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1.
J Wound Care ; 33(1): 43-50, 2024 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-38197283

RESUMEN

OBJECTIVE: Scar adherence due to a pathological healing process can cause physical and psychological disturbance. Soft tissue mobilisation (STM) techniques are widely used to treat and prevent scar adherence, but little is known on their effects. We aimed to analyse the effect of STM in patients with subacute post-surgical scar adhesions affecting the extremities. METHOD: A single-group quasi-experimental study was conducted on consecutive patients undergoing post-surgery limb rehabilitation. Patients with a baseline Adhesion Severity (AS) index of <0.5 at the worst scar point, as measured by the Adheremeter, were eligible. All patients who completed a minimum of five manual treatment sessions were included. The primary outcome was the AS index and the secondary outcome was the Italian version of the Patient and Observer Scar Assessment Scales (POSAS-I). RESULTS: A cohort of 19 patients underwent an average of eight STM sessions over a period of one month. The AS index value increased from a median of 0.12 at baseline (interquartile range (IQR): 0.05-0.25) to 0.41 post-treatment (IQR: 0.26-0.63; median change: 0.24; IQR: 0.16-0.40; p<0.001). A large effect size was observed for both AS and Observer Scar Assessment Scale (OSAS-I) (Cohen r=0.6), with a large probability of superiority (PS) (87% and 86%, respectively). A moderate effect was observed for the Patient Scar Assessment Scale (PSAS-I) (Cohen=0.4; PS=71%). Pre-post treatment changes exceeded the minimal detectable changes for the AS and OSAS-I in 68% of subjects, and for PSAS-I in 21% of subjects. CONCLUSION: STM manual techniques may produce a large effect on the mobility of adherent subacute post-surgical scars.


Asunto(s)
Cicatriz , Apnea Obstructiva del Sueño , Humanos , Cicatriz/prevención & control , Cicatrización de Heridas , Masaje , Examen Físico
2.
Epidemiol Prev ; 46(1-2): 68-76, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35354269

RESUMEN

OBJECTIVES: to investigate lifestyle, health-related behaviours, and nutritional knowledge among a sample of Italian university students and to identify social determinants of - and barriers to - healthier lifestyles. DESIGN: cross-sectional observational study. SETTING AND PARTICIPANTS: students attending degree courses in health professions in a single university in Northern Italy (No. 1,495) were invited to participate in a structured web survey. MAIN OUTCOME MEASURES: a comprehensive, validated questionnaire was used. Questions regarded nutritional knowledge and habits, smoking habit, physical activity, self-efficacy, and barriers to change. Anthropometric and sociodemographic information was collected. Descriptive statistics were used to summarize results. With single and multiple regression models, differences between subgroups and ranked predictors of students' attitudes towards healthy behaviours were analysed. Statistical significance was set at p<0.05. RESULTS: a total of 554 subjects completed the survey (participation rate: 42%; completion rate: 88%). Students showed good nutritional knowledge (73%), but some deficiencies related to low fruit/high sweets consumption, and a lack of basic macronutrients information. Only 30% of the students led a very active lifestyle and physical inactivity was greatest among overweight/obese students. Sedentary lifestyle and unhealthy diet were mainly associated with modifiable risk factors, e.g., being overweight and smoking. CONCLUSIONS: this study provides evidence that health profession students have good knowledge, but their health-related lifestyle is a concern, especially given the role of prescribers that they will play. Structured programmes need to be developed to address the modifiable risk factors associated with detrimental behaviours manifest already during the university years.


Asunto(s)
Estilo de Vida , Estudiantes , Estudios Transversales , Humanos , Italia/epidemiología , Universidades
3.
Epidemiol Prev ; 45(4): 245-253, 2021.
Artículo en Italiano | MEDLINE | ID: mdl-34549566

