Disability Outcome Measures Research Articles

The PANGAEA study design - a prospective, multicenter, non-interventional, long-term study on fingolimod for the treatment of multiple sclerosis in daily practice.

BackgroundFingolimod (Gilenya®) is an oral medication for patients with highly active relapsing-remitting Multiple Sclerosis (RRMS). Clinical trials and post-marketing experience on more than 114,000 patients have established a detailed safety profile. Total patient exposure now exceeds 195,000 patient-years as stated in the last financial report (Dec 2014) of the Novartis Pharma AG, Basel, Switzerland. However, less is known about the safety of long-term fingolimod use in daily practice. Here, we describe the study design of PANGAEA (Post-Authorization Non-interventional German sAfety of GilEnyA in RRMS patients), a prospective, multicenter, non-interventional, long-term study to collect safety, efficacy, and pharmacoeconomic data on RRMS patients treated with fingolimod (0.5 mg/daily) under real-world conditions in Germany.MethodsPANGAEA is striving to assess a real-world safety and efficacy profile of fingolimod, based on data from 4,000 RRMS patients, obtained during a 60-month observational phase. A pharmacoeconomic sub-study of 800 RRMS patients further collects patient-reported outcome measures of disability, quality of life, compliance, treatment satisfaction, and usage of resources during a 24-month observational phase. Descriptive statistical analyses of the safety set as well as of stratified subgroups such as patients with concomitant diabetes mellitus and pretreated patients (e.g., natalizumab) will be conducted.DiscussionPANGAEA seeks to confirm the current safety profile of fingolimod obtained in phase I-III clinical trials. The study design presented here will additionally provide guidance on the therapeutic use of fingolimod in clinical practice and possibly assists physicians in making evidence-based decisions.

Item response theory analysis of the modified Roland-Morris Disability Questionnaire in a population-based study.

This is a secondary analysis of a cross-sectional population-based survey. Shorten the modified 23-item Roland (mRoland) scale using item response theory (IRT) methods and describe where in the functional disability range each scale is the most precise. The Roland-Morris Disability Questionnaire is recommended for a functional disability outcome measure in patients with low back pain (LBP). One commonly used version is the Roland. It is unknown where in the functional disability range the Roland measures. One candidate individual with LBP in randomly selected households was interviewed, identifying 694 adults with chronic LBP. To justify the use of a unidimensional 2-parameter logistic IRT model, we performed both exploratory and confirmatory factor analysis. Exploratory factor analysis revealed one dominant eigenvalue. Confirmatory factor analysis results indicate that the 1-factor model fit well. IRT analysis revealed variability in the slopes, in the range from 1.07 to 3.10. The marginal reliability, an IRT-based analog to coefficient α, was 0.88. The mRoland produces reliable scores (i.e., with a standard error <0.3) from 1.4 standard deviations below the mean to roughly 0.2 above the mean. The mRoland measures one construct. The mRoland seems to be an excellent tool for measuring just-below-average levels of functional disability. The mRoland measures high levels of functional disability with relatively poor reliability and may be more appropriate for a less-disabled population with LBP. We demonstrate that the mRoland can be shortened to 11 items with minimal loss of information. We show that there are different ways to go about selecting the set of 11 items that yield short forms with different strengths. 3.

Replication of a cognitive behavioral therapy for chronic pain group protocol by therapists in training

