The Validity of the Modified Star Excursion Balance Test as a Predictor of Knee Extensor and Hip Abductor Strength

Objectives: To test the construct validity of the modified Star Excursion Balance Test (SEBT) in predicting the strength of knee extensors and hip abductors and to compare performance between dominant and non-dominant legs. Strength, as measured using hand held dynamometry, has been used as one of a variety of measures in order to subgroup patients with patellofemoral pain. This method is not well received in clinical practice due to time constraints and cost. In contrast, the SEBT is a quick and simple functional measure of dynamic stability. This study examined the validity of the SEBT as an alternate strength measure. Design: Within subject correlation. Each participant recorded maximum isometric contractions for hip abduction and knee extension using a HHD and performed the modified SEBT, on both legs, within one test period. Paired t tests were used to compare dominant and non-dominant legs and Pearson’s correlation analyses were used to explore for associations. Setting: Non-clinical environment, Participants: Eighteen healthy male amateur runner’s between 18 and 39 years old (mean age 36.1 years). Main outcome measures: Knee and hip moments normalised for leg length (Nm/m) for the HHD and percent of leg length reach score for each SEBT reach as well as a composite of all three. Results: There was no significant difference between dominant and non-dominant legs for all the tests (knee extension p = 0.72, hip abduction p = 0.90, SEBT composite p = 0.86) therefore data was combined into one set. There was no significant relationship between either hip abduction strength (r = 0.28, p = 0.11), or knee extension strength (r= 0.16, p = 0.17), with any combination of the SEBT. A moderate relationship (r = 0.52, p = 0.38) between hip abduction and SEBT posterolateral reach was seen, however, this was not statistically significant. Conclusion: There was no statistically significant association between either knee extension or hip abduction strength with the modified SEBT. This suggests that strength is unlikely to be a primary construct of the test and the SEBT is not a useful replacement for the HHD when testing strength

Prevalence, pattern and risk factors for work-related musculoskeletal disorders among Nigerian plumbers

Plumbing work is more manually driven in low-and-middle income countries (LMICs), and the prevalence of work-related musculoskeletal disorders (WMSDs) among workers who engage in plumbing in LMICs may be worse than earlier reports from developed countries. This study aimed to assess the prevalence, pattern and risk factors for work-related musculoskeletal disorders (WMSDs) among Nigerian plumbers. A total of 130 consenting plumber participated in this cross-sectional study. The Nordic Musculoskeletal questionnaire and the Job Factor Questionnaire were used to assess information on prevalence and pattern of WMSDs; and perceptions regarding work-related risks factors for WMSDs. Descriptive (mean, frequency, range, percentage and standard deviation) and inferential (Chi-square) statistics were used to analyze data. Alpha level was set at p<0.05. The mean age of the respondents is 36.56 ± 10.418 years. The mean years of experience and working hours per day are 14.15 ± 9.161 years and 8.28 ± 2.512 hours. Job characteristics were mostly installation of pipes and fixtures (99.2%), equipment and fixtures prior to installation (96.9%), and testing of plumbing system for leaks (88.5%). 12-month and 7-day prevalence of WMSDS were 84.6% and 50.8%. Low-back (63.8%), neck (55.4%) and knee (50%) were the most affected body sites. Having WMSDs limits normal activities involving the low-back (32.3%), knee (25.4%) and neck (23.8%). There was significant association between 12-month prevalence of WMSDs and use of saws and pipe cutters (χ2 = 4.483; p = 0.034), while sites of affectation had significant association with 12-month and 7-day prevalence of WMSDs (p<0.05) respectively. Nigerian plumbers have a high prevalence of WMSDs affecting most commonly the low back, neck and knee. Plumbing job factors pose mild to moderate risk to developing WMSDs, and use of saws and pipe cutters significantly influence WMSDs

Development and initial validation of the Bristol Impact of Hypermobility questionnaire

© 2016 Chartered Society of Physiotherapy Objectives Stage 1 – to identify the impact of joint hypermobility syndrome (JHS) on adults; Stage 2 – to develop a questionnaire to assess the impact of JHS; and Stage 3 – to undertake item reduction and establish the questionnaire's concurrent validity. Design A mixed methods study employing qualitative focus groups and interviews (Stage 1); a working group of patients, clinicians and researchers, and ‘think aloud’ interviews (Stage 2); and quantitative analysis of questionnaire responses (Stage 3). Setting Stages 1 and 2 took place in one secondary care hospital in the UK. Members of a UK-wide patient organisation were recruited in Stage 3. Participants In total, 15, four and 615 participants took part in Stages 1, 2 and 3, respectively. Inclusion criteria were: age ≥18 years; diagnosis of JHS; no other conditions affecting physical function; able to give informed consent; and able to understand and communicate in English. Interventions None. Main outcome measures The development of a questionnaire to assess the impact of JHS. Results Stage 1 identified a wide range of impairments, activity limitations and participation restrictions In Stage 2, a draft questionnaire was developed and refined following ‘think aloud’ analysis, leaving 94 scored items. In Stage 3, items were removed on the basis of low severity and/or high correlation with other items. The final Bristol Impact of Hypermobility (BIoH) questionnaire had 55 scored items, and correlated well with the physical component score of the Short Form 36 health questionnaire (r=−0.725). Conclusions The BIoH questionnaire demonstrated good concurrent validity. Further psychometric properties need to be established

