Prevalence and risk factors of work-related musculoskeletal disorders among physical therapists in Ho Chi Minh City, Vietnam.

BACKGROUND: Understanding risk factors linked to work-related musculoskeletal disorders (WMSDs) is crucial for enhancing health promotion and ensuring workplace safety among healthcare professionals particularly physical therapists (PTs). However, in Vietnam, there has been lack of an investigation. Therefore, this study was to determine whether potential risk factors contributed to the occurrence of WMSDs among PTs in Ho Chi Minh City. METHOD: An online self-reported questionnaire for WMSDs comprising the Nordic Musculoskeletal Questionnaire (NMQ), Job-risk and Environmental factors, the Perceived Stress Scale (PSS-4) and the coping strategies, were distributed to PTs. They were enrolled if they had: age ≥ 22 years, graduated from PT program, a full-time job with ≥1 year of experience. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were determined using Logistic regression. RESULTS: Our study found that within the past 12 months, the prevalence of WMSDs was 76.4% (n = 204/267): neck 58.4% and lower back 57.3%. PTs aged 22-29 years, < 4 years of education, and < 7 years of working experience were more likely to have WMSDs 2-3 times than those who did not. After adjusting for age, education, and work experience, PTs who engaged in manual techniques/exercises, lifting/transferring patients, and maintaining awkward postures were 5-7 times more likely to have WMSDs in the neck and lower back than those who did not. Environmental and psychological factors, such as number of treatment tables, size of electrotherapy rooms, using PTs modalities, and stress were significantly associated with WMSDs. More than 50% of PTs used modified positions and new treatment/techniques that did not aggravate their symptoms, as coping strategies. CONCLUSIONS: This study indicates potential risk factors associated with WMSDs, affecting the neck and lower back among PTs in Vietnam. These risk factors should be addressed to improve overall PTs health, retain skilled workers, and encourage them to continue working.

Thai Preschoolers' movement behaviors outside kindergarten: prevalence of meeting individual and integrated movement guidelines.

BACKGROUND: This study aimed to investigate movement behaviors of Thai preschoolers (aged 3-6 years) occurring outside kindergarten in urban areas across Thailand. METHODS: Surveillance of digital Media in eArLy chiLdhood Questionnaire® was used to collect data from 1051 parents recruited from 12 schools. Descriptive statistics and logistic regressions were applied for data analysis. RESULTS: Thai preschoolers engaged in physical activity (PA), sedentary screen time, and sleep on weekends significantly more than weekdays with no significant sex differences. Preschoolers met the sleep guidelines the most (62.3%), followed by PA guidelines (48.0%), and screen time (ST) guidelines the least (44.1%). Only 14.6% met the integrated movement guidelines, and 11% met none of the guidelines. Age was positively associated with meeting the PA guidelines, and negatively associated with meeting the sleep and integrated movement guidelines. The number of digital devices at home and geographical region influenced preschoolers in meeting the PA and ST guidelines. CONCLUSIONS: Thai preschoolers' time spent on all forms of activities outside kindergarten was significantly more on weekends than weekdays with no sex disparity. The prevalence of meeting the integrated movement guidelines was low, and needs to be addressed through comprehensive programs including all forms of activities concurrently. IMPACT: Thai preschoolers engaged in physical activity (PA), screen time (ST), and sleep on weekends significantly more than weekdays with no significant sex differences. Only 14.6% of preschoolers met the integrated movement guidelines. Age had a significant relationship with meeting the PA, sleep, and integrated movement guidelines. Meeting the PA and ST guidelines in preschoolers was positively associated with the number of digital devices at home. Despite some limitations, this study presented preschoolers' time engaged in the three movement behaviors concurrently, and provided important inputs for development of the national strategic plan to promote PA among Thai children and youth.

Balance, strength and physical activity after ankle sprain: Comparison between children with chronic ankle instability and copers.

