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Neck and shoulder pain is a common disorder which is often associated with a low-pressure pain threshold (PPT) of muscle tissues as manifested by hyperalgesia on palpation or the use of a pressure algometer. The objective of the present study was to evaluate the intratester repeatability of pressure algometer (Force-Five) on the neck and shoulder area in women with neck pain. The study was cross-sectional with single-group repeated measurements. PPT measurements in 20 women with chronic non-specific neck pain were measured on consecutive days at the levator scapulae, at two points on the trapezius muscles on each side and at the sternum as the only non-muscular site. The intratester repeatability of the PPT measurements was satisfactory or good (Intraclass correlation coefficient (ICC 0.78-0.93). The coefficient of repeatability ranged from 16.8 to 24.4N/cm2 and the coefficient of variation ranged from 10% to 22%, depending on the site tested. Considerable individual variation was observed when consecutive measures were analysed against their mean. On the group level the repeatability of the measurements allows the pressure algometer to be used for research purposes. However, on the individual level, due to the considerable variation found in the PPT results, caution is advised when interpreting the results in clinical practice.
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PMID:Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. 1695 83

Acute mountain sickness (AMS) is a common condition that affects people that ascend too rapidly to high altitude. It is typically assessed with the Lake Louise AMS Self-report Score (LLSelf) that uses a categorical numeric rating scale to answer five questions addressing AMS-related symptoms, such as headache. A 100-mm visual analog scale (VAS) is commonly used to assess subjective phenomena such as pain, but this scale has never been used for the self-assessment of AMS. The purpose of this study was to compare a VAS score to the total LLSelf and to evaluate the test-retest and interrater reliability of the VAS when used as an assessment of AMS. Participants (N = 356) completed both the LLSelf and the VAS on the summit of Mt. Whitney (4419 m). There was a significant relationship (r = 0.65, p < 0.01) between the LLSelf (2.8 +/- 2.0, mean +/- SD) and the VAS (14.4 +/- 14.1 mm). Fifty-seven participants were randomly selected for reliability testing of the VAS. Both test-retest reliability (ICC = 0.996, 95% CI = 0.992 to 0.998) and interrater reliability (ICC = 1.000, 95% CI = 0.999 to 1.000) were high. The mean difference in the VAS score between tests was <1 mm, as was the difference between raters. These results demonstrate excellent reliability for the VAS as an assessment of AMS.
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PMID:Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. 1739 14

This study's aim was to determine the between days reliability of surface EMG recordings from the superficial quadriceps during a multi joint sub-maximal fatiguing protocol. Three subject groups (healthy n=29; patellofemoral pain syndrome n=74; knee osteoarthritis n=55) performed the task at 60 maximum voluntary isometric contraction on three separate days. Spectral and amplitude EMG parameters were recorded from vastus medialis oblique, vastus lateralis and rectus femoris and were analysed for between days reliability using intraclass correlation coefficient (ICC((2,1))), the standard errors of measure and smallest detectable differences. For frequency results, initial and final frequency values had 'good' or 'excellent' reliability in all groups for all muscles. ICCs for median frequency slopes for vastus medialis oblique, vastus lateralis, and rectus femoris respectively, in the osteoarthritis group were 0.04, 0.55, and 0.72; in the patellofemoral pain group were 0.41, 0.17, and 0.33; in the healthy group were 0.68, 0.64, and 0.31. The standard errors of measurement and smallest detectable differences for all groups and for all muscles were unacceptably high. For amplitude results, ICC root mean squared initial and final values were 'good' to 'excellent' for all groups and all muscles, albeit with high measurement error. The ICCs for root mean squared slopes in all tests were 'poor' with extremely high measurement error. The poor between days reliability and high measurement error suggests that surface EMG should not be adopted to assess fatigue during multi joint sub-maximal isometric quadriceps testing.
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PMID:The reliability of surface electromyography to assess quadriceps fatigue during multi joint tasks in healthy and painful knees. 1762 11

