Translation and Validation of the Thai Version of the Nasal Obstruction Symptom Evaluation (NOSE) Scale.

Objective: The Nasal Obstruction Symptom Evaluation (NOSE) was developed to evaluate subjective outcomes of patients with deviated nasal septum and symptomatic nasal obstruction. Considering the differences in individuals' cultural, cross-cultural translation, adaptation, and validation of the instrument are necessary. The current study aimed to translate and validate the Thai version of the NOSE Questionnaire for patients with nasal septum deviation. Study Design: A single-center prospective instrument validation study. Setting: Thai tertiary referral center. Methods: The study was conducted to translate and adapt the original English version of the NOSE to Thai. After translating, psychometric testing was conducted. The primary outcomes were validity (content, construct, and discriminant), reproducibility (test-retest procedure), and internal consistency (reliability). A total of 105 participants, of which 46 were patients with nasal airway obstruction and 59 were healthy asymptomatic volunteers, were enrolled in this study. Results: The Thai-NOSE was found to be adequate for all tested psychometric properties with high internal consistency (Cronbach's α = .942), and to discriminate accurately between patients and healthy controls. The interitem and item-total correlations indicated a related construct among all items. A high level of reproducibility of the questionnaire was obtained in the test-retest procedure for each item (γ = 0.898). The initial test and retest scores indicated adequate reproducibility. Conclusion: The Thai-NOSE questionnaire is a reliable instrument with appropriate psychometric properties for assessing the severity and impact of nasal airway obstruction in patients with nasal septum deviation.

Development and validation of the dizziness symptoms questionnaire in Thai-outpatients / Desenvolvimento e validação do questionário de sintomas de tontura em pacientes tailandeses

Abstract Introduction "Dizziness" is a common complaint in clinical practice that can occur with anyone. However, since the symptom is caused by a wide range of disorders, a general clinician usually faces some difficulty to detect the cause. Objective This study aimed to formulate and validate a simple instrument that can be used to screen and predict the most likely cause of dizziness in Thai outpatients. Methods This study was divided into two phases. Phase I included 41 patients diagnosed with common causes of dizziness to determine the algorithm and construct the "structural algorithm questionnaire version 1". In addition, to test and retest its content validity and reliability until the instrument had an acceptable level of both. Phase II of the study pertained to evaluating its accuracy in clinical trials, 150 patients with dizziness had a face-to-face interview while they were waiting for their medical appointment. Results The degree of agreement between the algorithm results and clinical diagnoses was within an acceptable level (κ = 0.69). Therefore, this algorithm was used to construct the structural algorithm questionnaire version 1. The content validity of the structural algorithm questionnaire version 1 evaluated by seven experts. The content validity index values of the questionnaire ranged from 0.71 to 1.0. The Cohen's kappa coefficient (κ) of intra-rater reliability of the structural algorithm questionnaire version 1 was 0.71. In clinical trials, 150 patients with dizziness had a face-to-face interview while they were waiting for their appointment. The overall agreement between their questionnaire responses and final diagnoses by specialists showed a moderate degree of clinical accuracy (κ = 0.55). Conclusions The structural algorithm questionnaire version 1 had a well-developed design and acceptable quality pertaining to both validity and reliability. It might be used to differentiate the cause of dizziness between vestibular and non-vestibular disorders, especially of outpatients with dizziness symptoms.

