Translation and adaptation of the Pediatric Outcome Data Collecting Instrument (PODCI) into the Dutch language and preliminary validation in children with Neonatal Brachial Plexus Palsy.

PURPOSE: This study aimed to translate and cross-culturally adapt the Pediatric Outcome Data Collecting Instrument (PODCI) into the Dutch language and evaluate its measurement properties among children (age 3-10) with Neonatal Brachial Plexus Palsy (NBPP). METHODS: The PODCI was translated and adapted according to international guidelines and administered to 10 children with NBPP before and after surgery and thereafter twice again. Subsequently, the Mallet-score, Assisting Hand Assessment and active Range of Motion (aROM) were recorded. Cronbach's-α and correlations between the PODCI and other outcome measures were determined, as well as Intraclass Correlation Coefficients (ICC). In addition, effect sizes (ES), Standard Response Means (SRM) and change scores with the 95% Confidence Interval (95% CI) were calculated. RESULTS: The final Dutch PODCI `Upper Extremity and Physical Function' subscale and total score `Global Functioning' showed good internal consistency (Cronbach's-α 0.695/0.781) and reliability (ICC 0.97/0.80) and were significantly associated with aROM and the Mallet-score. After surgery a significant change of the total score (ES 0.57, SRM 1.23, change 4.22 points, 95% CI 1.04-7.4) was seen. CONCLUSION: The final Dutch PODCI had good measurement properties and appears useful in evaluating quality of life and functioning in children with NBPP.

Stick Together: A Nordic Walking Group Intervention for Breast Cancer Survivors.

Axillary lymph node dissection and axillary radiation as part of breast cancer treatment often result in arm and shoulder morbidity and limitations in daily functioning. Over and above the general benefits for cardiorespiratory fitness, Nordic Walking particularly targets at the muscles of the upper extremities and shoulder. This may increase shoulder range of motion and lead to a reduction in functional limitations. The aim of this study was to offer a Nordic Walking intervention to women after treatment for breast cancer and to investigate changes in subjective well-being and shoulder function. Three supervised Nordic Walking courses were organized (2009-2011). The intervention consisted of ten weekly 1-hour sessions focusing on upper body strength and condition. In total, 28 women participated in one of the cohorts. Results showed that after 10 weeks, patients' vitality had improved, whereas perceived shoulder symptom severity and limitations in daily activities had decreased. Goniometric data indicated that range of motion (forward flexion, abduction, and external rotation) of the affected shoulder improved significantly within 10 weeks of training. Group interviews at 6 months follow-up confirmed that patients had appreciated the physical and psychosocial benefits of the intervention. These benefits outweighed the practical disadvantages. Patient selection, assessment and training should take place under (para-)medical supervision and group instructors should have the knowledge and skills to work with a group of recent cancer survivors. Results from this explorative study suggest that Nordic Walking is a feasible and potentially valuable tool in the rehabilitation of patients with breast cancer.

An innovative care model coordinated by a physical therapist and nurse practitioner for osteoarthritis of the hip and knee in specialist care: a prospective study.

The subject of the study is to investigate whether health-related quality of life (HRQoL), pain and function of patients with hip or knee osteoarthritis (OA) improves after a specialist care intervention coordinated by a physical therapist and a nurse practitioner (NP) and to assess satisfaction with this care at 12 weeks. This observational study included all consecutive patients with hip or knee OA referred to an outpatient orthopaedics clinic. The intervention consisted of a single, standardized visit (assessment and individually tailored management advice, to be executed in primary care) and a telephone follow-up, coordinated by a physical therapist and a NP, in cooperation with an orthopaedic surgeon. Assessments at baseline and 10 weeks thereafter included the short form-36 (SF-36), EuroQol 5D (EQ-5D), hip or knee disability and osteoarthritis outcome score (HOOS or KOOS), the intermittent and constant osteoarthritis pain questionnaire (ICOAP) for hip or knee and a multidimensional satisfaction questionnaire (23 items; 4 point scale). Eighty-seven patients (57 female), mean age 68 years (SD 10.9) were included, with follow-up data available in 63 patients (72 %). Statistically significant improvements were seen regarding the SF-36 physical summary component score, the EQ-5D, the ICOAP scores for hip and knee, the HOOS subscale sports and the KOOS subscales pain, symptoms and activities of daily living. The proportions of patients reporting to be satisfied ranged from 79 to 98 % per item. In patients with hip and knee OA pain, function and HRQoL improved significantly after a single-visit multidisciplinary OA management intervention in specialist care, with high patient satisfaction.

Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial.

