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Maximos M, Dal Bello-Haas V, Tang A, Stratford P, Kalu M, Virag O, Kaasalainen S, Gafni A. Barriers and Facilitators of a Community-Based, Slow-Stream Rehabilitation, Hospital-to-Home Transition Program for Older Adults: Perspectives of a Multidisciplinary Care Team. Can J Aging 2024; 43:124-140. [PMID: 37665030 DOI: 10.1017/s0714980823000442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
The purpose of this study was to examine the perspectives of support staff, health care professionals, and care coordinators working in or referring to a community-based, slow-stream rehabilitation, hospital-to-home transition program regarding gaps in services, and barriers and facilitators related to implementation and functioning of the program. This was a qualitative descriptive study. Recruitment was conducted through purposive sampling, and 23 individuals participated in a focus groups or individual semi-structured interview. Transcripts were analyzed by six researchers using inductive thematic analysis. Themes that emerged were organized based on a socio-ecological framework. Themes were categorized as: (1) macro level, meaning gaps while waiting for program, limited program capacity, and gaps in service post-program completion; (2) meso level, meaning lack of knowledge and awareness of the program, lack of specific referral process and procedures, lack of specific eligibility criteria, and need for enhanced communication among care settings; or (3) micro level, meaning services provided, program participant benefits, person-centred communication, program structure constraints, need for use of outcome measures, and follow-up or lack of follow-up. Implementation of seamless patient information sharing, documentation, use of specific referral criteria, and use of standardized outcome measures may reduce the number of unsuitable referrals and provide useful information for referral and program staff.
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Affiliation(s)
- Melody Maximos
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Ada Tang
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Paul Stratford
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Michael Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Olivia Virag
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Sharon Kaasalainen
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Amiram Gafni
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
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Maximos M, Dal Bello-Haas V, Tang A, Stratford P, Kalu M, Virag O, Kaasalainen S, Gafni A. Barriers and Facilitators of a Community-Based, Slow-Stream Rehabilitation, Hospital-to-Home Transition Program for Older Adults: Perspectives of a Multidisciplinary Care Team-CORRIGENDUM. Can J Aging 2024; 43:141. [PMID: 37767688 DOI: 10.1017/s0714980823000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
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Harris S, Stratford P, Bray SR. Is It Really Worth the Effort? Examining the Effects of Mental Fatigue on Physical Activity Effort Discounting. J Sport Exerc Psychol 2022; 44:409-419. [PMID: 36270628 DOI: 10.1123/jsep.2021-0330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 07/20/2022] [Accepted: 08/10/2022] [Indexed: 06/16/2023]
Abstract
Physical activity (PA) guidelines are informed by epidemiological evidence but do not account for people's motivation for exerting physical effort. Previous research has shown that people are less motivated to engage in moderate- to vigorous-intensity PA when fatigued. In a two-study series, we investigated how intensity and duration affected people's willingness to engage in PA using an effort-discounting paradigm. A secondary purpose was to examine whether effort discounting was affected by mental fatigue. Both studies revealed a significant Intensity × Duration interaction demonstrating a reduced willingness to engage in PA of higher intensities across increasing duration levels. Study 1 demonstrated greater effort discounting for vigorous-intensity PA with increasing mental fatigue; however, this effect was not observed in Study 2. Findings provide novel insight toward people's motivation for engaging in PA based on the properties of the task, and some evidence suggesting feelings of fatigue may also influence motivation to exert physical effort.
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Affiliation(s)
- Sheereen Harris
- Department of Kinesiology, McMaster University, Hamilton, ON,Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON,Canada
| | - Steven R Bray
- Department of Kinesiology, McMaster University, Hamilton, ON,Canada
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Maximos M, Stratford P, Tang A, Dal Bello-Haas V. Description and Functional Benefits of Meeting Frequency, Intensity, and Time of Resistance and Cardiovascular Exercises: A Study of Older Adults in a Community-Based, Slow-Stream Rehabilitation, Hospital-to-Home Transition Program. Gerontol Geriatr Med 2022; 8:23337214221096303. [PMID: 35615344 PMCID: PMC9125058 DOI: 10.1177/23337214221096303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/18/2022] Open
Abstract
This prospective cohort study described cardiovascular and resistance exercises completed by older adults in a community-based, slow-stream rehabilitation, hospital-to-home transition program; compared exercises completed to the American College of Sports Medicine (ACSM) exercise guidelines; and, assessed differences in Late Life Function and Disability Index (LLFDI)-Function Component (FC) between older adults who met and did not meet the ACSM guidelines. Descriptive statistics and Factorial ANCOVA were conducted. For cardiovascular exercise 59.3% of participants met frequency, 73.4% met intensity, and 35.9% met time. For resistance exercise, 67.2% of participants met frequency, 42.2% met intensity, and 76.6% number of repetitions. Participants who met both frequency and time for cardiovascular exercise had higher LLFDI-FC scores, as did those who met intensity and/or number of repetitions for resistance exercise. The findings provide support that older adults engaged in a slow-stream rehabilitation program can meet the ACSM exercise guidelines for community-dwelling older adults, and that meeting the guidelines improves function.
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Affiliation(s)
- Melody Maximos
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
| | - Paul Stratford
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
| | - Ada Tang
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
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Miller E, Brooks D, O'Brien KK, Beavers L, Stratford P, Nonoyama M, Mori B. Assessing the inter-rater and intra-rater reliability of the Physical Therapy Competence Assessment for Airway Suctioning (PT-CAAS). Physiother Res Int 2022; 27:e1944. [PMID: 35174940 DOI: 10.1002/pri.1944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/01/2021] [Accepted: 01/29/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE The Physical Therapy Competence Assessment for Airway Suctioning (PT-CAAS) is a recently developed measure to assess the clinical competence of physiotherapists who perform airway suctioning with adults. The purpose of this study was to assess the inter-rater and intra-rater reliability of the PT-CAAS. METHODS Scoring rules were developed through expert consultation. Reliability was then assessed using nine videos of suctioning performed in a simulated learning environment. A repeated measures design was used, with two replicate sets of measurements made by each participant for all videos. Data were analyzed using a repeated measures model for the concurrent assessment of inter-rater and intra-rater reliability. Participants were physiotherapists with suctioning experience. RESULTS Twenty physiotherapists completed initial scoring and re-scoring for all nine videos; their data were included in the analysis. Intraclass correlation coefficients (ICCs) for inter-rater reliability ranged from 0.569 [lower one-sided 95% confidence interval (CI): 0.395; standard error of measurement (SEM): 0.963] for infection control to 0.759 (lower one-sided 95% CI: 0.612; SEM: 0.722) for post-suctioning assessment and care. The inter-rater ICC for overall performance was 0.752 (lower one-sided 95% CI: 0.602; SEM: 0.660). ICCs for intra-rater reliability ranged from 0.759 (lower one-sided 95% CI: 0.197; SEM 0.721) for infection control to 0.860 (lower one-sided 95% CI: 0.544; SEM: 0.550) for post-suctioning assessment and care. The intra-rater ICC for overall performance was 0.867 (lower one-sided 95% CI: 0.559; SEM: 0.483). DISCUSSION Evidence of moderate to good inter-rater and good intra-rater reliability was found; however, the results should be interpreted with caution given the wide CIs and relatively large SEMs. Improved assessor training and assessments of reliability using a larger sample size are recommended.
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Affiliation(s)
- Erin Miller
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,West Park Healthcare Centre, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kelly K O'Brien
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Beavers
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,Unity Health Toronto, Toronto, Ontario, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Mika Nonoyama
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada.,Respiratory Therapy & Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brenda Mori
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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Pryzbek M, MacDonald M, Stratford P, Richardson J, McQuarrie A, McKelvie R, Tang A. Long-Term Enrollment in Cardiac Rehabilitation Benefits of Cardiorespiratory Fitness and Skeletal Muscle Strength in Females with Cardiovascular Disease. Womens Health Rep (New Rochelle) 2021; 2:543-549. [PMID: 34909760 PMCID: PMC8665274 DOI: 10.1089/whr.2021.0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 06/14/2023]
Abstract
Background: The benefits of short-term cardiac rehabilitation (CR) for improving fitness are well known, but the effects of long-term maintenance-phase CR are less well established. Moreover, changes in cardiorespiratory fitness (CRF) and muscle strength with long-term CR have never been examined specifically in females, a population that is under-researched and under-represented in cardiovascular research. The objective of this retrospective pilot study was to estimate changes in CRF and muscle strength in females enrolled in a long-term CR program. Methods: Data from 39 females (mean ± standard deviation age 65 ± 9 years) enrolled for at least 1 year in a maintenance-phase CR program were analyzed. The program consisted of aerobic and resistance training, and data were collected annually for CRF (peak oxygen consumption [VO2peak, mL/kg/min]) and skeletal muscle strength (one-repetition maximum tests for chest press, seated row, and knee extension, kg). Mixed-model analyses were used to determine changes in CRF over the 5-year follow-up (203 observations) and muscle strength over 6 years (108 observations). Results: The CRF increased in females by 1.8%/year over 5 years of CR enrollment, and muscle strength increased by 0.6%-2.1%/year over 6 years. These findings are in contrast to the expected age-related declines in fitness over time. Conclusion: The positive long-term benefits on CRF and muscle strength in females provide initial preliminary support for maintenance-based CR, especially given that this population is commonly under-researched and under-represented in the CR literature.
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Affiliation(s)
- Mike Pryzbek
- School of Rehabilitation Science and McMaster University, Hamilton, Ontario, Canada
| | - Maureen MacDonald
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Paul Stratford
- School of Rehabilitation Science and McMaster University, Hamilton, Ontario, Canada
| | - Julie Richardson
- School of Rehabilitation Science and McMaster University, Hamilton, Ontario, Canada
| | - Angelica McQuarrie
- McMaster Physical Activity Centre of Excellence, Hamilton, Ontario, Canada
| | - Robert McKelvie
- Department of Cardiology, Western University and St. Joseph's Healthcare Centre London, London, Ontario, Canada
| | - Ada Tang
- School of Rehabilitation Science and McMaster University, Hamilton, Ontario, Canada
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Wojkowski S, Norman KE, Stratford P, Mori B. Physiotherapy Students' Performance in Clinical Education: An Analysis of 1 Year of Canadian Cross-Sectional Data. Physiother Can 2021; 73:358-367. [PMID: 34880542 DOI: 10.3138/ptc-2020-0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: This research examines 1 year of cross-sectional, Canada-wide ratings from clinical instructors using the Canadian Physiotherapy Assessment of Clinical Performance (ACP) and analyzes the performance profiles of physiotherapy students' performance ratings over the course of their entry-to-practice clinical placements. Method: Canadian physiotherapy programmes that use the ACP were invited to submit anonymized, cross-sectional data for placements completed during 2018. Descriptive analyses and summary statistics were completed. Mixed-effects modelling was used to create typical performance profiles for each evaluation criterion in the ACP. Stepwise ordered logistic regression was also completed. Results: Ten programmes contributed data on 3,290 placements. Profiles were generated for each ACP evaluative item by means of mixed-effects modelling; three profiles are presented. In all cases, the predicted typical performance by the end of 24 months of study was approximately the rating corresponding to entry level. Subtle differences among profiles were identified, including the rate at which a student may be predicted to receive a rating of "entry level." Conclusions: This analysis identified that, in 2018, the majority of Canadian physiotherapy students were successful on clinical placements and typically achieved a rating of "entry level" on ACP items at the end of 24 months.
