The reliability and validity of the Turkish version of the Facial Disability Index.

PURPOSE: To translate and cross-culturally adapt the Turkish version of the Facial Disability Index (FDI) and evaluate its psychometric properties, including reliability and validity. METHODS: Translation of the original FDI was followed by international guidelines. Paralysis classification was evaluated with House-Brackman Rating System (HBGS). Patients completed Short Form-36 (SF-36) along with the Turkish version of the FDI and refilled the Turkish FDI one week later. Internal consistency and test-retest reliability were analyzed using Cronbach's alpha coefficient and intraclass correlation coefficient (ICC), respectively. Construct validity was assessed by calculating the Spearman's correlation coefficient. Also, exploratory factor analysis was carried out by identifying the factor structure of the scale. RESULTS: After the pre-test of the Turkish FDI, there was no need for linguistic and cultural adaptation. The internal consistency of the physical function subscale was high (0.82). The social/well-being subscale's Cronbach alpha (0.63) was within the acceptable range. Test-retest reliability was excellent (ICC of physical function = 0.91 and social/well-being = 0.93, p < 0.05). The physical function subscale was correlated with the PF subscale of SF-36 and HBGS (r = -0.837 and 0.292, respectively; p < 0.05). Besides, the social/well-being function subscale was correlated with HBGS and all subscales of SF-36, except RP (p < 0.05). Factor analysis results of the Turkish FDI were similar to the other version studies. CONCLUSION: The Turkish version of the FDI is a valid and reliable questionnaire in patients with peripheral facial paralysis.IMPLICATIONS FOR REHABILITATIONThe Turkish version FDI is the first Turkish tool translated cross-culturally adapted for specific assessment of facial paralysis.The Turkish version of the FDI is a valid and reliable questionnaire and can be used in all native Turkish speaking patients in peripheral facial paralysis.This assessment tool can be used in clinical routine and research settings to evaluate facial paralysis.

The relationship of radiographic findings with pain, function, and quality of life in patients with knee osteoarthritis.

PURPOSE: The aim of the study was to investigate the relationship between pain, function and quality of life with radiographic findings in patients with knee osteoarthritis (OA). METHODS: A total of 86 patients diagnosed with knee OA were included in the study. Demographic, physical, and pathological information was collected. Visual analog scale (VAS) was used to determine pain levels. The evaluation of radiographic findings was conducted by Kellgren-Lawrence (K&L) rating scale. The Turkish version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire was used to evaluate the patient's disability and functional status. The objective functional status was assessed using the commonly used physical performance test, the Timed up and Go Test (TUG). The Turkish version of the Short Form 36 (SF-36) questionnaire was used for quality of life assessment. The "Spearman rank correlation coefficient" was used to investigate the relationship between pain, function and quality of life with radiographic findings. RESULTS: The mean age of the participants was 61.08 ± 9.27 years. There was a strong correlation between VAS at activity and K&L (p < 0.05). There was a negative correlation between Physical Function (PF) (p < 0.05) and General Health (GH) (p < 0.05) subscore of the SF-36 with K&L. In addition, K&L and TUG were positively correlated (p < 0.05). CONCLUSION: Radiographic findings were associated with pain in activity and functional status based on physical performance, but not with clinical results based on Patient Reported Outcome Measures (PROMs). As the patient's radiographic findings worsened, the level of pain increased and functionality decreased.

Psychometrical properties of the Turkish translation of the New Knee Society Scoring System.

OBJECTIVE: To translate the New Knee Society Scoring System (KSS) into Turkish and to evaluate the psychometric properties of the translated questionnaire. METHODS: This study was conducted on 66 knees of 43 pre-op patients who were scheduled for total knee arthroplasty (TKA) and 50 knees of 26 knee arthroplasty patients at least 6 months postoperatively. KSS was translated and culturally adapted according to the guidelines of Guillemin and Beaton. Demographic and clinical characteristics of the patients were recorded. Patients completed WOMAC, KOOS and SF-36 surveys along with the Turkish version of the new KSS. After the initial evaluation, patients were asked to refill the new KSS 1 week later. Internal consistency and reliability were tested using Cronbach's alpha coefficient and intraclass correlation coefficient (ICC). Validity was assessed by calculating the Spearman's correlation coefficient between the new KSS and WOMAC, KOOS and SF-36 scores. RESULTS: The mean ages of the pre and post-operative groups were 67.16 ± 7.85 years and 71.65 ± 6.95 years respectively. The Cronbach's alpha coefficients of the new KSS calculated for symptoms (0.814), patient satisfaction (0.947), patient expectations (pre-op = 1.000, post-op = 0.997) and functional activities (0.864) were high. The ICC scores ranged between 0.790 and 0.951. The pain subscore of the new KSS and the pain subscores of the WOMAC (r = -0.720; p < 0.01), KOOS (r = 0.550; p < 0.01) and SF-36 (r = -0.434; p < 0.01) were highly correlated. Emotional role functioning (RH), mental health (MH) and social role functioning (SF) subscores of SF-36 showed no correlation with the all subscores of the new KSS (p > 0.05). No floor or ceiling effects in the new KSS scores were detected. CONCLUSION: It is concluded that the new KSS is a valid and reliable questionnaire which can be used in evaluating the pre and post-operative Turkish speaking TKA patients. LEVEL OF EVIDENCE: Level III Diagnostic Study.

