Arabic version of the Extended Nordic Musculoskeletal Questionnaire, cross-cultural adaptation and psychometric testing.

BACKGROUND: The Extended Nordic Musculoskeletal Questionnaire (NMQ-E) had never been adapted into Arabic. We culturally adapted the NMQ-E to Arabic in five stages and investigated its psychometric properties. METHODS: After translating and cross-culturally adapting the NMQ-E into Arabic, through forward translation, translation synthesis, backward translation, expert committee review, and pilot testing, the psychometric properties were investigated. The construct validity was assessed by having the participants completing the Arabic version of the NMQ-E with four Arabic scales that measured musculoskeletal pain in all regions covered in the NMQ-E. Participants' baseline records were also used to evaluate internal consistency (Cronbach's α). Seven days later, participants completed the Arabic NMQ-E again to evaluate its test-retest reliability employing intraclass correlation coefficient (ICC) and standard error of measurement (SEM) for the age questions, and Cohen's kappa coefficient (κ), the proportion of observed agreement (Po), the proportion of positive agreement (Ppos), and the proportion of negative agreement (Pneg) for the dichotomous items. RESULTS: A total of 127 participants, 70 males and 57 females with mean age 32.5 ± 12.2 years, were included. Significant differences were found between participants with and without musculoskeletal pain in the corresponding scales, signifying the content validity of the questionnaire. Cronbach's α for both the prevalence and consequences pain sections combined ranged from 0.30 to 1.00. The test-retest reliability of the age questions was excellent, with ICC values ranging between 0.995 and 1.00. The SEM was 0.77 for the neck region and 0 for the rest of the regions. The prevalence questions demonstrated almost perfect agreement, with κ values ranging between 0.82 and 1.00, the Po between 0.94 and 1.00, the Ppos between 0.80 and 1.00, and the Pneg between 0.93 and 1.00. The consequences of pain questions showed moderate-to-perfect agreement, with κ values ranging between 0.57 and 1.00, between 0.83 and 1.00 for the Po, between 0.50 and 1.00 for the Ppos, and between 0.86 and 1.00 for the Pneg. CONCLUSIONS: The results suggest that the Arabic NMQ-E is a valid and reliable tool that can be used to screen Arab adults for the prevalence and consequences of musculoskeletal pain.

Cross-Cultural Adaptation and Psychometric Properties of the Arabic Version of the Fall Risk Questionnaire.

A simple, valid, and reliable self-assessment fall-risk questionnaire in Arabic is needed to significantly promote awareness and develop fall-prevention programs. This study translated and adapted the Fall Risk Questionnaire (FRQ) into Arabic and determined its validity and reliability among Saudi Arabian older adults in two phases: (1) cross-culturally adapting the FRQ into Arabic and (2) assessing the adapted questionnaire's psychometric properties in two sessions with 110 Arabic-speaking participants aged ≥65 years. Pearson's r showed that the Arabic FRQ had a significant moderate negative relationship with the Berg Balance Scale and fair-to-moderate positive correlations with Five Time Sit to Stand and Time Up and Go. The receiver operating characteristic curve indicated a significant area under the curve = 0.81. The cut-off score was 7.5 and associated with 73.7% sensitivity and 73.6% specificity. Internal consistency was estimated as good, with Cronbach's α = 0.77. Deletion of item 1 slightly increased Cronbach's α to 0.78. The Arabic FRQ demonstrated excellent test-retest reliability, with an intraclass correlation coefficient = 0.95 (95% CI: 0.92-0.97). It is highly valid and reliable in providing valuable data for evaluating fall risk in adults aged ≥65 years and for consulting a specialist for further investigation if necessary.

The effectiveness of Kinesio taping and conventional physical therapy in the management of chronic low back pain: a randomized clinical trial.

