Evaluation of newborn hearing screening program in Jordan.

Introduction: The Newborn Hearing Screening (NHS) program was officially launched in Jordan in 2021. Since its inception, no studies have examined the effectiveness of the program. This study seeks to assess the effectiveness and outcomes of the NHS program in Jordan. Methods: A retrospective cross-sectional study was conducted to investigate the program coverage rate, referral rate, loss to follow-up rate and the hearing status of newborns who successfully completed the necessary diagnostic assessment. Live births in all hospitals administered by the Ministry of Health (MoH) in Jordan from July 2021 to November 2023 were included. Results: Out of 25,825 newborns delivered, 99.4% (25,682) were screened. A referral rate of 0.7% (189) was recorded. Approximately 61.9% of those referred (n = 117) had normal hearing, while 31.7% (60 infants) were diagnosed with hearing loss. The prevalence of congenital hearing loss was 0.14%, and the mean age for identifying hearing loss was 11 months. Discussion: The current status of the NHS program in Jordan is promising. The program has achieved most benchmarks recommended by the Joint Committee on Infant Hearing (JCIH), demonstrating encouraging outcomes. There is a need to investigate and address the factors causing delays in the identification of hearing loss in Jordan.

Using an Arabic Version of the Life-Space Assessment to Evaluate How Gait Speed and Gender Predict Mobility Restrictions among Older Adults.

Background and Objectives: The Life-Space Assessment (LSA) serves as an assessment tool for evaluating mobility and participation in older adults. To date, no studies have investigated the validity and reliability of the LSA within Arabic-speaking communities. The purpose of this study was to examine the reliability and validity of an Arabic version of the LSA and to investigate the potential predictors of mobility restrictions in older Arabic-speaking adults. Materials and Methods: This study involved a cohort of 75 Arabic-speaking older adults (with a mean age of 67.2 ± 5.9). The LSA was administered twice, with a one-week interval, to assess its test-retest reliability. The internal consistency and test-retest reliability of the LSA were assessed using Cronbach's alpha and intra-class correlation coefficients (ICCs), respectively. The validity of the LSA was determined by analyzing its correlation with outcome measures related to the fear of falling, depression, quality of life, lower limb strength, physical performance, and gait speed. Results: The test-retest reliability of the LSA composite score demonstrated good results (ICC = 0.83). The validity of the LSA was supported by significant correlations between its scores and factors such as gender, education level, and all other outcome measures. Notably, being female and having a lower gait speed emerged as significant predictors of mobility restrictions in older Arabic-speaking adults, accounting for 49% of the variance (R2 = 49%) in the multiple logistic regression analysis conducted. Conclusions: The Arabic version of the LSA has proven to be a reliable and valid measure of mobility and participation among older Arabic-speaking adults. This study endorses the application of the Arabic LSA in both research and clinical settings involving older adults and emphasizes the need for further investigation to fully understand its psychometric features in other Arabic-speaking individuals afflicted with neurological and musculoskeletal conditions.

Human Umbilical Cord-Derived Mesenchymal Stem Cells in the Treatment of Multiple Sclerosis Patients: Phase I/II Dose-Finding Clinical Study.

Multiple sclerosis (MS) is a chronic neuro-inflammatory disease resulting in disabilities that negatively impact patients' life quality. While current treatment options do not reverse the course of the disease, treatment using mesenchymal stromal/stem cells (MSC) is promising. There has yet to be a consensus on the type and dose of MSC to be used in MS. This work aims to study the safety and efficacy of two treatment protocols of MSCs derived from the umbilical cord (UC-MSCs) and their secretome. The study included two groups of MS patients; Group A received two intrathecal doses of UC-MSCs, and Group B received a single dose. Both groups received UC-MSCs conditioned media 3 months post-treatment. Adverse events in the form of a clinical checklist and extensive laboratory tests were performed. Whole transcriptome analysis was performed on patients' cells at baseline and post-treatment. Results showed that all patients tolerated the cellular therapy without serious adverse events. The general disability scale improved significantly in both groups at 6 months post-treatment. Examining specific aspects of the disease revealed more parameters that improved in Group A compared to Group B patients, including a significant increase in the (CD3+CD4+) expressing lymphocytes at 12 months post-treatment. In addition, better outcomes were noted regarding lesion load, cortical thickness, manual dexterity, and information processing speed. Both protocols impacted the transcriptome of treated participants with genes, transcription factors, and microRNAs (miRNAs) differentially expressed compared to baseline. Inflammation-related and antigen-presenting (HLA-B) genes were downregulated in both groups. In contrast, TNF-alpha, TAP-1, and miR142 were downregulated only in Group A. The data presented indicate that both protocols are safe. Furthermore, it suggests that administering two doses of stem cells can be more beneficial to MS patients. Larger multisite studies should be initiated to further examine similar or higher doses of MSCs.

