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BackgroundThere are various instruments and methods to evaluate spinal health and functional status. Whole-spine patient reported outcome (PRO) measures, such as the Spine Functional Index (SFI), assess the spine from the cervical to lumbo-sacral sections as a single kinetic chain. The aim of this study was to cross-culturally adapt the SFI for Persian speaking patients (SFI-Pr) and determine the psychometric properties of reliability and validity (convergent and construct) in a Persian patient population.MethodsThe SFI (English) PRO was translated into Persian according to published guidelines. Consecutive symptomatic spine patients (104 female and 120 male aged between 18 and 60) were recruited from three Iranian physiotherapy centers. Test-retest reliability was performed in a sub-sample (n = 31) at baseline and repeated between days 3–7. Convergent validity was determined by calculating the Pearson’s r correlation coefficient between the SFI-Pr and the Persian Roland Morris Questionnaire (RMQ) for back pain patients and the Neck Disability Index (NDI) for neck patients. Internal consistency was assessed using Cronbach’s α. Exploratory Factor Analysis (EFA) used Maximum Likelihood Extraction followed by Confirmatory Factor Analysis (CFA).ResultsHigh levels of internal consistency (α = 0.81, item range = 0.78–0.82) and test-retest reliability (r = 0.96, item range = 0.83–0.98) were obtained. Convergent validity was very good between the SFI and RMQ (r = 0.69) and good between the SFI and NDI (r = 0.57). The EFA from the perspective of parsimony suggests a one-factor solution that explained 26.5% of total variance. The CFA was inconclusive of the one factor structure as the sample size was inadequate. There were no floor or ceiling effects.ConclusionsThe SFI-Pr PRO can be applied as a specific whole-spine status assessment instrument for clinical and research studies in Persian language populations.

Purpose: Because walking is the main activity of humans for movement, many research studies have been conducted to understand its details. One of the main issues in this regard is gait symmetry and the effect of various factors on it. Accordingly, the present study aimed to review the selected factors affecting gait symmetry. Methods:A literature review was performed on articles published from 2000 to 2016 using Science Direct, Google scholar, PubMed, Ovid Medline, Scopus and Medline databases. The search keywords were "gait asymmetry", "bilateral coordination", "bilateral asymmetry", "limb dominance", "laterality", "limb preference" and "performance asymmetry."Results: A total of 60 scientific articles were selected according to the research criteria by searching the relevant articles published from 2000 to 2016 in reliable scientific databases. Conclusion:A review of the previous studies shows that walking in normal people is asymmetric in terms of the lower limb function. Also, limb disorder due to the illness and or disorder creates gait asymmetry. Therefore, regaining perfect symmetry or decreasing gait asymmetry by exercise and intervention in such individuals is considered a method to examine the success of rehabilitation process. However, as factors like movement speed and age can affect gait asymmetry, they should be controlled during the examination of gait asymmetry. Moreover, this information could be useful for gait assessment, clinical prescriptions for patients with abnormalities, designing orthosis and prosthesis, as well as improving the performance of athletes.

Introduction The Upper Limb Functional Index (ULFI) is a patient-reported outcome measure (PROM) designed to evaluate both the functional status and the level of participation in patients with upper limb musculoskeletal disorders (ULMSDs). The purpose of this study was translation, cross-cultural adaptation, and psychometric evaluation of the original ULFI into Persian (ULFI-Pr). Methods The original ULFI was translated into Persian through double forward and backward translations. Consecutive symptomatic upper limb patients (n = 180, male = 60%, age = 38.21 ± 7.13) were recruited and completed the ULFI-Pr and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. Internal consistency and test-retest reliability were determined using Cronbach’s Alpha and the Intra-class Correlation Coefficient (ICC2.1). Criterion validity was analyzed by evaluating the Pearson’s r correlation coefficient between the ULFI-Pr and DASH questionnaires. Construct validity was examined through exploratory factor analysis (EFA) using Maximum Likelihood Extraction with Promax rotation. Results The original ULFI was translated and cross-culturally adapted into Persian with only minor wording changes. The ULFI-Pr demonstrated high levels of internal consistency (α = 0.91) and test-retest reliability (ICC2.1=0.92). The correlation between the ULFI and DASH was high (r = 0.71). The EFA demonstrated a one-factor structure that explained 38.2% of total variance. No floor or ceiling effects were observed. Conclusion The ULFI-Pr can be considered as a region-specific, single-factor structure PROM for evaluation of patients with upper limb disorders for clinical and research purposes in Persian language populations.