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  1. Article ; Online: Reliability and validity of Oswestry Disability Index among patients undergoing lumbar spinal surgery.

    Koivunen, Konsta / Widbom-Kolhanen, Sara / Pernaa, Katri / Arokoski, Jari / Saltychev, Mikhail

    BMC surgery

    2024  Volume 24, Issue 1, Page(s) 13

    Abstract: Background: The objective of this study was to explore the internal consistency and factor structure of the Oswestry Disability Index among patients undergoing spinal surgery. The sample consisted of 1,515 patients who underwent lumbar spinal surgery at ...

    Abstract Background: The objective of this study was to explore the internal consistency and factor structure of the Oswestry Disability Index among patients undergoing spinal surgery. The sample consisted of 1,515 patients who underwent lumbar spinal surgery at a university hospital between 2018 and 2021.
    Methods: The patients responded to the Oswestry Disability Index within 2 months before surgery. Cronbach's alpha was used to assess the internal consistency. The factor structure was evaluated using exploratory and confirmatory factor analyses.
    Results: The average age of 1,515 patients was 58.5 (SD 15.8) years and 53% were women. The mean ODI score was 43.4% (SD 17.4%). Of the patients, 68% underwent microsurgical excision of the lumbar intervertebral disc displacement or decompression of the lumbar nerve roots. The internal consistency of the Oswestry Disability Index was found to be good, with an alpha of 0.87 (95% CL 0.86 to 0.88). Exploratory factor analysis resulted in unidimensional structure. Item loadings on this retained factor were moderate to substantial for all 10 items. One-factor confirmatory factor analysis model demonstrated an acceptable fit. The correlations between the main factor "disability" and the individual items varied from moderate (0.44) to substantial (0.76). The highest correlations were observed for items "traveling", "personal care", and "social life". The lowest correlations were observed for the item "standing".
    Conclusions: The Oswestry Disability Index is a unidimensional and internally consistent scale that can be used to assess the severity of disability in patients undergoing lumbar spinal surgery. In the studied population, "traveling," "social life," "sex life" and "personal care" were the most important items to define the severity of disability, while "walking" and "standing" were the least important items. The generalizability of the results might be affected by the heterogeneity and modest size of the studied cohort.
    Trial registration: Not applicable.
    MeSH term(s) Humans ; Female ; Male ; Reproducibility of Results ; Disability Evaluation ; Surveys and Questionnaires ; Intervertebral Disc Displacement/surgery ; Neurosurgical Procedures ; Lumbar Vertebrae/surgery
    Language English
    Publishing date 2024-01-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050442-1
    ISSN 1471-2482 ; 1471-2482
    ISSN (online) 1471-2482
    ISSN 1471-2482
    DOI 10.1186/s12893-023-02307-w
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  2. Article ; Online: Associations of socioeconomic and lifestyle characteristics, psychological symptoms, multimorbidity, and multisite pain with sciatica - a 15-year longitudinal study.

    Anttila, Sanna / Määttä, Juhani / Heikkala, Eveliina / Arokoski, Jari / Karppinen, Jaro / Oura, Petteri

    The spine journal : official journal of the North American Spine Society

    2024  Volume 24, Issue 5, Page(s) 842–850

    Abstract: Background context: Sciatica is defined as pain radiating from the low back to the leg, usually below the knee. It is a disabling condition that causes a major burden to health care and society. Previous evidence of the multifactorial etiology of ... ...

