The aims of this study were to culturally translate and validate the Persian version of Tegner and Marx activity rating scales and to investigate their psychometric properties in a sample of patients (n = 100) with anterior cruciate ligament (ACL) injury. Four questionnaires were completed by the respondents: Tegner and Marx activity scales, Knee injury and Osteoarthritis Outcome Score (KOOS) and Short-Form 12 Health Survey (SF-12). The Tegner and Marx were re-administered to 45 patients in the retest session, with time interval of 2-6 days between the two sessions. Test-retest reliability and internal consistency were assessed using intra-class correlation coefficient (ICC) and Cronbach's alpha, respectively. To evaluate construct validity of Tegner and Marx compared to similar and dissimilar concepts of KOOS and SF-12, the Spearman's rank correlation was used. Both Tegner and Marx activity scales have a high ICC level. The minimum Cronbach's alpha level of 0.70 was exceeded by Marx scale. In terms of construct validity, most of a priori hypotheses were confirmed. The Persian version of Tegner and Marx seems to be suitable for Iranian patients with ACL injury. Future studies are needed to investigate the psychometric properties of these questionnaires for Iranian patients with different knee problems.

To evaluate the responsiveness and determine the minimal clinically important changes (MCICs), anchored by the patient response to a 7-point global rating scale, for Knee Injury and Osteoarthritis ...

The purpose of this study was to investigate differences between individuals with various forward head posture (FHP) severities with and without postural neck pain using craniovertebral angle and forward shoulder angle. Ninety participants age 20 to 50 years were categorized into the following 4 groups based on observational method and presence or absence of postural neck pain: (1) slight FHP group without pain, (2) slight FHP group with pain, (3) moderate-to-severe FHP group without pain, and (4) moderate-to-severe FHP group with pain. A digital imaging technique was used to measure the craniovertebral angle and forward shoulder angle in a standing position. A 1-way analysis of variance test showed a significant difference for craniovertebral angle in the 4 groups (F = 22.04, P < .001). Tukey's test showed the difference in this variable was significant between slight FHP groups (with or without pain) and moderate-to-severe FHP groups (with or without pain) (P < .001). Although overall F indicated a significant difference (F = 4.11, P < .009) of the forward shoulder angle in 4 groups, Tukey's test revealed this was only significantly different in 2 groups: slight FHP with pain and moderate-to-severe FHP with pain (P = .005). The craniovertebral angle in the 2 groups of moderate-to-severe FHP was significantly smaller than that in the 2 groups of slight FHP. However, the forward shoulder angle in the group of moderate-to-severe FHP with pain was only significantly smaller than that in slight FHP with pain. The results showed that including pain as a factor of categorization did not lead to a significant difference between various groups regarding craniovertebral angle and forward shoulder angle.

To investigate the responsiveness and determine the minimally important differences (MID) of Persian versions of the Kujala patellofemoral scale (KPS), lower extremity functional scale (LEFS), and functional index questionnaire (FIQ) in patients with patellofemoral pain syndrome (PFPS). Outcome measures including the Persian KPS, LEFS, and FIQ were administered to 233 patients at baseline and then again 4 weeks after physiotherapy. Moreover, the 7-point global rating scale was completed by the patients at 4 weeks. Responsiveness was evaluated using the correlation analysis and the receiver operating characteristics (ROC) method. Correlation analysis showed that the relationship of all outcome measures with the global rating scale falls within the fair range of relationship (Gamma = 0.26-0.40). Moreover, the results of ROC analysis showed that the all outcome measures have acceptable high responsiveness index. Furthermore, the MIDs of 9.5, 4.5, and 1.5 points were obtained for the Persian KPS, LEFS, and FIQ, respectively. The Persian-versions of all outcome measures are responsive for evaluating change following physiotherapy intervention. The MID values obtained in this study will help the clinicians and researchers to determine if a patient with PFPS has experienced a true change following a physiotherapy intervention. Implications for Rehabilitation Persian-versions of the KPS, LEFS, and FIQ can be used as three "responsive" outcome measures in clinical studies of patients with patellofemoral pain syndrome (PFPS). These assessment tools have clinical relevance for rehabilitation specialists working on patients with PFPS. The minimally important differences provide valuable information for the clinicians and researchers to make decision about the identification of a clinical change in health status of patients with PFPS.

To evaluate the accuracy of and determine the best cutoff point for craniovertebral angle (CVA) and forward shoulder angle (FSA) in discriminating between two groups of individuals with different s...

Introduction: Knee injury and Osteoarthritis Outcome Score (KOOS) is a widely used patient-reported outcome measure designed for patients with knee osteoarthritis. Purpose: To evaluate responsiveness and determine minimal important change (MIC) for Persian-version of KOOS in patients with knee osteoarthritis following physiotherapy intervention. Method: One hundred and forty-six consecutive patients with knee osteoarthritis, undergoing 4-week physiotherapy completed KOOS alongside Oxford Knee Score at baseline and at 4-week follow-up. Patients also rated their overall changes on an external anchor at follow-up. Responsiveness was examined in two ways: by testing four hypotheses regarding pre-defined correlations between change scores of KOOS subscales and Oxford Knee Score and external anchor, and by calculating receiver operating characteristic (ROC) curve. MIC was determined by identifying an optimal cutoff on ROC curve. Results: KOOS appeared to be responsive, as all expected hypotheses were accepted. Also, all subscales showed area under the curve (AUC) > 0.70. The MIC values reflecting improvement for Pain, Symptoms, Activities of Daily Living (ADL), Sports and Recreation (Sport/Rec), and Quality of Life (QoL) subscales were 15, 12.5, 15.5, 17.5, 12.5 points, respectively. Conclusions: All subscales of KOOS have adequate responsiveness and are able to measure the change in patients with knee osteoarthritis following a 4-week physiotherapy intervention.