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Mention de date : 2019
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Dépouillements
Ajouter le résultat dans votre panierA Cost-Effectiveness Analysis of a Randomized Control Trial of a Tailored, Multifactorial Program to Prevent Falls Among the Community-Dwelling Elderly / David B. Matchar in Archives of Physical Medicine and Rehabilitation, Vol. 100, n° 1 (2019)
Titre : A Cost-Effectiveness Analysis of a Randomized Control Trial of a Tailored, Multifactorial Program to Prevent Falls Among the Community-Dwelling Elderly Type de document : Article Auteurs : David B. Matchar ; Kirsten Eom ; Pamela W. Duncan Année de publication : 2019 Article en page(s) : p. 1-8 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptationMots-clés : Costs and Cost Analysis Coûts et analyse des coûts Accidental Falls Chutes accidentelles Randomized controlled trial Essai contrôlé randomisé Résumé : Objective
To perform a cost-effectiveness analysis of a multifactorial, tailored intervention to reduce falls among a heterogeneous group of high-risk elderly people.
Design
Randomized control trial.
Settings
Communities.
Participants
Adults aged at least 65 years (N=354) seen at the emergency department (ED) for a fall or fall-related injury and discharged home.
Interventions
The intervention group received a tailored program of physical therapy focused on progressive training in strength, balance, and gait for a period of 3 months. They also received screening and referrals for low vision, polypharmacy, and environmental hazards. The Short Physical Performance Battery (SPPB) test was assessed at regular intervals to allocate participants into either a home-based or group center-based program. The control group received usual care prescribed by a physician and educational materials on falls prevention.
Main Outcome Measures
The incremental cost-effectiveness ratio (ICER) over the 9-month study period based on intervention costs and utility in terms of quality-adjusted life years (QALYs) calculated from EuroQol-5D scores.
Results
The ICER was 120,667 Singapore dollars (S$) per QALY gained (S$362/0.003 QALYs), above benchmark values (S$70,000). However, the intervention was more effective and cost-saving among those with SPPB scores of greater than 6 at baseline, higher cognitive function, better vision and no more than 1 fall in the preceding 6 months. The intervention was also cost-effective among those with 0-1 critical comorbidities (S$22,646/QALY).
Conclusion
The intervention was, overall, not cost-effective, compared to usual care. However, the program was cost-effective among healthier subgroups, and even potentially cost-saving among individuals with sufficient reserve to benefit.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119120
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 1-8[article]
Titre : Effects of a Patient-Centered Graded Exposure Intervention Added to Manual Therapy for Women With Chronic Pelvic Pain: A Randomized Controlled Trial Type de document : Article Auteurs : José Ariza-Mateos ; Irene Cabrera-Martos ; Araceli Ortiz-Rubio Année de publication : 2019 Article en page(s) : p. 9-16 Langues : Anglais (eng) Descripteurs : HE Vinci
Activités de la vie quotidienne ; Douleur chronique ; Peur ; Rééducation et réadaptationMots-clés : Activities of daily living Chronic pain Fear Women Femmes Résumé : Objective
To explore the effects of a 6-week patient-centered graded exposure intervention added to manual therapy in women with chronic pelvic pain (CPP) and fear of movement/(re)injury.
Design
Prospective 3-armed randomized controlled trial.
Setting
Faculty of Health Sciences.
Participants
A total of 49 women with CPP and substantial fear of movement were randomly allocated to 1 of 3 groups: (1) patient-centered graded exposure intervention added to manual therapy; (2) manual therapy; (3) control group.
Interventions
The 6-week intervention consisted of 12 sessions in the group receiving manual therapy and 6 additional sessions of graded exposure therapy in the group receiving both interventions.
Main Outcome Measures
Primary outcomes were fear-avoidance behavior assessed using the Fear-Avoidance Beliefs Questionnaire and pain interference and severity evaluated with the Brief Pain Inventory. The secondary outcome was disability evaluated with the Oswestry Disability Index. All the variables were assessed in a blinded manner at baseline, after the treatment, and at 3-month follow-up.
Results
Our results show interaction effects (P<.05 for all the outcomes. graded exposure added to manual therapy is distinctly superior alone in maintaining improvements long-term fear-avoidance behavior and physical functioning.> Conclusions
Graded exposure added to manual therapy is a promising approach with long-term effects for women with CPP and fear of movement/(re)injury.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119121
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 9-16[article]
Titre : Efficacy of Internet-Delivered Mindfulness for Improving Depression in Caregivers of People With Spinal Cord Injuries and Chronic Neuropathic Pain: A Randomized Controlled Feasibility Trial Type de document : Article Auteurs : Jasmine Heath Hearn ; Imogen Cotter ; Katherine Anne Finlay Année de publication : 2019 Article en page(s) : p. 17-25 Langues : Anglais (eng) Descripteurs : HE Vinci
Anxiété ; Education ; Méditation ; Qualité de vie ; Rééducation et réadaptationMots-clés : Anxiety Quality of life Telemedicine Résumé : Objectives
To explore the feasibility and efficacy of web-based mindfulness training for carers of people with spinal cord injury (SCI).
Design
Randomized controlled feasibility study with 3-month follow-up.
Setting
Community setting.
