Depression and Anxiety Symptoms Among Lebanese Lower Limb Traumatic Amputees: Association with Education, Employment, Adjustment to Amputation and Prosthesis Satisfaction.

ObjectiveTo examine and compare the association between the presence of depression and anxiety symptoms and different sociodemographic and clinical factors including the adjustment to amputation and prosthesis satisfaction among Lebanese individuals with lower limb amputation (LLA). Method: This cross-sectional study was conducted between December 2022 and May 2023 among 72 participants with LLA. Participants completed a questionnaire that included sociodemographic and clinical variables, the revised Trinity Amputation and Prosthesis Experience Scale (TAPES-R), and the Hopkins Symptom Checklist (HSCL-25). Result: Using the HSCL depression and anxiety cut-off, 25% of participants were categorized as having depression symptoms, with unemployment being significantly associated (p-value < .05) with depression. Similarly, 25% were classified as having anxiety symptoms, with both lower education and unemployment (p-value < .05) significantly linked to anxiety. TAPES-R subscales scores exhibited significant differences between non-depressed and depressed, as well as non-anxious and anxious participants (p-value < .05). Correlation analysis demonstrated significant relationship between HSCL scales and TAPES-R subscales; lower scores in adjustment to amputation and prosthesis satisfaction were moderately associated with increased rates of depression (r ranging between -0.331 and -0.500, p-values < .005) and increased rates of anxiety symptoms (r ranging between -0.362 and -0.441, p-values < .002). In addition, higher scores in activity limitation were moderately correlated to increased rates of depression and anxiety (r = 0.438 for anxiety and 0.490 for depression; p < .001). Conclusion: Mental health symptoms are associated with educational level, employment status, and adjustment to amputation and prosthesis satisfaction in Lebanese individuals with LLA. These findings should be considered to achieve optimal prosthetic rehabilitation.

The Radboud dysarthria assessment: validity and reliability of the Arabic version.

PURPOSE: To cross-culturally adapt and validate the Radboud Dysarthria Assessment (RDA) and the speech component of the Radboud Oral Motor inventory for Parkinson's disease (ROMP-speech) into the Arabic language among Lebanese subjects with dysarthria. MATERIALS AND METHODS: This study included 50 participants with dysarthria. The Arabic versions of the RDA (A-RDA) and the ROMP-speech (A-ROMP-speech) were administered in addition to the Arabic Speech Intelligibility test, the Lebanese Voice Handicap Index-10 (VHI-10lb) and semantic verbal fluency tasks. The maximum performance tasks were analyzed using the Praat software. The A-RDA qualitative recording form and the A-ROMP-speech were assessed for construct validity and internal consistency. The convergent validity of the maximum performance tasks, the severity scale, and the A-ROMP-speech were evaluated. RESULTS: Exploratory factor analysis of the qualitative recording form extracted 3 factors explaining 82.973% of the total variance, and it demonstrated high internal consistency (α = 0.912). The maximum performance tasks of the RDA correlated significantly with the corresponding Praat scores. The severity scale and the A-ROMP-speech correlated fairly to strongly with the Arabic Speech Intelligibility test (rs=-0.695 and -0.736, p < 0.001) and the VHI-10lb (r = 0.539 and 0.640, p < 0.001). CONCLUSION: The A-RDA and the A-ROMP-speech are valid and reliable dysarthria tools among Lebanese subjects.

The present study cross-culturally adapts and validates a dysarthria assessment tool in the Arab culture.The Arabic Radboud Dysarthria Assessment (A-RDA) and the speech component of the Arabic Radboud Oral Motor inventory for Parkinson's disease-speech component (A-ROMP-speech) are valid and reliable measures to be used among Lebanese individuals with dysarthria.The use of the A-RDA and the A-ROMP-speech will contribute to better therapeutic outcomes and will lead to a common language among speech and language therapists.

Impact of spasticity on quality of life of Lebanese individuals with spinal cord injury: Validity and reliability of the Arabic modified patient-reported impact of spasticity measure.

CONTEXT: Spasticity is one of the most complicated problems after spinal cord injury (SCI). Different assessment tools are used to assess spasticity and its impact on individuals with SCI. The modified Patient-Reported Impact of Spasticity Measure (mPRISM) is a recommended tool to measure spasticity in spinal cord damage. OBJECTIVE: To translate and cross-culturally adapt mPRISM to Arabic and examine its validity and reliability in a sample of Lebanese adults with SCI. DESIGN: A cross-sectional study. PARTICIPANTS: 107 individuals with SCI. OUTCOME MEASURES: mPRISM. INTERVENTION: mPRISM was translated into Arabic, and pilot testing of the pre-final version was conducted. Exploratory factor analysis, Poisson regression, and Cronbach's alpha were performed to evaluate the construct and convergent validity and reliability of the Arabic version of mPRISM (AR-mPRISM). RESULTS: mPRISM was successfully translated and cross-culturally adapted to Arabic. Results of an exploratory factor analysis conducted on the scale showed a coherent 5-domain structure that explained 69.631% of the total variance. Convergent validity was demonstrated by a significant association with sociodemographic and injury correlates. The five extracted subscales demonstrated high internal consistency with a Cronbach's alpha > 0.8. CONCLUSION: Results support the construct and convergent validity and reliability of AR-mPRISM for assessing spasticity impact on the quality of life of Arabic Speaking SCI population.

