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1.
Yi-Jing Huang Gong-Hong Lin Shih-Chieh Lee Yi-Miau Chen Sheau-Ling Huang Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2018,99(3):529-533
Objectives
To examine both group- and individual-level responsiveness of the 3-point Berg Balance Scale (BBS-3P) and 3-point Postural Assessment Scale for Stroke Patients (PASS-3P) in patients with stroke, and to compare the responsiveness of both 3-point measures versus their original measures (Berg Balance Scale [BBS] and Postural Assessment Scale for Stroke Patients [PASS]) and their short forms (short-form Berg Balance Scale [SFBBS] and short-form Postural Assessment Scale for Stroke Patients [SFPASS]) and between the BBS-3P and PASS-3P.Design
Data were retrieved from a previous study wherein 212 patients were assessed at 14 and 30 days after stroke with the BBS and PASS.Setting
Medical center.Participants
Patients (N=212) with first onset of stroke within 14 days before hospitalization.Interventions
Not applicable.Main Outcome Measures
Group-level responsiveness was examined by the standardized response mean (SRM), and individual-level responsiveness was examined by the proportion of patients whose change scores exceeded the minimal detectable change of each measure. The responsiveness was compared using the bootstrap approach.Results
The BBS-3P and PASS-3P had good group-level (SRM, .60 and SRM, .56, respectively) and individual-level (48.1% and 44.8% of the patients with significant improvement, respectively) responsiveness. Bootstrap analyses showed that the BBS-3P generally had superior responsiveness to the BBS and SFBBS, and the PASS-3P had similar responsiveness to the PASS and SFPASS. The BBS-3P and PASS-3P were equally responsive to both group and individual change.Conclusions
The responsiveness of the BBS-3P and PASS-3P was comparable or superior to those of the original and short-form measures. We recommend the BBS-3P and PASS-3P as responsive outcome measures of balance for individuals with stroke. 相似文献2.
Chia-Hsin Chen Shih-Feng Lin Wan-Hui Yu Jau-Hong Lin Hao-Ling Chen Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2014
Objective
To compare the test-retest reliabilities of the scores of the Balance Computerized Adaptive Test (CAT) and the Biodex Balance System in patients with stroke.Design
A repeated-measures design (at a 1-wk interval) was used to examine the test-retest reliabilities of the scores of the Balance CAT and the Biodex Balance System.Setting
One rehabilitation unit in a local hospital.Participants
Patients (N=50) with stroke for more than 6 months and undergoing outpatient rehabilitation completed the Balance CAT and the eyes open (EO)/closed (EC) tests, but only 17 patients finished the Limit of Stability (LOS) test because they were unable to reach all the targets.Interventions
Not applicable.Main Outcome Measures
The Balance CAT and 2 computerized tests of the Biodex Balance System, namely the EO/EC test and the LOS, were used to evaluate balance function.Results
The test-retest reliabilities of the scores of the Balance CAT (Pearson r=.92, minimal detectable change [MDC] percent=12.8%) was excellent. Those of the EO/EC and LOS tests were poor to good (Pearson r=.56–.85, MDC%=50.8%–126.9%).Conclusions
The test-retest reliabilities of the scores of the Balance CAT were sufficient for assessing balance function in patients with stroke. Moreover, the test-retest reliabilities of the scores of the Balance CAT, one of the functional balance measures, were superior to those of the Biodex Balance System, 1 type of computerized posturography instrument. Therefore, the Balance CAT may be a more reliable measure for clinicians and researchers to use in assessing the balance function of patients with stroke for more than 6 months. 相似文献3.