OBJECTIVE: The objective of the study was to find out the effectiveness of Kinesio taping (KT) and conventional physical therapy (CPT) such as transcutaneous electrical nerve stimulation and supervised exercise therapy and CPT alone in chronic low back pain (CLBP) patients. METHODS: This randomized clinical trial conducted between June 2019 and December 2020, who were randomly assigned to two groups: the experimental group (KT with CPT) and the control group (CPT only). The following outcomes were measured at baseline and at the second and sixth weeks: pain using the Numerical Pain Rating Scale, lumbar flexion range of motion (ROM) by the modified Schober's method, and functional disability using the Oswestry Disability Index. Treatment effects were investigated using separate 2 × 3 mixed-model analyses of variance (ANOVAs). RESULTS: A total of 60 male adults with CLBP were included in this study. The experimental group showed a greater decrease in pain than the control group after 2 week of intervention (mean between-group difference 1.97 (95%CI 1.64-2.29). This was maintained during a 6-week follow-up of 2.71 (95%CI 2.54-2.87). At 2 weeks, the experimental group had a significantly greater improvement in disability, by 13.45 (95%CI 11.98-14.91). This effect was significant at the 6-week follow-up of 14.10 (95%CI 13.11-15.08). Similarly, lumbar flexion ROM was significantly better at the 2-week - 2.7 (95%CI -3.15- - 2.42) and 6-week follow-ups -3.9 (95%CI - 4.42- - 3.49). CONCLUSION: The study concluded that Kinesio taping with conventional physical therapy reduces pain and disability and improves lumbar flexion range of motion after 2 and 6 weeks of application. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05173948. Key Points • This is the first clinical study found the short-term clinical effectiveness of Kinesio taping and conventional physical therapy in the management of chronic low back pain. • This study found a new clinical evidence that Kinesio taping and conventional physical therapy provides better short-term outcomes in chronic low back pain. • These reports helpful for the clinicians and physical therapists to prevent and treat the symptoms and consequences of chronic low back pain in an effective manner.

Reliability of the Soleus H-Reflex in Different Sitting Postures.

The Soleus (SOL) Hoffmann reflex (H-reflex) is commonly recorded in sitting position. However, the reliability of recording is unknown. We assessed the reliability of SOL H-reflex amplitude measurements across multiple traces and sessions during erect, slumped, and slouched sitting postures using the generalizability theory. Five traces of the SOL H-reflex maximum amplitude (Hmax) were recorded from 10 healthy participants during erect, slumped, and slouched sitting postures in two sessions. A decision study analysis was then conducted to calculate the reliability coefficients of the Hmax for five traces and two sessions and to mathematically calculate the coefficients for seven and ten traces, and one and three sessions in the three sitting postures. For five traces and two sessions, the results showed reliability coefficients between 0.970 and 0.971, 0.980 and 0.979, and equal to 0.943 for erect, slumped, and slouched sitting, respectively. Averaging five traces of the Hmax in a single recording session was sufficient to obtain acceptable reliability in the three sitting postures (reliability range, 0.892-0.988). It was concluded that the SOL Hmax can be recorded during erect, slumped, and slouched sitting postures with adequate reliability.

Low back pain prevalence and risk factors among health workers in Saudi Arabia: A systematic review and meta-analysis.

OBJECTIVES: Low back pain (LBP) has a major impact on health workers, and its prevalence and risk factors among them in Saudi Arabia have been investigated previously. However, the results have never been comprehensively reviewed. Therefore, the aim of this study was to perform a systematic review and meta-analysis of the available literature to identify the prevalence and risk factors of LBP among health workers in Saudi Arabia. METHODS: MEDLINE/PubMed, Web of Science, Scopus, CINAHL, and Saudi peer-reviewed journals were searched for relevant literature. After quality assessment of the eligible articles, 18 studies targeting seven occupational categories, with a total number of 5345 health workers, were analyzed. RESULTS: Pooled prevalence rates of 40.8% (n = 7 studies), 65.0% (n = 13 studies), and 81.4% (n = 2 studies) were obtained for week, year, and career, respectively, across all professional groups. Nurses and physical therapists were more susceptible to LBP, in that order, than the other categories considering week and career periods. Age, body mass index, and female gender were the most commonly reported individual risk factors. Occupational risk factors mainly included work-related activities requiring back bending and twisting, lifting and pulling objects, and manual patient-handling. CONCLUSIONS: The results of this review indicate that LBP is highly prevalent among health workers in Saudi Arabia when compared with international rates. Proper prophylactic measures are necessary to reduce LBP and minimize its consequences. Further high-quality research is needed in different Saudi regions to achieve a broader understanding of LBP prevalence and causes.

