Introduction: Headache-related disability is influenced by attack frequency, intensity, and duration, but these do not fully capture the impact of headache on a person's life. The Headache Impact Test - 6 questionnaire is widely used, but the psychometric properties of its Italian version (HIT-6_IT) remain untested. This study evaluates the reliability and validity of the HIT-6_IT in people with migraine and tension-type headache. Materials and methods: For reliability evaluation, 55 stable participants with migraine or tension-type headache completed the HIT-6_IT twice, 14 days apart. A separate cohort of 110 participants from the same population was assessed to evaluate the validity of the scale, considering headache type, frequency, intensity, and HIT-6 scores. Reliability was measured by Cronbach's alpha, Intraclass Correlation Coefficient (ICC2,1), and Minimal Detectable Change 95% (MDC95). Construct validity was tested via correlations and subgroup comparisons. Results: HIT-6_IT showed excellent reliability (alpha = 0.77; ICC2,1 = 0.97; MDC95 = 2.52). Scores correlated with headache frequency (r = 0.36) and intensity (r = 0.30), differing significantly between diagnostic subgroups (p < 0.001), supporting the validity of the questionnaire. Discussion: HIT-6_IT is a reliable and valid tool for assessing the impact of migraine and tension-type headache, in both clinical and research settings.
Background and aimFunctional constipation (FC) represents a common pediatric disorder that significantly impairs the quality of life (QOL) in affected children. Therefore, the effects of acupuncture versus biofeedback training on bowel motility, stool consistency, anxiety levels, and QOL were compared in children with FC.Participants and methodsSixty children with FC, aged from 7 to 15 years, were randomly assigned to two equal groups (n = 30 each). Group A received acupuncture, while Group B received biofeedback training, both for four weeks. The primary outcome measures were bowel movement and stool consistency, evaluated using the CSBM and BSFS, respectively. The secondary outcome measures included anxiety levels and QOL, evaluated by SAS and PAC-QOL , respectively. The outcome measures were assessed pre- and post-treatment.ResultsPost-treatment analysis revealed significant within-group improvements for all outcomes (p = .001). Between-group comparisons of post-treatment scores demonstrated that Group B had significantly better outcomes than Group A across all primary and secondary measures. Specifically, in CSBMs with small effect size (r = -.286; p = .01), BSFS and PAC-QOL with moderate effect size (r = -.462; p = .001 and Cohen's d = 0.58; p = .02), respectively. Notably, large effect sizes for the SAS (Cohen's d = 1.43; p = .001).ConclusionsBoth interventions improve bowel motility and stool consistency, reducing anxiety levels, and boosting QOL among children with FC. However four-week trial, biofeedback demonstrated greater short-term improvements compared to acupuncture. Long-term follow-up is necessary to evaluate the durability of these effects and confirm long-term efficacy.
Background and aims: The COVID-19 pandemic prompted an Australian osteopathy program to develop a hybrid face-to-face and digitally enabled objective structured clinical examination (OSCE) using videoconferencing for remote assessment. This study aimed to explore the opportunities and challenges associated with the hybrid OSCE. Methods and participants: This pragmatic multiphase study evaluated reliability of asynchronous grading and explored participant perceptions using a survey. Ninety-one osteopathy learners undertook a summative assessment where synchronous grading (T1) occurred. Asynchronous grading (T2) was conducted 5 months later, total OSCE scores and individual criteria scores were compared. Analysis of correlation, agreement and test-retest reliability was performed to determine reliability. Survey data from 17 learners and three examiners were gathered using a modified Student Perceptions of e-Assessment Questionnaire (SPEAQ). Results: Moderate agreement (kappa w = 0.45, p < .001) and strong correlation (r = 0.69, p < .001) between total scores was achieved. Statistically significant correlation was achieved on only five of the 16 station criteria (rho = 0.41-0.44, p < .001) and both agreement and test-retest reliability were poor. This indicates total OSCE scores showed a consistent pattern between T1 and T2, although this consistency did not extend reliably to individual scoring criteria. Survey mean scores ranged from 3.75 to 4.84 (SD = 0.36-1.29) with the highest mean ratings being for affective, practicality and pedagogy domains. Conclusions: Results indicate asynchronous video-based grading may be feasible, but reliability was not consistently demonstrated within the constraints of this study. Positive perceptions were reported by learners and examiners indicating the digitally enabled OSCE was acceptable and offered pedagogical benefits that were unique to the hybrid format.
