Visual field asymmetries in visual word form identification.

Visual performance across the visual fields interacts with visual tasks and visual stimuli, and visual resolution decreases as a function of eccentricity, varying at isoeccentric locations. In this study, we investigated the extent of asymmetry and the rate of change in visual acuity threshold for visual word form (VWF) identification at horizontal and vertical azimuths across the fovea, and at eccentricities of 1°, 2°, 4°, 6° and 8° for 10%, 20%, 40%, and 80% contrast levels, to determine whether and how the eccentricities, meridians, and contrasts modulated the VWF identification acuity threshold. The stimuli were 16 traditional Chinese characters of similar legibility. Participants pressed a key to indicate the character presented, either monocularly or binocularly, at one of 21 randomly selected locations. A staircase procedure was used to determine the threshold, and a multiple linear regression model was used to fit the linear cortical magnification factor (CMF). We found that (1) the asymmetry was most pronounced on the vertical and superior azimuths, (2) the asymmetry between the right and left azimuths was not significant, (3) the CMF was significantly smaller on the vertical azimuth than on the horizontal azimuth, (4) the CMF was smaller on the superior vertical azimuth than on the inferior azimuth, and (5) monocular viewing and low contrast enhanced the CMF difference between azimuths. In conclusion, vertical and horizontal azimuths, location of eccentricity, contrast levels of word symbols, and monocular/binocular viewing have different effects on visual field asymmetry and cortical magnification factors.

Impacts of monocular, binocular, and functional visual acuity on vision-related quality of life in patients with type 2 diabetes.

Although the association between visual acuity (VA) and vision-related quality of life (VRQoL) has been well reported in patients with type 2 diabetes mellitus (T2DM), little is known about how unilateral and bilateral VA affects daily performance in such patients. For this cross-sectional study, patients were recruited from the Diabetes Shared Care Network of the Division of Endocrinology and Metabolism, Zhong-Xiao Branch, Taipei City Hospital in Taiwan. Ninety patients with T2DM (51 men and 39 women) with a mean age of 60.3 ± 10.5 (standard deviation) years, 47% of whom had diabetic retinopathy, were included. The purposes were to compare the impacts of VA in the better eye, both eyes, and three forms of functional acuity scores (FAS) on VRQoL in patients with T2DM. VRQoL and corrected VA were assessed with the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Early Treatment Diabetic Retinopathy Study (ETDRS) chart, respectively. Three FAS algorithms proposed by Colenbrander and the American Medical Association were used to assess FAS. Regression analyses were performed to determine the correlations among the five types of VA, the original composite scores, and the Rasch-calibrated composite scores of the NEI VFQ-25 on all patients with T2DM and on the same patients stratified by diabetic retinopathy (DR) and no-DR. The VA of both eyes had a higher impact on VRQoL and revealed a lower reduction estimated by the two forms of composite scores than did the VA of the better eye and three FAS algorithms (compared with binocular VA ß estimates, - 14.5%, - 15.8%, - 29.3%, and - 11.8% for original composite scores, and - 16.1%, - 14.0%, - 24.6%, and 10.3% for Rasch-calibrated composite scores). When the T2DM group was stratified into DR and no-DR groups, significant associations between VA and VRQoL were observed only in the DR group. The VA of both eyes also had the greatest impact and reduction after stratification. The results indicated that unilateral better-eye VA and VA estimated by the three FAS algorithms seems to underestimate the impact of visual impairment on self-report VRQoL in patients with T2DM. This study provides empirical support for the importance of binocular VA assessment in regular clinical diabetes eye care.

How do impairments in cognitive functions affect activities of daily living functions in older adults?

