共查询到20条相似文献,搜索用时 31 毫秒
1.
Shane L. Koppenhaver Jeffrey J. Hebert Julie M. Fritz Eric C. Parent Deydre S. Teyhen John S. Magel 《Archives of physical medicine and rehabilitation》2009,90(1):87-94
Koppenhaver SL, Hebert JJ, Fritz JM, Parent EC, Teyhen DS, Magel JS. Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles.
Objectives
To evaluate the intraexaminer and interexaminer reliability of rehabilitative ultrasound imaging (RUSI) in obtaining thickness measurements of the transversus abdominis (TrA) and lumbar multifidus muscles at rest and during contractions.Design
Single-group repeated-measures reliability study.Setting
University and orthopedic physical therapy clinic.Participants
A volunteer sample of adults (N=30) with current nonspecific low back pain (LBP) was examined by 2 clinicians with minimal RUSI experience.Interventions
Not applicable.Main Outcome Measures
Thickness measurements of the TrA and lumbar multifidus muscles at rest and during contractions were obtained by using RUSI during 2 sessions 1 to 3 days apart. Percent thickness change was calculated as thicknesscontracted-thicknessrest/thicknessrest. Intraclass correlation coefficients (ICC) were used to estimate reliability.Results
By using the mean of 2 measures, intraexaminer reliability point estimates (ICC3,2) ranged from 0.96 to 0.99 for same-day comparisons and from 0.87 to 0.98 for between-day comparisons. Interexaminer reliability estimates (ICC2,2) ranged from 0.88 to 0.94 for within-day comparisons and from 0.80 to 0.92 for between-day comparisons. Reliability estimates comparing measurements by the 2 examiners of the same image (ICC2,2) ranged from 0.96 to 0.98. Reliability estimates were lower for percent thickness change measures than the corresponding single thickness measures for all conditions.Conclusions
RUSI thickness measurements of the TrA and lumbar multifidus muscles in patients with LBP, when based on the mean of 2 measures, are highly reliable when taken by a single examiner and adequately reliable when taken by different examiners. 相似文献2.
Chang PF Ostir GV Kuo YF Granger CV Ottenbacher KJ 《Archives of physical medicine and rehabilitation》2008,89(2):231-236
Chang P-F, Ostir GV, Kuo Y-F, Granger CV, Ottenbacher KJ. Ethnic differences in discharge destination among older patients with traumatic brain injury.
Objective
To estimate the association between ethnicity and discharge destination in older patients with traumatic brain injury (TBI).Design
A retrospective analysis.Setting
Nationally representative sample of older patients from the Uniform Data System for Medical Rehabilitation in 2002 and 2003.Participants
Patients (N=9240) aged 65 years or older who received inpatient rehabilitation services for TBI.Interventions
Not applicable.Main Outcome Measures
Discharge destination (home, assisted living facility, institution) and ethnicity (white, black, Hispanic).Results
Multinomial logit models showed that older Hispanics (odds ratio [OR]=2.24; 95% confidence interval [CI], 1.66-3.02) and older blacks (OR=2; 95% CI, 1.55-2.59) with TBI were significantly more likely to be discharged home than older whites with TBI, after adjusting for relevant risk factors. Older blacks were also 78% less likely (OR=.22; 95% CI, .08-.60) to be discharged to an assisted living facility than whites after adjusting for relevant risk factors.Conclusions
Our findings indicate that older minority patients with TBI were significantly more likely to be discharged home than white patients with TBI. Studies are needed to investigate underlying factors associated with this ethnic difference. 相似文献3.
Marquez de la Plata CD Hart T Hammond FM Frol AB Hudak A Harper CR O'Neil-Pirozzi TM Whyte J Carlile M Diaz-Arrastia R 《Archives of physical medicine and rehabilitation》2008,89(5):896-903
Marquez de la Plata CD, Hart T, Hammond FM, Frol AB, Hudak A, Harper CR, O'Neil-Pirozzi TM, Whyte J, Carlile M, Diaz-Arrastia R. Impact of age on long-term recovery from traumatic brain injury.
