Translation and cross-cultural adaptation of an Arabic version of PROMIS® of dyspnea activity motivation, requirement item pool and sleep-related impairments item bank.

BACKGROUND: Patient-Reported Outcomes Measurement Information System (PROMIS®) Dyspnea Activity Motivation & Requirement item pool and sleep related impairments (SRI) item bank are designed in assessing the impact of dyspnea and sleep and guiding patient management. However, to effectively utilize this tool in Arabic-speaking populations, it is essential to perform a thorough translation and cultural adaptation process. Therefore, the aim of the study is to translate and cross-culturally adapt the translated items of the PROMIS® dyspnea activity motivation and requirement and SRI into Arabic. METHODS: A universal approach to translation adopted from PROMIS guideline document for translation and cultural adaptation, and the Chronic Illness Therapy translation methodology. The forward translation step followed by back work translation and Harmonization and quality assurance. Cognitive interview and pilot testing was conducted among 30 Arabic respondents across 5 different countries of Arabic speaker to produce a single version for Arab countries. RESULTS: A successful translation and cross-cultural adaptation into Arabic was achieved while maintaining equivalency. The translation was clear and more colloquial sentences were semantically equivalent and easy to understand. Equivalence of meaning of PROMIS® dyspnea activity motivation, requirement and SRI were achieved. All items were appropriate, relevant to culture and it measured the same concept as the original items. In Items 2 of the dyspnea activity motivation related to leisure activity "shopping", the term "catalog and website" was added instead of "catalog only" which makes item in line with the original source but more comprehensive and applicable to current shopping trends. CONCLUSIONS: The PROMIS® dyspnea activity motivation, requirement items pool and SRI item bank are culturally and linguistically suitable to be used in Arab country. By extending the accessibility of this measure to Arabic-speaking population, this study contributes significantly to the advancement of management and patient-centered care in the region. Further studies are necessary to evaluate the psychometric properties of these instruments.

The client satisfaction with device: a Rasch validation of the Arabic version in patients with upper and lower limb amputation.

BACKGROUND: The Client Satisfaction with Devices (CSD) module of the Orthotics and Prosthetics Users' Survey is an extensively used questionnaire that measures patients' satisfaction with orthosis and prosthesis. However, the validated version for Arabic speakers (CSD-Ar) is only applicable for orthosis users. OBJECTIVES: The aim of this study was to evaluate the psychometric proprieties of the CSD-Ar for prosthetics users. METHODS: The study used a convenience sample of prosthesis users from Saudi Arabia and Turkey (N = 183), who completed the CSD-Ar. The collected data were analysed using Rasch analysis to evaluate item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF) using WINSTEPS version 4.6.1. RESULTS: Based on the analysis, the four-response Likert-scale was acceptable, as shown by the category functioning test, All eight items did achieve a fit to the Rasch Model [(infit) and (outfit) mean-square 0.75 to 1.3]. Person separation reliability was 0.76, and item separation reliability was 0.94. A principal component analysis (PCA) showed satisfactory unidimensionality and no local item dependency. The DIF analysis showed no notable dependency among items on participant characteristics in terms of age, gender, duration of use, country, and level of amputation. CONCLUSION: This study contributes to the confidence of using CSD-Ar to evaluate users' satisfaction with different prostheses, affirming the need for further refinement of the quality of the outcome measure.

Role of Physical Therapy before and after Hematopoietic Stem Cell Transplantation: White Paper Report.

Hematopoietic stem cell transplantation (HSCT) patients can suffer from various musculoskeletal problems resulting in long-term functional incapacity. Physical therapy (PT), as a part of the healthcare team, has been historically advocated for regaining functional capacity and improving quality of life post-HSCT. Because of the nature of this condition and the burden of post-transplant complications, this patient group requires a unique approach toward their rehabilitation that takes into account their complex musculoskeletal presentation ranging from fascia, muscle, tendons, bones, and ligaments. However, to our knowledge there is no universal standardized PT protocol or pathway to help guide rehab specialists to achieve optimal gains for this patient group, and anecdotal evidence suggests that these patients do not always receive the PT care they require. Hence, in collaboration with the Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation, the Survivorship Special Interest Group of the American Society of Blood and Marrow Transplantation, and the Quality of Life Committee of the Eastern Mediterranean Blood and Marrow Transplantation, herein the Physical Therapy Association for Graft Versus Host Disease provides a brief review on role of PT in mitigating musculoskeletal complications in HSCT patients and makes evidence-based recommendations for incorporation of PT into routine HSCT care.

