Evaluating the effectiveness of a comprehensive education on low back pain treatment outcomes: A controlled clinical study.

OBJECTIVES: To investigate the effect of integrating an individualized, evidence-based low back pain comprehensive education package on low back pain treatment outcomes. DESIGN: Single-blind, controlled clinical study using the alternate allocation of patients. SETTING: Outpatient clinic. SUBJECTS: In total, 54 participants with chronic low back pain (46.75 ± 11.11 years, 80% females) were randomized to intervention (n = 27) or a control group (n = 27). INTERVENTION: The intervention group received additional four one-hour low back pain-related education sessions to eight 45 minutesstandard physical therapy sessions over 4 weeks. OUTCOME MEASURES: Assessed at baseline, post-intervention, and 3 months. Outcome measures included pain intensity (Visual Analogue Scale), knowledge (Low Back Pain Knowledge Questionnaire), attitude (the Back Pain Attitudes Questionnaire), disability (the Oswestry Disability Index), mental health symptoms (Depression Anxiety Stress Scale, DASS-21 scale), and fear-avoidance (Fear-Avoidance Beliefs Questionnaire). RESULTS: The intervention group showed significantly lower pain intensity ((4 weeks (3.58 ± 1.50 vs. 5.54 ± 1.92), 3 months (3.21 ± 1.74 vs. 5.69 ± 2.51)), higher knowledge ((4 weeks (21.67 ± 2.12 vs. 11.62 ± 3.47), three months (22.08 ± 3.40 vs. 12.23 ± 3.24)), lower negative attitudes ((4 weeks (99.29 ± 11.02 vs. 134.31 ± 12.97), 3 months (102.92 ± 15.58 vs. 132.42 ± 17.79)), lower disability ((4 weeks (26.30 ± 11.37 vs. 45.14 ± 18.67), 3 months (22.83 ± 16.06 vs. 44.13 ± 15.02)), lower stress score ((4 weeks (3.54 ± 3.01 vs. 8.81 ± 5.19), 3 months (3.21 ± 3.22 vs. 7.21 ± 4.36)), lower anxiety ((4 weeks (2.63 ± 3.16 vs. 6.42 ± 4.75), three months (2.63 ± 3.80 vs. 5.73 ± 4.44)), lower depression ((4 weeks (2.42 ± 2.15 vs. 6.42 ± 3.68), three months (2.63 ± 4.18 vs. 7.08 ± 4.41)), and lower fear-avoidance ((4 weeks (13.88 ± 12.32 vs. 50.88 ± 23.25), three months (15.50 ± 16.75 vs. 54.65 ± 31.81)). CONCLUSION: Integrating low back pain comprehensive education into standard physical therapy might optimize the treatment outcomes of low back pain.

Therapeutics effects of inhaled magnesium sulfate combined with adrenergic beta-2 agonist on children with acute asthma: Systematic review and meta-analysis.

AIM: To review the evidence on the effectiveness of inhaled magnesium sulfate (MgSO4) combined with beta-2 (B2) agonist as compared to inhaled B2 agonist alone in treating pediatric patients with moderate to severe asthma attacks METHODS: The search was conducted on five electronic databases namely the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, PubMed, Science Direct, and Google Scholar. RESULTS: Eight trials were included in the review. All studies involved a total of 1585 children aged 2-17 years with moderate to severe asthma attacks. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. Three studies that assessed the effect of inhaled MgSO4 as adjunctive therapy on vital signs revealed no effect of inhaled MgSO4 on vital signs (SMD -0.11, 95% CI 0.27-0.04, p = 0.16, I2 = 68%). Two studies that assessed the effect of inhaled MgSO4 as adjunctive therapy on asthma severity score (ASS) revealed no effect of inhaled MgSO4 on ASS (SMD 0.22, 95% CI 0.01-0.44, Z = 2.01, p = 0.04, I2 = 88%). Two studies that assessed the effect of inhaled MgSO4 as adjunctive therapy on peak expiratory flow rate (PEFR) revealed a large effect of B2 agonist alone on PEFR (SMD 2.02, 95% CI 0.83-3.2, p < 0.001, I2 = 98%). CONCLUSION: This review does not support the use of inhaled MgSO4 as adjunctive therapy to B2 agonist for asthmatic children.

