Influence of parental physical activity on offspring’s nutritional status: an intergenerational study in the 1993 Pelotas birth cohort

Objective: To investigate the influence of parental physical activity on offspring’s nutritional status in the 1993 Pelotas (Brazil) birth cohort. Design: Birth cohort study. Setting: The main outcomes were overweight and obesity status of children. The main exposure was parental physical activity over time, measured during the 11-, 15-, and 18-years of age follow-ups. The exposure was operationalized as cumulative, and the most recent measure before the birth of child. We adjusted Poisson regression models with robust variance to evaluate crude and adjusted associations between parental physical activity and offspring’s nutritional status. All analyses were stratified according to the sex of the parent. Participants: A total of 874 members from the 1993 Pelotas (Brazil) birth cohort followed-up at 22-years of age with their first-born child were analysed. Results: Children were, on average, 3.1 years old. Crude analyses showed that the mother’s cumulative physical activity measure had an indirect association with the prevalence of children’s obesity. The most recent maternal physical activity measure before the birth of the child was associated with 41% lower prevalence of obesity in children, even after adjustment for confounders. Conclusions: The most recent maternal physical activity measure was indirectly associated with the prevalence of obesity of children. No associations were found for fathers, reinforcing the hypothesis of a biological effect of maternal physical activity on offspring’s nutritional status.

Defining Potential Overutilization of Physical Therapy Consults on Hospital Medicine Services

Appropriate use of inpatient physical therapy services is important for preventing hospital-associated disability (HAD). We assessed potential overutilization of physical therapy consults on hospital medicine services using the Activity Measure-Post Acute Care (AM-PAC) score. Our sample included 3592 unique admissions (mean age, 66 years; 48% women) at a large academic medical center. Based on an AM-PAC cutoff of >43.63 (raw score, 18) in patients who were discharged to home, 38% of physical therapy consults were considered “potential overutilization.” Combined with age <65 years, 18% of consults remained “potential overutilization.” After adjustment for age, sex, and length of stay, patients admitted with high mobility scores were 5.38 times more likely to be discharged to home (95% CI, 4.36-2.89) compared with those with low mobility scores. Being more judicious with physical therapy consults and reserving skilled therapy for at-risk patients could help prevent HAD while also having a positive impact on healthcare systems.

Validation of the Japanese Version of the Patterns of Activity Measure-Pain in Individuals with Chronic Pain

Background The Patterns of Activity Measure-Pain (POAM-P) is a self-report questionnaire that measures avoidance, overdoing, and pacing in individuals with chronic pain. We aimed to develop and confirm the psychometric properties of the Japanese version of the POAM-P(POAM-P-J) in Japanese individuals with chronic pain. Methods We recruited 147 Japanese individuals with chronic pain (106 women; mean age 64.89 ± 12.13 years). The individuals completed the POAM-P-J, the Brief Pain Inventory (BPI), and the Hospital Anxiety and Depression Scale (HADS). The following psychometric properties of the POAM-P-J were confirmed: structural validity, internal consistency, test-retest reliability, and concurrent validity. Results We tested factor structure via confirmatory factor analyses (CFA). We chose the 3-factor model with six covariances. The POAM-P-J’s internal consistency and test-retest reliability were acceptable to good (α = 0.79–0.86; ICC = 0.72–0.87). The avoidance and overdoing scales were positively associated with pain severity, pain interference, and anxiety measures (all p < 0.05), but the pacing scale was not significantly associated with these pain-related measures. Conclusions Although the structural validity of the POAM-P-J remains questionable, its internal consistency, test-retest reliability, and concurrent validity were confirmed. The POAM-P-J is useful in both research and clinical practice for evaluating the activity patterns of Japanese patients with chronic pain.

Validation of the Japanese version of the Patterns of Activity Measure-Pain in Individuals with Chronic Pain

BackgroundThe Patterns of Activity Measure-Pain (POAM-P) is a self-report questionnaire that measures avoidance, overdoing, and pacing in individuals with chronic pain. We aimed to develop and confirm the psychometric properties of the Japanese version of the POAM-P(POAM-P-J) in Japanese individuals with chronic pain.MethodsWe recruited 147 Japanese individuals with chronic pain (106 women; mean age 64.89±12.13 years). The individuals completed the POAM-P-J, the Brief Pain Inventory (BPI), and the Hospital Anxiety and Depression Scale (HADS). The following psychometric properties of the POAM-P-J were confirmed: structural validity, internal consistency, test-retest reliability, and concurrent validity. ResultsWe tested factor structure via confirmatory factor analyses (CFA). We chose the 3-factor model with six covariances. The POAM-P-J’s internal consistency and test-retest reliability were acceptable to good (α = 0.79–0.86; ICC = 0.72–0.87). The avoidance and overdoing scales were positively associated with pain severity, pain interference, and anxiety measures (all p < 0.05), but the pacing scale was not significantly associated with these pain-related measures.ConclusionsAlthough the structural validity of the POAM-P-J remains questionable, its internal consistency, test-retest reliability, and concurrent validity were confirmed. The POAM-P-J is useful in both research and clinical practice for evaluating the activity patterns of Japanese patients with chronic pain.

