharmaceutical industries and other stakeholders a clear summary of comprehensive evidence on the SarQoL questionnaire published up to January 2023Query.
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Affiliation(s)
- Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium.
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | | | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jürgen Bauer
- Center for Geriatric Medicine and Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Nansa Burlet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | | | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168, Rome, Italy
| | - Andrea Laslop
- Scientific Office, Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | | | | | | | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, CERPOP UMR 1295, University of Toulouse III, Inserm, Toulouse, France
| | - René Rizzoli
- Service of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
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Atkinson TM, Lensing S, Lee JY, Chang D, Kim SY, Li Y, Lynch KA, Webb A, Holland SM, Lubetkin EI, Goldstone S, Einstein MH, Stier EA, Wiley DJ, Mitsuyasu R, Rosa-Cunha I, Aboulafia DM, Dhanireddy S, Schouten JT, Levine R, Gardner E, Logan J, Dunleavy H, Barroso LF, Bucher G, Korman J, Stearn B, Wilkin TJ, Ellsworth G, Pugliese JC, Arons A, Burkhalter JE, Cella D, Berry-Lawhorn JM, Palefsky JM. Construct validity and responsiveness of a health-related symptom index for persons either treated or monitored for anal high-grade squamous intraepithelial lesions (HSIL): AMC-A01/-A03. Qual Life Res 2023; 32:2293-2304. [PMID: 37020153 PMCID: PMC10330891 DOI: 10.1007/s11136-023-03391-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE To determine whether treatment of anal high-grade squamous intraepithelial lesions (HSIL), vs active monitoring, is effective in reducing incidence of anal cancer in persons living with HIV, the US National Cancer Institute funded the Phase III ANal Cancer/HSIL Outcomes Research (ANCHOR) clinical trial. As no established patient-reported outcomes (PRO) tool exists for persons with anal HSIL, we sought to estimate the construct validity and responsiveness of the ANCHOR Health-Related Symptom Index (A-HRSI). METHODS The construct validity phase enrolled ANCHOR participants who were within two weeks of randomization to complete A-HRSI and legacy PRO questionnaires at a single time point. The responsiveness phase enrolled a separate cohort of ANCHOR participants who were not yet randomized to complete A-HRSI at three time points: prior to randomization (T1), 14-70 (T2), and 71-112 (T3) days following randomization. RESULTS Confirmatory factor analysis techniques established a three-factor model (i.e., physical symptoms, impact on physical functioning, impact on psychological functioning), with moderate evidence of convergent validity and strong evidence of discriminant validity in the construct validity phase (n = 303). We observed a significant moderate effect for changes in A-HRSI impact on physical functioning (standardized response mean = 0.52) and psychological symptoms (standardized response mean = 0.60) from T2 (n = 86) to T3 (n = 92), providing evidence of responsiveness. CONCLUSION A-HRSI is a brief PRO index that captures health-related symptoms and impacts related to anal HSIL. This instrument may have broad applicability in other contexts assessing individuals with anal HSIL, which may ultimately help improve clinical care and assist providers and patients with medical decision-making.
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Affiliation(s)
- Thomas M Atkinson
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave, New York, NY, 10017, USA.
| | - Shelly Lensing
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jeannette Y Lee
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Di Chang
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Soo Young Kim
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave, New York, NY, 10017, USA
| | - Yuelin Li
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave, New York, NY, 10017, USA
| | - Kathleen A Lynch
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave, New York, NY, 10017, USA
- School of Global Public Health, New York University, New York, NY, USA
| | - Andrew Webb
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave, New York, NY, 10017, USA
| | - Susan M Holland
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave, New York, NY, 10017, USA
| | | | | | | | | | - Dorothy J Wiley
- University of California, Los Angeles School of Nursing, Los Angeles, CA, USA
| | - Ronald Mitsuyasu
- UCLA Center for Clinical AIDS Research and Education, Los Angeles, CA, USA
| | | | | | | | - Jeffrey T Schouten
- Virginia Mason Medical Center, Seattle, WA, USA
- Harborview Medical Center, Seattle, WA, USA
| | | | - Edward Gardner
- Public Health Institute at Denver Health, Denver, CO, USA
| | - Jeffrey Logan
- Public Health Institute at Denver Health, Denver, CO, USA
| | | | - Luis F Barroso
- Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Gary Bucher
- Anal Dysplasia Clinic MidWest, Chicago, IL, USA
| | - Jessica Korman
- Metropolitan Gastroenterology Group, Washington, DC, USA
| | | | | | | | - Julia C Pugliese
- ANCHOR Data Management Center of The Emmes Company, LLC, Rockville, MD, USA
| | - Abigail Arons
- ANCHOR Data Management Center of The Emmes Company, LLC, Rockville, MD, USA
| | - Jack E Burkhalter
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave, New York, NY, 10017, USA
| | - David Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Quigley A, Kaur N, Askari S, Mayo N. How Much Does Presenteeism Change in Response to Interventions or Alterations in Health Status? A Systematic Review and Meta-Analysis Using the COSMIN Methodology. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:231-244. [PMID: 36399282 DOI: 10.1007/s10926-022-10082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 05/12/2023]
Abstract
Purpose The purpose of this study was to estimate the extent to which measures of presenteeism among workers change in response to alterations in health status induced by treatment or natural history. Methods We searched eight databases in August 2020 for studies published since 2012 measuring presenteeism longitudinally. Two independent reviewers screened the titles, abstracts, and full-text articles and performed data extraction. Studies were stratified into longitudinal studies using presenteeism as an outcome and measurement studies designed to test the responsiveness of presenteeism measures. We appraised the methodological quality of the measurement studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. Standardized response means (SRMs) for interventional studies where participants reported improvement on anchor measures were quantitatively pooled.Results Our searches returned 2882 results. Eleven measurement studies and 126 longitudinal studies were included. Of the measurement studies (n = 2625 participants), 7 had adequate study quality and 4 studies were deemed doubtful. Anchors and responsiveness methods varied considerably. Our estimate of responsiveness from 5 measurement studies and 4 presenteeism measures is an SRM of 0.85 (95% CI 0.77, 0.92) and Cohen's d of 0.54 (95% CI 0.49, 0.58), translating to an average important change of 17/100. For deterioration, the value is - 17/100. Conclusions We found considerable variation regarding how responsiveness data was reported in measurement studies. There is evidence that responsiveness is strong for four presenteeism measures: the Work Productivity Survey, the Work Functioning Impairment Scale, the Work Role Functioning Questionnaire, and the Nurses Work Functioning Questionnaire.
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Affiliation(s)
- Adria Quigley
- Centre for Outcomes Research and Evaluation (CORE), McGill University Health Center (MUHC), MUHC-Research Institute, 5252 de Maisonneuve, Montreal, QC, H4A 3S5, Canada.
- School of Physiotherapy, Dalhousie University, Room 430, Forrest Building, 5869 University Avenue, Halifax, NS, B3H 4R2, Canada.
| | - Navaldeep Kaur
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 60-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Sorayya Askari
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Nancy Mayo
- Department of Medicine School of Physical and Occupational Therapy, Center for Outcomes Research and Evaluation (CORE), McGill University, McGill University Health Center (MUHC), MUHC-Research Institute, 5252 de Maisonneuve, Office 2B:43, Montreal, QC, H4A 3S5, Canada
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Sandin K, Shields G, Gjengedal RGH, Osnes K, Bjørndal MT, Reme SE, Hjemdal O. Responsiveness to change in health status of the EQ-5D in patients treated for depression and anxiety. Health Qual Life Outcomes 2023; 21:35. [PMID: 37061712 PMCID: PMC10105922 DOI: 10.1186/s12955-023-02116-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/28/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND The EQ-5D is a commonly used generic measure of health but evidence on its responsiveness to change in mental health is limited. This study aimed to explore the responsiveness of the five-level version of the instrument, the EQ-5D-5 L, in patients receiving treatment for depression and anxiety. METHODS Patient data (N = 416) were collected at baseline and at end of treatment in an observational study in a Norwegian outpatient clinic. Patients were adults of working age (18-69 years) and received protocol-based metacognitive or cognitive therapy for depression or anxiety according to diagnosis. Responsiveness in the EQ-5D was compared to change in the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). Effect sizes (Cohen's d), Standardised response mean (SRM), and Pearson's correlation were calculated. Patients were classified as "Recovered", "Improved", or "Unchanged" during treatment using the BDI-II and the BAI. ROC analyses determined whether the EQ-5D could correctly classify patient outcomes. RESULTS Effect sizes were large for the BAI, the BDI-II, the EQ-5D value and the EQ VAS, ranging from d = 1.07 to d = 1.84. SRM were also large (0.93-1.67). Pearson's correlation showed strong agreement between change scores of the EQ-5D value and the BDI-II (rs -0.54) and moderate between the EQ-5D value and the BAI (rs -0.43). The EQ-5D consistently identified "Recovered" patients versus "Improved" or "Unchanged" in the ROC analyses with AUROC ranging from 0.72 to 0.84. CONCLUSION The EQ-5D showed good agreement with self-reported symptom change in depression and anxiety, and correctly identified recovered patients. These findings indicate that the EQ-5D may be appropriately responsive to change in patients with depression and anxiety disorders, although replication in other clinical samples is needed.
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Affiliation(s)
- Kenneth Sandin
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, Oslo, 0319, Norway.
