The MDFRS is a reliable and valid disease-specific measure of functional status for patients with muscular dystrophy.

The results of this study indicate that the Chinese version of the ODI 2.1 is a reliable and valid instrument for the measurement of functional status in patients with low back pain.

Muscular dystrophy (MD) comprises a group of diseases characterized by progressive muscle weakness that induces functional deterioration. Clinical management requires the use of a well-designed scale to measure patients' functional status. This study aimed to investigate the quality of the functional scales used to assess patients with different types of MD. The Brooke scale and the Vignos scale were used to grade arm and leg function, respectively. The Barthel Index was used to evaluate the function of daily living activity. We performed tests to assess the acceptability of these scales. The characteristics of the different types of MD are discussed. This was a multicenter study and included patients diagnosed with Duchenne muscular dystrophy (DMD) (classified as severely progressive MD), Becker muscular dystrophy (BMD), limb girdle muscular dystrophy (LGMD) and facioscapulohumeral muscular dystrophy (FSHD). BMD, LGMD, and FSHD were classified as slowly progressive MD. The results demonstrated that the Brooke scale was acceptable for grading arm function in DMD, but was unable to discriminate between differing levels of severity in slowly progressive MD. The floor effect was large for all types of slowly progressive MD (range, 20.0-61.9), and was especially high for BMD. The floor effect was also large for BMD (23.8%) and FSHD (50.0%) using the Vignos scale. Grades 6-8 of the Vignos scale were inapplicable because they included items involving the use of long leg braces for walking or standing, and some patients did not use long leg braces. In the Barthel Index, a ceiling effect was prominent for slowly progressive MD (58.9%), while a floor effect existed for DMD (17.9%). Among the slowly progressive MDs, FSHD patients had the best level of functioning; they had better leg function and their daily living activities were less affected than patients with other forms of slowly progressive MD. The results of this study demonstrate the acceptability of the different applications used for measuring functional status in patients with different types of MD. Some of the limitations of these measures as applied to MD should be carefully considered, especially in patients with slowly progressive MD. We suggest that these applications be used in combination with other measures, or that a complicated instrument capable of evaluating the various levels of functional status be used.

The Chinese BCTQ is a reliable, valid and responsive disease-specific measure for assessment of symptoms and functional status in patients with CTS.

To examine the relative and absolute interrater reliability of handheld dynamometers (HHD) for assessing the lower extremity muscle strength, maximal voluntary contractions (MVCs) of 16 young adults for bilateral hip and knee muscles were tested using the break method. Three MVCs of each muscle group were required for obtaining the muscle strength. Participants' muscle strengths were tested by 2 raters. The intraclass correlation coefficients (ICCs) and the smallest real differences (SRD) were used to examine the relative and absolute reliabilities, and the Bland-Altman analyses were used to check whether systematic bias exists. The results showed that the relative reliabilities of all muscle groups were excellent (ICCs = 0.83-0.92) except for the knee extensors (ICC = 0.60). The SRD represents the smallest difference that indicates a real change for a single subject. The SRD% of all muscle groups was acceptable (ranging from 8.4 to 22.8 %), with the hip extensors being the smallest and knee extensors being the largest. The reliability of the knee extensors was unsatisfactory because of poor relative and absolute reliabilities and systematic bias. In addition to assessing the relative reliability in strength measurement, the absolute reliability provides the data of the measurement error, which is useful information in clinical practice to know whether the change in strength of a subject is real. Hand-held dynamometer is a reliable tool for quantifying most of the hip and knee strength except for the knee extensors. Modifying the measuring technique for knee extension is needed in future studies to improve the reliability.

Isometric and isokinetic knee strength deficits were examined on patients with anterior cruciate ligament (ACL) injury before and after ACL reconstruction. Muscle strengths of the uninjured and injured knees were measured from an ACL injured (n = 12) and a control (n = 15) group. Five isometric (10, 30, 50, 70, and 90° of knee flexion) and 5 isokinetic (50, 100, 150, 200, and 250°·s) strengths of quadriceps and hamstrings were measured prereconstruction and postreconstruction (3 and 6 months). Compared with the controls, the uninjured knee showed normal strength and patterns of length-tension and force-velocity relationships. Compared with the uninjured knee, the injured knees showed a generally 25-30% decrease in quadriceps and hamstrings strength with normal patterns of length-tension and force-velocity relationships. By 3 months of reconstruction, weakness of quadriceps of the injured knees was exacerbated, particularly at lengthened positions (∼ 40% of the uninjured knees at knee flexion 70 and 90°) and at slower velocities (∼35% of the uninjured knees at the 50 and 100°·s, p < 0.05), with flattened patterns of mechanical output. By 6 months of reconstruction, the quadriceps of the injured knees still showed significant weakness (∼50% of the uninjured knees) in both contraction types (isometric at knee flexion 90° and isokinetic at 50°·s, p < 0.05). The hamstrings of the injured knees had not shown significant changes after reconstruction. A strengthening program placing emphasis on greater knee flexion angles and slower movement speed with sufficient training duration post ACL reconstruction is recommended because of long-lasting and exacerbated weakness during 3 and 6 months postreconstruction.

The purpose of this study was to investigate health-related quality of life (HRQOL) and associated factors in patients with chronic neck pain (CNP). The HRQOL of patients with CNP was assessed by the Short Form-36 questionnaire in this cross-sectional study. To evaluate the psychological factors related to HRQOL, the Eysenck Personality Questionnaire, Chinese Health Questionnaire, and Beck Anxiety Inventory were used. The scores for the eight subscales of Short Form-36 were all lower than the Taiwanese age-matched normative values (p < 0.001). The two most strongly affected subscales were the role-physical subscale and the bodily pain subscale; both scores were below half the score of the age-/sex-matched normative values. The physical components summary score, a summary measure, was moderately correlated with age (rho = -0.43), education level (rho = 0.37) and Beck Anxiety Inventory score (rho = -0.36). The mental components summary score was moderately to highly correlated with the Chinese Health Questionnaire score (rho = -0.72), the neuroticism domain of Eysenck Personality Questionnaire (rho = -0.52) and Beck Anxiety Inventory score (rho = -0.41). The HRQOL of patients with CNP was worse than that of normal subjects across all domains. Furthermore, patients with a neurotic personality, minor psychiatric morbidity and higher anxiety status showed poor mental health, as measured by the Short Form-36. We found that patients with CNP had multiple physical and mental health problems in terms of. The mental health of patients with CNP was strongly associated with various psychological factors. Comprehensive assessment of the physical and mental functioning of patients with CNP can improve the management and care of these patients.

The adolescent and young men with DMD had poor health-related and global QOL. Poor QOL was related to both physical condition and social health. We suggest that rehabilitation programs focus on using assistive devices to facilitate arm function and encouraging participation in social activities to improve the QOL of patients with DMD. Implications for rehabilitation Duchenne muscular dystrophy (DMD) is a progressive muscle weakness disease that not only impacts physical health but also leads to poor quality of life in many domains. A valuable rehabilitation goal for patients with DMD is to encourage participation in social activities. Medical care and educational programs should plan a formal transition processes for patients with DMD from pediatric to adult care to maximum their quality of life. Arm function is associated with many domains of global quality of life, so a key element in improving quality of life may be to improve arm function.