Participants
Spouses or family caregivers (N=55) of people with SCI and chronic neuropathic pain were recruited via the direct care team and advertisements. Participants were older than 18 years (no upper age limit), with Internet access for the duration of the study. Participants were randomly allocated to an 8-week online mindfulness training intervention (n=28), or to receive 8 weeks of psychoeducational materials on SCI and chronic pain (n=27).
Interventions
An established web-based, mindfulness training course was delivered over 8 weeks. Participants completed 10 minutes of mindfulness practices, twice per day, 6 days per week, totaling 960 minutes. The control group received a weekly e-mail with psychoeducational materials (based on the established elements) on SCI and pain for 8 weeks.
Main Outcome Measure
Depression severity.
Results
Mindfulness reduced depression severity more than psychoeducation at T2 (mean difference= −.891; 95% confidence interval,−1.48 to −.30) and T3 (mean difference=−1.96; 95% confidence interval, −2.94 to −.97). Mindfulness training also reduced anxiety at T2 (mean difference=−.888; 95% confidence interval, −1.40 to −.38) and T3 (mean difference=−2.44; 95% confidence interval, −3.20 to −1.69).
Conclusions
Results indicate that Internet-delivered mindfulness training offers unique benefits and is viable for caregivers of people with SCI and chronic neuropathic pain. Further work should explore the feasibility of combined education and mindfulness training incorporating both patient and caregiver, for optimum benefit.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119122
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 17-25[article]
Titre : Effects of Electromechanical Exoskeleton-Assisted Gait Training on Walking Ability of Stroke Patients: A Randomized Controlled Trial Type de document : Article Auteurs : Yeon-Gyo Nam ; Jin Won Lee ; Jin-Woo Park Année de publication : 2019 Article en page(s) : p. 26-31 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Rééducation et réadaptationMots-clés : Gait Démarche Exoskeleton device Dispositif d'exosquelette Stroke Résumé : Objective
To assess the efficacy of electromechanical exoskeleton-assisted gait training on walking ability of stroke patients based on ambulatory function, muscle strength, balance, gait speed, and capacity.
Design
Randomized controlled trial.
Setting
University rehabilitation hospital.
Participants
Individuals (N=40) with stroke who could stand alone.
Interventions
Patients were randomly assigned to control and experimental groups. The control group underwent physical therapist-assisted gait training by conventional method. The experimental group underwent electromechanical gait training assisted by an exoskeleton device. Both types of gait training were performed for 30 minutes each day. The therapeutic interventions were provided for 5 days a week for a period of 4 weeks in both groups.
Main Outcome Measures
Functional ambulatory category (FAC) before and after gait training. Changes in FAC were the primary outcomes to evaluate the efficacy of electromechanical exoskeleton-assisted gait training. Changes in mobility, walking speed, walking capacity, leg muscle strength, daily activity, and balance were secondary outcomes.
Results
FAC in the control group was 2.44+1.55 in the pretraining and 2.75+1.53 in the post-training. FAC in the experimental group was 3.22+1.31 in the pretraining and 3.78+1.44 in the post-training. Although FAC between pre- and post-training sessions improved in both groups, the changes in FAC were statistically significant in the experimental group alone. Most secondary outcomes in both groups also showed improvement after gait training. However, the differential outcomes were not varied between the 2 groups after adjusting the data for age and stroke duration. We did not exclude patients based on time since stroke onset. The average stroke duration was 530.11+389.21 days in the experimental group. The changes in FAC of the experimental group were negatively correlated with stroke duration. No adverse events were noticed during gait training in either group.
Conclusions
Electromechanical exoskeleton-assisted gait training is as effective as conventional gait training by a physical therapist when administered by a gait trainer. As an overground walking system without harness, electromechanical exoskeleton replaced a physical therapist in assisted gait training for patients who stand alone. Because the ambulatory function of stroke patients was affected negatively by stroke duration, the effect of electromechanical-assisted gait training might decline with increased stroke duration.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119123
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 26-31[article]
Titre : Inadequate Postoperative Energy Intake Relative to Total Energy Requirements Diminishes Acute Phase Functional Recovery From Hip Fracture Type de document : Article Auteurs : Tatsuro Inoue ; Shogo Misu ; Toshiaki Tanaka Année de publication : 2019 Article en page(s) : p. 32-38 Langues : Anglais (eng) Descripteurs : HE Vinci
Activités de la vie quotidienne ; Ration calorique ; Rééducation et réadaptationMots-clés : Activities of daily living Energy intake Hip fractures Fractures de la hanche Résumé : Objective
To investigate whether postoperative voluntary energy intake (EI) affects functional recovery with hip fracture during the acute phase.
Design
Prospective cohort study.
Setting
Three acute care hospitals.
Participants
Hip fracture patients (N=200) who were consecutively admitted to 3 acute hospitals because of falling.
Interventions
Not applicable.