According to the American Psychological Association (Division 12), there is strong, long-standing research support for cognitive behavioral therapy (CBT) to treat chronic pain. Furthermore, meta-analytic comparisons have shown CBT to be highly efficacious. However, not all researchers agree with this conclusion. The purpose of the current pilot study was to determine whether a CBT outpatient, group-based treatment facilitated by junior therapists benefited veterans who suffer from mixed idiopathic, chronic, noncancer pain, thus replicating results from effective CBT programs from the past. A sample of 46 veterans aged 33 to 81 years with chronic, noncancer pain who participated in an outpatient CBT pain group therapy protocol at a Midwestern Veterans Affairs Medical Center between November 3, 2009, and September 2, 2010 was evaluated. All participants completed a pre- and postintervention assessment. Paired-samples t tests were conducted to evaluate the impact of the program on veterans’ scores on assessment measures. No significant difference was found between the pre- and posttest primary outcome measures of pain intensity. A significant difference was established between the pre- and posttest secondary outcome measure of catastrophizing. However, there were no other significant differences found among the remaining pre- and posttest secondary outcome measures of pain interference, disability, and psychological distress. Training junior therapists on how to use CBT protocols may be enhanced by paying greater attention to what mechanisms are responsible for the desired outcomes among veterans with chronic pain.

Effectiveness of device-based therapy for conservative management of low back pain.

[Purpose] Device based therapy for low back pain (LBP) involves quantitative assessment of muscle strength, resistance and lumbar motion and tailoring the rehabilitation protocol based on this objective assessment. The purpose of this study was to determine the effectiveness of device based therapy for LBP. [Subjects and Methods] In this retrospective study, clinical data of 235 patients who underwent device-based physiotherapy for low back pain was reviewed. Pre and post-treatment outcome measures for pain (visual analogue scale or VAS score), disability (Oswestry disability index) and functional ability were compared to determine effectiveness of device-based physiotherapy at the end of 6 weeks of treatment. [Results] All outcome measures including VAS Score and mean Oswestry Disability Score showed significant improvement at the end of 6 weeks of device-based physical therapy. Before treatment, 73% of patients had moderate to severe disability which reduced to 28% after treatment. [Conclusion] Device-based therapy is effective in relieving pain, improving function and reducing disability in patients with low back pain in the short term. Device-based therapy may help to objectively evaluate the function of the spine and paraspinal muscles and help the therapist tailor treatment accordingly.

A survey to investigate the association of pain, foot disability and quality of life with corns

BackgroundCorns are a common foot problem affecting a large proportion of the population. This study describes the characteristics of corns experienced by 201 participants taking part in a randomised controlled trial to investigate associations between demographic and corn parameters on pain, foot related disability and quality of life (QoL).MethodsPain from the main (index) corn was measured using a visual analogue scale (VAS); foot related disability was assessed with the Foot Disability Questionnaire (now known as the Manchester Foot Pain and Disability Index) and quality of life was recorded with the EQ-5D questionnaire. The effect of demographic and corn parameters on the pain and quality of life outcomes was assessed with analysis of variance (ANOVA) methods. The effect of the same factors on a linear combination of the foot-related disability outcome measures was assessed using multivariate ANOVA methods. Pain was also tested for its mediating properties on the causal pathway between the independent variables and quality of life.ResultsThe mean pain score was 5.29 points on a 10 cm VAS, with females reporting substantively higher pain levels than males. Age affected foot-related disability, with lower levels on all domains of the MFPDI reported in older participants; each year of advancing age was associated with falls of: 0.009 points on the Concern about Appearance (CA) domain; 0.047 points on the Functional Limitation (FL) domain and 0.048 points on the Pain Intensity (PI) domain. Sex and corn type also affected disability, with higher scores reported by females and participants with plantar corns.ConclusionsThe effect of pain was shown to mediate the relationship between sex and foot-related disability. The presence of plantar corns has a more detrimental effect on QoL than dorsal/inter-digital corns.Trial registrationISRCTN 13166839

The Effect of Pressure Pain Sensitivity and Patient Factors on Self-Reported Pain-Disability in Patients with Chronic Neck Pain

