Rehab F. M. Gwada

Background/Objectives: Chronic venous disease significantly impairs health-related quality of life (HRQoL). Although the Chronic Venous Insufficiency Questionnaire (CIVIQ-20) is widely used internationally, a validated Arabic version is lacking. The objectives of this study were to translate and culturally adapt the CIVIQ-20 into Arabic and to examine its reliability, construct, and discriminative validity in Arab patients with chronic venous disease. Methods: Following standardized guidelines, the CIVIQ-20 was translated and cross-culturally adapted. For psychometric evaluation, 139 participants with chronic venous disease were selected. They completed the Arabic version of Chronic Venous Insufficiency Questionnaire-20 (CIVIQ-20-Ar) and 36-Item Short Form Health Survey (SF-36). Psychometric evaluation included internal consistency (Cronbach’s alpha) and test–retest reliability using the two-way random intraclass correlation coefficient ICC _(2,1). Minimal detectable change (MDC₉₅) was assessed, along with both convergent validity (using the SF-36 as a comparator) and known-group validity (across CEAP severity stages), using seven predefined hypotheses. Results: The CIVIQ-20-Ar questionnaire had adequate internal consistency and very strong test–retest reliability. As hypothesized, the CIVIQ-20-Ar subscales and global index demonstrated a moderate-to-strong correlation with the SF-36 summary and domain scores (r = −0.42 to −0.79, p < 0.001), with the strongest correlation in the pain subscale (r = −0.79, p < 0.001). Known-group validity was established by significant score discrimination across advancing Clinical–Etiology–Anatomy–Pathophysiology (CEAP) severity stages (p < 0.01). Conclusions: The CIVIQ-20-Ar Questionnaire has adequate psychometric properties. Therefore, vascular surgeons, phlebologists, and rehabilitation specialists can use the CIVIQ-20-Ar in routine clinical practice and research to evaluate health-related quality of life in the Arabic-speaking population with chronic venous disease.

Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and has a high prevalence in Saudi Arabia. GDM increases the risk of adverse maternal and fetal outcomes and is associated with cardiovascular risk factors. Glycemic severity, represented by the continuous 1 h plasma glucose value from the diagnostic two-hour 75 g oral glucose tolerance test (OGTT), may provide additional insight into glycemic status among women with GDM. Physical activity (PA) plays a vital role in maternal health. Therefore, the aim of this study was to identify the associations between PA and glycemic severity among pregnant women with GDM in Saudi Arabia and to identify factors associated with glycemic severity. Methods: This cross-sectional study enrolled 96 pregnant women during routine second-trimester visits at a maternity clinic in Riyadh. PA was assessed using the Pregnancy Physical Activity Questionnaire (PPAQ). Glycemic severity was assessed using the continuous 1 h plasma glucose value obtained from the diagnostic two-hour 75 g OGTT. Results: One-way ANOVA demonstrated a significant association between PA levels and glycemic severity (F = 2.78; p < 0.04). Multiple linear regression identified low-intensity PA, non-employment, and smoking during pregnancy were significantly associated with higher glycemic severity (p < 0.05). Conclusions: The study identifies a significant association between PA and glycemic severity. Furthermore, employment status and smoking were also significantly associated with glycemic severity. These findings suggest that PA and other modifiable lifestyle factors play role in glucose regulation during pregnancy. However, the cross-sectional design precludes any inference of causality.

Background: Low back pain is a common musculoskeletal complaint among postpartum women due to physical changes that occur during pregnancy and delivery, which can lead to different disability levels. Therefore, the aim of this study was to evaluate the disability levels and associated factors of postpartum women within the first year after childbirth. Methods: A descriptive cross-sectional study design was used to gather data from post-partum women between 6 weeks and 12 months after childbirth using an online self-administered questionnaire. This questionnaire included demographic variables, the Nordic Musculoskeletal Symptoms Questionnaire, the Pain Intensity Numeric Rating Scale, and a back disability questionnaire. Results: Among 400 postpartum mothers, 71% reported low back pain, with 51.1% experiencing mild disability. Logistic regression showed significant predictors of disability, including cesarean delivery (6.49 times higher likelihood), having 4–5 children (1.98 times), and more than six children (3.45 times). Breastfeeding increased disability risk (2.44 times), while mixed feeding reduced it (0.52 times). The model explained 49.8% of disability variance (p < 0.001). Conclusions: Disability is a common problem among postpartum women, highlighting the importance of healthcare providers addressing these challenges.

