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1.
Tessa Hart John Whyte Monica Vaccaro Amanda R. Rabinowitz 《Archives of physical medicine and rehabilitation》2019,100(5):987-989
Objective
Determine agreement between self-reported dose and dose reflected in administrative records of outpatient physical, occupational, and speech therapies at 6 and 12 months after severe traumatic brain injury (TBI), for the purpose of examining accuracy and predictors of accuracy of self-reported health care utilization in this population.Design
Secondary analysis of survey used in a larger study; participants were queried about therapy doses using a structured interview, either alone or assisted by relatives if they so chose, with responses compared to administrative records.Setting
Rehabilitation center providing outpatient TBI therapies.Participants
Sixty-five people with severe TBI living in the community provided 6-month data (N=65); 54 provided 12-month data.Interventions
Not applicable.Main Outcome Measures
Degree of agreement with administrative records of scheduled and billed therapy appointments, measured using intraclass correlation coefficients (ICCs), with linear regression used to predict accuracy from demographic variables and cognitive status.Results
ICCs were in the moderate range at 6 months, but were more variable, with some in the poor range, at 12 months. Agreement was higher for scheduled than for billed (attended) appointments. Assisted and unassisted patients provided comparable agreement with records. No demographic factors were associated with accuracy, but lower cognitive FIM scores, as hypothesized, tended to predict lower agreement at 6 months.Conclusions
People with severe TBI can provide reasonable estimates of commonly prescribed outpatient therapy doses at 6 months postinjury. Accuracy may be improved by inviting patients to request assistance from relatives and by asking them to consider attended (vs scheduled) sessions. 相似文献2.
Hsieh-Chun Hsieh 《Archives of physical medicine and rehabilitation》2019,100(4):591-597
Objective
To evaluate a personal computer (PC) gaming platform as a means of improving postural balance in stroke patients.Participants
Stroke patients (N=54) were enrolled and randomly divided into experimental and control groups.Design
The experimental group underwent 12 weeks of rehabilitation involving playing PC games with the proposed gaming platform, whereas the control group played PC games with a computer mouse in the standing position.Interventions
The experimental PC gaming platform allowed trunk movements in 3 directions, including lateral, downward, or upward reaching.Main Outcome Measures
Balance control was assessed before and after the intervention with the Midot Posture Scale Analyzer (a pressure platform) by measuring the center of pressure during quiet stance. The Berg Balance Scale, Fullerton Advanced Balance Scale, and timed Up and Go tests were used to evaluate functional balance.Results
Analysis of covariance was used to assess how the PC games improve balance abilities. There were significant differences between the experimental and control groups in the results of sway kinematics and functional balance tests. The experimental group showed greater improvement than the control group.Conclusion
This new gaming platform with adaptive PC games could be a useful therapy to stroke rehabilitation in patients with postural imbalance. 相似文献3.
Jessica M. Jarvis Karen Choong Mary A. Khetani 《Archives of physical medicine and rehabilitation》2019,100(4):703-710
Objective(s)
Determine the associations between having participation-focused strategies and receiving rehabilitation services in the pediatric intensive care unit (PICU) with caregiver stress over 6 months post-PICU discharge.Design
Substudy of a data from Wee-Cover, a prospective cohort study.Setting
Two PICU sites.Participants
Caregivers (N=168) of children 1-17 years old admitted into a PICU for ≥48 hours.Main Outcome Measures
Data were collected from caregivers at enrollment and 3 and 6 months post-PICU discharge. Caregiver stress was assessed using the Pediatric Inventory for Parents. Having strategies to support their child’s participation in home-based activities was assessed using the Participation and Environment Measure (PEM). In PEM, caregivers report on strategies used to support their child’s participation in home-based activities. Data were dichotomized (yes, no) to denote having participation-focused strategies and if their child received PICU rehabilitation services. Additional covariates were history of a preexisting condition, child age, length of PICU stay, and change in functional capacities at PICU discharge.Results
History of a preexisting condition, time, and change in functional capacities significantly predicted caregiver stress frequency and difficulty. The interaction of having strategies-by-rehabilitation-by-time significantly predicted caregiver stress frequency and difficulty.Conclusion(s)
Results highlight the role of early rehabilitation and the importance of working with caregivers to develop participation-focused strategies to support their child’s functioning post-PICU. Families of children with a preexisting condition or those who experience a decrease in function during a PICU stay are susceptible to higher levels of stress and may be a priority population to target for rehabilitation services. 相似文献4.
