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Rita K. Bode Allen W. Heinemann Zeeshan Butt Jena Stallings Caitlin Taylor Morgan Rowe Elliot J. Roth 《Archives of physical medicine and rehabilitation》2010,91(9):1347-1356
Bode RK, Heinemann AW, Butt Z, Stallings J, Taylor C, Rowe M, Roth EJ. Development and validation of participation and positive psychologic function measures for stroke survivors.
Objective
To evaluate the reliability and validity of Neurologic Quality of Life (NeuroQOL) item banks that assess quality-of-life (QOL) domains not typically included in poststroke measures.Design
Secondary analysis of item responses to selected NeuroQOL domains.Setting
Community.Participants
Community-dwelling stroke survivors (n=111) who were at least 12 months poststroke.Interventions
Not applicable.Main Outcome Measures
Five measures developed for 3 NeuroQoL domains: ability to participate in social activities, satisfaction with participation in social activities, and positive psychologic function.Results
A single bank was developed for the positive psychologic function domain, but 2 banks each were developed for the ability-to-participate and satisfaction-with-participation domains. The resulting item banks showed good psychometric properties and external construct validity with correlations with the legacy instruments, ranging from .53 to .71. Using these measures, stroke survivors in this sample reported an overall high level of QOL.Conclusions
The NeuroQoL-derived measures are promising and valid methods for assessing aspects of QOL not typically measured in this population. 相似文献3.
Kevin W. Greve Jonathan S. Ord Kevin J. Bianchini Kelly L. Curtis 《Archives of physical medicine and rehabilitation》2009,90(7):1117-1126
Greve KW, Ord JS, Bianchini KJ, Curtis KL. Prevalence of malingering in patients with chronic pain referred for psychologic evaluation in a medico-legal context.
Objective
To provide an empirical estimate of the prevalence of malingered disability in patients with chronic pain who have financial incentive to appear disabled.Design
Retrospective review of cases.Setting
A private neuropsychologic clinic in a southeastern metropolitan area.Participants
Consecutive patients (N=508) referred for psychologic evaluation related to chronic pain over a 10-year period (1995-2005).Interventions
Not applicable.Main Outcome Measures
Prevalence of malingering was examined using 2 published clinical diagnostic systems (Malingered Pain-Related Disability and Malingered Neurocognitive Dysfunction) as well as statistical estimates based on well validated indicators of malingering.Results
The prevalence of malingering in patients with chronic pain with financial incentive is between 20% and 50% depending on the diagnostic system used and the statistical model's underlying assumptions. Some factors associated with the medico-legal context such as the jurisdiction of a workers' compensation claim or attorney representation were associated with slightly higher malingering rates.Conclusions
Malingering is present in a sizable minority of patients with pain seen for potentially compensable injuries. However, not all excess pain-related disability is a result of malingering. It is important not to diagnose malingering reflexively on the basis of limited or unreliable findings. A diagnosis of malingering should be explicitly based on a formal diagnostic system. 相似文献4.
James S. Krause Rickey Carter Yusheng Zhai Karla Reed 《Archives of physical medicine and rehabilitation》2009,90(4):628-633
Krause JS, Carter R, Zhai Y, Reed K. Psychologic factors and risk of mortality after spinal cord injury.
Objective
To identify the association of 2 distinct psychologic constructs, personality and purpose in life (PIL), with risk of early mortality among persons with spinal cord injury (SCI).Design
Prospective cohort study with health data collected in late 1997 and early 1998 and mortality status ascertained in December 2005.Setting
A large rehabilitation hospital in the southeastern United States.Participants
Adults (N=1386) with traumatic SCI, at least 1 year postinjury.Interventions
Not applicable.Main Outcome Measures
We first evaluated the significance of a single psychologic predictor (a total of 6 scales) while controlling for biographic and injury predictors using Cox proportional hazards modeling and subsequently built a comprehensive model based on an optimal group of psychologic variables.Results
There were a total of 224 (16.2%) observed deaths in the full sample. The total number of deaths was reduced to 164 in the final statistical model (of 1128 participants) because of missing data. All 6 psychologic factors were statistically significant in the model that was adjusted for biographic and injury factors, whereas only 3 psychologic factors were retained in the final comprehensive model, including 2 personality scales (Impulsive Sensation Seeking, Neuroticism-Anxiety) and the PIL scale. The final comprehensive model only modestly improved the overall prediction of survival compared with the model with only biographic and injury variables, because the pseudo-R2 increased from 0.121 to 0.129, and the concordance increased from 0.730 to 0.747.Conclusions
The results affirm the importance of psychologic factors in relation to survival after SCI. 相似文献5.
