<p><strong>Objectives: </strong>To assess the reliability and validity of the Patient Specific Functional Scale when administered to people living with Parkinson’s Disease.<strong></strong></p> <p><strong>Methods and Materials: </strong>Twenty six people living with Parkinson’s Disease from Hamilton and Burlington were interviewed four times within a four month period. The participants answered the Movement Disorders Sponsored Unified Disease Rating Scale part II, the Parkinson’s Disease Questionnaire 39, and the Patient Specific Functional Scale. Reliability assessment addressed test-retest reliability and reliability of the change scores using Intraclass Correlation Coefficients. Validity assessment focused on convergent construct validity and longitudinal validity by correlating the Patient Specific Functional Scale with the other measures administered.</p> <p><strong>Results: </strong>The<strong> </strong>test retest reliability of the scores yielded by the PSFS was ICCpre= 0.72 (95%CI=0.47-0.86); ICCpost=0.83 (95%CI=0.66-0.92). The reliability of change scores was 0.50. In relation to the validity, no significant correlations were found between the Patient Specific Functional Scale and the other measures. <strong></strong></p> <p><strong>Conclusions: </strong>The PSFS yields reliable scores when it is administered to people living with PD. The Patient Specific Functional Scale does not target the same outcomes as the MDS-UPDRS part II and the PDQ-39. The PSFS does not detect change in functioning in people living with PD within a four month period.</p> / Master of Science (MSc)

Context: Two-dimensional (2D) video analysis of frontal-plane dynamic knee valgus during common athletic screening tasks has been purported to identify individuals who may be at high risk of suffering knee injuries such as anterior cruciate ligament tear or patellofemoral pain syndrome. Although the validity of 2D video analysis has been studied, the associated reliability and measurement error have not. To assess the reliability and associated measurement error of a 2D video analysis of lower limb dynamic valgus. Design: Reliability study. Participants: 20 recreationally active university students (10 women age 21.5 ± 2.3 y, height 170.1 ± 6.1 cm, weight 66.2 ± 10.2 kg, and 10 men age 22.6 ± 3.1 y, height 177.9 ± 6.0 cm, weight 75.8 ± 7.9 kg). Main Outcome Measurement: Within-day and between-days reliability and measurement-error values of 2D frontal-plane projection angle (FPPA) during common screening tasks. Interventions: Participants performed single-leg squat and drop jump and single-leg landings from a standard 28-cm step with standard 2D digital video camera assessment. Results: Women demonstrated significantly higher FPPA in all tests except the left single-leg squat. Within-day ICCs showed good reliability and ranged from .59 to .88, and between-days ICCs were good to excellent, ranging from .72 to .91. Standard error of measurement and smallest detectable difference values ranged from 2.72° to 3.01° and 7.54° to 8.93°, respectively. Conclusions: 2D FPPA has previously been shown to be valid and has now also been shown to be a reliable measure of lower extremity dynamic knee valgus. Using the measurement error values presented along with previously published normative data, clinicians can now make informed judgments about individual performance and changes in performance resulting from interventions.

Thesis (MScPhysio (Interdisciplinary Health Sciences))--Stellenbosch University, 2008. / Introduction In clinical physiotherapy, there is a growing importance for the accuracy and reliability of assessment and outcome measures. The purpose of this study is to develop a valid outcome measure for orthopaedic trauma inpatients. Item generation was done by conducting a systematic review of published functional outcome measures and patients' interview. Item reduction was conducted by using a panel of physiotherapists and patients. Objectives The overall study objectives were: 1) To determine if a functional outcome measurement scale for trauma inpatients exists and has been published; 2) To generate functional items for the construction of a new outcome measurement tool for trauma inpatients; 3) To construct a new outcome measurement tool for trauma inpatients and assess elements of validity and reliability (face and content validity, response to change, internal consistency and floor and ceiling effects) of the new developed outcome measure. Methodology Convenience sampling was applied to collect data from 35 trauma inpatients in trauma wards at Rashid Hospital in Dubai, UAE. 88% of the trauma inpatients were male (total sample n= 100), mean age =34.75, and the standard deviation = 14.46. 21 functional activity items were generated from the collated results of the patient interviews. Internal consistency reliability, responsiveness and floor and ceiling effect were assessed. Data analysis was conducted using Statistica Version 7. Results The final number of functional activity items included in the newly developed Functional Scale outcome measure was 29 activity items relevant for trauma inpatients. A Cronbach's alpha ranged between 0.76 and 0.97. The lowest alpha result was for the 'ADL' activities at follow-up (0.76). The highest alpha result was for 'out of bed' activity at admission and discharge (0.97). The response to change of the Functional Scale for trauma inpatients over time results illustrates that there was a significant difference in the mean scores over three administrations of 'Bed', 'Out of bed' and 'ADL' activity items of Functional Scale for trauma inpatients (p=O.OOOO). In general, there was no significant floor and ceiling effects at admission or discharge for 'bed', 'out of bed' and 'ADL' activities, except there was a floor effect noted at discharge for 'bed' activities and 'ADL' activities, and a ceiling effect noted at admission for 'out of bed activities' only. Discussion and Conclusion The newly developed Functional Scale outcome measurement for trauma inpatients has been shown to be internally consistent and appears to be valid with respect to response to change in this sample of trauma inpatients. The results of this study thus suggest that the Functional Scale for trauma inpatients may be an appropriate tool when the goal is the assessment of change in disability functions in trauma inpatients, although further psychometric testing may be required.