Vestibular evoked myogenic potential (VEMP) test-retest reliability in adults.

BACKGROUND: The technique of measuring ocular vestibular evoked myogenic potentials (oVEMP) in response to Mini-shaker vibration is relatively new, there is a limited normative data to define the presence or absence of a response in the literature. OBJECTIVE: To determine the test-retest reliability of cervical and ocular VEMPs (cVEMP and oVEMP, respectively) to air-conducted sound (ACS) and bone-conducted vibration (BCV) stimulation and to determine normative ranges for the responses. METHODS: Twenty normal-hearing individuals (40 ears) and 20 hearing impaired volunteers with normal balance function (40 ears) were examined in this study. ACS cVEMP and BCV oVEMP (using a Mini-shaker) were recorded from both groups to assess the test-retest reliability and to collect normative VEMP data for P1/N1 latencies and amplitudes from 20 normal hearing individuals. To test reliability, VEMP recordings were repeated within the same session. RESULTS: The test-retest reliability for all the cVEMP parameters showed excellent reliability whereas oVEMP parameters showed between fair and excellent reliability depending on the parameter tested. Normative data for VEMP P1/N1 latencies and amplitudes were established. CONCLUSIONS: Normative data and test-retest reliability for BCV oVEMP using the Mini-shaker at 100 Hz were established in our study for the first time in the literature. Responses appear reliable.

Predictors of Dizziness and Hearing Disorders in People with Long COVID.

Background and Objectives: Individuals report persistent symptoms after becoming infected by SARS-CoV-2 (COVID-19) that last for >4 weeks (long-COVID syndrome). Dizziness and hearing loss have been reported among long-COVID symptoms. However, little is known about the potential predictors of dizziness and hearing loss in individuals with long COVID. This study aimed to explore the presence and correlates of dizziness and hearing loss in a sample of people with long-COVID syndrome. Materials and Methods: Individuals aged 18 years and older who were infected with COVID-19 at least 8 weeks prior to the start of the study were included if they were not diagnosed with dizziness or hearing loss before getting COVID-19. Demographics and COVID-19-related information were collected. Participants completed the Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence (ABC) scale, Falls Efficacy Scale International (FES-I), Modified Fatigue Impact Scale (MFIS), and Medical Outcomes Study Short Form 12 (SF-12). Finally, hearing was assessed using pure-tone audiometry (PTA) in a subsample. Results: Two hundred and nine individuals (66% female) with a mean (SD) age of 27 (9) participated in the study. Perceived dizziness and hearing loss were reported in 26 and 15.3% of the sample, respectively. Logistic regression was conducted to identify potential predictors of dizziness and hearing loss separately. After controlling for age and severity of dizziness, female sex and high fatigue severity were associated with an increased likelihood of reporting dizziness (R2 = 31%). The severity of dizziness and neurological symptoms during the acute stage of COVID-19 were associated with an increased likelihood of reporting hearing loss (R2 = 10.4%) after controlling for age. Conclusions: Dizziness and hearing loss present in long COVID and can be disabling. Females with high levels of fatigue should be questioned about persistent dizziness. Hearing loss should be considered in individuals with neurological symptoms and severe dizziness as a consequence of long COVID.

Relationship between Sleep Quality and Shoulder Disorders in People with Stroke.