Ya-Chen Lee Wan-Hui Yu Yu-Fen Lin I-Ping Hsueh Hung-Chia Wu Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2014
Objective
To examine the intrarater reliability, interrater reliability, and responsiveness of the Activities of Daily Living Computerized Adaptive Testing system (ADL CAT) in patients with stroke.Design
One repeated-measures design (at an interval of 7d) was used to examine the intrarater reliability and interrater reliability of the ADL CAT. For the responsiveness study, participants were assessed with the ADL CAT at admission to the rehabilitation ward and at discharge from the hospital.Setting
Eight rehabilitation units.Participants
Three different (nonoverlapping) groups of patients (N=157) were recruited. Fifty-five and 42 outpatients with chronic stroke participated in the intrarater and interrater reliability studies, respectively; 60 inpatients who had recently had a stroke participated in the responsiveness study.Interventions
Not applicable.Main Outcome Measure
ADL CAT.Results
The intraclass correlation coefficient values were .94 and .80 for the ADL CAT in the intrarater reliability and interrater reliability studies, respectively. The classical test theory–based minimal detectable change values were 6.5 and 9.5 for the ADL CAT in the intrarater reliability and interrater reliability studies, respectively. The Kazis' effect size and standardized response mean of the ADL CAT were moderate (.62–.73).Conclusions
The ADL CAT has good intrarater reliability and interrater reliability in outpatients with chronic stroke, and sufficient responsiveness in inpatients with stroke undergoing inpatient rehabilitation. Further investigations on the responsiveness of the ADL CAT in outpatients are needed to obtain more evidence on the utility of the ADL CAT. 相似文献4.
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5.
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6.
7.
Gong-Hong Lin Yi-Jing Huang Ya-Chen Lee Shih-Chieh Lee Chia-Yeh Chou Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2019,100(5):899-907
Objective
The authors aimed to develop and validate the Computerized Adaptive Testing System for Assessing 5 Functions in Patients with Stroke (CAT-5F) based on the Barthel Index (BI), Postural Assessment Scale for Stroke patients (PASS), and Stroke Rehabilitation Assessment of Movement (STREAM) to improve the efficiency of assessment. The purposes of the CAT-5F assessment are to describe patients’ levels of impairments or disabilities in the 5 functions and to serve as an outcome measure in patients with stroke.Design
This is a data-mining study based on data from a previous study using simulation analysis to develop and validate the CAT-5F.Setting
One rehabilitation unit in a medical center in Taiwan served as the setting for this study.Participants
Data were retrieved from totals of 540 (initial assessment) and 309 (discharge assessment) participants with stroke assessed in a previous study. The assessment data (N=540) were from the BI, PASS, and STREAM.Interventions
Not applicable.Main Outcome Measures
The outcome measures for this study were from BI, PASS, and STREAM.Results
The CAT-5F using the optimal stopping rule (limited reliability increased <0.010) had good Rasch reliability across the 5 functions (0.86-0.96) and needed 12.7 items, on average, for the whole administration. The concurrent validity (Pearson product-moment correlation coefficient, r=0.91-0.96) and responsiveness (standardized response mean=0.33-0.91) of the CAT-5F were sufficient in the patients.Conclusion
The CAT-5F has sufficient administrative efficiency, reliability, concurrent validity, and responsiveness to simultaneously assess basic activities of daily living, postural control, upper extremity/lower extremity motor functions, and mobility in patients with stroke. 相似文献8.
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9.
Gunilla E. Frykberg Anna Cristina Åberg Kjartan Halvorsen Jörgen Borg Helga Hirschfeld 《Archives of physical medicine and rehabilitation》2009,90(6):1009-1017
Frykberg GE, Åberg AC, Halvorsen K, Borg J, Hirschfeld H. Temporal coordination of the sit-to-walk task in subjects with stroke and in controls.
Objectives
To explore events and describe phases for temporal coordination of the sit-to-walk (STW) task, within a semistandardized set up, in subjects with stroke and matched controls. In addition, to assess variability of STW phase duration and to compare the relative duration of STW phases between the 2 groups.Design
Cross-sectional.Setting
Research laboratory.Participants
A convenience sample of persons with hemiparesis (n=10; age 50-67y) more than 6 months after stroke and 10 controls matched for sex, age, height, and body mass index.Interventions
Not applicable.Main Outcome Measures
Relative duration of STW phases, SE of measurement in percentage of the mean, and intraclass correlation coefficients (ICCs).Results
Four STW phases were defined: rise preparation, transition, primary gait initiation, and secondary gait initiation. The subjects with stroke needed 54% more time to complete the STW task than the controls did. ICCs ranged from .38 to .66 and .22 to .57 in the stroke and control groups, respectively. SEs of measurement in percentage of the mean values were high, particularly in the transition phase: 54.1% (stroke) and 50.4% (controls). The generalized linear model demonstrated that the relative duration of the transition phase was significantly longer in the stroke group.Conclusions
The present results extend existing knowledge by presenting 4 new phases of temporal coordination of STW, within a semistandardized set-up, in persons with stroke and in controls. The high degree of variability regarding relative STW phase duration was probably a result of both the semistandardized set up and biological variability. The significant difference in the transition phase across the 2 groups requires further study. 相似文献10.