Post-stroke fatigue level is significantly associated with mental health component of health-related quality of life: a cross-sectional study.

PURPOSE: Individuals post-stroke might have high levels of post-stroke fatigue (PSF) which might affect their quality of life. This study aimed to investigate the prevalence of post-stroke fatigue in Jordan and to comprehensively identify its possible associated factors. METHODS: A cross-sectional design was implemented through one-hour face-to-face assessment sessions. The modified fatigue impact scale, 12-item Short-Form Health Survey, Montreal Cognitive Assessment, Motor Assessment Log, Upper Extremity Fugl Meyer assessment, Nine Hole Peg Test, 10 Meter Walk Testing, active and passive goniometry, Hand-held dynamometry, and modified Ashworth scale were used as outcome measures. Prevalence of post-stroke fatigue and levels of quality of life were reported using descriptive analyses. Multiple variable linear regression analysis was used to identify PSF associated factors of post-stroke fatigue. P < 0.05 was considered significant for all statistical tests. RESULTS: 153 individuals with stroke participated in the study. A total of 117 participants (69.9%, 95% CI = 62.0-77.1%) were fatigued. Fatigue was significantly predicted by mental component of quality of life (ß -0.42 [95% CI -0.53--0.31]; p < 0.001), cognition (ß -0.69 [95% CI -1.08--0.29], p = 0.001), weekly sport hours (ß -0.94 [95% CI -1.73--0.14], p = 0.022), and shoulder abduction spasticity (ß -1.81 [95% CI -3.38--0.24], p = 0.024. The model explained 51% of the variation in the fatigue (F = 29.006, p < 0.001). CONCLUSION: Jordanian individuals with stroke have a high prevalence of fatigue. Mental related quality of life was significantly associated with PSF levels. Other factors significantly associated with PSF included cognition status, sport participation, and spasticity. Healthcare practitioners working in neurorehabilitation should take PSF and its significant correlates into consideration when treating individuals with stroke.

Sleep quality and its predictors among hospital-based nurses: a cross-sectional study.

PURPOSE: Sleep disorders are common among nurses and may have negative effects on their performance and well-being. This study aimed to investigate the level of sleep quality and its possible associated factors among hospital-based nurses in Jordan. METHODS: A cross-sectional design targeting Jordanian hospital-based nurses. In addition to demographics and work habits, the outcome measures included Pittsburgh Sleep Quality Index (PSQI), Nordic Musculoskeletal Questionnaire (NMQ), and Depression Anxiety Stress Scale (DASS). Data were analyzed descriptively and by a multiple variable linear regression analysis to identify predictors of sleep quality. RESULTS: In total, 597 nurses with a mean age of 32.1 (± 5.7) years participated in this study and 47% were men. PSQI mean score was 7.8 (± 3.7) and 68% of the participants showed sleep quality deficits. Stress (ß = 0.15 [95%CI 0.13 to 0.19, P < 0.001), depression (ß = 0.05 [95%CI 0.009 to 0.08], P = 0.015), the number of joints with 12 months musculoskeletal pain (ß = 0.25 [95%CI 0.15 to 0.36], P < 0.001) positively predicted decreased sleep quality. Manual handling training (ß = - 0.48 [95%CI -0.96 to 0.003], P = 0.048) and years of experience (ß = - 0.05 [95%CI -0.09 to 0.002], P = 0.039) negatively predicted decreased sleep quality. CONCLUSIONS: Nurses reported poor levels of sleep quality, high levels of mental health symptoms, and musculoskeletal pain complaints. Sleep quality among nurses and its predictors should be carefully considered by administrations of healthcare services.

Post-stroke depression, anxiety, and stress symptoms and their associated factors: A cross-sectional study.