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Affiliation(s)
- Sarah Wojkowski
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kathleen E Norman
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Paul Stratford
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Brenda Mori
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Robarts S, Denis S, Kennedy D, Dickson P, Juma S, Palinkas V, Rachevitz M, Boljanovic-Susic D, Stratford P. Patient gender does not influence referral to an orthopaedic surgeon by advanced practice orthopaedic providers: a prospective observational study in Canada. BMC Health Serv Res 2021; 21:952. [PMID: 34511124 PMCID: PMC8435171 DOI: 10.1186/s12913-021-06965-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background The role of an advanced practice physiotherapist has been introduced in many countries to improve access to care for patients with hip and knee arthritis. Traditional models of care have shown a gender bias, with women less often referred and recommended for surgery than men. This study sought to understand if patient gender affects access to care in the clinical encounter with the advanced practice provider. Our objectives were: (1) To determine if a gender difference exists in the clinical decision to offer a consultation with a surgeon; (2) To determine if a gender difference exists in patients’ decisions to accept a consultation with a surgeon among those patients to whom it is offered; and, (3) To describe patients’ reasons for not accepting a consultation with a surgeon. Methods This was a prospective study of 815 patients presenting to a tertiary care centre for assessment of hip and knee arthritis, with referral onward to an orthopaedic surgeon when indicated. We performed a multiple logistic regression analysis adjusting for severity to address the first objective and a simple logistic regression analysis to answer the second objective. Reasons for not accepting a surgical consultation were obtained by questionnaire. Results Eight hundred and fifteen patients (511 women, 304 men) fulfilled study eligibility criteria. There was no difference in the probability of being referred to a surgeon for men and women (difference adjusted for severity = − 0.02, 95% CI: − 0.07, 0.02). Neither was there a difference in the acceptance of a referral for men and women (difference = − 0.05, 95% CI: − 0.09, 0.00). Of the 14 reasons for declining a surgical consultation, 5 showed a difference with more women than men indicating a preference for non-surgical treatment along with fears/concerns about surgery. Conclusions There is no strong evidence to suggest there is a difference in proportion of males and females proceeding to surgical consultation in the model of care that utilizes advanced practice orthopaedic providers in triage. This study adds to the evidence that supports the use of suitably trained alternate providers in roles that reduce wait times to care and add value in contexts where health human resources are limited. The care model is a viable strategy to assist in managing the growing backlog in orthopaedic care, recently exacerbated by the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06965-5.
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Affiliation(s)
- Susan Robarts
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M4Y 1H1, Canada. .,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Suzanne Denis
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M4Y 1H1, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Deborah Kennedy
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M4Y 1H1, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Patricia Dickson
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M4Y 1H1, Canada.,Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shahiroz Juma
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M4Y 1H1, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Veronica Palinkas
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M4Y 1H1, Canada
| | - Maria Rachevitz
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M4Y 1H1, Canada
| | - Dragana Boljanovic-Susic
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M4Y 1H1, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Pryzbek M, MacDonald M, Stratford P, McQuarrie A, Richardson J, McKelvie R, Tang A. Long-term Enrollment in Cardiac Rehabilitation Benefits Cardiorespiratory Fitness and Skeletal Muscle Strength in Men With Cardiovascular Disease. Can J Cardiol 2019; 35:1359-1365. [PMID: 31495685 DOI: 10.1016/j.cjca.2019.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/10/2019] [Accepted: 05/16/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite known associations between fitness and recurrent cardiovascular events, changes in cardiorespiratory fitness (CRF) and muscle strength with long-term cardiac rehabilitation (CR) have not been extensively examined. The objectives of this study were to (1) examine changes in CRF and muscle strength associated with long-term CR program enrollment in men, and (2) compare these changes to previously published rates of decline (2.0% per year for CRF and 2.36% per year for muscle strength in healthy age-matched individuals). METHODS Data were extracted from the program charts of 160 men (64 ± 9 years) who were enrolled ≥ 1 year in a maintenance-phase CR program and who completed ≥ 2 exercise tests. CRF was represented by peak oxygen consumption (VO2peak, mL/min/kg). The skeletal muscle strength was assessed using 1-repetition maximum tests for chest press, seated row, and knee extension. Mixed model analyses with polynomial functions were used to determine changes in CRF (up to 5.5 years) and muscle strength (up to 10 years). RESULTS CRF increased nonlinearly up to 3 years (range, 0.33%-3.23% per year) and then declined nonlinearly to the 5.5-year endpoint (range, 1.03%-2.59% per year). Chest press and seated row strength declined at < 1% per year over 10 years, whereas knee extension increased nonlinearly by 0.18%-1.40% per year from baseline until 4 years and then declined nonlinearly at 1.00%-3.58% per year until the 10-year endpoint. All declines were similar to literature rates. CONCLUSIONS The results indicate that significant health benefits are associated with maintenance-phase CR programs for men. Enrollment was associated with preserved CRF and lower body muscle strength for 3-4 years.
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Affiliation(s)
- Mike Pryzbek
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Maureen MacDonald
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Angelica McQuarrie
- McMaster Physical Activity Centre of Excellence, Hamilton, Ontario, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Robert McKelvie
- St Joseph's Healthcare Centre London, Western University, London, Ontario, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
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Reid JC, Clarke F, Cook DJ, Molloy A, Rudkowski JC, Stratford P, Kho ME. Feasibility, Reliability, Responsiveness, and Validity of the Patient-Reported Functional Scale for the Intensive Care Unit: A Pilot Study. J Intensive Care Med 2019; 35:1396-1404. [PMID: 30669936 DOI: 10.1177/0885066618824534] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although many performance-based measures assess patients' physical function in intensive care unit (ICU) survivors, to our knowledge, there are no patient-reported ICU rehabilitation-specific measures assessing function. We developed the Patient-Reported Functional Scale-ICU (PRFS-ICU), which measures patients' perceptions of their ability to perform 6 activities (rolling, sitting edge of bed, sit-to-stand and bed-to-chair transfers, ambulation, and stair climbing). Each item is scored from 0 (unable) to 10 (able to perform at pre-ICU level) to a maximum of 60. OBJECTIVES Estimate the feasibility, reliability, responsiveness, and validity of the PRFS-ICU. METHODS This was a substudy of TryCYCLE, a single-center, prospective cohort examining the safety and feasibility of early in-bed cycling with mechanically ventilated patients (NCT01885442). To determine feasibility, we calculated the number of patients with at least 1 PRFS-ICU assessment during their hospital stay. To assess reliability, 2 raters blinded to each other's assessments administered the PRFS-ICU within 24-hours of each other. We calculated the intraclass correlation coefficient (ICC; 95% confidence interval [CI]), standard error of measurement (SEM, 95% CI), and minimal detectable change (MDC90). To assess validity, we estimated convergent validity of the PRFS-ICU with the Functional Status Score for ICU (FSS-ICU), Medical Research Council Sum Score (MRC-SS), Physical Function Test for ICU (PFIT-s), Katz Index of Independence in Activities of Daily Living (Katz ADLs), and a pooled index using Pearson's correlation coefficient (r, 95% CI). RESULTS Feasibility: 20 patients completed a PRFS-ICU assessment. Reliability and responsiveness: 16 patients contributed data. The ICC, SEM, and MDC90 were 0.91 (0.76, 0.97), 4.75 (3.51, 7.35), and 11.04 points, respectively. Validity: 19 patients contributed data and correlations were (r [95% CI]): FSS-ICU (0.40 [-0.14, 0.76]), MRC-SS (0.51 [0.02, 0.80]), PFIT-s (0.43 [-0.13, 0.78]), Katz ADLs (0.53 [0.10, 0.79]), and pooled index (0.48 [-0.14, 0.82]). CONCLUSIONS Our pilot work suggests the PRFS-ICU may be a useful tool to assess and monitor patients' perceptions of function over time.
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Affiliation(s)
- Julie C Reid
- Faculty of Health Sciences, School of Rehabilitation Science, 3710McMaster University, Institute of Applied Health Sciences, Hamilton, Ontario, Canada
| | - France Clarke
- Department of Health Research Methods, Evidence, and Impact, 3710McMaster University, McMaster University Medical Center, Hamilton, Ontario, Canada
| | - Deborah J Cook
- Department of Health Research Methods, Evidence, and Impact, 3710McMaster University, McMaster University Medical Center, Hamilton, Ontario, Canada.,Department of Medicine, 62703McMaster University, Health Sciences Center, Hamilton, Ontario, Canada
| | - Alexander Molloy
- Department of Physiotherapy, 25479St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Jill C Rudkowski
- Department of Medicine, 62703McMaster University, Health Sciences Center, Hamilton, Ontario, Canada
| | - Paul Stratford
- Faculty of Health Sciences, School of Rehabilitation Science, 3710McMaster University, Institute of Applied Health Sciences, Hamilton, Ontario, Canada
| | - Michelle E Kho
- Faculty of Health Sciences, School of Rehabilitation Science, 3710McMaster University, Institute of Applied Health Sciences, Hamilton, Ontario, Canada.,Department of Physiotherapy, 25479St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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Stratford P, Kennedy D, Clarke H. Confounding pain and function: the WOMAC's failure to accurately predict lower extremity function. Arthroplast Today 2018; 4:488-492. [PMID: 30569009 PMCID: PMC6287962 DOI: 10.1016/j.artd.2018.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/04/2018] [Accepted: 09/09/2018] [Indexed: 01/26/2023] Open
Abstract
Background Investigations have revealed the Western Ontario and McMaster Universities Osteoarthritis Index's (WOMAC) inability to provide distinct assessments of pain and function. The Lower Extremity Functional Scale (LEFS) has not displayed this deficiency. Our purposes were to investigate further the WOMAC physical function's (WOMAC-PF) ability to accurately assess lower extremity mobility in patients undergoing total knee arthroplasty (TKA) and to establish a relationship between pre- and post-TKA WOMAC-PF and LEFS scores that accounts for the apparent bias WOMAC pain scores impose on WOMAC-PF scores. Methods WOMAC, LEFS, and Timed-up-and-go measures were administered before TKA and 4 days, 6 weeks, and 3 months after TKA. To evaluate the WOMAC-PF and LEFS ability to provide a distinct assessment of pain and function, a paired t-test compared pre-TKA and 4 days after TKA values. Generalized estimating equation (GEE) analysis assessed the relationship between pre- and post-TKA values: dependent variable WOMAC-PF scores; independent variables LEFS scores, and measurement occasions. Results Timed-up-and-go and LEFS demonstrated a reduction in lower extremity function (P < .001); pain decreased (P < .001); and there was no significant change in WOMAC-PF scores (P = .61). GEE analysis revealed a linear relationship between WOMAC-PF and LEFS with similar slope coefficients for all four occasions. The relationship between WOMAC-PF and LEFS scores was virtually identical for the postarthroplasty assessment occasions. Conclusions Our findings support previous investigations that showed the WOMAC-PF's inability to provide a valid assessment in change in function. The GEE analysis coefficients can be used to convert LEFS scores to WOMAC-PF scores that adjust for the bias between pre- and post-TKA assessments.
