The Stair Climb Power Test as an Efficacy Outcome in Randomized Trials of Function Promoting Therapies in Older Men

Abstract Background Standardization of performance-based physical function measures that are reliable and responsive to intervention is necessary for efficacy trials of function promoting anabolic therapies (FPTs). Herein, we describe a standardized method of measuring stair climbing power (SCP) and evaluate its ability to assess improvements in physical function in response to an FPT (testosterone) compared to gait speed. Methods We used a 12-step SCP test with and without carrying a load (loaded, LSCP or unloaded, USCP) in two testosterone trials in older men. SCP was determined from mass, total step-rise, and time of ascent measured with an electronic timing system. Associations between SCP and leg press performance (strength and power), testosterone levels, and gait speed were assessed. Test–retest reliability was evaluated using interclass correlation and Bland–Altman analyses. Results Baseline SCP was negatively associated with age and positively with leg strength and power and gait speed. Both tests of SCP were safe and showed excellent reliability (intra-class correlation 0.91–0.97 in both cohorts). Changes in testosterone concentrations were associated with changes in USCP and LSCP, but not gait speed in mobility-limited men. Changes in leg press performance were associated with SCP in both trials. Conclusions Both USCP and LSCP are safe and have high test–retest reliability. Compared to gait speed, SCP is associated more robustly with leg press performance and is sensitive to testosterone therapy. The LSCP might be a more responsive outcome than gait speed to evaluate the efficacy of FPT in randomized trials.

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Measuring physical function in psoriatic arthritis: comparing the Multi-Dimensional Health Assessment Questionnaire to the Health Assessment Questionnaire Disability Index

The Journal of Rheumatology ◽

10.3899/jrheum.200927 ◽

2021 ◽

pp. jrheum.200927

Author(s):

Weiyu Ye ◽

Simon Hackett ◽

Claire Vandevelde ◽

Sarah Twigg ◽

Philip S. Helliwell ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Physical Function ◽

Health Assessment Questionnaire ◽

Health Assessment ◽

Clinic Visit ◽

Retest Reliability ◽

Floor Effects ◽

Test Retest Reliability ◽

Assessment Questionnaire ◽

Questionnaire Disability

Objective To compare physical function scales of the Multi-Dimensional Health Assessment Questionnaire (MDHAQ) to the Health Assessment Questionnaire Disability Index (HAQDI) in patients with psoriatic arthritis (PsA), and examine whether either questionnaire is less prone to ‘floor effects’. Methods Data were collected prospectively from 2018 to 2019 across three UK hospitals. All patients completed physical function scales within the MDHAQ and HAQDI in a single clinic visit. Agreement was assessed using medians and the Bland-Altman method. Intraclass correlation coefficients (ICCs) were used to assess test-retest reliability. Results 210 patients completed the clinic visit; one withdrew consent thus 209 were analysed. 60.0% were male, with mean age of 51.7 years and median disease duration of 7 years. In clinic, median MDHAQ and HAQDI including/excluding aids scores were 0.30, 0.50 and 0.50 respectively. Although the median score for HAQDI is higher than MDHAQ, the difference between the two mostly lies within 1.96 standard deviations from the mean suggesting good agreement. The ICCs demonstrated excellent test-retest reliability for both HAQ questionnaires.Similar numbers of patients scored ‘0’ on the MDHAQ and HAQDI including/excluding aids (48, 47, and 49 respectively). Using a score of ≤0.5 as a cut-off for minor functional impairment, 23 patients had a MDHAQ ≤0.5 when their HAQDI including aids >0.5. Conversely, 4 patients had a MDHAQ > 0.5 when the HAQDI including aids ≤0.5. ConclusionBoth HAQ questionnaires appear to be similar in detecting floor effects in patients with PsA.