The assessment of daily living activities could provide information about daily functions and participation restrictions to develop intervention strategies. The purposes of this study were to assess the scores of the Barthel Index (BI) and Lawton Instrumental Activities of Daily Living (IADL) scale in older adults with cognitive impairment and to explore the different effects that levels of cognitive functions have on changes in IADL functions. We recruited 31 participants with dementia, 36 with mild cognitive impairment (MCI), and 35 normal controls (NCs) from the neurology outpatient department of a regional hospital. The results of the demographic and clinical characteristics through the Lawton IADL scale, BI, Quick Mild Cognitive Impairment (Qmci) screen, Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE), were collected on the same day and compared with the Kruskal-Wallis test, Wilcoxon rank-sum test, Fisher's exact test, and a multiple linear regression analysis, as appropriate. In the BI, bathing was the most discriminating activity to differentiate patients with MCI and dementia; in the Lawton IADL scale, medication responsibility and shopping were the most discriminating activities to differentiate NCs and patients with MCI, and patients with MCI and dementia, respectively. In addition, the predictors of changes in Lawton IADL scale scores were the problem-solving score of the Clinical Dementia Rating scale, a Qmci score of > 20.4 and an age of ≤ 81.2 years, a MoCA score of < 9.4 and an age of > 81.2 years, and the MMSE score and an age of > 81.2 years. This study adds to the evidence that the description of basic and instrumental daily activities is integrated in older adults with cognitive impairment. Notably, the Qmci is the most significant predictor of changes in IADL function for "young" older adults, as are the MoCA and MMSE for "old" older adults.

Legibility Assessment of Visual Word Form Symbols for Visual Tests.

For a reliable visual test, it is important to evaluate the legibility of the symbols, which depends on several factors. Previous studies have compared the legibility of Latin optotypes. This study developed a visual function test based on identification visual capacity for a Chinese reading population. The legibility of word symbols was assessed with three methods: (1) Identification of the contrast thresholds of the character sets, (2) patterns of confusion matrices obtained from analysis of the frequency of incorrect stimulus/response pairs, and (3) pixel ratios of bitmap images of Chinese characters. Then characters of similar legibility in each character set were selected. The contrast thresholds of the final five character sets and the Tumbling E and Landolt C optotypes were evaluated. No significant differences in contrast threshold were found among the five selected character sets (p > 0.05), but the contrast thresholds were significantly higher than those of the E and C optotypes. Our results indicate that combining multiple methods to include the influences of the properties of visual stimuli would be useful in investigating the legibility of visual word symbols.

Psychometric and diagnostic properties of the Taiwan version of the Quick Mild Cognitive Impairment screen.

There is a need for a screening tool with capacities of accurate detection of early mild cognitive impairment (MCI) and dementia and is suitable for use in a range of languages and cultural contexts. This research aims to evaluate the psychometric and diagnostic properties of the Taiwan version of Qmci (Qmci-TW) screen and to explore the discriminating ability of the Qmci-TW in differentiating among normal controls (NCs), MCI and dementia. Thirty-one participants with dementia and 36 with MCI and 35 NCs were recruited from a neurology department of regional hospital in Taiwan. Their results on the Qmci-TW, Taiwanese version of the Montreal Cognitive Assessment (MoCA), and Traditional Chinese version of the Mini-Mental State Examination (MMSE) were compared. For analysis, we used Cronbach's α, intraclass correlation coefficient, Spearman's ρ, Kruskal-Wallis test, receiver operating characteristic curve analysis, and multivariate analysis, as appropriate. The Qmci-TW exhibited satisfactory test-retest reliability, internal consistency, and interrater reliability as well as a strong positive correlation with results from the MoCA and MMSE. The optimal cut-off score on the Qmci-TW for differentiating MCI from NC was ≤ 51.5/100 and dementia from MCI was ≤ 31/100. The MoCA exhibited the highest accuracy in differentiating MCI from NC, followed by the Qmci-TW and then MMSE; whereas, the Qmci-TW and MMSE exhibited the same accuracy in differentiating dementia from MCI, followed by the MoCA. The Qmci-TW may be a useful clinical screening tool for a spectrum of cognitive impairments.