    Abstract Background context: Sciatica is defined as pain radiating from the low back to the leg, usually below the knee. It is a disabling condition that causes a major burden to health care and society. Previous evidence of the multifactorial etiology of sciatica comes mostly from cross-sectional studies. Larger, longitudinal studies with a multidimensional set of variables are needed.
    Purpose: To examine how socioeconomic and lifestyle characteristics, psychological symptoms, multimorbidity, and multisite pain are associated with sciatica.
    Study design: A longitudinal study of the Northern Finland Birth Cohort 1966.
    Patient sample: In total 6,683 working-aged members of the Northern Finland Birth Cohort 1966.
    Outcome measures: Self-reported sciatic pain status over a 15-year study period.
    Methods: We conducted a 15-year longitudinal study from the age of 31 to 46. We used multivariable generalized estimation equations analysis to examine how socioeconomic characteristics (low education, unemployment, and living alone), lifestyle characteristics (overweight, obesity, current smoking, and physical inactivity), psychological symptoms (depression, anxiety), multimorbidity, and multisite pain were associated with sciatica.
    Results: At the age of 31, 21.1% of the study population reported sciatic pain and at the age of 46, 36.7%. Multisite pain was clearly the strongest factor associated with sciatica (odds ratio [OR] 2.61, 95% confidence interval [CI] 2.34‒2.92). In descending order of effect size, older age, low education, psychological symptoms, multimorbidity, overweight, obesity, physical inactivity and current smoking were positively associated with sciatica. Their ORs varied between 1.17 and 2.18. Living alone was negatively associated with sciatica (OR 0.81, 95% CI 0.72‒0.90).
    Conclusions: Multisite pain had the strongest association with sciatica. The effect sizes of the other factors were clearly smaller. To our knowledge this is the first study to evaluate the association of multisite pain with sciatica. This finding may have considerable implications for clinical work treating patients with sciatica.
    MeSH term(s) Humans ; Sciatica/epidemiology ; Sciatica/psychology ; Middle Aged ; Male ; Adult ; Female ; Longitudinal Studies ; Life Style ; Multimorbidity ; Socioeconomic Factors ; Finland/epidemiology
    Language English
    Publishing date 2024-01-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2037072-6
    ISSN 1878-1632 ; 1529-9430
    ISSN (online) 1878-1632
    ISSN 1529-9430
    DOI 10.1016/j.spinee.2023.12.013
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    Zs.A 5898: Show issues Location:
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  3. Article ; Online: ICF-linking and psychometric properties of upper extremity mobility outcome measures in spinal cord injury - a scoping review.

    Poutanen, Joonas / Savolainen, Sarianna / Shulga, Anastasia / Arokoski, Jari / Hiekkala, Sinikka

    The journal of spinal cord medicine

    2023  Volume 47, Issue 2, Page(s) 201–213

    Abstract: Objective: The purpose of this study was to explore the outcome measures used in upper extremity rehabilitation and research in spinal cord injury and to investigate their psychometry.: Design: Scoping review.: Data sources: PubMed, the Cochrane ... ...

    Abstract Objective: The purpose of this study was to explore the outcome measures used in upper extremity rehabilitation and research in spinal cord injury and to investigate their psychometry.
    Design: Scoping review.
    Data sources: PubMed, the Cochrane library, PEDro, Medline (Ovid).
    Eligibility criteria for selecting studies: The search process and study selection was carried out as follows: Firstly, a systematic search was carried out for articles on upper extremity rehabilitation after SCI. Performance or observational outcome measures which were designed for a clinical setting were collected from selected studies. Secondly, eligible outcome measures were linked to the ICF. The ICF-linked outcome measures were further screened for inclusion according to how comprehensively they covered ICF categories. Finally, a search of the selected outcome measures was performed to investigate their psychometry.
    Results: A total of four outcome measures and nine psychometric studies were selected for the scoping review; six studies addressed GRASSP, one addressed AuSpinal, one addressed SHFT and one addressed TRI-HFT. Of the 13 COSMIN measurement properties, studies of GRASSP covered seven, AuSpinal covered five and both SHFT and TRI-HFT covered three properties.
    Conclusions: The psychometric properties of GRASSP were most extensively studied showing eligible reliability and validity. Although there are still some measurement properties to be explored, GRASSP can be recommended for use in the evaluation of upper extremity mobility in the SCI rehabilitation and research. More research is needed on the psychometrics of other outcome measures in people with spinal cord injuries before the outcome measures can be unconditionally recommended.
    MeSH term(s) Humans ; Spinal Cord Injuries/rehabilitation ; Psychometrics ; Reproducibility of Results ; Outcome Assessment, Health Care ; Upper Extremity
    Language English
    Publishing date 2023-01-09
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1223949-5
    ISSN 2045-7723 ; 1079-0268
    ISSN (online) 2045-7723
    ISSN 1079-0268
    DOI 10.1080/10790268.2022.2161867
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    Zs.A 2416: Show issues Location:
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  4. Article ; Online: Physical performance capacity after pediatric kidney transplant and clinical parameters associated with physical performance capacity.

