Person:

Niu, Nina

Background: Valid measures of physical activity are critical research tools. The objective of this study was to develop a Spanish translation of the Yale Physical Activity Survey, and to provide preliminary evidence of its validity in a population of Dominican patients with lower extremity arthritis. Methods: A Dominican bilingual health care professional translated the Yale Physical Activity Survey (YPAS) from English to Spanish. Several Dominican adults reviewed the translation to ensure it was linguistically and culturally appropriate. The questionnaire was back-translated to English by a North American researcher who is fluent in Spanish. Discrepancies between the original and back-translated versions were resolved by the translator and back-translator. The Spanish translation was administered to 108 Dominican subjects with advanced hip or knee arthritis prior to (N = 44) or one to four years following (N = 64) total joint replacement. We assessed construct validity by examining the association of YPAS scores and measures of functional status and pain (WOMAC), quality of life (EQ-5D) and the number of painful lower extremity joints. Results: A higher YPAS Part II Activity Dimensions Summary Index score had weak to modest correlations with worse function and quality of life as measured with the WOMAC function scale (r = 0.21, p = 0.03), SF-36 Physical Activity Scale (r = 0.29, p = 0.004) and EQ-5D (r = 0.34, p = 0.0007). Total minutes of vigorous activity and walking had weak to modest correlation with these measures (WOMAC Function Scale (r = 0.15, p = 0.15), SF-36 Physical Activity Scale (r = 0.21, p = 0.04) and EQ-5D utility (r = 0.24, p = 0.02)). Correlations between the YPAS Part I energy expenditure score and these measures were lower (WOMAC Function Scale (r = 0.07, p = 0.49), SF-36 Physical Activity Scale (r = 0.03, p = 0.74) and EQ-5D utility (r = 0.18, p = 0.07)). Conclusions: We have developed a new Spanish translation of the Yale Physical Activity Survey and provided evidence of convergent validity in a sample of Dominican patients prior to or 1–4 years following total joint replacement.

Background: An increasing number of medical relief organizations have launched programs to perform total joint replacements in the developing world. There is a paucity of data on the clinical outcomes of these procedures. We documented pre- and post-operative pain and functional status in a group of low income Dominicans who underwent total hip or knee replacement performed by an American relief organization. Methods: In March 2009 and 2010, we surveyed patients participating in Operation Walk Boston, a medical relief organization that provides total joint replacements to patients in the Dominican Republic. Questionnaires included the Western Ontario and McMaster University Osteoarthritis (WOMAC) Index scales and the Short-Form 36 (SF-36) scales for physical activity and mental health. Scores were transformed to a 0 - 100 point scale (100 is best). Results: 81 individuals (mean age 61 years, 60% female) completed the pre-operative questionnaires. Twenty eight of the 35 who completed preoperative forms in 2009 also completed follow up forms in 2010 (follow-up rate 80%). Patients reported poor pre-operative WOMAC function (mean = 33.6, sd = 22.0) and WOMAC pain (mean = 38.4, sd = 22.9) scores preoperatively. Mean post-operative WOMAC pain and function scores were 86.4 (sd = 13.1) and 88.1 (sd = 11.4) respectively. Improvement in pain and function was similar for patients undergoing hip (n=11) and knee (n=17) replacements. Conclusion: Total joint replacement was effective in relieving pain and restoring function in this program. These results are useful for comparison to outcomes in developed countries and for establishing benchmarks for future programs.