Background and objective: The primary aim of the study was to investigate the relationship between sleep quality (SQ) and shoulder disorders in people after a stroke. The secondary aim was to explore the relationship between SQ and stroke outcomes, including the impact of stroke, fatigue, and quality of life (QOL). Material and Methods: A sample of 94 stroke patients was included. The Pittsburgh Sleep Quality Index (PSQI) was used to assess SQ, whereas the Shoulder Pain and Disability Index (SPADI) was utilized to assess shoulder pain and disability. The Stroke Impact Scale 16, the Modified Fatigue Impact Scale, and the Medical Outcomes Study Short Form 12 were also used as secondary measures. Results: The prevalence of poor SQ, shoulder pain, and shoulder disability in our sample was 60%, 78%, and 85%, respectively. The global PSQI score had a significant association with the SPADI pain subscale. There were some significant correlations between the PSQI subscales and shoulder pain and disability. The PSQI significantly correlated with stroke recovery, fatigue, and QOL. The daytime dysfunction PSQI subscale was significantly correlated with all shoulder and stroke outcomes and their subscale. Conclusion: SQ was associated more with the non-motor outcomes of stroke, including pain, cognitive fatigue, and mental status, than the motor outcomes. Considering SQ during upper extremity rehabilitation and care processes is essential.

Lower Limb Muscle Fatigue Alters Spatiotemporal Gait Parameters and Turning Difficulty Characteristics in Parkinson's Disease.

OBJECTIVE: To determine the effects of lower limb muscle fatigue on spatiotemporal gait parameters and turning difficulty characteristics during the extended Timed Up and Go (extended TUG) test in individuals with different severity stages of Parkinson's disease (PD). METHODS: Forty individuals with PD, classified as Hoehn and Yahr (H&Y) stages 2 and 3 participated in this pre- and post-experimental study design. The participants performed a continuous sit-to-stand task from a chair based on 30 cycles/min set-up to induce lower limb muscle fatigue. They performed extended TUG test immediately before and after completing the fatigue protocol. Spatiotemporal gait parameters and turning difficulty characteristics were recorded using two GoPro® Hero 4 Silver cameras. Data were subjected to a repeated-measure ANOVA. RESULTS: Individuals with PD experience significant changes in spatiotemporal gait parameters, specifically stride velocity and length, under conditions of lower limb muscle fatigue (p=0.001). These changes were more pronounced in individuals with PD in the H&Y stage 3 group. Additionally, both PD groups exhibited difficulty with turning, requiring more than five steps to complete a 180° turn and taking more than 3 seconds to accomplish it. CONCLUSION: These findings highlight the impact of muscle fatigue on gait performance in PD and suggest that individuals in later stages of the disease may be particularly affected. Further research is needed to explore interventions that can mitigate these gait impairments and improve mobility in individuals with PD.

Health-related quality of life and its correlates among individuals with stroke during the COVID-19 pandemic.

Strict safety procedures including lockdowns were adopted during the Corona virus (COVID-19) pandemic worldwide which might have influenced mental and physical health in affected communities. This study aimed to investigate the level of Health-related quality of life (HRQoL) and its correlates among individuals with stroke in Jordan during the COVID-19 pandemic. This was a cross-sectional study with a self-administered questionnaire, which included demographics, 12-item Short Form (SF-12) health survey, Depression Anxiety Stress Scale (DASS 21), and The Stroke Impact Scale 16 (SIS-16). Descriptive analyses were used to summarize study data. Factors significantly correlated with HRQoL were determined using Pearson correlation. A total of 97 individuals successfully completed the study with a mean age of 57.9 years (±57.9). The level of HRQoL (measured by SF-12) was significantly and negatively associated with mental health symptoms (depression, anxiety, and stress) and the stroke recovery subscale of the SIS-16. Furthermore, participants' HRQoL level was significantly and positively associated with participants' age, stroke chronicity, receiving rehabilitation, and amount of help asked from caregivers. Jordanians with stroke demonstrated a relatively low level of HRQoL and high levels of mental health symptoms during the COVID-19 pandemic. Healthcare administrators should carefully consider individuals with stroke HRQoL and its correlates while planning for future crises.

Distance learning in physiotherapy education during the COVID-19 pandemic: students' satisfaction, perceived quality, and potential predictors of satisfaction.

