Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study.

BACKGROUND: Brief whole-spine patient-reported outcome measures (PROMs) provide regional solutions and future directions for quantifying functional status, evidence, and effective interventions. The whole-spine regional Spine Functional Index (SFI-25) is used internationally in clinical and scientific contexts to assess general sub-acute/chronic spine populations. However, to improve structural validity and practicality a shortened version is recommended. This study developed a shortened-SFI from the determined optimal number of item questions that: correlated with criteria PROMs being highly with whole-spine, moderately with regional-spine, condition-specific and patient-specific, and moderately-low with general-health and pain; retained one-dimensional structural validity and high internal consistency; and improved practicality to reduce administrative burden. METHODS: A cross-sectional study (n = 505, age = 18-87 yrs., average = 40.3 ± 10.1 yrs) of sub-acute/chronic spine physiotherapy outpatients from an international sample of convenience. Three shortened versions of the original SFI-25 were developed using 1) qualitative 'content-retention' methodology, 2) quantitative 'factorial' methodology, and 3) quantitative 'Rasch' methodology, with a fourth 'random' version produced as a comparative control. The clinimetric properties were established for structural validity with exploratory (EFA) and confirmatory (CFA) factorial analysis, and Rasch analysis. Criterion validity used the: whole-spine SFI-25 and Functional Rating Index (FRI); regional-spine Neck Disability Index (NDI), Oswestry Disability Index (ODI), and Roland Morris Questionnaire (RMQ), condition-specific Whiplash Disability Questionnaire (WDQ); and patient-specific functional scale (PSFS); and determined floor/ceiling effect. A post-hoc pooled international sub-acute/chronic spine sample (n = 1433, age = 18-91 yrs., average = 42.0 ± 15.7 yrs) clarified the findings and employed the general-health EuroQuol-Index (EQ-5D), and 11-point Pain Numerical Rating Scale (P-NRS) criteria. RESULTS: A 10-item SFI retained structural validity with optimal practicality requiring no computational aid. The SFI-10 concept-retention-version demonstrated preferred criterion validity with whole-spine criteria (SFI-25 = 0.967, FRI = 0.810) and exceeded cut-off minimums with regional-spine, condition-specific, and patient-specific measures. An unequivocal one-dimensional structure was determined. Internal consistency was satisfactory (α = 0.80) with no floor/ceiling effect. Post-hoc analysis of the international sample confirmed these findings. CONCLUSION: The SFI-10 qualitative concept-retention version was preferred to quantitative factorial and Rasch versions, demonstrated structural and criterion validity, and preferred correlation with criteria measures. Further longitudinal research is required for reliability, error, and responsiveness, plus an examination of the practical characteristics of readability and administrative burden.

A Comparison Study of the Western Ontario Rotator Cuff Index, and the Constant-Murley Score with Objective Assessment of External Rotator Muscle Strength and Pain in Patients after Arthroscopic Rotator Cuff Repair.

Although rotator cuff injures are often associated with a limited range of motion and muscle weakness, being able to conduct pain-free and efficient performances of the activities as part of daily living seems to be more important for patients. The aim of this study was to investigate the correlation between two questionnaires-the disease-specific, subjective questionnaire termed the Western Ontario Rotator Cuff Index (WORC), and the shoulder-specific, subjective-objective questionnaire Constant-Murley score (CMS), with the objective assessment of external rotator muscle strength, and the subjective assessment of pain according to the visual analog scale (VAS) in patients after arthroscopic rotator cuff repair. The study was carried out among 47 patients twice-6 and 12 months after surgery, respectively. All patients completed the WORC, the CMS, and the VAS. Isokinetic evaluation of the external rotators was performed using the Biodex 4 ProSystem. The correlations of all assessed muscle strength parameters with both the CMS and the WORC were found to be statistically significant, being mostly average during the 1st examination and mostly strong during the 2nd examination. There was a significant improvement in all assessed tools as a result of the undertaken rehabilitation. There were weak correlations present between changes in the WORC and changes in the external rotator muscle strength, with correlations between WORC-Sport and EXT900-AVERAGE-POWER and PEAK-TORQUE also being found statistically significant. Correlations of changes in the CMS scale with changes in the external rotator muscle strength were weak and statistically insignificant. It seems that the WORC questionnaire can be recommended more for the population after rotator cuff repair, which allows for a reliable assessment of patients' ability to function and its changes in various areas of life, and at the same time does not require a direct assessment by a clinician or researcher.