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Development, reliability and validity of the Safe Use of Mobility Aids Checklist (SUMAC) for 4-wheeled walker use in people living with dementia

10.21203/rs.2.22127/v2 ◽

2020 ◽

Author(s):

Susan Hunter ◽

Alison Divine ◽

Humberto Omana ◽

Edward Madou ◽

Jeffrey Holmes

Keyword(s):

Focus Groups ◽

Physical Function ◽

Assessment Tool ◽

Rank Order ◽

Criterion Validity ◽

Minimal Detectable Change ◽

Retest Reliability ◽

People With Dementia ◽

Mobility Aid ◽

Test Retest Reliability

Abstract Background: Balance and gait problems are common and progressive in dementia. Mobility aid use in people with dementia increases the likelihood of falls three-fold. An assessment tool to quantify mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safety with use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change.Methods: Healthcare professionals (HCP) experienced in care and rehabilitation of people with dementia participated in focus groups for item generation of the new tool, entitled The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Ten individuals with dementia using a 4-wheeled walker were recorded performing the tasks within the SUMAC. Reliability was evaluated by having five HCP score participant videos on two occasions. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity was evaluated using scores determined by a consensus panel compared to the individual HCP scores using Spearman’s rank-order correlations. Criterion validity was assessed between SUMAC-PF and the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations. Results: Three focus groups (n=17) were completed and these generated a tool comprised of nine tasks and the components within each task that the clinicians would observe for physical function and safe use. Inter-rater reliability was statistically significant for the SUMAC-PF (ICC=0.92, 95%CI (0.81, 0.98), p<0.001) and SUMAC-EQ (ICC=0.82, 95%CI (0.54, 0.95), p<0.001). Test-retest reliability was also statistically significant for the SUMAC-PF (ICC=0.89, 95%CI (0.81, 0.94), p<0.001) and SUMAC-EQ (ICC=0.88, 95%CI (0.79, 0.93), p<0.001). The POMA gait subscale correlated strongly with the SUMAC-PF (r=0.84), but not EQ (r=0.39).Conclusions: Each of the scores of the SUMAC, physical function and safe use of the equipment, demonstrated content validity, strong inter-rater and test-retest reliability and strong criterion and concurrent validity for the assessment of mobility aid safety in people with dementia.

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Development, reliability and validity of the Safe Use of Mobility Aids Checklist (SUMAC) for 4-wheeled walker use in people living with dementia

10.21203/rs.2.22127/v1 ◽

2020 ◽

Author(s):

Susan Hunter ◽

Alison Divine ◽

Humberto Omana ◽

Edward Madou ◽

Jeffrey Holmes

Keyword(s):

Focus Groups ◽

Physical Function ◽

Assessment Tool ◽

Rank Order ◽

Criterion Validity ◽

Minimal Detectable Change ◽

Retest Reliability ◽

People With Dementia ◽

Mobility Aid ◽

Test Retest Reliability

Abstract Background Balance and gait problems are common and progressive in dementia. Mobility aid use in people with dementia increases the likelihood of falls three-fold. An assessment tool to quantify mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safety with use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change. Methods Healthcare professionals (HCP) experienced in care and rehabilitation of people with dementia participated in focus groups for item generation of the new tool, entitled The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Ten individuals with dementia using a 4-wheeled walker were recorded performing the tasks within the SUMAC. Reliability was evaluated by having five HCP score participant videos on two occasions. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity was evaluated using scores determined by a consensus panel compared to the individual HCP scores using Spearman’s rank-order correlations. Criterion validity was assessed between SUMAC-PF and the Performance-Oriented Mobility Assessment (POMA) using Spearman’s rank-order correlations. Results Three focus groups (n=17) were completed and these generated a tool comprised of nine tasks and the components within each task that the clinicians would observe for physical function and safe use. Inter-rater reliability was statistically significant for the SUMC-PF (ICC=0.72, 95%CI (0.33-0.92), p<0.001) and SUMAC-EQ (ICC=0.40, 95%CI (0.03-0.78), p=0.020). Test-retest reliability was also statistically significant for the SUMAC-PF (ICC=0.69, 95%CI (0.45-0.83), p<0.001) and SUMAC-EQ (ICC=0.73, 95%CI (0.53,0.85), p<0.001). The POMA correlated strongly with the SUMAC-PF (r=0.84), but not EQ (r=0.39). Conclusions Each of the scores of the SUMAC, physical function and safe use of the equipment, demonstrated content validity, strong inter-rater and test-retest reliability and strong criterion and concurrent validity for the assessment of mobility aid safety in people with dementia.