Main Outcome Measures
Patients were stratified into 3 groups based on the ratio of measured EI to estimated total energy expenditure (TEE) as inadequate (EI/TEE Results
The median hospital stay was 24 days. The inadequate group comprised 73 (36.5%) patients (median EI/TEE, 0.54; interquartile range, 0.42-0.64); intermediate group comprised 92 (46.0%) patients (median EI/TEE, 0.87; interquartile range, 0.78-0.94), and adequate group comprised 35 (17.5%) patients (median EI/TEE, 1.10; interquartile range, 1.04-1.15). Absolute functional gain (AFG) and efficiency of motor FIM gain (EFG) scores were higher in the adequate group than in the others (P<.01 after adjustment for potential confounders a significant association between postoperative ei group and logarithm of efg scores was observed to persist standardized reference: adequate p="0.03;" r2 the entire model="0.25).<br"> Conclusions
Postoperative EI that is less than 70% of TEE diminishes functional recovery with hip fracture.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119124
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 32-38[article]
Titre : Building a Rehabilitative Care Measurement Instrument to Improve the Patient Experience Type de document : Article Auteurs : Josephine McMurray ; Heather McNeil ; Alicia Gordon Année de publication : 2019 Article en page(s) : p. 39-44 Langues : Anglais (eng) Descripteurs : HE Vinci
Enquêtes sur les soins de santé ; Mesures des résultats rapportés par les patients (PROM) ; Rééducation et réadaptationMots-clés : Health care evaluation mechanisms Mécanismes d'évaluation des soins de santé Health care surveys Patient reported outcome measures Résumé : Objective
To develop and test face and content validity, and user interface design of a rehabilitative care patient experience measure.
Design
Mixed methods, cross-sectional validation study that included subject matter expert input. Cognitive interviewing tested user interface and design.
Setting
Outpatient rehabilitative care settings.
Participants
Subject matter experts (n=3), health care providers (n=137), and patients and caregivers (n=5) contributed to the question development. Convenience and snowball sampling were used to recruit rehabilitative care patients postdischarge (n=9) for cognitive interviews to optimize survey design and user interface (N=154).
Interventions
Not applicable.
Main Outcome Measure
This novel survey instrument measures 6 concepts previously identified as key to outpatient rehabilitative care patients’ experience: ecosystem issues, client and informal caregiver engagement, patient and health care provider relations, pain and functional status, group and individual identity, and open-ended feedback.
Results
502 survey questions from psychometrically tested instruments, secondary data from a related ethnographic study, and consultations with health care providers, patients, caregivers, and subject matter experts, were analyzed to create a 10-item questionnaire representing 6 key constructs that influence patient experience quality. Cognitive interviewing with 9 patients (3 rounds of 3 participants each), produced 3 progressively edited versions of the survey instrument. A final version required no further modifications.
Discussion
Rehabilitative care clients have characteristics that differentiate their experience from that of other sectors and patient groups, warranting a distinct experience measure. The survey instrument includes a parsimonious set of questions that address strategic issues in the ongoing improvement of care delivery and the patient experience in the rehabilitative care sector.
Conclusion
The rehabilitative care patient experience survey instrument developed has an acceptable user interface, and content and face validity. Psychometric testing of the survey instrument is reported elsewhere.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119125
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 39-44[article]
Titre : Measuring the Reliability and Construct Validity of the Pediatric Evaluation of Disability Inventory–Computer Adaptive Test (PEDI-CAT) in Children With Cerebral Palsy Type de document : Article Auteurs : Benjamin J. Shore ; Benjamin G. Allar ; Patricia E. Miller Année de publication : 2019 Article en page(s) : p. 45-51 Langues : Anglais (eng) Descripteurs : HE Vinci
Etudes de validation ; Paralysie cérébrale ; Rééducation et réadaptationMots-clés : Cerebral palsy Validation studies Résumé : Objective
The purpose of this study was to (1) investigate the construct validity and (2) test-retest reliability of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) in children with cerebral palsy (CP).
Design
A prospective convenience cross-sectional sample.
Setting
Multidisciplinary CP clinic in a tertiary level pediatric children’s hospital.
Participants
English- and Spanish-speaking school-aged children (N=101) with a diagnosis of CP, stratified by Gross Motor Function Classification System level, who presented to our multidisciplinary clinic. Participants were excluded if they underwent recent surgery ( Main Outcome Measures
Convergent and divergent validity were evaluated using Spearman correlation coefficient analysis; test-retest reliability was assessed using intraclass correlation coefficients (ICCs).
Results
Mean age was 12+3.7 years. Convergent validity was established between Mobility (PEDI-CAT) and Functional Mobility Scale (FMS) (5 m, r=0.85; 50 m, r=0.84; 500 m, r=0.76; P<.001 in ambulant children convergent validity was established between daily activities vs pediatric quality of life cp p and social speech communication nonambulant personal care priorities child health index with disabilities a lack correlation responsibility fms the mobility domains confirmed divergent validity. test-retest reliability excellent for all pedi-cat> Conclusions
The PEDI-CAT is an outcome measure that demonstrates strong construct validity and reliability in children with CP.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119126
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 45-51[article]
Titre : Developing a Barriers Scale in the Context of Travel: TRIP Type de document : Article Auteurs : Shu Cole ; Dubravka Svetina ; Gale Whiteneck Année de publication : 2019 Article en page(s) : p. 52-59 Langues : Anglais (eng) Descripteurs : HE Vinci
Environnement ; Rééducation et réadaptation ; Traumatismes de la moelle épinière ; VoyageMots-clés : Environment Spinal Cord Injuries Travel Résumé : Objective
To develop an environmental-barriers scale, Travel Restrictions Influencing Participation (TRIP), in the context of travel for people living with spinal cord injury (SCI).
Design
A mixed-method approach where, in the qualitative phase, items were developed and written based on results of interviewers with different stakeholder groups and, in the quantitative phase, survey data were collected to examine the psychometric properties of the scale.
