Spanish adaptation and validation of the child- and parent-report cystic fibrosis questionnaire-revised (CFQ-R)

Objective: To evaluate the psychometric properties of the Spanish versions of the child- and parent-report cystic fibrosis questionnaire-revised (CFQ-R). Methods: A Spanish adaptation of the CFQ-R was performed; 68 children with CF (6-13 years) and their parents completed the child- and parent-report CFQ-R, respectively, and the Revidierter KINDer Lebensqualitätsfragebogen (KINDL) questionnaire. The CFQ-R was completed twice, 7-10 days apart, and its psychometric properties were analyzed. Results: The internal consistency of both CFQ-R versions was adequate (child-report version, Cronbach's α >.60 for all domains except 'Treatment Burden' [α = .42] and 'Social Functioning' [α = .57]; parent-report version, α > .60 for all domains except 'Social Functioning' [α = .58]). For the child-report version, the lowest measurement error was for 'Emotional Functioning' (standard error of measurement [SEM]: 8.3%; minimal detectable change [MDC90 ]: 19.3%), and the highest was for 'Body Image' (SEM: 15%; MDC90 : 35%). For the parent-report version, the lowest measurement error was for 'Physical Functioning' (SEM: 7.1%; MDC90 : 16.5%), and the highest was for 'Weight' (SEM: 17.2%; MDC90 ; 40.1%). The correlation between the versions showed higher agreement for the domains related to observable signs ('Physical Functioning') and lower agreement for 'Emotional Functioning.' There was a significant correlation between the CFQ-R and KINDL. Conclusion: Both the child- and parent-report versions of the Spanish CFQ-R have adequate reliability and validity for clinical and research purposes. These versions can be administered before and after starting modulator therapy to assess its effect on daily functioning. The MDC90 can help identify, with a high probability, whether real changes have occurred in the quality-of-life subscales in children with CF

Spanish adaptation and validation of the empowerment of parents in the intensive care-neonatology (EMPATHIC-N) questionnaire

Introduction Parental satisfaction is rarely measured in the neonatal intensive care unit due to a lack of specific assessment tools. The Empowerment of Parents in The Intensive Care-Neonatology (EMPATHIC-N) questionnaire is an instrument to assess satisfaction in relation to family-centred care that has been validated in several countries, but not Spain. Objectives To perform the translation and cultural adaptation of the EMPATHIC-N to Spanish followed by its validation for the purpose of assessing satisfaction in parents with children admitted to the neonatal intensive care unit. Material and methods The questionnaire first underwent forward and backward translation and transcultural adaptation by a panel of experts through a standardized process based on the Delphi method, followed by a pilot study in 8 parents and then a cross-sectional study in the neonatal intensive care unit of a tertiary care hospital to assess the reliability and converging validity of the Spanish version. Results The study proved the comprehensibility, validity, feasibility, applicability and usefulness of the Spanish version of the EMPATHIC-N in the field of paediatric health after being evaluated by 19 professionals and 60 parents. The content validity was found to be excellent (0.93). The reliability and convergent validity of the Spanish version of the EMPHATIC-N was analysed in a sample of 65 completed questionnaires. The Cronbach α for each domain was greater than 0.7, indicating a high internal consistency. We assessed validity by analysing the correlation of the 5 domains with the with the 4 general satisfaction items. The validity was found to be adequate (rs, 0.4−0.76; P \u3c .01). Conclusions The Spanish version of the EMPATHIC-N questionnaire is a comprehensible, useful, valid and reliable instrument to measure satisfaction in the parents of children admitted to neonatal care units

Adaptación y validación espanola ˜ del Empowerment of Parents in the Intensive Care-Neonatology (EMPATHIC-N)