Individuals post-stroke are subject to increased levels of mental health symptoms. This is a cross-sectional study explored levels of depression, anxiety, and stress symptoms and identified their predictors among Jordanian individuals with stroke. Outcome measures included Depression Anxiety Stress Scale, Fugl-Meyer assessment, goniometry, hand-held dynamometry, nine-hole peg test, Ashworth scale, Motor Activity Log, ten-meter walk test, and 12-item Short-Form health survey (SF-12). Descriptive analyses were used to describe prevalence of mental health symptoms and multiple variable linear regression models were used to identify their predictors. A total of 153 individuals participated in the study. Proportions of participants with mental health symptoms were 74.5% for depression, 52.9% for anxiety, and 68% for stress. Significant predictors of post-stroke mental health symptoms were SF-12 Mental Composite Score and grip strength for depression, anxiety, and stress. Depression and stress symptoms were significantly associated with discontinuation of rehabilitation services. Furthermore, self-reports of fewer sleep hours was significantly associated with anxiety and stress. Finally, Gender and self-reported physical diseases other than stroke were significantly associated with depression symptoms. We conclude that high proportions of Jordanian individuals' post-stroke have suffered mental health symptoms. Future studies are required to design effective interventions to improve post-stroke mental health.

Efficacy of an innovative smartphone application for office workers with chronic non-specific low back pain: a pilot randomized controlled trial.

OBJECTIVE: To evaluate the efficacy of a newly developed evidence-based low back pain (LBP) management smartphone application. DESIGN: A double-blinded randomized controlled trial where participants randomly assigned to either an experimental group (EG) or a control group (CG). SETTING: Governmental and private institutions. PARTICIPANTS: About 40 office workers, aged 30 to 55 years, had pain due to non-specific LBP > 3 on Visual Analogue Scale, and with pain chronicity > 3 months. INTERVENTIONS: The EG received full version of the application 'Relieve my back' included evidence-based instructions and therapeutic exercises for LBP management, whereas the CG received placebo version included instructions about nutrition. MAIN MEASURES: Primary outcome measures included pain measured by Visual Analogue Scale (VAS), disability measured by Oswestry Disability Index (ODI), and quality of life measured by Short-Form Health Survey (SF-12). RESULTS: Following six weeks of using the application, compared to CG, the EG group demonstrated significant decrease in pain intensity (-3.45 (2.21) vs -0.11 (1.66), P < 0.001), in ODI score (-11.05 (10.40) vs -0.58 (9.0), P = 0.002), and significant increase in physical component of SF-12 (12.85 (17.20) vs -4.63 (12.04), P = 0.001). CONCLUSION: 'Relieve my back' application might be efficacious in reducing pain and disability and improving the quality of life of office workers with non-specific LBP.

Translation, cultural adaptation and validation of the Arabic version of the king's Parkinson's disease pain scale.

PURPOSE: Pain in Parkinson's disease (PD) is a highly prevalent non-motor symptom occurring in this population. The King's PD Pain Scale (KPPS) was developed to assess pain in people with PD. This study aimed to provide a cross-cultural adaptation and translation of the KPPS into the Arabic language (A-KPPS), and to investigate the construct and convergent validity, internal consistency, and reliability of the translated scale. MATERIALS AND METHODS: The English KPPS was translated into Arabic and back-translated into English by an independent translation team. The Arabic version was tested in 103 native Arabic speaking PD patients. We assessed construct validity, convergent validity, and test-retest reliability of the A-KPPS using factor analysis method, comparison with other valid and reliable measures, and using intra-class correlations, respectively. RESULTS: The A-KPPS had three main factors "somatic pain", "visceral and burning pain" and "orofacial pain", rather than the original four factors scale. The A-KPPS correlated with measures of disease motor severity, depression, anxiety, quality of life and pain (p < 0.05). Furthermore, the A-KPPS total score had high test-retest reliability (ICC = 0.9). CONCLUSIONS: The A-KPPS demonstrated moderate to good validity and reliability. The A-KPPS can facilitate the assessment and treatment of pain in Arabic-speaking people with PD worldwide.

Pain is a highly prevalent non-motor symptom of Parkinson's disease (PD) that is often overlooked.The King's PD Pain Scale (KPPS) is specially designed to assess pain localization, intensity, and frequency in people with PD.The Arabic translation of the KPPS is a valid and reliable tool for the assessment of pain in Arabic speaking people with PD.

Prevalence and Predictors of Leg Cramps in the Third Trimester of Pregnancy: A Cross-Sectional Study.