Heather A. Feldner Darrin Howell Valerie E. Kelly Sarah Westcott McCoy Katherine M. Steele 《Archives of physical medicine and rehabilitation》2019,100(4):663-675
Objective
To examine the perceived value, benefits, drawbacks, and ideas for technology development and implementation of surface electromyography recordings in neurologic rehabilitation practice from clinical stakeholder perspectives.Design
A qualitative, phenomenological study was conducted. In-depth, semistructured interviews and focus groups were completed. Sessions included questions about clinician perspectives and demonstrations of surface electromyography systems to garner perceptions of specific system features.Setting
The study was conducted at hospital systems in a large metropolitan area.Participants
Adult and pediatric physical therapists, occupational therapists, and physiatrists from inpatient, outpatient, and research settings (N=22) took part in the study.Interventions
Not applicable.Main Outcome Measures
Interviews and focus groups were audio-recorded, transcribed verbatim, then coded for analysis into themes.Results
Four major themes emerged: (1) low-tech clinical practice and future directions for rehabilitation; (2) barriers to surface electromyography uptake and potential solutions; (3) benefits of surface electromyography for targeted populations; and (4) essential features of surface electromyography systems.Conclusions
Surface electromyography systems were not routinely utilized for assessment or intervention following neurologic injury. Despite recognition of potential clinical benefits of surface electromyography use, clinicians identified limited time and resources as key barriers to implementation. Perspectives on design and surface electromyography system features indicated the need for streamlined, intuitive, and clinically effective applications. Further research is needed to determine feasibility and clinical relevance of surface electromyography in rehabilitation intervention. 相似文献5.
Cody Andrews Sean Smith Maggi Kennel Steve Schilling Claire Kalpakjian 《Archives of physical medicine and rehabilitation》2019,100(4):606-612
Objective
Determine the relationship between functional status and degree of specific organ involvement, physical performance, and subjective well-being chronic graft-vs-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation.Design
Observational cohort.Setting
Outpatient clinic.Participants
Adult patients (N=121) with cGVHD with 634 assessments.Interventions
Not applicable.Main Outcome Measures
Karnofsky Performance Status (KPS). Skin, fascia/joints, lungs, upper and lower extremity range of motion, liver, eye, mucosal, and gastrointestinal involvement were measured using the National Institutes of Health GVHD scale. Physical performance was assessed with the 2-minute walk test (2MWT) and hand grip strength. Subjective measures were the Patient Health Questionnaire 9 (PHQ-9) and Lee Symptom Burden (LSB) scale.Results
Myofascial (P<.001) and lung (P=.001) involvement, 2MWT (P<.001), LSB (P<.001), and PHQ-9 (P=.03) had the largest associations with KPS with liver (P=.05) and hand grip strength (P<.001) more modest associations with KPS.Conclusions
Patients with cGVHD experience multifactorial impairment in function associated with potentially modifiable symptoms physiatrists have the expertise to address to enhance function. More research is needed to determine rehabilitation interventions to mitigate the impact of cGVHD on function. 相似文献6.
