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Abstract: Objective: The aim of the study was to determine the internal consistency, test–retest reliability and measurement error of the Animated Activity Questionnaire (AAQ) for assessing activity limitations in hip and knee osteoarthritis (HKOA) patients. Methods: A total of 1,177 patients, from six countries (the Netherlands, UK, France, Denmark, Italy and Spain), completed the AAQ, a questionnaire consisting of videos displaying 17 activities with 3–5 levels of performance, from which patients choose the video that best matches their own performance. Unidimensionality was assessed by means of confirmatory factor analysis (CFA), using the following fit indices: the Tucker–Lewis index (TFI) >0.95, comparative fit index (CFI) >0.95, and root mean square error of approximation (RMSEA) <0.06. Cronbach's alpha was computed. In 238 patients who completed the AAQ twice, the intra‐class correlation coefficient (ICC) was calculated for test–retest reliability. The standard error of measurement (SEM) and the smallest detectable change (SDC) were calculated as parameters of measurement error. Results: The fit indices for unidimensionality were CFI 0.957, TLI 0.950, and RMSEA 0.144. Cronbach's alpha was 0.95. ICC for test–retest reliability was 0.93 (95% confidence interval 0.91 to 0.95), ranging from 0.85 to 0.98 across countries. SEM and SDC were 4.9 and 13.6, respectively, on a scale from 0 to 100, and ranging from 2.7 to 6.7, and from 7.5 to 18.4, respectively, across countries. The AAQ appeared to measure slightly more precisely in patients with knee problems and patients without prosthesis. Conclusion: The AAQ seemed to be unidimensional, and showed good internal consistency and test–retest reliability. The SDC indicated that changes in scores of at least 14% indicate real improvement in activity limitations. [ABSTRACT FROM AUTHOR]

Background: Information on the course of neck pain (NP) and low back pain (LBP) typically relies on data collected at few time intervals during a period of up to 1 year.Methods: In this prospective, multicentre practice-based cohort study, patients consulting a chiropractor responded weekly for 52 weeks to text messages on their cell phones. Data from 448 patients (153 NP, 295 LBP) who had returned at least one set of answers in the first 26 weeks were used. Outcome measures were pain intensity (VAS) and functional outcome, assessed using four different questions: pain intensity, limitation in activities of daily living (ADL), number of days with pain in the previous week and number of days limited in ADL. Distinct patterns of pain were analysed with quadratic latent class growth analysis.Results: The final model was a 4-class model for NP and LBP. The 'recovering from mild baseline pain' is most common (76.3% of NP patients/58.3% of LBP patients) followed by the 'recovering from severe baseline pain' class (16.3% NP/29.8% LBP). They follow similar trajectories when considered over a period of 6 months. Pain at baseline, duration of complaints, functional status, limitations in ADL and the score on psychosocial scales were the variables that most contributed to distinguish between groups.Conclusions: Most patients with NP or LBP presenting in chiropractic care show a trajectory of symptoms characterized by persistent or fluctuating pain of low or medium intensity. Only a minority either experience a rapid complete recovery or develop chronic severe pain.Significance: Ninety percentage of patients with neck pain or low back pain presenting to chiropractors have a 30% improvement within 6 weeks and then show a trajectory of symptoms characterized by persistent or fluctuating pain of low or medium intensity. Only a minority either experience a rapid complete recovery or develop chronic severe pain. [ABSTRACT FROM AUTHOR]

A response by Aaltje P. D. Jansen to a letter to the editor about his article "Yield of a New Method to Detect Cognitive Impairment in General Practice" is presented.