    Mäenpää, Heidi / Tainio, Juuso / Arokoski, Jari / Jahnukainen, Timo

    Pediatric nephrology (Berlin, Germany)

    2022  Volume 38, Issue 5, Page(s) 1633–1642

    Abstract: Background: History of chronic kidney disease and kidney transplantation is known to influence physical performance capacity. The aim of this study was to compare the physical performance of pediatric kidney transplant recipients to healthy controls and ...

    Abstract Background: History of chronic kidney disease and kidney transplantation is known to influence physical performance capacity. The aim of this study was to compare the physical performance of pediatric kidney transplant recipients to healthy controls and to find possible correlations between clinical parameters and physical performance capacity.
    Methods: Twenty-four pediatric kidney transplant recipients (62.5% boys) were tested at a median age of 10.8 years. Physical performance capacity was tested with a test set including six different components assessing muscle endurance, strength, speed, and flexibility. The control group consisted of 273 healthy age-matched schoolchildren. Clinical parameters were collected as part of routine follow-up protocol. The majority of patients (62.5%) had congenital nephrotic syndrome of Finnish type (CNS) as primary diagnosis, and therefore, the results of CNS recipients were compared to the other disease groups.
    Results: The physical performance capacity in pediatric kidney transplant recipients was lower compared to healthy controls. Surprisingly, no statistically significant correlation was found between graft function and physical performance capacity. The CNS patients scored worse than patients with other diagnoses in all test domains except for sit-and-reach and shuttle run, but the differences did not reach statistical significance.
    Conclusion: The physical performance of pediatric kidney transplant recipients is reduced, especially in those with congenital nephrotic syndrome. Clinical parameters, including graft function, did not predict physical performance capacity, suggesting that the reduced physical performance seems to be of multivariable cause. A higher resolution version of the Graphical abstract is available as Supplementary information.
    MeSH term(s) Male ; Humans ; Child ; Female ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods ; Nephrotic Syndrome ; Renal Insufficiency, Chronic ; Physical Functional Performance ; Transplant Recipients ; Graft Survival
    Language English
    Publishing date 2022-10-31
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-022-05758-0
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    Zs.A 2196: Show issues Location:
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  5. Article ; Online: Pain in hip and knee osteoarthritis.

    Arokoski, Jari

    Pain management

    2014  Volume 4, Issue 3, Page(s) 177–180

    MeSH term(s) Cognitive Therapy ; Humans ; Osteoarthritis, Hip/complications ; Osteoarthritis, Hip/therapy ; Osteoarthritis, Knee/complications ; Osteoarthritis, Knee/therapy ; Pain/etiology ; Pain Management/methods
    Language English
    Publishing date 2014-05
    Publishing country England
    Document type Journal Article
    ISSN 1758-1877
    ISSN (online) 1758-1877
    DOI 10.2217/pmt.14.12
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  6. Article ; Online: Omitting TMS component from paired associative stimulation with high-frequency PNS: A case series of tetraplegic patients.

    Pohjonen, Markus / Savolainen, Sarianna / Arokoski, Jari / Shulga, Anastasia

    Clinical neurophysiology practice

    2021  Volume 6, Page(s) 81–87

    Abstract: Objectives: Earlier studies have shown how chronic spinal cord injury (SCI) patients have benefitted from paired associative stimulation (PAS), consisting of high-frequency peripheral nerve stimulation (PNS) and high-intensity transcranial magnetic ... ...

