Evaluation of the Chinese version of the disability of the arm, shoulder and hand (DASH-HKPWH): cross-cultural adaptation process, internal consistency and reliability study

Abstract
The Disability of the Arm, Shoulder and Hand (DASH) was translated into Chinese by a physiotherapy team of the Prince of Wales Hospital, Hong Kong (DASH-HKPWH).

Objectives
This study evaluated the cross-cultural adaptation process, face validity, internal consistency and reliability of the DASH-HKPWH.

Method
Language officers and medical professionals from different fields were invited to translate and evaluate the face validity of the DASH-HKPWH. 88 patients were recruited to complete two DASH questionnaires on two occasions 1-2 weeks apart.

Results
Some adjustments were made to the translations based on the cultural and linguistic practice in Hong Kong. The face validity was satisfactory with a mean endorsement score of 3.2. The difference between the mean of DASH scores was not significant (t = −0.35, p = 0.73). The ICC (1,1) and Cronbach's alpha for the 30-item Disability/Symptom of the DASH-HKPWH was 0.77 and 0.94, respectively.

Conclusion
The translation was valid and reliable and acceptably equivalent to the original version. The questionnaire is suitable for measuring changes experienced by patients with any upper extremity disorders.

Construct validity of the Chinese version of the disability of the arm, shoulder and hand questionnaire (DASH-HKPWH)

The study evaluated the construct validity of the Chinese Hong Kong version of the disabilities of the arm, shoulder and hand questionnaire (DASH-HKPWH). Three hundred and thirty four patients with a broad range of upper extremity disorders were recruited into the study. Each completed DASH-HKPWH and SF-36 forms and their pain intensity (numeric pain rating scale) and grip strength were also measured. The mean DASH-HKPWH score was 40 (SD = 20). Principal component factor analysis identified a single factor, which accounted for 47% of the total variance. Pearson correlation was applied to assess convergent and divergent validity of the DASH-HKPWH by comparison with the above-mentioned subjective and objective measurements. Our findings were comparable to the DASH of other languages

Corticospinal adaptations and strength maintenance in the immobilized arm following 3 weeks unilateral strength training

Cross-education strength training has being shown to retain strength and muscle thickness in the immobilized contralateral limb. Corticospinal mechanisms have been proposed to underpin this phenomenon; however, no transcranial magnetic stimulation (TMS) data has yet been presented. This study used TMS to measure corticospinal responses following 3 weeks of unilateral arm training on the contralateral, immobilize arm. Participants (n = 28) were randomly divided into either immobilized strength training (Immob + train) immobilized no training (Immob) or control. Participants in the immobilized groups had their nondominant arm rested in a sling, 15 h/day for 3 weeks. The Immob + train group completed unilateral arm curl strength training, while the Immob and control groups did not undertake training. All participants were tested for corticospinal excitability, strength, and muscle thickness of both arms. Immobilization resulted in a group x time significant reduction in strength, muscle thickness and corticospinal excitability for the untrained limb of the Immob group. Conversely, no significant change in strength, muscle thickness, or corticospinal excitability occurred in the untrained limb of the Immob + train group. These results provide the first evidence of corticospinal mechanisms, assessed by TMS, underpinning the use of unilateral strength training to retain strength and muscle thickness following immobilization of the contralateral limb.

Parallel manipulators with a rotation-symmetric arm system

Parallel manipulators with a rotation-symmetric arm system possess all the typical advantages of parallel robots, such as high acceleration and high-accuracy positioning. Contrary to the majority of proposed parallel manipulators, the rotation-symmetric arm system leads to a large workspace in relation to the footprint of the manipulator. This paper focuses on a subclass of these manipulators with additional favorable qualities, including low inertia and high eigenfrequencies. These qualities are achieved using only 5-DOF lower arm links and by mounting all actuators on the nonmoving base column of the manipulator. The common feature of all previously proposed manipulators in this subclass is identified and several novel 3-DOF and 4-DOF members are introduced.

Kinematic analysis and workspace determination of hexarot-a novel 6-DOF parallel manipulator with a rotation-symmetric arm system

Parallel mechanisms possess several advantages such as the possibilities for high acceleration and high accuracy positioning of the end effector. However, most of the proposed parallel manipulators suffer from a limited workspace. In this paper, a novel 6-DOF parallel manipulator with coaxial actuated arms is introduced. Since parallel mechanisms have more workspace limitations compared to that of serial mechanisms, determination of the workspace in parallel manipulators is of the utmost importance. For finding position, angular velocity, and acceleration, in this paper, inverse and forward kinematics of the mechanism are studied and after presenting the workspace limitations, workspace analysis of the hexarot manipulator is performed by using MATLAB software. Next, using the obtained cloud of points from simulation, the overall borders of the workspace are illustrated. Finally, it is shown that this manipulator has the important benefits of combining a large positional workspace in relation to its footprint with a sizable range of platform rotations.

