EFAS Score - Validation of Portuguese Version by the Score Committee of the European Foot and Ankle Society (EFAS).

BACKGROUND: The Score Committee of the European Foot and Ankle Society (EFAS) developed, validated, and published the EFAS Score in ten languages (English, German, French, Italian, Polish, Dutch, Swedish, Finnish, Turkish, Portuguese). From other languages under validation, the Portuguese version completed data acquisition and underwent further validation. METHODS: The Portuguese version of the EFAS Score was developed and validated in three stages: 1) item (question) identification (completed during initial validation study), 2) item reduction and scale exploration (completed during initial validation study), 3) confirmatory analyses and responsiveness of Portuguese version (completed during initial validation study in nine other languages). The data were collected pre-operatively and post-operatively at a minimum follow-up of 3 months and mean follow-up of 6 months. Item reduction, scale exploration, confirmatory analyses and responsiveness were executed using classical test theory and item response theory. RESULTS: The internal consistency was confirmed in the Portuguese version (Cronbach's Alpha 0.84). The Standard Error of Measurement (SEM) was 0.27 and is similar to other language versions. Between baseline and follow-up, 69.4% of patients showed an improvement on their EFAS score, with adequate responsiveness (effect size 0.64). CONCLUSIONS: The Portuguese EFAS Score version was successfully validated in patients with a wide variety of foot and ankle pathologies. All score versions are freely available at www.efas.net.

Ankle and syndesmosis instability: consensus and controversies.

Ankle sprains are mainly benign lesions, but if not well addressed can evolve into permanent disability. A non-treated lateral, syndesmotic or medial ankle instability can evolve into ankle osteoarthritis. For this reason, diagnosis and treatment of these entities is of extreme importance.In general, acute instabilities undergo conservative treatment, while chronic instabilities are better addressed with surgical treatment. It is important to identify which acute instabilities are better treated with early surgical treatment.Syndesmosis injuries are frequently overlooked and represent a cause for persistent pain in ankle sprains. Unstable syndesmotic lesions are always managed by surgery.Non-treated deltoid ligament ruptures can evolve into a progressive valgus deformity of the hindfoot, due to its links with the spring ligament complex. This concept would give new importance to the diagnosis and treatment of acute medial ligament lesions.Multi-ligament lesions are usually unstable and are better treated with early surgery. A high suspicion rate is required, especially for combined syndesmotic and medial lesions or lateral and medial lesions.Ankle arthroscopy is a powerful tool for both diagnostic and treatment purposes. It is becoming mandatory in the management of ankle instabilities and multiple arthroscopic lateral/syndesmotic/medial repair techniques are emerging. Cite this article: EFORT Open Rev 2021;6:420-431. DOI: 10.1302/2058-5241.6.210017.

Schwannoma of the First Webspace: A Case Report.

CASE: A 65-year-old man presented with plantar foot pain associated with a mass in the first webspace. A Morton neuroma was considered the probable diagnosis. Despite nonoperative treatment the pain continued. Surgical excision was performed, and histology was interpreted as a schwannoma. Symptoms resolved after surgery. CONCLUSION: Schwannoma of the foot is a rare condition, and to the best of our knowledge, this is the first case reported in the first webspace. Definitive treatment and diagnosis is surgical excision. Surgeons should consider schwannomas in the differential diagnosis of plantar foot pain because this can be misdiagnosed as a Morton neuroma.

Varus talar tilt combined with an internal rotation pivot stress assesses the supination instability vector in lateral ankle ligaments' injury - cadaver study.

BACKGROUND: The lack of consensus on the relevance of the varus talar tilt test (VTTT) might be due to the divergence between the insufficiency vector of lateral ankle instability and the direction of this clinical test. Our hypothesis is that the VTTT is more accurate to diagnose lateral ankle ligaments rupture when it's applied with a pre-positioning of the foot in internal rotation (IR). METHODS: We compared, in 12 cadaver ankles, the varus opening during a classic VTTT with the same test starting in an IR pivot, using a new arthrometer. RESULTS: The classic VTTT caused a 13° tilt after ATFL section and 23,8° after ATFL and CFL section. The application of a VTTT with an IR prepositioning caused a 21,2° tilt after ATFL section (p = 0,002) and 29,5° after ATFL and CFL section (p = 0,006). CONCLUSION: The VTTT is better to identify lateral ankle ligaments' insufficiency when it's applied with a pre-positioning of the foot in internal rotation. The resulting vector is similar to the supination trauma.

