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You can download the brochure here. He also studied musicology and in earned a doctorate in the subject from the University of Helsinki, where worked as an assistant The sixth and seventh piano concertos Hermes and Khora were composed as dance works in close partnership with the ERI Dance Theatre. Hermes is scored for piano, soprano and string orchestra, while Khora has five percussion players instead of an orchestra.

Both concertos can also be performed as concert versions. Moon Concerto Piano Concerto No. Basic features of his style are its colourful, impressionistic sonority and energetic rhythms displaying the influence of Latin-American music, jazz and rock. In the s, particularly, he went in for marked contrasts of style within one and the same work as in Possible Worlds.

Among his latest works is the Concerto for Organ and Orchestra composed in in which the organ at times dances to the beat of an old Italian Saltarello, while at others it engages in sustained, intense dialogue with the orchestra creating an impressive, sublime atmosphere steeped in colour. He specialises in new Finnish music, a subject on which he has written works focusing on the history of ideas such as his doctoral dissertation The Idea of Innovation and Tradition , and the history of composition.

His book Aikamme musiikki is volume 4 of the history of Finnish music that won the Finlandia Prize for non-fiction in When plotting the ROC curve, the criterion standard of change score was dichotomized to identify those subjects who experienced a clinically meaningful reduction in symptoms. A questionnaire that does not discriminate more effectively than chance will have an AUC of 0. The optimal cutoff change score was identified as the cut point on the curve nearest the upper left-hand corner of the graph with equally balanced sensitivity and specificity.

The MCID has been defined as the smallest change on a scale that is important to patients. Thus, it allows clinicians to discriminate between patients who have improved and those whose condition remains unchanged. Furthermore, the MCID is useful for determining sample-size requirements for clinical trials and for distinguishing between statistical significance and clinical significance in published studies. Minor linguistic discrepancies were easily resolved in the expert committee meetings. The prefinal version performed well in the pilot test. The patients stated that the items were clear and that the majority were relevant to their shoulder problem.

The average time taken by the patients to answer all items was approximately 8 minutes. Reliability Internal consistency had a Cronbach alpha of. When the alpha coefficient was calculated for the overall scale by eliminating each of the 21 items 1 at a time, the range was 0. No items were missing from the 3 questionnaires at either the baseline or discharge assessment. Test-retest reliability yielded an ICC of 0. The standard error values were 0.

This indicates that the change scores yielded by the WOSI and DASH are significantly better than chance at identifying an improved patient from randomly selected pairs of improved and unimproved patients. This indicates that the discriminative ability of the WOSI was better than that of the DASH in this sample of patients with shoulder instability caused by a first-time traumatic anterior dislocation and treated by means of a rehabilitation protocol. The ROC curve was also used to provide an estimate of the MCID, taken as the point on the ROC curve nearest the upper left-hand corner of the graph cutoff score , which most effectively discriminates between patients who have improved and those whose condition is unchanged.

The sensitivity and specificity associated with the WOSI cutoff point of were 0. The sensitivity and specificity associated with the DASH cutoff point of 23 were 0. This study successfully translated the WOSI and established that the Italian version had psychometric properties similar to those established for the English version. This value exceeds. The Italian WOSI displayed an excellent reliability for both short-term 3 days, 64 patients and medium-term 14 weeks, 20 patients test-retest, with an ICC of 0.

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A larger sample size of patients would have provided a more stable ICC analysis for reliability, particularly for the medium-term retest. As a reminder, and to place these values in perspective, the range of possible scores on the WOSI is 0 to The quality of measurement questionnaires has usually been evaluated by considering the reliability and validity of such questionnaires; it has, however, been suggested that responsiveness should be another criterion in the choice of a measurement questionnaire.

Consequently, the data obtained by the analysis of the ROC curve in our study cannot be compared with those of other studies.

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Our ES value 1. The anchor-based method, however, demonstrated that the WOSI was clearly more responsive than the DASH in our sample of patients with shoulder instability treated by means of a rehabilitation program. These results indicate that responsiveness can be evaluated more effectively when distribution-based methods are not used on their own but combined with an anchor-based method.

If taken together, the data obtained by both the anchor-based and distribution-based methods demonstrate that the Italian version of the WOSI has very high sensitivity. This allows moderate differences in clinical change to be identified when patients undergo therapy and for there to be fewer patients necessary to detect a significant difference between treatment groups and control groups in a clinical study. The evidence presented in this study shows that the WOSI, a patient-rated disease-specific questionnaire, is a valid and reliable means of measuring change in pain and function over time in outpatients with shoulder instability treated with a rehabilitation program, and that it is significantly more responsive than the DASH, a patient-rated generic questionnaire.

This observation is consistent with those reported in other studies that found patient-rated disease-specific questionnaires to be more responsive to the target condition than patient-rated generic questionnaires. Choosing the ideal questionnaire for outcome measurements is realistically impossible, because each questionnaire has its own advantages and disadvantages that are dependent on factors such as the aims of the study clinical or research setting and the patient population enrolled.

One limitation regarding the generalizability of our results is that the study was performed exclusively in patients with shoulder instability caused by a first-time traumatic anterior dislocation, who were treated with a conservative nonsurgical rehabilitation program. Therefore, we cannot be confident that the psychometric data would be the same for individuals with chronic, recurrent, or multidirectional instability or those postsurgery. A methodological limitation of our study is that the sample size was too small to perform a factor analysis to assess convergent validity.

Another limitation is that we did not stratify our patients by age, which may be an important factor given that the patient's age at the time of the first shoulder dislocation is the most important prognostic factor for recurrence. Moreover, assessment of cross-cultural adaptation by means of reliability, validity, and responsiveness measurements does not depend on specific patient selection, because all comparisons are made within patients. The study's strengths include the standardized methods used for all procedures, particularly for the cross-cultural adaptation, and, for the first time, the use of all the recommended statistical methods to determine the responsiveness of the WOSI questionnaire.