Changes in quality of life associated with fragility fractures: Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS).

We investigated change in health-related quality of life due to fracture in Australian adults aged over 50 years. Fractures reduce quality of life with the loss sustained at least over 12 months. At a population level, the loss was equivalent to 65 days in full health per fracture.

Nocebo effects in the treatment of major depression: results from an individual study participant-level meta-analysis of the placebo arm of duloxetine clinical trials

BACKGROUND: The nocebo effect, when a harmless substance creates harmful effects in a person who takes it, is a clinically salient yet seldom studied phenomenon that may be associated with poorer treatment outcomes, perceived adverse events, and treatment discontinuation. The covert presence of nocebo responders in clinical trials may contribute to outcome variance in both placebo and active treatment arms for important primary and secondary endpoints. Nocebo effects are thought to be driven by expectancy and conditioning. METHOD: This study analyzed pooled clinical trial data in the placebo arms of controlled trials of antidepressant medications to investigate variables associated with the emergence of adverse outcomes in placebo-treated participants (N = 2,457). Specifically, we examined treatment-emergent adverse events (TEAEs) and discontinuation in placebo-treated individuals. Trials were commenced between 1993 and 2010 as studies of duloxetine versus active comparator and/or placebo. RESULTS: TEAEs were reported by 1,569 placebo-treated participants (63.9%), with 115 (4.7%) discontinuing from the studies due to TEAEs and 274 (11.2%) showing worsening of Hamilton Depression Rating Scale total score during placebo treatment. There was specifically no evidence to support the expectancy hypothesis, that reported TEAEs were influenced by adverse effects described in the clinical trials participant information and consent forms, or the conditioning hypothesis, that reported TEAEs would be influenced by adverse effect profiles of previous antidepressant medications used by these study participants. There was some evidence to suggest that people who had previously used complementary medications were more likely to report TEAEs. Variables specific to individual studies were the strongest predictors of TEAEs. DISCUSSION: In this study, TEAEs were very common among placebo-treated clinical trial participants. Unexpectedly, there was no evidence to associate TEAEs with adverse clinical outcomes, nor were the conditioning or expectancy hypotheses supported by these data. CONCLUSIONS: The nocebo effect is a common, covert, and poorly understood driver of clinical outcomes that requires further investigation.

The study to track human arm kinematics applying solutions of Wahba’s Problem upon inertial/magnetic sensors

Long-term, off-site human monitoring systems are emerging with respect to the skyrocketing expenditures engaged with rehabilitation therapies for neurological diseases. Inertial/magnetic sensor modules are well known as a worthy solution for this problem. Much attention and effort are being paid for minimizing drift problem of angular rates, yet the rest of kinematic measurements (earth’s magnetic field and gravitational orientation) are only themselves capable enough to track movements applying the theory for solving historicalWahbas Problem. Further, these solutions give a closed form solution which makes it mostly suitable for real time Mo-Cap systems. This paper examines the feasibility of some typical solutions of Wahba’s Problem named TRIAD method, Davenport’s q method, Singular Value Decomposition method and QUEST algorithm upon current inertial/magnetic sensor measurements for tracking human arm movements. Further, the theoretical assertions are compared through controlled experiments with both simulated and actual accelerometer and magnetometer measurements.

In search of the philosopher’s stone: alchemy, ARM and the Sydney Opera House

Since the Middle Ages, alchemists sought the Philosopher’s Stone; a mythical elixir of life and longevity and essential for – chrysopoeia – the transmutation of lead to gold, of base metals to noble ones. The Sydney Opera House is widely regarded within the discipline of architecture as a ‘flawed masterpiece;’ its iconic exterior celebrated as Sydney’s golden architectural icon, while the interiors by Peter Hall, are largely criticised as the leaden cousins of the building’s original major and minor hall designs. Like the mythical Philosopher’s Stone, Jørn Utzon’s designs for the interior of the building remained elusive until Unseen Utzon (1994/5). This exhibition revealed the major hall (now the Concert Hall) as an expanse lined with gold and red-radiating waves, and the minor hall (now the Opera Theatre) awash in silver and blue, an apparition of Uzton’s genius and completion of his original vision.