Translation, Cross-Cultural Adaptation, Reliability, and Validity of the Tamil Version of Fear-Avoidance Beliefs Questionnaire in Chronic Low Back Pain

Background: Excessive fear of movement, restricted physical activity, and cognitive distortions are frequently found with chronic low back pain (CLBP) subjects. The Fear-Avoidance Beliefs Questionnaire (FABQ) is the most well-founded and often used tool to measure fear and avoidance beliefs in CLBP subjects. In India, there is a diversity of culture, educational level, and language. So, there is a need to translate FABQ into the regional language Tamil, which will improve understanding of FABQ and reduce the language barrier of the Tamil population. Objective: To translate, cross-cultural adapt, and investigate the psychometric properties of the Tamil version of FABQ in CLBP subjects. Materials & Methods: The standard translation and adaptation guideline was used to translate FABQ into Tamil version FABQ. CLBP subjects referred to a low back rehabilitation program in an outpatient clinic took part in this study. They completed a FABQ-Tamil questionnaire [includes subscales for Physical Activity (FABQ-PA) and Work (FABQ-W)], pain rating visual analog scale and the Roland- Morris Disability Questionnaire (RMDQ)-Tamil version, on two occasions five days apart. Test-retest reliability, internal consistency and validity were evaluated. Results: Fifty CLBP subjects participated with a mean age of 39.94 (± 15.55) years. Convergent validity analysis displayed a moderate correlation between FABQ-PA and VAS (r = 0.63); FABQ-W and VAS (r = 0.64). Divergent validity analysis demonstrated a moderate correlation between FABQ-PA and RMDQ (r = 0.69) and a good correlation between FABQ-W and RMDQ (r = 0.85). The test-retest reliability was high; the intra-class correlation coefficients of FABQ-PA and FABQ-W were ICC-0.90 and 0.94, respectively. Cronbach\u27s alpha for the FABQ-PA and FABQ-W were 0.87 and 0.92, demonstrating high internal consistency. Conclusion: The findings of this study demonstrated that the FABQ-Tamil version questionnaire is a reliable and valid measure of fear of pain and fear-avoidance beliefs in the Tamil-speaking CLBP subject

Effects of positional coracohumeral ligament stretching on the size of calcium deposits in adhesive capsulitis

Adhesive capsulitis is a painful condition of unknown etiology with restriction of active and passive movements of the glenohumeral joint. The condition is a result of inflammation, adherence, and swelling in the lining of the shoulder joint capsule and its associated ligaments, causing resultant contracture of the capsule. We describe a patient with calcified and thickened coracohumeral ligament with adhesive capsulitis and diabetes mellitus

EFFECTIVENESS OF ISCHEMIC COMPRESSION ON TRAPEZIUS MYOFASCIAL TRIGGER POINTS IN NECK PAIN

Background: Neck pain is a common disorder prevailing among individuals of different populations. The myofascial pain syndrome is a disorder related to myofascial trigger points. It is defined as a hyperirritable locus in skeletal muscle and that is associated with a hypersensitive palpable nodule in a taut band of muscle. Manual therapy has got a profound role in treating and ischemic compression technique has been researched widely. Thus the study intends to analyse the effectiveness of Manual Therapy (Ischemic Compression) on functional outcome in neck pain. Methods: A single blinded randomized control study was conducted for subjects of sample size 30 who met the inclusion criteria and random allocation was made. The baseline parameters as like pain severity using VAS, pain pressure threshold using pressure Algometer, active cervical lateral flexion using 360 degree goniometer and disability using NDI were recorded. Study group received ischemic compression followed by myofascial stretches while the control group received ultrasonic therapy of 1.4watts/cm2. Both received Cryotherapy post session. After 2 weeks the baseline parameters were again recorded for t-test analysis. Result: There was no statistical significance between groups (p≥0.05). But active cervical lateral flexion showed improved mobility in study group and a high statistical significance within groups (p≤0.01) in relation to all parameters. Conclusion: Both ultrasonic therapy and Ischemic compression technique was found to show better improvement in pain pressure threshold and functional outcome in neck pain

