RESUMEN
This study aimed to adapt and validate the Knee Osteoarthritis Fears and Beliefs Questionnaire (KOFBeQ) for Chinese patients, thereby advancing the understanding of fear-avoidance behaviors. Adopting a cross-sectional design, data were collected for 241 subjects (78.8% women; mean age 68.0 ± 7.8 years) across various healthcare settings in Hong Kong. Exploratory factor analysis resulted in an 11-item questionnaire with three distinct subscales, covering fears and beliefs related to physicians and disease (six items), daily living activities (three items), and sports and leisure activities (two items). The overall Cronbach's α coefficient was 0.86, indicating strong internal consistency. The questionnaire exhibited favorable convergent validity. Confirmatory factor analyses confirmed a good model fit. Test-retest reliability analysis indicated a high intraclass correlation coefficient of 0.93 (95% confidence interval: 0.88, 0.96), and a Bland-Altman plot revealed a slight bias in two measurements (0.97 [0.19]) without a systematic trend. The adapted Chinese version of the KOFBeQ demonstrated robust psychometric properties in terms of validity and reliability, providing an effective tool for surveying Chinese patients with knee osteoarthritis. These findings offer valuable insights for clinicians and patients, aiding in informed decision-making and improved rehabilitation strategies.
RESUMEN
Meta-analysis is a common technique used to synthesise the results of multiple studies through the combination of effect size estimates and testing statistics. Numerous meta-analyses have investigated the efficacy of exercise programmes for stroke rehabilitation. However, meta-analyses may also report false-positive results because of insufficient information or random errors. Trial sequential analysis (TSA) is an advanced technique for calculating the required information size (RIS) and more restrictive statistical significance levels for the precise assessment of any specific treatment. This study used TSA to examine whether published meta-analyses in the field of stroke rehabilitation reached the RIS and whether their overall effect sizes were sufficient. A comprehensive search of six electronic databases for articles published before May 2022 was conducted. The intervention methods were divided into four primary groups, namely aerobic or resistance exercise, machine-assisted exercise, task-oriented exercise, and theory-based exercise. The primary outcome measure was gait speed and the secondary outcome measure was balance function. The data were obtained either from the meta-analyses or as raw data from the original cited texts. All data analysis was performed in TSA software. In total, 38 articles with 46 analysable results were included in the TSA. Only 17 results (37.0%) reached the RIS. In conclusion, meta-analysis interpretation is challenging. Clinicians must consider the RIS of meta-analyses before applying the results in real-world situations. TSA can provide accurate evaluations of treatment effects, which is crucial to the development of evidence-based medicine.
RESUMEN
BACKGROUND: Electromyography (EMG) is frequently used as a guide for exercise rehabilitation progression following rotator cuff repair. Knowledge of EMG activity during passive and active-assisted exercises may help guide clinicians when considering exercise prescription in the early post-operative period. PURPOSE: The purpose of this study was to investigate EMG activity of the rotator cuff and deltoid musculature during passive and active-assisted shoulder range of motion (ROM) exercises commonly performed in post-operative rehabilitation. STUDY DESIGN: Descriptive cohort laboratory study using healthy subjects. METHODS: In sixteen active healthy volunteers, surface and fine-wire EMG activity was measured in the supraspinatus, infraspinatus, subscapularis, and anterior, middle and posterior deltoid muscles during eight common ROM exercises. Mean %MVIC values and 95% confidence intervals were used to rank exercises from the least to the most amount of muscular activity generated during the exercises. RESULTS: Standard pendulum exercises generated low levels of EMG activity in the supraspinatus and infraspinatus (≤15% MVIC), while active-assisted table slides, and the upright wall slide generated low levels of EMG activity in only the supraspinatus. No exercises were found to generate low levels of muscular activation (≤15% MVIC) in the subscapularis. CONCLUSION: This study found no clear distinctions between the EMG activity of the supraspinatus or the infraspinatus occurring during common passive and active-assisted ROM exercises. Subdividing ROM exercises based on muscle activity, may not be necessary to guide progression of exercises prior to commencing active motion after rotator cuff repair. LEVEL OF EVIDENCE: Level 3b.