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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purposes of this investigation of patients with stroke were to 1) determine and compare shoulder lateral rotation range of motion (SLRROM) measured at the threshold of pain on the paretic and nonparetic sides; 2) establish the intrarater and interrater reliability of the measurements; and 3) determine the relationship between SLRROM measurements and the independent variables of age, sex, and time since onset of stroke. Subjects were 25 rehabilitation inpatients. The two investigators each measured the patients' SLRROM twice on both the paretic and nonparetic sides using a gravity goniometer. An analysis of variance (ANOVA) demonstrated that SLRROM was significantly less on the paretic side than on the nonparetic side (F = 28.98, p less than .001). The ANOVA demonstrated no difference in the two raters' measurements of SLRROM. The intraclass correlation coefficients (ICC[3,1]) and interrater reliability coefficients were all good to high (.874-.989). The SLRROM on the paretic side correlated significantly with time since onset of stroke (r = -.538, p less than .01). As a consequence of this study, we concluded that 1) patients with stroke tend to lose SLRROM on the paretic side, 2) SLRROM tends to decrease with time, and 3) measurements of SLRROM obtained with a gravity goniometer are reliable and sensitive.
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PMID:Decreased shoulder range of motion on paretic side after stroke. 277 40

Because spinal range of motion (ROM) is assessed routinely in clinical and research settings, a technique is needed that can be performed comfortably, quickly, and reliably. The purpose of this study was to determine if ROM data from asymptomatic subjects measured with the OSI CA 6000 Spine Motion Analyzer (OSI SMA) are reliable within and between observers. Thoracolumbar ROM, from approximately T7 to S2, was measured in all three planes in eight male and 13 female asymptomatic adult subjects (mean age = 29.7 years, SD = 5.6; mean height = 1.7 m, SD = 3.4, mean weight = 78.25 kg, SD = 34.6). A standardized protocol was used to fit each subject with appropriate hardware. Foot placement at a comfortable foot angle was standardized by the use of a template. Subjects performed three practice trials of flexion, extension, right and left sidebending, and right and left rotation. During testing, subjects performed four trials of each maximal pain-free motion. The hardware was completely removed and replaced by the same examiner, and ROM trials in all three planes were repeated. The same procedure was completed by a second examiner. Repeated measures analysis of variance and intraclass correlation coefficients (ICC [2,1] were used to analyze intra- and interobserver data. Intraobserver ICCs were 0.89 or higher for all motions. Interobserver ICCs were 0.85 or higher for all motions. Measurements of thoracolumbar ROM using the OSI SMA are sufficiently reliable within and between observers for clinical assessment and research purposes.
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PMID:Intraobserver and interobserver reliability of asymptomatic subjects' thoracolumbar range of motion using the OSI CA 6000 Spine Motion Analyzer. 798 81

Chronic placement of the head anterior to the body's center of gravity can be a component in the development of neurovascular and musculoskeletal dysfunction. In order to evaluate and treat dysfunction and pain, physical therapists need to be aware of variables that can affect head position. The objectives of this study were to investigate the interaction between wearing multifocal lenses and head posture; to determine the interaction of forward head posture and upper quarter pain; and to determine the intratester reliability of a head posture gauge. Head posture and self-reported pain were collected on 25 randomly chosen multifocal lens wearers between the ages of 40 and 50 and compared with a similar group of nonmultifocal lens wearers. The mean forward head posture in the two groups were significantly different (t = 2.06, one-tailed, p = 0.023). Subjects wearing multifocal lenses had a greater degree of forward head posture when compared with nonmultifocal lens wearers. A one-way analysis of variance was used to compare forward head posture with pain. In this sample, mean forward head posture levels did not differ significantly according to level of pain (p = 0.15). Intratester reliability of the head posture gauge was demonstrated to be high through the use of the intraclass correlation coefficient (ICC = 0.99). Wearing multifocal lenses may influence a person to hold his/her head in a position more forward than the ideal postural alignment.
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PMID:The interaction of wearing multifocal lenses with head posture and pain. 891 98