Jorge L. Candiotti Deepan C. Kamaraj Brandon Daveler Cheng-Shiu Chung Garrett G. Grindle Rosemarie Cooper Rory A. Cooper 《Archives of physical medicine and rehabilitation》2019,100(4):627-637
Objective
To compare the Mobility Enhancement roBotic (MEBot) wheelchair’s capabilities with commercial electric-powered wheelchairs (EPWs) by performing a systematic usability evaluation.Design
Usability in effectiveness, efficacy, and satisfaction was evaluated using quantitative measures. A semistructured interview was employed to gather feedback about the users’ interaction with MEBot.Setting
Laboratory testing of EPW driving performance with 2 devices in a controlled setting simulating common EPW driving tasks.Participants
A convenience sample of expert EPW users (N=12; 9 men, 3 women) with an average age of 54.7±10.9 years and 16.3± 8.1 years of EPW driving experience.Interventions
Not applicable.Main Outcome Measures
Powered mobility clinical driving assessment (PMCDA), Satisfaction Questionnaire, National Aeronautics and Space Administration’s Task Load Index.Results
Participants were able to perform significantly higher number of tasks (P=.004), with significantly higher scores in both the adequacy-efficacy (P=.005) and the safety (P=.005) domains of the PMCDA while using MEBot over curbs and cross-slopes. However, participants reported significantly higher mental demand (P=.005) while using MEBot to navigate curbs and cross-slopes due to MEBot’s complexity to perform its mobility applications which increased user’s cognitive demands.Conclusions
Overall, this usability evaluation demonstrated that MEBot is a promising EPW device to use indoors and outdoors with architectural barriers such as curbs and cross-slopes. Current design limitations were highlighted with recommendations for further improvement. 相似文献7.
Joseph Clark Amy Barnes Mike Campbell Clare Gardiner 《Journal of pain and symptom management》2019,57(4):793-801.e11
Context
Palliative care advocates argue that service implementation is feasible in all settings. Yet, services have developed patchily in low- and middle-income settings. Beyond Human Development Index indicators, there has been limited engagement with the broader development challenges facing nations tasked with implementing palliative care.Objective
The objective of this study was to describe how indicators of national development relate to levels of palliative care services in 207 countries around the world.Methods
We conducted a ecological study to identify relationships between potential predictor variables and the level of national palliative care development. A total of 28 predictor variables from the following six domains were selected using hypothesized relationships with levels of palliative care development: disease demographics, socioeconomics, health systems, politics, demographics, and economics. The outcome variable was level of national palliative care development on a six-point scale. Spearman's correlation was used to measure the strength of the association.Results
Twenty-six of 28 variables were statistically significantly associated with levels of palliative care development in 207 countries. Palliative care is more developed in countries with high—percentage of deaths from noncommunicable disease, population proportion aged 65+ years, gross national income, and tourism. Development is lower in countries with high levels of political corruption, infant mortality, deaths by infectious diseases, and weak democracy. Prevalence of undernourishment and levels of private health expenditure were not significantly associated with palliative care development.Conclusion
Palliative care development is highly consistent with broader national development indicators. It is less in countries where sudden deaths are more likely and benefits from palliative care provision are likely to be very limited. In such countries, resources may be prioritized toward life-prolonging therapies and key aspects of palliative care need only be implemented before fully integrated palliative services. Findings suggest that there may be a “tipping point” in societies, where the relative need for life-prolonging therapies becomes less than the need for integrated palliative care services. 相似文献8.
