共查询到20条相似文献，搜索用时 31 毫秒
1.
Jung Hwan Ahn Doo-Hyung Lee Hyuncheol Kang Michael Y. Lee Dae Ryong Kang Seung-Hyun Yoon 《PM & R》2018,10(1):19-27
Background
Intra-articular corticosteroid injection is a commonly used therapy for adhesive capsulitis, but not enough studies exist on the optimal timing of the injection.Objective
To determine whether intra-articular corticosteroid injection has better outcomes in patients with earlier stage than later stage of adhesive capsulitis.Study Design
Retrospective longitudinal studySetting
University-affiliated tertiary care hospital.Participants
Primary adhesive capsulitis patients (n=339) who were unresponsive to at least 1 month of conservative treatment and who had ultrasound-guided corticosteroid injection.Interventions
Not applicable.Main Outcome Measurements
Visual analogue scale, Shoulder Pain and Disability Index, and passive range of motion (flexion, abduction, external rotation, and internal rotation and extension) were evaluated at pretreatment, month 1 and 12 after the first injection.Results
The result of the multiple regressions, which considered the main and the interaction effect of confounding variables, showed that the differences of all outcomes in both short-term effect at month 1 and long-term effect at month 12 are greater when the duration of pain prior to injection is shorter. Among the confounders, the injection number in the difference of internal rotation and extension between month 0 and 12 (IRE Δ(0-12)) was statistically significant. IRE Δ(0-12) was also greater when the pain duration was shorter, though the decrease in IRE Δ(0-12) differed depending on the number of injections.Conclusions
Early injection improves outcomes of adhesive capsulitis at both short- and long-term follow-ups. If pain persists despite non-invasive and conservative treatments, early injection may be considered to shorten its natural history.Level of Evidence
III 相似文献2.
Kelly L.D. Pham Kristie F. Bjornson Marisa Osorio Kathryn B. Whitlock Teresa L. Massagli 《PM & R》2018,10(6):594-600
Background
The incidence of contact isolation for multidrug-resistant organisms is increasing in acute hospitals and inpatient rehabilitation units alike. There is limited evidence on the effect of contact isolation on functional outcomes during inpatient rehabilitation.Objective
To determine whether the use of a modified contact isolation protocol (MCI) resulted in noninferior functional outcomes compared with children without contact isolation (NCI) on inpatient rehabilitation.Design
This is a retrospective noninferiority study.Setting
One academically affiliated pediatric inpatient rehabilitation unit located in a children’s hospital.Patients
All children with any diagnosis admitted to inpatient rehabilitation from January 1, 2007, to December 31, 2014.Methods or Interventions
We compared functional outcomes for 2 groups of children.Main Outcome Measurements
Primary outcome measures included the Functional Independence Measure for Children (WeeFIM) efficiency and the change in the Developmental Functional Quotient (DFQ) for the WeeFIM. Noninferiority margins of 0.63 for the WeeFIM efficiency and 0.092 for the change in DFQ for the WeeFIM were used.Results
There were a total of 949 patients of whom 899 were NCI, 48 MCI, and 2 excluded due to missing information. Patients with MCI had functional outcomes that were noninferior to those with NCI including the WeeFIM efficiency (mean difference 0.002, 95% CI –0.38 to 0.404) and the change in DFQ for the WeeFIM (mean difference –0.05, 95% CI –0.058 to 0.003).Conclusions
The modified contact isolation protocol, having resulted in noninferior functional outcomes in inpatient rehabilitation may provide adequate contact isolation while allowing for noninferior functional outcomes. This may be a guide in the face of an ever-increasing need for contact isolation.Level of Evidence
III 相似文献3.
4.