Validation of the Polish Version of Knee Outcome Survey Activities of the Daily Living Scale in a Group of Patients after Arthroscopic Anterior Cruciate Ligament Reconstruction.

BACKGROUND: The study aimed to assess the reliability, validity, and responsiveness of the Polish version of Knee Outcome Survey Activities of the Daily Living Scale (KOS-ADLS) in a group of patients after arthroscopic reconstruction of the anterior cruciate ligament (ACL). METHODS: The study was a longitudinal study with repeated measures. One hundred and twelve subjects who qualified for arthroscopic ACL reconstruction (mean age = 31.8 years) were initially enrolled in this study. The Polish version of KOS-ADLS and Short Form-36 v. 2.0 (SF-36) were used. RESULTS: The Polish version of KOS-ADLS in subjects after ACL rupture demonstrated excellent internal consistency (Cronbach's alpha for KOS-ADLS- total = 0.91), and test-retest reliability using the intraclass correlation coefficient (ICC-total = 0.98). The standard error of measurement (SEM) value was 0.81 and the minimal detectable change (MDC) was 2.23 for KOS-ADLS-total. The validity analysis showed a moderate and low correlation between KOS-ADLS and different domains of SF-36 from r = 0.354 between KOS-ADLS activity and the physical component scale (PCS) of SF-36: to r = 0.206 between KOS-ADLS activity and the mental component scale (MCS) of SF-36. CONCLUSIONS: The Polish version of KOS-ADLS turned out to be a reliable, valid and responsive self-reported outcome measure, allowing for the self-assessment of symptoms and function related to the knee joint impairment after ACL reconstruction. Therefore, the scale can be applied in clinical practice and research.

Reliability, Validity and Responsiveness of the Polish Version of the Western Ontario Shoulder Instability Index (WOSI-PL) in Patients after Arthroscopic Repair for Shoulder Instability.

Apart from imaging and physical examination for shoulder instability (SI), medical history with patient feedback should be considered to assess the patient's condition and recovery. The aim of this study was to evaluate psychometric properties of the Polish version of Western Ontario Shoulder Instability Index (WOSI)-one of the most frequently used patient-reported outcome measures for SI. During examination 1, 74 patients after arthroscopic repair for SI (age x¯ = 30.01 ± 8.98) were tested. Examinations 2 and 3 involved 71 and 51 patients, respectively. They completed the Polish version of the WOSI, the shortened version of the Disabilities of Arm, Shoulder and Hand Questionnaire (QuickDASH), the Short Form-36 version 2.0 (SF-36 v. 2.0) and 7-point Global Rating Change scale (GRC). The WOSI-PL demonstrated high internal consistency (Cronbach's alpha for total = 0.94), and test-retest reliability (Total ICC2,1 = 0.99). High construct validity was found (89%) as the a priori hypotheses were confirmed. All domains and total scores of WOSI-PL showed a moderate to strong degree of responsiveness (ES = 0.37-0.44; SMR = 0.87-1.26). Minimal clinically important difference (MCID) for the Total WOSI-PL was 126.43 points/6% (95%CI 67.83-185.03) by the anchor-based method and 174.05 points/8% (95%CI 138.61-233.98) by the distribution-based method. The Polish version of the WOSI can be considered a reliable, valid and responsive PROM. It is recommended for assessing the quality of life in patients after arthroscopic repair for SI and can be applied in research and in the clinical setting for monitoring treatment and facilitating patient-centred therapeutic decisions.

