Reliability and validity of the Greek adaptation of the Modified Barthel Index in neurorehabilitation patients.

BACKGROUND: The Modified Barthel Index (MBI) (Shah version) is a widely used functional assessment measure with greater sensitivity and improved reliability compared to the original Barthel Index. AIM: The aim of this study was to adapt the MBI for use in Greece and measure its reliability and validity on a Greek neuro-rehabilitation population. DESIGN: Observational study. SETTING: KAT Hospital Rehabilitation Clinic and National Rehabilitation Centre in Athens, Greece. POPULATION: A total of 100 rehabilitation inpatients and outpatients consisting of 50 stroke and 50 spinal cord injury (SCI) patients were evaluated. METHODS: The MBI underwent the proper translation and cultural adaptation procedure as required by the World Health Organization and was administered to 100 rehabilitation patients. For criterion validity evaluation all patients were also assessed with the Katz Index of Independence in Activities of Daily Living (Katz Index) and the 36-Item Short Form Survey (SF-36) physical functioning subscale, both questionnaires having been validated for use in Greece. RESULTS: The unidimensionality solution was rejected and a two- factor solution was adopted based on exploratory and confirmatory factor analysis (Factor 1 - Transfers and Activities of Daily Living, Factor 2 - Mobility). Very high correlation was presented between the Katz Index score and the Greek MBI Factor 1 (r=0.888, P<0.001) and total score (r=0.873 P<0.001) respectively and high with MBI Factor 2 (r=0.561, P<0.001). High correlation was observed between the SF-36 physical functioning subscale score with MBI Factor 1 (r=0.522, P<0.001), MBI Factor 2 (r=0.590, P<0.001) and MBI Total score (r=0.580, P<0.001). The internal consistency of the MBI Factor 1, Factor 2 and Total score was 0.920, 0.860 and 0.923 respectively. Test-retest reliability was remarkably consistent (total score 0.994, P<0.001). CONCLUSIONS: The Greek version of the Modified Barthel Index has been found to exhibit satisfactory levels of reliability and validity. CLINICAL REHABILITATION IMPACT: The Greek MBI adaptation is an adequate and useful instrument for use on Greek neuro-rehabilitation patients.

Food for Special Medical Purposes and Nutraceuticals for Pain: A Narrative Review.

INTRODUCTION: The present paper focuses on the possible contribution of food compounds to alleviate symptomatic pains. Chronic pain can more easily be linked to anticipatory signals such as thirst and hunger than it is to sensory perceptions as its chronicity makes it fall under the behavioural category rather than it does senses. In fact, pain often negatively affects one's normal feeding behavioural patterns, both directly and indirectly, as it is associated with pain or because of its prostrating effects. NUTRITIONAL COMPOUNDS FOR PAIN: Several nutraceuticals and Foods for Special Medical Purposes (FSMPs) are reported to have significant pain relief efficacy with multiple antioxidant and anti-inflammatory properties. Apart from the aforementioned properties, amino acids, fatty acids, trace elements and vitamins may have a role in the modulation of pain signals to and within the nervous system. CONCLUSION: In our opinion, this review could be of great interest to clinicians, as it offers a complementary perspective in the management of pain. Trials with well-defined patient and symptoms selection and a robust pharmacological design are pivotal points to let these promising compounds become better accepted by the medical community.