Rehabilitation Research and Practice

Objective. To compare the effect of quadriceps isometric exercises performed in two different positions in addition to the combined physical therapy program on pain, stiffness, and physical function in patients with knee osteoarthritis (OA). Methods. A total of 30 patients with OA (age range 45 to 70 years) who were admitted to Istanbul Private Ekotom Medical Center, Department of Physical Medicine and Rehabilitation Outpatient Clinic, were included. The patients were randomly divided into two groups according to the type of performing the quadriceps isometric exercises as group 1 (performing in knee extension, ) and group 2 (performing in knee flexion, ). All patients also received a combined physical therapy program. Exercise protocols were applied six days a week for four weeks. The pain was evaluated using a 10 cm visual analog scale for pain (VAS) in rest and activity; pain, joint stiffness, and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. A significant difference was found in the VAS and WOMAC scores of both groups in group comparisons (). When the groups were compared in terms of change values, a significant difference was found in the WOMAC stiffness score in favor of group I (). Discussion. It is possible to obtain positive results with quadriceps isometric exercises to reduce pain and joint stiffness and increase physical function in patients with knee OA. However, exercises performed in knee extension were found to be more effective in reducing joint stiffness.

Background. The Functional Rating Index (FRI) is a self-report scale widely used to determine the level of disability in low back pain (LBP) populations. Objectives. This study was aimed at conducting the cross-cultural adaptation of the FRI-Arabic version (FRI-Ar) and testing the clinometric properties of FRI-Ar. Methods. The cross-cultural adaptation process was used to develop the FRI-Ar. This study included acute and subacute LBP patients. Each patient was asked to complete the questionnaires at three time points: baseline, 24-hour follow-up, and two-week follow-up. The questionnaires used were FRI-Ar, Roland-Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI), Numerical Pain Rating Scale (NPRS), Global Perceived Effect Scale (GPE), and Patient-Specific Functional Scale (PSFS). Statistical analysis was carried out to measure the instrument’s reliability, validity, and responsiveness. Results. The FRI was cross-culturally adapted to the Arabic language, and the adapted version was validated. Two hundred patients completed the questionnaires at the baseline; however, 120 patients completed the questionnaires at 24-hour and two-week follow-up. Cronbach’s alpha, interclass correlation coefficient (ICC_2,1), standard error of measurement (SEM), and minimal detectable change (MDC_95%) for the FRI-Ar were observed as 0.85, 0.85, 1.17 (2.9%), and 3.24, respectively. The FRI-Ar showed a moderate positive correlation only with the RMDQ, ODI, and NPRS (). Also, it showed the responsiveness with a small effect size () and standardized response mean (). Conclusion. The FRI-Ar was developed, and it showed good reliability and validity. However, it revealed the responsiveness with the small change. It can evaluate both pain and functional limitations in acute and subacute LBP patients. Before using it in the Arabic population with acute and subacute LBP, it is recommended to conduct further research to test internal and external responsiveness using an external criterion with a more extended follow-up period and suitable interventions.

Background and Purpose. The social standing of any occupation is often referred to as occupational prestige. Occupational prestige is often evaluated as how a particular occupation is regarded relative to other occupations by different groups in the society. Occupational prestige is a useful indicator of a profession’s marketability and desirability. As physical therapists (PTs) are essential members of the healthcare team, the aim of this study is to determine Saudi PT’s (students and graduates) perception of their occupational prestige and satisfaction with their career choice. Methods. A cross-sectional, mixed-method study was employed. Practicing PTs and PT students were recruited to fill out a self-administered questionnaire to rank nine different professions (including PT) across different dimensions. Further, participants reported on their job satisfaction and participated in a semistructured interview regarding their responses. Results. A total of 175 individuals participated in this study. The physical therapy profession was rated 6^th on level of education, last (9^th) on level of income and level of social standing, 5^th on level of responsibility, and 3^rd on level of usefulness. In the overall occupational prestige, the physical therapy profession was ranked the lowest compared to the other professions. Lastly, the data from the semistructured interviews corroborated the findings identified from the quantitative aspect of our study. Discussion. The overall results of the study indicate that the current perceived level of occupational prestige among Saudi PTs and PT students is somewhat disappointing. Participants generally viewed their profession in a low occupational prestige status, which is in contrast to previous studies conducted in other countries. While some of these results can be explained by the nature and history of the profession in Saudi Arabia, Academic institutions and policy makers should make an effort to promote the occupational prestige of the physical therapy profession.