RESUMEN

BACKGROUND: the relationship between physical exercise and gut microbiota has opened new therapeutic frontiers for many inflammatory diseases. However, there is still a lot of uncertainty about how to administer exercise. OBJECTIVES: to review the literature to bridge this gap and examine the relationship between cardiorespiratory fitness (CRF) and microbiota. DESIGN: systematic review. SETTING AND PARTICIPANTS: studies involving humans who undergoing exercise programmes of any lengths, intensities, and types were included. The research was carried out through PubMed, Scopus, and Web of Science. MAIN OUTCOME MEASURES: the primary outcome was change in gut microbiota composition (α and ß-diversity), while the secondary outcome was the CRF level. RESULTS: the 15 studies included (all with PEDro scale <=5) used aerobic training alone or combined with resistance exercises. In general, exercise has shown positive effects on the microbiota, influencing the faecal count of some bacterial phyla (in particular Bacteroidetes, Firmicutes, and Proteobacteria), with a weak tendency towards proportionality in relation to training duration and intensity. However, the evidence supporting the exercise effects on the gut microbiota and the relationship with CRF are of low quality. CONCLUSIONS: despite the weak evidence in favour of the effects of the practice of physical exercise on the intestinal microbiota, there are still many aspects that need to be explored. In particular, future studies shall have higher quality and methodological rigour, standardize the methods for outcome assessment, and determine type and thresholds of interventions intensity and duration.


Asunto(s)
Capacidad Cardiovascular , Microbioma Gastrointestinal , Ejercicio Físico , Humanos , Italia
4.
BMC Musculoskelet Disord ; 21(1): 679, 2020 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-33054739

RESUMEN

BACKGROUND: Dexterity impairments caused by carpal tunnel syndrome (CTS) make working and daily activities challenging. We aimed to investigate: i) the relationship between dexterity and nerve conduction studies (NCS) in workers with classic symptoms presentation; ii) the ability of the Functional Dexterity Test (FDT) to discriminate different levels of CTS severity as classified by NCS; iii) the diagnostic accuracy of a clinical battery composed of the FDT, Phalen's test and Tinel's sign. METHODS: In a convenience sample of individuals diagnosed with CTS, we correlated FDT net scores with the NCS-based classification by means of Spearman's (rho) test. Discriminative ability of the FDT was assessed by ANOVA, and a ROC curve determined cutoff thresholds. Sensitivity, specificity, and likelihood ratios (LRs) were used to investigate the diagnostic accuracy of the clinical battery. RESULTS: Data from 180 hands were collected. The FDT was significantly correlated (rho = 0.25, p <  0.001) with NCS. The FDT was able to discriminate subjects with severe/extreme NCS findings, and two thresholds (0.29-0.36) were identified. Adding the FDT to the provocative tests improved the overall diagnostic accuracy (specificity: 0.97, CI95% 0.83-0.99; LR+: 14.49, CI95% 2.09-100.53). CONCLUSIONS: Sensorimotor impairments related to CTS can affect hand dexterity. The FDT discriminated patients with severe NCS involvement. Positive results on the clinical battery (Phalen, Tinel, and FDT) could help to confirm the CTS diagnosis, showing a very high specificity and LR+. On the contrary, the low sensitivity is not able to rule out CTS in individuals with negative results.


Asunto(s)
Síndrome del Túnel Carpiano , Síndrome del Túnel Carpiano/diagnóstico , Mano , Humanos , Nervio Mediano , Conducción Nerviosa , Examen Neurológico , Curva ROC
5.
Med Lav ; 111(6): 493-502, 2020 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-33311424

RESUMEN

BACKGROUND: Neuro-muscular fatigue (ANM) in the upper limbs can cause impaired coordination and dexterity. The main purpose of the study was to investigate whether ANM induced by a working day produced a reduction in digital dexterity in a population of dental health workers (OSD). Secondary objective was to investigate whether there were relationships between any reductions in dexterity and independent socio-demographic variables (gender, age and profession). METHODS: A cohort of OSD was assessed before and at the end of a working day of at least 7 hours using the Functional Dexterity Test (FDT). The effects of ANM (time), of the tested limb (dominance), and of their interaction on dexterity were investigated using two-way ANOVA. A multiple linear regression model was applied to explore the relationship between dexterity performance and independent variables. RESULTS: A total of 50 OSDs were included. The net time of the FDT at the end of the day was always higher than in the morning. The ANOVA showed a significant difference for time (p <0.001) and side (p <0.001), but an effect from the interaction between the two factors was not identified (p = 0.428). The worsening of manual dexterity appears to be weakly correlated with age on both sides, and with the profession in the dominant limb. CONCLUSION: The ANM appears to have negatively affected the dexterity of both hands in the sample examined. The results of this study may be useful for planning the OSD's work agenda more carefully.