Development and initial validation of ability levels to interpret pediatric spinal cord injury activity measure and pediatric measure of participation scores

PURPOSE: To develop ability levels and descriptions to interpret Pediatric Spinal Cord Injury Activity Measure (PEDI-SCI AM) and Pediatric Measure of Participation (PMoP) scores. METHODS: Mixed-methods approach to 1.) create item maps using PEDI-SCI AM and PMoP calibration data; 2.) employ bookmarking methods and an iterative consensus process including semi-structured interviews, focus groups and surveys to establish PEDI-SCI AM and PMoP level score cut-points and descriptions; 3.) use calibration sample data to examine mean score differences across levels [analyses of variance (ANOVAs)] and assess the sample distribution (%) across levels; 4.) repeat in a separate validation sample; 5.) develop level descriptions. Throughout the mixed methods approach, the sample participants include children with spinal cord injury (SCI), parents of children with SCI, and professionals who work with children with SCI. RESULTS: Four or five ability levels were identified for each PEDI-SCI AM and PMoP domain along with descriptions for each level. ANOVA results revealed significant overall differences for level mean scores and pairwise comparisons (p < 0.05). Consensus (>80%) was achieved for all PEDI-SCI AM and some PMoP level descriptions. CONCLUSION: PEDI-SCI AM and PMoP score cut-points identify different levels of activity and participation among children with SCI. These levels and descriptions provide clinical relevance for PEDI-SCI and PMoP numeric scores.

Physiotherapists’ and Physiotherapy Assistants’ Perspectives on Using Three Physical Function Measures in the Intensive Care Unit: A Mixed-Methods Study

Purpose: We sought to understand physiotherapists’ and physiotherapist assistants’ perspectives on using three physical function measures in the intensive care unit (ICU) setting: the Activity Measure for Post-Acute Care Inpatient Mobility Short Form, the Johns Hopkins Highest Level of Mobility scale, and the Functional Status Score for the Intensive Care Unit. Method: A six-item questionnaire was developed and administered to physiotherapists and physiotherapist assistants working in adult ICUs at one U.S. teaching hospital. A single semi-structured focus group was conducted with seven physiotherapists, recruited using purposive sampling to include participants with a range of clinical experience. Results: Of 22 potential participants, 18 physiotherapists and 2 physiotherapist assistants completed the questionnaire. Seven physiotherapists participated in the focus group. The questionnaire found favourable perspectives on the use of the three physical function measures in clinical practice, and the focus group identified five themes related to clinicians’ experience with using them: (1) ease of scoring, (2) usefulness in inter-professional communication, (3) general ease of use, (4) responsiveness to change in physical function, and (5) generalizability across patients. Conclusions: The most frequently discussed themes in this study were ease of scoring and usefulness in inter-professional communication, highlighting their importance in designing and selecting physical function measures for clinical use in the ICU setting.

Arm activity measure (ArmA): psychometric evaluation of the Swedish version

Background Patient Reported Outcomes Measure (PROM) are commonly used in research and essential to understand the patient experience when receiving treatment. Arm Activity Measure (ArmA) is a valid and reliable self-report questionnaire for assessing passive (section A) and active (section B) real-life arm function in patients with disabling spasticity. The original English version of ArmA has been psychometrically tested and translated into Thai. Aims Translate and cross-culturally adapt ArmA to Swedish language and context. Further, to evaluate the reliability, validity and sensitivity of the Swedish version of the questionnaire (ArmA-S) in patients with disabling upper limb spasticity caused by injuries to the central nervous system (CNS). Materials and methods ArmA was translated and cross-culturally adapted according to established guidelines. Validity and reliability were evaluated in 61 patients with disabling spasticity. Face and content validity was evaluated by expert opinions from clinicians and feedback from patients with upper limb spasticity. Internal consistency reliability was assessed with Cronbach’s alpha and test-retest reliability was assessed using the quadratic weighted kappa. Results ArmA-S was shown to be clinically feasible, with good face and content validity and no floor or ceiling effects. Internal consistency of ArmA-S was high and equivalent to ArmA; with Chronbach´s alpha coefficients values of 0.94 and 0.93 for section A and B, respectively. Test-retest reliability was good, with kappa values of 0.86 and 0.83 for section A and B, respectively. Some layout modifications of ArmA-S were made to further increase the user-friendliness, test-retest reliability, and responsiveness. Conclusion ArmA-S was shown to be a reliable and valid self-report questionnaire for use in clinical practice and research to assess improvements in passive and active upper limb function in patients with disabling spasticity.