Sociodemographic and Socioeconomic Factors Influencing the Body Mass Composition of School-Age Children.

The purpose of the study was to evaluate the components of overweight, obesity, and body mass components among children aged 7 to 13 years against important sociodemographic factors. The analyses considered 315 school-age children from 7 to 13 years of age (164 boys and 151 girls). Each subject was assessed for body weight and height, body weight category, and main sociodemographic factors. Body mass components of body mass (body-fat percentage (BFP), muscle tissue, fat-free mass (FFM), and total body water (TBW) levels) were evaluated using the electrical bioimpedance method (BIA) and the TANITA 780 MC analyzer. A statistical analysis showed significant differences between the body composition of children living in cities in relation to children living in small towns and villages, and no significant differences were found between the results of children living in small towns and children living in villages. The presence of statistically significant differences between the values of the parameters of body composition of the studied children was demonstrated depending on the level of education of their fathers. The presence of statistically significant relationships between BMI of mothers and BFP of their children (p = 0.003), FFM (p = 0.003), muscle tissue (p = 0.001), and TBW (p = 0.001) has been demonstrated. The higher content of adipose tissue in children is strongly dependent on the higher BMI and body mass category of the mother, as well as the lower level of education of the father. The place of residence also significantly affects both the body fat content and the total body water content of body hydration. Living in the city is associated with better body composition.

Polish Cross-Cultural Adaptation of the Lower Limb Functional Index (LLFI) Demonstrates a Valid Outcome Measure for the Lower Limb Region and Joints.

This study aimed to perform linguistic and cross-cultural adaptation to establish a Polish version of the Lower Limb Functional Index (LLFI) as well as an evaluation of the psychometric properties. This was a two-stage, cross-sectional study. The first stage-linguistic and cultural adaptation, complied with the International Society for Pharmacoeconomics and Outcomes Research guidelines to produce the Lower Limb Functional Index, Polish version (LLFI-PL). The subjects were recruited to the second stage of the study from a sample of convenience (n = 125, age x- = 52.86 ± 19.53 years, 56% female, symptoms duration x- = 17.69 ± 18.39 weeks). Baseline reliability was performed on the LLFI-PL with retest period at 3-7 days. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC), EuroQol Health Questionnaire 5-Dimensions 5-Level (EQ-5D-5L), and an 11-point Pain Numerical Rating Scale (P-NRS) were completed to assess the validity of the LLFI-PL. Statistical analysis showed high internal consistency (α = 0.94), and excellent test-retest reliability (ICC2.1 = 0.96). The measurement error was SEM = 1.69% with MDC90 = 3.93%. Construct validity demonstrated strong correlations between the LLFI-PL and WOMAC (r = 0.81) and moderate correlations with the EQ-5D-5L (r = -0.63) and P-NRS (r = -0.39). Exploratory factor analysis confirmed a single-factor structure. The LLFI-PL is a psychometrically sound questionnaire for Polish-speaking patients with lower limb musculoskeletal conditions. The results support findings from the previous original English, Spanish, and Turkish versions.

Analysis of Vastus Lateralis and Vastus Medialis Activities in Men the Late Post-Surgery Period after ACL Reconstruction with LARS Synthetic Ligament.