Qualidade de serviços e satisfação de espectadores de eventos esportivos: uma revisão sistemática / Service quality and satisfaction of sporting events' audience: a systematic review / Calidad de servicios y satisfacción de espectadores de eventos deportivos: una revisión sistemática

O objetivo deste artigo foi analisar os modelos de avaliação da qualidade de serviços e a relação da qualidade dos serviços na satisfação de espectadores de eventos esportivos. O estudo é uma revisão sistemática. A busca por artigos originais publicados a partir de janeiro de 2000 até junho de 2017 foi realizada nas bases de dados: SPORTDiscus, Scopus, Web of Science e SciELO Citation Index. Foram incluídos 19 artigos. Os resultados apontaram a existência de inúmeros modelos de avaliação que estão relacionados com a qualidade de serviços no esporte. Atributos do serviço principal como qualidade do jogo e desempenho dos atletas, além de serviços periféricos, como instalação, empatia dos funcionários e segurança influenciaram significativamente a satisfação dos espectadores esportivos. Portanto, os resultados indicam que a percepção da qualidade de serviços é um antecedente da satisfação

This study analyzed service quality evaluation models and the relations among service quality and audience satisfaction in sporting events. The study is a systematic review. Original articles published from January 2000 to June 2017 were searched on databases SPORTDiscus, Scopus, Web of Science and SciELO Citation Index. Nineteen articles were included. The results pointed out the existence of numerous evaluation models related to service quality in sports. Core service attributes such as game quality and athletes' performance, in addition to peripheral services such as facilities, employee empathy and security, have significantly influenced sports audience's satisfaction. Therefore, these results indicate that service quality perception precedes satisfaction

El objetivo de este artículo fue analizar los modelos de evaluación de la calidad de servicios y su relación con la satisfacción de espectadores de eventos deportivos. El estudio es una revisión sistemática. La búsqueda de artículos originales publicados a partir de enero de 2000 y hasta junio de 2017 fue realizada en las siguientes bases de datos: SPORTDiscus, Scopus, Web of Science y SciELO Citation Index. Fueron incluidos 19 artículos. Los resultados mostraron la existencia de innumerables modelos de evaluación relacionados con la calidad de servicios en el deporte. Atributos del servicio principal, como: calidad del juego y desempeño de los atletas; servicios periféricos, como: instalaciones, empatía de los funcionarios y seguridad influenciaron significativamente sobre la satisfacción de los espectadores deportivos. Por lo tanto, los resultados indican que la percepción de la calidad de servicios es un antecedente de la satisfacción

Rotational Instability after Anterior Talofibular and Calcaneofibular Ligament Section: The Experimental Basis for the Ankle Pivot Test.

The clinical diagnosis of the anterior talofibular ligament (ATFL) rupture is based on the findings from the medical history and the anterior drawer test, a maneuver that allegedly pushes the talus and rearfoot anteriorly, although with great variability in its sensitivity. We consider that an ATFL rupture is best evaluated by a rotational vector (i.e., a pivot test) owing to the uncompromised medial ligaments that will block any pure anterior translation of the talus underneath the tibia. We idealized a constrained ankle cadaver model that only allows talar movements in the axial plane. Our hypothesis was that progressive sectioning of the lateral ankle ligaments in this model would cause a progressive and significant angular laxity in internal rotation. Our results showed 3.67 degrees ± 1.2 degrees of talus rotational laxity in the intact ankle, 9.6 degrees ± 3.2 degrees after ATFL sectioning, and 13.43 degrees ± 3.2 degrees after ATFL and calcaneofibular ligament sectioning, indicating almost threefold increase in internal talocrural rotation after single ATFL sectioning and an almost fourfold increase after double (ATFL and calcaneofibular ligament) sectioning. We consider this evidence of rotational ankle laxity to be a major step in defining the correct movement to diagnose an ATFL rupture and propose a new term to avoid further inconsistencies and variability, "the pivot test."

Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert.

PURPOSE: The purpose of this study is to propose recommendations for the treatment of patients with chronic lateral ankle instability (CAI) based on expert opinions. METHODS: A questionnaire was sent to 32 orthopaedic surgeons with clinical and scientific experience in the treatment of CAI. The questions were related to preoperative imaging, indications and timing of surgery, technical choices, and the influence of patient-related aspects. RESULTS: Thirty of the 32 invited surgeons (94%) responded. Consensus was found on several aspects of treatment. Preoperative MRI was routinely recommended. Surgery was considered in patients with functional ankle instability after 3-6 months of non-surgical treatment. Ligament repair is still the treatment of choice in patients with mechanical instability; however, in patients with generalized laxity or poor ligament quality, lateral ligament reconstruction (with grafting) of both the ATFL and CFL should be considered. CONCLUSIONS: Most surgeons request an MRI during the preoperative planning. There is a trend towards earlier surgical treatment (after failure of non-surgical treatment) in patients with mechanical ligament laxity (compared with functional instability) and in high-level athletes. This study proposes an assessment and a treatment algorithm that may be used as a recommendation in the treatment of patients with CAI. LEVEL OF EVIDENCE: V.

Percutaneous Osteotomies in Hallux Valgus: A Systematic Review.

Percutaneous and minimally invasive surgery is one of the greatest advances in the operating field of orthopedic since the late 1990s. The potential advantages include a shorter operative time, quicker recovery, and reduced hospital stay compared with traditional open surgery. However, scientific validation of the safety and efficacy of hallux valgus (HV) percutaneous surgery remains inconclusive. The objective of the present study was to systematically review the published data and clinical evidence for percutaneous HV surgery, evaluate the scientific method of the reports, and clarify the indications, safety, efficacy, and potential risks of these surgical techniques. Two reviewers independently identified the studies using a PubMed search, with the keywords "hallux valgus," "osteotomy," "minimally invasive," and "percutaneous." Quality assessment was performed using the Coleman methodology scale, and each study was assigned a level of evidence and grade of recommendation. Eighteen studies were included and reported a total of 1534 procedures for percutaneous HV surgery on 1397 patients. Of the 18 studies, 14 (77.8%) were level IV, 2 (11.1%) were level III, and 2 (11.1%) were level II. Overall, the average angle correction of the HV deformity improved postoperatively. Regarding the complications, although some investigators revealed no major complications, others described deformity recurrence in 7.8%, stiffness of the first metatarsophalangeal joint in 9.8%, malunion in 4% to 8.7%, and infection rates ranging from 1.9% to 14.3%. The main indication for percutaneous HV surgery is the correction of mild deformities. The complication rate was elevated even in experienced surgeons. In conclusion, future research in percutaneous techniques should include adequately sized randomized control trials, standardization of treatment protocols, and the use of validated tools for the measurement of clinical outcomes.

Comportamento da prática esportiva do estudante de enfermagem / Comportamiento de la práctica deportiva del estudiante de enfermería / The behavior of practicing sports among nursing students

RESUMO Objetivo Analisar os padrões de frequência de prática esportiva, as fases dos estágios de mudança e os prós e os contras do balanço decisional em estudantes de enfermagem, em função do sexo e do ano da licenciatura. Método Realizou-se um estudo transversal, descritivo e exploratório. Resultados Participaram do estudo 535 estudantes de ambos os sexos. A análise dos resultados revelou que 27,6% dos estudantes não apresentavam qualquer frequência de prática esportiva; 55,3% dos estudantes não tinham uma prática esportiva habitual consistente e continuada; os estudantes exibiam globalmente uma frequência de prática esportiva inexistente em níveis similares ao longo do ciclo de estudos; os estudantes do sexo masculino apresentavam porcentagens similares no seu posicionamento nos estágios de pré-contemplação e contemplação ao longo do ciclo de estudos; e em todas as fases dos estágios de mudança, os estudantes apresentaram valores superiores de prós em relação aos de contras para a prática esportiva. Conclusão Os resultados reforçam a pertinência da implementação de mecanismos de promoção e monitorização no envolvimento e participação regular na prática esportiva nos estudantes de enfermagem.

