FRI0637-HPR The Effects of Clinical Pilates Exercises on Kinestesia and Position Sense in Patients with Osteoarthritis of The Knee: Table 1 (original) (raw)
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PLOS ONE
The Myositis Activity Profile (MAP) is the only disease-specific questionnaire to assess limitations in activities of daily living (ADL) in patients with inflammatory myopathy (IM). Because a German version does not currently exist, this study's aim was to translate the MAP and assess reliability and construct validity of the new version. Therefore, a cross-cultural adaptation was performed following international guidelines. Forty-eight patients with IM completed the German-MAP, twice within two weeks. They were also assessed using the Health Assessment Questionnaire (HAQ), 36-Item Short Form Survey (SF36), Manual Muscle Test (MMT8), Quantitative Muscle Testing (QMT) and Functional Index (FI-2). For discriminant validity, 48 age-and gender-matched healthy controls completed the German-MAP. Reliability was assessed using weighted kappa (Kw). Correlations between the MAP and the HAQ, the physical (PCM) and mental (MCS) component scores of SF36 and the MMT8 and QMT muscle tests were assessed using Spearman correlation analysis. Discriminative validity was assessed by calculating the Area under the Curve (AUC). The German-MAP showed substantial reliability for the four subscales (Kw: 0.65-0.71) and moderate to substantial reliability for the single items (Kw: 0.57-0.77). The MAP showed good construct validity (high correlations with HAQ and PCM, moderate with FI-2, QMT and MMT8 and poor with MCS and pain) and acceptable discrimination for three subscales and two single items (AUC: 0.65-0.79). In conclusion, the German-MAP appears to be a reliable and valid questionnaire to assess ADL-limitations in patients with IM. Further research is required, both to substantiate these results and to evaluate responsiveness.
Development of the sporadic inclusion body myositis physical functioning assessment (sIFA)
Muscle & Nerve, 2016
INTRODUCTION: Sporadic inclusion body myositis (sIBM) is a progressive idiopathic inflammatory myopathy characterized by atrophy and weakness of proximal and distal muscle groups resulting in a loss of independence and the need for assistive devices and supportive care. To assess treatment benefit of new therapies, a patient-reported outcome measure of physical function was developed. METHODS: The tool was rigorously developed in accordance with the U.S. Food and Drug Administration (FDA) Patient Report Outcomes (PRO) Guidance. A single-visit, observational study was conducted. Standard qualitative analytical methods were employed to analyze interview data and generate questionnaire items. RESULTS: Twenty concept elicitation and 19 cognitive debriefing interviews were conducted, and 6 expert physicians were consulted. The tool consists of 11 items scored on a 0-10 numerical rating scale. Subjects completed the questionnaire utilizing either paper or electronic administration.
Muscle & nerve, 2016
To assess self-reported physical functioning in patients with sporadic inclusion body myositis (sIBM), the sIBM Physical Functioning Assessment (sIFA) was developed. This research establishes the validity, reliability, and responsiveness of the sIFA in patients with sIBM. Data from 3 small, noninterventional, observational studies were analyzed. Several measures of physical function were included to assess validity. Reliability (Cronbach alpha, test-retest intraclass correlations), construct validity (correlations, analyses of variance), and responsiveness (effect size estimates) were evaluated. Cronbach alphas (range=0.86-0.91) and test-retest reliability (0.91) were highly satisfactory. Correlations with other measures provided evidence of convergent validity. sIBM patients able to walk without assistive devices scored significantly better on the sIFA (means=36.0-47.05) than those who require power mobility or wheelchairs (means=54.9-71.5), demonstrating the discriminating ability...
