Assessment of upper limb capacity in children with unilateral cerebral palsy: construct validity of a Rasch-reduced Modified House Classification.

AIM: The aim of this study was to test and improve the unidimensionality and item hierarchy of the Modified House Classification (MHC) for the assessment of upper limb capacity in children with unilateral cerebral palsy (CP) using Rasch analysis. The construct validity of the Rasch-reduced item set was evaluated. METHOD: Modified House Classification items were scored from 369 videotaped assessments of 159 children with unilateral CP (98 males, 61 females; median age 6y 6mo, range 2y 1mo-17y 5mo). Construct validity was tested in 40 other children with unilateral CP (21 males, 19 females; median age 8y 2mo, range 3y 3mo-17y 6mo) by comparing total scores with the Manual Ability Classification System (MACS) and the ABILHAND-Kids scale. RESULTS: Fifteen MHC items could be included in the Rasch analysis. The excluded items were either too easy or too difficult. Fourteen items fitted the unidimensional model (χ(2) =41.3, df=39, p=0.37). The hierarchy of these items was different from the original MHC. There was a significant correlation with the MACS (r=-0.901, p<0.001) and the ABILHAND-Kids scale (r=0.558, p<0.001). INTERPRETATION: The original item hierarchy of the MHC can be improved in order to use its sum score for the assessment of upper limb capacity in children with unilateral CP. The Rasch-reduced 14-item MHC with weighted sum score shows good construct validity to measure functional capacity of the affected hand in children with unilateral CP.

Quality of resistance training description in COPD trials: study protocol for a systematic review.

INTRODUCTION: Limb muscle dysfunction is a common manifestation in patients with chronic obstructive pulmonary disease (COPD). Optimising of limb muscle function is therefore an important goal during pulmonary rehabilitation of patients with COPD. Resistance training (RT) is the best available intervention to achieve this goal. Previous systematic reviews on RT primarily focused on methodological quality. However, the intervention holds the essence of each experimental study. Replication of RT interventions requires clear, complete and accessible reporting of the essential components. The American College of Sports Medicine (ACSM) provides evidence-based guidelines for RT prescription and recommends RT models specific to desired outcomes, that is, improvements in strength, muscular hypertrophy, power or local muscle endurance. The aim of this review is to investigate if the application of the RT principles and key training variables is described sufficiently in current evidence on the effects of RT interventions in patients with COPD. METHODS AND ANALYSIS: Any research study (randomised, non-randomised controlled, controlled pre-post studies and observational studies) with an RT intervention in patients with COPD will be considered for this systematic review. Potentially relevant studies published in English from inception to 1 October 2017 will be identified from Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Physiotherapy Evidence Database (PEDro). Studies exploring the effects of RT following a single session and RT interventions limited to other respiratory chronic diseases will not be included. Additionally, studies including non-COPD participants will be excluded, if the COPD data are not separated. Pairs of reviewers will independently extract data using data collecting sheets. Quality appraisal of RT description will be performed in timeframes according to the latest published ACSM position statement on exercise or RT. ETHICS AND DISSEMINATION: This protocol is a systematic review and therefore ethical approval is not required. The results of this review will be disseminated through peer-reviewed publication and presented at scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42017067403.

Pain cognitions as predictors of the request for pain relief during the first stage of labor: a prospective study.

BACKGROUND: It is thought that pain cognitions determine coping behavior and success in adapting to labor. The aim of this study was to examine whether pain cognitions assessed by the labor pain coping and cognition list (LPCCL) predict the request for pain relief during the first stage of labor and which pain cognition is the strongest predictor of a request for pain relief over and above, and independent of, other pain cognitions. METHODS: Participants in this prospective study were 177 low-risk nulliparous pregnant women. Data were collected on two different occasions. The numerical pain intensity scale (NPS)-anticipated and the LPCCL were administered at 34-36 weeks' gestation followed by the NPS-during labor. RESULTS: Catastrophizing and external pain control predicted the request for pain relief during labor after adjustment for relevant demographic and clinical characteristics, respectively (adjusted odds ratio [OR] 2.61 [95% CI 1.45-4.68] and adjusted OR 1.90 [95% CI 1.16-3.10]). Catastrophizing was found to be the strongest and independent predictor among the pain cognitions while controlling for significant background variables (adjusted OR 2.61 p-value < 0.001). CONCLUSION: Catastrophizing seems to have a substantial impact on the request for pain relief in low-risk pregnant women.