Andrea Giordano

• Electronic Engineering Degree
• Researcher at Istituti Clinici Scientifici Maugeri IRCCS

Background Left Ventricular Assist Device (LVAD) implantation is an important treatment option for patients with advanced CHF. Referral to an early, intensive cardiac rehabilitation (CR) program in these patients seems still underused. This observational descriptive study aimed to evaluate the feasibility and efficacy of an early intensive CR progr...

Purpose: To perform a detailed psychometric Rasch analysis of the Prosthesis Embodiment Scale (PEmbS) administered in adults with lower limb amputation (LLA). Methods: A convenience sample of German-speaking adults with LLA (n = 150), recruited from German state agencies' databases, was asked to complete the PEmbS, a 10-item patient-reported sca...

Background: Prostheses are a primary rehabilitative intervention for people after lower limb amputation. To appropriately measure the effectiveness of prosthetic interventions, valid and reliable measures of prosthetic mobility are required. The Prosthetic Limb Users Survey of Mobility (PLUS-M) is a promising instrument for measuring prosthesis us...

The Short Physical Performance Battery (SPPB) is a commonly used tool to assess lower extremity function, composed of three assessments (standing balance, gait speed, and chair stand). While its validity for group-level decisions has been positively demonstrated, the measurement precision at the individual level needs more clarification. We aimed t...

Purpose To produce and validate an Italian version of the Lymphedema Life Impact Scale version 2 (LLISv2-It), a tool measuring the impact of lymphedema on health-related quality of life, and investigate its main psychometric characteristics. Methods After translation and cross-cultural adaptation of the LLISv2, we administered it to 156 subjects w...

Background: After peripheral facial palsy, the onset of facial synkinesis results in aesthetic disfigurement and local muscle tension or pain, with possible deterioration of patient's well-being and social participation. The availability of valid instruments to evaluate patient-reported severity of facial synkinesis is important to capture the sub...

Background: The Prosthesis Evaluation Questionnaire-Mobility Section (PEQ-MS) and the Prosthetic Mobility Questionnaire (PMQ 2.0) are two validated self-report questionnaires assessing mobility in people with lower-limb amputation. Objective: The aim of this study was to assess and compare the psychometric properties of PEQ-MS and PMQ 2.0 in a s...

Purpose: There is growing interest in measures that assess upper-limb lymphedema after breast cancer. Since no validated Italian version of the Lymphedema Quality of Life Questionnaire for upper limbs (LYMQOL-UL) exists, we aimed to culturally adapt and validate an Italian version (LYMQOL-UL-IT) in order to allow its use in Italian patients. Mate...

The Pain Catastrophizing Scale (PCS) is a widely studied tool to assess pain catastrophizing for chronic low back pain (LBP). Short forms of the PCS exist, but their measurement precision at individual level is unclear. This study aimed to analyze the Rasch psychometric characteristics of the PCS and three of its short forms (two 4-item and one 6-i...

Cardiopulmonary exercise testing is a prognostic tool in heart failure with reduced left ventricular ejection fraction (HFrEF). Prognosticating algorithms have been proposed, but none has been validated. In 2017, a predictive algorithm, based on peak oxygen consumption (VO2), ventilatory response to exercise (ventilation [VE] carbon dioxide product...

Aims: The 6-min walk test (6MWT) and cardiopulmonary exercise test (CPET) are both predictive in heart failure (HFrEF). Although 6MWT substitutes for CPET in HFrEF patients, as submaximal testing may be preferable, its prognostic superiority still needs to be verified, particularly in regard to beta blockers (BBs). We aimed to compare the prognost...

The aim of this study was to translate, culturally adapt and validate an Italian version of the Athlete Fear Avoidance Questionnaire (AFAQ-I). We conducted a cross-sectional evaluation of the psychometric properties of the AFAQ-I in university athletes with musculoskeletal injuries, culturally adapting it in accordance with international standards....

Background and purpose: The Mini-BESTest is a balance measure with robust psychometric properties widely used in people with Parkinson disease. The aim of this study was to examine-with advanced psychometric techniques-some key properties of the Mini-BESTest (including unidimensionality, functioning of rating categories, internal construct validit...