Cynthia Gagnon Isabelle Lessard Bernard Brais Isabelle Côté Caroline Lavoie Matthis Synofzik Jean Mathieu 《Archives of physical medicine and rehabilitation》2018,99(9):1747-1754
Objective
To document in adults affected by autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) the intra- and interrater reliability, standard error of measurement, agreement, minimal detectable change, and construct validity of the 9-Hole Peg Test (NHPT), the Standardized Finger-to-Nose Test (SFNT), and grip strength.Design
Metrologic study.Setting
Neuromuscular rehabilitation clinic.Participants
Genetically confirmed adult patients with ARSACS (N=42; 21 women; mean age, 38.6y).Interventions
Not applicable.Main Outcome Measures
Intra- and interrater reliability was determined using the intraclass correlation coefficient (ICC). Construct validity was determined by assessing the capacity of the NHPT, the SFNT, and grip strength to distinguish between participants based on sex, mobility stages, and age groups, and on performance on the Archimedes spiral and fast alternating hand movements tests.Results
All 3 tests have shown excellent reliability (ICC=.90–.98). However, the limit of agreement was influenced by the participant’s performance on the NHPT, and the minimal detectable change was very different for both hands (right=9.7 vs left=28.0). Construct validity was confirmed for the SFNT and NHPT, but it was not demonstrated for grip strength.Conclusions
Given the metrologic properties assessed in this study, the SFNT is an excellent measure to assess upper limb coordination, whereas the NHPT must be used with caution. The grip strength is reliable but does not seem to reflect disease severity. 相似文献11.
Ryan Gallagher Jodie Marquez Peter Osmotherly 《Archives of physical medicine and rehabilitation》2018,99(11):2244-2250
Objectives
To identify in patients with idiopathic normal pressure hydrocephalus (iNPH) undergoing a cerebrospinal fluid (CSF) tap test (TT) for consideration of a ventricular peritoneal (VP) shunt: (1) gait and balance measures, which identify symptom change; (2) differences present between pre– and post–CSF TT scores between patients classified as responders and nonresponder; (3) ability of patients with iNPH to accurately quantify change in their gait and balance symptoms from a CSF TT.Design
Prospective observational study. Post–CSF TT assessment was completed 2-4 hours post.Setting
Tertiary referral neurological and neurosurgical hospital.Participants
Patients (N=74) with iNPH receiving a 30 mL CSF TT for consideration of a VP shunt.Interventions
Patients underwent a battery of gait and balance measures pre– and post–CSF TT and indicated their perceived change on a global rating of change (GRC). Patients deemed to improve and offered VP shunt insertion by a neurologist or neurosurgeon were labeled responders.Main Outcome Measures
Performance oriented mobility assessment (Tinetti), Berg Balance Scale (BBS), timed Up and Go (TUG), 10-meter walk test (10MWT), GRC.Results
Forty patients were classified responders, 34 nonresponders. Significant differences were identified for responders: Tinetti (3.88 points), TUG (3.98 seconds), 10MWT (0.08 m/sec), and BBS (5.29 points). Significant differences were found for nonresponders for the Tinetti (0.91 points) and BBS (2.06 points). Change scores for responders and nonresponders were significantly different for all tests between responders and nonresponders. GRC scores for gait (+2 for responders, 0 for nonresponders) and balance (+2.5 for responders, 0 for nonresponders) were both significantly different.Conclusions
The Tinetti, BBS, and TUG can identify change in patients undergoing a CSF TT for iNPH. Patients appear to be able to accurately identify if change has occurred. 相似文献12.