Detecting Visual Function Abnormality with a Contrast-Dependent Visual Test in Patients with Type 2 Diabetes.

In addition to diabetic retinopathy, diabetes also causes early retinal neurodegeneration and other eye problems, which cause various types of visual deficits. This study used a computer-based visual test (Macular Multi-Function Assessment (MMFA)) to assess contrast-dependent macular visual function in patients with type 2 diabetes to collect more visual information than possible with only the visual acuity test. Because the MMFA is a newly developed test, this study first compared the agreement and discriminative ability of the MMFA and the Early Treatment Diabetic Retinopathy Study (ETDRS) contrast acuity charts. Then symbol discrimination performances of diabetic patients and controls were evaluated at 4 contrast levels using the MMFA. Seventy-seven patients and 45 controls participated. The agreement between MMFA and ETDRS scores was examined by fitting three-level linear mixed-effect models to estimate the intraclass correlation coefficients (ICCs). The estimated areas under the receiver operating characteristic (ROC) curve were used to compare the discriminative ability of diseased versus non-diseased participants between the two tests. The MMFA scores of patients and controls were compared with multiple linear regression analysis after adjusting the effects of age, sex, hypertension and cataract. Results showed that the scores of the MMFA and ETDRS tests displayed high levels of agreement and acceptable and similar discriminative ability. The MMFA performance was correlated with the severity of diabetic retinopathy. Most of the MMFA scores differed significantly between the diabetic patients and controls. In the low contrast condition, the MMFA scores were significantly lower for 006Eon-DR patients than for controls. The potential utility of the MMFA as an easy screening tool for contrast-dependent visual function and for detecting early functional visual change in patients with type 2 diabetes is discussed.

Measurement properties of streamlined wolf motor function test in patients at subacute to chronic stages after stroke.

UNLABELLED: BACKGROUND. Previous research using the streamlined Wolf Motor Function Test (SWMFT) has focused either on the 3- to 9-month period or on the >12-month period after stroke and lacked the information for those at 9 to 12 months. Whether SWMFT scores reflect motor deficit and recovery from early to late stages after stroke remains unclear. OBJECTIVE: A retrospective study using the Functional Ability Scale (FAS) was conducted to evaluate whether all SWMFTs items measure the poststroke recovery of upper extremity (UE) motor function and if they could be used for patients within 9 to 12 months after a stroke. METHODS: Rasch analysis was conducted, and data were drawn from patients 3 months to years after a stroke. RESULTS: The continuum of UE motor function in SWMFT-FAS was supported. Subacute patients had the best motor function, followed by the 9- to 12-month group, and then chronic patients. Variation in UE motor function was large (2.35-2.72 logits), and motor abilities of these 3 groups overlapped. The 8 SWMFT items could target a broad range of UE motor function, from -8.28 to 7.80 logits. The average difficulty of these 8 items also matched the UE motor ability of the subgroup at 9 to 12 months after stroke, and individual versions of the SWMFT performed well to assess the motor ability of this group. CONCLUSIONS: The SWMFTs had sound hierarchical properties. The SWMFT-Chronic or the SWMFT-Subacute could be used to evaluate UE function of this subgroup at 9 to 12 months after stroke.

Factors affecting employment outcomes for people with disabilities who received Disability Employment Services in Taiwan.

PURPOSE: One of the most important rehabilitation goals is to return people with disabilities to paid employment. The purposes of this study were (1) to explore employment status and (2) to identify factors that may affect the employment outcomes of people with disabilities who received Disability Employment Services (DES). METHODS: A retrospective study was conducted on clients who commenced and closed DES between January 2008 and December 2010 in a metropolitan city in Taiwan, using the files from the National Vocational Rehabilitation Services Documentary System. RESULTS: Sixty-nine percent (1,684 out of 2,452) of the clients in this study were engaged in paid employment after receiving DES. Logistic regression analyses indicated that clients with no psychiatric disability or mild impairment and with useful vocational qualifications, typical work experience, more post-employment services, and less pre-employment services were associated with a higher rate of successful employment outcomes. CONCLUSION: This study provides empirical evidence of the association between person- and DES-related factors and the employment outcomes of people with disabilities. Future improvements in health, school-to-work transition services, and vocational rehabilitation for people with disabilities should place more emphasis on providing work-based work experience, professional vocational training, access to college/professional education, career exploration, effective supported employment services, and other post-employment services.

