scholarly journals The five-repetition sit-to-stand test: evaluation of a simple and objective tool for the assessment of degenerative pathologies of the lumbar spine

2018 ◽  
Vol 29 (4) ◽  
pp. 380-387 ◽  
Author(s):  
Victor E. Staartjes ◽  
Marc L. Schröder
Keyword(s):  
Lumbar Spine ◽  
Functional Impairment ◽  
Convergent Validity ◽  
Intraclass Correlation ◽  
Leg Pain ◽  
Validity And Reliability ◽  
Sit To Stand ◽  
Objective Functional Impairment ◽  
Objective Functional ◽  
Objective Tool

OBJECTIVERecently, objective functional tests have generated interest since they can supplement an objective dimension to clinical assessment. The five-repetition sit-to-stand (5R-STS) test is a quick and objective tool that tests movements frequently used in everyday life. The aim of this prospective study was to evaluate the validity and reliability of the 5R-STS test in patients with degenerative pathologies of the lumbar spine.METHODSPatients and healthy volunteers completed the standardized 5R-STS, Roland-Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI), visual analog scale (VAS) for back and leg pain, and EQ-5D for health-related quality of life (HRQOL). To assess convergent validity, the 5R-STS test times were correlated with these questionnaires.RESULTSOverall, 157 patients and 80 volunteers were enrolled. Direct correlation with RMDQ (r = 0.49), ODI (r = 0.44), and VAS for back pain (r = 0.31) and indirect correlation with the EQ-5D index (r = −0.41) were observed (p < 0.001). The 5R-STS test showed no correlation with VAS for leg pain and EQ-5D VAS (p > 0.05). In 119 individuals, the 5R-STS test demonstrated excellent test-retest reliability with an intraclass correlation coefficient of 0.98. The upper limit of normal, distinguishing patients with and without objective functional impairment, was identified as 10.35 seconds. A severity stratification classified patients with test times of 10.5–15.2, 15.3–22.0, or greater than 22.0 seconds as having mild, moderate, or severe functional impairment, respectively.CONCLUSIONSThe 5R-STS test is a simple and effective tool to describe objective functional impairment. A patient able to perform the test in 10.4 seconds can be considered to have no relevant objective functional impairment.Clinical trial registration no.: NCT03303300 (clinicaltrials.gov)

scholarly journals Objective functional impairment in lumbar degenerative disease: concurrent validity of the baseline severity stratification for the five-repetition sit-to-stand test

2020 ◽  
Vol 33 (1) ◽  
pp. 4-11
Author(s):  
Anita M. Klukowska ◽  
Marc L. Schröder ◽  
Martin N. Stienen ◽  
Victor E. Staartjes
Keyword(s):  
Functional Impairment ◽  
Concurrent Validity ◽  
Leg Pain ◽  
Linear Regression Models ◽  
Lumbar Degenerative Disease ◽  
Baseline Severity ◽  
Sit To Stand ◽  
Patient Reported ◽  
Objective Functional Impairment ◽  
Objective Functional

OBJECTIVEThe five-repetition sit-to-stand (5R-STS) test provides a new dimension of clinical assessment by capturing objective functional impairment (OFI). Through the utilization of data from two prospective studies, the authors sought to evaluate the concurrent validity of the proposed 5R-STS baseline severity stratification (BSS) for OFI with the following levels based on time to completion in seconds: none, ≤ 10.4; mild, 10.5–15.2; moderate, 15.3–22.0; and severe, > 22.0 seconds.METHODSPatients with degenerative diseases of the spine performed the 5R-STS test and completed visual analog scales (VASs) for back and leg pain, the Oswestry Disability Index (ODI), the Roland-Morris Disability Questionnaire (RMDQ), and EQ-5D questionnaires. The degree of OFI severity was assessed based on the previously proposed BSS, and its association with patient-reported scales was evaluated using ANOVA as well as crude and adjusted linear regression models.RESULTSOur sample included 240 patients, of whom 101 exhibited no OFI, whereas 80, 34, and 25 were judged to have mild, moderate, and severe OFI, respectively. A higher baseline severity was strongly associated with loss of working ability (p < 0.001), as well as results of all patient-reported scales (p ≤ 0.001), with the exception of the VAS for leg pain (p = 0.556). Crude and adjusted regression analyses corroborated these findings, although only patients with moderate and severe OFI as judged by using the 5R-STS BSS demonstrated clinically relevant differences compared with patients without OFI.CONCLUSIONSThe degree of OFI—based on the 5R-STS BSS—is strongly associated with measures of back pain, subjective functional impairment, and health-related quality of life. However, leg pain severity is not reflected within the dimension of OFI measured by the 5R-STS. The proposed BSS appears to be a concurrently valid and clinically relevant measure of OFI in patients with degenerative spinal pathologies.

Validity and Reliability of a Measurement of Objective Functional Impairment in Lumbar Degenerative Disc Disease

Neurosurgery ◽  
2015 ◽  
Vol 79 (2) ◽  
pp. 270-278 ◽  
Author(s):  
Oliver P. Gautschi ◽  
Nicolas R. Smoll ◽  
Marco V. Corniola ◽  
Holger Joswig ◽  
Ivan Chau ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Functional Impairment ◽  
Degenerative Disc Disease ◽  
Short Form ◽  
Intraclass Correlation ◽  
Disc Disease ◽  
Lumbar Degenerative Disc Disease ◽  
Degenerative Disc ◽  
Objective Functional Impairment ◽  
Objective Functional

Abstract BACKGROUND: There are few objective measures of functional impairment to support clinical decision making in lumbar degenerative disc disease (DDD). OBJECTIVE: We present the validation (and reliability measures) of the Timed Up and Go (TUG) test. METHODS: In a prospective, 2-center study, 253 consecutive patients were assessed using the TUG test. A representative cohort of 110 volunteers served as control subjects. The TUG test values were assessed for validity and reliability. RESULTS: The TUG test had excellent intra- (intraclass correlation coefficient: 0.97) and interrater reliability (intraclass correlation coefficient: 0.99), with a standard error of measurement of 0.21 and 0.23 seconds, respectively. The validity of the TUG test was demonstrated by a good correlation with the Visual Analog Scale (VAS) back (Pearson's correlation coefficient [PCC]: 0.25) and VAS (PCC: 0.29) leg pain, functional impairment (Roland-Morris Disability Index [PCC: 0.38] and Oswestry Disability Index [PCC: 0.34]), as well as with health-related quality of life (Short Form-12 Mental Component Summary score [PCC: −0.25], Short Form-12 Physical Component Summary score [PCC: −0.32], and EQ-5D [PCC: −0.28]). The upper limit of “normal” was 11.52 seconds. Mild (lower than the 33rd percentile), moderate (33rd to 66th percentiles), and severe objective functional impairment (higher than the 66th percentile) as determined by the TUG test was &lt;13.4 seconds, 13.4 to 18.4 seconds, and &gt;18.4 seconds, respectively. CONCLUSION: The TUG test is a quick, easy-to-use, valid, and reliable tool to evaluate objective functional impairment in patients with lumbar degenerative disc disease. In the clinical setting, patients scoring a TUG test time of over 12 seconds can be considered to have functional impairment.

scholarly journals Validation of the baseline severity stratification of objective functional impairment in lumbar degenerative disc disease

2017 ◽  
Vol 26 (5) ◽  
pp. 598-604 ◽  
Author(s):  
Martin N. Stienen ◽  
Nicolas R. Smoll ◽  
Holger Joswig ◽  
Marco V. Corniola ◽  
Karl Schaller ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Degenerative Disc Disease ◽  
Leg Pain ◽  
Disc Disease ◽  
Lumbar Degenerative Disc Disease ◽  
Degenerative Disc ◽  
Baseline Severity ◽  
Vas Score ◽  
Objective Functional Impairment ◽  
Objective Functional

OBJECTIVEThe Timed Up and Go (TUG) test is a simple, objective, and standardized method to measure objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). The objective of the current work was to validate the OFI baseline severity stratification (BSS; with levels of “none,” “mild,” “moderate,” and “severe”).METHODSData were collected in a prospective IRB-approved 2-center study. Patients were assessed with a comprehensive panel of scales for measuring pain (visual analog scale [VAS] for back and leg pain), functional impairment (Roland-Morris Disability Index [RMDI] and Oswestry Disability Index [ODI]), and health-related quality of life (HRQOL; EQ-5D and SF-12). OFI BSS was determined using age- and sex-adjusted cutoff values.RESULTSA total of 375 consecutive patients scheduled for lumbar spine surgery were included. Each 1-step increase on the OFI BSS corresponded to an increase of 0.53 in the back pain VAS score, 0.69 in the leg pain VAS score, 1.81 points in the RMDI, and 5.93 points in the ODI, as well as to a decrease in HRQOL of −0.073 in the EQ-5D, −1.99 in the SF-12 physical component summary (PCS), and −1.62 in the SF-12 mental component summary (MCS; all p < 0.001). Patients with mild, moderate, and severe OFI had increased leg pain by 0.90 (p = 0.044), 1.54 (p < 0.001), and 1.94 (p < 0.001); increased ODI by 7.99 (p = 0.004), 12.64 (p < 0.001), and 17.13 (p < 0.001); and decreased SF-12 PCS by −2.57 (p = 0.049), −3.63 (p = 0.003), and −6.23 (p < 0.001), respectively.CONCLUSIONSThe OFI BSS is a valid measure of functional impairment for use in daily clinical practice. The presence of OFI indicates the presence of significant functional impairment on subjective outcome measures.

