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Before foreign language questionnaires, such as patient reported outcome measures (PROMs), can be scientifically used in the national language, guideline-based translation, cultural adaptation and comprehensive verification of their validity and reliability are needed. The aim of this study was to assess the psychometric properties of the German version of the LCI-5 (LCI-5-D) on a sample of people with lower limb amputation (LLA).The LCI-5 was translated into German (LCI-5-D) based on the ISPOR guidelines for cross-cultural adaptation following pilot testing. The final LCI-5-D was administered to n = 52 lower limb amputees in order to determine the validity and reliability of both the total score and the subscores ("basic items" and "advanced items"). Internal consistency (Cronbach's alpha), test-retest reliability (ICC2,1), standard error of the mean (SEM), minimal detectable change (MDC), item-to-total correlation, and item-to-subscale correlation were calculated. Floor and ceiling effects were checked. For construct validity, the Rivermead Mobility Index (RMI) and timed up and go (TUG) test were correlated, and differences of defined subgroups (amputation height and prosthesis user type) were calculated.On average, the score of the LCI-5-D was 40.13 ± 16.64 points. High ceiling effects were present for the subscale "basic items" (57.7% maximum score). Internal consistency showed excellent results (Cronbach's α = 0.97). A strong correlation to the RMI (r = 0.863; p 0.001) and to the TUG (r = - 0.714; p 0.001) demonstrated construct validity. Test-rest reliability was measured after an averaged time span of 5.3 ± 2.47 days and resulted in very high reliability [ICC (2,1) = 0.97; p 0.001]. MDC was 7.57 points for the total score.The LCI-5-D is a valid and reliable PROM for measuring mobility with prostheses in German-speaking lower limb amputees, which is rather suitable for people with low to moderate mobility abilities. It can be used in a German-speaking population.Bevor fremdsprachige Fragebögen, wie z. B. patient reported outcome measures (PROMs), in der Landessprache wissenschaftlich eingesetzt werden können, sind leitfadengestützte Übersetzungen, eine kulturelle Adaptation und eine umfassende Überprüfung ihrer Validität und Reliabilität erforderlich. Ziel dieser Studie war es, die psychometrischen Eigenschaften der deutschen Version des LCI-5 (LCI-5-D) an einer Stichprobe von Personen mit Majoramputation der unteren Extremitäten zu überprüfen.Der LCI-5 wurde in Anlehnung an die ISPOR-Richtlinie ins Deutsche übersetzt (LCI-5-D) und in einer Pilot-Studie getestet. Der endgültige LCI-5-D wurde an n = 52 Unterschenkelamputierten auf Validität und Reliabilität untersucht, und zwar sowohl der LCI-5-D-Gesamtscore als auch der daraus berechenbaren Teilscores („Basis-Items“ und „Advanced Items“). Es wurden die interne Konsistenz (Cronbachs Alpha), die Test-Retest-Reliabilität (ICC2,1), der Standardfehler des Mittelwertes (SEM) und die minimal detektierbare Differenz (MDC), sowie die Trennschärfe der Items berechnet. Boden- und Decken-Effekte wurden ebenfalls überprüft. Für das Messen der Konstruktvalidität wurden der parallel erhobene Rivermead Mobility Index (RMI) und der Timed Up and Go Test (TUG) korreliert und Differenzen definierter Untergruppen (Amputationshöhe und Prothesenträger-Typ) berechnet.Im Durchschnitt lag der Score des LCI-5-D bei 40,13 ± 16,64 Punkten. Hohe Deckeneffekte lagen nur für die Subskala „Basic-items“ vor (57,7% Maximalwert). Die interne Konsistenz zeigte hervorragende Ergebnisse (Cronbachs α = 0,97). Eine starke Korrelation zum RMI (r = 0,863; p 0,001) und zum TUG (r = − 0,714; p 0,001) belegen die Konstruktvalidität. Die Test-Rest-Reliabilität wurde nach einer gemittelten Zeitspanne von 5,3 ± 2,47 Tagen gemessen und ergab eine sehr hohe Reliabilität (ICC [2, 1] = 0,97; p 0,001). Der MDC betrug 7,57 Punkte für den Gesamtscore.Der LCI-5-D ist ein valides und reliables PROM zur Messung der Mobilität mit Prothesen bei deutschsprachigen Patienten mit Majoramputation der unteren Extremität. Der Score ist am besten für Personen mit geringen bis mittleren Mobilitätsfähigkeiten geeignet. Der LCI-5-D kann in einer deutschsprachigen Population eingesetzt werden und wird reliable, valide und objektive Aussagen über die Mobilität mit Prothese treffen können.