Objective
To determine whether older persons are at increased risk for progressive functional decline after traumatic brain injury (TBI).Design
Longitudinal cohort study.Setting
Traumatic Brain Injury Model Systems (TBIMS) rehabilitation centers.Participants
Subjects enrolled in the TBIMS national dataset.Interventions
Not applicable.Main Outcome Measures
Disability Rating Scale (DRS), FIM instrument cognitive items, and the Glasgow Outcome Scale-Extended.Results
Participants were separated into 3 age tertiles: youngest (16-26y), intermediate (27-39y), and oldest (≥40y). DRS scores were comparable across age groups at admission to a rehabilitation center. The oldest group was slightly more disabled at discharge from rehabilitation despite having less severe acute injury severity than the younger groups. Although DRS scores for the 2 younger groups improved significantly from year 1 to year 5, the greatest magnitude of improvement in disability was seen among the youngest group. In addition, after dividing patients into groups according to whether their DRS scores improved (13%), declined (10%), or remained stable (77%) over time, the likelihood of decline was found to be greater for the 2 older groups than for the youngest group. A multiple regression model showed that age has a significant negative influence on DRS score 5 years post-TBI after accounting for the effects of covariates.Conclusions
This study supported our primary hypothesis that older patients show greater decline over the first 5 years after TBI than younger patients. In addition, the greatest amount of improvement in disability was observed among the youngest group of survivors. These results suggest that TBI survivors, especially older patients, may be candidates for neuroprotective therapies after TBI. 相似文献4.
Barbic S, Brouwer B. Test position and hip strength in healthy adults and people with chronic stroke.
Objective
To determine if peak torques generated by the hip flexors and extensors are dependent on test position in healthy adults and in people with chronic stroke.Design
Cross-sectional study.Setting
Motor performance laboratory.Participants
Volunteers were 10 young (20.7±1.5y), 10 older adults (62.1±7y), and 10 stroke survivors (60.6±10y) who were an average of 5 years poststroke.Interventions
Not applicable.Main Outcome Measures
Isokinetic (60°/s) peak concentric hip flexor and extensor torques (in Nm/kg) generated in supine and standing positions.Results
Peak flexor torques measured in standing were generally higher than in supine (P=.018); a pattern evident in all groups, but significant only in stroke. An interaction between test position and group for hip extensor strength (P=.016) reflected 2 distinct patterns in which torques were highest in standing among the young subjects and highest in supine after stroke.Conclusions
Isokinetic hip flexor and extensor strength measured in standing and supine are comparable in young and older healthy people. In chronic stroke, the test position may over or underestimate maximum peak torque depending on the muscle group tested, particularly on the side ipsilateral to the lesion. These findings may have implications for predicting functional ability from strength measurements. 相似文献5.
Kashluba S Hanks RA Casey JE Millis SR 《Archives of physical medicine and rehabilitation》2008,89(5):904-911
Kashluba S, Hanks RA, Casey JE, Millis SR. Neuropsychologic and functional outcome after complicated mild traumatic brain injury.
Objective
To investigate the extent to which neuropsychologic and functional outcome after complicated mild traumatic brain injury (TBI) parallels that of moderate TBI recovery.Design
A longitudinal study comparing neuropsychologic and functional status of persons with complicated mild TBI and moderate TBI at discharge from inpatient rehabilitation and at 1 year postinjury.Setting
Rehabilitation hospital with a Traumatic Brain Injury Model System.Participants
Persons with complicated mild TBI (n=102), each with an intracranial brain lesion documented through neuroimaging and a highest Glasgow Coma Scale (GCS) score in the emergency department between 13 and 15, and 127 persons with moderate TBI.Interventions
Not applicable.Main Outcome Measures
FIM instrument, Disability Rating Scale, Community Integration Questionnaire, Wechsler Memory Scale logical memory I and II, Rey Auditory Verbal Learning Test, Trail-Making Test, Controlled Oral Word Association Test, Symbol Digit Modalities Test, Wisconsin Card Sorting Test, and block design.Results
Few differences in neuropsychologic performance existed between the TBI groups. Less severely impaired information processing speed and verbal learning were seen in the complicated mild TBI group at rehabilitation discharge and 1 year postinjury. Despite overall improvement across cognitive domains within the complicated mild TBI group, some degree of impairment remained at 1 year postinjury on those measures that had identified participants as impaired soon after injury. No differences on functional ability measures were found between the TBI groups at either time period postinjury, with both groups exhibiting incomplete recovery of functional status at the 1-year follow-up.Conclusions
When classifying severity of TBI based on GCS scores, consideration of a moderate injury designation should be given to persons with an intracranial bleed and a GCS score between 13 and 15. 相似文献6.