As more adults are living into old age, they are predisposed to cardiovascular disease (CVD) and the demand for cardiac rehabilitation is increasing. We aimed to verify predictors of length of stay (LOS) in young (Y) vs older (O) vs very old (VO) CVD patients, admitted to residential cardiac rehabilitation. Patients’ demographic and clinical charac...

Aims: To evaluate cardiac rehabilitation (CR)-derived predictors of outcome in patients discharged from rehabilitation after transcatheter aortic valve replacement (TAVR). Methods: We retrospectively analyzed data from 232 TAVR patients (aged 82±6 years, 55% females) discharged following an average 3-week residential CR program in the period Jan...

Background and aims: The indication for cardiopulmonary exercise testing (CPET) in predictive evaluation has been extended beyond chronic heart failure (HF) patients to include asymptomatic left ventricular dysfunction (ALVD) patients, but its prognostic value is still unclear. We aimed to verify if CPET can predict outcome in ALVD and to identify...

Objective To investigate the psychometric properties of the validated Italian version of the Facial Disability Index (FDI), a patient-reported outcome measure widely used to assess individuals with peripheral facial palsy. Design Methodological research on cross-sectional data from a convenience sample. Setting Outpatient university rehabilitatio...

Objective: Statins exert pleiotropic effects by influencing several mechanisms, including synaptogenesis, neurogenesis, cerebral flow regulation, and angiogenesis. Results from in vitro and animal models suggest that statins could have beneficial effect on functional recovery and outcome after stroke events. However, results in human studies are st...

Purpose To evaluate exercise-based rCR derived outcome predictors in patients referred after TAVR. Methods Data of 232 patients (aged 82±6 years, 45%males) admitted to an average 3-week rCR program after TAVR (walking, up to 30 minutes of cycling or treadmill session twice daily, respiratory and calisthenic training) from January 2009 to December...

Background. The aim of this study was to translate, culturally adapt and validate an Italian version of the Athlete Fear Avoidance Questionnaire (AFAQ-I). Methods. We conducted a cross-sectional evaluation of the psychometric properties of the AFAQ-I in athletes with musculoskeletal injuries, culturally adapting it in accordance with international...

Introduction: Parkinson's disease (PD) is a chronic neurodegenerative disease involving a progressive alteration of the motor and non-motor function. PD influences the patient's daily living and reduces participation and quality of life in all phases of the disease. Early physical exercise can mitigate the effects of symptoms but access to speciali...

Background: The Pain Catastrophizing Scale (PCS), a widely used tool to assess catastrophizing related to spinal disorders, shows valid psychometric properties in general but the minimal important change (MIC) is still not determined. Design: Prospective observational study. Aim: To assess responsiveness and MIC of the PCS in individuals with...

This study aimed to compare, through Rasch analysis, the psychometric properties of the Locomotor Capabilities Index (LCI-5) and Prosthetic Mobility Questionnaire (PMQ 2.0) in German lower-limb prosthesis users. The questionnaires were concurrently administered to a convenience sample of 98 consecutively recruited individuals with lower limb amputa...

Background The Short Physical Performance Battery (SPPB) test is a well-established tool to assess physical performance, and to identify frail patients. Assessment of the SPPB in a specific population of elder patients in cardiac rehabilitation phase after a cardiac event is missing. Aim The aim of this study was to correlate SPPB and the cardiac...

Background and aim Growing attention is being given to utilising physical function measures to better understand and manage knee osteoarthritis (OA). The Fremantle Knee Awareness Questionnaire (FreKAQ), a self-reported measure of body-perception specific to the knee, has never been validated in Italian patients. The aims of this study were to cultu...

Patients with chronic obstructive pulmonary disease (COPD) report reduced physical activity (PA). There are only few tools available to assess PA and sedentary behavior in these patients, and none of them aims to differentiate between sedentary and active patterns. The aim of the study was to evaluate an easy tool to profile daily activity time in...