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway.
| | - Gemma Shields
- Manchester Centre for Health Economics, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England
| | - Ragne G H Gjengedal
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, Oslo, 0319, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
| | - Kåre Osnes
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, Oslo, 0319, Norway
| | - Marianne T Bjørndal
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, Oslo, 0319, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
| | - Silje E Reme
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, Oslo, 0319, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Odin Hjemdal
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, Oslo, 0319, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
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Hocaoglu MB, Murtagh FEM, Walshe C, Chambers RL, Maddocks M, Sleeman KE, Oluyase AO, Dunleavy L, Bradshaw A, Bajwah S, Fraser LK, Preston N, Higginson IJ. Adaptation and multicentre validation of a patient-centred outcome scale for people severely ill with COVID (IPOS-COV). Health Qual Life Outcomes 2023; 21:29. [PMID: 36964550 PMCID: PMC10036974 DOI: 10.1186/s12955-023-02102-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/20/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Patient-centred measures to capture symptoms and concerns have rarely been reported in severe COVID. We adapted and tested the measurement properties of the proxy version of the Integrated Palliative care Outcome Scale-IPOS-COV for severe COVID using psychometric approach. METHODS We consulted experts and followed consensus-based standards for the selection of health status measurement instruments and United States Food and Drug Administration guidance for adaptation and analysis. Exploratory Factor Analysis and clinical perspective informed subscales. We tested the internal consistency reliability, calculated item total correlations, examined re-test reliability in stable patients, and also evaluated inter-rater reproducibility. We examined convergent and divergent validity of IPOS-COV with the Australia-modified Karnofsky Performance Scale and evaluated known-groups validity. Ability to detect change was examined. RESULTS In the adaptation phase, 6 new items were added, 7 items were removed from the original measure. The recall period was revised to be the last 12-24 h to capture fast deterioration in COVID. General format and response options of the original Integrated Palliative care Outcome Scale were preserved. Data from 572 patients with COVID from across England and Wales seen by palliative care services were included. Four subscales were supported by the 4-factor solution explaining 53.5% of total variance. Breathlessness-Agitation and Gastro-intestinal subscales demonstrated good reliability with high to moderate (a = 0.70 and a = 0.67) internal consistency, and item-total correlations (0.62-0.21). All except the Flu subscale discriminated well between patients with differing disease severity. Inter-rater reliability was fair with ICC of 0.40 (0.3-0.5, 95% CI, n = 324). Correlations between the subscales and AKPS as predicted were weak (r = 0.13-0.26) but significant (p < 0.01). Breathlessness-Agitation and Drowsiness-Delirium subscales demonstrated good divergent validity. Patients with low oxygen saturation had higher mean Breathlessness-Agitation scores (M = 5.3) than those with normal levels (M = 3.4), t = 6.4 (186), p < 0.001. Change in Drowsiness-Delirium subscale correctly classified patients who died. CONCLUSIONS IPOS-COV is the first patient-centred measure adapted for severe COVID to support timely management. Future studies could further evaluate its responsiveness and clinical utility with clinimetric approaches.
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Affiliation(s)
- Mevhibe B Hocaoglu
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ, UK.
- Global Health and Social Medicine, Harvard Medical School, Boston, USA.
| | - Fliss E M Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Catherine Walshe
- International Observatory on End-of-Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Rachel L Chambers
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ, UK
| | - Matthew Maddocks
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ, UK
| | - Katherine E Sleeman
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ, UK
- King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
| | - Adejoke O Oluyase
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ, UK
| | - Lesley Dunleavy
- International Observatory on End-of-Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Andy Bradshaw
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Sabrina Bajwah
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ, UK
| | - Lorna K Fraser
- Health Sciences, University of York, York, North Yorkshire, UK
| | - Nancy Preston
- International Observatory on End-of-Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Irene J Higginson
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ, UK
- King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
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Comparing the effects of reduced social contact on psychosocial wellbeing before and during the COVID-19 pandemic: a longitudinal survey from two Norwegian counties. Qual Life Res 2023; 32:1771-1784. [PMID: 36773270 PMCID: PMC9922041 DOI: 10.1007/s11136-023-03350-z] [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] [Accepted: 01/15/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE To determine changes to people's social contact during COVID-19, and whether reduced social contact was associated with changes to psychosocial wellbeing. METHODS Questionnaire data were collected from a sample of adult respondents (18 years or more) in two Norwegian counties participating pre-COVID-19 (September 2019-February 2020; n = 20,196) and at two time points during COVID-19 (June [Mid] and November/December [Late] 2020; n = 11,953 and n = 10,968, respectively). The main outcome measures were participants' self-reported changes to social contact, loneliness, psychological distress, and life satisfaction. RESULTS The proportion of respondents reporting less social contact due to COVID-19 decreased from 62% in Mid-2020 to 55% in Late-2020. Overall, reported psychological wellbeing remained unchanged or improved from pre-COVID-19 to Mid-2020. From Mid-2020 to Late-2020, however, a reduction in psychological wellbeing was observed. Poorer psychological wellbeing was found for those with less social contact during the pandemic compared with people reporting unchanged social contact. This effect increased over time and was observed for all age groups at Late-2020. At Mid-2020, the importance of change in social contact for change in psychological wellbeing was greatest among young adults (< 30 years), while no significant differences were found for the oldest age group. CONCLUSION The association between COVID-19-era changes to social contact and loneliness, psychological distress, and life satisfaction is complex and appears to be age-dependent. Future studies should consider the quality of social contact and cultural contexts in which social restrictions are imposed.
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Regierer AC, Weiß A, Kiltz U, Sieper J, Schwarze I, Bohl-Bühler M, Kellner H, Poddubnyy D, Zink A, Braun J, Listing J, Strangfeld A. The Sensitivity to Change of the ASAS Health Index in an Observational Real-Life Cohort Study. J Rheumatol 2023; 50:185-191. [PMID: 35914790 DOI: 10.3899/jrheum.220212] [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: 07/20/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The Assessment of Spondyloarthritis international Society Health Index (ASAS HI) measures global functioning and health in patients with axial spondyloarthritis (axSpA) covering domains of physical, emotional, and social functioning. The main aim of this study was to investigate the sensitivity to change of ASAS HI in comparison with established variables of disease activity, function, and mental health. METHODS Patients with axSpA from the disease register RABBIT-SpA with follow-up time of at least 12 months and available ASAS HI questionnaires were included. Patients received questionnaires addressing disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score [ASDAS]), physical function (Bath Ankylosing Spondylitis Functional Index [BASFI]), mental health (5-item World Health Organization Well-Being Index [WHO-5]), and global functioning (ASAS HI). Standardized response means (SRMs) were calculated to compare the sensitivity to change of different variables. RESULTS Six hundred and sixty-seven patients were included, 552 treated with biologic disease-modifying antirheumatic drugs (bDMARDs) and 115 with conventional synthetic DMARDs and/or nonsteroidal antiinflammatory drugs (control group). Between baseline and month 12, the mean ASAS HI declined from 6.9 to 5.1 in the bDMARD group and from 5.9 to 5.6 in the conventionally treated group. In the bDMARD group, the SRM of ASAS HI was 0.52, compared to 0.59 for BASFI, 0.65 for WHO-5, 0.73 for BASDAI, and 0.90 for ASDAS. The following ASAS HI domains were most frequently affected: pain (78% agreed), maintaining body position (75%), and energy/drive (73%). In the patients receiving bDMARDs, there was an improvement in all items. In the control group, the largest improvement was seen in pain. CONCLUSION As expected, ASDAS and BASDAI as disease activity scores showed high sensitivity to change, whereas changes in physical function (BASFI), mental health (WHO-5), and the broader concept of functioning and health (ASAS HI) were moderate.
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Affiliation(s)
- Anne C Regierer
- A.C. Regierer, MD, PhD, A. Weiß, PhD, J. Listing, PhD, German Rheumatism Research Center (DRFZ Berlin), Epidemiology and Health Care Research, Berlin;
| | - Anja Weiß
- A.C. Regierer, MD, PhD, A. Weiß, PhD, J. Listing, PhD, German Rheumatism Research Center (DRFZ Berlin), Epidemiology and Health Care Research, Berlin
| | - Uta Kiltz
- U. Kiltz, MD, PhD, J. Braun, MD, PhD, Rheumazentrum Ruhrgebiet, Herne, and Ruhr-University Bochum
| | - Joachim Sieper
- J. Sieper, MD, PhD, Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin
| | - Ilka Schwarze
- I. Schwarze, MD, Private Rheumatology Practice, Leipzig
| | | | | | - Denis Poddubnyy
- D. Poddubnyy, MD, PhD, Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, and German Rheumatism Research Center (DRFZ Berlin), Epidemiology and Health Care Research, Berlin
| | - Angela Zink
- A. Zink, PhD, A. Strangfeld, MD, PhD, German Rheumatism Research Center (DRFZ Berlin), Epidemiology and Health Care Research, Berlin, and Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Braun
- U. Kiltz, MD, PhD, J. Braun, MD, PhD, Rheumazentrum Ruhrgebiet, Herne, and Ruhr-University Bochum
| | - Joachim Listing
- A.C. Regierer, MD, PhD, A. Weiß, PhD, J. Listing, PhD, German Rheumatism Research Center (DRFZ Berlin), Epidemiology and Health Care Research, Berlin
| | - Anja Strangfeld
- A. Zink, PhD, A. Strangfeld, MD, PhD, German Rheumatism Research Center (DRFZ Berlin), Epidemiology and Health Care Research, Berlin, and Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Selvi O, Azizoğlu M, Temel G, Tulgar S, Chitneni A, Nur Çınar E, Özer Z, Gürkan Y, Gurkan Y. Translation and Validation of the Turkish Version of the Quality of Postoperative Recovery Score QoR-15: A Multi-Centred Cohort Study. Turk J Anaesthesiol Reanim 2022; 50:443-448. [PMID: 36511494 PMCID: PMC9885813 DOI: 10.5152/tjar.2022.21417] [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] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The Quality of Recovery-15 questionnaire is a self-rated questionnaire used to assess the quality of the postoperative recovery and health status of patients in the early period following surgery. The aim of this study was to assess the reliability, validity, and responsiveness of the Turkish version of the Quality of Recovery-15. METHODS After approval by the Maltepe University local ethics committee, this observational study was conducted among patients who received surgical interventions at Mersin University Hospital between July 2019 and January 2020. Reliability, feasibility, and validity were assessed to validate the Turkish version of the Quality of Recovery-15. RESULTS The completion rate of the form was determined to be 92% and a total of 200 patients were enrolled in the study. The Cronbach's alpha of the global Turkish version of the Quality of Recovery-15 was 0.927. Test-retest reliability was 0.84 [CI 95%: 0.75-0.90] and Cohen's effect size was 0.319. The total standardized response mean was determined as 0.53. CONCLUSIONS This is the first study in which the Quality of Recovery-15 scale was translated into Turkish with our knowledge. The Turkish version of the Quality of Recovery-15 showed satisfactory reliability and validity in evaluating the quality of recovery after surgery in the Turkish population.
