Factor structure and validity of the shoulder pain and disability index in a population-based study of people with shoulder symptoms

Background: The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that aims to measure pain and disability associated with shoulder disease. The aim of the present study was to investigate the construct validity and factor structure of the SPADI in a population-based study of patients with self-reported chronic shoulder symptoms. Methods: The North West Adelaide Health Study is a representative longitudinal cohort study of people aged 18 years and over. The original sample was randomly selected and recruited by telephone interview. Overall, 3 206 participants returned to the clinic during the second stage (2004-2006) and were asked to report whether they had pain, aching or stiffness on most days in either of their shoulders. Data was also collected on body mass index and shoulder range of motion (ROM) and demographic factors. The SPADI (numeric rating scale) was administered to participants with shoulder symptoms. Principal components factor analysis, with varimax rotation of factor loadings, was used to assess subscale structure of SPADI. Correlations between the SPADI, shoulder ROM and SF-36 were performed. Results: Overall, 22.3% of participants indicated that they had pain, aching or stiffness in either of their shoulders. SPADI results were available for 588 of participants with current shoulder symptoms. The internal consistency of the SPADI subscales were high (Cronbach's alpha > 0.92). Two factors, explaining 61.4% of the total variance were extracted by factor analysis. These were interpreted as disability and pain respectively. There was a strong negative correlation between SPADI disability subscale scores and shoulder range of motion. SPADI disability, but not pain, subscale scores were correlated with age. Conclusions: The SPADI is a valid measure to assess pain and disability in people with shoulder pain in a population-based study. In this setting, the SPADI had a bidimensional structure with both pain and disability subscales.Catherine L Hill, Susan Lester, Anne W Taylor, Michael E Shanahan, Tiffany K Gil

Clear cell carcinoid tumor of the distal common bile duct

BACKGROUND: Carcinoid tumors rarely arise in the extrahepatic bile duct and can be difficult to distinguish from carcinoma. There are no reports of clear cell carcinoid (CCC) tumors in the distal bile duct (DBD) to the best of our knowledge. Herein, we report a CCC tumor in the DBD and review the literature concerning extrahepatic bile duct carcinoid tumors. CASE PRESENTATION: A 73-old man presented with fever and occult obstructive jaundice. Ultrasonography, computed tomography (CT) and magnetic resonance cholangiopancreaticography (MRCP) demonstrated a nodular tumor projection in the DBD without regional lymph node swelling. Under suspicion of carcinoma, we resected the head of the pancreas along with 2(nd )portion duodenectomy and a lymph node dissection. The surgical specimen showed a golden yellow polypoid tumor in the DBD (0.8 × 0.6 × 0.5 cm in size). The lesion was composed of clear polygonal cells arranged in nests and a trabecular pattern. The tumor invaded through the wall into the fibromuscular layer. Immunohistochemical stains showed that neoplastic cells were positive for neuron-specific enolase (NSE), chromogranin A, synaptophysin, and pancreatic polypeptide and negative for inhibin, keratin, CD56, serotonin, gastrin and somatostatin. The postoperative course was uneventful and he is living well without relapse 12 months after surgery. CONCLUSION: Given the preoperative difficulty in differentiating carcinoid from carcinoma, the pancreaticoduodenectomy is an appropriate treatment choice for carcinoid tumors located within the intra-pancreatic bile duct

Effectiveness of physical therapy interventions for children with cerebral palsy: A systematic review

Background To assess the effectiveness of physical therapy (PT) interventions on functioning in children with cerebral palsy (CP). Methods A search was made in Medline, Cinahl, PEDro and the Cochrane library for the period 1990 to February 2007. Only randomized controlled trials (RCTs) on PT interventions in children with diagnosed CP were included. Two reviewers independently assessed the methodological quality and extracted the data. The outcomes measured in the trials were classified using the International Classification of Functioning, Disability and Health (ICF). Results Twenty-two trials were identified. Eight intervention categories were distinguished. Four trials were of high methodological quality. Moderate evidence of effectiveness was established for two intervention categories: effectiveness of upper extremity treatments on attained goals and active supination, and of prehensile hand treatment and neurodevelopmental therapy (NDT) or NDT twice a week on developmental status, and of constraint-induced therapy on amount and quality of hand use. Moderate evidence of ineffectiveness was found of strength training on walking speed and stride length. Conflicting evidence was found for strength training on gross motor function. For the other intervention categories the evidence was limited due to low methodological quality and the statistically insignificant results of the studies. Conclusion Due to limitations in methodological quality and variations in population, interventions and outcomes, mostly limited evidence on the effectiveness of most PT interventions is available through RCTs. Moderate evidence was found for some effectiveness of upper extremity training. Well-designed trials are needed especially for focused PT interventions.BioMed Central Open acces