Onychomycosis is a common nail disorder associated with pain, discomfort and varying degrees of physical impairment and loss of dexterity. Psychological and social limitations result from reactions of others to visible impairment. The goal of this research is to validate a questionnaire to measure the impact of toenail onychomycosis on health-related quality of life (HRQoL). One hundred and fifty onychomycosis patients were enrolled in an observational study at eight sites in the US. Attending physicians reported information on clinical status at enrolment. Patients completed a questionnaire covering HRQoL that included general and disease-specific items measuring the impact of onychomycosis on activities and appearance, plus problems and symptoms associated with toenail infection. The subscales of the instrument showed high internal consistency reliability (range = 0.63-0.95). Construct validity reflected the close association of physical functioning scores with onychomycosis impairment. Test-Retest reliability was good to excellent for all scales (ICC = 0.52-0.89). Discriminant validity was evidenced by persons who are younger and female reporting worse disease-specific HRQoL. Responsiveness to clinical change was noted for all disease-specific scale scores for improved patients. This instrument has demonstrated reliability, validity and responsiveness for use in observational and clinical studies of toenail onychomycosis patients. Data indicate that onychomycosis patients report significant pain and discomfort reflecting the need for HRQoL measurement.
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PMID:A health-related quality of life measure for use in patients with onychomycosis: a validation study. 1045 45

This study was conducted to test the psychometric properties of a newly developed health-related quality-of-life (HRQoL) questionnaire. A total of 172 symptomatic GERD patients completed a 57-item questionnaire (containing the SF-12; symptom frequency/bothersomeness; problems related to activities, sleep, work disability; overall HRQoL; and treatment satisfaction) at baseline, week 1 [retest (N = 25)], and week 4 [follow-up (N = 100)]. Internal-consistency reliability was acceptable for most scales (range: 0.74-0.92). Test-retest reliability was acceptable for most scales (ICC: 0.74-0.85). Construct validity was demonstrated based on observed correlations. Known-groups validity was upheld, as patients who experienced more symptom days and patients who reported higher pain reported worse HRQoL than those with less symptoms or less severe pain. When categorized according to change in pain severity, Guyatt's statistic for the "improved" and "worse" groups demonstrated responsiveness, although many of the scales for the "stable" group were also responsive. In conclusion, the HRQoL questionnaire was found to be reliable, valid, and responsive.
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PMID:Development of a health-related quality-of-life questionnaire for individuals with gastroesophageal reflux disease: a validation study. 1048 23

Cervical range of motion (ROM) is evaluated in both clinical and research settings. This study's purpose was to determine if ROM data obtained with the OSI CA 6000 Spine Motion Analyser (SMA) from asymptomatic and symptomatic cervical subjects were reliable within and between testers. Cervical ROM was measured in all three planes in 30 adult asymptomatic and 20 adult symptomatic subjects. A standardized protocol was used to fit each subject with the OSI SMA cervical hardware. Subjects were tested in a seated position with the trunk stabilized. Subjects performed four trials of each pain-free cervical motion during testing. The hardware was completely removed and replaced by the same tester and ROM trials in all three planes were repeated for intratester asymptomatic and symptomatic reliability. The same procedure was completed by a second tester for asymptomatic intratester and intertester reliability. Repeated measures analysis of variance and intraclass correlation coefficients (ICC [2,1 and 2 k]) were used to analyse intra- and intertester reliability data. Intratester ICCs were 0.85 or higher (except for flexion 0.76) for asymptomatic subjects and 0. 87 or higher (except for flexion 0.68) for symptomatic subjects for all motions. Intertester ICCs were 0.88 or higher for all motions. Standard error of measurements were less than 3.92 degrees for all motions. Measures of cervical spinal ROM obtained with the OSI SMA showed good intertester reliablity for all motions, and good intratester reliability for all motions with the exception of the motion of flexion for one of the examiners, which showed moderate reliability.
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PMID:Reliability of cervical range of motion using the OSI CA 6000 spine motion analyser on asymptomatic and symptomatic subjects. 1090 83