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Affiliation(s)
- Onur Selvi
- Department of Anaesthesiology, Cambridge University Addebrooke’s Hospital, Cambridge, United Kingdom,Corresponding author: Onur Selvi, e-mail:
| | - Mustafa Azizoğlu
- Department of Anaesthesiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Gülhan Temel
- Department of Anaesthesiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Serkan Tulgar
- Department of Anaesthesiology, Samsun University Faculty of Medicine, Samsun, Turkey
| | - Ahish Chitneni
- Department of Anaesthesiology, A.T Still University in Arizona (SOMA), Arizona, USA
| | - Ece Nur Çınar
- Department of Anaesthesiology, West Middlesex Hospital, London, United Kingdom
| | - Zeliha Özer
- Department of Anaesthesiology, Maltepe University Faculty of Medicine, İstanbul, Turkey
| | - Yavuz Gürkan
- Department of Anaesthesiology, Koç University Faculty of Medicine, İstanbul, Turkey
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Pereira R, Silveira J, Dias S, Cardoso A, Mata A, Marques D. Bleaching efficacy and quality of life of different bleaching techniques - randomized controlled trial. Clin Oral Investig 2022; 26:7167-7177. [PMID: 35976497 PMCID: PMC9383653 DOI: 10.1007/s00784-022-04678-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate bleaching efficacy and oral health-related quality of life (ORHQoL) of three bleaching systems with similar hydrogen peroxide (HP) concentration for up to 6 months post-treatment. MATERIALS AND METHODS A randomized controlled trial was designed with three parallel groups: group A - in-office 6% HP paint-on varnish; group B - at-home 6% HP with adaptable tray; group C - at-home 16% carbamide peroxide with custom tray. At three different stages (baseline, after bleaching, and 6-month follow-up), ORHQoL was evaluated by the OHIP-14 questionnaire and tooth color of the upper canines and central incisors were measured by two shade guides and a spectrophotometer (measuring CIE L*a*b* with respective color/whiteness differences - ΔE00/ΔWID). Results were presented as mean and 95% confidence intervals and statistical tests were performed appropriately, considering a significance level of α = 0.05. RESULTS All groups presented significant color differences (P < 0.05) between all stages, with ΔE00/ΔWID surpassing the perceptibility threshold in 98% cases, with group C's results being significantly (P < 0.05) higher when compared to other groups, although with significantly (P < 0.05) higher values of color relapse. Significative ORHQoL improvements (P < 0.05) were detected after bleaching in a global analysis with no differences between techniques. CONCLUSIONS All techniques presented bleaching efficacy, color stability, and improvements in ORHQoL up to 6 months post-treatment. CLINICAL SIGNIFICANCE Clinicians may consider both at-home and in-office bleaching techniques with 6% HP to attain long-lasting satisfactory clinical results while producing positive changes in ORHQoL.
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Affiliation(s)
- Ruben Pereira
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - João Silveira
- Oral Biology and Biochemistry Research Group - LIB-Phys FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Susana Dias
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Cardoso
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - António Mata
- Oral Biology and Biochemistry Research Group - LIB-Phys FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Duarte Marques
- Oral Biology and Biochemistry Research Group - LIB-Phys FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
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Michaelis M, Rieger MA, Burgess S, Töws V, Abma FI, Bültmann U, Amick BC, Rothermund E. Evaluation of measurement properties of the German Work Role Functioning Questionnaire. BMC Public Health 2022; 22:1750. [PMID: 36109729 PMCID: PMC9479368 DOI: 10.1186/s12889-022-13893-4] [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: 03/17/2022] [Accepted: 07/27/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE We assessed the measurement properties of the German Work Role Functioning Questionnaire (WRFQ) after its cross-cultural adaptation of the Dutch version. The WRFQ is a generic role-specific instrument that measures how a particular health status influences the ability to meet work demands. METHODS We performed an observational study among German employees assessing the following measurement properties: 1) structural, 2) convergent and 3) discriminant validity, 4) floor and ceiling effects, 5) internal consistency, 6) reproducibility and 7) responsiveness. Participants were recruited from an online access panel sample aged 18 to 64 years having worked more than 12 hours in the last 4 weeks prior to study enrollment (n(T0) = 653, n(T1) = 66, n(T2) = 95). RESULTS Measurement properties proved to be good except for structural validity and responsiveness. An exploratory factor analysis showed limited replicability of three of the four original subscales. CONCLUSION With the WRFQ German version, the extent can be measured, to which employees with a certain health level experience problems can meet their work demands. This widely used health-related work outcome measurement tool, that helps to identify employees with decreasing work functioning, is now also available in German. This gives researchers and practitioners the opportunity to address work functioning in practice, e.g. in intervention studies in occupational health or rehabilitation. Further research to examine valid subscales is needed.
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Affiliation(s)
- Martina Michaelis
- grid.411544.10000 0001 0196 8249Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany ,Research Centre for Occupational and Social Medicine (FFAS), Freiburg, Germany
| | - Monika A. Rieger
- grid.411544.10000 0001 0196 8249Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany
| | - Stephanie Burgess
- grid.411544.10000 0001 0196 8249Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany
| | - Viktoria Töws
- grid.410712.10000 0004 0473 882XDepartment of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Femke I. Abma
- grid.4494.d0000 0000 9558 4598Department of Health Sciences, University of Groningen, University Medical Center Groningen, Community and Occupational Medicine, Groningen, The Netherlands
| | - Ute Bültmann
- grid.4494.d0000 0000 9558 4598Department of Health Sciences, University of Groningen, University Medical Center Groningen, Community and Occupational Medicine, Groningen, The Netherlands
| | - Benjamin C. Amick
- grid.241054.60000 0004 4687 1637Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Eva Rothermund
- grid.410712.10000 0004 0473 882XDepartment of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany ,grid.6582.90000 0004 1936 9748Leadership Personality Centre Ulm (LPCU), Ulm University, Ulm, Germany
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Borland E, Edgar C, Stomrud E, Cullen N, Hansson O, Palmqvist S. Clinically Relevant Changes for Cognitive Outcomes in Preclinical and Prodromal Cognitive Stages: Implications for Clinical Alzheimer Trials. Neurology 2022; 99:e1142-e1153. [PMID: 35835560 PMCID: PMC9536741 DOI: 10.1212/wnl.0000000000200817] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/19/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Identifying a clinically meaningful change in cognitive test score is essential when using cognition as an outcome in clinical trials. This is especially relevant because clinical trials increasingly feature novel composites of cognitive tests. Our primary objective was to establish minimal clinically important differences (MCIDs) for commonly used cognitive tests, using anchor-based and distribution-based methods, and our secondary objective was to investigate a composite cognitive measure that best predicts a minimal change in the Clinical Dementia Rating-Sum of Boxes (CDR-SB). METHODS From the Swedish BioFINDER cohort study, we consecutively included cognitively unimpaired (CU) individuals with and without subjective or mild cognitive impairment (MCI). We calculated MCIDs associated with a change of ≥0.5 or ≥1.0 on CDR-SB for Mini-Mental State Examination (MMSE), ADAS-Cog delayed recall 10-word list, Stroop, Letter S Fluency, Animal Fluency, Symbol Digit Modalities Test (SDMT) and Trailmaking Test (TMT) A and B, and triangulated MCIDs for clinical use for CU, MCI, and amyloid-positive CU participants. For investigating cognitive measures that best predict a change in CDR-SB of ≥0.5 or ≥1.0 point, we conducted receiver operating characteristic analyses. RESULTS Our study included 451 cognitively unimpaired individuals, 90 with subjective cognitive decline and 361 without symptoms of cognitive decline (pooled mean follow-up time 32.4 months, SD 26.8, range 12-96 months), and 292 people with MCI (pooled mean follow-up time 19.2 months, SD 19.0, range 12-72 months). We identified potential triangulated MCIDs (cognitively unimpaired; MCI) on a range of cognitive test outcomes: MMSE -1.5, -1.7; ADAS delayed recall 1.4, 1.1; Stroop 5.5, 9.3; Animal Fluency: -2.8, -2.9; Letter S Fluency -2.9, -1.8; SDMT: -3.5, -3.8; TMT A 11.7, 13.0; and TMT B 24.4, 20.1. For amyloid-positive CU, we found the best predicting composite cognitive measure included gender and changes in ADAS delayed recall, MMSE, SDMT, and TMT B. This produced an AUC of 0.87 (95% CI 0.79-0.94, sensitivity 75%, specificity 88%). DISCUSSION Our MCIDs may be applied in clinical practice or clinical trials for identifying whether a clinically relevant change has occurred. The composite measure can be useful as a clinically relevant cognitive test outcome in preclinical AD trials.