Real-world incidence and prevalence of low back pain using routinely collected data

Low back pain (LBP) is a common health problem among adults of working age population, and its prevalence or incidence increases with increasing in age. The purpose of this review was to examine the real-world prevalence or incidence of LBP. A systematic review of the literature was conducted in accordance to the PRISMA guideline. Allied and Complementary Medicine Database, Cumulative Index of Nursing and Allied Health Literature, MEDLINE, SportDiscuss and Scopus electronic databases were searched using specifically developed search strategies to identify studies using patients’ electronic medical records published in English up to February 2019. The quality of the included studies was assessed using a tool that consists of ten items addressing a risk of bias. The search yielded 756 published studies, of which 13 were deemed relevant and were included in this review. The included studies reported incidence or prevalence data from Canada, United States of America (USA), Sweden, Belgium, Finland, Israel, and Netherlands. All the included studies were assessed to be methodologically sound (low risk of bias). The prevalence and incidence of LBP ranged from 1.4 to 20.0% and 0.024–7.0%, respectively. Three studies reported that the Odds of LBP in male patient was higher than their female counterparts (odds ratio > 1; range 1.11–17.29). Nine studies identified the risk factors of LBP to be age, sex, and race. The remaining four studies also listed high intensity of physical activity, high spinal load, lifting, bending, and twisting as the risk factors for LBP. The results of this study highlighted there is a substantial difference within studies that estimated the prevalence and incidence of LBP. This finding could inform healthcare policy makers to critically examine the data sources of prevalence and incidence studies; this in return might help for resource allocation to manage the condition

Validation of the Yoruba Version of the Pain Self-Efficacy Questionnaire in patients with chronic low back pain

STUDY DESIGN: Cultural adaptation and psychometric analysis. OBJECTIVE: This study determined the test-retest reliability, acceptability, internal consistency, divergent validity of the Yoruba pain self-efficacy questionnaire (PSEQ-Y). It also examined the ceiling and floor effects and the small detectable change (SDC) of the PSEQ-Y among patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA: There are various indigenous language translations of the PSEQ and none adapted to African language. However, translations of the PSEQ into Nigerian languages are not readily available. METHODS: The validity testing phase of the study involved 131 patients with LBP, while 83 patients with LBP took part in the reliability phase. Following the Beaton recommendation for cultural adaptation of instruments, the PSEQ was adapted into the Yoruba language. The psychometric properties of the PSEQ-Y determined comprised: internal consistency, divergent validity, test-retest reliability, and SDC. RESULTS: The mean age of the participants was 52.96 ± 17.3 years. The PSEQ-Y did not correlate with the Yoruba version of Visual Analogue Scale (VAS-Y) scores (r = -0.05; P = 0.59). The values for the internal consistency and the test-retest reliability of the PSEQ-Y were 0.79 and 0.86, with the 95% confidence interval of the test-retest reliability ranging between 0.82 and 0.90. The standard error of measurement (SEM) and the SDC of the PSEQ-Y were 1.2 and 3.3, respectively. The PSEQ-Y had no floor or ceiling effect, as none of the respondents scored either the minimal or maximal scores. CONCLUSION: This is the first study in Nigeria to culturally adapt PSEQ. The PSEQ-Y showed adequate psychometric properties similar to existing versions. Therefore, the tool can be used to assess pain self-efficacy in clinical and research settings and help to improve the health outcomes of patients chronic LBP.Level of Evidence: 3

Awareness, attitude and expectations of physiotherapy students on telerehabilitation

