The utility of faces pain scale in a chronic musculoskeletal pain model

The main aim of this study was to investigate the clinical utility and sensitivity to change of faces pain scale (FPS) in patients with shoulder pain, chosen as a chronic pain model. The secondary aim was to determine the association of FPS with psychologic status and quality of life of these patients. Methods. Thirty Turkish patients with chronic shoulder pain were included in the study. Pain intensity was evaluated by visual analog scale (VAS), which is a commonly used pain scale besides FPS. Depression and quality of life were screened by Beck Depression Inventory (BDI) and Short Form-36 (SF-36). All assessments were done before and after the physical therapy. Results. There was a statistically significant decrease in pain severity after the treatment as indicated by FPS and VAS (P = 0.000). The standardized response mean (SRM) value of FPS of 2.35 was accepted as a good responsiveness. The FPS showed a strong correlation with VAS (r = 0.62 and 0.73) both before and after the treatment. Also, moderate to strong correlations were detected between the FPS and physical functioning (PF), physical role (PR), bodily pain (BP), emotional role (ER), general health (GH), mental health (MH) subscales of SF-36 (r = -0.58–0.80), and BDI scores (r = 0.39) before the treatment. However, there were moderate and weak correlations with FPS and PR and social functioning (SF) subscales of SF-36 only after the treatment (r = -0.52 and r = -0.39). Conclusions. FPS is a satisfactory tool to assess pain in patients with chronic pain conditions and demonstrates sensitivity to detect changes after the treatment

The utility of the faces pain scale in the assessment of shoulder pain in turkish stroke patients: its relation with quality of life and psychologic status

This study was planned to investigate the utility of the vertical Faces Pain Scale (FPS) in the assessment of pain in stroke patients using the shoulder pain model and to assess its utility in the Turkish patient population. The secondary aim was to analyze the association of FPS with the quality of life and depression in the study population. Thirty stroke patients (group I) and 30 controls (group II), all suffering from shoulder pain were included in the study. The patients with subacute shoulder pain and with no other known diseases and impairments were recruited as a control group. Shoulder pain was evaluated by the commonly used pain scales including the Visual Analogue Scale, Likert Pain Scale and 0–10 Numerical Rating Scale besides FPS. Depression was screened using Beck Depression Inventory (BDI) and quality of life was evaluated using Short Form-36 (SF-36). FPS showed good correlations with the other pain scales in both the groups (r= 0.950–0.972 and 0.674–0.926, respectively). In group I, there were significant correlations between FPS and physical functioning, pain and emotional role subscales of SF-36 (r= – 0.432, 0.707 and – 0.461, respectively). Although there was a low correlation between the FPS and BDI scores, it was not statistically significant. In group II, FPS showed significant correlations with the BDI scores and all subscales of SF-36 except social functioning and vitality (r= – 0.679 to 0.848). FPS had a high degree of convergent validity and can be used in the assessment of shoulder pain in stroke patients. It may be a good alternative for pain assessment especially in patients with speech disorders and illiterate patients

Reliability, construct validity and measurement potential of the ICF comprehensive core set for osteoarthritis

<p>Abstract</p> <p>Background</p> <p>This study aimed to investigate the reliability and construct validity of the International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for osteoarthritis (OA) in order to test its possible use as a measuring tool for functioning.</p> <p>Methods</p> <p>100 patients with OA (84 F, 16 M; mean age 63 yr) completed forms including demographic and clinical information besides the Short Form (36) Health Survey (SF-36^®) and the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC). The ICF Comprehensive Core Set for OA was filled by health professionals. The internal construct validities of "Body Functions-Body structures" (BF-BS), "Activity" (A), "Participation" (P) and "Environmental Factors" (EF) domains were tested by Rasch analysis and reliability by internal consistency and person separation index (PSI). External construct validity was evaluated by correlating the Rasch transformed scores with SF-36 and WOMAC.</p> <p>Results</p> <p>In each scale, some items showing disordered thresholds were rescored, testlets were created to overcome the problem of local dependency and items that did not fit to the Rasch model were deleted. The internal construct validity of the four scales (BF-BS 16 items, A 8 items, P 7 items, EF 13 items) were good [mean item fit (SD) 0.138 (0.921), 0.216 (1.237), 0.759 (0.986) and -0.079 (2.200); person item fit (SD) -0.147 (0.652), -0.241 (0.894), -0.310 (1.187) and -0.491 (1.173) respectively], indicating a single underlying construct for each scale. The scales were free of differential item functioning (DIF) for age, gender, years of education and duration of disease. Reliabilities of the BF-BS, A, P, and EF scales were good with Cronbach's alphas of 0.79, 0.86, 0.88, and 0.83 and PSI's of 0.76, 0.86, 0.87, and 0.71, respectively. Rasch scores of BF-BS, A, and P showed moderate correlations with SF-36 and WOMAC scores where the EF had significant but weak correlations only with SF36-Social Functioning and SF36-Mental Health.</p> <p>Conclusion</p> <p>Since the four different scales derived from BF-BS, A, P, and EF components of the ICF core set for OA were shown to be valid and reliable through a combination of Rasch analysis and classical psychometric methods, these might be used as clinical assessment tools.</p

