The development of a reliable and valid instrument to measure the osteoporosis-related knowledge: validation of the Hungarian version of Osteoporosis Knowledge Assessment Tool (OKAT).

BACKGROUND: Osteoporosis is one of the most common chronic musculoskeletal diseases. Osteoporosis-related knowledge is an important contributor in to prevent osteoporosis. There is no validated reliable questionnaire to measure the knowledge in Hungary. The aim of the study was to validate the Osteoporosis Knowledge Assessment Tool (OKAT) Hungarian version. METHODS: The research was a randomized validation study of a new Hungarian language instrument. The questionnaire was administered to 557 randomly selected healthy women (age between 25 and 44 years) from December 2018 to July 2019 in Baranya county, Hungary. The reliability was examined by the Flesch reading ease and McNemar's test. We examined item discrimination and item-total correlations, inter-item consistency (Cronbach's alpha coefficient) and principal component factor analysis. RESULTS: Significant differences (p <  0.001) were reported between total scores and the age categories. Significant (p <  0.001) correlation (r = 0.25) was found between the education level and the knowledge. Significantly (p <  0.001) higher knowledge were found in health care profession (14.53 ± 3.58) than the non-health care profession (9.99 ± 4.04). Participants with osteoporosis or fracture in family history had better knowledge (p <  0.001). Flesch reading ease was 44, the questionnaire had a Ferguson's sigma of 0.94 and a Cronbach's alpha of 0.81. There were no negative inter-item correlations psychometric properties of the OKAT, all items had more than 70% of correlations (p <  0.001). CONCLUSIONS: The Hungarian version of the Osteoporosis Knowledge Assessment Tool is a reliable and objective questionnaire to measure women's knowledge in Hungary.

Health questionnaire on back care knowledge and spine disease prevention for 6-10 years old children: development and psychometric evaluation.

BACKGROUND: Back school programs, that improve back care and spine disease prevention knowledge are recommended at the age of 4-14 years. There is Health Questionnaire on Back Care Knowledge in the literature for children aged 14-17 years. At other ages, there is no questionnaire examining this knowledge. We aimed to develop a Health Questionnaire on Back Care and Spine Disease Prevention Knowledge for 6-10 years old children and validate its psychometric properties (internal consistency, test-retest reliability, agreement, convergent validity, discriminant validity) in 6-10 years old children, who attended back school program or not. METHODS: 463 children took part in the research (6-10 years old). The development was performed according to the Delphi method. The final version contained 7 questions. 463 participants completed the questionnaire twice with an interval of 7 days to evaluate test-retest reliability. The internal consistency was tested by Cronbach's alpha value, test-retest reliability was calculated by Intraclass Correlation Coefficients (ICC), Standard Error of Measurement (SEM) and 95% of Minimal Detectable Change (MDC95) and Bland-Altman plots. Convergent validity was tested against the age variable and discriminant validity was tested by Kruskal-Wallis tests among the different subgroups. RESULTS: Cronbach's alpha of the total score was (α=0.797), showed a strong internal consistency with minimal SEM (0.606) and MDC95 (1.680). The test-retest result for the total score was strong (0.989), for the questions showed moderate to strong results (0.742-0.975), the limits of agreement of the Bland-Altman plot showed a narrow error of measurement range (-3.49-1.29), and the value of mean differences was -1.10 (SD ± 1.22). The convergent validity showed a weak, but significant relationship between total score and age (R=0.171; p < 0.001). The discriminant validity showed significantly different mean scores in non-back school and back school groups. CONCLUSION: For the examination of back care and spine disease prevention knowledge of 6-10 years old children, the questionnaire proved to be a valid and reliable tool. The knowledge requested in the questionnaire covers the knowledge material of the theoretical part of the back school for children aged 4-10 years.

[Prevalence, potential risk factors and sequelae of diastasis recti abdominis]. / A rectus diastasis prevalenciája, lehetséges rizikófaktorai és szövodményei.

