Reliability of Ultrasound Measurements of the Median Nerve in Asymptomatic Subjects Using a Handheld Device.

This study investigated the reliability of measuring the median nerve cross-sectional area (CSA) at the carpal tunnel inlet using a handheld ultrasound device (HUD) compared to a standard ultrasound system, focusing on intra- and inter-operator reproducibility among novice and expert operators. Employing a prospective cross-sectional design, 37 asymptomatic adults were assessed using both devices, with measurements taken by an expert with over five years of experience and a novice with less than six months. The CSA was determined using manual tracing and ellipse methods, with reproducibility evaluated through intraclass correlation coefficients (ICCs) and agreement assessed via Bland-Altman plots. Results showed a high degree of agreement between the devices, with excellent intra-operator reproducibility (ICC > 0.80) for the expert, and moderate reproducibility for the novice (ICCs ranging from 0.539 to 0.841). Inter-operator reliability was generally moderate, indicating acceptable consistency across different experience levels. The study concludes that HUDs are comparable to standard ultrasound systems for assessing median nerve CSA in asymptomatic subjects, with both devices providing reliable measurements. This supports the use of HUDs in diverse clinical environments, particularly where access to traditional ultrasound is limited. Further research with a larger sample and symptomatic patients is recommended to validate these findings.

Multiple Long-Term Conditions and Disability are Independently Associated with Higher Risk of Fall Among Community Adults: a Cross-Sectional Study.

Background: Previous studies have suggested an association between falls and the presence of Multiple Long-Term Conditions (MLTC) or disabilities. However, there is limited understanding of how these factors independently or collectively contribute to the risk of falls and fear of falling among community-dwelling adults. Objective: This study examined the independent association between MLTC and the presence of disability with the risk of falls among community adults. Methods: A cross-sectional study included 324 adults (age ≥ 50). Demographic and clinical data included age, sex, body mass index (BMI), MLTC (≥ two chronic diseases) risk of fall (ie, history of fall in the previous 12-months, number of falls, and recurrent falls). The Barthel Index and Falls Efficacy Scale-International (FES-I) were used to assess disability and fear of fall, respectively. Results: MLTC (Odds Ratio (OR) 2.50, 95% Confidence Interval (CI) [1.26, 4.95], p=0.009), and disability (OR 1.71, 95% CI [1.04, 2.79], p = 0.034) were independently associated with history of falls. MLTC (Incidence Rate Ratio (IRR) 2.87, 95% CI [1.93, 4.29], p < 0.001) and disability (IRR 1.86 95% CI [1.46, 2.36], p < 0.001) were independently associated with an increased number of falls. MLTC (OR 4.50, 95% CI [1.78, 11.36], p = 0.001) and disability (OR 2.82, 95% CI [1.58, 5.05], p < 0.001) were independently associated with recurrent falls. MLTC (B = 6.45, p < 0.001) and disability (B = 3.05, p = 0.025) were independently associated with increased fear of falling. Conclusion: This study indicated that both MLTC and disability are independently associated with falls, number of falls and fear of falling in this population.

Validation of the Arabic Version of the Attitude Toward Education and Advice for Low Back Pain Questionnaire.

Purpose: This cross-sectional study aimed to validate the Arabic version of the Attitude toward Education and Advice for Low Back Pain (AxEL) Questionnaire. Patients and Methods: This study was conducted in two phases. First, the AxEL questionnaire was translated into Arabic and cross-culturally adapted. Second, the psychometric properties (such as validity) of the translated AxEL were evaluated. Results: The results showed that back translators and language specialists had no trouble translating the AxEL. The translators' agreement was very high (88.2%), and the questionnaire items were logically and clearly translated from English into Arabic. Conclusion: The Arabic version of AxEL is a valid tool that can assess individuals' beliefs and attitudes towards low back pain (LBP). It fills a significant void in cross-cultural research and can help healthcare providers understand the attitudes and beliefs influencing individuals' management of LBP within the Arabic context.

Effects of Plyometric-Based Hydro-Kinesiotherapy on Pain, Muscle Strength, Postural Stability, and Functional Performance in Children with Hemophilic Knee Arthropathy: A Randomized Trial.

