RESUMO
PURPOSE: To adapt and validate the English version of the Foot and Ankle Outcome Score (FAOS) into Spanish FAOS-CL, following the WHO guidelines. METHODS: A cross-sectional study including 318 outpatients with non-traumatic conditions. Validity, acceptability and internal consistency including correlations with the Medical Outcome Study Short Form 36 are reported. RESULTS: The preliminary version resulted from the forward and back-translation and a pilot administration. Validation response rate was 99.22%. Substantial ceiling effects were observed for Symptoms and ADL and floor effect for QoL sub-scales. The FAOS-CL had excellent internal consistency (Cronbach's α = 0.98). The principal component analysis gave five factors explaining the 72.6% of the variance. The FAOS-CL items significantly correlate with their sub-scales. FAOS-CL sub-scales significantly correlated with SF-36 components and subcomponents. CONCLUSION: The first Spanish version of the FAOS was generated. Culturally adapted and validated with high reliability capable of evaluating different foot and ankle conditions.
Assuntos
Adaptação Psicológica , Articulação do Tornozelo/cirurgia , Traumatismos do Pé/cirurgia , Qualidade de Vida , Traduções , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Chile , Comparação Transcultural , Estudos Transversais , Feminino , Traumatismos do Pé/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto JovemRESUMO
We sought to translate and culturally adapt the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHFS) into Turkish and determine the selected psychometric properties of the translated version. The AOFAS-AHFS is widely used to evaluate disability associated with foot and ankle injuries but has not yet been translated or culturally adapted for Turkish-speaking individuals. The AOFAS-AHFS was translated into Turkish using the Beaton guidelines. The measurement properties of the Turkish AOFAS-AHFS (internal consistency, construct validity, and floor and ceiling effects) were tested in 72 patients (94 feet, 50 [69.4%] females; average ± SD age 44.88 ± 16.30 years) with a variety of foot and ankle pathologic features. Construct validity was analyzed using the Turkish version of the Foot and Ankle Ability Measure (FAAM) and the Medical Outcomes Study short-form 12-item survey (SF-12). The Turkish version of the AOFAS-AHFS showed excellent test-retest reliability (intraclass correlation coefficient 0.91). The correlation coefficients between the AOFAS-AHFS and the FAAM activities of daily living and FAAM sport were r = 0.41, p = .01 and r = 0.37, p = .03, respectively. The correlation coefficients between the AOFAS-AHFS and the SF-12 physical component scale was r = 0.27, p = .08. The weakest correlation was found between the AOFAS-AHFS and the SF-12 mental component scale (r = -0.03, p = .73). The Turkish version of the AOFAS-AHFS has sufficient reliability and validity to measure patient-reported outcomes for Turkish-speaking individuals with a variety of foot and ankle disorders.
Assuntos
Traumatismos do Tornozelo/terapia , Traumatismos do Pé/terapia , Atividades Cotidianas , Adolescente , Adulto , Idoso , Traumatismos do Tornozelo/psicologia , Comparação Transcultural , Feminino , Traumatismos do Pé/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções , Turquia , Adulto JovemRESUMO
A new operant test for preclinical pain research, termed the Mechanical Conflict System (MCS), is presented. Rats were given a choice either to remain in a brightly lit compartment or to escape to a dark compartment by crossing an array of height-adjustable nociceptive probes. Latency to escape the light compartment was evaluated with varying probe heights (0, .5, 1, 2, 3, and 4 mm above compartment floor) in rats with neuropathic pain induced by constriction nerve injury (CCI) and in naive control rats. Escape responses in CCI rats were assessed following intraperitoneal administration of pregabalin (10 and 30 mg/kg), morphine (2.5 and 5 mg/kg), and the tachykinin NK1 receptor antagonist, RP 67580 (1 and 10 mg/kg). Results indicate that escape latency increased as a function of probe height in both naive and CCI rats. Pregabalin (10 and 30 mg/kg) and morphine (5 mg/kg), but not RP 67580, decreased latency to escape in CCI rats suggesting an antinociceptive effect. In contrast, morphine (10 mg/kg) but not pregabalin (30 mg/kg) increased escape latency in naive rats suggesting a possible anxiolytic action of morphine in response to light-induced fear. No order effects following multiple test sessions were observed. We conclude that the MCS is a valid method to assess behavioral signs of affective pain in rodents.
