Reliability and Validity of the Turkish Version of the Oxford Participation and Activities Questionnaire in Older People

Background

Activities and participation play important roles in the maintenance of healthy aging. The maintenance of these factors optimizes social life to increase the quality of life with aging. However, there is a lack of questionnaires in Turkish to evaluate activity and participation among older people. This study translated and cross-culturally adapted the Oxford Participation and Activities Questionnaire (Ox-PAQ) into Turkish and investigated its psychometric properties in the older adult population.

Methods

The Turkish version of the Ox-PAQ was produced after a translation and back-translation process. The Ox-PAQ was administered to 230 and 60 individuals for construct validity and reliability analyses, respectively. To assess the test-retest reliability of the Turkish Ox-PAQ, the questionnaire was reapplied 7 days after the first interview. Cronbach’s alpha (α) was used to evaluate the internal consistency. The Ox-PAQ was compared to the Short Form-12 and the Katz Index of Independence in Activities of Daily Living Scale to determine its validity.

Results

The Turkish Ox-PAQ showed excellent internal consistency (α=0.98) and test-retest reliability (intraclass correlation coefficient=0.98, 0.96, and 0.97 for the subscales of routine activity level, social engagement, and emotional well-being, respectively). In the validity analysis, factor analysis demonstrated a probable structure of the three factors that together explained 66.35% of the total variance. The Turkish Ox-PAQ was correlated with the other comparison measures used in this study.

Conclusion

The Turkish Ox-PAQ is a reliable and valid questionnaire to evaluate the participation and activity levels of older people (Clinical Trial Number: NCT04368754).

THU0621-HPR SARC-F SCALE ON SCREENING SARCOPENIA AND PHYSICAL FUNCTION IN PATIENTS WITH KNEE OSTEOARTRITIS

Background:

Sarcopenia has been defined as a loss of muscle mass and consequently of muscle function. In patients affected by osteoarthritis (OA) a more likely and accelerated development of sarcopenia has been reported. The SARC-F is a simple sarcopenia screening tool includes five assessment items: strength, assistance walking, rising from a chair, climbing stairs, and falls. SARC-F ≥ 4 is defined as sarcopenia.

Objectives:

The present study aimed to examine the utility of SARC-F in the patients with knee osteoarthritis.

Methods:

Patients with radiographic and clinic evidence of tibiofemoral OA (Kellgren-Lawrence score ≥2) were included. Sarcopenia were identified using the SARC-F scale. Patients with a total score 4 and higher than 4 were classified as having sarcopenia. Patients were assessed by The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), four-meter walking test, hand grip test, shortened version of the falls efficacy scale-international (the short FES-I) and EuroQol- 5 Dimension (EQ-5D). A multiple linear regression model was used to identify independent predictors of SARC-F.

Results:

A total 76 patients with median age 61 ranged 55 to 78 years old (72.4% female) were screened in this study (Table 1). Of the sample, 38.1% of patients were sarcopenic as a SARC-F (Figure 1). Through multiple regression analyses, SARC-F scores was significantly associated with four-meter walking test, hand grip, WOMAC-Function, EQ-5D and short FES-I describing between 57% and 63% of the variance (adjusted R2) (Table 2). Also, poor physical performance and grip strength were associated with SARC-F ≥ 4 independently (P<0.005).

Table 1.

Summary Table of Characteristics of sarcopenic vs non-sarcopenic patients with knee OA

MeasuresSarcopenic patients with knee OA (n:47)Sarc-F≥4Non-Sarcopenic patients with knee OA (n:29)Sarc-F<4p valueφAge,mean(SD)62.7(6.9)59.3 (6.9)0.294BMI,mean(SD)27.84 (9.56)28.54 (8.38)0.327WOMAC,mean(SD)43.52 (10.83)28.06 (14.9)0.001*GRADE (K-L) med (min-max)3(2-4)2(2-4)0.008*Hand Grip,mean(SD)20 33 (4.89)28.22 (7.13)0.001*4 m Walking Test, mean(SD)11.88 (4.24)9.55 (4.30)0.001*EQ-5D,mean(SD)9.41 (1.52)7. 13 (1.75)0.001*EQ-5D-VAS,mean(SD)44.31 (14.12)66.90 (16.25)0.001*Short FES-I,mean(SD)18. 06 (9.45)9.04 (5.32)0.001*Number of falls the past year,mean(SD)4.01 (1.24)3.14 (2.74)0.674

φMann Whitney U test; *p< 0.05; BMI, Body mass index; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index EQ-5D, EuroQol-5 Dimension; FES-I, Falls Efficacy Scale-International

Table 2.