Introduction Parental satisfaction is rarely measured in the neonatal intensive care unit due to a lack of specific assessment tools. The EMpowerment of PArents in THe Intensive Care-Neonatology (EMPATHIC-N) questionnaire is an instrument to assess satisfaction in relation to family-centred care that has been validated in several countries, but not Spain. Objectives To perform the translation and cultural adaptation of the EMPATHIC-N to Spanish followed by its validation for the purpose of assessing satisfaction in parents with children admitted to the neonatal intensive care unit. Material and methods The questionnaire first underwent forward and backward translation and transcultural adaptation by a panel of experts through a standardized process based on the Delphi method, followed by a pilot study in 8 parents and then a cross-sectional study in the neonatal intensive care unit of a tertiary care hospital to assess the reliability and converging validity of the Spanish version. Results The study proved the comprehensibility, validity, feasibility, applicability and usefulness of the Spanish version of the EMPATHIC-N in the field of paediatric health after being evaluated by 19 professionals and 60 parents. The content validity was found to be excellent (0.93). The reliability and convergent validity of the Spanish version of the EMPHATIC-N was analysed in a sample of 65 completed questionnaires. The Cronbach α for each domain was greater than 0.7, indicating a high internal consistency. We assessed validity by analysing the correlation of the 5 domains with the with the 4 general satisfaction items. The validity was found to be adequate (rs, 0.4-0.76; P < .01). Conclusions The Spanish version of the EMPATHIC-N questionnaire is a comprehensible, useful, valid and reliable instrument to measure satisfaction in the parents of children admitted to neonatal care units

Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions

Alfonso Gil-Mart&iacute;nez,1&ndash;3 Alba Paris-Alemany,1&ndash;4 Ibai L&oacute;pez-de-Uralde-Villanueva,1&ndash;3 Roy La Touche1&ndash;4 1Department of Physiotherapy, 2Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Aut&oacute;noma de Madrid, 3Hospital La Paz Institute for Health Research, IdiPAZ, 4Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain Abstract: Thanks to advances in neuroscience, biopsychosocial models for diagnostics and treatment (including physical, psychological, and pharmacological therapies) currently have more clinical support and scientific growth. At present, a conservative treatment approach prevails over surgery, given it is less aggressive and usually results in satisfactory clinical outcomes in mild&ndash;moderate temporomandibular disorder (TMD). The aim of this review is to evaluate the recent evidence, identify challenges, and propose solutions from a clinical point of view for patients with craniofacial pain and TMD. The treatment we propose is structured in a multimodal approach based on a biobehavioral approach that includes medical, physiotherapeutic, psychological, and dental treatments. We also propose a new biobehavioral model regarding pain perception and motor behavior for the diagnosis and treatment of patients with painful TMD. Keywords: biobehavioral, review, temporomandibular disorders, biobehavioral orofacial pain, multimodal approach, motor behavior, disabilit

Cross-cultural adaptation and psychometric properties of the spanish version of the tampa scale for kinesiophobia for temporomandibular disorders

© 2020 by the authors; licensee MDPI, Basel, Switzerland.The aim was to perform a translation, cross-cultural adaptation, and psychometric evaluation of the Spanish version of the Tampa Scale of Kinesiophobia for Temporomandibular Disorders (TSK-TMD-S). The study sample included 110 patients with TMD. We translated and cross-culturally adapted the TSK-TMD-S using standard methodology and analysed its internal consistency, test-retest reliability, construct validity, floor and ceiling effects, and discriminant validity. Confirmatory factor analysis extracted two factors and 10 items deemed essential for the scale. The TSK-TMD-S demonstrated good internal consistency (Cronbach’s α of 0.843, 0.938, and 0.885 for the entire scale, activity avoidance subscale, and somatic focus subscale, respectively; intraclass correlation coefficient, 0.81–0.9). No floor or ceiling effects were identified for this final version of the scale. The TSK-TMD-S total score showed moderate positive correlation with the craniofacial pain and disability inventory, visual analogue scale, general TSK and pain catastrophizing scale, and a moderate negative correlation with maximal mouth-opening. The receiver operating characteristic curve analysis showed that the subclassification employed for the TSK-TMD-S discriminates different kinesiophobia levels with a diagnostic accuracy between sufficient and good. The optimal cut-off point for considering kinesiophobia is 23 points. TSK-TMDS appears to be a valid and reliable instrument for measuring kinesiophobia in patients with TMD

Validación y fiabilidad de la versión española de la escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS)