BACKGROUND: The aim of the study was to assess the activity of the vastus lateralis (VAL) and vastus medialis (VAM) within 3-5 years after anterior cruciate ligament (ACL) reconstruction with a LARS synthetic ligament (the Ligament Advanced Reinforcement System) compared to muscle activity in the non-operated limb and in the limbs of the controls during selected functional tests. MATERIAL AND METHODS: 20 men after ACL reconstruction using LARS synthetic ligament were qualified to the study group. The control group included 20 healthy men. Lysholm scale used to assess the functionality of the knee joint. To test muscle activity, TELEMYO DTS surface electromyography (sEMG) recording kit by Noraxon was used. The examined muscles on both limbs were the VAL and the VAM. The subjects were asked to perform the test-movements (dynamic ascent and descent from 25 cm step and slowly squats). RESULTS: Statistically significant differences were noted only for the values of VAL SA_SD (the quotients of mean sEMG values of the VAL muscle during step ascent - SA and descent -SD; Z=2.83; p=0.0047) and VAM SA_SD (Z=1.98; p=0.0401) parameters. In each analyzed parameter higher values were recorded among people from the control group. Weak but significant correlations were found between the VAL and VAM: SA_SD and the results obtained on the Lysholm Scale. CONCLUSIONS: 1. In the group of patients after LARS, quadriceps activity disorders persisted in tested dynamic activities. 2. In the therapy planning or sports training in the distant period after ACL reconstruction with LARS, emphasis should be placed on quadriceps muscle training, and the sEMG test may be helpful in optimizing the management strategy.

Psychometric properties of the Polish version of the 36-item WHODAS 2.0 in patients with hip and knee osteoarthritis.

PURPOSE: To examine psychometric properties of the Polish version of the 36-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) in the population with hip and knee osteoarthritis (OA). METHODS: This was a longitudinal study with repeated measures during retest examinations. Subjects from a Polish Specialist Hospital (age = 68.3 ± 9.2years, 71% female, 44.2% knee OA, 55.8% hip OA) were tested three times. They completed the Polish version of the 36-item WHODAS 2.0, the SF-36 Health Survey 2.0, the Western Ontario and Macmaster Universities Osteoarthritis Index 3.1, the Hospital Anxiety and Depression Scale, and the Numerical Rating Scale. RESULTS: The 36-item WHODAS 2.0-Polish version demonstrated high internal consistency (Cronbach's alpha for total = 0.94), and test-retest reliability (Total ICC2,1 = 0.98). High construct validity was found as 12 out of 15 a priori hypotheses (80%) were confirmed. Most domains and Total Scores in the 36-item WHODAS 2.0 (Total ES = - 0.62, SMR = - 1.09) showed a moderate degree of responsiveness. Minimal clinically important difference (MCID) for the Total WHODAS 2.0 was 3.29 in patients undergoing rehabilitation for knee or hip OA. CONCLUSIONS: The Polish version of the 36-item WHODAS 2.0 assesses disability according to ICF in a reliable, valid and responsive way. Therefore, it provides considerable support in clinical practice and national and international scientific research of patients with hip or knee OA.

Psychometric Properties of the Polish Version of the 36-Item WHODAS 2.0 in Patients with Low Back Pain.

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is considered by the World Health Organization (WHO) to be a useful tool for assessing the functioning and disability of the general population as well as the effectiveness of the applied interventions. Until this study, no data regarding the validity of the 36-item WHODAS 2.0 in chronic low back pain (LBP) in Poland have been explored. This study was conducted on 92 patients suffering from chronic LBP admitted to the rehabilitation ward. The Polish version of the 36-item WHODAS 2.0, the Sf-36 Health Survey (SF-36), the Oswestry Disability Index (ODI), the Hospital Anxiety and Depression Scale (HADS) and the Visual Analogue Scale (VAS) questionnaires were applied to assess patients. The scale score reliability of the entire tool for the study population was very high. The Cronbach's alpha test result for the entire scale was 0.92. For the overall result of the WHODAS 2.0, the Intraclass Correlation Coefficient (ICC1,2) was 0.928, which confirmed that the scale was consistent over time. The total result and the vast majority of domains of the 36-item WHODAS 2.0 correlated negatively with domains of the SF-36 questionnaire; thus, a higher WHODAS 2.0 score was associated with a lower score on the SF-36 questionnaire. We found that the minimal clinically important difference (MCID) for the total WHODAS 2.0 score in patients after rehabilitation for LBP was 4.87. Overall, the results indicated that the Polish version of the 36-item WHODAS is suitable for assessing health and disability status in patients with LBP.

The Relationship Between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study.

The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (n = 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (p < 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.

