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1.
James F. Malec Flora M. Hammond 《Archives of physical medicine and rehabilitation》2018,99(3):603-606.e1
Objective
To determine the minimal clinically important difference (MCID) for a Rasch measure derived from the Irritability/Lability and Agitation/Aggression subscales of the Neuropsychiatric Inventory (NPI)—the Rasch NPI Irritability and Aggression Scale for Traumatic Brain Injury (NPI-TBI-IA).Design
Distribution-based statistical methods were applied to retrospective data to determine candidates for the MCID. These candidates were evaluated by anchoring the NPI-TBI-IA to Global Impression of Change (GIC) ratings by participants, significant others, and a supervising physician.Setting
Postacute rehabilitation outpatient clinic.Participants
274 cases with observer ratings; 232 cases with self-ratings by participants with moderate-severe TBI at least 6 months postinjury.Interventions
Not applicable.Main Outcome Measure
NPI-TBI-IA.Results
For observer ratings on the NPI-TBI-IA, anchored comparisons found an improvement of 0.5 SD was associated with at least minimal general improvement on GIC by a significant majority (69%–80%); 0.5 SD improvement on participant NPI-TBI-IA self-ratings was also associated with at least minimal improvement on the GIC by a substantial majority (77%–83%). The percentage indicating significant global improvement did not increase markedly on most ratings at higher levels of improvement on the NPI-TBI-IA.Conclusions
A 0.5 SD improvement on the NPI-TBI-IA indicates the MCID for both observer and participant ratings on this measure. 相似文献2.
Chien-Yu Huang Li-Chen Tung Yeh-Tai Chou Hing-Man Wu Kuan-Lin Chen Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2018,99(3):512-520
Objectives
To (1) develop a computerized adaptive test for gross motor skills (GM-CAT) as a diagnostic test and an outcome measure, using the gross motor skills subscale of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT-GM) as the candidate item bank; and (2) examine the psychometric properties and the efficiency of the GM-CAT.Design
Retrospective study.Setting
A developmental center of a medical center.Participants
Children with and without developmental delay (N=1738).Interventions
Not applicable.Main Outcome Measures
The CDIIT-GM contains 56 universal items on gross motor skills assessing children's antigravity control, locomotion, and body movement coordination.Results
The item bank of the GM-CAT had 44 items that met the dichotomous Rasch model's assumptions. High Rasch person reliabilities were found for each estimated gross motor skill for the GM-CAT (Rasch person reliabilities =.940-.995, SE=.68-2.43). For children aged 6 to 71 months, the GM-CAT had good concurrent validity (r values =.97-.98), adequate to excellent diagnostic accuracy (area under receiver operating characteristics curve =.80-.98), and moderate to large responsiveness (effect size =.65-5.82). The averages of items administered for the GM-CAT were 7 to 11, depending on the age group.Conclusions
The results of this study support the use of the GM-CAT as a diagnostic and outcome measure to estimate children's gross motor skills in both research and clinical settings. 相似文献3.
Sarah Gunn Gerald H. Burgess John Maltby 《Archives of physical medicine and rehabilitation》2018,99(9):1805-1810
Objective
To explore the factor structure of the UK Functional Independence Measure and Functional Assessment Measure (FIM+FAM) among focal and diffuse acquired brain injury patients.Design
Criterion standard.Setting
A National Health Service acute acquired brain injury inpatient rehabilitation hospital.Participants
Referred sample of adults (N=447) admitted for inpatient treatment following an acquired brain injury significant enough to justify intensive inpatient neurorehabilitationIntervention
Not applicable.Outcome Measure
Functional Independence Measure and Functional Assessment Measure.Results
Exploratory factor analysis suggested a 2-factor structure to FIM+FAM scores, among both focal-proximate and diffuse-proximate acquired brain injury aetiologies. Confirmatory factor analysis suggested a 3-factor bifactor structure presented the best fit of the FIM+FAM score data across both aetiologies. However, across both analyses, a convergence was found towards a general factor, demonstrated by high correlations between factors in the exploratory factor analysis, and by a general factor explaining the majority of the variance in scores on confirmatory factor analysis.Conclusions
Our findings suggested that although factors describing specific functional domains can be derived from FIM+FAM item scores, there is a convergence towards a single factor describing overall functioning. This single factor informs the specific group factors (eg, motor, psychosocial, and communication function) after brain injury. Further research into the comparative value of the general and group factors as evaluative/prognostic measures is indicated. 相似文献4.
