Evidence for validity and reliability of a french version of the FAAM

BACKGROUND: The Foot and Ankle Ability Measure (FAAM) is a self reported questionnaire for patients with foot and ankle disorders available in English, German, and Persian. This study plans to translate the FAAM from English to French (FAAM-F) and assess the validity and reliability of this new version.METHODS: The FAAM-F Activities of Daily Living (ADL) and sports subscales were completed by 105 French-speaking patients (average age 50.5 years) presenting various chronic foot and ankle disorders. Convergent and divergent validity was assessed by Pearson's correlation coefficients between the FAAM-F subscales and the SF-36 scales: Physical Functioning (PF), Physical Component Summary (PCS), Mental Health (MH) and Mental Component Summary (MCS). Internal consistency was calculated by Cronbach's Alpha (CA). To assess test re-test reliability, 22 patients filled out the questionnaire a second time to estimate minimal detectable changes (MDC) and intraclass correlation coefficients (ICC).RESULTS: Correlations for FAAM-F ADL subscale were 0.85 with PF, 0.81 with PCS, 0.26 with MH, 0.37 with MCS. Correlations for FAAM-F Sports subscale were 0.72 with PF, 0.72 with PCS, 0.21 with MH, 0.29 with MCS. CA estimates were 0.97 for both subscales. Respectively for the ADL and Sports subscales, ICC were 0.97 and 0.94, errors for a single measure were 8 and 10 points at 95% confidence and the MDC values at 95% confidence were 7 and 18 points.CONCLUSION: The FAAM-F is valid and reliable for the self-assessment of physical function in French-speaking patients with a wide range of chronic foot and ankle disorders

Could local dynamic stability serve as an early predictor of falls in patients with moderate neurological gait disorders? A reliability and comparison study in healthy individuals and in patients with paresis of the lower extremities.

Falls while walking are frequent in patients with muscular dysfunction resulting from neurological disorders. Falls induce injuries that may lead to deconditioning and disabilities, which further increase the risk of falling. Therefore, an early gait stability index would be useful to evaluate patients in order to prevent the occurrence of future falls. Derived from chaos theory, local dynamic stability (LDS), defined by the maximal Lyapunov exponent, assesses the sensitivity of a dynamic system to small perturbations. LDS has already been used for fall risk prediction in elderly people. The aim of the present study was to provide information to facilitate future researches regarding gait stability in patients with neurological gait disorders. The main objectives were 1) to evaluate the intra-session repeatability of LDS in patients and 2) to assess the discriminative power of LDS to differentiate between healthy individuals and neurological patients. Eighty-three patients with mild to moderate neurological disorders associated with paresis of the lower extremities and 40 healthy controls participated in the study. The participants performed 2×30 s walking wearing a 3D accelerometer attached to the lower back, from which 2×35 steps were extracted. LDS was defined as the average exponential rate of divergence among trajectories in a reconstructed state-space that reflected the gait dynamics. LDS assessed along the medio-lateral axis offered the highest repeatability and discriminative power. Intra-session repeatability (intraclass correlation coefficient between the two repetitions) in the patients was 0.89 and the smallest detectable difference was 16%. LDS was substantially lower in the patients than in the controls (33% relative difference, standardized effect size 2.3). LDS measured in short over-ground walking tests seems sufficiently reliable. LDS exhibits good discriminative power to differentiate fall-prone individuals and opens up the possibility of future clinical applications for better prediction of fall risk in neurological patients

Characterization of a Benchmark Database for Myoelectric Movement Classification

In this paper, we characterize the NINAPRO database and its use as a benchmark for hand prosthesis evaluation. The database is a publicly available resource that aims to support research on advanced myoelectric hand prostheses. The database is obtained by jointly recording surface electromyography signals from the forearm and kinematics of the hand and wrist while subjects perform a predefined set of actions and postures. Besides describing the acquisition protocol, overall features of the datasets and the processing procedures in detail, we present benchmark classification results using a variety of feature representations and classifiers. Our comparison shows that simple feature representations such as mean absolute value and waveform length can achieve similar performance to the computationally more demanding marginal discrete wavelet transform. With respect to classification methods, the nonlinear support vector machine was found to be the only method consistently achieving high performance regardless of the type of feature representation. Furthermore, statistical analysis of these results shows that classification accuracy is negatively correlated with the subject's Body Mass Index. The analysis and the results described in this paper aim to be a strong baseline for the NINAPRO database. Thanks to the NINAPRO database (and the characterization described in this paper), the scientific community has the opportunity to converge to a common position on hand movement recognition by surface electromyography, a field capable to strongly affect hand prosthesis capabilities. © 2014 IEEE

Association of moderate alcohol use and binge drinking during pregnancy with neonatal health

