Cross-cultural adaptation, reliability, and validity of the work role functioning questionnaire 2.0 to Persian

Purpose: To translate and cross-culturally adapt, the Work Role Functioning Questionnaire 2.0 to Persian (WRFQ-Pr), and evaluate reliability and validity. Material and Methods: Standardized protocols were followed including forward-backward translation then synthesis/consolidation. Subsequent pilot investigation of the draft WRFQ-Pr (n = 50, male = 68%, age = 33.5 ± 7.3 years) tested the alternative wording and determined face and content validity through readability, understandability, interpretation, and cultural relevance. Participants (n = 288) were recruited from a convenience sample to assess: construct validity through exploratory factor analysis (EFA) using Promax rotation and maximum least squares extraction; and internal consistency using Cronbach’s α coefficient. Test-retest reliability was evaluated from the intraclass correlation coefficient (ICC2.1). Results: The forward-backward translation was achieved with eight items (1,3,4,5,9,11,12,22) modified and reformulated due to idiomatic issues. Internal consistency for the subscales ranged from α = 0.87–0.95, and the test-retest reliability was ICC(2,1)=0.92 (CI: 0.89–0.95). The EFA showed a four-factor solution, being identical to the original version, however items 20–22 loaded with items 23–26 in one factor, which was re-named “flexibility and social demand.” One item (#26) did not load above the required 0.30 threshold and was removed from the WRFQ-Pr. No floor or ceiling effects were found. Conclusions: The WRFQ translation and cross-cultural adaptation to Persian (WRFQ-Pr) was performed successfully. The determined properties of reliability and validity were comparable to those of the original English version.IMPLICATIONS FOR REHABILITATION The WRFW can simultaneously evaluate the health status of the worker, the existence of impairments, the involved factors in creating ability/disability at work, and the outcome of the interventions. There is no instrument available for the Persian-speaking population to evaluate related disability at work and the condition of return to work after a rehabilitation intervention. The WRFQ was translated and culturally adapted into Persian. The WRFW-Pr demonstrated excellent internal consistency, test-retest reliability and a four-factor structure

Slacklining as therapy to address non-specific low back pain in the presence of multifidus arthrogenic muscle inhibition

Low back pain (LBP) represents the most prevalent, problematic and painful of musculoskeletal conditions that affects both the individual and society with health and economic concerns. LBP is a heterogeneous condition with multiple diagnoses and causes. In the absence of consensus definitions, partly because of terminology inconsistency, it is further referred to as non-specific LBP (NSLBP). In NSLBP patients, the lumbar multifidus (MF), a key stabilizing muscle, has a depleted role due to recognized myocellular lipid infiltration and wasting, with the potential primary cause hypothesized as arthrogenic muscle inhibition (AMI). This link between AMI and NSLBP continues to gain increasing recognition. To date there is no 'gold standard' or consensus treatment to alleviate symptoms and disability due to NSLBP, though the advocated interventions are numerous, with marked variations in costs and levels of supportive evidence. However, there is consensus that NSLBP management be cost-effective, self-administered, educational, exercise-based, and use multi-modal and multi-disciplinary approaches. An adjuvant therapy fulfilling these consensus criteria is 'slacklining', within an overall rehabilitation program. Slacklining, the neuromechanical action of balance retention on a tightened band, induces strategic indirect-involuntary therapeutic muscle activation exercise incorporating spinal motor control. Though several models have been proposed, understanding slacklining's neuro-motor mechanism of action remains incomplete. Slacklining has demonstrated clinical effects to overcome AMI in peripheral joints, particularly the knee, and is reported in clinical case-studies as showing promising results in reducing NSLBP related to MF deficiency induced through AMI (MF-AMI). Therefore, this paper aims to: rationalize why and how adjuvant, slacklining therapeutic exercise may positively affect patients with NSLBP, due to MF-AMI induced depletion of spinal stabilization; considers current understandings and interventions for NSLBP, including the contributing role of MF-AMI; and details the reasons why slacklining could be considered as a potential adjuvant intervention for NSLBP through its indirect-involuntary action. This action is hypothesized to occur through an over-ride or inhibition of central down-regulatory induced muscle insufficiency, present due to AMI. This subsequently allows neuroplasticity, normal neuro-motor sequencing and muscle re-activation, which facilitates innate advantageous spinal stabilization. This in-turn addresses and reduces NSLBP, its concurrent symptoms and functional disability. This process is hypothesized to occur through four neuro-physiological processing pathways: finite neural delay; movement-control phenotypes; inhibition of action and the innate primordial imperative; and accentuated corticospinal drive. Further research is recommended to investigate these hypotheses and the effect of slacklining as an adjuvant therapy in cohort and control studies of NSLBP populations

