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Supplemental material, sj-docx-1-smo-10.1177_20503121231178047 for Multiple sclerosis and lower urinary tract symptoms: A survey of prevalence, characteristic and urological evaluations by Farzaneh Sharifiaghdas, Behzad Narouie, Maryam Taheri, Saba Jalali, Bita Shalbafan, Mohaddeseh Azadvari, Mehdi Dadpour, Hamidreza Rouientan, Mohadese Ahmadzade and Hamideh Hanafi Bojd in SAGE Open Medicine

Mohaddeseh Azadvari,1,2 Seyede Zahra Emami Razavi,2 Masumeh Shahrooei,3 Abdorreza Naser Moghadasi,3 Amirreza Azimi,3 Hamid Reza Farhadi-Shabestari3 1Physical Medicine and Rehabilitation Department, Sina Hospital, Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; 2Physical Medicine and Rehabilitation Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; 3Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IranCorrespondence: Seyede Zahra Emami Razavi Imam Khomeini Hospital, Keshavarz AVE, Tehran 1419733141, IranTel +98 21 6119 2291Fax +98 21 66581604Email zemamirazavi@gmail.comBackground: Bladder dysfunction is one of the most disabling problems in multiple sclerosis patients, associated with lower quality-of-life and social isolation. There have been few studies regarding bladder dysfunction in Iranian patients with multiple sclerosis. Therefore, this study was designed to assess bladder dysfunction in Iranian patients with multiple sclerosis.Methods: This cross-sectional study was conducted in the MS Clinic of Sina Hospital (affiliated to Tehran University of Medical Sciences) between January 2019 and January 2020. Patients were asked to fill the valid and reliable Persian version of the 8-item Actionable Bladder Symptom Screening Tool (ABSST) questionnaire. Demographic data and accompanying symptoms such as fatigue, depression, anxiety, bowel dysfunction, urinary problems and walking status were recorded.Results: Two hundred and twenty-eight cases were enrolled. One hundred and eighty-three were female (80.3%) and 45 (19.7%) were male (F/M ratio=4). The mean ABSST score was 6.8± 5.7. Based on the cut-off value of eight, 83 (28.8%) had actionable bladder symptoms (36.4%). The mean age and duration of the disease were significantly higher in the group with ABSST≥ 8. The number of patients with urinary retention, dribbling, and incontinence was significantly higher in the second group, while the number of individuals who could walk without help was significantly higher in the first group (ABSST< 8). Logistic regression analysis by considering an ABSST score of less or more than 8 as dependent and age, sex, duration of the disease, marital status, education level, and BMI as independent variables showed that age, education level, and duration of the disease are independent predictors.Conclusion: According to these results, nearly one-third of Iranian patients with MS suffer from an overactive bladder, which should be considered by physicians.Keywords: multiple sclerosis, bladder dysfunction, Iran

Mohaddeseh Azadvari, 1 Abdorreza Naser Moghadasi, 1 Amir Reza Azimi, 1 Farzaneh Sharifiaghdas, 2 Seyede Zahra Emami Razavi, 1 Sharareh Eskandarieh, 1 Maryam Hosseini, 1 Shahram Rahimi-Dehgolan, 1 Mohammad Ali Sahraian 1 1Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, I. R. of Iran; 2Urology Department, Shahid Labbafinejad Hospital, Urology Nephrology Research Center (UNRC), Shahid Beheshti University of Medical Science(SBMU), Tehran, I. R. of IranCorrespondence: Seyede Zahra Emami Razavi Tel +98 2161192291Fax +98 21 66581604Email zemamirazavi@gmail.comPurpose: Multiple sclerosis (MS) is the most neurologic disease among individuals of 20– 45 years. About 75% of MS patients report bladder problems that have a moderate-high impact on their life. The present study aimed to translate and determine the validity and reliability of the Persian version of ABSST questionnaire.Methods: The standard validation process for preparing the Persian version of ABSST was performed by means of an expert committee. After a pilot study and confirming the harmonized translated form, we tested the final version of questionnaire on 40 patients with a definite diagnosis of MS symptoms, once at the baseline and another after two weeks in order to prevent recall-induced agreement. Test-retest reliability was calculated as Spearman’s correlation coefficient. Also, content validity indices (CVIs), as well as internal consistency were analyzed in STATA.Results: Forty participants with a mean age of 38.8 years were included in this study. Only 20% of them were male. The Persian version achieved a good internal consistency with a Cronbach-α value of 0.91, relatively similar to the original version. The coefficients for measuring the correlation between each item score with the total score of our questionnaire were between 0.58– 0.89. This value confirmed an appropriate validity for the Persian version of ABSST. Regarding test-retest reliability assessment, total Spearman`s coefficient was 0.85; with 0.84 for the severity of symptoms and 0.87 for the impact of urologic disorders on patients` social life.Conclusion: The current findings proved that this accurate questionnaire could be used to investigate urinary symptoms among Persian-speaking MS patients.Keywords: reliability studies, reliability, questionnaires, urinary symptoms, multiple sclerosis

Background: Valid and reliable tools are required to measure patient satisfaction with physical therapy care. The aim of this study was to translate the MedRisk instrument for measuring patient satisfaction with physical therapy care (MRPS) into Persian language and to evaluate its measurement properties. Methods: A cross-sectional and prospective validation study design was adopted. The development of the Persian MRPS (MRPSp) followed the standard guidelines with ���forward���������backward��� translation, consensus agreement of expert panel, and pilot testing. The final MRPSp was evaluated for reliability and validity. Results: A total of 114 patients (mean age 52.14 years, 72 females) participated in this study. The patients��� satisfaction was high as reflected in the ceiling effect (25.4%). The overall Cronbach���s �� was 0.91. Corrected item-total correlations ranged from 0.22 to 0.88. Principal component analysis suggested a 7-item ���internal��� factor (alpha = 0.95) and a 3-item ���external��� factor (alpha = 0.74). The correlations of factors with two global measures of satisfaction were significant ranging from 0.247 to 0.789. Individual items of MRPSp had significant positive correlations with two global measures (r = 0.233���0.736). The standard error of measurement was between 0.97 and 2.14. The smallest detectable change was between 2.7 and 5.93. Conclusion: The Persian version of the MRPS is a two-factor reliable and valid instrument for measuring patient satisfaction with physical therapy care.