Asunto(s)
Odontología , Fatiga , Mano , Personal de Salud , Análisis de Varianza , Estudios de Cohortes , Humanos , Modelos Lineales
6.
Med Lav ; 109(1): 31-39, 2018 02 01.
Artículo en Italiano | MEDLINE | ID: mdl-29405175

RESUMEN

BACKGROUND: The diagnosis of carpal tunnel syndrome (STC) is centered on the symptoms. However, patients also show an impairment of sensorimotor functions, but the relationship between STC and manual dexterity has never been investigated. OBJECTIVES: To analyze the correlation between manual dexterity and severity of the STC. Another objective was the diagnostic accuracy of the clinical battery including provocative tests (Phalen, Tinel) and Functional Dexterity Test (FDT). METHODS: A sample of 80 subjects with suspected STC was subdivided into 4 groups based on EMG (severe/extreme-GrA, moderate-GrB, mild/minimal-GrC, negative-GrD) and evaluated in blind by Phalen, Tinel and FDT. The relationship between the FDT and the allocation of subjects was investigated by Spearman's rho, while the groups were compared with univariate ANOVA and Tukey's post hoc analysis. Diagnostic accuracy of the clinical battery was expressed by sensitivity, specificity, and likelihood ratios (LR). RESULTS: A moderate (r=0.48, p minor of 0.001) correlation was found between FDT and the 4 groups. ANOVA has returned a significant difference between GrA vs. all others and between GrB vs. GrD. The battery showed a sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) of 70%, 94%, 11.98 and 0.31 respectively. CONCLUSIONS: The results of this study supported the hypothesis that STC patients also have a dexterity impairment. The FDT was able to discriminate between three levels of severity (negative, mild to moderate, severe to extreme), maintaining a good level of diagnostic accuracy in addition to provocative tests.


Asunto(s)
Síndrome del Túnel Carpiano/diagnóstico , Síndrome del Túnel Carpiano/fisiopatología , Mano/fisiopatología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad
7.
Clin Rehabil ; 31(4): 532-543, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27141086

RESUMEN

OBJECTIVE: To investigate dimensionality and the measurement properties of the Italian Lower Extremity Functional Scale using both classical test theory and Rasch analysis methods, and to provide insights for an improved version of the questionnaire. DESIGN: Rasch analysis of individual patient data. SETTING: Rehabilitation centre. PARTICIPANTS: A total of 135 patients with musculoskeletal diseases of the lower limb. RESULTS: Patients were assessed with the Lower Extremity Functional Scale before and after the rehabilitation. Rasch analysis showed some problems related to rating scale category functioning, items fit, and items redundancy. After an iterative process, which resulted in the reduction of rating scale categories from 5 to 4, and in the deletion of 5 items, the psychometric properties of the Italian Lower Extremity Functional Scale improved. The retained 15 items with a 4-level response format fitted the Rasch model (internal construct validity), and demonstrated unidimensionality and good reliability indices (person-separation reliability 0.92; Cronbach's alpha 0.94). Then, the analysis showed differential item functioning for six of the retained items. The sensitivity to change of the Italian 15-item Lower Extremity Functional Scale was nearly equal to the one of the original version (effect size: 0.93 and 0.98; standardized response mean: 1.20 and 1.28, respectively for the 15-item and 20-item versions). CONCLUSION: The Italian Lower Extremity Functional Scale had unsatisfactory measurement properties. However, removing five items and simplifying the scoring from 5 to 4 levels resulted in a more valid measure with good reliability and sensitivity to change.


Asunto(s)
Evaluación de la Discapacidad , Extremidad Inferior/fisiopatología , Enfermedades Musculoesqueléticas/rehabilitación , Evaluación de Resultado en la Atención de Salud/métodos , Recuperación de la Función/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Pacientes Internos , Italia , Masculino , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/fisiopatología , Pacientes Ambulatorios , Análisis de Componente Principal , Psicometría , Centros de Rehabilitación , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Adulto Joven
8.
J Hand Ther ; 30(1): 113-115, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27894678

RESUMEN

These authors use a custom-fabricated orthotic device to improve hand motion and function for a client with hand dystonia after stroke. Clinical observation and reasoning resulted in an effective solution to control the dystonia that was acceptable to the client. - Kristin Valdes, OTD, OT, CHT, Practice Forum Editor.