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Affiliation(s)
- Emma Borland
- From the Clinical Memory Research Unit (E.B., E.S., N.C., O.H., S.P.), Department of Clinical Sciences, Lund University; Department of Neurology(E.B.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Science (C.E.), Cogstate, London, United Kingdom; and Memory Clinic (E.S., O.H., S.P.), Skåne University Hospital, Malmö, Sweden.
| | - Chris Edgar
- From the Clinical Memory Research Unit (E.B., E.S., N.C., O.H., S.P.), Department of Clinical Sciences, Lund University; Department of Neurology(E.B.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Science (C.E.), Cogstate, London, United Kingdom; and Memory Clinic (E.S., O.H., S.P.), Skåne University Hospital, Malmö, Sweden
| | - Erik Stomrud
- From the Clinical Memory Research Unit (E.B., E.S., N.C., O.H., S.P.), Department of Clinical Sciences, Lund University; Department of Neurology(E.B.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Science (C.E.), Cogstate, London, United Kingdom; and Memory Clinic (E.S., O.H., S.P.), Skåne University Hospital, Malmö, Sweden
| | - Nicholas Cullen
- From the Clinical Memory Research Unit (E.B., E.S., N.C., O.H., S.P.), Department of Clinical Sciences, Lund University; Department of Neurology(E.B.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Science (C.E.), Cogstate, London, United Kingdom; and Memory Clinic (E.S., O.H., S.P.), Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- From the Clinical Memory Research Unit (E.B., E.S., N.C., O.H., S.P.), Department of Clinical Sciences, Lund University; Department of Neurology(E.B.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Science (C.E.), Cogstate, London, United Kingdom; and Memory Clinic (E.S., O.H., S.P.), Skåne University Hospital, Malmö, Sweden
| | - Sebastian Palmqvist
- From the Clinical Memory Research Unit (E.B., E.S., N.C., O.H., S.P.), Department of Clinical Sciences, Lund University; Department of Neurology(E.B.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Science (C.E.), Cogstate, London, United Kingdom; and Memory Clinic (E.S., O.H., S.P.), Skåne University Hospital, Malmö, Sweden
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Yapp LZ, Scott CEH, Howie CR, MacDonald DJ, Simpson AHRW, Clement ND. Meaningful values of the EQ-5D-3L in patients undergoing primary knee arthroplasty. Bone Joint Res 2022; 11:619-628. [PMID: 36047008 PMCID: PMC9533244 DOI: 10.1302/2046-3758.119.bjr-2022-0054.r1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIMS The aim of this study was to report the meaningful values of the EuroQol five-dimension three-level questionnaire (EQ-5D-3L) and EuroQol visual analogue scale (EQ-VAS) in patients undergoing primary knee arthroplasty (KA). METHODS This is a retrospective study of patients undergoing primary KA for osteoarthritis in a university teaching hospital (Royal Infirmary of Edinburgh) (1 January 2013 to 31 December 2019). Pre- and postoperative (one-year) data were prospectively collected for 3,181 patients (median age 69.9 years (interquartile range (IQR) 64.2 to 76.1); females, n = 1,745 (54.9%); median BMI 30.1 kg/m2 (IQR 26.6 to 34.2)). The reliability of the EQ-5D-3L was measured using Cronbach's alpha. Responsiveness was determined by calculating the anchor-based minimal clinically important difference (MCID), the minimal important change (MIC) (cohort and individual), the patient-acceptable symptom state (PASS) predictive of satisfaction, and the minimal detectable change at 90% confidence intervals (MDC-90). RESULTS The EQ-5D-3L demonstrated good internal consistency with an overall Cronbach alpha of 0.75 (preoperative) and 0.88 (postoperative), respectively. The MCID for the Index score was 0.085 (95% confidence interval (CI) 0.042 to 0.127) and EQ-VAS was 6.41 (95% CI 3.497 to 9.323). The MICCOHORT was 0.289 for the EQ-5D and 5.27 for the EQ-VAS. However, the MICINDIVIDUAL for both the EQ-5D-3L Index (0.105) and EQ-VAS (-1) demonstrated poor-to-acceptable reliability. The MDC-90 was 0.023 for the EQ-5D-3L Index and 1.0 for the EQ-VAS. The PASS for the postoperative EQ-5D-3L Index and EQ-VAS scores predictive of patient satisfaction were 0.708 and 77.0, respectively. CONCLUSION The meaningful values of the EQ-5D-3L Index and EQ-VAS scores can be used to measure clinically relevant changes in health-related quality of life in patients undergoing primary KA.Cite this article: Bone Joint Res 2022;11(9):619-628.
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Affiliation(s)
- Liam Z Yapp
- Department of Orthopaedics, Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK.,Department of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Chloe E H Scott
- Department of Orthopaedics, Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK.,Department of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Colin R Howie
- Department of Orthopaedics, Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK.,Department of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Deborah J MacDonald
- Department of Orthopaedics, Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK.,Department of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - A Hamish R W Simpson
- Department of Orthopaedics, Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK.,Department of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Nick D Clement
- Department of Orthopaedics, Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK.,Department of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
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Shah VV, Vitorio R, Hasegawa N, Carlson-Kuhta P, Nutt JG, King LA, Mancini M, Horak FB. Effects of a Cognitively Challenging Agility Boot Camp Program on Balance and Gait in People With Parkinson's Disease: Does Freezing of Gait Status Matter? Neurorehabil Neural Repair 2022; 36:603-612. [PMID: 36004814 DOI: 10.1177/15459683221119757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIM Individuals with Parkinson's disease (PD) with and without freezing of Gait (FoG) may respond differently to exercise interventions for several reasons, including disease duration. This study aimed to determine whether both people with and without FoG benefit from the Agility Boot Camp with Cognitive Challenges (ABC-C) program. METHODS This secondary analysis of our ABC-C trial included 86 PD subjects: 44 without FoG (PD-FoG) and 42 with FoG (PD + FoG). We collected measures of standing sway balance, anticipatory postural adjustments, postural responses, and a 2-minute walk with and without a cognitive task. Two-way repeated analysis of variance, with disease duration as covariate, was used to investigate the effects of ABC-C program. Effect sizes were calculated using standardized response mean (SRM) for PD-FoG and PD + FoG, separately. RESULTS The ABC-C program was effective in improving gait performance in both PD-FoG and PD + FoG, even after controlling for disease duration. Specifically, dual-task gait speed (P < .0001), dual-cost stride length (P = .012), and these single-task measures: arm range of motion (P < .0001), toe-off angle (P = .005), gait cycle duration variability (P = .019), trunk coronal range of motion (P = .042), and stance time (P = .046) improved in both PD-FoG and PD + FoG. There was no interaction effect between time (before and after exercise) and group (PD-FoG/PD + FoG) in all 24 objective measures of balance and gait. Dual-task gait speed improved the most in PD + FoG (SRM = 1.01), whereas single-task arm range of motion improved the most in PD-FoG (SRM = 1.01). CONCLUSION The ABC-C program was similarly effective in improving gait (and not balance) performance in both PD-FoG and PD + FoG.
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Affiliation(s)
- Vrutangkumar V Shah
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Rodrigo Vitorio
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, UK
| | - Naoya Hasegawa
- Department of Rehabilitation Science, Hokkaido University, Sapporo, Hokkaido, Japan
| | | | - John G Nutt
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Laurie A King
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- APDM Wearable Technologies, A Clario company, Portland, OR, USA
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35
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Stevens M, Raat H, Ferrando M, Vallina B, Lucas R, Middlemiss L, Rédon J, Rocher E, van Grieken A. A comprehensive urban programme to reduce energy poverty and its effects on health and wellbeing of citizens in six European countries: study protocol of a controlled trial. BMC Public Health 2022; 22:1578. [PMID: 35986259 PMCID: PMC9389758 DOI: 10.1186/s12889-022-13968-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Nearly 11% of the European population is affected by energy poverty. Energy poverty is defined by the European Commission (2016) as the inability to afford basic energy services to guarantee a decent standard of living. Energy poverty is considered a complex, multidimensional problem that affects environment, housing, urban development, and health. Living in energy poverty conditions is associated with poorer human health and wellbeing. Hence, the WELLBASED intervention programme aims to design, implement and evaluate a comprehensive urban programme, based on the social-ecological model, to reduce energy poverty and its effects on the citizens’ health and wellbeing in six European urban study sites: Valencia, Spain; Heerlen, The Netherlands; Leeds, United Kingdom; Edirne, Turkey; Obuda, Hungary, and; Jelgava, Latvia. Methods A controlled trial is performed. A total of 875 participants are recruited (125–177 per study site) to receive the WELLBASED intervention programme for 12 months (intervention condition) and 875 participants act as controls (control condition). Data will be collected with a baseline measurement at inclusion (T0), and follow-up measurements after 6 months (T1), 12 months (T2), and 18 months (T3). In both study arms, effects of the WELLBASED intervention programme are measured: health-related quality of life (HR-QoL), mental health, frailty in older adults, self-perceived health, chronic conditions, and care utilization. At the same time points, household expenditure on energy and energy consumption are obtained. In the intervention arm, health-monitoring data (i.e. peak flow, oxygen saturation, blood pressure, and heart rate) are obtained monthly and sleep quality with a three-month interval. Household data with regard to temperature, humidity and air quality are collected near real-time by home sensors. Qualitative interviews are conducted in each study site to evaluate the impacts of the WELLBASED intervention programme and to help explain findings. Discussion The WELLBASED intervention programme will provide new insights into the effectiveness of a comprehensive urban programme to tackle energy poverty and its effects on health and wellbeing across Europe. Hence, this study can contribute to European-wide replicable solutions for policy-makers and city practitioners to alleviate energy poverty. Trial registration ISRCTN registry number is ISRCTN14905838. Date of registration is 15/02/2022. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13968-2.