Setting
Home, work, and community settings.
Participants
People living with SCI, caregivers/family members, therapists, and travel professionals (N=333).
Interventions
None.
Main Outcome Measures
A 19-item TRIP scale that measures the travel barriers encountered by people with SCI.
Results
Results from 83 semi-structured in-depth interviews with 4 stakeholder groups guided the writing of items in the TRIP scale. Seven cognitive interviews and an expert panel conducted reviews for content validity of the scale, and 19 items were included in the quantitative assessment of the scale. A total of 250 patients enrolled in the Rocky Mountain Regional Spinal Injury System was systematically selected to report their experience with each travel barrier. Item-response theory–based Rasch analysis revealed that TRIP has acceptable psychometric properties.
Conclusions
The 19-item TRIP scale demonstrates promising psychometric properties for the scale to be used in clinical settings to quickly identify environmental barriers individuals with SCI encounter when traveling. It has the potential to assist with developing interventions that will improve the travel experience of individuals with SCI or to assist with strategies to overcome travel barriers.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119127
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 52-59[article]
Titre : Ability of Patient-Reported Outcomes to Characterize Patient Acceptable Symptom State (PASS) After Attending a Primary Care Physical Therapist and Medical Doctor Collaborative Service: A Cross-Sectional Study Type de document : Article Auteurs : Jeff Houck ; Daniel Kang ; Tyler Cuddeford Année de publication : 2019 Article en page(s) : p. 60-66 Langues : Anglais (eng) Résumé : Objectives
To determine if the Patient-Reported Outcome Measurement Information System (PROMIS) physical function, pain interference, self-efficacy, and global rating of normal function (GRNF) scales are able to accurately characterize a patient’s acceptable symptom state (PASS).
Design
A cross-sectional analysis, using receiver operator curves and chi-square analysis to explore criteria to determine thresholds (80% and 95% sensitivity/specificity) for PASS that are applicable to PROMIS and GRNF scales.
Setting
Phone survey after primary care.
Participants
Patients (N=94) attending primary care for musculoskeletal problems.
Interventions
Not applicable.
Main Outcomes Measures
Accuracy and proportion of patients classified as PASS Yes or No.
Results
Receiver operator curve analysis showed significant area under the curve (AUC) values for each PROMIS scale (AUC>.72) and the GRNF rating (AUC=.74). Identified PROMIS thresholds suggested PASS was achieved when scores were at or slightly worse than the US population average. A score of ≥7 and ≤4 characterized patients that were PASS Yes and No, respectively, on the GRNF rating. A moderate (80%) specificity/sensitivity criteria yielded 72.3%-73.5% accuracy for a majority of participants (>69.9%).
Conclusion
This analysis suggests the PROMIS and GRNF scales are able to characterize PASS status with moderate accuracy (∼70%) for a large portion of patients (∼70%). New to this study is the association of self-efficacy with PASS status. PROMIS scales at or slightly worse than the US population average characterized PASS status.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119128
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 60-66[article]
Titre : Development of the Measure of Experiential Aspects of Participation for People With Physical Disabilities Type de document : Article Auteurs : Jeffrey G. Caron ; Kathleen A. Martin Ginis ; Meredith Rocchi Année de publication : 2019 Article en page(s) : p. 67-77 Langues : Anglais (eng) Descripteurs : HE Vinci
Activités de la vie quotidienne ; Personnes handicapées ; Qualité de vie ; Rééducation et réadaptationMots-clés : Activities of daily living Disabled persons Quality of life Surveys and questionnaires Enquêtes et questionnaires Résumé : Objectives
To create a parsimonious, psychometrically sound measure of experiential aspects of participation (MeEAP) for people with physical disabilities.
Design
Cross-sectional.
Setting
Online survey.
Participants
Respondents were a purposive sample of adults (N=228, n=118 female, mean age=49.66+14.71, range=19-83). Each respondent indicated having a physical disability and participating in employment, mobility, sport, and/or exercise life domains.
Interventions
None.
Main Outcome Measures
The MeEAP was designed to be conceptually aligned with 6 experiential aspects of participation among people with physical disabilities: autonomy, belongingness, challenge, engagement, mastery, and meaning.1 The measure was also designed to be relevant across employment, mobility, sport, and exercise life domains. Higher scores on MeEAP items were hypothesized to be associated with higher levels of life satisfaction.
Results
The final 12-item scale (2 items per subscale) had strong model fit (Satorra-Bentler scaled χ2(39)=58.26, P<.001 comparative fit index=".98," tucker-lewis root mean square error of approximation=".05," standardized residual=".03)" and good reliability validity estimates. results regression analyses indicated that the meeap explained variance in life satisfaction.> Conclusions
The MeEAP is the first measure to capture all 6 experiential aspects of participation for individuals with physical disabilities across 4 major life domains. The MeEAP can be used as an outcome measure or as a mediator to help explain broader outcomes (eg, life satisfaction). The MeEAP could also be used for program evaluation to provide insights about the types of interventions needed to promote full participation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119129
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 67-77[article]
Titre : Did Clarification of Medicare Guidelines Change Outpatient Physical Therapy and Occupational Therapy Usage? A Retrospective Analysis Type de document : Article Auteurs : Justine Dee ; Benjamin Littenberg Année de publication : 2019 Article en page(s) : p. 78-85 Langues : Anglais (eng) Descripteurs : HE Vinci
Ergothérapie ; Rééducation et réadaptationMots-clés : Health expenditures Dépenses de santé Health services for the aged Services de santé pour personnes âgées Linear models Modèles linéaires Logistic models Modèles logistiques Medicare Part B Medicare part B (USA) Occupational therapy Odds ratio Physical therapy modalities Techniques de physiothérapie Résumé : Objective
To determine if there was a change in the number of outpatient physical therapy (PT) and occupational therapy (OT) visits for Medicare beneficiaries, and in the number of beneficiaries receiving extended courses of >12 therapy visits, after the Jimmo vs Sebelius settlement.