Computed tomography findings as early predictors of long-term language impairment in patients with traumatic brain injury.

This study aims to assess the relationship between computed tomography (CT) findings, during the acute phase of hospitalization, and long-term language impairment in people with traumatic brain injury (TBI). Another aim was to assess the receptive and expressive abilities of subjects with TBI based on the location of the injury. This is a retrospective observational study including 49 participants with TBI due to war injuries. The Arabic Diagnostic Aphasia Battery (A-DAB-1) was administered to the participants and the Helsinki CT score was computed to quantify brain damage. The results showed that the Helsinki CT score was negatively correlated with the total score of the A-DAB-1 (r = -0.544, p-value < 0.0001). Simple linear regression supported such findings and reflected an inversely proportional relationship between both variables (p-value < 0.0001). When compared with subjects having right hemisphere damage, subjects with left hemisphere and bilateral brain damage performed more poorly on language tasks respectively as follows: A-DAB-1 overall score (92.08-66.08-70.28, p-value = 0.021), Content of descriptive speech (9.57-6.69-7.22, p-value = 0.034), Verbal fluency (6.57-3.54-3.89, p-value = 0.002), Auditory comprehension (9.71-7.54-7.78, p-value = 0.039), Complex auditory commands (9.71-7.65-7.56, p-value = 0.043), Repetition (9.75-7.08-7.61, p-value = 0.036), Naming (9.93-7.15-8.11, p-value = 0.046). Following TBI, CT findings on admission can significantly predict long-term language abilities, with left side lesions inducing poorer outcomes.

Chronic pain among Lebanese individuals with spinal cord injury: Pain interference and impact on quality of life.

Background: Chronic pain is one of the most disabling consequences of spinal cord injury (SCI). Although studies have identified a link between chronic pain and decreased quality of life (QOL) among this population, few studies have looked into the experience of chronic pain in Lebanese individuals with SCI and the impact of pain characteristics on QOL. Thus, the present study evaluated the chronic pain experience and its associated factors among Lebanese individuals with SCI in order to determine the impact of pain on QOL. Methods: A cross-sectional study was conducted on 81 Lebanese individual with SCI between August 1st and October 31, 2022. The collected information included sociodemographic characteristics, SCI-related information, pain-related variables, and the 12-item Short Form Health Survey (SF-12). Factors associated with pain interference were evaluated using a linear regression model. One-way ANOVA and independent sample t-test were used to evaluate the association of different baseline and pain characteristics with QOL. Results: In the present study, 81.5% of participants reported chronic pain with the majority of them having neuropathic pain type. Employment status (P = 0.034), type of pain (P = 0.009), and pain severity (P = 0.028) were significantly associated with pain interference. Unemployed participants and those with severe chronic pain, particularly neuropathic pain, had lower QOL. Conclusion: Chronic pain was found to be highly prevalent among Lebanese patients with SCI. Pain interference and QOL were significantly affected by employment status and pain type. Therefore, targeting chronic pain and its associated factors in rehabilitation practice is warranted.

Neuroanatomical regions associated with non-progressive dysarthria post-stroke: a systematic review.

BACKGROUND: Dysarthria is a common and persisting sequela to stroke. It can have a negative influence on psychological wellbeing, and quality of life. This systematic review aimed to describe and identify the neuroanatomical regions associated with non-progressive dysarthria following stroke. METHODS: A systematic search of PubMed, Ovid Medline, CINAHL, Cochrane, Scopus, and ScienceDirect was conducted to identify all relevant articles published in peer-reviewed journals up to December 2021. Following data extraction, the National Institutes of Health (NIH) quality assessment tools were used to evaluate the methodological quality of the included studies. RESULTS: Out of 2186 papers found in the literature related to dysarthria post-stroke, 24 met the inclusion criteria. Eligible articles assessed 1150 post-stroke subjects. Out of them, 420 subjects had dysarthria from isolated lesions. Regarding dysarthric subjects with ischemic strokes, 153 sustained supratentorial infarctions, while 267 had infratentorial infarctions. The majority had pontine infarctions (n = 142), followed by infarctions in the corona radiata (n = 104), and the cerebellum (n = 64). CONCLUSION: This systematic review is the first step toward establishing a neuroanatomical model of dysarthria throughout the whole brain. Our findings have many implications for clinical practice and provide a framework for implementing guidelines for early detection and management of dysarthria post-stroke.

Cross-cultural adaptation and validation of the Arabic Project for the Epidemiological Analysis of Critical Care Patients (PAEEC) scale in individuals with traumatic brain injury in Lebanon.