Cross-Cultural Adaptation, Validity, and Reliability of the Persian Version of the Orebro Musculoskeletal Pain Screening Questionnaire

Study DesignObservational study.PurposeTo cross-culturally translate the Orebro Musculoskeletal Pain Screening Questionnaire (OMPQ) into Persian and then evaluate its psychometric properties (reliability, validity, ceiling, and flooring effects).Overview of LiteratureTo the authors' knowledge, prior to this study there has been no validated instrument to screen the risk of chronicity in Persian-speaking patients with low back pain (LBP) in Iran. The OMPQ was specifically developed as a self-administered screening tool for assessing the risk of LBP chronicity.MethodsThe forward–backward translation method was used for the translation and cross-cultural adaptation of the original questionnaire. In total, 202 patients with subacute LBP completed the OMPQ and the pain disability questionnaire (PDQ), which was used to assess convergent validity. 62 patients completed the OMPQ a week later as a retest.ResultsSlight changes were made to the OMPQ during the translation/cultural adaptation process; face validity of the Persian version was obtained. The Persian OMPQ showed excellent test–retest reliability (intraclass correlation coefficient=0.89). Its internal consistency was 0.71, and its convergent validity was confirmed by good correlation coefficient between the OMPQ and PDQ total scores (r=0.72, p<0.05). No ceiling or floor effects were observed.ConclusionsThe Persian version of the OMPQ is acceptable for the target society in terms of face validity, construct validity, reliability, and consistency. It is therefore considered a useful instrument for screening Iranian patients with LBP

Enhancing Older People’s Outdoor Activities Through User-Centered (Shopping Bag) Product Design; A Qualitative Study Based on the User-Centered Approach

Objectives The elderly population comprises a large portion of the world's population. The physical constraints faced by this group affect mental and social aspects of their life. Designing and creating new methods may be a solution to a more active contribution in the community. We aimed to study the elderly's social activities and related problems by concentration on their outdoor activities and their result and suggest a product improve them. &nbsp; Methods & Materials This qualitative study was based on the user-centered approach. Data were collected using questionnaires, observation, interviews and documentation of the participants&rsquo; feedbacks. The elderly were selected using. The study was conducted in four stages. First, the questionnaires were distributed among 42 patients. Then 19 seniors (12 women, 7 men) were interviewed. Then their feedback and ideas were documented. Finally, satisfaction was surveyed as the final phase to check the suggested product. Based on their ideas and also studying related and similar samples, data were collected and practical solutions were proposed. Results In the first phase the participants mentioned shopping as their most significant outdoor activity followed by exploring their favorite places for shopping which were fruit and vegetable markets. The problems related to shopping bags were explored through interviews. We found that the elderly need a product to simplify the shopping process of daily goods in order to improve their social activity. An adjustable, safe and stagnate product can increase the satisfaction and also reduce dependence on others in the elderly.&nbsp; Conclusion Considering the elderly's problems in shopping, a solution in product design is proposed to facilitate shopping and prevent difficulties such as forgetfulness. In future studies considering the anthropometrical measures to adjust the proposed solutions with the specific needs of users is suggested

Designing and Evaluating the Validity and Reliability of the Biofeedback Tool for Healthy People With Postural Kyphosis