BACKGROUND AND PURPOSE: Physiotherapy (PT) is an allied health profession that is generally taught at universities with face-to-face learning to deliver the required knowledge and practical skills of PT. The education sector has transitioned to distance learning (DL) during the COVID-19 pandemic. The study aimed to evaluate PT students' perception of quality of DL and satisfaction with DL, and identify potential predictors of student satisfaction with DL during the COVID-19 pandemic. METHODS: A cross-sectional design was used. An online survey included demographic information, and the Distance Education Learning Environments Survey (DELES) was sent to PT students in Jordan. Regression analyses were used to identify the predictors of student satisfaction with DL. RESULTS: A total of 296 students completed the survey. Most students rated the overall quality of DL as good. However, they were not satisfied with DL. Instructor support for students, personal relevance, previous experience in DL, and being a master's student were the potential predictors of DL satisfaction. CONCLUSION: PT students rated the quality of DL as good with low level of satisfaction. Students' perceptions of and satisfaction with using DL were correlated to several potential predictors that could be considered for improving the DL experience in PT education.

Evidence for a left ear bias in incidence of Meniere's disease.

OBJECTIVE: To explore a side of lesion differences in Meniere's disease (MD). DESIGN: A retrospective review (2019-2021) was conducted of patients with definite MD, as defined by 2015 Bárány Society diagnostic criteria. Testing information included pure tone audiometry, tympanometry, and extra-tympanic electrocochleography (ECochG). Normative ECochG data from healthy subjects determined the 95% cut-off value for clinical abnormality. STUDY SAMPLE: 107 patients with definite MD were included in the study and 40 healthy controls. RESULTS: The review identified 75 patients with unilateral MD and 32 patients with bilateral MD according to their clinical histories. 79% of unilateral cases were found to have MD on the L ear. 94% of bilateral MD cases had L ears more affected than R ears. Objective ECochG testing indicated a greater incidence of elevated SP/AP area curve and amplitude ratios in L ears. On binomial testing, all results indicate a highly significant bias of MD to the L side. CONCLUSIONS: Unilateral MD appears more common on the L side than the R, suggesting that the disease process underlying MD is not symmetrical. MD also appears more common in females than males. It appears that there is a physiological asymmetry in the progression/cause of MD.

Ataxia Rating Scales: Content Analysis by Linking to the International Classification of Functioning, Disability and Health.

Ataxia management is mainly based on rehabilitation, symptomatic management, and functional improvement. Therefore, it is important to comprehensively assess ataxic symptoms and their impact on function. Recently, the movement disorders society recommended four generic ataxia rating scales: scale for assessment and rating of ataxia (SARA), international cooperative ataxia rating scales, Friedreich's ataxia rating scale (FARS), and unified multiple system atrophy rating scale (UMSARS). The aim of the study was to analyze and compare the content of the recommended ataxia rating scales by linking them to the international classification of functioning, disability and health (ICF). A total of 125 meaningful concepts from 93 items of the four included scales were linked to 57 different ICF categories. The ICF categories were distributed in body structure (n = 8), body function (n = 26), activity and participation (n = 20), and environmental factors (n = 3) components. UMSARS and FARS were the only ones that have addressed the body structure or environmental factors component. The content analysis of ataxia rating scales would help clinicians and researchers select the most appropriate scale and understand ataxic symptoms and their impact on function. It seems that SARA is the optimal scale for rapid assessment of ataxia or in busy clinical settings. UMSARS or FARS are more appropriate for the investigating the impact of ataxia on overall health, and monitoring ataxia progression and disability.

Effects of Transcranial Direct Current Stimulation on Sleep in Athletes: A Protocol of a Randomized Controlled Trial.

BACKGROUND: Sleep disturbances are common among athletes. There is recently a growing interest in improving sleep quality by using noninvasive brain stimulation techniques such as transcranial direct current stimulation (tDCS). We hypothesized that bilateral dorsolateral prefrontal cortex anodal tDCS could improve sleep in different sports athletes. A randomized controlled trial is to be conducted to test this hypothesis. METHODS: Eighty-four athletes are selected based on specific eligibility criteria and randomly allocated to the intervention or control group. Each participant will receive a 20-min session of bilateral anodal tDCS with an intensity of 1.5 mA (0.057 mA/cm2) in density 3 times a week for 2 weeks. The tDCS current will be delivered only for 30 seconds in the control group. This study's outcome is a set of subjective and objective sleep parameters. CONCLUSION: This study assessed the effect of a novel tDCS protocol represented by bilateral anodal stimulation and may result in important advances in sleep management among athletes. Because of the high incidence and impact of athletes' poor sleep quality, it is particularly important to explore effective interventions. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05318352.