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Affiliation(s)
- Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Deborah Kennedy
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,Holland Orthopaedic & Arthritic Centre of Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Hance Clarke
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, and Department of Anesthesia, University of Toronto, Toronto, ON, Canada
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Choo SX, Bosch J, Richardson J, Stratford P, Harris JE. Cross-cultural adaptation and psychometric evaluation of the Singapore version of the Chedoke Arm and Hand Activity. Disabil Rehabil 2018; 41:2570-2577. [PMID: 29786453 DOI: 10.1080/09638288.2018.1472817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Purpose: To develop a Singapore version of the Chedoke Arm and Hand Activity Inventory (CAHAI) and to estimate the construct validity and inter-rater reliability. Materials and methods: The Translation and Cross-Cultural Adaptation of Objectively Assessed Outcome measure procedure was used to systematically adapt the CAHAI. We recruited 56 adults admitted to an inpatient stroke facility to evaluate the psychometric properties of the Singapore version of the CAHAI. The Singapore version of the CAHAI, Fugl-Meyer Assessment of Upper Extremity (FMA-UE), and the Action Research Arm Test (ARAT) were administered to all participants. We used Spearman's rank correlation coefficients to estimate convergent and discriminative validity, and reliability was estimated using the intra-class correlation coefficient and standard error of measurement. Results: Implementation of the Translation and Cross-Cultural Adaptation of Objectively Assessed Outcome measure procedure resulted in the modification to two test items. The Singapore version of the CAHAI demonstrated convergent validity with the FMA-UE (rs = 0.87; 95% CI: 0.76, 0.92) and ARAT (rs = 0.80; 95% CI: 0.63, 0.9). Discriminative validity between the Singapore version of the CAHAI and FMA-UE pain subscale was rs= 0.42 (95% CI: 0.22, 0.59). Reliability of the Singapore version of the CAHAI was 0.97 (95% CI: 0.94, 0.99) and standard error of measurement of 4.80 points (95% CI: 4.23, 5.55). Conclusion: The Singapore version of the CAHAI demonstrated good validity and reliability, similar to the properties of the original CAHAI. Implications for rehabilitation The Singapore version of the Chedoke Arm and Hand Activity Inventory demonstrates evidence of construct validity and inter-rater reliability. The Singapore version of the Chedoke Arm and Hand Activity Inventory can be used by clinicians and researchers to evaluate function in the affected upper extremity for persons with stroke in Singapore.
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Affiliation(s)
- Silvana X Choo
- School of Rehabilitation Science, McMaster University , Hamilton , Canada.,Department of Occupational Therapy, Singapore General Hospital , Singapore
| | - Jackie Bosch
- School of Rehabilitation Science, McMaster University , Hamilton , Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University , Hamilton , Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University , Hamilton , Canada
| | - Jocelyn E Harris
- School of Rehabilitation Science, McMaster University , Hamilton , Canada
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13
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Johnson D, Harris JE, Stratford P, Richardson J. Interrater Reliability of Three Versions of the Chedoke Arm and Hand Activity Inventory. Physiother Can 2018; 70:133-140. [PMID: 29755169 DOI: 10.3138/ptc.2016-70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The purpose of this study was to estimate the interrater reliability of three shortened versions of the Chedoke Arm and Hand Activity Inventory (CAHAI-7, CAHAI-8, CAHAI-9) when used with persons with acquired brain injury (ABI). The CAHAI is an assessment of upper limb function with high reliability in the stroke and ABI populations. In the stroke population, three shortened versions of the measure have established reliability. Clinicians report time constraints as a barrier to using standardized assessments; thus, establishing the reliability of the shortened versions of the CAHAI in the ABI population may increase the use of this measure. Method: This was an observational, parameter estimation study. The participants were recruited from an in-patient ABI rehabilitation programme. The administration of the CAHAI to six persons with ABI was video recorded, and the video recordings were assessed by six clinicians to estimate interrater reliability. A Latin square design was used to balance the order in which the raters evaluated the videos. A repeated-measures analysis of variance was performed, and the variance components were used to calculate an intra-class correlation coefficient (ICC) and standard error of measurement (SEM) with 95% confidence limits (CLs) for each of the shortened versions. Results: Interrater reliability was high for all three versions: CAHAI-7, ICC=0.96 (95% CL: 0.89, 0.99; SEM 2.65); CAHAI-8, ICC=0.96 (95% CL: 0.90, 0.99; SEM 2.72); and CAHAI-9, ICC=0.95 (95% CL: 0.85, 0.99; SEM 3.49). Conclusions: These results suggest that the three shortened versions of the CAHAI demonstrate high reliability in the ABI population. These versions may be particularly useful when time constraints or patient tolerance are an issue.
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Affiliation(s)
- Denise Johnson
- School of Rehabilitation Science, McMaster University.,Regional Rehabilitation Centre, Hamilton Health Sciences, Hamilton, Ont
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Jeong Y, Law M, Stratford P, DeMatteo C, Missiuna C. Measuring Participation of Children and Environmental Factors at Home, School, and in Community: Construct Validation of the Korean PEM-CY. Phys Occup Ther Pediatr 2017; 37:541-554. [PMID: 28266879 DOI: 10.1080/01942638.2017.1280870] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIMS To determine construct validity of the Korean Participation and Environment Measure for Children and Youth (KPEM-CY) in South Korea. METHODS A total of 184 parents of children with (n = 80) and without disabilities (n = 104) aged 5 to 13 years completed the KPEM-CY. Construct validity was analyzed by assessing differences in the participation and environment scores for children with and without disabilities across age and gender. RESULTS Validity of the KPEM-CY was supported by significant differences in participation and environmental factors for subgroups (p < .05). Children with disabilities participated less in typical activities and had more environmental barriers than those without disabilities across all settings. Parents of children with disabilities reported a higher level of desire to change their children's participation patterns. Similar participation patterns and environmental factors, which were influenced by interaction effects between disability and age, were confirmed at home and in the community. CONCLUSIONS KPEM-CY is a valid measure to assess participation and environmental factors in home, school, and community settings for Korean children, aged 5-13 years, with and without disabilities.
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Affiliation(s)
- Yunwha Jeong
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | - Mary Law
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | - Paul Stratford
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | - Carol DeMatteo
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | - Cheryl Missiuna
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
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15
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Choo SX, Stratford P, Richardson J, Bosch J, Pettit SM, Ansley BJ, Harris JE. Comparison of the sensitivity to change of the Functional Independence Measure with the Assessment of Motor and Process Skills within different rehabilitation populations. Disabil Rehabil 2017; 40:3177-3184. [DOI: 10.1080/09638288.2017.1375033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Silvana X. Choo
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
- Department of Occupational Therapy, Singapore General Hospital, Singapore
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Jackie Bosch
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Susan M. Pettit
- Restorative Care Program, St. Peter’s Hospital, Hamilton Health Sciences, Hamilton, Canada
| | - Barbara J. Ansley
- Research and Program Evaluation, Rehabilitation and Seniors, Hamilton Health Sciences, Hamilton, Canada
| | - Jocelyn E. Harris
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
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Robarts S, Stratford P, Kennedy D, Malcolm B, Finkelstein J. Evaluation of an advanced-practice physiotherapist in triaging patients with lumbar spine pain: surgeon-physiotherapist level of agreement and patient satisfaction. Can J Surg 2017; 60:266-272. [PMID: 28730987 DOI: 10.1503/cjs.013416] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Surgery for lumbar spine pain is indicated for specific etiologies. Given the majority of individuals referred to spine surgeons are not surgical candidates, care delivery is inefficient, with consultations being of limited value for most. Using specially trained physiotherapists in triage is a human resource strategy that may optimize surgeons' time and the patient experience. METHODS An advanced-practice physiotherapist (APP) and a surgeon assessed consecutive patients with lumbar spine pain presenting at an academic health centre's spine surgery clinic. The second assessor was blinded to the outcome of the first. We used the κ statistic to evaluate surgeon-APP level of chance-corrected agreement concerning patients' need for a surgical consultation. To assess satisfaction with the APP, patients completed a modified version of the validated Visit-specific Questionnaire. RESULTS The sample included 102 participants (54 women) with a mean age of 54.3 ± 14.3 years and a mean Oswestry Disability Index score of 35.4 ± 16.6. The assessors' overall agreement was 86%. The κ coefficient for the need for a surgical consultation was 0.69 (95% confidence interval 0.54-0.84). The APP identified that 77% of patients did not require a surgical consultation. Twenty-one patients underwent surgery. Satisfaction scores for the APP were very high (mean score 92 out of 100). CONCLUSION In triaging patients with lumbar spine pain, the APP and surgeon had a high level of agreement. An APP performing triage at a surgical centre can effectively reduce wait lists by 70%, reserving surgical consultations for those patients in whom they are indicated.
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Affiliation(s)
- Susan Robarts
- From the Department of Rehabilitation, Sunnybrook Holland Orthopaedic and Arthritic Centre, Toronto, Ont. (Robarts, Kennedy); the School of Rehabilitation Science, McMaster University, Hamilton, Ont. (Stratford, Kennedy); the Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont. (Malcom, Finkelstein); and the Department of Surgery, Faculty of Medicine, University of Toronto, Ont. (Finkelstein)
| | - Paul Stratford
- From the Department of Rehabilitation, Sunnybrook Holland Orthopaedic and Arthritic Centre, Toronto, Ont. (Robarts, Kennedy); the School of Rehabilitation Science, McMaster University, Hamilton, Ont. (Stratford, Kennedy); the Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont. (Malcom, Finkelstein); and the Department of Surgery, Faculty of Medicine, University of Toronto, Ont. (Finkelstein)
| | - Deborah Kennedy
- From the Department of Rehabilitation, Sunnybrook Holland Orthopaedic and Arthritic Centre, Toronto, Ont. (Robarts, Kennedy); the School of Rehabilitation Science, McMaster University, Hamilton, Ont. (Stratford, Kennedy); the Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont. (Malcom, Finkelstein); and the Department of Surgery, Faculty of Medicine, University of Toronto, Ont. (Finkelstein)
| | - Barry Malcolm
- From the Department of Rehabilitation, Sunnybrook Holland Orthopaedic and Arthritic Centre, Toronto, Ont. (Robarts, Kennedy); the School of Rehabilitation Science, McMaster University, Hamilton, Ont. (Stratford, Kennedy); the Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont. (Malcom, Finkelstein); and the Department of Surgery, Faculty of Medicine, University of Toronto, Ont. (Finkelstein)
| | - Joel Finkelstein
- From the Department of Rehabilitation, Sunnybrook Holland Orthopaedic and Arthritic Centre, Toronto, Ont. (Robarts, Kennedy); the School of Rehabilitation Science, McMaster University, Hamilton, Ont. (Stratford, Kennedy); the Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont. (Malcom, Finkelstein); and the Department of Surgery, Faculty of Medicine, University of Toronto, Ont. (Finkelstein)
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Abstract
BACKGROUND The Chedoke Arm and Hand Activity Inventory (CAHAI) is an assessment of upper limb function designed for use in the stroke population. The CAHAI has strong reliability and validity in this population; however, it is unknown whether this measure can be used with other clinical populations such as acquired brain injury (ABI). PURPOSE The purpose of this study was to estimate the inter-rater reliability of the CAHAI when used with persons with ABI. METHODS The research design was an observational parameter estimation study. The administration of the CAHAI was videotaped for 6 persons with ABI. To estimate inter-rater reliability each video was assessed independently by 6 clinicians yielding a total of 36 assessments. A Latin square design was used to balance the order raters evaluated the videos. Shrout and Fleiss Type 2,1 intra class correlation coefficients (ICC) and standard error of measurement (SEM) were calculated to estimate inter-rater reliability of the CAHAI. RESULTS Inter-rater reliability was high ICC = 0.96 (95% CL: 0.88, 0.99) and the SEM was 3.35 (95% CL: 2.63, 4.63) CAHAI points. CONCLUSIONS These results suggest that the CAHAI, although designed for use in the stroke population, can be used reliably in the ABI population.
