Reliability and Validity of the Turkish Version of the Modified Dynamic Gait Index in the Elderly.

The modified Dynamic Gait Index (mDGI) is one of the valid instruments used in the evaluation of gait disorders. This study aimed to translate the mDGI into Turkish and evaluate the evidence for its reliability and validity for use in an elderly population. For test-retest reliability, the mDGI was administered twice, and for inter-rater reliability, the mDGI was administered alone on the same day by two raters. Concurrent validity of the mDGI was assessed using Pearson's correlation analysis between the Turkish version of the mDGI score and the Timed Up and Go (TUG), Berg Balance Scale (BBS), and 10-m Walk Test (10-MWT), respectively. The internal consistency of the mDGI was found to be excellent (Cronbach's alpha = 0.97) and test-retest (ICC = 0.95; 95% Cl (0.84-0.95)) and inter-rater reliability (ICC = 0.95; 95% Cl (0.85-0.95)) were excellent. A negative, moderate correlation was found between mDGI and TUG (r = -0.73, p < .0001), and a positive, moderate correlation with BBS (r = 0.71, p < .0001) and 10-MWT (r = 0.72, p < .0001). The Turkish version of the mDGI was found to be a valid and reliable assessment instrument for gait and balance in the elderly.

The effect of exercise on adrenocortical responsiveness of patients with chronic low back pain, controlled for psychological strain.

OBJECTIVE: To investigate the effects of high-intensity aerobic exercise on adrenocortical responsiveness and on standard outcome measures in patients with chronic low back pain. DESIGN: Controlled clinical trial. SETTING: Physical therapy department of a university general hospital. SUBJECTS: Sixty-four patients with chronic low back pain were randomly allocated into positive and negative suppression test groups and assigned to exercise protocol. INTERVENTIONS: Subjects in the positive and negative dexamethasone suppression test groups received a 12-week high-intensity aerobic exercise programme. MAIN OUTCOME MEASURES: Dexamethasone suppression test as an index of adrenocortical responsiveness, pain measured with the McGill Pain Questionnaire, functional status measured with the Roland Morris Disability Questionnaire, and psychological strain measured with the Hospital Anxiety and Depression Scale. RESULTS: Data analysis in the positive group identified a significant reduction of pain by 30% (t(30) = 11.2, P<0.001), a recovery of the lost functioning by 34% (t(30) = 19.7, P<0.001), a reduction of anxiety/depression by 25% (t(30) = 10.2, P<0.001), and a change in adrenocortical responsiveness by 40% (t(30) = 14.1, P<0.001). In the dexamethasone suppression test negative group, data analysis identified a significant reduction of pain by 8% (t(31) = 4.2, P<0.001), a recovery of lost functioning by 10% (t(31) = 4.8, P<0.001), a reduction of anxiety/depression by 11% (t(31) = 5.0, P<0.001), and no change in adrenocortical responsiveness (t(31) = 1.2, P=0.22). In univariate analysis between-subject differences were significant for dexamethasone suppression test (F(61) = 163, P<0.001), and for anxiety/depression (F(61) = 21.3, P<0.001). CONCLUSION: Exercise alleviated pain, functional disability and anxiety/depression, also improved adrenocortical responsiveness in patients with chronic low back pain with dexamethasone suppression test positive values.