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Bally ELS, van Grieken A, Ye L, Ferrando M, Fernández-Salido M, Dix R, Zanutto O, Gallucci M, Vasiljev V, Carroll A, Darley A, Gil-Salmerón A, Ortet S, Rentoumis T, Kavoulis N, Mayora-Ibarra O, Karanasiou N, Koutalieris G, Hazelzet JA, Roozenbeek B, Dippel DWJ, Raat H. 'Value-based methodology for person-centred, integrated care supported by Information and Communication Technologies' (ValueCare) for older people in Europe: study protocol for a pre-post controlled trial. BMC Geriatr 2022; 22:680. [PMID: 35978306 PMCID: PMC9386998 DOI: 10.1186/s12877-022-03333-8] [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: 12/01/2021] [Accepted: 07/23/2022] [Indexed: 12/04/2022] Open
Abstract
Background Older people receive care from multiple providers which often results in a lack of coordination. The Information and Communication Technology (ICT) enabled value-based methodology for integrated care (ValueCare) project aims to develop and implement efficient outcome-based, integrated health and social care for older people with multimorbidity, and/or frailty, and/or mild to moderate cognitive impairment in seven sites (Athens, Greece; Coimbra, Portugal; Cork/Kerry, Ireland; Rijeka, Croatia; Rotterdam, the Netherlands; Treviso, Italy; and Valencia, Spain). We will evaluate the implementation and the outcomes of the ValueCare approach. This paper presents the study protocol of the ValueCare project; a protocol for a pre-post controlled study in seven large-scale sites in Europe over the period between 2021 and 2023. Methods A pre-post controlled study design including three time points (baseline, post-intervention after 12 months, and follow-up after 18 months) and two groups (intervention and control group) will be utilised. In each site, (net) 240 older people (120 in the intervention group and 120 in the control group), 50–70 informal caregivers (e.g. relatives, friends), and 30–40 health and social care practitioners will be invited to participate and provide informed consent. Self-reported outcomes will be measured in multiple domains; for older people: health, wellbeing, quality of life, lifestyle behaviour, and health and social care use; for informal caregivers and health and social care practitioners: wellbeing, perceived burden and (job) satisfaction. In addition, implementation outcomes will be measured in terms of acceptability, appropriateness, feasibility, fidelity, and costs. To evaluate differences in outcomes between the intervention and control group (multilevel) logistic and linear regression analyses will be used. Qualitative analysis will be performed on the focus group data. Discussion This study will provide new insights into the feasibility and effectiveness of a value-based methodology for integrated care supported by ICT for older people, their informal caregivers, and health and social care practitioners in seven different European settings. Trial registration ISRCTN registry number is 25089186. Date of trial registration is 16/11/2021.
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Affiliation(s)
- E L S Bally
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A van Grieken
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - L Ye
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Ferrando
- R&D+I Consultancy, Kveloce I+D+i (Senior Europa SL), Valencia, Spain
| | - M Fernández-Salido
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - R Dix
- Fundación de La Comunidad Valenciana Para La Promoción Estratégica, El Desarrollo Y La Innovación Urbana (Las Naves), Valencia, Spain
| | - O Zanutto
- European Project Office Department, Istituto Per Servizi Di Ricovero E Assistenza Agli Anziani (Institute for Hospitalization and Care for the Elderly), Treviso, Italy
| | - M Gallucci
- Local Health Authority N.2 Treviso, Centre for Cognitive Disease and Dementia, Treviso, Italy
| | - V Vasiljev
- Faculty of Medicine, Department of Social Medcine and Epidemiology, University of Rijeka, Rijeka, Croatia
| | - A Carroll
- School of Medicine, University College Dublin, Dublin, Ireland
| | - A Darley
- School of Medicine, University College Dublin, Dublin, Ireland
| | | | - S Ortet
- Innovation Department, Cáritas Diocesana de Coimbra, Coimbra, Portugal
| | - T Rentoumis
- Alliance for Integrated Care, Athens, Greece
| | | | - O Mayora-Ibarra
- Center for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | | | | | - J A Hazelzet
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - B Roozenbeek
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - D W J Dippel
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - H Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Oen K, Toupin-April K, Feldman BM, Berard RA, Duffy CM, Tucker LB, Tian J, Rumsey DG, Guzman J. Validation of the parent global assessment as a health-related quality of life measure in juvenile idiopathic arthritis: results from ReACCh-Out. Rheumatology (Oxford) 2022; 62:SI152-SI162. [PMID: 35713497 PMCID: PMC9949712 DOI: 10.1093/rheumatology/keac350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To (i) validate the JIA parent global assessment (parent global) as a health-related quality of life (HRQoL) instrument; (ii) evaluate measurement properties of accepted HRQoL measures relative to those of the parent global; and (iii) assess causal pathways determining parent global scores. METHODS Data from the Research in Arthritis in Canadian Children emphasizing outcomes (ReACCh-Out) cohort were used. Measurement properties were assessed in 344 patients at enrolment and 6 months later. Causal pathways were tested by structural equation modelling to understand root causes and mediators leading to parent global scores. RESULTS Construct validity was supported by Spearman correlations of 0.53-0.70 for the parent global with the Juvenile Arthritis Quality of Life Questionnaire, Quality of My Life health scale (HRQoML), Pediatric Quality of Life Inventory (PedsQL)-Parent, and Child Health Questionnaire (CHQ)-Physical. Exceptions were PedsQL-Child (0.44) and CHQ-Psychosocial (0.31). Correlations were lower (0.14-0.49) with disease activity measures (physician global assessment of disease activity, active joint count, ESR). Responsiveness of the parent global to improvement according to parent ratings (0.51) was acceptable and within the range (0.32-0.71) of that of other measures. Reliability estimates and measurement errors for all measures were unsatisfactory, likely due to the prolonged time between assessments. Causal pathways for the parent global matched those previously reported for HRQoML. CONCLUSIONS Our results offer support for the parent global as a valid measure of HRQoL for JIA. If confirmed, existing studies using the parent global may be re-interpreted, enhancing our knowledge of HRQoL in children with JIA.
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Affiliation(s)
- Kiem Oen
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg
| | - Karine Toupin-April
- School of Rehabilitation Sciences and Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario Research Institute and Institut du Savoir Montfort, Ottawa
| | - Brian M Feldman
- Division of Rheumatology, The Hospital for Sick Children, and Departments of Pediatrics and Medicine, and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto
| | - Roberta A Berard
- Pediatric Rheumatology, Children’s Hospital, London Health Sciences Centre, London
| | - Ciẚran M Duffy
- Children’s Hospital of Eastern Ontario and Department of Pediatrics, University of Ottawa, Ottawa
| | - Lori B Tucker
- Division of Pediatric Rheumatology, British Columbia Children’s Hospital, and Department of Pediatrics, University of British Columbia, Vancouver
| | - Jiahao Tian
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby
| | - Dax G Rumsey
- Paediatric Rheumatology, Stollery Children’s Hospital and Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Jaime Guzman
- Correspondence to: Jaime Guzman, BC Children’s Hospital, 4500 Oak Street, Room K4-122 Vancouver, BC V6H 3N1, Canada. E-mail:
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Tsuboi T, Satake Y, Hiraga K, Yokoi K, Hattori M, Suzuki M, Hara K, Ramirez-Zamora A, Okun MS, Katsuno M. Effects of MAO-B inhibitors on non-motor symptoms and quality of life in Parkinson's disease: A systematic review. NPJ Parkinsons Dis 2022; 8:75. [PMID: 35697709 PMCID: PMC9192747 DOI: 10.1038/s41531-022-00339-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/24/2022] [Indexed: 11/09/2022] Open
Abstract
Non-motor symptoms (NMS) are common among patients with Parkinson's disease and reduce patients' quality of life (QOL). However, there remain considerable unmet needs for NMS management. Three monoamine oxidase B inhibitors (MAO-BIs), selegiline, rasagiline, and safinamide, have become commercially available in many countries. Although an increasing number of studies have reported potential beneficial effects of MAO-BIs on QOL and NMS, there has been no consensus. Thus, the primary objective of this study was to provide an up-to-date systematic review of the QOL and NMS outcomes from the available clinical studies of MAO-BIs. We conducted a literature search using the PubMed, Scopus, and Cochrane Library databases in November 2021. We identified 60 publications relevant to this topic. Overall, rasagiline and safinamide had more published evidence on QOL and NMS changes compared with selegiline. This was likely impacted by selegiline being introduced many years prior to the field embarking on the study of NMS. The impact of MAO-BIs on QOL was inconsistent across studies, and this was unlikely to be clinically meaningful. MAO-BIs may potentially improve depression, sleep disturbances, and pain. In contrast, cognitive and olfactory dysfunctions are likely unresponsive to MAO-BIs. Given the paucity of evidence and controlled, long-term studies, the effects of MAO-BIs on fatigue, autonomic dysfunctions, apathy, and ICD remain unclear. The effects of MAO-BIs on static and fluctuating NMS have never been investigated systematically. More high-quality studies will be needed and should enable clinicians to provide personalized medicine based on a non-motor symptom profile.
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Affiliation(s)
- Takashi Tsuboi
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Yuki Satake
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keita Hiraga
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Yokoi
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Neurology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Makoto Hattori
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Suzuki
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Clinical laboratory, Nagoya University Hospital, Nagoya, Japan
| | - Kazuhiro Hara
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Adolfo Ramirez-Zamora
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Merza EY, Pearson SJ, Lichtwark GA, Malliaras P. The acute effects of higher versus lower load duration and intensity on morphological and mechanical properties of the healthy Achilles tendon: a randomized crossover trial. J Exp Biol 2022; 225:275126. [PMID: 35470387 PMCID: PMC9167578 DOI: 10.1242/jeb.243741] [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: 11/01/2021] [Accepted: 04/19/2022] [Indexed: 11/20/2022]
Abstract
The Achilles tendon (AT) exhibits volume changes related to fluid flow under acute load which may be linked to changes in stiffness. Fluid flow provides a mechanical signal for cellular activity and may be one mechanism that facilitates tendon adaptation. This study aimed to investigate whether isometric intervention involving a high level of load duration and intensity could maximize the immediate reduction in AT volume and stiffness compared with interventions involving a lower level of load duration and intensity. Sixteen healthy participants (12 males, 4 females; age 24.4±9.4 years, body mass 70.9±16.1 kg, height 1.7±0.1 m) performed three isometric interventions of varying levels of load duration (2 s and 8 s) and intensity (35% and 75% maximal voluntary isometric contraction) over a 3 week period. Freehand 3D ultrasound was used to measure free AT volume (at rest) and length (at 35%, 55% and 75% of maximum plantarflexion force) pre- and post-interventions. The slope of the force–elongation curve over these force levels represented individual stiffness (N mm−1). Large reductions in free AT volume and stiffness resulted in response to long-duration high-intensity loading whilst less reduction was produced with a lower load intensity. In contrast, no change in free AT volume and a small increase in AT stiffness occurred with lower load duration. These findings suggest that the applied load on the AT must be heavy and sustained for a long duration to maximize immediate volume reduction, which might be an acute response that enables optimal long-term tendon adaptation via mechanotransduction pathways. Summary: High levels of load duration and intensity have the greatest acute effect on the free Achilles tendon volume and stiffness.