OBJECTIVE: The aim of this study was to compare muscle strength, balance, and physical activity between children with chronic ankle instability and copers. DESIGN: Cross-sectional study. SETTING: Pediatric Physical Therapy laboratory. PARTICIPANTS: Children aged between 7 and 12 years old from regular schools who had a history of unilateral ankle sprain. MAIN OUTCOME MEASURES: Lower extremity strength, Static and dynamic standing balance, and Level of physical activity. RESULTS: Fifteen children with chronic ankle instability and 15 copers were recruited. Demographic data showed no differences between group except for sex and the Cumberland Ankle Instability Tool-Youth (CAITY) score. Children with CAI had a significantly lower score during the standing long jump test (p < 0.05), poorer performance of single leg stance test (p < 0.001) and Y-Balance test in the anterior, posteromedial, and posterolateral directions (p < 0.05) when compared to copers. Total METs per week was significantly higher in the copers (p < 0.05). CONCLUSION: Children with chronic ankle instability exhibited weaker lower limb strength, poorer static and dynamic standing balance, and participate in less physical activity compared to those in a coper group which may have future negative health consequences. Knowledge about the differences between the two groups may provide guidance for physical educators and physical therapists. (200 words).

Translation and Cross-Cultural Adaptation of Nepali Version of the Montreal Cognitive Assessment.

BACKGROUND: Montreal Cognitive Assessment is widely used in stroke to detect cognitive impairment. The superiority of it over other outcome measures has been well established. It has been cross-culturally translated and has shown excellent psychometric properties. To assess the intervention effect on cognition of Nepalese individuals with stroke using the Montreal Cognitive Assessment, an adapted Nepali version is required as the Nepalese cultural context and language are completely different than the original was developed. Thus, the objective of this study is to translate and cross-culturally adapt Montreal Cognitive Assessment in the Nepali language and see its test-retest reliability and internal consistency. METHODS: After translating and cross-culturally adapting the Montreal Cognitive Assessment into Nepali using Beaton guidelines. Its Nepali version was administered to 28 individuals with stroke twice keeping the interval of two weeks. Test-retest reliability and internal consistency were assessed using the Intraclass correlation coefficient and Cronbach's alpha. RESULTS: The Montreal Cognitive Assessment was translated into Nepali with significant cultural adaptations and the Nepali version demonstrated excellent psychometric properties as hypothesized. The test-retest reliability and internal Consistency were excellent. The Intraclass correlation coefficient of the total score was 0.990 and Cronbach's alpha value was 0.994 for total scores. CONCLUSIONS: The Nepali version of Montreal Cognitive Assessment is reliable to use as a diagnostic tool for detecting cognitive impairment in patients with stroke. It is comprehensive, easy to administer and culturally appropriate.

Factors associated with reduced risk of musculoskeletal disorders among office workers: a cross-sectional study 2017 to 2020.

BACKGROUND: Prolonged sitting at work should be avoided to reduce the risks of either noncommunicable diseases (NCDs) or musculoskeletal disorders (MSDs) among office workers. A short duration of breaks in sitting every hour can reduce cardiometabolic risk factors contributing to NCDs. However, the recommendation for a break from sitting at work to reduce the risks of MSDs has not been identified. Therefore, this study aimed to determine whether breaking by changing position at work, physical activity, physical fitness, stress and sleep were associated with MSDs among office workers. METHODS: A cross-sectional study was conducted from 2017 to 2020. Participants aged 20-59 years and using a computer at work ≥ 4 days/week were recruited. Data were collected using an online self-reporting questionnaire for computer users and 5 domains of physical fitness tests. Odds ratio (OR) with 95% confidence interval (CI) and multivariate logistic regression were used for statistical analysis. RESULTS: Prevalence of MSDs was 37.9% (n = 207/545) and the most area of complaint were the neck, shoulders and back. A nonsignificant association between physical fitness and MSDs among office workers was obtained. After adjusting for age, sex, body mass index, and comorbidity, moderate-to-vigorous intensity physical activity (MVPA) ≥ 150 min/week and sitting at work ≥ 4 h/day were MSDs risk factors (OR = 1.57, 95%CI = 1.04-2.37). Frequently changing positions from sitting to standing or walking at work every hour could reduce the risks of MSDs by more than 30%. The risks of MSDs increased among office workers who commuted by staff shuttle bus and personal car and had high to severe stress and slept < 6 h/day (1.6 to 2.4 times). CONCLUSION: Our findings indicated MVPA and prolonged sitting were MSD risk factors. We recommend office workers change position from sitting to standing or walking during work every hour and sleep ≥ 6 h/day to reduce risks of MSDs.