Jonathan S. Ilgen James K. Takayesu Kriti Bhatia Regan H. Marsh Sachita Shah Susan R. Wilcox William H. Krauss Eric S. Nadel 《The Journal of emergency medicine》2011,41(2):190-195
Background
Teaching our residents to teach is a vital responsibility of Emergency Medicine (EM) residency programs. As emergency department (ED) overcrowding may limit the ability of attending physicians to provide bedside instruction, senior residents are increasingly asked to assume this role for more junior trainees. Unfortunately, a recent survey suggests that only 55% of all residencies provide instruction in effective teaching methods. Without modeling from attending physicians, many residents struggle with this responsibility.Objectives
We introduced a “Resident-as-Teacher” curriculum in 2002 as a means to address a decline in bedside instruction and provide our senior residents with a background in effective teaching methods.Discussion
Here, we describe the evolution of this resident-as-teacher rotation, outline its current structure, cite potential pitfalls and solutions, and discuss the unique addition of a teach-the-teacher curriculum.Conclusion
A resident-as-teacher rotation has evolved into a meaningful addition to our senior residents' training, fostering their growth as educators and addressing our need for bedside instruction. 相似文献7.
Thomedi Ventura Cynthia Harrison-Felix Nichole Carlson Carolyn DiGuiseppi Barbara Gabella Allen Brown Michael DeVivo Gale Whiteneck 《Archives of physical medicine and rehabilitation》2010,91(1):20-29
Ventura T, Harrison-Felix C, Carlson N, DiGuiseppi C, Gabella B, Brown A, DeVivo M, Whiteneck G. Mortality after discharge from acute care hospitalization with traumatic brain injury: a population-based study.
Objective
To characterize mortality after acute hospitalization with traumatic brain injury (TBI) in a socioeconomically diverse population.Design
Population-based retrospective cohort study.Setting
Statewide TBI surveillance program.Participants
Colorado residents with TBI discharged alive from acute hospitalization between 1998 and 2003 (N=18,998).Interventions
Not applicable.Main Outcome Measures
Vital status at the end of the study period (December 31, 2005) and statewide population mortality rates were used to calculate all-cause and cause-specific standardized mortality ratios (SMRs) and life expectancy compared with population mortality rates. The influence of demographics, injury severity, and comorbid conditions on time until death was investigated using age-stratified Cox proportional hazards modeling.Results
Patients with TBI carried about 2.5 times the risk of death compared with the general population (SMR=2.47; 95% confidence interval [CI], 2.31-2.65). Life expectancy reduction averaged 6 years. SMRs were largest for deaths caused by mental/behavioral (SMR=3.84; 95% CI, 2.67-5.51) and neurologic conditions (SMR=2.79; 95% CI, 2.07-3.77) and were smaller but significantly higher than 1.0 for an array of other causes. Injury severity and older age increased mortality among young people (age <20y). However, risk factors for mortality among adults age 20 and older involved multiple domains of demographics (eg, metropolitan residence), injury-related measures (eg, falls versus vehicular incidents), and comorbidity (eg, ≥3 comorbid health conditions versus none).Conclusions
TBI confers an increased risk of mortality in the months and years after hospital discharge. Although life expectancy is reduced across the population, the excess in mortality lessens as time since injury increases. Specific risk factors (eg, high injury severity, poor general health) pose an especially high threat to survival and should prompt an increased vigilance of health status, especially among younger patients. 相似文献8.
