Feasibility and Efficacy of Low-to-Moderate Intensity Aerobic Exercise Training in Reducing Resting Blood Pressure in Sedentary Older Saudis with Hypertension Living in Social Home Care: A Pilot Randomized Controlled Trial.

Background and Objectives: The effect of non-pharmacological aerobic exercise training on blood pressure in sedentary older individuals receiving social home care in Saudi Arabia has not been investigated. This study aimed to examine the effects of aerobic exercise on blood pressure in sedentary older Saudis with hypertension residing in these settings. Materials and Methods: A pilot randomized control trial was conducted with 27 sedentary individuals, aged 60-85, diagnosed with hypertension, and living in social home care in Makkah, Saudi Arabia. Recruitment took place between November 2020 and January 2021, and participants were randomly assigned to either the experimental or control group. The experimental group engaged in three 45 min sessions of low-to-moderate intensity aerobic activity per week for eight weeks. This trail was registered with the ISRCTN registry (ISRCTN50726324). Results: Following eight weeks of mild to moderate aerobic exercise training, the primary outcome of resting blood pressure showed a significant reduction in the experimental group (systolic blood pressure: mean difference [MD] = 2.91 mmHg, 95% confidence interval [CI] = 1.61, 4.21, p = 0.001; and diastolic blood pressure: MD = 1.33 mmHg, 95% CI = 1.16, 1.50, p = 0.001) compared to the control group. Within the experimental group, there was also a significant decrease in systolic blood pressure (MD = -2.75 mmHg, 95% CI = -7.73, 2.22, p = 0.005) and diastolic blood pressure (MD = -0.83 mmHg, 95% CI = -5.81, 4.14, p = 0.02). Conclusions: This trial demonstrates the feasibility and potential benefits of low-to-moderate intensity aerobic exercise training in reducing resting blood pressure among sedentary older Saudis with hypertension residing in this aged care setting.

Associations between social determinants and the presence of chronic diseases: data from the osteoarthritis Initiative.

BACKGROUND: Some studies investigated the relationship between musculoskeletal conditions and chronic diseases. However, no study examined the association between social determinants and chronic diseases among people at high risk for knee osteoarthritis. Thus, the current study was aimed to address this gap. METHODS: A secondary data analysis was conducted on a total of 3280 men and women aged 45 to 79 who were recruited in the Osteoarthritis Initiative. RESULTS: Multivariable logistic regression analyses show that age ≥ 65 years was associated with 1.98, 1.96, and 1.46 times odds of the presence of diabetes, heart attack, and multi-morbidity, respectively than age ≤ 64 years. Men were associated with 1.39, 1.41, 1.76, and 2.24 times odds of the presence of arthritis, cancer, diabetes, and heart attack, respectively than women. African American/Asian/ non-Caucasian was associated with 2.71, 2.56, and 1.93 times odds of the presence of arthritis, diabetes, and heart attack, respectively than Caucasian. Primary school/less education was associated with twice or more times the odds of arthritis and chronic obstructive pulmonary disease (COPD) than ≥high school education. Unemployment was associated with 1.41-, 1.73-, 1.58-, and 1.70-time odds of the presence of arthritis, cancer, COPD, and heart attack, respectively, then employed. Unmarried/widowed/separated was associated with 1.41, 1.75, 2.77, 2.76, 1.86, and 3.34 times odds of the presence of arthritis, asthma, cancer, COPD, diabetes, and heart attack, respectively than married. Annual income < 50,000 was associated with 1.33-, 1.44-, and 1.38-time odds of the presence of arthritis, diabetes, and multi-morbidity, respectively, then annual income ≥50,000. Overweight/obese was associated with 2.28 times the odds of the presence of diabetes than healthy weight. Current/former smoker was associated with 1.57, 2.47, 2.53, 1.63, and 1.24 times odds of the presence of arthritis, cancer, COPD, heart attack, and multi-morbidity, respectively than a nonsmoker. Consuming alcohol was associated with 1.32-, 1.65-, 1.50-, and 1.24-time odds of the presence of arthritis, COPD, diabetes, and multi-morbidity, respectively, then nonalcoholic. CONCLUSIONS: Social determinants are associated with the presence of chronic diseases. Some of the social determinants are modifiable or treatable. Thus, these findings can inform public health strategies in the United States.

Normative Data for Handgrip Strength in Saudi Older Adults Visiting Primary Health Care Centers.