Effects of visual rehabilitation on a child with severe visual impairment.

We examined the effects of visual rehabilitation, including a chromatic luminance discrimination program and a fixation training program, on a 6-yr-old boy with severe visual impairment. Single-subject ABA and AB designs were used. The programs were conducted 2×/wk and included 6 to 7 sessions for the baseline phase and 10 to 11 sessions for the intervention phase. Play was integrated into the visual training programs. Goggle visual evoked potential (VEP) testing was used to evaluate neural activity in the primary visual cortex. Correct responses increased and response times were shortened after training in luminance discrimination. The total and maximum fixation time also improved, as did P100 latency and amplitude of VEPs. While walking, the boy was able to detect obstacles he had not noticed before training. The results indicate the value of visual training and the possibility of brain plasticity in a child with severe visual impairment.

Factors associated with quality of life among people with spinal cord injury: application of the International Classification of Functioning, Disability and Health model.

OBJECTIVE: To identify the factors that influence an individual's quality of life (QOL) after spinal cord injury (SCI) based on the International Classification of Functioning, Disability and Health (ICF) framework. DESIGN: Cross-sectional exploratory study. SETTING: Taiwan community. PARTICIPANTS: Community-dwelling adults (N=341) who had suffered an SCI at least 1 year previously and were between the ages of 18 and 60 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): A combination of self-report questionnaire and interview. The dependent variable, QOL, was measured by the abbreviated version of the World Health Organization Quality of Life, while the independent variables-participation, activity, impairment, and contextual factors-were measured using the Frenchay Activity Index, Barthel Index, and a demographic form. RESULTS: Multivariate analysis results indicated that participation, activity, and marital status are significant factors in the QOL outcome. Results also indicated that among the various factors that affect each domain of QOL (physical health, psychological health, social relationships, and environment), participation was the strongest determinant. CONCLUSIONS: The ICF provided an excellent framework with which to explore the factors influencing QOL after SCI. The results demonstrated that marital status, participation, and activity exert the strongest influence on QOL, while impairment and other variables do not directly influence QOL.

Pruning a decision tree for selecting computer-related assistive devices for people with disabilities.

Many disabled individuals lack extensive knowledge about assistive technology, which could help them use computers. In 1997, Denis Anson developed a decision tree of 49 evaluative questions designed to evaluate the functional capabilities of the disabled user and choose an appropriate combination of assistive devices, from a selection of 26, that enable the individual to use a computer. In general, occupational therapists guide the disabled users through this process. They often have to go over repetitive questions in order to find an appropriate device. A disabled user may require an alphanumeric entry device, a pointing device, an output device, a performance enhancement device, or some combination of these. Therefore, the current research eliminates redundant questions and divides Anson's decision tree into multiple independent subtrees to meet the actual demand of computer users with disabilities. The modified decision tree was tested by six disabled users to prove it can determine a complete set of assistive devices with a smaller number of evaluative questions. The means to insert new categories of computer-related assistive devices was included to ensure the decision tree can be expanded and updated. The current decision tree can help the disabled users and assistive technology practitioners to find appropriate computer-related assistive devices that meet with clients' individual needs in an efficient manner.

Estimation of life expectancies and loss-of-life expectancies for workers with permanent occupational disabilities of the extremities--a 21-year follow-up study.