Assessment of park paths and trails to promote physical accessibility among wheelchair users in Saudi Arabia.

Background: Individuals with mobility disabilities are less likely to meet physical activity standards and are at greater risk of developing non-communicable chronic diseases at earlier ages. Public parks are an essential resource for participation in physical activity. However, environmental factors may limit the participation of wheelchair users. The objective of this study was to evaluate the feasibility of using the Path Environment Audit Tool (PEAT) and to explore the wheelchair accessibility of five public parks in Saudi Arabia through descriptive analysis. Methods: A descriptive study design was implemented to evaluate wheelchair accessibility features of five public parks in Riyadh, Saudi Arabia, and process, resource, and management assessments were conducted. Phone GPS-App Strava was used to track the segments and measure their distances. Results: Audits in multiple parks using PEAT were time-consuming despite being user-friendly. The descriptive analysis of paths and trails across the five parks showed some positive features, such as adequate bollard/gate clearance, but the path slope and condition of the path surfaces were more variable. Conclusion: This study is the first to examine wheelchair accessibility in public parks in Saudi Arabia. Preliminary audits of paths/trials in five public parks revealed the strengths and weaknesses of accessibility and features that promote physical activity participation for wheelchair users. These findings can guide future use of PEAT in large-scale studies and inform environmental modifications.

Activities-specific balance confidence scale: a Rasch evaluation of the Arabic version in lower-limb prosthetic users.

PURPOSE: To evaluate the psychometric properties of the Arabic version of the Activities-Specific Balance Confidence Scale using the 5-option response categories for individuals with lower limb amputation (ABC-5/Ar). MATERIALS AND METHODS: This was a methodological study on a convenience sample of individuals with unilateral lower-limb amputation attending outpatient rehabilitation centres in Saudi Arabia and Turkey (N = 155). Rasch analysis (WINSTEPS version 4.6.5) was used to examine the 5-categories rating scale structure, item fit, item difficulty hierarchy, person separation index, unidimensionality, local item dependency, and differential item functioning. RESULTS: The ABC-5/Ar 5-response option demonstrated an appropriate model fit. Most items fit the Rasch model, except for item #12 "walk in a crowded mall," which showed an overfitting value of 0.63. The person separation indices 2.95 (Cronbach's α = 0.96). Principal component analysis of residuals confirmed the unidimensionality of the scale; however, local dependency was detected between item #14 "Ride in escalator holding rail," and item #15 "Ride in escalator not holding rail." CONCLUSIONS: The findings suggest that the ABC-5/Ar shows promise in assessing balance confidence in Arabic-speaking lower-limb prosthesis users. However, further studies with larger sample sizes and in diverse clinical contexts are needed to confirm its effectiveness in various clinical settings.

Overall, our Rasch-based study provides additional evidence to support the psychometric appropriateness of using the Activity-specific Balance Confidence scale with the 5-category options (ABC-5) of the Arabic version among lower prosthesis users.Clinicians and researchers should be mindful of cultural and contextual differences that exist among Arabic-speaking population which may influence how participants responded to certain items in the scale.It is essential to conduct a comprehensive psychometric evaluation to guide the implementation and interpretation of scales, particularly in Arabic-speaking countries due to the scarcity of validated and standardised outcome measures to assess prosthesis users' confidence.

Translation and Cultural Adaptation into Arabic of Patient-Reported Outcome Measurement Information System® Item Banks: Cognitive Function Abilities and Physical Function for Samples with Mobility Aid Users.

