Test-Retest Reliability of the Swedish Version of the Orthotics and Prosthetics Users’ Survey.

Test-retest reliability of the Swedish version of the Orthotics and Prosthetics Users’ Survey.

Prosthet Orthot Int. 2013 May 7;
Jarl G, Holmefur M, Hermansson LM

Background:The Orthotics and Prosthetics Users’ Survey consists of five modules to assess outcomes of orthotic and prosthetic interventions: lower extremity functional status, upper extremity functional status, client satisfaction with device, client satisfaction with services and health-related quality of life.Objectives:To investigate the test-retest reliability and calculate the smallest detectable difference for all modules of the Swedish Orthotics and Prosthetics Users’ Survey.Study design:Test-retest reliability study design.Methods:A total of 69 patients at a Department of Prosthetics and Orthotics completed Orthotics and Prosthetics Users’ Survey on two occasions separated by a 2-week interval, giving 18 answers on lower extremity functional status, 41 on upper extremity functional status, 53 on client satisfaction with device, 12 on client satisfaction with services and 67 answers on health-related quality of life. Raw scores were converted into Orthotics and Prosthetics Users’ Survey units on a 0-100 scale. Intra-class correlation coefficients, Bland-Altman plots, common person linking plots and t-tests of person mean measures were used to investigate the reliability. The 95% confidence level smallest detectable differences were calculated.Results:The intra-class correlation coefficients ranged from 0.77 to 0.96 for the modules, and no systematic differences were detected between the response occasions. The smallest detectable differences ranged from 7.4 to 16.6 units.Conclusions:The test-retest reliability was satisfactory for all Orthotics and Prosthetics Users’ Survey modules. The smallest detectable difference was large on all modules except the health-related quality of life module.Clinical relevanceThe Orthotics and Prosthetics Users’ Survey modules are reliable and, thus, can be recommended for repeated measurements of patients over time. Relatively large changes are needed to achieve statistical significance when assessing individual patients. HubMed – rehab

Maximum voluntary isometric pinch contraction and force-matching from the fourth to the eighth decades of life.

Int J Rehabil Res. 2013 May 6;
Herring-Marler TL, Spirduso WW, Eakin RT, Abraham LD

