Translation and validation of the German version of the Young Spine Questionnaire.

BACKGROUND: Back pain in childhood and adolescence increases the risk for back pain in adulthood, but validated assessment tools are scarce. The aim of this study was to validate the Young Spine Questionnaire (YSQ) in a German version (G-YSQ) in children and adolescents. METHODS: Children and adolescents between 10 and 16 years (N = 240, 166 females, mean age = 13.05 ± 1.70 years), recruited in chiropractic practices and schools, completed the G-YSQ (translated according to scientific guidelines) and the KIDSCREEN-10 (assessing health-related quality of life) at three time points. Test-retest reliability was determined calculating intraclass correlation coefficients [ICC(3,1)] using start and two week-data. Construct validity was investigated testing a priori hypotheses. To assess responsiveness, the patients additionally filled in the Patient Global Impression of Change (PGIC) after three months and the area under the curve (AUC) of receiver operating curves was calculated. RESULTS: The ICC(3,1) was 0.88 for pain intensity and pain frequency, indicating good reliability, 0.68 for week prevalence and 0.60 for point prevalence, indicating moderate reliability. Pain intensity, frequency and prevalence differed between patients and controls (p < 0.001) and, except point prevalence, between older (> 12 years) and younger control participants (p < 0.01). Health-related quality of life of participants with severe pain (in one or several spinal regions) was lower (KIDSCREEN-10, total score: F(4,230) = 7.26, p < 0.001; KIDSCREEN-10, self-rated general health: H(4) = 51.94, p < 0.001) than that of participants without pain or with moderate pain in one spinal region. Thus, altogether these findings indicate construct validity of the G-YSQ. The AUC was 0.69 (95 % CI = 0.57-0.82) and 0.67 (95 % CI = 0.54-0.80) for week and point prevalence, respectively, indicating insufficient responsiveness of the G-YSQ. CONCLUSIONS: Apart from the question on point prevalence, construct validity and sufficient test-retest reliability was shown for the G-YSQ. However, its responsiveness needs to be improved, possibly by asking for pain frequency during the last week instead of (dichotomous) week prevalence. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02955342, registered 07/09/2016, https://clinicaltrials.gov/ct2/results?cond=&term=NCT02955342&cntry=CH&state=&city=Zurich&dist= .

Pediatric Patients in Swiss Chiropractic Clinics: A Questionnaire Survey.

OBJECTIVES: The purpose of this study was to investigate practice characteristics of chiropractors who treat pediatric patients in Swiss chiropractic clinics. METHODS: An online survey questionnaire was created and tested for face and content validity. Participation by Swiss chiropractors was voluntary and anonymous and completed November to December 2015. The data were analyzed using SPSS. The analysis consisted of descriptive statistics. RESULTS: The sample consisted of 144 chiropractors, which represented a 53% response rate, and 98% of the responding practitioners treated patients younger than age 18. The proportion of pediatric patients treated was 8.7%. The most common pediatric age groups were schoolchildren and adolescents, with infants younger than 6 months being the third most common. Musculoskeletal complaints were the most common conditions treated in all age groups. In children younger than 2 years old, nonmusculoskeletal conditions were well represented. Prophylactic examination was common among children 6 years and younger. A total of 61% of responding chiropractors received direct referrals from medical doctors and 56% received direct referrals from pediatricians. The most common age groups for referrals from pediatricians were schoolchildren and adolescents. Only 15% of the chiropractors wrote reports about their pediatric patients to their pediatrician often or regularly; 90% of the responding chiropractors stated they rarely or never refer to a pediatric specialist, and 80% of the chiropractors have never or have rarely been invited to attend medical congresses or to teach the pediatric health care community about chiropractic care for children. CONCLUSION: The majority of chiropractors in Switzerland treat pediatric patients, most commonly schoolchildren and adolescents for musculoskeletal disorders.

Methods to Diagnose, Classify, and Monitor Infantile Deformational Plagiocephaly and Brachycephaly: A Narrative Review.

OBJECTIVE: The purpose of this study is to review the literature for possible methods in diagnosing, classifying, and monitoring deformational plagiocephaly and brachycephaly. METHODS: A search was conducted on articles through February 2014 in PubMed (Medline) and Google Scholar. Articles were included if they met the following criteria: (1) they were written in English or German; (2) they involved humans; (3) they were published in the last 10 years; (4) they had a primary research question about all possible methods for diagnosing, classifying, and monitoring deformational plagiocephaly and brachycephaly; and (5) an abstract was available. RESULTS: The search resulted in 58 articles. After the review, the number was reduced to 16. Of the 16 articles included, 9 were reliability studies on measurements of deformational plagiocephaly. Six measurement tools for diagnosing, classifying, and monitoring deformational plagiocephaly and brachycephaly were found: visual assessment, anthropometric measurements with a caliper, measurements with a flexicurve, plagiocephalometry, 3-dimensional photography, and radiological imaging. CONCLUSION: This study found that visual assessment, flexicurve, anthropometric measurements with a caliper, and plagiocephalometry are useful measurements. At present, the plagiocephalometry and the anthropometric measurements with a caliper are more reliable methods than the visual assessment and the measurement with a flexicurve.