RESUMEN Objetivo Analizar los estándares de frecuencia de práctica deportiva, las fases de los estadíos de cambio e los pro y contra del balance de decisiones en estudiantes de enfermería, en función del sexo y del año de licenciado. Método Se llevó a cabo un estudio transversal, descriptivo y exploratorio. Resultados Participaron en el estudio 535 estudiantes de ambos sexos. El análisis de los resultados reveló que el 27,6% de los estudiantes no presentaban cualquier frecuencia de práctica deportiva; el 55,3% de los estudiantes no tenían una práctica deportiva habitual consistente y continuada; los estudiantes exhibían globalmente una frecuencia de práctica deportiva inexistente en niveles similares a lo largo del ciclo de estudios; los estudiantes del sexo masculino presentaban porcentajes similares en su posicionamiento en los estadíos de pre contemplación y contemplación a lo largo del ciclo de estudios; y en todas las fases de los estadíos de cambio, los estudiantes presentaron valores superiores de pro con relación a los de contra para la práctica deportiva. Conclusión Los resultados refuerzan la pertinencia de la implementación de mecanismos de promoción y monitoreo en la involucración y participación regular en la práctica deportiva de los estudiantes de enfermería.

ABSTRACT Objective Analyzing the frequency patterns of practicing sports, the stages of change phases and the pros and cons of decision-making balance in nursing students related to gender and which year of study they are in. Method A cross-sectional, descriptive and exploratory study. Results 535 students of both genders participated in the study. An analysis of the results revealed that 27.6% of the students did not present any frequency of practicing sports; 55.3% of the students did not have a consistent or continuous habit of practicing sports; students overall exhibited a non-existing frequency of practicing sports at similar levels throughout the study cycle; male students presented similar percentages in their positioning in the precontemplation and contemplation stages throughout the study cycle; and throughout all the stages of change phases students showed higher values for pros over cons related to practicing sports. Conclusion The results reinforce the relevance for implementing mechanisms for promoting and monitoring nursing students' involvement and regular participation in practicing sports.

Resiliência, suporte social e prática esportiva: relações e possibilidades de intervenção social / Resilience, social support and sports practice: relations and social intervention possibilities

Embora nos últimos anos tenha vindo a aumentar o número de pesquisas que examinam a resiliência e o suporte social no contexto do esporte de competição, são ainda necessários estudos que examinem estas variáveis em contexto não competitivo, junto de crianças e jovens. Esta pesquisa teve por objetivo estudar a prática esportiva, a resiliência e o suporte social junto de 1052 com idades entre os 12 e os 20 anos (15,53 ± 1,68), estudantes de escolas públicas brasileiras. Inicialmente, examinaram-se as relações entre o sexo e a idade com a prática esportiva, resiliência e suporte social. Em seguida, averiguou-se a existência de diferenças nos níveis de resiliência e suporte social em função de diferentes níveis de prática esportiva. Os participantes preencheram uma bateria de questionários. Os resultados revelaram que os alunos mais novos praticavam esporte com mais frequência que as moças e os mais velhos. Não foram encontradas diferenças entre sexos nos níveis de resiliência, mas as moças estavam mais satisfeitas com o suporte social do que os rapazes. Os alunos no início da adolescência eram menos resilientes e estavam menos satisfeitos com o seu suporte social do que os jovens adultos e os alunos a meio da adolescência, respetivamente. Os resultados apontam ainda para uma relação significativa entre a prática esportiva e a resiliência, bem como entre a prática esportiva e o grau de satisfação dos sujeitos com suas redes de suporte social, independentemente do número de sujeitos que compunham esta rede. (AU)