Is Going Beyond Rasch Analysis Necessary to Assess the Construct Validity of a Motor Function Scale?
Tiffanie Guillot Sylvain Roche Pascal Rippert Dalil Hamroun Jean Iwaz René Ecochard Carole Vuillerot 《Archives of physical medicine and rehabilitation》2018,99(9):1776-1782.e9
Objective
To examine whether a Rasch analysis is sufficient to establish the construct validity of the Motor Function Measure (MFM) and discuss whether weighting the MFM item scores would improve the MFM construct validity.Design
Observational cross-sectional multicenter study.Setting
Twenty-three physical medicine departments, neurology departments, or reference centers for neuromuscular diseases.Participants
Patients (N=911) aged 6 to 60 years with Charcot-Marie-Tooth disease (CMT), facioscapulohumeral dystrophy (FSHD), or myotonic dystrophy type 1 (DM1).Interventions
None.Main Outcome Measure(s)
Comparison of the goodness-of-fit of the confirmatory factor analysis (CFA) model vs that of a modified multidimensional Rasch model on MFM item scores in each considered disease.Results
The CFA model showed good fit to the data and significantly better goodness of fit than the modified multidimensional Rasch model regardless of the disease (P<.001). Statistically significant differences in item standardized factor loadings were found between DM1, CMT, and FSHD in only 6 of 32 items (items 6, 27, 2, 7, 9 and 17).Conclusions
For multidimensional scales designed to measure patient abilities in various diseases, a Rasch analysis might not be the most convenient, whereas a CFA is able to establish the scale construct validity and provide weights to adapt the item scores to a specific disease. 相似文献5.
Alex W.K. Wong Stephen C.L. Lau Mandy W.M. Fong David Cella Jin-Shei Lai Allen W. Heinemann 《Archives of physical medicine and rehabilitation》2018,99(9):1763-1775
Objective
To determine the extent to which the content of the Quality of Life in Neurological Disorders (Neuro-QoL) covers the International Classification of Functioning, Disability and Health (ICF) Core Sets for multiple sclerosis (MS), stroke, spinal cord injury (SCI), and traumatic brain injury (TBI) using summary linkage indicators.Design
Content analysis by linking content of the Neuro-QoL to corresponding ICF codes of each Core Set for MS, stroke, SCI, and TBI.Setting
Three academic centers.Participants
None.Interventions
None.Main Outcome Measures
Four summary linkage indicators proposed by MacDermid et al were estimated to compare the content coverage between Neuro-QoL and the ICF codes of Core Sets for MS, stroke, MS, and TBI.Results
Neuro-QoL represented 20% to 30% Core Set codes for different conditions in which more codes in Core Sets for MS (29%), stroke (28%), and TBI (28%) were covered than those for SCI in the long-term (20%) and early postacute (19%) contexts. Neuro-QoL represented nearly half of the unique Activity and Participation codes (43%–49%) and less than one third of the unique Body Function codes (12%?32%). It represented fewer Environmental Factors codes (2%?6%) and no Body Structures codes. Absolute linkage indicators found that at least 60% of Neuro-QoL items were linked to Core Set codes (63%?95%), but many items covered the same codes as revealed by unique linkage indicators (7%?13%), suggesting high concept redundancy among items.Conclusions
The Neuro-QoL links more closely to ICF Core Sets for stroke, MS, and TBI than to those for SCI, and primarily covers activity and participation ICF domains. Other instruments are needed to address concepts not measured by the Neuro-QoL when a comprehensive health assessment is needed. 相似文献6.