Alexander J. Bajorek Chloe Slocum Richard Goldstein Jacqueline Mix Paulette Niewczyk Colleen M. Ryan Carla Tierney Hendricks Ross Zafonte Jeffrey C. Schneider 《PM & R》2017,9(1):1-7
Background
A significant proportion of burn injury patients are admitted to inpatient rehabilitation facilities (IRFs). There is increasing interest in the use of functional variables, such as cognition, in predicting IRF outcomes. Cognitive impairment is an important cause of disability in the burn injury population, yet its relationship to IRF outcomes has not been studied.Objective
To assess how cognitive function affects rehabilitation outcomes in the burn injury population.Design
Retrospective study.Setting
Inpatient rehabilitation facilities in the United States.Participants
A total of 5347 adults admitted to an IRF with burn injury between 2002 and 2011.Methods or Interventions
Multivariable regression was used to model rehabilitation outcome measures, using the cognitive domain of the Functional Independence Measure (FIM) instrument as the independent variable and controlling for demographic, medical, and facility covariates.Main Outcome Measurements
FIM total gain, readmission to an acute care setting at any time during inpatient rehabilitation, readmission to an acute care setting in the first 3 days of IRF admission, rate of discharge to the community setting, and length of stay efficiency.Results
Cognitive FIM total at admission was a significant predictor of FIM total gain, length of stay efficiency, and acute readmission at 3 days (P < .05). Cognitive FIM total scores did not have an impact on acute care readmission rate or discharge to the community setting.Conclusions
Cognitive status may be an important predictor of rehabilitation outcomes in the burn injury population. Future work is needed to further examine the impact of specific cognitive interventions on rehabilitation outcomes in this population.Level of Evidence
II 相似文献5.
Heidi Prather Andrew Creighton Chris Sorenson Scott Simpson Maria Reese Devyani Hunt Monica Rho 《PM & R》2018,10(5):455-461
Background
In young and middle-aged adults with and without hip deformity, hip pain receives treatment focused primarily related to hip structure. Because this hip pain may be chronic, these patients develop other coexisting, modifiable disorders related to pain that may go undiagnosed in this young and active population, including insomnia and anxiety.Objective
The objective of this study was to compare assessments of insomnia and anxiety in young and middle-aged adults presenting with hip pain with no greater than minimal osteoarthritis (OA) compared to asymptomatic healthy controls. Comparisons between types of hip deformity and no hip deformity in hip pain patients were performed to assess whether patients with specific hip deformities were likely to have insomnia or anxiety as a cofounding disorder to their hip pain.Design
Prospective case series with control comparison.Setting
Two tertiary university physiatry outpatient clinics.Participants
A total of 50 hip pain patients aged 18-40 years and 50 gender- and age-matched healthy controls.Methods
Patients were enrolled if 2 provocative hip tests were found on physical examination and hip radiographs had no or minimal OA. Radiographic hip deformity measurements were completed by an independent examiner. Comparisons of insomnia and anxiety were completed between 50 hip pain patients and 50 controls and between patients with different types of hip deformity.Main Outcome Measures
Insomnia Severity Index (ISI) and Pain Anxiety Symptoms Scale (PASS).Results
A total of 50 hip pain patients (11 male and 39 female) with mean age of 31.2 ± 8.31 years enrolled. Hip pain patients slept significantly less (P = .001) per night than controls. Patients experienced significantly greater insomnia (P = .0001) and anxiety (P = .0001) compared to controls. No differences were found in insomnia and anxiety scores between hip pain patients with and without hip deformity or between different types of hip deformity.Conclusion
Hip pain patients with radiographs demonstrating minimal to no hip arthritis with and without hip deformity experience significant cofounding yet modifiable disorders of sleep and anxiety. If recognized early in presentation, treatment of insomnia and anxiety ultimately will improve outcomes for hip patients treated either conservatively or surgically for their hip disorder.Level of Evidence
II 相似文献6.
Samman Shahpar Alex W.K. Wong Susan Keeshin Sarah M. Eickmeyer Patrick Semik Masha Kocherginsky Stacy McCarty 《PM & R》2018,10(9):926-933
Background
Malignant brain tumors cause significant impairments in function because of the nature of the disease. Nevertheless, patients with malignant brain tumors can make functional gains equivalent to those with stroke and traumatic brain injury in the inpatient rehabilitation setting. However, the efficacy of outpatient rehabilitation in this population has received little study.Objective
To determine if an interdisciplinary outpatient rehabilitation program will improve functional outcomes in patients with malignant brain tumors.Design
Nonrandomized prospective longitudinal study.Setting
Six affiliated outpatient sites of one institution.Patients
Forty-nine adults with malignant brain tumors were enrolled.Methods
Patients received interdisciplinary therapy services, with duration determined by the therapist evaluations. The therapists scored the Day Rehabilitation Outcome Scale (DayROS) and Disability Rating Scale (DRS) on admission and discharge. The caregivers filled out the DRS at discharge, 1 month, and 3 months after discharge.Main Outcome Measurements
The primary study outcome measure was the DayROS, which is a functional measure similar to the Functional Independence Measure. DRS was another functional outcome measure assessing basic self-care, dependence on others, and psychosocial adaptability.Results
Forty-six of 49 enrolled patients (94%) completed the day rehabilitation program. The average length of stay was 76.9 days. There was a significant improvement in total DayROS (P < .001), mobility (P < .001), Activities of Daily Living ( P < .001), and communication (P < .001) DayROS subscores from admission to discharge. There were no significant changes over time in the DRS scores. Women had higher DayROS gains (P = .003) and better therapist DRS scores from admission to discharge than men (P = .010).Conclusions
Patients with malignant brain tumors can make functional gains in an interdisciplinary outpatient rehabilitation program. This level of care should be considered in this patient population.Level of Evidence
II 相似文献7.