Design
Cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS) comparing calendar years 2011-2012 to 2014-2015.
Setting
Community in-home survey.
Participants
Medicare Part-B recipients who received outpatient PT/OT (N=1183, median age 70.8) during pre–Jimmo settlement (2011-2012) and post–Jimmo settlement (2014-2015) time periods.
Intervention
Not applicable.
Main Outcome Measures
Number of therapy visits/patient/year and number of subjects who received >12 therapy visits/year estimated by linear and logistic regressions controlling for potential confounders (age, body mass index [BMI], and geographic region).
Results
The unadjusted median number of therapy visits/year increased from 7 to 8 after the settlement. Linear regression estimated a 1.02 increase in the number of therapy visits after the settlement (95% confidence interval [CI] 0.23, 1.80; P=.01). The odds of having >12 therapy visits/year increased (odds ratio=1.41; 95% CI 1.02,1.96; P=.04). We observed a significant interaction between race and the effect of the settlement on the odds of having >12 therapy visits (OR 3.64; 95% CI 1.58, 8.39). Non-Hispanic white subjects saw an increase in utilization while a combined group of black, Hispanic and Asian subjects’ utilization declined.
Conclusion
Utilization of outpatient PT/OT changed after the 2013 Jimmo settlement. Further research is needed to determine the effect on patient outcomes and cost.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119130
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 78-85[article]
Titre : Opioid Prescription Patterns for Adults With Longstanding Disability and Inflammatory Conditions Compared to Other Users, Using a Nationally Representative Sample Type de document : Article Auteurs : Yuan Hong ; Marco Geraci ; Margaret A. Turk Année de publication : 2019 Article en page(s) : p. 86-94 Langues : Anglais (eng) Descripteurs : HE Vinci
Analgésiques morphiniques ; Rééducation et réadaptationMots-clés : Analgesics Opioid Résumé : Objectives
To investigate the opioid prescription patterns for adults with longstanding physical disability and inflammatory conditions, compared to a mixed group of other opioid users, after excluding cancer patients.
Design
Nationally representative cross-sectional study, 2010-2014.
Setting
Medical Expenditure Panel Survey (MEPS).
Participants
The participants (N=7134) were adults who participated in MEPS and had at least 1 opioid prescription, did not have cancer, and were between 18 years and 64 years of age. The participants were grouped as longstanding physical disability (group 1), inflammatory conditions (group 2), and a mixed group with at least 1 opioid prescription during the 2-year study period (comparison group). Participants with both groups of conditions were excluded.
Interventions
Not applicable.
Main Outcome Measure
Morphine milligram equivalent (MME) doses for each participant were cumulated over a 2-year panel period.
Results
By using quantile regression, cumulative MME in groups 1 and 2 was higher than the comparison group across all the percentiles, and differences between condition groups and comparison group became larger in higher percentiles. Participants in group 1 had the highest cumulative MME in 75th and 90th percentiles after controlling for other covariates.
Conclusions
This study documented the opioid prescription patterns for patients with longstanding physical disability or inflammatory conditions. All indexed groups (groups 1 and 2) had higher MME use compared to the comparison group.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119131
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 86-94[article]
Titre : The Burden of Traumatic Spinal Cord Injury in the United States: Disability-Adjusted Life Years Type de document : Article Auteurs : Trent O. Hall ; Ryan P. McGrath ; Mark D. Peterson Année de publication : 2019 Article en page(s) : p. 95-100 Langues : Anglais (eng) Descripteurs : HE Vinci
Épidémiologie ; Médecine physique et de réadaptation ; Morbidité ; Mortalité ; Rééducation et réadaptation ; Traumatismes de la moelle épinièreMots-clés : Epidemiology Morbidity Mortality Physical and Rehabilitation Medicine Spinal cord injuries Résumé : Objective
To quantify the burden of traumatic spinal cord injury (SCI) as defined by nonfatal health loss and premature mortality among a large sample of participants over a 44-year period, and estimate the national burden of SCI in the United States for the year 2010.
Design
Longitudinal.
Setting
National SCI Model Systems and Shriners Hospitals.
Participants
Individuals (N=51,226) were categorized by neurologic level of injury as cervical (n=28,178) or thoracic and below (n=23,048).
Main Outcome Measures
The burden of SCI was calculated in years lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY).
Results
For those with cervical level injuries, the overall YLLs and YLDs were 253,745 and 445,709, respectively, for an estimated total of 699,454 DALYs. For those with thoracic and below level injuries, the overall YLLs and YLDs were 153,885 and 213,160, respectively, for an estimated total of 367,045 DALYs. Proportionally adjusted DALYs attributable to SCI in 2010 were 445,911.