Our data indicate that the Italian version of the WOSI questionnaire is a valid, reliable, and responsive tool that can be used to measure self-reported outcomes in Italian patients with shoulder instability caused by a first-time traumatic anterior dislocation. Therefore, because the WOSI, unlike the DASH and SF, is a disease-specific questionnaire, we suggest that it be used as a standard outcome measure in Italian patients who undergo a rehabilitation program for shoulder instability.

The WOSI questionnaire for shoulder instability was cross-culturally adapted to the Italian language, and its measurement properties have been validated. In addition to providing an Italian version of the WOSI, this study adds to the evidence supporting the psychometric properties of the original English questionnaire, which is now available also in Italian.

Caution is needed in the generalizability of our results, because our sample of patients was limited to those with shoulder instability caused by a first-time traumatic anterior dislocation undergoing a nonsurgical rehabilitation program. Kirkley, MD and S.

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Griffin, CSS. Tutti i diritti riservati. Il permesso di riprodurre il WOSI viene regolarmente concessa dagli autori a soggetti e organizzazioni per il proprio uso. AJSM 26 6 —, Gentile Sig. Se ha dei dubbi riguardo la spalla coinvolta o se ha qualsiasi altra domanda, La preghiamo di richiedere tutti i chiarimenti prima di iniziare la compilazione del questionario. Quanto era dolente o pulsante la sua spalla? Quanta debolezza o mancanza di forza ha avuto alla spalla?

Quanta fatica o mancanza di resistenza ha avuto alla spalla? Quanti scatti o scrosci ha avvertito alla spalla? Quanto ha sentito rigida la sua spalla? Quanto fastidio ha provato ai muscoli del collo a causa del suo problema alla sua spalla? Quanto ha sentito instabile o cedevole la sua spalla?

Quanto ha compensato il movimento della sua spalla con altri muscoli? Quanta paura ha di cadere sulla spalla? Quanta frustrazione prova a causa del suo problema alla spalla? Domanda 1. Domanda 2. Si riferisce a un dolore sordo di sottofondo, che si contrappone ai dolori acuti che sono rapidi o improvvisi. Domande 3. Domanda 4. Domanda 5. Si riferisce ai rumori avvertiti alla spalla durante i movimenti. Domanda 6. Questo non si riferisce ad una ridotta ampiezza di movimento. Domanda 7. Domanda 8. Si riferisce alla sensazione che la spalla sia parzialmente o totalmente fuoriuscita dall'articolazione, scivolando verso il basso o in varie direzioni.

Domanda 9. Domanda Si riferisce alla mancanza di movimento completo della spalla in una o in tutte le direzioni. Si riferisce a quanto, consciamente o inconsciamente, ha protetto il suo braccio tenendolo vicino al corpo, fasciandolo o indossando un tutore.

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Questo non si riferisce al sollevamento di oggetti al di sopra della testa, ma al sollevamento di un oggetto pesante al di sotto del livello della spalla. Per esempio buste della spesa, attrezzi da lavoro, libri, palla da bowling. Si riferisce alla paura di cadere sulla sua spalla o sulla sua mano tesa dal lato della spalla infortunata. Si riferisce al livello di fitness efficienza che Lei manteneva prima del problema alla sua spalla, incluso una diminuzione della fitness efficienza cardiovascolare, del livello di forza, o del tono muscolare.

Si riferisce all'essere sempre consapevole della sua spalla o di prenderla in considerazione prima di fare qualsiasi cosa. Si riferisce alla preoccupazione che la sua spalla peggiori invece di migliorare o rimanere sempre uguale. Misurare la distanza dal margine sinistro della linea e calcolare il punteggio fino ad un massimo di registrato con l'approssimazione di 0,5 mm. Riportare il punteggio ottenuto nell'apposito spazio.

Per ottenere il valore percentuale si sottrae il punteggio numerico ottenuto per es. Research Report. Study Design. Cross cultural Adaptation Process. Key Points. Versione Italiana Italian version. J Orthop Sports Phys Ther ;42 6 J Orthop Sports Phys Ther ;47 6 Epub 12 May Epub 8 Jan Epub 8 Nov Epub 24 Apr J Orthop Sports Phys Ther ;43 3 Volume 42, Issue 6 June Pages: - Related Articles Articles citing this article: Google Scholar. Related Articles In: PubMed. Altman DG. Practical Statistics for Medical Research.

Andresen EM. Criteria for assessing the tools of disability outcomes research. Arch Phys Med Rehabil. Apolone G , Mosconi P. J Clin Epidemiol. Beaton DE. Understanding the relevance of measured change through studies of responsiveness. Spine Phila Pa Many faces of the minimal clinically important difference MCID : a literature review and directions for future research. Curr Opin Rheumatol. Guidelines for the process of cross-cultural adaptation of self-report measures.

Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. Responsiveness of functional status in low back pain: a comparison of different instruments.

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Cronbach's alpha. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Cole B , Warner J. Anatomy, biomechanics and pathophysiology of glenohumeral instability. Disorders of the Shoulder: Diagnosis and Management. Defining clinically meaningful change in health-related quality of life. Management of shoulder dislocation--are we doing enough to reduce the risk of recurrence?

Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. Control Clin Trials. Defining the clinically important difference in pain outcome measures. Fleiss JL.

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Reliability of measurement. Statistical Methods for Rates and Proportions. Practical Statistics for Nursing and Health Care. Guillemin F. Cross-cultural adaptation and validation of health status measures. Scand J Rheumatol. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines.