BACKGROUND AND OBJECTIVE

The Oswestry Disability Index (ODI)–English is a valid and reliable instrument for disability measurement in low back pain (LBP) patients. There is no existing ODI–Ilokano that evaluates LBP patients. This study aimed to cross-culturally adapt the ODI–English into Ilokano.

The ODI–English was cross-culturally adapted into Ilokano through a process that included forward translation, synthesis of the translations, back translation, expert committee review, and testing of the pre-final version.

Forward translation focused on capturing the essence of terms related to pain intensity, personal care, and daily activities, achieving consensus on phrases that accurately mirrored the original English meanings. Subsequent synthesis refined these translations, emphasizing idiomatic and conceptual equivalence over literal interpretations, particularly in nuanced areas like sleep disturbance and social life activities. Backward translation processes aligned Ilokano and English terms, especially for pain intensity and personal care, ensuring consistency across languages. The expert committee review addressed spelling, word choice, and sentence structure, making strategic adjustments for cultural relevance. Pilot testing with participants from Ilocos Norte and Ilocos Sur, Philippines highlighted comprehension challenges with specific terms, leading to adaptations like replacing 'milya' and 'yarda' with metric units and retaining culturally sensitive terms with supplementary English explanations.

This study refined the ODI–English into a culturally adapted Ilokano version, focusing on semantic, idiomatic, and cultural equivalence. Incorporating pilot testing feedback, such as modifying measurement units and addressing sensitive terms, highlighted the thorough adaptation process. The collaborative translation efforts and diverse patient input ensured a culturally resonant ODI version for Ilokano speakers. This adaptation enhances physical therapy practices by improving patient assessments and advocates for adapting patient-reported outcomes to diverse cultures, advancing patient-centered care.

BACKGROUND

Due to the COVID-19 outbreak, schools had to switch online. The sudden transition to blended teaching and learning (BTL) poses challenges for students and teachers, especially for health science programs that require hands-on practical experience. The validity, reliability, and responsiveness of these self-report questionnaires (SRQs) should be established to ensure the accuracy of the results as intended by the SRQ.

This study critically appraised, compared, and summarized the psychometric properties of SRQ evaluating BTL among health science university students. This review determined the SRQ’s reliability, internal consistency, various forms of validity (content, criterion, construct), and responsiveness.

Following a 10-step procedure based on COSMIN guidelines, we conducted a systematic review of SRQs used by health science university students to evaluate blended teaching and learning. Studies were eligible if they reported psychometric properties of SRQs related to blended learning among university health science students; exclusions included studies focusing on perceptions, attitudes, self-efficacy, and satisfaction, as well as articles such as biographies, editorials, and conference materials. Searches covered multiple electronic databases until April 26, 2023, including PubMed, EMBASE, Web of Science, MEDLINE (OVID), PsycInfo, CINAHL, EBSCOHOST, ERIC, Scopus, Science Direct, Google Scholar, JSTOR, Acta Medica Philippina, Philippine Journal of Health Research and Development, and HERDIN, managed through Zotero. Two independent reviewers performed database searches, title and abstract screening, and full-text evaluations, with a third reviewer resolving any disputes. The COSMIN Risk of Bias Checklist was employed to evaluate included studies on the development and various measurement properties of SRQs. The reviewers assessed SRQ standards, including validity, reliability, internal consistency, measurement error, responsiveness, interpretability, and feasibility. Data extraction and result tabulation were independently completed, with content comparison by two health education experts. This evaluation categorized the SRQs into three quality and validity levels.

The study examined five articles; four were rated as 'doubtful' and one as 'inadequate' in the overall development of SRQ. All four 'doubtful' studies demonstrated questionable content validity when university students were asked about the questionnaire's relevance, comprehensiveness, and comprehensibility. Only half of these studies achieved an 'adequate' rating for content validity based on expert opinions on relevance and comprehensiveness. All but one study scored from 'very good' to 'adequate' in structural validity. Three out of the four studies scored a very good rating for internal consistency, while one was deemed 'inadequate' in internal consistency, cross-cultural validity, and reliability. Three out of four studies scored 'very good' on construct validity, but all overlooked criterion validity and responsiveness. Conducted in various locations, including Australia, Romania, Turkey, and Taiwan, these studies highlighted both common characteristics and limitations in questionnaire development according to the COSMIN guidelines. Four studies were deemed reliable and valid for BTL constructs (Category A); Wu et al. requires further validation (Category B). Study limitations included heterogeneity in populations, settings, and questionnaire versions, potential subjective bias in SRQ content comparison, and the evolving nature of SRQs in blended learning contexts.

The systematic review reports the development and evaluation of SRQs for BTL while identifying gaps in their applicability to health science programs. The Blended Learning Scale (BLS) of Lazar et al. and the Blended Learning Questionnaire (BLQ) of Ballouk et al. showed an ‘adequate' rating for content validity. BLS revealed very good structural validity, internal consistency, and adequate content validation. Although the BLQ lacked Confirmatory Factor Analysis, it yielded valuable constructs for evaluating health sciences students' experiences in BTL. Both tools require improvements on recall period, completion time, interpretability, and feasibility. The review underscores the necessity for cont inuous assessment and enhancement of such instruments in BTL, advocating a rigorous scale development process. Furthermore, it encourages the customization of teaching and learning evaluation tools to suit specific institutional contexts while promoting further validation of these questionnaires across different populations in future research.

BACKGROUND AND OBJECTIVE

Mindfulness-based interventions (MBI), a novel treatment, and cognitive behavioral therapy (CBT), the standard treatment, are both effective in treating anxiety in adolescents. This study determined the effectiveness of mindfulness-based interventions versus cognitive behavioral therapy in reducing symptoms of anxiety among adolescents experiencing social anxiety through a systematic review and meta-analysis.

A systematic approach was used to identify eligible studies. Electronic databases, reference lists of relevant articles, and gray literature were searched. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and subgroups. Heterogeneity was measured using visual assessment, the I2 statistic, and chi-square test.

Randomized controlled trials comparing MBI to CBT for adolescents diagnosed with social anxiety or social phobia disorder were analyzed, with non-randomized studies being excluded. Structured searches in electronic databases, reference lists, and gray literature were conducted by four independent reviewers who initially identified potential articles through title and abstract screening. After a comprehensive review of full-text articles and a consensus-building process, the selection of included articles was finalized. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and to examine subgroups, with heterogeneity being assessed through visual evaluation, the I² statistic, and chi-square tests. Total number of participants was 255; 101 were male and 158 were women. Mean age was 27.5 years old, and diagnosed with Social Anxiety Disorder, Social Phobia, or DSM-IV-Defined-Anxiety-Disorder. They were divided into two groups: 125 participated in 8- to 12-week MBI sessions lasting 2 hours each, while 130 underwent 2-hour CBT sessions spanning 8, 12, or 14 weeks. There is moderate quality of evidence reporting non-significant difference on MBI vs CBT's effectiveness in alleviating symptoms of social anxiety [mean (95% CI) = -0.04 (-0.58, 0.51)].

Study found that there were no significant differences between Mindfulness-Based Interventions and Cognitive Behavioral Therapy in reducing social anxiety in adolescents. Mindfulness interventions have advantages in terms of cost-effectiveness for reducing symptoms of anxiety. Future research should include larger sample sizes and longer follow-up periods to further assess long-term effects of these interventions.

BACKGROUND

Ahigh-quality measurement tool is essential to accurately assess the innovative teaching strategies in health professions education. The Blended Teaching Assessment Tool (BTAT) aims to evaluate quality blended teaching or instructional delivery in Philippine health science programs. However, there is a lack of studies examining students' cognitive processes to support the validity of questionnaires.

Cognitive interviewing (CI) was employed to determine whether students interpreted and responded to the items correctly. Content analysis was done using Tourangeau's Cognitive framework. Four CIs were conducted by an expert moderator and note-taker with a total of 8 health science students (2 groups with 3 members, and 2 one-on-one interview) for around 1 to 2 hours via Zoom following a retroactive approach with verbal and spontaneous probing, guided by a semi-structured interview questionnaire.

Various issues related to comprehension, retrieval, judgment, and response were identified, leading to significant revisions of the tool from 82 items across 8 dimensions to 53 items across 5 dimensions. The challenges included unfamiliar terminology, ambiguous phrasing, complex statements, inconsistencies and irrelevance to students' real-life experiences. These findings emphasize the importance of students' feedback in enhancing the validity and reliability of assessment tools.

The Cognitive Interview identified crucial issues in comprehension, retrieval, judgment, and response, making it essential for developing the Blended Teaching Assessment Tool and ensuring valid responses on the quality of blended teaching and learning delivery.