Multiple linear regression analysis for SARC-F

βtP value95% Confidence Interval(lower-upper bound)Walking Speed0.111.200.23-0.31/ 0.12Hand Grip-0.35-1.730.04-0.20 / 0.01WOMAC-Function0.262.310.010.00 / 0.05Short FES-I0.181.960.010.04 / 0.01EQ-5D0.222.290.020.02 / 0.39EQ-5D VASR2= 0.61-0.24-2.730.001-0.04 / -0.00

WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index, EQ-5D, EuroQol-5 Dimension; FES-I, Falls Efficacy Scale-International

Figure 1.

Sarcopenic vs non-sarcopenic patients according to sex

Conclusion:

In this study, sarcopenia defined by the SARC-F questionnaire has a predictive value of clinical characteristics of patients to predict sarcopenia parameters and poor physical performance in patients with knee OA.

References:

[1]Papalia, R., Zampogna, B., Torre, G., Lanotte, A., Vasta, S., Albo, E., ... & Denaro, V. (2014). Sarcopenia and its relationship with osteoarthritis: risk factor or direct consequence?.Musculoskeletal surgery,98(1), 9-14.

Disclosure of Interests:

None declared

Balance disorder, falling risks and fear of falling in obese individuals: cross-sectional clinical research in Isparta

OBJECTIVE

To examine the effect of obesity according to gender on balance, posture, the risk of falling and the fear of falling.

METHODS

The cross-sectional study was conducted at the Department of Sports Medicine, Suleyman Demirel University, Isparta, Turkey, from December 2016 to June 2017, and comprised individuals aged 40-60 years who were divided into obese and non-obese groups based on their body mass index values. Demographic data was recorded before collecting target data using Tinetti Falls Efficacy Scale, Activities-Specific Balance Confidence Scale, History of Falls Scale, Single Leg Stance Test, Functional Reach Test and the New York Posture Rating Test. SPSS 20 was used for data analysis.

RESULTS

Of the 251 subjects, 129(51.4%) were females and 122(48.6%) were males. The obese group had 125(49.8%) subjects. There was a significant difference between the history of stumbling in obese males and the history of stumbling and falls in obese females (p<0.05). A high restriction in activity was determined in obese females because of fear of falling (p<0.05). There was impaired posture in all 125(100%) obese individuals and they had all experienced loss of balance. Despite loss of balance and impaired posture in obese males, they did not experience fear of falling and no difference was determined in confidence (p>0.05). Fear of falling was high in obese females and confidence in daily activities was low (p<0.05). Significant negative relationship was found among body mass index, loss of balance and poor posture (p<0.05). No significant relationship was determined in males between obesity and Tinetti Falls Efficacy Scale and Activities-Specific Balance Confidence Scale scores (p>0.05).

CONCLUSIONS

Obesity causes loss of balance and posture. However, despite functional losses in obese males, as there was no fear of falling and a deceptive sense of confidence, this prevented prediction of the risk of falling.

The effect of emotional distress on functional outcomes in acute stroke patients

Objective

To investigate the effect of emotional distress on functional outcomes in acute stroke patients.

Materials and Methods

The study included 91 patients (51 females and 40 males) who were followed up with a diagnosis of acute stroke in the Neurology Department of Suleyman Demirel University Training and Research Hospital. The treatment programs of patients progressed in accordance with the functional level. Demographic data of age, gender, and educational level of the patients were recorded. The outcomes were evaluated with application of the patient distress scale (PDS), the functional ındependence measure (FIM), and the physiotherapy functional mobility profile (PFMP) before starting the rehabilitation program and on discharge from the clinic. The Montebello Rehabilitation Factor Score (MRFS) was used to evaluate the rehabilitation outcomes.