Functional outcome following inpatient rehabilitation among individuals with complete spinal cord injury in Nepal.

STUDY DESIGN: Descriptive study. OBJECTIVES: To describe functional outcomes using Spinal Cord Independence Measure III (SCIM III) following inpatient rehabilitation among individuals with complete spinal cord injury (SCI) in the low-income setting of Nepal; to evaluate functional changes from rehabilitation admission to discharge and to compare functional outcomes between neurological levels of injury (NLI) at discharge. SETTING: Spinal Injury Rehabilitation Centre (SIRC), Kavrepalanchowk, Nepal. METHODS: We present data of all individuals with complete SCI who completed rehabilitation at SIRC in 2017. Data collected included: demographics, aetiology, neurological assessment, admission/discharge SCIM III scores, and length of stay. Data were analyzed using descriptive statistics. Pre/post-SCIM III scores were analyzed using Related-Samples Wilcoxon signed-rank test. Comparative analysis between NLIs was done using the Kruskal Wallis ANOVA test followed by pairwise Mann-Whitney U tests. RESULTS: Ninety-six individuals were included. Mean (SD) age was 33.5 (14.2) years, with a male/female ratio of 3.4:1. Median admission and discharge total SCIM III scores for cervical, thoracic and lumbosacral levels were 10 and 21, 16 and 61, and 41 and 79.5, respectively. Median total SCIM III score change between admission and discharge were 11 (p = 0.003), 43 (p < 0.001) and 40 (p = 0.068) for cervical, thoracic and lumbar groups, respectively. CONCLUSIONS: This study is the first of its kind to describe functional outcomes among individuals with complete SCI in the low-income setting of Nepal. All SCI groups showed a positive trend in SCIM III from admission to discharge, with improvements reaching statistical significance among groups with cervical and thoracic NLIs.

The Effects of Ramp Gradients and Pushing-Pulling Techniques on Lumbar Spinal Load in Healthy Workers.

BACKGROUND: Many tasks in industrial and health care setting are involved with pushing and pulling tasks up or down on a ramp. An efficient method of moving cart which reduces the risk of low back pain should be concerned. This study aimed to investigate the effects of handling types (HTs) and slope on lumbar spinal load during moving a cart on a ramp. We conducted a 2 × 2 × 4 factorial design with three main factors: 2 HTs, 2 handling directions of moving a cart and 4 degrees of ramp slope. METHODS: Thirty healthy male workers performed 14 tasks consist of moving a cart up and down on the ramp of 0°, 10°, 15°, and 20° degrees with pushing and pulling methods. Joint angles from a 3D motion capture system combined with subject height, body weight, and hand forces were used to calculate the spinal load by the 3DSSPP program. RESULTS: Our results showed significant effect of HT, handling directions and slope on compression and shear force of the lumbar spine (p < 0.001). When the ramp gradient increased, the L4/5 compression forces increased in both pushing and pulling (p < 0.001) Shear forces increased in pulling and decreased in pushing in all tasks. At high slopes, pulling generated more compression and shear forces than that of pushing (p < 0.01). CONCLUSION: Using the appropriate technique of moving a cart on the ramp can reduce the risk of high spinal load, and the pushing is therefore recommended for moving a cart up/down on ramp gradients.

Cross-cultural adaptation of the Cumberland Ankle Instability Tool - Youth Thai version.