Gabrielle Alvarez Stacy J. Suskauer Beth Slomine 《Archives of physical medicine and rehabilitation》2019,100(4):687-694
Objectives
To investigate behavioral and demographic features of levels of consciousness in young children with brain injury, including the classifications of consciousness: conscious state (CS), minimally conscious state (MCS), and vegetative state (VS), and to investigate the course of recovery in children with disorders of consciousness (DOC).Design
Retrospective chart review and post hoc analysis.Setting
Pediatric inpatient rehabilitation unit.Participants
Children aged 6 months to 5 years (N=54) admitted for inpatient rehabilitation directly from an acute care hospital following new neurologic injury from 2011 to 2016.Interventions
Not applicable.Main Outcome Measures
Clinically abstracted behavioral features of DOC and levels of consciousness at admission and discharge, based on established guidelines from the Aspen Neurobehavioral Conference Workgroup.Results
Children in MCS were younger than children in CS. Commonly observed behaviors in children in VS were mouth movements or vocalizations, flexion withdrawal or motor posturing, visual or auditory startle, and localization to sound. Common features of MCS were contingent affect, visual fixation or pursuit, automatic motor behavior, and contingent communicative intent. No children in MCS showed command following or intelligible verbalizations. All children in CS showed functional object use, while functional communication was observed in a subset. By discharge, more than half of children in VS emerged to MCS, and a third emerged from MCS to CS. No child emerged from VS to CS.Conclusions
Visual and motor skills may be most applicable, and language-based skills may be least applicable for the assessment of DOC in very young children. Accurate classifications of consciousness may have important prognostic implications, and additional research is needed to develop clear guidelines for assessment of DOC in this population. 相似文献9.
Objective
To evaluate the effect of implementing hourly rounds on a mother–baby unit (MBU) on the perception of care by women admitted to the hospital for birth or with pregnancy complications.Design
Retrospective, quantitative, before–after study.Setting/Local Problem
The MBU of a large metropolitan hospital in the northeastern United States was the setting. With considerable resources allocated to hourly rounding implementation, there was a need to examine whether hourly rounds influenced the perception of communication with nurses by women admitted to the hospital for prenatal care and women's likelihood to recommend the hospital.Participants
Women ages 18 years and older discharged from the MBU.Intervention/Measurements
Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS) survey responses collected from women at discharge, before and after hourly rounds implementation on the MBU, were compared. Aggregate data were retrieved from Press Ganey reports.Results
No significant change in women’s perceptions of nursing care and communication was found when comparing pre- and postintervention samples.Conclusion
Although we found no statistically significant change in perception of care, we have identified opportunities for future research. More research is need to explore what approaches for hourly rounds implementation and sustainability are most effective. Additionally, there is a need to study whether vital aspects of care identified by pregnant women admitted to the hospital are similar or different compared with other populations. 相似文献10.
Jill Chamberlain Susan McCarty Joanne Sorce Betsy Leesman Sarah Schmidt Elizabeth Meyrick Simone Parlier Linda Kennedy Debra Crowley Lori Coultas 《Journal of neonatal nursing : JNN》2019,25(2):74-77
Objective
Determine impact delayed newborn bathing for 24 hours has on exclusive breastfeeding rates, temperature and glucose stability, and percentage of weight loss and, to determine if there was a difference in the nurses’ knowledge and comfort levels regarding delayed bathing pre and post implementation.Design
Pre-post retrospective chart review and, pre-post survey.Setting
Midwestern health system with three hospitals that has a combined average delivery rate of 2100 births.Participants
330 charts were reviewed pre-implementation, 330 charts were reviewed post-implementation, and 100 RNs were asked to participate in the pre and post-survey.Methods
Newborn baths were delayed 24 hours after birth unless contraindicated by a blood borne pathogen or upon parental requests.Results
Post-intervention there was a significant decrease in the number of blood glucose level checks (p?=?.002) and the amount of blood glucose levels equal or below 45 (p?=?.001). There was a trend in decreased weight loss post-intervention, but was not significant (p?=?.227). Cold stress significantly decreased (p?<?.001) post-intervention. Exclusive breastfeeding rates did not change. Nurses’ perception of comfort and knowledge level increased post-intervention.Conclusion
Delaying an infant's bath until 24 hours after birth seems to have positive impact on the infant's temperature regulation as well as glucose stability. 相似文献11.