Understanding the effects of age and sex on pinch strength, variability, and accuracy and how one’s hand function changes with age better enables those in the preventative and rehabilitative fields to combat these losses. The present study examined fine motor maximum pinch strength [maximum voluntary isometric contraction (MVIC)] as well as the ability to maintain 5% MVIC accurately and consistently in five decades. One hundred adults in five groups, 20 in each decade of life from 30 to 79 years old, were nonrandomly recruited from the community.A two-way analysis of variance applied to MVIC, and a two-way multivariate analysis of variance applied to the variability (coefficient of variability) and accuracy (root mean square error), plus correlation and regression analyses, were used to determine decade and sex effects on pinch force. The task involved using isometric pinch control of a computer cursor to match a 5% of MVIC force level represented by a horizontal line.MVIC and force-matching steadiness and accuracy across all ages were not significantly different until the eighth decade (P<0.01). Men were stronger (P<0.001) but performed low-level force-matching with greater error (P<0.001) than women. Strength was not correlated with steadiness but was weakly correlated with accuracy (r=0.293, P<0.01), and steadiness and accuracy were strongly correlated (r=0.783, P<0.001).Decade and sex were moderate and strong predictors of accuracy and steadiness, respectively. In conclusion, age and sex differences were evident in pinch-force strength and control.Das Verständnis für die Auswirkung von Alter und Geschlecht auf Kraft, Variabilität und Präzision des Pinchgriffs sowie die Veränderungen der Handfunktion mit zunehmendem Alter ermöglichen den in der Prävention und Rehabilitation tätigen Fachkräften, besser mit diesen Verlusten umzugehen. Die vorliegende Studie analysierte die maximale feinmotorische Kraft des Pinchgriffs [maximale willkürliche isometrische Kontraktion (MVIC)] und die Fähigkeit zur präzisen und konsistenten Wahrung von 5 % MVIC über fünf Lebensjahrzehnte hinweg. Insgesamt 100 Erwachsene im Alter von 30 bis 79 Jahren aus der Öffentlichkeit wurden nicht-randomisiert auf fünf Gruppen verteilt, jeweils 20 pro Lebensjahrzehnt.Eine 2-Wege-Varianzanalyse, bezogen auf MVIC, eine multivariate 2-Wege-Varianzanalyse, bezogen auf die Variabilität (Koeffizient der Variabilität), und die Präzision (Wurzel des mittleren quadratischen Prognosefehlers (RMSE) plus Korrelations- und Regressionsanalysen wurden zur Ermittlung der Auswirkungen von Lebensjahrzehnt und Geschlecht auf die Griffkraft herangezogen. Im Rahmen der Aufgabenstellung wurde die isometrische Kontrolle des Pinchgriffs bei einem Computer-Cursor 5 % eines MVIC-Kraftlevels angepasst, dargestellt als horizontale Linie.MVIC, kraftangepasste Stetigkeit und Präzision über alle Altersgruppen hinweg unterschieden sich bis zum achten Lebensjahrzehnt (P<0,01) nicht signifikant. Männer waren stärker (P<0,001), wiesen aber eine niedrigere und stärker fehlerbehaftete Kraftanpassung (P<0,001) als Frauen auf. Stärke korreliert nicht mit Stetigkeit, korreliert aber schwach mit Präzision (r=0,293, P<0,01); Stetigkeit und Präzision korrelieren stark miteinander (r=0,783, P<0,001).Lebensjahrzehnt und Geschlecht waren moderate bzw. starke Prädiktoren der Präzision bzw. der Stetigkeit. Abschließend lässt sich sagen, dass Alters- und Geschlechtsunterschiede bei Griffstärke und -kontrolle offenkundig waren.Comprender los efectos de la edad y el sexo en la fuerza de pinza, la variabilidad, la precisión y en cómo la funcionalidad de las manos cambia con la edad permite que los profesionales del sector preventivo y de rehabilitación puedan combatir dichas pérdidas. El presente estudio tuvo como objetivo examinar la fuerza máxima de pinza motora fina [contracción isométrica voluntaria máxima (CIVM)], así como la capacidad de mantener el 5% de la CIVM de forma precisa y consistente a lo largo de cinco décadas. Cien adultos fueron reclutados y divididos en cinco grupos de forma no aleatoria, asignando 20 adultos a cada una de las cinco décadas desde los 30 años a los 79.Se utilizó un análisis de varianza con dos factores aplicado a la CIVM, además de un análisis de varianza multivariable de dos factores aplicado a la variabilidad (coeficiente de variabilidad) y a la precisión (error cuadrático medio), así como análisis de correlación y regresión, con el fin de determinar los efectos que la edad y el sexo ejercen en la fuerza de pinza. El ejercicio consistía en utilizar el control isométrico de pinza mediante el cursor de un ordenador hasta alcanzar el 5% del nivel de fuerza de la CIVM, representado por una línea horizontal.No se observaron diferencias significativas en la CIVM ni en la firmeza y precisión de la fuerza de pinza entre las distintas edades (P<0,01). Los hombres mostraron niveles mayores de fuerza (P<0,001) que las mujeres, pero también presentaron una menor capacidad de precisión y un mayor grado de error (P<0,001). No se observó una correlación entre la fuerza y la firmeza, pero se obtuvo una leve correlación entre la fuerza y la precisión (r=0,293, P<0,01) y una fuerte correlación entre la firmeza y la precisión (r=0,783, P<0,001).La edad y el sexo constituyen un factor predictivo moderado y fuerte de la precisión y la firmeza, respectivamente. De este estudio se concluye que las diferencias de edad y sexo son evidentes en la fuerza y el control del movimiento de pinza.Comprendre les effets de l'âge et du sexe sur la force de pincement, la variabilité et la précision, ainsi que la façon dont la fonction de la main évolue avec l'âge permet aux intervenants dans les domaines de la prévention et de la rééducation de mieux lutter contre ces pertes. La présente étude a examiné la force de pincement motrice maximale [la contraction isométrique volontaire maximale (MVIC)] ainsi que la capacité à maintenir avec précision et cohérence 5 % de la MVIC sur cinq décennies. Une centaine d'adultes répartis dans cinq groupes, 20 dans chaque décennie de la vie de 30 à 79 ans, ont été recrutés de façon non aléatoire dans la collectivité.Une analyse bidirectionnelle de la variance appliquée à la MVIC, une analyse bidirectionnelle de variance multivariée appliquée à la variabilité (coefficient de variabilité) et à la précision (erreur quadratique moyenne), ainsi que la corrélation et des analyses de régression, ont été utilisées pour déterminer les effets de la décennie et du sexe sur la force de pincement. La tâche consistait à utiliser le contrôle isométrique par le pincement d'un curseur d'ordinateur pour correspondre à un niveau de 5% de la force MVIC représentés par une ligne horizontale.La MVIC et la constance et la précision d'adaptation de la force pour tous les âges n'étaient pas significativement différentes jusqu'à la huitième décennie (P<0,01). Les hommes étaient plus forts (P<0,001), mais s'acquittaient de l'adaptation de la force de faible niveau avec un plus grand taux d'erreur (P<0,001) que les femmes. La force ne présentait pas de corrélation avec la constance mais une faible corrélation avec la précision (r=0,293, P<0,01), et la stabilité et la précision présentaient une forte corrélation (r=0,783, P<0,001).La décennie et le sexe étaient des prédicteurs respectivement modérés et forts de la précision et de la constance. En conclusion, les différences d'âge et de sexe étaient évidentes dans l'intensité et le contrôle de la force de pincement. HubMed – rehab