Ettie Ben-Shabat Mithu Palit Natalie A. Fini Catherine T. Brooks Adele Winter Anne E. Holland 《Archives of physical medicine and rehabilitation》2013
Objective
To examine the intra- and interrater reliability of the Modified Tardieu Scale (MTS) for lower limb assessment of adults with chronic neurologic injuries.Design
Single-center intra- and interrater reliability study.Setting
Outpatient neurorehabilitation unit.Participants
Adults (N=30; mean age ± SD, 54.1±12.5y) with various chronic neurologic injuries and lower limb spasticity.Interventions
Two experienced physiotherapists performed slow (R2) and fast (R1) passive movements for lower limb muscles half an hour apart on the same day (interrater reliability), while a third physiotherapist took goniometric measurements only. One physiotherapist repeated the assessment 1 to 3 days earlier or later (intrarater reliability). Assessors qualitatively rated the resistance to fast passive movements.Main Outcome Measures
Intraclass correlation coefficients (ICCs) and limits of agreement (LOA) were calculated for R1, R2, and R2–R1. Kappa coefficients were calculated for tibialis range of movement and qualitative spasticity ratings.Results
Intra- and interrater R1 and R2 measurements showed moderate to high reliability for the affected hamstrings, rectus femoris, gastrocnemius, soleus (mean ICC ± SD, .79±.08), and tibialis anterior (mean κ ± SD, .58±.10). Only intrarater measurements of the affected tibialis posterior were moderately reliable (R1=.57, R2=.77). Seven of 16 spasticity angle measurements of the affected muscles were moderately reliable. LOA were mostly unacceptably wide. Qualitative spasticity ratings were moderately reliable for affected hamstrings, gastrocnemius, and tibialis muscles (mean κ ± SD, .52±.10).Conclusions
The MTS is reliable for assessing spasticity in most lower limb muscles of adults with chronic neurologic injuries. Repeated MTS measurements of spasticity are best based on R1 measurements rather than spasticity angle or qualitative ratings of spasticity. Optimally, MTS measurements should be undertaken by the same clinician. 相似文献13.
Rosalee Dewar Andrew P. Claus Kylie Tucker Robert S. Ware Leanne M. Johnston 《Archives of physical medicine and rehabilitation》2019,100(4):695-702
Objective
To evaluate the reproducibility, including reliability and agreement, of the Kids Balance Evaluation Systems Test (Kids-BESTest) and the short form of Kids-BESTest (Kids-Mini-BESTest) for measuring postural control in school-aged children with cerebral palsy.Design
Psychometric study of intrarater, interrater, and test-retest reliability and agreement.Setting
Clinical laboratory and home.Participants
Convenience sample of children (N=18) aged 8 to 17 years with ambulant cerebral palsy (CP) (Gross Motor Function Classification System I-II) with spastic or ataxic motor type.Intervention
Not applicable.Main Outcome Measures
Postural control was assessed using the Kids-BESTest and the Kids-Mini-BESTest. An experienced physiotherapist assessed all children in real time and the testing session was videotaped. The same physiotherapist viewed and scored the video twice, at least 2 weeks apart, to assess intrarater reproducibility. Another experienced physiotherapist scored the same video to determine interrater reproducibility. Thirteen children returned for a repeat assessment with the first physiotherapist within 6 weeks and their test-retest performance was rated in real time and with video.Results
Excellent reliability was observed for both the Kids-BESTest (intraclass correlation coefficient [ICC] 0.96-0.99) and Kids-Mini-BESTest (ICC 0.79-0.98). The smallest detectable change was good to excellent for all Kids-BESTest agreement analyses (5%-9%), but poor to good for Kids-Mini-BESTest analyses (9%-16%).Conclusion
The Kids-BESTest shows an excellent ability to discriminate postural control abilities of school-aged children with CP and it has a low smallest detectable change, suitable for use as a preintervention and postintervention outcome measure. Although the Kids-Mini-BESTest is 5 to 10 minutes shorter to administer, it has poorer reproducibility and focuses only on falls-related balance, which excludes 2 domains of postural control. 相似文献14.