    Abstract Objectives: Earlier studies have shown how chronic spinal cord injury (SCI) patients have benefitted from paired associative stimulation (PAS), consisting of high-frequency peripheral nerve stimulation (PNS) and high-intensity transcranial magnetic stimulation (TMS). Since high-frequency PNS is poorly characterized, its therapeutic effect without TMS should be evaluated. We tested the effect of PNS combined with motor imagery in chronic SCI patients using the same parameters of PNS as in earlier PAS-based studies that also used TMS.
    Methods: Five patients with chronic incomplete SCI and tetraplegia received a 6-week treatment of PNS combined with motor imagery to the weaker upper limb. Patients were evaluated with Manual Muscle Testing (MMT), hand function tests (Box and block, grip and pinch strength dynamometry), and spasticity.
    Results: There was no significant change in hand function tests or spasticity. MMT values improved significantly immediately after the PNS period (0.59 ± 0.17, p = 0.043) and in the 1-month follow-up visit (0.87 ± 0.18, p = 0.043). However, improvement of MMT values was weaker than in chronic tetraplegic patients in a corresponding PAS study that used identical PNS stimulation but also included the TMS component omitted here (Tolmacheva et al., 2019a, Clin Neurophysiol Pract).
    Conclusions: The lack of effect on functional hand tests with the protocol presented here suggests that the synergistic effect of PNS and TMS components is essential for the full therapeutic effect previously observed with PAS intervention. The moderate improvement of the MMT score suggests the possible usefulness of PNS and motor imagery for some of those tetraplegic SCI patients who have contraindications to TMS.
    Significance: These results add to the understanding of the PAS therapeutic mechanism by highlighting the importance of dual stimulation for achieving the full therapeutic effect of long-term PAS with a high-frequency PNS component.
    Language English
    Publishing date 2021-02-20
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2467-981X
    ISSN (online) 2467-981X
    DOI 10.1016/j.cnp.2021.01.004
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  7. Article ; Online: Facilitators and barriers in the rehabilitation process described by persons with spinal cord injury: a deductive-inductive analysis from the Finnish spinal cord injury study.

    Tallqvist, Susanna / Eskola, Kaarina / Täckman, Anni / Kauppila, Anna-Maija / Koskinen, Eerika / Anttila, Heidi / Rajavaara, Marketta / Arokoski, Jari / Hiekkala, Sinikka

    Annals of medicine

    2024  Volume 55, Issue 2, Page(s) 2303398

    Abstract: Background: This study aimed to determine the factors that promote and facilitate rehabilitation as well as challenges and possible barriers perceived by people with spinal cord injury (SCI).: Materials and methods: This study was part of a larger, ... ...

    Abstract Background: This study aimed to determine the factors that promote and facilitate rehabilitation as well as challenges and possible barriers perceived by people with spinal cord injury (SCI).
    Materials and methods: This study was part of a larger, mixed-method Finnish Spinal Cord Injury (FinSCI) study. We interviewed 45 persons with SCI representing participants from the FinSCI study and used a qualitative approach and a deductive-inductive content analysis to analyse the data.
    Results: We identified 28 facilitators and 19 barriers in the rehabilitation process. The majority of the facilitators and barriers were related to the rehabilitation planning phase. There were more barriers than facilitators in applying for and accessing treatment or rehabilitation and during the implementation of rehabilitation. Facilitators consisted of successful, realized, or planned treatments or rehabilitation events; clear goals; multidisciplinary teamwork; support and monitoring in various changing situations; and the rehabilitees' own capabilities and activities, among other things. The barriers included delays, challenges and deficiencies in the planning and implementation of treatment or rehabilitation; the lack of different skills; and resources of rehabilitation professionals; and different personal factors, which made the rehabilitation process cumbersome.
    Conclusions: Good communication and interaction between stakeholders are crucial for the progress of rehabilitation.
    MeSH term(s) Humans ; Finland ; Spinal Cord Injuries/rehabilitation
    Language English
    Publishing date 2024-01-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1004226-x
    ISSN 1365-2060 ; 1651-2219 ; 0785-3890 ; 1743-1387
    ISSN (online) 1365-2060 ; 1651-2219
    ISSN 0785-3890 ; 1743-1387
    DOI 10.1080/07853890.2024.2303398
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    Zs.A 680: Show issues Location:
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  8. Article ; Online: Sex-related differential item functioning of the Jenkins Sleep Scale: a cross-sectional study among 77 967 employees in the Finnish public sector.

