Movement control dysfunction [MCD] reduces active control of movements. Patients with MCD might form an important subgroup among patients with non specific low back pain. The diagnosis is based on the observation of active movements. Although widely used clinically, only a few studies have been performed to determine the test reliability. The aim of this study was to determine the inter- and intra-observer reliability of movement control dysfunction tests of the lumbar spine. We videoed patients performing a standardized test battery consisting of 10 active movement tests for motor control in 27 patients with non specific low back pain and 13 patients with other diagnoses but without back pain. Four physiotherapists independently rated test performances as correct or incorrect per observation, blinded to all other patient information and to each other. The study was conducted in a private physiotherapy outpatient practice in Reinach, Switzerland. Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated. The kappa values for inter-tester reliability ranged between 0.24 – 0.71. Six tests out of ten showed a substantial reliability [k > 0.6]. Intra-tester reliability was between 0.51 – 0.96, all tests but one showed substantial reliability [k > 0.6]. Physiotherapists were able to reliably rate most of the tests in this series of motor control tasks as being performed correctly or not, by viewing films of patients with and without back pain performing the task.
The "Comprehensive ICF Core Set for Osteoporosis" is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of functioning problems of patients with osteoporosis. The objective of this study was to validate this ICF Core Set from the perspective of physical therapists.Using a 3-round Delphi technique survey, physical therapists, experienced in the treatment of patients with osteoporosis, were surveyed about patient problems, resources, and aspects of the environment relevant to the physical therapy management of individuals with OP. Responses were translated ("linked") into ICF language by using standardized rules.Fifty-seven physical therapists across 25 countries representing each World Health Organization region named 816 factors (patient problems, available resources, and environmental influences). These 816 factors were linked to 160 ICF categories. Twenty-five categories with an agreement among the participants exceeding 75% were not represented in the Comprehensive ICF Core Set for Osteoporosis. Fifteen concepts were linked to the as yet undeveloped ICF component. Personal Factors and 9 concepts were found not to be covered by the ICF.The validity of the Comprehensive ICF Core Set for Osteoporosis was largely supported by the participants. Nine concepts (eg, "posture," "alignment," "ergonomics") identified by participants are not covered by the ICF and require further investigation.
The original version of this article unfortunately contained a mistake in the Table 2. The data under column head "Left handgrip strength (n = 336)" was erroneously omitted during the production process. The corrected Table 2 is given below.
Multiple sclerosis (MS) is one of the world's most common neurologic disorders leading to severe disability in young adults. MS-related fatigue directly impacts on the quality of life and activity levels of people with MS. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions can offer tools to help symptom management. Following a user-centered design and evidence-based process, an mHealth solution called More Stamina was created to help persons with MS manage their fatigue.The overall study aims are to explore the feasibility, acceptability, and usability of More Stamina, a mobile app for fatigue self-management for persons with MS.A mixed-methods, multicenter study will be used to assess the feasibility, acceptability, and usability of More Stamina. The study will take place during the third and fourth quarters of 2020 (Q3-Q4 2020) in 3 locations: Argentina, Spain, and Switzerland. A longitudinal cohort study will take place, and think-aloud protocols, open-ended interviews, and short answer questionnaires will be used. Persons with MS will be recruited from the different locations. This study seeks to enroll at least 20 patients that meet the criteria from each site for the longitudinal cohort study (total n=60).Ethical approval has been granted in Argentina and is pending in Spain and Switzerland. Outcomes will be published in peer-reviewed medical journals and presented at international conferences.Findings from this study will be used to help understand the role that mHealth can play in fatigue management in MS.ClinicalTrials.gov NCT04244214; https://clinicaltrials.gov/ct2/show/NCT04244214.PRR1-10.2196/18196.
Cooling of thermosensitive patients with multiple sclerosis (MS) can improve clinical symptoms. In order to study the effectiveness of an advanced lightweight cooling-garment technology based on aquatic evaporation, a single-blinded balanced crossover study was performed on 20 patients with an Expanded Disability Status Scale score ≤6.5. The results using a tight-cuff cooling-garment prototype for peripheral cooling suggest improvement of a timed-walking test, leg-strength, fine-motor skills and subjective benefits. Preliminary data of the heart rate variability (HRV) including six patients suggest that the MS patients show an abnormal HRV after sham condition, which is normalized after cooling. Technical information was gained about the cooling activity and the practicability and handling of the device. These encouraging findings promote further adaptations of the prototype to increase its cooling properties and ameliorate the practicability of the cooling garment. Multiple Sclerosis 2007; 13: 232–237. http://msj.sagepub.com
