Return to play criteria after hamstring muscle injury in professional football: a Delphi consensus study.

BACKGROUND: Hamstring muscle injury (HMI) is the most common injury in professional football and has a high re-injury rate. Despite this, there are no validated criteria to support return to play (RTP) decisions. AIM: To use the Delphi method to reach expert consensus on RTP criteria after HMI in professional football. METHODS: All professional football clubs in England (n=92) were invited to participate in a 3-round Delphi study. Round 1 requested a list of criteria used for RTP decisions after HMI. Responses were independently collated by 2 researchers under univocal definitions of RTP criteria. In round 2 participants rated their agreement for each RTP criterion on a 1-5 Likert Scale. In round 3 participants re-rated the criteria that had reached consensus in round 2. Descriptive statistics and Kendall's coefficient of concordance enabled interpretation of consensus. RESULTS: Participation rate was limited at 21.7% (n=20), while retention rate was high throughout the 3 rounds (90.0%, 85.0%, 90.0%). Round 1 identified 108 entries with varying definitions that were collated into a list of 14 RTP criteria. Rounds 2 and 3 identified 13 and 12 criteria reaching consensus, respectively. Five domains of RTP assessment were identified: functional performance, strength, flexibility, pain and player's confidence. The highest-rated criteria were in the functional performance domain, with particular importance given to sprint ability. CONCLUSION: This study defined a list of consensually agreed RTP criteria for HMI in professional football. Further work is now required to determine the validity of the identified criteria.

Rasch Analysis of the Italian version of Pain Catastrophizing Scale (PCS-I).

OBJECTIVE: The aim of this study was to investigate the psychometric properties of the Italian version of the Pain Catastrophizing Scale (PCS-I) in patients with chronic low back pain. METHODS: In a cross sectional study a total of 150 subjects with chronic low back pain were included. The Italian translation of the PCS was administered to all subjects. The properties of the Italian version of the PCS were explored by a Rasch analysis. RESULTS: The PCS-I, by means of few modifications, fitted the Rasch model and passed the independent t-test for a unidimensional scale. The response categories for item 2 ``I fell I can't go on'' needed to be collapsed from 4 to 3 levels. Only the item 7 ``I keep thinking to of other painful events'' showed fit residual that exceeded the chosen thresholds of ± 2.5. No Differential functioning (DIF) was observed for age, sex, marital status, BMI and smoking. CONCLUSION: The Italian version of PCS, with the purposed modifications, seems to reflect a unidimensional construct of Pain Catastrophizing. The scale seemed to be quite robust across age, sex, marital status, BMI and smoking. Targeting of the scale was moderate. A raw score to metric conversion was proposed.

Rasch analysis of the Italian version of fear avoidance beliefs questionnaire (FABQ-I).

PURPOSE: To perform a Rasch analysis (RA) of the Fear Avoidance Beliefs questionnaire (FABQ-I) in a sample of chronic non-specific low back pain (CLBP) patients. The RA is expected to provide information about the internal construct validity and all the single items consistency of the FABQ-I and then contributing to the knowledge about the questionnaire's clinimetric properties. METHODS: One hundred and fifty subjects with CLBP were enrolled into the study. The FABQ-I have been studied by means of RA. The sample size needed to obtain stable person, item and rating-scale calibrations for use with the Rasch model was based on the level of error expected in the measure. RESULTS: RA did not support the total scale as an unidimensional measure of Fear Avodiance Beliefs. Also the analysis of the Physical Activity (PA) and Word (WO) subscales as well as the attempts of manipulation failed in achieving an acceptable fit to the Rasch model. CONCLUSION: FABQ-I may be considered to reflect a multiple psychological constructs describing scale. The raw score of the FABQ-I and changes in scores must be interpreted with caution because as a general measure of fear avoid beliefs was not supported.