Maria T. Schultheis Valerie Weisser Jocelyn Ang Elie Elovic Richard Nead Nicole Sestito Cassandra Fleksher Scott R. Millis 《Archives of physical medicine and rehabilitation》2010,91(3):465-473
Schultheis MT, Weisser V, Ang J, Elovic E, Nead R, Sestito N, Fleksher C, Millis SR. Examining the relationship between cognition and driving performance in multiple sclerosis.
Objective
To identify cognitive predictors of driving performance after multiple sclerosis (MS).Design
Prospective design examining predictive value of cognitive measures on driving performance.Setting
All data were collected in an outpatient research setting and an outpatient driver rehabilitation program.Participants
Participants were community-dwelling persons (N=66) with clinically defined MS (86% relapsing-remitting, 14% progressive) with a mean age of 43.47 years. All were active drivers who met vision requirements established by their respective states, and none required adaptive driving equipment.Intervention
Not applicable.Main Outcome Measures
Participants were administered a comprehensive neuropsychologic assessment and a clinical behind-the-wheel (BTW) driving evaluation. Additional measures of driving performance included history of traffic violations and collisions (since MS onset).Results
Logistic regression indicated that information processing speed (Symbol Digit Modality Test [SDMT]) was the strongest predictor of BTW performance. A logistic regression revealed that the strongest predictors of collision and violation frequency were visuospatial learning and recall (7/24 Spatial Recall Test [SPART 7/24]).Conclusions
These findings indicate that information processing and visuospatial skills are predictive of driving performance among persons with MS. These measures (SDMT and SPART 7/24) may serve as screening methods for identifying the potential impact of cognitive impairment on driving. Furthermore, the findings raise questions regarding the appropriateness of the BTW evaluation to evaluate driving difficulties accurately among individuals with MS. 相似文献6.
Objectives
We aimed to evaluate assessment tools to measure the psychological impact of providing CPR to a relative. We set out to evaluate the Revised Impact of Event Scale (IES-R) and Texas Inventory of Grief (TIG) for comparing CPR providers and non-providers, and to establish whether research of this nature had a negative impact on the participants. We also collected narrative data from CPR providers.Methods
Prospective sampling of relatives of patients presenting to hospital who had witnessed their relative have a cardiac arrest and who had performed or witnessed CPR. Participants performed two interviews and completed the IES-R and the TIG.Results
Twenty-nine cardiac arrest victims presented, with ten relatives enrolled. The IES-R and TIG were feasible, and registered moderate responses from CPR providers and non-providers.There was no significant difference in the IES-R score between CPR providers and non-providers (1.96 vs. 1.04, p = 0.3). There was no significant difference between scores obtained at two different time points (1.75 vs. 1.63, p = 0.43). Participants demonstrated a moderate response on the TIG (mean TIG score 2.8, SD 1.7). Participants did not have a negative perception of study involvement, and actually perceived a benefit from discussion with a health professional.Conclusion
It is acceptable and achievable to prospectively assess the response of a cardiac arrest victim's relatives to the provision of CPR. The test instruments used were appropriate and feasible. Results suggested a sample size of 48 to achieve a statistically significant result. 相似文献7.
Adam T. Hirsh Aaron P. Turner Dawn M. Ehde Jodie K. Haselkorn 《Archives of physical medicine and rehabilitation》2009,90(4):646-651
Hirsh AT, Turner AP, Ehde DM, Haselkorn JK. Prevalence and impact of pain in multiple sclerosis: physical and psychologic contributors.