Brodie M. Sakakibara William C. Miller Paula W. Rushton Jan Miller Polgar 《Archives of physical medicine and rehabilitation》2018,99(1):17-25
Objectives
To examine the dimensionality of the Wheelchair Use Confidence Scale for power wheelchair users (WheelCon-P), to identify items that do not fit the Rasch rating scale model as well as redundant items for elimination, and to determine the SEMs and reliability estimates for the entire range of measurements.Design
Secondary analysis of cross-sectional data.Setting
Community.Participants
Volunteer participants (N=189) using wheelchairs (mean age of the sample, 56.7±13.0y; mean years of wheelchair use experience, 20.4±16.4).Interventions
Not applicable.Main Outcome Measures
59-Item WheelCon-P.Results
Principal component analyses confirmed the presence of 2 self-efficacy dimensions: mobility and social situation. Eleven mobility items and 5 social situation items fit the Rasch rating scale model. Three items misfit the model using all 16 items (ie, WheelCon-P short form). In each of the mobility, social situation, and WheelCon-P short form range of measurements, the 2 lowest and 2 highest measures had internal consistency reliability estimates below .70; all other measures had reliability estimates above .70.Conclusions
The WheelCon-P is composed of 2 self-efficacy dimensions related to mobility and social situations. The scores from the WheelCon-P short form and the 11-item mobility and 5-item social situation dimensions using a 0 to 10 response scale have good reliability. 相似文献7.
8.
Sarah L. Martindale Erica L. Epstein Katherine H. Taber 《Archives of physical medicine and rehabilitation》2018,99(12):2485-2495
Objective
To characterize behavioral and health outcomes in veterans with traumatic brain injury (TBI) acquired in nondeployment and deployment settings.Design
Cross-sectional assessment evaluating TBI acquired during and outside of deployment, mental and behavioral health symptoms, and diagnoses.Setting
Veterans Affairs Medical Centers.Participants
Iraq and Afghanistan veterans who were deployed to a warzone (N=1399).Interventions
Not applicable.Main Outcome Measures
Comprehensive lifetime TBI interview, Structured Clinical Interview for DSM-IV Disorders, Combat Exposure Scale, and behavioral and health measures.Results
There was a main effect of deployment TBI on depressive symptoms, posttraumatic stress symptoms, poor sleep quality, substance use, and pain. Veterans with deployment TBI were also more likely to have a diagnosis of bipolar, major depressive, alcohol use, and posttraumatic stress disorders than those who did not have a deployment TBI.Conclusions
TBIs acquired during deployment are associated with different behavioral and health outcomes than TBI acquired in nondeployment environments. The presence of TBI during deployment is associated with poorer behavioral outcomes, as well as a greater lifetime prevalence of behavioral and health problems in contrast to veterans without deployment TBI. These results indicate that problems may persist chronically after a deployment TBI and should be considered when providing care for veterans. Veterans with deployment TBI may require treatment alterations to improve engagement and outcomes. 相似文献9.