INTRODUCTION: There is scant knowledge on diastasis recti which occurs mostly in 3rd trimester of pregnancy. AIM: Our aim was to assign the prevalence of diastasis recti and the possible risk factors and to investigate its association with some chronical diseases, like low back pain and urinary incontinence. METHOD: 200 women's interrectus distance was measured who filled out a self-made diastasis recti questionnaire, the SF-36, Oswestry Disability Index and the International Consultation on Incontinence Modular Questionnaire - Urinary Incontinence Short Form questionnaires. RESULTS: Prevalence of the condition was 46.5%. In case of risk factors, relationship between number of deliveries and interrectus distance was significant. We found a significant difference in quality of life, in presence of low back pain and urinary incontinence between the normal and the abnormal group. CONCLUSIONS: In line with the literature we found, that diastasis recti can predispose on serious sequelae, hence on decreased quality of life. Orv. Hetil., 2017, 158(12), 454-460.

Investigating the Combined Effects of Fascial Distortion Model Manual Therapy and Balance-Strength Training in Individuals with Chronic Ankle Instability.

BACKGROUND: The Fascial Distortion Model (FDM) is a relatively new manual therapy approach in the field of musculoskeletal physical therapy, and its potential effectiveness in treating chronic ankle instability (CAI) remains unexplored. METHODS: A randomized controlled trial with 23 participants was conducted. Patients were randomly assigned to either the FDM + balance-strength training (BST) group (n = 8), receiving extra FDM sessions weekly in addition to two sessions of BST, or the BST group (n = 7). Healthy controls (n = 8) did not receive any treatment and participated only in pre- and post-test measurements. Objective measurements including Y-Balance Test Lower Quarter (YBT-LQ), Flamingo Balance Test (FBT), Weight-Bearing Lunge Test (WBLT), ankle joint range of motion (ROM), and Cumberland Ankle Instability Tool (CAIT) were recorded at baseline and the end of the intervention. The results demonstrated significant differences between the FDM + BST and BST groups for supination ROM (p = 0.008) and similarly for WBLT (p = 0.041), FBT (p = 0.40), YBT-LQ (p = 0.023), and CAIT score (p = 0.008). Moreover, while both groups demonstrated significant improvement at the post-test compared with their pre-test for plantarflexion and pronation ROM, WBLT, and CAIT score, the FDM + BST group demonstrated significant improvements in supination ROM, FBT, and YBT-LQ. CONCLUSION: Our study suggests that the addition of FDM concepts to a BST may lead to enhanced improvements in ankle ROM, static and dynamic balance, and self-reported outcomes in individuals with CAI compared to BST.

[Hungarian adaptation and validation of the Osteoporosis Questionnaire (OPQ)]. / Egy csontritkulás-specifikus kérdoív magyar nyelvu adaptációja és validálása.

INTRODUCTION: Osteoporosis affects one in three women and one in five men over the age of 50. We do not have an osteoporosis-related knowledge questionnaire over the age of 50, which is considered strong evidence in the prevention and treatment of the disease. OBJECTIVE: Aim of the study was to validate the Hungarian form of the Osteoporosis Questionnaire in Hungarian-speaking women over the age of 50. METHOD: The questionnaire was validated into Hungarian according to Beaton's six-step method. Our sample consisted of 326 women. During our statistical analysis, we calculated descriptive statistics, difference tests, Cronbach's alpha value, and Spearman's correlation coefficient for test-retest and for external validity. Quality of life and physical activity were examined to support the external validity. RESULTS: Our sample (63.08 ± 9.36 years) scored 8.76 ± 6.94 points on the questionnaire. Cronbach's alpha value was 0.89. For the test-retest, Spearman's correlation coefficient showed a value of p≥0.25 for all the questions. Significant correlations were found between knowledge and age (R = 0.37; p<0.001) and years of using hormone replacement therapy (R = 0.34; p = 0.02). The correlation analysis showed significant (p<0.001) correlation between knowledge and all sub-dimensions of quality of life. Significant correlation was found between transport movement (p<0.001; R = 0.21), intensive (p<0.001; R = 0.354), moderate recreational activity (p<0.001; R = 0.348), total moderate (p = 0.041; R = 0.125) total intense movements (p = 0.018; R = 0.145) and knowledge. DISCUSSION: The Hungarian questionnaire was validated in accordance with international practice. CONCLUSION: The Hungarian version of the Osteoporosis Questionnaire is a reliable, adaptable questionnaire for measuring the osteoporosis-related knowledge of the Hungarian female population over 50. Orv Hetil. 2022; 163(51): 29-37.

[Study of the functional capacity and health status of patients with hip as well as knee osteoarthritis]. / A csípo-, valamint térdízületi arthrosisos betegek funkcióképességének és egészségi állapotának vizsgálata.

