Validity and Reliability of the World Health Organization Disability Assessment Schedule 2.0 36-Item Persian Version for Persons with Multiple Sclerosis / 가정의학회지

Background@#No previous studies have assessed the psychometric properties of the 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in the Persian language of Iran. This study was designed and conducted to evaluate the validity and reliability of the Persian version using a sample of persons with multiple sclerosis in Ahvaz, Iran. @*Methods@#The methodological study was conducted in two stages: First, the 36 items of the original WHODAS 2.0 were translated to create a Persian version, after which the translation validity and psychometric properties were tested. The factor structure of the instrument was also tested using exploratory and confirmatory factor analyses. @*Results@#The intraclass correlation coefficients were very good to excellent, varying between 0.82 and 0.99 for the six domains, and all domains had Cronbach’s α reliability values of above 0.70. For construct validity, results showed negative and strong correlation between the total score of WHODAS 2.0 and the Multiple Sclerosis Quality of Life-54. Exploratory factor analysis divided the Persian version of WHODAS 2.0 into seven factors for multiple sclerosis patients. @*Conclusion@#The results of this study indicate that the Persian version of WHODAS 2.0 is a valid and reliable instrument to study the disabilities of people with multiple sclerosis.

Gender differences in intra limb coordination while walking in older people

Knowledge about gender differences in intra-limb coordination during walking provides insight into the adaptability of central nervous system for controlling gait in older adults. We assessed the variability and phase dynamic of the intra-limb coordination in older men and women during walking. Twenty two older people, 11 female and 11 male, participated in this study. They were asked to perform walk on a treadmill at their preferred speed. Deviation phase and mean absolute relative phase values -indicators of variability and phase dynamic of intra-limb coordination, respectively- were calculated using the data collected by a motion capture system. We used independent sample t-test for statistical analysis. The results showed that women had a significant higher deviation phase in pelvis-thigh intersegmental relationships on both sides. Additionally, the mean absolute relative phase of left pelvis-thigh, thigh-shank and shank-foot were significantly different between men and women. While women showed a lower mean absolute relative phase in pelvis-thigh, men had a lower mean absolute relative phase in shank-thigh inter-segmental relationships. We suggest that gender could affect the intra-limb coordination variability and phase dynamic during walking in older people. This may be a reflection of the great adaptability of neuromuscular system to modify control strategies for walking in older women/ men

eccentric torque production capacity of the ankle, knee, and hip muscle groups in patients with unilateral chronic ankle instability

The aim of this study was to investigate eccentric torque production capacity of the ankle, knee, and hip muscle groups in patients with unilateral chronic ankle instability [C AI] as compared to healthy matched controls. In this case-control study, 40 participants [20 with CAl ;and 20 controls] were recruited based on convenient non-probability sampling. The average peak torque to body weight [APT/PW] ratio of reciprocal eecentric contraction of ankle dorsi flexor/plantar flexor, ankle exertor/invertor, knee flexor/extensor, hip flexor/extensor and hip abductor/adductor was determined using an isokinetic dynamometer. All subjects participated in two separate sessions with a rest interval of 48 to 72 hours, in each testing session, the torque production capacity of the ankle, knee, and hip muscle groups of only one lower limb was measured. At first, 3 repetitions of maximal eccentric-eccentric contraction were performed for the reciprocal muscles of a joint in a given movement direction. Then, the same procedure of practice and testing trials was repeated for the next randomly-ordered muscle group or joint of the same limb. There was no significant interaction of group [CAI and healthy controls] by limb [injured and non-injured] for any muscle groups. Main effect of limb was not significant. Main effect of group was only significant for eccentric torque production capacity of ankle dorsi flexor and hip flexor muscle groups. The APT/BW ratio of these muscles was significantly lower in the CAI group than the healthy controls [P<0.05]. CAI is associated with eccentric strength deficit of ankle dorsi flexor and hip flexor muscles as indicated by reduction in torque production capacity of these muscles compared to healthy controls. This strength deficit appeared to exist in both the injured and non-injured limbs of the patients