Arthritis Care & Research, 2011
in validation of these core set measures, and no validation studies have yet been performed in patients with IBM, although they are now being used frequently in myositis therapeutic trials. We end the chapter with tools that have been used primarily in research studies and a few therapeutic trials, which have some supporting validation in certain subgroups of patients with myositis. These tools are primarily organ-specific measures, including strength and functional assessments and cutaneous assessment tools. Quantitative muscle testing and the IBM Functional Rating Scale are the most commonly used instruments to assess patients with IBM, and although they have little supporting validation in myositis, quantitative muscle testing has been well validated in other myopathies and has been used frequently as an endpoint in therapeutic trials for IBM. Although the methods for the assessment of myositis patients have been limited in their scope, great strides have been made in the last decade in the development of new partially validated tools (see Table 1) and international multidisciplinary consensus in using these measures that should enhance our understanding of the diverse effects of myositis on many organ systems and the development of new therapies. Physician and Patient/Parent Global Activity General Description Purpose-An overall rating of the disease activity related to myositis, defined as potentially reversible pathology or physiology resulting from the underlying disease process (1). Content-The physician global assessment of disease activity is to be judged by the physician based on all the information available at the time of the evaluation, including the subject's appearance, medical history, physical examination, laboratory testing, and the prescribed medical therapy. Adult patients or parents of children with myositis completing the patient/ parent assessments are asked to take into account all of the active inflammation in their own or their child's muscles, skin, joints, intestines, heart, lungs, or other parts of the body, which can improve with treatment. Patients over 10 years of age might also be able to complete a global activity assessment independent of their parents' ratings (5). The global disease activity score is recorded on a 10-cm visual analog scale (VAS), which is often anchored at the endpoints and middle. For patients and parents, a smiley face is often included at the 0 cm anchor and a sad face at the 10-cm anchor to improve understanding of the scale. A 5-point Likert scale can also be used as an alternative to the VAS. Number of items-One item, either a VAS or a Likert scale rating. Response options-For the VAS rating, a score of 0 to 10 (down to 1 decimal place) is used, and for the Likert scale, a Medical Research Council (MRC) grade of 0 (no disease activity), 1 (mild disease activity), 2 (moderate disease activity), 3 (severe disease activity), or 4 (extremely severe disease activity). The 10-cm VAS may have better precision, sensitivity, and specificity, but the two scales correlate highly (5). Recall period for items-Scoring of the global disease activity requires that the activity be assessed at present, although a recall period of up to 2-4 weeks for the components of global disease activity is acceptable for stable patients who are assessed less frequently. Endorsements-The physician global disease activity has been included as a core set activity measure for patients with adult and juvenile PM, DM, and IBM by IMACS (5) and as a core set activity measure for juvenile DM by the American College of Rheumatology Rider et al.
Arthritis & Rheumatism, 2006
Methods. Previously performed FI (n ؍ 287) were analyzed for internal redundancy and consistency, and ceiling and floor effects. Content was evaluated and a preliminary revised FI was developed. To evaluate the construct validity of the preliminary revised FI, it was compared with isokinetic measurements of muscular strength and endurance, the Myositis Activities Profile, disease impact on general wellbeing, and creatine phosphokinase levels. Minor adjustments were made and the revised FI was investigated for interrater reliability and intrarater reliability over a 1-week period. After this, some minor, additional adjustments were made leading to the final version, FI-2. Results. Five tasks were removed from the original FI due to ceiling effects. Performance pace and number of repetitions were modified for the remaining tasks. A moderate correlation (r s ؍ 0.58) was found between the shoulder flexion task of the preliminary revised FI and isokinetic measurements of shoulder flexion endurance. Intraclass correlation coefficient (ICC) for interrater reliability of the revised FI varied from 0.86 -0.99 with no systematic differences. ICC for intrarater reliability varied from 0.56 -0.99 with systematic differences (P < 0.05) between test and retest in 3 of the tasks. The sit-up task was excluded due to low intrarater reliability resulting in the final 7-item FI-2. There was a good correlation between tasks on the right and left side suggesting that the FI-2 could be performed unilaterally. Conclusion. The FI-2 is a valid and reliable outcome measure of impairment for patients with polymyositis or dermatomyositis. It is well tolerated and the unilateral FI-2 requires a maximum of 20 minutes to perform. Further evaluation of sensitivity to change and testing in healthy individuals needs to be conducted.
Reliability of the Adult Myopathy Assessment Tool in Individuals With Myositis
Arthritis Care and Research, 2015
Objective. The Adult Myopathy Assessment Tool (AMAT) is a 13-item performance-based battery developed to assess functional status and muscle endurance. The purpose of this study was to determine the intrarater and interrater reliability of the AMAT in adults with myositis. Methods. Nineteen raters (13 physical therapists and 6 physicians) scored videotaped recordings of patients with myositis performing the AMAT for a total of 114 tests and 1,482 item observations per session. Raters rescored the AMAT test and item observations during a followup session (mean ؎ SD 19 ؎ 6 days between scoring sessions). All raters completed a single, self-directed, electronic training module prior to the initial scoring session. Results. Intrarater and interrater reliability correlation coefficients were >0.94 for the AMAT functional subscale, endurance subscale, and total score (all P < 0.02 for H o , <0.75). All AMAT items had satisfactory intrarater agreement (kappa statistics with Fleiss-Cohen weights, with values w ؍ 0.57-1.00). Interrater agreement was acceptable for each AMAT item (؍ 0.56-0.89) except the sit up (؍ 0.16). The standard error of measurement and 95% confidence interval range for the AMAT total scores did not exceed 2 points across all observations (AMAT total score range 0-45). Conclusion. The AMAT is a reliable, domain-specific assessment of functional status and muscle endurance for adult subjects with myositis. Results of this study suggest that physicians and physical therapists may reliably score the AMAT following a single training session. The AMAT functional subscale, endurance subscale, and total score exhibit interrater and intrarater reliability suitable for clinical and research use.
