Biomedical subjects

S M Bierma-Zeinstra

Publications and source records attributed to S M Bierma-Zeinstra.

6 recordsLinked to original sources

PubMed2004

Internal consistency and validity of a new physical workload questionnaire.

AIMS: To examine the dimensionality, internal consistency, and construct validity of a new physical workload questionnaire in employees with musculoskeletal complaints. METHODS: Factor analysis was applied to the responses in three study populations with musculoskeletal disorders (n = 406, 300, and 557) on 26 items related to physical workload. The internal consistency of the resulting subscales was examined. It was hypothesised that physical workload would vary among different occupational groups. The occupations of all subjects were classified into four groups on the basis of expected workload (heavy physical load; long lasting postures and repetitive movements; both; no physical load). Construct validity of the subscales created was tested by comparing the subscale scores among these occupational groups. RESULTS: The pattern of the factor loadings of items was almost identical for the three study populations. Two interpretable factors were found: items related to heavy physical workload loaded highly on the first factor, and items related to static postures or repetitive work loaded highly on the second factor. The first constructed subscale "heavy physical work" had a Cronbach's alpha of 0.92 to 0.93 and the second subscale "long lasting postures and repetitive movements", of 0.86 to 0.87. Six of eight hypotheses regarding the construct validity of the subscales were confirmed. CONCLUSIONS: The results support the internal structure, internal consistency, and validity of the new physical workload questionnaire. Testing this questionnaire in non-symptomatic employees and comparing its performance with objective assessments of physical workload are important next steps in the validation process.

Adult↗

PubMed2001

Hip problems in older adults: classification by cluster analysis.

No validated classification system of hip disorders in primary care is available. This study explores whether it is possible to obtain such a classification with the method of cluster analyses. A total of 224 consecutive patients aged 50 years or older, consulting the general practitioner for pain in the hip region, and referred for X-ray investigation of the hip, underwent a standardized examination. Ward's cluster analysis with variables from history and physical examination of the hip region resulted in a classification with nine different clusters. These clusters were reproduced in 10 random subsamples and with an alternative cluster analysis. Significant relationships of various external variables (radiological and sonographic signs and variables of low-back and knee examination) with the distinctive clusters were found. Twenty of the approached experts recognized the symptoms in seven clusters as identifiable syndromes. However, further validation of the achieved classification system, especially with respect to the clinical importance, is needed before introducing it into clinical practice.

Cluster Analysis↗

PubMed2001

Measuring the sacral inclination angle in clinical practice: is there an alternative to radiographs?

BACKGROUND: In patients with low back pain (LBP) the position of the pelvis is often a focus of physical or manual therapy. The "gold standard" to determine sacral inclination is by radiograph, but methods to measure sacral inclination externally with an inclinometer have also been introduced. OBJECTIVE: To determine the validity of the inclinometer in measuring the sacral inclination in patients with LBP. SUBJECTS: Adult patients with LBP who were referred by the general practitioner to the hospital for radiograph examination of the lumbosacral spine were included. METHODS: Measurement of sacral inclination acquired with the inclinometer, simultaneous with the x-ray exposure, was compared with the "gold standard" measurement of sacral inclination on the radiograph. Regression analysis was used to define the measurement error. RESULTS: Of 50 consecutive patients with LBP, radiographs of 41 patients were useful for the required measurements on the radiograph. The mean difference between the radiographic and inclinometer method was 23.12 degrees. The measurement error was 8.26 degrees. Regression analyses showed poor correlation between both methods (r = 0.28). CONCLUSIONS: The method we used to measure sacral inclination with an inclinometer proved to be invalid.

Adult↗

PubMed2000

How do general practitioners manage hip problems in adults?

OBJECTIVE: To investigate the medical management, and its consistency and determinants, of hip problems in adult patients. SETTING: General practice, The Netherlands. DESIGN: Observational study based on four "paper patients" and on computerised patients records (CPRs) of 400 patients (20 per general practitioner), aged 50 years and over, with new hip problems. SUBJECTS: 20 general practitioners. MAIN OUTCOME MEASURES: Examination, diagnosis and treatment of hip patients. RESULTS: Medical history and physical examination consisted mainly of questions concerning pain localisation and onset, and examining passive hip motion. The paper patients, except for the one with alarming symptoms, and the CPRs showed high variation in management between general practitioners, particularly for medication prescription and X-ray requests. Main factors influencing medical management were patients' age, number of visits and attitude of the individual general practitioner. A specific diagnosis was registered for only 32% of the 400 patients. The diagnosis osteoarthritis varied greatly between general practitioners even after adjustment for patients' age, gender and number of visits. Patients with osteoarthritis were infrequently referred to physical therapy and received nonsteroidal anti-inflammatory drugs (NSAIDs) more often than paracetamol. CONCLUSION: Diagnosis and treatment of hip problems varies widely between general practitioners. Treatment of patients with osteoarthritis is inconsistent with published recommendations.

Aged↗

PubMed2000

Sonography for hip joint effusion in adults with hip pain.

OBJECTIVE: To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. METHODS: Patients (n = 224) aged 50 years or older with hip pain, referred by the general practitioner for radiological investigation, underwent a standardised examination. The distance between the ventral capsule and the femoral neck, an increase in which represents joint effusion, was measured sonographically. Joint effusion was defined in three different ways: "effusion" according to Koski's definition, "major effusion", and "asymmetrical effusion" based on only individual side differences. RESULTS: "Effusion" was present in 80 (38%), "major effusion" in 20 (9%), and "asymmetrical effusion" in 47 (22%) patients. Pain in the groin or medial thigh, pain aggravated by lying on the side, decreased extension/internal rotation/abduction/flexion, painful external rotation, and pain on palpation in the groin showed a significant relation (adjusted for age and radiological osteoarthritis of the hip) with ultrasonic hip joint effusion. "Major effusion" showed a significant relation with an increased ESR. When patients with bilateral pain and increased ESR were excluded, a side difference in the range of motion of extension of the hip was shown to be a good predictor for "asymmetrical effusion" (positive predictive value: 71%, negative predictive value: 80%). CONCLUSION: This study showed a relatively high prevalence of ultrasonic joint effusion in adults with hip pain in general practice. Furthermore the results indicate a relation between joint effusion and clinical signs.

Aged↗

PubMed1998

Comparison between two devices for measuring hip joint motions.

OBJECTIVE: To compare the reliability of measurements of hip motions obtained with two instruments, an electronic inclinometer and a two-arm goniometer, and to investigate whether the two instruments, and different body positions, produce the same measurement data. METHODS: Maximal active and passive hip movements were measured simultaneously with both instruments, in nine subjects during 10 consecutive measurements at short intervals. RESULTS: Intra-observer variability was lower with the inclinometer in measurements of passive hip rotations. The two instruments showed equal intra-observer variability for hip movements in general. The inclinometer showed lower inter-observer variability in the measurements of active internal rotation. More rotational movement was measured with the two-arm goniometer; more extension and flexion with the inclinometer. Also, more rotational movement was found in the prone position compared to sitting and supine positions. CONCLUSIONS: The inclinometer is more reliable in measurements of hip rotation. For hip movements in general the two-arm goniometer is just as accurate when used by only one observer. The two instruments, and some positions, are not interchangeable during consecutive measurements.

Adult↗