Translation, validity, and reliability of the Foot Posture Index (FPI-6) - Turkish version.

PURPOSE: The aim of this study was to translate the English version of the Foot Posture Index (FPI-6) into Turkish and to examine its psychometric properties. METHODS: After the forward-backward translation process, the internal consistency and intra - and inter-rater reliability were evaluated by using Cronbach's α and Intraclass Correlation Coefficient (ICC2,k) (two-way random effects model with absolute agreement type), respectively. The agreement between reliability assessments was investigated by the standard error of measurement (SEM) and the minimal detectable change (MDC95%). Criterion validity was assessed in relationship between the Turkish FPI-6 and Foot Function Index (FFI) and the American Orthopedic Foot and Ankle Society (AOFAS). RESULTS: The study was completed with 45 patients with foot/ankle problems. The internal consistency (Cronbach's α = 0.85; 0.78, respectively), intra-reliability (ICC2,k = 0.96; 0.94, respectively), and inter-reliability (ICC2,k = 0.93; both of them) of the Turkish version of the FPI-6 were excellent for the dominant and non-dominant lower limb. The SEM was low, and the agreement was considered to have high absolute reliability, as demonstrated by the smallest change in measurement error. The Turkish FPI-6 also had moderate correlations with the FFI and AOFAS (p < .05). CONCLUSIONS: It has been proven that the Turkish FPI-6 is valid and reliable and can be used by Turkish-speaking researchers and clinicians in patients with various foot-ankle problems.

Effect of intramuscular fat in the thigh muscles on muscle architecture and physical performance in the middle-aged women with knee osteoarthritis.

BACKGROUND: We investigated intramuscular fat (IMF) in quadriceps femoris (QF) and hamstring muscles in the middle-aged women with knee osteoarthritis (KOA). We also examined the relationship between muscular infiltration of QF and hamstring muscles and muscle architecture and physical performance of the women with KOA. METHODS: In this cross-sectional study, 72 women were included. Body muscle and fat mass were measured by BIA, isometric muscle strength was evaluated by hand-held dynamometer. IMF and muscle architecture were calculated from rectus femoris (RF), vastus intermedius (VIM), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST) and semimembranosus (SM) using B-mode ultrasonography. KOA-related symptoms and functions were assessed with KOOS. The functional performance assessments were evaluated with Stair Climbing Test, 20-Meter Walking Test. RESULTS: Women with KOA had more IMF in RF, VIM, VL, VM and BF, ST, SM muscles compared to the healthy women. Pennation angles decreased as the IMF in the RF, VM, BF and ST decreased. As the IMF of the RF and VM increased isometric knee extensor strength decreased and KOOS symptom score, pain score and ADL score increased in women with KOA. Walking and stair climbing speed deteriorated as the IMF in RF, VIM, VM, BF increased in the middle-aged women. As the IMF in BF increased isometric knee flexor strength decreased and KOOS scores increased. Physical performance scores deteriorated as the IMF in BF increased in middle-aged women with KOA. CONCLUSION: IMF in QF and hamstring muscles were higher in the middle-aged women with KOA group compared with that in the healthy group. Weakness of the QF and hamstring muscles may due to the changes in architectural properties of muscle depending on muscular infiltration. IMF in knee muscles is an important determining factor in performance and physical function of middle-aged women with KOA.

Effectiveness of supervised and functional level-based exercise program in elderly inpatients: Randomised controlled trial.

OBJECTIVE: The aim of this study was to compare the effectiveness of supervised and unsupervised functional level-based exercises program for elderly inpatients on physical activity, mobility, health-related quality of life and depression status. DESIGN: A single-blinded randomised controlled trial. SETTING: Internal medicine service. SUBJECTS: Patients aged 65 years or older. INTERVENTIONS: A supervised functional level-based exercise program was applied to the intervention group by a physiotherapist, for 40 min 5 times a week during their hospitalisation. Patients in the control group were asked to perform an unsupervised functional level-based exercise program which was described by the physiotherapist during the first visit. MAIN MEASURES: Mobility, physical activity level and health-related quality of life were assessed at admission and discharge in both groups. Depression status was evaluated at admission and 3 months after discharge. RESULTS: Sociodemographic features between intervention group (n = 62) and control group (n = 62) were similar. The intervention group showed a higher increment in mobility, physical activity level and quality of life scores than the control group (d = 0.62, p < 0.05; d = 0.57, p < 0.05; d = 1.12, p < 0.05 respectively). Inpatients in the intervention group, depression scores were lower 3 months after discharge (d = 0.42, p < 0.05). The length of stay in the hospital was not different between the groups. CONCLUSIONS: A supervised functional level-based exercise program is more effective than an unsupervised functional level-based exercise program for mobility, physical activity, depression and quality of life in elderly inpatients. These positive contributions are seen within a short period like a 5 to 10 days stay in hospital. TRIAL REGISTRATION: ClinicalTrials.gov(NCT03516032).

