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Objective: To explore the test-retest reliability and construct validity of the standardized Physical Activity and Disability Survey (PADS) and its acceptability to people with multiple sclerosis. Design: Participants completed the PADS twice with seven days between repeated measures, while also wearing an Actical accelerometer. Semi-structured interview questions were used to explore the acceptability of the PADS. Subjects: Thirty participants were recruited from the Multiple Sclerosis Society of Auckland, New Zealand. Mean age of participants was 54 years (range 27–76). Main measures: Physical Activity and Disability Survey (PADS) and Actical accelerometer. Results: A wide range of standardized PADS scores were recorded at each time-point (ranges 6.7–83.3 and 6.7–87.4). While standardized PADS scores between time-points had a high intraclass correlation coefficient of 0.92 (95% confidence interval (CI) 0.88, 0.98), Bland-Altman 95% limits of agreement (-17.4, 17.4) were modest. Accelerometer activity counts were not accurately predicted by standardized PADS scores (wide 95% prediction intervals). Participants reported the PADS was easy to understand and complete, enabling them to give an accurate picture of their physical activity. Conclusions: The PADS appears to be a potentially appropriate measure of activity for people with multiple sclerosis, particularly in terms of the wide range of activities it covers and its ability to detect varying levels of physical activity. We suggest the test-retest reliability and validity of the PADS could be improved with some minor revisions. [ABSTRACT FROM AUTHOR]

Background: Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality) in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ) over 30-years. Methods: Four stroke incidence population-based register studies were undertaken in adult residents (aged ≥15 years) of Auckland NZ in 1981–1982, 1991–1992, 2002–2003 and 2011–2012. All used standard World Health Organization (WHO) diagnostic criteria and multiple overlapping sources of case-ascertainment for hospitalised and non-hospitalised, fatal and non-fatal, new stroke events. Ethnicity was consistently self-identified into four major groups. Crude and age-adjusted (WHO world population standard) annual incidence and mortality with corresponding 95% confidence intervals (CI) were calculated per 100,000 people, assuming a Poisson distribution. Results: 5400 new stroke patients were registered in four 12 month recruitment phases over the 30-year study period; 79% were NZ/European, 6% Māori, 8% Pacific people, and 7% were of Asian or other origin. Overall stroke incidence and 1-year mortality decreased by 23% (95% CI 5%-31%) and 62% (95% CI 36%-86%), respectively, from 1981 to 2012. Whilst stroke incidence and mortality declined across all groups in NZ from 1991, Māori and Pacific groups had the slowest rate of decline and continue to experience stroke at a significantly younger age (mean ages 60 and 62 years, respectively) compared with NZ/Europeans (mean age 75 years). There was also a decline in 28-day stroke case fatality (overall by 14%, 95% CI 11%-17%) across all ethnic groups from 1981 to 2012. However, there were significant increases in the frequencies of pre-morbid hypertension, myocardial infarction, and diabetes mellitus, but a reduction in frequency of current smoking among stroke patients. Conclusions: In this unique temporal series of studies spanning 30 years, stroke incidence, early case-fatality and 1-year mortality have declined, but ethnic disparities in risk and outcome for stroke persisted suggesting that primary stroke prevention remains crucial to reducing the burden of this disease. [ABSTRACT FROM AUTHOR]