Background and objective: Handgrip strength (HGS) plays a vital role as a predictor of adverse health outcomes. Several studies have established HGS norms by age, sex, hand, occupation, culture or disability in different countries and for children in Saudi Arabia. However, standardized values for Saudi older adults have not yet been reported. Therefore, the current study was aimed to establish normative data for HGS in Saudi older adults visiting primary health care centers (PHCCs). Material and Method: In this descriptive cross-sectional study, HGS in kilograms was measured using a hydraulic hand dynamometer in Saudi older adults (n = 2045) aged ≥60 years visiting 15 PHCCs selected randomly from the five geographical regions of Riyadh, Saudi Arabia between January 2015 and April 2017. The average mean from three successive trials, standard deviations, and 95% confidence intervals presented for the left and right hands of men and women in six age groups (60-64, 65-69, 70-74, 75-79, 80-84, and 85+ years). The analyses were performed using the ANOVA test for all the age groups and to determine whether any differences exist between them. Results: The average mean HGS was significantly (p < 0.0001) differ by the left and right hands of men and women in six age groups. Conclusions: The current study presents specific norms for HGS in Saudi older adults by age, sex, and hand. Further studies are required to examine the utility of these norms for prediction of morbidity and mortality in this population.

Longitudinal Relationship Between Knee Pain Status and Incident Frailty: Data from the Osteoarthritis Initiative.

Objective: Examine the longitudinal association between knee pain and prefrailty/frailty. Design: Longitudinal study. Setting: Five clinical centers across the United States. Subject: Data from 3,053 nonfrail participants aged 45-79 years at baseline from the Osteoarthritis Initiative. Methods: According to self-reported knee pain at baseline, the participants were placed into three groups: no knee pain (N = 1,600), unilateral knee pain (N = 822), and bilateral knee pain (N = 631). Frailty status was assessed over time using the five frailty indicators (unintentional weight loss, exhaustion, weak energy, slow gait speed, and little physical activity). Based on the number of frailty indicators present, prefrailty (1-2) and frailty (≥3) were diagnosed. Generalized estimating equations logistic regression analyses were conducted to examine the relationship between knee pain status and prefrailty/frailty. Results: After adjusting for age, sex, race, education, marital status, smoking status, comorbidities, and body mass index, unilateral knee pain at baseline was associated with an increased odds of developing prefrailty (odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.01-1.27) and frailty (OR = 1.89, 95% CI = 1.38-2.62), and bilateral knee pain at baseline was also associated with an increased risk of prefrailty (OR = 1.41, 95% CI = 1.24-1.62) and frailty (OR = 2.21, 95% CI = 1.63-3.01) over time in comparison with no knee pain. The interaction of knee pain status by time was not significantly associated with either prefrailty or frailty. Conclusions: Knee pain (particularly bilateral knee pain) is associated with an increased risk of developing prefrailty and frailty over time.

Length of Stay and Functional Outcomes Among Patients with Stroke Discharged from an Inpatient Rehabilitation Facility in Saudi Arabia.

BACKGROUND In many countries, the length of stay (LOS) for inpatient rehabilitation following stroke has gradually decreased. It is unclear whether this trend is associated with differences in functional outcomes, especially in developing countries. This study aimed to examine associations between LOS and functional outcomes among patients with stroke discharged from an inpatient rehabilitation facility in Saudi Arabia. MATERIAL AND METHODS This retrospective study included all patients (N=409) aged ≥18 years who were admitted to an inpatient rehabilitation for stroke during 2008-2014. There were no deaths in the cohort during the study period. Patients were divided into 4 groups according to days of rehabilitation: ≤30 days (n=114), 31-60 days (n=199), 61-90 days (n=72), and >90 days (n=24). Multivariate regression analyses were used to evaluate functional outcomes using the functional independence measure (FIM). RESULTS The fully adjusted model showed that higher total and subscale FIM scores were significantly associated with a LOS ≤30 days (total ß: 18.2, standard error [SE]=4.43, P≤0.0001; motor-FIM: ß=13.9, SE=3.70, P=0.0002; cognitive-FIM: ß=4.3, SE=1.29, P=0.001), and 31-60 days (total ß: 11.3, SE=4.07, P=0.005; motor-FIM: ß=8.8, SE=3.40, P=0.009; cognitive-FIM: ß=2.4, SE=1.19, P=0.038) compared with >90 days. CONCLUSIONS A short or intermediate LOS is not necessarily associated with worse outcomes, assuming adequate care is provided.