Jennifer H. Marwitz Adam P. Sima Jeffrey S. Kreutzer Laura E. Dreer Thomas F. Bergquist Ross Zafonte Douglas Johnson-Greene Elizabeth R. Felix 《Archives of physical medicine and rehabilitation》2018,99(2):264-271
Objectives
To evaluate (1) the trajectory of resilience during the first year after a moderate-severe traumatic brain injury (TBI); (2) factors associated with resilience at 3, 6, and 12 months postinjury; and (3) changing relationships over time between resilience and other factors.Design
Longitudinal analysis of an observational cohort.Setting
Five inpatient rehabilitation centers.Participants
Patients with TBI (N=195) enrolled in the resilience module of the TBI Model Systems study with data collected at 3-, 6-, and 12-month follow-up.Interventions
Not applicable.Main Outcome Measure
Connor-Davidson Resilience Scale.Results
Initially, resilience levels appeared to be stable during the first year postinjury. Individual growth curve models were used to examine resilience over time in relation to demographic, psychosocial, and injury characteristics. After adjusting for these characteristics, resilience actually declined over time. Higher levels of resilience were related to nonminority status, absence of preinjury substance abuse, lower anxiety and disability level, and greater life satisfaction.Conclusions
Resilience is a construct that is relevant to understanding brain injury outcomes and has potential value in planning clinical interventions. 相似文献10.
Anthony H. Lequerica Christian Lucca Nancy D. Chiaravalloti Irene Ward John D. Corrigan 《Archives of physical medicine and rehabilitation》2018,99(9):1811-1817
Objective
To test the feasibility and validity of an online version of an established interview designed to determine a lifetime history of traumatic brain injury (TBI).Design
Cross-sectional.Setting
General community.Participants
A volunteer sample of individuals (N= 265) from the general population across the United States.Interventions
Not applicable.Main Outcome Measure(s)
Online version of the Ohio State University Traumatic Brain Injury Identification Method, Rivermead Postconcussion Symptoms Questionnaire (RPQ), Patient-Reported Outcomes Measurement Information System Cognitive Concerns Scale.Results
The measure was completed by 89.4% of the sample with most participants completing the measure in <8 minutes. After controlling for age, sex, psychiatric history, drug or alcohol history, and history of developmental disability, worst TBI severity was significantly associated with scores on the RPQ, F(2,230)=4.56, P=.011, and having a TBI within the past 2 years was associated with higher scores on the cognitive factor subscale of the RPQ, F(1,75)=7.7, P=.007.Conclusions
The online administration of the Ohio State University Traumatic Brain Injury Identification Method appears to be feasible in the general population. Preliminary validity was demonstrated for the indices of worst TBI severity and time since most recent TBI. 相似文献11.
Shih-Chieh Lee Yi-Jing Huang Gong-Hong Lin Yeh-Tai Chou Chia-Yeh Chou Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2018,99(2):306-313
Objective
To develop a computerized adaptive test of social functioning (Social-CAT) for patients with stroke.Design
This study contained 2 phases. First, a unidimensional item bank was formed using social-related items with sufficient item fit (ie, infit and outfit mean square [MNSQ]). The social-related items were selected from 3 commonly used patient-reported quality-of-life measures. Items with differential item functioning (DIF) of sex were deleted. Second, we performed simulations to determine the best set of stopping rules with both high reliability and efficiency. The participants' responses to the items were extracted from a previous study.Setting
Rehabilitation wards and departments of rehabilitation/neurology of 5 general hospitals.Participants
Patients (N=263) with stroke (47.1% were inpatients).Interventions
Not applicable.Main Outcome Measure
Social-CAT.Results
The unidimensionality of the 24 selected items was supported (infit and outfit MNSQs =0.8–1.2). One item had DIF of sex and was deleted. The item bank was composed of the remaining 23 items. With the best set of stopping rules (person reliability ≥.90 or limited reliability increased ≤.001), the Social-CAT used on average 10 items to achieve sufficient reliability (average person reliability =.88; 81.0% of the patients with reliability ≥.90).Conclusions
The Social-CAT appears to be a unidimensional measure with acceptable reliability and efficiency, and it could be useful for both clinicians and patients in time-pressed clinical settings. 相似文献12.
