Physiotherapy approach in stroke rehabilitation: Development and testing of a survey of current practice

2021 ◽  
pp. 1-9
Author(s):  
Francesco Ferrarello ◽  
Lorenzo Capolli ◽  
Suchi Kader ◽  
Mauro Di Bari
Keyword(s):  
Stroke Rehabilitation ◽  
Intraclass Correlation ◽  
Questionnaire Development ◽  
Assistive Device ◽  
Cognitive Interviewing ◽  
Time Interval ◽  
Educational Strategies ◽  
Clinical Practices ◽  
Policy Makers ◽  
Methodological Considerations

BACKGROUND AND PURPOSE: Physiotherapy is a key discipline in stroke rehabilitation. Physiotherapists sometimes select interventions following personal preference rather than a scientific rational. Data on physiotherapy approaches used in stroke rehabilitation may help policy makers and educators to plan education strategies and implement efficient clinical practices, thus improving rehabilitation effectiveness. We aimed to develop and test a questionnaire designed to survey physiotherapy interventions utilized in stroke rehabilitation. METHODS: We used a multistep questionnaire development method (literature review and synthesis; questionnaire drafting; expert validation; cognitive interviewing). Afterwards the survey proceeded to reliability testing; the outcomes of interest were completion time, estimated comprehensiveness of the lists of interventions, and intraclass correlation coefficient (ICC). RESULTS AND DISCUSSION: Retrieved survey tools, their items, and a taxonomy were useful for the questionnaire development. We interviewed four experts; changes were made to the survey following their suggestions. Thirteen physiotherapists participated in cognitive interviewing and further changes were made. Thirty-five raters participated in the test-retest study. Most participants considered the list of physiotherapy interventions and assistive device exhaustive. Median compilation time and time interval between the two compilations were 7 minutes and 21 days. The observed ICC was 0.844 (95% confidence interval, 0.829/0.857). Our method provided a valid and reliable questionnaire, however further methodological considerations of sampling methods and contact delivery modes are needed. CONCLUSIONS: If adequately implemented, the questionnaire can provide information about interventions utilized in stroke rehabilitation practice by physiotherapists. Data eventually acquired could be useful for planning educational strategies and implementing effective clinical practices.

Psychometric Comparisons of 2 Versions of the Fugl-Meyer Motor Scale and 2 Versions of the Stroke Rehabilitation Assessment of Movement

2008 ◽  
Vol 22 (6) ◽  
pp. 737-744 ◽  
Author(s):  
I-Ping Hsueh ◽  
Miao-Ju Hsu ◽  
Ching-Fan Sheu ◽  
Su Lee ◽  
Ching-Lin Hsieh ◽  
...  
Keyword(s):  
Stroke Rehabilitation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Stroke Patients ◽  
Chronic Patients ◽  
Retest Reliability ◽  
Intraclass Correlation Coefficients ◽  
Mild Stroke ◽  
Test Retest Reliability ◽  
Rehabilitation Assessment

Objective. To provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM). Methods. For the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions. Results. Only the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho ≥ .91) and satisfactory predictive validity (rho = .72-.77). The scales showed responsiveness (effect size d ≥ 0.34; standardized response mean ≥ 0.95; P < .0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients ≥ .96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results. Conclusions. The 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.

scholarly journals ADAPT study: adaptation of evidence-informed complex population health interventions for implementation and/or re-evaluation in new contexts: protocol for a Delphi consensus exercise to develop guidance

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e038965
Author(s):  
Mhairi Campbell ◽  
Graham Moore ◽  
Rhiannon E Evans ◽  
Dmitry Khodyakov ◽  
Peter Craig
Keyword(s):  
Population Health ◽  
Expert Opinion ◽  
Health Interventions ◽  
Institutional Research ◽  
Delphi Consensus ◽  
Policy Makers ◽  
Delphi Exercise ◽  
Complex Population ◽  
Methodological Considerations ◽  
The University

