BackgroundSocial support (SS) has been identified as an essential buffer to stressful life events. Consequently, there has been a surge in the evaluation of SS as a wellbeing indicator. The Multidimensional Perceived Social Support Scale (MSPSS) has evolved as one of the most extensively translated and validated social support outcome measures. Due to linguistic and cultural differences, there is need to test the psychometrics of the adapted versions. However, there is a paucity of systematic evidence of the psychometrics of adapted and translated versions of the MSPSS across settings.ObjectivesTo understand the psychometric properties of the MSPSS for non-English speaking populations by conducting a systematic review of studies that examine the psychometric properties of non-English versions of the MSPSS.MethodsWe searched Africa-Wide Information, CINAHL, Medline and PsycINFO, for articles published in English on the translation and or validation of the MSPSS. Methodological quality and quality of psychometric properties of the retrieved translations were assessed using the COSMIN checklist and a validated quality assessment criterion, respectively. The two assessments were combined to produce the best level of evidence per language/translation.ResultsSeventy articles evaluating the MSPSS in 22 languages were retrieved. Most translations [16/22] were not rigorously translated (only solitary backward-forward translations were performed, reconciliation was poorly described, or were not pretested). There was poor evidence for structural validity, as confirmatory factor analysis was performed in only nine studies. Internal consistency was reported in all studies. Most attained a Cronbach’s alpha of at least 0.70 against a backdrop of fair methodological quality. There was poor evidence for construct validity.ConclusionThere is limited evidence supporting the psychometric robustness of the translated versions of the MSPSS, and given the variability, the individual psychometrics of a translation must be considered prior to use. Responsiveness, measurement error and cut-off values should also be assessed to increase the clinical utility and psychometric robustness of the translated versions of the MSPSS.Trial registrationPROSPERO - CRD42016052394.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0912-0) contains supplementary material, which is available to authorized users.

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BackgroundPhantom limb pain (PLP) is characterized by the anatomical shifting of neighbouring somatosensory and motor areas into a deafferented cortical area of the brain contralateral to the amputated limb. It has been shown that maladaptive neuroplasticity is positively correlated to the perception of PLP in amputees. Recent studies support the use of graded motor imagery (GMI) and its component to alleviate the severity of PLP and disability. However, there is insufficient collective empirical evidence exploring the effectiveness of these treatment modalities in amputees with PLP. This systematic review will therefore explore the effects of GMI and its individual components on PLP and disability in upper and lower limb amputees.MethodsWe will utilize a customized search strategy to search PubMed, Cochrane Central register of Controlled Trials, MEDLINE, Embase, PsycINFO, PEDro, Scopus, CINAHL, LILACS, DARE, Africa-Wide Information and Web of Science. We will also look at clinicaltrials.gov (http://www.clinicaltrials.gov/), Pactr.gov (http://www.pactr.org/) and EU Clinical trials register (https://www.clinicaltrialsregister.eu/) for ongoing research. Two independent reviewers will screen articles for methodological validity. Thereafter, data from included studies will be extracted by two independent reviewers through a customized pre-set data extraction sheet. Studies with a comparable intervention and outcome measure will be pooled for meta-analysis. Studies with high heterogeneity will be analysed through random effects model. A narrative data analysis will be considered where there is insufficient data to perform a meta-analysis.DiscussionSeveral studies investigating the effectiveness of GMI and its different components on PLP have drawn contrasting conclusions regarding the efficacy and applicability of GMI in clinical practice. This systematic review will therefore gather and critically appraise all relevant data, to generate a substantial conclusion and recommendations for clinical practice and research on this subject.Systematic review registrationPROSPERO CRD42016036471Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0322-5) contains supplementary material, which is available to authorized users.