    Juhola, Juhani / Arokoski, Jari P A / Ervasti, Jenni / Kivimäki, Mika / Vahtera, Jussi / Myllyntausta, Saana / Saltychev, Mikhail

    BMJ open

    2024  Volume 14, Issue 3, Page(s) e074867

    Abstract: Objectives: To investigate if the Jenkins Sleep Scale (JSS) demonstrates sex-related differential item functioning (DIF).: Design: Cross-sectional study.: Setting: Survey data from the Finnish Public Sector study (2015-2017).: Participants: 77 ... ...

    Abstract Objectives: To investigate if the Jenkins Sleep Scale (JSS) demonstrates sex-related differential item functioning (DIF).
    Design: Cross-sectional study.
    Setting: Survey data from the Finnish Public Sector study (2015-2017).
    Participants: 77 967 employees in the Finnish public sector, with a mean age of 51.9 (SD 13.1) years and 82% women.
    Outcome measures: Item response theory estimates: difficulty and discrimination parameters of the JSS and differences in these parameters between men and women.
    Results: The mean JSS total score was 6.4 (4.8) points. For all four items of the JSS, the difficulty parameter demonstrated a slight shift towards underestimation of the severity of sleep difficulties. The discrimination ability of all four items was moderate to high. For the JSS composite score, overall discrimination ability was moderate (0.98, 95% CI 0.97 to 0.99). Mild uniform DIF (p<0.001) was seen: two items showed better discrimination ability among men and two others among women.
    Conclusions: The JSS showed overall good psychometric properties among this healthy population of employees in the Finnish public sector. The JSS was able to discriminate people with different severities of sleep disturbances. However, when using the JSS, the respondents might slightly underestimate the severity of these disturbances. While the JSS may produce slightly different results when answered by men and women, these sex-related differences are probably negligible when applied to clinical situations.
    MeSH term(s) Male ; Humans ; Female ; Middle Aged ; Cross-Sectional Studies ; Public Sector ; Finland/epidemiology ; Psychometrics ; Sleep ; Surveys and Questionnaires ; Reproducibility of Results
    Language English
    Publishing date 2024-03-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-074867
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  9. Article ; Online: Physical performance after pediatric solid organ transplantation.

    Mäenpää, Heidi / Tainio, Juuso / Jalanko, Hannu / Arokoski, Jari / Jahnukainen, Timo

    Pediatric transplantation

    2021  Volume 26, Issue 2, Page(s) e14163

    Abstract: Introduction: Low physical activity is a well-recognized problem in pediatric solid organ transplant recipients; however, little is known about the differences between transplant groups. Physical performance testing was performed in a cohort of ... ...

    Abstract Introduction: Low physical activity is a well-recognized problem in pediatric solid organ transplant recipients; however, little is known about the differences between transplant groups. Physical performance testing was performed in a cohort of pediatric kidney, liver, and heart transplant recipients.
    Methods: Fifty-one patients (54.9% boys), including 17 liver, 20 kidney, 2 combined liver-kidney, and 12 heart transplant recipients, were tested at the median age of 11.5 (7.5-14.9) years. The results were compared with a control group, which consisted of 425 healthy schoolchildren. The physical performance test included six different tests of endurance, strength, flexibility, and speed.
    Results: The transplant recipients performed worse on most tests when compared with the control subjects (leg-lift test 42.0 vs. 44.9 repetitions, p = .002; repeated squatting 21.6 vs. 23.9 repetitions, p < .001; sit-up test 9 vs. 17 vs. 9 repetitions, p < .001, back extension 20 vs. 35 repetitions, p < .001; and shuttle run test 26.5 vs. 23.7 seconds, p < .001). None of the test results differed statistically significantly between the transplant groups.
    Conclusion: The physical performance of pediatric solid organ transplant recipients is lower than that of their healthy peers but do not differ between different transplant groups. More systematic rehabilitation programs and follow-up are needed.
    MeSH term(s) Adolescent ; Case-Control Studies ; Child ; Female ; Finland ; Heart Transplantation ; Humans ; Kidney Transplantation ; Liver Transplantation ; Male ; Organ Transplantation ; Physical Functional Performance ; Transplant Recipients
    Language English
    Publishing date 2021-10-18
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 1390284-2
    ISSN 1399-3046 ; 1397-3142
    ISSN (online) 1399-3046
    ISSN 1397-3142
    DOI 10.1111/petr.14163
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    Zs.A 4947: Show issues Location:
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  10. Article: The Current State of Remote Physiotherapy in Finland: Cross-sectional Web-Based Questionnaire Study.