OBJECTIVES: This study aims to estimate the life expectancies and loss-of-life expectancies of workers with permanent occupational disabilities of the upper and lower limbs in Taiwan. METHODS: We collected all cases of permanent occupational disability in the upper and lower limbs from the Bureau of Labor Insurance database of compensation claims between 1986-2006; these data were linked with the national mortality registry to obtain a survival function. Workers were divided into eight groups according to their injury types, three of which fulfilled the condition of constant excess hazard and the survival functions were extrapolated to 50 years using a semi-parametric method. RESULTS: Of the subjects involved in the study, 1016 with toe amputations, 995 with foot or leg amputations, and 4339 with foot or leg non-amputations showed a life expectancy of 1.8 [95% confidence interval (95% CI) -1.3- -4.9], 4.9 (95% CI 2.2- -7.6), and 4.5 (95% CI 2.1- -6.9) years, respectively. The above method was validated by extrapolating partial cohorts based on the first 10 years of follow-up data to 21-year and comparing actual survival rates using the Kaplan Meier method. The relative bias of three groups was <8%. CONCLUSIONS: The semi-parametric extrapolation method is a feasible and accurate approach for projecting life expectancy and expected years of life lost for groups with occupational amputations of the lower extremities. The value of life lost among these groups should be considered when determining compensation for these workers and assessing the cost-effectiveness of preventive occupational health services.

Wheelchair-related accidents: relationship with wheelchair-using behavior in active community wheelchair users.

OBJECTIVE: To report the prevalence, mechanisms, self-perceived causes, consequences, and wheelchair-using behaviors associated with wheelchair-related accidents. DESIGN: A case-control study. SETTING: Community. PARTICIPANTS: A sample of experienced, community-dwelling, active manual and powered wheelchair users (N=95) recruited from a hospital assistive technology service center. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Wheelchair-using behaviors, wheelchair-related accidents over a 3-year period, and the mechanisms and consequences of the accidents. RESULTS: Among the 95 participants, 52 (54.7%) reported at least 1 accident and 16 (16.8%) reported 2 or more accidents during the 3 years prior to the interview. A total of 74 accidents, were categorized into tips and falls (87.8%), accidental contact (6.8%), and dangerous operations (5.4%). A logistic regression found individuals who failed to maintain their wheelchairs regularly (odds ratio [OR]=11.28; 95% confidence interval [CI], 2.62-48.61) and used a wheelchair not prescribed by professionals (OR=4.31; 95% CI, 1.10-16.82) had significantly greater risks of accidents. In addition to the risk factor, lack of regular wheelchair maintenance, the Poisson regression corroborated the other risk factor, seat belts not used (incident rate ratio=2.14; 95% CI, 1.08-4.14), for wheelchair-related accidents. CONCLUSIONS: Wheelchair-related accidents are closely related to their wheelchair-using behaviors. Services including professional evaluation, repair, maintenance, and an educational program on proper wheelchair use may decrease the risks of wheelchair accidents.

Increased mortality risk for workers with a compensated, permanent occupational disability of the upper or lower extremities: a 21-year follow-up study.

This 1986-2006 study sought to determine whether specific causes led to increased mortality risks for Taiwanese workers with an approved compensation claim for permanent occupational disability (ACCPOD) of the upper or lower extremities. All cases of ACCPOD between 1986 and 2006 were collected from the database of compensation claims at the Bureau of Labor Insurance. Standardized mortality ratios and 95% confidence intervals were calculated for different causes of death among workers with an ACCPOD of the upper or lower extremities. A total of 800,047 person-years were accrued for 71,001 workers with a single type of disability. Standardized mortality ratios were significantly increased for all causes, including liver cirrhosis, injuries, and intentional self-harm. Standardized mortality ratios for workers with amputations of the lower extremities increased to 7.66 (95% confidence interval (CI): 5.36, 10.61), 2.40 (95% CI: 1.44, 3.75), 2.07 (95% CI: 1.03, 3.70), and 5.09 (95% CI: 2.20, 10.03) for those with diabetes mellitus, cerebrovascular disease, liver cirrhosis, and chronic renal failure, respectively. The authors concluded that workers with occupational disabilities involving an upper or lower extremity should be assisted to prevent further injuries or intentional self-harm, whereas those with lower limb amputations should be provided care related to proactive control of diabetes mellitus and associated complications during rehabilitation.