Resumo Introdução "Tontura' é uma queixa comum na prática clínica que pode ocorrer com qualquer pessoa. No entanto, como o sintoma pode ser causado por uma grande quantidade de distúrbios, o clínico geral normalmente enfrenta alguma dificuldade em detectar sua causa. Objetivo Formular e validar um instrumento simples que pode ser usado para rastrear e predizer a causa mais provável de tontura em pacientes ambulatoriais tailandeses. Método Este estudo foi dividido em duas fases. A fase I consistiu em determinar o algoritmo, usaram‐se 41 pacientes com diagnóstico de causa comum de tontura, depois construir o questionário de algoritmo estrutural versão 1 (structural algorithm questionnaire version 1) e testar e retestar a validade de seu conteúdo e sua confiabilidade até que o instrumento apresentasse um nível aceitável de ambos. A fase II do estudo consistiu em avaliar a precisão do instrumento em ensaios clínicos, 150 pacientes com tontura foram pessoalmente entrevistados enquanto aguardavam o atendimento médico. Resultados O grau de concordância entre os resultados do algoritmo e os diagnósticos clínicos ficou dentro de um nível aceitável (κ = 0,69). Portanto, esse algoritmo foi usado para construir o questionário de algoritmo estrutural versão 1. A validade de conteúdo do questionário foi avaliada por sete especialistas. Os valores do índice de validade de conteúdo do questionário variaram de 0,71 a 1,0. O coeficiente kappa de Cohen (κ) de confiabilidade intraexaminador foi de 0,71. Em estudos clínicos, 150 pacientes com tontura foram pessoalmente entrevistados enquanto aguardavam a consulta com o médico. A concordância geral entre as respostas ao questionário e os diagnósticos finais dos especialistas mostrou um grau moderado de acurácia clínica (κ = 0,55). Conclusões O questionário de algoritmo estrutural versão 1teve um desenho bem desenvolvido e qualidade aceitável no que diz respeito à validade e confiabilidade. Pode ser usado para diferenciar a causa da tontura entre distúrbios vestibulares e não vestibulares, especialmente em pacientes ambulatoriais com sintomas de tontura.

Translation and Validation of the Dizziness Handicap Inventory into Thai Language.

OBJECTIVE: To translate and evaluate psychometric properties of Thai version of the Dizziness Handicap Inventory (DHI-TH). STUDY DESIGN: A cross-sectional study. SETTING: Ambulatory. PATIENTS: Fifty patients with dizziness at a vestibular clinic. MAIN OUTCOME MEASURES: Translation and cross-cultural adaptation of the original English version of the DHI was performed according to published guidelines. Psychometric evaluation included internal consistency, content validity, test-retest reliability, convergent validity, discriminant ability, and responsiveness. Responsiveness was examined in 28 patients with vestibular dysfunction who received vestibular rehabilitation for 6 to 8 weeks. RESULTS: There were no floor and ceiling effects. The Cronbach's alpha was good for the total score (0.87) and subscale scores (0.70 physical, 0.73 emotional, and 0.71 functional). Excellent test-retest reliability was demonstrated for the total and subscales (ICC ranged from 0.91 to 0.97, p < 0.001). The SEM was 3.50 and the MDC was 9.68. The total and subscales of DHI-TH were moderately correlated with the SF-36-TH scores (r ranged from -0.40 to -0.63). An optimal cut-off point for detection of dizziness was 21 points (98% sensitivity, 94% specificity). Responsiveness of the DHI-TH was excellent. The ES and SRM were large (1.25 and 1.59, respectively). The DHI-TH discriminated well between patients with self-perceived improved dizziness versus unchanged dizziness (AUC = 0.87). The MCID was 17 points (82.0% sensitivity, 82.0% specificity). CONCLUSION: The DHI-TH demonstrated good psychometric properties for patients with dizziness. The DHI-TH is a valid and reliable instrument recommended as a measure of disability and quality of life in Thai patients with dizziness.

Development and validation of the dizziness symptoms questionnaire in Thai-outpatients.

INTRODUCTION: "Dizziness" is a common complaint in clinical practice that can occur with anyone. However, since the symptom is caused by a wide range of disorders, a general clinician usually faces some difficulty to detect the cause. OBJECTIVE: This study aimed to formulate and validate a simple instrument that can be used to screen and predict the most likely cause of dizziness in Thai outpatients. METHODS: This study was divided into two phases. Phase I included 41 patients diagnosed with common causes of dizziness to determine the algorithm and construct the "structural algorithm questionnaire version 1". In addition, to test and retest its content validity and reliability until the instrument had an acceptable level of both. Phase II of the study pertained to evaluating its accuracy in clinical trials, 150 patients with dizziness had a face-to-face interview while they were waiting for their medical appointment. RESULTS: The degree of agreement between the algorithm results and clinical diagnoses was within an acceptable level (κ = 0.69). Therefore, this algorithm was used to construct the structural algorithm questionnaire version 1. The content validity of the structural algorithm questionnaire version 1 evaluated by seven experts. The content validity index values of the questionnaire ranged from 0.71 to 1.0. The Cohen's kappa coefficient (κ) of intra-rater reliability of the structural algorithm questionnaire version 1 was 0.71. In clinical trials, 150 patients with dizziness had a face-to-face interview while they were waiting for their appointment. The overall agreement between their questionnaire responses and final diagnoses by specialists showed a moderate degree of clinical accuracy (κ = 0.55). CONCLUSIONS: The structural algorithm questionnaire version 1 had a well-developed design and acceptable quality pertaining to both validity and reliability. It might be used to differentiate the cause of dizziness between vestibular and non-vestibular disorders, especially of outpatients with dizziness symptoms.