Context
The predominating definition of autonomy as a capacity to make an independent rational choice may not be suitable for patients in palliative care. Therefrom arises the actual need for more contextualized perspectives on autonomy to promote the quality of life and satisfaction with care of terminally ill patients.Objectives
This review aimed to develop a theoretical structural model of autonomy at the end of life based on patients' end-of-life care preferences.Methods
In this review, we used systematic strategy to integrate and synthesize findings from both qualitative and quantitative studies investigating patients' view on what is important at the end of life and which factors are related to autonomy. A systematic search of EMBASE (OVID), MEDLINE (OVID), Academic Search Complete (EBSCO), CINAHL (EBSCO), and PsycINFO (EBSCO) was conducted for studies published between 1990 and December 2015 providing primary data from patients with advanced disease.Results
Of the 5540 articles surveyed, 19 qualitative and eight quantitative studies met the inclusion criteria. We identified two core structural domains of autonomy: 1) being normal and 2) taking charge. By analyzing these domains, we described eight and 13 elements, respectively, which map the conceptual structure of autonomy within this population of patients.Conclusion
The review shows that maintaining autonomy at the end of life is not only a concern of making choices and decisions about treatment and care but that emphasis should be also put on supporting the patients' engagement in daily activities, in contributing to others, and in active preparation for dying. 相似文献12.
Ting-ting Yeh Ku-chou Chang Ching-yi Wu 《Archives of physical medicine and rehabilitation》2019,100(5):821-827
Objective
To investigate the efficacy of a sequential combination of aerobic exercise and cognitive training on cognitive function and other health-related outcomes in stroke survivors with cognitive decline.Design
Intervention study and randomized controlled trial.Setting
Hospital-based rehabilitation units.Participants
Survivors of stroke with cognitive decline (N=30) were randomized to sequential combination training (SEQ) (n=15) or an active control (n=15) group.Interventions
The SEQ group received 30 minutes of aerobic exercise, followed by 30 minutes of computerized cognitive training. The control group received 30 minutes of nonaerobic physical exercise, followed by 30 minutes of unstructured mental activities.Main Outcome Measures
The primary outcome measure was cognitive function. Secondary outcome measures included physical function, social participation, and quality of life.Results
Compared with the control group, the SEQ group had significantly improved Montreal Cognitive Assessment scores (P=.03) and Wechsler Memory Scale span scores (P=.012) after training. The endurance and mobility level measured by the 6-minute walk test (P=.25) was also enhanced in the SEQ group relative to the control group. However, the transfer of sequential training to social participation (Community Integration Questionnaire) and quality of life (EuroQoL questionnaire) was limited (P>.05 for both).Conclusions
Aerobic exercise combined with computerized cognitive training has better effects on the cognitive functional status of survivors of stroke than an active control. The cognitive functional status of stroke survivors was better after participation in aerobic exercise combined with computerized training than after active control therapy, demonstrating the clinical significance of this combination therapy. 相似文献13.
14.
Kiran Satpute Toby Hall Richa Bisen Pramod Lokhande 《Archives of physical medicine and rehabilitation》2019,100(5):828-836
Objectives
To evaluate the effect of spinal mobilization with leg movement (SMWLM) on low back and leg pain intensity, disability, pain centralization, and patient satisfaction in participants with lumbar radiculopathy.Design
A double-blind randomized controlled trial.Setting
General hospital.Participants
Adults (N=60; mean age 44y) with subacute lumbar radiculopathy.Interventions
Participants were randomly allocated to receive SMWLM, exercise and electrotherapy (n=30), or exercise and electrotherapy alone (n=30). All participants received 6 sessions over 2 weeks.Main Outcome Measures
The primary outcomes were leg pain intensity and Oswestry Disability Index score. Secondary variables were low back pain intensity, global rating of change (GROC), straight leg raise (SLR), and lumbar range of motion (ROM). Variables were evaluated blind at baseline, post-intervention, and at 3 and 6 months of follow-up.Results
Significant and clinically meaningful improvement occurred in all outcome variables. At 2 weeks the SMWLM group had significantly greater improvement than the control group in leg pain (MD 2.0; 95% confidence interval [95% CI], 1.4-2.6) and disability (MD 3.9; 95% CI, 5.5-2.2). Similarly, at 6 months, the SMWLM group had significantly greater improvement than the control group in leg pain (MD 2.6; 95% CI, 1.9-3.2) and disability (MD 4.7; 95% CI, 6.3-3.1). The SMWLM group also reported greater improvement in the GROC and in SLR ROM.Conclusion
In patients with lumbar radiculopathy, the addition of SMWLM provided significantly improved benefits in leg and back pain, disability, SLR ROM, and patient satisfaction in the short and long term. 相似文献15.