BACKGROUND: This study aimed to translate the original version of the Cumberland Ankle Instability Tool (CAITY) into a Thai version by using cross-cultural adaptation, and to examine the psychometric properties and cut-off score of the CAITY - Thai version (CAITY-T). METHODS: Six cross-cultural adaptation steps were used to translate and validate the psychometric properties with 267 participants, 140 with chronic ankle instability (CAI) and 127 without CAI. Their mean age was 12.3 ± 2.42 years. Validation was carried out for internal consistency and concurrent validity against a visual analog scale for global perceived ankle instability, and for discriminant validity (receiver operating characteristic curve). The CAITY-T was completed twice by 133 volunteer children (49.62%) for test-retest reliability. The cut-off score was determined using Youden's index. RESULTS: The CAITY was successfully adapted for the Thai language. Validation showed good internal consistency (Cronbach's α = 0.767) and concurrent validity (Pearson correlation coefficient = 0.8 right ankle and 0.784 left ankle). The test-retest reliability was substantial with an intraclass correlation coefficient (2,1) of 0.865 (95% Confidence Interval = 0.809-0.904). The receiver operating characteristic curve and Youden's index showed the cut-off score that discriminated between children with and without CAI on the CAITY-T at ≤25. The CAITY-T obtained 95.2% sensitivity, 97% specificity, 0.05 negative, and 32 positive likelihood ratios. CONCLUSION: The CAITY-T was valid and available for Thai children aged 8-16 years. It displayed positive reliability, good validity, and an acceptable cut-off score. The cut-off score for children had high sensitivity, specificity, and positive and negative likelihood ratios.

A structural equation model of falls at home in individuals with chronic stroke, based on the international classification of function, disability, and health.

PURPOSE: To use structural equation model (SEM) to explain falls at home in individuals with chronic stroke, based on the International Classification of Functioning, Disability and Health (ICF). MATERIALS AND METHODS: A cross sectional observation study was conducted in home-dwelling individuals with chronic stroke (N = 236; 148 non-fallers, 88 fallers). Participants were assessed; structural impairments using Modified Ashworth Scale, Fugl-Meyer Assessment upper (FMA-UE), lower (FMA-LE), and sensory function, ankle plantarflexor strength; activity limitations using Timed Up and Go Test, Step Test, Berg Balance Scale, Barthel Index (BI); participation restrictions using Stroke Impact Scale-participation (SIS-P); and contextual factors using home hazard environments, home safety surroundings, risk behaviors, and Fall-related Self Efficacy. The measurement model was analyzed by confirmatory factor analysis. The SEM was conducted to analyze a structural model of falls at home. RESULTS: FMA-UE was significantly (p<0.01) associated with FMA-LE, combining as one variable in the structural impairments. In the measurement model, variables were fit to their domains, except variables of contextual factors, but the ICF domains did not correspond to disability. A structural model of falls at home demonstrated a significant (p<0.01) direct path of contextual factors and activity limitations with falls at home. The structural impairments showed a significant (p<0.01) direct path with activity limitations. All variables, except BI, SIS-P and risk behaviors, related to their domains in the structural model. CONCLUSIONS: A structural model of falls at home proposes contextual factors being the strongest association with falls at home that home hazard environments seem the most influence in its domain. The activity limitations presented by balance ability are directed to falls at home. The structural impairments are associated with falls at home through activity limitations. Home assessment to decrease home hazard environments is suggested to prevent falls at home for individuals with chronic stroke.

Standardised criteria for classifying the International Classification of Activities for Time-use Statistics (ICATUS) activity groups into sleep, sedentary behaviour, and physical activity.