The aim of this study is to assess the reliability and validity of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) in Moroccan patients with knee osteoarthritis. The WOMAC was translated and back translated to and from dialectal Arabic, pre-tested and reviewed by a committee following the Guillemin criteria. The Moroccan version of the WOMAC was administered twice during a 24-48 h interval to 71 Moroccan patients with symptomatic knee osteoarthritis, fulfilling the revised criteria of the American College of Rheumatology. The test-retest reliability was assessed using intra-class correlation coefficient, and the Bland and Altman method. Internal consistency was assessed by Cronbach's alpha coefficient. Construct validity was tested by correlating the WOMAC subscales with visual analogic scale (VAS) of pain, VAS of handicap, maximum distance walked and clinical characteristics. The Moroccan version of the WOMAC showed good reliability, with ICC values of the three dimensions: pain, stiffness and physical function being 0.80, 0.77 and 0.89, respectively. Bland and Altman analysis showed that means of differences did not differ significantly from 0 and that no systematic trend was observed. Internal consistency with Cronbach's alpha for pain was found to be 0.76, and its equivalents for stiffness and physical function subscales were evaluated at 0.76, 0.90, respectively. Construct validity showed statistically significant correlation with all WOMAC subscales and VAS of pain (rho=0.38, 0.42, 0.63 respectively, P<0.01). Correlation between VAS handicap (rho=0.38 P<0.001) and maximum distance walked (rho=-0.40, P<0.01) was observed with physical function subscale. There was no correlation between age, duration of disease, BMI and severity of pain and physical function in knee OA. The Moroccan version of the WOMAC is a comprehensible, reliable, and valid instrument to measure outcome in patients with knee OA.
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PMID:Translation and validation of Moroccan Western Ontario and McMaster Universities (WOMAC) osteoarthritis index in knee osteoarthritis. 1809 69

Post-nasal drip is a troublesome complaint resulting, among other causes, from lower turbinates mucous membrane hypertrophy due to chronic rhinitis. The therapy of choice in patients with no satisfactory reaction to pharmacological treatment is mucotomy that consists in submucous removing of the lower turbinates. The purpose of the study was to assess the effectiveness of bipolar coagulation mucotomy in patients with post-nasal drip. The procedure was performed in 28 patients aged from 22 to 60 years (mean=36.5, SD=12.6), who were questioned about the intensity of post-nasal drip prior to and after surgery, using a 0-3 points scale. Mucotomy was performed with an ERBE ICC 300 bipolar device, maximal power 40 W, under local anaesthesia with lidocaine. The patients were followed-up for 3 months. Prior to the procedure, all of them declared post-nasal drip intensity at 3 points. A month after the mucotomy, 16 individuals were asymptomatic (0 points) and two groups of 6 patients described their complains at 1 and 2 points each (the difference was statistically significant at p<0.001). 3 months after surgery the intensity of complaints did not differ from that observed 1 month after the operation. Mucotomy performed with a bipolar coagulation is an easy, effective, painless procedure performed under local anaesthesia on an ambulatory basis. It does not require expensive surgical equipment. There is no risk of bleeding, pain or other complications. Mucotomy can be carried out accurately under direct vision.
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PMID:[Effectiveness of bipolar coagulation in treatment of post-nasal drip in patients with chronic rhinitis--preliminary report]. 1818 25

Abilities of the Short-Form McGill Pain Questionnaire to assess change have scarcely been addressed in previous studies. The aim of the present study was to examine test-retest reliability, sensitivity to change and responsiveness to clinically important change using a Norwegian version (NSF-MPQ) in different groups of patients. ICC(1,1) values for test-retest reliability (relative reliability) assessed 1-3 days apart for total, sensory and affective scores were, respectively, 0.75, 0.76 and 0.62 in patients with musculoskeletal pain (n=58), and 0.93, 0.95 and 0.79 in patients with rheumatic pain (n=25). Variability in total scores (absolute reliability) was less in patients with rheumatic pain (within-subject standard deviation, S(w)=2.70) than in patients with musculoskeletal pain (S(w)=4.28). Sensitivity to change by standardized response mean (SRM) was mostly large (>0.80) for three patient groups reporting improvement after treatment. More sensitivity to change was demonstrated by the total and sensory scores than by the affective score, and sensitivity of the total score was similarly good to capture improvement as the Visual Analogue Scale (VAS). Indication was provided that mean improvement of groups in NSF-MPQ total scores should be >5 on the 0-45 scale to demonstrate a clinically important change. Responsiveness to clinically important change by receiver operating characteristic curve analysis was modest, as area under the curve indicating ability to discriminate improved and not improved patients with musculoskeletal pain, was only 0.61. The study indicates mostly satisfactory test-retest reliability and responsiveness values of the NSF-MPQ, but shows that the measurement properties vary between groups of patients with pain.
Eur J Pain 2008 Oct
PMID:The Short-Form McGill Pain Questionnaire as an outcome measure: test-retest reliability and responsiveness to change. 1828 93