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Affiliation(s)
- Denise Johnson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,Hamilton Health Sciences, Hamilton, ON, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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18
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Stratford P, Kennedy D. Responsiveness of four patient-reported outcome measures to assess physical function in patients with knee osteoarthritis: comments on the article by Mahler et al. Scand J Rheumatol 2016; 46:168-169. [PMID: 27928927 DOI: 10.1080/03009742.2016.1238960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- P Stratford
- a School of Rehabilitation Science , McMaster University , Hamilton , ON , Canada
| | - D Kennedy
- b Holland Orthopaedic and Arthritic Centre , Toronto , ON , Canada
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19
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Barclay R, Miller PA, Pooyania S, Stratford P. Development of a Telephone Interview Version of the Chedoke-McMaster Stroke Assessment Activity Inventory. Physiother Can 2016; 68:216-222. [PMID: 27909370 DOI: 10.3138/ptc.2015-44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: To develop a telephone version of the Chedoke-McMaster Stroke Assessment Activity Inventory (CMSA-AI) and estimate the test-retest reliability, interrater reliability (between participant and proxy), and construct validity of the scores for individuals with stroke. Methods: Adults with stroke and their caregivers or proxies were included. Participants were assessed with the CMSA-AI at discharge from a stroke rehabilitation unit and interviewed using the telephone version (TCMSA-AI). Two months after discharge, participants were evaluated with the CMSA-AI and interviewed over the phone using the TCMSA-AI on two occasions 2-3 days apart. Proxies were interviewed with the TCMSA-AI within another 2-3 days. Results: The mean age of the 53 participants with stroke was 62 years; 59% were male; 43% had right-side hemiparesis; 42 completed follow-up interviews; and 18 had proxies who also participated. Test-retest reliability showed an intra-class correlation coefficient of 0.98 (95% CI: 0.96, 0.99) for the total score, 0.96 (95% CI: 0.91, 0.98) for the Gross Motor Function Index, and 0.96 (95% CI: 0.91, 0.98) for the Walking Index, and an interrater reliability (between participant and proxy) of 0.75 (95% CI: 0.28, 0.90) for total score. Spearman's rho correlation between CMSA-AI and TCMSA-AI total scores was 0.62 (lower-sided 95% CI: 0.42) at discharge and 0.90 (lower-sided 95% CI: 0.82) at 2 months after discharge. Correlations between the change scores of the CMSA-AI and TCMSA-AI were 0.50 or lower. Conclusion: There is potential for remote evaluation of the functional mobility of individuals with stroke in research and clinical settings.
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Affiliation(s)
- Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba
| | - Patricia A Miller
- School of Rehabilitation Science, McMaster University, Hamilton, Ont
| | | | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, Ont
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Jeong Y, Law M, DeMatteo C, Stratford P, Kim H. Knowledge Translation from Research to Clinical Practice: Measuring Participation of Children with Disabilities. Occup Ther Health Care 2016; 30:323-343. [PMID: 27331906 DOI: 10.1080/07380577.2016.1192311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This knowledge translation project was conducted to increase occupational therapy practitioners' awareness of the importance of measuring participation of children with disabilities. The Knowledge to Action process framework (KTA framework) guided knowledge translation via a web-based seminar (webinar) to practitioners working with children and educators teaching in occupational therapy programs in South Korea. Two hundred and seventy six views of the webinar were recorded within a month and 15 practitioners and 13 educators completed the online evaluation survey. The participants indicated that the webinar helped them understand the participation concept and its associated measures and raised awareness of practitioners' current use of measurement and intervention that do not focus on participation of children with disabilities. This project led practitioners and educators to realize the importance of measuring participation of children with disabilities and contributes to inform the importance of knowledge translation science to facilitate the evidence-based practice.
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Affiliation(s)
- Yunwha Jeong
- a School of Rehabilitation Science, McMaster University, Hamilton , Ontario , Canada
| | - Mary Law
- a School of Rehabilitation Science, McMaster University, Hamilton , Ontario , Canada
| | - Carol DeMatteo
- a School of Rehabilitation Science, McMaster University, Hamilton , Ontario , Canada
| | - Paul Stratford
- a School of Rehabilitation Science, McMaster University, Hamilton , Ontario , Canada
| | - Hwan Kim
- b College of Rehabilitation Sciences, Daegu University , Kyeongsan , South Korea
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Di Rezze B, Rosenbaum P, Zwaigenbaum L, Hidecker MJC, Stratford P, Cousins M, Camden C, Law M. Developing a classification system of social communication functioning of preschool children with autism spectrum disorder. Dev Med Child Neurol 2016; 58:942-8. [PMID: 27189758 DOI: 10.1111/dmcn.13152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2016] [Indexed: 11/27/2022]
Abstract
AIM Impairments in social communication are the hallmark of autism spectrum disorder (ASD). Operationalizing 'severity' in ASD has been challenging; thus, stratifying by functioning has not been possible. The purpose of this study is to describe the development of the Autism Classification System of Functioning: Social Communication (ACSF:SC) and to evaluate its consistency within and between parent and professional ratings. METHOD (1) ACSF:SC development based on focus groups and surveys involving parents, educators, and clinicians familiar with preschoolers with ASD; and (2) evaluation of the intra- and interrater agreement of the ACSF:SC using weighted kappa (кw ). RESULTS Seventy-six participants were involved in the development process. Core characteristics of social communication were ascertained: communicative intent; communicative skills and reciprocity; and impact of environment. Five ACSF:SC levels were created and content-validated across participants. Best capacity and typical performance agreement ratings varied as follows: intrarater agreement on 41 children was кw =0.61 to 0.69 for parents, and кw =0.71 to 0.95 for professionals; interrater agreement between professionals was кw =0.47 to 0.61, and between parents and professionals was кw =0.33 to 0.53. INTERPRETATION Perspectives from parents and professionals informed ACSF:SC development, providing common descriptions of the levels of everyday communicative abilities of children with ASD to complement the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Rater agreement demonstrates that the ACSF:SC can be used with acceptable consistency compared with other functional classification systems.
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Affiliation(s)
- Briano Di Rezze
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | | | | | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Martha Cousins
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Chantal Camden
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Mary Law
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
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Lai L, Binkley J, Jones V, Kirkpatrick S, Furbish C, Stratford P, Thompson W, Sidhu A, Farley C, Okoli J, Beech D, Gabram S. Implementing the Prospective Surveillance Model (PSM) of Rehabilitation for Breast Cancer Patients with 1-Year Postoperative Follow-up, a Prospective, Observational Study. Ann Surg Oncol 2016; 23:3379-84. [DOI: 10.1245/s10434-016-5315-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Indexed: 11/18/2022]
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Jeong Y, Law M, Stratford P, DeMatteo C, Kim H. Cross-cultural validation and psychometric evaluation of the Participation and Environment Measure for Children and Youth in Korea. Disabil Rehabil 2016; 38:2217-28. [PMID: 26728903 DOI: 10.3109/09638288.2015.1123302] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To develop the Korean version of the Participation and Environment Measure for Children and Youth (KPEM-CY) and examine its psychometric properties. METHOD The PEM-CY was cross-culturally translated into Korean using a specific guideline: pre-review of participation items, forward/backward translation, expert committee review, pre-test of the KPEM-CY and final review. To establish internal consistency, test-retest reliability and construct validity of the KPEM-CY, 80 parents of children with disabilities aged 5-13 years were recruited in South Korea. RESULTS Across the home, school and community settings, 76% of participation items and 29% of environment items were revised to improve their fit with Korean culture. Internal consistency was moderate to excellent (0.67-0.92) for different summary scores. Test-retest reliability was excellent (>0.75) in the summary scores of participation frequency and extent of involvement across the three settings and moderate to excellent (0.53-0.95) in all summary scores at home. Child's age, type of school and annual income were the factors that significantly influenced specific dimensions of participation and environment across all settings. CONCLUSIONS Results indicated that the KPEM-CY is equivalent to the original PEM-CY and has initial evidence of reliability and validity for use with Korean children with disabilities. Implications for rehabilitation Because 'participation' is a key outcome of the rehabilitation, measuring comprehensive participation of children with disabilities is necessary. The PEM-CY is a parent-report survey measure to assess comprehensive participation of children and youth and environment, which affect their participation, at home, school and in the community. A cross-cultural adaptation process is mandatory to adapt the measurement tool to a new culture or country. The Korean PEM-CY has both reliability and validity and can therefore generate useful clinical data for Korean children with disabilities.
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Affiliation(s)
- Yunwha Jeong
- a School of Rehabilitation Science, McMaster University , Hamilton , ON , Canada
| | - Mary Law
- a School of Rehabilitation Science, McMaster University , Hamilton , ON , Canada
| | - Paul Stratford
- a School of Rehabilitation Science, McMaster University , Hamilton , ON , Canada
| | - Carol DeMatteo
- a School of Rehabilitation Science, McMaster University , Hamilton , ON , Canada
| | - Hwan Kim
- b College of Rehabilitation Sciences, Daegu University , Kyeongsan , South Korea
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Jeong Y, Law M, DeMatteo C, Stratford P, Kim H. The role of occupational therapists in the contexts of a natural disaster: a scoping review. Disabil Rehabil 2015; 38:1620-31. [DOI: 10.3109/09638288.2015.1106597] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Clarke H, Pagé G, McCartney C, Huang A, Stratford P, Andrion J, Kennedy D, Awad I, Gollish J, Kay J, Katz J. Pregabalin reduces postoperative opioid consumption and pain for 1 week after hospital discharge, but does not affect function at 6 weeks or 3 months after total hip arthroplasty. Br J Anaesth 2015; 115:903-11. [DOI: 10.1093/bja/aev363] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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O'Brien KK, Solomon P, Bergin C, O'Dea S, Stratford P, Iku N, Bayoumi AM. Reliability and validity of a new HIV-specific questionnaire with adults living with HIV in Canada and Ireland: the HIV Disability Questionnaire (HDQ). Health Qual Life Outcomes 2015; 13:124. [PMID: 26263898 PMCID: PMC4542093 DOI: 10.1186/s12955-015-0310-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 07/20/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Our aim was to assess internal consistency reliability, construct validity, and test-retest reliability of the HDQ with adults living with HIV in Canada and Ireland. METHODS We recruited adults 18 years of age or older living with HIV from hospital clinics and AIDS service organizations in Canada and Ireland. We administered the HDQ paired with reference measures (World Health Organization Disability Assessment Schedule, SF-36 Questionnaire, Medical Outcomes Study Social Support Survey), and a demographic questionnaire. We calculated HDQ disability presence, severity and episodic scores (scored from 0-100). We calculated Cronbach's alpha and Intraclass Correlation Coefficients (ICC) (Canada only) for the disability severity and episodic scores and considered coefficients >0.80 and >0.70 as acceptable, respectively. To assess construct validity, we tested 40 a priori hypotheses of correlations between scores on the HDQ and reference measures and two known group hypotheses comparing HDQ presence and severity scores based on age and comorbidity. We considered acceptance of at least 75% of hypotheses as demonstrating support for construct validity. RESULTS Of the 235 participants (139 Canada; 96 Ireland), the majority were men (74% Ireland; 82% Canada) and were taking antiretroviral therapy (88% Ireland; 91% Canada). Compared with Irish participants, Canadian participants were older (median age: 48 versus 41 years) and reported living with a higher median number of comorbidities (4 versus 1). Cronbach's alpha for Irish and Canadian participants were 0.97 (95% confidence interval (CI): 0.97-0.98) and 0.96 (95 % CI: 0.95-0.98), respectively, for the severity scale and 0.98 (95 % CI: 0.97-0.98) and 0.96 (95 % CI: 0.95-0.98), respectively, for the episodic scale. Of the 40 construct validity correlation hypotheses, 32 (80%) and 22 (55%) were supported among the Canadian and Irish samples respectively; both (100%) known group hypotheses were also supported. ICC values for Canadian participants ranged from 0.80 (95 % CI: 0.71, 0.86) in the cognitive domain to 0.89 (95 % CI: 0.83, 0.92) in the social inclusion domain. CONCLUSIONS The HDQ demonstrates internal consistency reliability and a variable degree of construct validity when administered to adults living with HIV in Canada and Ireland. The HDQ demonstrates test-retest reliability when administered to adults with HIV in Canada. Further validation of the HDQ outside of Canada is needed.
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Affiliation(s)
- Kelly K O'Brien
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, ON, M5G 1V7, Canada. .,Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, 4th Floor, 155 College Street, Toronto, ON, M5T 3M6, Canada. .,School of Rehabilitation Science, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada.
| | - Patricia Solomon
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada.
| | - Colm Bergin
- Department of Genito Urinary Medicine and Infectious Diseases, Hospital 5, St. James's Hospital, James's Street, Dublin 8, Ireland. .,Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Siobhán O'Dea
- Department of Genito Urinary Medicine and Infectious Diseases, Hospital 5, St. James's Hospital, James's Street, Dublin 8, Ireland.