BackgroundCerebral palsy (CP) is the most common, life-long paediatric disability. Taking care of a child with CP often results in caregiver burden/strain in the long run. As caregivers play an essential role in the rehabilitation of these children, it is therefore important to routinely screen for health outcomes in informal caregivers. Consequently, a plethora of caregiver burden outcome measures have been developed; however, there is a dearth of evidence of the most psychometrically sound tools. Therefore, the broad objective of this systematic review is to evaluate the psychometrical properties and clinical utility of tools used to measure caregiver burden in caregivers of children with CP.Methods/designThis is a systematic review for the evaluation of the psychometric properties of caregiver burden outcome tools. Two independent and blinded reviewers will search articles on PubMed, Scopus, Web of Science, CINAHL, PsychINFO and Africa-Wide Google Scholar. Information will be analysed using predefined criteria. Thereafter, three independent reviewers will then screen the retrieved articles. The methodological quality of studies on the development and validation of the identified tools will be evaluated using the four point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Finally, the psychometric properties of the tools which were developed and validated from methodological sound studies will then be analysed using predefined criteria.DiscussionThe proposed systematic review will give an extensive review of the psychometrical properties of tools used to measure caregiver burden in caregivers of children with CP. We hope to identify tools that can be used to accurately screen for caregiver burden both in clinical setting and for research purposes.Systematic review registrationPROSPERO CRD42015028026.

European Journal of Rheumatology (Eur J Rheumatol) is an international, open access peer reviewed journal committed to promoting the highest standards of scientific exchange and education. The journal is published quarterly on January, April, July and October. The aim of the European Journal of Rheumatology is to cover various aspects of rheumatology for its readers, encompassing the spectrum of diseases with arthritis, musculoskeletal conditions, autoinflammatory diseases, connective tissue disorders, osteoporosis, translational research, the latest therapies and treatment programs. European Journal of Rheumatology publishes original articles, invited reviews, case based reviews, letters to the editor and images in rheumatology. The publication language of the journal is English.

Aims: This study aimed to investigate motor performance in children with cystic fibrosis (CF) and the relationship with respiratory and anthropometric outcome measures. Methods: A cross-sectional exploratory study investigated 12 children with CF, mean (SD) age 6.17 (0.67) years, using the Movement Assessment Battery for Children 2 nd edition (MABC-2), spirometry, body weight, height, body mass index and age related anthropomorphic z-scores. Results: MABC-2 total scores indicated 9/12 (75%) children performed below average (<50 th percentile), of which 4/12 children (33.3%) had motor delay and 2/12 (16.7%) were at risk for motor delay. The balance subscale showed the lowest scores, with 5/12 (41.7%) participants performing at or below the 5 th percentile and a median (IQR) percentile score of 9.00 (5.00-62.50). A significant negative correlation was found between the manual dexterity subscale and both height and height for age z-scores (p=0.017 and p=0.019 respectively), as well as peak expiratory flow in liter (p=0.027). The balance subscale scores were positively correlated with forced expiratory volume in %predicted (p=0.048). No other significant correlations were found. Conclusion: Children with CF may be at risk for delayed motor development, particularly their balance skills. Poor lung function might affect motor development but further research is recommended.

Background Approximately one in every 1200 South Africans is affected by a neuromuscular disease (NMD). Weak respiratory muscles and ineffective cough contribute to the development of respiratory morbidity and mortality. Early identification of individuals at risk of respiratory complications, through peak expiratory cough flow (PCF) measurement, may improve patient outcomes through timely initiation of cough augmentation therapy. Objectives The aim of this study was to investigate the relationship between peak expiratory flow (PEF), forced vital capacity (FVC) and PCF in South African children with neuromuscular disorders. Methods A retrospective descriptive study of routinely collected data was conducted. Results Forty-one participants (aged 11.5 ± 3.6 years; 75.6% male) were included. There was a strong linear correlation between PCF and PEF ( R = 0.78; p = 0.0001) and between PCF and FVC ( R = 0.61; p = 0.0001). There was good agreement between PCF and PEF, with intraclass correlation coefficient of 0.8 (95% confidence interval, 0.7–0.9; p < 0.0001). Peak expiratory flow < 160 L.min −1 and FVC < 1.2 L were significantly predictive of PCF < 160 L.min −1 (suggestive of cough ineffectiveness), whilst PEF < 250 L.min −1 was predictive of PCF < 270 L.min −1 , the level at which cough assistance is usually implemented. Conclusion PEF and FVC may be surrogate measures of cough effectiveness in children with neuromuscular disorders. Clinical implications PEF and FVC may be considered for clinical use as screening tools to identify patients at risk for pulmonary morbidity related to ineffective cough.

Background and purpose: Pneumonia is the most important respiratory problem in low-to-