Heavy drinking and smoking during pregnancy are known to have a negative impact on the unborn child. However, the impact of low-to-moderate alcohol consumption and binge drinking has been debated recently. The aim of this study was to examine the relationship of moderate prenatal drinking and binge drinking with birthweight, being small for gestational age (SGA) at birth, preterm birth, and neonatal asphyxia.; Moderate alcohol drinking, binge drinking, and several possible confounders were assessed in 1,258 pregnant women; information on neonatal health was obtained at birth.; Results indicate that 30.8% of the women drank at low levels (>2 glasses/wk), 7.9% drank moderately (2 to 4 glasses/wk), and 0.9% showed higher levels of drinking (5 glasses/wk); 4.7% reported binge drinking (defined as 3 glasses/occasion). 6.4% of the children were SGA (>10th percentile of birthweight adjusted for gestational age), 4.6% were preterm (>37th week of gestation), and 13.0% showed asphyxia (arterial cord pH >7.10 and/or arterial cord lactate 7 at 5 minutes). When controlling for maternal age, citizenship, occupational status, parity, smoking, use of prescription/over-the-counter drugs, illicit drug use, and child gender moderate drinking was related to lower birthweight (p > 0.01), and moderate drinking and binge drinking were associated with neonatal asphyxia at trend level (p = 0.06 and p = 0.09). Moderate drinking and binge drinking were not related to length of gestation.; In contrast to recent reviews in the field, our results assume that moderate drinking and binge drinking are risk factors for neonatal health

MODERATE ALCOHOL USE AND NEONATAL HEALTH

Meyer-Leu Y, Lemola S, Daeppen J-B, Deriaz O, Gerber S. Association of Moderate Alcohol Use and Binge Drinking During Pregnancy with Neonatal Health. Alcoholism: Clinical and Experimental Research. 2011:no-no.Background: Heavy drinking and smoking during pregnancy are known to have a negative impact on the unborn child. However, the impact of low-to-moderate alcohol consumption and binge drinking has been debated recently. The aim of this study was to examine the relationship of moderate prenatal drinking and binge drinking with birthweight, being small for gestational age (SGA) at birth, preterm birth, and neonatal asphyxia. Methods: Moderate alcohol drinking, binge drinking, and several possible confounders were assessed in 1,258 pregnant women; information on neonatal health was obtained at birth. Results: Results indicate that 30.8% of the women drank at low levels (6.35 mmol and/or Apgar score <7 at 5 minutes). When controlling for maternal age, citizenship, occupational status, parity, smoking, use of prescription/over-the-counter drugs, illicit drug use, and child gender moderate drinking was related to lower birthweight (p < 0.01), and moderate drinking and binge drinking were associated with neonatal asphyxia at trend level (p = 0.06 and p = 0.09). Moderate drinking and binge drinking were not related to length of gestation. Conclusions: In contrast to recent reviews in the field, our results assume that moderate drinking and binge drinking are risk factors for neonatal health

Intrasession reliability of local dynamic stability.

<p>Forty healthy individuals (Healthy controls) and 83 patients exhibiting mild to moderate neurological disorders (Patients) walked 2×30 sec. at preferred speed. A 3D accelerometer recorded the trunk acceleration in medio-lateral (ML), vertical (V) and antero-posterior (AP) directions. The cadence (or step frequency, SF) was assessed by spectral analysis of the vertical acceleration signal. Local dynamic stability was evaluated by computing the rate of the average divergence among nearby trajectories in a reconstructed state-space that reflects the dynamics of locomotion (Lyapunov exponent method). The average divergence was computed either over one step (λ_0.5) or over one stride (λ₁). The absolute agreement among the two repetitions by intraclass correlation coefficient (ICC(A,k), the standard error of measurement (SEM), and the relative smallest detectable difference (SDD) are shown. The 95% confidence intervals (CI) were computed by bootstrapping (5000 resamples).</p

Cadence: descriptive statistics and comparisons between healthy controls and patients.

<p>Forty healthy individuals (Healthy controls) and 83 patients exhibiting mild to moderate neurological disorders (Patients) walked 2×30 sec. at preferred speed. A 3D accelerometer recorded the trunk acceleration. The cadence (or step frequency) was assessed by spectral analysis (Fourier transform) of the vertical acceleration signal. The results of the two 30sec. walking bouts were averaged. The spread of the data among participants is presented with boxplots (median and quartiles). Mean and SD are shown at the bottom of the figure. The bold values are as follows: top: the relative difference (RD) between controls and patients, expressed as percentage; middle: effect size (ES), i.e., mean difference normalized by SD of the controls (Glass's delta); p: p-value of the t-test between controls and patients (unequal variance).</p

Participants' characteristics.

<p>The values are means (SD).</p

Summary of the domains assessed with the INTERMED.

<p>(adapted from De Jonge P et al 2003 <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0094268#pone.0094268-deJonge2" target="_blank">[51]</a>, a full description of domains assessed in the INTERMED is available at: <a href="http://www.intermedfoundation.org/" target="_blank">http://www.intermedfoundation.org/</a>).</p

Comparison predictive Values in the development and the validation sample.

<p>Compares diagnostic properties in the development sample with the validation sample. Threshold = Chosen cut-off for the dichotomizing in test negatives (i.e. return to work, below thresholds; non return to work, equal or above threshold).</p