Translation and validation of the Arabic version of the patient determined disease steps in people with multiple sclerosis.

BACKGROUND: The Patient Determined Disease Steps (PDDS) is a patient-reported outcome that measures disease severity in People with Multiple Sclerosis (PwMS). It is crucial to have instruments in various languages to ease the use and interpretation of clinical and research findings among PwMS. OBJECTIVE: To translate the PDDS into the Arabic language and explore its reliability and criterion validity with the EDSS, and convergent validity with fatigue, walking, and balance assessments. METHODS: Backward and forward translation methods were used to generate the PDDS translated version (PDDS-A). A total of 115 PwMS, mean age: 33.7 (SD, 10.6) completed the PDDS-A, the EDSS, and the Modified Fatigue Impact Scale Arabic version (MFIS-A). A sub-sample N = 89 performed walking and balance assessments. The PDDS-A was reevaluated after 2-3 weeks to measure its test-retest reliability. RESULTS: There was a strong correlation between the PDDS-A and EDSS (rho = 0.864). PDDS-A was moderately associated with the MFIS-A total score (rho = 0.598) and its subcomponents (physical: rho = 0.642, and cognitive: rho = 0.474). The PDDS-A showed significant correlations with walking endurance and speed, and balance. There was excellent test-retest reliability: 0.942 (95% CI 0.896-0.968). CONCLUSION: The PDDS-A is a reliable and valid tool that can be used among Arabic-speaking PwMS.

Should We Lose Sleep Over Sleep Disturbances After Sports-Related Concussion? A Scoping Review of the Literature.

OBJECTIVE: A single, severe traumatic brain injury can result in chronic sleep disturbances that can persist several years after the incident. In contrast, it is unclear whether there are sleep disturbances after a sports-related concussion (SRC). Considering growing evidence of links between sleep disturbance and neurodegeneration, this review examined the potential links between diagnosed SRCs and sleep disturbances to provide guidance for future studies. METHODS: The scoping review undertook a systematic search of key online databases (Scopus, MEDLINE, SportDiscus, and Web of Science) using predetermined search terms for any articles that examined sleep after concussion. A screening criterion using agreed inclusion and exclusion criteria was utilized to ensure inclusion of relevant articles. DESIGN: This scoping review is guided by the PRSIMA Scoping Review report. RESULTS: Ten studies met the inclusion criteria, reporting on 896 adults who had experienced an SRC. Comparison with 1327 non-SRC adults occurred in 8 studies. Nine studies subjectively examined sleep, of which all but one study reported sleep disturbances after an SRC. Three studies objectively measured sleep, with 2 studies indicating large coefficients of variation of sleep duration, suggesting a range of sleep responses after an SRC. The only study to examine overnight polysomnography showed no differences in sleep metrics between those with and without an SRC. No studies examined interventions to improve sleep outcomes in people with concussion. CONCLUSIONS: This scoping review indicates preliminary evidence of sleep disturbances following an SRC. The heterogeneity of methodology used in the included studies makes consensus on the results difficult. Given the mediating role of sleep in neurodegenerative disorders, further research is needed to identify physiological correlates and pathological mechanisms of sleep disturbances in SRC-related neurodegeneration and whether interventions for sleep problems improve recovery from concussion and reduce the risk of SRC-related neurodegeneration.

The long-term effect of neurodynamics vs exercise therapy on pain and function in people with carpal tunnel syndrome: A randomized parallel-group clinical trial.

