Responsiveness of the Work Role Functioning Questionnaire (Spanish version) in a general working population.

OBJECTIVE: To examine the responsiveness of the Work Role Functioning Questionnaire (Spanish version) (WRFQ-SpV) so that it could be used in evaluative studies. METHODS: A longitudinal survey was performed. Combinations of distribution- and anchor-based approaches were used. Five hypotheses were tested, examining validity of change scores. The consensus-based standards for the selection of health status measurement instruments (COSMIN) guided the study design. RESULTS: One hundred two participants (mean age, 47.3 years; SD = 10.3 years) completed the WRFQ-SpV twice, within a mean interval of 3.7 (SD = 1.8) months. Four hypotheses were confirmed and one was rejected. It was verified that the WRFQ-SpV was able to detect (true) changes over time. CONCLUSION: Suggestive evidence about the possible use of the WRFQ-SpV with evaluative purposes was provided. More research is needed to examine the instrument responsiveness for groups whose health is stable or deteriorates.

Reliability and validity of the work role functioning questionnaire (Spanish version).

PURPOSE: Recently, the cross-cultural adaptation of the Work Role Functioning Questionnaire to Spanish was carried out, achieving satisfactory psychometric properties. Now we examined the reliability and validity of the adapted [Work role functioning questionnaire-Spanish version (WRFQ-SpV)] in a general working population with and without (physical and mental) health issues to evaluate its measurement properties. METHODS: A cross-sectional study was conducted among active workers. For reliability, we calculated Cronbach alphas to assess 'internal consistency', and the standard error of measurement (SEM) to evaluate 'measurement error'. We assessed the 'structural validity' through confirmatory factor analyses and 'construct validity' by means of hypotheses testing. The consensus-based standard for the selection of health status measurement instruments (COSMIN) taxonomy were used in the design of the study. RESULTS: A total of 455 workers completed the questionnaire. It showed excellent internal consistency (α = 0.98). The SEM for the overall scale was 7.10. The original five factor structure reflected fair dimensionality of the construct (Chi square, 1,445.8; 314 degrees of freedom; root mean square error of approximation = 0.08; comparative fit index >0.95 and weighed root mean residual >0.90). For construct validity, all hypotheses were confirmed differentiating groups with different jobs, health conditions and ages. Moderate to strong correlations were found between WRFQ-SpV and a related construct (work ability). CONCLUSIONS: Our study provides evidence of the reliability and validity of the WRFQ-SpV to measure health-related work functioning in day-to-day practice and research in occupational health care and the rehabilitation of disabled workers. It should be useful to monitor improvements in work functioning after implementing rehabilitation and/or accommodation programs. Longitudinal studies are needed to assess the responsiveness of the questionnaire.

Correlation of dorsiflexion angle and plantar pressure following arthrodesis of the first metatarsophalangeal joint.

BACKGROUND: The correlation between angle of fusion of the first metatarsophalangeal (1MTTP) joint and pressures under metatarsal heads and hallux has not been well characterized. The main purpose was to investigate the correlation between fusion dorsiflexion angle of the 1MTTP joint and plantar pressures under the first metatarsal head and hallux during gait. METHODS: Patients who underwent arthrodesis of the 1MTTP joint from 2005 to 2010 were seen for a follow-up examination. Of 27 patients, 15 (22 feet) with a mean follow-up of 26.2 months were evaluated in the study. Main outcomes included the fusion clinical and radiological dorsiflexion angles and the mean and maximum dynamic plantar pressures under all 5 metatarsal heads and under the hallux. Plantar pressures were measured through an in-shoe system while patients walked normally along a corridor. RESULTS: The dorsiflexion angle was positively correlated with mean dynamic plantar pressures under the first metatarsal head: P = .02 (r = 0.5) for clinical angle, and P = .01 (r = 0.58) for radiological angle. Patients with 15 degrees or more of clinical dorsiflexion angle demonstrated higher mean dynamic plantar pressure under the first metatarsal head (P = .05) and higher maximum dynamic plantar pressure under the second metatarsal head (P = .04) compared with patients with less than 15 degrees. In contrast, the latter patients demonstrated higher mean dynamic plantar pressure beneath the hallux (P = .04). Patients with 30 degrees or more of radiological dorsiflexion angle demonstrated significantly higher mean dynamic plantar pressure under the first metatarsal head (P = .04) compared with patients with less than 30 degrees. CONCLUSION: Higher dorsiflexion angles correlate with higher plantar pressures under the first metatarsal head. Lower dorsiflexion angles increase plantar pressures beneath the hallux during gait. CLINICAL RELEVANCE: Significant increase in plantar pressure under the first metatarsal head may be avoided by performing the arthrodesis of the 1MTTP joint below 30° and 15° for the radiological and clinical dorsiflexion angles, respectively.

Bilateral stress fracture of the carpal scaphoid: report in a child and review of the literature.

We describe a case of a bilateral stress fracture of the carpal scaphoid in a 13-year-old boy. The patient played as a goalkeeper from the age of 5 years and presented with a 2-year history of intermittent pain in both wrists. Our patient underwent open reduction and bone grafting from the iliac crest in both wrists (6 months apart). He subsequently became asymptomatic and resumed sport activities. This patient presented with what was considered a rare case of a stress fracture of both scaphoid bones secondary to repetitive dorsiflexed movements. The patient denied the presence of acute symptoms after a fall and did not perceive the onset of pain as being related to any trauma to the wrist, particularly while playing soccer. A review of other similar cases previously published is also presented.

Stress fracture of the femoral neck as a complication of total knee arthroplasty.

Stress fracture of the hip is a rare complication of total knee arthroplasty that occurs most often in patients in whom a significant deformity of the knee has been corrected, particularly those with poor mobility before surgery. We report 4 cases of ipsilateral fracture of the femoral neck after total knee arthroplasty.