IntroductionComplex population health interventions that are effective in one context may not be effective elsewhere, and may even be harmful. As such, an intervention may require adaptation to ensure it fits with a new context. To date, there is no overarching guidance to help researchers to adapt and evaluate interventions in new contexts, and no criteria to support research funders or journals assess proposed or reported adaptations or evaluation. There is limited assistance for policy-makers and practitioners to decide if evidence-informed interventions are appropriate to their context, or if adaptation and further evaluation is needed. This Delphi exercise will contribute to the development of guidance for these communities to support the adaptation, implementation and/or re-evaluation of complex population health interventions in new contexts.MethodsWe will conduct a Delphi consensus exercise to gather expert opinion from researchers, research funders, journal editors and policy-makers. Expert opinion will be sought on: appropriate definitions and concepts, identifying key methodological considerations and establishing adaptations and processes to be undertaken during adaptation of complex population health interventions in new contexts.Ethics and disseminationEthics approval for the Delphi exercise has been obtained from the University of Glasgow and and the RAND institutional research board. Dissemination of the results of this study will be through peer-reviewed publications, workshops at national and international conferences, and a summary of the guidance developed for key organisations and stakeholders.

scholarly journals Tinnitus healthcare: a survey revealing extensive variation in opinion and practices across Europe

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e029346 ◽  
Author(s):  
Rilana F F Cima ◽  
Dimitris Kikidis ◽  
Birgit Mazurek ◽  
Haúla Haider ◽  
Chistopher R Cederroth ◽  
...  
Keyword(s):  
Health Service ◽  
Clinical Guideline ◽  
Treatment Options ◽  
Clinical Problem ◽  
Service Evaluation ◽  
European Countries ◽  
Clinical Practices ◽  
Policy Makers ◽  
Evaluation Survey ◽  
Health Service Evaluation

Tinnitus remains a scientific and clinical problem whereby, in spite of increasing knowledge on effective treatment and management for tinnitus, very little impact on clinical practice has been observed. There is evidence that prolonged, obscure and indirect referral trajectories persist in usual tinnitus care.ObjectiveIt is widely acknowledged that efforts to change professional practice are more successful if barriers are identified and implementation activities are systematically tailored to the specific determinants of practice. The aim of this study was to administer a health service evaluation survey to scope current practice and knowledge of standards in tinnitus care across Europe. The purpose of this survey was to specifically inform the development process of a European clinical guideline that would be implementable in all European countries.DesignA health service evaluation survey was carried out.SettingThe survey was carried out online across Europe.ParticipantsClinical experts, researchers and policy-makers involved in national tinnitus healthcare and decision-making.Outcome measuresA survey was developed by the study steering group, piloted on clinicians from the TINNET network and underwent two iterations before being finalised. The survey was then administered to clinicians and policy-makers from 24 European countries.ResultsData collected from 625 respondents revealed significant differences in national healthcare structures, use of tinnitus definitions, opinions on characteristics of patients with tinnitus, assessment procedures and particularly in available treatment options. Differences between northern and eastern European countries were most notable.ConclusionsMost European countries do not have national clinical guidelines for the management of tinnitus. Reflective of this, clinical practices in tinnitus healthcare vary dramatically across countries. This equates to inequities of care for people with tinnitus across Europe and an opportunity to introduce standards in the form of a European clinical guideline. This survey has highlighted important barriers and facilitators to the implementation of such a guideline.

scholarly journals Qualitative Interviewing: Testing Health Surveys Among Vietnam War Veterans at the Age of 70 Years

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983269
Author(s):  
April S. Fales ◽  
Yasmin S. Cypel ◽  
Marsha E. Dunn ◽  
Ann L. Truelove ◽  
Erick K. Ishii ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Vietnam War ◽  
Questionnaire Development ◽  
Usability Testing ◽  
Cognitive Interviewing ◽  
Item Recall ◽  
Subject Recruitment ◽  
Vietnam Era ◽  
Stage 1 ◽  
Two Stages

