Inter- and intra-rater reliability of brief BESTest in balance evaluation of patients with stroke: Brief report

Background: Impaired balance is one of the most common symptoms that occur after stroke. There are several tests for evaluating balance in neurological disorders. Briefbalance evaluation systems test (Brief-BESTest) is the short version of BESTest that assess the systems contributing to postural control. The purpose of this study was to investigate the inter- and intra-rater reliability of the Persian version of Brief-BESTest for balance evaluation in patients with stroke. Methods: Patients with stroke recruited from the Tehran University of Medical Sciences Physiotherapy Clinics in Tehran participated in this cross-sectional study. Patients were included in the study with first ever stroke, able to follow instructions, able to walk without aid, and willingness to participate in the study. The study was conducted from August to December 2016. Two physiotherapists independently scored the videotaped performance of patients on Persian Brief-BESTest in one session for inter-rater reliability. The first physiotherapist recorded the patients� performance on Persian Brief-BESTest after 1 week for intra-rater reliability. The physiotherapists were blinded to each other�s scores. Intraclass correlation coefficient (ICC) was used to assess the reliability. SPSS statistical software, version 18 (IBM, Armonk, NY, USA) was used for all analyses. Results: Thirty patients with stroke (10 males, 20 females, mean age 57.3±13.5 years, duration 40.7±47.3 months) participated in this study. The ICC values for inter-rater reliability and intra-rater reliability of total scores were 0.98 (95 CI: (0.95-0.99)) and 0.99 (95 CI: (0.98-0.99)), respectively. The ICC values for inter- and intra-rater reliability of each item score were 0.72-1.0, and 0.87-1.0 respectively. Conclusion: The Persian version of Brief-BESTest has high inter- and intra-rater reliability for evaluation of balance in patients with stroke. Therefore, it is recommended for use by clinicians in the clinic and for research purposes in the clinical trials. © 2018, Tehran University of Medical Sciences. All rights reserved

Reliability and Validity of the Persian Version of the Mini-Balance Evaluation Systems Test in Patients with Stroke

Background: Stroke can cause balance disorders, which often lead to falls and fall-related injuries. The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a balance test that has been recently translated into Persian. The reliability and validity of the Persian version of Mini-BESTest have not been assessed in patients with stroke. Objectives: To assess the reliability and validity of the Persian version of the Mini-BESTest in patients with stroke. Methods: A cross-sectional study was designed. Thirty patients with stroke participated in this study. Patients were tested using the Mini-BESTest according to the Persian instructions, and two raters independently rated each patient�s performance. Each patient was matched with a healthy adult in the terms of age and gender. Healthy subjects were also tested for discriminative validity. Results: There was excellent correlation between two raters on the Persian version of the Mini-BESTest total scores (rPearson = 0.98, P < 0.001) and its sections (rPearson > 0.9). There was a significant difference between stroke patients and healthy subjects confirming the discriminative validity of the Persian version of the Mini-BESTest (19.4 ± 5.4 vs. 24.8 ± 2.3, P < 0.001). Limitations: We only assessed stroke patients, and the results may not be generalized to other patients with balance deficits. Conclusions: The Persian version of the Mini-BESTest is a reliable and valid tool for balance evaluation of stroke patients. © 2020, The Author(s)

COVID-19 AND FEAR, WHICH COMES FIRST?

Today people have a few unanswered questions in their mind, such as "Do negative emotions will co-survive with the COVID-19 pandemic? Which one is worse? Which one will disappear quicker? Is there any connection between negative emotions and being infected by COVID-19 or the severity of infected individual\u27s symptoms ? How are we supposed to live with COVID-19 and adapt our emotional system to the virus for more than one upcoming year? These uncertainties could result in massive pressure on people. While there is no clear consensus regarding what establishes psychological stress on an individual, the effect of negative affect and psychological stress on increased susceptibility to disease due to altered immune functions is well established. Here we are going through the possible effect of emotions associated with the present pandemic on COVID-19 course of disease and severity of symptoms

COVID-19 AND FEAR, WHICH COMES FIRST?

