Urdu translation and cross-cultural validation of Cumberland Ankle Instability Tool (CAIT).

BACKGROUND: The Cumberland Ankle Instability Tool (CAIT) is a self-assessment tool for people with chronic ankle instability (CAI). This tool had been translated and validated in many languages but there is no Urdu version of CAIT available. OBJECTIVE: The aim was to translate the CAIT into the Urdu Language and determine its validity and reliability. METHODS: A standardized step-wise forward and backward translation process was followed. Content, construct, convergent validity, internal consistency, and test-retest reliability were determined. A pilot study was done on 10 patients with CAI. The final version was investigated in 120 patients (mean age 26.6 ± 4.8 yrs) with CAI for validity and test-retest reliability in which 105 participants filled the questionnaire in the second week. Internal consistency was calculated by Cronbach's alpha. Intraclass correlation (ICC2,1) was calculated to assess test-retest reliability between two weeks. Standard error of measurement (SEM) and smallest detectable change (SDC) were calculated. Convergent validity was determined by correlating Urdu CAIT with the Foot and Ankle Outcome Score (FAOS) using Spearman's correlation co-efficient. Factor analysis describes the structure of underlying factors. RESULTS: Content validity index was > 0.80 of each question. Internal consistency was acceptable (Cronbach's alpha > 0.75). Convergent validity with FAOS total score showed a moderate negative correlation (r = -0.68) with U-CAIT and negatively correlated with subscales of FAOS. Test-retest reliability was excellent ICC2,1 > 0.80. Scree plot showed 3 factors > 1eigen value. CONCLUSION: The Urdu version of CAIT is a valid and reliable assessment tool for patients with chronic ankle instability. It has good content validity, construct validity and reliability.

Urdu translation of Shoulder Pain and Disability Index (SPADI) and its validity and reliability on adhesive capsulitis patients.

BACKGROUND: Excessive scar tissues around the shoulder are the results of shoulder pathologies that lead to pain and disability. The Shoulder pain and disability index (SPADI) is used to measure the level of pain and disability in patients with shoulder pathology. SPADI is translated into Urdu and its validity and reliability are measured on patients with adhesive capsulitis. OBJECTIVE: The study was aimed to translate the SPADI in Urdu and to evaluate its reliability and validity in patients with shoulder adhesive capsulitis. METHODS: Translation of SPADI in Urdu was conducted by applying the standardized process. Two forward translations in Urdu were made T1 and T2 by bilingual translators. Urdu version of SPADI was drafted after experts' opinion. Two Backward English translations of Urdu SPADI were made BT1 and BT2 and the back translation was finalized by the consensus of all experts. After this process of reviewing by the professional experts, 3rd version of Urdu SPADI was drafted. The Final version was drafted after its application on 10 patients. Its reliability and validity were tested on 150 patients with shoulder adhesive capsulitis. RESULTS: Content Validity Index was good with values of each item > 0.85. For Test-retest reliability, the Intraclass correlation coefficient (ICC2,1) was measured with a value of 0.89 which showed good Test-retest reliability. The internal consistency and reliability of SPADI were calculated by Cronbach's alpha for a total score with a value of 0.94. Construct validity and Concurrent validity were determined. In Construct validity, factor analysis of Urdu SPADI showed two factors and a cumulative variance of 75.443%. CONCLUSION: It was concluded that the Urdu version of SPADI is a valuable translation that is a valid assessment tool for patients with shoulder adhesive capsulitis. It has good validity and test-retest reliability.

Urdu translation and cross-cultural validation of the Fugl-Meyer assessment in people with stroke.

PURPOSE: The purpose of this study was to translate the FMA for Upper and Lower Extremity into Urdu and determine the validity and reliability of the translated Urdu FMA in people with chronic stroke. MATERIALS AND METHODS: A Standardized step-wise forward-backward translation of FMA into Urdu was conducted with the help of bilingual translators, experts from Riphah International University, and experts familiar with the original FMA scale to ensure conceptual equivalency. The final version was constructed after pilot testing of the Urdu FMA on 10 stroke patients. Inter- and intra-rater reliability, content, concurrent and construct validity were determined in 50 individuals with chronic stroke (mean age 53.2 years). RESULTS: Intra- and inter-rater reliability, determined by Weighted kappa was satisfactory (k = 0.75-0.99). Internal consistency determined by Cronbach alpha was above 0.80. The content validity Index was acceptable (0.92). Moderate correlations were found with Functional Independence Measure, Modified Rankin Scale, and National Institute of Health Stroke Severity (r = 0.69-0.79). The factor analysis showed that two factors (upper and lower extremity) explained 67.8% of the variance. CONCLUSION: The Urdu FMA is reliable and valid for the assessment of sensorimotor function in people with chronic stroke and can therefore be recommended for use in clinical and research applications.IMPLICATIONS FOR REHABILITATIONThe Urdu FMA is now available for use in Pakistan.The Urdu FMA is reliable and valid for the assessment of sensorimotor function in people with chronic stroke.The use of Urdu FMA is recommended to clinicians to estimate stroke severity and motor recovery.

Effects of Supervised Structured Aerobic Exercise Training Program on Interleukin-6, Nitric Oxide Synthase-1, and Cyclooxygenase-2 in Type 2 Diabetes Mellitus.

OBJECTIVE: To determine the effects of supervised structured aerobic exercise training (SSAET) program on interleukin-6 (IL-6), nitric oxide synthase 1 (NOS-1), and cyclooxygenase-2 (COX-2) in type 2 diabetes mellitus (T2DM). STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Riphah Rehabilitation and Research Centre, Railways General Hospital, Rawalpindi, from January 2015 to June 2016. METHODOLOGY: Patients of either gender of minimum one year history of T2DM ranging from 40-70 years of age were included. Those with chronic systemic diseases, history of regular exercise, smoking, and those on dietary plan were excluded. Atotal of 195 patients were screened; 120 were selected and 102 agreed to participate in the study. They were randomly placed into experimental and control groups. SSAETprogram, routine medication, and dietary plan were applied in experimental group; whereas, control group was managed with routine medication and dietary plan for 25 weeks. IL-6, NOS-1, and COX-2 were assessed at baseline and 25 weeks. RESULTS: SSAET program, routine medication and dietary plan showed significantly improved IL-6 (pre-mean=0.25 ±0.11ng/ml, post-mean=0.19 ±0.04 ng/ml), NOS-1 (pre-median=4.65 ng/ml, IQ range=1.04 ng/ml), (post-median=2.72 ng/ml, IQ range=1.60 ng/ml), and COX-2 (pre-mean=18.72 ±4.42 ng/ml, post-mean=15.18 ±2.63 ng/ml) in experimental group, as compared with control group managed by routine medication and dietary plan, where deterioration was noted in IL-6 (pre-mean=0.23 ±0.08 ng/ml, post-mean=0.27 ±0.08 ng/ml) and COX-2 (pre-mean=18.49 ±4.56 ng/ml, postmean=19.10 ±4.76 ng/ml), while NOS-1 slight improvement (pre-mean=4.99 ng/ml, IQ range=2.67 ng/ml), (postmean=4.56 ng/ml, IQ range=3.85 ng/ml). Statistically at the baseline the p-values were not significant (p>0.05) in both experimental and control groups for IL-6, COX-2 and NOS-1; while after 25 weeks of intervention, the experimental group showed significant improvement (p<0.05) in comparison with the control group. CONCLUSION: SSAET program, routine medication, and dietary plan had positive effect on IL-6, NOS-1, and COX-2 in T2DM patients.