IntroductionThe development of professional touch is an important skill in the education of healthcare professionals. However, variability in clinical exposure, limited opportunities for repeated practice, and challenges in structured feedback and competency validation have prompted interest in simulation-based and technology-enhanced approaches, including haptic-enabled eXtended Reality (XR). Such approaches may also support patient and learner safety by allowing safer early skill development before clinical application. However, little is known about the scope of prior research in this field.MethodsThis scoping review followed the Joanna Briggs Institute (JBI) scoping review template and methodology guidelines. Five databases were searched (CINAHL, MEDLINE, SCOPUS, IEEE, and AMED) to identify literature exploring the use of haptic-enabled XR technologies to support the development of professional touch skills in healthcare education. The search was limited to English-language publications from 1990 to March 2026. Themes were synthesised and reported using the PAGER framework.ResultsThe review included ten studies on haptic-enabled XR in healthcare education. Most studies employed grounded force feedback devices, demonstrating effectiveness in skill acquisition for palpatory diagnosis and procedural training. One validation study suggested simulator accuracy, and only one randomised control trial was identified and showed non-inferiority to traditional methods. Despite promising findings, limitations persist in feedback fidelity, long-term validation, standardised outcome measures, and economic transparency.ConclusionsThis scoping review aimed to map and describes how haptic-enabled XR technologies have been used to support the development of professional touch skills in healthcare education. The findings show promise for enhancing training in professional touch. However, further rigorous and longitudinal research is required before widespread adoption can be recommended.
BackgroundTotal hip arthroplasty (THA) is highly successful for pain relief and patient satisfaction, yet randomized controlled trials consistently show no difference between supervised physical therapy and self-directed exercise at 12 months. Paradoxically, patients report normalized function at 12 months, yet demonstrate strength deficits compared with healthy controls. This narrative review examines why these deficits persist and what factors may explain the apparent equivalence of rehabilitation approaches.MethodsLiterature was identified through PubMed, CINAHL, and the Cochrane Library, and searched (2004-2026) for literature on exercise dosing, risk stratification, and implementation barriers in THA rehabilitation.ResultsEvidence reveals a measurement paradox: 95% of THA trials use patient-reported outcomes that normalize by 12 months, whereas only 22% assess strength in which deficits persist. Approximately 68.7% of patients recover well with self-directed exercise, though 31.3% initially discharged to self-directed care ultimately require formal rehabilitation. Validated tools can identify high-risk patients preoperatively. System-level barriers limit the implementation of evidence-based dosing.ConclusionThe path forward requires standardized outcome measures capturing strength restoration, validated risk stratification to identify patients requiring intervention, and evidence-based dosing for those with persistent deficits.
Background: Migraine is common among university students and may impair academic participation and daily functioning. To date, no studies have examined migraine in an Irish University setting. Methods: A cross-sectional online survey was conducted among students at University College Dublin (2020-2021). Associations with demographics, physical activity, and comorbidities were examined using chi-square tests, prevalence ratios (PRs), and logistic regression. Results: Of 494 respondents, 124 (25.1%) reported migraine. Prevalence was higher among students >30 years old (53.4% vs. 21.3%; PR 2.51), females (28.6% vs. 13.8%; PR 2.06), postgraduates (34.8% vs. 21.2%; PR 1.64), non-athletes (29.1% vs. 10.5%; PR 2.77), and those not meeting physical activity guidelines (31.1% vs. 22.0%; PR 1.41). Migraine was more prevalent among those reporting physical and mental health conditions. Variables that remained independently associated with migraine in adjusted cross-sectional models included older age (AOR approximate to 4), female gender (AOR approximate to 2), and physical (AOR approximate to 3) and mental health conditions (AOR approximate to 1.7). Conclusions: These findings highlight the relevance of migraine within the student population and may inform future research and service planning.
Introduction: Physiotherapy plays a vital role in palliative care for patients with advanced cancer. However, access to physiotherapy is often limited in resource-limited communities. To address this gap, a screening tool tailored to clinical needs and contextual constraints is needed. Objective: To develop and validate the content of the FisioCan-CP, a physiotherapy screening tool for patients with advanced cancer receiving palliative care in resource-limited communities. Methods: A methodological study was conducted in two phases: (1) development of the instrument based on clinical data, targeted literature review, and expert brainstorming; and (2) content validation by Delphi method. Results: Eleven preliminary items were generated and submitted to expert evaluation. In the first Delphi round, 10 items reached the consensus threshold, resulting in the exclusion of the delirium item, the merging of two functionality-related items, and the addition of fall risk. In the second round, all remaining items achieved high agreement (Content Validity Index >0.90). The final FisioCan-CP consists of 10 items: functional limitation, immobility syndrome, frailty, moderate/severe pain, asthenia/fatigue, lymphedema, vascular changes, pressure injuries, dyspnea, and fall risk. Conclusion: The FisioCan-CP demonstrated strong content validity and provides an initial, conceptually grounded tool to support physiotherapy referral in palliative care.