Objective
To characterize the prevalence and impact of pain in veterans with multiple sclerosis (MS) and to assess their association with demographic, biologic, and psychologic variables.Design
Cross-sectional cohort study linking computerized medical record information to mailed survey data.Setting
Veterans Health Administration (VHA).Participants
Sixty-four percent (2994/4685) of veterans with MS who received services in VHA and also returned survey questionnaires.Interventions
Not applicable.Main Outcome Measures
Items assessing pain intensity, pain interference, and physical and mental health functioning.Results
Ninety-two percent of participants reported bodily pain within the prior 4 weeks, with 69% of the total sample indicating pain of moderate or higher intensity. Eighty-five percent indicated that pain caused functional interference during the past 4 weeks, with 71% of the total sample reporting pain-related interference that was moderate or greater. No significant sex or race differences emerged for the pain indices. A significant but modest relationship between increasing age and pain interference emerged (r=.05, P<.01); however, age was not significantly related to pain intensity. Multivariate regression analyses identified pain intensity (β=.73), physical health functioning (β=-.07), and mental health functioning (β=-.13) variables as significant, unique contributors to the prediction of pain interference. The interaction of pain intensity and physical functioning was also significant but of minimal effect size (β=-.03).Conclusions
Pain is highly prevalent and causes substantial interference in the lives of veterans with MS. The functional impact of pain in veterans with MS is influenced by pain intensity, physical health, and emotional functioning. Clinical practice should take each of these domains into consideration and reflect a biopsychosocial conceptualization. 相似文献8.
Ettlin T Schuster C Stoffel R Brüderlin A Kischka U 《Archives of physical medicine and rehabilitation》2008,89(7):1290-1293
Ettlin T, Schuster C, Stoffel R, Brüderlin A, Kischka U. A distinct pattern of myofascial findings in patients after whiplash injury.
Objective
To identify objective clinical examinations for the diagnosis of whiplash syndrome, whereby we focused on trigger points.Design
A cross-sectional study with 1 measurement point.Setting
A quiet treatment room in a rehabilitation center.Participants
Patients (n=124) and healthy subjects (n=24) participated in this study. Among the patient group were patients with whiplash-associated disorders (n=47), fibromyalgia (n=21), nontraumatic chronic cervical syndrome (n=17), and endogenous depression (n=15).Interventions
Not applicable.Main Outcome Measure
Each patient and control subject had a manual examination for trigger points of the semispinalis capitis, trapezius pars descendens, levator scapulae, scalenus medius, sternocleidomastoideus, and masseter muscles bilaterally.Results
Forty (85.1%) of the patients with whiplash had positive trigger points in the semispinalis capitis muscle. The patients with whiplash had a significantly higher prevalence of positive trigger points in the semispinalis capitis muscle than any of the control groups (P<.05). For the other examined muscles, the prevalence of trigger points in the patients with whiplash did not differ significantly from the patients with fibromyalgia or nontraumatic chronic cervical syndrome. It did differ from the patients with endogenous depression and the healthy controls.Conclusions
Patients with whiplash showed a distinct pattern of trigger point distribution that differed significantly from other patient groups and healthy subjects. The semispinalis capitis muscle was more frequently affected by trigger points in patients with whiplash, whereas other neck and shoulder muscles and the masseter muscle did not differentiate between patients with whiplash and patients with nontraumatic chronic cervical syndrome or fibromyalgia. 相似文献9.
Sara R. Piva G. Kelley Fitzgerald James J. Irrgang Julie M. Fritz Stephen Wisniewski Gerald T. McGinty John D. Childs Manuel A. Domenech Scott Jones Anthony Delitto 《Archives of physical medicine and rehabilitation》2009,90(2):285-295
Piva SR, Fitzgerald GK, Irrgang JJ, Fritz JM, Wisniewski S, McGinty GT, Childs JD, Domenech MA, Jones S, Delitto A. Associates of physical function and pain in patients with patellofemoral pain syndrome.
Objectives
To explore whether impairment of muscle strength, soft tissue length, movement control, postural and biomechanic alterations, and psychologic factors are associated with physical function and pain in patients with patellofemoral pain syndrome (PFPS).Design
Cross-sectional study.Setting
Rehabilitation outpatient.Participants
Seventy-four patients diagnosed with PFPS.Interventions
Not applicable.Main Outcome Measures
Measurements were self-reported function and pain; strength of quadriceps, hip abduction, and hip external rotation; length of hamstrings, quadriceps, plantar flexors, iliotibial band/tensor fasciae latae complex, and lateral retinaculum; foot pronation; Q-angle; tibial torsion; visual observation of quality of movement during a lateral step-down task; anxiety; and fear-avoidance beliefs.Results
After controlling for age and sex, anxiety and fear-avoidance beliefs about work and physical activity were associated with function, while only fear-avoidance beliefs about work and physical activity were associated with pain.Conclusions
Psychologic factors were the only associates of function and pain in patients with PFPS. Factors related to physical impairments did not associate to function or pain. Our results should be validated in other samples of patients with PFPS. Further studies should determine the role of other psychologic factors, and how they relate to anxiety and fear-avoidance beliefs in these patients. 相似文献10.