The O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) has been proposed as a treatment outcome measure in interstitial cystitis (IC). The psychometric properties of the ICSI were assessed for reliability and validity in a randomized, double-blind clinical study of 300, 600, and 900 mg daily dose of pentosan polysulfate sodium (PPS) in patients with IC. The ICSI contains 4 items that measure urgency and frequency of urination, nighttime urination, and pain or burning. The ICSI index score is the sum of the item scores (range: 0-20). ICSI scores were obtained at baseline, 4, 8, 12, 16, 24, and 32 weeks of treatment. Patients' overall ratings of improvement of symptoms (PORIS) scores evaluating improvements in pain, urgency, and overall IC symptoms were also collected except at baseline. A total of 376 patients were included in the analysis. Psychometric properties evaluated included variability (range), test-retest reliability (intraclass correlation coefficient [ICC]), internal consistency (the Cronbach alpha), construct validity (convergent, discriminant), responsiveness, and clinically meaningful change. The ICSI items and index score had good variability and test-retest reliability. The ICSI demonstrated internal consistency reliability and was responsive to change. Participants indicating a 75% improvement in PORIS had a 48% mean reduction in the ICSI score, while participants reporting 100% improvement in PORIS had a 77% mean reduction in the ICSI score. The ICSI is a valid, reliable, and responsive measure of change in IC symptoms. This outcome measure should be utilized in future treatment outcomes studies in IC.
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PMID:Psychometric validation of the O'leary-Sant interstitial cystitis symptom index in a clinical trial of pentosan polysulfate sodium. 1137 52

INTRODUCTION:: Little information exits concerning the effect, if any, foot orthoses have upon how the foot is loaded during normal walking. The purpose of this study was to determine if there was a difference in the initiation of forefoot loading with different densities of foot orthoses. METHODS:: Ten volunteers (5 men, 5 women) between the age of 23 and 43 years (mean=30.3 yrs) participated in this study. None of the subjects had a history of congenital deformity, hallux valgus, malleolar torsion or a history of injury or pain to either lower extremity 12 months prior to the start of the investigation. Two different pair of foot orthoses were provided to each subject in the study. One pair consisted of UCO-BKS medium width foot orthoses with a durometer rating of 55-60 (Shore A gauge). Forefoot and/or rearfoot wedging was applied to these orthoses if indicated from a physical examination. This orthotic condition was labeled RIGID. The second pair consisted of UCO-BF foot orthoses with a durometer rating of 30-35 (Shore A gauge). This orthotic condition was labeled SOFT. In addition to the foot orthoses, each of the 10 subjects were fitted with the same type of footwear (Reebok Boston Road). Following a 'break-in' period for the footwear and orthotics, each subject walked along a 12 m walkway with the EMED PEDAR insole placed inside their shoes. A total of 10 consecutive walking trials were collected at each subject's self-selected speed. Using the NOVELWin MASKS program, the plantar surface of the forefoot was divided into 3 different areas, Lateral, Central and Medial. The time of initiation of loading for each of these masks was then determined. Reliability of the loading initiation times was determined using type (2,1) intraclass correlation coefficients. Differences between the three forefoot areas were determined using a one-way, repeated measuresANOVA and Tukey's post hoc analysis, if indicated. An alpha level of 0.05 was used for all tests of statistical significance. RESULTS:: The ICC values for the initiation of loading in the forefoot were in excess of.936. The result of theANOVA test revealed that the medial forefoot is loaded significantly earlier with a RIGID foot orthotic compared to either the SHOE ONLY or SOFT foot orthotic condition. This earlier loading caused a reversal of the normal loading sequence of plantar pressure in the forefoot during walking. DISCUSSION:: Previous studies have reported that approximately 10 degrees of forefoot movement, independent to hindfoot motion occurs during the loading response of walking. An additional 3 degrees has been shown to occur from the end of the loading response to mid-stance. It would appear from the findings of this study that rigid orthoses prevent this normal independent movement between the forefoot and hindfoot, since the rigid orthoses cause earlier loading of the medial forefoot. The soft orthoses permitted the same lateral to medial forefoot loading pattern also observed in barefoot walking. CONCLUSION:: The results of this study indicate that the use of a rigid foot orthosis inside a shoe, alters the timing of forefoot loading during walking. These findings suggest that the use of soft orthoses permit a more normal forefoot to hindfoot movement pattern during the loading phase of walking.
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PMID:The effect of foot orthotics on the initiation of plantar surface loading. 1141 99