Diagnostic ability is essential for expert professional practice. Several instruments have been developed to assess diagnostic skills independent of specific knowledge. One such instrument is the diagnostic thinking inventory (DTI), which is used in different settings to evaluate diagnostic performance and has shown acceptable reliability and validity. The aim of the present study was to translate and validate a German version (DTI-G). Cultural adaptation and translation were performed according to international guidelines. Internal consistency and item discrimination indexes were calculated. The factorial structure of the DTI-G, test-retest reliability and known-groups validity were tested. A total of 388 physiotherapists completed the questionnaire. The internal consistency was good for the overall score of the DTI-G (Cronbach’s a = 0.84). Exploratory factor analysis yielded a five-factor solution with 21 items that explained 55% of the total variance across items. A confirmatory principal component analysis resulted in the same five-factor structure, showing an acceptable to good overall fit of the model (CFI = 0.93; RMSEA = 0.05; SRMR = 0.06). Test-retest reliability was found to be good (intraclass correlation coefficient ICC2,1 = 0.87, p < 0.001, n = 118). The difference between participants with more than 9 years of clinical experience and those with less than 9 years of clinical experience (median split) was significant (t385 = 6.00, p < 0.001), supporting known-groups validity. The results support construct validity and indicate good test-retest reliability of the DTI-G. The DTI-G can be used to measure and develop diagnostic ability of physiotherapists in clinical practice and education. Further research is necessary to validate the questionnaire for other health professions.

BACKGROUND Osteoarthritis of the knee is the most common cause for disability and limited mobility in the elderly, with considerable individual suffering and high direct and indirect disease-related costs. Nonsurgical interventions such as exercise, enhanced physical activity, and self-management have shown beneficial effects for pain reduction, physical function, and quality of life (QoL), but access to these treatments may be limited. Therefore, home therapy is strongly recommended. However, adherence to these programs is low. Patients report lack of motivation, feedback, and personal interaction as the main barriers to home therapy adherence. To overcome these barriers, electronic health (eHealth) is seen as a promising opportunity. Although beneficial effects have been shown in the literature for other chronic diseases such as chronic pain, cardiovascular disease, and diabetes, a systematic literature review on the efficacy of eHealth interventions for patients with osteoarthritis of knee is missing so far. OBJECTIVE The aim of this study was to compare the efficacy of eHealth-supported home exercise interventions with no or other interventions regarding pain, physical function, and health-related QoL in patients with osteoarthritis of the knee. METHODS MEDLINE, CENTRAL, CINAHL, and PEDro were systematically searched using the keywords osteoarthritis knee, eHealth, and exercise. An inverse variance random-effects meta-analysis was carried out pooling standardized mean differences (SMDs) of individual studies. The Cochrane tool was used to assess risk of bias in individual studies, and the quality of evidence across studies was evaluated following the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS The literature search yielded a total of 648 results. After screening of titles, abstracts, and full-texts, seven randomized controlled trials were included. Pooling the data of individual studies demonstrated beneficial short-term (pain SMD=−0.31, 95% CI −0.58 to −0.04, low quality; QoL SMD=0.24, 95% CI 0.05-0.43, moderate quality) and long-term effects (pain −0.30, 95% CI −0.07 to −0.53, moderate quality; physical function 0.41, 95% CI 0.17-0.64, high quality; and QoL SMD=0.27, 95% CI 0.06-0.47, high quality). CONCLUSIONS eHealth-supported exercise interventions resulted in less pain, improved physical function, and health-related QoL compared with no or other interventions; however, these improvements were small (SMD