《Archives of physical medicine and rehabilitation》2023,104(9):1432-1438
ObjectiveTo examine the test–retest reliability, minimal detectable change (MDC), responsiveness, and efficiency of the Computerized Adaptive Test of Social Functioning (Social-CAT) in patients with stroke.DesignRepeated-assessments design.SettingA department of rehabilitation of a medical center.ParticipantsIn total, 31 patients with chronic stroke and 65 patients with subacute stroke were recruited.InterventionNot available.Main Outcome MeasureSocial-CAT.ResultsThe Social-CAT showed acceptable test–retest reliability (intraclass correlation coefficient, 0.80) and small random measurement error (MDC%: 18.0%). However, heteroscedasticity was found (r between the means and the absolute change scores: 0.32), so the MDC% adjusted cut-off score is recommended for determining real improvement. Regarding responsiveness, the Social-CAT showed large differences (Kazis’ effect size and standardized mean response: 1.15 and 1.09, respectively) in subacute patients. Regarding efficiency, the Social-CAT required an average of 5 items and less than 2 minutes for completion.ConclusionsOur findings indicate that the Social-CAT is a reliable and efficient measure with good test–retest reliability, small random measurement error, and good responsiveness. Thus, the Social-CAT is a useful outcome measure for routine monitoring of the changes in social function of patients with stroke. 相似文献
15.
16.
Mehdi Kargarfard Ardalan Shariat Lee Ingle Joshua A. Cleland Mina Kargarfard 《Archives of physical medicine and rehabilitation》2018,99(2):234-241
Objective
To assess the effects of an 8-week aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS).Design
Randomized controlled design.Setting
Referral center of an MS society.Participants
Women (N=32; mean age ± SD, 36.4±8.2y) with diagnosed relapsing-remitting MS. After undergoing baseline testing by a neurologist, participants were allocated to either an intervention (aquatic training program, n=17) or a control group (n=15).Interventions
The intervention consisted of an 8-week aquatic training program (3 supervised training sessions per week; session duration, 45–60min; 50%–75% estimated maximum heart rate).Main Outcome Measures
Six-minute walk test (6-MWT), balance (Berg Balance Scale [BBS]), and perceptions of fatigue (Modified Fatigue Impact Scale; [MFIS]) at baseline and after the 8-week intervention. Differences over time between the experimental and control groups were assessed by a 2×2 (group by time) repeated-measures analysis of variance.Results
Thirty-two women completed the 8-week aquatic training intervention (experimental group, n=17; control group, n=15). All outcome measures improved in the experimental group: 6-MWT performance (pretest mean ± SD, 451±58m; posttest mean ± SD, 503±57m; P<.001); BBS (pretest mean ± SD, 53.59±1.70; posttest mean ± SD, 55.18±1.18; P<.001), and MFIS (pretest mean ± SD, 43.1±14.6; posttest mean ± SD, 32.8±5.9; P<.01). A significant group-by-time interaction was evident between the experimental and control groups for 6-MWT (P<.001, partial eta2 [ηp2]=.551), BBS (P<.001, ηp2=.423), and MFIS (P<.001, ηp2=.679).Conclusions
Aquatic exercise training improved functional capacity, balance, and perceptions of fatigue in women with MS. 相似文献17.
Rafael Mesquita Daisy J.A. Janssen Emiel F.M. Wouters Jos M.G.A. Schols Fabio Pitta Martijn A. Spruit 《Archives of physical medicine and rehabilitation》2013
Objective
To investigate the within-day test-retest reliability of the Timed Up & Go (TUG) test in patients with advanced chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), and chronic renal failure (CRF).Design
Cross-sectional.Setting
Patients' home environment.Participants
Subjects (N=235, 64% men; median age, 70y [interquartile range, 61–77y]; median body mass index, 25.6kg/m2 [interquartile range, 22.8–29.4kg/m2]) with advanced COPD (n=95), CHF (n=68), or CRF (n=72).Interventions
Not applicable.Main Outcome Measure
Time to complete the TUG test. Three trials were performed on the same day and by the same assessors. The intraclass correlation coefficient (ICC), kappa coefficient, standard error of measurement, and absolute and relative minimal detectable change (MDC) values were calculated.Results
Good agreement was observed, in general, for both the total sample and subgroups (COPD, CHF, CRF), with ICC values ranging from .85 to .98, and kappa coefficients from .49 to 1.00. However, statistical improvement occurred in the total sample from the first to the second trial with large limits of agreement (mean difference, −.97s; 95% confidence interval, 3.00 to −4.94s; P<.01). The third trial added little or no information to the first 2 trials. For the total sample, a standard error of measurement value of approximately 1.6 seconds, an absolute value of MDC at the 95% confidence level (MDC95%) of approximately 4.5 seconds, and a relative value of MDC at the 95% confidence level (MDC95%%) of approximately 35% were found between the first 2 trials, with similar values found for the subgroups.Conclusions
The TUG test is reliable in patients with advanced COPD, CHF, or CRF after 2 trials. Values of standard error of measurement and MDC may be used in daily clinical practice with these populations to define what is expected and what represents true change in repeated measures. 相似文献18.