Objective: This study aimed to estimate the prevalence and determine predictors of leg cramps among pregnant women in their third trimester. Methods: A sample of pregnant women in their third trimester who routinely visited local clinics in Jordan was recruited. Participants completed a socio-demographic and clinical characteristics questionnaire, the numeric pain rating scale (NPRS) for leg cramp pain intensity, the Arabic version of the Pregnant Physical Activity Questionnaire (PPAQ), the Nordic Musculoskeletal Questionnaire (NMQ), Short Form Health Survey (SF-12), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS). In addition, magnesium (Mg) and calcium (Ca) serum levels were examined. Logistic regression analyses were used to identify predictors of leg cramps occurrence. A linear regression model was used to investigate predictors of leg cramps pain intensity among pregnant women who reported leg cramps. Results: Two hundred and five (n=205) pregnant women completed the study. The estimated prevalence of leg cramps was 58%. Logistic regression results showed that not receiving assistance with housework (OR 0.46, p=0.025), progress in the number of gestational weeks (OR 1.10, p=0.021), the number of previous pregnancies (OR 1.21, p=0.049), having leg swelling (OR 2.28, p=0.019), and having gastrointestinal (GIT) problems (OR 2.12, P=0.046) were associated with a higher odds of leg cramps occurrence. In the subsample with pregnant women with leg cramps, linear regression results showed that pregnant women with high school education versus elementary school (ß=0.70, p=0.012), number of working hours (ß=0.11, p=0.010), using vitamins supplements (ß=-1.70, p=0.043), having diabetes after pregnancy (ß=1.05, p=0.036), having sciatica (ß=0.58, p=0.028), having hip pain (ß =-.33, p=0.029), and higher PSQI total score (ß=0.09, p=0.020) were the significant predictors of leg cramp pain intensity. Conclusion: Many health-related conditions, as well as work and home-related work characteristics, may be considered risk factors for the occurrence of leg cramps and increased leg cramps pain intensity in pregnancy.

Physiotherapists' job satisfaction in the workplace: A cross-sectional study in Jordan, Lebanon, West Bank, and Gaza.

BACKGROUND: Job satisfaction among physiotherapists has been studied in many developing and developed countries, but not yet in areas recently affected by wars and refugee crises in the Middle East, including Jordan, Lebanon, West Bank, and Gaza regions. OBJECTIVES: To explore physiotherapists' job satisfaction in Jordan, Lebanon, West Bank, and Gaza and examine differences in job satisfaction according to regions, gender, academic qualifications, and years of clinical experience. METHODS: A cross-sectional study using a self-administered online questionnaire. The questionnaire consisted of participants' characteristics and a 17-items Likert scale of job satisfaction. RESULTS: A total of 413 participants completed the online questionnaire. Most of the respondents were older than 27 years (55%), males (53.8%), and holding a bachelor's degree (70.2%), and had 5-10 years of experience (70.4%). The overall job satisfaction was 66.1%. There was no significant difference in job satisfaction according to the region in all questionnaire items. Female physiotherapists reported higher satisfaction in receiving career advice (p = .013). In many items, physiotherapists with higher qualifications and longer years of experience reported higher satisfaction (p < 0.05). Salaries and remunerations, lack of continuing education support, and lack of evidence-based practice in the workplace were the main reasons for job dissatisfaction. CONCLUSION: To improve physiotherapy job satisfaction, healthcare administrators should increase physiotherapists' financial rewards, support continuing education, and set evidence-based practice policies.

Knowledge related to low back pain and its associated factors in patients with low back pain: A cross-sectional study.