Cultural translation and adaptation of the Alberta Infant Motor Scale Thai version.

BACKGROUND: The Alberta Infant Motor Scale (AIMS) is a widely used screening tool used to measure gross-motor maturation for clinical and research usage in various countries. A cross-cultural translation and adaptation process is essential to produce reliable and applicable translated assessment tools. AIMS: The purposes of this cross-sectional study were to obtain the Alberta Infant Motor Scale Thai version and to determine its reliability, validity, and applicability. METHODS: The process of translation and cultural adaptation of the AIMS Thai version was performed. The conceptual, semantic, and idiomatic equivalences of the language of the AIMS Thai version were strictly reviewed by committee. The intra-rater/inter-rater reliabilities and concurrent validity with the Bayley III were examined in 30 full-term typically developing infants. Then, 19 infants from an orphanage and 23 typically developing infants were assessed using the final translated version of the AIMS. RESULTS: The AIMS Thai version was generated systematically. Two therapists showed high intra-rater reliability using the Thai AIMS with an ICC of 0.995 (95% CI 0.989-0.998) and 0.979 (95%CI 0.919-0.992), and the inter-rater reliability was 0.988 (95%CI 0.976-0.994). The concurrent validity of the AIMS Thai version and the Bayley III was 0.969 (p < 0.01). The AIMS percentile of gross-motor development of orphaned infants (94.7%) were equal or lower than the 5th percentile, while the AIMS percentile of home-raised infants ranged from the 5th to the 90th percentile. CONCLUSION: The translated and adapted AIMS Thai version is reliable and valid to use in Thai infants.

Altered postural sway during quiet standing in women with clinical lumbar instability.

[Purpose] The current study aimed to investigate the center of pressure, as an indicator of postural sway, to determine any differences between women with clinical lumbar instability and asymptomatic low back pain. [Participants and Methods] Thirty healthy and fifteen clinical lumbar instability participants were measured for their postural sway in the anterior-posterior and medial-lateral directions. The women were tested for postural sway on a force plate in quiet standing and eyes closed. Center of pressure path length and mean velocity in the anterior-posterior and medial-lateral directions and total area of excursion were measured and analyzed for 30 seconds. [Results] Clinical lumbar instability participants showed a significantly increase when compared with healthy participants, in path length and mean velocity in both directions and total area of excursion. [Conclusion] The findings suggest that chronic low back pain patients with clinical lumbar instability have increased postural sway when vision is deprived. The clinical significance of this has not yet been determined but may provide an opportunity for therapy directed at improving balance control in this patient group.

The Gross Motor Function Classification System Family Report Questionnaire: reliability between special-education teachers and caregivers.

AIM: The aim of this study was to investigate the reliability of the Thai Gross Motor Function Classification System Family Report Questionnaire (GMFCS-FR) and the possibility of special-education teachers and caregivers in the community using this system in children with cerebral palsy (CP). METHOD: The reliability was examined by two teachers and two caregivers who classified 21 children with CP aged 2 to 12 years. A GMFCS-FR workshop was organized for raters. The teachers and caregivers classified the mobility of 362 children. The rater reliability was analysed using the weighted kappa coefficient. The possibility of using the GMFCS-FR is reported. The reliability of using the GMFCS-FR in the community was analysed by the intraclass correlation coefficient. RESULTS: The intrarater reliability ranged from 0.91 to 1.00. The interrater reliability between teachers was 0.85 (95% confidence interval [CI] 0.69-0.97) and between caregivers was 0.84 (95% CI 0.70-0.97). Ninety-seven percent of raters used the Thai GMFCS-FR correctly. The overall intraclass correlation coefficient between raters was 0.90 (95% CI 0.88-0.92). INTERPRETATION: The Thai GMFCS-FR is a reliable system for classifying the motor function of young children with CP by teachers and caregivers in the community.