BACKGROUND AND PURPOSE: In many physical therapy programs for subjects with adhesive capsulitis of the shoulder, mobilization techniques are an important part of the intervention. The purpose of this study was to compare the effectiveness of high-grade mobilization techniques (HGMT) with that of low-grade mobilization techniques (LGMT) in subjects with adhesive capsulitis of the shoulder. SUBJECTS: One hundred subjects with unilateral adhesive capsulitis lasting 3 months or more and a > or =50% decrease in passive joint mobility relative to the nonaffected side were enrolled in this study. METHODS: Subjects randomly assigned to the HGMT group were treated with intensive passive mobilization techniques in end-range positions of the glenohumeral joint, and subjects in the LGMT group were treated with passive mobilization techniques within the pain-free zone. The duration of treatment was a maximum of 12 weeks (24 sessions) in both groups. Subjects were assessed at baseline and at 3, 6, and 12 months by a masked assessor. Primary outcome measures included active and passive range of motion and shoulder disability (Shoulder Rating Questionnaire [SRQ] and Shoulder Disability Questionnaire [SDQ]). An analysis of covariance with adjustments for baseline values and a general linear mixed-effect model for repeated measurements were used to compare the change scores for the 2 treatment groups at the various time points and over the total period of 1 year, respectively. RESULTS: Overall, subjects in both groups improved over 12 months. Statistically significant greater change scores were found in the HGMT group for passive abduction (at the time points 3 and 12 months), and for active and passive external rotation (at 12 months). A statistically significant difference in trend between both groups over the total follow-up period of 12 months was found for passive external rotation, SRQ, and SDQ with greater change scores in the HGMT group. DISCUSSION AND CONCLUSION: In subjects with adhesive capsulitis of the shoulder, HGMTs appear to be more effective in improving glenohumeral joint mobility and reducing disability than LGMTs, with the overall differences between the 2 interventions being small.

Impact of adhesive capsulitis and economic evaluation of high-grade and low-grade mobilisation techniques.

The purpose of this study was to estimate the impact of adhesive capsulitis on costs and health and to compare the cost-utility of high-grade and low-grade mobilisation techniques. In a randomised controlled trial, 92 patients with adhesive capsulitis received either high-grade mobilisation techniques or low-grade mobilisation techniques and were followed for one year. Outcome measures were quality adjusted life years (QALYs) according to the Short Form 6D (SF-6D) and societal costs estimated from cost questionnaires. Estimated costs and QALYs in both randomisation groups were similar, except for the number of treatment sessions (18.6 for high-grade mobilisation techniques versus 21.5 for low-grade mobilisation techniques), with an estimated cost difference of 105 euros in favour of high-grade mobilisation techniques (p = 0.001, 95% CI 43 euros to 158 euros). In the entire sample, the average valuation of health improved from 0.597 at baseline to 0.745 after a year. The burden due to adhesive capsulitis was estimated at 0.048 QALY and 4,521 euros per patient. About half these costs were due to absenteeism which, during the first quarter, amounted to 38% of the total working hours. In conclusion, the cost-utility analysis does not allow for an evidence-based recommendation on the preferred treatment. Based on the clinical outcome measures, high-grade mobilisation techniques are still preferred to low-grade mobilisation techniques. The estimated substantial burden, both to the patient and to society, suggests that effective early treatment of adhesive capsulitis is warranted to attempt to accelerate recovery.

Translation, adaptation and validation of the Shoulder Rating Questionnaire (SRQ) into the Dutch language.

OBJECTIVE: To translate and adapt the original English version of the Shoulder Rating Questionnaire (SRQ) into the Dutch language (SRQ-DLV) and evaluate its internal consistency, reliability, validity and responsiveness to clinical changes. DESIGN: Prospective study. SETTING: Outpatient departments of orthopaedics, radiology and physical therapy of an academic and a non-academic hospital. SUBJECTS: One hundred and seven patients treated for unilateral shoulder disorder (adhesive capsulitis 68, calcifying tendinitis 22, impingement syndrome or rotator cuff tear 17). METHODS: The original SRQ was translated and adapted following international guidelines. The SRQ-DLV was used among other measures of body function and structure, activities and societal participation in order to determine reliability, internal consistency, validity and responsiveness. Assessments were done at baseline and three months after treatment, with the SRQ-DLV being re-administered within one week before the baseline measurement and the start of the treatment for testing reliability. RESULTS: Cronbach's alpha for internal consistency was 0.89 for the total questionnaire and 0.81, 0.80, 0.72 and 0.84 for the domains pain, daily activities, sports/recreational activities and work, respectively. Test-retest reliability of the SRQ-DLV and its subscales ranged from 0.63 to 0.86. The summary score of the SRQ-DLV correlated with measures of shoulder function, daily activities and quality of life. Except for the work subscale of the SRQ-DLV, large effect sizes, reflecting its responsiveness to clinical changes after treatment, were found for both the summary and the subscales scores. CONCLUSIONS: Empirical data support that the SRQ-DLV is a reliable, valid and responsive measure to be used in clinical trials including Dutch patients with various shoulder disorders.