AIM: To explore how plyometric-based hydro-kinesiotherapy (Plyo-HKT) would affect pain, muscle strength, postural stability, and functional performance in a convenience sample of children with hemophilic knee arthropathy (HKA). METHODS: Forty-eight children with HKA (age: 8-16 years) were randomly allocated to the Plyo-HKT group (n = 24; underwent the Plyo-HKT for 45 min, twice/week over 12 wk in succession) or the comparison group (n = 24; performed the standard exercise rehabilitation at an equivalent frequency and duration). Pain, peak concentric torque of quadriceps and hamstring (produced at two angular velocities: 120 and 180 o/sec), dynamic limits of postural stability (DLPS), and functional performance [Functional Independence Score in Hemophilia (FISH) and 6-Minute Walk Test (6-MWT)] were assessed pre- and post-intervention. RESULTS: In contrast with the comparison group, the Plyo-HKT group achieved more favorable pre-to-post changes in pain (p = .028, η2p = 0.10), peak torque of quadriceps [120°/sec (p = .007, η2P = 0.15); 180°/sec (p = .011, η2P = 0.13)] and hamstring [120°/sec (p = .024, η2P = 0.11); 180°/sec (p = .036, η2P = 0.09)], DLPSdirectional [forward (p = .007, η2P = 0.15); backward (p = .013, η2P = 0.12); affected side (p = .008, η2P = 0.14); non-affected side (p = .002, η2P = 0.20)], DLPSoverall (p < .001, η2P = 0.32), and functional performance [FISH (p < .001, η2p = 0.26); 6-MWT (p = .002, η2p = 0.19)]. CONCLUSION: Plyo-HKT is likely helpful for reducing pain, improving strength, enhancing postural stability, and boosting functional capabilities in children with HKA. Physical rehabilitation practitioners should, therefore, consider this intervention strategy.

Efficacy of accommodating variable-resistance training on muscle architecture, peak torque, and functional performance in patients with juvenile idiopathic arthritis: A randomized controlled trial.

Purpose: This study sought to find out if a 6-week accommodating variable-resistance (AcVR) training might enhance muscle architecture, peak torque, and functional performance in patients with juvenile idiopathic arthritis (Juv-IA). Methods: Fifty-eight patients with polyarticular Juv-IA (aged 12-18 years) were involved in a randomized controlled trial. They were allocated into two groups: the AcVR group (n = 29; underwent AcVR training, and the control group (n = 29; received the usual exercise regimen). Interventions were applied three times a week over six consecutive weeks. Measurements were done at baseline and after the intervention. The primary outcome measures were muscle architecture and peak torque, with functional capacity being the secondary measure. Results: Compared to the control group, the AcVR group showed favorable pre-to-post changes in muscle architecture [fascicle length (P = 0.0007, η2p = .18), pennation angle (P = 0.0004, η2p = .20), and muscle thickness (P = 0.001, η2p = .17)]. Further, the AcVR group revealed a greater increase in peak concentric torque of knee extensors at angular speeds of 120°/sec [right side (P = 0.0032, η2p = .08); left side (P = 0.039, η2p = .07)] and 180°/sec [right side (P = 0.01, η2p = .11); left side (P = 0.014, η2p = .10)]. Furthermore, The AcVR group achieved more conducive changes in functional performance [6-min walk test (P = 0.003, η2p = .15), timed up and down stair test (P = 0.009, η2p = .12), and 4 × 10 m shuttle run test (P = 0.036, η2p = .08)]. Conclusion: A 6-week AcVR training is potentially effective for improving muscle architectural qualities, enhancing peak muscle torque, and boosting functional performance in patients with Juv-IA without experiencing any detrimental side effects.

The key determinants of low back pain among lifestyle behaviors in adolescents: A cross-sectional study from Saudi Arabia.