Cross-cultural adaptation and validation of the Polish version of the Spine Functional Index.

PURPOSE: The purpose of this study was a cross-cultural adaptation of the Spine Functional Index to produce a Polish version (SFI-PL). Further, the psychometric properties were evaluated with standardized criteria patient reported outcome measures (PROMs) in a symptomatic Polish spine population. METHODS: Linguistic adaptation complied with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines to produce the SFI-PL. Subjects with spine conditions, all areas and multi-area, were recruited from a Polish Specialist Hospital (n = 225, age = 45.7 ± 16.0 years, range 18-87, female = 60%, symptoms duration = 13.93 ± 27.56 weeks, range 5-84). Baseline internal consistency, reliability and validity were examined and included the SFI-PL, Oswestry Disability Index (ODI), Neck Disability Index (NDI), EuroQol 5 Dimensions, 5-level version (EQ-5D-5L) and an 11-point pain Numerical Rating Scale (NRS) with retest at 3-7 days (= 5 days). Practicality for readability was considered within the face and content validity and completion and scoring time calculated. RESULTS: Statistical analysis showed excellent internal consistency (α = 0.90) and high test-retest reliability (ICC = 0.98). The error score was determined with the SEM = 3.14 (MDC 90% CI = 7.33%). The construct validity analysis demonstrated strong correlations between the SFI-PL, the NDI (r = 0.73) and the ODI (r = 0.82); moderate with the EQ index value (0.70) and EQ-VAS (r = 0.56). Time to complete (229 s) and score (27 s) were determined. CONCLUSIONS: The SFI-PL is a psychometrically sound PROM for Polish-speaking patients with spine conditions. The results support previous findings from the original-English and six other language versions for internal consistency, reliability, measurement error and validity. These slides can be retrieved under Electronic Supplementary Material.

Burnout syndrome in physiotherapists working in the Podkarpackie province in Poland.

BACKGROUND: Burnout is most often referred to as a syndrome of characteristic mental and somatic symptoms, which are the result of chronic stress most often associated with professional work. OBJECTIVE: The aim of this study was to assess the prevalence of burnout syndrome among physiotherapists and its determinants related to sex, age, education, workplace, occupational activity, work experience and financial situation. MATERIAL AND METHODS: Eighty-six professionally active full-time physiotherapists participated in the study. Maslach Burnout Inventory (MBI) was used to measure burnout. RESULTS: In the examined group of physiotherapists, we observed a low level of Emotional Exhaustion (x¯= 15.99) and Depersonalization level (x¯= 4.31), while Personal Accomplishment was moderate but approaching high level (x¯= 31.63). A significant relationship between sex, education, work experience, place of work, scope of professional activities, financial situation, and individual dimensions of burnout syndrome were observed. CONCLUSION: A significantly reduced sense of personal accomplishment occurred commonly in a studied group of physiotherapists. Professional burnout is most likely to occur in men, in people with higher education, in those working in hospital departments with more work experience, and those in a poor financial situation. Employers should take care of their employees' mental health as a part of burnout prophylaxis.

Comparison of results of ACL reconstruction using LARS method and autogenous ST/GR graft.

PURPOSE: The objective of the study was assessment of the function of the knee joint after ACL reconstruction using the LARS method and autogenous graft. The study was of a retrospective character and included 96 patients who had undergone reconstruction of the torn ACL. The study was conducted within 36-48 months after surgery. METHODS: In order to compare the results of the ACL reconstruction performed with 2 types of grafts, the following instruments were used: Lysholm Knee Scoring Scale, SF 36v2 questionnaire for assessment of health-related quality of life, and Biodex System 4 for isokinetic muscle testing. RESULTS: No differences in the evaluation of the quality of life measured using SF 36v2 questionnaire were observed between the LARS and ST GR groups. Using the Lysholm Scale, the distribution of knee function scores was compared according to the type of surgery. There are no grounds to confirm the differences in the distribution of knee function scores considering the type of graft (p = 0.756). Isokinetic test showed a significant weakening of muscle strength in the operated limb, compared to the strength of the healthy limb. CONCLUSIONS: The type of graft used for ACL reconstruction does not exert an effect on the quality of life of patients or the level of their knee joint function. Extensor and flexor muscles strength of the knee joint was lower in the operated limb, irrespective of the type of graft used. Weak relationships were observed between the level of knee joint function and extensor muscle strength of this joint.