Juan Carlos Arango-Lasprilla Jessica M. Ketchum David Cifu Flora Hammond Camilo Castillo Elizabeth Nicholls Thomas Watanabe Anthony Lequerica Xiaoyan Deng 《Archives of physical medicine and rehabilitation》2010,91(10):1495-1504
Arango-Lasprilla JC, Ketchum JM, Cifu D, Hammond F, Castillo C, Nicholls E, Watanabe T, Lequerica A, Deng X. Predictors of extended rehabilitation length of stay after traumatic brain injury.
Objective
To develop a prediction rule for acutely identifying patients at risk for extended rehabilitation length of stay (LOS) after traumatic brain injury (TBI) by using demographic and injury characteristics.Design
Retrospective cohort study.Setting
Traumatic Brain Injury Model Systems.Participants
Sample of TBI survivors (N=7284) with injuries occurring between 1999 and 2009.Interventions
Not applicable.Main Outcome Measures
Extended rehabilitation LOS defined as 67 days or longer.Results
A multivariable model was built containing FIM motor and cognitive scores at admission, preinjury level of education, cause of injury, punctate/petechial hemorrhage, acute-care LOS, and primary payor source. The model had good calibration, excellent discrimination (area under the receiver operating characteristic curve = .875), and validated well. Based on this model, a formula for determining the probability of extended rehabilitation LOS and a prediction rule that classifies patients with predicted probabilities greater than 4.9% as at risk for extended rehabilitation LOS were developed.Conclusions
The current predictor model for TBI survivors who require extended inpatient rehabilitation may allow for enhanced rehabilitation team planning, improved patient and family education, and better use of health care resources. Cross-validation of this model with other TBI populations is recommended. 相似文献9.
Macciocchi S Seel RT Thompson N Byams R Bowman B 《Archives of physical medicine and rehabilitation》2008,89(7):1350-1357
Macciocchi S, Seel RT, Thompson N, Byams R, Bowman B. Spinal cord injury and co-occurring traumatic brain injury: assessment and incidence.
Objectives
To examine prospectively the incidence and severity of co-occurring traumatic brain injury (TBI) in persons with traumatic spinal cord injury (SCI) and to describe a TBI assessment process for SCI rehabilitation professionals.Design
A prospective, cohort design to collect and analyze clinical variables relevant for diagnosing co-occurring TBI.Setting
An urban, single-center National Institute of Disability and Rehabilitation Research Model Spinal Cord Injury System in the Southeastern United States.Participants
People (N=198) who met inclusion criteria and provided consent within an 18-month recruitment window.Interventions
Not applicable.Main Outcome Measure
FIM cognitive scale.Results
Based on participants' presence and duration of posttraumatic amnesia, initial Glasgow Coma Scale total score, and presence of cerebral lesion documented by neuroimaging, 60% of our traumatic SCI sample also sustained a TBI (n=118). Most co-occurring TBIs were mild (34%). Co-occurring mild complicated (10%), moderate (6%), and severe TBI (10%) were less common but still occurred in a significant percentage (26%) of persons with traumatic SCI. Persons with traumatic SCI who were injured in motor vehicle collisions and falls were more likely to sustain a co-occurring TBI. Cervical level traumatic SCI was associated with greater rates of TBI but not more severe injuries. Tree analyses established a practical algorithm for classifying TBI severity associated with traumatic SCI. Analysis of variance established criterion validity for the algorithm's TBI severity classifications.Conclusions
Findings from our prospective study provide strong support that TBI is a common co-occurring injury with traumatic SCI. Incomplete acute care medical record documentation of TBI in the traumatic SCI population remains a considerable issue, and there is a significant need to educate emergency department and acute care personnel on the TBI clinical data needs of acute rehabilitation providers. A systematic algorithm for reviewing acute care medical records can yield valid estimates of TBI severity in the traumatic SCI population. 相似文献10.