Establishing preventive measures and treatment strategies for adolescents with low back pain (LBP) may be greatly enhanced by fully grasping the complex interaction between LBP and lifestyle behaviors. The key objective of this study was to explore the possible associations between lifestyle behaviors and LBP among adolescents in Saudi Arabia. A cross-sectional study was conducted among high school students from 5 major regions in Saudi Arabia. Participants were enlisted for the research project between May and November 2021. To evaluate the presence/severity of LBP, physical activity, sedentary duration, sleep quality, nutrition, health responsibility, interpersonal relationships, spiritual growth, and stress management, a well-established web-based survey was employed. A total of 2000 students participated, with 57.9% reporting LBP. Students with LBP had lower scores on overall health-promoting lifestyle behaviors and all subscales, including physical activity, compared to those without LBP. Linear regression analysis revealed significant associations between sedentary duration and global sleep quality with pain severity among students with LBP. This study highlights the association between lifestyle behaviors and LBP among adolescents in Saudi Arabia. Promoting physical activity, reducing sedentary behavior, and improving sleep quality may be crucial in preventing and managing LBP in this population. Comprehensive strategies targeting lifestyle behaviors should be implemented to improve the well-being of adolescents and reduce the burden of LBP. Further research is needed to better understand the underlying mechanisms and develop effective preventive and treatment strategies for LBP among adolescents.

Optimization of Postural Control, Balance, and Mobility in Children with Cerebral Palsy: A Randomized Comparative Analysis of Independent and Integrated Effects of Pilates and Plyometrics.

The paradigm of comprehensive treatment approaches for children with cerebral palsy has gained traction, prompting clinicians to deliberate between independent and integrated treatment delivery. However, this decision-making process is often hindered by the dearth of empirical evidence available to inform optimal therapeutic strategies. This study, therefore, sought to compare the effects of Pilates-based core strengthening (PsCS), plyometric-based muscle loading (PlyoML), and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP (age: 12-18 years) were randomized to PsCS (n = 27), PlyoML (n = 27), or a combined intervention (n = 27; equated for total sets/repetitions) group. The three interventions were applied twice/week over 12 successive weeks. Postural control (directional and overall limits of stability-LoS), balance, and mobility (Community Balance and Mobility Scale-CB&M; Functional Walking Test-FWT; Timed Up and Down Stair test-TUDS) were assessed pre- and post-intervention. The combined group exhibited greater increases in directional LoS compared to PsCS and PlyoML including the backward (p = 0.006 and 0.033, respectively), forward (p = 0.015 and 0.036, respectively), paretic (p = 0.017 and 0.018, respectively), and non-paretic directions (p = 0.006 and 0.004, respectively)], and this was also the case for overall LoS (p < 0.001 versus PsCS and PlyoML). In addition, the combined group displayed greater improvements compared to the PsCS and PlyoML groups regarding CB&M (p = 0.037 and p = 0.002, respectively), FWT (p = 0.012 and p = 0.038, respectively), and TUDS (p = 0.046 and p = 0.021, respectively). In conclusion, the combined PsCS and PlyoML exercise program promotes considerably greater improvements in postural control, balance, and mobility compared to unimodal training in children with ULCP.

Demographic and clinical characteristics of children with limb loss in Saudi Arabia: A retrospective study.

PURPOSE: The aim of this study was to describe the demographic and clinical characteristics of children with limb loss in Saudi Arabia. METHODS: This is a retrospective study on children attending a limb loss clinic in a tertiary hospital in Riyadh, Saudi Arabia, between July 2012 and June 2020. Descriptive statistics were computed to describe the sample characteristics. A Chi-Squared test was conducted to explore the relationship between a child's sex with the type of limb loss (congenital or acquired) and extent of limb loss (major and minor) and the association between child's age and the mechanism of injury in traumatic limb loss. RESULTS: A total of 122 children aged 2-16 years were included of whom 52% were boys. Congenital limb loss represented 57% of the sample with upper extremity loss accounting for 63.7% of all limb loss in this type. Trauma-related limb loss represented the most frequent etiology (88.2%) in the acquired limb loss group. Road traffic accidents accounted for 51.7% of the mechanism of injuries in trauma-related limb loss. Child's sex was not associated with the type of limb loss nor the extent of limb loss ( p > 0.05). In addition, child's age was not associated with the mechanism of injury in traumatic limb loss ( p > 0.05). CONCLUSION: Child's sex was not a determinant of type nor the extent of limb loss. Most of the acquired limb loss was trauma-related with road traffic accidents as the most common mechanism of injury. The findings of this study illuminate the importance of ongoing prosthetic care for children with a limb loss because young children may require multiple prostheses as they grow in age and size.

Prevalence and risk factors for falls among community-dwelling adults in Riyadh area.