Translation, cross-cultural adaptation and validation of the polish version of the Oxford Shoulder Score in patients undergoing arthroscopic rotator cuff repair.

BACKGROUND: The Oxford Shoulder Score (OSS) is a simple and reliable, joint-specific, self-reported outcome measure. It can be applied in patients with shoulder disease other than instability. The purpose of this study was to perform a translation, cultural adaptation of the Polish version of the OSS and to evaluate its selected psychometric properties in patients after arthroscopic rotator cuff repair. METHODS: Sixty-nine subjects participated in the study, with a mean age 55.5 (ranging from 40 to 65 years). The OSS has been translated using the widely accepted guidelines. All patients completed the Polish version of OSS (OSS-PL), the short version of the Disabilities of Arm, Shoulder and Hand Questionnaire (QuickDASH), the Short Form-36 v. 2.0 (SF-36) and the 7-point Global Rating of Change Scale (GRC). RESULTS: High internal consistency of 0.96 was found using Cronbach's alpha coefficient. Reliability of the OSS resulted in Intraclass Correlation Coefficient (ICC) = 0.99, Standard Error of Measurement (SEM) = 1.14 and Minimal Detectable Change (MDC) = 3.15. The validity analysis showed a moderate (General health r = 0.34) to high (Physical role functioning r = 0.82) correlation between the OSS-PL and SF-36 and a high correlation between the OSS-PL and the QuickDASH (r = - 0.92). CONCLUSIONS: The Polish version of OSS is a reliable and valid, self-reported questionnaire, which can be applied in patients with a rotator cuff tear undergoing reconstruction surgery. The very good psychometric properties of the Polish version of the OSS indicate that it can be used in clinical practice and scientific research.

Validation of the Polish version of the Western Ontario Rotator Cuff Index in patients following arthroscopic rotator cuff repair.

BACKGROUND: The Western Ontario Rotator Cuff Index (WORC) is a joint specific outcome tool that assesses the quality of life in patients with various rotator cuff problems. Our purpose was to evaluate selected psychometric characteristics (internal consistency, validity, reliability and agreement) of the Polish version of WORC in patients undergoing rotator cuff repair. METHODS: Sixty-nine subjects took part in the study with a mean age 55.5 (range 40-65). All had undergone arthroscopic rotator cuff repair in 2015-2016. Data from 57 patients in whom symptoms in the shoulder joint had not changed within 10-14 days were analyzed in a WORC test-retest using the Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). WORC was compared to the short version of the Disabilities of Arm, Shoulder and Hand Questionnaire (QuickDash) and the Short Form-36 v. 2.0 (SF-36). RESULTS: High internal consistency of 0.94 was found using Cronbach's alpha coefficient. Reliability of the WORC resulted in ICC = 0.99, agreement assessed with SEM and MDC amounted to 1.62 and 4.48 respectively. The validity analysis of WORC showed strong correlations with QuickDash and SF-36 PCS (Physical Component Summary), while moderate with SF-36 MCS (Mental Component Summary). WORC had no floor or ceiling effect. CONCLUSIONS: The Polish version of the WORC is a reliable and valid tool with high internal consistency for assessing the quality of life in patients undergoing arthroscopic rotator cuff repair.

The Importance of the Double Product in the Six-Minute Walk Test to Predict Myocardial Function.