Cross-cultural adaptation and validation of the Saudi Arabic version of the Knee Injury and Osteoarthritis Outcome Score (KOOS).

The Knee Injury Osteoarthritis Outcome Score (KOOS) is a widely used joint-specific measure employed to evaluate pain, symptoms, activities of daily living, recreational activities, and quality of life in patients with knee osteoarthritis (OA). Although the original KOOS has been translated into many languages, a Saudi Arabic version is not available. This study aimed to culturally adapt and evaluate the psychometric properties of the Saudi Arabic version of the KOOS in patients with knee OA. The original KOOS was translated and adapted into Saudi Arabic version over six stages according to the guidelines suggested by Beaton and recommended by the American Association of Orthopedic Surgeons Outcome Committee. Patients diagnosed with knee OA (n = 136) were recruited to examine the psychometric properties, such as internal consistency that was tested using Cronbach's alpha, test-retest reliability that was analyzed using the intra-class correlation coefficient (ICC2,1), and construct validity that examined by testing the correlations between the new version subscales, Form 36 Health Survey subscales, and the Visual Analog Scale, Spearman's correlation coefficient (rs) was used to measure the correlations. A total of 122 (89.7%) of the 136 participants with knee OA completed the second re-test of new Saudi Arabic version. Excellent internal consistency (Cronbach's alpha = 0.87-0.92) was detected in the subscales of the adapted version, as well as excellent test-retest reliability (ICC2,1 = 0.92-0.94). The pattern of correlation between the subscales of the Saudi Arabic version of the KOOS, SF-36 domains and the Visual Analog Scale for pain supported the construct validity of the adapted version. The Saudi Arabic version of the KOOS was well accepted and exhibited excellent reliability, internal consistency, and construct validity in Saudi patients with knee OA.

Functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis.

OBJECTIVE: To examine the functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis. METHODS: In this retrospective study, we included data from the medical record of all 383 patients with uni- or bilateral hemiparesis after stroke who were admitted to King Fahad Medical City-Rehabilitation Hospital between 2008 and 2014 in Riyadh, Kingdom of Saudi Arabia. According to the site of hemiparesis, we classified patients into 3 groups: right hemiparesis (n=208), left hemiparesis (n=157), and bilateral hemipareses (n=18). The patients (n=49) who did not have either site of hemiparesis were excluded. The Functional Independence Measures (FIM) instrument was used to assess the score at admission and discharge. A post hoc test was conducted to examine the functional recovery differences between groups. Multiple regression analyses were used to confirm the findings. RESULTS: Amongst the three groups, there were significant (p<0.05) differences in the total-FIM score as well as motor- and cognitive-FIM sub-scores between admission and discharge of stroke rehabilitation. The differences were significantly greater in the bilateral hemipareses group than in either unilateral hemiparesis group. Multiple regression analyses also confirmed that the site of hemiparesis significantly (p<0.05) differs in the total-FIM score as well as motor-FIM and cognitive-FIM sub-scores. CONCLUSION: Our results demonstrate that differences in functional recovery after stroke rehabilitation may be influenced by the site of hemiparesis after stroke.

Stroke rehabilitation. A call to action in Saudi Arabia.

Stroke is a major cause of death and other complications worldwide. In Saudi Arabia, stroke has become an emerging health issue leading to disability and death. However, stroke care including rehabilitation services, in Saudi Arabia lags behind developed countries. Stroke rehabilitation is an essential recovery option after stroke and should start as early as possible to avoid potential complications. The growing evidence on stroke rehabilitation effectiveness in different health care settings and outcome measures used widely are reviewed in this call to action paper.

Health-related quality of life in older adults with bilateral knee pain and back pain: data from the Osteoarthritis Initiative.