Prevalence and individual risk factors associated with clinical lumbar instability in rice farmers with low back pain.

INTRODUCTION: Clinical lumbar instability (CLI) is one of the subgroups of chronic non-specific low back pain. Thai rice farmers often have poor sustained postures during a rice planting process and start their farming at an early age. However, individual associated factors of CLI are not known and have rarely been diagnosed in low back pain. This study aimed to determine the prevalence and individual associated factors of CLI in Thai rice farmers. METHODS: A cross-sectional survey was conducted among 323 Thai rice farmers in a rural area of Khon Kaen province, Thailand. Face-to-face interviews were conducted using the 13-item Delphi criteria questionnaire, after which an objective examination was performed using aberrant movement sign, painful catch sign, and prone instability test to obtain information. Individual factors such as sex, body mass index, waist-hip ratio, smoking, and number of years of farming experience, were recorded during the face-to-face interview. RESULTS: The prevalence of CLI in Thai rice farmers calculated by the method described in this study was 13% (age 44±10 years). Number of years of farming experience was found to be significantly correlated with the prevalence of CLI (adjusted odds ratio =2.02, 95% confidence interval =1.03-3.98, P<0.05). CONCLUSION: This study provides prevalence of CLI in Thai rice farmers. Those with long-term farming experience of at least 30 years have a greater risk of CLI.

Capacity of adolescents with cerebral palsy on paediatric balance scale and Berg balance scale.

The Berg balance scale (BBS) and the paediatric balance scale (PBS) are reliable tools for measuring balance ability. However, reports of BBS and PBS scores in adolescent cerebral palsy have been limited. The objectives of this study were to investigate functional balance capacities, as tested with the BBS and PBS in adolescents with cerebral palsy, to compare the total PBS and BBS scores between Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) levels and to compare the static balance PBS and BBS scores within each GMFCS-E&R level. Fifty-eight school-aged adolescents with cerebral palsy between the ages of 12 and 18 years with GMFCS-E&R levels of I to IV were recruited. The Kruskal-Wallis test was utilized to compare the median scores for the PBS and BBS between the different GMFCS-E&R levels. Wilcoxon signed-rank tests were performed to examine the differences in the static balance scores between the PBS and the BBS within the same GMFCS-E&R levels. The results reveal that there were differences in the BBS and PBS scores among the four GMFCS-E&R levels. A significant difference was found between the BBS and PBS scores only among the patients with cerebral palsy and level III GMFCS-E&R. The BBS and PBS are valid and reliable tools for clinical examination and for distinguishing between levels of functional balance in adolescents with cerebral palsy.

Performance of motor imitation in children with and without dyspraxia.

BACKGROUND: Motor imitation is truly essential for young children to learn new motor skills, social behavior and skilled acts or praxis. The present study aimed to investigate motor imitation ability between typically-developing children and dyspraxic children and to examine the development trends in both children groups. MATERIAL AND METHOD: The comparison ofmotor imitation was studied in 55 typically-developing children and 59 dyspraxic children aged 5 to 8 years. The Motor Imitation subtest consisted of two sections, imitation of postures and imitation of verbal instructions. Typically-developing children and dyspraxic children were examined for developmental trends. The independent samples t-test was used to analyze the differences between both groups. Two-way analysis of variance (ANOVA) was used to analyze inter-age differences for each age group. RESULTS: The results revealed significant differences between dyspraxic and typically-developing children. Both typically-developing and dyspraxic children demonstrated age trends. The older children scored higher than younger children. CONCLUSION: Imitation is a primary learning strategy of young children. It is essential that children with dyspraxia receive early detection and need effective intervention. Typically-developing children and dyspraxic children showed higher mean score on the Imitation of Posture section than the Verbal Instructions section. Motor imitation competency, therefore, changes and improves with age.

Development of an assessment tool for motor praxis ability in children aged 5-8 years.