The Vietnam Era Health Retrospective Observational Study (VE-HEROeS) is a nationwide study designed to compare the health of U.S. Vietnam era veterans to age- and sex-matched U.S. residents. Two self-administered mail questionnaires, one for veterans and the other for the U.S. nonmilitary population, were developed using already validated and newly developed items. A pretest was conducted to evaluate item recall and comprehension, new-item response validity, and the overall survey experience (usability of survey materials including the screener questionnaire for nonveterans). Subject recruitment was completed using convenience sampling and a $50 incentive. Cognitive interviewing and usability interviewing, two qualitative research methods, were implemented. Interviews were conducted in two stages (Stage 1, cognitive interviewing, n = 12; Stage 2, usability testing, n = 8) by three experienced methodologists. Concurrent probing techniques, unscripted probes, and retroactive probing were used to elicit response from 14 veterans and six nonveterans (mostly male, White, and aged 65-70 years). Information about the overall survey process was also obtained through observation during usability testing. Results signify that qualitative research is an important part of questionnaire development targeting older veterans due to issues involving comprehension, interpretability, and recall.

scholarly journals Application of artificial neural networks to predict the COVID-19 outbreak

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Hamid Reza Niazkar ◽  
Majid Niazkar
Keyword(s):  
Neural Networks ◽  
Artificial Neural Networks ◽  
Incubation Period ◽  
Prediction Models ◽  
Time Interval ◽  
Policy Makers ◽  
Ann Models ◽  
Artificial Neural ◽  
Relative Errors ◽  
Mean Square Errors

Abstract Background Millions of people have been infected worldwide in the COVID-19 pandemic. In this study, we aim to propose fourteen prediction models based on artificial neural networks (ANN) to predict the COVID-19 outbreak for policy makers. Methods The ANN-based models were utilized to estimate the confirmed cases of COVID-19 in China, Japan, Singapore, Iran, Italy, South Africa and United States of America. These models exploit historical records of confirmed cases, while their main difference is the number of days that they assume to have impact on the estimation process. The COVID-19 data were divided into a train part and a test part. The former was used to train the ANN models, while the latter was utilized to compare the purposes. The data analysis shows not only significant fluctuations in the daily confirmed cases but also different ranges of total confirmed cases observed in the time interval considered. Results Based on the obtained results, the ANN-based model that takes into account the previous 14 days outperforms the other ones. This comparison reveals the importance of considering the maximum incubation period in predicting the COVID-19 outbreak. Comparing the ranges of determination coefficients indicates that the estimated results for Italy are the best one. Moreover, the predicted results for Iran achieved the ranges of [0.09, 0.15] and [0.21, 0.36] for the mean absolute relative errors and normalized root mean square errors, respectively, which were the best ranges obtained for these criteria among different countries. Conclusion Based on the achieved results, the ANN-based model that takes into account the previous fourteen days for prediction is suggested to predict daily confirmed cases, particularly in countries that have experienced the first peak of the COVID-19 outbreak. This study has not only proved the applicability of ANN-based model for prediction of the COVID-19 outbreak, but also showed that considering incubation period of SARS-COV-2 in prediction models may generate more accurate estimations.

scholarly journals Detectable Changes in Physical Performance Measures in Elderly African Americans

2010 ◽  
Vol 90 (6) ◽  
pp. 921-927 ◽  
Author(s):  
Kathleen Kline Mangione ◽  
Rebecca L. Craik ◽  
Alyson A. McCormick ◽  
Heather L. Blevins ◽  
Meaghan B. White ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Intraclass Correlation ◽  
Assistive Device ◽  
Minimal Detectable Change ◽  
6Mwt Distance ◽  
African American Older Adults