Kornetti DL Fritz SL Chiu YP Light KE Velozo CA 《Archives of physical medicine and rehabilitation》2004,85(7):1128-1135
Kornetti DL, Fritz SL, Chiu Y-P, Light KE, Velozo CA. Rating scale analysis of the Berg Balance Scale. Arch Phys Med Rehabil 2004;85:1128-35.
Objectives
To examine, using Rasch analysis, the rating scale performance of the Berg Balance Scale (BBS) and to describe the 45/56 cutoff score in functional terms.Design
Retrospective chart review of BBS scores. Rasch rating scale analysis was performed on these data.Setting
Outpatient Veterans Affairs medical center.Participants
One hundred (99 men, 1 woman) community-dwelling veterans referred for balance deficits (age range, 64-88y).Interventions
Not applicable.Main outcome measure
The BBS.Results
Condensing item-rating categories allowed the elimination of underutilized categories and constructed categories that better separated people of differing abilities. Rating pivot points were developed for each item to represent a transition between passing and failing. Following pivot-point development and rating scale rescoring, person and item measures became more evenly distributed across the BBS and resulted in changes in item difficulty order. In our sample, functional indicators of a score of at least 45/56 were a rating of passing the item “tandem stance,” as well as passing 2 of the following 3 items: “alternating foot,” “standing on one leg,” and “look behind.”Conclusions
Our findings provide direction for improving the rating scale structure for each of the items and establish a connection between the BBS cutoff score of 45/56 and functional ability. 相似文献11.
C. Jenkins K.L. Barker K.A. Reilly H. Pandit C.A.F. Dodd D.W. Murray 《Physiotherapy》2006,92(4):214-218
Objectives
To describe an accelerated protocol for early discharge of patients undergoing Oxford medial unicompartmental knee arthroplasty using a minimally invasive approach.Design
Prospective observational study.Setting
Specialist orthopaedic National Health Service hospital.Participants
One hundred consecutive patients (40 female, 60 male) undergoing Oxford medial unicompartmental knee arthroplasty with an average age of 64 (range 44-80) years.Outcome measures
Oxford knee score, American Knee Society score (objective and functional) and the ability to perform functional tasks were recorded pre-operatively and 6 weeks and 1 year postoperatively. Success was taken as an improvement in these scores or as an increased ability to perform functional tasks.Results
Satisfactory results were attained after accelerated discharge, with the mean objective American Knee Society score increasing from 41/100 (95% confidence interval 38.0-44.5) pre-operatively to 87/100 (95% confidence interval 83.1-90.3) at 1 year, and the Oxford knee score increasing from 24/48 (95% confidence interval 21.9-25.2) to 41/48 (95% confidence interval 39.6-42.8) over the same period. All monitored functional activities improved. The mean values before surgery and 6 weeks and 1 year after surgery are presented.Conclusion
Outcome following minimally invasive Oxford medial unicompartmental knee replacement is not compromised with the use of an accelerated treatment protocol. 相似文献12.
Marcotte TD Rosenthal TJ Roberts E Lampinen S Scott JC Allen RW Corey-Bloom J 《Archives of physical medicine and rehabilitation》2008,89(9):1753-1758
Marcotte TD, Rosenthal TJ, Roberts E, Lampinen S, Scott JC, Allen RW, Corey-Bloom J. The contribution of cognition and spasticity to driving performance in multiple sclerosis.
Objective
To examine the independent and combined impact of cognitive dysfunction and spasticity on driving tasks involving high cognitive workload and lower-limb mobility in persons with multiple sclerosis (MS).Design
Single-visit cohort study.Setting
Clinical research center.Participants
Participants included 17 drivers with MS and 14 referent controls. The group with MS exhibited a broad range of cognitive functioning and disability. Of the 17 patients with MS, 8 had significant spasticity in the knee used to manipulate the accelerator and brake pedals (based on the Modified Ashworth Scale).Interventions
Not applicable.Main Outcome Measures
A brief neuropsychologic test battery and 2 driving simulations. Simulation 1 required participants to maintain a constant speed and lane position while attending to a secondary task. Simulation 2 required participants to adjust their speed to accelerations and decelerations of a lead car in front of them.Results
Patients with MS showed greater variability in lane position (effect size, g=1.30), greater difficulty in maintaining a constant speed (g=1.25), and less ability to respond to lead car speed changes (g=1.85) compared with controls. Within the MS group, in a multivariate model that included neuropsychologic and spasticity measures, cognitive functioning was the strongest predictor of difficulty in maintaining lane position during the divided attention task and poor response time to lead car speed changes, whereas spasticity was associated with reductions in accuracy of tracking the lead car movements and speed maintenance.Conclusions
In this preliminary study, cognitive and physical impairments associated with MS were related to deficits in specific components of simulated driving. Assessment of these factors may help guide the clinician regarding the types of driving behaviors that would put patients with MS at an increased risk for an automobile crash. 相似文献13.