INTRODUCTION: The Six-Minute Walk Test (6MWT) is a widely used test to measure the physical performance of patients to assess the effectiveness of treatment, to qualify for rehabilitation, and to evaluate its effects.. AIM: This paper focuses on the assessment of the growth of a double product (DP) during the 6MWT and its diagnostic value in the assessment of patients with heart failure. MATERIAL AND METHODS: The paper has retrospective character. We analyzed medical records of 412 patients hospitalized for cardiac reasons, in whom a 6MWT was performed. The patients were divided into two groups: one with diagnosed heart failure and a control group. RESULTS: The patients with diagnosed heart failure, compared to the control group, were characterized by a shorter walking distance and greater DP increase at equal walking intervals. After distinguishing the group with the preserved and decreased left ventricle ejection fraction, the value of the DP increase was still higher compared to the control group. The mean DP increase corresponding to one meter of walk was the only one that correlated negatively with the left ventricular ejection fraction. CONCLUSION: The assessment of the increase of the DP during the march test seems to be a better parameter reflecting the efficiency of the myocardium from the distance of the march.

Polish Cross-Cultural Adaptation and Validation of the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) in Patients Undergoing Total Knee Arthroplasty.

BACKGROUND The Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) is a self-reported questionnaire used for the evaluation of the overall health of patients with knee dysfunctions. The purpose of this study was to perform a cross-cultural adaptation of the Polish version of KOS-ADLS and to evaluate its psychometric properties in patients at the end-stage of knee osteoarthritis who were qualified for a total knee replacement (TKR). MATERIAL AND METHODS Seventy patients consecutively qualified for surgical TKR procedure participated in this study. To adapt the KOS-ADLS, the following scales and reference tests were used: Knee injury and Osteoarthritis Outcome Score (KOOS), Visual Analogue Scale (VAS), Time Up and Go test (TUG), and Five Times Sit to Stand test (5×STS). The studies were conducted 3 times: 2 weeks before surgery (first study), 6 to 13 days later (retest), and 6 months after surgery. RESULTS The Polish version of KOS-ADLS showed excellent reliability (ICC=0.89 SEM=2.68, MDC=7.43) and high responsiveness (ES=4.76, SRM=3.18). The internal consistency was poor in the first assessment (Cronbach's alpha=0.68), but acceptable in the post-surgery evaluation (Cronbach's alpha=0.86). There were fair and moderate correlations found between KOS-ADLS and VAS scales in the first examination, TUG, and 5×STS. Stronger correlations were observed between the results obtained in KOS-ADLS and KOOS. CONCLUSIONS The Polish version of the KOS-ADLS demonstrated good reliability, validity, and responsiveness for use in patients who have undergone TKR surgery.

The Assessment of Static Balance in Patients after Total Hip Replacement in the Period of 2-3 Years after Surgery.

INTRODUCTION: The aim of this study was to assess static balance of patients after Total Hip Replacement (THR) compared with the age-matched, asymptomatic control group, considering the subject's gender and the time since the surgery. MATERIALS AND METHODS: The Total Hip Replacement (THR) group consisted of 55 subjects (mean age: 56.3 ± 8.7 years) and the control group consisted of 48 subjects (mean age: 58 ± 6.2 years). For the assessment of static balance, a stabilometric force platform was used. All subjects performed two 30-second trials in the double-leg stance position with eyes opened and closed. In the study group, the stabilometric assessment was performed once within the period of 24 to 36 months after the surgery. RESULTS: Subjects from the study group had significantly increased mediolateral COP velocity in the test with eyes opened, as well as the values of most of the COP parameters (excluding COP path area) in the test with eyes closed, compared to the control group. Higher values of the selected COP parameters were observed in the male subjects from the study group. CONCLUSION: In contrast to a number of papers, our study revealed some deficits in static balance in patients after THR up to 2-3 years after surgery.

[Factors affecting the maintenance of occupational activity over a 2-3-year period after total hip replacement]. / Czynniki wplywajace na utrzymanie aktywnosci zawodowej w okresie 2­3 lat po zabiegu calkowitej endoprotezoplastyki stawu biodrowego.