Donna Bergman Lynnette Rasmussen Kate Wan-Chu Chang Lynda J-S. Yang Virginia S. Nelson 《PM & R》2018,10(1):64-71
Background
The term self-determination refers to decision-making, goal setting, and perseverance to achieve those goals. Numerous studies have established the importance of self-determination to enhance learning and improve postschool outcomes. However, most studies evaluate students with learning disabilities, cognitive impairment, or behavioral disabilities. There is an absence of research on self-determination for adolescents with physical disabilities.Objective
To assess self-determination of adolescents with neonatal brachial plexus palsy (NBPP) compared with their typically developing peers via self-reported measures of function.Design
Case-control study.Setting
Brachial plexus clinic.Participants
Twenty adolescents with NBPP (aged 10-17 years) and their parents and 20 age/gender-matched typically developing adolescents and their parents were recruited. Non–English-speaking participants and those with other physical impairments were excluded from study.Methods
Participants completed demographic and American Institutes for Research (AIR) self-determination surveys. One of two designated occupational therapists evaluated participant physical function.Main Outcome Measurements
A demographic survey and AIR self-determination assessment were administered, and active range of motion measurements in shoulder forward flexion, elbow flexion, elbow extension, forearm pronation, and supination were obtained. Grip/pinch strength, MRC muscle strength, 9-Hole Peg Test, and Mallet scale scores also were evaluated.Results
Despite physical differences, adolescents with NBPP presented similar self-determination levels as their typically developing peers. Adolescents with NBPP rated their opportunities to engage in self-determined behaviors at school significantly lower than at home. Both adolescents with NBPP and those in the control group rated their opportunities to engage in self-determined behaviors at school significantly lower than at home.Conclusions
Adolescents with NBPP presented similar self-determination scores as their age/gender-matched typically developing peers. These results could be a reflection of our program’s patient- and family-centered care approach. Therefore, caregivers and providers should encourage personal development and fulfillment in adolescents with NBPP. Teachers and schools should be aware that opportunities for acquiring self-determination skills might be more limited at school than at home in this age group.Level of Evidence
III 相似文献8.
Christian Larivière Dany H. Gagnon Sharon M. Henry Richard Preuss Jean-Pierre Dumas 《PM & R》2018,10(5):483-493
Background
Lumbar stabilization exercise programs (LSEP) produce positive effects on clinical outcomes, but the underlying mechanisms remain relatively unexplored. Psychological and neuromuscular mechanisms can be involved, such as a better activation of the lumbar multifidus, which represents one possibility.Objectives
To determine the following: (1) the effect of an LSEP on lumbar multifidus muscle thickness and activation, as measured with rehabilitative ultrasound imaging (RUSI), in patients with low back pain (LBP); (2) the correlation between RUSI measures and any change in clinical outcomes following the LSEP; and (3) the reliability of RUSI measures in control subjects over 8 weeks.Design
One-arm clinical trial with healthy subjects as a control group; reliability study.Setting
LSEP delivered in a clinical setting; outcomes measured in a laboratory setting.Participants
A total of 34 patients with nonacute LBP and 28 healthy control subjects.Methods
Outcomes were measured before and after an 8-week LSEP in patients with LBP, and at the same time interval (without treatment, to assess reliability) in control subjects.Main Outcome Measurements
Pain numeric rating scale, Oswestry Disability Index (function), as well as RUSI measures for the lumbar multifidus (LM) muscles at 3 vertebral levels (L5-S1, L4-5, and L3-4) during rest (static) and dynamic contractions (percent thickness change).Results
Patients did not show systematic changes in RUSI measures relative to controls, even though RUSI impairments were observed at baseline (dynamic measure at L5-S1) and even though patients had significant improvements in pain and disability. Correlational analyses with these clinical outcomes suggested that patients had reduced muscle thickness at baseline that was associated with a greater reduction in disability following LSEP; however, LM activation measured at baseline showed the opposite. Static RUSI measures showed excellent reliability at the L4-5 and L3-4 levels, whereas dynamic measures were not reliable.Conclusions
Patients showed less muscle activation than controls at baseline (L5-S1 level), but the LSEP did not normalize this impairment. The links between RUSI measures and the change in clinical outcomes during LSEP should be further explored.This clinical trial has been recorded in the International Standard Registered Clinical/soCial sTudy Number (ISRCTN) registry (ID: ISRCTN94152969).Level of Evidence
II 相似文献9.