Background
Depression and traumatic brain injury (TBI) substantially contribute to the U.S. health care burden. Depression is a known risk factor for prolonged recovery after TBI. However, the effect of depression treatment on health care utilization has yet to be studied.Objective
To examine whether an association exists between pharmacologic treatment of depression at the time of mild or concussive TBI and the number of subsequent clinician visits for persistent injury-related symptoms.Design
Retrospective medical record review.Setting
Tertiary care medical center.Participants
A total of 120 patients (mean age 45.6 years) with a history of depression who subsequently experienced a mild or concussive TBI were included.Methods
Individuals were identified with co-occurring diagnoses of depression and mild or concussive TBI by retrospective electronic medical record review. The diagnosis of depression must have preceded the diagnosis of TBI.Main Outcome
The number of clinician visits for postinjury symptoms were counted at 3, 6, and 12 months postinjury.Results
Clinician visits for persistent injury-related symptoms were significantly fewer at all 3 time points for the group treated for depression at time of injury.Conclusions
Depressed individuals who were pharmacologically treated for depression at the time of TBI had significantly fewer clinician visits for persistent postinjury symptoms than those not pharmacologically treated for depression at the time of injury. Routine depression screening in patients with a high risk for TBI may identify a mood disorder that could contribute to persistent symptoms if left untreated, with its effective management potentially reducing health-related costs.Level of Evidence
III 相似文献13.
Gong-Hong Lin Yi-Jing Huang Shih-Chieh Lee Sheau-Ling Huang Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2018,99(4):676-683
Objective
To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke.Design
Simulation study.Setting
One rehabilitation unit in a medical center.Participants
Patients with subacute stroke (N=301; mean age, 67.3±10.9; intracranial infarction, 74.5%).Interventions
Not applicable.Main Outcome Measures
The UE and LE subscales of the Fugl-Meyer Assessment, Postural Assessment Scale for Stroke Patients, and Barthel Index.Results
The CAT-FAS adopting the optimal stopping rule (limited reliability increase of <.010) had good Rasch reliability across the 4 domains (.88–.93) and needed few items for the whole administration (8.5 items on average). The concurrent validity (CAT-FAS vs original tests, Pearson r=.91–.95) and responsiveness (standardized response mean, .65–.76) of the CAT-FAS were good in patients with stroke.Conclusions
We developed the CAT-FAS, and our results support that the CAT-FAS has sufficient efficiency, reliability, concurrent validity, and responsiveness in patients with stroke. The CAT-FAS can be used to simultaneously assess patients' functions of UE, LE, postural control, and basic activities of daily living using, on average, no more than 10 items; this efficiency is useful in reducing the assessment burdens for both clinicians and patients. 相似文献14.
Cynthia Harrison-Felix Jody K. Newman Lenore Hawley Clare Morey Jessica M. Ketchum William C. Walker Kathleen R. Bell Scott R. Millis Cynthia Braden James Malec Flora M. Hammond C.B. Eagye Laura Howe 《Archives of physical medicine and rehabilitation》2018,99(11):2131-2142
Objective
To evaluate the effectiveness of a replicable group treatment program for improving social competence after traumatic brain injury (TBI).Design
Multicenter randomized controlled trial comparing 2 methods of conducting a social competency skills program, an interactive group format versus a classroom lecture.Setting
Community and veteran rehabilitation centers.Participants
Civilian, military, and veteran adults with TBI and social competence difficulties (N=179), at least 6 months postinjury.Interventions
The experimental intervention consisted of 13 weekly group interactive sessions (1.5h) with structured and facilitated group interactions to improve social competence, and the control consisted of 13 traditional classroom sessions using the same curriculum with brief supplemental individual sessions but without structured group interaction.Main Outcome Measures
Profile of Pragmatic Impairment in Communication (PPIC), an objective behavioral rating of social communication impairments after TBI. LaTrobe Communication Questionnaire (LCQ), Goal Attainment Scale (GAS), Satisfaction with Life Scale, Posttraumatic Stress Disorder Checklist-C (PCL) civilian version, Brief Symptom Inventory 18 (BSI-18), Scale of Perceived Social Self-Efficacy (PSSE).Results
Social competence goals (GAS) were achieved and maintained for most participants regardless of treatment method. Significant improvements in the primary outcome (PPIC) and 2 of the secondary outcomes (LCQ and BSI) were seen immediately posttreatment and at 3 months posttreatment in the alternative treatment arm only; however, these improvements were not significantly different between the group interactive structured treatment and alternative treatment arms. Similar trends were observed for PSSE and PCL-C.Conclusions
Social competence skills improved for persons with TBI in both treatment conditions. The group interactive format was not found to be a superior method of treatment delivery in this study. 相似文献15.