The effects of exercise reminder software program on office workers' perceived pain level, work performance and quality of life

WOS: 000306361805186PubMed ID: 22317655In direct proportion to current technological developments, both the computer usage in the workplaces is increased and requirement of leaving the desk for an office worker in order to photocopy a document, send or receive an e-mail is decreased. Therefore, office workers stay in the same postures accompanied by long periods of keyboard usage. In recent years, with intent to reduce the incidence of work related musculoskeletal disorders several exercise reminder software programs have been developed. The purpose of this study is to evaluate the effectiveness of the exercise reminder software program on office workers' perceived pain level, work performance and quality of life. 39 healthy office workers accepted to attend the study. Participants were randomly split in to two groups, control group (n=19) and intervention group (n=20). Visual Analogue Scale to evaluate the perceived pain was administered all of the participants in the beginning and at the end of the study. The intervention group used the program for 10 weeks. Findings showed that the control group VAS scores remained the same, but the intervention group VAS scores decreased in a statistically significant way (p<0.01). Results support that such exercise reminder software programs may help to reduce perceived pain among office workers. Further long term studies with more subjects are needed to describe the effects of these programs and the mechanism under these effects

Exercise reminder software for office workers

14th International Conference on Human-Computer Interaction, HCI International 2011 --9 July 2011 through 14 July 2011 --Orlando, FL --85613Computers are widely used instruments in workplaces. Despite the low level of physical load, computer usage requires repetitive motions and staying in same position for a long time. That's why great number of computer users may contract musculoskeletal disorders. Frequent rests can prevent musculoskeletal discomfort, but OW generally do not break their work until discomfort occurs. The rest breaks can be reminded by computer software. The purpose of this study was to develop exercise reminder software (ERS) for OW in Turkish Language. An exercise protocol was designed to prevent most common MSDs among OW. The software was designed under C# with video play, exercise description and exercise log properties and the source code is open for scientific purpose. The software is compatible with Windows XP and Vista. The developed software is the first known ERS in Turkish Language. Future studies may focus on integration of distance patient follow up systems. © 2011 Springer-Verlag

The cross-cultural adaptation of the work role functioning questionnaire to Turkish

14th International Conference on Human-Computer Interaction, HCI International 2011 --9 July 2011 through 14 July 2011 --Orlando, FL --85613The aim of this study was to perform a cross-cultural adaptation of the Work Role Functioning Questionnaire into Turkish. The cross-cultural adaptation was performed as it is recommended in the international guidelines with the following steps: forward translation, synthesis, back-translation, consolidation of translations with expert committee, and pre-testing. The pre-final version of WRFQ-TV was conducted with 40 office workers with no specific health problem. The translation process of the questionnaire was completed without any major problem. The lay out was changed because 65% of the participants did not completely understand the questionnaire. The data shows acceptable results regarding to the psychometric properties of the WRFQ-TV. Cronbach'salpha for each subscale was >0.77, exceptfor the physical demand scale and social demand scale. This study resulted that the cross-cultural adaptation of the WRFQ-TV was successful. Future studies may focus on reliability of the WRFQ-TV. © 2011 Springer-Verlag

Hydrotherapy For Rett Syndrome

Objective: The effects of hydrotherapy on an 11-year-old girl with stage III Rett syndrome were investigated. Methods: The Halliwick method was used to apply hydrotherapy in a swimming pool twice a week for 8 weeks. The girl's physical abilities were assessed 3 times: before and 5 minutes after a single hydrotherapy session and after 8 weeks of hydrotherapy. The tests included analysis of stereotypical movements, functional hand use, hand skills, gait and balance, hyperactive behaviour, communication and social interaction. Results: Immediately after hydrotherapy, stereotypical movements decreased and this decrease continued during the following 8 weeks. The girl's feeding activities and hand skills increased markedly. After 8 weeks of hydrotherapy, her walking balance was improved, interaction with her environment increased and hyperactive behaviour and anxiety decreased. Conclusion: In conclusion, after the application of hydrotherapy, stereotypical hand movements had decreased and purposeful hand functions and feeding skills increased in this case. Whether hydrotherapy has a positive effect on the functional use of the hand in Rett syndrome should be investigated using more subjects.WoSScopu