Rapport LJ, Coleman Bryer R, Hanks RA. Driving and community integration after traumatic brain injury.
Objective
To examine resumption of driving after traumatic brain injury (TBI) and its relation to community integration.Design
Cross-sectional cohort study; survey and cognitive data.Settings
Inpatient rehabilitation hospital of the Traumatic Brain Injury Model Systems and community.Participants
Persons (N=261) ranging from 3 months to 15 years postinjury.Interventions
Not applicable.Main Outcome Measures
Barriers to Driving Questionnaire, Driver Survey, Community Integration Measure, and Craig Hospital Assessment and Reporting Technique.Results
Forty-four percent of survivors had resumed driving; of nondrivers, 48% reported a strong desire to resume driving. Nondriver survivors who sought to resume driving generally rated themselves as currently fit to drive, viewed themselves as having physical and cognitive profiles like those of survivor drivers, and reported their greatest barriers to driving as social and resource related. However, cognitive functioning was similar to nondriver survivors who did not seek to resume driving and significantly worse than survivors who were currently driving. Nondrivers showed poorer community integration than did drivers, even after accounting for injury severity, social support, negative affectivity, and use of alternative transportation. Use of alternative transportation was common among nondrivers, but it was unrelated to community integration outcomes. Cognitive functioning moderated risk of adverse incident: among survivors with low cognitive functioning and high self-estimates of driving ability, which is indicative of unawareness of deficit, adverse incidents showed positive relation to amount of driving and inverse relation to cognitive functioning.Conclusions
Driving status has unique and independent association with post-TBI community integration. Additional research is needed to evaluate transportation barriers that undermine full engagement in community living after TBI and to determine which barriers to driving reflect valid risk to survivors and the public. 相似文献14.
Chung Reen Kim Jong Yoon Yoo Sang Hoon Lee Dong Ho Lee Seung Chul Rhim 《Archives of physical medicine and rehabilitation》2010,91(10):1587-1592
Kim CR, Yoo JY, Lee SH, Lee DH, Rhim SC. Gait analysis for evaluating the relationship between increased signal intensity on T2-weighted magnetic resonance imaging and gait function in cervical spondylotic myelopathy.
Objective
To determine relationships between increased signal intensity (ISI) on T2-weighted cervical spine magnetic resonance imaging (MRI) and parameters of gait analysis in patients with cervical spondylotic myelopathy (CSM).Design
Retrospective comparative study.Setting
Gait analysis laboratory.Participants
Patients (N=36) who undertook cervical laminectomy or laminoplasty because of CSM.Interventions
Not applicable.Main Outcome Measures
Subjects were evaluated by using the modified Japanese Orthopaedic Association (JOA) scale, the Nurick scale, cervical spine MRI, and gait analysis. Two radiologists classified patients into 3 groups: intense, faint, and no ISI.Results
Relative to patients without ISI, those with ISI showed significantly slower gait speed, longer step time, decreased single-limb support time, increased double-limb support time, and limited range of motion of knee and ankle (P<.05). Increased intensity tended to correlate with poor gait function including slower gait speed, longer step time, decreased single-limb support time, and increased double-limb support time. The modified JOA and Nurick scale did not correlate with ISI.Conclusions
In patients with CSM who received surgical treatment, more intense ISI on T2-weighted MRI correlated preoperatively with increased difficulties in gait function. Gait analysis may be a useful tool for evaluating gait functions in cervical myelopathy. 相似文献15.
Marjon D. van Eijsden-Besseling Karien A. van den Bergh J. Bart Staal Rob A. de Bie Wim J. van den Heuvel 《Archives of physical medicine and rehabilitation》2010,91(6):862-867
van Eijsden-Besseling MD, van den Bergh KA, Staal JB, de Bie RA, van den Heuvel WJ. The course of nonspecific work-related upper limb disorders and the influence of demographic factors, psychologic factors, and physical fitness on clinical status and disability.
Objective
To assess the course of nonspecific work-related upper limb disorders (WRULD) and the influence of sociodemographic factors, psychologic factors, and physical fitness on clinical status and functional disability.Design
Retrospective cohort study with cross-sectional analysis among computer workers with several stages of nonspecific WRULD; average follow-up 4 years. Sociodemographic and medical characteristics were assessed based on medical records at onset and diagnosis. After informed consent at follow-up, participants received a questionnaire assessing psychologic and physical fitness characteristics.Setting
Outpatient department of rehabilitation medicine, University Hospital Maastricht; tertiary referral center for nonspecific WRULD.Participants
Computer workers (N=182) with nonspecific WRULD, 18 to 50 years, first consultation 1998 to 2001; those with specific WRULD and incomplete medical records and treatment charts were excluded.Interventions
Not applicable.Main Outcome Measures
Stage of nonspecific WRULD (clinical status) and Disabilities of Arm, Shoulder and Hand questionnaire [DASH] (functional disability).Results
A total of 104 patients (57%) returned the completed questionnaire at follow-up (November 2003). Fourteen percent developed chronic benign pain syndrome, 9% recovered. The remaining (77%) worsened slightly. A higher DASH score was associated with being elderly (unstandardized regression coefficient [B=.64]), being a woman (B=10.42), having a lower educational achievement (B=9.72), and poorer self-reported physical fitness level (B=1.68); lower educational achievement and poorer self-reported physical fitness were associated with a more severe clinical status. Psychologic factors did not influence disability or clinical status.Conclusions
The prognosis of computer workers with nonspecific WRULD is not favorable. Those with a lower educational achievement and poorer self-reported physical fitness are at risk for a more severe clinical status and functional disability. Being elderly and a woman are also risk factors for further disability. A prospective cohort study is needed to unravel these relationships. Nevertheless, computer workers with nonspecific WRULD should be encouraged to enter fitness programs. 相似文献16.
Fatima El Fakiri Arno W. Hoes Rianne A.A. Frenken 《European Journal of Cardiovascular Nursing》2008,7(4):296-302
Background
A RCT, conducted to examine the effectiveness of a structured collaboration in general practice to provide intensified preventive care in patients at high cardiovascular risk yielded no effect in the total group but differences across healthcare centres and ethnic groups become apparent. We conducted a process evaluation to explain these differences.Methods
We assessed the reach of the target group and whether key intervention components (individual educational sessions, structured team meetings, and risk assessments) were performed as planned (maximum score for protocol completion is 11).Results
The reach was initially 91%, but only a minority of patients completed the intervention activities as planned. The average score of the number of intervention components was low (5.66 out of 11 (sd 2.8)) and varied between centres (4.84 to 7.40) and ethnic groups (4.89 to 7.38), with team meetings as the least implemented activity conform plan.Conclusion
This study indicates that adding a practice nurse and a peer health educator to the general practice did not seem to result in the desired collaboration between the healthcare personnel. Further research is needed to investigate the reasons behind the low participation rate of the patients in the intervention. 相似文献17.
Cleland JA, Childs JD, Whitman JM. Psychometric properties of the Neck Disability Index and numeric pain rating scale in patients with mechanical neck pain.
Objective
To examine the psychometric properties including test-retest reliability, construct validity, and minimum levels of detectable and clinically important change for the Neck Disability Index (NDI) and the numeric rating scale (NRS) for pain in a cohort of patients with neck pain.Design
Single-group repeated-measures design.Setting
Outpatient physical therapy (PT) clinics.Participants
Patients (N=137) presenting to PT with a primary report of neck pain.Interventions
Not applicable.Main Outcome Measures
All patients completed the NDI and the NRS at the baseline examination and at a follow-up. At the time of the follow-up, all patients also completed the global rating of change, which was used to dichotomize patients as improved or stable. Baseline and follow-up scores were used to determine the test-retest reliability, construct validity, and minimal levels of detectable and clinically important change for both the NDI and NRS.Results
Test-retest reliability was calculated using an intraclass correlation coefficient (ICC) (NDI ICC=.50; 95% confidence interval [CI], .25-.67; NRS ICC=.76; 95% CI, .51-.87). The area under the curve was .83 (95% CI, .75-.90) for the NDI score and .85 (95% CI, .78-.93) for the NRS score for determining between stable and improved patients. Thresholds for the minimum clinically important difference (MCID) for the NDI were 19-percentage points and 1.3 for the NRS.Conclusions
Both the NDI and NRS exhibit fair to moderate test-retest reliability in patients with mechanical neck pain. Both instruments also showed adequate responsiveness in this patient population. However, the MCID required to be certain that the change in scores has surpassed a level that could be contributed to measurement error for the NDI was twice that which has previously been reported. Therefore the ongoing analyses of the properties of the NDI in a patient population with neck pain are warranted. 相似文献18.
