Rasch analysis, reliability, and validity of the Turkish version of the Lumbar Spine Instability Questionnaire.

Background/aim: Lumbar instability is an important condition that can be seen frequently in people with low back pain, affecting both the progression and the choice of appropriate exercise. The Lumbar Spine Instability Questionnaire (LSIQ) is a simple and low-cost tool for evaluating disturbed back stability in people with low back pain. The aim of this study is to develop the Turkish version of the LSIQ (LSIQ-T) and to evaluate its psychometric properties using the Rasch model. Materials and methods: One hundred participants with chronic low back pain completed the LSIQ-T. The LSIQ-T was repeated for 30 participants after 1 week to establish its test-retest reliability. While internal and external construct validity were investigated using Rasch analysis and the Spearman correlation coefficient, respectively, reliability was evaluated in terms of internal consistency by Cronbach's alpha and the Person Separation Index (PSI). Results: All items of the LSIQ-T were found to fit the Rasch model (chi-square: 34.07 (df = 15), p = 0.0033). The internal construct validity was good, the overall mean item fit residual was 0 (SD: 0.765), and the mean person fit residual was 0.322 (SD: 1.123). Internal consistency reliability was low with a PSI of 0.63 although Cronbach's alpha was acceptable (0.68). When the test-retest reliability was examined via differential item functioning (DIF) by time, none of the items showed DIF. Conclusion: The LSIQ-T is a valid unidimensional scale for the Turkish population. Although the LSIQ-T had low internal consistency, it demonstrated unidimensionality and is appropriate for use. Therefore, the LSIQ-T can be used in clinical practice and scientific research.

The use of neuroimaging, Prechtl's general movement assessment and the Hammersmith infant neurological examination in determining the prognosis in 2-year-old infants with hypoxic ischemic encephalopathy who were treated with hypothermia.

BACKGROUND: The use of neuroimaging, the General Movement Assessment (GMA), and the Hammersmith Infant Neurological Examination (HINE) to identify the risk of neurodevelopmental delay in early infancy is recommended. AIM: The aim of this study was to examine the predictive power of neuroimaging, GMA and HINE for neurodevelopmental delay and cerebral palsy (CP) in infants with hypoxic ischemic encephalopathy (HIE) who were treated with hypothermia. STUDY DESIGN: Retrospective cohort. SUBJECTS AND OUTCOME MEASURES: This retrospective study included 47 (18 female and 29 male) infants who were treated with hypothermia due to HIE. Neonates with a diagnosis of HIE were followed and assessed using neuroimaging, GMA, HINE and the Bayley Scales of Infant and Toddler Development-II (Bayley II) between 3 m and 2 years of age. RESULTS: Out of the 47 infants with HIE, no fidgety movements were observed in 5 infants. The sensitivity and specificity in determining the psychomotor developmental index (PDI) score were 97% and 100%, respectively, for MRI; 92.9% and 100% for GMA; and 91.9% and 80% for the HINE. The sensitivity and specificity in determining the mental developmental index (MDI) score were 95% and 85.7%, respectively, for MRI; 90.5% and 80% for GMA; and 91.9% and 50% for HINE. The sensitivity and specificity in determining CP diagnosis at the age of 2 years were 83.3% and 95%, respectively, for MRI; 83.3% and 100% for GMA; and 83.3% and 87.8% for HINE. CONCLUSION: The interpretation of MRI, GMA, and HINE that are performed within the early period of life may be the gold standard for the early detection of neurodevelopmental risks in 2-year-old infants with HIE. Clinical implementation of these methods in the early period in the follow-up of these infants offers useful information for the early identification of neurodevelopmental risk and for planning early intervention.

Reliability and Validity of the Turkish Version of the Fremantle Back Awareness Questionnaire.

STUDY DESIGN: Cross-cultural adaptation and psychometric analysis. OBJECTIVE: To develop the Turkish version of the Fremantle Back Awareness Questionnaire (FreBAQ-T) and to evaluate its psychometric properties. SUMMARY OF BACKGROUND DATA: There is a growing interest in the role that the disturbance of body perception may lead to long-lasting pain problems such as chronic low back pain (CLBP). The Fremantle Back Awareness Questionnaire (FreBAQ) is a simple and low-cost way of evaluating disturbed back awareness in people with CLBP. METHODS: The FreBAQ was translated from English into Turkish using the forward-backward-forward method. One hundred four participants with low back pain completed the FreBAQ-T. The FreBAQ-T was repeated in 15 participants after 1 week to establish test-retest reliability. Although internal and external construct validity was investigated using Rasch analysis and Spearman correlation coefficient, respectively; reliability was evaluated in terms of internal consistency by Cronbach alpha and Person Separation Index. RESULTS: All items of the FreBAQ-T were found to fit the Rasch Model (chi-square 6.17 [df = 9], P = 0.723). The internal construct validity was good, overall mean item fit residual was -0.305 (standard deviation: 0.369) and mean person fit residual was -0.290 (standard deviation: 1.349). The reliability was good with Cronbach alpha of 0.87 and Person Separation Index of 0.82. When the test-retest was examined via differential item functioning by time, none of the items showed differential item functioning. CONCLUSION: The FreBAQ-T is a valid, reliable, and unidimensional scale for patients with CLBP. This scale will allow assessing back-specific perception in the Turkish population with CLBP. LEVEL OF EVIDENCE: 3.