Eda Tonga

Cross-cultural adaptation, reliability and validity of the Turkish version of the spine functional index

BackgroundThe Spine Functional Index (SFI) is a patient reported outcome measure with sound clinimetric properties and clinical viability for the determination of whole-spine impairment. To date, no validated Turkish version is available. The purpose of this study is to cross-culturally adapted the SFI for Turkish-speaking patients (SFI-Tk) and determine the psychometric properties of reliability, validity and factor structure in a Turkish population with spine musculoskeletal disorders.MethodsThe SFI English version was culturally adapted and translated into Turkish using a double forward and backward method according to established guidelines. Patients (n = 285, cervical = l29, lumbar = 151, cervical and lumbar region = 5, 73% female, age 45 ± 1) with spine musculoskeletal disorders completed the SFI-Tk at baseline and after a seven day period for test-retest reliability. For criterion validity the Turkish version of the Functional Rating Index (FRI) was used plus the Neck Disability Index (NDI) for cervical patients and the Oswestry Disability Index (ODI) for back patients. Additional psychometric properties were determined for internal consistency (Chronbach’s α), criterion validity and factor structure.ResultsThere was a high degree of internal consistency (α = 0.85, item range 0.80-0.88) and test-retest reliability (r = 0.93, item range = 0.75-0.95). The factor analysis demonstrated a one-factor solution explaining 24.2% of total variance. Criterion validity with the ODI was high (r = 0.71, p < 0.001) while the FRI and NDI were fair (r = 0.52 and r = 0.58, respectively). The SFI-Tk showed no missing responses with the ‘half-mark’ option used in 11.75% of total responses by 77.9% of participants. Measurement error from SEM and MDC90 were respectively 2.96% and 7.12%.ConclusionsThe SFI-Tk demonstrated a one-factor solution and is a reliable and valid instrument. The SFI-Tk consists of simple and easily understood wording and may be used to assess spine region musculoskeletal disorders in Turkish speaking patients.

Cross-cultural adaptation, reliability and validity of the Turkish version of the Lower Limb Functional Index

Abstract Purpose: This study aims to adapt culturally a Turkish version of the Lower Limb Functional Index (LLFI) and to determine its validity, reliability, internal consistency, measurement sensitivity and factor structure in lower limb problems. Method: The LLFI was translated into Turkish and cross-culturally adapted with a double forward–backward protocol that determined face and content validity. Individuals (n = 120) with lower limb musculoskeletal disorders completed the LLFI and Short Form-36 questionnaires and the Timed Up and Go physical test. The psychometric properties were evaluated for the all participants from patient-reported outcome measures made at baseline and repeated at day 3 to determine criterion between scores (Pearson’s r), internal consistency (Cronbachs α) and test–retest reliability (intraclass correlation coefficient – ICC2.1). Error was determined using standard error of the measurement (SEM) and minimal detectable change at the 90% level (MDC90), while factor structure was determined using exploratory factor analysis with maximum likelihood extraction and Varimax rotation. Results: The psychometric characteristics showed strong criterion validity (r = 0.74–0.76), high internal consistency (α = 0.82) and high test–retest reability (ICC2.1 = 0.97). The SEM of 3.2% gave an MDC90 = 5.8%. The factor structure was uni-dimensional. Conclusions: Turkish version of LLFI was found to be valid and reliable for the measurement of lower limb function in a Turkish population. Implications for Rehabilitation Lower extremity musculoskeletal disorders are common and greatly impact activities among the affected individuals pertaining to daily living, work, leisure and quality of life. Patient-reported outcome (PRO) measures have advantages as they are practical, cost-effective and clinically convenient for use in patient-centered care. The Lower Limb Functional Index is a recently validated PRO measure shown to have strong clinimetric properties.

Activity performance problems of patients with cardiac diseases and their impact on quality of life.

[Purpose] To describe the functional consequences of patients with cardiac diseases and analyze associations between activity limitations and quality of life. [Subjects and Methods] Seventy subjects (mean age: 60.1±12.0 years) were being treated by Physical Medicine and Rehabilitation and Cardiology Departments were included in the study. Activity limitations and participation restrictions as perceived by the individual were measured by the Canadian Occupational Performance Measure (COPM). The Nottingham Extended Activities of Daily Living (NEADL) Scale was used to describe limitations in daily living activities. To detect the impact of activity limitations on quality of life the Nottingham Health Profile (NHP) was used. [Results] The subjects described 46 different types of problematic activities. The five most identified problems were walking (45.7%), climbing up the stairs (41.4%), bathing (30%), dressing (28.6%) and outings (27.1%). The associations between COPM performance score with all subgroups of NEADL and NHP; total, energy, physical abilities subgroups, were statistically significant. [Conclusion] Our results showed that patients with cardiac diseases reported problems with a wide range of activities, and that also quality of life may be affected by activities of daily living. COPM can be provided as a patient-focused outcome measure, and it may be a useful tool for identifying those problems.