Assuntos
Aprendizagem da Esquiva/fisiologia , Condicionamento Operante , Conflito Psicológico , Reação de Fuga/fisiologia , Etologia/instrumentação , Traumatismos do Pé/fisiopatologia , Hiperalgesia/fisiopatologia , Dor Nociceptiva/fisiopatologia , Analgésicos/administração & dosagem , Analgésicos/uso terapêutico , Animais , Ansiolíticos/administração & dosagem , Ansiolíticos/uso terapêutico , Comportamento de Escolha , Condicionamento Operante/fisiologia , Escuridão , Relação Dose-Resposta a Droga , Medo , Traumatismos do Pé/psicologia , Hiperalgesia/etiologia , Hiperalgesia/psicologia , Injeções Intraperitoneais , Isoindóis/administração & dosagem , Isoindóis/uso terapêutico , Ligadura , Luz/efeitos adversos , Masculino , Morfina/administração & dosagem , Morfina/uso terapêutico , Neuralgia/tratamento farmacológico , Neuralgia/etiologia , Neuralgia/fisiopatologia , Antagonistas dos Receptores de Neurocinina-1/administração & dosagem , Antagonistas dos Receptores de Neurocinina-1/uso terapêutico , Dor Nociceptiva/tratamento farmacológico , Dor Nociceptiva/psicologia , Pregabalina/administração & dosagem , Pregabalina/uso terapêutico , Ratos , Ratos Sprague-Dawley , Tempo de Reação/efeitos dos fármacos , Nervo Isquiático/lesões , Nervo Isquiático/fisiopatologiaRESUMO
The purpose of this study is to compare the long-term clinical outcomes of patients who were treated with either hind foot reconstruction or amputation in complex hind foot injuries accompanied with bone and soft tissue loss due to land-mine explosions. Between 1994 and 2004, all patients with hind foot complex injuries due to land-mine explosion, who were operated in our clinic, were enrolled to the study. All patients were evaluated with Short-Form 36 (SF-36), Foot and Ankle Disability Index (FADI) and Body Image Quality of Life Inventory (BIQLI) after a mean of 15.1 ± 2.2 (range 9-19) years of follow-up. Demographic characteristics, number of operations, necessity of psychiatric treatment and all complications were compared between groups. There were a total of 42 patients [21 in reconstruction group (Gr I) and 21 in amputation group (Gr II)]. The mean age at the time of final follow-up was 38.4 ± 3.04 years in Gr I and 38.2 ± 4.24 years in Gr II (p = 0.732). The mean follow-up duration was 15.7 ± 2.07 years in Gr I and 14.57 ± 2.29 years in Gr II (p = 0.081). The number of operations was significantly higher in Gr I (8.66 ± 10.2 times vs. 4.42 ± 7.7 times, respectively, p = 0.001). The mean FADI score at the final follow-up was 64.3 ± 18.1 in Gr I. In amputation group, more patients needed psychotherapy due to major depression (12 patients vs. 4 patients, p = 0.012). Major complications in Gr I were musculocutaneous flap atrophy in calcaneal region (n = 8 patients), limited ankle motion (n = 11) and painful osteophytes on plantar region (n = 6). In Gr II, stump problems were dominating (pain and tenderness n = 10, ulcer n = 2, allergic skin lesions n = 7, painful neuroma n = 10, bony spur n = 5, paresthesia n = 1, excessive sweating n = 12). At the final visit, although SF-36 scores were similar between groups (p = 0.182), extremity reconstruction group had significantly higher BIQLI scores than the amputation group (p = 0.016). If the dorsalis pedis is intact and midfoot and forefoot is relatively protected, hind foot reconstruction should be attempted. Long-term outcomes of hind foot reconstruction are satisfactory with minor complications and better BIQLI.
Assuntos
Amputação Cirúrgica/métodos , Traumatismos por Explosões/cirurgia , Traumatismos do Pé/cirurgia , Técnica de Ilizarov , Salvamento de Membro/métodos , Procedimentos de Cirurgia Plástica/métodos , Adulto , Amputação Cirúrgica/efeitos adversos , Amputação Cirúrgica/psicologia , Artralgia/etiologia , Traumatismos por Explosões/etiologia , Traumatismos por Explosões/psicologia , Calcâneo/lesões , Calcâneo/cirurgia , Transtorno Depressivo Maior/etiologia , Avaliação da Deficiência , Seguimentos , Traumatismos do Pé/etiologia , Traumatismos do Pé/psicologia , Calcanhar/lesões , Calcanhar/cirurgia , Humanos , Salvamento de Membro/efeitos adversos , Masculino , Osteófito/etiologia , Qualidade de Vida , Procedimentos de Cirurgia Plástica/efeitos adversos , Estudos Retrospectivos , Retalhos Cirúrgicos , Adulto JovemRESUMO
BACKGROUND: In 2012, the American Orthopaedic Foot & Ankle Society(®) established a national network for collecting and sharing data on treatment outcomes and improving patient care. One of the network's initiatives is to explore the use of computerized adaptive tests (CATs) for patient-level outcome reporting. QUESTIONS/PURPOSES: We determined whether the CAT from the NIH Patient Reported Outcome Measurement Information System(®) (PROMIS(®)) Physical Function (PF) item bank provides efficient, reliable, valid, precise, and adequately covered point estimates of patients' physical function. METHODS: After informed consent, 288 patients with a mean age of 51 years (range, 18-81 years) undergoing surgery for common foot and ankle problems completed a web-based questionnaire. Efficiency was determined by time for test administration. Reliability was assessed with person and item reliability estimates. Validity evaluation included content validity from expert review and construct validity measured against the PROMIS(®) Pain CAT and patient responses based on tradeoff perceptions. Precision was assessed by standard error of measurement (SEM) across patients' physical function levels. Instrument coverage was based on a person-item map. RESULTS: Average time of test administration was 47 seconds. Reliability was 0.96 for person and 0.99 for item. Construct validity against the Pain CAT had an r value of -0.657 (p < 0.001). Precision had an SEM of less than 3.3 (equivalent to a Cronbach's alpha of ≥ 0.90) across a broad range of function. Concerning coverage, the ceiling effect was 0.32% and there was no floor effect. CONCLUSIONS: The PROMIS(®) PF CAT appears to be an excellent method for measuring outcomes for patients with foot and ankle surgery. Further validation of the PROMIS(®) item banks may ultimately provide a valid and reliable tool for measuring patient-reported outcomes after injuries and treatment.