The effectiveness of a functional training programme for patients with chronic low back pain--a pilot study.

INTRODUCTION: To investigate the effect of an individualised functional training programme for patients with low back pain (LBP). METHODS: A randomised, controlled trial with single-blind design was conducted. Patients with non-specific LBP for at least 3 months were recruited and randomised into training and control groups. Both groups maintained their current treatment, and the training group participated in an additional programme for 100 h. Measures were performed initially and after completing the programme, and included rating determining impairment associated with pain, Oswestry disability index (ODI) and functional capacity evaluation (FCE). RESULTS: Thirteen in the training group completed the training and measurements, and 12 in the control group completed their measurements. Twelve items in FCE had significant improvement in training group, but only one in control group. Severity of pain (11.8 +/- 3.6-5.6 +/- 3.6), activity limitation from pain (3.2 +/- 1.5-1.5 +/- 1.1) and emotional disturbance by pain (4.3 +/- 1.7-2.2 +/- 1.4) significantly decreased in the training group, no significant change in the control group. The ODI demonstrated a significant reduction (p = 0.044) in the training group (22 +/- 9-16 +/- 9), but not in the control group. CONCLUSION: An individualised functional training programme benefits chronic LBP patients.

Validity of the Loewenstein occupational therapy cognitive assessment in people with intellectual disabilities.

We examined the psychometric properties (internal consistency, concurrent criterion validity, and known-group validity) of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) in people with intellectual disabilities. A total of 111 people with intellectual disabilities and 19 people with no disabilities were included. We used Cronbach's alpha, Spearman's rho, the Kruskal-Wallis test, and one-way analysis of variance for analysis, where appropriate. Results showed good internal consistency on Orientation, Visual Perception, Spatial Perception, Visuomotor Organization, and Thinking Operations subscales (Cronbach's alphas = .82, .74, .76, .86, and .80, respectively), but not on the Motor Praxis subscale (alpha = .48). We found significant correlations between participants' performance on the Pictorial IQ test and disability level and scores on the LOTCA. The known-group validity of the LOTCA in people with intellectual disabilities was satisfactory. We concluded that the LOTCA is a suitable instrument for measuring cognitive abilities and visual perception in people with intellectual disabilities.

Minimal detectable change and clinically important difference of the Wolf Motor Function Test in stroke patients.

OBJECTIVES: This study aimed to establish the minimal detectable change (MDC) and clinically important differences (CID) of the Wolf Motor Function Test (WMFT) in patients with stroke, and to assess the proportions of patients' change scores exceeding the MDC and CID after stroke rehabilitation. METHODS: A total of 57 patients received 1 of the 3 treatments for 3 weeks and underwent clinical assessments before and after treatment. The MDC, at 90% confidence (MDC( 90)), was calculated from the standard error of measurement to indicate a real change for individual patients. Anchor-based and distribution-based approaches were used to triangulate the values of minimal CID. The percentages of patients exceeding the MDC and minimal CID were also examined. RESULTS: The MDC(90) of the WMFT was 4.36 for the performance time (WMFT time) and 0.37 for the functional ability scale (WMFT FAS). The minimal CID ranged from 1.5 to 2 seconds on the WMFT time and from 0.2 to 0.4 points on the WMFT FAS. The MDC and CID proportions ranged from 14% to 30% on the WMFT time and from 39% to 65% on the WMFT FAS, respectively. CONCLUSIONS: The change score of an individual patient has to reach 4.36 and 0.37 on the WMFT time and WMFT FAS to indicate a real change. The mean change scores of a stroke group on the WMFT time and WMFT FAS should achieve 1.5 to 2 seconds and 0.2 to 0.4 points to be regarded as clinically important changes. Furthermore, the WMFT FAS may be more responsive than the WMFT time based on the results of proportions exceeding the threshold criteria.

