Recovery Courses of Patients Who Return to Work by 3, 6 or 12 Months After Total Knee Arthroplasty.

Purpose This study compared the preoperative levels and postoperative recovery courses of physical and mental impairments, activity limitations and participation restrictions of working-age patients who return to work (RTW) by 3, 6 or 12 months after total knee arthroplasty (TKA). Methods A prospective survey study including TKA patients (aged < 65) (n = 146) who returned to work (RdTW) in the first postoperative year. Three groups were compared: those who returned by 3 (n = 35), 6 (n = 40) or 12 (n = 29) months. Surveys were completed preoperatively and at 6 weeks and 3, 6 and 12 months postoperatively. Outcomes represented domains of the International Classification of Functioning, i.e. physical impairments (pain, stiffness, vitality), mental impairments (mental health and depressive symptoms), activity limitations (physical functioning) and participation restrictions (social and work functioning). Results Preoperative knee-specific pain and physical functioning levels were better among patients who RdTW by 3 months, compared to those who returned by 12 months. Patients who RdTW by 3 months experienced significantly better recovery from physical impairments than those who returned by 6 months (on general pain) or 12 months (on general and knee-specific pain and on stiffness). Patients returning by 3 months experienced significantly better recovery from activity limitations (on knee-specific physical functioning). Conclusions To optimize return to work outcome after TKA surgery, the focus should lie on physical impairments (general and knee-specific pain, stiffness) and activity limitations (knee-specific physical functioning) during recovery.

French translation and validation of the Cumberland Ankle Instability Tool, an instrument for measuring functional ankle instability.

BACKGROUND: Ankle sprains are one of the most common musculoskeletal injuries, and can lead to chronic ankle instability (CAI). The Cumberland Ankle Instability Tool (CAIT) measures a subset of CAI, functional ankle instability (FAI). Because no French version existed, we set out to translate and validate the CAIT in French. METHODS: The CAIT was translated using a forward-backward methodology. We examined its psychometric properties and calculated a cut-off score for FAI in a sample of 102 subjects (median age 22 years). RESULTS: The CAIT was translated without significant problems. The CAIT-F can discriminate between those with and without FAI (p < 0.001), with a cut-off score of ≤ 23 points. The test-retest reliability is excellent (ICC = 0.960), as is the internal consistency (α = 0.885). Construct validity was confirmed. No floor or ceiling effects were detected among subjects with FAI. CONCLUSIONS: The CAIT is now available in French, and is a valid and reliable instrument.

French translation and validation of the Achilles Tendon Total Rupture Score "ATRS".

BACKGROUND: To provide a cross-cultural French adaptation of the Achille's Tendon Total Rupture Score (ATRS) and to assess its psychometric performances. METHOD: The ATRS questionnaire was first translated and inter-culturally adapted into French according to international guidelines. Then, 95 subjects were recruited to complete the French version of the ATRS twice (2 weeks of interval). The SF-36 and VISA-A were used as comparative questionnaires. The psychometric properties of the questionnaire were evaluated (test-retest reliability, internal consistency, construct validity, floor/ceiling effects). RESULTS: Thetest-retest reliability was excellent (ICC of 0,966 (95% CI:0.644-0.879)) and the internal consistency very high (Cronbach's alpha of 0,98). The convergent and divergent construct validity were also confirmed. Finally, none of the subjects obtained the lowest score (0) or the maximal score (100) to the questionnaire. CONCLUSION: A valid and reliable French version of the ATRS is now available.

French translation and validation of the "Anterior Knee Pain Scale" (AKPS).