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Affiliation(s)
- Eman Y Merza
- Department of physiotherapy, Faculty of Medicine, Nursing and Health Science, Monash University, Frankston Vic 3199, Melbourne, Australia
| | - Stephen J Pearson
- Centre for Health, Sport and Rehabilitation Sciences Research, University of Salford, Greater Manchester, M5 4WT, UK
| | - Glen A Lichtwark
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Brisbane, Australia
| | - Peter Malliaras
- Department of physiotherapy, Faculty of Medicine, Nursing and Health Science, Monash University, Frankston Vic 3199, Melbourne, Australia
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40
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Responsiveness and Validity of Weight-Bearing Test for Measuring Loading Capacity in Patients With Triangular Fibrocartilage Complex Injury. J Sport Rehabil 2022; 31:876-884. [PMID: 35461186 DOI: 10.1123/jsr.2021-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/26/2022] [Accepted: 03/11/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT Weight-bearing test (WBT) is a noninvasive quantitative test which has been used recently to determine loading capability of the individuals. The aim of this study was to strengthen the evidence for using the WBT test for measuring weight-bearing capacity of the upper-extremity with the specific objective of examining the internal and external responsiveness and concurrent validity of the test in patients with triangular fibrocartilage complex injury. DESIGN Single-group repeated measures. METHODS Internal responsiveness was assessed using effect size statistics. The correlation coefficient was used to examine external responsiveness by testing 5 hypotheses regarding predefined correlations between the changes in the measurements. Concurrent validity was evaluated by analyzing correlations between the WBT and other measurements. Thirty-one patients with triangular fibrocartilage complex injury were included for the analysis of the concurrent validity. Eighteen patients who completed all measurements at baseline and at 3-month follow-up enrolled for the responsiveness analysis. Measurements included the WBT, pain intensity, grip strength, and upper extremity functional level. RESULTS The WBT test was able to detect statistically significant changes in weight-bearing capacity between baseline and follow-up (P = .0001). The effect size of the WBT was large. Three out of 5 hypotheses (60%) were confirmed, a good correlation was found between changes scores of the WBT and grip strength (r = .478; P < .05). There were significant correlations between the WBT and other measurements (r value range from -.401 to .742; P < .05). A higher correlation was found between the WBT and grip strength (r = .742; P = .0001). CONCLUSIONS The responsiveness and concurrent validity of the WBT test confirmed that it is able to measure change in weight-bearing capacity in patients with triangular fibrocartilage complex injury.
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Caimmi M, Giovanzana C, Gasperini G, Molteni F, Molinari Tosatti L. Robot Fully Assisted Upper-Limb Functional Movements Against Gravity to Drive Recovery in Chronic Stroke: A Pilot Study. Front Neurol 2022; 12:782094. [PMID: 35350582 PMCID: PMC8957862 DOI: 10.3389/fneur.2021.782094] [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: 09/23/2021] [Accepted: 12/29/2021] [Indexed: 11/22/2022] Open
Abstract
Background Stroke is becoming more and more a disease of chronically disabled patients, and new approaches are needed for better outcomes. An intervention based on robot fully assisted upper-limb functional movements is presented. Objectives To test the immediate and sustained effects of the intervention in reducing impairment in chronic stroke and to preliminarily verify the effects on activity. Methodology Nineteen patients with mild-to-severe impairment underwent 12 40-min rehabilitation sessions, 3 per week, of robot-assisted reaching and hand-to-mouth movements. The primary outcome measure was the Fugl-Meyer Assessment (FMA) at T1, immediately after treatment (n = 19), and at T2, at a 6-month follow-up (n = 10). A subgroup of 11 patients was also administered the Wolf Motor Function Test Time (WMFT TIME) and Functional Ability Scale (WMFT FAS) and Motor Activity Log (MAL) Amount Of Use (AOU), and Quality Of Movement (QOM). Results All patients were compliant with the treatment. There was improvement on the FMA with a mean difference with respect to the baseline of 6.2 points at T1, after intervention (n = 19, 95% CI = 4.6–7.8, p < 0.0002), and 5.9 points at T2 (n = 10, 95% CI = 3.6–8.2, p < 0.005). Significant improvements were found at T1 on the WMFT FAS (n = 11, +0.3/5 points, 95% CI = 0.2–0.4, p < 0.004), on the MAL AOU (n = 11, +0.18/5, 95% CI = 0.07–0.29, p < 0.02), and the MAL QOM (n = 11, +0.14/5, 95% CI = 0.08–0.20, p < 0.02). Conclusions Motor benefits were observed immediately after intervention and at a 6-month follow-up. Reduced impairment would appear to translate to increased activity. Although preliminary, the results are encouraging and lay the foundation for future studies to confirm the findings and define the optimal dose-response curve. Clinical Trial Registration www.ClinicalTrials.gov, identifier: NCT03208634.
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Affiliation(s)
- Marco Caimmi
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council of Italy, Milan, Italy
| | - Chiara Giovanzana
- Villa Beretta Rehabilitation Centre, Valduce Hospital, Costa Masnaga, Italy
| | - Giulio Gasperini
- Villa Beretta Rehabilitation Centre, Valduce Hospital, Costa Masnaga, Italy
| | - Franco Molteni
- Villa Beretta Rehabilitation Centre, Valduce Hospital, Costa Masnaga, Italy
| | - Lorenzo Molinari Tosatti
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council of Italy, Milan, Italy
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Philpott HT, Birmingham TB, Dima R, Pinto R, Bryant D, Appleton CT. Test-Retest Reliability and Sensitivity to Change of Ultrasound-Based Methods of Measuring Synovial Inflammation in Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2022; 75:902-910. [PMID: 35294110 DOI: 10.1002/acr.24882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 02/24/2022] [Accepted: 03/10/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To assess test-retest reliability of musculoskeletal ultrasound (US) measures of inflammation in patients with knee osteoarthritis (OA) and to assess the sensitivity to change of US measures of inflammation in patients with knee OA. METHODS To mimic a common clinical scenario, 36 patients (n = 70 knees) with symptomatic knee OA who were in stable condition underwent 2 assessments within 14 days by different operators and different US machines, graded by a single rater. Test-retest reliability was measured using Cohen's kappa coefficient, intraclass correlation coefficient (ICC), and absolute agreement parameters. A total of 51 patients (n = 72 knees) were tested immediately before and 21-28 days after intraarticular glucocorticoid injection to investigate sensitivity to change and longitudinal construct validity. Paired t-tests and standardized response mean (SRM) were used to assess sensitivity to change. Multivariate linear regression was used to investigate longitudinal construct validity of US with Knee Injury and Osteoarthritis Outcome Score (KOOS) pain scores, while adjusting for covariates. RESULTS US measures of inflammation demonstrated moderate (κ = 0.41, 0.60) to substantial (κ = 0.61, 0.80) agreement. Quantitative measures of synovitis and effusion demonstrated good test-retest reliability (ICC2,1 0.71, 0.92). US measures of synovitis and effusion demonstrated low-to-moderate sensitivity to change (SRM -0.29, -0.50). The associations between changes in US measures and KOOS pain scores over time were low, and 95% confidence intervals included zero. CONCLUSION In a clinical setting, US measures of inflammatory features of knee OA have substantial reliability and low-to-moderate sensitivity to change, whereas measures of structural OA features are less reliable. Longitudinal construct validity of US measures of synovitis and effusion to KOOS pain scores is not strongly supported.
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Affiliation(s)
- Holly T Philpott
- Bone and Joint Institute, University of Western Ontario and London Health Sciences Centre-University Hospital, London, Ontario, Canada
| | - Trevor B Birmingham
- Bone and Joint Institute, University of Western Ontario and London Health Sciences Centre-University Hospital, London, Ontario, Canada
| | - Robert Dima
- Bone and Joint Institute, University of Western Ontario and London Health Sciences Centre-University Hospital, London, Ontario, Canada
| | - Ryan Pinto
- Bone and Joint Institute, University of Western Ontario and London Health Sciences Centre-University Hospital, London, Ontario, Canada
| | - Dianne Bryant
- Bone and Joint Institute, University of Western Ontario and London Health Sciences Centre-University Hospital, London, Ontario, Canada
| | - C Thomas Appleton
- Bone and Joint Institute, Schulich School of Medicine and Dentistry, and London Health Sciences Centre-University Hospital, University of Western Ontario, London, Ontario, Canada
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Kishimoto Y, Hashizume A, Imai Y, Nakatochi M, Yamada S, Ito D, Torii R, Nagano Y, Fujimoto H, Katsuno M. Quantitative evaluation of upper limb ataxia in spinocerebellar ataxias. Ann Clin Transl Neurol 2022; 9:529-539. [PMID: 35293156 PMCID: PMC8994984 DOI: 10.1002/acn3.51528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 11/12/2022] Open
Abstract
Objective To quantitatively evaluate upper limb ataxia using a novel pen‐like sensor device in patients with spinocerebellar ataxia (SCA) and to assess its validity, reliability, and sensitivity to disease progression. Methods We designed a cross‐sectional and longitudinal study of patients with SCA and healthy controls. Upper limb ataxia was evaluated using a device that measures the three‐dimensional position every 10 msec. Participants were instructed to move a pen‐like part of the device iteratively between two buttons. We evaluated the time, length, velocity, and variation coefficient of the stroke, and calculated the distortion index using the mean squared error. The following scales were also evaluated: Scale for the Assessment and Rating of Ataxia (SARA), the International Cooperative Ataxia Rating Scale (ICARS), and the nine‐hole pegboard test. Subjects were followed 12 months after the baseline evaluation. Results A total of 42 patients with SCA and 33 healthy controls were enrolled and evaluated. For all ataxia indices measured using the device there were significant differences between healthy controls and patients with SCA. Among the ataxia indices, the distortion index showed the strongest correlation with the SARA and ICARS upper limb score (Pearson's r = 0.647 and 0.722, respectively). Test–retest reliability was high for most of the ataxia indices. In the longitudinal analysis, the distortion index showed high standardized response mean and adjusted effect size, regardless of disease severity. Interpretation Our study demonstrated that the distortion index is a reliable functional marker that is sensitive to longitudinal change in patients with SCA.