The aim of this study is to cross-culturally adapt the Project for the Epidemiological Analysis of Critical Care Patients (PAEEC) Quality of Life (QoL) scale into the Arabic language and to examine its clinimetric properties, including validity and reliability among Lebanese native speaker with traumatic brain injury (TBI). This is a cross-sectional study including 49 men with TBI aged between 20 and 59 years. The Arabic version of the PAEEC (PAEEC-A) was administered to the subjects or their primary caregiver as well as the Short Form Health Survey 36 (SF-36). The internal consistency, test-retest reliability, content, construct and convergent validity were evaluated. The PAEEC-A displayed high internal consistency (Chronbach's alpha = 0.916) and test-retest reliability (Intraclass Correlation coefficient = 0.966). Exploratory factor analysis extracted a 3-factor model that explained 68.48% of the total variance. As for the convergent validity, Spearman correlations between the PAEEC-A total score and the physical and mental components of the SF-36 were -0.788 and -0.794, respectively (p-value < 0.0001 for both). The findings indicate that the PAEEC-A has robust clinimetric properties and is a valid and reliable quality of life measure among Lebanese men with traumatic brain injury.

Assessing the psychological impact of COVID-19 outbreak and its related factors on Lebanese individuals with physical disabilities.

BACKGROUND: In February 2020, the Lebanese authorities announced the first Coronavirus 2019 (COVID-19) case. Since then, the cases increased significantly, but information on the public's psychological status and specifically individuals with physical disabilities is still limited. PURPOSE: The study aims to assess the psychological impact of the COVID-19 outbreak on Lebanese individuals with physical disabilities and study the associated factors. MATERIALS AND METHODS: This is a cross-sectional study involving 118 individuals with physical disabilities. Each filled out an online survey with three sections: a personal questionnaire, the Arabic versions of the Hopkins Symptom Checklist-25 and the Fear of COVID-19 scale. Data regarding participants' baseline characteristics, fear, anxiety, and depression were collected and analyzed using the Chi-square test and regressions models. RESULTS: Individuals with physical disabilities exhibited mild fear of COVID-19, with fear being correlated with age, educational level, and employment status. Furthermore, 22.9% of the population was found to be anxious, and 31.5% were depressed. Anxiety was associated with both marital status and employment status. Finally, depression was proved to be influenced by marital status, employment, and educational level. CONCLUSION: Results extracted showed that individuals with physical disabilities require substantial attention in order to manage their psychological state during pandemics.

Prediction of quality of life by Helsinki computed tomography scoring system in patients with traumatic brain injury.

PURPOSE: The aim of this study is to assess the association between the Computed Tomography (CT) findings on admission, according to the Helsinki computed tomography CT score, and patient's Quality of Life (QoL) following traumatic brain injury (TBI) in Lebanon. METHODS: A retrospective study was performed on 49 males suffering from war induced TBI. Participants were stratified into two groups based on the date of injury. Helsinki CT score was calculated for CT scans of participants. Outcomes were assessed using QoL scales including the Project for the Epidemiological Analysis of Critical Care Patients scale (PAEEC). RESULTS: Correlation analysis showed that QoL, up to 4 years post-TBI, was significantly associated with Helsinki CT classification. Group 1 of subjects living with TBI for 1-2 years revealed a correlation coefficient r = 0.536, p-value = 0.027, whereas, group 2 including subjects who are injured since 3-4 years, had a correlation coefficient r = 0.565, p-value = 0.001. CONCLUSION: The present study showed that patients with traumatic brain injury experienced significant quality of life deterioration up to 4 years post-TBI. Our findings propose the important role of Helsinki score in predicting the quality of life among patients with TBI.

Validity and Reliability of the Arabic Patient Health Questionnaire-9 in Patients with Spinal Cord Injury in Lebanon.

BACKGROUND: Depression is a prevalent and disabling condition associated with spinal cord injury (SCI). Such associated negative factor warrants the use of valid and reliable psychological assessment tools among this group. One of the available assessment means is the Patient Health Questionnaire-9 (PHQ-9), a short screening measure that evaluates depression status. Our aim is to test the psychometric properties of the Arabic version of the PHQ-9 including validity and reliability among Lebanese individuals with SCI. METHODS: This is a cross-sectional study conducted between January and June 2018, including 51 participants with SCI. Questionnaire and assessment measures were administered to the subjects. The internal consistency, test-retest reliability, and the factor structure of the PHQ-9 were evaluated in addition to the convergent validity, which was established by comparing the scale's total score with the scores of the Hamilton Depression Rating Scale. RESULTS: Exploratory factor analysis revealed 3 factors accounting for 66.2% of the total variance. The scale demonstrated good internal consistency (Cronbach's alpha = 0.71) and test-retest reliability (Intraclass correlation coefficient = 0.88). Significant correlation was found between the PHQ-9 and the Hamilton Depression Rating Scale (r = 0.71) suggesting good convergent validity. CONCLUSIONS: Our findings suggest that the PHQ-9 has good psychometric properties and is a valid and reliable measure of depression among the Lebanese individuals with SCI.