Today people have a few unanswered questions in their mind, such as "Do negative emotions will co-survive with the COVID-19 pandemic? Which one is worse? Which one will disappear quicker? Is there any connection between negative emotions and being infected by COVID-19 or the severity of infected individual\u27s symptoms ? How are we supposed to live with COVID-19 and adapt our emotional system to the virus for more than one upcoming year? These uncertainties could result in massive pressure on people. While there is no clear consensus regarding what establishes psychological stress on an individual, the effect of negative affect and psychological stress on increased susceptibility to disease due to altered immune functions is well established. Here we are going through the possible effect of emotions associated with the present pandemic on COVID-19 course of disease and severity of symptoms

Ambiguity tolerance among medical students and its relationship with personality and participation in the mentoring program: A cross-sectional study

Background: Low ambiguity tolerance (AT) can lead to burnout and impact medical students� quality of life. Interventions are effective in increasing tolerance in ambiguous situations. Mentors can be facilitators in ambiguous situations. We aimed to determine the AT among Tehran University of medical sciences (TUMS) medical students and assess its relation with personality traits and mentor-seeking behavior. Methods: A cross-sectional study was designed. We used Budner AT questionnaire and the Ten Item Personality Inventory in our study. Questionnaires were sent to 350 randomly selected TUMS medical students in different years of education. Two hundred six students completed the questionnaires. The response rate was 58.85. Results: The mean AT score was 59.77 among TUMS medical students. No significant difference was seen between different genders and students with different marital statuses. Also, AT was constant among students at different years at medical school and at different education levels (P > 0.05). Students who had participated in the mentoring program were significantly more intolerant of novel situations (P = 0.01). However, they did not have significantly different scores in other subscales of AT scale and its total score than those who had not participated in the mentoring program (P > 0.05). Conclusion: Medical students are more intolerant of ambiguity at TUMS than medical students abroad, and there should be interventions to help them cope in ambiguous situations. Mentoring programs may also be considered for future interventions as participants who participate in the program are less tolerant of ambiguity in novel situations. © 202

Brain analysis with a complex network approach in stroke patients based on electroencephalography: a systematic review and meta-analysis

Background and purpose: Brain function can be networked, and these networks typically present drastic changes after having suffered a stroke. The objective of this systematic review was to compare EEG-related outcomes in adults with stroke and healthy individuals with a complex network approach. Methods: The literature search was performed in the electronic databases PubMed, Cochrane and ScienceDirect from their inception until October 2021. Results: Ten studies were selected, nine of which were cohort studies. Five of them were of good quality, whereas four were of fair quality. Six studies showed a low risk of bias, whereas the other three studies presented a moderate risk of bias. In the network analysis, different parameters such as the path length, cluster coefficient, small-world index, cohesion and functional connection were used. The effect size was small and not significant in favor of the group of healthy subjects (Hedges’g = 0.189 [−0.714, 1.093], Z = 0.582, p = 0.592). Conclusions: The systematic review found that there are structural differences between the brain network of post-stroke patients and healthy individuals as well as similarities. However, there was no specific distribution network to allows us to differentiate them and, therefore, more specialized and integrated studies are needed

Development, cross-cultural adaptation, and psychometric characteristics of the persian progressive aphasia language scale in patients with primary progressive aphasia: A pilot study

Introduction: Primary Progressive Aphasia (PPA) is a neurological condition characterized by progressive dissolution of language capabilities. The Progressive Aphasia Language Scale (PALS) is an easy-to-apply bedside clinical scale capable of capturing and grading the key language features essential for the classification of PPA. The objective of the present study was to develop and validate the Persian version of the PALS (PALS-P) as a clinical language assessment test. Methods: In this cross-sectional study, PALS was translated and adapted into Persian according to the international guidelines. A total of 30 subjects (10 subjects with PPA and 20 control subjects without dementia) were recruited to evaluate the intra-rater reliability and discriminant validity of PALS-P. Results: The intra-rater reliability of the PALS-P within a 14-day interval was excellent for each subtest (ICC agreement range=0.81-1.0). PALS-P results were statistically significant among groups, suggesting its discriminative validity. Conclusion: This preliminary study indicates that PALS-P was successfully developed and translated. It seems to be a valid and reliable screening tool to assess language skills in Persian-speaking subjects with progressive aphasia

Knee Muscle Reciprocal Co-Activation in Patellofemoral Pain Syndrome During Isokinetic Exercise: A Voluntary Response Index Analysis