BACKGROUND: Patients' knowledge about low back pain (LBP) negatively influences LBP prognosis. Studying the extent of patients' knowledge about LBP may help clinicians design effective LBP treatment strategies. OBJECTIVE: To explore the level of LBP knowledge and its associated factors in patients with LBP. METHODS: A cross-sectional study with a representative sample. Participants with acute or chronic LBP completed a self-administered questionnaire including sociodemographic and clinical characteristics. We used the Low Back Pain Knowledge Questionnaire (LBP_KQ) to assess knowledge, the Fear-Avoidance Beliefs Questionnaire for LBP (FABQ_LBP) to assess fear of movement, the Oswestry Disability Index (ODI) to assess functional disability, Depression Anxiety Stress Scales (DASS 21) to assess mental health status, and the Numeric Pain Rating Scale (NPRS) to assess pain intensity. RESULTS: A total of 271 individuals with LBP completed the study. The mean age of participants was 39.86 (± 11.27), the LBP chronicity median was 18 (IQR = 44) months, and 56.5% of the participants were females. The mean LBP_KQ score was 9.29 (± 3.89)/24. An educational level higher than high school (diploma education (ß= 1.202 [95%CI: 5.633 to 11.498], p< 0.001), bachelor or higher education (ß= 2.270 [95%CI: 1.107 to 3.433], p< 0.001)), and using pain killers (ß= 1.180 [95%CI: 0.140 to 2.221], p= 0.026) were significantly associated with higher LBP_KQ score. While being employed (ß=-1.422 [95%CI: -2.462 to -0.382], p= 0.008) and having higher DASS Anxiety score (ß=-0.144 [95%CI: -0.240 to -0.048], p= 0.003) were significantly associated with lower LBP_KQ score. CONCLUSIONS: Individuals with chronic LBP in Jordan demonstrated relatively low levels of LBP knowledge related to their condition. Rehabilitation personnel, healthcare stakeholders, and policymakers should carefully monitor the level of LBP knowledge and its associated factors.

The Effect of Visual Impairment and Its Severity on Vision-Related and Health-Related Quality of Life in Jordan: A Comparative Cross-Sectional Study.

Purpose: To assess the effect of visual impairment (VI), its severity, and ocular diseases on vision-related and health-related quality of life (QoL) in Jordan. Patients and Methods: A comparative, cross-sectional, hospital-based study was conducted among a group of 278 patients with VI aged ≥ 18 years, and age and sex-matched control group of 278 individuals with no VI. An interviewer administered the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12) to all participants. Results: All the mean VFQ-25 subscales scores, physical component scale (PCS) and the mental component scale (MCS) of the SF-12 were significantly lower in patients with VI compared to controls with no VI. The VFQ-25 subscales (except general health and ocular pain), PCS, and MCS scores significantly decreased with more severity of VI. In the adjusted multivariate analysis, lower level of education (p=0.013), male sex (p=0.016), and the presence of cerebrovascular disease (p=0.019) were significantly associated with lower VFQ-25 composite scores in visually impaired patients compared to controls. Ocular disease duration of >5 years and progressive VI were significantly associated with lower VFQ-25 composite scores (p= 0.026 and p<0.001) respectively, in patients with VI. Glaucoma had a significantly larger reduction in mean scores of all the VFQ-25 subscales, and the PCS of the SF-12 compared to all other ocular diseases. Conclusion: Both VI and increasing severity of impairment were associated with reduced vision-related and health-related quality of life in adult Jordanians. Glaucoma patients and less educated people were particularly affected. Routine assessment of QoL in visually impaired patients and improving referral protocols to vision rehabilitation services is recommended to improve the QoL in those patients.

Arabic translation, cross-cultural adaptation, and psychometric properties of the low back pain knowledge questionnaire.

BACKGROUND: Low Back Pain Knowledge Questionnaire (LBP_KQ) was originally developed and validated for English speakers but not yet available for Arabic speakers. PURPOSE: To translate, cross-culturally adapt, and test the psychometric properties of the Arabic version of the LBP_KQ. METHODS: Translation and cross-cultural adaptation were performed according to recommended guidelines. Construct validity was assessed through principal component analysis, and contrasted groups including physical therapists, nurses, and patients with low back pain. Concurrent validity was assessed by the correlation of LBP_KQ with the fear avoidance-belief questionnaire and depression, anxiety, and stress scale. Reliability was assessed using internal consistency (Cronbach's α) and test-retest reliability using intra-class correlation coefficient (ICC) and Bland-Altman analyses. Sensitivity to change was measured by comparing an educational intervention group (IG) and a control group (CG). RESULTS: The questionnaire has four components. Physical therapists had significantly (p < .001) higher LBP_KQ scores than nurses and patients indicating good construct validity. There was a significant correlation between LBP_KQ and fear avoidance-belief questionnaire total score (r = 0.200, p = .04), depression score (r = -0.219, p = .024), anxiety score (r = -0.251, p < .01), stress score (r = -0.199, p < .041). Cronbach's α was 0.662, and ICC (2,1) was 0.760 which reflects good reliability. There was a significant difference in LBP_KQ scores between IG and CG (p < .001) indicating sensitivity to change. CONCLUSION: The Arabic version of LBP_KQ is valid, reliable, and sensitive to change.

