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1.
Am J Med Genet A ; 194(6): e63541, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38234177

RESUMO

Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic disorder that can cause an individual significant chronic pain (CP). CP affects quality of life and daily functioning, yet there are limited effective treatments for CP within NF1. The current study describes the impact of CP using the Neurofibromatosis Pain Module (NFPM). The NFPM is a self-reported clinical assessment that evaluates the impact of CP across multiple domains (e.g., interference, severity, tolerance, and symptomology) and three prioritized pain regions. A cross-sectional study (N = 242) asked adults with NF1 to describe and rate their pain using the NFPM. The results indicated that they reported moderate pain severity (M = 6.6, SD = 2.0) on a 0-10 scale, that 54% (n = 131) had been in pain at least 24 days in the last 30, for 75% (n = 181) sleep was affected, and 16% reported that nothing was effective in reducing their CP for their primary pain region. The current results extend previously published work on CP within adults with NF1 and indicate that more emphasis on understanding and ameliorating CP is required. The NFPM is a sensitive clinical measure that provides qualitative and quantitative responses to inform medical providers about changes in CP.


Assuntos
Dor Crônica , Neurofibromatose 1 , Medição da Dor , Qualidade de Vida , Humanos , Neurofibromatose 1/complicações , Neurofibromatose 1/genética , Feminino , Masculino , Dor Crônica/genética , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Adolescente , Adulto Jovem , Idoso , Autorrelato , Inquéritos e Questionários
2.
J Neuroeng Rehabil ; 20(1): 57, 2023 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-37131238

RESUMO

BACKGROUND: Markerless motion capture (MMC) technology has been developed to avoid the need for body marker placement during motion tracking and analysis of human movement. Although researchers have long proposed the use of MMC technology in clinical measurement-identification and measurement of movement kinematics in a clinical population, its actual application is still in its preliminary stages. The benefits of MMC technology are also inconclusive with regard to its use in assessing patients' conditions. In this review we put a minor focus on the method's engineering components and sought primarily to determine the current application of MMC as a clinical measurement tool in rehabilitation. METHODS: A systematic computerized literature search was conducted in PubMed, Medline, CINAHL, CENTRAL, EMBASE, and IEEE. The search keywords used in each database were "Markerless Motion Capture OR Motion Capture OR Motion Capture Technology OR Markerless Motion Capture Technology OR Computer Vision OR Video-based OR Pose Estimation AND Assessment OR Clinical Assessment OR Clinical Measurement OR Assess." Only peer-reviewed articles that applied MMC technology for clinical measurement were included. The last search took place on March 6, 2023. Details regarding the application of MMC technology for different types of patients and body parts, as well as the assessment results, were summarized. RESULTS: A total of 65 studies were included. The MMC systems used for measurement were most frequently used to identify symptoms or to detect differences in movement patterns between disease populations and their healthy counterparts. Patients with Parkinson's disease (PD) who demonstrated obvious and well-defined physical signs were the largest patient group to which MMC assessment had been applied. Microsoft Kinect was the most frequently used MMC system, although there was a recent trend of motion analysis using video captured with a smartphone camera. CONCLUSIONS: This review explored the current uses of MMC technology for clinical measurement. MMC technology has the potential to be used as an assessment tool as well as to assist in the detection and identification of symptoms, which might further contribute to the use of an artificial intelligence method for early screening for diseases. Further studies are warranted to develop and integrate MMC system in a platform that can be user-friendly and accurately analyzed by clinicians to extend the use of MMC technology in the disease populations.


Assuntos
Inteligência Artificial , Captura de Movimento , Humanos , Movimento , Movimento (Física) , Fenômenos Biomecânicos , Tecnologia
3.
Sensors (Basel) ; 23(8)2023 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-37112316