BACKGROUND: Globally, the International Classification of Activities for Time-Use Statistics (ICATUS) is one of the most widely used time-use classifications to identify time spent in various activities. Comprehensive 24-h activities that can be extracted from ICATUS provide possible implications for the use of time-use data in relation to activity-health associations; however, these activities are not classified in a way that makes such analysis feasible. This study, therefore, aimed to develop criteria for classifying ICATUS activities into sleep, sedentary behaviour (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), based on expert assessment. METHOD: We classified activities from the Trial ICATUS 2005 and final ICATUS 2016. One author assigned METs and codes for wakefulness status and posture, to all subclass activities in the Trial ICATUS 2005. Once coded, one author matched the most detailed level of activities from the ICATUS 2016 with the corresponding activities in the Trial ICATUS 2005, where applicable. The assessment and harmonisation of each ICATUS activity were reviewed independently and anonymously by four experts, as part of a Delphi process. Given a large number of ICATUS activities, four separate Delphi panels were formed for this purpose. A series of Delphi survey rounds were repeated until a consensus among all experts was reached. RESULTS: Consensus about harmonisation and classification of ICATUS activities was reached by the third round of the Delphi survey in all four panels. A total of 542 activities were classified into sleep, SB, LPA, and MVPA categories. Of these, 390 activities were from the Trial ICATUS 2005 and 152 activities were from the final ICATUS 2016. The majority of ICATUS 2016 activities were harmonised into the ICATUS activity groups (n = 143). CONCLUSIONS: Based on expert consensus, we developed a classification system that enables ICATUS-based time-use data to be classified into sleep, SB, LPA, and MVPA categories. Adoption and consistent use of this classification system will facilitate standardisation of time-use data processing for the purpose of sleep, SB and physical activity research, and improve between-study comparability. Future studies should test the applicability of the classification system by applying it to empirical data.

Parental misperception of child's weight and related factors within family norms.

PURPOSE: Parental perception of their child's weight may be a crucial factor in parental ability for action with regard to their child's weight problem. This aim of this study was to investigate parental perception of their child's weight status and dietary healthiness, amount of food consumed and physical activity level and its related factors. METHODS: A cross-sectional survey was conducted among children (Grades 4-6) selected by cluster sampling in two schools. Children were invited to participate in the measurements of anthropometry and their parents were asked to classify their child's weight and health behaviors. RESULTS: In total, 41.8% of parents misperceived their child's weight, of which 82% underestimated their child's weight, in particular regarding overweight or obesity. As parents of overweight or obese children underestimated their child's weight, around 65% were not concerned with their child's current weight and about becoming overweight in the future. Factor associated with underestimation of overweight children was not having a sibling, while among children with normal weight, the underestimation was associated with boys, lower body mass index (BMI), maternal employment and low household income. Furthermore, parents underestimating their child's weight were more likely to be optimistic about their child's dietary healthiness, food amount taken, and physical activity level than those with correct child's weight estimates. CONCLUSIONS: Findings show a high proportion of parental misperception of their child's weight status. Family-based weight control interventions will need to incorporate parental misperceptions of the body weight and health behaviors of their children.

Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial.

BACKGROUND: Physical exercise (PE), virtual reality-based exercise (VRE), and brain exercise (BE) can influence physical and cognitive conditions in older persons. However, it is not known which of the three types of exercises provide the best effects on physical and cognitive status, and which exercise is preferred by older persons. This study compared the effects of PE, VRE, and BE on balance, muscle strength, cognition, and fall concern. In addition, exercise effort perception and contentment in older persons was evaluated. METHODS: Eighty-four older persons (n = 84) were randomly selected for PE, VRE, BE, and control groups. The exercise groups received 8-week training, whereas the control group did not. Balance was assessed by Berg Balance Scale (BBS) and Timed Up and Go test (TUG), muscle strength by 5 Times Sit to Stand (5TSTS) and left and right hand grip strength (HGS), cognition by Montreal Cognitive Assessment (MoCA) and Timed Up and Go test Cognition (TUG-cog), fall concern by Fall Efficacy Scale International (FES-I), exercise effort perception by Borg category ratio scale (Borg CR-10), and exercise contentment by a questionnaire. RESULTS: After exercise, PE significantly enhanced TUG and 5TSTS to a greater extent than VRE (TUG; p = 0.004, 5TSTS; p = 0.027) and BE (TUG; p = 0,012, 5TSTS; p < 0.001). VRE significantly improved MoCA (p < 0.001) and FES-I (p = 0.036) compared to PE, and 5TSTS (p < 0.001) and FES-I (p = 0.011) were improved relative to BE. MoCA was significantly enhanced by BE compared to PE (p < 0.001) and both MoCA and TUG-cog were improved compared to VRE (p = 0.04). PE and VRE significantly (p < 0.001) increased Borg CR-10 in all exercise sessions, whereas BE showed a significant improvement (p < 0.001) in the first 4 sessions. Participants had a significantly greater satisfaction with BE than controls (p = 0.006), and enjoyed VRE and BE more than PE (p < 0.001). Subjects in all exercise groups exhibited benefits compared to the control group (p < 0.001). CONCLUSIONS: PE provided the best results in physical tests, VRE produced measurable improvements in physical and cognition scores, while BE enhanced cognition ability in older persons. Older persons preferred VRE and BE compared to PE. Both exercises are suggested to older persons to improve physical and cognitive conditions.