Assuntos
Traumatismos do Tornozelo/diagnóstico , Articulação do Tornozelo/fisiopatologia , Avaliação da Deficiência , Doenças do Pé/diagnóstico , Traumatismos do Pé/diagnóstico , Pé/fisiopatologia , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Traumatismos do Tornozelo/fisiopatologia , Traumatismos do Tornozelo/psicologia , Traumatismos do Tornozelo/cirurgia , Articulação do Tornozelo/cirurgia , Fenômenos Biomecânicos , Feminino , Pé/cirurgia , Doenças do Pé/fisiopatologia , Doenças do Pé/psicologia , Doenças do Pé/cirurgia , Traumatismos do Pé/fisiopatologia , Traumatismos do Pé/psicologia , Traumatismos do Pé/cirurgia , Conhecimentos, Atitudes e Prática em Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos , Medição da Dor , Pacientes/psicologia , Percepção , Valor Preditivo dos Testes , Estudos Prospectivos , Psicometria , Recuperação de Função Fisiológica , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Resultado do Tratamento , Estados Unidos , Adulto JovemRESUMO
BACKGROUND: Landmine injuries cause extensive soft and bony tissue loss of the weight-bearing areas, particularly the heel. Reconstruction of these injuries is challenging, and there are no studies that report long-term functional results. OBJECTIVE: To determine the quality of life and long-term functionality of patients who had heel reconstruction with free muscle flap after landmine injuries. DESIGN: A case-control study. PARTICIPANTS: Nine male patients who had heel reconstruction with free muscle flap. Ten male volunteers without any gait disorder were included in the study as the control group. METHODS AND INTERVENTIONS: Functional ambulation scale, visual analog scale, energy expenditure index, 6-minute walking test, 10-m walking test, and Short Form 36 were performed to determine the quality of life and functionality of the participants. RESULTS: There were no statistically significant differences between the 2 groups in terms of functional ambulation scale, energy expenditure index, 6-minute walking test, and 10-m walking test. Regarding Short Form 36 scores, all subgroup values were lower in the reconstruction group, whereas only those of general health, vitality, and physical-emotional role limitation subgroups showed statistical significance. Mean visual analog scale scores were found to be statistically different between the groups (P < .05). Mean Freiburg Ankle scores showed moderate functionality. CONCLUSION: Despite the associated physical and emotional trauma, combat-injured veterans with heel reconstruction after landmine injuries had adequate and functional ambulation at long-term follow-up. Early rehabilitation and close cooperation between surgeons and rehabilitation physicians during the care of these patients will enhance patient outcomes.
Assuntos
Traumatismos por Explosões/psicologia , Traumatismos por Explosões/cirurgia , Traumatismos do Pé/psicologia , Traumatismos do Pé/cirurgia , Calcanhar/lesões , Qualidade de Vida , Retalhos Cirúrgicos/irrigação sanguínea , Atividades Cotidianas , Adaptação Fisiológica , Adulto , Traumatismos por Explosões/complicações , Traumatismos por Explosões/reabilitação , Estudos de Casos e Controles , Explosões , Seguimentos , Traumatismos do Pé/etiologia , Calcanhar/cirurgia , Humanos , Escala de Gravidade do Ferimento , Masculino , Medição da Dor , Procedimentos de Cirurgia Plástica/métodos , Procedimentos de Cirurgia Plástica/reabilitação , Recuperação de Função Fisiológica , Medição de Risco , Estatísticas não Paramétricas , Resultado do Tratamento , Suporte de Carga , Adulto JovemRESUMO
We developed the Oxford ankle foot questionnaire to assess the disability associated with foot and ankle problems in children aged from five to 16 years. A survey of 158 children and their parents was carried out to determine the content, scaling, reliability and validity of the instrument. Scores from the questionnaire can be calculated to measure the effect of foot or ankle problems on three domains of children's lives: physical, school and play, and emotional. Scores for each domain were shown to be internally consistent, stable, and to vary little whether reported by child or parent. Satisfactory face, content and construct validity were demonstrated. The questionnaire is appropriate for children with a range of conditions and can provide clinically useful information to supplement other assessment methods. We are currently carrying out further work to assess the responsiveness of questionnaire scores to change over time and with treatment.