OBJECTIVES. The Groningen Activity Restriction Scale (GARS) is a non-disease-specific instrument to measure disability in activities of daily living (ADL) and instrumental activities of daily living (IADL). It was developed in studies of Dutch samples consisting of elderly or chronically ill people. The psychometric properties of the GARS demonstrated in these studies were highly satisfactory. This paper addresses the psychometric properties of the GARS across countries. METHODS. Data of 623 patients with recently diagnosed rheumatoid arthritis from four European countries were analyzed by means of a principal components analysis and a Mokken scale analysis for polychotomous items. RESULTS. The results of the analyses were highly satisfactory: there was one strong and reliable general factor representing one underlying dimension of disability in ADL and IADL, and there was a clear hierarchical ordering of the items included in the GARS. The validity of the GARS was strongly suggested by the pattern of associations of the GARS with age, sex, and other existing health status measures. CONCLUSIONS. The psychometric characteristics of the GARS, which measures disability in ADL and IADL simultaneously, make this instrument very useful for comparative research across countries.

A short-form of the McGill Pain Questionnaire (SF-MPQ) has been translated into Swedish. One hundred women with either fibromyalgia (FS) or rheumatoid arthritis (RA) filled out the SF-MPQ three times--the RA patients monthly while receiving their routine care, and the FS patients over 6 months while participating in an experimental treatment. Results indicated that the MPQ 15-item descriptor section was internally consistent (Cronbach's alphas .73 to .89), but lacked content validity in the RA sample. Test-retest reliabilities ranged from .45 to .73. Convergent construct validity was demonstrated by significant correlations between the SF-MPQ and other pain measurements. A principal components analysis showed that the 15-item descriptor section has three distinct factors: acute sensory, chronic sensory, and affective. We conclude that the SF-MPQ is reliable and valid for use with FS patients.

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survivors ofthis second cohort were re-examined at the ages of 75 and 79 (220 men, 318 women; participation rate 82%). Our study deals with a subsample of the 79 year olds from cohort II and a subsample of 85 year olds, including survivors of the original first cohort and 85 year olds invited and examined for the first time. SAMPLINGThe design and sampling have previously been described"2"4 in detail. In summary, the sample of 70 year olds (cohort I) in 1971-72 was consecutively assigned numbers from 1 to 5 in order to permit subsampling. These 'proband figures' were unchanged throughout the longitudinal study. The last invited 85 year olds were assigned numbers 11 to 13. All 85 year olds were interviewed about joint complaints. Probands numbered 3, 5, and 13 were selected for clinical joint examination and radiographic examination of the wrists, hands, and knee joints. In this report only the interviews on the probands selected for joint exination are referred to.

Objective. The aim of this study was to examine physical performance in women with fibromyalgia (FM) using methods that are easy to use in clinical settings and to compare our findings with published norms or a healthy comparison group. Methods. Measures of shoulder pain and range-ofmotion, isometric shoulder endurance, neck rotation, leg strength, hand grip strength, back flexibility, 6-minute walk distance, and symptom duration were completed on 97 subjects with FM. The comparison group was 30 age-matched healthy women. Results. The FM group had significantly lower physical functioning scores on all variables when compared to the healthy group or published norms. When pain at rest was controlled, pain on motion was the most significant predictor of variance in shoulder range of motion, whereas range of motion was the most significant predictor of right shoulder endurance and grip strength of both hands. Conclusions. Women with FM are markedly below average in physical performance abilities when measured by clinical tests. Persons with fibromyalgia [FM) are an increasing part of the case load in the health care system. Along with complaints of generalized widespread pain, fatigue, stiffness, and disturbed sleep, many patients with FM report that their overall physical performance is reduced when compared to the time before the onset of the syndrome. Difficulties in performing activities of daily living as well as activities related to employment have been reported [1,2]. Additionally, researchers have shown that persons with FM have reduced muscle strength and endurance [3-71, impaired ability when assessed with a "work simulator" [8], reduced ability to sustain intensive exercise, and low levels of aerobic fitness [9,10]. Most muscle testing has been carried out using elaborate laboratory equipment. The suggestion has been made, however, that functional tests may be of greater value to estimate muscle performance in FM patients [7].The aim of this study was to examine physical performance in women with FM using methods that are easy to use in a clinical setting. Where possible we compared the results to normal values reported in the literature. For other measures where there were no reported norms, we used an age-matched healthy comparison group. The relationships between age, symptom duration, pain, and the physical performance variables were studied. SUBJECTS AND METHODS SubjectsThe 97 FM subjects for this study were part of an experimental study of education and physical therapy carried out in Gothenburg, Sweden, and reported earlier