16.
Lou-Ching Kuo Jin-Hua Chen Chih-Hsin Lee Ching-Wen Tsai Chia-Chin Lin 《Journal of pain and symptom management》2019,57(5):933-943
Context
At the end of life, chronic obstructive pulmonary disease (COPD) and lung cancer (LC) patients exhibit similar symptoms; however, a large-scale study comparing end-of-life health care utilization between these two groups has not been conducted in East Asia.Objectives
To explore and compare end-of-life resource use during the last six months before death between COPD and LC patients.Methods
Using data from the Taiwan National Health Insurance Research Database, we conducted a nationwide retrospective cohort study in COPD (n = 8640) and LC (n = 3377) patients who died between 1997 and 2013.Results
The COPD decedents were more likely to be admitted to intensive care units (57.59% vs 29.82%), to have longer intensive care unit stays (17.59 vs 9.93 days), and to undergo intensive procedures than the LC decedents during their last six months; they were less likely to receive inpatient (3.32% vs 18.24%) or home-based palliative care (0.84% vs 8.17%) and supportive procedures than the LC decedents during their last six months. The average total medical cost during the last six months was approximately 18.42% higher for the COPD decedents than for the LC decedents.Conclusion
Higher intensive health care resource use, including intensive procedure use, at the end of life suggests a focus on prolonging life in COPD patients; it also indicates an unmet demand for palliative care in these patients. Avoiding potentially inappropriate care and improving end-of-life care quality by providing palliative care to COPD patients are necessary. 相似文献17.
Duncan Mortimer Jessica Trevena-Peters Adam McKay Jennie Ponsford 《Archives of physical medicine and rehabilitation》2019,100(4):648-655
Objective
To evaluate the cost-effectiveness of structured activities of daily living (ADL) retraining during posttraumatic amnesia (PTA) plus treatment as usual (TAU) vs TAU alone for inpatient rehabilitation following severe traumatic brain injury (TBI).Design
Trial-based economic evaluation from a health-system perspective.Setting
Inpatient rehabilitation center.Participants
Participants (N=104) admitted to rehabilitation and in PTA for >7 days following severe TBI.Interventions
Structured ADL retraining during PTA plus TAU vs TAU alone. Structured ADL retraining was manualized to minimize the risk of agitation and maximize functional improvement, following principles of errorless and procedural learning and targeting individualized therapy goals. TAU included physiotherapy and/or speech therapy during PTA plus ADL retraining after PTA emergence.Main Outcome Measures
FIM total scores at baseline, PTA emergence, hospital discharge, or final follow-up (2mo postdischarge) where FIM total scores were calculated as the sum of 5 FIM motor self-care items and a FIM meal-preparation item.Results
Structured ADL retraining during PTA significantly increased functional independence at PTA emergence (mean difference: 4.90, SE: 1.4, 95% confidence interval [CI]: 1.5, 8.3) and hospital discharge (mean difference: 5.22, SE: 1.4, 95% CI: 1.8, 8.7). Even in our most pessimistic scenario, structured ADL retraining was cost-saving as compared to TAU (mean: -$7762; 95% CI: -$8105, -$7419). Together, these results imply that structured ADL retraining dominates (less costly but no less effective) TAU when effectiveness is evaluated at PTA emergence and hospital discharge.Conclusions
Structured ADL retraining during PTA yields net cost-savings to the health system and offers a cost-effective means of increasing functional independence at PTA emergence and hospital discharge. 相似文献18.