Translation and cross-cultural adaptation of the low back pain treatment belief questionnaire and its clinimetric properties.

BACKGROUND: The Low Back Pain Treatment Beliefs Questionnaire (LBP-TBQ) was developed to systematically measure patients' preferences about common treatments for low back pain (LBP). However, the questionnaire is not available in the Arabic language. OBJECTIVE: To translate and cross-culturally adapt the LBP-TBQ to the Arabic language and assess its clinimetric properties. METHODS: The LBP-TBQ was translated into Arabic version according to published guidelines. In pilot testing, the face and content validity of the translated questionnaire was assessed. Two hundred and fifty patients with LBP completed the translated LBP-TBQ for five common LBP treatments. In addition, a subgroup of 51 participants completed the questionnaire on two consecutive occasions to examine the test-retest reliability. RESULTS: Confirmatory factor analysis results showed that the Arabic version of LBP-TBQ has three factors: (1) "credibility", (2) "effectiveness and fitness", and (3) "concerns", and this 3-factors model had the best fit for the data for all the five treatments. Cronbach's α of the total items ranged from 0.812 to 0.899, while the sub-scores ranged from 0.557 to 0.837, indicating moderate to high internal consistency. The ICC(2,1) ranged from 0.626 to 0.909, which shows acceptable to good test-retest reliability. Correlation with other LBP questionnaires was < 0.3, demonstrating acceptable discriminant validity. Finally, the questionnaire showed acceptable criterion validity for all the subscales and the general questionnaire. CONCLUSIONS: The Arabic version of LBP-TBQ is reliable, valid, and appropriate to use in clinical and research settings.

Physiotherapists' knowledge, perception, and attitude regarding COVID-19 and infection control: An online cross-sectional survey in Jordan.

BACKGROUND: The COVID-19 pandemic highlighted the importance of knowledge and awareness of healthcare practitioners regarding infection control. OBJECTIVE: To explore Jordanian physiotherapists' knowledge and perception of COVID-19, awareness about protection measures, and attitude towards infection prevention. METHODS: A cross-sectional online survey was used. Data were collected from licensed physiotherapists currently living in Jordan. A structured survey was used to collect the data consisting of five parts: 1) General information about the physiotherapists including sociodemographic, academic training, and employment setting, 2) General knowledge about COVID-19, 3) Infection protection in the workplace, 4) Perception of COVID-19, and 5) Attitude towards COVID-19 in daily life and during work. RESULTS: A total of 147 physiotherapists completed the survey with a mean age of 30.56 (7.70) and years of experience of 7.28 (7.21). The mean of the total knowledge score was 17.18 (2.32)/ 26. There was a significant difference in the total knowledge score between COVID-19 trained physiotherapists and untrained (t = 2.895, p = 0.004). About 70.8% of the physiotherapists perceived COVID-19 as a very dangerous disease, 69.4% considered physiotherapy a high-risk profession, and 41% perceived COVID-19 does not require any special treatment. Approximately 85% of physiotherapists avoided going to crowded places and wore a mask when leaving home. 75-86.6% of physiotherapists would consider appropriate protective measures during their work. CONCLUSIONS: Physiotherapists showed suboptimal knowledge, perception, and attitude towards COVID-19. There is a need for training courses to increase physiotherapists' knowledge about COVID-19 and improve their perception and attitude towards COVID-19.

Predictors of neck disability among undergraduate students: A cross-sectional study.