This study's objective was to examine the association of self-reported bilateral knee pain (KP) and back pain (BP) with health-related quality of life (HRQoL) among older adults. In this cross-sectional study, data for 1252 older adults (≥65 years) were included from the Osteoarthritis Initiative project. Self-reported bilateral KP and BP were used to classify participants into four groups: (1) neither bilateral KP nor BP; (2) no bilateral KP with BP; (3) bilateral KP without BP; and (4) both bilateral KP and BP. Health-related quality of life was measured using the health survey short form (SF)-12. We used multiple linear regression analyses to examine the associations of bilateral KP and/or BP with the HRQoL. After controlling for covariates, bilateral KP and BP were associated with poorer HRQoL [physical composite scale (PCS): estimated average (ß) = -13.1, SE = 1.15, p < 0.0001; mental composite scale: ß = -2.71, SE = 1.09, p = 0.013, respectively] compared with the group with neither bilateral KP nor BP. In conclusion, older adults with coexisting bilateral KP and BP had significantly poorer physical and mental HRQoL when compared to peers without these conditions.

Physical Therapy Entry-level Education and Post-professional Training in Saudi Arabia: A Comparison of Perceptions of Physical Therapists from Five Regions.

[Purpose] The goal of this study was to examine potential differences in physical therapists' perceptions of content areas for the new entry-level Doctor of Physical Therapy (DPT) curricula and specialties for post-graduate residency and fellowship programs among five geographical regions in Saudi Arabia. [Subjects and Methods] All physical therapists in Saudi Arabia were invited to participate in this cross-sectional study, which was conducted via a web-based survey. The first domain queried the importance of introducing 10 content areas into future DPT curricula. The second domain concerned the importance of developing residency and fellowship programs in nine subspecialties. Descriptive statistics were generated, and an analysis of variance with a post hoc Tukey's HSD test was used to evaluate the significance of differences in the physical therapists' perceptions across the geographical regions. [Results] In total, 148 participants responded to the survey. Significant differences were found among respondents in different geographical regions for 4 of the 10 skills and 3 of the 9 subspecialties. [Conclusion] Understating the variations between the five regions would be helpful in developing a new model for future DPT and post-professional programs that addresses potentially unique needs perfectly. Future research is needed to confirm the findings in a wide range of stakeholders.

Association Between Musculoskeletal Pain and Frailty Over Time in Older Adults.

BACKGROUND AND PURPOSE: There is a high frequency of frailty in patients with musculoskeletal pain. Pain from osteoarthritis and lower back pain may be associated with frailty. However, the future risk of frailty among older adults with pain remains unclear. Thus, the primary objective of this study was to examine the association between musculoskeletal pain and the risk of becoming prefrail and frail in older adults. PARTICIPANTS AND METHODS: A secondary analysis was performed using data from baseline and 1-, 2-, 3-, 4-, 6-, and 8-year follow-ups of the Osteoarthritis Initiative (OAI). The OAI recruited participants from 4 clinical sites in the United States, between February 2004 and May 2006. A self-reported questionnaire was used to determine the baseline musculoskeletal pain status in older adults (n = 1780) 65 years and older, including pain in the lower back, hip, knee, and at 2 or more sites. Using the Fried phenotypic criteria, participants were classified as nonfrail, prefrail, and frail at each period over 8 years. RESULTS: After adjusting for age, sex, race, education, marital status, annual income, smoking status, comorbidities, and body mass index, binary logistic regression modeling using generalized estimating equations revealed that in older adults musculoskeletal pain in the lower back and at multiple sites was associated with a slightly but significantly decreased risk of prefrailty over time (adjusted odds ratio [AOR] = 0.98, 95% CI = 0.95-0.99, P = .019; AOR = 0.96, CI = 0.92-0.99, P = .032). The association between musculoskeletal pain and frailty among older adults was not statistically significant (all P > .05). CONCLUSIONS: Musculoskeletal pain did not independently significantly increase the risk of prefrailty or frailty over time. It remains possible that when musculoskeletal is combined with other factors, the risk of prefrailty and frailty may be heightened. Further research into the combination of characteristics that best predict prefrailty and frailty, including but not limited to musculoskeletal pain, is warranted.

Evidence-based Health Care Continuing Education Seminars Improve Academic Staff Knowledge and Attitudes in Saudi Arabia.

