Yavuz Yakut

Validation of the Turkish Version of the Oswestry Disability Index for Patients With Low Back Pain

Study Design. Validation of a translated, culturally adapted questionnaire. Objectives. To translate and culturally adapt the Turkish version of the Oswestry Disability Index (ODI) (2.0), and to validate its use for assessing disability in Turkish patients with low back pain. Summary of Background Data. The ODI is a reliable evaluation instrument for disability, but no validated Turkish version is available. Methods. A total of 95 outpatients with low back pain were assessed by the ODI. Sixty-five of these patients were observed on a second occasion. Translation/retranslation of the English version of the ODI was done blindly and independently by four different individuals, and adapted by a team. Individuals were given the ODI and other scales (Visual Analog Scale, Schober Test, and the Roland-Morris Disability Questionnaire) on their first visit and a week later. Results. Scores of the two ODIs were 27.10 (SD 16.22) on day 1 and 22.88 (SD 13.94) on day 7, with an intraclass correlation coefficient of r = 0.938 (P < 0.001). Cronbach’s alpha was 0.918 (day 1) and 0.895 (day 7) in the validation. Concurrent validity, measured by comparing ODI responses with the results of Visual Analog Scale and Schober test, was r = 0.367 (P < 0.01), r = −0.068 (P = 0.591) for day 1, and r = 0.392 (P < 0.01), r = −0.041 (P = 0.745) for day 7, respectively. Construct validity, tested by determining the correlation between the Turkish ODI and the Turkish adaptation of the Roland-Morris Disability Questionnaire, yielded r = 0.815 (P < 0.001) on day 1 and r = 0.708 (P < 0.001) on day 7. Conclusion. The Turkish version of ODI has good comprehensibility, internal consistency, and validity and is an adequate and useful instrument for the assessment of disability in patients with low back pain.

Reliability and validity of the Turkish version short-form McGill pain questionnaire in patients with rheumatoid arthritis

The translation of existing pain measurement scales is considered important in producing internationally comparable measures for evidence based practice. In measuring the pain experience, the short-form of McGill’s pain questionnaire (SF-MPQ) is one of the most widely used and translated instruments. The purpose of this study was to examine whether the Turkish version of the SF-MPQ is a valid and reliable tool to assess pain and to be used as a clinical and research instrument. Translation retranslation of the English version of the SF-MPQ was done blindly and independently by four individuals and adapted by a team. Eighty-nine rheumatological patients awaiting control by a rheumatologist were assessed by the Turkish version of the SF-MPQ in the morning and in the afternoon of the same day. Internal consistency was found adequate at both assessments with Cronbach’s alpha 0.705 for test and 0.713 for retest. For reliability of the total, sensory, affective, and evaluative total pain intensity, high intraclass correlations were demonstrated (0.891, 0.868, 0.716, and 0.796, respectively). Correlation of total, sensory and affective score with the numeric rating scale was tested for construct validity demonstrating r = 0.637 (p < 0.001) for test and r = 0.700 (p < 0.001) for retest. Correlation with erythrocycte sedimentation rates for concurrent validity was found to be r = 0.518 (p < 0.001) for test and r = 0.497 (p < 0.001) for retest. The results of this study indicate that the Turkish version of the SF-MPQ is a reliable and valid instrument for the measurement of pain in Turkish speaking patients with rheumatoid arthritis.

The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study.

Objectives. The aim of this study was to conduct the cross-cultural adaptation of Neck Disability Index (NDI) and investigate the validity and reliability of Turkish version in patients with neck pain. Summary of Background Data. The NDI is a reliable evaluation instrument for disability but there are no published Turkish version. Methods. Eighty-eight patients with neck pain for at least 3 months were included in the study. NDI, The Neck Pain and Disability Scale and Visual Analogue Scale (VAS) were completed by all subjects. Test-retest reliability was determined by using intraclass correlation coefficient and Pearson’s correlation analysis. For the determination of concurrent validity, the relation between NDI and VAS was examined by Pearson’s correlation analysis and for the determination of construct validity, the relation between NDI and Neck Pain and Disability Scale was investigated. Results. Intraclass correlation coefficient score for test-retest reliability was 0.979 (95%, confidence interval = 0.968–0.986). For concurrent validity, the relation between NDI and VAS was investigated, the r value for test and retest was 0.508 and 0.620, respectively (P < 0.0001). For construct validity, the relation between NDI and the Turkish version of NPDA was investigated, the r value for test and retest was 0.659 (P < 0.0001) and 0.728 (P < 0.0001), respectively. Conclusion. The Turkish version of NDI was found to be a valid and reliable method of measurement for evaluating disability, caused by problems of the neck region as it is easy to comprehend by the patients and the time needed to apply is short in clinics.