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada.
| | - Nkem Iku
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, ON, M5G 1V7, Canada.
| | - Ahmed M Bayoumi
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, 4th Floor, 155 College Street, Toronto, ON, M5T 3M6, Canada. .,Centre for Research on Inner City Health, Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. .,Department of Medicine, University of Toronto, Toronto, ON, Canada.
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Bamm EL, Rosenbaum P, Wilkins S, Stratford P. Performance of the measures of processes of care for adults and service providers in rehabilitation settings. Patient Relat Outcome Meas 2015; 6:157-65. [PMID: 26089710 PMCID: PMC4467744 DOI: 10.2147/prom.s81361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts. Objective The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Design A validation study Settings In-patient rehabilitation facilities. Main outcome measures MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Results Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71–0.88 for health care professionals, 0.82–0.90 for patients, and 0.87–0.94 for family members), as well as moderate to good correlations between domains (0.40–0.78 for health care professionals and 0.52–0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire. Conclusion MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.
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Affiliation(s)
- Elena L Bamm
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Peter Rosenbaum
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada ; CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Seanne Wilkins
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Barclay R, Miller P, Pooyania S, Stratford P. Telephone interview version of the Chedoke-Mcmaster Stroke Assessment Activity Inventory – psychometric properties. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bamm EL, Rosenbaum P, Wilkins S, Stratford P, Mahlberg N. Exploring Client-Centered Care Experiences in In-Patient Rehabilitation Settings. Glob Qual Nurs Res 2015; 2:2333393615582036. [PMID: 28462306 PMCID: PMC5342279 DOI: 10.1177/2333393615582036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/24/2015] [Accepted: 03/24/2015] [Indexed: 11/09/2022] Open
Abstract
Patient or client-centered care has been widely accepted as an essential component of health care delivery in many countries. Few studies explore actual implementation of client-centered principles and clients’ and health care providers’ (HCPs) experiences with these approaches. Our objective was to explore current models of delivery of rehabilitation services from the perspectives of patients, families, and HCPs. We conducted semistructured interviews with patients, families, and HCPs of one of four rehabilitation facilities in South-Central Ontario, Canada. Being on common grounds/Working toward client set goals was the main category identified by both clients and HCPs. Although successful partnerships were created, the majority of clients assumed a passive position. Clients needed more information about the rehabilitation progression and alternative treatment options. The results of the study suggest that we need to encourage and educate clients to become motivated, well-informed, proactive participants in their care.
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Barreca S, Gowland CK, Stratford P, Huijbregts M, Griffiths J, Torresin W, Dunkley M, Miller P, Masters L. Development of the Chedoke Arm and Hand Activity Inventory: Theoretical Constructs, Item Generation, and Selection. Top Stroke Rehabil 2015; 11:31-42. [PMID: 15592988 DOI: 10.1310/ju8p-uvk6-68vw-cf3w] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Chedoke Arm and Hand Activity Inventory (CAHAI) was developed to address the need for a valid, clinically relevant, responsive functional assessment of the recovering paretic upper limb. The purpose of this article is to describe the development of the measure including its theoretical constructs, item generation, and item selection. From the literature, survivors of stroke, and their caregivers, 751 items were generated. Using factor analyses stem leaf plots, clinical judgment, and pilot testing on individuals with stroke, the list was reduced to 13 bilateral, real-life items. Research continues to provide evidence of the CAHAI's test-retest and interrater reliability as well as construct, concurrent, and longitudinal validity.
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Affiliation(s)
- Susan Barreca
- Orthopedic and Rehabilitation Services, Hamilton Health Sciences, Hamilton, Ontario, Canada
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Clarke H, Katz J, McCartney C, Stratford P, Kennedy D, Pagé M, Awad I, Gollish J, Kay J. Perioperative gabapentin reduces 24 h opioid consumption and improves in-hospital rehabilitation but not post-discharge outcomes after total knee arthroplasty with peripheral nerve block. Br J Anaesth 2014; 113:855-64. [DOI: 10.1093/bja/aeu202] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Razmjou H, Stratford P, Kennedy D, Holtby R. Pattern of recovery following total shoulder arthroplasty and humeral head replacement. BMC Musculoskelet Disord 2014; 15:306. [PMID: 25234000 PMCID: PMC4190476 DOI: 10.1186/1471-2474-15-306] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 09/18/2014] [Indexed: 12/14/2022] Open
Abstract
Background Understanding the pattern of recovery and expected rate of change after shoulder arthroplasty is helpful to clinicians and patients for setting realistic expectations and goals. The purpose of this study was to describe the pattern of recovery over a 2-year period for patients receiving either a Total Shoulder Arthroplasty (TSA) or Humeral Head Replacement (HHR). Methods This was a secondary analysis of prospectively collected data of patients who had undergone TSA or HHR and were followed for up to 2 years. Patients were seen prior to surgery and at 6 months, one year and two years after surgery and completed the American Shoulder and Elbow Surgeon’s (ASES) questionnaire, Relative Constant Murley score (RCMS) and underwent range of motion and strength assessment. Results Data of 134 patients who had surgery from April 2001 to July 2011 were used for analysis. One hundred and eight patients underwent TSA (81%) and 26 (19%) had HHR. Both surgeries were associated with a statistically significant improvement in physical symptoms, ASES, RCMS, range of motion and strength (p <0.0001). The greatest change for all outcomes occurred within the first 6-months of surgery. Improvement in ASES, RCMS continued up to 12-months and then plateaued. Improvement in physical symptoms leveled off at 6-months in the HHR group but continued up to 12-months in the TSR group. Strength showed improvement in both groups up to 24-months post-surgery. Conclusion Both TSA and HHR groups showed a statistically significant improvement in perceived disability, range of motion and strength over two years with the greatest improvement made by 6 months. The recovery profiles for the surgeries showed different patterns. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-306) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helen Razmjou
- Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, Ontario M1Y 1H1, Canada.
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O'Brien KK, Bayoumi AM, Stratford P, Solomon P. Which dimensions of disability does the HIV Disability Questionnaire (HDQ) measure? A factor analysis. Disabil Rehabil 2014; 37:1193-201. [PMID: 25116628 DOI: 10.3109/09638288.2014.949358] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess the dimensions of disability measured by the HIV Disability Questionnaire (HDQ), a newly developed 72-item self-administered questionnaire that describes the presence, severity and episodic nature of disability experienced by people living with HIV. METHODS We recruited adults living with HIV from hospital clinics, AIDS service organizations and a specialty hospital and administered the HDQ followed by a demographic questionnaire. We conducted an exploratory factor analysis using disability severity scores to determine the domains of disability in the HDQ. We used the following steps: (a) ensured correlations between items were >0.30 and <0.80; (b) conducted a principal components analysis to extract factors; (c) used the Scree Test and eigenvalue threshold >1.5 to determine the number of factors to retain; and d) used oblique rotation to simplify the factor loading matrix. We assigned items to factors based on factor loadings of >0.30. RESULTS Of the 361 participants, 80% were men and 77% reported living with at least two concurrent health conditions in addition to HIV. The exploratory factor analysis suggested retaining six factors. Items related to symptoms and impairments loaded on three factors (physical [20 items], cognitive [3 items], and mental and emotional health [11 items]) and items related to worrying about the future, daily activities, and personal relationships loaded on three additional factors (uncertainty [14 items], difficulties with day-to-day activities [9 items], social inclusion [12 items]). CONCLUSIONS The HDQ has six domains: physical symptoms and impairments; cognitive symptoms and impairments; mental and emotional health symptoms and impairments; uncertainty; difficulties with day-to-day activities and challenges to social inclusion. These domains establish the scoring structure for the dimensions of disability measured by the HDQ. Implications for Rehabilitation As individuals live longer and age with HIV, they may be living with the health-related consequences of HIV and concurrent health conditions, a concept that may be termed disability. Measuring disability is important to understand the impact of HIV and its comorbidities. The HIV Disability Questionnaire (HDQ) is a self-administered questionnaire developed to describe the presence, severity and episodic nature of disability experienced by people living with HIV. The HDQ is comprised of six domains of disability including: physical symptoms and impairments (20 items); cognitive symptoms and impairments (3 items); mental and emotional health symptoms and impairments (11 items); uncertainty (14 items); difficulties with day-to-day activities (9 items) and challenges to social inclusion (12 items). These domains represent the dimensions of disability measured by the HDQ. The HDQ is the first known HIV-specific disability measure for adults living with HIV. The HDQ may be used by clinicians and researchers to assess disability experienced by adults living with HIV.
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Affiliation(s)
- Kelly K O'Brien
- Department of Physical Therapy, University of Toronto , Toronto, Ontario , Canada
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Dobson F, Bennell K, Hinman R, Roos E, Abbott H, Stratford P, Davis A, Buchbinder R, Snyder-Mackler L, Hansen P, Thumboo J, Henrotin Y. OARSI recommended performance-based tests to assess physical function in osteoarthritis of the hip or knee: authors' reply. Osteoarthritis Cartilage 2013; 21:1625-6. [PMID: 23883594 DOI: 10.1016/j.joca.2013.07.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/13/2013] [Indexed: 02/02/2023]
Affiliation(s)
- F Dobson
- The University of Melbourne, Physiotherapy, 161 Barry Street, Carlton, Victoria 3010, Australia.
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Razmjou H, Stratford P, Holtby R. A shortened version of the Western ontario rotator cuff disability index: development and measurement properties. Physiother Can 2012; 64:135-44. [PMID: 23450087 DOI: 10.3138/ptc.2010-51] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The objective of this study was to develop and examine the measurement properties of a shortened version of the Western Ontario Rotator Cuff Index (WORC), the SHORTWORC, in individuals with rotator-cuff pathology. METHODS The study occurred in two stages, both using secondary analysis of existing data sets. The first stage used cross-sectional data from candidates for rotator-cuff surgery to develop the SHORTWORC. The second stage examined various measurement properties of the SHORTWORC by analyzing scores from the WORC, the American Shoulder and Elbow Surgeons questionnaire, and the Constant-Murley score obtained from patients before and after rotator-cuff surgery. Approaches to validating the SHORTWORC included calculating the standard error of measurement (SEM) at an instant in time, performing a confirmatory factor analysis, correlating findings among the questionnaires, and examining differences between men and women. Sensitivity to change was investigated using standardized response mean and relative efficiency. RESULTS Data for 712 patients were used to develop the SHORTWORC, the final version of which consisted of 7 questions. Data for 166 patients (86 men, 80 women; mean age 57±11 years) were used for validation. The SEM based on internal consistency (SEMIC) was calculated as 7.43 SHORTWORC points. The SHORTWORC had similar convergent validity (r=0.72-0.82) and sensitivity to change (SRM=1.20 vs. 1.25, p>0.05) to the longer version. The relative efficiency of the SHORTWORC was 3.19 times that of the WORC (95% CI, 1.50-71.51) in discriminating men's from women's level of disability. CONCLUSIONS The SHORTWORC has indicators of validity, relative efficiency, and sensitivity to change comparable to those of the original version but has a smaller response burden. Purpose: The objective of this study was to develop and examine the measurement properties of a shortened version of the Western Ontario Rotator Cuff Index (WORC), the SHORTWORC, in individuals with rotator-cuff pathology. Methods: The study occurred in two stages, both using secondary analysis of existing data sets. The first stage used cross-sectional data from candidates for rotator-cuff surgery to develop the SHORTWORC. The second stage examined various measurement properties of the SHORTWORC by analyzing scores from the WORC, the American Shoulder and Elbow Surgeons questionnaire, and the Constant–Murley score obtained from patients before and after rotator-cuff surgery. Approaches to validating the SHORTWORC included calculating the standard error of measurement (SEM) at an instant in time, performing a confirmatory factor analysis, correlating findings among the questionnaires, and examining differences between men and women. Sensitivity to change was investigated using standardized response mean and relative efficiency. Results: Data for 712 patients were used to develop the SHORTWORC, the final version of which consisted of 7 questions. Data for 166 patients (86 men, 80 women; mean age 57±11 years) were used for validation. The SEM based on internal consistency (SEMIC) was calculated as 7.43 SHORTWORC points. The SHORTWORC had similar convergent validity (r=0.72−0.82) and sensitivity to change (SRM=1.20 vs. 1.25, p>0.05) to the longer version. The relative efficiency of the SHORTWORC was 3.19 times that of the WORC (95% CI, 1.50–71.51) in discriminating men's from women's level of disability. Conclusions: The SHORTWORC has indicators of validity, relative efficiency, and sensitivity to change comparable to those of the original version but has a smaller response burden.