Conclusions
SCIs accounted for over 1 million years of healthy life lost in a national sample over a 44-year span. We estimated that 445,911 DALYs resulted from SCIs in the US in 2010 alone, placing the national burden of SCIs above other impactful conditions such as human immunodeficiency virus/acquired immune deficiency syndrome. Future investigations may employ DALYs to monitor trends in SCI burden in response to innovations in SCI care and identify subgroups of persons with SCIs for whom tailored interventions might improve DALYs.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119132
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 95-100[article]
Titre : Effectiveness of Supervised Home-Based Exercise Therapy Compared to a Control Intervention on Functions, Activities, and Participation in Older Patients After Hip Fracture: A Systematic Review and Meta-analysis Type de document : Article Auteurs : Isolde A.R. Kuijlaars ; Lieke Sweerts ; Maria W.G. Nijhuis-van der Sanden Année de publication : 2019 Article en page(s) : p. 101-114 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Personne âgée fragile ; Rééducation et réadaptationMots-clés : Community health services Services de santé communautaires Frail Elderly Exercise Hip fractures Fractures de la hanche Résumé : Objective
The aim of this review was to investigate whether supervised home-based exercise therapy after hospitalization is more effective on improving functions, activities, and participation in older patients after hip fracture than a control intervention (including usual care). Furthermore, we aimed to account the body of evidence for therapeutic validity.
Data Sources
Systematic searches of Medline, Embase, and CINAHL databases up to June 30, 2016.
Study Selection
Randomized controlled trials studying supervised home-based exercise therapy after hospitalization in older patients (≥65y) after hip fracture.
Data Extraction
Two reviewers assessed methodological quality (Physiotherapy Evidence Database) and therapeutic validity (Consensus on Therapeutic Exercise Training). Data were primary analyzed using a best evidence synthesis on methodological quality and meta-analyses.
Data Synthesis
A total of 9 articles were included (6 trials; 602 patients). Methodological quality was high in 4 of 6 studies. One study had high therapeutic validity. We found limited evidence in favor of home-based exercise therapy for short- (≤4mo) and long-term (>4mo) performance-based activities of daily living (ADL) and effects at long-term for gait (fast) and endurance. Evidence of no effectiveness was found for short- and long-term effects on gait and self-reported (instrumental) ADL and short-term effects on balance, endurance, and mobility. Conflicting evidence was found for strength, long-term balance, short-term gait (comfortable), long-term self-reported ADL, and long-term mobility.
Conclusions
Research findings show no evidence in favor of home-based exercise therapy after hip fracture for most outcomes of functions, activities, and participation. However, trials in this field have low therapeutic validity (absence of rationale for content and intensity and reporting of adherence), which results in interventions that do not fit patients’ limitations and goals.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119133
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 101-114[article]
Titre : Systematic Review of Mobile Health Applications in Rehabilitation Type de document : Article Auteurs : Ryan Nussbaum ; Christopher Kelly ; Eleanor Quinby Année de publication : 2019 Article en page(s) : p. 115-127 Langues : Anglais (eng) Descripteurs : HE Vinci
Applications mobiles ; Médecine physique et de réadaptation ; Rééducation et réadaptation ; SmartphoneMots-clés : Mobile applications Physical and rehabilitation medicine Ordiphone Résumé : Objective
To conduct systematic review to better define how medical mobile applications (apps) have been used in environments relevant to physical medicine and rehabilitation.
Data Sources
PUBMED, IEEE, ACM Digital Library, SCOPUS, INSPEC, and EMBASE.
Study Selection
A 10-year date limit was used, spanning publication dates from June 1, 2006, to June 30, 2016. Terms related to physical medicine and rehabilitation as well as mobile apps were used in 10 individual search strategies.
Data Extraction
Two investigators screened abstracts and applied inclusion and exclusion criteria. Full-length articles were retrieved. Duplicate articles were removed. If a study met all criteria, the article was reviewed in full.
Data Synthesis
Specific variables of interest were extracted and added to summary tables. Summary tables were used to categorize studies according themes, and a list of app features was generated.
Conclusions
The search yielded abstracts from 8116 studies, and 102 studies were included in the systematic review. Approximately one-third of the studies evaluated apps as interventions, and the remaining two-thirds of the studies assessed functioning of the app or participant interaction with the app. Some apps may have positive benefits when used to deliver exercise or gait training interventions, as self-management systems, or as measurement tools.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119134
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 115-127[article]
Titre : Effectiveness of Exercise Interventions for Pain Reduction in People With Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials Type de document : Article Auteurs : Thibaut Demaneuf ; Zoe Aitken ; Amalia Karahalios Année de publication : 2019 Article en page(s) : p. 128-139 Langues : Anglais (eng) Descripteurs : HE Vinci
Douleur ; Exercice physique ; Méta-analyse ; Pain ; Rééducation et réadaptation ; Sclérose en plaquesMots-clés : Exercise Meta-analysis Multiple sclerosis Résumé : Objective
To systematically review the evidence of the effect of exercise compared with passive control on pain in people with multiple sclerosis.
Data Source and Study Selection
Five electronic databases were searched for randomized controlled trials published up to March 2017 that recruited people with multiple sclerosis where exercise was the intervention and pain was an outcome (PROSPERO registration number CRD42017060489).