Results

Mean age of the cases was 68.08 ± 12.66 years. The difference points were calculated for the total scores of the result measurements as Δ PDS 3.72 ± 7.18, ΔFIM 8.74 ± 15.15, and Δ PFMP 4.96 ± 8.82. The MRFS effect points were determined as 0.19 ± 0.31, and the MRFS performance points as 0.03 ± 0.07. A statistically significant negative correlation was determined between Δ FIM, ΔPFMP, MRFS effect points, MRFS performance points, and Δ PDS points (P < 0.01).

Conclusion

The results of the study showed that acute stroke patients with a good emotional state had better functional outcomes. It can be concluded that evaluating the emotional state and existing problems while planning of rehabilitation programs will make a positive contribution to both the functional and emotional states of acute stroke patients.

The effect of TENS on pain, function, depression, and analgesic consumption in the early postoperative period with spinal surgery patients

AIM

The aim of our study was to examine the effects of the use of Transcutaneous Electrical Nerve Stimulation (TENS) in patients who had undergone spinal surgery on pain, functionality, depression and consumption of analgesic agents.

MATERIAL AND METHODS

Fifty-Four patients were randomized and placed into two groups, patient-controlled analgesia (PCA) plus TENS and only PCA. To assess the pain levels of the patients, the Visual Analog Scale (VAS) was used. In the assessment of their functional levels, the Timed Up and Go test (TUG) was utilized and in the assessment of their depression, the Beck Depression Inventory (BDI) was used. The measurements were performed before the operation and on the first and second postoperative days. The side effects were recorded from the analgesic agents.

RESULTS

During the first and second days after the operation, a decrease in the pain levels was noticed in the TENS group (p < 0.05. In the TENS group, the consumption of analgesic agents also decreased and thus side effects were less frequent. From the viewpoint of functional and depression levels, no significant difference between the groups was noticed (p > 0.05).

CONCLUSION

TENS was effective in reducing analgesic agent-related side effects and in reducing analgesic consumption. In addition, TENS also decreased activity related pain.

Motor assessment of upper extremity function and its relation with fatigue, cognitive function and quality of life in multiple sclerosis patients

OBJECTIVES

The aim of this study was to assess the motor function of upper extremity and its relation with fatigue, cognitive function and quality of life in Multiple Sclerosis (MS) patients.

DESIGN

Cross-sectional and controlled study.

SETTING

Outpatient clinic in a university hospital.

SUBJECTS

Thirty-one patients with MS (25 women, 6 men; mean age 39.74 +/- 10.10 years; mean EDSS, 2.56 +/- 1.91) and 30 healthy subjects (20 women, 10 men; mean age 33.56 +/- 8.85 years) were enrolled into the study.

MAIN MEASURES

Nine-hole peg test (9-HPT) and Valpar Component Work Sample Test (VCWS-4), Upper Extremity Index (UEI), Paced Auditory Serial Addition Test (PASAT), Fatigue Severity Scale (FSS), and the Multiple Sclerosis Quality of Life-54 (MSQOL-54).

RESULTS

MS patients showed significant impairment in upper extremity motor functions, cognitive function and excessive fatigue compared to controls (p < 0.05). 9-HPT in MS group correlated with EDSS, UEI and MSQOL-54 physical health and cognitive function, whereas VCWS-4 scores (assembly right, assembly left and disassembly) correlated only with EDSS and UEI. No correlation was found between the VCWS-4 and cognitive function and fatigue in both of the groups. Compared to control group, a strong correlation existed between the 9-HPT and VCWS-4 in MS patients (p < 0.05).

CONCLUSION

The results indicate that disability level (EDSS), UEI and cognitive function in MS patients are related with impairment in upper extremity motor function. This again contributes to an impairment in physical domain of quality of life. A strong correlation of the 9-HPT with VCWS-4 supports the use of the 9-HPT as a measure of manual dexterity and gross motor functions.