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Affiliation(s)
- Yoshiyuki Kishimoto
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsushi Hashizume
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Clinical Research Education, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuta Imai
- Department of Basic Medicinal Sciences, Nagoya University Graduate School of Pharmaceutical Sciences, Nagoya, Japan
| | - Masahiro Nakatochi
- Public Health Informatics Unit, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinichiro Yamada
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Daisuke Ito
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryota Torii
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshitaka Nagano
- Department of Electronic Robot Engineering, Aichi University of Technology, Gamagori, Japan
| | - Hideo Fujimoto
- Department of Computer Science and Engineering, Nagoya Institute of Technology Graduate School of Engineering, Nagoya, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Duarte V, Zaror C, Villanueva J, Andreo M, Dallaserra M, Salazar J, Pont À, Ferrer M. Oral Health-Related Quality of Life Changes in Patients with Dentofacial Deformities Class II and III after Orthognathic Surgery: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1940. [PMID: 35206128 PMCID: PMC8872566 DOI: 10.3390/ijerph19041940] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/01/2022] [Accepted: 02/05/2022] [Indexed: 01/27/2023]
Abstract
Our aim was to assess the impact of combined orthodontic-surgical treatment on patients' oral health-related quality of life (OHRQoL) according to type of dentofacial deformities, by synthesizing the available evidence. METHODS Search was conducted in the PubMed, Embase/MEDLINE, Scopus, and Cochrane databases. The eligibility criteria were studies that measured OHRQoL before-after orthognathic surgery, with results disaggregated by Class II and III. Two researchers independently performed the selection process, data extraction, and methodological quality assessment. Meta-analysis of the standard mean differences (SMD) was performed using random effect models. RESULTS The search identified 1047 references. Thirteen studies met the inclusion criteria, and four were included in the meta-analysis. The SMD of OHRQL global score showed large improvement 4-7 months after surgery in Class II and III patients (2.09, 95% CI 0.68 to 3.49 and 1.96, 95% CI 1.22 to 2.70, respectively). The sensitivity analyses, excluding studies with weak methodological quality, showed that Class III patients' improvement in functional limitation was significantly higher than in Class II patients (SMD 0.57, 95% CI 0.12-1.02). CONCLUSIONS There is not enough evidence to support differences between Class II and III patients in the OHRQoL impact after orthognathic surgery, but findings suggest lower improvement of some domains in Class II patients.
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Affiliation(s)
- Valentina Duarte
- Faculty of Sciences, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile
- Oral & Maxillofacial Surgery, Hospital Carlos Van Buren, Valparaíso 2340000, Chile;
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Carlos Zaror
- Department of Paediatric Dentistry and Orthodontic, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
- Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
| | - Julio Villanueva
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universidad de Chile, Santiago 8380000, Chile; (J.V.); (M.D.)
- Cochrane Associated Center, Faculty of Dentistry, University of Chile, Santiago 8380000, Chile
- Department of Oral & Maxillofacial Surgery, Hospital Clínico San Borja-Arriarán, Santiago 8320000, Chile
| | - Matías Andreo
- Oral & Maxillofacial Surgery, Hospital Carlos Van Buren, Valparaíso 2340000, Chile;
| | - Matías Dallaserra
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universidad de Chile, Santiago 8380000, Chile; (J.V.); (M.D.)
- Cochrane Associated Center, Faculty of Dentistry, University of Chile, Santiago 8380000, Chile
| | | | - Àngels Pont
- Health Services Research Group IMIM, Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (À.P.); (M.F.)
- CIBER en Epidemiología y Salud Pública, CIBERESP, 28029 Madrid, Spain
| | - Montse Ferrer
- Health Services Research Group IMIM, Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (À.P.); (M.F.)
- CIBER en Epidemiología y Salud Pública, CIBERESP, 28029 Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, 08003 Barcelona, Spain
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van de Velde NM, Gegenava T, Koeks Z, Butcher SC, Roest AA, Bax JJ, Atsma DE, Spitali P, Ajmone Marsan N, Niks EH. Value of Global Longitudinal Strain for Identification and Monitoring of Left Ventricular Dysfunction in Becker Muscular Dystrophy. Am J Cardiol 2022; 162:170-176. [PMID: 34756724 DOI: 10.1016/j.amjcard.2021.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 01/16/2023]
Abstract
Cardiac involvement is the main cause of death in Becker muscular dystrophy (BMD). Identification of left ventricular (LV) function is crucial, but standard echocardiographic measurements such as LV ejection fraction (LVEF) might not be sensitive enough to detect early myocardial dysfunction. We explored the value of LV global longitudinal strain (GLS) as a more accurate echocardiographic parameter to detect and monitor LV dysfunction in BMD. Furthermore, we studied possible factors associated with LV dysfunction and progression. A total of 40 patients with BMD (age 39.0 ± 13.2 years) and 21 matched controls were included. Clinical variables, pulmonary tests, serum biomarkers, and echocardiograms were collected at baseline and after 2 years. LV systolic function was assessed by LVEF and LV GLS; a significant progression in LV dysfunction was defined as an absolute LV GLS deterioration ≥15%. Responsiveness to cardiac disease progression was determined using standardized response means. Patients showed impaired LVEF and LV GLS compared with controls (p <0.001). Of interest, 31 patients (77.5%) showed impaired LV GLS (defined as greater than -18%), whereas only 24 patients (60%) had reduced LVEF. LV GLS and LVEF correlated with troponin I (ρ = 0.553 and -0.523) and N-terminal pro-b-type natriuretic peptide (ρ = 0.506 and -0.585), but not with skeletal muscle or pulmonary function. At follow-up (2.0 ± 0.5 years, n = 29), LV GLS worsened significantly (-1.3 ± 0.8%, p = 0.002, standardized response mean = 0.70, annually = 0.60%), whereas LVEF remained stable. No risk factors for LV dysfunction progression were identified. In BMD, LV GLS is frequently impaired and shows deterioration over time compared with LVEF. LV GLS could be used as a more sensitive parameter to identify and monitor LV dysfunction.
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Affiliation(s)
- Nienke M van de Velde
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Duchenne Center Netherlands
| | - Tea Gegenava
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Zaïda Koeks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Steele C Butcher
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Arno Aw Roest
- Division of Paediatric Cardiology, Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Douwe E Atsma
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Pietro Spitali
- Duchenne Center Netherlands; Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik H Niks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Duchenne Center Netherlands.
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Wurst R, Brame J, Ramsenthaler C, König D, Fuchs R. A questionnaire to assess eating behavior: Structure, validity and responsiveness of a new German eating behavior scale (SEV). Appetite 2022; 168:105668. [PMID: 34517073 DOI: 10.1016/j.appet.2021.105668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 01/02/2023]
Abstract
Numerous weight-loss interventions promoting healthy and weight-reducing eating behavior have been developed over the past years. To evaluate the effectiveness of such interventions for eating behavior change, short, validated and sensitive instruments are needed. In this study series, we developed and validated a new outcome measure to assess health-conscious and weight-controlling eating behavior for the evaluation of weight-loss interventions. The preliminary version of the German eating behavior scale (Skala zumErnährungsverhalten [SEV]) included 40 items. Three studies were conducted to (a) reduce the preliminary item pool, (b) investigate structural validity and internal consistency using exploratory and confirmatory factor analyses (EFA, CFA), as well as McDonald's ω, and (c) test construct validity with physiological and behavioral parameters. Responsiveness to change was also assessed after a 12-week weight-loss intervention. EFA indicated a two-factor solution with health-conscious (hc-EB) and weight-controlling eating behavior (wc-EB) as subscales, CFA confirmed the two-factor solution with acceptable model fit. Internal consistencies of both subscales were also acceptable to good (hc-EB: ω = 0.88; wc-EB: ω = 0.78). Significantly small to moderate correlations to the Healthy Eating Index (r = 0.51) as well as blood glucose (r = 0.31), blood lipids (r = 0.23), and vascular age (r = 0.31) were found, supporting the construct validity of the SEV and its subscales. Both subscales detected intervention-related changes in eating behavior among subjects of a weight-loss intervention with Standardized Response Means of 0.52 and 0.67, indicating good responsiveness of the SEV. In sum, findings provide evidence that the SEV is a valid and responsive measure to assess health-conscious and weight-controlling eating behavior.