BACKGROUND: Many cross-sectional studies have examined the predictors of neck pain among adolescents and working-age populations, but there are limited studies included undergraduate students. OBJECTIVE: To investigate the predictors of neck disability among undergraduate students. METHODS: A cross-sectional study using a self-administered online survey. Students completed the survey that included socio-demographic factors, academic-related factors, health and lifestyle factors, and standardized questionnaires including Neck Disability Index (NDI), 12-Item Short-Form Health Survey (SF-12), Depression Anxiety Stress Scales (DASS-21), and Pittsburgh Sleep Quality Index (PSQI). Students who reported an NDI score higher than 15 were considered as having a neck disability. A multivariable logistic regression model was used to identify the significant predictors of neck disability. RESULTS: Of all students (n = 1292), 20.8% reported neck disability. Among all possible predictors, students' major satisfaction (OR 1.46 [95% CI 1.06-2.01]; p = 0.019), DASS-21 anxiety score (OR 1.06 [95% CI 1.03-1.09]; p < 0.001), SF-12 total score (OR 0.89 [95% CI 0.86-92]; p < 0.001), and PSQI score (OR 1.21 [95% CI 1.15-1.28]; p < 0.001) were the only significant predictors of neck disability. CONCLUSIONS: Increased levels of academic stressors and anxiety, and decreased levels of quality of life and sleep quality are associated with increased neck disability among undergraduate students.

Translation, cross cultural adaptation, and construct validation of the Arabic version of the Frenchay Activities Index in people with multiple sclerosis.

BACKGROUND AND PURPOSE: Assessing functional status in people with multiple sclerosis (PwMS) has a major role in determining how to help patients to reach their optimal level of living independently in the community. The Frenchay Activity Index (FAI) is a commonly used scale to evaluate functional status in rehabilitation research and practice settings. The aim of this study was to translate the FAI into the standard Arabic language through the process of cross-cultural adaptation and to explore the internal consistency and construct validity of the produced Arabic version of FAI (A-FAI) among a sample of Arabic-speaking PwMS. METHOD: The English version of the FAI was translated into Arabic according to the published guidelines. Cronbach's α was used to assess the internal consistency of the A-FAI, and principal factor analysis was conducted to explore the construct validity. RESULTS: Hundred and six subjects participated in the study. The A-FAI has acceptable internal consistency as Cronbach's α was 0.70. The principal factor analysis revealed that the instrument has four main factors: domestic chore, leisure, hobbies, and work, rather than the original three factors scale. DISCUSSION: The A-FAI has acceptable internal consistency and validity. A-FAI provides essential information about the participation level in instrumental activities of daily living activities among PwMS speaking the Arabic language.

Validity and Reliability of a Cardiopulmonary Resuscitation Attitudes Questionnaire Among Allied Health Profession Students.

AIM: To investigate the structural validity and internal consistency of a cardiopulmonary resuscitation attitudes questionnaire among Allied Health Professions (AHP) university students. METHODS: Structural validity of a 17-item questionnaire was tested using principal component analysis. A group of AHP university students completed the questionnaire. Internal consistency of the questionnaire was measured by Cronbach's α. RESULTS: A total of 856 AHP students completed the questionnaire (mean age= 20.8 (±1.1) years, 74.0% were females). The analysis reduced a 17-item questionnaire to an 11-item questionnaire. The final questionnaire had three distinct factors; (1) attitudes towards mouth-to-mouth ventilation (MMV), (2) attitudes towards chest compressions (CC), and (3) the importance of cardiopulmonary resuscitation (CPR). It had factor loadings ranging from 0.629 to 0.878 and could explain 66% of the variance in the attitude. The questionnaire had acceptable internal consistency (Cronbach α=0.83; 95% CI=81.5) and was feasible with no floor or ceiling effect. CONCLUSION: The 11-item CPR attitude questionnaire had acceptable structural validity and internal consistency and good parsimony and unidimensionality. The questionnaire can be used to measure the university students' attitude and assess the effectiveness of CPR training activities. Future studies are required to measure the responsiveness and applicability to other cohorts.

The effect of age and gender on acute postoperative pain and function following lumbar spine surgeries.