Aparna Arjunan Nancye M. Peel Ruth E. Hubbard 《Archives of physical medicine and rehabilitation》2019,100(5):859-864
Objective
Both slow gait speed (GS) and higher levels of frailty are associated with adverse outcomes in community-dwelling older people. However these measures are not routinely utilized to stratify risk status in the hospital setting. Here we assessed their predictive validity in older inpatients.Design
A prospective cohort study.Setting
Inpatient rehabilitation wards of a tertiary hospital.Participants
Adults 65 years and older (N=258).Interventions
A frailty index (FI) was calculated from routinely collected data and GS was determined from a timed 10-meter walk test.Main Outcome Measures
Adverse outcomes were longer length of stay (≥75th percentile), poor discharge outcome (discharge to a higher level of care or inpatient mortality), and inpatient delirium and falls.Results
Mean age ± SD was 79±8 years and 54% were women. Mean FI ± SD on admission was 0.42±0.13 and an FI could be derived in all participants. Mean GS ± SD was 0.26±0.33 m/sec. Those unable to complete a timed walk on admission (50%) were allocated a GS of 0. There was a weak but significant inverse relationship between FI and GS (correlation coefficient -0.396). Both parameters were significantly associated with longer length of stay (P<.001), poor discharge outcome (P≤.001), and delirium (P<.05).The prevalence of adverse outcomes was highest in the cohort who were more frail and unable to mobilize at admission to rehabilitation.Conclusions
FI and GS each showed predictive validity for adverse outcomes. In a geriatric rehabilitation setting, they measure different aspects of vulnerability and combining the 2 may add value in identifying patients most at risk. 相似文献19.
Natalie A. Fini Angela T. Burge Julie Bernhardt Anne E. Holland 《Archives of physical medicine and rehabilitation》2019,100(5):883-890
Objective
The aim of this study was to determine the duration of physical activity (PA) monitoring required for reliable measurements following stroke.Design
Single-center, prospective, observational study.Setting
PA was measured in a community setting.Participants
Adults (N=70) poststroke.Main Outcome Measures
The SenseWear armband was used to monitor PA for 5 days (≥10 hours wear per day).Data Analysis
Variance among 2, 3, 4, and 5 days of consecutive measurements for PA variables was examined using intraclass correlation coefficients (ICCs). The minimum number of days to achieve acceptable reliability (ICC ≥0.8) was calculated. Differences between weekdays and weekend days were investigated using paired t tests and Wilcoxon signed rank tests.Results
Two days of measurement was sufficient to achieve an ICC ≥0.8 for daily averages of total energy expenditure, step count, and time spent sedentary (≤1.5 metabolic equivalent tasks [METs]) and in light (1.5-3 METs) and moderate- to vigorous-intensity (>3 METs) PA. At least 3 days were required to achieve an ICC ≥0.8 when investigating the number of and time spent in bouts (≥10 minutes) of moderate to vigorous PA and sedentary behavior. Participants took significantly more steps (P=.03) and spent more time in light PA (P=.03) on weekdays than weekends.Conclusion
Following stroke, 2 days of measurement appears sufficient to represent habitual PA for many simple variables. Three or more days may be necessary for reliable estimates of bouts of PA and sedentary behavior. Consistent inclusion or exclusion of a weekend day is recommended for measuring step count and light PA. Short periods of monitoring provide reliable PA information and may make PA measurement more feasible in the clinical setting. 相似文献20.
Jonathan Tsehaie Kim R. Spekreijse Robbert M. Wouters Reinier Feitz Steven E.R. Hovius Harm P. Slijper Ruud W. Selles 《Archives of physical medicine and rehabilitation》2019,100(5):844-850