A Comparison of Balance Performance: Computerized Dynamic Posturography and a Random Motion Platform
Steven P. Broglio Jacob J. Sosnoff Karl S. Rosengren Kate McShane 《Archives of physical medicine and rehabilitation》2009,90(1):145-150
Broglio SP, Sosnoff JJ, Rosengren KS, McShane K. A comparison of balance performance: computerized dynamic posturography and a random motion platform.
Objective
To establish the clinical utility of the PROPRIO 5000 as a balance assessment device by establishing convergent validity with the NeuroCom sensory organization test (SOT).Design
Cross-sectional.Setting
Balance research laboratory.Participants
Young adults (N=40; 21.1±1.4y).Interventions
Not applicable.Main Outcome Measures
Performance on each of the 6 NeuroCom SOT testing conditions and PROPRIO 5000 dynamic motion analysis score.Results
Correlational analyses between output variables yielded significant relationships between the dynamic motion analysis score from the 0 to 10 second (r=−.38), 10 to 20 second (r=−.34), and 20 to 30 second (r=−.35) intervals and the SOT composite balance score.Conclusions
The initial stages of the PROPRIO 5000 and the NeuroCom SOT battery may evaluate similar aspects of postural control. However, as the magnitude of PROPRIO perturbations increased, the relationship between the devices diverged and the complete PROPRIO assessment is not thought to pair with the SOT assessment. Differences between the 2 devices may be associated with varying degrees of test difficulty and the necessary postural control strategies involved in responding to continual balance perturbations (PROPRIO 5000) or to different sensory inputs (SOT). 相似文献19.
Kristen A. Scopaz Sara R. Piva Stephen Wisniewski G. Kelley Fitzgerald 《Archives of physical medicine and rehabilitation》2009,90(11):1866-1873
Scopaz KA, Piva SR, Wisniewski S, Fitzgerald GK. Relationships of fear, anxiety, and depression with physical function in patients with knee osteoarthritis.
Objectives
To explore whether the psychologic variables anxiety, depression, and fear-avoidance beliefs, and interactions between these variables, are associated with physical function in patients with knee osteoarthritis (OA). We hypothesized lower levels of function would be related to higher anxiety, higher depression, and higher fear-avoidance beliefs, and that high levels of 2 of these factors simultaneously might interact to have a greater adverse effect on physical function.Design
Cross-sectional, correlational design.Setting
Institutional practice.Participants
Subjects included patients with knee OA (N=182; age, mean ± SD, 63.9±8.8y; 122 women).Interventions
Not applicable.Main Outcome Measures
Self-report measures of function included the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, the Lower Extremity Function Scale (LEFS), and the Knee Outcome Survey-Activity of Daily Living Scale. The Get Up and Go test was used as a physical performance measure of function. Self-report measures for psychologic variables included the Beck Anxiety Inventory, the Center for Epidemiological Studies Depression Scale, and the Fear Avoidance Belief Questionnaire-Physical Activity Scale modified for the knee.Results
Higher anxiety was related to poorer function on the WOMAC physical function. Both high anxiety and fear-avoidance beliefs were related to poorer function on the LEFS and Knee Outcome Survey-Activity of Daily Living Scale. There was no association between the psychologic variables and the Get Up and Go test. The anxiety × depression interaction was associated with the LEFS.Conclusions
Anxiety and fear-avoidance beliefs are associated with self-report measures of function in patients with knee OA. Depression may influence scores on the LEFS under conditions of low anxiety. 相似文献20.
Spaeth DM Mahajan H Karmarkar A Collins D Cooper RA Boninger ML 《Archives of physical medicine and rehabilitation》2008,89(5):996-1003
Spaeth DM, Mahajan H, Karmarkar A, Collins D, Cooper RA, Boninger ML. Development of a wheelchair virtual driving environment: trials with subjects with traumatic brain injury.