Refinement and validation of the Social Participation Restrictions Questionnaire: an application of Rasch analysis and traditional psychometric analysis techniques

Objectives: The primary aim of this research was to refine and validate the Social Participation Restrictions Questionnaire (SPaRQ). The SPaRQ is a hearing-specific, patient-reported outcome measure that was originally developed through consultation with adults with hearing loss, clinicians, and researchers. This research comprised two studies. Study 1 aimed to assess the psychometric properties of the SPaRQ and to improve these properties by amending the questionnaire (e.g. removing items) as required. Study 2 aimed to validate the refined SPaRQ. Design: In Study 1, 279 adults with hearing loss completed a long-form, 53-item SPaRQ. Rasch analysis, a modern psychometric analysis technique, was used to assess a range of psychometric properties for the questionnaire (e.g. unidimensionality, fit to the Rasch model). The properties of the individual items were also assessed (e.g. response dependency, differential item functioning). In Study 2, 102 adults with hearing loss completed the refined SPaRQ. In addition, they completed three questionnaires that had been designed to measure related constructs. These were a hearing-specific questionnaire (Hearing Handicap Inventory for the Elderly), a generic health and disability questionnaire (shortened World Health Organization Disability Assessment Schedule 2.0), and a brief depression and anxiety screening questionnaire (Patient Health Questionnaire-4). Traditional psychometric analysis techniques (e.g. Cronbach’s alpha) were used to assess the construct validity and internal consistency of the refined SPaRQ. Results: Rasch analysis was used to refine the SPaRQ. The result was a 19-item measure divided into two subscales. The 9-item Social Behaviors subscale measured difficulties with performing actions in a social context due to hearing loss. The 10-item Social Perceptions subscale measured negative thoughts and feelings experienced in a social context due to hearing loss. Both Rasch analysis and the traditional psychometric analysis techniques demonstrated that each subscale had strong psychometric properties. In particular, each subscale passed the test of unidimensionality, displayed good fit to the Rasch model, and had high internal consistency. In addition, it was found that, as predicted, each subscale had strong, positive correlations with the hearing-specific questionnaire and moderate, positive correlations with the generic health and disability questionnaire and the depression and anxiety screening questionnaire. Taken together, these findings support the construct validity of the 19-item SPaRQ. Conclusions: This was one of the first studies to devise a new hearing-specific outcome measure using Rasch analysis. Rasch analysis proved to be a powerful technique for supporting decisions regarding which items to retain in order to achieve a psychometrically robust questionnaire. Additional support for the robustness of this questionnaire came from the utilization of traditional psychometric analysis techniques. Therefore, this questionnaire has the potential to be used in research and clinical practice to evaluate whether auditory rehabilitation interventions improve social participation in adults with hearing loss. The next stage of this research will be to further validate this questionnaire by assessing its responsiveness in a clinical population. The combined use of modern and traditional psychometric analysis techniques should be considered in future questionnaire development and validation research

Adaptation of the Shoulder Disability Questionnaire to the Turkish population, its reliability and validity

The objective of this study was to adapt the Shoulder Disability Questionnaire (SDQ) for use in Turkey, and to test its reliability and validity. Eighty patients with shoulder pain were included in the study. Pain severity at rest, with motion and during sleeping was assessed by using a numeric pain scale. The shoulder's active and passive range of motion were measured by a goniometer and recorded. The Constant-Murley scale was used for functional assessment. The Turkish version of the SDQ, which was adapted by using guidelines, was completed by the patients. To assess reproducibility, the SDQ was completed by 32 patients who did not improve 1 week later. The reliability of the adapted version was good, with high internal consistency (Cronbach's alpha=0.76) and test-retest reliability (Pearson's correlation coefficient=0.88). The Turkish version of the SDQ was found to have a moderate correlation with pain at rest, with motion and during sleeping. The Turkish version of the SDQ was found to be reliable and valid. The moderate correlation of the questionnaire with clinical parameters including pain shows its validity, but the questionnaire should be tested extensively for detecting changes within time, for use in the follow-up and clinical practice

Coexistance of fibromyalgia syndrome and conversion disoreder: A case presentation