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Affiliation(s)
- Helen Razmjou
- Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre ; Department of Physical Therapy
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Clarke H, Woodhouse LJ, Kennedy D, Stratford P, Katz J. Strategies Aimed at Preventing Chronic Post-surgical Pain: Comprehensive Perioperative Pain Management after Total Joint Replacement Surgery. Physiother Can 2011; 63:289-304. [PMID: 22654235 DOI: 10.3138/ptc.2009-49p] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE Chronic post-surgical pain (CPSP) is a frequent outcome of musculoskeletal surgery. Physiotherapists often treat patients with pain before and after musculoskeletal surgery. The purposes of this paper are (1) to raise awareness of the nature, mechanisms, and significance of CPSP; and (2) to highlight the necessity for an inter-professional team to understand and address its complexity. Using total joint replacement surgeries as a model, we provide a review of pain mechanisms and pain management strategies. SUMMARY OF KEY POINTS By understanding the mechanisms by which pain alters the body's normal physiological responses to surgery, clinicians selectively target pain in post-surgical patients through the use of multi-modal management strategies. Clinicians should not assume that patients receiving multiple medications have a problem with pain. Rather, the modern-day approach is to manage pain using preventive strategies, with the aims of reducing the intensity of acute postoperative pain and minimizing the development of CPSP. CONCLUSIONS The roles of biological, surgical, psychosocial, and patient-related risk factors in the transition to pain chronicity require further investigation if we are to better understand their relationships with pain. Measuring pain intensity and analgesic use is not sufficient. Proper evaluation and management of risk factors for CPSP require inter-professional teams to characterize a patient's experience of postoperative pain and to examine pain arising during functional activities.
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Affiliation(s)
- Hance Clarke
- Hance Clarke, MSc, MD, FRCPC: Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto; Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre; and Department of Anesthesia, University of Toronto, Toronto, Ontario
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Schuchardt M, Toelle M, Huang T, Wiedon A, Van Der Giet M, Mill C, George S, Jeremy J, Santulli G, Illario M, Cipolletta E, Sorriento D, Del Giudice C, Anastasio A, Trimarco B, Iaccarino G, Jobs A, Wagner C, Kurtz A, De Wit C, Koller A, Suvorava T, Weber M, Dao V, Kojda G, Tsaousi A, Lyon C, Williams H, George S, Barth N, Loot A, Fleming I, Keul P, Lucke S, Graeler M, Heusch G, Levkau B, Biessen E, De Jager S, Bermudez-Pulgarin B, Bot I, Abia R, Van Berkel T, Renger A, Noack C, Zafiriou M, Dietz R, Bergmann M, Zelarayan L, Hammond J, Hamelet J, Van Assche T, Belge C, Vanderper A, Langin D, Herijgers P, Balligand J, Perrot A, Neubert M, Dietz R, Posch M, Oezcelik C, Posch M, Waldmuller S, Perrot A, Berger F, Scheffold T, Bouvagnet P, Ozcelik C, Lebreiro A, Martins E, Lourenco P, Cruz C, Martins M, Bettencourt P, Maciel M, Abreu-Lima C, Pilichou K, Bauce B, Rampazzo A, Carturan E, Corrado D, Thiene G, Basso C, Piccini I, Fortmueller L, Kuhlmann M, Schaefers M, Carmeliet P, Kirchhof P, Fabritz L, Sanchez J, Rodriguez-Sinovas A, Agullo E, Garcia-Dorado D, Lymperopoulos A, Rengo G, Gao E, Zincarelli C, Koch W, Fontes-Sousa A, Silva S, Gomes M, Ferreira P, Leite-Moreira A, Capuano V, Ferron L, Ruchon Y, Ben Mohamed F, Renaud JF, Morgan P, Falcao-Pires I, Goncalves N, Gavina C, Pinho S, Moura C, Amorim M, Pinho P, Leite-Moreira A, Christ T, Molenaar P, Diez A, Ravens U, Kaumann A, Kletsiou E, Giannakopoulou M, Bozas E, Iliodromitis E, Anastasiou-Nana M, Papathanassoglou E, Chottova Dvorakova M, Mistrova E, Perez N, Slavikova J, Hynie S, Sida P, Klenerova V, Massaro M, Scoditti E, Carluccio M, Storelli C, Distante A, De Caterina R, Cingolani H, Zakrzewicz A, Hoffmann C, Hohberg M, Chlench S, Maroski J, Drab M, Siegel G, Pries A, Farrell K, Holt C, Zahradnikova A, Schrot G, Ibatov A, Wilck N, Fechner M, Arias A, Meiners S, Baumann G, Stangl V, Stangl K, Ludwig A, Polakova E, Christ A, Eijgelaar W, Daemen M, Li X, Penfold M, Schall T, Weber C, Schober A, Hintenberger R, Kaun C, Zahradnik I, Pfaffenberger S, Maurer G, Huber K, Wojta J, Demyanets S, Titov V, Nazari-Jahantigh M, Weber C, Schober A, Chin-Dusting J, Zahradnikova A, Vaisman B, Khong S, Remaley A, Andrews K, Hoeper A, Khalid A, Fuglested B, Aasum E, Larsen T, Titov V, Fluschnik N, Carluccio M, Scoditti E, Massaro M, Storelli C, Distante A, De Caterina R, Diebold I, Petry A, Djordjevic T, Belaiba R, Sossalla S, Fratz S, Hess J, Kietzmann T, Goerlach A, O'shea K, Chess D, Khairallah R, Walsh K, Stanley W, Falcao-Pires I, Ort K, Goncalves N, Van Der Velden J, Moreira-Goncalves D, Paulus W, Niessen H, Perlini S, Leite-Moreira A, Azibani F, Tournoux F, Fazal L, Neef S, Polidano E, Merval R, Chatziantoniou C, Samuel J, Delcayre C, Azibani F, Tournoux F, Fazal L, Polidano E, Merval R, Hasenfuss G, Chatziantoniou C, Samuel J, Delcayre C, Mgandela P, Brooksbank R, Maswanganyi T, Woodiwiss A, Norton G, Makaula S, Sartiani L, Maier L, Bucciantini M, Spinelli V, Coppini R, Russo E, Mugelli A, Cerbai E, Stefani M, Sukumaran V, Watanabe K, Ma M, Weinert S, Thandavarayan R, Azrozal W, Sari F, Shimazaki H, Kobayashi Y, Roleder T, Golba K, Deja M, Malinowski M, Wos S, Poitz D, Stieger P, Grebe M, Tillmanns H, Preissner K, Sedding D, Ercan E, Guven A, Asgun F, Ickin M, Ercan F, Herold J, Kaplan A, Yavuz O, Bagla S, Yang Y, Ma Y, Liu F, Li X, Huang Y, Kuka J, Vilskersts R, Schmeisser A, Vavers E, Liepins E, Dambrova M, Mariero L, Rutkovskiy A, Stenslokken K, Vaage J, Duerr G, Suchan G, Heuft T, Strasser J, Klaas T, Zimmer A, Welz A, Fleischmann B, Dewald O, Voelkl J, Haubner B, Kremser C, Mayr A, Klug G, Braun-Dullaeus R, Reiner M, Pachinger O, Metzler B, Pisarenko O, Shulzhenko V, Pelogeykina Y, Khatri D, Studneva I, Barnucz E, Loganathan S, Nazari-Jahantigh M, Hirschberg K, Korkmaz S, Merkely B, Karck M, Szabo G, Bencsik P, Gorbe A, Kocsis G, Csonka C, Csont T, Weber C, Shamloo M, Woodburn K, Ferdinandy P, Szucs G, Kupai K, Csonka C, Csont C, Ferdinandy P, Kocsisne Fodor G, Bencsik P, Schober A, Fekete V, Varga Z, Monostori P, Turi S, Ferdinandy P, Csont T, Leuner A, Eichhorn B, Ravens U, Morawietz H, Babes E, Babes V, Popescu M, Ardelean A, Rus M, Bustea C, Gwozdz P, Csanyi G, Luzak B, Gajda M, Mateuszuk L, Chmura-Skirlinska A, Watala C, Chlopicki S, Kierzkowska I, Sulicka J, Kwater A, Strach M, Surdacki A, Siedlar M, Grodzicki T, Olieslagers S, Pardali L, Tchaikovski V, Ten Dijke P, Waltenberger J, Renner M, Redwan B, Winter M, Panzenboeck A, Jakowitsch J, Sadushi-Kolici R, Bonderman D, Lang I, Toso A, Tanini L, Pizzetti T, Leoncini M, Maioli M, Tedeschi D, Oliviero C, Bellandi F, Toso A, Tanini L, Pizzetti T, Leoncini M, Maioli M, Tedeschi D, Casprini P, Bellandi F, Toso A, Tanini L, Pizzetti T, Leoncini M, Maioli M, Tedeschi D, Amato M, Bellandi F, Molins B, Pena E, Badimon L, Ferreiro Gutierrez J, Ueno M, Alissa R, Dharmashankar K, Capodanno D, Desai B, Bass T, Angiolillo D, Chabielska E, Gromotowicz A, Szemraj J, Stankiewicz A, Zakrzeska A, Mohammed S, Molla F, Soldo A, Russo I, Germano G, Balconi G, Staszewsky L, Latini R, Lynch F, Austin C, Prendergast B, Keenan D, Malik R, Izzard A, Heagerty A, Czikora A, Lizanecz E, Rutkai I, Boczan J, Porszasz R, Papp Z, Edes I, Toth A, Colantuoni A, Vagnani S, Lapi D, Maroz-Vadalazhskaya N, Koslov I, Shumavetz V, Glibovskaya T, Ostrovskiy Y, Koutsiaris A, Tachmitzi S, Kotoula M, Giannoukas A, Tsironi E, Rutkai I, Czikora A, Darago A, Orosz P, Megyesi Z, Edes I, Papp Z, Toth A, Eichhorn B, Schudeja S, Matschke K, Deussen A, Ravens U, Castro M, Cena J, Walsh M, Schulz R, Poddar K, Rha S, Ramasamy S, Park J, Choi C, Seo H, Park C, Oh D, Lebreiro A, Martins E, Almeida J, Pimenta S, Bernardes J, Machado J, Abreu-Lima C, Sabatasso S, Laissue J, Hlushchuk R, Brauer-Krisch E, Bravin A, Blattmann H, Michaud K, Djonov V, Hirschberg K, Tarcea V, Pali S, Korkmaz S, Loganathan S, Merkely B, Karck M, Szabo G, Pagliani L, Faggin E, Rattazzi M, Puato M, Presta M, Grego F, Deriu G, Pauletto P, Kaiser R, Albrecht K, Schgoer W, Theurl M, Beer A, Wiedemann D, Steger C, Bonaros N, Kirchmair R, Kharlamov A, Cabaravdic M, Breuss J, Uhrin P, Binder B, Fiordaliso F, Balconi G, Mohammed S, Maggioni M, Biondi A, Masson S, Cervo L, Latini R, Francke A, Herold J, Soenke W, Strasser R, Braun-Dullaeus R, Hecht N, Vajkoczy P, Woitzik J, Hackbusch D, Gatzke N, Duelsner A, Tsuprykov O, Slavic S, Buschmann I, Kappert K, Massaro M, Scoditti E, Carluccio M, Storelli C, Distante A, De Caterina R, Barandi L, Harmati G, Simko J, Horvath B, Szentandrassy N, Banyasz T, Magyar J, Nanasi P, Kaya A, Uzunhasan I, Yildiz A, Yigit Z, Turkoglu C, Doisne N, Zannad N, Hivert B, Cosnay P, Maupoil V, Findlay I, Virag L, Kristof A, Koncz I, Szel T, Jost N, Biliczki P, Papp J, Varro A, Bukowska A, Skopp K, Hammwoehner M, Huth C, Bode-Boeger S, Goette A, Workman A, Dempster J, Marshall G, Rankin A, Revnic C, Ginghina C, Revnic F, Yakushev S, Petrushanko I, Makhro A, Segato Komniski M, Mitkevich V, Makarov A, Gassmann M, Bogdanova A, Rutkovskiy A, Mariero L, Stenslokken K, Valen G, Vaage J, Dizayee S, Kaestner S, Kuck F, Piekorz R, Hein P, Matthes J, Nurnberg B, Herzig S, Hertel F, Switalski A, Bender K, Kienitz