PURPOSE: This study aimed to provide Arabic-speaking individuals with tools to assess their cognitive abilities and physical function and to contribute to a better understanding of these capabilities in this population. Thus, the specific objective was to translate into Arabic and culturally adapt two Patient-Reported Outcome Measurement Information System (PROMIS) item banks: the Adult Cognitive Function Abilities and the Physical Function for Samples with Mobility Aid Users item banks. This study employed the Functional Assessment of Chronic Illness Therapy (FACIT) multilingual translation methodology to ensure cultural and linguistic relevance. The translation process included forward and back translations, expert reviews, and finalisation by a language coordinator. Cognitive debriefing interviews were conducted with 30 native healthy Arabic speakers to assess the clarity and comprehension of translated items. Most items were well understood, but two items related to cognitive ability and four related to physical functions required revision to address participant confusion. The translations were refined based on the participants' feedback and expert recommendations. This study followed a rigorous translation process and included cognitive debriefing interviews to ensure linguistic and cultural equivalence. The availability of these tools in Arabic enhances cross-cultural research and practice in healthcare and contributes to a global understanding of cognitive and physical functions.

Computational Identification and Functional Analysis of Potentially Pathogenic nsSNPs in the NLRP3 Gene Linked to Alzheimer's Disease.

Single Nucleotide Polymorphisms (SNPs) are key in understanding complex diseases. Nonsynonymous single-nucleotide polymorphisms (nsSNPs) occur in protein-coding regions, potentially altering amino acid sequences, protein structure and function. Computational methods are vital for distinguishing deleterious nsSNPs from neutral ones. We investigated the role of NLRP3 gene in neuroinflammation associated with Alzheimer's disease (AD) pathogenesis. A total of 893 missense (nsSNPs) were obtained from the dbSNP database and subjected to rigorous filtering using bioinformatics tools like SIFT, Align GVGD, PolyPhen-2, and PANTHER to identify potentially damaging variants. Of these, 18 nsSNPs were consistently predicted to have deleterious effects across all tools. Notably, 16 of these variants exhibited reduced protein stability, while only 4 were predicted to be buried within the protein structure. Among the identified nsSNPs, rs180177442 (R262L and R262P), rs201875324 (T659I), and rs139814109 (T897M) were classified as high-risk variants due to their significant deleterious impact, probable damaging effects, and association with decreased protein stability. Molecular docking and simulation analyses were conducted utilizing Memantine, a standard drug utilized in AD treatment, to investigate potential interactions with the altered protein structures. Additional clinical and genetic investigations are necessary to elucidate the underlying mechanisms that link NLRP3 polymorphisms with the initiation of AD.

Arabic Translation and Psychometric Validation of PROMIS General Life Satisfaction Short Form in the General Population.

This study aimed to translate the Patient-Reported Outcomes Measurement Information System (PROMIS) General Life Satisfaction Short Form (GLS SF5a) into the Arabic language and psychometrically validate the scale in the general population of Saudi Arabia. The translation processes followed the international recommendations of the FACIT Measurement System. The study was a multicentre cross-sectional study conducted in Riyadh, Saudi Arabia. A total of 657 individuals who were above 18 years of age and able to write and comprehend Arabic completed the GLS SF5a. Rasch analysis was used to evaluate item fit, reliability indices, item difficulty, principal component analysis and local item dependency. WINSTEPS (v. 5.6.0) was used for the analysis. The translation process and cognitive defibring were completed with no issues. The rating scale categories had a disordered threshold. All items, except one, demonstrated a satisfactory fit to the Rasch model. The reliability of the person separation was 0.86. The scale was unidimensional, and no items showed local dependency. Overall, this study confirms the psychometric properties of the Arabic version of the PROMIS GLS SF5a, which can be used as an instrument for measuring general life satisfaction in the general population. Further research is required to explore responsiveness, interpretability and feasibility in the clinical setting.

Association Between Self-Reported Kinesiophobia and Single-Leg Hop for Distance in Patients With ACL Reconstruction: A Systematic Review.