Konversiyon, herhangi bir organik patoloji olmaksızın bireyin motor ya da duyu organlarında ortaya çıkan fonksiyon kaybıdır. Psikolojik rahatsızlıklar kas iskelet sistemine ait semptomları taklit ederek tanı ve tedavide karışıklığa neden olabilir. Kas iskelet sistemi semptomları için organik bir neden olsa dahi, beraberinde konversiyon bozukluğu olabileceği ve tedaviyi daha da zorlaştıracağı unutulmamalıdır. Bu makalede, tipik kas iskelet sistemi semptomları ile başvuran ve fibromiyalji sendromu tanısı yanında konversiyon bozukluğu tanısı da konulan 17 yaşında bayan bir hasta sunulmaktadır.Conversion is loss of function in motor or sensory organs without any underlying pathology. Psychological disturbances may simulate typical symptoms of musculoskeletal conditions and cause controversy in diagnosis and management. It should be remembered that despite the presence of an organic cause for musculoskeletal symptoms, conversion disorder may coexist and complicate the treatment. In this paper, a 17 years old female patient who had typical musculoskeletal symptoms and diagnosed to have fibromyalgia syndrome together with conversion disorder is presented

Prevalence of Rheumatoid Arthritis and Spondyloarthritis in Turkey: A Nationwide Study

WOS:000435672000003PubMed ID: 30207568Objectives: This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania. Material and methods: The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.013.1 years; range, 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.516.8 years; range, 16 to 97 years) by trained general practitioners across the country, in 25 provinces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis. Results: In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%). Conclusion: The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA

Relationship Between Bone Mineral Density and Functional Parameters of Paraplegic Patients in Short-Term After Spinal Cord Injury-Original Investigation

Aim: To determine the relationship between bone mineralization and functional activity level of paraplegic patients in short-term after spinal cord injury (SCI). Material and Methods: Thirty paraplegic patients and twentynine healthy controls were admitted to this study. Bone mineral density (BMD) and Z-scores, together with serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone and 25-hydroxyvitamin-D levels, urinary calcium and deoxypyridinoline excretion were measured. All patients underwent a rehabilitation program including range of motion and progressive resistance exercises, upper body ergometry exercises, standing training with long leg orthosis, wheelchair ambulation or walking either by orthosis or walking aids five times/week during hospitalization. Results: There was no difference between the groups regarding BMD values and Z-scores. Mean serum calcium and parathyroid hormone levels were lower (p=0.016 and p<0.001, respectively), serum phosphorus and alkaline phosphatase levels were higher (p<0.001 and p=0.049, respectively) in the paraplegics as compared to the controls. Positive correlations were found between the radius BMD values and total duration of upper body ergometry exercise (r=0.550, p=0.027) and wheelchair use (r=0.622, p=0.010) and also between the femur BMD values and total duration of therapeutic standing (r=0.351, p=0.039). There was an inverse relationship between the femur BMD values and total duration of immobilization (r= -0.404, p= 0.033). Conclusion: Early rehabilitation interventions may prevent bone demineralization. Paraplegic patients should be followed and evaluated also in long term for the increased risk of osteoporosis. (From the World of Osteoporosis 2008;14: 57-61

The awareness of physicians and allied health professionals about cardiopulmonary rehabilitation: A cross-sectional survey study [Kardiyopulmoner rehabilitasyon konusunda hekimler ve diger sagli{dotless}k çali{dotless}şanlari{dotless}ni{dotless}n farki{dotless}ndali{dotless}k düzeyi: Kesitsel bir anket çali{dotless}şmasi{dotless}]

Objective: Cardiopulmonary (CPR) programs were developed to improve and stabilize the physical, psychological, social, mental, professional, and economic conditions of patients with cardiovascular and pulmonary diseases. Although it is known that CPR reduces mortality and morbidity, it is not widely implemented as it is in Turkey. In this study, we aimed to determine the level of CPR awareness among physicians and allied health professionals. Material and Methods: This was a multi-center, cross-sectional survey study. The study included physicians, nurses, physiotherapists, and other allied health professionals who were informed about the survey and provided written consent to participate. Results: A total of 727 volunteers from 12 different centers were included in the study. Of the participants, 59.5% were physicians, 31.4% were nurses, 5.9% were physiotherapists, and 3.2% were other allied health professionals; 79.3% participants answered the question on if they have had any idea about CPR. Participants indicated that patients should be referred to cardiac pulmonary rehabilitation after a coronary artery bypass (83.8%), chronic obstructive pulmonary disease (83.2%), and cardiac valve surgery (38.9%). Only 40.1% of the survey participants provided information about CPR to patients, while 20.5% did not provide any information about CPR. Conclusion: This survey study determined that in centers where CPR could be implemented, health professionals have knowledge about CPR. If the study were conducted nationwide, the level of awareness might be even lower. Although it is an idea of CPR, the level of knowledge for this issue is not adequate. As the number of the CPR centers will increase, the knowledge of doctors and allied health professionals will advance. © 2014 by Turkish Society of Physical Medicine and Rehabilitation