Sean M. Phelan Lauren R. Bangerter Greta Friedemann-Sanchez Kandace A. Lackore Megan A. Morris Courtney H. Van Houtven Kathleen F. Carlson Michelle van Ryn Kristin J. Harden Joan M. Griffin 《Archives of physical medicine and rehabilitation》2018,99(11):2222-2229
Objective
To assess the association between perceived stigma and discrimination and caregiver strain, caregiver well-being, and patient community reintegration.Design
A cross-sectional survey study of 564 informal caregivers of U.S. military service veterans of wars in Iraq and Afghanistan who experienced traumatic brain injuries or polytrauma (TBI/PT).Setting
Care settings of community-dwelling former inpatients of U.S. Department of Veterans Affairs Polytrauma Rehabilitation Centers.Participants
Caregivers of former inpatients (N=564), identified through next-of-kin records and subsequent nominations.Interventions
Not applicable.Main Outcome Measures
Caregiver strain, depression, anxiety, loneliness, and self-esteem; as well as care recipient community reintegration, a key aspect of TBI/PT rehabilitation.Results
Family stigma was associated with strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration. Caregiver stigma-by-association was associated with strain, depression, anxiety, loneliness, and lower self-esteem. Care recipient stigma was associated with caregiver strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration.Conclusions
Perceived stigma may be a substantial source of stress for caregivers of U.S. military veterans with TBI/PT, and may contribute to poor outcomes for the health of caregivers and for the community reintegration of the veterans for whom they provide care. 相似文献16.
Moriah J. Brier Rhonda M. Williams Aaron P. Turner Alison W. Henderson Ann Marie Roepke Daniel C. Norvell Helene Henson Joseph M. Czerniecki 《Archives of physical medicine and rehabilitation》2018,99(3):452-458
Objective
To describe the relationship between caregiver-specific support and conflict, and psychosocial outcomes among individuals experiencing their first dysvascular lower extremity amputation (LEA).Design
Cross-sectional cohort study using self-report surveys.Setting
Department of Veterans Affairs, academic medical center, and level I trauma center.Participants
Individuals undergoing their first major LEA because of complications of peripheral arterial disease (PAD) or diabetes who have a caregiver and completed measures of caregiver support and conflict (N=137; 94.9% men).Interventions
Not applicable.Main Outcome Measures
The Patient Health Questionnaire-9 to assess depression and the Satisfaction With Life Scale to assess life satisfaction.Results
In multiple regression analyses, controlling for global levels of perceived support, self-rated health, age, and mobility, caregiver-specific support was found to be associated with higher levels of life satisfaction and caregiver-specific conflict was found to be associated with lower levels of life satisfaction and higher levels of depressive symptoms.Conclusions
The specific relationship between individuals with limb loss and their caregivers may be an important determinant of well-being. Conflict with caregivers, which has received little attention thus far in the limb loss literature, appears to play a particularly important role. Individuals with limb loss may benefit from interventions with their caregivers that both enhance support and reduce conflict. 相似文献17.