CONTEXT: Psychological readiness is a significant factor in determining successful return to sport (RTS) and physical activities after anterior cruciate ligament (ACL) reconstruction. Knowing the influence of kinesiophobia on physical tests that are used to guide RTS, such as the single-leg hop for distance (SLHD), would contribute to advancing clinical practice. OBJECTIVE: To investigate the association between kinesiophobia and SLHD performance in patients after ACL reconstruction. DATA SOURCES: A comprehensive search strategy entailed surveying 6 databases for relevant articles published from January 2009 to March 2021. STUDY SELECTION: Articles published in English that were a minimum of level 3 evidence describing kinesiophobia, as measured by the Tampa Scale for Kinesiophobia, and related to SLHD performance in patients after ACL reconstruction. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 3. DATA EXTRACTION: Study characteristics, sample population demographics, instrument(s), or approach(s) used to assess kinesiophobia and SLHD performance, and corresponding results. RESULTS: A total of 152 potential studies were identified, 106 studies underwent screening, 40 were reviewed in full, and 7 studies were included. Meta-analysis could not be performed because of differences in experimental design among studies and instances of missing outcome data. Currently, moderate evidence indicates patients with ACL reconstruction that exhibit less kinesiophobia perform better on the SLHD test. CONCLUSION: The outcomes of this review propose that sports health practitioners consider the influence of kinesiophobia on SLHD performance as a criterion for RTS and physical activities in patients after ACL reconstruction. Higher quality studies are necessary to establish the extent of association between these variables.

Psychometric evaluation of the Arabic version of the Quebec user evaluation of satisfaction with assistive technology (A-QUEST 2.0) in prosthesis users.

BACKGROUND: The evaluation of patient satisfaction and perceptions plays a vital role in determining the quality of prosthesis users' devices and the competency of healthcare services. AIM: To evaluate the psychometric properties of the Arabic Quebec User Evaluation of Satisfaction with Assistive Technology (A-QUEST 2.0) with prosthetics users. DESIGN: A methodological study. SETTING: Saudi Arabia, Turkey. POPULATION: A convenience sample of outpatient prosthesis users (N.=183). METHODS: The A-QUEST 2.0 includes two subscales respectively evaluating the user's satisfaction with the device and the services provided. The data for each subscale were investigated using Rasch analysis to evaluate the item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF). RESULTS: Both subscales met the Rasch criteria for the functioning of rating scale categories. All items showed an acceptable fit to the Rasch model. The person separation indices for the Device and Services subscales were 2.21 (Cronbach's α=0.90) and 1.72 (Cronbach's α=0.85), respectively. Therefore, the two subscales are sensitive enough to distinguish between at least three different levels of satisfaction. The unidimensionality of each subscale was confirmed, and none of the items displayed differential item functioning across age, gender, location of amputation, country, and duration of use. CONCLUSIONS: Overall, the findings indicate the psychometric evaluation of A-QUEST 2.0 is effective with prosthesis users across different clinical contexts and cultures. Thus, the A-QUEST 2.0 allows for a comprehensive understanding of users' perceptions of prosthesis characteristics, particularly among subjects with lower limb amputations caused by traumatic injuries. CLINICAL REHABILITATION IMPACT: Our paper provides clinicians dealing with Arabic patients a validated outcome measure for satisfaction with prosthesis. Besides providing information in the development of new products and service delivery. Further studies are necessary to improve the measure's metric quality in different contexts and for different prosthesis devices.

Saudi Expert Consensus-Based Autism Spectrum Disorder Statement: From Screening to Management.