Enhanced Upper Extremity Functions with a Single Session of Action-Observation-Execution and Accelerated Skill Acquisition Program in Subacute Stroke.

BACKGROUND: Action-observation-execution (AOE) primes physical training. We examined the immediate effect of AOE with accelerated skill acquisition program (ASAP) on dexterity in subacute stroke. METHODS: Twelve individuals from 1 to 6 months after stroke were allocated into two groups by matching age and side of stroke. After AOE of 30 minutes, the experimental group received ASAP for 60 minutes whereas the control group received dose-equivalent usual care. The movement time (MT) and functional ability (FA) of hand items of the Wolf motor function test (WMFT), hand functions and global recovery of stroke impact scale (SIS), and intrinsic motivation items of stroke rehabilitation motivation scale were assessed at baseline, after training, and during one-week follow-up. Data were analyzed within and between the groups. RESULTS: AOE significantly decreased MT of flipping cards of WMFT and hand functions of SIS. Total MT was markedly reduced. AOE with ASAP demonstrated significant group-by-time interactions on MT of lifting pencil of WMFT, total MT, and global recovery. Grip strength, FA, and hand functions were significantly improved only in the experimental group. Both groups improved motivation significantly. CONCLUSIONS: The AOE with ASAP enhanced dexterity, which persisted for at least a week. This intervention might improve dexterity in subacute stroke. TRIAL REGISTRATION NUMBER: This trial is registered with TCTR20161007001.

The Persisted Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation to Augment Task-Specific Induced Hand Recovery Following Subacute Stroke: Extended Study.

OBJECTIVE: To examine the long-term effects of the low-frequency repetitive transcranial magnetic stimulation (LFrTMS) combined with task-specific training on paretic hand function following subacute stroke. METHODS: Sixteen participants were randomly selected and grouped into two: the experimental group (real LFrTMS) and the control group (sham LF-rTMS). All the 16 participants were then taken through a 1-hour taskspecific training of the paretic hand. The corticospinal excitability (motor evoke potential [MEP] amplitude) of the non-lesioned hemisphere, and the paretic hand performance (Wolf Motor Function Test total movement time [WMFT-TMT]) were evaluated at baseline, after the LF-rTMS, immediately after task-specific training, 1 and 2 weeks after the training. RESULTS: Groups comparisons showed a significant difference in the MEP after LF-rTMS and after the training. Compared to the baseline, the MEP of the experimental group significantly decreased after LF-rTMS and after the training and that effect was maintained for 2 weeks. Group comparisons showed significant difference in WMFT-TMT after the training. Only in the experimental group, the WMFT-TMT of the can lifting item significantly reduced compared to the baseline and the effect was sustained for 2 weeks. CONCLUSION: The results of this study established that the improvement in paretic hand after task-specific training was enhanced by LF-rTMS and it persisted for at least 2 weeks.

Break in Sedentary Behavior Reduces the Risk of Noncommunicable Diseases and Cardiometabolic Risk Factors among Workers in a Petroleum Company.