Objectives: This study aimed to assess fall prevalence, identify related risk factors, and establish cut-off scores for fall risk measures among community-dwelling adults in Riyadh region of Saudi Arabia. Methods: A cross-sectional study was conducted in community, Riyadh city, Saudi Arabia. A sample of 276 Saudi citizens aged ≥40 years who were able to read and write in Arabic. Fall history and number of falls in the past 12 months were determined via self-reports. Variables assessed included demographic information, self-reported chronic diseases, depressive symptoms, and back pain severity. Results: Participants were classified as either fallers (n = 28, 10.14%) or non-fallers. Fallers were more likely to have arthritis (odds ratio [OR]: 7.60, p = 0.001), back pain (OR: 5.22, p = 0.002), and higher depressive symptom scores (OR: 1.09, p = 0.013) than non-fallers. The number of reported falls was significantly associated with an elevated body mass index (incidence rate ratio [IRR]: 1.09, p = 0.045), arthritis (IRR: 8.74, p < 0.001), back pain (IRR: 4.08, p = 0.005), neurological diseases (IRR: 13.75, p < 0.007), and depressive symptoms (IRR: 1.08, p = 0.005). Cut-off scores predictive of falls associated with back pain and depressive symptoms were 1.5 (sensitivity: 0.61; specificity: 0.79; area under the curve [AUC]: 0.70) and 11.5 score (sensitivity: 0.57; specificity: 0.76; AUC: 0.66), respectively. Conclusions: The prevalence of falls was relatively low among the individuals considered in this study. Chronic conditions, back pain severity, and depressive symptoms were determined to be associated with falls among community-dwelling individuals in Saudi Arabia.

The Practice of Shared Decision-Making Among Physiotherapists and Patients with Musculoskeletal Conditions.

Purpose: Shared decision-making (SDM) may be interpreted as a set of core values rather than as a consensus definition. This study aimed to explore how SDM between patients and physiotherapists may lead to patient satisfaction. Patients and Methods: A cross-sectional study was conducted to examine the relationship between SDM and patient satisfaction. The study targeted physiotherapists and patients with musculoskeletal pain or disorders. A structured questionnaire (the nine-item Shared Decision-Making Questionnaire) was developed to show the extent to which patients felt involved in the process by scoring nine items from 0 to 5 on a six-point scale. t-tests were performed to estimate differences in SDM perceptions between patients and physiotherapists, and regression analyses were performed to estimate the best predictors of SDM. Results: The questionnaire was completed by a total of 106 patients and nine physiotherapists. The demographic information of the samples was presented with frequency analysis. This study's findings demonstrate no variations in the final SDM perceptions between patients and physiotherapists, but when SDM was contrasted step-by-step (as items), many variances were discovered. These distinctions reinforce the notion that regardless of the end outcome, the process of reaching a consensus has a distinct profile depending on the type of medical care. Therapists emphasize the first steps, possibly because there is sufficient evidence to make a therapeutic decision. However, patients highlight the final steps, perhaps because the moment for a decision based on the consultation's nature is approaching. Conclusion: This study demonstrates that SDM is a complex process that must be examined in multiple stages. However, in physiotherapy contexts, this process exhibits extremely different patterns, reflecting a significantly different perspective of the decision-making process.

Arabic Patient-Reported Measures of Activity and Participation for Children: A Systematic Review of Psychometric Properties.

AIM: To systematically review measurement properties of Arabic patient-reported outcome measures (PROMs) that assess activity and participation in children with and without health conditions. METHOD: Four databases were searched. Arabic PROMs with focus on activity and/or participation constructs were selected. Data on measurement properties were extracted and the methodological quality of the studies was assessed by COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) risk of bias checklist. RESULT: Of the total 149 articles screened, only 10 studies involving 10 measures that assessed activity and/or participation in children with or without health conditions were included. The focus of all PROMs is primarily on the activity of daily living at home and/or school, but dimensions of measurement differed across PROMs. None of the PROMs demonstrated sufficient properties for all psychometrics. The most studied psychometric property was internal consistency, whereas the least studied psychometric property was structural validity. Responsiveness was not investigated in any of the studies included. CONCLUSIONS: Despite the presence of Arabic PROMs on activity and participation for children, none of the reviewed measures satisfied all psychometric properties. Clinicians and researchers are encouraged to carefully select PROMs that are psychometrically sound and appropriate for the construct being measured.