RESUMO

Recovery after ankle fracture surgery can be slow and even present functional deficits in the long term, so it is essential to monitor the rehabilitation process objectively and detect which parameters are recovered earlier or later. The aim of this study was (1) to evaluate dynamic plantar pressure and functional status in patients with bimalleolar ankle fracture 6 and 12 months after surgery, and (2) to study their degree of correlation with previously collected clinical variables. Twenty-two subjects with bimalleolar ankle fractures and eleven healthy subjects were included in the study. Data collection was performed at 6 and 12 months after surgery and included clinical measurements (ankle dorsiflexion range of motion and bimalleolar/calf circumference), functional scales (AOFAS and OMAS), and dynamic plantar pressure analysis. The main results found in plantar pressure were a lower mean/peak plantar pressure, as well as a lower contact time at 6 and 12 months with respect to the healthy leg and control group and only the control group, respectively (effect size 0.63 ≤ d ≤ 0.97). Furthermore, in the ankle fracture group there is a moderate negative correlation (-0.435 ≤ r ≤ 0.674) between plantar pressures (average and peak) with bimalleolar and calf circumference. The AOFAS and OMAS scale scores increased at 12 months to 84.4 and 80.0 points, respectively. Despite the evident improvement one year after surgery, data collected using the pressure platform and functional scales suggest that recovery is not yet complete.


Assuntos
Fraturas do Tornozelo , Desempenho Físico Funcional , Humanos , Fraturas do Tornozelo/cirurgia
4.
Sensors (Basel) ; 22(8)2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35459036

RESUMO

Ankle fractures can cause significant functional impairment in the short and long term. In recent years, gait analysis using inertial sensors has gained special relevance as a reliable measurement system. This study aimed to evaluate the differences in spatiotemporal gait parameters and clinical−functional measurements in patients with bimalleolar ankle fracture and healthy subjects, to study the correlation between the different variables, and to analyze the test−retest reliability of a single inertial sensor in our study population. Twenty-two subjects with bimalleolar ankle fracture six months after surgery and eleven healthy subjects were included in the study. Spatiotemporal parameters were analyzed with the G-WALK sensor. Functional scales and clinical measures were collected beforehand. In the ankle fracture group, the main differences were obtained in bilateral parameters (effect size: 0.61 ≤ d ≤ 0.80). Between-group differences were found in cadence, speed, stride length, and stride time (effect size: 1.61 ≤ d ≤ 1.82). Correlation was moderate (0.436 < r < 0.554) between spatiotemporal parameters and clinical−functional measures, explaining up to 46% of gait performance. Test−retest reliability scores were high to excellent (0.84 ≤ ICC ≤ 0.98), with the worst results in the gait phases. Our study population presents evident clinical−functional impairments 6 months after surgery. The G-WALK can be considered a reliable tool for clinical use in this population.


Assuntos
Fraturas do Tornozelo , Fraturas do Tornozelo/cirurgia , Marcha , Análise da Marcha , Humanos , Reprodutibilidade dos Testes , Caminhada
5.
J Hand Ther ; 35(2): 174-185, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35491299

RESUMO

BACKGROUND: The aim of this study was to synthesize the psychometric evidence on different patient reported outcome measures (PROMs) for shoulder disorders. METHODS: This overview conducted a search of six databases. Included systematic reviews must address at least one psychometric property from a PROM for shoulder disorders. Risk of bias was assessed by A MeaSurement Tool to Assess Systematic Reviews (AMSTAR). RESULTS: Thirteen systematic reviews were identified that assessed measurement properties of 15 different PROMs. Based on AMSTAR, 1 review had a high risk of bias and 7 reviews had a moderate risk of bias. Excellent test-reliability scores of intraclass correlation coefficients (0.85-0.99) were reported by the Disabilities of the Arm, Shoulder and Hand, Shoulder Pain and Dsiability Index, American Shoulder and Elbow Surgeon score and Western Ontario Rotator Cuff Index. Construct validity was supported (r = 0.5-0.8) for the Disabilities of the Arm, Shoulder and Hand, Shoulder Pain and Dsiability Index, American Shoulder and Elbow Surgeon score and Western Ontario Rotator Cuff Index. Limited evidence of responsiveness was reported across various PROMs. CONCLUSION: Strong reliability and convergent validity properties have been reported across multiple reviews for the Disabilities of the Arm, Shoulder and Hand, Shoulder Pain and Dsiability Index, American Shoulder and Elbow Surgeon score, Simple Shoulder Test and Western Ontario Rotator Cuff Index, which could be considered for a core clinical outcome set.