Statistical Analysis
A random-effects meta-analysis was conducted to estimate the standardized mean difference of the effect of exercise on pain between treatment and control groups. We assessed risk of bias, fitted meta-regression models to explore heterogeneity between studies, and assessed small study effects.
Data Synthesis
Ten studies met the inclusion criteria (total sample size=389), and all studies were at high risk of bias. We found that exercise interventions were associated with less pain compared with passive control groups (standardized mean difference=−.46; 95% CI, −.92 to .00). There was high between-study heterogeneity (I2=77.0%), which was not explained by the prespecified study characteristics. There was also some evidence of small study effects.
Conclusion
This is the first systematic review of the effect of exercise interventions on pain in people with multiple sclerosis, a chronic neurological disorder that affects 2.5 million people. We found some evidence that exercise compared with passive control alleviates pain in this population, but there were limitations in reporting and study quality with high risk of bias of individual studies and heterogeneity between studies.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119135
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 128-139[article]
Titre : Convergent Validity and Responsiveness of the SULCS Type de document : Article Auteurs : Jayme S. Knutson ; Amy S. Friedl ; Kristine M. Hansen Année de publication : 2019 Article en page(s) : p. 140-143 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Membre supérieur ; Mesures des résultats rapportés par les patients (PROM) ; Psychométrie ; Rééducation et réadaptationMots-clés : Patient Reported Outcome Measures Psychometrics Stroke Upper extremity Résumé : Objective
To evaluate the convergent validity and responsiveness of the Stroke Upper Limb Capacity Scale (SULCS) in comparison to the Arm Motor Ability Test (AMAT), the Box and Blocks Test (BBT), and the upper limb Fugl-Meyer Assessment (FMA). The SULCS is a relatively new measure that was designed to be easier to score and less time consuming than some existing measures.
Design
Prospective repeated-measures design.
Setting
Clinical research laboratory of a large public hospital.
Participants
Patients (N=61) Intervention
Participants received 12 weeks of therapy that included neuromuscular electrical stimulation of the paretic finger and thumb extensors. The SULCS, AMAT, BBT, and FMA were administered at weeks 0, 6, 12 (end of therapy), 20, 28, and 36 (6mo post-therapy).
Main Outcome Measures
Convergent validity was evaluated with Spearman’s correlation coefficients between pairs of measures at each time point. Responsiveness from 0 to 12 weeks and 0 to 36 weeks was evaluated with the standardized response mean (SRM).
Results
The SULCS demonstrated strong correlation with the AMAT (ρ=0.81-0.93), BBT (ρ=0.73-0.92), and FMA (ρ=0.78-0.92), at all 6 time points. All 4 measures had moderate to large SRMs (SULCS, 0.71-0.77; AMAT, 0.83-0.97; BBT, 0.73-0.82; FMA, 0.75-0.76). There was no significant difference in responsiveness among the 4 measures.
Conclusions
The results support the use of the SULCS to measure upper limb capacity in patients who are less than 2 years poststroke with moderate to severe hemiplegia.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119136
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 140-143[article]
Titre : The Rehabilitation Treatment Specification System: Implications for Improvements in Research Design, Reporting, Replication, and Synthesis Type de document : Article Auteurs : Jarrad H. Van Stan ; Marcel P. Dijkers ; John Whyte Année de publication : 2019 Article en page(s) : p. 146-155 Langues : Anglais (eng) Descripteurs : HE Vinci
Évaluation de résultat (soins) ; Méthodes ; Rééducation et réadaptation ; ThérapeutiqueMots-clés : Meta-analysis as topic Méta-analyse comme sujet Methods Outcome Assessment (Health Care) Therapeutics Translational medical research Recherche médicale translationnelle Résumé : Despite significant advances in measuring the outcomes of rehabilitation interventions, little progress has been made in specifying the therapeutic ingredients and processes that cause measured changes in patient functioning. The general approach to better clarifying the process of treatment has been to develop reporting checklists and guidelines that increase the amount of detail reported. However, without a framework instructing researchers in how to describe their treatment protocols in a manner useful to or even interpretable by others, requests for more detail will fail to improve our understanding of the therapeutic process. In this article, we describe how the Rehabilitation Treatment Specification System (RTSS) provides a theoretical framework that can improve research intervention reporting and enable testing and refinement of a protocol’s underlying treatment theories. The RTSS framework provides guidance for researchers to explicitly state their hypothesized active ingredients and targets of treatment as well as for how the individual ingredients in their doses directly affect the treatment targets. We explain how theory-based treatment specification has advantages over checklist approaches for intervention design, reporting, replication, and synthesis of evidence in rehabilitation research. A complex rehabilitation intervention is used as a concrete example of the differences between an RTSS-based specification and the Template for Intervention Description and Replication checklist. The RTSS’s potential to advance the rehabilitation field can be empirically tested through efforts to use the framework with existing and newly developed treatment protocols. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119137
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 146-155[article]
Titre : The Importance of Voluntary Behavior in Rehabilitation Treatment and Outcomes Type de document : Article Auteurs : John Whyte ; Marcel P. Dijkers ; Tessa Hart Année de publication : 2019 Article en page(s) : p. 156-163 Langues : Anglais (eng) Descripteurs : HE Vinci