Elizabeth K. Wise Christine Mathews-Dalton Sureyya Dikmen Nancy Temkin Joan Machamer Kathleen Bell Janet M. Powell 《Archives of physical medicine and rehabilitation》2010,91(9):1357-1362
Wise EK, Mathews-Dalton C, Dikmen S, Temkin N, Machamer J, Bell K, Powell JM. Impact of traumatic brain injury on participation in leisure activities.
Objective
To determine how participation in leisure activities for people with traumatic brain injury (TBI) changes from before injury to 1 year after injury.Design
Prospective evaluation of leisure participation at 1 year after TBI.Setting
Level I trauma center.Participants
Rehabilitation inpatients (mean age, 35.3 years; 77% male; 77% white) with moderate to severe TBI (N=160).Interventions
Not applicable.Main Outcome Measure
Functional Status Examination.Results
At 1 year after injury, 81% had not returned to preinjury levels of leisure participation. Activities most frequently discontinued included partying, drug and alcohol use, and various sports. The activity most often reported as new after injury was watching television. Of the small fraction who returned to preinjury levels, 70% did so within 4 months of injury. Sixty percent of those who did not return to preinjury levels were moderately to severely bothered by the changes.Conclusions
At 1 year after injury, many TBI survivors engage in a reduced number of leisure activities, which are more sedentary and less social, with a substantial fraction dissatisfied with these changes. While discontinuing some activities may be viewed as a positive change, there are few new ones to replace them. 相似文献11.
Morales-Asencio JM Morilla-Herrera JC Martín-Santos FJ Gonzalo-Jiménez E Cuevas-Fernández-Gallego M Bonill de Las Nieves C Tobías-Manzano A Rivas-Campos A 《International journal of nursing studies》2009,46(2):189-196
Background
The information generated by nurses through standardised nursing languages is insufficiently evaluated and exploited, mainly in home care services, as is its potential impact on outcomes.Objectives
To find out how often nursing diagnoses are made during nursing home care visits, and to explore their relation with use of resources, mortality, institutionalisation and satisfaction.Design
Observational, longitudinal follow-up study.Settings
Home care services delivered by Primary Healthcare Districts in Málaga, Costa del Sol, Almería and Granada, in Spain.Participants
Patients and caregivers who initiated the Home Care Programme.Methods
The accumulated incidence of nursing diagnosis was analysed over 34 months of follow-up. Diagnoses were made by nurse case managers in their daily practice. Several regression models were devised to analyse their linkage with the use of resources, mortality, institutionalisation and satisfaction.Results
Two hundred and forty-seven subjects were included (129 patients and 118 caregivers). 93.8 had been diagnosed (2.8 diagnoses per subject). Risk of caregiver strain and mobility impairment accounted for 40% of total home visits (p = 0.033). Significant differences were observed in the use of physiotherapy and rehabilitation services. The home visits for caregivers were, in 78% of cases, due to the recipient’s baseline functional status. No relation was detected for institutionalisation or for patient satisfaction. There was a higher rate of anxiety diagnosed in the caregiver when the recipient was at greater risk for mortality (RR: 2.08 CI 95%: 1.26-3.42) (p = 0.012).Conclusions
These data confirm results from other studies which find nursing diagnoses to be sound predictors of resources use. Their synergy with other case-mix systems in home care should be investigated. 相似文献12.
13.
Carolina Bottari Clément Dassa Constant Rainville Élisabeth Dutil 《Archives of physical medicine and rehabilitation》2010,91(5):734-742
Bottari C, Dassa C, Rainville C, Dutil É. A generalizability study of the Instrumental Activities of Daily Living Profile.