10.
Francisco Rodriguez-Fontan Nicolas S. Piuzzi Matthew J. Kraeutler Cecilia Pascual-Garrido 《PM & R》2018,10(12):1353-1359
Background
Bone marrow aspirate concentrate (BMC) is one of the few cell-based therapies available as a possible biological treatment for early osteoarthritis (OA). Its efficacy, safety, and benefit compared with other treatments are still to be determined.Objective
To assess the clinical outcomes of patients undergoing intra-articular injection of BMC for the treatment of early knee and hip OA.Design
Prospective, cohort study.Setting
Single institution, quaternary level of care.Patients
Nineteen patients (16 female and 3 male), totaling 25 joints (10 knees, 15 hips), treated with intra-articular BMC for early OA between 2014 and 2016. The mean age at time of the procedure was 58 ± 12.7 years (range, 30-80 years). The mean follow-up was 13.2 ± 6.3 months (range, 6-24 months). Inclusion criteria included ≥18 years; knee OA, Kellgren–Lawrence grade I-II; hip OA, Tönnis grade I-II; first-time intra-articular BMC therapy, after unsuccessful symptomatic and conservative treatments (ie, physical therapy, analgesics and anti-inflammatory drugs) for 6 months. Exclusion criteria included pregnancy; malignancy; rheumatologic diseases; infection; Kellgren–Lawrence grade III-IV; Tönnis grade III; and previous intra-articular injections or surgery.Interventions
All patients had autologous bone marrow aspirate harvested from the iliac crest and centrifuged to achieve BMC, for intra-articular injection.Main Outcome Measurements
The hypothesis was formulated before the study. Patient-reported outcomes measures were assessed preoperatively and at last follow-up using the Western Ontario and McMaster Universities Arthritis Index.Results
Western Ontario and McMaster Universities Arthritis Index improved from a baseline of 40.8 ± 18.3% to 20.6 ± 17% (P < .001) at final follow-up. The satisfaction rate was 63.2%. The minimal clinically important difference threshold of 9.15 points was reached by 64% of the patients. Two patients were converted to total hip arthroplasty at 8 months after BMC injection.Conclusions
Intra-articular injections of BMC for the treatment of early knee or hip OA were safe and demonstrated satisfactory results in 63.2% of patients. Future studies are necessary to determine the efficacy of this technique and its safety profile.Level of Evidence
II 相似文献11.
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12.
Hsiu-Yun Hsu Chia-Wen Ke Ta-Shen Kuan Hsiu-Ching Yang Ching-Liang Tsai Li-Chieh Kuo 《PM & R》2018,10(2):146-153
Background
The presence of subtle losses in hand dexterity after stroke affects the regaining of independence with regard to activities of daily living. Therefore, awareness of ipsilesional upper extremity (UE) function may be of importance when developing a comprehensive rehabilitation program. However, current hand function tests seem to be unable to identify asymptomatic UE impairments.Objectives
To assess the motor coordination as well as the sensory perception of an ipsilesional UE using biomechanical analysis of performance-oriented tasks and conducting a Manual Tactile Test (MTT).Design
Case-controlled study.Setting
A university hospital.Participants
A total of 21 patients with unilateral stroke, along with 21 matched healthy control subjects, were recruited.Methods
Each participant was requested to perform a pinch?holding-up activity (PHUA) test, object-transport task, and reach-to-grasp task via motion capture, as well as the MTT.Main Outcome Measurements
The kinetic data of the PHUA test, kinematics analysis of functional movements, and time requirement of MTT were analyzed.Results
Patients with ipsilesional UE had an inferior ability to scale and produce pinch force precisely when conducting the PHUA test compared to the healthy controls (P < .05). The movement time was statistically longer and peak velocity was significantly lower (P < .05) in the performance-oriented tasks for the ipsilesional UE patients. The longer time requirement in 3 MTT subtests showed that the ipsilesional UE patients experienced degradation in sensory perception (P < .001).Conclusion
Comprehensive sensorimotor assessments based on functional perspectives are valid tools to determine deficits in the sensation-perception-motor system in the ipsilesional UE. Integration of sensorimotor training programs for ipsilesional UE in future neuro-rehabilitation strategies may provide more beneficial effects to regain patients’ motor recovery and to promote daily living activity independence than focusing on paretic arm motor training alone.Level of Evidence
III 相似文献13.