Background/Objective: Culturally adapted frailty screening tools are essential for improving health outcomes, facilitating clinical decision-making, promoting effective care planning, and ensuring accurate frailty assessment across diverse cultural contexts; their use among clinicians and academics is therefore supported. The purpose of this study was to assess internal consistency, test–retest reliability, and validity of the Arabic FRAIL scale (FRAIL-AR scale) for Arabic-speaking populations with colorectal cancer (CRC). Methods: This cross-sectional study included 137 participants diagnosed with CRC who completed the FRAIL-AR scale, the EORTC QLQ-C30 physical function subscale, and functional performance-based Timed Up and Go (TUG) and Five Times Sit-to-Stand (5xSTS) tasks. Internal consistency was assessed using Kuder–Richardson formula 20 (KR-20), and test–retest reliability was determined using the two-way random intraclass correlation coefficient ICC _(2.1). Convergent validity was evaluated by assessing the correlation between the FRAIL-AR scale against the EORTC QLQ-C30 physical function scale, TUG, and 5xSTS. Results: The FRAIL-AR scale exhibited good internal consistency (KR-20 = 0.80) and test–retest reliability (ICC _(2.1) = 0.89, 95% CI 0.77–0.94). Correlation analysis showed a weak negative correlation between the overall FRAIL-AR scale scores and EORTC QLQ-C30 physical function scale scores (r = −0.38, p < 0.05), while it exhibited a moderate positive correlation with TUG (r = 0.75, p < 0.01) and 5xSTS (r = 0.63, p < 0.01) scores. FRAIL-AR scores showed significant known-groups validity with higher frailty scores in older-age individuals (p < 0.01), females (p < 0.05), and those with comorbid conditions (≥5) (p < 0.05). Conclusion: The FRAIL-AR scale’s validity and reliability make it an appropriate tool for geriatricians, oncologists, and healthcare providers to evaluate and monitor frailty among Arabic-speaking colorectal cancer patients.

Fear of falling (FOF) is closely associated with increased disability among older adults, resulting in significant public health concerns. This study aimed to determine the risk factors and predictors of falling (FOF) in older adults in Saudi Arabia. This cross-sectional study recruited 170 older adults (aged ≥ 60 years) from 3 tertiary hospitals and the Geriatric Society Center in Jeddah. FOF was assessed using the Falls Efficacy Scale-International (FES-I). Data were collected using the short Geriatric Depression Scale-15 (GDS-15) and physical functional assessments, including activities of daily living questionnaire, time up and go test, and hand grip strength. The prevalence of FOF among the older Saudi adults was 46.5%. Predictors of FOF included poor health perception (OR = 10.5, 95% CI = 1.26–87.73; P = .03), female gender (OR = 6.17, 95% CI = 1.57–24.14; P = .009), vision problems (OR = 3.81, 95% CI = 1.58–9.21; P = .003), a history of falls (OR = 3.29, 95% CI = 1.35–8.01; P = .009), and the timed up and go score (OR = 1.38, 95% CI = 1.09–1.17; P = .007), while no medication use is more likely to have less FOF (OR = 0.03, 95% CI = 0–0.40, P = .007). FOF is a prevalent issue and is associated with several factors, highlighting the importance of FOF assessments among older adults in Saudi Arabia.