Physical therapy utilization in subjects with work-related musculoskeletal disorders: Taiwan experience.

INTRODUCTION: This study aimed to investigate the use of physical therapy (PT) services by subjects with work-related musculoskeletal disorders (WMSDs) and to identify factors associated with long-term use of PT in Taiwan. METHODS: Data including demographic characteristics, work history, pain and disability ratings, and psychosocial status were collected by questionnaire. Subjects who were referred to PT were interviewed weekly by telephone to obtain information about use of PT. RESULTS: A total of 160 subjects participated in this study. Of these, 85 subjects (53.1%) did not receive PT. Of the 75 subjects who received PT, 53 (70.7%) received short-term treatment (<30 days) and 22 (29.3%) received long-term treatment (> or =30 days). The number of treatment sessions for the treatment groups was 7.8 sessions +/- 9.0. Logistic regression analysis identified age (odds ratio [OR] = 1.074, P = 0.007) and the subject's confidence that the disorder would be diagnosed as an occupational injury ("yes" and "not sure" vs. "no"; OR = 4.288, P = 0.012) as significant factors affecting the duration of treatment. CONCLUSIONS: Almost 30% of the subjects referred to PT received long-term treatment (> or =30 days), the significant factors affecting this classification were subject's age and confidence in a diagnosis of WMSD.

Reliability and validity of a physical capacity evaluation used to assess individuals with intellectual disabilities and mental illness.

Physical capacity evaluations (PCEs) are important and frequently offered services in work practice. This study to investigate the reliability and validity of the National Taiwan University Hospital Physical Capacity Evaluation (NTUH PCE) on a sample of 149 participants consisted of three groups: 45 intellectual disability (ID), 56 mental illness (MI), and 48 no disability (ND). Intraclass correlation coefficient (ICC), Cronbach alpha, and one-way ANOVA were calculated where appropriate. Results indicated that most subtests of the NTUH PCE had good to excellent test-retest reliability (ICC, 0.75-0.95), with the exception of subtests of the position tolerance section for ID and MI groups and the hand coordination section for the ND group. Good internal consistency was shown on strength, mobility, and hand coordination sections (alpha, 0.96, 0.90, and 0.95, respectively), with the exception of the position tolerance section (alpha=0.37). The known group validity of the NTUH PCE in people with disabilities was satisfactory. In conclusion, although some improvements are needed in some subtests, the NTUH PCE is suitable for measuring physical work-related abilities of people with disabilities.

Incidence and risk factors of neck discomfort: a 6-month sedentary-worker cohort study.

INTRODUCTION: This study aimed to evaluate the six-month incidence and possible risk factors of neck discomfort among sedentary workers. METHODS: Data, including demographic characteristics, work history, psychological characteristics and prevalent neck discomfort of 157 sedentary workers was collected by a questionnaire. A follow-up questionnaire was administered six months later to calculate the incidence of symptoms and related disability. RESULTS: The six-month incidence of neck discomfort was 23.5% (12/51). The two groups of prevalent and non-prevalent subjects showed no difference in demographic data and work characteristics except for work load (p<0.05) and score in "job control" in the Job Content Questionnaire (JCQ) (p<0.05). In logistic regression, light-load work (versus no-load work, OR = 0.10, p = 0.023) and higher score of 'job control' in JCQ (OR = 0.86, p = 0.031) were significant protecting factors. CONCLUSION: The six-month incidence rates of neck discomfort in our subjects were high. Light-load work and a higher score of 'job control' were important preventive factors. The results provide an epidemiological basis for prevention of neck discomfort in different working populations.