Safety of a home exercise programme in patients with polymyositis and dermatomyositis: a pilot study
Rheumatology (Oxford, England), 1999
To investigate whether a home exercise programme could safely be performed by patients with stable, inactive polymyositis (PM) and dermatomyositis (DM), regarding disease activity, muscle function, health status and pain. Ten patients with reduced muscle function completed the study. A home exercise programme including exercises for strength in the upper and lower limbs, neck and trunk, for mobility in the upper limbs and moderate stretching was developed. The patients exercised for 15 min and took a 15 min walk 5 days a week during a 12 week period. Assessments included clinical evaluation of disease activity, serum creatinine phosphokinase (CPK) levels, magnetic resonance imaging (MRI) of the quadriceps, repeated muscle biopsy of the vastus lateralis, a muscle function index (FI), a walking test and a health status instrument (the SF 36) performed at the start of the study and after 12 weeks. After 12 weeks of exercise, there were no signs of increased disease activity as assessed...
PLOS ONE
Manual muscle testing (MMT) and hand-held dynamometry (HHD) are commonly used in people with inflammatory myopathy (IM), but their clinimetric properties have not yet been sufficiently studied. To evaluate the reliability and validity of MMT and HHD, maximum isometric strength was measured in eight muscle groups across three measurement events. To evaluate reliability of HHD, intra-class correlation coefficients (ICC), the standard error of measurements (SEM) and smallest detectable changes (SDC) were calculated. To measure reliability of MMT linear Cohen's Kappa was computed for single muscle groups and ICC for total score. Additionally, correlations between MMT8 and HHD were evaluated with Spearman Correlation Coefficients. Fifty people with myositis (56±14 years, 76% female) were included in the study. Intra-and interrater reliability of HHD yielded excellent ICCs (0.75-0.97) for all muscle groups, except for interrater reliability of ankle extension (0.61). The corresponding SEMs% ranged from 8 to 28% and the SDCs% from 23 to 65%. MMT8 total score revealed excellent intra-and interrater reliability (ICC>0.9). Intrarater reliability of single muscle groups was substantial for shoulder and hip abduction, elbow and neck flexion, and hip extension (0.64-0.69); moderate for wrist (0.53) and knee extension (0.49) and fair for ankle extension (0.35). Interrater reliability was moderate for neck flexion (0.54) and hip abduction (0.44); fair for shoulder abduction, elbow flexion, wrist and ankle extension (0.20-0.33); and slight for knee extension (0.08). Correlations between the two tests were low for wrist, knee, ankle, and hip extension; moderate for elbow flexion, neck flexion and hip abduction; and good for shoulder abduction. In conclusion, the MMT8 total score is a reliable assessment to consider general muscle weakness in people with myositis but not for
Annals of the Rheumatic Diseases, 2016
subacute (25%) or chronic (55%) myositis were included. Participants were 56.5 ±10.13 years old and 75% of them were female. The median combined difficulty and importance of the 32 items of the MAP was 5.67 (range 5.3-6.5). Correlations between the total score of the MAP and the Short Physical Performance Battery (-0.52), Grip Ability Test (0.52), Progressive Isoinertial Lifting Evaluation (lumbal part:-0.62, cervical part-0.60) and the 6 minute walk test (-0.69) were moderate and the correlation with the one leg stand test was low (-0.26). Healthy participants had significant lower scores (single items, subscales and total score) than patients (p≤0.05). Cronbach's alpha coefficients for the four subscales varied between 0.85 and 0.92. Conclusions: This initial validation of the German version of the MAP showed that the 32 items from the English version were also suitable for Swiss conditions. Cronbach's alpha coefficients were similar to those from the English version. As expected the MAP correlated moderately with functional tests, except with the one leg stand. Although balance may be important in patients with IM, the MAP does not cover balance ability. In summary, the MAP seems to be a valid and easy applicable methodology for assessing limitations of activity in daily life. However, further research is required to confirm these preliminary results and to test reliability. References: [1] Alexanderson H, Lundberg IE, Stenstrom CH: Development of the myositis activities profile-validity and reliability of a self-administered questionnaire to assess activity limitations in patients with polymyositis/dermatomyositis. J Rheumatol 2002 [2] Alexanderson H, Reed AM, Ytterberg SR: The Myositis Activities Profile-initial validation for assessment of polymyositis/dermatomyositis in the USA.