Objective
To establish generalizability estimates of the Instrumental Activities of Daily Living (IADL) Profile when administered to persons with a moderate or severe traumatic brain injury (TBI) within their home and community environment.Design
Generalizability theory was used to estimate generalizability and dependability coefficients as well as the relative contribution of identified sources of measurement error to total measurement error. Decision studies were used to enable the investigators to determine the optimal measurement design.Setting
The IADL Profile was administered in subjects' homes and community environments.Participants
Convenience sample of adults with a moderate or severe TBI (N=30, aged 16-65y).Interventions
Not applicable.Main Outcome Measures
IADL Profile scores include 6 factor scores (going to the grocery store/shopping for groceries, having a meal with guests/cleaning up, putting on outdoor clothing, obtaining information, making a budget, and preparing a hot meal) and 1 total score.Results
The greatest sources of measurement error were the subject-item interactions (3-random-facet design) and the subject-rater interactions (2-random-facet design). One hundred percent of generalizability coefficients of factor scores indicated acceptable to excellent reliability. Indices of dependability confirmed that 1 evaluator could reliably score the tool on a single occasion after having received a 3-day training workshop.Conclusions
The IADL Profile administered to persons with a moderate or severe TBI provides occupational therapists with a reliable set of measures of IADL independence capable of both capturing and analyzing the complex interactions between personal and environmental factors. 相似文献14.
Julie Bernhardt Karen Borschmann Dominic Crock Keith Hill Anne McGann Mary DeGori 《Physiotherapy》2005,91(4):209-222
Objectives
Following hip fracture, the amount of time an individual spends on their feet (‘uptime’) may be an important marker of recovery. Using an automated device that measured uptime (Uptimer), we aimed to: (1) compare hip fracture patients’ uptime with age- and gender-matched community dwelling older people; (2) identify whether uptime changed during the transition from hospital to home; and (3) examine the relationship between uptime and existing functional measures.Design
Prospective, observational study.Setting
Rehabilitation hospital and community.Participants
Patients undergoing rehabilitation after hip fracture surgery who aimed to return home at the end of rehabilitation, and age- and gender-matched community dwellers.Interventions
Patients received standard care.Main outcome measures
Uptime over 24 hours was measured on three occasions in hip fracture patients: 1 week before, 1 day before and 1 week after discharge home. Uptime over 24 hours was measured once in age- and gender-matched community dwelling older people. Functional mobility, self-reported activity, pain, mood and endurance were also assessed.Results
Thirteen hip fracture patients (mean age 80.4 years) and 13 community dwelling participants completed testing. Once home, hip fracture patients spent 3.4 hours/day (25th, 75th percentiles 2.8, 5.2) upright, while community dwelling healthy older people were upright for 6.5 hours/day (6.1, 8.7). A trend for uptime to increase between hospital and home was observed. Hip fracture uptime at home correlated significantly with self-reported activity, functional mobility and gait endurance (P < 0.05).Conclusions
This study highlighted uptime limitations of hip fracture patients at home. We discuss possible future directions for research using the Uptimer. 相似文献15.
Background
Despite the established benefits of cardiac rehabilitation (CR) in improving health outcomes for people with cardiovascular disease, adherence to regular physical activity at recommended levels remains suboptimal. Self-efficacy has been shown to be an important mediator of health behaviour, including exercise.Objectives
To assess the psychometric properties of Bandura's exercise self-efficacy (ESE) scale in an Australian CR setting.Design
Validation study.Setting
Cardiac rehabilitation.Participants
One hundred and ten patients (Mean: 60.11, S.D.: 10.57 years).Methods
Participants completed a six-minute walk test (6MWT) and Bandura's exercise self-efficacy scale at enrolment and on completion of a 6-week CR program.Results
Bandura's ESE scale had a single factor structure with high internal consistency (0.95), and demonstrated no floor or ceiling effects. A comparison of ESE scores by distance walked on 6MWT indicated those who recorded more than 500 m at baseline had significantly higher ESE scores (Mean: 116.26, S.D.: 32.02 m) than those patients who only achieved up to 400 m on the 6MWT at baseline (Mean: 89.94, S.D.: 29.47 m) (p = 0.044). A positive and significant correlation between the change in scores on the ESE scale and the change in the 6MWT distance (r = 0.28, p = 0.035) was seen.Conclusions
The ESE scale was a robust measure of exercise self-efficacy over the range of patients attending this outpatient cardiac rehabilitation program. Interventions to improve self-efficacy may increase CR patient's efficacy for regular physical activity. 相似文献16.
