Job requirements and physical demands (JRPD) questionnaire: cross-cultural adaptation and psychometric evaluation in Iranian Army personnel with chronic low back pain.

BACKGROUND: Biomechanical risk factors have been identified as the main predisposing factor of chronic low back pain (CLBP), especially in Army personnel. The Job Requirements and Physical Demands (JRPD) questionnaire has been developed to assess the biomechanical exposures related to CLBP. Examining the biomechanical risk factors could prevent CLBP. This study aimed to translate and cross-culturally adapt the JRPD into Persian and assess its psychometric properties among Iranian male Army personnel with CLBP. METHODS: In this cross-sectional study, the content validation of the JRPD was assessed after translating to Persian. The Persian JRPD was administered to 198 male Army personnel with CLBP, with an interval of 7 days, to assess test-retest reliability, including Cronbach's α, intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimal detectable change at 95% confidence interval (MDC95%). Scores of the Persian JRPD were correlated with the scores of visual analog scale (VAS), Borg's category-ratio (CR10) scale, general health questionnaire-28 (GHQ-28), and physical functioning (PF1 and PF2) subscale of the 12-item short-form health survey (SF-12) to assess convergent validity using Spearman correlation for a priori hypotheses. RESULTS: The Persian JRPD had good content validity evidenced by the higher content validity index (> 0.70). The questionnaire had a significant positive negligible to weak correlation with the VAS (rho = 0.27; p < 0.001), Borg's CR10 scale (rho = 0.19; p = 0.009), and the total score of GHQ-28 and its domains (rho ≤0.34; p < 0.05); and significant negative weak correlation with PF2 (rho = - 0.27; p < 0.001) and significant negative moderate correlation with PF1 (rho = - 0.35; p < 0.001), thus confirming the priori hypotheses (89%, 8/9). The internal consistency and ICC (α = 0.91; ICC = 0.80) were highly adequate, with SEM and MDC95% of 7.91 and 21.3 respectively. CONCLUSIONS: The JRPD was successfully adapted into Persian and had adequate psychometric properties in terms of content and convergent validity, internal consistency, and test-retest reliability. The questionnaire is found useable to assess the CLBP-related biomechanical exposures in Iranian male Army personnel.

Evaluating a new verbal working memory-balance program: a double-blind, randomized controlled trial study on Iranian children with dyslexia.

BACKGROUND: It is important to improve verbal Working Memory (WM) in reading disability, as it is a key factor in learning. There are commercial verbal WM training programs, which have some short-term effects only on the verbal WM capacity, not reading. However, because of some weaknesses in current verbal WM training programs, researchers suggested designing and developing newly structured programs that particularly target educational functions such as reading skills. In the current double-blind randomized clinical trial study, we designed a new Verbal Working Memory-Balance (VWM-B) program which was carried out using a portable robotic device. The short-term effects of the VWM-B program, on verbal WM capacity, reading skills, and postural control were investigated in Iranian children with developmental dyslexia. RESULTS: The effectiveness of the VWM-B program was compared with the VWM-program as a traditional verbal WM training. In comparison with VWM-program, the participants who received training by the VWM-B program showed superior performance on verbal WM capacity, reading skills, and postural control after a short-term intervention. CONCLUSIONS: We proposed that the automatized postural control resulting from VWM-B training had a positive impact on improving verbal WM capacity and reading ability. Based on the critical role of the cerebellum in automatizing skills, our findings support the cerebellar deficit theory in dyslexia. TRIAL REGISTRATION: This trial was (retrospectively) registered on 8 February 2018 with the Iranian Registry of Clinical Trials (IRCT20171219037953N1).

A new postural stability-indicator to predict the level of fear of falling in Parkinson's disease patients.

BACKGROUND: Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson's disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error. OBJECTIVES: In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. METHODS: Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRis; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF-related behavior(s). RESULTS: FTR1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = - 0.63, p < 0.001), Pull test (r = - 0.65, p < 0.001), Timed Up and Go test (r = - 0.57, p < 0.001), and Berg Balance Scale (r = 0.62, p < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. CONCLUSIONS: Using the proposed assessment technique, we can accurately predict the intensity of FoF in PD patients. Also, the FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

Caring-Related Chronic Low Back Pain and Associated Factors among Mothers of Children with Cerebral Palsy.

BACKGROUND: Literature indicated some risk factors for low back pain; however, there is insufficient knowledge on the effect of caring-related physical activities and individual characteristics on Chronic Low Back Pain (CLBP) in mothers of children with Cerebral Palsy (CP). OBJECTIVE: The main aim of the current study was to determine the association between caring-related physical activities, Body Mass Index (BMI), education level, and CLBP in mothers of children with CP. DESIGN: Case-control observational study. Setting. Pediatric rehabilitation clinics. Participants. Mothers of children with CP. Main Outcome Measures. Measures is comprised of a self-administered questionnaire that included the demographic characteristics items, pain visual analog scale, and three items of the job-related physical demands questionnaire. The logistic regression model served to assess the association. RESULTS: The control group included 81 healthy mothers, with a mean (SD) age of 39 (8.45) years, and the case group contained 90 mothers who suffered from CLBP, with a mean (SD) age of 37 (8.64) years. Performing lifting movements (OR 13.73, ß = 2.62, p < .001), BMI (OR 11.85, ß = 2.47, p = .011), repetitive bending (OR 7.67, ß = 2.04, p = .010), forward-flexion (OR 6.71, ß = 1.91, p = .033), and level of education (OR .21, ß = -1.53, p = .020), in descending order of odds ratios, were found to be significant predictors of the CLBP in mothers of children with CP. CONCLUSION: Avoiding caring-related harmful physical activities, maintaining body weight within a healthy range, and increasing knowledge for accurate lifting/handling techniques can be helpful to prevent the CLBP in mothers of children with CP.