Objective Kyphosis is one of the common abnormalities of the spine. However, correct preservation of the posture can play an important role in preventing and treating kyphosis. Biofeedback systems are among the methods used to prevent postural dysfunction. This study aimed to design a biofeedback tool to prevent kyphosis and evaluated reliability and validity of this tool. Materials & Methods total of 17 students aged between 18 and 30 years participated in the study as inappropriately. In this study, a flexible ruler was used as a golden standard to measure the kyphosis. First, a microcontroller-based kyphosis control biofeedback device was designed using a flexural sensor. This device consists of a vibration generator that activates when microcontroller detects a kyphotic situation. In other words, by changing the physical condition, the flexural sensor resistance used in the smart biofeedback tool changes accordingly and the data collected by the flexural sensor are converted into a voltage variation with a simple resistance circuit. The output of the flexural sensor is input to the microcontroller so that as soon as the microcontroller detects an incorrect physical condition, it sends a control signal (based on the predefined threshold for the microcontroller) in a vibration feedback. If the curvature value is more than the threshold and lasts for at least 30 seconds, it will alert the user with vibration feedback. Vibration alert continues as long as the user is in the kyphotic situation and stops as soon as the user leaves the kyphotic situation and returns to the natural state. After installing the designed biofeedback tool on the target area of the body, the tool error is evaluated by counting the number of warnings in the normal state and lack of warning in the kyphotic condition. In addition, to check the repeatability of the biofeedback tool, measurements were made in two neutral conditions and a tissue for each situation twice, with a distance of 2 hours. In this research, the tool validity was measured by Kappa coefficient based on sensitivity, specificity, and reliability.  Results Correction of the physical condition is an effective technique used to reduce mechanical stress on the neck and shoulders by taking a natural state of the body. Wearable technology is a way to achieve this objective by continuously monitoring the physical condition of the person and giving him or her the needed feedback when the person’s physical condition deviates from normal condition. In this research, a wearable tool was designed that people can use it very easily. Therefore, it can be used as a useful, simple, and non-invasive tool for clinical evaluation and measurement of kyphotic postural information. With further development of data recordings and feedback mechanisms, this system can be transformed into a portable tracking and posturing system to educate patients with spine deviations. This system is an inexpensive user-friendly device. The results showed that the sensitivity of the designed biofeedback tool was 17.64% and its property was 100%. The kappa index was calculated at 100% for both neutral states, but in the first one, 17.64% was measured in the first load and 12% in the second time. Regarding the repeatability of the biofeedback tool, the studies showed that the results of the first and second times did not differ significantly. Conclusion To the results, the biofeedback tool has sufficient validity in the neutral state, but it was not sufficient in the paper situation . In other words, the designed biofeedback device does not correctly diagnose the physical condition of the body in accordance with the golden standard (flexible ruler). In this regard, further consideration should be given to address its deficiencies. In addition, Kappa index values showed that the biofeedback tool was not well-suited to the kyphotic condition. However, this tool has a great deal of reliability at the time

Sonographic Measurement of Condylar Translation, Joint space and Mouth Opening in Healthy and Subjects with Temporomandibular Joint Disorders

Objectives: A sonographic approach can be used to quantify joint movement, muscle thickness, and available joint space. This study aimed to compare the amount of mouth opening, joint articular distance, and both anterior and inferior translation of the mandibular condyle between healthy participants and individuals with temporomandibular joint (TMJ) disorders. Methods: A cross-sectional study design was used with 52 participants (control: 26 healthy and TMJ: 26 symptomatic individuals) recruited using convenience sampling. The joint space distance and the anterior and inferior condylar translation on both sides were evaluated using sonography during maximum mouth opening and closing. Mouth opening was measured with a graduated ruler. Reliability was performed on a subgroup (n=10) with an interval of 3-7 days. Results: The reliability was good to excellent (ICC=0.57-0.94). The highest reliability was related to the joint space distance. The mean values for mouth opening were 43.1 and 35.3mm, respectively for healthy and TMJ patients. The anterior condylar translation was 7.14-7.57mm, inferior condylar translation was 2.35-2.66mm, and the joint space distance was 49.4-0.44mm. No significant differences were found between the left and right sides in either group. The mouth opening and joint space values were significantly higher in the healthy group while the rate of anterior transition movement was higher but not significant. Furthermore, there was a significant negative relationship between pain, mouth opening, and joint distance. Discussion: Sonography can be considered an accurate tool for the assessment of joint space and condylar translation in individuals with symptomatic TMJ disorders