BACKGROUND AND PURPOSE: Understanding the factors contributing to the variability in postoperative pain and function following lumbar spine surgeries (LSS) is necessary to plan inpatient rehabilitation and optimize surgical outcomes. In particular, variability due to age and gender has not been studied. This study's aim was to evaluate the variability in postoperative pain and function, during hospital stay, due to age and gender following LSS. METHODS: We conducted a retrospective analysis of 585 patients who underwent LSS during their hospital stay. Univariate ANCOVA was performed to study the differences in postoperative pain, and multivariate ANCOVA was performed to study the differences in postoperative function (gait distance, independency combined score, and balance combined score) between age groups (older adults [≥65 years of age] vs. younger adults) and gender. RESULTS: Younger patients reported statistically, but not clinically, significant higher postoperative pain than older patients (ß = 0.652 [95% CI (0.382-0.986)], p < 0.001), and males reported statistically, but not clinically, significant lower postoperative pain than female patients (ß = -0.583 [95% CI (-0.825 to -0.252)], p < 0.001) with adjustment of covariates. Male patients walked significantly longer distance than female patients (ß = 0.272 [95% CI (0.112-0.432)], p = 0.001) with adjustment of covariates. However, these were clinically insignificant. With adjustment of preoperative diagnosis, type of surgery, severity of illness, and prior level of function, there was no statistically significant difference between age groups in walking distance, and between age and gender groups in independency combined score and balance combined scores. DISCUSSION: Following LSS, the difference in postoperative pain between age groups and gender are statistically but not clinically significant, suggesting patients require similar effective postoperative pain management regardless of age and gender. The apparent difference in age and gender in postoperative functional outcomes could be due to other factors.

The prevalence of upper quadrants work-related musculoskeletal disorders and their predictors among registered nurses.

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) represent a significant health challenge facing nurses. However, very few studies investigated the prevalence of WMSDs among nurses and their predictors comprehensively using a valid and reliable set of standardized outcome measures. OBJECTIVE: This study aimed to investigate the prevalence WMSDs of upper quadrants and their predictors among registered nurses in Jordanian hospitals. METHODS: A cross-sectional study recruited 597 registered nurses from different hospitals in Jordan. A self-administered survey distributed in targeted hospitals wards. Outcome measures included Nordic Musculoskeletal Questionnaire (NMQ), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), sociodemographic data, and manual handling and work habits. Prevalence of musculoskeletal complaints was reported using descriptive analysis. Logistic regression analyses were used to identify predictors of WMSDs at each upper quadrant body site. RESULTS: Twelve-month WMSDs prevalence was the highest at the neck (61.1%), followed by the upper back (47.2%), shoulders (46.7%), wrist and hands (27.3%), and finally at the elbow (13.9%). Being a female, poor sleep quality, high physical activity level, poor ergonomics, increased workload, and mental stress were significant predictors of increased upper quadrant WMSDs among nurses. CONCLUSIONS: Upper quadrant WMSDs among nurses in Jordan are highly prevalent. Identified significant predictors of these WMSDs should be given full consideration by clinicians and health policymakers. Future studies are needed to reveal the progressive nature of upper quadrant WMSDs and strategies to modify their risk factors.

University professors' mental and physical well-being during the COVID-19 pandemic and distance teaching.

BACKGROUND: Strict strategies including lockdowns and working from home were adopted worldwide during the coronavirus (COVID-19) pandemic. University professors suddenly shifted to work from home adopting distance teaching. OBJECTIVES: This study aimed to investigate Health-Related Quality of Life (HRQoL) and its associated occupational and health factors during COVID-19 among university professors. METHODS: A cross-sectional design targeted university professors of all majors in Jordan. The study self-administered survey included demographics and lifestyle data, 12-item Short Form health survey (SF-12), Depression Anxiety Stress Scale (DASS 21), professor' evaluation of distance teaching, Neck Disability Index (NDI), and International Physical Activity Questionnaire (IPAQ). Descriptive analyses were conducted to demonstrate primary outcome measures data. Factors associated with HRQoL were determined using a multiple variable linear regression analysis. RESULTS: A total of 299 university professors successfully completed the study. Participants' SF-12 physical health component score was 74.08 (±18.5) and 65.74 (±21.4) for mental health component. Higher depression, stress, neck disability, and weight change were significantly associated with lower HRQoL level. While higher satisfaction with distance teaching, health self-evaluation, and work load change were significantly associated with higher HRQoL level. The regression model explained 66.7%of the variance in professors' HRQoL (r2 = 0.667, F = 82.83, P < 0.001). CONCLUSIONS: Jordanian university professors demonstrated good HRQoL and mental health levels during COVID-19 lockdown. Factors associated with professors' HRQoL should be considered by academic institutions in determining the best occupational setup of teaching activities in future pandemics.