Ruth J. Dalemans Luc P. de Witte Anna J. Beurskens Wim J. van den Heuvel Derick T. Wade 《Archives of physical medicine and rehabilitation》2010,91(3):395-399
Dalemans RJ, de Witte LP, Beurskens AJ, van den Heuvel WJ, Wade DT. Psychometric properties of the community integration questionnaire adjusted for people with aphasia.
Objectives
To describe the feasibility of the Community Integration Questionnaire (CIQ) adjusted for use in people with aphasia and to report its psychometric properties in people with aphasia (internal consistency, factor analysis, test-retest reliability, convergent validity).Design
A cross-sectional, interview-based psychometric study. Test-retest reliability was evaluated in 20 people (minimal to severe aphasia) by 2 different interviewers within a 2-week period.Setting
Community.Participants
In total 490 stroke survivors with (minimal to severe) aphasia were approached, of which 165 (34%) participants returned the answering letter. Participants (N=150) agreed to take part and were interviewed using a structured interview format.Interventions
Not applicable.Main Outcome Measures
Community Integration Questionnaire (CIQ), Frenchay Aphasia Screening Test, Barthel Index, Dartmouth Coop Functional Health Assessment Charts (COOP)-World Organisation of Family Doctors (WONCA) Charts, Life Satisfaction Questionnaire.Results
A total of 150 stroke survivors with aphasia completed the CIQ adjusted for people with aphasia. The CIQ adjusted for people with aphasia was a feasible instrument. Results showed good internal consistency for the CIQ total (standardized Cronbach α=.75), excellent test-retest reliability (intraclass correlation coefficient=.96), moderate correlations with the Barthel Index, the COOP-WONCA, and the Life Satisfaction Questionnaire with regard to construct validity. Significant relations were found with regard to age and aphasia severity.Conclusions
The CIQ adjusted for people with aphasia seems to be an adequate instrument to assess participation in people with aphasia. 相似文献17.
Mazzini L Campini R Angelino E Rognone F Pastore I Oliveri G 《Archives of physical medicine and rehabilitation》2003,84(11):1637-1641
Mazzini L, Campini R, Angelino E, Rognone F, Pastore I, Oliveri G. Posttraumatic hydrocephalus: a clinical, neuroradiologic, and neuropsychologic assessment of long-term outcome. Arch Phys Med Rehabil 2003;84:1637-41.
Objectives
To detect the clinical and radiologic characteristics of posttraumatic hydrocephalus (PTH), to define its prognostic value, and to assess the effects of shunt surgery.Design
Correlational study on a prospective cohort.Setting
Brain injury rehabilitation center.Participants
One hundred forty patients with severe traumatic brain injury (TBI) referred to an inpatient intensive rehabilitation unit of primary care in a university-based system.Interventions
Not applicable.Main outcome measures
The Glasgow Outcome Scale (GOS), Disability Rating Scale (DRS), FIM™ instrument, and Neurobehavioural Rating Scale (NRS), as well as single-photon emission computed tomography (SPECT) and magnetic resonance imaging.Results
PTH was found in 45% of patients. Risk factors for PTH were as follows: age (P<.04), duration of coma (P<.0001), and decompressive craniectomy (P<.0001). PTH correlated with the degree of hypoperfusion in the temporal lobes (P<.001). Patients who showed clinical deterioration improved after surgery. PTH correlated significantly with GOS, DRS, FIM, and NRS (P<.0001) 1 year after the trauma, and it influenced the appearance of posttraumatic epilepsy (P<.02).Conclusions
PTH concerns about 50% of patients with severe TBI. It influences functional and behavioral outcome and the appearance of posttraumatic epilepsy. The selection of patients for surgery can be defined principally on a clinical basis. SPECT may be helpful for differentiating ventricular enlargement due to cortical atrophy and hydrocephalus. 相似文献18.