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Background: Self-efficacy refers to the beliefs (i.e., confidence) individuals have in their capabilities to perform skills needed to accomplish a specific goal or behavior. Research in the treatment of various health conditions such as chronic pain, balance disorders, and diabetes shows that self-efficacy beliefs play an important role in treatment outcomes and management of the condition. This article focuses on the application of self-efficacy to the management of tinnitus. The first step in formally incorporating self-efficacy in existing treatment regimens or developing a self-efficacy approach for tinnitus treatment is to have a valid and reliable measure available to assess the level of tinnitus self-efficacy. Purpose: The objective of this study was to develop the Self-Efficacy for Tinnitus Management Questionnaire (SETMQ) and to obtain the psychometric properties of the questionnaire in a group of patients with tinnitus. Research Design: Observational study. Study Sample: A total of 199 patients who were enrolled in the Tinnitus Clinic at the James H. Quillen Veterans Affairs Medical Center participated in the current study. Data Collection and Analysis: The SETMQ was mailed to patients enrolled in the Tinnitus Clinic. The participants who completed one copy of the SETMQ were mailed a second copy to complete approximately 2 weeks later. An exploratory factor analysis was conducted to identify the most coherent subscale structure of the SETMQ. The internal consistency and test‐retest reliability for each of the subscales and the questionnaire as a whole were assessed. The validity of the SETMQ also was evaluated by investigating the relations between the SETMQ and other clinical measures related to tinnitus. Results: Five components emerged from the factor analysis that explained 75.8% of the variance related to the following areas: (1) routine tinnitus management, (2) emotional response to tinnitus, (3) internal thoughts and interaction with others, (4) tinnitus concepts, and (5) use of assistive devices. Four items failed to load on any factor and were discarded, resulting in 40 items on the final SETMQ. The internal consistency reliability of the overall questionnaire and for each subscale was good (Chronbach's α ranged from .74 to .98). Item-total correlations ranged from .47 to .86, indicating that each item on the SETMQ correlated at a moderate or marked level with the SETMQ aggregate score. Intraclass correlation coefficients were computed to determine the test‐retest reliability of the SETMQ total scale and separately for each subscale, which were all above .80, indicating good test‐retest reliability. Correlations among the SETMQ subscales and various tinnitus-related measures (e.g., Tinnitus Handicap Inventory, tinnitus loudness rating, tinnitus distress rating, etc.) were significant, albeit indicative of fair to good relations overall (range r = ‐.18 to ‐.53). Conclusions: The results of the current study suggest that the SETMQ is a valid and reliable measure that may be an insightful instrument for clinicians and investigators who are interested in assessing tinnitus self-efficacy. Incorporating self-efficacy principles into tinnitus management would provide clinicians with another formalized treatment option. A self-efficacy approach to treating tinnitus may result in better outcomes compared with approaches not focusing on self-efficacy principles.