Assuntos
Lesões do Manguito Rotador , Dor de Ombro , Humanos , Medidas de Resultados Relatados pelo Paciente , Reprodutibilidade dos Testes , Lesões do Manguito Rotador/cirurgia , Ombro , Dor de Ombro/diagnóstico , Inquéritos e Questionários , Revisões Sistemáticas como Assunto
6.
Australas Psychiatry ; 28(2): 175-179, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31637964

RESUMO

OBJECTIVE: To compare the acceptability of three distinct physical activity measurement tools in people with psychosis: an objective measurement tool, a self-report measure, and an exercise capacity test. METHODS: We measured the completion rate for each measurement tool. Participants rated the ease/difficulty of each measure using a 7-point Likert scale. Participants were also asked to rank the three tools in order of the ease of use. RESULTS: Sixty-six per cent (46/69) of participants completed all three assessment tools, and 60.9% (42/69) completed the acceptability questionnaire. The majority of the participants found it easy to complete all three measurement tools. The majority (52.8%) of the participants ranked the objective measurement tool as the easiest to use. CONCLUSION: All three measures were acceptable to people with psychosis, but objective measurement tools may be easier to use.


Assuntos
Teste de Esforço/métodos , Exercício Físico , Transtornos Psicóticos/reabilitação , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Autorrelato , Adulto Jovem
7.
J Sport Rehabil ; 30(4): 680-684, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32932236

RESUMO

CONTEXT: Technological advances have given smartphones the capabilities of sensitive clinical measurement equipment at lesser cost and higher availability. The Clinometer is a smartphone application that can be used to measure the joint range of motion in a clinical setting, but psychometric properties of the tool's use measuring cervical range of motion (CROM) are not established. OBJECTIVES: The purpose of this study was to examine the validity and intrarater reliability of the Clinometer application for the measurement of CROM (ie, flexion, extension, rotation, lateral flexion) and to determine the minimal detectable change and SEM. DESIGN: A blinded, repeated-measures correlational design was employed. SETTING: The study was conducted collaboratively between 2 athletic training clinics. PARTICIPANTS: A convenience sample of healthy adults ages 18-30 years were recruited. Participants with any history in the last 3 months of cervical or thoracic pathology, pain, or any musculoskeletal injury were excluded. MAIN OUTCOME MEASURES: Three repetitions of each motion were measured by a primary researcher with a goniometer. The same researcher then conducted 3 blinded measurements with the Clinometer application following the same procedure. A second researcher, blinded to the goniometer measurements, recorded the results. Thirty minutes later, testing was repeated with the application. The Pearson correlation was calculated to determine validity of the application compared with goniometry. RESULTS: The measurements between devices had moderate to excellent concurrent validity, with the coefficients ranging between 0.544 and 0.888, P < .01. Test-retest reliability of the CROM measurement using the application was moderate to excellent, with intraclass correlation coefficients ranging between .774 and .928. Across all movements, the SEM ranged from 1.17° to 2.01°, and the minimal detectable change ranged from 1.18° to 2.02°. CONCLUSION: The Clinometer application is a valid and reliable instrument for measuring active CROM. LEVEL OF EVIDENCE: clinical measurement, level 1b.


Assuntos
Aplicativos Móveis , Pescoço/fisiologia , Amplitude de Movimento Articular/fisiologia , Smartphone , Adulto , Artrometria Articular/instrumentação , Artrometria Articular/métodos , Correlação de Dados , Feminino , Humanos , Masculino , Fotografação , Psicometria , Reprodutibilidade dos Testes , Rotação , Postura Sentada , Decúbito Dorsal , Adulto Jovem
8.
Clin Chem Lab Med ; 57(7): 954-966, 2019 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-30471218

RESUMO

B-type natriuretic peptide (BNP) is a circulating biomarker that is mainly applied in heart failure (HF) diagnosis and to monitor disease progression. Because some identical amino acid sequences occur in the precursor and metabolites of BNP, undesirable cross-reactions are common in immunoassays. This review first summarizes current analytical methods, such as immunoassay- and mass spectrometry (MS)-based approaches, including the accuracy of measurement and the inconsistency of the results. Second, the review presents some promising approaches to resolve the current barriers in clinical BNP measurement, such as how to decrease cross-reactions and increase the measurement consistency. Specific approaches include research on novel BNP assays with higher-specificity chemical antibodies, the development of International System of Units (SI)-traceable reference materials, and the development of structure characterization methods based on state-of-the-art ambient and ion mobility MS technologies. The factors that could affect MS analysis are also discussed, such as biological sample cleanup and peptide ionization efficiency. The purpose of this review is to explore and identify the main problems in BNP clinical measurement and to present three types of approaches to resolve these problems, namely, materials, methods and instruments. Although novel approaches are proposed here, in practice, it is worth noting that the BNP-related peptides including unprocessed proBNP were all measured in clinical BNP assays. Therefore, approaches that aimed to measure a specific BNP or proBNP might be an effective way for the standardization of a particular BNP form measurement, instead of the standardization of "total" immunoreactive BNP assays in clinical at present.


Assuntos
Espectrometria de Massas/métodos , Peptídeo Natriurético Encefálico/análise , Biomarcadores/análise , Insuficiência Cardíaca/diagnóstico , Humanos
9.
J Hand Ther ; 32(2): 222-232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30587433

RESUMO

STUDY DESIGN: Systematic review. INTRODUCTION: The Patient-Rated Elbow Evaluation (PREE) and the self-report section of the American Shoulder and Elbow Surgeons-elbow form (pASES-e) are 2 patient-reported outcome measures (PROMs) commonly used to assess pain and disability arising from elbow disorders. PURPOSE OF THE STUDY: To systematically review and summarize the quality and content of the evidence that is available on the psychometric properties of the PREE and pASES-e. METHODS: We systematically searched the online databases PubMed, EMBASE, ProQuest, Scopus, Cumulative Index to Nursing and Allied Health Literature, UptoDate, ProQuest Dissertations & Theses, and Google Scholar. Ninety-one articles were retrieved, and after screening, 9 were included in the final analysis. Data extraction and quality appraisal was performed by 2 independent raters. Descriptive synthesis of the reviewed studies was completed. RESULTS: Seven of the 9 studies had a quality score of 75% or higher. Agreement between the raters was good (kappa, 0.81). Both the PROMs did not demonstrate any floor and ceiling effects except for the satisfaction subscale of the pASES-e. Factor analysis revealed multidimensionality in the function subscale for both the PROMs. Construct validity was good with correlations above 0.70. Both were highly reliable with interclass correlation coefficient of >0.90. They were also highly responsive with an effect size and standardized response mean above 1. The minimal clinical important difference was not estimated for either measures. DISCUSSION: This study concluded that strong clinical measurement properties exist for both the PREE and the pASES-e. We identified gaps in the current evidence for both the ASES-e and the PREE. Future studies need to calculate clinically important estimates like MCID, SEM, and others; and provide clear and specific conclusions. CONCLUSION: The PREE and pASES-e have been established to be valid, reliable, and sensitive to change in both clinical and research settings based on high-quality evidence.


Assuntos
Artralgia/fisiopatologia , Articulação do Cotovelo/fisiopatologia , Medidas de Resultados Relatados pelo Paciente , Avaliação da Deficiência , Humanos , Medição da Dor , Psicometria , Autorrelato
10.
Violence Vict ; 33(6): 1055-1071, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30573550

RESUMO

Counselors in Rape Crisis Centers (RCCs) provide crucial services to survivors of sexual violence. However, little is known about RCCs, including the treatment goals and assessment strategies of counselors. Counselors in all Texas RCCs (n = 83) were invited to participate in a web-based survey. Participants were asked to indicate which treatment goals they frequently identified and assessed, as well as their usual assessment techniques. Counselors endorsed treatment goals around self-esteem, empowerment, and relational functioning, along with trauma and mental health. Fewer counselors endorsed goals around drugs/alcohol or school/work/sexual functioning. Few counselors reported use of standardized measures. Counselors in urban settings were more likely to endorse goals related to mental health. There are discrepancies between counselors' goals and how often outcomes are assessed. Increased assessment could promote the provision of effective services and access to funding.


Assuntos
Conselheiros/psicologia , Objetivos , Conhecimentos, Atitudes e Prática em Saúde , Estupro/psicologia , Estupro/reabilitação , Adulto , Idoso , Aconselhamento , Intervenção em Crise , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Saúde Mental , Pessoa de Meia-Idade , Poder Psicológico , Avaliação de Programas e Projetos de Saúde , Autoimagem , Inquéritos e Questionários , Texas , Resultado do Tratamento , Adulto Jovem
11.
Cardiovasc Drugs Ther ; 31(2): 179-186, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28421332

RESUMO

PURPOSE: The Statin-Associated Muscle Symptom Clinical Index (SAMS-CI) is a method for assessing the likelihood that a patient's muscle symptoms (e.g., myalgia or myopathy) were caused or worsened by statin use. The objectives of this study were to prepare the SAMS-CI for clinical use, estimate its inter-rater reliability, and collect feedback from physicians on its practical application. METHODS: For content validity, we conducted structured in-depth interviews with its original authors as well as with a panel of independent physicians. Estimation of inter-rater reliability involved an analysis of 30 written clinical cases which were scored by a sample of physicians. A separate group of physicians provided feedback on the clinical use of the SAMS-CI and its potential utility in practice. RESULTS: Qualitative interviews with providers supported the content validity of the SAMS-CI. Feedback on the clinical use of the SAMS-CI included several perceived benefits (such as brevity, clear wording, and simple scoring process) and some possible concerns (workflow issues and applicability in primary care). The inter-rater reliability of the SAMS-CI was estimated to be 0.77 (confidence interval 0.66-0.85), indicating high concordance between raters. With additional provider feedback, a revised SAMS-CI instrument was created suitable for further testing, both in the clinical setting and in prospective validation studies. CONCLUSIONS: With standardized questions, vetted language, easily interpreted scores, and demonstrated reliability, the SAMS aims to estimate the likelihood that a patient's muscle symptoms were attributable to statins. The SAMS-CI may support better detection of statin-associated muscle symptoms in clinical practice, optimize treatment for patients experiencing muscle symptoms, and provide a useful tool for further clinical research.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Músculo Esquelético/efeitos dos fármacos , Mialgia/induzido quimicamente , Inquéritos e Questionários , Retroalimentação Psicológica , Humanos , Entrevistas como Assunto , Idioma , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Mialgia/diagnóstico , Mialgia/fisiopatologia , Variações Dependentes do Observador , Valor Preditivo dos Testes , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Fluxo de Trabalho
12.
J Shoulder Elbow Surg ; 25(9): 1523-31, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27038564

RESUMO

BACKGROUND: Loss of shoulder internal rotation (IR) range of motion (ROM) is prevalent in overhead athletes, but it can also be seen in nonathletic persons. A paucity of normative data exists, however, for shoulder IR ROM in positions other than supine, especially in nonathletic persons. The aim of this study was to determine shoulder IR ROM differences between the sidelying, semi-sidelying, and supine positions as well as to establish initial normative values for IR ROM for the sidelying and semi-sidelying positions in nonathletic persons. METHODS: IR ROM was measured on 204 nonathletic persons using the sidelying, semi-sidelying, and supine positions. Mean values of IR ROM for each position were calculated. Differences in IR ROM across the 3 positions and side-to-side differences were examined, including the influence of sex and age on IR ROM. RESULTS: Intra-rater and inter-rater reliability for the sidelying position was excellent. The sidelying position had significantly less IR ROM compared with the other positions, and there was a significant side-to-side IR ROM difference, greatest for the sidelying position (6.8°). Women had significantly more IR ROM than men did, with sidelying normative values of 49° and 55° for female dominant and nondominant shoulders, respectively, and 42° and 51° for male dominant and nondominant shoulders, respectively. CONCLUSION: This investigation establishes initial normative IR ROM values for the sidelying position for both shoulders and sexes. Health care providers can begin to examine IR ROM deficits using these normative values for the sidelying position.