OBJECTIVES: To develop a Motor Praxis Ability Test (MPAT) and examine its psychometric properties. METHODS: The study consisted of two phases: items and scoring criteria of MPAT were developed in phase I. Content validity was clarified by the expert panel discussion method. The preliminary psychometric properties of the MPAT were examined in phase II. Data were collected with two samples consisting of typically-developing children and dyspraxic children. RESULTS: The results revealed high internal consistency reliability. The inter-rater and test-retest reliability for the total score of both sample groups were excellent. The results also revealed that the MPAT was able to discriminate between typical children and dyspraxic children. CONCLUSION: The current study concluded that the MPAT is a highly valid and reliable assessment tool. It can be also used as an appropriate assessment tool for screening and evaluating dyspraxia in children aged 5-8 years.

Effects of task-specific training on functional ability in children with mild to moderate cerebral palsy.

OBJECTIVE: To examine the relationship between Five times sit-to-stand Test (FTSST) and functional tests and investigate the effects of task-specific training on functional ability in children with mild to moderate cerebral palsy (CP). METHODS: Twenty-one subjects were randomly assigned to experimental and control groups. Motor Assessment Scale (MAS: sit-to-stand), Pediatric Balance Scale (PBS), Functional Reach Test and FTSST were tested before training, after training and at follow-up at 6 weeks post training. RESULTS: FTSST correlated significantly with MAS (ρ = -0.733) and with PBS (ρ = -0.813) in all children with CP. There were no significant differences in all outcomes between groups. However, FTSST and MAS in children with Gross Motor Function Classification System-Expanded and Revised levels I-II were significantly different between pre and post training within the experimental group (p = 0.03). CONCLUSIONS: FTSST is a reliable and valid functional outcome measure after the task-specific training in children with mild to moderate CP.

Five-times-sit-to-stand test in children with cerebral palsy: reliability and concurrent validity.

BACKGROUND/PURPOSE: Five-times-sit-to-stand test (FTSST) is a reliable tool for measuring lower limb functional strength and balance ability. However, reports of the reliability of FTSST in children with cerebral palsy have been scarce. The purposes of this study were (1) to investigate the test-retest and inter-rater reliability of the FTSST and (2) to investigate the correlation between the FTSST and standard functional balance tests in children with cerebral palsy. STUDY DESIGN: Cross-sectional study. MATERIALS AND METHODS: Thirty-three school children aged from 6 to 18 years with Gross motor functional classification system expanded and revised version (GMFCS-E&R) level I to III were recruited. Reliability of the FTSST and concurrent validity between FTSST and Timed up and go test (TUG) and Berg balance scale (BBS) were determined using the Pearson product moment correlation. RESULTS: The intra-class correlation coefficient (ICC) for test-retest and inter-rater reliability of FTSST were 0.91 and 0.88 respectively. FTSST showed moderate correlation with TUG (r = 0.552, P < 0.01) and with BBS (r = -0.561, P < 0.01). CONCLUSION: FTSST is a reliable assessment tool and correlates with functional balance ability tests in children with mild to moderate cerebral palsy.

Effect of 10-week core stabilization exercise training and detraining on pain-related outcomes in patients with clinical lumbar instability.

BACKGROUND AND AIMS: Clinical lumbar instability causes pain and socioeconomic suffering; however, an appropriate treatment for this condition is unknown. This article examines the effect of a 10 week core stabilization exercise (CSE) program and 3 month follow-up on pain-related outcomes in patients with clinical lumbar instability. METHODS: Forty-two participants with clinical lumbar instability of at least 3 months in duration were randomly allocated either to 10 weekly treatments with CSE or to a conventional group (CG) receiving trunk stretching exercises and hot pack. Pain-related outcomes including pain intensity during instability catch sign, functional disability, patient satisfaction, and health-related quality of life were measured at 10 weeks of intervention and 1 and 3 months after the last intervention session (follow-up); trunk muscle activation patterns measured by surface electromyography were measured at 10 weeks. RESULTS: CSE showed significantly greater reductions in all pain-related outcomes after 10 weeks and over the course of 3 month follow-up periods than those seen in the CG (P<0.01). Furthermore, CSE enhanced deep abdominal muscle activation better than in the CG (P<0.001), whereas the CG had deterioration of deep back muscle activation compared with the CSE group (P<0.01). For within-group comparison, CSE provided significant improvements in all pain-related outcomes over follow-up (P<0.01), whereas the CG demonstrated reduction in pain intensity during instability catch sign only at 10 weeks (P<0.01). In addition, CSE showed an improvement in deep abdominal muscle activation (P<0.01), whereas the CG revealed the deterioration of deep abdominal and back muscle activations (P<0.05). CONCLUSION: Ten week CSE provides greater training and retention effects on pain-related outcomes and induced activation of deep abdominal muscles in patients with clinical lumbar instability compared with conventional treatment.