Although prolonged sitting appears as a novel risk factor related to health outcomes for all ages, its association needs to be replicated in occupational conditions. This study explored the associations between sedentary behavior and four noncommunicable diseases (NCDs) as well as two cardiometabolic risk factors (CMRFs) among workers in a petroleum company, Thailand. All workers were invited to complete the online self-report questionnaire. Sedentary behavior was measured as the amount of time sitting at work, during recreation, and while commuting. Out of 3365 workers contacted, 1133 (34%) participated. Prevalence of NCDs and CMRFs was 36% and was positively associated with sedentary behavior. After adjusting for age, BMI, and exercise, the risk of NCDs and CMRFs for sedentary office work was 40% greater compared with more active field work. Those who took a break without sitting more than twice a day and commuted by walking or cycling had less risk of NCDs and CMRFs. The total duration of sedentary behavior was 10 h/day, and two-thirds of that total was workplace sitting. This was significantly associated with NCDs and CMRFs (p < 0.001). Day-and-night rotating shiftwork was negatively associated with NCDs and CMRFs (p < 0.001). Sedentary behavior should be considered a health risk among workers. Hence, to promote a healthy lifestyle and safe workplace, organizations should encourage standing activities during break and physically active commutes, and have workers avoid prolonged sitting.

PHYSICAL ACTIVITY, SELF-ESTEEM, AND QUALITY OF LIFE AMONG PEOPLE WITH PHYSICAL DISABILITY.

Physical activity (PA) can improve health and quality of life (QOL) of healthy people. However, the association between PA and QOL among people with physical disability (PWPD) is inconclusive. This study was conducted to determine the relationships between factors including intensity of PA, activitiy in daily living (ADL), stress, and self-esteem that influences self-reported QOL among PWPD. The relationships were further explored using the in-depth interview method to find out whether the intensity of PA, stress, and self-esteem are related to QOL perception in PWPD. One hundred sixty PWPD aged 18-48 years who studied at a vocational school were enrolled. A mixed method case study was conducted: cross-sectional survey and in-depth interview. Five questionnaires, including the Barthel Index, Perceived Stress Scale (PSS), Rosenberg Self-Esteem Scale (RSES), and Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) were distributed. QOL was measured using the WHOQOL_BREF. Multiple linear regression was used to determine factors for QOL prediction. For in-depth interview, ten persons from each group (poor-to-fair and good QOL) volunteered to explore further about life satisfaction related to physical disability. One hundred forty-six (91%) subjects completed all questionnaires. One hundred fourteen (77%) reported poor-to-fair QOL. QOL was explained by self-esteem and ADL (adjusted R² 34.7%, p < 0.001) after adjusted for age, stress, and PA. Although PA could not explain QOL in PWPD, good QOL reported high activities (28.40 ± 30.20 MET hour/day) compared to poor and fair QOL (17.94 ± 22.06 and 21.70 ± 17.75 MET hour/day). Those who had good QOL reported that they were proud to be independent and did not feel inferior. PA participation among people with disabilities should therefore be encouraged.

Correlation between Weight Transfer on Paretic Limb While Standing in Three Directions and Fugl-Meyer Assessment for Lower Extremities in Individuals with Stroke.

OBJECTIVE: To determine the correlation between percent weight transfer on paretic limb while standing and the Fugl-Meyer lower extremity motor assessment scale (FMA_LE) in individuals after stroke. MATERIAL AND METHOD: Individuals after stroke who had limited community ambulation and walking speed less than 0.8 m/s were included in the study. Lower extremity motor control was measured in all participants by the FMA _LE and weight transfer onparetic limb while standing on bathroom scales in three directions (lateral,forward and backward). The percent weight transfer on the paretic limb (%WTpar) was the maximum of weight transfer in each direction divided by total body weight. Pearson's correlation coefficient was usedfor statistical analysis. RESULTS: Forty-four individuals after stroke aged 61.27 +/- 12.09 years volunteered to participate in the present study. Their walking speed and FMA LE were 0.37 +/- 0.21 m/s and 18.95+4.11 scores. The %WTpar scores while standing in each direction were 64.15 +/- 13.30% for lateral, 58.20 +/- 13.35% for forward and 61.10 +/- 10.52% for backward. A significant correlation was found between %WTpar in backward direction and FMA LE (r = 0.38, p = 0.001). CONCLUSION: The weight transfer on the paretic leg in backward direction could be used as a clinical assessment tool to identify lower extremity performance in individuals after stroke. To minimize the gap of the ordinal scale in FMA_LE, assessment with metric units should be added. Weight transfer assessment while standing on bathroom scales in different directions provided continuous data and should be added to determine lower extremity motor assessment in individuals after stroke.