scholarly journals Efficacy of intraoperative epidural triamcinolone application in lumbar microdiscectomy: a matched-control study

2018 ◽  
Vol 28 (3) ◽  
pp. 291-299 ◽  
Author(s):  
Martin N. Stienen ◽  
Holger Joswig ◽  
Ivan Chau ◽  
Marian C. Neidert ◽  
David Bellut ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Nerve Root ◽  
Short Form ◽  
Leg Pain ◽  
Control Group ◽  
Lumbar Microdiscectomy ◽  
Objective Functional Impairment ◽  
And Control ◽  
Objective Functional ◽  
Age And Sex

OBJECTIVEThe purpose of this study was to investigate whether the intraoperative application of an epidural steroid (ES) on the decompressed nerve root improves short- and midterm subjective and objective clinical outcomes after lumbar microdiscectomy.METHODSThis study was a retrospective analysis of a 2-center database including consecutive cases in which patients underwent lumbar microdiscectomy. All patients who received ES application (40 mg triamcinolone, ES group) were matched by age and sex to patients who had not received ES application (control group). Objective functional impairment (OFI) was determined using age- and sex-adjusted T-scores of the Timed Up and Go (TUG) test. Back and leg pain (visual analog scale), functional impairment (Oswestry Disability Index [ODI], Roland-Morris Disability Index [RMDI], and health-related quality of life (hrQoL; 12-Item Short Form Health Survey [SF-12] physical component summary [PSC] score and EuroQol [EQ-5D index]) were measured at baseline, on postoperative day 3, and at postoperative week 6.RESULTSFifty-three patients who received ES application were matched with 101 controls. There were no baseline demographic or disease-specific differences between the study groups, and preoperative pain, functional impairment, and hrQoL were similar. On postoperative day 3, the ES group had less disability on the RMDI (mean 7.4 vs 10.3, p = 0.003) and higher hrQoL as determined by the SF-12 PCS (36.5 vs 32.7, p = 0.004). At week 6, the ES group had less disability on the RMDI (3.6 vs 5.7, p = 0.050) and on the ODI by trend (17.0 vs 24.4, p = 0.056); better hrQoL, determined by the SF-12 PCS (44.3 vs 39.9, p = 0.018); and lower OFI (TUG test T-score 100.5 vs 110.2, p = 0.005). The week 6 responder status based on the minimum clinically important difference (MCID) was similar in the ES and control groups for each metric. The rates and severity of complications were similar, with a 3.8% and 4.0% reoperation rate in the ES group and control group, respectively (p = 0.272). There was a tendency for shorter hospitalization in the ES group (5.0 vs 5.8 days, p = 0.066).CONCLUSIONSIntraoperative ES application on the decompressed nerve root is an effective adjunct treatment that may lower subjective and objective functional impairment and increase hrQoL in the short and intermediate term after lumbar microdiscectomy. However, group differences were lower than the commonly accepted MCIDs for each metric, indicating that the effect size of the benefit is limited.■ CLASSIFICATION OF EVIDENCE Type of question: therapeutic; study design: retrospective cohort trial; evidence: Class II.

Validity and reliability of the Mandarin version of the Treatment Burden Questionnaire among stroke patients in Mainland China

2021 ◽  
Author(s):  
Qi Zhang ◽  
Ke Zhang ◽  
Miao Li ◽  
Jiaxin Gu ◽  
Xintong Li ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Convergent Validity ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Therapeutic Interventions ◽  
Treatment Burden ◽  
Validity And Reliability ◽  
Stroke Patients ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Objectives To examine the validity and reliability of the Mandarin version of the Treatment Burden Questionnaire (TBQ) among stroke patients. Background Stroke patients need long-term management of symptoms and life situation, and treatment burden has recently emerged as a new concept that can influence the health outcomes during the rehabilitation process. Methods The convenience sampling method was used to recruit 187 cases of stroke patients in a tertiary grade hospital in Tianjin for a formal investigation. Item analysis, reliability and validity tests were carried out. The reliability test included internal consistency and test–retest reliability. And as well as content, structure and convergent validity were performed for the validity test. Results Of the 187 completed questionnaires, only 180 (96.3%) were suitable for analysis. According to the experts’ evaluation, the I-CVI of each item was from 0.833 to 1.000, and the S-CVI was 0.967. The exploratory factor analysis yielded three-factor components with a cumulative variation of 53.054%. Convergent validity was demonstrated using measures of Morisky’s Medication Adherence Scale 8 (r = –0.450, P &lt; 0.01). All correlations between items and global scores ranged from 0.403 to 0.638. Internal consistency reliability and test–retest reliability were found to be acceptable, as indicated by a Cronbach’s α of 0.824 and an intraclass correlation coefficient of 0.846, respectively. Conclusions The Mandarin TBQ had acceptable validity and reliability. The use of TBQ in the assessment of treatment burden of stroke survivor may benefit health resources allocation and provide tailor therapeutic interventions to construct minimally disruptive care.