PURPOSE: To linguistically and cross-culturally translate the Anterior Knee Pain Scale into French and to evaluate the reliability and validity of this translated version of the questionnaire. METHODS: The translation part was performed in six stages, according to international guidelines: (i) two initial translations from English to French; (ii) synthesis of the two translations; (iii) backward translations into the original language; (iv) expert committee to compare the backward translations with the original questionnaire; (v) pre-final version testing and (VI) expert committee appraisal. To validate the French version of the Anterior Knee Pain Scale, we assessed its validity, reliability and floor/ceiling effects. To do this, volunteer patients from the French part of Belgium and from France, with patellofemoral pain were asked to answer the French version of the Anterior Knee Pain Scale at baseline and after 7 days, as well as the generic SF-36 questionnaire. RESULTS: The Anterior Knee Pain Scale was translated without any major difficulties. A total of 101 subjects aged 34.5 ± 11.4 years (58.4% of women) were included in this study. Results indicated an excellent test-retest reliability (Intra-class correlation coefficient (ICC) = 0.97, 95%CI: 0.96-0.98), a high internal consistency (Cronbach's alpha = 0.87), a consistent construct validity (high correlations with the SF-36 questionnaire were found with domains related to physical function (r = 0.80), physical role (r = 0.70) and pain (r = 0.64)) and low or moderate correlations with domains related to mental health (r = 0.26), vitality (r = 0.32) and social function (r = 0.41). Moreover, no floor/ceiling effects have been found. CONCLUSIONS: A valid French version of the Anterior Knee Pain Scale is now available and can be used with confidence to better assess the disease burden associated with patellofemoral pain. It was successfully cross-culturally adapted into French. Implications for rehabilitation The results on psychometric properties of the French Anterior Knee Pain Scale are comparable with six validated versions obtained for the Finnish, the Turkish, the Chinese, the Dutch, the Thai and the Persian populations. The French translated version of the Anterior Knee Pain Scale is a reliable and valid instrument for assessing the functional limitations associated with patellofemoral pain. The test-retest reliability of the French Anterior Knee Pain Scale was excellent, the internal consistency was high and the construct validity was consistent. There were no floor/ceiling effects.

Treatment adherence therapy in people with psychotic disorders: randomised controlled trial.

BACKGROUND: Interventions to improve adherence to treatment in people with psychotic disorders have produced inconclusive results. We developed a new treatment, treatment adherence therapy (TAT), whose intervention modules are tailored to the reasons for an individual's non-adherence. AIMS: To examine the effectiveness of TAT with regard to service engagement and medication adherence in out-patients with psychotic disorders who engage poorly. METHOD: Randomised controlled study of TAT v. treatment as usual (TAU) in 109 out-patients. Most outcome measurements were performed by masked assessors. We used intention-to-treat multivariate analyses (Dutch Trial Registry: NTR1159). RESULTS: Treatment adherence therapy v. TAU significantly benefited service engagement (Cohen's d = 0.48) and medication adherence (Cohen's d = 0.43). Results remained significant at 6-month follow-up for medication adherence. Near-significant effects were also found regarding involuntary readmissions (1.9% v. 11.8%, P = 0.053). Symptoms and quality of life did not improve. CONCLUSIONS: Treatment adherence therapy helps improve engagement and adherence, and may prevent involuntary admission.

Correlation between ventilation and EEG-defined arousal during sleep onset in young subjects.

In studies of elderly individuals, ventilation and EEG-defined arousal have been shown to vary periodically and synchronously. Such results have been interpreted as indicating the primacy of sleep/wake state in causing ventilatory instability during sleep onset. However, because the elderly individuals studied were periodic breathers, the results do not unequivocally support this conclusion. In this study the relationship between ventilation and EEG-defined arousal was assessed in a group of 21 young, healthy men in whom ventilatory instability during sleep onset was not periodic. Ventilation and EEG (O1-A2) recordings were collected, and the longest uncontaminated periods from early and late in sleep onset were selected for subsequent analysis. The 84 time series (21 subjects, 2 variables, and 2 occasions in sleep onset) were subjected to spectral analysis to identify periodicity, and the relationship between the two variables was determined by cross-correlational methods. The results indicated that the time series were nonperiodic, yet significant correlations were observed between the two variables. The data support the view that during sleep onset ventilatory instability is driven primarily by variations in sleep/wake arousal level.