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Affiliation(s)
- Ramona Wurst
- University of Freiburg, Department of Sport Psychology, Freiburg, Germany.
| | - Judith Brame
- University of Freiburg, Department of Nutrition and Sports, Freiburg, Germany
| | - Christina Ramsenthaler
- University of Freiburg, Department of Sport Psychology, Freiburg, Germany; Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Daniel König
- University of Freiburg, Department of Nutrition and Sports, Freiburg, Germany; University of Vienna, Department of Sports Science, Institute for Nutrition and Sports, Vienna, Austria
| | - Reinhard Fuchs
- University of Freiburg, Department of Sport Psychology, Freiburg, Germany
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Duarte V, Zaror C, Villanueva J, Werlinger F, Vidal C, Solé P, O Ryan JA, Requena R, Dallaserra M, Rojas R, Burgos M, Ferrer M. Changes in health-related quality of life after orthognathic surgery: a multicenter study. Clin Oral Investig 2021; 26:3467-3476. [PMID: 34854989 PMCID: PMC8637059 DOI: 10.1007/s00784-021-04315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022]
Abstract
Objective To evaluate changes in general and oral health-related quality of life (HRQoL) in patients with dentofacial deformity undergoing orthognathic surgery, and whether these changes vary according to type of deformity. Material and methods This is a prospective longitudinal multicenter study of patients with dentofacial deformities (n = 90). The Orthognathic Quality of Life Questionnaire (OQLQ), Oral Health Impact Profile (OHIP-14), and Short-Form Health Survey version2 (SF-36v2) were self-completed by patients before surgery, 3 and 6 months after orthognathic surgery. Change was tested using paired t-test, and compared between Class II and Class III of dentofacial deformity by unpaired t-test. The magnitude of change was examined estimating the standardized response mean (SRM). Results The OQLQ and OHIP-14 showed statistically significant improvements 6 months after surgery, compared with the pre-surgical evaluation, but the SF-36v2 only in the physical component summary. The SRM was large in OQLQ oral function (-1.11) and dentofacial facial aesthetics (-0.76) dimensions, and moderate in most of OHIP-14 dimensions. Differences in mean change between Class II and III were statistically significant for global scores of OQLQ (-10.08 vs -20.30, p = 0.0271) and OHIP-14 (-3.79 vs -10.56, p = 0.0144). Conclusions A significant improvement was observed in oral HRQoL and in the physical component of general health in patients with dentofacial deformities Class II and III after orthognathic surgery. Improvement was greater among Class III than in Class II patients. Clinical relevance These results provide patients, oral health care professionals, and planners with valuable information to make evidence-based decisions and facilitate shared clinical decision-making, taking into account the patients’ perspective.
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Affiliation(s)
- Valentina Duarte
- Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
- Department of Oral & Maxillofacial Surgery, Hospital Carlos Van Buren, San Ignacio 725, Valparaíso, Chile.
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Carlos Zaror
- Department of Paediatric Dentistry and Orthodontic, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
- Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
| | - Julio Villanueva
- Department of Oral & Maxillofacial Surgery and Cochrane Associated Center, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
- Department of Oral & Maxillofacial Surgery, Hospital Clínico San Borja-Arriarán, Santiago, Chile
| | - Fabiola Werlinger
- Center for Epidemiology and Surveillance of Oral Disease (CEVEO), Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Constanza Vidal
- Department of Oral & Maxillofacial Surgery, Hospital Carlos Van Buren, San Ignacio 725, Valparaíso, Chile
| | - Pedro Solé
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
- Department of Oral & Maxillofacial Surgery, Clínica Universidad de Los Andes, Santiago, Chile
| | - Juan Alberto O Ryan
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Roberto Requena
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
- Department of Oral & Maxillofacial Surgery, Clínica Universidad de Los Andes, Santiago, Chile
| | - Matías Dallaserra
- Department of Oral & Maxillofacial Surgery and Cochrane Associated Center, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - René Rojas
- Department of Oral & Maxillofacial Surgery, Clínica Santa María, Santiago, Chile
| | - Marcela Burgos
- Clinical Psychologist, Private Practice, Santiago, Chile
| | - Montse Ferrer
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Measurement properties of the Nepali version of the Quick-DASH in patients with shoulder pain. Musculoskelet Sci Pract 2021; 56:102437. [PMID: 34416559 DOI: 10.1016/j.msksp.2021.102437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/07/2021] [Accepted: 07/31/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To examine the measurement properties of the Nepali version of the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH-NP). MATERIALS AND METHODS The Nepali DASH and Shoulder Pain and Disability Index (SPADI) were completed at baseline assessment, and again at follow-up with the Nepali Global Rating of Change (GROC-NP) score. The 11 items of the QuickDASH-NP were extracted from the DASH and tested for confirmatory factory analysis (CFA), exploratory factor analysis (EFA), internal consistency (α), item-total correlation (ITC), test-retest reliability (ICC), measurement errors, hypothesis testing (correlation with DASH and SPADI) and responsiveness (effect size-ES, standardised response mean-SRM). RESULTS A total of 156 participants completed questionnaires at baseline and 121 at follow-up with all questionnaires valid (no participant leaving more than one question blank). CFA suggested a poor fit for the single-factor model. The EFA demonstrated two factors with acceptable internal consistency (α = 0.79 and 0.75) for each factor. The test-retest reliability was excellent (ICC = 0.94; 95%CI:0.92-0.98), correlation was positive and very strong with the DASH-NP (r = 0.96) and strong with the SPADI-NP (r = 0.81). The Standard Error of Measurement was 2.83 and Smallest Detectable Change 7.84/100. The ES and SRM were moderate to high. CONCLUSIONS The QuickDASH-NP is reliable, valid, and able to detect change in shoulder symptoms among Nepali participants. It offers a short, easy to complete self-reporting tool for clinical use and research.
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Caumo W, Alves RL, Vicuña P, Alves CFDS, Ramalho L, Sanches PRS, Silva DP, Torres ILDS, Fregni F. Impact of bifrontal home-based transcranial direct current stimulation in pain catastrophizing and disability due to pain in fibromyalgia: a randomized, double-blind sham-controlled study. THE JOURNAL OF PAIN 2021; 23:641-656. [PMID: 34785366 DOI: 10.1016/j.jpain.2021.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 09/05/2021] [Accepted: 11/08/2021] [Indexed: 11/15/2022]
Abstract
This randomized, double-blind trial tested the hypothesis that twenty sessions of home-based anodal(a)-transcranial direct current stimulation (tDCS) (2mA for 20 min) bifrontal, with anodal on the left dorsolateral prefrontal cortex (l-DLPFC) would be better than sham-(s)-tDCS to reduce scores on Pain Catastrophizing Scale (PCS) and disability-related to pain (DRP) assessed by the Profile of Chronic Pain: Screen (PCP:S) (primary outcomes). Secondary outcomes were depressive symptoms, sleep quality, heat pain threshold (HPT), heat pain tolerance (HPTo), and serum brain-derived-neurotrophic-factor (BDNF). Forty-eight women with fibromyalgia, 30-65 years-old were randomized into 2:1 groups [a-tDCS (n=32) or s-tDCS (n=16)]. Post hoc analysis revealed that a-tDCS reduced the PCS total scores by 51.38% compared to 26.96% in s-tDCS, and a-tDCS reduced PCP:S total scores by 31.43% compared to 19.15% in s-tDCS. The a-tDCS improved depressive symptoms, sleep quality and increased the HPTo. The delta-value in the serum BDNF (mean post treatment end minus pre-treatment) was conversely correlated with the a-tDCS effect in pain catastrophizing. In contrast, the a-tDCS impact on reducing the DRP at the treatment end was positively associated with a reduction in the serum BDNF and improvement of depressive symptoms, sleep quality and pain catastrophizing symptoms. PERSPECTIVE: Home-based bifrontal tDCS with a-tDCS on the l-DLPFC are associated with a moderate effect size (ES) in the following outcomes: (i) Decreased rumination and magnification of pain catastrophizing. (ii) Improved the disability for daily activities due to fibromyalgia symptoms. Overall, these findings support the feasibility of self-applied home-based tDCS on DLPFC to improve fibromyalgia symptoms.
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Affiliation(s)
- Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil; Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Boston, MA, USA; Pain and Palliative Care Service at HCPA, Brazil; Department of Surgery, School of Medicine, UFRGS, Brazil.
| | - Rael Lopes Alves
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
| | - Paul Vicuña
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
| | - Camila Fernanda da Silveira Alves
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
| | - Leticia Ramalho
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
| | | | | | | | - Felipe Fregni
- Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Boston, MA, USA; School of Medicine, UFRGS; Laboratorio de Farmacologia da Dor e Neuromodulação: Investigacoes Pre-clinicas, Centro de Pesquisa Experimental (CPE), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
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The Relationship Between Changes in Movement and Activity Limitation or Pain in People With Knee Osteoarthritis: A Systematic Review. J Orthop Sports Phys Ther 2021; 51:492-502. [PMID: 34592828 DOI: 10.2519/jospt.2021.10418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To report whether changes in knee joint movement parameters recorded during functional activities relate to change in activity limitation or pain after an exercise intervention in people with knee osteoarthritis (OA). DESIGN Etiology systematic review. LITERATURE SEARCH Four databases (MEDLINE, Embase, CINAHL, and AMED) were searched up to January 22, 2021. STUDY SELECTION CRITERIA Randomized controlled trials or cohort studies of exercise interventions for people with knee OA that assessed change in knee joint movement parameters (moments, kinematics, or muscle activity) and clinical outcomes (activity limitation or pain). DATA SYNTHESIS A descriptive synthesis of functional activities, movement parameters, and clinical outcomes. RESULTS From 3182 articles, 22 studies met the inclusion criteria, and almost all were of low quality. Gait was the only investigated functional activity. After exercise, gait parameters changed 26% of the time, and clinical outcomes improved 90% of the time. A relationship between group-level changes in gait parameters and clinical outcomes occurred 24.5% of the time. Two studies directly investigated an individual-level relationship, reporting only 1 significant association out of 8 correlations tested. CONCLUSION Most studies reported no change in gait-related movement parameters despite improvement in clinical outcomes, challenging the belief that changing movement parameters is always clinically important in people with knee OA. J Orthop Sports Phys Ther 2021;51(10):492-502. doi:10.2519/jospt.2021.10418.
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