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Cross-cultural translation, adaptation and validation of a Japanese version of the Functional Index for Hand Osteoarthritis (J-FIHOA)

10.21203/rs.2.20873/v2 ◽

2020 ◽

Author(s):

Yasunobu Nakagawa ◽

Shigeru Kurimoto ◽

Emmanuel Maheu ◽

Yuichiro Matsui ◽

Yuri Kanno ◽

...

Keyword(s):

Physical Function ◽

Japanese Version ◽

Measurement Properties ◽

Hand Osteoarthritis ◽

Functional Index ◽

Retest Reliability ◽

Stable Conditions ◽

Sf 36 ◽

Test Retest Reliability

Abstract Background: Hand osteoarthritis (OA) has a wide spectrum of clinical presentations and physical function is one of the core domains where patients suffer. The Functional Index for Hand Osteoarthritis (FIHOA) is a leading assessment tool for hand OA-related functional impairment. Our objective was to make a Japanese version of FIHOA (J-FIHOA) and validate it among Japanese hand OA patients. Methods: Forward and backward translation processes were completed to create a culturally adapted J-FIHOA. A prospective, observational multicenter study was undertaken for the validation process. Seventeen collaborating hospitals recruited Japanese hand OA patients who met the American College of Rheumatology criteria. A medical record review and responses to the following patient-rated questionnaires were collected: J-FIHOA, Hand20, Health Assessment Questionnaire (HAQ), numerical rating scale for pain (NRS pain) and Short Form 36 Health Survey (SF-36). We explored the structure of J-FIHOA using factor analysis. Cronbach’s alpha coefficients and item-total correlations were calculated. Correlations between J-FIHOA and other questionnaires were evaluated for construct validity. Participants in clinically stable conditions repeated J-FIHOA at a one- to two-week interval to assess test-retest reliability. To evaluate responsiveness, symptomatic patients who started new pharmacological treatments had a 1-month follow-up visit and completed the questionnaires twice. Effect size (ES) and standardized response mean (SRM) were calculated with pre- and post-treatment data sets. We assessed responsiveness, comparing ES and SRM of J-FIHOA with other questionnaires (construct approach). Results: A total of 210 patients participated. J-FIHOA had unidimensional structure. Cronbach’s alphas (0.914 among females and 0.929 among males) and item-total correlations (range, 0.508 to 0.881) revealed high internal consistency. Hand20, which measures upper extremity disability, was strongly correlated with J-FIHOA (r=0.82) while the mental and role-social components of SF-36 showed no correlations (r=−0.24 and −0.26, respectively). Intraclass correlation coefficient for test-retest reliability was 0.83 and satisfactory. J-FIHOA showed the highest ES and SRM (−0.68 and −0.62, respectively) among all questionnaires, except for NRS pain. Conclusions: Our results showed J-FIHOA had good measurement properties to assess physical function in Japanese hand OA patients both for ambulatory follow-up in clinical practice, and clinical research and therapeutic trials.

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Cross-Cultural Adaptation, Translation, and Validation of the Toronto Extremity Salvage Score for Extremity Bone and Soft Tissue Tumor Patients in Netherlands

Sarcoma ◽

10.1155/2017/6197525 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Julie J. Willeumier ◽

C. W. P. G. van der Wal ◽

Robert J. P. van der Wal ◽

P. D. S. Dijkstra ◽

Thea P. M. Vliet Vlieland ◽

...