Saudi Arabian Physical Therapists' Knowledge, Attitudes, and Clinical Practice in Diabetes Prevention and Management.

Objective: This study explores physical therapists' current knowledge, attitudes, and practice toward the management and prevention of diabetes in Saudi Arabia. Patients and Methods: A cross-sectional survey was distributed among physical therapists in Saudi Arabia. The questionnaire included several sections concerning their knowledge, attitude, and current practice toward diabetic management. A total of 301 physical therapists (32% female) participated in our study. Results: The results suggest that only half of the participants agreed that diabetes management and prevention were within physical therapy's scope of service. However, approximately 30% of the participants did not regularly check or ask about the glucose levels of their patients with diabetes. Only 55% of the participants correctly answered the knowledge test questions. Conclusion: This study found that physical therapists in Saudi Arabia have a modest level of diabetes knowledge. The findings indicate that physical therapy educational programs should address diabetes management. Furthermore, continued education is required for current practicing physical therapists in Saudi Arabia.

Prevalence of lower back pain and its associations with lifestyle behaviors among college students in Saudi Arabia.

BACKGROUND: Lower back pain (LBP) is a common musculoskeletal disorder that may affect students' daily lives. Recent psychological research showed a relevant connection between LBP and multidimensional health. However, the association between LBP and lifestyle behavior has not been established, and improving knowledge in this area may help develop preventive strategies and optimize college students' quality of life. METHODS: A cross-sectional study of 1420 college students in Saudi Arabia was conducted, and participants who attended Saudi Universities were recruited from May 2021 to November 2021. An established validated online survey assessed LBP, sleep quality, time spent sedentary (sedentary duration), health responsibility, physical activity, nutrition, spiritual growth, interpersonal relationships, and stress management. Generalized Linear Regression was used to assess the associations between LBP severity and lifestyle behaviors after controlling for covariates. RESULTS: LBP was prevalent among college students from Saudi Arabia. Most of the sample were young (23.81 ± 6.02), and female (83.7%). There were significant differences between students with and without LBP regarding age, BMI, sex, marital status, pain severity, overall lifestyle behavior, health responsibility, physical activity, nutrition, stress management, and global sleep quality. After controlling for age, BMI, sex, and marital status, there were significant associations between pain severity and global sleep quality (ß=0.2, p < .001, CI: 16 to 0.24), and sedentary duration (ß=0.03, p = .01, CI:0.009 to 0.06). CONCLUSIONS: This study helped define the prevalence of LBP in college students in Saudi Arabia and evaluated the association between LBP and lifestyle behaviors. The findings showed that students with higher levels of poor sleep quality or sedentary behavior had higher levels of pain. Promoting sleep quality and reducing sedentary behavior may help establish preventive strategies for LBP in college students.

Translation and Validation of the Arabic Version of the Athlete Psychological Strain Questionnaire.

CONTEXT: The international sports community is becoming more proactive in clinical mental health practice and research. An athlete-specific psychological distress screening tool can identify potential mental health illness. DESIGN: The Athlete Psychological Strain Questionnaire (APSQ) is a simple screening tool for detecting early signs of athlete-specific strain and related mental health concerns. METHODS: We evaluated the internal consistency and reliability of the translated and culturally adjusted Arabic version of the APSQ (APSQ-Ar) with Arabic-speaking elite athletes. The final translation underwent standard forward and backward translation, an inspection by a team of experts, and then preliminary testing. The APSQ-Ar was cross-culturally validated and then assessed for internal consistency and reliability among (n = 98) Arabic-speaking athletes. RESULTS: There were no problems with the patients' understanding or interpretation of the items on the APSQ-Ar translation. The intraclass correlation value was .93 (95% confidence interval, .89-.95), and the mean difference was 2.4 with a minimal detectable change of 5.12, demonstrating strong test-retest reliability. Moreover, Cronbach alpha showed excellent internal consistency (.76). CONCLUSIONS: The APSQ-Ar was demonstrated to be good, reliable, and internally consistent. With APSQ-Ar, sports medicine professionals in Arabic-speaking countries will be able to identify psychological distress and symptoms in athletes and, as a result, provide them with mental health support.