The study was conducted to estimate the extent to which pressure pain sensitivity (PPS) and patient factors predict pain-related disability in patients with neck pain (NP), and to determine if PPS differs by gender. Forty-four participants with a moderate level of chronic NP were recruited for this cross sectional study. All participants were asked to complete self-reported assessments of pain, disability and comorbidity and then underwent PPS testing at 4-selected body locations. Pearson`s r w was computed to explore relationships between the PPS measures and the self-reported assessments. Regression models were built to identify predictors of pain and disability. An independent sample t-test was done to identify gender-related differences in PPS, pain-disability and comorbidity. In this study, greater PPS (threshold and tolerance) was significantly correlated to lower pain-disability (r = -.30 to -.53, p≤0.05). Age was not correlated with pain or disability but comorbidity was (r= 0.42-.43, p≤0.01). PPS at the 4-selected body locations was able to explain neck disability (R2=25-28%). Comorbidity was the strongest predictor of neck disability (R2 =30%) and pain (R2=25%). Significant mean differences for gender were found in PPS, disability and comorbidity, but not in pain intensity or rating. This study suggests that PPS may play a role in outcome measures of pain and disability but between-subject comparisons should consider gender and comorbidity issues.

A medicinal herb-based natural health product improves the condition of a canine natural osteoarthritis model: A randomized placebo-controlled trial

An oral herb-based natural health product (NHP) was evaluated in the canine natural osteoarthritis model. At baseline, the peak vertical force (PVF, primary endpoint) and case-specific outcome measure of disability (CSOM) were recorded in privately-owned dogs. Dogs (16/group) were randomized to receive NHP formulations or a negative control. The PVF was measured at week (W) 4 and W8. Daily locomotor activity was recorded using accelerometer. The CSOMs were assessed bi-weekly by the owner. The NHP-treated dogs (n = 13) had higher PVF at W4 (p = 0.020) and W8 (p < 0.001) when compared to baseline. The changes at W8 were higher than control dogs (n = 14, p < 0.027) and consistent with Cohen's d effect size of 0.7 (95% confidence interval: 0.0–1.5). The NHP-treated dogs had higher locomotor activity at W8 (p = 0.025) when compared to baseline. No significant change was observed for the CSOM. The NHP improved the clinical signs of osteoarthritis in this model.

Disease-specific guidelines for reporting adverse events for peripheral vascular medical devices

Disease-specific guidelines for reporting adverse events for peripheral vascular medical devices

Full-thickness rotator cuff tears in patients younger than 55 years: clinical outcome of arthroscopic repair in comparison with older patients

The purpose of this study was to examine whether younger patients had a similar response to repair of a full-thickness rotator cuff tear (RCT) as older patients. A secondary analysis was conducted of prospectively collected data of patients with full-thickness RCTs. Patients were categorized into patients <55 years of age and patients 55 and older. Patient-related outcome measures of disability at 2 years following surgery were the Short Western Ontario Rotator Cuff (Short WORC), American Shoulder and Elbow Surgeon's (ASES) assessment form, and absolute Constant-Murley score (ACMS). Review of the database between 2001 and 2011 identified 344 patients (median age 62, range 24-90). Of these, 83 (24 %) patients were younger than 55 years of age (median age 48, range 24-54) and 261 (76 %) were in the older age group (median age 66, range 55-90). The median follow-up was 24 months (range 23-25). Patients in the younger age group had a higher prevalence of traumatic events (p = 0.02), had sustained more work-related injuries (p < 0.0001), and had a higher ratio of smaller tears (p = 0.0001). No difference was seen between groups with respect to post-operative scores of Short WORC, ASES, or ACMS. Pre-operative scores, having a work-related claim, increased tear size, and concomitant procedures affected the 2-year outcome scores. This study shows that younger patients with full-thickness RCTs who undergo an arthroscopic repair do as well as older individuals regardless of the measure used to document their recovery. Retrospective outcome study, Level II.