Background: Studies on structural validity of the Quebec Back Pain Disability Scale (QBPDS) showed uncertain unidimensionality. Aim: To investigate dimensionality and internal construct validity of the QBPDS, using advanced psychometric methods. Design: Secondary analysis of data from a cross-sectional observational study, SETTING: Outpatient...

Objective: Short (2- and 4-item) forms of the Pain Self-Efficacy Questionnaire (PSEQ) have been proposed, but their measurement precision at the individual level is unclear.The purpose of this study was to analyze the Rasch psychometric characteristics of PSEQ and its 3 short forms (one 4-item and two 2-item versions) in an Italian-speaking popula...

The availability of psychometrically-sound and parsimonious outcome measures is key for optimizing decision-making about prosthetic fitting and rehabilitation in lower limb prosthesis users. Despite the increasing clinical use of observational and self-reported scales for assessing mobility and balance, there is currently no scale that accounts for...

Objective: To examine the psychometric properties of the Fear-Avoidance Beliefs Questionnaire (FABQ) and its two subscales, in subjects with chronic low back pain (LBP). Design: Methodological research based on a cross-sectional observational study. Methods: A convenience sample of 155 Italian subjects with chronic LBP (57% men; mean age: 43±1...

Purpose To evaluate exercise-based rCR derived outcome predictors in patients referred after TAVR. Methods Data of 434 patients (aged 81±6 years) admitted to an average 3-week rCR program after TAVR (walking, up to 30 minutes of cycling or treadmill session twice daily, respiratory and calistenic training) from January 2009 to December 2017 and ho...

Objective To examine the psychometric properties of the Activities-specific Balance Confidence (ABC) scale administered in the Slovene version with a simplified 5-option response format (ABC-5/SLO) using Rasch analysis. Design Methodological research on data gathered in a cross-sectional study. Setting Outpatient university rehabilitation clinic....

Urinary incontinence is a clinical condition that can negatively affect activities, psychosocial well-being, and health-related quality of life. The Incontinence Impact Questionnaire short version (IIQ-7) is useful to quantify quickly the urinary incontinence-related life-impact. Previous psychometric studies on the IIQ-7, using classical test theo...

Background: The Fear-Avoidance Beliefs Questionnaire (FABQ) is a widely used outcome measure. There is still a lack of information concerning responsiveness and minimal clinically important difference (MCID), limiting its use for clinical and research purposes. Aim: To examine reliability, responsiveness and MCID of the two FABQ scales in subjec...

Background The advent of beta-blockers (BBs) has revolutionized the treatment of heart failure due to left ventricular dysfunction (HFrEF), as these drugs increase survival and reduce hospitalization without a significant impact on exercise tolerance. In this new prognostic scenario, the predictive role of cardiopulmonary exercise testing (CPET) ha...

Exercise oscillatory ventilation (EOV) is an ominous sign in heart failure due to reduced left ventricular ejection fraction (HFrEF) whatever it is represented. But EOV is detected also in normal healthy individuals and in other cardiovascular disease (CVD) patients, however, its prevalence in these is not completed clear. The aim was to describe t...

Purpose: To culturally adapt and validate the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 (short forms) for use in Italian-speaking women with urinary incontinence. Methods: We developed Italian versions of the two questionnaires through forward-backward translation, expert review and cognitive interviews. We then admini...

Background: There is increasing interest in psychometrically sound outcome measures of mobility for people with lower limb amputation (LLA), in order to accurately monitor the impact of the prosthetic training during and after rehabilitation. Aim: To determine the minimum detectable change (MDC) and minimal clinically important difference (MCID)...

Background: Elderlies in cardiac rehabilitation show a particular frailty due to specific aging issues, thus specific professional psychophysical care is required. Aim: This study aimed at evaluating the effect of a cardiac rehabilitation program enhanced with psychological support on the psychophysical health of ≥75elderlies. Moreover, the asso...

Background: The Patient and Observer Scar Assessment Scale (POSAS) v2.0 is a widely used instrument to evaluate postsurgical scars. Its two subscales respectively investigate the patient's and clinician's opinion on the scar quality. However, psychometric studies of the POSAS have indicated that its metric performance is suboptimal, and structural...