Although in recent years the number of research examining resilience and social support in competitive sports context has increased, further studies are needed to examine these variables in non-competitive contexts, with children and young people. This research aimed to study sports practice, resilience and social support in 1052 Brazilian students from public schools, aged 12 and 20 years old (15.53 ± 1.68). Initially, we examined the relationship between sex and age with sports practice, resilience and social support. Afterwards, we examined differences in resilience and social support across different levels of sports practice. Participants completed a pack of questionnaires. The results revealed that the boys and younger students practiced sport more often than girls and older students. No differences were found between sexes in resilience levels, but girls were more satisfied with their perceived social support than boys. Students in their early teens were less resilient and were less satisfied with the social support they perceived than young adults and students in their mid-teens, respectively. The results also indicated a significant relationship between sports practice and resilience, as well as between sports and the level of satisfaction with the social support network, regardless of the number of subjects that made up that network. (AU)

Análise fatorial confirmatória da versão Brasileira da Escala de Resiliência (ER - Brasil) / Confirmatory factor analysis of the Brazilian version of a Resilience Scale (ER - Brazil)

A criação de instrumentos psicológicos com indicadores favoráveis de validade é de extrema importância para o estudo e desenvolvimento de um determinado construto teórico, em especial quando este se trata de um fenômeno relativamente novo, como é o caso da resiliência, que é compreendida de forma geral como o processo que permite aos indivíduos sobreporem-se os riscos e tirar ganhos positivos desta experiência. O objetivo desta pesquisa foi proceder à avaliação da estrutura fatorial para contexto brasileiro da escala de resiliência de Wagnild e Young (1993). Para realização do estudo participaram 359 estudantes de ambos os sexos com idade variando de 12 a 20 anos. A partir de procedimentos de análise fatorial confirmatória verificou-se que a estrutura dimensional que possui melhores índices estatísticos ao contexto brasileiro foi a de cinco fatores: autossuficiência, sentido da vida, equanimidade, perseverança e singularidade existencial.

The development of psychological instruments with favorable validity indicators is of utmost importance for the study and development of a theoretical construct, in particular when it is a relatively new phenomenon, such as resilience, which is understood generally as the process that allows individuals to overlap their risks and obtain positive gains from this experience. The objective of this research was to evaluate the factorial structure for Brazilian context relating to the resilience scale by Wagnild and Young (1993). To conduct the study 359 students of both sexes aged 12-20 years participated. From procedures of confirmatory factor analysis it was found that the dimensional structure that has better statistical indices for the Brazilian context was that of five factors: self-sufficiency, meaning of life, fairness, perseverance and existential uniqueness.

Arthroscopic treatment of tenosynovitis of the flexor hallucis longus tendon.

BACKGROUND: Tenosynovitis of the flexor hallucis longus (FHL) tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. A traumatic cause for this situation, such as an ankle sprain, is considered rare. In case of failure of conservative treatment, the tendon can be surgically released, which is usually done through an open procedure. This article presents the results of an arthroscopic release of the FHL. METHODS: Twenty-seven patients underwent surgery for FHL tenosynovitis over a period of 18 months. The mean age of the patients was 34 years. All patients related the onset of the condition with an ankle sprain. Eighteen patients were on worker's compensation and five had sport-related accidents. None of the patients was a professional athlete or a ballet dancer. The mean follow-up was 32 months. The outcome was measured with a satisfaction questionnaire and with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring system. RESULTS: The mean postoperative AOFAS score was 89 with 70% excellent or good results. Mean satisfaction rate was 4 (range, 0 to 5); 89% of the patients would undergo the procedure again. Twenty-two patients (81%) returned to the same level of activity in work and sports. A complication rate of 18% (five patients) and reoperation rate of 4% (one patient) were found. CONCLUSION: Arthroscopic release of the FHL tendon was a valid procedure. It was a minimally invasive surgery that allowed good visualization of the involved structures and yielded good results. This condition can be related to trauma and is not an exclusive disease of ballet dancers or overuse.