Background and Objective: Mindfulness-based interventions (MBI), a novel treatment, and cognitive behavioral therapy (CBT), the standard treatment, are both effective in treating anxiety in adolescents. This study determined the effectiveness of mindfulness-based interventions versus cognitive behavioral therapy in reducing symptoms of anxiety among adolescents experiencing social anxiety through a systematic review and meta-analysis. Methods: A systematic approach was used to identify eligible studies. Electronic databases, reference lists of relevant articles, and gray literature were searched. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and subgroups. Heterogeneity was measured using visual assessment, the I2 statistic, and chi-square test. Results: Randomized controlled trials comparing MBI to CBT for adolescents diagnosed with social anxiety or social phobia disorder were analyzed, with non-randomized studies being excluded. Structured searches in electronic databases, reference lists, and gray literature were conducted by four independent reviewers who initially identified potential articles through title and abstract screening. After a comprehensive review of full-text articles and a consensus-building process, the selection of included articles was finalized. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and to examine subgroups, with heterogeneity being assessed through visual evaluation, the I² statistic, and chi-square tests. Total number of participants was 255; 101 were male and 158 were women. Mean age was 27.5 years old, and diagnosed with Social Anxiety Disorder, Social Phobia, or DSM-IV-Defined-Anxiety-Disorder. They were divided into two groups: 125 participated in 8- to 12-week MBI sessions lasting 2 hours each, while 130 underwent 2-hour CBT sessions spanning 8, 12, or 14 weeks. There is moderate quality of evidence reporting non-significant difference on MBI vs CBT's effectiveness in alleviating symptoms of social anxiety [mean (95% CI) = -0.04 (-0.58, 0.51)]. Conclusion Study found that there were no significant differences between Mindfulness-Based Interventions and Cognitive Behavioral Therapy in reducing social anxiety in adolescents. Mindfulness interventions have advantages in terms of cost-effectiveness for reducing symptoms of anxiety. Future research should include larger sample sizes and longer follow-up periods to further assess long-term effects of these interventions.
Adolescent ; Mindfulness ; Anxiety ; Cognitive Behavioral Therapy ; Occupational Therapy

BACKGROUND: Facemasks are used to minimize SARS-CoV-2 spread during the COVID-19 pandemic. However, facemask use during exercise is associated with possible adverse effects. OBJECTIVES: To compare the effects of facemask use vs. non-facemask use on subjective responses, COVID- 19 incidence, and physiologic changes in healthy adults during exercise. METHODS: The systematic review (PROSPERO registration number: CRD42022296247) will follow the PRISMA-P guidelines and use electronic databases Science Direct, PubMed, Google Scholar, Herdin, and EbscoHost. This will cover randomized parallel groups or randomized crossover studies investigating tolerability, physiologic effects, and the impact on SARS-COV2 incidence of commercially-available cloth, surgical, or FFR/N95 facemasks compared to no-facemask conditions during exercise among healthy adults, including studies published from the earliest date to January 31, 2022. Outcomes of interest will be facemask tolerability in 10 domains of comfort and objective cardiopulmonary, gas exchange, and metabolic responses. Mean differences (MD) or standardized mean differences (SMD) with a 95% confidence interval (CI) will be calculated overall and for subgroups using RevMan software (version 5.4.1). Pooled and subgroup estimates will be calculated using random-effects meta-analysis. The chi-squared test, I2 statistics, and visual analysis will assess heterogeneity. The GRADEpro will determine the certainty of the level of evidence. EXPECTED RESULTS An evidence-based recommendation using GRADE on the changes attributed to facemask use during exercise will be available. This will be useful for organizations when developing appropriate guidelines for exercising while mitigating the risk of SARS-CoV-2 transmission. Future researchers may use this study when redesigning comfortable facemasks without compromising filtration capability.

BACKGROUND: The emergence of Telerehabilitation in managing hypertension showed positive outcomes as an alternative approach to deliver healthcare services. With the ongoing COVID-19 pandemic which necessitates less physical contact, the study aims to determine the effectiveness of Telerehabilitation versus the usual care in hypertension management among adults in communities, especially in rural settings. METHODS: A comprehensive electronic search was conducted in the following databases: ProQuest, EBSCOhost, AHA Journals, PubMed, Google Scholar, Scopus, HERDIN, Web of Science, JSTOR, and ScienceDirect in March 2022 and was updated in August 2022. Inclusion criteria are randomized controlled trial studies that involve participants aged ≥ 18 years old with hypertension or baseline blood pressure of >140/90 mmHg and the use of technologies and digital services to address hypertension versus non-Telerehabilitation approaches in rural communities or through community- based rehabilitation. Exclusion criteria are non-randomized controlled trials, qualitative studies, unfinished and article type records. The revised Cochrane Collaboration Risk of Bias tool will be used to evaluate the content for risk of bias, quality, and internal validity. An electronic data collection form and Raxter will be utilized to extract and to organize the following: demographics, objectives, design, settings, interventions, outcome measures, and significant findings. Review Manager (RevMan) version 5.4 will be used to perform quantitative synthesis of the pooled data if homogeneity is observed in the outcomes. EXPECTED RESULTS The study will determine the effectiveness of Telerehabilitation in managing hypertension and aiding in its implementation in response to the global trend of urbanization in rural areas.
Telerehabilitation