EFFECTIVENESS OF ISCHEMIC COMPRESSION ON TRAPEZIUS MYOFASCIAL TRIGGER POINTS IN NECK PAIN

Background: Neck pain is a common disorder prevailing among individuals of different populations. The myofascial pain syndrome is a disorder related to myofascial trigger points. It is defined as a hyperirritable locus in skeletal muscle and that is associated with a hypersensitive palpable nodule in a taut band of muscle. Manual therapy has got a profound role in treating and ischemic compression technique has been researched widely. Thus the study intends to analyse the effectiveness of Manual Therapy (Ischemic Compression) on functional outcome in neck pain. Methods: A single blinded randomized control study was conducted for subjects of sample size 30 who met the inclusion criteria and random allocation was made. The baseline parameters as like pain severity using VAS, pain pressure threshold using pressure Algometer, active cervical lateral flexion using 360 degree goniometer and disability using NDI were recorded. Study group received ischemic compression followed by myofascial stretches while the control group received ultrasonic therapy of 1.4watts/cm2. Both received Cryotherapy post session. After 2 weeks the baseline parameters were again recorded for t-test analysis. Result: There was no statistical significance between groups (p≥0.05). But active cervical lateral flexion showed improved mobility in study group and a high statistical significance within groups (p≤0.01) in relation to all parameters. Conclusion: Both ultrasonic therapy and Ischemic compression technique was found to show better improvement in pain pressure threshold and functional outcome in neck pain. Keywords: Myofascial trigger points, Trapezius muscle, Ischemic compression, Pressure Algometer, cervical lateral flexion and neck disability inde

SONOGRAPHIC EVALUATION OF PLANTAR FASCIA FOLLOWING LOW-LEVEL LASER THERAPY IN PLANTAR FASCIITIS

Background: Plantar fasciitis is the most common cause of inferior heel pain resulted from repeated trauma leading to a microscopic tear in the plantar fascia. There is a need to study the non-invasive nature of low-level laser therapy in reducing pain and enhance healing. Therefore the study aimed to find out the efficacy of low-level laser therapy in plantar fasciitis. Methods: The study design is a pre-post experimental design. Thirty patients(21 females & 9 males) with plantar fasciitis who fulfilled the inclusion criteria participated in the study. Baseline parameters using musculoskeletal ultrasonogram of the plantar fascia, numerical pain rating scale, ankle joint mobility testing and foot and ankle ability measure questionnaire were recorded. Subjects in the control group received ultrasonic therapy, while the experimental group received irradiation of Low-Level Laser Therapy (LLLT) for two weeks comprising 12 sessions and the above-specified outcome measures were re-evaluated after two weeks. Results: The results showed significant improvement in pain severity (p<0.04) and ankle dorsiflexion range of motion (p<0.00) and ankle ability measure but no significant change in plantar fascia thickness following low-level laser therapy was observed. A positive correlation (r=0.9) was found between plantar fascia thickness and post foot and ankle ability measure-ADL scores (p=0.02). Conclusion: The findings suggest that low-level laser therapy helps in pain reduction and improving range of motion in plantar fasciitis with minimal effect on the thickness of plantar fascia

Cross-cultural adaption, reliability and validity of an Indian (Tamil) version for the Shoulder Pain and Disability Index

AbstractThe objective of the study was to cross-culturally adapt the Shoulder Pain and Disability Index (SPADI) into a regional Indian language (Tamil) and to test the reliability and linguistic validity of the index in Tamil-speaking Indian participants. Cross-cultural adaptation and psychometric testing of SPADI was undertaken at the Outpatient Physiotherapy Department of the Sri Ramachandra University Hospital in Chennai, India. The Test-retest reliability was quantified using the interclass correlation coefficient (ICC) and Cronbach alpha was calculated to assess internal consistency of the Tamil questionnaire. The construct validity was assessed using Spearman rank correlation coefficients. The reliability of the total Tamil SPADI and its subsets (Intraclass correlation coefficient >0.90) were found to be higher than that of the English SPADI and the German SPADI in this population. The internal consistency of the Tamil SPADI (Cronbach's alpha >0.95) was slightly higher than the English and the German versions. Thus, the cross-culturally adapted version of the English SPADI into a regional Indian language (Tamil) is easy to use and is a reliable and valid measure of shoulder pain and disability in the Tamil speaking population