Purpose: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition marked by airflow limitation and symptoms like chronic cough, breathlessness, and chest tightness. These factors, along with exacerbations and polypharmacy, may predispose COPD patients to urinary incontinence (UI). Unique challenges such as increased intra-abdominal pressure, pelvic floor weakness, and comorbidities may worsen UI and impair health-related quality of life (HRQoL). This study aimed to identify factors associated with UI severity in COPD patients and to examine its impact on HRQoL. Methods: This cross-sectional study included 101 participants diagnosed with COPD who were reported to have UI. Participants completed the following questionnaires: the health status and UI severity were recorded using the COPD Assessment Test (CAT), International Consultation on Incontinence Questionnaire- Urinary Incontinence – short form (ICIQ-UI short form), and Incontinence Impact Questionnaire – short form (IIQ-7). Results: UI severity was correlated with age, BMI, smoking, comorbidities, medications, chest tightness, and breathlessness. Severe UI predictors included age (OR=1.07), BMI (OR=1.09), and number of medications (OR=5.04), whereas breathlessness predicted moderate (OR=1.72) and severe UI (OR=1.87). Among COPD patients, 82.2% reported a mild impact of UI on HRQoL, and 6.9% reported a severe impact. Notably, among those experiencing moderate-to-severe HRQoL impairment, 63.6% had severe UI. Conclusion: This study highlights urinary incontinence (UI) as a prevalent and impactful comorbidity in individuals with COPD, significantly affecting their HRQoL. UI severity was associated with clinical factors such as older age, higher body mass index (BMI), greater medication burden, and breathlessness. Notably, greater UI severity corresponded to more substantial impairments in HRQoL, with severe cases reporting greater negative effects on daily functioning. These findings underscore the importance of routine screening for UI in COPD patients and the implementation of targeted continence care strategies to enhance overall quality of life. Plain Language Summary: This study highlights significant correlations between UI, HRQoL, and factors such as age, BMI, and breathlessness. This study emphasizes the need for routine UI screening in patients with COPD to improve HRQoL through specialized continence care.

This study examined the psychometric properties of the Arabic Quick-Disability of the Arm, Shoulder, and Hand (QDASH-Ar) for breast cancer (BC) survivors. In this cross-sectional study, a convenient sample of 88 BC survivors was recruited and completed both the QDASH-Ar and Short Form-36 (SF-36) Arabic questionnaires. Internal consistency and test–retest reliability were assessed using Cronbach’s alpha and the two-way random intraclass correlation coefficient [ICC _(2.1)], respectively. Standard error of measurement (SEM) was used to calculate the minimal detectable change (MDC). Spearman correlation coefficients were used to test construct validity between QDASH-Ar and SF-36. The results demonstrated that QDASH-Ar had a Cronbach’s alpha of 0.86 and an ICC _(2.1) of 0.92. The scale’s SEM and MDC were 2.69 and 7.47, respectively. The correlation coefficients between the Quick-DASH score and the subscales of SF-36 ranged from −0.27 to −0.65, supporting the predefined hypotheses for construct validity. The discriminant validity was proven by the Quick-DASH total score between BC survivors with and without lymphedema (20.89 ± 12.78 vs. 33.63 ± 11.58, P < 0.01). In conclusion, QDASH-Ar demonstrated acceptable internal consistency, excellent test–retest reliability, and moderate to strong construct validity. Clinicians and researchers can use this valid instrument to assess and monitor upper extremity activity limitations and symptoms in BC survivors.

There is limited evidence regarding the combined effect of exercise and compression garment on breast cancer–related lymphedema (BCRL). Therefore, we investigate the effect of low-intensity resistance training alone or in combination with a compression garment on lymphedema volume, self-reported lymphedema symptoms, and shoulder mobility and function. A total of 60 women with unilateral BCRL were randomly assigned to low-intensity resistance exercises (Rex group, n = 30) or exercises and compression garment (Rex-Com-group, n = 30). Both groups take part in exercises program consisted of 10–12 repetitions at 50 to 60% of one repetition maximum (IRM), three times weekly, for 8 weeks. The primary outcome was lymphedema volume determined by percentage reduction of excess limb volume (ELV). Secondary outcomes were lymphedema symptoms (pain, heaviness, and tightness) and shoulder mobility and function using the disabilities of the arm, shoulder, and hand (DASH) questionnaire. All measurements were standardized and performed before (week 0, W0), after the intervention (week 8, W8), and at follow-up (week 12, W12). A significant reduction in percentage of ELV (p < 0.01), pain severity (p < 0.05), a sensation of heaviness (p < 0.05) and tightness (p < 0.001), and improvement in shoulder range of motion (p < 0.05) and function on DASH scores (p < 0.05) were observed at W8 and W12 in both groups. However, no between-group differences were observed over time. These findings suggest that low-intensity resistance training, irrespective of garment use, can effectively reduce limb volume and lymphedema symptoms, and increase shoulder mobility and function.