Seizures as the first manifestation of chromosome 22q11.2 deletion syndrome in a 40-year old man: a case report

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Assessing activity participation in the ACL injured population: a systematic review of activity rating scale measurement properties

Background: Participation is an important factor in assessing both the requirement for and outcome from anterior cruciate ligament reconstruction. Many patient-reported rating scales exist; however, measurement properties have not been well established. Objective: To provide a systematic review to identify currently available activity rating scales for anterior cruciate ligament injured subjects and to evaluate current knowledge of their measurement properties. Methods: Systematic searches of four databases (Medline, AMED, EMBASE, and CINAHL) without date or language restriction, using terms structured around the PICOS system were completed on 1st March 2011. Citation tracking, reference screening and contact with lead authors of key papers completed the search strategy. Studies using participation rating scales were identified to assess frequency of reporting and cited validation. Studies assessing one or more psychometric properties of the identified rating scales were subject to independent data extraction and critical appraisal by two independent authors using published tools. Results: Thirty-one rating scales were identified from 241 outcome studies. Most scales were inadequately developed or validated prior to use. Only three scales (Tegner, CSAS, and Marx) had psychometric analysis in eight studies of mixed quality. Only the Tegner scale has adequate assessment of reliability, validity, and responsiveness. The use of type, intensity, and frequency variables in the identified scales is discussed. Conclusions: The Tegner scale has been adequately validated; however, other rating scales require further validation. A comprehensive comparative analysis of clinical applicability and psychometric testing of existing scales, including clinically useful statistics, is required