Are fewer circumference measurements reliable to determine volume measurements in lower limb lymphedema compared to every 4th cm?

Objective: In lymphedema management, lower limb volume is commonly assessed by circumference measurementevery 4th cm which is however time-consuming. The aim of this study is to evaluate the agreement between volumemeasurements derived from circumference measurements every 4th cm (V4) with every 8th cm (V8) and every 12th cm(V12) in patients with lower limb lymphedema (LLL) and to determine the test-retest reliability of these methods.Material-Method: Thirty women with unilateral or bilateral LLL were measured twice, two weeks apart usingcircumference measurements every 4th cm. Inclusion criteria: (i) primary or secondary LLL; (ii) persistent lymphedemafor the past 6 months; (iii) daily treatment with compression stockings. Exclusion criteria: (i) ongoing LE treatment; (ii)comorbidity affecting lower limb volume. Volume was calculated using the truncated cone formulae. Statistics: Intraclasscorrelation coefficient (ICC), Bland-Altman plots with limits of agreement, standard error of measurement (SEM%) and thesmallest real difference (SRD%).Results (preliminary): Overall, there are high agreement between the V4 and the V8 and V12 methods (ICCs 0.99).Also, the test-retest reliability is high for all three methods (ICC 0.99 for V4, V8 and V12, respectively) and the measurementerror low both for a group of subjects (SEM%: 1.2%-1.5%) and a single subject (SRD%: 3.4%-4.1%).Conclusions: The V8 and V12 methods agree sufficiently with the V4 gold standard method. All three methods are reliablewith small measurement errors indicating that real clinical changes can be detected over time. Fewer circumferencemeasurements can therefore be recommended in the management of LL

Sense of Coherence and the association with sociodemographics and disability related factors in persons with late effects of polio

BACKGROUND: Sense of Coherence (SOC) is important for successful adaptation in persons with life-long disabilities. A previous study has shown that persons with Late Effects of Polio (LEoP) have a level of SOC indicating that they generally have the ability to understand, handle and being motivated when dealing with stressful events and problems arising in their lives. However, no study has explored the associations between SOC, sociodemographics and disability related factors in persons with LEoP.OBJECTIVE: To explore the associations between SOC, sociodemographics and disability related factors in persons with LEoP.DESIGN: A cross-sectional design.SETTING: University hospital outpatient clinic.STUDY PARTICIPANTS: Ninety-three persons (mean age 74 years, 52% women) with LEoP.MAIN OUTCOME MEASUREMENTS: Swedish versions of the Sense of Coherence scale (SOC-13), Self-reported Impairments in Persons with late effects of Polio (SIPP) scale, Reintegration to Normal Living Index (RNL-I) (subscales "Daily functioning" and "Perceptions of Self") and Satisfaction With Life Scale (SWLS).METHODS: The participants responded to a postal survey with background information and the four rating scales. To determine factors associated with SOC, a hierarchical regression analysis was performed with SOC as the dependent variable.RESULTS: Higher age, less bothered by symptoms of LEoP, better perceptions of self and higher life satisfaction were significantly associated with a greater SOC score. The final model explained 60% of the variance in the SOC (R2 Adj= 0.60, p<.001).CONCLUSION: The strong association between SOC, higher age and disability related factors is important to consider in the rehabilitation of persons with LEoP. This knowledge can assist rehabilitation professionals to plan interventions that enable people with LEoP to develop strategies to better manage their daily life. This article is protected by copyright. All rights reserved

Measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in persons on the autism spectrum : A preliminary Rasch analysis

Background: Persons on the autism spectrum exhibit poorer body awareness than neurotypical persons. Since movement quality may be regarded as an expression of body awareness, assessment of movement quality is important. Sound assessments of measurement properties are essential if reliable decisions about body awareness interventions for persons on the autism spectrum are to be made, but there is insufficient research. Objective: To assess measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in an autism and a neurotypical reference group. Methods: Persons on the autism spectrum (n=108) and neurotypical references (n=32) were included. All were assessed with BAS MQ. Data were analyzed according to the Rasch model. Results: BAS MQ was found to have acceptable unidimensionality, supported by the fit statistics. The hierarchical ordering showed that coordination ability was the most difficult, followed by stability and relating. Response category functioning worked as intended for 19 out of 23 items. There were few difficult items, which decreased targeting. Reliability measures were good. BAS MQ discriminated between the autism and the reference groups, with the autism group exhibiting poorer movement quality, reflecting clinical observations and previous research. Conclusions: BAS MQ was found to have acceptable measurement properties, though suffering from problems with targeting item difficulty to person ability for persons on the autism spectrum. The BAS MQ may, along with experienced movement quality, contribute to clinically relevant information of persons on the autism spectrum, although we encourage refinements and further analyses to improve its measurement properties. We acknowledge all the participants. The study was supported by the Faculty of Medicine at Lund University, Sweden and funded by Habilitation &amp; Health in Region Västra Götaland, Sweden; the Skaraborg Institute for Research and Development, Sweden; and the Renee Eander Fund, Sweden. The funding sources had no active involvement in the conduct of the research.</p