New exercise-integrated technology can monitor the dosage and quality of exercise performed against an elastic resistance band by adolescents with patellofemoral pain:an observational study

Question: Is the exercise-integrated Bandcizer™ system feasible for recording exercise dosage (time under tension (TUT) and repetitions) and pain scores among adolescents with patellofemoral pain? Do adolescents practise the exercises as prescribed (TUT and repetitions)? Do adolescents accurately report the exercises they do in an exercise diary? Design: Observational feasibility study. Participants: Twenty adolescents between 15 and 19 years of age with patellofemoral pain. Intervention: Participants were prescribed three exercise sessions per week (one with and two without supervision) for 6 weeks. The exercises included three hip and one knee exercise with an elastic resistance band. Participants were instructed to perform three sets with a predefined TUT (3 seconds concentric; 2 seconds isometric; 3 seconds eccentric; 2 seconds pause), equating to 80 seconds for 10 repetitions (one set). Outcome measures: The exercise-integrated system consisted of a sensor attached to the elastic resistance band that was connected to the Bandtrainer app on an electronic tablet device. Pain intensity was reported on a visual analogue scale on the app. Participants also completed a self-report exercise diary. Results: No major problems were reported with the system. Participants performed 2541 exercise sets during the 6 weeks; 5% were performed with the predefined TUT (ie, within 10 seconds of the 80-second target) and 90% were performed below the target TUT. On average, the participants received 15% of the instructed exercise dosage based on TUT. The exercise dosage reported in the exercise diaries was 2.3 times higher than the TUT data from the electronic system. Pain intensity was successfully collected in 100% of the exercise sets. Conclusion: The system was feasible for adolescents with patellofemoral pain. The system made it possible to capture detailed data about the TUT, repetitions and sets during home-based exercises together with pain intensity before and after each exercise. [Rathleff MS, Bandholm T, McGirr KA, Harring SI, Sørensen AS, Thorborg K (2016) New exercise-integrated technology can monitor the dosage and quality of exercise performed against an elastic resistance band by adolescents with patellofemoral pain: an observational study. Journal of Physiotherapy 62: 159–163

Translation and validation of the Child and the Adolescent HARDSHIP (Headache-attributed restriction, disability, social handicap and impaired participation) questionnaire into Danish language

Background. The prevalence of headaches among children and adolescents varies considerably between countries. This may be due to a lack of appropriate instruments to capture the prevalence. The purpose of this study was to translate the Child and Adolescent HARDSHIP questionnaires from English into Danish language, conduct cross-cultural adaptation, face validation by cognitive interviewing and conduct a pilot study exploring time requirements. Methods. The questionnaire was translated using the guidelines proposed by “The Global Campaign to Reduce the Burden of Headache.” A total of 25 children from 6 to 12 years of age completed the questionnaire with 24 h between test and retest to assess reliability. A total of 169 children and adolescents from 6 to 17 years of age completed the translated questionnaire to assess time requirements for completing it. Results. Only minor discrepancies were observed in the translation process. Test-retest reliability of the translated questionnaire showed substantial agreement (kappa: 0.65–0.78). The questionnaires were completed within 30 min (age 6–11 years of age) and within 15 min (age 12–17 years of age) respectively. Discussion. No major problems were observed in the forward translations of the questionnaires. The face validation prompted no major changes in the questionnaire. The face-to-face interviews showed that pupils of different ethnic backgrounds than Danish and pupils in the age group of 6–11 had more difficulty in understanding a minority of the questions. The Danish Child and Adolescent HARDSHIP questionnaire therefore complies with the intentions of the originators, aiming at a maximal completion time of 45 min and in comparison with actual completion time. The test-retest study showed substantial agreement between test and retest in the headache, migraine and MOH domains and questions referring to time.The Child and Adolescent HARDSHIP questionnaire, includes a section specifically recording a four-week period.The Child and Adolescent HARDSHIP questionnaire is intended to measure burden of headache in large populations and there is therefore no need to reflect the states of individuals. We therefore find the substantial reliability of the Danish version of the Child and Adolescent HARDSHIP questionnaire to be adequate, without supplementing with a diary. The pilot study indicates that headache is a major problem among children and adolescents in Denmark. A total of 95.3% of the pupils have experienced headache in their life, 76.6% during the last year. A total of 14% left school early because of their headache and 14.9% missed school during the last four weeks, due to headache. 49.2% have experienced headaches during the last week and 47% describe the headache as “quite bad.” A total of 24.1% have taken pills or medicine during the last week due to headache. This pilot study clearly demonstrates the need to investigate the burden of headache among Danish schoolchildren as it seems to have a profound effect on their lives