OBJECTIVE: To assess the influence of a monthly evidence-based health care (EBHC) seminar series on academic staff knowledge, attitudes, and barriers regarding EBHC practice. METHODOLOGY: All academic staff in the College of Applied Medical Sciences (CAMS), King Saud University, Saudi Arabia, were sent a validated web-based survey. The survey contained 35 items regarding 3 domains: knowledge (14 items), attitudes (11 items), and barrier factors (10 items). A 5-point Likert scale was used and descriptive statistics were generated for demographic data and participants' responses to each item. RESULTS: Among academic staff at CAMS, 79 of 198 (40%) completed the survey. Among the survey respondents, 58% had attended at least one EBHC seminar. Those who had attended at least one seminar had better knowledge of 8 items compared with those who did not attend any seminars (P<.05). Academic staff members who attended at least one seminar were more likely to have a positive attitude regarding EBHC. Insufficient time was the only factor that significantly differed between the 2 groups, serving as a barrier to EBHC practice. CONCLUSIONS: Our findings suggest that EBHC seminars may improve the abilities and skills of academic staff for using EBHC.

Are physical therapy interns competent in patient management skills? Assessment of the views of clinical and academic physical therapists.

[Purpose] This study aimed at evaluating PT interns' performance from the perspectives of clinical and academic physical therapists (PTs). [Methods] An online questionnaire based on a modified version of the Clinical Internship Evaluation Tool (CIET) was used to evaluate PT interns' performance in patient management skills. Assessors comprised clinical and academic PTs from Saudi Arabia. The survey aimed at assessing the competency of interns in 25 patient management skills comprising four major domains: clinical examination, patient evaluation, diagnosis and prognosis, and intervention. Assessors were also asked to rank the importance of possessing each skill and evaluating the internship programs at their facilities. A multivariate logistic regression analysis assessed whether the demographic variables between the two groups influenced their views. [Results] A total of 148 participants (112 clinical PTs and 36 academic PTs) responded to the survey. The majority of the participants agreed that interns were competent in all 25 skills. Differences between the two groups of assessors were observed for five out of the 25 skills. Interestingly, skills with the highest means were perceived as the most important skills by both groups of assessors. There was no association between sociodemographic variables and evaluation scores. [Conclusion] There were no differences observed between clinical and academic PTs in their evaluation of PT interns in 20 of the 25 clinical skills. There were indications of a need for further improvement in certain competencies and skills such as clinical examination, evaluation, diagnosis and prognosis, and intervention.

The Changing Incidence and Prevalence of Falls and Its Disability Burden Among the Geriatric Population in Saudi Arabia from 1990 to 2019: A Longitudinal Analysis Using Global Burden of Disease Study Data.

BACKGROUND: Falls represent a significant and growing public health issue among older adults worldwide. This study provides a comprehensive analysis of the trends in the incidence, prevalence, and disability burden of falls among older adults in Saudi Arabia over 29 years, with a focus on gender disparities. METHODS: Utilizing the Global Burden of Disease (GBD) Study data, this observational analysis tracked the epidemiology of falls from 1990 to 2019. The study employed ICD-9 and ICD-10 codes to identify falls, analyzing incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs), stratified by gender and reported with 95% uncertainty intervals (UIs). RESULTS: The incidence and prevalence of falls increased for both genders from 1990 to 2019, with males showing a higher relative increase in prevalence rates (57% for males vs. 26% for females). The disability burden, indicated by DALYs, increased by 4% for males and decreased by 10% for females, whereas YLDs saw an increase of 38% for males and 8% for females. The analysis highlights a notable rise in both the frequency of falls and their associated disability, with gender-specific variations emphasizing greater impacts on males. CONCLUSIONS: The findings illustrate a significant increase in fall-related incidents and associated disabilities among older adults in Saudi Arabia, with distinct gender differences. These trends call for targeted public health interventions and further research into the underlying causes of falls, risk factors, and effective prevention strategies. Such measures are essential to mitigate the impact of falls, improve health outcomes, and enhance the quality of life for the aging population.

Deaths, causes, and their frequency among Saudi citizens: A descriptive analysis of data from the 2017 Population Characteristics Survey.

BACKGROUND: The number of deaths, causes, and frequency measures are crucial in determining the health of a country's population. OBJECTIVE: The current study aimed to estimate deaths, causes of death, and their frequency for Saudi nationals in 2017. METHODS: In this descriptive study, we used data from the 2017 Population Characteristics Survey (n = 14,215,901) and performed secondary data analysis between November 2021 and February 2022. We used a total number of survey samples to compute the deaths. The cause of death was determined by dividing the total number of fatalities according to sex. We calculated the overall population-, administrative region-, and gender-wise percentages, rates per 1,000 people per year, the ratios for mortality, and their reasons. RESULTS: There were 58,915 (0.4%) total deaths, including 0.3% and 0.2% deaths among females and males, respectively. The illness was the most frequent cause of mortality (46.5% or 465 per 1,000 population/year), notably in women (52.5% or 525 per 1,000 population/year). The fatality rate was higher due to traffic accidents (a total of five in every female and four males in every female). CONCLUSION: In 2017, illness-especially in women-was the cause of death. Road car accidents had a high mortality rate, especially among males. Saudi Arabia has lower death rates than other Arab nations and high-, moderate-, and low-income nations.

