Translation, cross-cultural adaptation and psychometric properties of the Urdu version of the back pain functional scale in low back pain patients.

BACKGROUND: Translation and validation of important scales in other languages reduce bias in reporting the functional status of the patient. OBJECTIVE: To translate the Back Pain Functional Scale into Urdu (BPFSu), adapt it for use in other cultures, and evaluate its psychometric properties. METHOD: According to Beaton guidelines, translation and cultural adaption was carried out. On 100 Urdu-literate men and women aged 18-60 years with lower back pain, the final BPFSu was assessed for psychometric qualities. First at baseline and again after 7 days, participants completed the BPFSu, the Functional Rating Index (FRI), and the Numeric Pain Rating Scale (NPRS). RESULTS: Internal consistency of the BPFSu was excellent (Cronbach's alpha: 0.937). No floor and ceiling effects were found Excellent test-retest reliability (ICC = 0.882, CI 95%; 0.830-0.919) was achieved. Spearman correlation coefficient showed criterion validity with the NPRS (rho =â⁢⁢0.701, p⩽ 0.001) and Pearson correlation coefficient showed construct validity with the FRI (r=â⁢⁢0.740, p⩽ 0.001). The minimum detectable changes were 9.96, while the standard error of measurement was 3.6. CONCLUSION: The BPFSu is a valid and reliable instrument for assessing physical function in individuals experiencing low back discomfort.

Effects of virtual reality exercises and routine physical therapy on pain intensity and functional disability in patients with chronic low back pain.

Objectives: To compare the effects of Virtual Reality exercises and routine physical therapy on pain and functional disability in patients with chronic low-back pain. METHODS: The single-blind randomised controlled trial was conducted from April to October 2020 at the Physiotherapy Department of the Government Services Hospital, Lahore, Pakistan, and comprised patients of either gender, aged 25-50 years with chronic non-radiating low-back pain who were randomised into two equal groups. Group A received routine physical therapy, while group B received Virtual Reality exercises with routine physical therapy. Visual Analogue Scale and Modified Oswestry Disability Index were used to measure outcomes at baseline and after 4th, 8th and 12th sessions. Data was analysed using SPSS 24. RESULTS: Of the 84 patients, there were 42(50%) in each of the two groups. There were 28((33%) males and 56(66.6%) females. The mean age in group A was 37.5±12.5 years and in group B it was 38.2±11.8 years. Pain score at baseline was 6.62±1.04 in group A and 6.50±1.24 in group B which decreased to 3.32±0.81 and 1.00±0.60 respectively after the 12th session (p<0.05). Functional disability score at baseline was 65.08+8.94 in group A and 69.16±9.13 in Group B which decreased to 40.56±8.59 and 16.04±6.82 respectively after the 12th session (p<0.05). Group B showed significantly better results than group A (p<0.05). CONCLUSIONS: Virtual Reality exercises in combination with routine physical therapy had dominant effect on functional disability and low-back pain. Trial Registration Number (IRCTID): IRCT20200330046895N1.

Comparison between qualitative and quantitative measurement of strength deficit in shoulder flexors of young females: A cross- sectional study.

OBJECTIVE: To determine the accuracy of manual muscle testing as a diagnostic tool to detect strength deficit across grades 5 and 4 in shoulder flexors at different percentage deficits of dynamometric strength. METHODS: The cross-sectional study was conducted at the University of South Asia, Lahore, in collaboration with the Association of Fatima Jinnah Old Graduates, Lahore, Pakistan, from May to June 2019. It included young healthy females aged 18-39 years without any ailment of upper extremity or generalised health problem. The strength of shoulder flexors was measured through manual muscle testing and hand-held dynamometer. Data was analysed using SPSS 25. RESULTS: There were 300 women with a mean age of 23.11±4.71 years. The majority 124(41.3%) were aged 20-24 years. The strength of the dominant shoulder flexors of 194(64.7%) participants and the strength of non-dominant shoulder flexors of 206(68.7%) was in grade 4. The overall diagnostic accuracy of manual muscle testing at 10% dynamometric measures was 68.67% (95% confidence interval: 63.21-73.65%) in non-dominant shoulder flexors, and 61.67% (95% confidence interval: 56.05-66.99%) in dominant shoulder flexors. The positive predictive value and specificity of manual muscle testing was better at 10% strength deficit in comparison with dynamometric measures, whereas negative predictive value and sensitivity was better at 20% strength deficit. CONCLUSIONS: The subjective area of grades 4 and 5 showed better, though not ideal, diagnostic worth at 10% deficit of dynamometric measures in shoulder flexors.