Effects of two different quadriceps strengthening exercise approaches on cardiovascular fitness in healthy female subjects: a single blind randomized study.

OBJECTIVE There are limited number of documents showing the relations between cardiovascular fitness and muscle strength. This study aimed to determine the effects of two different quadriceps strengthening exercise approaches on cardiovascular fitness in healthy female subjects. METHODS Forty female university students participated in this study on a voluntary basis. The participants were randomly assigned to do either isokinetic exercise (IE) or progressive resistive exercise (PRE) in two different groups. Both training schemes were performed three times a week for a period of two weeks. The subjects were given a maximum symptom limited exercise test on a treadmill before and after (each) training period. RESULTS Total exercise duration increased and Borg scale level decreased significantly after training in the two groups (p < 0.05). Maximal systolic blood pressure, recovery heart rate, and recovery diastolic blood pressure decreased significantly in the IE Group (p < 0.05). Resting and recovery systolic blood pressure decreased significantly in the PRE Group (p < 0.05). Compared to PRE group, improvement for Borg Scale level, recovery heart rate and recovery diastolic blood pressure were more obvious in IE Group (p < 0.05). CONCLUSIONS This study demonstrated that both quadriceps strengthening methods have displayed improvements in cardiovascular fitness. Further research with larger sample groups may need to be carried out.

Effectiveness of Client-Centered Occupational Therapy in Patients With Rheumatoid Arthritis: Exploratory Randomized Controlled Trial

Objectives This study aims to examine the effectiveness of client-centered occupational therapy in patients with rheumatoid arthritis (RA). Patients and methods The study included 40 patients (2 males, 38 females; range 39 to 60 years) with RA. Patients were divided into two groups as intervention group (n=20) and control group (n=20) by random sampling method. Each group was given 10 sessions of physical therapy program. In addition, the intervention group received client-centered occupational therapy. Patients were evaluated with Turkish versions of Short-Form McGill Pain Questionnaire, Health Assessment Questionnaire, The Arthritis Impact Measurement Scales 2, RA Quality of Life Questionnaire, and Canadian Occupational Performance Measurement. Results Pain, activity limitation, and participation restriction scores decreased significantly more in the intervention group compared to the control group. Also, quality of life increased significantly in the intervention group (p<0.05). Conclusion Our findings suggest that occupational therapy intervention reduces activity limitation and participation restrictions in patients with RA. Therefore, such interventions may be generalized for this patient group.

[The relationship between scapular dyskinesia, pain, range of motion, and flexibility in patients with neck and shoulder problems].

OBJECTIVES To investigate the relationship between scapular dyskinesia, pain, and flexibility in patients with neck, shoulder, or both injuries. METHODS A total of 160 patients who came to Baskent University Hospital, Department of Physical Medicine and Rehabilitation with pathology and pain in the neck and shoulder regions were included to our study. Patients were divided into three groups; Neck group, shoulder group and neck+shoulder group. Visual Analog Scale (VAS) for pain intensity, goniometer for range of motion, and tape measurement for evaluation of flexibility was used. Lateral Scapular Slide Test (LSST) and Scapular Retraction Test (SRT) vs Skapular Assisstance Test (SAT) were used for evaluation of scapular dyskinesia. RESULTS SRT (r=0.617, p=0.000) and SAT (r=0.565, p=0.000) positivity was found to be correlated with dominant and non-dominant sides in patients with neck pathology. Pain at night and during rest were found to correlate with pain during activity in patients with neck+shoulder pathology (r=0.572, p=0.002). No significant correlation was found between pain intensity and scapular dyskinesia in all groups. LSST values were found under 1.5 cm and therefore, scapular mobilization was considered as normal (LSST1=0.76±0.74; LSST2=0.68±0.81; LSST3=0.75±0.75). CONCLUSION In addition to joint limitations and flexibility, scapular dyskinesia should also be evaluated in order to solve problems related to pain in patients with neck, shoulder and neck+shoulder pathology. In future studies, the classification of groups according to pathology may help to understand the impact of scapular dyskinesia on the pathology of shoulder and neck pain.