BACKGROUND: The purpose of this paper was to assess the occupational activity in patients after hip replacement over a 2-3-year post operational period and to analyze the effect of selected factors (age, gender, body mass index (BMI), functional state and self-assessed health status) on this activity. MATERIAL AND METHODS: In the research 107 people (56 women and 51 men) participated. The average age of the subject's was 55.1 years. A standardized author's survey questionnaire, including questions about personal and clinical data, occupational activity and self-assessment of health status, was applied. The body mass and height were measured and the BMI index was calculated. The 100 points Harris Hip Score (HHS) was used to assess the functional state in the respondents. RESULTS: After the operation about 60% of the patients were not occupationally active; 44 (41.1%) respondents received the state health benefit, 18 (16,8%) respondents were eligible for pension benefit, and 2 (1.9%) respondents were unemployed with benefit. No one unemployed before the operation undertook work afterwards. Neither gender nor the character of the job or BMI exerted statistically significant effect on the occupational activity after the operation. Significant differences were noted in undertaking the occupational activity after the operation in patients with different level of functional efficiency assessed with the use of HHS (p = 0.0350) and different level of self-assessed health statuse (p = 0.0057). CONCLUSIONS: More than half of the respondents have not returned to work after total hip replacement, while people doing intellectual work most frequently returned to occupation after surgery. Age, functional efficiency, and self-assessed health status of the patient had a significant influence on their return to work. Med Pr 2018;69(2):191-198.

Comparison of the Effectiveness of Shockwave Therapy with Selected Physical Therapy Procedures in Patients with Tennis Elbow Syndrome.

Wstep. Lokiec tenisisty jest to zespól bólowy tkanek miekkich okolicy nadklykcia bocznego kosci ramiennej. Celem pracy bylo porównanie skutecznosci terapii radialna fala uderzeniowa (RSWT) z zabiegami laseroterapii i ultradzwieków w badanej grupie. Material i metody. Badania przeprowadzono na grupie 77 pacjentów, których poddano terapii radialna fala uderze-niowa (RSWT; grupa pierwsza - 40 osób) vs laser i ultradzwieki (grupa druga - 37 osób). Do pomiaru efektów terapii wy-ko--rzystano testy funkcjonal-ne Milla i Thomsona, kwestionariusz EQ-5D-5L do ogólnej oceny stanu zdrowia oraz specy-ficz-ny kwestiona-riusz Patient - Rated Tennis Elbow Ewaluation (PRTEE) oceny funkcjonalnej pacjentów z "lokciem tenisisty'. Wyniki. Zarówno w pomiarze testem Thomsona i Milla odnotowano istotna statystycznie poprawe wyników w oby-dwu gru-pach. Efekty leczenia istotnie statystycznie róznily sie pomiedzy grupami w pomiarze testem Milla (p=0,006). Efekty terapii mie-rzone w skali PRTEE istotnie statystycznie róznily sie w dwóch badanych grupach w kazdej z kategorii (p<0,001) na korzysc grupy leczonej RSWT. W skali EQ-5D-5L wieksza statystycznie poprawe zaobserwowano w grupie leczonej RSWT jedynie w kategorii samoobslugi (p=0,024). Wnioski. 1. Zarówno leczenie z zastosowaniem laseroterapii i ultradzwieków jak i radialnej fali uderzeniowej istotnie wplywaja na zmniejszenie dolegliwosci bólowych, a tym samym na poprawe funkcji konczyny górnej oraz jakosci zycia osób z zespolem lokcia tenisisty. 2. Wykazano wieksza krótkotrwala skutecznosc terapii z zastosowaniem radialnej fali uderzeniowej w porównaniu do laseroterapii i ultradzwieków w eliminowaniu bólu oraz poprawie funkcji konczyny górnej. 3. Fala uderzeniowa wydaje sie byc skuteczna terapia dla pacjentów z zespolem lokcia tenisisty, niemniej nalezy prowadzic dalsze badania dotyczace dlugotrwalych efektów prezentowanej metody leczenia.