Keyword(s):

Soft Tissue ◽

Physical Function ◽

Short Form ◽

Intraclass Correlation ◽

Retest Reliability ◽

Sf 36 ◽

Toronto Extremity Salvage Score ◽

Patient Reported ◽

Test Retest Reliability ◽

Extremity Salvage

Purpose. The aim of this study was to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) to Dutch and to validate the translated version. Methods. The TESS lower and upper extremity versions (LE and UE) were translated to Dutch according to international guidelines. The translated version was validated in 98 patients with surgically treated bone or soft tissue tumors of the LE or UE. To assess test-retest reliability, participants were asked to fill in a second questionnaire after one week. Construct validity was determined by computing Spearman rank correlations with the Short Form- (SF-) 36. Results. The internal consistency (0.957 and 0.938 for LE and UE, resp.) and test-retest reliability (intraclass correlation coefficients 0.963 and 0.969 for LE and UE, resp.) were good for both questionnaires. The Dutch LE and UE TESS versions correlated most strongly with the SF-36 physical function dimension (r=0.737 for LE, 0.726 for UE) and the physical component summary score (r=0.811 and 0.797 for LE and UE). Interpretation. The Dutch TESS questionnaire for lower and upper extremities is a consistent, reliable, and valid instrument to measure patient-reported physical function in surgically treated patients with a soft tissue or bone tumor.

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Assessment of test-retest reliability and internal consistency of the Wisconsin Gait Scale in hemiparetic post-stroke patients

Advances in Rehabilitation ◽

10.1515/rehab-2015-0048 ◽

2016 ◽

Vol 30 (3) ◽

pp. 41-53 ◽

Cited By ~ 4

Author(s):

Agnieszka Guzik ◽

Mariusz Drużbicki ◽

Grzegorz Przysada ◽

Andrzej Kwolek ◽

Agnieszka Brzozowska-Magoń ◽

...

Keyword(s):

Motor Control ◽

Internal Consistency ◽

Lower Limb ◽

Barthel Index ◽

Gait Speed ◽

Muscle Tone ◽

Stroke Patients ◽

Retest Reliability ◽

Post Stroke ◽

Test Retest Reliability

Abstract Introduction: A proper assessment of gait pattern is a significant aspect in planning the process of teaching gait in hemiparetic post-stroke patients. The Wisconsin Gait Scale (WGS) is an observational tool for assessing post-stroke patients’ gait. The aim of the study was to assess test-retest reliability and internal consistency of the WGS and examine correlations between gait assessment made with the WGS and gait speed, Brunnström scale, Ashworth’s scale and the Barthel Index. Material and methods: The research included 36 post-stroke patients. The patients’ gait was assessed with the use of the Wisconsin Gait Scale, gait speed with the use of walk test, the level of motor control in a paretic lower limb – according to Brunnström recovery stages, muscle tone in a paretic lower limb – according to modified Ashworth’s scale and functional independence was assessed using the Barthel Index. Gait was assessed with the use of the WGS twice, with a 7-day interval, by three experienced physiotherapists. Results: The analysis of internal consistency of the WGS revealed that the Cronbach’s α coefficient was high in the case of all the three raters and ranged from 0.85 to 0.88. It was noted that the coefficient of variation for all the comparisons was below 10%. When assessing the repeatability of the results, it was revealed that correlations between both measurements made by particular raters were very strong and highly significant. The WGS results significantly correlated with Brunnström scale, Ashworth’s scale and gait speed. Conclusions: It was concluded that the WGS has a high internal consistency and test-retest reliability. Also, significant correlations were found between gait assessment made with the use of the WGS and gait speed, level of motor control and muscle tone of a paretic lower limb. The WGS constitutes a promising tool for a qualitative, observational analysis of gait in post-stroke patients and allows for proper planning, monitoring and assessing rehabilitation results.

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