INTRODUCTION: Hip as well as knee osteoarthritis are common diseases. There are numerous therapeutic possibilities to address the problem. OBJECTIVE: To study the effectiveness of the complex conservative treatment in patients with hip as well as knee osteoarthritis. METHOD: In addition to a self-made questionnaire, we applied the visual analogue scale, the Functional Independence Measure, the Barthel Index and the Medical Outcomes Study (MOS) - 36-Item Short-Form Health Survey. Apart from these, joint range of motion was measured. The members of the examined group had different physiotherapy treatments (thermal water, physiotherapy, classic Swedish massage, Bemer treatment, wraps, physiotherapy). RESULTS: The results of the visual analogue scale and the Barthel Index were significantly different between the two measurements. Regarding the Functional Independence Measure, we did not find significant difference between the two groups. As for measuring the study group's health condition, we observed improvement in the case of both the physical and mental health dimensions. During the examination of joint range of motion in the study group, after analyzing the participants' data, we detected improvement, except for the passive extension of the left knee. CONCLUSION: The 3-week complex conservative therapy can be an appropriate form of treatment to improve the functionality and the health condition in the case of hip as well as knee osteoarthritis. Orv Hetil. 2022; 163(48): 1917-1922.

The Hungarian adaptation and validation of the Osteoporosis Health Belief Scale / Az Osteoporosis Health Belief Scale kérdoív magyar nyelvu validálása.

Összefoglaló. Bevezetés: A nemzetközi szakirodalomban számos betegséget illetoen elérheto betegségspecifikus tudást és attitudöt méro kérdoív. Magyarországon az osteoporosis témakörében validált kérdoívek tárháza meglehetosen hiányos. Célkituzés: Célunk volt a csontritkulás-specifikus magatartás és attitud vizsgálatára alkalmas Osteoporosis Health Belief Scale (OHBS-) kérdoív magyar nyelvre történo validációja, melynek segítségével mérhetové válna a magyar anyanyelvu nok csontritkulással kapcsolatos attitudje. Módszer: A kérdoív magyar nyelvre validálása a 2000-ben megfogalmazott hatlépcsos irányelv szerint történt. A külso validitás vizsgálatához az Osteoporosis Knowledge Assessment Tool (OKAT-) kérdoívet használtuk. Mintánkat 600 fo alkotta; statisztikai számításaink során leíró statisztikát készítettünk, különbözoségi vizsgálatokat végeztünk, a belso konzisztencia vizsgálatára Cronbach-alfa-értéket számítottunk, a konvergens validitás és a teszt-reteszt mérések vizsgálatához Spearman-féle korrelációs koefficienst számítottunk. A kérdoív belso struktúrájának vizsgálatához faktorelemzést végeztünk. Ennek megfeleloen Kaiser-Meyer-Olkin (KMO)-tesztet és Bartlett-próbát számítottunk. Eredmények: Mintánk (37,7 ± 13,15 életév) az OHBS (126,28 ± 14,85 pont) és az OKAT (8,78 ± 3,1) tekintetében egyaránt alacsony pontszámot ért el. A teljes kérdoívre kivetített Cronbach-alfa-érték 0,802 volt. A faktorelemzés (KMO = 0,886; Bartlett-próba p<0,001) 7 faktort különített el, melyek megfeleltethetok az eredeti faktoroknak. A teszt-reteszt során a Spearman-féle korrelációs koefficiens 0,921 és 1,000 közötti értéket mutatott. Az OKAT- és az OHBS-dimenziók összevetésekor számos szignifikáns kapcsolatot találtunk. Megbeszélés: A vizsgálati eredmények megfelelnek az eredeti kérdoív szerinti, továbbá a más nyelvre történt validálás során kapott eredményeknek. Következtetés: Eredményeink alapján a magyar nyelvu OHBS csontritkulás-specifikus attitudöt és magatartást vizsgáló kérdoívet megbízható és valid kérdoívnek tartjuk. Orv Hetil. 2021; 162(37): 1494-1501. INTRODUCTION: In the international literature, several disease-specific questionnaires are available for many diseases. The opportunities of validated questionnaires are incomplete about osteoporosis in Hungarian language. OBJECTIVE: The aim of the study was to validate the Osteoporosis Health Belief Scale (OHBS) into Hungarian that would make it possible to measure the osteoporosis-related attitude for Hungarian-speaking women. METHOD: The questionnaire was validated into Hungarian according to the six-step guideline outlined in 2000. The Osteoporosis Knowledge Assessment Tool (OKAT) questionnaire was used to examine external validity. Our sample consisted of 600 women. We performed descriptive statistics; Cronbach's alpha value was calculated for internal consistency, we calculated Spearman's correlation coefficient to examine external validity. We carried out factor analysis (Kaiser-Meyer-Olkin [KMO] test, Bartlett test) to examine whether the new questionnaire is suitable for measurements in the given language the same way as the original questionnaire. RESULTS: Our sample (37.7 ± 13.15 years of age) achieved low score for both OHBS (126.28 ± 14.85) and OKAT (8.78 ± 3.1). The Cronbach's alpha value was 0.802. Factor analysis (KMO = 0.886; Bartlett test p<0.001) identified 7 factors that can be similar to the original factors. During the test-retest, the Spearman correlation coefficient showed a value between 0.921 and 1.000. When comparing the OKAT and OHBS dimensions we found several significant relationships. DISCUSSION: The results of the study are similar to the results of the original questionnaire validation as well as to other OHBS validation studies. CONCLUSION: Based on the results, we consider that the Hungarian form of the OHBS is a reliable and valid questionnaire. Orv Hetil. 2021; 162(37): 1494-1501.