Background African American older adults have higher rates of self-reported disability and lower physical performance scores compared with white older adults. Measures of physical performance are used to predict future morbidity and to determine the effect of exercise. Characteristics of performance measures are not known for African American older adults. Objective The purpose of this study was to estimate the standard error of measurement (SEM) and minimal detectable change (MDC) for the Short Physical Performance Battery (SPPB), Timed “Up & Go” Test (TUG) time, free gait speed, fast gait speed, and Six-Minute Walk Test (6MWT) distance in frail African American adults. Design This observational measurement study used a test-retest design. Methods Individuals were tested 2 times over a 1-week period. Demographic data collected included height, weight, number of medications, assistive device use, and Mini-Mental Status Examination (MMSE) scores. Participants then completed the 5 physical performance tests. Results Fifty-two participants (mean age=78 years) completed the study. The average MMSE score was 25 points, and the average body mass index was 29.4 kg/m2. On average, participants took 7 medications, and the majority used assistive devices. Intraclass correlation coefficients (ICC [2,1]) were greater than .90, except for the SPPB score (ICC=.81). The SEMs were 1.2 points for the SPPB, 1.7 seconds for the TUG, 0.08 m/s for free gait speed, 0.09 m/s for fast gait speed, and 28 m for 6MWT distance. The MDC values were 2.9 points for the SPPB, 4 seconds for the TUG, 0.19 m/s for free gait speed, 0.21 m/s for fast gait speed, and 65 m for 6MWT distance. Limitations The entire sample was from an urban area. Conclusions The SEMs were similar to previously reported values and can be used when working with African American and white older adults. Estimates of MDC were calculated to assist in clinical interpretation.

scholarly journals Reliability Measurement of Corneal Wavefront Aberrations using Corneal Videokeratograph Atlas 9000

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Noorshazana Mat Rejab @ Md Rejab ◽  
Mohd Radzi Hilmi ◽  
Khairidzan Mohd Kamal ◽  
Md Muziman Syah Md Mustafa
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Spherical Aberration ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Time Interval ◽  
Wavefront Aberration ◽  
Wavefront Aberrations ◽  
The Mean ◽  
Reliability Measurement

Introduction: Accurate corneal wavefront aberration measurements are essential in determining patient’s suitability, vision outcomes and patient satisfaction in laser refractive surgeries. This study aimed to evaluate the reliability measurement of higher-order aberration (HOA) using corneal videokeratograph Atlas 9000. Materials and method:  38 eyes of 19 participants were recruited in this study. Comprehensive eye examination was done to ensure all participants eligibility, and any conditions in which obstruct the central cornea were excluded. Corneal wavefront aberrations were measured based on Zernike polynomials. In assessing repeatability, three repetitive measurements in five minutes in a single session were taken by 2 experience examiners. For reproducibility measurement, similar approach was done with the time-interval between measurements was set at one week. Bland-Altman, limits of agreement (LoA) and intraclass correlation coefficients (ICCs) were used to evaluate the reliability measurement. Results: Bland-Altman and LoA findings revealed no significant differences for both repeatability and reproducibility measurement. For repeatability testing, the mean differences for vertical trefoil, oblique trefoil and spherical aberration were -0.096 ± 0.493, 0.001 ± 0.048, 0.008 ± 0.035, 0.004 ± 0.029, 0.010 ± 0.053 with LoA of 1.930, 0.188, 0.138, 0.114, and 0.208 respectively. Intraclass correlation coefficient (ICC) excellent reliability of 0.841 for all parameters. Likewise, reproducibility  testing showed similar findings  with the mean difference were -0.018 ± 0.091, 0.016 ± 0.061, -0.0004 ± 0.036, -0.002 ± 0.042, 0.003 ± 0.026, with LoA of 0.356, 0.24, 0.141,0.164, and 0.102 respectively. Intraclass correlation coefficient (ICC) shows excellent reliability of more than 0.9 for all parameters. LoA of less than 1.0 were observed in all measurements (except for repeatability of vertical trefoil) indicates high consistency of the measurements. Conclusions: Corneal videokeratograph Atlas 9000 provides excellent HOA measurement reliability.

Sign in / Sign up

Export Citation Format

Share Document