Cross-cultural adaptation and psychometric testing of the Arabic version of the Modified Low Back Pain Disability Questionnaire.

BACKGROUND: The Modified Low Back Pain Disability Questionnaire (MLBPDQ) is used for evaluating the functional disability in patients with low back pain (LBP). However, the measurement characteristics of the MLBPDQ among Arab patients are unknown. In this study, we aimed to translate and cross-culturally adapt the MLBPDQ into Arabic and evaluate its psychometric properties. METHODS: An Arabic version of the MLBPDQ was developed through forward translation, translation synthesis, and backward translation. Sixty-eight patients (55 males and 13 females) with a mean age 37.01 ± 7.57 years were recruited to assess its psychometric properties. Reliability was evaluated using internal consistency (Cronbach's α), test retest reliability (utilizing intraclass correlation coefficient [ICC]), standard error of measurement (SEM), minimal detectable change at 95% confidence level (MDC95%), and 95% limits of agreement (LOA). The construct validity was investigated by correlating the new translation with four other measures of LBP (using Spearman's rho). Finally, receiver operating characteristic curve was constructed to compute the sensitivity, using the area under the curve (AUC), and the minimum important change (MIC). An alpha level of 0.05 was set for statistical tests and all the psychometric values were tested against a priori hypotheses. RESULTS: The culturally aligned MLBPDQ showed good internal consistency (Cronbach's α = 0.85). The ICC, SEM, MDC95%, and LOA between baseline and two days later were 0.98, 1.60, 4.43, and -4.23 to 7.70, respectively, while the values between baseline and 14 days later were 0.94, 2.77, 7.67, and -6.59 to 13.53, respectively. The scale also demonstrated moderate to excellent correlation (rho = 0.54­0.86) with the other four questionnaires. The AUC value of the Arabic-MLBPDQ was 0.68, and the MIC was 3 points. CONCLUSION: The Arabic version of the MLBPDQ demonstrates adequate psychometric properties and can be used to assess disability level in patients with LBP in Arabic-speaking communities.

Electromyographic activity of quadriceps muscle during sit-to-stand in patients with unilateral knee osteoarthritis.

OBJECTIVE: The sit-to-stand (STS) is a simple test to evaluate the functional performance of the quadriceps muscle in patients with knee osteoarthritis (OA). The aim was to evaluate the electromyographic (EMG) activity of the ipsilateral quadriceps during STS task at different seat heights and feet positions in patients with severe unilateral OA. The EMG activity was recorded in a group of eight participants with unilateral OA during the performance of STS task in four conditions: (1) knee-height seat with feet together, (2) knee-height seat with feet askew (feet side by side and heel-to-toe), (3) low-height seat (25% lower than knee-height seat) with feet together, and (4) low-height seat with feet askew. RESULTS: There was a statistically significant difference among the four conditions in the EMG activity (p =0.004). Particularly, the EMG activity of the quadriceps was significantly higher when participants rose from the low height with their feet askew than when they rose from the knee height with their feet placed together (p =0.004) or askew (p =0.002). These results recommend considering initial feet position and seat height when evaluating the functional activity of the quadriceps in patients with unilateral OA using STS test.

Cryotherapy intervention in relieving arteriovenous fistula cannulation-related pain among hemodialysis patients at the King Khalid Hospital, Tabuk, Kingdom of Saudi Arabia.

Pain during arteriovenous fistula (AVF) cannulation remains a common problem in hemodialysis (HD) patients that leads to noncompliance to lifetime maintenance HD. This study was performed to determine the effect of cryotherapy on reducing pain during AVF cannulation among HD patients in the King Khalid Hospital, Tabuk, Kingdom of Saudi Arabia. This is an experimental study which included 62 patients undergoing HD through an AVF. Randomization was used to assign the patients into the experimental (received cryotherapy) and control (no cryotherapy) groups. The Arabic version of Wong-Baker pain rating scale was used to determine the pain score. There was a significant difference in the pre-and post-intervention pain scores among the experimental group, while there was no such difference in the control group. The null hypothesis was rejected based on a P <0.05. Our study suggests that cryotherapy intervention to relieve AVF cannulation-related pain among adult patients undergoing HD is effective. Therefore, it is recommended that cryotherapy should be considered as a complementary intervention to reduce pain related to AVF cannulation.