A Cross-Sectional Study Using STROBE Platform to Examine Sleep Characteristics, Mental Health and Academic Performance of Female Applied Medical Sciences Students in the Southwest of Saudi Arabia.

Background: Medical students are expected to excel in their academics. Hence exposing them to a certain amount of strain may sometimes cause sleep disruptions. The purpose of this study was to determine the sleep quality among Saudi Applied Medical Sciences students and its potential connections with their academic performance and mental health. Methods: This online cross-sectional questionnaire-based study was conducted at Jazan University's College of Applied Medical Sciences in Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI), a known indicator of sleep quality, a validated mental health measure; Depression Anxiety Stress Scales-21 (DASS-21), and Academic Performance Scale (APS) with 89 internal consistencies were included in the questionnaire. The cumulative grade point average (GPA) was also used as a covariate to evaluate students' academic success. Results: 112 people responded (response rate = 93%), and 105 of them presented comprehensive information about their backgrounds, way of life, academic standing, sleep patterns, and mental health. Participants' average GPA and APS scores were 4.23 ± 0.52 and 33.16 ± 5.63, respectively. The mean global PSQI score was 6.47 with 2.34 of standard deviation (SD). The majority of individuals (60%) had poor sleep quality particularly due to abnormal sleep latency and lesser sleep duration, as determined by their PSQI score. The prevalence rates for depression, anxiety, and stress were higher; 53%, 54% and 40%, respectively. Both depression and anxiety were substantially correlated with poor sleep quality (p-value = 0.008, p-value = 0.01, respectively). Sleep quality had no significant effect on GPA while global PSQI and depression were significantly negatively correlated with an APS score of participants (p-value = 0.007 and 0.015, respectively). Conclusions: Higher rates of poor sleep quality and psychologically negative emotions were prevalent. Unhealthy sleep patterns were linked to increased levels of anxiety and depression. Self-perceived academic performance was negatively impacted by inadequate sleep and negative emotions, despite the fact that the GPA results were unaffected.

Translation and Validation of the Arabic Version of the Athlete Sleep Screening Questionnaire.

Sleep improves the cognitive and physical performance of athletes. A detailed questionnaire that detects sleep disruptions is required to identify sleep-deprived athletes. This study evaluates the translated Athlete Sleep Screening Questionnaire (ASSQ), a tool suggested by the International Olympic Committee, among Arabic-speaking athletes. The ASSQ was translated into Arabic and examined for floor or ceiling effects, internal consistency, and validity among Arabic-speaking athletes. The Arabic Pittsburgh Sleep Quality Index (PSQI) was employed to assess convergent validity. Ninety athletes (28.9% women) participated and completed this study's questionnaires. The Cronbach's alpha for the ASSQ-Sleep Difficulty Score (SDS) was 0.435, and that of the ASSQ-chronotype was 0.632. The SDS and chronotype subset of the ASSQ demonstrated excellent test-retest reliability, with intraclass correlation coefficients of 0.84 and 0.938, respectively. The ASSQ-SDS correlated positively with the PSQI (0.734, p = 0.001). The ASSQ-chronotype was inversely associated with the PSQI (p = 0.001). This study's findings can assist clinicians in assessing sleep disorders in sports. The Arabic version of the ASSQ has satisfactory psychometric qualities and can identify clinically relevant sleep problems in athletes.

Osteoarthritis and Diabetes: Where Are We and Where Should We Go?

Diabetes mellitus (DM) and osteoarthritis (OA) are chronic noncommunicable diseases that affect millions of people worldwide. OA and DM are prevalent worldwide and associated with chronic pain and disability. Evidence suggests that DM and OA coexist within the same population. The coexistence of DM in patients with OA has been linked to the development and progression of the disease. Furthermore, DM is associated with a greater degree of osteoarthritic pain. Numerous risk factors are common to both DM and OA. Age, sex, race, and metabolic diseases (e.g., obesity, hypertension, and dyslipidemia) have been identified as risk factors. These risk factors (demographics and metabolic disorder) are associated with DM or OA. Other possible factors may include sleep disorders and depression. Medications for metabolic syndromes might be related to the incidence and progression of OA, with conflicting results. Given the growing body of evidence indicating a relationship between DM and OA, it is vital to analyze, interpret, and integrate these findings. Therefore, the purpose of this review was to evaluate the evidence on the prevalence, relationship, pain, and risk factors of both DM and OA. The research was limited to knee, hip, and hand OA.