Cameron J.B. Cunningham Heather C. Finlayson William R. Henderson Russell J. O’Connor Andrew Travlos 《PM & R》2018,10(5):494-500
Background
Critical illness polyneuromyopathy (CIPNM) increasingly is recognized as a source of disability in patients requiring intensive care unit (ICU) admission. The prevalence and impact of CIPNM on patients in the rehabilitation setting has not been established.Objectives
To determine the proportion of at-risk rehabilitation inpatients with evidence of CIPNM and the functional sequelae of this disorder.Design
Prospective observational study.Setting
Tertiary academic rehabilitation hospital.Patients
Rehabilitation inpatients with a history of ICU admission for at least 72 hours.Methods
Electrodiagnostic studies were performed to evaluate for axonal neuropathy and/or myopathy in at least one upper and one lower limb.Main Outcome Measurements
The primary outcome was prevalence of CIPNM. Secondary outcomes included Functional Independence Measure (FIM) scores, rehabilitation length of stay (RLOS), and discharge disposition.Results
A total of 33 participants were enrolled; 70% had evidence of CIPNM. Admission FIM score, discharge FIM, FIM gain, and FIM efficiency were 64.1, 89.9, 25.5, and 0.31 in those with CIPNM versus 78.4, 94.6, 16.1, and 0.33 in those without CIPNM, respectively. Average RLOS was 123 days versus 76 days and discharge to home was 57% versus 90% in the CIPNM and non-CIPNM groups, respectively.Conclusions
CIPNM is very common in rehabilitation inpatients with a history of ICU admission. It was associated with a lower functional status at rehabilitation admission, but functional improvement was at a similar rate to those without CIPNM. Longer RLOS stay may be required to achieve the same functional level.Level of Evidence
III 相似文献14.
Bradley F. Thompson Matthew J. Pingree Wenchun Qu Naveen S. Murthy Nirusha Lachman Mark Friedrich Hurdle 《PM & R》2018,10(4):382-390
Background
Ultrasound is rarely used for guiding lumbosacral epidural steroid injections due to its technical limitations. For example, sonographic imaging lacks the ability to confirm epidural spread and identify vascular uptake. The perceived risk that these limitations pose to human subjects has precluded any large scale clinical trials to date.Objective
To compare the accuracy of ultrasound versus fluoroscopic guidance for first sacral transforaminal epidural injections.Design
Cadaveric comparative study using dichotomous outcomes.Setting
A fluoroscopy suite and anatomic laboratory at an academic medical center.Subjects
Four unembalmed adult human cadavers with no history of spinal surgery.Methods
Eight sites were injected twice by one interventionalist, using fluoroscopic and ultrasound guidance. In the fluoroscopy arm, contrast spread was assessed using computed tomography. In the ultrasound arm, latex spread was assessed using gross anatomic dissection. Any visible evidence of epidural spread constituted a positive result.Main Outcome Measurements
Comparison of the success of obtaining epidural contrast flow was the primary outcome measure. Secondary outcome measures included average duration, rate of intravascular uptake, and quantity of intravascular uptake.Results
All injections performed in both the ultrasound arm and the fluoroscopy arm had positive epidural spread. The average duration was 3.03 minutes with fluoroscopy and 4.76 minutes with ultrasound. The rate of intravascular uptake was 37.5% with fluoroscopy and 50% with ultrasound. Within the ultrasound arm, greater intravascular spread and duration variability were recorded.Conclusion
Although ultrasonography can provide reliable image guidance for cannulating the first sacral foramen in cadavers, it would have limited clinical utility due to its inability to visualize relevant neurovascular structures deep to the osseus roof and exclude intravascular uptake.Level of Evidence
IV 相似文献15.
16.