MC, Pott L, Fornai L, Angelini A, Erika Amstalden Van Hove E, Fedrigo M, Thiene G, Heeren R, Kruse M, Pongs O, Lehmann H, Martens-Lobenhoffer J, Hammwoehner M, Roehl F, Bukowska A, Bode-Boeger S, Goette A, Radicke S, Cotella C, Sblattero D, Schaefer M, Ravens U, Wettwer E, Santoro C, Seyler C, Kulzer M, Zitron E, Scholz E, Welke F, Thomas D, Karle C, Schmidt K, Radicke S, Dobrev D, Ravens U, Wettwer E, Houshmand N, Menesi D, Ravens U, Wettwer E, Cotella D, Papp J, Varro A, Szuts V, Szuts V, Houshmand N, Puskas L, Jost N, Virag L, Kiss I, Deak F, Varro A, Tereshchenko S, Gladyshev M, Kalachova G, Syshchik N, Gogolashvili N, Dedok E, Evert L, Wenzel J, Brandenburger M, Bogdan R, Richardt D, Reppel M, Hescheler J, Dendorfer A, Terlau H, Wiegerinck R, Galvez-Monton C, Jorge E, Martinez R, Ricart E, Cinca J, Bagavananthem Andavan G, Lemmens Gruber R, Brack K, Coote J, Ng G, Daimi H, Haj Khelil A, Neji A, Ben Hamda K, Maaoui S, Aranega A, Chibani J, Franco Jaime D, Tanko AS, Brack K, Coote J, Ng G, Doisne N, Hivert B, Cosnay P, Findlay I, Maupoil V, Daniel JM, Bielenberg W, Stieger P, Tillmanns H, Sedding D, Fortini C, Toffoletto B, Fucili A, Beltrami A, Fiorelli V, Francolini G, Ferrari R, Beltrami C, Castellani C, Ravara B, Tavano R, Thiene G, Vettor R, De Coppi P, Papini E, Angelini A, Molla F, Soldo A, Biondi A, Staszewsky L, Russo I, Gunetti M, Fagioli F, Latini R, Suffredini S, Sartiani L, Stillitano F, Mugelli A, Cerbai E, Krausgrill B, Halbach M, Soemantri S, Schenk K, Lange N, Hescheler J, Saric T, Muller-Ehmsen J, Kavanagh D, Zhao Y, Yemm A, Kalia N, Wright E, Farrell K, Wallrapp C, Geigle P, Lewis A, Stratford P, Malik N, Holt C, Krausgrill B, Raths M, Halbach M, Schenk K, Hescheler J, Muller-Ehmsen J, Zagallo M, Luni C, Serena E, Cimetta E, Zatti S, Giobbe G, Elvassore N, Serena E, Cimetta E, Zaglia T, Zatti S, Zambon A, Gordon K, Elvassore N, Mioulane M, Foldes G, Ali N, Harding S, Gorbe A, Szunyog A, Varga Z, Pirity M, Rungaruniert S, Dinnyes A, Csont T, Ferdinandy P, Foldes G, Mioulane M, Iqbal A, Schneider MD, Ali N, Harding S, Babes E, Babes V, Khodjaeva E, Ibadov R, Khalikulov K, Mansurov A, Astvatsatryan A, Senan M, Astvatsatryan A, Senan M, Nemeth A, Lenkey Z, Ajtay Z, Cziraki A, Sulyok E, Horvath I, Lobenhoffer J, Bode-Boger S, Li J, He Y, Yang X, Wang F, Xu H, Li X, Zhao X, Lin Y, Juszynski M, Ciszek B, Jablonska A, Stachurska E, Ratajska A, Atkinson A, Inada S, Li J, Sleiman R, Zhang H, Boyett M, Dobrzynski H, Fedorenko O, Hao G, Atkinson A, Yanni J, Buckley D, Anderson R, Boyett M, Dobrzynski H, Ma Y, Ma X, Hu Y, Yang Y, Huang D, Liu F, Huang Y, Liu C, Jedrzejczyk T, Balwicki L, Wierucki L, Zdrojewski T, Makhro A, Agarkova I, Vogel J, Gassmann M, Bogdanova A, Korybalska K, Pyda M, Witowski J, Ibatov A, Sozmen N, Seymen A, Tuncay E, Turan B, Huang Y, Ma Y, Yang Y, Liu F, Chen B, Li X, Houston-Feenstra L, Chiong JR, Jutzy K, Furundzija V, Kaufmann J, Kappert K, Meyborg H, Fleck E, Stawowy P, Ksiezycka-Majczynska E, Lubiszewska B, Kruk M, Kurjata P, Ruzyllo W, Ibatov A, Driesen R, Coenen T, Fagard R, Sipido K, Petrov V, Aksentijevic D, Lygate C, Makinen K, Sebag-Montefiore L, Medway D, Schneider J, Neubauer S, Gasser R, Holzwart E, Rainer P, Von Lewinski D, Maechler H, Gasser S, Roessl U, Pieske B, Krueger J, Kintscher U, Kappert K, Podramagi T, Paju K, Piirsoo A, Roosimaa M, Kadaja L, Orlova E, Ruusalepp A, Seppet E, Auquier J, Ginion A, Hue L, Horman S, Beauloye C, Vanoverschelde J, Bertrand L, Fekete V, Zvara A, Pipis J, Konya C, Csonka C, Puskas L, Csont T, Ferdinandy P, Gasser S, Rainer P, Holzwart E, Roessl U, Kraigher-Krainer E, Von Lewinksi D, Pieske B, Gasser R, Gonzalez-Loyola A, Barba I, Rodriguez-Sinovas A, Fernandez-Sanz C, Agullo E, Ruiz-Meana M, Garcia-Dorado D, Forteza M, Bodi Peris V, Monleon D, Mainar L, Morales J, Moratal D, Trapero I, Chorro F, Leszek P, Sochanowicz B, Szperl M, Kolsut P, Piotrowski W, Rywik T, Danko B, Kruszewski M, Stanley W, Khairallah R, Khanna N, O'shea K, Kristian T, Hecker P, Des Rosiers R, Fiskum G, Fernandez-Alfonso M, Guzman-Ruiz R, Somoza B, Gil-Ortega M, Attane C, Castan-Laurell I, Valet P, Ruiz-Gayo M, Maroz-Vadalazhskaya N, Denissevich T, Shumavetz V, Ostrovskiy Y, Schrepper A, Schwarzer M, Amorim P, Schoepe M, Mohr F, Doenst T, Chiellini G, Ghelardoni S, Saba A, Marchini M, Frascarelli S, Raffaelli A, Scanlan T, Zucchi R, Van Den Akker N, Molin D, Kolk F, Jeukens F, Olde Engberink R, Waltenberger J, Post M, Van Den Akker N, Molin D, Verbruggen S, Schulten H, Post M, Waltenberger J, Rochais F, Kelly R, Aberg M, Johnell M, Wickstrom M, Siegbahn A, Dimitrakis P, Groppalli V, Ott D, Seifriz F, Suter T, Zuppinger C, Kashcheyeu Y, Mueller R, Wiesen M, Saric T, Gruendemann D, Hescheler J, Herzig S, Falcao-Pires I, Fontes-Sousa A, Lopes-Conceicao L, Bras-Silva C, Leite-Moreira A, Bukauskas F, Palacios-Prado N, Norheim F, Raastad T, Thiede B, Drevon C, Haugen F, Lindner D, Westermann D, Zietsch C, Schultheiss HP, Tschoepe C, Horn M, Graham H, Hall M, Richards M, Clarke J, Dibb K, Trafford A, Cheng CF, Lin H, Eigeldiger-Berthou S, Buntschu P, Frobert A, Flueck M, Tevaearai H, Kadner A, Mikhailov A, Torrado M, Centeno A, Lopez E, Lourido L, Castro Beiras A, Popov T, Srdanovic I, Petrovic M, Canji T, Kovacevic M, Jovelic A, Sladojevic M, Panic G, Kararigas G, Fliegner D, Regitz-Zagrosek V, De La Rosa Sanchez A, Dominguez J, Sedmera D, Franco D, Aranega A, Medunjanin S, Burgbacher F, Schmeisser A, Strasser R, Braun-Dullaeus R, Li X, Ma Y, Yang Y, Liu F, Han W, Chen B, Zhang J, Gao X, Bayliss C, Song W, Stuckey D, Dyer E, Leung MC, Monserrat L, Marston S, Sorriento D, Santulli G, Fusco A, Trimarco B, Iaccarino G, Revnic C, Ginghina C, Revnic F, Paillard M, Liang J, Strub G, Gomez L, Hait N, Allegood J, Lesnefsky E, Spiegel S, Zuchi C, Coiro S, Bettini M, Ciliberti G, Mancini I, Tritto I, Becker L, Ambrosio G, Adam T, Sharp S, Opie L, Lecour S, Khaliulin I, Parker J, Halestrap A, Kandasamy A, Schulz R, Schoepe M, Schwarzer M, Schrepper A, Osterholt M, Amorim P, Mohr F, Doenst T, Fernandez-Sanz C, Ruiz-Meana M, Miro-Casas E, Agullo E, Boengler K, Schulz R, Garcia-Dorado D, Menazza S, Canton M, Sheeran F, Di Lisa F, Pepe S, Borchi E, Manni M, Bargelli V, Giordano C, D'amati G, Cerbai E, Nediani C, Raimondi L, Micova P, Balkova P, Kolar F, Neckar J, Novak F, Novakova O, Schuchardt M, Toelle M, Pruefer N, Pruefer J, Jankowski V, Jankowski J, Van Der Giet M, Han W, Su Y, Zervou S, Aksentijevic D, Lygate C, Neubauer S, Seidel B, Korkmaz S, Radovits T, Hirschberg K, Loganathan S, Barnucz E, Karck M, Szabo G, Aggeli I, Kefaloyianni E, Beis I, Gaitanaki C, Lacerda L, Somers S, Opie L, Lecour S, Brack K, Coote J, Ng G, Paur H, Nikolaev V, Lyon A, Harding S, Bras-Silva C. Sunday, 18 July 2010. Cardiovasc Res 2010. [DOI: 10.1093/cvr/cvq176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bamm EL, Rosenbaum P, Stratford P. Validation of the measure of processes of care for adults: a measure of client-centred care. Int J Qual Health Care 2010; 22:302-9. [DOI: 10.1093/intqhc/mzq031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Schneider GM, Smith AD, Hooper A, Stratford P, Schneider KJ, Westaway MD, Frizzell B, Olson L. Minimizing the source of nociception and its concurrent effect on sensory hypersensitivity: an exploratory study in chronic whiplash patients. BMC Musculoskelet Disord 2010; 11:29. [PMID: 20144214 PMCID: PMC2829507 DOI: 10.1186/1471-2474-11-29] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 02/09/2010] [Indexed: 12/21/2022] Open
Abstract
Background The cervical zygapophyseal joints may be a primary source of pain in up to 60% of individuals with chronic whiplash associated disorders (WAD) and may be a contributing factor for peripheral and centrally mediated pain (sensory hypersensitivity). Sensory hypersensitivity has been associated with a poor prognosis. The purpose of the study was to determine if there is a change in measures indicative of sensory hypersensitivity in patients with chronic WAD grade II following a medial branch block (MBB) procedure in the cervical spine. Methods Measures of sensory hypersensitivity were taken via quantitative sensory testing (QST) consisting of pressure pain thresholds (PPT's) and cold pain thresholds (CPT's). In patients with chronic WAD (n = 18), the measures were taken at three sites bilaterally, pre- and post- MBB. Reduced pain thresholds at remote sites have been considered an indicator of central hypersensitivity. A healthy age and gender matched comparison group (n = 18) was measured at baseline. An independent t-test was applied to determine if there were any significant differences between the WAD and normative comparison groups at baseline with respect to cold pain and pressure pain thresholds. A dependent t-test was used to determine whether there were any significant differences between the pre and post intervention cold pain and pressure pain thresholds in the patients with chronic WAD. Results At baseline, PPT's were decreased at all three sites in the WAD group (p < 0.001). Cold pain thresholds were increased in the cervical spine in the WAD group (p < 0.001). Post-MBB, the WAD group showed significant increases in PPT's at all sites (p < 0.05), and significant decreases in CPT's at the cervical spine (p < 0.001). Conclusions The patients with chronic WAD showed evidence of widespread sensory hypersensitivity to mechanical and thermal stimuli. The WAD group revealed decreased sensory hypersensitivity following a decrease in their primary source of pain stemming from the cervical zygapophyseal joints.