    Hellstén, Thomas / Arokoski, Jari / Sjögren, Tuulikki / Jäppinen, Anna-Maija / Kettunen, Jyrki

    JMIR rehabilitation and assistive technologies

    2022  Volume 9, Issue 2, Page(s) e35569

    Abstract: Background: The ongoing COVID-19 pandemic has required social, health, and rehabilitation organizations to implement remote physiotherapy (RP) as a part of physiotherapists' daily practice. RP may improve access to physiotherapy as it delivers ... ...

    Abstract Background: The ongoing COVID-19 pandemic has required social, health, and rehabilitation organizations to implement remote physiotherapy (RP) as a part of physiotherapists' daily practice. RP may improve access to physiotherapy as it delivers physiotherapy services to rehabilitees through information and communications technology. Even if RP has already been introduced in this century, physiotherapists' opinion, amount of use, and form in daily practice have not been studied extensively.
    Objective: This study aims to investigate physiotherapists' opinions of the current state of RP in Finland.
    Methods: A quantitative, cross-sectional, web-based questionnaire was sent to working-aged members of the Finnish Association of Physiotherapists (n=5905) in March 2021 and to physiotherapists in a private physiotherapy organization (n=620) in May 2021. The questionnaire included questions on the suitability of RP in different diseases and the current state and implementation of RP in work among physiotherapists.
    Results: Of the 6525 physiotherapists, a total of 9.9% (n=662; n=504, 76.1% female; mean age 46.1, SD 12 years) answered the questionnaire. The mean suitability "score" (0=not suitable at all to 10=fully suitable) of RP in different disease groups varied from 3.3 (neurological diseases) to 6.1 (lung diseases). Between early 2020 (ie, just before the COVID-19 pandemic) and spring 2021, the proportion of physiotherapists who used RP increased from 33.8% (21/62) to 75.4% (46/61; P<.001) in the public sector and from 19.7% (42/213) to 76.6% (163/213; P<.001) in the private sector. However, only 11.7% (32/274) of physiotherapists reported that they spent >20% of their practice time for RP in 2021. The real-time method was the most common RP method in both groups (public sector 46/66, 69.7% vs private sector 157/219, 71.7%; P=.47). The three most commonly used technical equipments were computers/tablets (229/290, 79%), smartphones (149/290, 51.4%), and phones (voice call 51/290, 17.6%). The proportion of physiotherapists who used computers/tablets in RP was higher in the private sector than in the public sector (183/221, 82.8% vs 46/68, 67.6%; P=.01). In contrast, a higher proportion of physiotherapists in the public sector than in the private sector used phones (18/68, 26.5% vs 33/221, 14.9%; P=.04).
    Conclusions: During the COVID-19 pandemic, physiotherapists increased their use of RP in their everyday practice, although practice time in RP was still low. When planning RP for rehabilitees, it should be considered that the suitability of RP in different diseases seems to vary in the opinion of physiotherapists. Furthermore, our results brought up important new information for developing social, health, and rehabilitation education for information and communications technologies.
    Language English
    Publishing date 2022-06-07
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2798120-4
    ISSN 2369-2529
    ISSN 2369-2529
    DOI 10.2196/35569
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