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Gill I, Davidson SA, Stevenson PG, Robinson R, Pool D, Valentine J. Outcomes following intensive day rehabilitation for young people in Western Australia. J Pediatr Rehabil Med 2023:PRM220102. [PMID: 38108363 DOI: 10.3233/prm-220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
PURPOSE Intensive rehabilitation aims to improve and maintain functioning in young people who experience disability due to illness or injury. Day rehabilitation may have advantages for families and healthcare systems over inpatient models of rehabilitation. METHODS This study evaluated the goals and outcomes of a cohort of young people in Western Australia who attended a specialist intensive day rehabilitation programme ("iRehab") at Perth Children's Hospital. Analysis of the iRehab service database was performed. Rehabilitation goals and outcomes were recorded as per the Canadian Occupational Performance Measure (COPM), Children's Functional Independence Measure (WeeFIM), and Goal Attainment Scale (GAS). RESULTS There were 586 iRehab admissions between August 11, 2011, and December 31, 2018. Admissions were divided by diagnosis: Cerebral Palsy (228, 38.5%), Acquired Brain Injury (125, 21.3%), Spinal Cord Disorders (91, 15.5%), and Other (141, 24.2%). Mean COPM Performance increased by 2.78 points from admission to discharge (95% CI 2.58 to 2.98, p < 0.001). Mean COPM Satisfaction was 3.29 points higher at discharge than admission (95% CI 3.07 to 3.51, p < 0.001). Mean total WeeFIM score improved by 6.51 points between admission and discharge (95% CI 5.56 to 7.45, p < 0.001), and by 3.33 additional points by six months post discharge (95% CI 2.14 to 4.53, p < 0.001). Mean GAS T-scores increased by 27.85 (95% CI 26.73 to 28.97, p < 0.001) from admission to discharge, and by 29.64 (95% CI 28.26 to 31.02, p < 0.001) from admission to six months post discharge, representing improvement consistent with team expectations. CONCLUSION This study describes a model by which intensive rehabilitation can be delivered in a day rehabilitation setting. A diverse population of young people who experienced disability achieved significant improvements in occupational performance, independence, and goal attainment after accessing intensive day rehabilitation. Improvements were measured in all diagnostic subgroups and were maintained six months after discharge.
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Affiliation(s)
- Irwin Gill
- Kids Rehab WA, Perth Children's Hospital, Perth, Australia
| | | | - Paul G Stevenson
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Rae Robinson
- Kids Rehab WA, Perth Children's Hospital, Perth, Australia
| | - Dayna Pool
- Kids Rehab WA, Perth Children's Hospital, Perth, Australia
| | - Jane Valentine
- Kids Rehab WA, Perth Children's Hospital, Perth, Australia
- Curtin University, Perth, Australia
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Bailey A, Chenoweth T, Fisher Z, Joannides M, Watters S, Mazzucchelli J, Taylor S, Harris C. Identifying Suitable Cognitive Assessments for Children and Adolescents with Acquired Brain Injury for use by Occupational Therapists in Acute and Subacute Hospital Contexts: A Scoping Review. Dev Neurorehabil 2022; 25:485-500. [PMID: 35850609 DOI: 10.1080/17518423.2022.2099031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To appraise the literature evaluating psychometric properties and clinical utility of cognitive assessments available for use by occupational therapists in acute and subacute hospital contexts with children aged 4-18 years diagnosed with an acquired brain injury. METHODS Scoping review. Assessments and associated studies were evaluated for their methodologic quality using the COnsensus-based standard for the Selection of health Measurement INstruments (COSMIN) strategy. RESULTS Forty-one studies evaluated 49 different assessments and reported on assessment psychometrics (n = 40), clinical utility (n = 1) and five reported on both. Fourteen assessments with the strongest psychometric properties and clinical utility were shortlisted. CONCLUSION A gold standard assessment was not identified. Instead, a shortlist of functional, performance-based, technology-based, and self-report assessments were identified as relevant for the setting and population, but requiring further investigation. Future development of a cognitive assessment in partnership with therapists working in tertiary pediatric settings will ensure optimal clinical utility and validity.
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Affiliation(s)
- Ashleigh Bailey
- School of Allied Health, Curtin University, Perth, Australia
| | | | - Zoe Fisher
- School of Allied Health, Curtin University, Perth, Australia
| | | | - Samantha Watters
- Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
| | - Jodie Mazzucchelli
- Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
| | - Susan Taylor
- School of Allied Health, Curtin University, Perth, Australia.,Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
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3
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Crumlish L, Wallace SJ, Copley A, Rose TA. Exploring the measurement of pediatric cognitive-communication disorders in traumatic brain injury research: A scoping review. Brain Inj 2022; 36:1207-1227. [PMID: 36303459 DOI: 10.1080/02699052.2022.2111026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To synthesize information about the constructs measured, measurement instruments used, and the timing of assessment of cognitive-communication disorders (CCDs) in pediatric traumatic brain injury (TBI) research. METHODS AND PROCEDURES Scoping review conducted in alignment with Arksey and O'Malley's five-stage methodological framework and reported per the PRISMA extension for Scoping Reviews. Inclusion criteria: (a) cohort description, case-control, and treatment studies; (b) participants with TBI aged 5-18 years; (c) communication or psychosocial outcomes; and (d) English full-text journal articles. The first author reviewed all titles, abstracts, and full-text articles; 10% were independently reviewed. OUTCOMES AND RESULTS Following screening, a total of 687 articles were included and 919 measurement instruments, measuring 2134 unique constructs, were extracted. The Child Behavior Checklist was the most used measurement instrument and 'Global Outcomes/Recovery' was the construct most frequently measured. The length of longitudinal monitoring ranged between ≤3 months and 16 years. CONCLUSIONS AND IMPLICATIONS We found considerable heterogeneity in the constructs measured, the measurement instruments used, and the timing of CCD assessment in pediatric TBI research. A consistent approach to measurement may support clinical decision-making and the efficient use of data beyond individual studies in systematic reviews and meta-analyses.