Autologous Growth Factor Injections in Chronic Tendinopathy

Reference: de Vos RJ, van Veldhoven PLJ, Moen MH, Weir A, Tol JL. Autologous growth factor injections in chronic tendinopathy: a systematic review. Br Med Bull. 2010;95:63–77. Clinical Question: The authors of this systematic review evaluated the literature to critically consider the effects of growth factors delivered through autologous whole-blood and platelet-rich–plasma (PRP) injections in managing wrist-flexor and -extensor tendinopathies, plantar fasciopathy, and patellar tendinopathy. The primary question was, according to the published literature, is there sufficient evidence to support the use of growth factors delivered through autologous whole-blood and PRP injections for chronic tendinopathy? Data Sources: The authors performed a comprehensive, systematic literature search in October 2009 using PubMed, MEDLINE, EMBASE, CINAHL, and the Cochrane library without time limits. The following key words were used in different combinations: tendinopathy, tendinosis, tendinitis, tendons, tennis elbow, p...

Accurately measuring the quality and effectiveness of cervical spine surgery in registry efforts: determining the most valid and responsive instruments

Background contextThere is a growing demand to measure the real-world effectiveness and value of care across all specialties and disease states. Prospective registries have emerged as a feasible way to capture real-world care across large patient populations. However, the proven validity of more robust and cumbersome patient-reported outcome instruments (PROi) must be balanced with what is feasible to apply in large-scale registry efforts. Hence, commercial registry efforts that measure quality and effectiveness of care in an attempt to guide quality improvement, pay for performance, or value-based purchasing should incorporate measures that most accurately represent patient-centered improvement. PurposeWe set out to establish the relative validity and responsiveness of common PROi in accurately determining effectiveness of cervical surgery for neck and arm pain in registry efforts. Study designProspective cohort study. Patient sampleEighty-eight patients undergoing primary anterior cervical discectomy and fusion (ACDF) for neck and arm pain. Outcome measuresPatient-reported outcome measures for pain (numeric rating scale for neck pain [NRS-NP] and arm pain [NRS-AP]), disability (neck disability index [NDI]), general health (short-form 12-item survey physical component summary [SF-12 PCS] and mental component summary [SF-12 MCS]), and quality of life (Euro-Qol-5D [EQ-5D]) were assessed. MethodsEighty-eight patients undergoing primary ACDF for neck and arm pain were entered into a Web-based prospective registry. Baseline and 12-month patient-reported outcomes (NRS-NP, NRS-AP, NDI, SF-12 PCS, SF-12 MCS, and EQ-5D) were assessed. Patients were also asked whether they experienced a level of improvement after ACDF that met their expectation (meaningful improvement). To assess the validity of NRS-NP, NRS-AP, and NDI (measures of pain and disability) to discriminate between meaningful and nonmeaningful improvement and the validity of SF-12 PCS, SF-12 MCS, and EQ-5D (measures of general health and quality of life) to discriminate between meaningful and nonmeaningful improvement, receiver-operating characteristic curves were generated for each outcome instrument. The greater the area under the curve (AUC), the more valid the discriminator. The difference between standardized response means (SRMs) in patients reporting meaningful improvement versus not was calculated to determine the relative responsiveness of each outcome instrument to changes in pain and QOL after surgery. ResultsFor pain and disability, both NDI (AUC=0.75) and NRS-AP (AUC=0.74) were valid discriminators of meaningful improvement. Numeric rating scale for neck pain (AUC=0.69) was a poor discriminator. Neck disability index was also most responsive to postoperative improvement (SRM difference 0.78), followed by NRS-AP (SRM difference 0.59) and NRS-NP (SRM difference 0.46). For general health and quality of life, SF-12 PCS (AUC=0.79) was the only valid discriminator of meaningful improvement. Euro-Qol-5D (AUC=0.68) and SF-12 MCS (AUC=0.44) were poor discriminators. Short-form 12 physical component summary (SRM difference 1.08) was also most responsive compared with EQ-5D (SRM difference 0.89) and SF-12 MCS (SRM difference 0.01). ConclusionsFor pain and disability, NDI is the most valid and responsive measure of improvement after surgery for neck and arm pain. Numeric rating scale for neck pain and NRS-AP are poor substitutes for NDI when measuring effectiveness of care in registry efforts. For health-related quality of life, only SF-12 PCS could accurately discriminate meaningful improvement after cervical surgery and was found to be most valid and responsive. Large-scale registry efforts aimed at measuring effectiveness of cervical spine surgery should use NDI and SF-12 to accurately assess improvements in pain, disability, and quality of life.

Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review

Objective: To establish the effectiveness of eccentric exercise as a treatment intervention for lateral epicondylitis. Data sources: ProQuest, Medline via EBSCO, AMED, Scopus, Web of Science, CINAHL. Review methods: A systematic review was undertaken to identify randomized and controlled clinical trials incorporating eccentric exercise as a treatment for patients diagnosed with lateral epicondylitis. Studies were included if: they incorporated eccentric exercise, either in isolation or as part of a multimodal treatment protocol; they assessed at least one functional or disability outcome measure; and the patients had undergone diagnostic testing. The methodological quality of each study was assessed using the Modified Cochrane Musculoskeletal Injuries Group score sheet. Results: Twelve studies met the inclusion criteria. Three were deemed ‘high’ quality, seven were ‘medium’ quality, and two were ‘low’ quality. Eight of the studies were randomized trials investigating a total of 334 subjects. Following treatment, all groups inclusive of eccentric exercise reported decreased pain and improved function and grip strength from baseline. Seven studies reported improvements in pain, function, and/or grip strength for therapy treatments inclusive of eccentric exercise when compared with those excluding eccentric exercise. Only one low-quality study investigated the isolated effects of eccentric exercise for treating lateral epicondylitis and found no significant improvements in pain when compared with other treatments. Conclusion: The majority of consistent findings support the inclusion of eccentric exercise as part of a multimodal therapy programme for improved outcomes in patients with lateral epicondylitis.

Family Intervention for Adolescents With Suicidal Behavior: A Randomized Controlled Trial and Mediation Analysis

Family processes are a risk factor for suicide but few studies target this domain. We evaluated the effectiveness of a family intervention, the Resourceful Adolescent Parent Program (RAP-P) in reducing adolescent suicidal behavior and associated psychiatric symptoms. A preliminary randomized controlled trial compared RAP-P plus Routine Care (RC) to RC only, in an outpatient psychiatric clinic for N = 48 suicidal adolescents and their parents. Key outcome measures of adolescent suicidality, psychiatric disability, and family functioning were completed at pre-treatment, 3-month, and 6-month follow-up. RAP-P was associated with high recruitment and retention, greater improvement in family functioning, and greater reductions in adolescents' suicidal behavior and psychiatric disability, compared to RC alone. Benefits were maintained at follow-up with a strong overall effect size. Changes in adolescent's suicidality were largely mediated by changes in family functioning. The study provides preliminary evidence for the use of family-focused treatments for adolescent suicidal behavior in outpatient settings. Clinical trial registration information-Family intervention for adolescents with suicidal behaviour: A randomized controlled trial and mediation analysis; http://anzctr.org/; ACTRN12613000668707.

The Role of Patients' Expectation of Appropriate Initial Manual Therapy Treatment in Outcomes for Patients With Low Back Pain