Resumen: Introducción: La escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS) es un instrumento diseñado para identificar a pacientes con dolor de características neuropáticas. Objetivo: Evaluar la validez y fiabilidad de la versión española del S-LANSS. Métodos: Se incluyó un total de 182 pacientes con dolor crónico para evaluar la validez discriminante y convergente del S-LANSS, incrementándose la muestra hasta 321 pacientes para valorar la validez de constructo y la fiabilidad de la escala. Se utilizó como variable criterio la versión validada al español del ID-Pain. Todos los participantes cumplimentaron el cuestionario ID-Pain, el S-LANSS, y la Escala Numérica del Dolor. La validez discriminante se evaluó mediante el análisis del área bajo la curva de características operativas para el receptor, y la sensibilidad y especificidad. La validez de constructo se evaluó mediante un análisis factorial y mediante el análisis del odds-ratio de cada ítem del S-LANSS respecto a la puntuación total. La validez convergente y la fiabilidad se valoraron con la R de Pearson y el alfa de Cronbach respectivamente. Resultados: El punto de corte óptimo del S-LANSS fue ≥ 12 puntos (área bajo la curva = 0,89; sensibilidad = 88,7; especificidad = 76,6). El S-LANSS presentó un factor y, además, cada ítem contribuyó significativamente a la puntuación total positiva del S-LANSS (p < 0,05). El S-LANSS mostró una relación significativa con el ID-Pain (R = 0,734) y un alfa de Cronbach de 0,71. Conclusión: La versión española del S-LANSS es válida y fiable para identificar pacientes con dolor crónico con características neuropáticas. Abstract: Introduction: The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features. Objective: To assess the validity and reliability of the Spanish-language version of the S-LANSS scale. Methods: Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively. Results: The optimal cut-off point for S-LANSS was ≥ 12 points (AUC = .89; sensitivity = 88.7; specificity = 76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P < .05). The S-LANSS showed a significant correlation with ID-Pain (r = .734, α = .71). Conclusion: The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features. Palabras clave: Dolor crónico, Dolor neuropático, Evaluación del dolor, Validez, Fiabilidad, Estudio transcultural, Keywords: Chronic pain, Neuropathic pain, Pain assessment, Validity, Reliability, Transcultural stud

Supplementary Material for: Effectiveness of a Home-Based Active Video Game Programme in Young Cystic Fibrosis Patients

<p><b><i>Background:</i></b> Exercise-based rehabilitation is already a part of cystic fibrosis (CF) treatment; however, patient adherence is low. <b><i>Objectives:</i></b> To assess the effectiveness of a home exercise programme using active video games (AVGs) as a training modality for children and adolescents with CF. <b><i>Methods:</i></b> Thirty-nine children with CF were randomised to a control group (CG, <i>n</i> = 20, age 11 ± 6 years; FEV₁ 86.2 ± 20.5% of predicted) or a training group (AVGG, <i>n</i> = 19, age 13 ± 3 years; FEV₁ 82.7 ± 21.7% of predicted). The home training protocol consisted of 30- to 60-min sessions, 5 days/week, for 6 weeks using a Nintendo Wii™ platform. Exercise capacity was measured by the 6-min walk test (6MWT) and modified shuttle walk test (MSWT); muscular strength was estimated using the horizontal jump test (HJT), medicine ball throw (MBT), and hand grip strength (right [RHG]; left [LHG]); and quality of life was rated using the Cystic Fibrosis Questionnaire-Revised (CFQ-R). All the children were measured at baseline, after rehabilitation, and at 12 months. <b><i>Results:</i></b> For the group × time interaction ANOVAs, the AVGG showed significant between-group differences in exercise capacity: 6MWT farthest walking distance, 38.4 m (<i>p</i> < 0.01); MSWT farthest walking distance, 78.4 m (<i>p</i> < 0.05); and muscular strength: HJT 9.8 cm, MBT 30.8 cm, RHG 7 kg, and LHG 6.5 kg (<i>p</i> < 0.01), before versus after intervention. The CFQ-R reported significantly higher scores on respiratory symptoms after the intervention and favoured the AVGG, and there was an improvement in other domains after 12 months. Adherence to the home exercise programme was 95% during the 6- week intervention period. <b><i>Conclusion:</i></b> A home-based programme using AVGs can effectively improve exercise capacity, muscular strength and quality of life in the short-term in children and adolescents with CF. The effects of training on muscle performance and quality of life were sustained over 12 months.</p