INTRODUCTION: Carpal tunnel syndrome (CTS) is a common disorder that limits function and quality of life. Little evidence is available on the long-term effect of neurodynamics and exercise therapy. PURPOSE OF THE STUDY: This study aimed to examine the long-term effect of neurodynamic techniques vs exercise therapy in managing patients with CTS. STUDY DESIGN: Parallel group randomized clinical trial. METHODS: Of 57 patients screened, 51 were randomly assigned to either receiving four sessions of neurodynamics and exercise or home exercise therapy alone as a control. Blinded assessment was performed before treatment allocation, at treatment completion, and 6 months posttreatment. Outcome measures included Symptom Severity Scale (SSS), Functional Status Scale (FSS), Shortened version of the Disabilities of the Arm, Shoulder, and Hand (DASH), Numerical Pain Rating Scale, grip strength and range of motion. RESULTS: Data from 41 individuals (52 hands) were analyzed. The neurodynamics group demonstrated significant improvement in all outcome measures at 1 and 6 months (P < .05). Mean difference in SSS was 1.4 (95% CI= 0.9-1.4) at 1 month and 1.6 (95% CI = 0.9-2.2) at 6 months. Mean difference in FSS was 0.9 (95% CI = 0.4-1.4) at 1 month and 1.4 (95% CI = 0.7-2.0) at 6 months. Significant between-group differences were found in pain score at 1 month (-1.93) and in FSS (-0.5) and Shortened version of DASH (-12.6) at 6 months (P < .05). No patient needed surgery 1 year after treatment. CONCLUSIONS: Although both treatments led to positive outcomes, neurodynamics therapy was superior in improving function and strength and in decreasing pain.

Collegiate Athletes' Concussion Awareness, Understanding, and -Reporting Behaviors in Different Countries With Varying Concussion Publicity.

CONTEXT: Concussions are a global public health concern, and education on the importance of self-reporting may not reach all athletes to the same degree around the world. OBJECTIVE: To determine if differences were present in the concussion awareness, understanding, and -reporting behaviors of collegiate athletes' in 3 countries with varied degrees of concussion publicity. DESIGN: Cross-sectional survey. SETTING: Collegiate sports medicine clinics. PATIENTS OR OTHER PARTICIPANTS: Collegiate athletes in the United States (n = 964; high publicity), Ireland (n = 302; moderate publicity), and Jordan (n = 129; low publicity). The degree of concussion publicity was categorized based on the extent of national public health awareness initiatives, care guidelines, research publications, and mass media coverage. MAIN OUTCOME MEASURE(S): Participants completed a 10- to 15-minute survey on concussion awareness, understanding, and -reporting behaviors. The main outcome measures were concussion education (awareness; 21 options; select all sources of concussion information), concussion knowledge (understanding; maximum score of 49), and diagnosed/nondisclosed concussion history (reporting behaviors; self-report yes/no items). RESULTS: A higher proportion of Jordanian athletes reported never having received concussion information previously (73.6%) than Irish (24.2%) or US athletes (9.4%). Knowledge differed among countries (P < .0001, η2 = .28), with US athletes displaying higher total knowledge scores (40.9 ± 4.5) than Jordanian (35.1 ± 5.6) and Irish (32.1 ± 3.5) athletes. Greater percentages of Irish and US athletes reported a history of a diagnosed concussion (31.8% and 29.6%, respectively) and history of concussion nondisclosure (25.2% and 15.5%, respectively) than Jordanian athletes (2.3% and 0.0% for history of a diagnosed concussion and history of concussion nondisclosure, respectively). CONCLUSIONS: In the United States, where concussion publicity is high, formal legislation exists, and sports medicine resources and concussion awareness and understanding were increased. More culturally appropriate concussion initiatives are needed globally to ensure that athletes around the world can identify concussive injuries and understand the dangers of continued sport participation while concussed.

Predictors of sleep quality among university students: the use of advanced machine learning techniques.

PURPOSE: To assess the prevalence of sleep disturbances among university students and investigate potential correlated factors and their relative importance in quantifying sleep quality using advanced machine learning techniques. METHODS: A total of 1600 university students participated in this cross-sectional study. Sociodemographic information was collected, and the Pittsburgh Sleep Quality Index (PSQI) was administered to assess sleep quality among university students. Study variables were evaluated using logistic regression and advanced machine learning techniques. Study variables that were significant in the logistic regression and had high mean decrease in model accuracy in the machine learning technique were considered important predictors of sleep quality. RESULTS: The mean (SD) age of the sample was 26.65 (6.38) and 57% of them were females. The prevalence of poor sleep quality in our sample was 70%. The most accurate and balanced predictive model was the random forest model with a 74% accuracy and a 95% specificity. Age and number of cups of tea per day were identified as protective factors for a better sleep quality, while electronics usage hours, headache, other systematic diseases, and neck pain were found risk factors for poor sleep quality. CONCLUSIONS: Six predictors of poor sleep quality were identified in university students in which 2 of them were protective and 3 were risk factors. The results of this study can be used to promote health and well-being in university students, improve their academic performance, and assist in developing appropriate interventions.