BACKGROUND: There is a large gap between the needs of individuals diagnosed with autism spectrum disorder (ASD) and the currently available services in Saudi Arabia. Services are often difficult to access, inconsistent in quality, incomplete, unsatisfactory, and costly. As such, there is a national need for expert consensus on the appropriate standards for the assessment and management of children on the autism spectrum. METHODOLOGY: A guideline development group (GDC) was formed by professionals representing all related specialties and institutions involved in the management of individuals on the autism spectrum in Saudi Arabia. They met on a regular basis over 21 months. The guideline development process consisted of five steps starting from reviewing existing guidelines and ending with discussing and writing this manuscript. A formal voting process was utilized and recommendations were discussed until a consensus was reached. RESULTS: There was consensus on the following: A specialized diagnostic assessment needs to be carried out by an experienced multidisciplinary team for children referred to assess for ASD. They should be assessed for medical etiology, their behavioral history carefully reviewed, and symptoms directly observed. Longitudinal assessments are encouraged to reflect the effects of symptoms on the individual's ability to function while with their family, among peers, and in school settings. An additional formal assessment of language, cognitive, and adaptive abilities as well as sensory status is essential to complete the diagnostic process. Interventions should be individualized, developmentally appropriate, and intensive, with performance data relevant to intervention goals to evaluate and adjust interventions. Target symptoms must be identified to address and develop monitoring systems to track change. CONCLUSION: ASD is a complex condition with widely varying clinical manifestations, thus requiring evaluation and intervention by a range of professionals working in coordination. Behavioral and environmental interventions are the key to optimal outcomes, in conjunction with medications when indicated for specific symptoms. Parental involvement in interventions is vital to sustaining therapeutic gains.

Recommendations on service delivery to help reduce suffering and anxiety in patients and caregivers post-hematopoietic cell transplantation: a case report.

BACKGROUND: The aim of this study is to highlight the importance of having a central case managing team and to make some strong recommendations that can have a positive impact on the lives of hematopoietic stem cell transplantation survivors. CASE PRESENTATION: A 2-year-old white child who was diagnosed with acute myeloid leukemia and underwent hematopoietic stem cell transplantation in May 2014 relapsed in March 2017, and underwent a second hematopoietic stem cell transplantation in July 2017, at which point he suffered from graft-versus-host disease. This case report presents his journey and that of his caregivers, and the challenges they faced as patient and parents in pursuit of optimal quality of life during the survivorship period. The case study emphasizes not only the challenges faced by patients but also identified gaps in post-hematopoietic cell transplantation care service delivery. Furthermore, the case study also highlights the importance of involving caregivers in post-transplant care and having a better communication process and service facilitation process throughout the journey of the patient and their carer. CONCLUSIONS: Transplant centers have a duty of care, and a proactive approach with a well-defined pathway is needed for managing post-transplant complications and reducing stress and anxiety for patients and their caregivers.

Psychometric properties of the Client Satisfaction with Device module of the Orthotics and Prosthetics Users' Survey (OPUS): a scoping review.

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.

Understanding the Process and Challenges for Return-to-Work Post-Hematopoietic Cell Transplantation from a Musculoskeletal Perspective: A Narrative Review.

The current paper seeks to inform healthcare professionals on how adapting various components of return to work (RTW) programs that are already in use by other musculoskeletal rehabilitation settings can help optimize return to work process for patients with or without musculoskeletal manifestations, posthematopoietic cell transplantation. Since there is no universally agreed RTW structure for hematopoietic cell transplant patients, a narrative approach has been taken utilizing evidence from the existing musculoskeletal return to work assessment publications to help draw parallel for the hematopoietic cell transplant patients. Databases were searched including PUBMED, CINHAL, AMED, SCOPUS, and Cochrane using keywords RTW, functional restoration program, hematopoietic cell transplant, bone marrow transplant, stem cell transplant, and musculoskeletal functional assessment. The authors have managed to outline and propose a structured RTW assessment and monitoring program which can aid in getting patients back to employment by utilizing the functional capacity and job evaluation to help hematopoietic cell transplantation patients reintegrate socially. Patients undergoing hematopoietic cell transplant require additional support and a robust assessment system to allow safe RTW. The proposed model of RTW assessment can prove to be beneficial in helping patients return to work safely. Clinical Significance. To acknowledge the individuality in functional limitation is important in determining not only the rehab needs but also the RTW capabilities. The proposed RTW plan not only promotes an individualized approach to patients but also provides a structure for return to work assessments for hematopoietic cell transplantation patients, thus, eliminating the need for guess work by healthcare professionals. In line with the International Classification of Functioning, Disability, and Health (ICF) recommendations, a RTW assessment combined with a job evaluation helps healthcare professionals and stakeholders to understand the unique challenges and strengths of a patient and thereby design an individualized therapy approach.