scholarly journals Beurteilung funktioneller Einschränkungen bei degenerativen Erkrankungen der Lendenwirbelsäule: Wer hat Recht – der Arzt, der Patient oder der objektive Test?

Praxis ◽  
2017 ◽  
Vol 106 (19) ◽  
pp. 1041-1052 ◽  
Author(s):  
Martin N. Stienen ◽  
David Bellut ◽  
Luca Regli ◽  
Oliver N. Hausmann ◽  
Oliver P. Gautschi
Keyword(s):  
Functional Impairment ◽  
Timed Up And Go ◽  
Objective Functional Impairment ◽  
Objective Functional

Zusammenfassung. Zur exakten Erfassung von Schmerzen, funktionellen Einschränkungen und gesundheitsbezogener Lebensqualität bei Patienten mit degenerativen Wirbelsäulenerkrankungen existiert eine Reihe validierter Messinstrumente. Neben der Beurteilung durch den Therapeuten sowie «subjektiven» patientenorientierten Messmethoden (PROMs) wurde in den vergangenen Jahren der «Timed Up and Go»(TUG)-Test systematisch untersucht und als krankheitsspezifisches Messinstrument validiert. Heute kann eine objektive funktionelle Einschränkung (OFI = Objective Functional Impairment) in wenigen Sekunden und kostenfrei mithilfe einer Smartphone-Applikation bestimmt werden. Die Bestimmung von Z- oder T-Werten, die TUG-Testergebnisse in Relation zur Populationsnorm setzen, ermöglichen eine alters- und geschlechtsadjustierte Ergebnisinterpretation. Diese Übersichtsarbeit fasst die aktuellen Erkenntnisse zu objektiven Messmethoden bei degenerativen Wirbelsäulenpathologien inklusive deren Vor- und Nachteile zusammen und vergleicht sie mit den bisherigen Beurteilungsmethoden für funktionelle Outcomes.

scholarly journals The Quantitative Checklist for Autism in Toddlers (Q-CHAT): A preliminary psychometric study in Chile

2021 ◽  
Author(s):  
Gabriel Gatica-Bahamonde ◽  
Paula Alarcon ◽  
Alejandra Mendez Fadol ◽  
Carrie Allison ◽  
Simon Baron-Cohen ◽  
...  
Keyword(s):  
Factor Structure ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Community Sample ◽  
Intraclass Correlation ◽  
Autistic Traits ◽  
Validity And Reliability ◽  
Early Screening ◽  
Probabilistic Sampling ◽  
Interaction Factor

The aim of this study was to examine the psychometric properties of an adapted version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT), an early screening tool that quantifies autistic traits dimensionally, in a community sample of Chilean children aged 18-24 months. An intentional non-probabilistic sampling was used. All primary caregivers of children aged 18-24 months who attended health check-up at four primary care clinics in Chile's Araucanía region during the study period were invited to participate. One hundred and eighty-eight toddlers were screened. Evidence of construct validity was determined through Exploratory Factor Analysis (EFA), evidence of convergent validity with the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F), and evidence of reliability through internal consistency and test-retest. The EFA showed a two-factor structure, which explained 42.2 % of the variance: “Restrictive and Repetitive Patterns” (factor 1), and “Communication and Social Interaction” (factor 2). The total Q-CHAT scores correlated positively and significantly with the total M-CHAT-R/F scores (r=0.59, p&lt;0.01) with a large effect size. Internal consistency was acceptable for the scale in general (α=0.74), acceptable for factor 1 (α = 0.76) and good (α=0.85) for factor 2. Regarding test-retest stability, the intraclass correlation coefficient was good (ICC=0.86, p&lt;0.001). In terms of the factor structure evidenced by the EFA, the two factors are theoretically consistent with the current diagnostic criteria of the DSM-5. The evidence of validity and reliability of Q-CHAT is encouraging when considering its use as an early detection tool in Chile.

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