Estimation of diaphragm depth based on waist circumference in the Thai population.

INTRODUCTION/AIMS: There is a potential risk of causing a pneumothorax during needle electromyography of the diaphragm. The diaphragm depth can be estimated from body mass index (BMI), but this may not be practical in bedbound patients. The objectives of this study were to formulate correlation equations to estimate diaphragm depth based on waist circumference (WC) and determine their validity. METHODS: Personal data, weight, height, and WC were collected from healthy volunteers, and the diaphragm depth from the skin and diaphragm thickness of the participants were measured by ultrasonography. These data were used to formulate the equations for estimation of diaphragm depth based on WC, and the equations were validated by comparing the estimated diaphragm depths between BMI-based equations and WC-based equations. RESULTS: A total of 100 volunteers (48 men and 52 women) were recruited. The median age of the participants was 27 y (interquartile range, 26). The mean WC was 83.3 cm (SD, 7.8 cm). The diaphragm depth ranged between 1.0 and 2.7 cm. Equations for estimation of the diaphragm depth were created for each hemidiaphragm using data from 80 participants: left hemidiaphragm depth = (0.03 × WC) - 0.89 (r2  = 0.56); right hemidiaphragm depth = (0.03 × WC) - 0.94 (r2  = 0.55) with 10%-20% errors in 20 tested participants. The estimated diaphragm depths calculated from BMI and WC were comparable. DISCUSSION: The WC-based equation can be used in addition to palpation techniques for guiding needle EMG insertion when ultrasound guidance is not available.

Investigating psychometric properties of the arm activity measure - Thai version (ArmA-TH) sub-scales using the Rasch model.

BACKGROUND: This study investigated the ArmA-TH sub-scale measurement properties based on item response theory using the Rasch model. METHODS: Patients with upper limb hemiplegia resulting from cerebrovascular and other brain disorders were asked to complete the ArmA-TH questionnaire. Rasch analysis was performed to test how well the ArmA-TH passive and active function sub-scales fit the Rasch model by investigating unidimensionality, response category functioning, reliability of person and item, and differential item functioning (DIF) for age, sex, and education. RESULTS: Participants had stroke or other acquired brain injury (n = 185), and the majority were men (126, 68.1 %), with a mean age of 55 (SD 22). Most patients (91, 49.2 %) had graduated from elementary/primary school. For the ArmA-TH passive function scale, all items had acceptable fit statistics. The scale's unidimensionality and local independence were supported. The reliability was acceptable. A disordered threshold was found for five items, and none indicated DIF. For the ArmA-TH active function scale, one item was misfit and three were locally dependent. The reliability was good. No items showed DIF. All items had disordered thresholds, and the data fitted the Rasch model better after rescoring. CONCLUSIONS: Both sub-scales of ArmA-TH fitted the Rasch model and were valid and reliable. The disordered thresholds should be further investigated.

Preliminary evaluation of the reliability, validity and feasibility of the arm activity measure - Thai version (ArmA-TH) in cerebrovascular patients with upper limb hemiplegia.

BACKGROUND: Upper limb hemiplegia following cerebrovascular diseases can result in significant functional limitation. To assess such functional disturbance requires a comprehensive, valid and reliable tool. The Arm Activity Measure (ArmA) is a comprehensive, valid and reliable self-report questionnaire to assess real-life function for upper limb hemiplegia. However, it has never been translated for use in different languages. The purpose of this study is to translate and cross-culturally adapt the Arm Activity Measure (ArmA) questionnaire into a Thai version and to evaluate content validity, internal consistency and feasibility. METHODS: The ArmA was translated and culturally adapted according to published cross-cultural adaptation guidelines resulting in the Thai version of ArmA (ArmA-TH). Forty Thai patients with upper limb hemiplegia resulting from cerebrovascular disorders participated in field-testing of the ArmA-TH. Its feasibility was evaluated. Content validity index for item (I-CVI) and score (S-CVI) were examined. Inter-rater reliability was evaluated by Gwet's AC2. Internal consistency was measured using Cronbach's alpha coefficient. RESULTS: Forty patients (29 males, 11 females) with upper limb spasticity due to stroke or TBI were included. The average age of patients was 54.5 years (SD 15.0). Twenty-seven patients (67.5%) completed the questionnaire within 5 min or less, average time taken was 4.45 (1.73) min. For both subscales, patients reported the ArmA-TH to be relevant (85%) and easy to use (67.5%). More than 80% of patients found the passive subscale useful, almost 80% found the active subscale useful. Overall S-CVI was 0.83, S-CVI for passive and active function subscale was 0.79 and 0.86 respectively. The inter-rater reliability coefficients for ArmA-TH was 0.81. Cronbach's alpha was 0.90 for the overall ArmA, 0.89 and 0.88 for the passive and active function subscales. CONCLUSIONS: The ArmA-TH was a feasible self-report questionnaire to assess hemiplegic upper limb function with good content validity, inter-rater reliability and internal consistency.

Construct validity, test-retest reliability and internal consistency of the Thai version of the disabilities of the arm, shoulder and hand questionnaire (DASH-TH) in patients with carpal tunnel syndrome.

OBJECTIVE: This study evaluated additional psychometric properties of the Thai version of the disabilities of the arm, shoulder and hand questionnaire (DASH-TH) which included, test-retest reliability, construct validity, internal consistency of in patients with carpal tunnel syndrome. As for determining construct validity, the Thai EuroQOL questionnaire (EQ-5D-5L) was also administered in order to examine convergent and divergent validity. RESULTS: Fifty patients completed both questionnaires. The DASH-TH showed excellent test-retest reliability (intraclass correlation coefficient = 0.811) and internal consistency (Cronbach's alpha = 0.911). The exploratory factor analysis yielded a six-factor solution while the confirmatory factor analysis denoted that the hypothesized model adequately fit the data with a comparative fit index of 0.967 and a Tucker-Lewis index of 0.964. The related subscales between the DASH-TH and the Thai EQ-5D-5L were significantly correlated, indicating the DASH-TH's convergent and discriminant validity. The DASH-TH demonstrated good reliability, internal consistency construct validity, and multidimensionality, in assessing the upper extremity function in carpal tunnel syndrome patients.