ObjectivesThe purpose of this study was to compare the outcomes of patients with low back pain who had a matched, unmatched, or were indifferent with their pretreatment expectation/preference to the manual therapy thrust or nonthrust intervention. A secondary purpose was to explore baseline patient characteristics affiliated with a preference of manual therapy treatment type (thrust or nonthrust manipulation). MethodsThe study is a secondary analysis of a prospective randomized controlled trial that enrolled 149 patients with low back pain, from 16 distinct outpatient physical therapy practices within the United States. Patient's pretreatment expectations were identified before randomization. The intervention included manual therapy (thrust or nonthrust manipulation) with a standardized exercise program, which was carried out for 2 treatment sessions. Six outcomes captured the constructs of (a) disability, (b) pain perception, (c) care intensity, (d) fear avoidance behaviors, and (e) perception of extent of recovery. Descriptive statistics, analysis of variance (and Tukey, a post hoc test), Fisher exact test, and a multivariate logistic regression analysis were used for analysis. ResultsThere were no statistical differences in any of the 6 dedicated outcomes measures between the matched, unmatched, and no preference groups. Therapist-determined patient “irritability” was associated with patient preference of nonthrust treatment, and higher body mass index was associated with patient preference of thrust treatment. ConclusionsThis study shows that patients demonstrated no statistical difference in disability or pain outcome measures when matched, unmatched, or indifferent to the intervention.

Patients with Very Early-onset Systemic Juvenile Idiopathic Arthritis Exhibit More Inflammatory Features and a Worse Outcome

Systemic juvenile idiopathic arthritis (SJIA) frequently leads to disability and damage. Predictive factors for a poor outcome include persistent systemic features and younger age at onset. We describe and analyze disease features in patients with early-onset (EO) SJIA (disease onset before age 18 mo) and compare them to patients with later-onset (LO) disease. Clinical features at onset, activity measures (occurrence of macrophage activation syndrome, remission), and outcome measures for disability [Childhood Health Assessment Questionnaire (CHAQ) ≥ 0.5] and damage [radiographic joint destruction, Juvenile Arthritis Damage Index (JADI) score, growth retardation] observed during followup were analyzed retrospectively in patients with SJIA followed for ≥ 3 years since disease onset. In total 132 patients were included. SJIA started at age ≤ 18 months in 19 (14%) patients and at a later age in 113 (86%) children. At onset, serositis (p < 0.01) and hepatomegaly (p < 0.05) were more frequent in EO patients, who also exhibited lower hemoglobin levels (p < 0.03) and higher platelet counts (p < 0.03) than patients with LO. Macrophage activation syndrome occurred in 20 patients (11 EO and 9 LO; p < 0.0001). Remission was achieved by 49 patients (37%; 4 EO and 45 LO). At last visit, destructive hip disease (p < 0.04), growth retardation (p < 0.01), radiographic damage (p < 0.02), and disability (p < 0.04) were more frequent in patients with EO disease, who had higher JADI scores (p < 0.003). Patients with EO exhibited a more aggressive and destructive disease course than patients with LO SJIA.

Functional outcome after major orthopedic surgery

Regional anesthesia can provide optimal pain management and stress reduction. This article aims to establish the impact of regional anesthesia in facilitating the recovery process, measured by significant clinical outcomes. The most common outcome assessing the effectiveness of regional anesthesia following major orthopedic procedures has been pain intensity. In recent literature, more precise outcome measures of disability and related to patient's quality of life and ability to return to daily activities have been introduced. Those found in the period of this review and discussed in this article are maximum voluntary isovolumetric contraction, range of motion, walking tests, time up and go, cumulated ambulation score, stair climb test, Short Musculoskeletal Function Assessment, Western Ontario McMaster Osteoarthritis Index, constant Murley score, Knee Society evaluation, Community Health Activities Model Program for Seniors, Short Form 12 and 16. Performance based outcomes have been found to correlate poorly with self-reported outcomes after knee arthroplasty. In order to establish the role of regional anesthesia in functional outcome after major orthopedic surgery, assessment of pain control is no longer sufficient. New clinically relevant outcomes must be introduced and used for procedure-specific studies.