Musculoskeletal Disorder Symptoms in Saudi Allied Dental Professionals: Is there an Underestimation of Related Occupational Risk Factors?

This study aims to examine the prevalence of musculoskeletal disorder (MSD) symptoms in allied dental professionals (ADPs) in Saudi Arabia and risk factors for MSDs. The study also explores ADPs' opinions and attitudes about the effect of MSD symptoms on the quality of life and potential mitigatory measures. This is a prospective cross-sectional study. Participants were 355 licensed dental staff (average age 33.6 ± 8.1 years, 69% women) working as assistants, lab technicians, radiology technicians, or sterilization technicians with at least six months' work experience. The self-administrated questionnaire comprised socio-demographics, work-related factors, and items from the Nordic Musculoskeletal Questionnaire. Multivariate and univariate logistic regressions were conducted to investigate risk factors for MSD symptoms. Overall, 93% of ADPs complained of MSD symptoms in at least one body site in the past 12 months. Factors related to work conditions (e.g., 'keeping an uncomfortable posture for long periods of time', 'lifting heavy objects') and years of experience were proven to be significant risk factor for developing MSDs. The cohort of ADPs showed a high MSD symptoms prevalence. Efforts are imperative in addressing the risk factors of ergonomics and the workplace environment, and more rigorous studies are needed to further investigate risk factors.

Occupational therapy practitioners' decision-making preferences, attitudes, awareness and barriers in relation to evidence-based practice implementation in Saudi Arabia.

AIM: Evidence-based practice (EBP) plays a significant part in healthcare. There has been little research into the standard of care that healthcare workers provide to patients in Saudi Arabia. The purpose of this study was to investigate occupational therapy practitioners' (OTPs) decision-making preferences, attitudes and awareness in relation to EBP as well as to discover any barriers possibly limiting EBP implementation. METHODS: A cross-sectional study was conducted using an online survey. The survey was distributed to OTPs in Saudi Arabia from May to July 2018. Data were collected on demographics, decision-making preferences, attitudes and awareness as well as on the barriers obstructing implementation of EBP. The percentages and frequencies of OTPs' responses were analysed and reported. Pearson's Chi-square test was performed to explore the association between demographic variables and the attitudes and awareness of OTPs. The data were analysed using IBM SPSS Statistics 24. RESULTS: A total of 144 participants responded to the questionnaire, out of which 54 participants were excluded as they only completed the demographics section, and they did not answer any of the following sections. Among the completed responses (n = 90), one undergraduate participant was excluded. The final number of respondents whose data were analysed was 89 (61.8%). Out of the respondents, 58.4% were female and 73% had completed a bachelor's degree. No formal training in EBP was received by many of the respondents (53.9%). Although the attitude of 79.8% of OTPs about using research in practice was positive, a number were unfamiliar with some of the terms and with EBP implementation. The most important barrier to EBP implementation mentioned by the respondents was that their previous education had involved insufficient teaching (45%), while 42.7% mentioned inadequate resources and funding and 38.2% pointed to a lack of skills and research knowledge. The only significant association found in this study was between the awareness of OTPs and their education level. CONCLUSION: Although the attitude of OTPs toward EBP implementation was positive, their awareness regarding the use of EBP was relatively low, indicating a gap in how they understand and apply EBP in Saudi Arabia. Thus, its inclusion in the curricula for graduates and undergraduates should be considered.

Are graft-versus-host-disease patients missing out on the vital occupational therapy services? a systematic review.