Background and Objective: Explosion in information technology knowledge and utilization among young people, referred to as digital natives, seems less explored in the health sector and training. This study was aimed to assess awareness, attitude and expectations of physiotherapy students on telerehabilitation. Methods: This cross-sectional survey employed systematic probability sampling technique to recruit 200 physiotherapy students. A self-developed questionnaire which was tested for its face and content validity was used to obtain data. Data was analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05. Results: The mean age of the respondents was 21.2 ± 2.04 years. There was higher prevalence of moderate awareness (43%) and positive attitude towards telerehabilitation (39%). Majority of the respondents (62%) had high expectation towards future telerehabilitation products and services. There was significant association between level of awareness of telerehabilitation and age (X2 = 7.119; p = 0.001). Discussion: The responding students in this study are by age in the class of digital natives, who should be conversant with technology. This could account for the higher moderate level of awareness of telerehabilitation. However, the higher rates of negative attitude towards telerehabilitation could be attributed to prevailing barriers to its utilization in Nigeria. Nonetheless, a large percentage of the students had high expectations for the future of telerehabilitation. Conclusion: Nigerian physiotherapy students have moderate awareness and high expectation for future telerehabilitation applications. However, a larger number of them hold negative attitude towards it use

Clinical and Cost Effectiveness of Pre-Operative Physiotherapy for Patients Undergoing Anterior Cruciate Ligament Reconstruction in Riyadh, Saudi Arabia.

Purpose: To examine the clinical and cost effectiveness of a pre-operative physiotherapy programme for the management of Saudi patients with ACL injury. Methods: A pragmatic quasi-randomised controlled trial (RCT) was conducted to evaluate a newly developed pre-operative physiotherapy protocol. A total of 84 patients with ACL injury participated in the study; 45 in the Control group and 39 in the Intervention group (median age 27.5 years, IQR 8.5). The intervention protocol consisted of twelve 45-minute long sessions over 4 weeks and included 3 types of exercise: a warm-up session, muscle strengthening exercises and balance exercises. Measurements were taken upon enrollment and two weeks post-surgery. Outcomes included the knee injury and osteoarthritis outcome score (KOOS), ROM, muscle strength, pain, health state and quality of life (QoL). Cost-effectiveness of the intervention was examined using the incremental cost-effectiveness ratio (ICER) was used based on resource use and quality-adjusted life years (QALY). Data analysis described the measurements using medians and interquartile ranges (IQR) and assessed differences between the two groups using Mann-Whitney U-test. Results: Patients in the intervention group showed significant improvement in the primary outcomes compared to the control group as demonstrated by the KOOS scores (p < 0.001). Muscle strength was higher in the intervention group for both quadriceps and hamstring muscles (p < 0.01) with improvement in range of motion especially during flexion (p < 0.001). In addition, QoL was significantly better in the intervention group (p < 0.001). The measured ICER indicated that the intervention can be deemed to be cost-effective (£1150 per QALY gained). Conclusion(s): The present study suggests that a standardised pre-operative physiotherapy programme was clinically and cost effective for patients undergoing ACL reconstruction in KSA. Clinicians and decision makers are to be aware of these findings as they may provide justification for resource allocation in the management of patient with this condition. Implications: Based on the findings of the present study, pre-operative physiotherapy should be integrated into the Saudi healthcare system as a routine practice in hospitals and rehabilitation clinics. Based on the findings in relation to cost-effectiveness of the intervention in the present research, effectiveness of pre-operative physiotherapy in regards to the short term may potentially justify the resources that are required to implement it for use

Translation, cross-cultural adaptation and psychometric evaluation of Yoruba version of the short-form 12 health survey

Background. Short Form 12 (SF-12) health survey has found its utility in clinical and research settings because of its short length that spares time. Though several translations into other languages do exist there is none available in Yoruba language. Hence, this study’s objective was to culturally adapt and determine the reliability and validity of the Yoruba translated version of the SF-12. Methods. Forward and backward translations of SF-12 into Yoruba version of SF-12 (Y-SF-12) were done using the International Quality of Life Assessment Project Guidelines. Healthy participants were assessed using both English and Yoruba versions of SF-12 for the validation phase, and two weeks later were reassessed with the Y-SF-12 for the reliability phase. Results. Participants were 225 males and 171 females. The mean scores for each scale range from 73.4 to 86.1, with no gender difference. All scale and domain scores evidenced a negative skew and ranges from -1.79 to -0.62. Concurrent validity (0.879 – 0.938) and convergent validity (0.786 – 0.907) appeared to be good as reflected by their correlation values. The internal consistency of Y-SF-12 was good as Cronbach’s Alpha ranged between 0.899 and 0.968, while the Intraclass Correlation Coefficient (ICC) ranged between 0.775 and 0.949. Conclusion. This is the first study to assess the psychometric properties of the Y-SF-12. It appears to be valid and may be an appropriate tool for assessing health-related quality of life among Yoruba population. The tool may help to improve the health outcomes of individuals, and redress health inequalities in low and middle-income countries