Translation, Validity, and Reliability of the Upper Extremity Fugl-Meyer Assessment (FMA-UE) in Persian Speaking Stroke Patients

Objectives: Fugl-Meyer Assessment (FMA) is the common scale for clinical and functional evaluation of sensorimotor conditions and related Upper Extremity (UE) dysfunction after stroke. This study was done to translate and cross-culturally adjust the original upper extremity FMA (FMA-UE) into Persian and to evaluate the psychometric properties of the translated version.  Methods: A procedure of forward/backward translation based on the published guidelines was adopted and two independent bilingual translators performed the translations in each stage. The conceptual and semantic equivalence was obtained through a consensus between experts. Consecutive stroke patients (n=47, male=63%) with a mean age of 61.54±10.9 years were recruited. Content, face, and concurrent validity was calculated using the content validity index, a cognitive interview, and correlation with the Wolf Motor Function Test (WMFT). Internal consistency and intra-rater reliability were determined by calculating Cronbach’s alpha and the Intra-Class Correlation coefficient (ICC2.1). Results: During the forward translation and cultural adjustment, some wording changes were performed. In the forward translation, the most challenging clarifications are related to anatomical terms and positions. The total FMA-Persian score demonstrated acceptable internal consistency (α=0.86) and intra-rater reliability (ICC2.1=0.96). Joint passive motion showed the lowest reliability among all domains. The FMA motor subscales showed a floor effect, while sensation, joint passive motion, and pain domains showed ceiling effects. The correlation between the FMA-UE score and the WMFT was 0.78 (P<0.001).  Discussion: The FMA-UE translation and adjustment were performed successfully into the Persian language. The results of the current study found FMA-UE as an acceptable, reliable, and valid instrument for evaluating the upper limb function after stroke in Persian-speaking patients. However, it should be noted that floor and ceiling effects are respectively present in the domains of the motor subscales and for sensation, passive motion, and pain

The Prevalence of Musculoskeletal Symptoms in Iranian Spinner Workers in the Textile Industry and its Association With Demographic and Lifestyle Characteristics

Objectives: This study aimed to identify the annual and weekly prevalence of Musculoskeletal Disorders (MSDs) and their relation to demographic characteristics, such as Body Mass Index (BMI), work experience, and physical activity in spinner workers in the textile industry. We also conducted a comparison between the annual and weekly prevalence of MSDs.  Methods: The study sample included 700 male spinner workers (Mean±SD age: 32.6±6.5 years) from 10 companies in Najaf Abad City, Isfahan Province, Iran. Information about MSDs was collected through the Extended Nordic Musculoskeletal Questionnaire (ENMQ) from November 2018 to September 2019. Demographic characteristics were collected using a demographic checklist through a direct interview by one investigator.  Results: The present study findings suggested that the Mean±SD duration of work hours per week was 56.6±8.4 hours. The Mean±SD times of experiencing an injury equaled 27.8±33.1 months. The annual prevalence of MSDs was reported to be 74.4% for at least one of the 9 body regions. The highest annual prevalence rates belonged to the knees (54.0%), lower back (34.3%), and shoulders (23.1%). In contrast, the most weekly prevalent regions were the knees (44.6%), lower back (26.9%), and ankles (15.9%). Generally, the weekly prevalence was significantly lower than that of the annual prevalence (P<0.008). Job experience, marital status, and physical exercise presented a significant relationship with the annual prevalence of MSDs in the neck, shoulders, elbows, wrists, hands, knees, and ankle/foot. Contrarily, there was a significant relationship between job experience and the weekly prevalence of MSDs in the shoulder, lower back, and knee regions. The prevalence of neck, shoulders, wrists/hands, low back, knee, and ankle/foot pain was significantly increased in married workers. Furthermore, exercise history could cause a significant decrease in the prevalence of MSDs. Discussion: The high prevalence of MSDs in spinner workers is affected by some demographic characteristics; thus, such data should be considered in planning the prevention strategies within the textile industry