Reliability and validity of the Functional Rating Index in older people with low back pain: preliminary report.

Background and aims: The Functional Rating Index (FRI) was developed to provide an assessment instrument which has not only clinical usefulness but also quantifies the patient’s current state of pain and dysfunction in a reliable and valid manner for spinal conditions. There is no study on the FRI applied to older people with low back pain (LBP). The primary aim of this study was to evaluate the validity and reliability of the FRI in older people with LBP. Methods: A total of 76 subjects aged 65 to 90 years with LBP, of which 37 were cognitively intact and were followed up on a second occasion, were assessed by the FRI, numeric rating scale (NRS), Roland Morris Questionnaire (RMQ) and spinal movement test. Reliability was assessed by statistical analysis of test results for test-retest and internal consistency. To assess construct validity, the FRI was compared with the RMQ. Concurrent validity was assessed using the NRS and spinal mobility test. Results: The FRI demonstrated high internal consistency, with al-pha=0.921 for test and alpha=0.901 for retest. Item-scale correlations were between 0.549–0.871. Test-retest correlation was 0.913 (p=0.000). There was very good construct validity between the FRI and the RMQ for test (r=0.663, p<0.000) and retest (r=0.603, p<0.000). The FRI showed high correlation with the NRS (r=0.701, p<0.000 for test; r=0.743, p<0.000 for retest) and no correlation with the spinal movement test (r=0.173, p=0.307 for test; r=0.024, p=0.888 for retest). Conclusions: In this preliminary report, the FRI appears to be easy to administer, seems to have significant validity and reliability, and may be useful in geriatric assessment of older people with LBP.

Core stabilisation reduces compensatory movement patterns in patients with injury to the arm: a randomized controlled trial

Objective: To investigate the effects of adding core stabilisation exercises to traditional rehabilitation in patients with arm injuries. Design: Randomized controlled trial. Setting: Outpatient clinic. Subjects: Twenty-seven patients with elbow and wrist injuries were randomized to a stabilisation or control group. Interventions: The stabilisation group received core stabilisation training and traditional arm rehabilitation and the control group received traditional arm rehabilitation alone for three days/week for six weeks. Main measures: Pre- and post-treatment assessments comprising an analysis of compensatory movement patterns and trunk muscle strength as well as functional measurements of the arm, including pain, range of motion, disabilities of arm, shoulder and hand questionnaire and endurance and fatigue severity were performed. Results: Inter-group comparison revealed significantly greater improvements in the degree of mean change (SD) in total compensation (in degrees) of the head (–14.47 (21.65)) and trunk (–5.56 (5.71)) as well as total compensation (–50.02 (48.62)) for the stabilisation group than for the control group (p < 0.05). Increase in trunk muscle strength (2.43 (3.46)) was statistically significant in the stabilisation group compared with the control group. No significant differences were found for functional measures, including pain, range of motion, disabilities of arm, shoulder and hand or endurance and fatigue severity between the groups, although trends towards greater improvement were observed in the stabilisation group. Conclusions: Adding core stabilisation exercises to traditional arm rehabilitation for patients with traumatic arm injury reduces compensatory movement patterns. Trends towards better functional outcomes in the stabilisation group are worth testing in a large-scale trial.

Effects of active/passive interventions on pain, anxiety, and quality of life in women with fibromyalgia: Randomized controlled pilot trial

ABSTRACT The authors of this study compared the effects of pilates exercises and connective tissue massage (CTM) on pain intensity; pain-pressure threshold; and tolerance, anxiety, progress, and health-related quality of life in females with fibromyalgia. It was a pilot, assessor masked, randomized controlled trial conducted between January and August of 2013. Twenty-one women with fibromyalgia were randomly assigned to the pilates exercise program (six of whom did not complete the program), and 22 were randomly assigned to CTM (one of whom did not complete this program). Each group received the assigned intervention three times per week during a 4-week period. The Visual Analogue Scale, algometry, State-Trait Anxiety Inventory, Fibromyalgia Impact Questionnaire, and Nottingham Health Profile were used at baseline and at the end of treatments. Significant improvements were found in both groups for all parameters. However, the scores for pain-pressure threshold were significantly elevated and the symptoms of anxiety were significantly diminished in the exercise group compared to the massage group. Thus, exercise and massage might be used to provide improvements in women with fibromyalgia. The exercise group showed more advantages than the massage group and thus might be preferred for patients with fibromyalgia. However, an adequately powered trial is required to determine this with certainty.

