Objective. The aim of the current study was to develop and then to determine preliminary validity of a physical activity questionnaire specifically designed for ambulatory, chronic stroke patients. Methods. This cross-sectional study recruited 92 chronic stroke patients. In Phase I, the SPAQ was developed and its content validity index (CVI) determined. In Phase II, we examined (1) the concurrent validity of SPAQ vs. the International Physical Activity Questionnaire-Short Form (IPAQ-SF); (2) the convergent validity of SPAQ vs. the Functional Ambulation Category (FAC), vs. the six-minute walk test (6-MWT), vs. the timed up and go test (TUGT), vs. the Motricity Index, vs. the National Institutes of Health Stroke Scale (NIHSS), and vs. the Modified Rankin Scale (MRS); and (3) the discriminant validity of the SPAQ vs. the Montreal Cognitive Assessment (MoCA). The concurrent validity and convergent and divergent validity were analysed using Spearman’s rank correlation coefficient. The agreement between the SPAQ and IPAQ-SF was assessed using the Kappa statistic. Results. The SPAQ has 12 items in 3 main components which covers low (7 items), moderate (3 items), and vigorous (2 items) physical activity. The SPAQ had a CVI of 0.93. Spearman’s correlation coefficient (rs) for SPAQ vs. IPAQ-SF was 0.53 (p < 0.001). The SPAQ yielded substantial agreement with the IPAQ-SF (Kappa = 0.65). For convergent validity, the SPAQ had a moderate correlation with the 6-MWT, MI, NIHSS, FAC, TUGT, and MRS (p < 0.05). For discriminant validity, the SPAQ was not correlated with the MoCA (rs = 0.061, p = 0.68). Conclusion. The SPAQ can be used to practically assess physical activity in chronic stroke patients, and it has acceptable psychometric properties which are comparable to other standard physical activity questionnaires. Future work should determine the validity of the SPAQ using an objective device such as an accelerometer.
Swallowing disorder or dysphagia is quite common in hospitalised patients. Using fibre‐optic endoscopic evaluation of swallowing (FEES) is one of the clinical standards for evaluating swallowing disorder to prevent serious consequences such as aspiration pneumonia. This study aimed to determine the prevalence and the associated risk of dysphagia in hospitalised patients by using FEES finding. We retrospectively analysed the FEES records from the patients who were screened and suspected of swallowing problems by a certified nurse of dysphagia nursing (CNDN). The FEES findings were compared between dysphagia and without dysphagia to evaluate the associated risk of dysphagia. Six‐hundred and nine FEES records were analysed. We found dysphagia 76% in patients who suspected swallowing problems by CNDN. FEES was assessed after the subjects had been admitted for 22 days on average. There was no difference in age between dysphagia and without dysphagia participants. However, the advanced age (age > 85 years old) increased the odd of dysphagia 1.18, P = .03. The primary disease of the subjects was mainly cerebrovascular disease (24%) and pneumonia (22%). Abnormal FEES findings including soft palate elevation, velopharyngeal contraction, whiteout, volitional cough, glottis closure during breath holding, cough reflex and presence of secretion in pharynx were found in hospitalised patients with dysphagia. The prevalence of dysphagia was high in hospitalised patients. Hence, screening the swallowing problem by nurse and FEES evaluation is essential to detect and prevent the complication in the patient who has dysphagia.
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