Physical function has been identified as a core outcome to be assessed in low back pain (LBP). However, all recommended physical function measures are Patient-Reported Outcome Measures (PROMs). Performance-Based Measures (PBMs) are important measures that are practical and are prone to fewer biases. Two systematic reviews provided evidence on the psychometric properties of PBMs but were not comprehensive. Therefore, the purpose of this study was to identify PBMs developed for or used to assess physical function in LBP and to review studies evaluating the psychometric properties of these PBMs systematically. The first manuscript of the thesis was the systematic review protocol developed using the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) manual 2018. The protocol was also registered on PROSPERO (CRD42020147968). The protocol also outlined the use of the COMINS Risk of Bias (COSMIN-ROB) checklist 2018; standard priory hypotheses and criterions developed to evaluate the results of each psychometric property; as well as a GRADE criterion (Grading of Recommendations, Assessment, Development and Evaluations) to assess the level of evidence. Two reviewers independently screened, evaluated, and extracted data. The second manuscript was the systematic review written in the format of a journal for future submission. Our database search identified 47 studies assessing 115 PBMs. In general, findings included five different LBP diagnoses (e.g., non-specific LBP) and different LBP durations (e.g., acute, chronic). The level of evidence of each PBM or psychometric property mainly were generated from single studies. A high risk of bias assessed by the COSMIN-ROB checklist was found for most of the included studies. Overall, the included studies' results often did not meet our priory hypotheses for good psychometric properties. Hence, most PBMs' psychometric properties were found to have a low level of evidence. There was not a single PBM that demonstrated a good level of evidence for all properties. In conclusion, significant heterogeneity was found between studies leading to a limited level of evidence. PBMs need to be used with great caution. High-quality studies that investigate PBMs' psychometric properties are needed. / Thesis / Master of Science Rehabilitation Science (MSc) / Low Back Pain (LBP) care costs the Canadian health care system millions of dollars every year. Most clinicians and researchers use self-report questionnaires filled out by their patients to assess physical function. However, performance measures where patients perform tasks while being observed are also recommended to assess physical function. Performance-based measures can be used alone or in combination with self-report measures. To select the most appropriate performance measures, we need to know how good and trustworthy these measures are. Therefore, the purpose of this study was to collect all possible performance measures that were developed or used to assess physical function in LBP patients; then summarized the available evidence on their psychometric properties (reliability, validity and responsiveness). We searched five scientific databases and found 47 studies that evaluated 115 performance measures. Most included studies were of low quality and evaluated different tests or test properties. We found that most measures were not reliable, accurate or were sensitive to change. Therefore, clinicians and researchers need caution when selecting and interpreting results of these performance measures when evaluating physical function in LBP.

Background: This study aimed to evaluate physical function, measured with self-reported outcomes and performance-based measures (PBMs), in patients 6-10 months following hip arthroscopy (HA) compared to an asymptomatic control group.   Methods: A cross-sectional comparison (21 patients, 22 controls) based on self-reported outcomes (HAGOS), range of motion (ROM), muscle strength and PBMs (The Y-balance test (cm), medial and lateral triple hop test (cm) and Illinois agility test (s)). Independent sample t test was performed to asses between-group differences.   Results: HA-patients reported significantly worse self-reported outcomes in all HAGOS subscales, greatest difference was in QoL (-37,3 (95% CI -47,9; -26,8) p<0.001). HA-patients also reported significantly lower results (p<0.05) in active and passive flexion (ROM) and external rotation (strength). No significant differences were observed regarding PBMs.   Conclusions: HA-patients reported significantly lower hip function following HA compared with the control group. Lower muscle strength and ROM were observed in patients however, few differences were significant. No significant differences were observed regarding PBMs. This could indicate that physical function is re-established in patients 6-10months after surgery or that tests were not sensitive enough to detect potential remaining functional limitations in this patient group.

Les séquelles neuropsychologiques associées aux tumeurs cérébrales pédiatriques représentent un enjeu de santé publique. Les troubles des fonctions exécutives sont désormais avérés chez ces enfants mais la nature des processus perturbés, les modalités d'évaluation à préconiser et l'impact des variables démographiques/médicales liées à la maladie restent méconnus. L'objectif de cette thèse était de mieux comprendre le profil de perturbation des différents processus exécutifs dans ce contexte clinique, en confrontant des mesures basées sur la performance et des indicateurs de vie quotidienne (dans le contexte familial et scolaire). Dans cette perspective, nous avons 1) analysé le profil exécutif de 171 enfants d’âge scolaire atteints d'une tumeur cérébrale à la BRIEF (Inventaire d'évaluation comportementale des fonctions exécutives) et 2) étudié la convergence de ces indicateurs avec des mesures basées sur la performance adaptées en français auprès de 27 patients appariés à des enfants sains. L’influence des variables cliniques sur les profils exécutifs a été examinée. Des difficultés exécutives étendues mais variables ont été identifiées dans le quotidien des patients (tous types histologiques et localisations) au domicile et à l’école, avec par ailleurs des difficultés accrues rapportées par les parents en cas d’irradiation à un âge précoce. Des perturbations du contrôle exécutifs ont confirmées dans les mesures directes, dont la convergence avec les questionnaires apparait cependant limitée. Sur la base de ces résultats, sont discutés les apports respectifs de ces deux types d’outils pour appréhender la problématique exécutive dans le cadre des tumeurs pédiatriques. / Neuropsychological sequelae associated with pediatric brain tumors represent a major public health issue.Disorders of executive functions have been identified among these children, but the nature of the impaired processes, recommended evaluation modalities and the impact of demographic and medical variables related to the disease remain unclear. The aim of this thesis was to get a broader understanding of the disturbance profile of the different executive processes in this disease context, comparing performance-based measures and daily life indicators (in both the school and home environment). From this perspective, we have 1) analyzed the executive profile of 171 school age children with a brain tumor in the BRIEF (Behavior Rating Inventory of Executive Function) and 2) examined the association of these indicators with performance-based measures adapted in French in 27 patients matched to healthy children. The influence of clinical variables on the executive profiles was discussed. Broad and variable executive difficulties have been identified in patients’ everyday life (all tumor types and locations) at home as well as school, with also increased difficulties reported by parents in the case of radiation therapy at an early age. Disturbances of executive control are confirmed in direct measures, whose convergence with the questionnaires appears however limited. Based on these results, respective contributions of these two types of tools are discussed in order to understand the executive issue in pediatric brain tumor survivors.