The Relationship Between Knee Osteoarthritis-Related Pain Severity and Daily Activities Involving the Upper and Lower Limbs in Saudi Adults: A Cross-Sectional Study.

Introduction Earlier research has shown an association between pain intensity and everyday activities in adults. However, it is vital to examine the relationship within the context of Saudi people who have knee osteoarthritis. Therefore, this study aimed to explore the connection between pain intensity and daily activities involving the lower and upper limbs among patients with knee osteoarthritis in Saudi Arabia. Methods This study enrolled 209 individuals aged 55 years and above who were diagnosed with radiographic knee osteoarthritis by physicians from five hospitals in Riyadh, Saudi Arabia, between March 2016 and March 2017. Participants were divided into two groups based on their pain intensity, measured using the visual analog scale. The first group included 141 individuals with mild or moderate pain, while the second group comprised 68 individuals with severe pain. The study assessed the physical functioning of these individuals by evaluating their ability to perform daily activities involving the lower and upper limbs, using the Physical Functioning Subscale of the 36-item Short Form Health Survey, which includes 10 items. Results Adjusted logistic regression analysis revealed that individuals experiencing severe pain related to knee osteoarthritis were more likely to encounter difficulties in climbing several flights of stairs (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.09-1.29), and one flight of stairs (OR = 1.19, 95% CI = 1.06-1.34), with challenges in bending, kneeling, or stooping (OR = 1.14, 95% CI = 1.05-1.23), walking more than one mile (OR = 1.15, 95% CI = 1.06-1.25), walking several blocks (OR = 1.17, 95% CI = 1.08-1.27), and walking one block (OR = 1.19, 95% CI = 1.06-1.34) than those with mild or moderate pain. Conclusion Our study results highlight the significant impact of severe pain on activities like climbing stairs, bending, kneeling, stooping, and walking longer distances among people with knee osteoarthritis in Saudi Arabia.

Associations Among Knee Osteoarthritis Severity, Body Mass Index, and Physical Functions in Saudi Arabian Adults: A Multi-Center Cross-Sectional Study.

Background The purpose of this study was to investigate the associations among knee osteoarthritis severity, body mass index, and physical functions in Saudi Arabian adults. Methodology In this multi-center, cross-sectional study, we performed a secondary data analysis that included 189 adults aged 55 years or above with doctor-diagnosed knee osteoarthritis enrolled in five hospitals in Riyadh, Saudi Arabia, between March 2016 and March 2017. According to knee osteoarthritis severity, all of the individuals were divided into the following three groups: mild (n = 36), moderate (n = 75), and severe (n = 78). A high body mass index was defined as a body mass index score of >25 kg/m2. Physical function was evaluated using the 36-item physical functioning subscale. Results Severe knee osteoarthritis had a significantly 6.47-fold (95% confidence interval (CI) = 2.95-14.22, p < 0.0001) higher risk of physical function than those with mild knee osteoarthritis after adjusting for age, sex, educational status, occupational status, affected knee with osteoarthritis, knee pain, and body mass index. However, moderate knee osteoarthritis had a 1.22-fold higher risk of physical function, but the association was not statistically significant (95% CI = 0.60-2.49, p = 0.578). Conclusions Severe but not moderate knee osteoarthritis was more likely to have the worst physical function than mild knee osteoarthritis among adults with a high body mass index in Saudi Arabia.

The Severity of Pain and Comorbidities Significantly Impact the Dependency on Activities of Daily Living among Musculoskeletal Patients in Jizan, Saudi Arabia.