Hansen TS Larsen K Engberg AW 《Archives of physical medicine and rehabilitation》2008,89(11):2114-2120
Hansen TS, Larsen K, Engberg AW. The association of functional oral intake and pneumonia in patients with severe traumatic brain injury.
Objectives
To investigate the incidence and onset time of pneumonia for patients with severe traumatic brain injury (TBI) in the early phase of rehabilitation and to identify parameters associated with the risk of pneumonia.Design
Observational retrospective cohort study.Setting
Subacute rehabilitation department in a university hospital in Denmark.Participants
Patients (N=173) aged 16 to 65 years with severe TBI who were admitted during a 5-year period. Patients are transferred to the brain injury unit as soon as they ventilate spontaneously.Interventions
Not applicable.Main Outcome Measure
Pneumonia.Results
Twenty-seven percent of the patients admitted to the brain injury unit were in treatment for pneumonia; pneumonia developed in 12% of the patients during rehabilitation; the condition occurred within 19 days of admission in all but 1 patient. Of these patients, 81% received nothing by mouth. Three factors identified patients at highest risk of pneumonia: Glasgow Coma Scale score less than 9 (1 day after cessation of sedation); Rancho Los Amigos Scale score less than 3 (on admission); and no oral intake on admission. Having a tracheotomy tube and/or feeding tube was also associated with a higher occurrence of pneumonia.Conclusions
Among patients with severe TBI, 27% had pneumonia at transfer from the intensive care unit. Pneumonia developed in only 12% of the participants during rehabilitation. Patients with a low level of consciousness and patients with a tracheotomy tube or feeding tube had a higher likelihood of pneumonia. 相似文献19.
Ripley DL Harrison-Felix C Sendroy-Terrill M Cusick CP Dannels-McClure A Morey C 《Archives of physical medicine and rehabilitation》2008,89(6):1090-1096
Ripley DL, Harrison-Felix C, Sendroy-Terrill M, Cusick CP, Dannels-McClure A, Morey C. The impact of female reproductive function on outcomes after traumatic brain injury.
Objectives
To determine the impact of traumatic brain injury (TBI) on female menstrual and reproductive functioning and to examine the relationships between severity of injury, duration of amenorrhea, and TBI outcomes.Design
Retrospective cohort survey.Setting
Telephone interview.Participants
Women (N=30; age range, 18-45y), between 1 and 3 years postinjury, who had completed inpatient rehabilitation for TBI.Interventions
Not applicable.Main Outcome Measures
Data collected included menstrual and reproductive functioning pre- and postinjury, demographic, and injury characteristics. Outcome measures included the Glasgow Outcome Scale-Extended (GOS-E), the Mayo-Portland Adaptability Inventory-4 (MPAI-4), and the Medical Outcome Study 12-Item Short-Form Health Survey, Version 2 (SF-12v2).Results
The median duration of amenorrhea was 61 days (range, 20-344d). Many subjects' menstrual function changed after TBI, reporting a significant increase in skipped menses postinjury (P<.001) and a trend toward more painful menses (P=.061). More severe TBI, as measured by the duration of posttraumatic amnesia, was significantly predictive of a longer duration of amenorrhea (P=.004). Subjects with a shorter duration of amenorrhea scored significantly better on the SF-12 physical component subscale (P=.004), the GOS-E (P=.05), and the MPAI-4 participation subscale (P=.05) after controlling for age, injury severity, and time postinjury.Conclusions
The severity of TBI was predictive of duration of amenorrhea and a shorter duration of amenorrhea was predictive of better ratings of global outcome, community participation, and health-related quality of life postinjury. 相似文献20.
Marieke R. Benedictus Jacoba M. Spikman Joukje van der Naalt 《Archives of physical medicine and rehabilitation》2010,91(9):1436-1441
Benedictus MR, Spikman JM, van der Naalt J. Cognitive and behavioral impairment in traumatic brain injury related to outcome and return to work.