A systematic review of phacoemulsification cataract surgery in virtual reality simulators.

Medicina (Kaunas). 2013; 49(1): 1-8
Lam CK, Sundaraj K, Sulaiman MN

The aim of this study was to review the capability of virtual reality simulators in the application of phacoemulsification cataract surgery training. Our review included the scientific publications on cataract surgery simulators that had been developed by different groups of researchers along with commercialized surgical training products, such as EYESI® and PhacoVision®. The review covers the simulation of the main cataract surgery procedures, i.e., corneal incision, capsulorrhexis, phacosculpting, and intraocular lens implantation in various virtual reality surgery simulators. Haptics realism and visual realism of the procedures are the main elements in imitating the actual surgical environment. The involvement of ophthalmology in research on virtual reality since the early 1990s has made a great impact on the development of surgical simulators. Most of the latest cataract surgery training systems are able to offer high fidelity in visual feedback and haptics feedback, but visual realism, such as the rotational movements of an eyeball with response to the force applied by surgical instruments, is still lacking in some of them. The assessment of the surgical tasks carried out on the simulators showed a significant difference in the performance before and after the training. HubMed – rehab

Impact of a nurse-run clinic on prevalence of urinary incontinence and everyday life in men undergoing radical prostatectomy.

J Wound Ostomy Continence Nurs. 2013 May-Jun; 40(3): 309-12
Lombraña M, Izquierdo L, Gómez A, Alcaraz A

: To determine the prevalence of urinary incontinence (UI) in patients undergoing prostatectomy and to evaluate the impact of UI on the everyday life in order to select the patients eligible to enter a pelvic floor rehabilitation program.: The sample comprised 114 consecutive men undergoing laparoscopic or open radical prostatectomy between April 2007 and April 2008. Participants’ mean age was 59 years (range, 46-67 years). The research setting was a hospital-based clinic in Barcelona, Spain. Patients who required an indwelling urinary catheter due to other factors were excluded from the trial. During admission, nursing staff explained the study and obtained informed consent from patients willing to participate in the trial.: The impact of UI on daily living was evaluated via administration of the International Consultation on Incontinence Questionnaire-Short Form. Impact of UI was evaluated before surgery, and after 1 and 12 months following indwelling catheter removal.: A total of 95.5% patients developed UI 1 month following bladder catheter removal. Slightly less than 1 in 4 patients (24.8%) indicated that UI had no effect on activities of daily living. In contrast, 27.5% indicated that UI had a moderate impact and 47.7% indicated a severe impact. Ninety-one patients reported performing pelvic floor muscle exercises to improve UI, but only 45% were found to be performing them correctly. When evaluated at 1 year following catheter removal, 52.64% of the patients continued to experience UI. The majority (79.8%) indicated that UI did not impact their daily lives, 8.8% indicated a moderate impact, and 20.4% reported that UI had a severe impact on daily life. Seventy patients (61.4%) continued to perform pelvic floor muscle exercises; after 1 year, 93% were deemed to be correctly identifying, contracting, and relaxing their pelvic floor muscles.: Urinary incontinence remains prevalent as long as 12 months following catheter removal. Incontinence exerts a moderate to severe impact on daily life in 27.5% to 20.4% of respondents. In order to minimize the negative impact as much as possible, we advocate a pelvic floor muscle training program overseen by RNs. HubMed – rehab