Cross-Cultural Adaptation of the Compendium of Physical Activity: Thai Translation and Content Validity.

OBJECTIVE: To translate the compendium physical activity (compendium) proposed by Ainsworth to Thai and to validate the Thai translated version. MATERIAL AND METHOD: Five steps of cross-cultural adaption were conducted as follows: (1) forward translation, (2) group review, (3) backward translation, (4) group review and final decision and (5) a pilot study. Eight hundred and twenty-one activities ofthe compendium were translated to Thai by two independents translators. Thai translated version was considered by 23 persons who have studied physical activity for at leastfive years. Backward translation was carried out by two bilingual translators. The research team completed the final Thai translation by comparing original and translated versions. For pilot study the Thai translated version was validated by 22 allied health persons. Data was analyzed by multi-rater agreement (Fleiss's kappa) and qualitative analysis. RESULTS: For translations and group review, recommendations included; (a) changing to lay language with the same meaning, (b) converting the U.S. customary unit to the metric unit, and (c) using consistent language. More than 80% of 22 persons accepted the Thai translation and the Kappa agreement rangedfrom 0.187 to 0.694. Some activities demonstratedpoor multi-rater agreement and required additional definitions. CONCLUSION: Thai translated compendium physical activity was constructed to reduce the language barrier and promote physical activity in Thailand. The poor to moderate agreement of each major heading of translation may partly be due to Western culture. Many activities in the compendium were assembled but they were not recognized by Thais. Hence, Thai compendium physical activity should to be developed in afuture study.

Walking and stair climbing abilities in individuals after chronic stroke with and without mental health problem.

OBJECTIVE: To compare muscle strength, balance, walking and stair climbing abilities among individuals after chronic stroke with or without mental health problems; to describe their physiological response after stress stimulation. MATERIAL AND METHOD: Subjects who had their first stroke more than one year ago were classified for mental health problems according to the Depression Anxiety Stress Scale-21. Lower extremity muscle strength of the quadriceps and plantar flexors, was measured by dynamometer Balance and walking performance was measured by the Berg Balance Scale (BBS), 10-m walk test and timing of stair climbing. Community participation and spiritual well-being were measured. The physiological response of stress stimulation was assessed by the long stress test protocol of the biofeedback device. RESULTS: Forty-five subjects with chronic stroke aged 40-80 years were grouped by with (n = 25) and without mental health problems (n = 20). Significant differences were found in quadriceps muscle strength, BBS, walking and stair climbing speed, community participation and spiritual well-being between two groups. In the stress stimulus phase, the electromyography and heart rate variability demonstrated significant difference between those with and without stress. CONCLUSION: Individuals with chronic stroke with mental health problems demonstrated decreased quadriceps muscle strength, balance and locomotor performances.

Fall prediction in thai elderly with timed up and go and tandem walk test: a cross-sectional study.

OBJECTIVE: To examine the timed up and go (TUG) and tandem walk test (TWT) as fall prediction assessments in Thai elderly. MATERIAL AND METHOD: Elderly subjects aged between 60 and 86 years and living in Nakhonpathom and Samutsakhon provinces were classified as fallers and non-fallers by self-report in the past six months. The TUG and TWT were used to predict falls. The optimal cutoff score and validity indexes were determined by plotting the receiver operating characteristic (ROC) curve and crosstabs analysis. RESULTS: One hundred and sixty-one elderly subjects were classified as fallers (7 males and 43 females) and non-fallers (24 males and 87 females). The area under the curve (AUC) of ROC were 0.62 (95% CI = 0.59, 0.76; p = 0.0001) for TUG and 0.605 (95% CI = 0.514, 0.696; p = 0.033) for TWT error score. The cutoff scores were 10.5 seconds for TUG (74% sensitivity and 57.7% specificity) and five scores for TWT error (62% sensitivity and 55% specificity). CONCLUSION: TUG and TWT error were useful tools to explain faller status in Thai community-dwelling for theelderly. TWT time was not sensitive enough to detect the elders who were at risk of falls.