Are fatigue scales the same? A content comparison using the International Classification of Functioning, Disability and Health.

BACKGROUND: Fatigue is a common impairment in a wide range of disorders. Numerous fatigue scales have been designed in an attempt to quantify this impairment without any clear distinction between them. The International Classification of Functioning, Disability and Health (ICF) is a useful tool for content comparison of measurement scales. OBJECTIVE: To explore the content of generic fatigue scales using the ICF. METHODS: Twenty generic fatigue scales were identified and linked to the ICF by two health care professionals according to the established linking rules. The contents of the 20 scales were compared and the inter-rater agreement was estimated using kappa coefficients. RESULTS: The content of generic fatigue scales varies and was found to focus mostly on body functions, activities and participation components of the ICF with a moderate to high degree of inter-observer agreement. CONCLUSIONS: The content comparison of fatigue questionnaires would assist clinicians and researchers in selecting the most appropriate measurement for use and precisely analyze the results of these measurements.

Factors influencing the deterioration from cognitive decline of normal aging to dementia among nursing home residents.

BACKGROUND: A dearth of differential research exists regarding the determinants of mild cognitive impairment (MCI) and moderate cognitive impairment or dementia among nursing home residents. This study aimed to identify and examine the association between medical factors (number of comorbidities, hospitalization, disability, depression, frailty and quality of life) and moderate cognitive impairment or dementia in nursing homes residents. METHODS: A cross-sectional design was used in this study. Convenience sampling of 182 participants was conducted in nursing homes located in the central part of Jordan. Montreal cognitive assessment (MoCA) was used to screen both MCI and moderate cognitive impairment or dementia. Bivariate analysis, including t-test and ANOVA test, and logistic and linear regression models were used to examine and identify the medical factors associated with moderate cognitive impairment or dementia compared to mild cognitive impairment. RESULTS: Most nursing home residents had MCI (87.4%) compared to a few with moderate cognitive impairment or dementia. Age (t = - 2.773), number of comorbidities (t = - 4.045), depression (t = - 4.809), frailty (t = - 4.038), and quality of life physical (t = 3.282) and mental component summaries (t = 2.469) were significantly different between the stages of cognitive impairment. Marital status (t = - 4.050, p <  0.001), higher-income (t = 3.755, p <  0.001), recent hospitalization (t = 2.622,p = 0.01), depression (t = - 2.737, p = 0.007), and frailty (t = 2.852, p = 0.005) were significantly associated with mental ability scores among nursing home residents. CONCLUSION: The coexistence of comorbidities and depression among nursing home residents with MCI necessitates prompt management by healthcare providers to combat depressive symptoms in order to delay the dementia trajectory among at-risk residents. TRAIL REGISTRATION: ClinicalTrials.gov NCT04589637 , October 15,2020, Retrospectively registered.

The effect of stem cell therapy and comprehensive physical therapy in motor and non-motor symptoms in patients with multiple sclerosis: A comparative study.

INTRODUCTION: People with multiple sclerosis (PwMS) experience a wide range of disabilities which negatively impact their quality of life (QOL). Several interventions have been used in PwMS such as medication, physical therapy exercises and stem cell therapy to improve their QOL. However, there is a limited evidence on the benefits of combining interventions. The purpose of this study is to explore the effect of combining physical therapy exercises (PTE) and Wharton Jelly mesenchymal stem cell (WJ-MSCs) injections on motor and non-motor symptoms versus each intervention alone in PwMS. METHODS: Sixty PwMS will be allocated to either PTE, WJ-MSCs, or a combined group, followed up for 12 months and examined using a comprehensive battery of measures. Participants in the PTE group will receive 2 sessions per week of a supervised exercise program for 6 months followed by a home exercise program for another 6 months. The WJ-MSCs group will receive 3 WJ-MSCs injections in the first 6 months then they will be encouraged to follow an active life style. The third group will receive both interventions. DISCUSSION: This study will aid in a better understanding of the combined effect of physical therapy and mesenchymal stem cell therapy. The results from this proposed study may reduce disability, improve QOL in PwMS, and consequently, reduce the cost associated with the life-time care of these individuals worldwide. TRIAL REGISTRATION NUMBER: NCT03326505.