It was highlighted that the original article [1] had an omission in the Abstract. This Correction article shows the omitted sentence: “This article [1] was awarded the SIAMOC Best Methodological Paper 2018”.

Aims Cardiac rehabilitation may improve physical and functional recovery after transcatheter aortic valve implantation (TAVI), but outcome predictors in TAVI patients are usually based on assessments made before or at the time of TAVI without regard to cardiac rehabilitation referral. We aimed to assess exercise-based cardiac rehabilitation-derived...

Gait impairment is a risk factor for falls in patients with Parkinson’s disease (PD). Gait can be conveniently assessed by electronic walkways, but there is need to select which spatiotemporal gait variables are useful for assessing gait in PD. Existing models for gait variables developed in healthy subjects and patients with PD show some methodolo...

The aim of this study was to examine the metric properties of the Prosthetic Mobility Questionnaire, an outcome measure of mobility following lower-limb amputation, in Slovene outpatients undergoing rehabilitation. The 12-item Prosthetic Mobility Questionnaire was administered to 148 Slovene adults (74% men) with unilateral lower-limb amputation si...

Objective: To determine the sensitivity to change and minimal clinically important difference (MCID) for the self-administered Locomotor Capabilities Index-5 (LCI-5) in people with lower limb amputation undergoing prosthetic training. Design: Prospective single-group observational study. Methods: The LCI-5 was administered to 110 patients (69...

Objective: To validate the Slovene version of the Orthotics and Prosthetics Users' Survey (OPUS) 8-item Client Satisfaction with Device (CSD) questionnaire in upper-limb prosthesis users and to further verify measurement properties of this tool with Rasch analysis. Design: Participants consisted of a convenience sample of 76 adults (54 men) usin...

Background In multiple sclerosis (MS), the impact of spasticity on the patient’s life is a key issue, and it is fundamental that existing tools measuring the patient’s perspective undergo psychometric analysis and refinement to optimize confidence in their use in clinical practice and research. Objective We examined—by Rasch analysis (RA)—the main...

The aim of this study was to analyse the Cold Intolerance Symptom Severity (CISS) questionnaire in its Italian validated version, using Rasch analysis, to gain insights for a possible refinement of the questionnaire. The CISS was administered to a convenience sample of 96 consecutively recruited outpatients with upper limb peripheral nerve injury....

Exercise ventilation/perfusion matching in continuous-flow left ventricular assist device recipients (LVAD) has not been studied systematically. Twenty-five LVAD and two groups of 15 reduced ejection fraction chronic heart failure (HFrEF) patients with peak VO2 matched to that of LVAD (HFrEF-matched) and ≥14 ml/kg/min (HFrEF≥14), respectively, unde...

Background Several patients with Parkinson´s disease (PD) can walk normally along straight trajectories, and impairment in their stride length and cadence may not be easily discernible. Do obvious abnormalities occur in these high-functioning patients when more challenging trajectories are travelled, such as circular paths, which normally implicate...

HSP60 has been implicated in chronic inflammatory disease pathogenesis, including chronic obstructive pulmonary disease (COPD), but the mechanisms by which this chaperonin would act are poorly understood. A number of studies suggest a role for extracellular HSP60, since it can be secreted from cells and bind Toll-like receptors; however, the effect...

Purpose: To cross-culturally translate the Multiple Sclerosis Spasticity Scale into Italian and to evaluate its psychometric properties in patients with multiple sclerosis. Methods: The Italian version of Multiple Sclerosis Spasticity Scale was developed in accordance with international standards and subsequently administered to 232 Italian adults...

Objectives The aim of this study was to develop and validate a questionnaire designed to measure the impact of sleep impairment on emotional distress in patients with various sleep disorders. Methods Five experts created an item data-bank pertaining to sleep-related psychological symptoms and somatic perceptions. Fifty patients in two focus groups...