Asunto(s)
Trastornos Distónicos/rehabilitación , Dedos/fisiopatología , Aparatos Ortopédicos , Accidente Cerebrovascular/fisiopatología , Anciano , Trastornos Distónicos/fisiopatología , Diseño de Equipo , Humanos , Masculino
9.
Int Wound J ; 14(6): 1262-1268, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28782201

RESUMEN

The Patient and Observer Scar Assessment Scale (POSAS) is one of the most robust instruments to assess scar quality, but there is no Italian version, and no other competing instruments are available in Italian. The aim of this study was to translate and validate an Italian version of POSAS (POSAS-I). POSASv2.0 was culturally adapted in accordance with international standards. The psychometric assessment included acceptability/feasibility, internal consistency, reproducibility, construct validity and sensitivity to change. Cultural equivalence of POSAS-I with the English version was confirmed. The validation study included 102 subjects with surgical scars. Both subscales demonstrated acceptable internal consistency (Cronbach's α = 0·72-0·80). Reproducibility of the OSAS-I (ICCs = 0·93-0·94; SEM = 1·8 points; MDC95 = 5·1 points) was superior to that of PSAS-I (ICC = 0·65; SEM = 5·7 points; MDC95 = 15·7 points). OSAS-I showed moderate to good correlations with the Vancouver Scar Scale (VSS), Global Rating of Change Scale (GRCS) and PSAS-I. Sensitivity to change was large for PSAS-I (effect size = 1·08; standardised response mean = 0·96) and moderate to large for OSAS-I (ES = 0·69; SRM = 0·92). This study confirmed that POSAS-I can be used to assess patients with surgical scars in the Italian population. OSAS-I is useful for clinical and research purposes, while PSAS-I should be better used to capture patients' own opinions and symptoms in clinical settings.


Asunto(s)
Cicatriz/clasificación , Participación del Paciente , Estándares de Referencia , Adulto , Anciano , Anciano de 80 o más Años , Comparación Transcultural , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Traducciones
10.
Med Lav ; 107(2): 112-28, 2016 Mar 24.
Artículo en Italiano | MEDLINE | ID: mdl-27015027

RESUMEN

BACKGROUND: In the last few years, the incidence of upper limbs tendon injuries has seen a dramatic increase among workers. Conservative treatment is the first choice to relieve symptoms, allowing a safe return to work. However, the scientific evidence of its  efficacy is widely debated. OBJECTIVE AND METHODS: Research and literature review on the efficacy of conservative treatment of upper limbs tendon injuries in occupational settings. RESULTS: A total of 271 references were found on Medline and Embase up to May 2015. 116 papers were excluded, 155 articles were included and the full text read. CONCLUSIONS: After a timely diagnosis, a prompt start of the rehabilitation programme and a limitation of complete rest are useful to relieve pain, increase functionality and reduce work absenteeism in the long term. Conservative treatment combinations, such as manual therapy, specific exercises focused on increasing flexibility and muscle strength and specific-gesture training, achieves more significant results than a single isolated treatments. Currently, there is no strong scientific evidence to support prolotherapy and Platelet-Rich Plasma (PRP). However, current promising results will encourage further studies. Awareness among both employers and employees about prevention and risk factors should be enhanced.


Asunto(s)
Enfermedades Profesionales/patología , Enfermedades Profesionales/terapia , Tendinopatía/patología , Tendinopatía/terapia , Extremidad Superior/patología , Terapia por Ejercicio , Humanos , Incidencia , Italia/epidemiología , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/rehabilitación , Aparatos Ortopédicos , Tendinopatía/epidemiología , Tendinopatía/etiología , Tendinopatía/rehabilitación , Resultado del Tratamiento
11.
Arch Phys Med Rehabil ; 96(1): 98-104, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25239282