Classification ; Participation des patients ; Rééducation et réadaptation ; ThérapeutiqueMots-clés : Patient outcome assessment Évaluation des résultats des patients Patient participation Therapeutics Treatment Outcome Résultat thérapeutique Volition Résumé : Most rehabilitation treatments are volitional in nature, meaning that they require the patient’s active engagement and effort. Volitional treatments are particularly challenging to define in a standardized fashion, because the clinician is not in complete control of the patient’s role in enacting these treatments. Current recommendations for describing treatments in research reports fail to distinguish between 2 fundamentally different aspects of treatment design: the selection of treatment ingredients to produce the desired functional change and the selection of ingredients that will ensure the patient’s volitional performance. The Rehabilitation Treatment Specification System (RTSS) is a conceptual scheme for standardizing the way that rehabilitation treatments are defined by all disciplines across all areas of rehabilitation. The RTSS highlights the importance of volitional behavior in many treatment areas and provides specific guidance for how volitional treatments should be specified. In doing so, it suggests important crosscutting research questions about the nature of volitional behavior, factors that make it more or less likely to occur, and ingredients that are most effective in ensuring that patients perform desired treatment activities. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119138
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 156-163[article]
Titre : Advancing Rehabilitation Practice Through Improved Specification of Interventions Type de document : Article Auteurs : Jeanne M. Zanca ; Lyn S. Turkstra ; Christine C. Chen Année de publication : 2019 Article en page(s) : p. 164-171 Langues : Anglais (eng) Descripteurs : HE Vinci
Classification ; Participation des patients ; Rééducation et réadaptation ; ThérapeutiqueMots-clés : Patient outcome assessment Évaluation des résultats des patients Patient participation Therapeutics Volition Résumé : Rehabilitation clinicians strive to provide cost-effective, patient-centered care that optimizes outcomes. A barrier to this ideal is the lack of a universal system for describing, or specifying, rehabilitation interventions. Current methods of description vary across disciplines and settings, creating barriers to collaboration, and tend to focus mostly on functional deficits and anticipated outcomes, obscuring connections between clinician behaviors and changes in functioning. The Rehabilitation Treatment Specification System (RTSS) is the result of more than a decade of effort by a multidisciplinary group of rehabilitation clinicians and researchers to develop a theory-based framework to specify rehabilitation interventions. The RTSS describes interventions for treatment components, which consist of a target (functional change brought about as a direct result of treatment), ingredients (actions taken by clinicians to change the target), and a hypothesized mechanism of action, as stated in a treatment theory. The RTSS makes explicit the connections between functional change and clinician behavior, and recognizes the role of patient effort in treatment implementation. In so doing, the RTSS supports clinicians’ efforts to work with their patients to set achievable goals, select appropriate treatments, adjust treatment plans as needed, encourage patient participation in the treatment process, communicate with team members, and translate research findings to clinical care. The RTSS may help both expert and novice clinicians articulate their clinical reasoning processes in ways that benefit treatment planning and clinical education, and may improve the design of clinical documentation systems, leading to more effective justification and reimbursement for services. Interested clinicians are invited to apply the RTSS in their local settings. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119139
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 164-171[article]
Titre : A Theory-Driven System for the Specification of Rehabilitation Treatments Type de document : Article Auteurs : Tessa Hart ; Marcel P. Dijkers ; John Whyte Année de publication : 2019 Article en page(s) : p. 172-180 Langues : Anglais (eng) Descripteurs : HE Vinci
Classification ; Participation des patients ; Rééducation et réadaptation ; ThérapeutiqueMots-clés : Patient outcome assessment Évaluation des résultats des patients Patient participation Therapeutics Volition Résumé : The field of rehabilitation remains captive to the black-box problem: our inability to characterize treatments in a systematic fashion across diagnoses, settings, and disciplines, so as to identify and disseminate the active ingredients of those treatments. In this article, we describe the Rehabilitation Treatment Specification System (RTSS), by which any treatment employed in rehabilitation may be characterized, and ultimately classified according to shared properties, via the 3 elements of treatment theory: targets, ingredients, and (hypothesized) mechanisms of action. We discuss important concepts in the RTSS such as the distinction between treatments and treatment components, which consist of 1 target and its associated ingredients; and the distinction between targets, which are the direct effects of treatment, and aims, which are downstream or distal effects. The RTSS includes 3 groups of mutually exclusive treatment components: Organ Functions, Skills and Habits, and Representations. The last of these comprises not only thoughts and feelings, but also internal representations underlying volitional action; the RTSS addresses the concept of volition (effort) as a critical element for many rehabilitation treatments. We have developed an algorithm for treatment specification which is illustrated and described in brief. The RTSS stands to benefit the field in numerous ways by supplying a coherent, theory-based framework encompassing all rehabilitation treatments. Using a common framework, researchers will be able to test systematically the effects of specific ingredients on specific targets; and their work will be more readily replicated and translated into clinical practice. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119140
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 172-180[article]
Titre : Extraordinary Contributions to Disability and Rehabilitation Research and Unwavering Leadership: A Tribute to Ruth Brannon Type de document : Article Auteurs : Stephanie A. Kolakowsky-Hayner ; Wayne A. Gordon Année de publication : 2019 Article en page(s) : p. 181-183 Langues : Anglais (eng) Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=119141
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 1 (2019) . - p. 181-183[article]