Nobushige Takahashi Hidetoshi Takahashi Osamu Takahashi Ryosuke Ushijima Rie Umebayashi Junji Nishikawa Yasutomo Okajima 《PM & R》2018,10(2):168-174
Background
Spasticity is a common sequela of upper motor neuron pathology, such as cerebrovascular diseases and cerebral palsy. Intervention for spasticity of the ankle plantarflexors in physical therapy may include tone-inhibiting casting and/or orthoses for the ankle and foot. However, the physiological mechanism of tone reduction by such orthoses remains unclarified.Objective
To investigate the electrophysiologic effects of tone-inhibiting insoles in stroke subjects with hemiparesis by measuring changes in reciprocal Ia inhibition (RI) in the ankle plantarflexor.Design
An interventional before–after study.Setting
Acute stroke unit or ambulatory rehabilitation clinic of a university hospital in Japan.Participants
Ten subjects (47-84 years) with hemiparesis and 10 healthy male control subjects (31-59 years) were recruited.Methods
RI of the spastic soleus in response to the electrical stimulation of the deep peroneal nerve was evaluated by stimulus-locked averaging of rectified electromyography (EMG) of the soleus while subjects were standing.Main Outcome Measurements
The magnitude of RI, defined as the ratio of the lowest to the baseline amplitude of the rectified EMG at approximately 40 milliseconds after stimulation, was measured while subjects were standing with and without the tone-inhibiting insole on the hemiparesis side.Results
Enhancement of EMG reduction with the tone-inhibiting insole was significant (P < .05) in the subjects with hemiparesis, whereas no significant changes were found in controls.Conclusion
Tone-inhibiting insoles enhanced RI of the soleus in subjects after stroke, which might enhance standing stability by reducing unfavorable ankle plantarflexion tone.Level of Evidence
III 相似文献17.
Background
Ideally, high-stakes examinations assess 1 dimension of medical knowledge to produce precise estimates of a candidate’s performance. It has not been reported whether the American Board of Physical Medicine and Rehabilitation Part 1 Certification Examination (ABPMR-CE-1) is unidimensional or not.Objective
To examine the ABPMR-CE-1 to measure how many dimensions it assesses.Design
Retrospective observational study.Setting
We assessed examination results from the 2015 ABPMR-CE-1.Participants
A total of 489 deidentified candidates taking the 2015 ABPMR-CE-1.Methods
A 1-parameter Item Response Theory (IRT) measurement model was utilized. A Principal Components Analysis (PCA) of standardized residual correlations was used to detect multidimensionality.Main Outcome Measure
Number of primary dimensions reflected in the 325 test questions.Results
The results of the dimensionality analysis indicated that the ABPMR-CE-1 examination is highly unidimensional from a psychometric perspective. Expert content review of the substantive content of small contrasting clusters of questions provided additional assurance of the unidimensional nature of the examination.Conclusions
The ABPMR-CE-1 appears indeed to measure a single construct, which suggests a sound structure of the examination. It closely approximates the assumption of statistical unidimensionality.Level of Evidence
Not applicable. 相似文献18.
19.
Background
Mild traumatic brain injury (mTBI) can have long-term cognitive and functional consequences, and recent mTBI has been associated with impaired performance on measures related to driving ability. However, it remains unclear whether mTBI history is associated with poorer driving performance.Objective
To examine the longer-term effects of mTBI on self-reported driving ability.Design
Retrospective cross-sectional study.Setting
Online.Participants
Three hundred eighty-nine participants (169 who reported an mTBI history and 220 without an mTBI history).Intervention
Comparing participants who report a history of mTBI with those who do not report a history of mTBI.Outcomes
Self-report measures of mTBI history, frequency of aberrant driving behaviors, recent history of car accidents and citations, and previous psychological diagnoses and current symptoms.Results
Participants with a history of mTBI reported an overall higher frequency of aberrant driving behaviors and committing more driving violations that risked the safety of others than comparison participants. Participants with mTBI also were more likely to have been involved in a car accident within the past 6 months and the past 3 years. Of participants with mTBI, reports of driving violations decreased with longer time since the most recent injury. Driving violations and crash risk also decreased with increased age and years of driving experience.Conclusions
Individuals with a history of mTBI are more likely to deliberately drive in a manner that risks the safety of others and are at a heightened risk of being involved in a recent car crash. Future work should examine predictor variables in greater depth and incorporate performance-based measures of driving ability to further explore these topics.Level of Evidence
III 相似文献20.
Hyun-Mi Oh Geun-Young Park Young Min Choi Hyung Jung Koo Yongjun Jang Sun Im 《PM & R》2018,10(8):789-797