Andrea R.S. Huebner Amy Cassedy Tanya M. Brown H. Gerry Taylor Terry Stancin Michael W. Kirkwood Shari L. Wade 《PM & R》2018,10(5):462-471
Background
Mental health problems are common after pediatric traumatic brain injury (TBI). Many patients in need of mental health services do not receive them, but studies have not consistently used prospective and objective methods or followed samples for more than 1 year.Objective
To examine adolescents’ use of mental health services after TBI.Design
Secondary analysis from multicenter prospective randomized controlled trial.Setting
Five level 1 U.S. trauma centers.Participants
Adolescents aged 12-17 years with moderate-to-severe TBI were recruited for a randomized clinical trial (n = 132 at baseline, 124 at 6 months, 113 at 12 months, and 101 at 18 months).Methods
Participants were randomly assigned to counselor-assisted problem-solving or Internet resource comparison. Follow-up assessments were completed at 6, 12, and 18 months after baseline. Generalized estimating equations with a logit link were used to examine use of mental health services. Treatment group and participant impairment were examined as predictors of use.Main Outcome Measurements
Mental health care use was measured with the Service Assessment for Children and Adolescents; daily functioning and clinical outcome with the Child and Adolescent Functional Assessment Scale; behavioral and emotional functioning with the Child Behavior Checklist; and executive dysfunction with the Behavior Rating Inventory of Executive Function.Results
Use of mental health services ranged from 22% to 31% in the 2 years post-TBI. Participants with impairments were about 3 times more likely than those without impairments to receive services (odds ratio 4.61; 95% confidence interval 2.61-8.14; P < .001). However, 50%-68% of patients identified as impaired had unmet mental health care needs.Conclusions
Less than one half of adolescents with behavioral health needs after TBI received mental health services. Future studies are needed to examine barriers associated with seeking services after TBI and psychoeducation as preventive care for this population.Level of Evidence
II 相似文献18.
Christine M. McDonough Pengsheng Ni Kara Peterik Judith D. Hershberg Lesli R. Bell Leighton Chan Diane E. Brandt Alan M. Jette 《Archives of physical medicine and rehabilitation》2018,99(9):1798-1804
Objective
To examine the validity of the self-report Work-Disability Functional Assessment Battery (WD-FAB) physical function scales relative to clinician ratings of function and a performance-based functional capacity evaluation called the Physical Work Performance Evaluation (PWPE).Design
Cross-sectional.Setting
Outpatient rehabilitation.Participants
Adults (N=50) participating in physical therapy for musculoskeletal conditions.Interventions
Not applicable.Main Outcome Measures
Patients completed the PWPE and the WD-FAB physical function scales including Changing and Maintaining Body Position, Whole Body Mobility, Upper Body Function, and Upper Extremity Fine Motor. The physical therapist also answered the WD-FAB questions on the patient’s physical functioning. The WD-FAB computer-adaptive test version administered up to 10 items for each scale. The PWPE produces ratings from 0 to 5 indicating overall Level of Work ability: 0 (unable to work); 1 (sedentary); 2 (light); 3 (medium); 4 (heavy); 5 (very heavy). The PWPE also produces Level of Work ability ratings in the Dynamic Strength, Position Tolerance, and Mobility subsections.Results
Participating in the study were 50 patients with 1 or more conditions (shoulder, n=21; knee, n=16; low back, n=13; ankle/foot, n=10; neck, n=8; hip, n=7). The patient-based WD-FAB scores demonstrated moderate, statistically significant correlations with the provider proxy WD-FAB report (R=.49-.65). The WD-FAB Upper Body Function scale scores demonstrated moderate strength relationships with the PWPE overall ratings. The Whole Body Mobility and Changing and Maintaining Body Position scales did not demonstrate statistically significant relationships with the PWPE overall ratings.Conclusions
We found moderate evidence for validity for the WD-FAB Upper Body Function, Whole Body Mobility, and Changing and Maintaining Body Position scales relative to clinician report and varied evidence relative to the PWPE in this clinical sample. 相似文献19.
Colin M. Bosma Nashwa Mansoor Chiara S. Haller 《Archives of physical medicine and rehabilitation》2018,99(8):1576-1583