This is the S2 file database.xlsx. This is the complete MaSQuDI-17 database. (XLSX)

This is the S1 file MaSQuDI-17.pdf. This is the complete MaSQuDI-17 test. (PDF)

We aimed to verify by Rasch analysis whether the Mini-BESTest, a balance measure, confirms its main psychometric properties in patients with subacute stroke undergoing rehabilitation in three different countries (Slovenia, Croatia, and Italy), and to examine the stability of item hierarchy and difficulty across the three national versions through a...

Background It is not known whether determinants of ventilation (VE)/volume of exhaled carbon dioxide (VCO2) slope during incremental exercise may differ at different stages of reduced ejection fraction chronic heart failure natural history. Methods and Results VE/VCO2 slope was fitted up to lowest VE/VCO2 ratio, that is, a proxy of the VE/perfusio...

We read with attention the article by Benka Wallen et al.1 The aim of their study was to examine the dimensionality of the Mini-BESTest, as well as the properties of its items and their interrelationship, in a sample of elderly individuals with mild-to-moderate Parkinson disease (PD). New studies on the psychometric features of the tool in specific...

Background: The effect of an early comprehensive rehabilitation programme on the evolution of disability after cardiac surgery and the long-term effect of the residual functional status has not yet been investigated. Aim: To analyse the recovery from disability after cardiac surgery and to assess the impact of residual disability on long-term ou...

Objective: To perform a psychometric analysis of the Fatigue Severity Scale (FSS) using Rasch analysis in a sample of Italian subjects with multiple sclerosis. Methods: The 9-item FSS was administered to 156 Italian-speaking subjects with multiple sclerosis. Responses were assessed using Cronbach's alpha, item-remainder correlations, factor anal...

Objective To investigate dimensionality and the measurement properties of the Italian Lower Extremity Functional Scale using both classical test theory and Rasch analysis methods, and to provide insights for an improved version of the questionnaire. Design Rasch analysis of individual patient data. Setting Rehabilitation centre. Participants A t...

Background: The Brief Balance Evaluation System Test (Brief-BESTest) has been recently proposed as a clinical tool for quickly measuring balance disorders, but its measurement properties require investigation. Objective: To perform a detailed analysis of the psychometric properties of Brief-BESTest, by means of Classical Test Theory and Rasch An...

Purpose: The analysis of biomarkers with a prognostic value in chronic heart failure (CHF) is in constant progress. This study aimed to evaluate the short-term prognostic value of angiopoietin-2 (Ang2), galectin-3 (Gal-3), myeloperoxidase (MPO), endostatin (End), and pro-brain natriuretic peptide (pro-BNP) as a conventionally accepted prognosis bi...

Background: The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet i...

It is unclear whether the BBS is an effective tool for the measurement of early postural control impairments in patients with Parkinson's Disease (PD). To evaluate BBS' content validity, internal construct validity, reliability and targeting in patients with PD within the Rasch analysis framework. Observational, cross-sectional study. Outpatient Re...

Background: In heart failure (HF), women show better survival despite a comparatively low peak oxygen consumption (V˙o2): this raises doubt about the accuracy of risk assessment by cardiopulmonary exercise testing (CPET) in women. Accordingly, we aimed to check (1) whether the predictive role of well-known CPET risk indexes, ie, peak V˙o2 and vent...

Diabetes increases the risk of in-hospital complications in medical or surgical patients. Few data are available in the rehabilitation phase after cardiac surgery. To assess the influence of diabetes on outcome and complication rate in the rehabilitation phase after cardiac surgery. Data prospectively recorded in the Hospital Information System fro...

Cardiopulmonary exercise testing is a non-invasive method widely used to monitor various physiological signals, describing the cardiac and respiratory response of the patient to increasing workload. Since this method is physically very demanding, innovative data analysis techniques are needed to predict patient response thus lowering body stress an...

A high slope of the ventilation vs. carbon dioxide relationship (VE/VCO2 slope) during incremental exercise has been reported in several congenital heart disease (CHD) types, but it is not clear whether the main cause of high VE/VCO2 slope is excessive ventilation or reduced perfusion. We studied 169 adolescent and adult patients with repaired, non...