Assuntos
Postura/fisiologia , Amplitude de Movimento Articular/fisiologia , Articulação do Ombro/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Reprodutibilidade dos Testes , Rotação , Fatores Sexuais , Adulto Jovem
13.
Nurse Educ Today ; 133: 106046, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38007985

RESUMO

BACKGROUND: The wellbeing of nursing professionals can be affected by emotionally challenging situations. Emotional intelligence (EI) is a recognised ability to manage stress, reduce work overload, and improve clinical relationships and decision making. Therefore, these emotional skills should be identified and developed throughout nursing education. OBJECTIVES: The aim of this study is to create an observer-based emotional measurement tool to assess the level of emotional skills in university students. DESIGN: This is a cross-sectional study. SETTING: Complutense University in Madrid, Spain. PARTICIPANTS: A total of 415 first- and fourth-year nursing students participated. METHODS: The Situational Emotional Response Scale (ERES) is a questionnaire for observing emotional competence in nursing practice. It underwent content validation using the Delphi method with 6 experts, resulting in a final version of 34 items. Focus group sessions were conducted with nursing students to ensure readability and appropriateness. Participants completed the ERES after viewing two clinical interaction videos, resulting in two sets of responses. Half of the responses were used for exploratory factor analysis (EFA) and half for confirmatory factor analysis (CFA). RESULTS: A total of 415 nursing students participated in the study. Four factors were extracted, explaining 55.1 % of the variance. The CFA was conducted with 208 students, yielding a total of 4 factors and a variance of 55.1 %. The internal consistency of the scale was high, with Cronbach's α and McDonald's ω coefficients of 0.947 and 0.949, respectively. Test-retest reliability showed a moderate intra-class correlation coefficient of 0.604 (95 % CI: 0.503-0.688) over a 15-day interval. CONCLUSIONS: The ERES questionnaire is well grounded in the theoretical framework of emotional competence as manifested in clinical practice. The empirical evidence provided by this study suggests that the ERES is a reliable, valid, useful, and innovative instrument for measuring emotional competence in university students.


Assuntos
Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Reprodutibilidade dos Testes , Estudos Transversais , Emoções , Inquéritos e Questionários , Psicometria
14.
Braz J Phys Ther ; 28(5): 101112, 2024 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-39340897

RESUMO

BACKGROUND: The modified Fresno test is a questionnaire developed to evaluate Evidence-Based Practice among physical therapists. A previous study has indicated that a shorter version with 9 items would be more appropriate for Brazilian physical therapists. OBJECTIVES: To test the measurement properties of the modified Fresno test - Brazilian-Portuguese short version. METHODS: To analyze the reliability of the modified Fresno test - Brazilian-Portuguese short version by two raters (intra and inter-rater) in a sample of 133 physical therapists. The intraclass correlation coefficient (ICC2,1) and standard error of measurement (SEM) was used to assess the test-retest reliability. Internal consistency was tested using the Cronbach's alpha coefficient. An expert committee analyzed content validity using the content validity index (CVI). Confirmatory factor analysis (CFA) using the principal components method was used to assess construct validity. Responsiveness was estimated using effect size, and ceiling and floor effects were also investigated. RESULTS: Inter-rater and intra-rater reliability were, respectively: ICC= 0.93 (95 % CI 0.91, 0.95); rater 1 - ICC= 0.95 (95 % CI 0.94, 0.97); rater 2 - ICC= 0.98 (95 % CI 0.98, 0.99). The agreement was very good (values ≤ 5 %). Internal consistency was good for most instrument items (≥ 0.80). The CVI showed agreement among the expert committee members (0.96). The Cronbach's alpha coefficients calculated for the corrected item total showed values greater than 0.40. In the CFA, the "model 2" showed acceptable indices (≥ 0.90). Responsiveness was classified as very small. No ceiling and floor effects. CONCLUSION: The Fresno Modified Test - Brazilian-Portuguese short version has good to excellent reliability. CFA showed that the fit indices were adequate to be used in the population of interest.