Limited research has been carried out on the effects of pain, comorbidity, and impaired function in musculoskeletal patients in Jizan, Saudi Arabia. A cross-sectional study was conducted on 115 patients (aged ≥ 55 years) with physician-diagnosed musculoskeletal conditions in Jizan to investigate the association between pain severity, comorbidities, and dependence on activities of daily living (ADLs). Self-reported questionnaires were used to collect data on pain, comorbidities, and physical function measured by ADLs. In ADLs, participants were categorized as dependent (n = 36) or independent (n = 79). Logistic regression analysis was employed to determine the predictors of dependence. The results showed that higher pain severity (adjusted odds ratio (OR): 1.69, 95% confidence interval (CI): 1.21-2.38, p = 0.002) and a greater number of comorbidities (adjusted OR: 1.52, 95% CI: 1.06-2.17, p = 0.021) were independently associated with dependence in ADLs. These associations remained significant even after controlling for covariates. This study concluded that patients with musculoskeletal conditions in Jizan who experience high levels of pain and comorbidities are at risk of dependence on basic daily activities. Therefore, addressing pain and comorbidities is crucial for maintaining independence and improving quality of life. Personalized rehabilitation programs are needed to manage these conditions in this region.

Cross-cultural adaptation and validation of the Arabic version of McGill quality of life: revised questionnaire in the patients with cancer.

PURPOSE: The aims of this study were to translate and culturally adapt the McGill Quality of Life Questionnaire-revised (MQOL-R) to modern standard Arabic and to examine its reliability, construct, and discriminative validity in Arab patients with cancer. MATERIALS AND METHODS: Translation and cultural adaptation of the English MQOL-R to modern standard Arabic were performed according to international guidelines. For psychometric evaluation, 125 participants with cancer were selected and completed the MQOL-R along with Global Health Status/QoL and functional subscales of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and Eastern Cooperative Oncology Group performance status rating (ECOG-PS). The MQOL-R was tested for internal consistency, test-retest reliability, and construct validity. RESULTS: The Arabic MQOL-R questionnaire had adequate internal consistency with Cronbach's alphas between 0.75 and 0.91. Test-retest reliability was very strong (ICC2.1 =0.91 to 0.96, p < 0.001). As hypothesized, the Arabic MQOL-R subscales demonstrated moderate to excellent correlation with functional subscales of EORTC QLQ-C30, and moderate to good correlation with Global health status/QoL. CONCLUSION: The Arabic MQOL-R Questionnaire has adequate psychometric properties. Hence, it can be utilized in rehabilitation settings and research to measure health-related quality of life in the Arabic-speaking cancer population.IMPLICATIONS FOR REHABILITATIONThe Arabic version of McGill Quality of Life- Revised Questionnaire (MQOL-R) has been successfully translated, adapted, and validated into Modern Standard Arabic language.The Arabic MQOL-R is reliable and valid for measuring health-related quality of life in the Arabic-speaking cancer population.The Arabic MQOL-R can be used for clinical, rehabilitation and research purposes to evaluate the health-related quality of life in the Arabic-speaking cancer population.

Development and Validation of a New Patient-Reported Outcome Measure in the Arabic Language for Patients with Knee Osteoarthritis in Saudi Arabia.

Purpose: In Western countries, several patient-reported outcomes (PROs) measures have been developed and validated for knee osteoarthritis (OA) patients. While few PROs have been adopted for these patients in Saudi Arabia, which do not reflect all aspects of the Saudi socio-cultural context. Given this shortcoming, this study aimed to develop a new PRO measure in Arabic that covers all concepts related to health, function, and participation encompassing environmental and personal factors. Patients and Methods: A cross-sectional study was conducted on 73 males and females aged ≥55 diagnosed with radiographic knee OA recruited from the orthopedic and physiotherapy departments of five hospitals in Riyadh, Saudi Arabia, between September 2016 and March 2017. Physicians confirmed knee OA according to the American College of Rheumatology standards. We examined the psychometric properties of the new Arabic PRO measure. Results: The internal consistency and test-retest (a one-week interval) reliabilities were found acceptable and excellent with Cronbach's alpha and the intra-class correlation coefficient, ranging from 0.69 to 0.85 and 0.88 to 0.91, respectively. The construct validity was found fair with the correlation between the subscales Body Function and Physical Function (rs =0.63), Activity & Participation and Physical Function (rs =0.72), and Body Function and Bodily Pain (rs =0.58). We found a weak to fair correlation between the new Arabic PRO measure's subscales and the SF-36 physical composite scale (PCS: rs =0.34-0.69) compared to the mental-composite scale (MCS: rs =0.16-0.55). Conclusion: The 33-item new Arabic PRO measure is a well-accepted, reliable, and valid tool for use in knee OA patients in the Saudi cultural context.