This study investigated the psychometric properties of a battery of physical performance tests, characterized physical function in patients with cancer referred for rehabilitation, and provided normative standards against which to compare disease progression and/or future treatment effectiveness. A total of 109 patients with cancer (55 women and 54 men) and 105 control subjects (66 women and 39 men) participated. Subjects completed self-report questionnaires regarding pain, physical function, and fatigue, and also performed nine physical performance tests: the time taken to complete various tasks (picking up coins, tying a belt, reaching up, putting on a sock, standing from sitting, a 50-foot fast walk, a 50-foot walk at preferred speed), the distance walked in 6 minutes, and the distance reached forward while standing were measured. Inter-tester and test-retest reliability was good to excellent for all tests (ICC(11) 0.69 to 0.99). Known group analyses controlling for age were significant (P < 0.001) for all physical performance tests. Control subjects significantly and systematically outperformed those with cancer by a factor of two or three. Examination of the correlation matrices showed relatively low correlations between performance and external measures (r = 0.01 to 0.45). In contrast, correlations among performance measures were generally in the range of r = 0.25 to 0.85. Correlations between self-report of function and performance of functional tests were moderate, suggesting that the two methods of measuring function are complementary and both should be used for assessment and as outcome measures.
J Pain Symptom Manage 2002 Oct
PMID:Physical function in patients with cancer: psychometric characteristics and clinical usefulness of a physical performance test battery. 1250 9

OBJECTIVE: Patellofemoral pain syndrome (PFPS) is a common clinical entity seen by the sports medicine specialist. The ultimate goal of rehabilitation is to return the patient to the highest functional level in the most efficient manner. Therefore, it is necessary to assess the progress of patients with PFPS using reliable functional performance tests. Our purpose was to evaluate the intrarater reliability of 5 functional performance tests in patients with PFPS. DESIGN AND SETTING: We used a test-retest reliability design in a clinic setting. SUBJECTS: Two groups of subjects were studied: those with PFPS (n = 29) and those with no known knee condition (n = 11). The PFPS group included 19 women and 10 men with a mean age of 27.6 +/- 5.3 years, height of 169.80 +/- 10.5 cm, and weight of 69.59 +/- 15.8 kg. The normal group included 7 women and 4 men with a mean age of 30.3 +/- 5.2 years, height of 169.55 +/- 9.9 cm, and weight 69.42 +/- 14.6 kg. MEASUREMENTS: The reliability of 5 functional performance tests (anteromedial lunge, step-down, single-leg press, bilateral squat, balance and reach) was assessed in 15 subjects with PFPS. Secondly, the relationship of the 5 functional tests to pain was assessed in 29 PFPS subjects using Pearson product moment correlations. The limb symmetry index (LSI) was calculated in the 29 PFPS subjects and compared with the group of 11 normal subjects. RESULTS: The 5 functional tests proved to have fair to high intrarater reliability. Intrarater reliability coefficients (ICC 3,1) ranged from.79 to.94. For the PFPS subjects, a statistical difference existed between limbs for the anteromedial lunge, step-down, single-leg press, and balance and reach. All functional tests correlated significantly with pain except for the bilateral squat; values ranged from.39 to.73. The average LSI for the PFPS group was 85%, while the average LSI for the normal subjects was 97%. CONCLUSIONS: The 5 functional tests proved to have good intrarater reliability and were related to changes in pain. Future research is needed to examine interrater reliability, validity, and sensitivity of these clinical tests.
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PMID:Intrarater Reliability of Functional Performance Tests for Subjects With Patellofemoral Pain Syndrome. 1293 82


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