The aim of this review is to show the importance of occupational therapy/hand therapy for chronic graft-versus-host-disease (GVHD) patients and to outline the current state of the literature. GVHD of the hand can cause functional loss, reduced activities of daily life, poor social interaction, and loss of income because of limitations in work. Hand therapy, which is a specialty practised by both occupational therapists and physical therapists, has been proven to be an effective approach for hand-related musculoskeletal disorders; however, the literature search suggests that it is an underutilized specialty around the world. An electronic search was performed from 1997 to 2017 using OneFile (GALE), Medline/PubMed (NLM), Scopus (Elsevier), Science Citation Index Expanded (Web of Science), ProQuest Central (New), ProQuest Hospital Collection, Health Reference Center Academic (Gale), Health Research Premium Collection, Science Direct Journals (Elsevier), ProQuest Health & Medical Complete, Medical Database, Wiley Online Library, and SciTech Premium Collection for the period from 1994 to April 2017. Only randomized-controlled trials involving occupational therapy or hand therapy in patients with chronic hand GVHD were included in the final analysis. The search was limited to articles in English. Two reviewers independently assessed the methodological quality and extracted the data. The JADAD scoring method was used to score the articles. After the duplicates were excluded, 5466 articles were identified by the electronic database search for screening, out of which 5465 articles were excluded after reviewing. One article was further excluded on obtaining the full text as it was a case study. Hand therapy specialty, although a vital part of the recovery process for the patients with hand GVHD, is an underutilized specialty and well-designed trials are urgently needed for musculoskeletal hand GVHD, especially for focused hand therapy interventions.

A systematic review of questionnaires to assess patient satisfaction with limb orthoses.

BACKGROUND: Assessment of patient satisfaction with orthosis is a key point for clinical practice and research, requiring questionnaires with robust psychometric properties. OBJECTIVES: To identify which validated questionnaires are used to investigate patient satisfaction with orthosis in limb orthotics and to analyse (1) their main fields of clinical application, (2) the orthosis-related features analysed by the questionnaires and (3) the strength of their psychometric properties. STUDY DESIGN: Systematic review. METHODS: A literature search using MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus databases for original articles published within the last 20 years was performed. RESULTS: A total of 106 papers pertaining to various clinical fields were selected. The main features of patient satisfaction with orthosis analysed were as follows: aesthetic, ease in donning and doffing the device, time of orthotic use and comfort. CONCLUSION: Of the questionnaires used to investigate patient satisfaction with orthosis, only four are adequately validated for this purpose: two for generic orthotic use (Quebec User Evaluation of Satisfaction with assistive Technology 2.0 and Client Satisfaction with Device of Orthotics and Prosthetic Users' Survey) and two for specific application with orthopaedic shoes (Questionnaire for the Usability Evaluation of orthopaedic shoes and Monitor Orthopaedic Shoes). Further development, refinement and validation of outcome measures in this field are warranted. CLINICAL RELEVANCE: Given the importance of analysing patient satisfaction with orthosis (PSwO), appropriate instruments to assess outcome are needed. This article reviews the currently available instruments and reflects on how future studies could be focused on the development, refinement and validation of outcome measures in this field.

Translation into Arabic of the Quebec User Evaluation of Satisfaction with assistive Technology 2.0 and validation in orthosis users.

The assessment of patient satisfaction with the orthosis is a key point for clinical practice and research, requiring the availability of questionnaires with robust psychometric properties. The aim of this study was the translation into Arabic and Rasch validation of the Quebec User Evaluation of Satisfaction with assistive Technology (A-QUEST 2.0), one of the few standardized instruments appropriate for assessment of patient satisfaction with the orthosis. The translation was carried out in accordance with guideline recommendations. The translated version was administered to a convenience sample of 100 individuals with various health conditions using orthosis (59% men, mean age 36 years). Data were analyzed using confirmatory factor analysis, followed by Rasch analysis for each of the two subscales, that is satisfaction with the Device (eight items) and with Services (four items). The results of the confirmatory factor analysis verified the bidimensionality of A-QUEST 2.0. Rasch criteria for the functioning of rating scale categories were fulfilled for both subscales. All items except one showed an adequate fit to the Rasch model. The person separation reliability for A-QUEST 2.0_Device was 2.19 and Cronbach's α 0.83; A-QUEST 2.0_Services separation reliability was 2.79 and Cronbach's α was 0.89. Thus, the two subscales could define a hierarchy of persons along each measured construct with at least three different levels of satisfaction. This Rasch validation of A-QUEST 2.0, in patients with various types of orthoses, provides additional evidence of the psychometric properties (and particularly the internal construct validity) of the questionnaire, and provides insights for further improving its metric quality.