Ultrasound imaging of quadriceps muscle in patients with knee osteoarthritis: The test-retest and inter-rater reliability and concurrent validity of echo intensity measurement.

BACKGROUND: Echo intensity(EI) on ultrasonography images of skeletal muscle reflects muscle composition. OBJECTIVES: The primary aim of the study was to investigate the inter-rater and test-retest reliability of EI using grayscale histogram analysis of the cross-sectional area of quadriceps femoris(QF) muscle in patients with knee osteoarthritis(KOA). The secondary aim of the study was to determine the concurrent validity of the Free Hand Tool(FHT) when compared to Rectangular Marquee Tool(RMT) for calculating the region of interest(ROI) in ImageJ. METHODS: This study included thirty patients with KOA. Echogenicity of the QF muscle were performed by two different raters. The reliability analysis was applied using intraclass correlation coefficient(ICC), standard error of measurement(SEM) and coefficient of variation(CV). Spearman rank correlation coefficients were calculated for assessing concurrent validity of the FHT to RMT. The Bland-Altman plots was used to show disagreement between tools. Wilcoxon signed-rank test was used for differences in assessments between test/retest sessions, raters, tools. RESULTS: The inter-rater and test-retest reliability of the EI using FHT and RMT was found to be excellent (ICCFHT = 0.91-0.95, 0.98-0.99, ICCRMT = 0.91-0.98, 0.91-0.99,respectively). Bland-Altman analysis demonstrated a slight bias when region ROI calculations were collected from RMT or FHT (bias ranging from 2.75 to-2.40 a. u). There were no significant differences between test/retest sessions, raters and tools(p > 0.05). Spearman correlation coefficient showed excellent correlation between tools used for echogenicity assessment of QF muscle(p < 0.001). CONCLUSION: EI assessment using ultrasonography in the QF muscle showed excellent reliability. Evaluating muscle echogenicity using both FHT and RMT appears to be reliable and validity for monitoring muscle changes due to KOA.

Reliability and Validity of the Turkish Version of the Oxford Participation and Activities Questionnaire in Older People.

BACKGROUND: Activities and participation play important roles in the maintenance of healthy aging. The maintenance of these factors optimizes social life to increase the quality of life with aging. However, there is a lack of questionnaires in Turkish to evaluate activity and participation among older people. This study translated and cross-culturally adapted the Oxford Participation and Activities Questionnaire (Ox-PAQ) into Turkish and investigated its psychometric properties in the older adult population. METHODS: The Turkish version of the Ox-PAQ was produced after a translation and back-translation process. The Ox-PAQ was administered to 230 and 60 individuals for construct validity and reliability analyses, respectively. To assess the test-retest reliability of the Turkish Ox-PAQ, the questionnaire was reapplied 7 days after the first interview. Cronbach's alpha (α) was used to evaluate the internal consistency. The Ox-PAQ was compared to the Short Form-12 and the Katz Index of Independence in Activities of Daily Living Scale to determine its validity. RESULTS: The Turkish Ox-PAQ showed excellent internal consistency (α=0.98) and test-retest reliability (intraclass correlation coefficient=0.98, 0.96, and 0.97 for the subscales of routine activity level, social engagement, and emotional well-being, respectively). In the validity analysis, factor analysis demonstrated a probable structure of the three factors that together explained 66.35% of the total variance. The Turkish Ox-PAQ was correlated with the other comparison measures used in this study. CONCLUSION: The Turkish Ox-PAQ is a reliable and valid questionnaire to evaluate the participation and activity levels of older people (Clinical Trial Number: NCT04368754).