Mari Gunnes Bent Indredavik Birgitta Langhammer Stian Lydersen Hege Ihle-Hansen Anne Eitrem Dahl Torunn Askim 《Archives of physical medicine and rehabilitation》2019,100(12):2251-2259
ObjectiveTo investigate the associations between participants’ adherence to a physical activity and exercise program after stroke and functional recovery 18 months after inclusion.DesignSecondary analyses of the intervention arm in the multisite randomized controlled trial Life After Stroke (LAST).SettingPrimary health care services in 3 Norwegian municipalities.ParticipantsOf the participants enrolled (N=380), 186 (48.9%) were randomized to the intervention. The study sample comprised community dwelling individuals included 3 months after stroke, with mean age of 71.7 ± 11.9 years and 82 (44.1%) women. According to the National Institutes of Health Stroke Scale, 97.3% were diagnosed as having mild (National Institutes of Health Stroke Scale<8) and 2.7% with moderate (8-16 on the National Institutes of Health Stroke Scale) stroke.InterventionMonthly coaching by physiotherapists encouraging participants to adhere to 30 minutes of daily physical activity and 45-60 minutes of weekly exercise.Main Outcome MeasuresThe primary outcome was Motor Assessment Scale (MAS). Secondary outcome measures were 6-minute walk test, Timed Up and Go (TUG), Berg Balance Scale (BBS), and the physical domains of the Stroke Impact Scale (SIS). Adherence was assessed by combining participants’ training diaries and physiotherapists’ reports.ResultsThe relationship between adherence and functional recovery was analyzed with simple and multiple linear regression models. Adjusted for age, sex, dependency, and cognition, results showed statistically significant associations between adherence and functional outcomes after 18 months, as measured by MAS, TUG, BBS, and SIS (P≤.026).ConclusionsIncreased adherence to physical activity and exercise was associated with improved functional recovery after mild to moderate stroke. This emphasizes the importance of developing adherence-enhancing interventions. Dose-response studies are recommended for future research. 相似文献
19.
Bridget Hill Gavin Williams John Olver Scott Ferris Andrea Bialocerkowski 《Archives of physical medicine and rehabilitation》2018,99(4):629-634
Objective
To evaluate reproducibility (reliability and agreement) of the Brachial Assessment Tool (BrAT), a new patient-reported outcome measure for adults with traumatic brachial plexus injury (BPI).Design
Prospective repeated-measure design.Setting
Outpatient clinics.Participants
Adults with confirmed traumatic BPI (N=43; age range, 19–82y).Interventions
People with BPI completed the 31-item 4-response BrAT twice, 2 weeks apart. Results for the 3 subscales and summed score were compared at time 1 and time 2 to determine reliability, including systematic differences using paired t tests, test retest using intraclass correlation coefficient model 1,1 (ICC1,1), and internal consistency using Cronbach α. Agreement parameters included standard error of measurement, minimal detectable change, and limits of agreement.Main Outcome Measure
BrAT.Results
Test-retest reliability was excellent (ICC1,1=.90–.97). Internal consistency was high (Cronbach α=.90–.98). Measurement error was relatively low (standard error of measurement range, 3.1–8.8). A change of >4 for subscale 1, >6 for subscale 2, >4 for subscale 3, and >10 for the summed score is indicative of change over and above measurement error. Limits of agreement ranged from ±4.4 (subscale 3) to 11.61 (summed score).Conclusions
These findings support the use of the BrAT as a reproducible patient-reported outcome measure for adults with traumatic BPI with evidence of appropriate reliability and agreement for both individual and group comparisons. Further psychometric testing is required to establish the construct validity and responsiveness of the BrAT. 相似文献20.
Benjamin J. Shore Benjamin G. Allar Patricia E. Miller Travis H. Matheney Brian D. Snyder Maria Fragala-Pinkham 《Archives of physical medicine and rehabilitation》2019,100(1):45-51