Oxford Knee Score: cross-cultural adaptation and validation of the Turkish version in patients with osteoarthritis of the knee.

OBJECTIVE: The Oxford Knee Score (OKS) is a valid, short, self-administered, and site- specific outcome measure specifically developed for patients with knee arthroplasty. This study aimed to cross-culturally adapt and validate the OKS to be used in Turkish-speaking patients with osteoarthritis of the knee. METHODS: The OKS was translated and culturally adapted according to the guidelines in the literature. Ninety-one patients (mean age: 55.89±7.85 years) with knee osteoarthritis participated in the study. Patients completed the Turkish version of the Oxford Knee Score (OKS-TR), Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Index (WOMAC) questionnaires. Internal consistency was tested using Cronbach's α coefficient. Patients completed the OKS-TR questionnaire twice in 7 days to determine the reproducibility. Correlation between the total results of both tests was determined by Spearman's correlation coefficient and intraclass correlation coefficients (ICC). Validity was assessed by calculating Spearman's correlation coefficient between the OKS, WOMAC, and SF-36 scores. Floor and ceiling effects were analyzed. RESULTS: Internal consistency was high (Cronbach's α: 0.90). The reproducibility tested by 2 different methods showed no significant difference (p>0.05). The construct validity analyses showed a significant correlation between the OKS and the other scores (p<0.05). There was no floor or ceiling effect in total OKS score. CONCLUSION: The OKS-TR is a reliable and valid measure for the self-assessment of pain and function in Turkish-speaking patients with osteoarthritis of the knee.

Cross-cultural adaptation and validation of the Turkish version of Oxford hip score.

INTRODUCTION: The purpose of this study was to translate the Oxford hip score (OHS) into Turkish and to evaluate the psychometric properties by testing the internal consistency, reproducibility, construct validity, and responsiveness in patients with hip osteoarthritis (OA). PATIENTS AND METHODS: Oxford hip score was translated and culturally adapted according to the guidelines in the literature. Seventy patients (mean age 61.45 ± 9.29 years) with hip osteoarthritis participated in the study. Patients completed the Turkish Oxford hip score (OHS-TR), the Short-Form 36 (SF-36), and Western Ontario and McMaster Universities Index (WOMAC). Internal consistency was tested using Cronbach's α coefficient. Patients completed OHS-TR questionnaire twice in 7 days for determining the reproducibility. Correlation between the total results of both tests was determined by the Pearson correlation coefficient and intraclass correlation coefficient (ICC). Validity was assessed by calculating the Pearson correlation coefficient between the OHS-TR and WOMAC and SF-36 scores. Floor and ceiling effects were analyzed. RESULTS: The internal consistency was high (Cronbach's α 0.93). The construct validity showed a significant correlation between the OHS-TR and WOMAC and related SF-36 domains (p < 0.001). The ICC's ranged between 0.80 and 0.99. There was no floor or ceiling effect in total OHS-TR score. CONCLUSIONS: The OHS-TR questionnaire is valid, reliable, and responsive for the Turkish-speaking patients with hip OA.

Oxford Shoulder Score: cross-cultural adaptation and validation of the Turkish version.

BACKGROUND: The Oxford Shoulder Score (OSS) is a questionnaire developed to evaluate patients with certain shoulder problems. This study aimed to translate and culturally adapt a Turkish version of the OSS and validate its use for assessing Turkish patients with shoulder pathology. PATIENTS AND METHODS: OSS was translated and culturally adapted according to the guidelines in the literature. Eighty-four patients (mean age 49.26 ± 11.92 years) with shoulder problems participated. Patients completed the Turkish OSS, the Short Form 36 (SF-36), and the Shoulder Pain and Disability Index (SPADI). Internal consistency was tested using Cronbach α coefficient. Reproducibility was assessed by asking patients to complete another OSS 48 h after the first test. Correlation between the total results of both tests was determined by the Pearson correlation coefficient and ICC. Validity was assessed by calculating the Pearson correlation coefficient between the OSS and SPADI and SF-36 scores. Floor and ceiling effects were analyzed. RESULTS: The internal consistency was high (Cronbach's α 0.92). The reproducibility tested by two different methods showed no significant difference. Correlation between the OSS and SPADI and SF-36 physical component summary score were -0.7, and 0.6, respectively (p < 0.001). There was no floor or ceiling effect in total OSS score. CONCLUSION: The Turkish version of the OSS proved to be valid, reliable and reproducible instrument as demonstrated by high Cronbach α and Pearson Correlation Coefficients. The application and evaluation of the instrument was feasible and minimally time consuming for use in clinical trials in Turkish-speaking patients with shoulder problems.

Effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea.

OBJECTIVE: To compare the effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea. DESIGN: A prospective, randomized, and controlled study. SETTING: Hacettepe University School of Physical Therapy and Rehabilitation. PATIENTS: Thirty-four volunteer subjects with primary dysmenorrhea (mean age: 21.35 +/- 1.70 years) were included. Statistical analyses were performed in 32 subjects who completed all measures. INTERVENTIONS: Fifteen subjects received interferential current application for 20 minutes and 17 subjects received transcutaneous electrical nerve stimulation for 20 minutes when they were experiencing dysmenorrhea. OUTCOME MEASURES: Physical characteristics, years since menarche, length of menstrual cycle (days), and duration of menstruation (days) were recorded. Visual analog scale ( VAS) intensities of menstrual pain, referred lower limb pain, and low back pain were recorded before treatment, and immediately, 8 hours, and 24 hours after treatment. RESULTS: Intensities of the evaluated parameters decreased beginning from just after the applications in both groups (P<0.05). Intensity of referring low back pain in first three measurement times was different between the groups (P<0.05), but this difference is thought to be due to the baseline values of the groups. So, it can be said that no superiority existed between the methods (P>0.05). CONCLUSION: Both transcutaneous electrical nerve stimulation and interferential current appear to be effective in primary dysmenorrhea. As they are free from the potentially adverse effects of analgesics, and no adverse effects are reported in the literature nor observed in this study, a clinical trial of their effectiveness in comparison with untreated and placebo-treated control groups is warranted.

Single-injection femoral nerve block. Effects on the independence level in functional activities in the early postoperative period in patients with total knee arthroplasty.

OBJECTIVE: To investigate the efficacy of single injection femoral nerve block (FNB) on the independence level in functional activities in the early postoperative period in patients with total knee arthroplasty (TKA). METHODS: We conducted this prospective, randomized, blinded trial in the Department of Orthopedics and Traumatology, Hacettepe University Hospital Ankara, Turkey, between June 2003 and April 2004. Twenty-three patients scheduled for elective TKA were randomly divided into 3 groups. Group I received preemptive single injection FNB, group II received postoperative single injection FNB, and group III served as a control group. Intravenous morphine patient controlled analgesia (PCA) was used following surgery in all groups. Morphine dose and pain score defined by the visual analog scale (VAS) were recorded postoperatively at the 15th minute, 30th minute, 1st, 4th, 6th, 12th, 24th, and 48th hours. A standard rehabilitation protocol was applied for all patients. The independence level in functional activities was assessed during the first 2 postoperative days and at discharge with the Iowa Level of Assistance Scale (ILAS) and the Iowa Ambulation Speed Scale (IASS). Physical therapists that enrolled in the study were blinded to the groups. RESULTS: Pain scores were significantly different between the groups (p<0.05). The preemptive and postoperative FNB group`s VAS scores were both significantly lower than the control group (p<0.05). However, there was no significant difference in VAS scores between preemptive and postoperative FNB groups (p>0.05). There was no statistically significant difference between the groups in any of the functional scores in the first 2 postoperative days, and at discharge (p>0.05). CONCLUSION: Single injection FNB provided effective analgesia in patients undergoing TKA. However, the independence level in functional activities in the early postoperative period was not influenced by the analgesia method.

High independence level in functional activities reduces hospital stay after total hip arthroplasty regardless of pain intensity.

OBJECTIVE: The purpose of this study is to investigate the relationship between independence level in functional activities and pain, and length of hospital stay in the early postoperative period in patients with total hip arthroplasty (THA). METHODS: The study was performed over 26 end stage hip arthritis patients who were hospitalized in the Department of Orthopedics and Traumatology, Hacettepe University Hospital, Ankara, Turkey, between January 2000 and July 2003 for THA and operated with the same surgical technique by the same surgeon. All patients were mobilized in the first postoperative day and a standard rehabilitation protocol was applied to all patients. The independence level in functional activities of the cases was assessed with Iowa Level of Assistance Scale (ILAS). Iowa Ambulation Speed Scale (IASS) was used to evaluate the speed of ambulation in the early postoperative period. Pain was assessed with visual analogue scale (VAS). RESULTS: There was no statistically significant relation between pain intensity and independence level in functional activities on the second and sixth postoperative days (p>0,05), but independence level scores in functional activities on the second and sixth days were correlated with hospital stay length (p<0.05). CONCLUSION: The results of this study indicate that in patients with THA, pain does not affect the independence level in functional activities in the early postoperative period. In the same period as the independence level improves, the hospital stay length decreases. This is an important factor that may reduce both the hospital costs and the possible complications due to prolonged hospital stay.