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Made available in DSpace on 2016-06-02T20:19:05Z (GMT). No. of bitstreams: 1 DissDFML.pdf: 4036926 bytes, checksum: 7de4e9f504405a41c208a231ddcb7e1c (MD5) Previous issue date: 2007-02-26 / Financiadora de Estudos e Projetos / Several studies have shown the important role of the anterior cruciate ligament (ACL) in the knee proprioception. However, there are still few studies that had evaluate the characteristics of proprioception acuity in the early period of rehabilitation after the ACL-reconstructed surgery, over all when it was associated to functional outcomes. Thus, the objective of this study was to evaluate knee proprioception and subjective knee function in subjects who had an ACL injury, before and after (3 months) the reconstruction surgery with the middle third of patellar tendon autograft; and in control subjects. Ten volunteers who had unilateral ACL injury (26.9±6.8 years) reconstructed group - and fifteen health volunteers (22.1±3.0 years) control group performed a proprioceptive evaluation (joint position sense - JPS during active and passive movements, threshold for detection of passive movement TDPM) on a Biodex Multi-Joint System III Pro isokinetic dynamometer, at 2º/s and at two target-angles (30º and 60º of knee flexion). The variables analyzed were the mean of angular displacement (TDPM) and the mean of absolute error (JPS) in relation to each target-angle. The subjective knee function was evaluated by Lysholm scale. The analyses of variance showed subjective functional deficit in involved limb, compared to the uninvolved limb, as well as in relation to the control group, in both test moments (p<0.01). Although no significant, the results showed a tendency for higher TDPM in the reconstructed group (p=0.06). There was no significant difference in the mean of absolute error between the groups (p>0.05), for any modality of JPS, target-angles or test moments. The TDPM showed strong correlation with the subjective knee functional score (just in the involved limb). Under the experimental conditions utilized, the subjects who had an anterior cruciate ligament injury didn t show proprioceptive deficits in relation to the control group, although of the subjective functional limitations presented. / Diversos estudos têm evidenciado o importante papel do ligamento cruzado anterior (LCA) na propriocepção do joelho. No entanto, ainda há poucos estudos que tenham investigado as características da acuidade proprioceptiva no período inicial de reabilitação após a reconstrução cirúrgica do LCA, sobretudo quando associada a aspectos funcionais. Diante do exposto, foi objetivo do presente estudo avaliar a sensibilidade proprioceptiva e a função subjetiva do joelho em indivíduos com lesão do LCA, antes e após (3 meses) a reconstrução cirúrgica pelo terço médio do tendão patelar autógeno; e em indivíduos controle. Dez voluntários com lesão unilateral do LCA (26,9±6,8 anos) grupo reconstruído - e quinze clinicamente sadios (22,1±3,0 anos) - grupo controle - realizaram uma avaliação proprioceptiva (percepção da posição articular PPA - durante os movimentos ativo e passivo, limiar de detecção do movimento passivo LDMP) no dinamômetro isocinético Biodex Multi-Joint System III Pro, a 2º/s e em dois ângulos-alvo (30º e 60º de flexão do joelho). As variáveis estudadas foram o deslocamento angular médio (LDMP) e o erro absoluto (PPA) em relação a cada ângulo-alvo. A função subjetiva do joelho foi avaliada por meio da Escala de Lysholm. A análise de variância indicou déficit funcional subjetivo no membro envolvido, comparado ao membro contralateral, bem como em relação ao grupo controle, nos dois períodos de teste (p<0,01). Embora não significativo, os resultados indicaram tendência de maior LDMP para o grupo reconstruído (p=0,06). Não houve diferença significativa entre os grupos quanto à média de erro absoluto (p>0,05), para qualquer uma das modalidades de PPA, ângulos-alvo ou períodos considerados. O LDMP apresentou forte correlação com o escore funcional do joelho (apenas para o membro envolvido). Nas condições experimentais utilizadas, os indivíduos com lesão do LCA não apresentaram déficits proprioceptivos significativos em relação ao grupo controle, apesar das limitações funcionais verificadas subjetivamente.

Objective: The primary aim of the study was to examine the automated linguistic analysis of the open-ended problem (PQ) and life-effects (LEQ) questionnaires to understand the psychological effects of tinnitus. Design: The study used a cross-sectional design. Participants completed online questionnaires which included demographic questions, several standardised patient-reported outcome measures (PROMs), and two open-ended questions focussing on PQ and LEQ related to tinnitus. The response to open-ended questions was analysed using the Linguistic Inquiry Word Count (LIWC) software to identify the frequency of text on various linguistic dimensions relevant to tinnitus. Study sample: 336 individuals with tinnitus. Results: The study results point to two broad findings. First, although PQ and LEQ have some similarities with PROMs (e.g. the linguistic dimension negative emotions having a weak positive correlation with anxiety and depression), no correlation with the number of dimensions suggests that the open-ended questions identify additional elements that are not captured in PROMs. Second, more linguistic dimensions from the PQ correlate with PROMs compared to LEQ suggesting that the current PROMs are problem-oriented. Conclusions: The study results support the idea that the use of open-ended questions in addition to PROMs may help optimise the efforts in examining the effects of chronic conditions such as tinnitus.

This thesis explored symptom clusters in patients with lung cancer before, during and after oncological treatment. A literature review and an interview study was used to explore the symptom cluster experience from the patients’ perspective. A large diversity of symptom cluster constellations were identified, in which fatigue was the most commonly occurring symptom, followed by dyspnea, pain, depression, cough and nutritional impact symptoms. Many symptom assessment instruments were identified, measuring mostly the intensity-dimension alone or in combination with timing. The results also stress that living with symptom clusters during treatment is more about survival than actually living. Patients’ symptom management strategies were shaped by impacting conditions such as knowledge and earlier experience of symptoms. Symptoms were often regarded as unavoidable by the patients and something to accept. How symptoms were recognized by health care professionals further added to the normalization of symptom clusters. Subsequently, patients would not always ask for support, and their quality of life was negatively affected. Holistic person-centered care including multi-dimensional symptom assessment is considered essential to ensure adequate symptom cluster management for patients with lung cancer.