Um olhar sobre a prática desportiva, bem-estar subjetivo e integração social de imigrantes... em Portugal e no mundo / A look at sport, subjective well-being and social integration of immigrants... in Portugal and the wolrd

O presente artigo de revisão centrou-se na prática desportiva e na sua relação com o bem-estar subjetivo e a integração social de imigrantes procurando fazer o levantamento da informação disponível na literatura acerca dessa temática a um nível mais global e, particularmente em Portugal, que a partir dos anos 80 se tornou num país de imigração. O levantamento bibliográfico incluiu livros, artigos científicos pesquisados em bases de dados internacionais, sites especializados e institucionais. A revisão da literatura permitiu verificar que: os imigrantes tendem a praticar menos desporto assim como a ter menores níveis de bem-estar subjetivo comparativamente à população autóctone; a prática desportiva relaciona-se positivamente com o bem-estar subjetivo também nos imigrantes; o desporto pode desempenhar um importante papel para a integração social dos imigrantes, apesar de nalguns contextos reforçar as diferenças inter-étnicas; em Portugal, não foram encontrados estudos específicos sobre a prática desportiva de imigrantes.

This review article focused on the sport and its relationship with subjective welfare and social integration of immigrants, seeking to survey the information available in the literature about this topic to a more global level and particularly in Portugal, which from the 80's became a country of immigration. The search included books, journal articles surveyed in international databases, specialized sites and institutional. The literature review showed that: immigrants tend to practice less sport as well as having lower levels of subjective welfare compared to the native population; sport is positively related to subjective welfare also in immigrants, the sport can play an important role for the social integration of immigrants, although in some contexts can reinforce the inter-ethnic differences and in Portugal, there weren't found specific studies on the sportive practice of immigrants.

Arthroscopic repair of chronic lateral ankle instability.

BACKGROUND: The current "gold standard'' for treatment of chronic lateral ankle instability is the Broström-Gould procedure. Most authors recommend this type of operation even after an arthroscopic inspection of the joint. We review our results with an arthroscopic method of lateral ankle ligament repair. MATERIALS AND METHODS: A method of arthroscopic lateral ligament repair with an anchor placed in the fibula is described. We used this technique on 31 consecutive patients (28 were available for followup). Twenty-one patients had work or traffic accidents, four suffered casual falls. and three had sport-related lesions. The patients were evaluated after 24.5 month average followup. RESULTS: The average postoperative AOFAS score was 85.3 (82.3 in the workers-compensation group and 94.4 in the others) and average satisfaction was 3.8 (3.5 to workers-compensation and 4.6 for the others). Complications occurred in nine patients (29%), but only three cases had ongoing problems. We had two recurrences (another sprain without instability on the stress radiograph). Three patients had some wound healing problems and three had injuries of the superficial peroneal nerve, one of which is persistent. One patient developed a deep venous thrombosis postoperatively. CONCLUSION: With this method, we achieved good clinical results. We had several complications but most of them were minor. It was a simple procedure with less morbidity to most patients. We believe it produced an anatomical repair of the lateral ligament with clinical and functional results similar to other techniques.

A prática desportiva dos estudantes universitários e suas relações com as autopercepções físicas, bem-estar subjectivo e felicidade / University students' sport practice and its relations with physical self-perceptions, subjective well-being and happiness

A presente investigação analisou as relações entre a prática desportiva de estudantes universitários e o modo como estes se percepcionavam a si próprios e às suas vidas. Participaram nesta investigação 2284 estudantes de ambos os sexos, com idades entre os 18 e os 30 anos (M = 21,87 ±2,37), que preencheram um questionário sobre a sua prática desportiva, bem como versões portuguesas do Physical Self-Perception Profile (Fox & Corbin, 1989), da Subjective Happiness Scale (Lyubomirsky & Lepper, 1999), da Satisfaction With Life Scale (Diener, Emmons, Larsen, & Griffin, 1985) e da Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988). Em geral, a análise dos resultados revelou que os indivíduos que possuíam mais confiança física e que avaliavam a sua vida mais positivamente praticavam desporto mais regularmente; porém, verificou-se igualmente que quem se percebia menos forte fisicamente e tinha uma auto-estima mais baixa também praticava desporto mais regularmente do que os pares.