The aim of the present study was to investigate the psychometric properties and validate the Portuguese version of the Fear Avoidance Beliefs Questionnaire (FABQ-Brazil). This instrument assesses how beliefs and fear of individuals with lower back pain affect two subscales related to their physical activities (FABQ-Phys) and work (FABQ-Work). The questionnaire was translated into Brazilian Portuguese, following the recommended methodology, and applied to 53 individuals with non-specific chronic lower back pain. The test-retest intra-class correlation coefficients (ICC = 0.84 and 0.91) and the internal consistency (Cronbach's = 0.80 and 0.90) for FABQ-Phys and FABQ-Work, respectively, were acceptable. The stepwise multiple regression analyses revealed statistically significant correlations between all isolated items with their respective subscales, and the set of the items explained 99% of the changes in scores for each subscale. No significant correlations were found between the subscales; however, both the FABQ-Phys and FABQ-Work subscales were positively associated with pain intensity (visual numerical scale) and degree of disability (Roland Morris Questionnaire). These findings supported the evidence that the FABQ-Brazil showed adequate psychometric properties for individuals with chronic lower back pain.
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PMID:[The Brazilian version of the Fear Avoidance Beliefs Questionnaire]. 1832 49

Three-dimensional (3D) ultrasound based (US) and usual Revel visual techniques were compared to measure head repositioning ability in 41 healthy subjects and 41 subjects with neck pain. Head repositioning absolute value of the global error (AE) was calculated by both techniques after active head rotations. The AE was 3.6 degrees and 3.7 degrees for healthy subjects and 6.3 degrees and 6.1 degrees for neck-pain subjects for the visual and US techniques, respectively. The AE was higher in neck-pain subjects (p<0.001), and a value of 4.5 degrees was identified as a threshold of abnormal repositioning for both techniques. The test-retest reliability, calculated in the neck-pain subjects, was moderate (intraclass correlation coefficient [ICC]=0.68) for both techniques. The correlation between the two techniques for AE was poor for both groups with successive measurement of visual and US techniques (r=0.32 and 0.46, respectively) but excellent with simultaneous measurement (r=0.95 for both groups). Moreover, we showed substantial agreement between the techniques in discriminating healthy and neck-pain subjects (kappa=0.65). The Revel visual technique is more appropriate for clinical practice, but with improved software, the 3D US method could provide additional quantitative and qualitative data invaluable for research.
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PMID:Comparison of visual and ultrasound based techniques to measure head repositioning in healthy and neck-pain subjects. 1851 16

The objective of this study was to cross-culturally adapt and validate the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS). This version was obtained with forward/backward translations, consensus panels and pre-testing. The Portuguese KOS-ADLS and Medical Outcomes Study, 36-item Short Form (SF-36) questionnaires, visual analogue scales (VAS) of pain, disability and discomfort, and a form for patient's characteristics were administered to 168 subjects with knee osteoarthritis (OA). Reliability was acceptable (Cronbach's alpha = 0.91; ICC = 0.97). There were significant correlations with SF-36 physical component subscales, all VAS, and duration of knee OA. The subjects with bilateral knee OA and that need walking aids obtained lower scores (p < 0.001). No floor/ceiling effects were detected. Responsiveness to physical therapy was showed (standardized effect size = 0.62; standardized response mean = 1.02). The Portuguese KOS-ADLS evidenced acceptable reliability, validity, floor/ceiling effects, and responsiveness.
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PMID:Cross-cultural adaptation and validation of the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS). 1877 53

Evaluating pain in adults with intellectual and developmental disability (IDD) is a challenge. The Non-Communicating Adults Pain Checklist (NCAPC) was recently developed from the Non-Communicating Children's Pain Checklist (NCCPC) and examined in a group of adults with IDD (N=228) and found to hold satisfactory construct validity, internal consistency and sensitivity to pain. To further explore its basis for clinical use, intra and interrater reliability of the NCAPC was investigated. Data collection was done by videotaping the participants before and during influenza vaccination. Intrarater reliability was evaluated by the first author on a group of 50 randomly selected individuals (mean age 42.5, range 19-72) and was found at 0.94. Interrater reliability was investigated in two stages. In the initial step different groups of health care workers (caregivers, nurses, case managers, and therapists), each including five raters, viewed a sample of 12 adult participants with IDD (3 at each level of IDD mean age was 49 years, range 16-72), that were extracted from the population sample. Interrater reliability of all raters within the groups varied from low to very high (ICC(1,1)=0.40-0.88). Interrater reliability was very high in caregivers. The Physical -and Occupational therapists are one group were considered potential users of the measure. In the second stage 3 participants from each of the groups showing high interrater reliability (caregivers and therapist) evaluated interrater reliability in a randomly selected group of 40 individuals (mean age 41.2, range 15-72). Interrarter reliability for the therapists and caregivers was found at 0.91 and 0.92 correspondingly. The researchers conclude that that the NCAPC have been found to hold high reliability values.
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PMID:Reliability of the Non-Communicating Adult Pain Checklist (NCAPC), assessed by different groups of health workers. 1903 59


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