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Affiliation(s)
- Geoff M Schneider
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Hand C, Richardson J, Letts L, Stratford P. Construct validity of the late life function and disability instrument for adults with chronic conditions. Disabil Rehabil 2009; 32:50-6. [DOI: 10.3109/09638280902998789] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Richardson J, Stratford P, Cripps D. Assessment of reliability of the hand-held dynamometer for measuring strength in healthy older adults. Physiother Theory Pract 2009. [DOI: 10.3109/09593989809070043] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hand C, Richardson J, Letts L, Stratford P. Construct validity of the late life function and disability instrument for adults with chronic conditions. Disabil Rehabil 2009. [DOI: 10.1080/09638280902998789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hand C, Stratford P, Richardson J, Letts L. Poster 68: Validity of the Late Life Function and Disability Index With Adults with Chronic Conditions. Arch Phys Med Rehabil 2008. [DOI: 10.1016/j.apmr.2008.08.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bryant D, Stratford P, Marx R, Walter S, Guyatt G. Patients can provide a valid assessment of quality of life, functional status, and general health on the day they undergo knee surgery. J Bone Joint Surg Am 2008; 90:264-70. [PMID: 18245584 DOI: 10.2106/jbjs.g.00336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND In the interest of efficiency, investigators often offer participants in surgical trials the option of completing baseline assessments on the day of surgery. The emotional affects of this day may, however, increase bias or random error. We studied the validity and reliability of collecting subjective ratings of health on the day of surgery. METHODS One hundred and seventy-seven patients undergoing anterior cruciate ligament reconstruction and/or knee arthroscopy completed quality-of-life, functional status, and general health instruments at four weeks preoperatively, on the day of surgery, and one year postoperatively. We evaluated results with use of three conceptual frameworks: (1) that ratings provided four weeks preoperatively provide a gold standard for preoperative ratings, (2) that there is no gold standard for preoperative ratings and that, if valid, ratings on the day of surgery should be highly correlated with ratings at four weeks preoperatively and moderately and similarly correlated with ratings at one year postoperatively, and (3) that ratings provided four weeks preoperatively and on the day of surgery are measuring identical constructs and should therefore show high reliability. RESULTS Most patients (97%) had a chronic injury as the interval between the injury and surgery was more than ninety days. Data collected on the day of surgery demonstrated high predictive validity with data collected within one month before surgery. There was no significant heterogeneity between variances for data collected four weeks preoperatively and on the day of surgery. The correlation between data collected on the day of surgery and four weeks preoperatively was moderate to high (range, 0.64 to 0.93), and the correlation between preoperative ratings and the one-year postoperative ratings was moderate (range, 0.40 to 0.59) across all instruments. Agreement between the ratings provided four weeks preoperatively and on the day of surgery was excellent (intraclass correlation coefficient, 0.64 to 0.91), and the standard error of measurement was small across instruments. CONCLUSIONS In the treatment of chronic knee injuries, patients can accurately rate their quality of life, general health, and functional status on the day on which they undergo surgery.
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Affiliation(s)
- Dianne Bryant
- Faculty of Health Sciences, Elborn College, Room 1438, The University of Western Ontario, London, ON N6G 1H1, Canada.
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Denis S, Shannon HS, Wessel J, Stratford P, Weller I. Association of low back pain, impairment, disability & work limitations in nurses. J Occup Rehabil 2007; 17:213-26. [PMID: 17252204 DOI: 10.1007/s10926-007-9065-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Health care professionals use measures of pain and impairment to identify potential disability and subsequently to predict workers' ability to do their work. However, there is little evidence that measures used are associated with ability to do one's job. METHODS A cross-sectional study was conducted. Nurses (n = 100) were classified into either off/modified work (due to LBP) or regular work groups. Trunk ROM, trunk muscular endurance, pain and disability were measured relative to the outcomes work status and Work Limitations Questionnaire (WLQ) score. RESULTS Regression analyses which included Roland Morris Questionnaire (RMQ, disability) and Sørenson (back extensor endurance) in the final models correctly classified the work status of 87% of the participants and accounted for 60% of variance in the WLQ score. CONCLUSIONS Use of the RMQ and Sørenson test as diagnostic and prognostic tools should be considered in assisting return to work and treatment decision-making in female nurses with LBP.
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Affiliation(s)
- Suzanne Denis
- Departments of Occupational Health & Safety and Rehabilitation, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Center, 43 Wellesly St. East, Toronto, Ontario, M4Y 1H1, Canada.
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Bryant D, Norman G, Stratford P, Marx RG, Walter SD, Guyatt G. Patients undergoing knee surgery provided accurate ratings of preoperative quality of life and function 2 weeks after surgery. J Clin Epidemiol 2006; 59:984-93. [PMID: 16895823 DOI: 10.1016/j.jclinepi.2006.01.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2005] [Revised: 01/09/2006] [Accepted: 01/22/2006] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate patients' ability to recall their preoperative self-reported quality of life, function, and general health 2 weeks postoperatively. STUDY DESIGN AND SETTING We randomized consecutive patients undergoing arthroscopic knee surgery to group I (assessments at 4 weeks preoperatively, on the day of surgery, and 2 weeks and 12 months postoperatively) or group II (assessments at 2 weeks and 12 months postoperatively). At each visit patients completed disease-specific, knee-specific, and generic health rating scales. At a median of 2 weeks postoperative (range, 0.6 to 14 weeks), patients completed questionnaires according to their recollection of their health 2 weeks before surgery. RESULTS Agreement between actual and recalled data was excellent for disease-specific (ICC(WOMET)=0.88 (95% CI 0.82-0.91), ICC(ACL-QOL)=0.86 (95% CI 0.75-0.91)), knee-specific (ICC(IKDC)=0.92 (95% CI 0.90-0.94), ICC(KOOS)=0.93 (95% CI 0.91 to 0.95), and general physical health (ICC(SF-36(PCS))=0.81 (95% CI 0.75-0.86)) instruments. Agreement for general mental health was moderate (ICC(SF-36(MCS))=0.67 (95% CI 0.58-0.75). Greater error associated with recalled ratings contributed to small increases in sample size requirements or small decreases in power to detect differences between groups. CONCLUSION Patients recalled their preoperative quality of life, function, and general health at 2 weeks postoperative with sufficiently high accuracy to warrant substituting prospectively collected baseline data with recalled ratings.
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Affiliation(s)
- Dianne Bryant
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, Elborn College, Room 1438, London, Ontario N6G 1H1, Canada.
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MacDermid JC, Solomon P, Law M, Russell D, Stratford P. Defining the effect and mediators of two knowledge translation strategies designed to alter knowledge, intent and clinical utilization of rehabilitation outcome measures: a study protocol [NCT00298727]. Implement Sci 2006; 1:14. [PMID: 16820055 PMCID: PMC1557530 DOI: 10.1186/1748-5908-1-14] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2006] [Accepted: 07/04/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A substantial number of valid outcome measures have been developed to measure health in adult musculoskeletal and childhood disability. Regrettably, national initiatives have merely resulted in changes in attitude, while utilization remains unacceptably low. This study will compare the effectiveness and mediators of two different knowledge transfer (KT) interventions in terms of their impact on changing knowledge and behavior (utilization and clinical reasoning) related to health outcome measures. METHOD/DESIGN Physical and occupational therapists (n = 144) will be recruited in partnership with the national professional associations to evaluate two different KT interventions with the same curriculum: 1) Stakeholder-Hosted Interactive Problem-Based Seminar (SHIPS), and 2) Online Problem-Based course (e-PBL). SHIPS will consist of face-to-face problem-based learning (PBL) for 2 1/2 days with outcome measure developers as facilitators, using six problems generated in consultation with participants. The e-PBL will consist of a 6-week web-based course with six generic problems developed by content experts. SHIPS will be conducted in three urban centers in Canada. Participants will be block-allocated by a minimization procedure to either of the two interventions to minimize any prognostic differences. Trained evaluators at each site will conduct chart audits and chart-stimulated recall. Trained interviewers will conduct semi-structured interviews focused on identifying critical elements in KT and implementing practice changes. Interviews will be transcribed verbatim. Baseline predictors including demographics, knowledge, attitudes/barriers regarding outcome measures, and Readiness to Change will be assessed by self-report. Immediately post-intervention and 6 months later, these will be re-administered. Primary qualitative and quantitative evaluations will be conducted 6-months post-intervention to assess the relative effectiveness of KT interventions and to identify elements that contribute to changing clinical behavior. Chart audits will determine the utilization of outcome measures (counts). Incorporation of outcome measures into clinical reasoning will be assessed using an innovative technique: chart-stimulated recall. DISCUSSION A strategy for optimal transfer of health outcome measures into practice will be developed and shared with multiple disciplines involved in primary and specialty management of musculoskeletal and childhood disability.
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Affiliation(s)
- Joy C MacDermid
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
- Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, N6A 3A8, Canada
| | - Patty Solomon
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
| | - Mary Law
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
| | - Dianne Russell
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
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Abstract
Standardized outcome measures can enhance clinical decision making in hand therapy. Processes in which evidence is used to make decisions on individual patients with respect to the patient's level of impairment and disability as well as the significance of any changes observed after interventions are consistent with an evidence-based approach. Evidence can enhance clinical decision making and provide objective criteria for goal setting and evaluation. The authors review the necessary concepts and approaches to applying evidence on outcome measures using a vignette that describes a patient with rotator cuff pathology who has provided a Disability of the Arm, Shoulder, and Hand (DASH) score during clinical assessment.
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Affiliation(s)
- Joy C MacDermid
- School of Rehabilitation Science, McMaster University Hamilton, Ontario, Canada.
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