Home-based general versus center-based selective rehabilitation in patients with posterior tibial tendon dysfunction

OBJECTIVE The aim of this study was to compare the effect of home-based and supervised center-based selective rehabilitation in patients with Grade 1 to 3 posterior tibial tendon dysfunction (PTTD). METHODS The study included 49 subjects diagnosed with PTTD and referred to physiotherapy by an orthopedic surgeon. Subjects were randomly assigned into a home-based rehabilitation (21 cases; mean age: 33.56 ± 17.59) group or center-based rehabilitation (28 cases; mean age: 28.57 ± 14.74 years). The patients in the home-based rehabilitation group followed a home program of cold application, strengthening exercises for the posterior tibial and intrinsic muscles, and stretching in the subtalar neutral position. The patients in the center-based rehabilitation group followed a selective, supervised treatment consisting of the home protocol plus re-education of the non-functional tibialis posterior, proprioceptive neuromuscular facilitation methods, electrical stimulation, joint mobilization and taping techniques. Both groups received appropriate orthotics. All subjects were assessed before and after treatment for pain, muscle strength, foot function index (FFI) scores and specific tests for PTTD. RESULTS Statistical analysis showed significant differences between pre- and post-treatment results for pain, first metatarsophalangeal angle, forefoot abduction angle, FFI scores and foot and ankle muscle strengths in the center-based group and for the tibialis posterior muscle strength in the home-based group (p<0.05). Intergroup comparison, however, showed no differences between the groups at the end of the treatment program with the exception of posterior tibial muscle strength (p<0.05). CONCLUSION Home- and center-based forms of rehabilitation seem to be equally effective in relieving pain and improving functional outcome in patients with Grade 1 to 3 PTTD. A patient-selective, supervised program may provide a better improvement in tibialis posterior strength than home-based rehabilitation.

Perception of risk of HIV and sexual risk behaviours among students in the United States, Turkey and South Africa

The aim of this study was to examine HIV sexual risk behaviours and perception of HIV risk among 1 095 students from the United States of America (US), Turkey and South Africa. Randomly selected students who were enrolled in general education courses completed a structured questionnaire. Results revealed statistically significant differences in specific HIV-related sexual behaviours among students from the three countries and among male and female students in each country. A higher percentage of US and South African students engage in HIV risky sexual behaviours compared with their Turkish counterparts, and a higher percentage of female students in the US and South Africa engage in HIV sexual risk behaviours compared with their male colleagues. A higher proportion of Turkish male students engaged in sexual risk behaviours compared with their female counterparts. The perception of HIV risk was low among US and Turkish students, and high among South African students. There was no agreement between engaging in risky sexual behaviour and self-perception of HIV risk among South African female students, while agreement was poor for US male and female students, Turkish male and female students, and South African male students. The observed optimistic bias needs to be considered in the design and implementation of HIV prevention programmes for these populations.

Reliability and validity of reverse visual analog scale (right to left) in different intensity of pain

AbstractThe objective of the study was to assess the reliability and validity of the reverse visual analog scale (RVAS—right to left) in the measurement of pain. Design: Three measurements (visual analog scale (left to right)—VAS, RVAS and numeric rating scale—NRS) were used for severe and mild pain intensity with a one hour interval. Subjects: Fifty-one normal volunteers were included in the study. Methods: Pain threshold and pain tolerance were obtained by pressure algometry over the trigger point of the trapezius muscle. From these scores, severe and mild pain perceptions of each subject were calculated. Pressure algometry was applied with a one hour interval. The subjects were asked to rate pain intensity by placing a mark on a VAS, RVAS and NRS in each session. Results: The construct validity showed that there was a high correlation between VAS, RVAS and NRS (which ranged from r = 0.767 to r = 0.943, p = 0.000). The test-retest reliability of RVAS in severe pain was higher than that of VAS (ICC = 0.7...

Comparison of pain, kinesiophobia and quality of life in patients with low back and neck pain.

[Purpose] The purpose of this study was to compare patients with low back and neck pain with respect to kinesiophobia, pain, and quality of life. [Subjects and Methods] Three-hundred patients with low back (mean age 43.2±11 years) and 300 with neck pain (mean age 42.8±10.2 years) were included in this study. Pain severity was evaluated by using the Short-Form McGill Pain Questionnaire, which includes a Visual Analogue Scale, quality of life by the Nottingham Health Profile, and kinesiophobia by the Tampa Scale for Kinesiophobia. [Results] Pain severity was similar in both groups, with a Visual Analogue Scale score of 6.7±2 in the low back pain and 6.8±2 in the neck pain group. Nottingham Health Profile pain [z=−4.132] and physical activity scores [z=−5.640] in the low back pain group were significantly higher. Kinesiophobia was also more severe in the low back pain group, with a mean 42.05±5.91 versus 39.7±6.0 Tampa Scale for Kinesiophobia score [z=−4.732]. [Conclusion] Patients with low back pain developed more severe kinesiophobia, regardless of the pain severity, and had greater pain perception and lower physical activity levels. Kinesiophobia adversely affects the quality of life and requires effective management of low back pain.