Psychometric properties of the Czech versions of the Impact of Pediatric Epilepsy Scale (IPES) and Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48).

OBJECTIVE: In order to introduce a complex system of monitoring and evaluation of the heath-related quality of life (HRQoL) of children and adolescents with epilepsy (CWE) and their families in the Czech Republic, we aimed to validate the Czech versions of two appropriate instruments - the Impact of Pediatric Epilepsy Scale (IPES) and the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48). METHODS: The verification of the 11-item IPES was carried out in the group of parents of 248 CWE aged 2-18 years. One hundred and thirty-five CWE from the given group aged 11-18 years then completed the 48-item QOLIE-AD-48. Internal consistency, test-retest reliability (with a three-month interval) and the factorial structure of the Czech versions were determined and compared with the original instruments. RESULTS: We found that the Czech version of the IPES exhibited very good psychometric properties including high internal consistency (Cronbach's alpha, α, of 0.93), high test-retest reliability (intraclass correlation coefficient, ICC, of 0.76) and the same 3-factor structure as the original instrument. The superiority of this 3-factor solution over the alternate 2-factor model proposed for some language versions of the IPES was determined using confirmatory factor analysis. We found 8 items in the Czech version of the QOLIE-AD-48 belonging to original Attitudes towards epilepsy and Social support subscales that do not fit well with the Czech version due to their low correlation with the total score and insufficient test-retest reliability and should be omitted. For the remaining 40 items, we have determined high internal consistency (α = 0.95) and test-retest reliability (ICC = 0.82). Confirmatory factor analysis revealed that the 6-factor solution derived from the original instrument (without two removed subscales) was appropriate for the Czech version. The individual subscales exhibited high internal consistency with α = 0.61-0.91. The external validation of both instruments was confirmed based on a significant correlation between test results and physicians' reports of the characteristics of the child's epilepsy. CONCLUSIONS: The Czech versions of both instruments studied are reliable and valid, and can be used in the next research focusing on the effect of different treatment approaches on the HRQoL of CWE and their families.

The use of muscle dynamometer for correction of muscle imbalances in the area of deep stabilising spine system.

Dorsal pain caused by spine dysfunctions belongs to most frequent chronic illnesses. The muscles of the deep stabilising spine system work as a single functional unit where a dysfunction of only one muscle causes dysfunction of the whole system. Non-invasive, objective and statistically measurable evaluation of the condition of deep stabilising spine system has been made possible by the construction of muscular dynamometer. The aim of our work has been the assessment of deep stabilising spine system by diaphragm test and muscular dynamometer measurements. Based on an initial examination, a 6-week intervention programme was established including instructions on physiological body posture and correct basic body stabilisation for the given exercises and muscle strengthening. Consecutive measurements are then compared with the initial ones. It was presumed that a smaller number of the tested subjects would be able to correctly activate the deep stabilising spine system muscles before the intervention programme when compared to those after the intervention programme. A positive change of 87% has been found. It is clear that if a person actively approaches the programme, then positive adaptation changes on the deep stabilising spine system are seen only after 6 weeks. With the muscular dynamometer, activation of deep stabilising spine system can be objectively measured. Changes between the initial condition of a subject and the difference after some exercise or rehabilitation are especially noticeable. Also, the effect of given therapy or correct performance of the exercise can be followed and observed.

Technical means for objectification of medical treatments in the area of the deep stabilisation spinal system.

Information regarding two versions of an instrument called a muscle dynamometer, which enables detailed information about muscle activity in the deep stabilisation spinal system (DSSS), presented in this article. The MD01 (muscle dynamometer ver. 01) is a simple electromechanical instrument that allows measurement of muscle activity in two areas of the lumbar spine region. Measurements on patients have confirmed the usefulness of quantifying the initial state of a patient before rehabilitation as well as monitoring rehabilitation treatment; the MD01 is a suitable device for obtaining these measurements. However, a new and improved version of the MD01, the MD02, has been developed. The MD02 allows measurements in four different body regions and now has a PC interface, which allows achieving of patient information and data export for use with statistical software.

The objectification of therapeutical methods used for improvement of the deep stabilizing spinal system.

OBJECTIVE: Despite the ever ongoing development in the examination procedures, it is still impossible to exactly diagnose a large percentage of patients with vertebral and back (low-back and neck) pains. This is due to an insufficiently clear connection between symptoms, pathological changes and results from the imaging techniques. Besides a morphological and neurological examination, a grave diagnostic attention should be given to a possible muscular dysfunction. A simple electromechanical device called muscle dynamometer (MD01) has been constructed for the purpose of enabling to effortlessly, objectively and precisely examine the muscle power-output in the lumbar spine area and reveal a possible, often found and therapeutically treated, dysfunction of the deep stabilizing spine system (DSSS). METHODS: The six-week-rehabilitation-course, aimed at correcting the body posture and strengthening the DSSS muscles, during which two groups of healthy adolescents (girls and boys, aged 12-16) have been obtained. RESULTS: The statistically significant change (p<0.001) between the values of input and output measurements of the condition of DSSS. CONCLUSIONS: The effectiveness of therapeutical training is confirmed and the objectification of the condition of the DSSS muscles by means of the muscle dynamometer (MD01) is verified.