Cross-sectional study of female pelvic floor dysfunction in a Hungarian population / Noi kismedencei funkciózavarok keresztmetszeti vizsgálata magyarországi populáción.

Összefoglaló. Bevezetés és célkituzés: A noi kismedencei funkciózavarok változatos tünetekkel jelentkezhetnek, és jelentosen befolyásolják az érintettek életminoségét. Vizsgálatunk célja volt felmérni a medencefenék-diszfunkciós tüneteket és azok hatását az egyén életminoségére. Módszer: Vizsgálatunkba 203 not vontunk be. Az adatgyujtést két kérdoív, egy általunk összeállított és az Australian Pelvic Floor Questionnaire segítségével végeztük. Az adatok statisztikai elemzéséhez SPSS 20.0 rendszert használtunk. Spearman-korrelációt, khi-négyzet-próbát, Mann-Whitney-féle U-tesztet, Kruskal-Wallis-próbát és többváltozós lineáris regressziót alkalmaztunk. A szignifikanciaszintet p≤0,05 határnál állapítottuk meg. Eredmények: A hólyagdiszfunkciók gyakorisága (56,2%) szignifikáns kapcsolatot mutatott az életkor növekedésével (p<0,001), az obesitassal (p<0,001), a szülésszámmal és -móddal (p<0,001; p<0,001), az episiotomiával (p<0,001) és a prolapsusmutétekkel (p = 0,010). A süllyedéses kismedencei kórképek gyakorisága (27,1%) szignifikáns kapcsolatot mutatott az életkor növekedésével (p = 0,002), a szülésszámmal és -móddal (p<0,001; p<0,001) és a korábbi episiotomiával (p<0,001). Az analis incontinentia gyakorisága (58,9%) a magasabb testtömegindexszel (p = 0,029) volt szignifikáns kapcsolatban. Szexuális diszfunkciót (53,2%) allergia és tüdobetegségek (p = 0,048) jelenlétével kapcsolatban találtunk. A többes diszfunkció elofordulási gyakorisága az életkor növekedésével (p<0,001), az obesitassal (p = 0,043), a korábbi hysterectomiával (p = 0,046) és prolapsusmutétekkel (p<0,001) mutatott szignifikáns kapcsolatot. Minden diszfunkció esetén kimutatható volt az életminoség-romlás (hólyagfunkciók: p<0,001; bél- és székletürítési funkciók: p<0,001, hüvelyfali süllyedés: p<0,001, szexuális funkciók: p<0,001). Következtetés: Az általunk vizsgált noi populációban nagy arányban találtunk kismedencei funkciózavarokat, melyek kedvezotlen hatással voltak az érintettek életminoségére. Orv Hetil. 2021; 162(43): 1724-1731. INTRODUCTION AND OBJECTIVE: Pelvic floor dysfunction (PFD) can cause several complaints in women and has an adverse effect on the quality of life (Qol). The aim of our study was to evaluate the prevalence of pelvic floor dysfunction and its effect on Qol. METHOD: 203 women were included. We used two questionnaires, a self-constructed and the Australian Pelvic Floor Questionnaire. Statistical analysis was performed by SPSS 20.0. Spearman's correlation, chi-square, Mann-Whitney U, Kruskal-Wallis tests and multivariate linear regression were used. Statistical significance was set at p≤0.05. RESULTS: There was a significant association between the prevalence of urinary incontinence (56.2%) and age (p<0.001), obesity (p<0.001), number and mode of deliveries (p<0.001; p<0.001), episiotomy (p<0.001) and pelvic organ prolapse (POP) surgery (p = 0.010); between the occurrence of POP (27.1%) and age (p = 0.002), the number and mode of deliveries (p<0.001; p<0.001) and episiotomy (p<0.001); between the prevalence of anal incontinence (58.9%) and obesity (p = 0.029); between sexual dysfunction (SD) (53.2%) and respiratory disease and allergy (p = 0.048). Multiple PFD was significantly associated with age (p<0.001), obesity (p = 0.043), hysterectomy (p = 0.046) and POP surgery (p = 0.010). There was a significant difference between women having more severe PFD than milder complaints regarding Qol (bladder p<0.001; bowel p<0.001; SD p<0.001 and POP p<0.001). CONCLUSION: Pelvic floor dysfunction was common in our study population and had a great adverse effect on Qol. Orv Hetil. 2021; 162(43): 1724-1731.