The purpose of this study was to examine the relationships between university students' sport practice and the way they perceived themselves and their lives. Participated in this investigation 2284 male and female students, with ages between 18 and 30 years (M = 21.87 ±2.37), who filled out a questionnaire to assess their levels of sport practice, as well the Portuguese versions of the Physical Self-Perception Profile (Fox & Corbin, 1989), the Subjective Happiness Scale (Lyubomirsky & Lepper, 1999), the Satisfaction With Life Scale (Diener, Emmons, Larsen, & Griffin, 1985) and the Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988). Overall, the analysis of the results showed that students who were more physically confident and evaluated their lives more positively did sport more regularly; however, results also showed that students who reported lower levels of physical strength and self-esteem practiced sport more regularly than their peers.

Como avaliar a percepção de competência e aceitação social de crianças com paralisia cerebral?Estudo inicial para a determinação das propriedades psicométricas da versão portuguesa da Dutch Pictorial Scale of Perceived Competence and Social Acceptance in Children with Cerebral Palsy / How to measure children with cerebral palsy's perception of competence and social acceptance?Preliminary study to determinate the psychometric properties of the portuguese version of the Dutch Pictorial Scale of Perceived Competence and Social Acceptance in Children with Cerebral Palsy

O principal objectivo deste estudo consistiu na determinação das propriedades psicométricas da versão portuguesa da Dutch Pictorial Scale of Perceived Competence and Social Acceptance in Children with Cerebral Palsy. Participaram neste estudo 108 crianças (60 rapazes e 48 raparigas) com paralisia cerebral, com idades entre os 4 e os 9 anos, distribuídas em hemiplegicas, diplégicas e tetraplégicas e com um QI igual ou superior a 70. A maioria (n=98) frequentava o ensino regular, enquanto apenas 10 frequentavam escolas especiais. O instrumento foi aplicado num segundo momento a 41 das crianças, com um intervalo máximo de duas semanas. Os resultados da correlação de Pearson relativamente aos dois momentos (entre 0.80 e 0.98) bem como o valor do alfa de Cronbach (entre 0.69 e 0.93) evidenciam uma boa fiabilidade da versão portuguesa. Também os valores das inter-correlações entre as quatro subescalas (r=0.60 ou superior) bem como os valores médios das respostas das crianças em função de diferentes características (idade, sexo, condição médica) para as diferentes subescalas apoiam a validade interna do instrumento. Em suma, os resultados do nosso estudo, na sua globalidade, parecem confirmar as propriedades psicométricas da versão portuguesa da Dutch Pictorial Scale, pelo que esta parece constituir-se como um instrumento fiável e válido para a avaliação do modo como as crianças portuguesas com Paralisia Cerebral se percebem no domínio cognitivo, físico e social.

The main purpose of this study was to examine the psychometric properties of the Portuguese version of the Dutch Pictorial Scale of Perceived Competence and Social Acceptance in Children with Cerebral Palsy. The sample was made up of 108 children (60 boys and 48 girls) with cerebral palsy, aged between 4 and 9 years, who suffered hemiplegia, diplegia or quadriplegia and had an IQ of 70 or higher. Most of the children (n=98) attended regular schools (integrated in kindergarten or primary school); indeed, only 10 children attended special schools for children with special needs. A sub-sample of 41 children filled out the scale in two different moments, separated one to two weeks maximum. The results of Pearson correlations between the two administrations (ranging 0.80 to 0.98) and the Cronbach's alpha (ranging 0.69 to 0.93) showed good reliability of the Portuguese version of the Dutch Pictorial Scale. Moreover, the inter-correlations between the four subscales (r=0.60 or higher) as well the mean scores associated by children with different characteristics (age, sex, medical condition) to the different subscales supported the internal validity of the instrument. Therefore, this study provides initial evidence about the psychometric properties of the Portuguese version of the Dutch Pictorial Scale, which is why its use is recommended to assess the perceived competence and social acceptance of Portuguese children with cerebral palsy.