Our objective was to verify and expand previous evidence of psychometric inadequacies in the ALSFRS-R, in a different sample of subjects suffering from ALS. Since 2009, a prospective registry records all incident cases of ALS in Emilia Romagna Region, Italy (4.4 million inhabitants) referred to its 17 neurological departments. For each patient, dem...

To create a new outcome measure of mobility in people with lower limb amputation, based on a pool of 14 items assessing prosthetic mobility, comprising the 12-item Prosthesis Evaluation Questionnaire (Mobility Section) plus 2 new items. Cross-sectional study. A total of 100 subjects (median age 58 years; 46 males; median body mass index 23.8) who h...

Few data have assessed the incidence, site and predictors of infections following cardiac surgery after discharge, particularly during an early rehabilitation phase. To assess the epidemiology and predictors of infections occurring after cardiac surgery. Data prospectively recorded from 5464 patients, consecutively included in a residential cardiac...

Recently, a new balance scale, the Mini--BESTest, was introduced. This scale can be administered in about 15 min, and focuses on 'dynamic balance'. In spite of the recently increased use of this scale, further psychometric studies seem called for to enhance confidence in its use in different fields of clinical practice and research. To re--examine...

Turning involves complex reorientation of the body and is accompanied by asymmetric motion of the lower limbs. We investigated the distribution of the forces under the two feet, and its relation to the trajectory features and body medio-lateral displacement during curved walking. Twenty-six healthy young participants walked under three different ra...

The assessment of patient satisfaction with the orthosis is a key point for clinical practice and research, requiring the availability of questionnaires with robust psychometric properties. The aim of this study was the translation into Arabic and Rasch validation of the Quebec User Evaluation of Satisfaction with assistive Technology (A-QUEST 2.0)...

Objective: To perform a comprehensive analysis of the psychometric properties and dimensionality of the Upper Limb Functional Index (ULFI) using both classical test theory and Rasch analysis (RA). Design: Prospective, single-group observational design. Setting: Freestanding rehabilitation center. Participants: Convenience sample of Italian-s...

Background and Objectives: Assessing patient satisfaction with orthosis (PSwO) is a key point for clinical practice to increase a patient’s adherence to therapeutic programs and reduce orthotic-related costs. The Client Satisfaction with Device (CSD) module of the Orthotics and Prosthetics Users’ Survey (OPUS) is one of the most widely-used questio...

Background In continuous-flow left ventricular assist device (LVAD) recipients, little is known about the relative pump- and left ventricle-generated blood flow (PBF and LVBF, respectively) contribution to peak systemic perfusion during incremental exercise and about how PBF/LVBF interplay and exercise capacity may be affected by pump speed increas...

Objective: To analyse in patients with Parkinson's disease the psychometric performance of the Activities-specific Balance Confidence scale (ABC) and its 3 short versions, using both a classical test theory approach and Rasch analysis. Methods: A sample of 217 patients with Parkinson's disease was assessed by ABC and the 3 short versions: Berg B...

The aim of this study was to carry out a psychometric analysis, using both Classical Test Theory and Rasch analysis (RA) methods, of the Iowa Level of Assistance Scale (ILAS) administered in patients with recent total hip arthroplasty (THA) or total knee arthroplasty, to examine its metric properties and provide insights for a refined version. A to...

The comparison of the performance of the numerical rating scale (NRS) versus visual analog scale (VAS) in the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) showed that the 11-point NRS is psychometrically superior to the 10-cm VAS. This finding is in agreement with previous stud...

Study design: Prospective, single-group observational design. Objectives: To determine the minimal clinically important difference (MCID) for the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure and its shortened version (QuickDASH) in patients with upper-limb musculoskeletal disorders, using a triangulation of distribution- and...

The aim of this study was to perform a psychometric analysis of the Italian Fibromyalgia Impact Questionnaire Revised version (FIQR), using both classical test theory (CTT) and Rasch analysis (RA) in order to better analyse its construct validity and provide a rational basis for a possible improvement of its metric quality. The study involved 503 p...