Background. Type 2 diabetes mellitus (T2DM) has been reported to affect the vestibular system resulting in dizziness and vertigo complaints. This complication is known to disable the social participation. The Participation Scale Short Simplified (PSSS) has been developed to quantify the severity of social participation restrictions. The aim of this study was to translate and cross-culturally adapt the PSSS into Indonesian Bahasa (PSSS-Ina). The measurement properties of the translated version and the factors contributing to the severe participation restriction were determined. Methods. The participants comprised 55 T2DM with vestibular dysfunction (VD) in the community center for diabetes mellitus in Central Java, Indonesia. The signs of VD were confirmed by head impulse test, Dix Hallpike Test, and supine roll test. The PSSS-Ina was administered twice with a four-week interval. The physical examination was also performed to identify the contributing factors. Results. The test–retest reliability of the PSSS Indonesian Bahasa version (PSSS-Ina) between two measurement sessions was excellent (ICC of 0.93, , and 95% CI: 0.88–0.95). The correlation coefficient between two administrations was high (). Based on the demonstrated content validity, the values of the corrected item and total correlation were greater than 0.3. No floor and ceiling effects were observed. The good internal consistency was confirmed with Cronbach’s alpha of 0.84. The factor analysis produced three factors of activity participation, social engagement, and work-related participation. The multiple logistic regression revealed that the balance performance of mCTSIB was the main factor contributing to the severe participation restriction reflected by the PSSS-Ina score. Conclusion. The Indonesian version of the PSSS-Ina demonstrated excellent comprehensibility and reliability in individuals suffering T2DM with VD. This tool is therefore helpful in identifying the participation limitation in individuals with VD.

This study is aimed at comparing the design and configuration of the most commonly used manual wheelchair models through cardiorespiratory responses, perceived exertion, and mobility performance using two different manual wheelchairs, during mobility tasks. A within-group controlled experiment was designed with three independent and four dependent variables. The independent variables included wheelchairs, with the levels active wheelchair with a rigid frame and passive wheelchair with foldable frame; conditions with the levels straight line, slalom, and agility; and speed with levels comfortable and fast. Dependent variables included oxygen uptake (VO₂), distance travelled, speed, and perceived exertion. Results show that the active wheelchair yielded more beneficial characteristics although only the effect of wheelchair type on VO₂ efficiency (oxygen uptake per meter travelled) was statistically significant with a large effect size (, ). The better VO₂ efficiency was achieved with the active wheelchair under all tested conditions. The effect of wheelchair type on Borg scores was also statistically significant, although with a small effect size (, ); thus, active wheelchair use had lower Borg scores under all trials and was considered less exhausting than the passive wheelchair. In summary, use of the active wheelchair resulted in the users expending less energy per meter travelled and at the same time experiencing less fatigue. This may benefit overall wheelchair mobility and possibly reduce health complications.

A self-report measure is considered a practical alternative tool for longitudinal monitoring and for community models of disability. Spinal Cord Independence Measure Self-Report (SCIM-SR) was developed to measure the functional independence of the spinal cord injury (SCI) population. For the application of this questionnaire in Nepali setting, the cross-cultural adaptation and reliability of the Nepali version of the SCIM-SR were also warranted. The aim of the study was to cross-culturally adapt the Nepali version of the SCIM-SR and determine its reliability. The English version of the SCIM-SR was translated into the Nepali language with cross-cultural adaptations following the Beaton guidelines. A total of 45 community-dwelling individuals with SCI administered the Nepali version of the SCIM-SR two times, with an interval of one week. The intraclass correlation coefficient (ICC) and Cronbach’s alpha (α) were used to assess the test-retest reliability and internal consistency, respectively. Cross-cultural equivalence was achieved between the English version and the Nepali version of the SCIM-SR. The test-retest reliability was excellent, with ICCs for the total score 0.968 (95% confidence interval 0.941–0.982), self-care subscale 0.964 (0.934–0.980), respiration and sphincter management subscale 0.941 (0.893–0.968), and mobility subscale 0.966 (0.938–0.981). The internal consistency reached an acceptable range for the total score and most of the subscales except for those of respiration and sphincter management. Cronbach’s α coefficients for the total score, self-care subscale, respiration and sphincter management subscale, and mobility subscale were 0.801, 0.959, 0.506, and 0.838, respectively. The Nepali version of the SCIM-SR was cross-culturally adapted and can be used as a reliable self-report instrument to assess functional independence among the community-dwelling SCI population in Nepal.