The reliability and validity of the Norwegian version of the Victorian Institute of Sports Assessment for gluteal tendinopathy questionnaire (VISA-G-Norwegian) for patients with greater trochanteric pain syndrome.

BACKGROUND: Greater Trochanteric Pain Syndrome (GTPS) is a common chronic musculoskeletal condition that may affect physical function, quality of life and sleep. The Victorian Institute of Sport Assessment-Gluteal questionnaire (VISA-G) has been developed as a Patient-Reported Outcome Measurement (PROM) to address pain, everyday activities, physical activities, and difficulty with weight bearing activities. The aim of the study was to test the reliability, validity and floor and ceiling effects of the Norwegian version of the VISA-G (VISA-G-Norwegian) in a population with GTPS in a specialist health care setting. METHODS: This psychometric evaluation of the VISA-G-Norwegian questionnaire were conducted with a prospective observational design. The VISA-G was translated into Norwegian following recommended guidelines. A subgroup repeated the VISA-G-Norwegian a week after the initial submission. For the reliability, the Intraclass Correlation Coefficient (ICC2.1), Standard Error of the Measurement (SEM) and the Smallest Detectable Change (SDC95%) were calculated. Internal consistency was measured using a Cronbach´s alpha. Floor and ceiling effects were evaluated, and construct validity was assessed with three a priori hypotheses. RESULTS: 78 participants were included in the study of which 47 stable participants undertook the test-retest reliability arm of the study. The ICC2.1 for the total score was 0.85 (95% CI 0.68, 0.92), SEM was 6.6 points and SDC95% 18.4 points. Cronbach`s alpha was 0.77 (95% CI 0.69, 0.84). No floor or ceiling effects were found in the total score, but ceiling effect was found in three of the eight items. For construct validity, one of the three hypotheses were confirmed. VISA-G-Norwegian correlated to the modified Harris Hip Score (mHHS), Oswestry Disability Questionnaire (ODI) and Numeric Pain Rating Scale (NPRS), 0.64, -0.75 and - 0.63 respectively. CONCLUSION: The VISA-G-Norwegian has acceptable reliability and validity, despite ceiling effect of individual items. The large SDC95% should be considered when measuring change in similar cohorts with GTPS. For a potential future version, it would be recommended to consider response options for questions with ceiling effect and the comprehensibility of question eight. TRIAL REGISTRATION: Registered at ClinicalTrials.gov the 28/02/2020 (NCT04289922).

Energy expenditure of transfemoral amputees during floor and treadmill walking with different speeds.

BACKGROUND: Walking energy expenditure, calculated as the percent utilization of the maximal aerobic capacity, is little investigated in transfemoral amputees. OBJECTIVES: Compare the energy expenditure of healthy participants (control participants) and transfemoral amputees walking with their respective preferred walking speeds on the treadmill (TPWS) and floor (FPWS). STUDY DESIGN: Randomized cross-over study. METHODS: Oxygen uptake (VO2) was measured when walking with the FPWS and TPWS. VO2max was measured by an incremental treadmill test. RESULTS: Mean ± standard deviation VO2max of the transfemoral amputees and control participants were 30.6 ± 8.7 and 49.0 ± 14.4 mL kg(-1) min(-1), respectively (p < 0.05). TPWS for the transfemoral amputees and control participants was 0.89 ± 0.2 and 1.33 ± 0.3 m s(-1), respectively (p < 0.01). FPWS for the transfemoral amputees and control participants was 1.22 ± 0.2 and 1.52 ± 0.1 m s(-1), respectively (p < 0.01). Walking on floor with the FPWS, the energy expenditure of the transfemoral amputees and control participants was 54% and 31% of VO2max, respectively (p < 0.01). Walking on the treadmill with the TPWS, the energy expenditure of the transfemoral amputees and control participants was 42% and 29% of the VO2max, respectively (p < 0.05). CONCLUSION: Energy expenditure is higher for the transfemoral amputees than the control participants, regardless of walking surface. There are minimal differences in energy expenditure between treadmill and floor walking for the control participants but large differences for the transfemoral amputees. CLINICAL RELEVANCE: During walking, the transfemoral amputees expend a larger percentage of their maximal aerobic capacity than healthy participants. With a low VO2max, ordinary activities, such as walking, become physically more challenging for the transfemoral amputees than the control participants, and this may, in turn, have a negative effect on the walking range of the transfemoral amputees.