Effect of endurance exercise on resting testosterone levels in sedentary subjects.

OBJECTIVE: To investigate the effects of moderate-intensity and low frequency exercise on resting serum testosterone and cortisol levels, resting heart rate, and isokinetic strength among healthy sedentary young men. DESIGN: A randomized controlled study. Forty sedentary young men aged 18 to 25 years old, pedaled 50 minutes on a bicycle ergometry at 60% of maximal effort once a week for 12 weeks in an exercise group. OUTCOME MEASURES: Resting total and free serum testosterone, serum cortisol, anthropometric data, resting heart rate, and isokinetic strength during shoulder and knee extensions. RESULTS: Resting serum total and free testosterone, as well as cortisol did not differ significantly between groups. Neither group showed any significant changes in anthropometric data and isokinetic strength at the end of study. However, the resting heart rate of the exercise group reduced significantly after the training (p < 0.05). Also, the isokinetic strength of shoulder and knee significantly increased (p < 0.05). CONCLUSIONS: Twelve weeks of moderate-intensity and low frequency training had no effect on resting serum testosterone, but were sufficient to increase aerobic fitness among sedentary young men. The type of exercise training may encourage sedentary individuals to participate regularly in the program on physical activity.

Effect of once a week endurance exercise on fitness status in sedentary subjects.

OBJECTIVE: To study whether 3-months aerobic exercise training at moderate intensity once a week can increase fitness status in healthy sedentary young men. MATERIAL AND METHOD: Randomized controlled study was performed in 37 sedentary young men, 18 to 25 years old. The exercise group (19) was assigned to work on bicycle ergometry at 60% of maximal effort, once a week for 12 weeks. The control group (18) lived a normal life style. Before and after training, aerobic fitness (VO2(max)), resting heart rate, lipid profile, and isokinetic power and strength of shoulder and knee were evaluated. RESULTS: In the exercise group, there was a significant increase in most fitness parameters compared with control, VO2(max) (19.7%), isokinetic power and strength of shoulder and knee (14.9%), and resting heart rate decreased (7.4%). CONCLUSION: Moderate-intensity training once a week for at least 12 weeks was sufficient to increase aerobic fitness in sedentary young men. This low frequency of exercise training may be used to encourage sedentary individuals for more compliance with physical activity.

Eye-head coordination during postural perturbation as a predictor of falls in community-dwelling elderly women.

OBJECTIVES: To assess the functional significance of eye-head coordination during postural perturbations and to determine the contribution of angular vestibulo-ocular reflex (AVOR) suppression to the prediction of 1-year fall history in community-dwelling elderly women. DESIGN: Descriptive analysis of factors correlated with falls. SETTING: Community-based independent and senior assisted living facilities. PARTICIPANTS: Volunteer sample of 38 older women (mean age +/- standard deviation, 81.6+/-3.9y; range, 74-92y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Multiple and logistic regression variables (slope coefficients, partial R2, percent-correct fall history classifications) and fall prediction equations generated by using minimal sets of predictor variables. RESULTS: Instantaneous AVOR gain and sedative use were predictors of 1-year history of falls in all minimal sets of predictor variables. R2 for the prediction models varied from.47 to.62 and indicated substantial shared variance with the 1-year history of falling. Elderly women who failed to suppress the AVOR gain were 18 times more likely to have experienced a fall in the past year compared with elderly women who showed AVOR suppression (odds ratio=18; 95% confidence interval, 1.63-198.42). CONCLUSIONS: When controlling for all other variables in the model, instantaneous AVOR gain accounted for nearly 30% of the variance of fall history. The strong association between 1-year fall history, the use of sedatives, and changes in the AVOR gain supports a functional link between AVOR suppression and effective balance in elderly women.