[The Hungarian translation and validation of the Low Back Pain Knowledge Questionnaire]. / Egy deréktáji fájdalommal kapcsolatos betegségspecifikus tudást felméro külföldi kérdoív hazai, magyar nyelvu validálása.

Introduction: Many disease-specific questionnaires, which analyze patients' functional status, quality of life or the progression of the disease, have been validated in Hungarian. The low back pain (LBP) patients' knowledge about their problem has not been measured by an officially validated Hungarian tool. Aim: The aim of our study was to translate and validate the Low Back Pain Knowledge Questionnaire (LKQ) and to assess its validity and reliability. Method: We used the translation-back translation method as the first step. Then we used a synthesis of the back translations reviewed by independent translators. We enrolled 218 people in our study: 101 of them were chronic LBP patients and 73 acute LBP patients. For the validation process, we used the Roland-Morris Disability Index to compare our questionnaire. We calculated Cronbach's alpha values and correlation coefficients. Results: The Hungarian version of LKQ correlated well with the Roland-Morris Index and it proved to be a valid questionnaire (correlation coefficient: -0.393; Cronbach's alpha value 0.894). Conclusion: We found the Hungarian version of LKQ a valid and reliable tool to measure patients' knowledge about LBP. We recommend future studies should apply bigger and more homogenous populations to assess LBP disease-specific knowledge in this country. Orv Hetil. 2019; 160(42): 1663-1672.

Effect of Active and Passive Mechanical Thromboprophylaxis and Consensual Effect on the Venous Blood Flow Velocity Among Hemiparetic Patients.

Our aim was to measure the venous blood flow velocity (VBFV) in case of hemiparetic patients, after passive and active thromboembolic methods, as well as the consensual effect in the hemiparetic limb following the active venous exercises in the healthy limb. We examined 215 patients, with the median age of 58.0 (55.0-63.0) years. The VBFV was measured with a HADECO BIDOP ES-100 V II type Doppler ultrasound device, using an 8 MHz head, on the femoral vein at the level of the hip joint. For statistical analysis, SPSS version 22 was used. After passive movement, on the hemiparetic side, compared to the value in resting state, the VBFV significantly (12.6; 11.6-13.5 cm/s; P < .001) increased. Following active venous exercises performed on the healthy side, the VBFV significantly (18.0; 15.6-19.6 cm/s; P < .001) increased compared to the value in resting state. Following the active venous exercises performed on the healthy side, the VBFV measured on the hemiparetic side (consensual effect) was significantly (15.1 [14.1-16.5] cm/s; P < .001) higher than the value on the hemiparetic side in resting state. Active and passive mechanical thromboprophylaxis methods can be effective. Movements of the healthy limb significantly increase the VBFV in the inactive limb, and patients can perform it themselves several times a day.