BACKGROUND: The COVID-19 pandemic has led to innumerable challenges in the practice of physical therapy (PT) in both local and global settings. Healthcare settings often use Personal Protective Equipment (PPE) to prevent contamination. Despite its benefits, compliance is challenged by issues such as discomfort, availability, accessibility, and individual perception. OBJECTIVES: Considering the contrasting roles and nature of healthcare practitioners' work and the differences in the demands of PPE usage, this study aims to develop a profession-specific questionnaire on the perceptions of physical therapists on PPE usage in response to the COVID-19 pandemic with good face and content validity. METHODS: The study comprises Phase 1 for questionnaire development and Phase 2 for questionnaire validation. Five experts recruited using purposive sampling participated in three rounds of the validation process. Each expert evaluated the face and content validity through Google Forms. Consequently, an expert panel evaluation to reach a consensus on the final items. Google sheets were utilized for analysis. EXPECTED RESULTS The final questionnaire will have 35 items covering the Health Belief Theory domains. All items will receive FVI (overall agreement scores), I-CVI, S-CVI/Ave, and S-CVI/UA scores that meet the cut-off. The final questionnaire will be useful in evaluating physical therapists' perceptions of using PPE due to COVID-19 and may also be helpful to organizations, policymakers, and other entities in their decision-making for PPE protocols, guidelines, and implementation. Future researchers can use this study to conduct a pilot study that assesses other psychometric properties of the tool.

Background: Lateral epicondylalgia (LE) causes ineffective handgrip due to microtrauma on the elbow's common extensor origin. Objectives: This study will determine the differences in the Extensor Digitorum Communis' (EDC) fascia slide, percentage maximum voluntary contraction (%MVC), static maximum handgrip strength (SMHGT), muscle activation onset time (MAOT) in LE and non-LE elbows, with and without Biomechanical Tape (BMT). The study will determine differences in Visual Analogue Scales (VAS) and Patient Rated Tennis Elbow Evaluation (PRTEE) scores of patients with and without BMT. Methods: Nineteen participants' elbows with unilateral LE with and without BMT will be evaluated using musculoskeletal ultrasound (MSK) and electromyography (EMG) on Days 1, 3, and 5. A Physiotherapist-Sonographer, a Physiotherapist-EMG user, and a Research Assistant using Jamar hydraulic dynamometer will evaluate the participants. The participants will perform Mill's test during MSK and SMHGT using the dynamometer during EMG. A Chi-squared test will evaluate the relationship between BMT and fascia slide. Two-way repeated-measures ANOVA will compare the fascia slide, %MVC, SMHGT, and MAOT between elbows with and without BMT. It will be blocked according to elbow status (i.e., LE, no LE). Dunnett post hoc test will determine the groups whose results differed significantly. Differences in PRTEE scores at Days 1 and 5 will be determined. A p-value <0.05 indicates a significant difference in scores. Expected Results We expect decreased fascial slide measurements on EDC, VAS, PRTEE scores, and increased %MVC, MAOT, and SMHGT on taped elbows. Results will determine the underpinning mechanism behind the short-term effects of BMT.
Electromyography

BACKGROUND: Myofascial Pain Syndrome (MPS) is a persistent pain on the shoulders and cervical spine related to limitation of motion (LOM), muscle weakness, and loss of function. It is a cumulative, repetitive injury causing disability among the middle-aged working population. This study will determine the differences in upper trapezius' superficial and deep fascia displacements among participants with and without MPS based on the effects of cervical active range of motion (AROM). METHODS: This is a retrospective records review study with two interlinked parts. In the reliability study, the Tracker will determine the physiotherapy interns' intertester and intratester reliability in assessing the musculoskeletal ultrasound videos. Using MedCalc Software and the Bland-Altman plot, the single measures ICC will determine the reliability. In determining clinically acceptable use of the Tracker, a <0.40 cut-off reliability will be used. In the case-control study, physiotherapy interns will assess 2,904 musculoskeletal ultrasound videos. The difference between the superficial and deep fascia displacements will be determined using paired t-test and the mean differences using an independent t-test. A significant difference between groups will be determined using a p-value of <0.05. RESULTS This study expects that cervical AROM with overpressure will displace the superficial and deep fascia of the upper trapezius, particularly among patients with MPS. Proving the correlation between LOM and altered fascia displacement will help rehabilitation professionals create new manual therapy techniques and emphasize the use of existing fascia-related treatments.