Slacklining: A narrative review on the origins, neuromechanical models and therapeutic use

International audienceSlacklining, the neuromechanical action of balance retention on a tightened band, is achieved through self-learned strategies combining dynamic stability with optimal energy expenditure. Published slacklining literature is recent and limited, including for neuromechanical control strategy models. This paper explores slacklining’s definitions and origins to provide background that facilitates understanding its evolution and progressive incorporation into both prehabil-itation and rehabilitation. Existing explanatory slacklining models are considered, their application to balance and stability, and knowledge-gaps highlighted. Current slacklining models predominantly derive from human quiet-standing and frontal plane movement on stable surfaces. These provide a multi-tiered context of the unique and complex neuro-motoric requirements for slacklining’s multiple applications, but are not sufficiently comprehensive. This consequently leaves an incomplete understanding of how slacklining is achieved, in relation to multi-directional instability and complex multi-dimensional human movement and behavior. This paper highlights the knowledge-gaps and sets a foundation for the required explanatory control mechanisms that evolve and expand a more detailed model of multi-dimensional slacklining and human functional movement. Such a model facilitates a more complete understanding of existing performance and rehabilitation applications that opens the potential for future applications into broader areas of movement in diverse fields including prostheses, automation and machine-learning related to movement phenotypes

Investigating the Effects of Different Working Postures on Cognitive Performance

Objective Individuals performance at the workplace is affected by different adopted postures. Sitting postures are mostly used during office work. Improper sitting postures may cause muscle fatigue and discomfort in the spine and also result in mental workload. Poor posture may result in human errors and delay in information processing. Previous studies have demonstrated the relationship between static sitting postures and cognitive factors such as reaction time to an auditory stimulus. Also, some recent studies have demonstrated the effect of static postures on cognitive performance. To our knowledge, none of the studies had considered the sitting and standing postures effects on cognitive performance simultaneously. The aim of this study was to evaluate cognitive performance during three different static working postures: standard sitting, standing, and self-selected sitting postures. Materials & Methods This semi-experimental design study was conducted on the twenty-nine healthy students (aged 20-30 years). The non-probability sampling method was selected. All participants provided their written informed consent. Participants with no musculoskeletal disorders, heart disease, spine surgery, and history of depression and stress were selected. Their depression status and level of stress were measured using Beck questionnaire. The study was approved by the Ethics Committee of University of Social Welfare and Rehabilitation Sciences. Subjects performed complex Stroop test and typing activity in an office-like laboratory setting at the University of Social Welfare and Rehabilitation Sciences. Stroop test lasted about 9-12 minutes, and a typing task was also designed for approximately 5 minutes for all subjects. Three random postures were selected based on common postures used in the office. The effects of the postures (standard standing, standard sitting, and self-selected sitting posture) on dependent variables such as total test duration and reaction time to congruent and incongruent stimulus, number of typing words and number of typing error were assessed with Repeated Measures ANOVA. To examine the differences between groups, the paired t-test was used. Results The results demonstrated that reaction time measure and number of typing error (accuracy) were affected by postures (P=0.001). Post hoc analysis demonstrated that reaction time was significantly different between self-selected sitting posture and standard sitting posture (P=0.001), self-selected sitting posture and standard standing posture (P=0.043), standard sitting posture and standard standing posture (P=0.001). With considering the average amount of reaction time to congruent and incongruent cases, it was observed that there is less reaction time in the standardized sitting posture (M=628.67 ms) compared to the self-selected sitting posture (M=689.41 ms) and standard standing posture (M= 675.16 ms). Also, among the three postures studied a significant difference was observed in the number of typing error words (P=0.001). The number of typing error (accuracy) was lower in this posture compared to the two other postures (M=1.58). Conclusion This study demonstrates that cognitive performance is affected by working postures. This study demonstrates that standard sitting posture is the best posture. Therefore, it is recommended that sitting posture can help in increasing cognitive performance in the workplace