15.
Orthop Traumatol Surg Res ; : 103981, 2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39209256

RESUMO

INTRODUCTION: The threshold of a Leg Length Discrepancy (LLD) by clinical examination on a sheet or centimeter paper (CP) is not known precisely whether or not it concerns limbs equipped with a hip prosthesis. We therefore conducted a prospective in silico study in order to: (1) determine the reproducibility and sensitivity of the clinical measurement of the LLD in different ideal and "degraded" clinical situations, (2) determine the threshold from which the human eye is capable of detecting a length inequality in clinic, (3) to determine whether the use of a graduated support (centimeter paper) improves the clinical measurement threshold. HYPOTHESIS: Our hypothesis was that clinical measurement on a centimeter support would improve clinical measurement accuracy. MATERIAL AND METHODS: This was an in silico study, the experiment was conducted on a mannequin. Different inequalities were created on a mannequin and photographed with a total of 30 inequalities from -22 to +22 mm on sheet or centimeter paper (CP). This was a multicenter study, with 40 different readers. We asked the readers to make a second measurement one month later. We evaluated the inter- and intra-observer reproducibility. The error rate at the threshold of 3 mm and 5 mm were calculated versus the gold standard. Finally, we determined at which thresholds respectively 75% and 95% of the measurements were correct. RESULTS: A total of 4140 measurements were performed and compared to the gold standard. With a threshold of 75% accurate measurement, the LLD detection threshold was 2.8 mm on centimeter paper and 4.5 mm on sheet. With a threshold of 95% accurate measurement, the LLD detection threshold was 3.4 mm on centimeter paper and 5.2 mm on sheet. Interobserver agreement (assessed overall on the 40 observers by Krippendorff's generalized Kappa) was 0.86 (95% confidence interval (CI95%) = 0.79 to 0.92) on CP and 0.71 (CI95% = 0.63 to 0.79) on sheet. Intra-observer agreement assessed by the intraclass correlation coefficient among observers who made 2 measurements had a median value (IQR) of 0.96 (0.94 to 0.99) on CP and 0.90 (0.83 to 0.94) on sheet. DISCUSSION: The clinical detection threshold on sheet at the patient's bed appears close to 5 mm. A more precise measurement is possible with graduated centimeter paper. A study in daily practice on patients in real situations would confirm our results. LEVEL OF EVIDENCE: III; prospective diagnostic comparative in Silico study.

16.
Semin Arthritis Rheum ; 66: 152361, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38360468

RESUMO

BACKGROUND: PROMIS-29 T-scores query health-related quality of life (HRQL) in 7 domains, physical function, pain, fatigue, anxiety, depression, sleep quality, and social participation, to establish population norms. An MDHAQ (multidimensional health assessment questionnaire) scores these 7 domains and includes medical information such as a FAST4 (fibromyalgia assessment screening tool) index. We analyzed PROMIS-29 T-scores in rheumatoid arthritis (RA) patients vs population norms and for positive vs negative fibromyalgia (FM) screens and compared PROMIS-29 T-scores to MDHAQ scores to assess HRQL. METHODS: A cross-sectional study was performed at one routine visit of 213 RA patients, who completed MDHAQ, PROMIS-29, and reference 2011 FM Criteria. PROMIS-29 T-scores were compared in RA vs population norms and in FM+ vs FM- RA patients, based on MDHAQ/FAST4 and reference criteria. Possible associations between PROMIS-29 T-scores and corresponding MDHAQ scores were analyzed using Spearman correlations and multiple regressions. RESULTS: Median PROMIS-29 T-scores indicated clinically and statistically significantly poorer status in 26-29% FM+ vs FM- RA patients, with larger differences than in RA patients vs population norms for 6/7 domains. MDHAQ scores were correlated significantly with each of 7 corresponding PROMIS-29 domains (|rho|≥0.62, p<0.001). Linear regressions explained 55-73% of PROMIS-29 T-score variation by MDHAQ scores and 56%-70% of MDHAQ score variation by PROMIS-29 T-scores. CONCLUSIONS: Scores for 7 PROMIS-29 domains and MDHAQ were highly correlated. The MDHAQ is effective to assess HRQL and offers incremental medical information, including FAST4 screening. The results indicate the importance of assessing comorbidities such as fibromyalgia screening in interpreting PROMIS-29 T-scores.