Fatigue and Cognitive Decline Associated With Depressive Symptoms Among Community-Dwelling Adults.

To investigate the prevalence of depressive symptoms in community-dwelling Saudi adults aged ≥50 years and the associated risk factors. Patient Health Questionnaire 9 (PHQ-9) was dichotomized as depressive symptoms when the participants scored ≥10. Risk factors included age, sex, body mass index, education, employment, marital status, number of chronic diseases and medications, fatigue severity scale (FSS), and Montreal Cognitive Assessment (MoCA). Among the 206 participants, the prevalence of depressive symptoms was 17.48%. The number of chronic diseases, medications, and fatigue symptoms were significantly higher in those with depressive symptoms, whereas cognitive functions were significantly lower. Fatigue symptoms and cognitive functions were significantly associated with depressive symptoms. The cut-off scores for risk factors were ≥42 (FSS) and ≤23 (MoCA scale). Fatigue and cognitive impairments were the only risk factors that distinguished participants with and without depressive symptoms.

The Five Times Sit-to-Stand Test is associated with both history of falls and fear of falling among community adults aged 50 years and older.

BACKGROUND: Limited evidence has examined the association between balance and mobility measures with risk of fall. AIM: To determine the prevalence and balance measures associated with falls and fear of falling among community adults aged 50 years and older. METHODS: This cross-sectional study included community-dwelling adults aged ≥ 50 years, living in Saudi Arabia. The participants were asked to report any history of falls in the past 12 months and fear of falling using the Falls Efficacy Scale (FES-I). Balance/mobility measures included the Timed Up and Go (TUG) test, Functional Reach Test (FRT), 10-m walk test (10-MWT), 6-min walk test (6-MWT), and Five Times Sit-to-Stand Test (5XSST). RESULTS: Two hundred and six participants, including 96 women, were included. The prevalence of falls was 12.6%, and the 5XSST was the only balance measure significantly associated with falls (OR 1.17, 95% CI [1.03, 1.33], p = 0.019) with a cutoff score of 13.93 s or more, a sensitivity of 0.73, and a specificity of 0.58. An increase in 5XSST time was associated with an increase in FES-I score, while a decrease in other balance measures (10-MWT, TUG, FRT, and 6-MWT) was associated with an increase in FES-I scores. CONCLUSION: Adults living in Saudi Arabia had a low prevalence of falls. The 5XSST was the only significant balance/mobility measure that distinguished fallers from non-fallers.

Cross-Cultural Adaptation and Validation of the Arabic Version of the Mini-BESTest among Community-Dwelling Older Adults in Saudi Arabia.

Backgrounds: The Mini-BESTest is a clinical assessment of balance impairment; however, the translation and psychometric properties in the Arabic-speaking population have not yet been investigated. The purpose of this study was to translate into Arabic and evaluate the psychometric properties of the Mini-BESTest in Saudi community-dwelling older adults. Methods: This is a cross-sectional transcultural adaptation and validation study. A total of 144 community-dwelling older adults were enrolled (mean age = 66.2 ± 6.2 years). The translation and cross-cultural adaptation of the Mini-BESTest from English to Arabic was performed using standardized guidelines. Test−retest reliability was examined using the intraclass correlation coefficient (ICC) with one week between test and retest. The internal consistency was assessed using Cronbach's alpha. Construct validity of the Mini-BESTest was assessed using balance such as Berg Balance Scale (BBS) and Falls Efficacy Scale International (FES-I). Results: The Arabic version of the Mini-BESTest showed good internal consistency (Cronbach's alpha = 0.93). The scale shows excellent test−retest reliability (ICC = 0.99, 95% CI, 0.98−0.99) and excellent inter-rater reliability (ICC = 0.93, 95% CI, 0.70−0.97), which is indicative of the measure's stability and repeatability. Mini-BESTest total scores showed an excellent inter-rater agreement. There was a significant correlation between total score of the Mini-BESTest and BBS (r = 0.72; p < 0.001). Mini-BESTest had a moderate association with FES-I. Conclusion: The Arabic version of the Mini-BESTest is a reliable and valid test for assessing balance in older adults. More research is needed to confirm the test's reliability and validity in a specific population, such as those with neurological problems.