RESUMEN

OBJECTIVE: To perform a comprehensive analysis of the psychometric properties and dimensionality of the Upper Limb Functional Index (ULFI) using both classical test theory and Rasch analysis (RA). DESIGN: Prospective, single-group observational design. SETTING: Freestanding rehabilitation center. PARTICIPANTS: Convenience sample of Italian-speaking subjects with upper limb musculoskeletal disorders (N=174). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Italian version of the ULFI. Data were analyzed using parallel analysis, exploratory factor analysis, and RA for evaluating dimensionality, functioning of rating scale categories, item fit, hierarchy of item difficulties, and reliability indices. RESULTS: Parallel analysis revealed 2 factors explaining 32.5% and 10.7% of the response variance. RA confirmed the failure of the unidimensionality assumption, and 6 items out of the 25 misfitted the Rasch model. When the analysis was rerun excluding the misfitting items, the scale showed acceptable fit values, loading meaningfully to a single factor. Item separation reliability and person separation reliability were .98 and .89, respectively. Cronbach alpha was .92. CONCLUSIONS: RA revealed weakness of the scale concerning dimensionality and internal construct validity. However, a set of 19 ULFI items defined through the statistical process demonstrated a unidimensional structure, good psychometric properties, and clinical meaningfulness. These findings represent a useful starting point for further analyses of the tool (based on modern psychometric approaches and confirmatory factor analysis) in larger samples, including different patient populations and nationalities.


Asunto(s)
Evaluación de la Discapacidad , Enfermedades Musculoesqueléticas/fisiopatología , Enfermedades Musculoesqueléticas/psicología , Calidad de Vida , Extremidad Superior/fisiopatología , Adulto , Anciano , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Psicometría , Reproducibilidad de los Resultados
14.
G Ital Med Lav Ergon ; 37(2): 115-9, 2015.
Artículo en Italiano | MEDLINE | ID: mdl-26364445

RESUMEN

BACKGROUND: Outcome measures are the scientific basis for assessment and comparison of the effects of rehabilitative interventions. Among the instruments proposed for the evaluation of musculoskeletal disorders of the upper limb, the Upper Limb Functional Index (ULFI) was recently validated and translated into several languages, but it does not yet exist an Italian version yet. OBJECTIVE: To obtain an Italian validated version of ULFI, called ULFI-I. MATERIALS & METHODS: The translation process was conducted following the international guidelines of the forwardlbackward translation. The ULFI-I was subsequently validated by calculating: (1) internal consistency (Cronbach's a and item-to-total correlation), (2) criterion validity (correlation r with the Disabilities of the Arm, Shoulder and Hand Questionnaire, DASH), and (3) test-retest reliability (ICC(2,1)) and measurement error (Standard Error of measurement, SEM and Minimal Detectable Change, MDC90. For the first two points we used a sample of 57 patients with upper limb orthopedic conditions, while the analysis of the. reliability required a further administration of the questionnaire carried out 3 days before on 33 subjects. I. Statistical analysis showed good levels of internal consistency (Cronbach's alpha=.90, item-to-total correlation between .45 and .73), high criterion validity (r=.81, P<0.01) and excellent reliability test-retest reliability (ICC(2,1)=.94, CI=.89-.97). The SEM was found to be equal to 5 points, with a MDC90 estimated at 12 points. CONCLUSION: In this study the ULFI-I showed good psychometric properties, combined with speed and ease of administration and scoring. Its use will facilitate the comparison of data collected in Italy with international studies, ensuring greater uniformity of assessment.


Asunto(s)
Enfermedades Musculoesqueléticas/diagnóstico , Evaluación de Resultado en la Atención de Salud , Extremidad Superior/fisiopatología , Comparación Transcultural , Humanos , Italia , Lenguaje , Enfermedades Musculoesqueléticas/fisiopatología , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
16.
Med Lav ; 105(5): 357-65, 2014 Jul 15.
Artículo en Italiano | MEDLINE | ID: mdl-25134631

RESUMEN

BACKGROUND: Valid and reliable outcome measures are fundamental for evaluating and comparing the effects of rehabilitation. Among the different tools used for the assessment of musculoskeletal disorders of the lower limb, the Foot and Ankle Ability Measure (FAAM) has been shown to have good psychometric properties. However, it has not yet been translated into Italian. The module regarding the performance of daily living activities (FAAM/ADL), in particular, can be applied also in an occupational setting. OBJECTIVE: To obtain an Italian version of the FAAM, and to validate the FAAM-I/ADL. METHODS: The cultural adaptation was performed according to international guidelines for forward/backward translation. The activities of daily living (ADL) module of the FAAM-I (FAAM-I/ADL) was validated with classical test theory methods in a convenience sample of 57 patients. Different parameters were calculated: internal consistency (Cronbach's α and item-to-total correlation); criterion validity, through Pearson's correlation (r) with the Lower Extremity Functional Scale (LEFS); test-retest reliability (ICC2,1); Standard Error of Measurement (SEM); and Minimal Detectable Change (MDC95). RESULTS: The statistical analysis showed good internal consistency (Cronbach's α=.96, item-to-total correlation ranged between .51 and .85), high criterion validity (r=.66, p<0.01) and excellent test-retest reliability (ICC2, 1=.98, CI95%=.97-.99). The SEM was 2.7 points, with a MDC95 of 7.5 points. CONCLUSIONS: FAAM-I/ADL shows good psychometric properties, together with speed and ease of administration and scoring. Its use will facilitate the comparison of Italian data with international studies, ensuring greater uniformity of assessment.


Asunto(s)
Actividades Cotidianas , Traumatismos del Tobillo/rehabilitación , Evaluación de la Discapacidad , Lenguaje , Limitación de la Movilidad , Enfermedades Musculoesqueléticas/rehabilitación , Adolescente , Adulto , Anciano , Algoritmos , Femenino , Enfermedades del Pie/rehabilitación , Humanos , Italia , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Traducciones
17.
Phys Ther ; 104(5)2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38438144

RESUMEN

OBJECTIVE: The objective of this study was to perform a meta-analysis of the minimal clinically important difference (MCID) of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and its shortened version (ie, the QuickDASH). METHODS: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, and Scopus were searched up to July 2022. Studies on people with upper limb musculoskeletal disorders that calculated the MCID by anchor-based methods were included. Descriptive and quantitative synthesis was used for the MCID and the minimal detectable change with 90% confidence (MDC90). Fixed-effects models and random-effect models were used for the meta-analysis. I2 statistics was computed to assess heterogeneity. The methodological quality of studies was assessed with the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist for measurement error and an adaptation of the checklist for the studies on MCID proposed by Bohannon and Glenney. RESULTS: Twelve studies (1677 patients) were included, producing 17 MCID estimates ranging from 8.3 to 18.0 DASH points and 8.0 to 18.1 QuickDASH points. The pooled MCIDs were 11.00 DASH points (95% CI = 8.59-13.41; I2 = 0%) and 11.97 QuickDASH points (95% CI = 9.60-14.33; I2 = 0%). The pooled MDC90s were 9.04 DASH points (95% CI = 6.46-11.62; I2 = 0%) and 9.03 QuickDASH points (95% CI = 6.36-11.71; I2 = 18%). Great methodological heterogeneity in the calculation of the MCID was identified among the primary studies. CONCLUSION: Reasonable MCID ranges of 12 to 14 DASH points and 12 to 15 QuickDASH points were established. The lower boundaries represent the first available measure above the pooled MDC90, and the upper limits represent the upper 95% CI of the pooled MCID. IMPACT: Reasonable ranges for the MCID of 12 to 14 DASH points and 12 to 15 QuickDASH points were proposed. The lower boundaries represent the first available measure above the pooled MDC90, and the upper limits represent the upper 95% CI of the pooled MCID. Information regarding the interpretability of the 2 questionnaires was derived from very different methodologies, making it difficult to identify reliable thresholds. Now clinicians and researchers can rely on more credible data. The proposed MCIDs should be used to assess people with musculoskeletal disorders. Heterogeneity was found related particularly to the anchor levels used in the primary studies. To promote comparability of MCID values, shared rules defining the most appropriate types of anchoring will be needed in the near future.


Asunto(s)
Evaluación de la Discapacidad , Diferencia Mínima Clínicamente Importante , Enfermedades Musculoesqueléticas , Humanos , Encuestas y Cuestionarios/normas , Extremidad Superior/fisiopatología
18.
J Hand Ther ; 26(1): 62-7; quiz 68, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23041087

RESUMEN

STUDY DESIGN: Clinical measurement. INTRODUCTION: Among the available tests for fine finger dexterity, the Functional Dexterity Test (FDT) has been indicated as a valid instrument to measure outcome in different conditions. PURPOSE OF THE STUDY: To analyze test-retest reliability, to study the influence of gender, age and hand dominance on the FDT score, and to collect reference norms for adult and elderly age-groups. METHODS: Test-retest reliability was calculated with the Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM) in a subgroup of 324 healthy volunteers. An enlarged sample of 698 subjects, tested at least once, was used to present stratified data for age group, sex, and hand dominance, and ANOVA was used to investigate statistically significant differences between groups. RESULTS: The FDT showed excellent reliability (ICC > 0.90; SEM: <2 s for net times; <3 s for total scores). Age, gender and hand dominance significantly influenced FDT scores (p < 0.05), but no interaction between variables was found. CONCLUSIONS: FDT is confirmed as reliable, and up-to-date reference norms over a broad range of ages of the Italian adult population have been provided. LEVEL OF EVIDENCE: NA.