Assuntos
Artrite Reumatoide , Fibromialgia , Qualidade de Vida , Humanos , Fibromialgia/diagnóstico , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/psicologia , Artrite Reumatoide/fisiopatologia , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Transversais , Idoso , Inquéritos e Questionários/normas , Adulto
17.
J Orthop Sports Phys Ther ; 54(10): 1-3, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39348217

RESUMO

SYNOPSIS: In 2025, JOSPT will continue its mission to enhance research in the field of musculoskeletal rehabilitation. JOSPT aims to support authors who are working to advance the research methods applied to answer clinical questions in the musculoskeletal rehabilitation field. Using the most robust methods helps authors ensure their studies can have immediate impact on health policies and clinical practice. With this editorial, we introduce a new gold open-access journal, JOSPT Methods, where research will be available to read for free, immediately upon publication. J Orthop Sports Phys Ther 2024;54(10):1-3. doi:10.2519/jospt.2024.12972.


Assuntos
Doenças Musculoesqueléticas , Publicações Periódicas como Assunto , Humanos , Doenças Musculoesqueléticas/reabilitação , Projetos de Pesquisa , Pesquisa de Reabilitação
18.
Disabil Rehabil ; : 1-9, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39192538

RESUMO

PURPOSE: The prosthetic socket provides the critical interface between prosthesis and residuum. The purpose of this pilot study was to explore the effect of altering socket-residuum coupling integrity on limb and body control, through the use of vacuum-assisted suspension. A secondary purpose was to explore the potential use of two measurement tools designed to assess mobility in a clinical context. MATERIALS AND METHODS: Individuals with unilateral transtibial amputation performed intentional sway (n = 7) and treadmill walking (n = 6) tasks at three vacuum levels. Sway deviation from a straight-line path to peripheral targets was measured using an instrumented balance platform. Step width variability and targeting accuracy were measured using an augmented reality treadmill. RESULTS: There was a significant difference in intentional sway performance toward the target on the anterior diagonal toward the prosthetic side (p = 0.036); higher vacuum levels tended toward less deviation from a straight-line path. We found no group differences between total intentional sway deviation, step width variability or stepping accuracy across vacuum levels. CONCLUSIONS: Improved socket-residuum coupling integrity via vacuum may have measurable effects on functional control that warrant further investigation. We highlight limitations of the clinical testing paradigms to inform future work.Implications for rehabilitationThe fit of the socket is a critical factor in the success of lower limb prosthesis use.Vacuum-assisted suspension modifies the coupling between the residuum and socket.Changes in socket-residuum coupling may lead to measurable differences in control; however, these may be activity and person-specific.Clinically intended instrumented tests of movement function derived for an intact anatomy should be used with caution when assessing prosthesis users.

19.
Psychiatr Serv ; : appips20240082, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39188149

RESUMO

Measurement-informed care (MIC), also known as measurement-based care or patient-reported outcomes, for behavioral health conditions has had low uptake in the United States. To advance MIC in the near term, the authors reviewed nationally endorsed behavioral health measures and worked with national experts to recommend a core set of outpatient measures to prioritize for use. The resulting set of measures is for common behavioral and comorbid conditions and is outcomes based, low burden, and suitable for value-based payment. The panel of national experts also recommended developing a consensus on quality-of-life measures and functional measures for use across diagnostic categories of the core set.

20.
iScience ; 26(11): 108155, 2023 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-37876822

RESUMO

Blood oxygen saturation is an important clinical parameter, especially in postoperative hospitalized patients, monitored in clinical practice by arterial blood gas (ABG) and/or pulse oximetry that both are not suitable for a long-term continuous monitoring of patients during the entire hospital stay, or beyond. Technological advances developed recently for consumer-grade fitness trackers could-at least in theory-help to fill in this gap, but benchmarks on the applicability and accuracy of these technologies in hospitalized patients are currently lacking. We therefore conducted at the postanaesthesia care unit under controlled settings a prospective clinical trial with 201 patients, comparing in total >1,000 oxygen blood saturation measurements by fitness trackers of three brands with the ABG gold standard and with pulse oximetry. Our results suggest that, despite of an overall still tolerable measuring accuracy, comparatively high dropout rates severely limit the possibilities of employing fitness trackers, particularly during the immediate postoperative period of hospitalized patients.

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