Effectiveness of a Home-Based Active Video Game Programme in Young Cystic Fibrosis Patients

Background: Exercise-based rehabilitation is already a part of cystic fibrosis (CF) treatment; however, patient adherence is low. Objectives: To assess the effectiveness of a home exercise programme using active video games (AVGs) as a training modality for children and adolescents with CF. Methods: Thirty-nine children with CF were randomised to a control group (CG, n = 20, age 11 ± 6 years; FEV1 86.2 ± 20.5% of predicted) or a training group (AVGG, n = 19, age 13 ± 3 years; FEV1 82.7 ± 21.7% of predicted). The home training protocol consisted of 30- to 60-min sessions, 5 days/week, for 6 weeks using a Nintendo Wii™ platform. Exercise capacity was measured by the 6-min walk test (6MWT) and modified shuttle walk test (MSWT); muscular strength was estimated using the horizontal jump test (HJT), medicine ball throw (MBT), and hand grip strength (right [RHG]; left [LHG]); and quality of life was rated using the Cystic Fibrosis Questionnaire-Revised (CFQ-R). All the children were measured at baseline, after rehabilitation, and at 12 months. Results: For the group × time interaction ANOVAs, the AVGG showed significant between-group differences in exercise capacity: 6MWT farthest walking distance, 38.4 m (p < 0.01); MSWT farthest walking distance, 78.4 m (p < 0.05); and muscular strength: HJT 9.8 cm, MBT 30.8 cm, RHG 7 kg, and LHG 6.5 kg (p < 0.01), before versus after intervention. The CFQ-R reported significantly higher scores on respiratory symptoms after the intervention and favoured the AVGG, and there was an improvement in other domains after 12 months. Adherence to the home exercise programme was 95% during the 6- week intervention period. Conclusion: A home-based programme using AVGs can effectively improve exercise capacity, muscular strength and quality of life in the short-term in children and adolescents with CF. The effects of training on muscle performance and quality of life were sustained over 12 months.Depto. de Radiología, Rehabilitación y FisioterapiaFac. de Enfermería, Fisioterapia y PodologíaTRUEpu

Minimal Clinically Important Differences in Hand Pain Intensity (Numerical Pain Rate Scale) and Related-Function (Boston Carpal Tunnel Questionnaire) in Women With Carpal Tunnel Syndrome

Objective To calculate the minimal clinically important differences (MCIDs) for hand pain intensity and the Boston Carpal Tunnel Questionnaire (BCTQ) in a sample of women with carpal tunnel syndrome (CTS). Design Secondary analysis of a randomized controlled trial. Setting A Hospital Rehabilitation Unit. Participants One hundred twenty women with clinical and electromyographic diagnosis of CTS who were randomly assigned into 2 groups (N=120). Interventions One group received 3 sessions of manual physical therapy (n=60) and the other group received surgery (n=60). Main Outcome Measures Mean and the worst pain intensity (numerical pain rate scale, 0-10 points) and functional status and symptoms’ severity subscales of the BCTQ questionnaire were assessed before and 1 month after treatment. The Global Rating of Change (GROC) was used as the anchor variable for determining the MCID. Results A change of 1.5 and 2.5 points in mean and the worst pain intensity represents the MCID for Numerical Pain Rating Scale, whereas a change of 0.23 and 0.64 points in functional status and symptoms’ severity represents the MCID for each subscale of the BCTQ. All variables showed acceptable discrimination between patients classified as “improved” and those classified as “stable/not improved” (area under the curve≥0.72). Mean pain intensity (Youden index, 0.53; sensitivity: 73.3%; specificity: 80%) and symptoms’ severity (Youden index, 0.69; sensitivity: 90%; specificity: 77.8%) showed the best discriminative ability expressed as a percentage of prediction. Participants classified as “improved” had significantly greater improvements in pain intensity, functional status, and symptoms’ severity compared with those classified as “stable/not improved”. Conclusion A change of 1.5 and 2.5 points in mean and the worst pain and a change of 0.23 and 0.64 points in functional status and symptoms’ severity represents the MCID for pain intensity and BCTQ in women with CTS 1 month after treatment.Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería)Fac. de Enfermería, Fisioterapia y PodologíaTRUEpu