Asunto(s)
Mano/fisiología , Destreza Motora/fisiología , Adulto , Factores de Edad , Anciano , Análisis de Varianza , Femenino , Lateralidad Funcional/fisiología , Humanos , Italia , Masculino , Persona de Mediana Edad , Valores de Referencia , Reproducibilidad de los Resultados , Factores Sexuales , Adulto Joven
19.
Clin J Sport Med ; 22(4): 319-26, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22450591

RESUMEN

OBJECTIVE: To investigate the immediate effects on maximal muscle strength of kinesiotaping (KT) applied to the dominant quadriceps of healthy subjects. DESIGN: Single-blind, placebo-controlled crossover trial. SETTING: "Salvatore Maugeri" Foundation. PARTICIPANTS: With ethical approval and informed consent, a convenience sample of 36 healthy volunteers were recruited. Two subjects did not complete the sessions and were excluded from the analysis. INTERVENTIONS: Subjects were tested across 3 different sessions, randomly receiving 2 experimental KT conditions applied with the aim of enhancing and inhibiting muscle strength and a sham KT application. MAIN OUTCOME MEASURES: Quadriceps muscle strength was measured by means of an isokinetic maximal test performed at 60 and 180 degrees per second. Two secondary outcome measures were performed: the single-leg triple hop for distance to measure limb performance and the Global Rating of Change Scale (GRCS) to calculate agreement between KT application and subjective perception of strength. RESULTS: Compared with baseline, none of the 3 taping conditions showed a significant change in muscle strength and performance (all P > 0.05). Effect size was very low under all conditions (≤0.08). Very few subjects showed an individual change greater than the minimal detectable change. Global Rating of Change Scale scores demonstrated low to moderate agreement with the type of KT applied, but some placebo effects were reported independently of condition. CONCLUSIONS: Our findings indicated no significant effect in the maximal quadriceps strength immediately after the application of inhibition, facilitation, or sham KT. These results do not support the use of KT applied in this way to change maximal muscle strength in healthy people.


Asunto(s)
Vendajes , Fuerza Muscular/fisiología , Manipulaciones Musculoesqueléticas/métodos , Músculo Cuádriceps/fisiología , Adolescente , Adulto , Estudios Cruzados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Método Simple Ciego
20.
Int J Rehabil Res ; 44(3): 193-199, 2021 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-34356037

RESUMEN

Patient's satisfaction with device is an important clinical outcome in prosthetics and orthotics. The Client Satisfaction with Device (CSD) - one of the five modules of the Orthotics and Prosthetics Users' Survey (OPUS) - has been defined as the only outcome measure specifically developed to measure user satisfaction with a prosthesis or an orthosis. The aim of this study was to provide a comprehensive review of the psychometric properties of the CSD, summarizing the present evidence on this measure, and verifying if the scoring system is consistent in the literature. A systematic literature search was conducted utilizing PRISMA guidelines. Articles were searched in PubMed and Scopus databases using search terms relating to the psychometric properties of the CSD. Thirteen articles assessing the psychometric properties of the CSD met the inclusion criteria for this review. The CSD has been translated and validated in several languages. However, these versions are not consistent across the studies since they include different number of items, with different number of response options, and scoring systems. The CSD - where used in its eight-item version, rated with a four-point rating scale - can be judged as a tool with acceptable psychometric properties for assessing satisfaction with devices in prosthesis and orthosis users. This CSD version seems the best one for optimizing coverage and psychometric quality with the fewest number of items. Further studies are warranted to assess the degree of suitability of this scale in specific populations of users of prostheses or orthoses and to analyze its psychometric properties in further cultural contexts.


Asunto(s)
Miembros Artificiales , Satisfacción del Paciente , Humanos , Satisfacción Personal , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
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