AB1168-HPR Physical Inacivity in Adults with Rheumatic Diseases

Background Physical inactivity is a frequent complication of rheumatic diseases, and also common in the general population. However, there is surprisingly little research available comparing daily life physical activity between patients with rheumatic diseases and healthy controls.The new studies recommend that healthcare professionals encourage people with rheumatic conditions to participate in regular physical activity to improve aerobic fitness and increase the quality of life. The first step in this issue that determine the level of physical activity in people with rheumatic disease. Objectives The aim of this study was to evaluate levels of physical activity of patients with rheumatoid arthritis, osteoarthritis and fibromyalgia and to compare the results with healthy subjects and each other. Methods Our study was carried out on 50 rheumatoid arthritis patients (age: 51,98±9,50), 95 osteoarthritis patients (Age: 52, 98±6,83) and 82 fibromyalgia patients (Age: 53,62±7,12) who have been diagnosed in Baskent University Hospital Rheumatology department and 110 healthy subjects (Age: 51,7±8,37). The International Physical Activity Questionnaire (IPAQ) was used to determine the level of physical activity. All sub parameters score (walking, moderate intensity PA, vigorous intensity PA, total PA) in IPAQ were calculated. All datas were compared between rheumatic diseases (rheumatoid arthritis, osteoarthritis, fibromyalgia) and healthy controls, and each other. Results Age, body mass index, disease duration, education levels of patients were similar. There were significant differences in walking and total physical activity scores in IPAQ between the rheumatoid arthritis, osteoarthritis, fibromyalgia patients and the control group (p<0.05). 36.6% of the fibromyalgia group, 28.4% of the osteoarthritis group, 38% of the rheumatoid arthritis group and 22.7% of healthy subjects were found to be inactive. 45.1% of the fibromyalgia group, 42.1% of the osteoarthritis group, 46% of the rheumatoid arthritis group and 36.4% of healthy subjects were found to be insufficiently active. Conclusions As a result, when compared to healthy people, physical activity levels were significantly decreased in patients with rheumatoid arthritis, osteoarthritis, fibromyalgia. The decrease of physical activity levels were more clear in patients with rheumatoid arthritis than in patients with osteoarthritis and fibromyalgia. In cases of rheumatic diseases, exercise and daily physical activity programs must be included in physiotherapy and rehabilitation treatment approaches. References Manning V, Hurley M, Scott D, Bearne L. Physıcal Inactıvıty In Adults Wıth Rheumatıc Condıtıons.British Health Professionals Rheumatology. 2011. Abstract. De Groot, IB., Bussmann, JB., Stam, HJ., Verhaar, JA. (2008). Actual everyday physical activity in patients with end-stage hip or knee osteoarthrit is compared with healthy controls. Osteoarthritis Cartilage. 16(4): 436e42. Raftery, G., Bridges, M., Heslop, P., Walker, DJ. (2009). Are fibromyalgia patients as inact ive as they say they are? Clin Rheumatol. 28(6): 711-4. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4551

AB0840-HPR Physical activity level and physical fitness in patients with rheumatoid arthritis

Background Physical activity is decreased in patients with rheumatoid arthritis as a consequence of joint pain, restricted mobility, fatigue, reduced muscle mass, strength and endurance. However, there is surprisingly little research available comparing daily life physical activity between patients with RA and healthy controls. The new studies recommend that healthcare professionals encourage people with rheumatic conditions to participate in regular physical activity to improve aerobic fitness and increase the quality of life. The first step in this issue that determine the level of physical activity in people with rheumatic disease. Objectives The aim of this study was to evaluate levels of physical activity and physical fitness of patients with rheumatoid arthritis and to compare the results with healthy controls. Methods Our study has been carried out in Baskent University Hospitals, Department of Physical Medicine and Rehabilitation outpatient clinics, on 31rheumatoid arthritis patient (Age:50,35±7,80), 31 healthy people (Age:51,03±7,61). Participants completed the long format International Physical Activity Questionnaire (IPAQ). The pain severity was assessed by McGill pain questionnaire. Measurement of body composition(BMİ), muscle endurance (sit up test ), Cardio Respiratory Endurance(6-minute walk test), flexibility(sit and reach test-body lateral flexion ) and balance (KAT 3000 ) were evaluated for to determine the health related physical fitness of cases. Results There were significant differences in health related physical fitness in testing, sit-up tests (r=-2,927 p= 0,003); 6-minute walk test ( symptoms (r=-2,531 p= 0,011) and Borg scale score (r=-3,167 p= 0,002)) and static balance scores (r=-2,365 p=0,18) dynamic balance scores(-1,844) between two groups (p<0.05). There were significant differences in IPAQ scores between two groups (p<0.05). There is a negative correlation between IPAQ moderate intensity physicalactivity score with McGill affective score (r=-431 p=0,16).%29of patientswith rheumatoid were inactive,(%51.6) insufficiently active,(%19,4) active.%51,6 of healthy people is active,% 41,9 insufficiently active,% 6,5 active. Conclusions As a result, when compared to healthy people, physical activity and physical fitness levels were decreased in Patients with rheumatoid arthritis. Exerciseprograms may be recommended to improve patients’ physical activity and physical fitness levels and to prevent the risks associated withphysical inactivity. References Mancuso CA, Rincon M, Sayles W, Paget SA. Comparison of energy expenditure from lifestyle physical activities between patients with rheumatoid arthritis and healthy controls. Arthritis Rheum 2007;57 (4):672–8. Manning V, Hurley M, Scott D, Bearne L. Physical Inactivity In Adults With Rheumatic Condıtıons. British Health Professionals Rheumatology.2011 Jarma, J., Seppo, I., Iikka, M., Matti, E. (2002) A Health- Related Fitness and Functional Performance Test Battery for Middle- Aged and Older Adults: Feasibility and Health-Related Content Validity. Arch Phys Med Rehabil. 83: 666- 677 Disclosure of Interest None Declared