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)

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

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

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

Prevalence rate of neck, shoulder and lower back pain in association with age, body mass index and gender among Malaysian office workers

Background: Malaysian office workers often experience Musculoskeletal Discomfort (MSD) which is typically related to the low back, shoulders, and neck. Objectives: The objective of this study was to examine the occurrence of lower back, shoulder, and neck pain among Malaysian office workers. Methods: 752 subjects (478 women and 274 men) were randomly selected from the Malaysian office workers population of 10,000 individuals. The participants were aged between 20-50 years and had at least one year of work experience. All participants completed the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Instructions to complete the questinnaire were given to the participants under the researchers supervision in the morning before they started a day of work. The participants were then classified into four categories based on body mas index (BMI) (BMI:≤18.4, 18.5-24.99, 25-29.99, ≥30) and age (Age: 20-29, 30-39, 40-49, ≥50). Results: There was a significant association between pain severity in gender and right (p = 0.046) and left (p = 0.041) sides of the shoulders. There was also a significant association between BMI and severity of pain in the lower back area (p = 0.047). It was revealed that total pain score in the shoulders was significantly associated with age (p = 0.041). Conclusions: The results of this study demonstrated that a significant correlation existed between pain servity for gender in both right and left shoulder. These findings require further scientific investigation as do the identification of effective preventative stratgies

Borg CR-10 scale as a new approach to monitoring office exercise training

Background: There are many potential training exercises for office workers in an attempt to prevent musculoskeletal disorders. However, to date a suitable tool to monitor the perceived exertion of those exercises does not exist. Objective: The primary objective of this study was to examine the validity and reliability of the Borg CR-10 scale to monitor the perceived exertion of office exercise training. Methods: The study involved 105 staff members employed in a government office with an age range from 25 to 50 years. The Borg CR-10 scale was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. Face validity and content validity were also examined. Results: Reliability was found to be high for the Borg CR-10 scale (0.898). Additionally a high correlation between the Borg CR-10 scale and Visual Analog Scale (VAS) was identified (rs = 0.754, P < 0.01). Conclusions: This study found the Borg CR-10 scale to be a reliable and valid tool for monitoring the perceived exertion of office exercise training and may potentially be useful for occupational therapists to measure physical activity intensity levels

The effect of continuous ultrasound on chronic low back pain: protocol of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Chronic non-specific low-back pain (LBP) is one of the most common and expensive musculoskeletal disorders in industrialized countries. Similar to other countries in the world, LBP is a common health and socioeconomic problem in Iran. One of the most widely used modalities in the field of physiotherapy for treating LBP is therapeutic ultrasound. Despite its common use, there is still inconclusive evidence to support its effectiveness in this group of patients. This randomised trial will evaluate the effectiveness of continuous ultrasound in addition to exercise therapy in patients with chronic LBP.</p> <p>Methods and design</p> <p>A total of 46 patients, between the ages 18 and 65 years old who have had LBP for more than three months will be recruited from university hospitals. Participants will be randomized to receive continuous ultrasound plus exercise therapy or placebo ultrasound plus exercise therapy. These groups will be treated for 10 sessions during a period of 4 weeks. Primary outcome measures will be functional disability and pain intensity. Lumbar flexion and extension range of motion, as well as changes in electromyography muscle fatigue indices, will be measured as secondary outcomes. All outcome measures will be measured at baseline, after completion of the treatment sessions, and after one month.</p> <p>Discussion</p> <p>The results of this trial will help to provide some evidence regarding the use of continuous ultrasound in chronic LBP patients. This should lead to a more evidence-based approach to clinical decision making regarding the use of ultrasound for LBP.</p> <p>Trial registration</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2251">NTR2251</a></p

Constraints on perception of information from obstacles during foot clearance in people with chronic stroke

The aim of this study was to examine effects of different types of task constraints on coupling of perception and action in people with chronic stroke when crossing obstacles during a walking task. Ten participants with hemiplegic chronic stroke volunteered to walk over a static obstacle under two distinct task constraints: simple and dual task. Under simple task constraints, without specific instructions, participants walked at their preferred speed and crossed over an obstacle. Under dual task constraints the same individuals were required to subtract numbers whilst walking. Under both distinct task constraints, we examined emergent values of foot distance when clearing a static obstacle in both affected and unaffected legs, measured by a 3D motion tracking system. Principal Component Analysis was used to quantify task performance and discriminant analysis was used to compare gait performance between task constraints. Results suggested that patients, regardless of affected body side, demonstrated differences in perception of distance information from the obstacle, which constrained gait differences in initial swing, mid-swing and crossing phases. Further, dual task constraints, rather than hemiplegic body side, was a significant discriminator in patients' perceptions of distance and height information to the obstacle. These findings suggested how performance of additional cognitive tasks might constrain perception of information from an obstacle in people with chronic stroke during different phases of obstacle crossing, and thus may impair their adaptive ability to successfully manoeuvre around objects