Introduction: The origin of the Patellofemoral Pain Syndrome (PFPS) is not still completely clear and may have a biomechanical or biochemical cause. Motor control dysfunction may have a role in this condition. Voluntary Response Index (VRI) is able to show changes in the central nervous system motor output that occur with intervention, recovery, or progression of the disorder. Therefore, the outcomes may contribute to offer another tool for PFPS motor control evaluation. The aim of the present study, therefore, was to assess the changes in the quadriceps and hamstring reciprocal coactivation patterns that may be observed in individuals with PFPS using the VRI. Methods and Materials: A total of 24 female participants, 12 with sound knees and 12 with PFPS participated in the present study. The study was accomplished in the Biomechanics Laboratory at Rehabilitation School of Tehran University of Medical Sciences in 2015. The participants sat on a Biodex dynamometer. They were asked to perform 10 continuous knee extension and flexion motions with maximal strength at 45˚/s and 300˚/s, distinctly. Simultaneously, electromyographic activities of the vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), and biceps femoris (BF) were recorded and VRI was calculated. A two-way analysis of variance was run to assess the effect of group and velocity on the VRI (similarity index and magnitude). Results: There was no velocity or group main effect observed for the VRI (P>0.05). In addition, no significant velocity × group interaction was found for the VRI (P>0.05). Conclusion: PFPS may not be linked to altered quadriceps and hamstring reciprocal co-activation patterns during isokinetic exercise. In addition, angular velocity may not be an important parameter in voluntary motor control assessment during isokinetic exercise.Keywords: Reciprocal co-activation; Voluntary response index; Patellofemoral pain syndrome; Isokineti

Multimodal impact of acupuncture, exercise therapy, and concurrent functional electrical stimulation on osteoarthritis of the knee: a case report

Knee osteoarthritis (OA) causes functional limitation in weight-bearing activities including walking. To investigate the multimodal impact of acupuncture, exercise therapy, and concurrent functional electrical stimulation (FES) on knee osteoarthritis. We designed a multidisciplinary treatment package including acupuncture; home based exercise therapy, and concurrent functional electrical stimulation during treadmill walking. Outcomes measurements included the numerical rating scale (NRS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Tampa Scale of Kinesiophobia (TSK). Measurements were completed at baseline and following the treatment phase which consisted of six individual sessions. A 48-year-old male, office worker presented with a history of chronic right knee. During the previous year, he was diagnosed with knee osteoarthritis after clinical physical examination by a sports medicine physician. Following our novel training intervention, the patient reported a reduction in pain intensity from 8 to 2 on the NRS, improved in all KOOS subscale scores, and improved in the TSK scale (reduction from 15 to 11). In addition, the patient reported that he was able to return to work and undertake normal activities of daily living with reduced knee pain. This case report showed that our novel multimodal intervention including six sessions of acupuncture, exercise therapy, and treadmill walking with functional electrical stimulation (FES) had a positive impact on knee pain and function in a middle-aged male with knee osteoarthritis

Responsiveness of Minimal Clinically Important Change for the Persian Functional Rating Index in Patients with Chronic Low Back Pain

Study Design A prospective, within-group cohort study of 46 patients with chronic low-back pain (CLBP). Purpose To assess the responsiveness of the Persian Functional Rating Index (PFRI) and to determine the minimal clinically important change (MCIC) of the PFRI in a cohort of patients with CLBP. Overview of Literature The FRI is an instrument for assessing pain and disability in patients with low-back pain. No study so far has examined the responsiveness of the PFRI. Methods Forty-six patients with CLBP with a mean age of 50.33±14.28 completed the PFRI, the Persian Roland–Morris Disability Questionnaire (PRMDQ), and a Visual Analog Scale (VAS) before and after 10 physiotherapy sessions. A Global Rating of Change Scale (GRCS) was completed after treatment. Results The changes in PFRI scores were statistically significant using the paired t-test (p<0.001). The PFRI revealed high effect sizes (range, 0.93–1.82). The PFRI showed significant correlations with the VAS (0.86), the PRMDQ (0.66), and the GRCS (0.45). The area under the receiver operator characteristic curve for the PFRI was good (0.76; 95% confidence interval, 0.56–0.95). The MCIC for PFRI was 10.63 points. Conclusions The results supported the responsiveness of the PFRI in patients with CLBP and showed the amount of change in PFRI scores perceived as worthwhile by the patients