Commentary on ‘Disability outcome measures in multiple sclerosis clinical trials’

In order to fully understand and explore the effectiveness of any intervention for the management of multiple sclerosis (MS), it is important to have robust, valid, reliable, and universally applied measures. The recent article, ‘Disability outcome measures in multiple sclerosis clinical trials’ by Cohen, Reingold, Polman and Wolinsky (2012), explores this issue in regards to the effective measurement of MS-related disability, and the utilisation of patient-reported outcome measures, whilst highlighting the need for collaboration between the academic and clinical communities. Although it is important to examine disability measures, it is also equally important to recognise that physical function is only one aspect of a person’s experience; for example, quality of life and psychological well-being are also important aspects to assess. The application of e-health technologies and patient registers could be a useful method of gaining additional information, using patient-reported outcomes. This commentary explores these issues in relation to points raised by the Cohen et al. paper.

Revisiting The Multiple Sclerosis Functional Composite: proceedings from the National Multiple Sclerosis Society (NMSS) Task Force on Clinical Disability Measures

This article describes proceedings from a meeting of the National Multiple Sclerosis Society (NMSS) Task Force on Clinical Disability Measures (the TF). The TF was appointed by the NMSS Research Programs Advisory Committee with the goal of pooling and analyzing existing datasets to explore the utility of novel disability outcome measures based on the Multiple Sclerosis Functional Composite (MSFC) approach. The TF seeks to determine the suitability of the MSFC approach as a primary clinical outcome measure for registration trials in MS. The TF met in Washington, DC, Dec. 14 and 15, 2011, and provided unanimous support for a collaborative approach involving representatives from academic medicine, the pharmaceutical industry, regulatory agencies, the NMSS and the Critical Path Institute. There was also unanimous agreement that analysis of existing datasets would be useful in making progress toward the objective. The TF placed high value on determining the clinical meaning of individual component measures for the MSFC, and in establishing optimal analysis methods for MSFC so that scores would be more interpretable than the originally recommended z-score method. The background for a collaborative project aimed at developing an improved disability outcome measure is described in this paper.

Persian translation and validation of the Kujala Patellofemoral Scale in patients with patellofemoral pain syndrome

Purpose: To culturally translate and validate the Persian version of Kujala Patellofemoral Scale (KPS) and evaluate the test-retest reliability, internal consistency, construct validity and ceiling or floor effects of this instrument in patients with patellofemoral pain syndrome (PFPS). Method: After standard forward and backward translations, 100 patients with PFPS completed the Persian versions of the KPS and Short-Form 36 Health Survey (SF-36) in the first visit. With time interval of 2–3 days after the first visit, 47 patients filled out the KPS in the second visit. Test-retest reliability and internal consistency were assessed using intraclass correlation coefficient (ICC2,1) with 95% confidence interval (95% CI) and Cronbach’s α coefficient, respectively. The Spearman’s rank correlation (rs) was used to assess the correlations between the Persian KPS and SF-36 subscales. Results: The acceptable level of ICC >0.70 (ICC = 0.96, 95% CI = 0.93–0.98) and Cronbach’s α coefficient >0.70 (α = 0.81) was obtained for the Persian KPS. There were low to moderate correlations (rs = 0.25–0.60, p < .01) between the Persian KPS and Persian SF-36 subscales of mental and physical health components. However, correlations between the Persian KPS and SF-36 physical components were higher than correlations between the Persian KPS and SF-36 mental components. No ceiling and floor effects were seen for the Persian KPS. Conclusions: The Persian version of KPS is a reliable and valid outcome measure of disability and seems to be a suitable instrument for use in clinical practice of Iranian patients with chronic PFPS.Implications for RehabilitationThe results on psychometric properties of the Persian Kujala Patellofemoral Scale are comparable with three validated versions obtained for the Finnish, Turkish and Chinese populations.Persian version of the Kujala Patellofemoral Scale has acceptable reliability/validity and now can be used in “clinical” and “research” settings of Iranian patients with chronic patellofemoral pain syndrome.

Validation of the Charcot-Marie-Tooth Pediatric Scale as an Outcome Measure of Disability (P05.142)

Validation of the Charcot-Marie-Tooth Pediatric Scale as an Outcome Measure of Disability (P05.142)