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Abstract Background Multiple studies suggest that reduced postural orientation is a possible risk factor for both patello-femoral joint pain (PFP) and rupture of the anterior cruciate ligament (ACL). In order to prevent PFP and ACL injuries in adolescent athletes, it is necessary to develop simple and predictive screening tests to identify those at high risk. Single Leg Mini Squat (SLMS) is a functional and dynamic real-time screening test, which has shown good validity and reproducibility in evaluation of postural orientation of the knee in an adult population. The aim of this study was to determine the inter-tester reproducibility of SLMS in the age group of 9–10 and 12–14 years by evaluating postural orientation of the ankle, knee, hip and trunk. Further on, this study exemplify the divergence of kappa values when using different methods of calculating kappa for the same dataset. Methods A total of 72 non-injured children were included in the study. Postural orientation of the ankle, knee, hip and trunk for both legs was determined by two testers using a four-point scale (ordinal, 0–3). Prevalence, overall agreement as well as four different methods for calculating kappa were evaluated: linear weighted kappa in comparison with un-weighted kappa, prevalence-adjusted bias-adjusted kappa (PABAK) and quadratic weighted kappa. Results The linear weighted kappa values ranged between 0.54-0.86 (overall agreement 0.86-0.97), reflecting a moderate to almost perfect agreement. When calculating un-weighted kappa (with and without PABAK) and quadratic weighted kappa, the results spread between 0.46-0.88, 0.50-0.94, and 0.76-0.95, reflecting the various results when using different methods of kappa calculation. Conclusions The Single Leg Mini Squat test has moderate to almost perfect reproducibility in children aged 9–10 and 12–14 years when evaluating postural orientation of the ankles, knees, hips and trunk, based on the excellent strength of agreement as presented by linear weighted kappa. The inconsistency in results when using different methods of kappa calculation demonstrated the linear weighted kappa being generally 15% lower than the quadratic weighted values. On average, prevalence-adjusted bias-adjusted kappa increased the un-weighted kappa values by 7% and 12% by children aged 9–10 and 12–14, respectively.

Background: Elderly people with dementia are known to be less physically active compared with elderly, healthy people, emphasizing the need for interventions in order to maintain a high level of independence in activities of daily living. The aim was to evaluate the effect of long-term, group-based rehabilitation including physical activity on physical performance in elderly, community-dwelling people with mild to moderate dementia. Methods: A quasi-experimental study of 18 elderly, community-dwelling people, diagnosed with mild to moderate dementia, participated in an ongoing rehabilitation programme based on integrated physical, cognitive and social activities. The outcome measure was physical performance: the 30-second sit-to-stand test, Guralnik balance test, 10-metre walking speed test, timed 6-metre walk test and a timed dual task walk test. The repeated measure ANOVA was used to analyse any overall differences between related means. Results: No significant effect of time was found for the five outcome measures during the entire period. The variation in the estimate of most outcome scores was higher within subjects than between subjects during the period. Profile plots illustrated that three of the participants, who experienced severe cognitive deterioration, markedly declined in all physical performance tests. Conclusion: The expected, progressive deterioration in physical performance was delayed in a small group of home-dwelling people with mild to moderate dementia participating in long-term, group-based rehabilitation. Long-term, group-based rehabilitation may have the overall potential to delay deterioration in activities of daily living performance in home-dwelling people with mild to moderate dementia; however, more studies with larger samples are needed to confirm the findings of this study. [ABSTRACT FROM AUTHOR]

Background: People with dementia may benefit from the effect of physical activity on behavioural and psychological symptoms of dementia. Qualitative synthesis of the importance of physical activity might complement and help clarify quantitative findings on this topic. The purpose of this systematic mixed studies review was to evaluate findings from both quantitative and qualitative methods about the effect and importance of physical activity on behavioural and psychological symptoms of dementia in people with dementia. Methods: The systematic literature search was conducted in EMBASE, CINAHL, PubMed, PEDro and PsycINFO. Inclusion criteria were: people with a light to moderate degree of dementia, interventions including physical activity and outcomes focusing on behavioural and psychological symptoms of dementia or quality of life. To assess the methodological quality of the studies, the AMSTAR and GRADE checklists were applied for the quantitative studies and the CASP qualitative checklist for the qualitative studies. Results: A small reduction in depression level and improved mood were seen in some quantitative studies of multi-component physical activity interventions, including walking. Due to high heterogeneity in the quantitative studies, a single summary of the effect of physical activity on behavioural and psychological symptoms of dementia should be interpreted with some caution. Across the qualitative studies, the common themes about the importance of physical activity were its 'socially rewarding' nature, the 'benefits of walking outdoors' and its contribution to 'maintaining self-hood'. Conclusion: For people with dementia, there was a small, quantitative effect of multi-component physical activity including walking, on depression level and mood. People with dementia reported the importance of walking outdoors, experiencing the social rewards of physical activity in groups, as well as physical activity were a means toward maintaining self-hood. [ABSTRACT FROM AUTHOR]

Aim: Several biomechanical factors, such as knee joint hypermobility (KJH), are suggested to play a role in the etiology of knee joint symptoms and knee osteoarthritis. Nevertheless, the prevalence or consequences of KJH solely or included in the classification of generalized joint hypermobility (GJHk) is unknown for a general population. Therefore, the objectives were to report the prevalence of self‐reported GJHk and KJH, as well as the association of these conditions to knee joint symptoms, severity and duration of symptoms, and health‐related quality of life (HRQoL) in a Danish adult population. Method: This study is a cross‐sectional population‐based survey of 2056 Danish adults. Respondents received online questionnaires of GJHk and KJH, knee joint symptoms, the severity and duration of these, as well as HRQoL. Results: Total response rate was 49% (n = 1006). The prevalence of self‐reported GJHk and KJH was 13% and 23%, mostly representing women. More than half of the respondents with GJHk and KJH had knee joint symptoms. The odds for reporting knee joint symptoms, severity of knee joint symptoms and duration of knee joint symptoms were twice as high for respondents with GJHk and KJH. Respondents with GJHk and KJH reported lower HRQoL. Conclusion: GJHk and KJH were frequently reported in the Danish adult population, mostly in women. Respondents with GJHk and KJH were two times more likely to report knee joint‐related symptoms such as pain, reduced performance of usual activity and lower HRQoL. The impact of these conditions on HRQoL is comparable with knee osteoarthritis. [ABSTRACT FROM AUTHOR]