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Affiliation(s)
- Lauren Crumlish
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Queensland Aphasia Research Centre, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Queensland Aphasia Research Centre, Australia
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Resch C, Van Kruijsbergen M, Ketelaar M, Hurks P, Adair B, Imms C, De Kloet A, Piskur B, Van Heugten C. Assessing participation of children with acquired brain injury and cerebral palsy: a systematic review of measurement properties. Dev Med Child Neurol 2020; 62:434-444. [PMID: 31975385 PMCID: PMC7079076 DOI: 10.1111/dmcn.14465] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 12/24/2022]
Abstract
AIM To examine which instruments used to assess participation of children with acquired brain injury (ABI) or cerebral palsy (CP) align with attendance and/or involvement constructs of participation; and to systematically review measurement properties of these instruments in children with ABI or CP, to guide instrument selection. METHOD Five databases were searched. Instruments that quantified 'attendance' and/or 'involvement' aspects of participation according to the family of participation-related constructs were selected. Data on measurement properties were extracted and methodological quality of the studies assessed. RESULTS Thirty-seven instruments were used to assess participation in children with ABI or CP. Of those, 12 measured attendance and/or involvement. The reliability, validity, and responsiveness of eight of these instruments were examined in 14 studies with children with ABI or CP. Sufficient measurement properties were reported for most of the measures, but no instrument had been assessed on all relevant properties. Moreover, most psychometric studies have marked methodological limitations. INTERPRETATION Instruments to assess participation of children with ABI or CP should be selected carefully, as many available measures do not align with attendance and/or involvement. Evidence for measurement properties is limited, mainly caused by low methodological study quality. Future studies should follow recommended methodological guidelines. WHAT THIS PAPER ADDS Twelve instruments used to assess participation of children with acquired brain injury (ABI) or cerebral palsy (CP) aligned with attendance/involvement. Seven instruments have some psychometric evidence supporting their use with children with CP. For children with ABI, only the Child and Adolescent Scale of Participation has shown preliminary evidence of measurement properties.
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Affiliation(s)
- Christine Resch
- Department of Neuropsychology and PsychopharmacologyFaculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands,Limburg Brain Injury CenterMaastrichtthe Netherlands
| | - Mette Van Kruijsbergen
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center Utrecht, and De Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center Utrecht, and De Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Petra Hurks
- Department of Neuropsychology and PsychopharmacologyFaculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Brooke Adair
- Centre for Disability and Development ResearchAustralian Catholic UniversityMelbourneAustralia,Generation VictoriaMurdoch Children's Research InstituteParkvilleAustralia
| | - Christine Imms
- Centre for Disability and Development ResearchAustralian Catholic UniversityMelbourneAustralia
| | - Arend De Kloet
- Basalt Rehabilitationthe Haguethe Netherlands,The Hague University of Applied Sciencesthe Haguethe Netherlands
| | - Barbara Piskur
- Research Centre for Autonomy and Participation for People with Chronic IllnessesZuyd University of Applied SciencesHeerlenthe Netherlands
| | - Caroline Van Heugten
- Department of Neuropsychology and PsychopharmacologyFaculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands,Limburg Brain Injury CenterMaastrichtthe Netherlands,School for Mental Health and NeuroscienceFaculty of Health, Medicine and Life SciencesMaastricht University Medical CenterMaastrichtthe Netherlands
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5
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Eldridge BJ, Galea MP, Kissane AL, Broder JC, Brilleman SL, Wolfe R, Williams G. High-Level Mobility Assessment Tool Normative Values for Children. Phys Ther 2020; 100:324-331. [PMID: 31742357 DOI: 10.1093/ptj/pzz168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/20/2019] [Accepted: 08/13/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Physical therapists need to be able to evaluate high-level gross motor skills of children to determine their capacity to engage in activities such as running, jumping, hopping, and stair climbing. The High-Level Mobility Assessment Tool (HiMAT) has excellent interrater and retest reliability and is less susceptible to a ceiling effect than existing mobility scales in children who are 6 to 17 years old and have traumatic brain injury. OBJECTIVE The purposes of this study were to develop normative HiMAT score ranges for Australian children and to investigate the relationship between children's HiMAT scores and their age, height, weight, and body mass index (BMI). DESIGN This study used a cross-sectional design. METHODS Children included in this study were 5 to 12 years old, had no condition affecting their mobility, could follow 2-stage instructions, and had written informed consent from their parent or guardian. A total 1091 children were assessed at their local school, where their height, weight, and HiMAT score were recorded. The relationships between children's age, height, weight, and BMI were summarized using Spearman rank correlations. Truncated regression models were used to determine the most appropriate predictor variable for developing sex-specific normative ranges. RESULTS There was a positive correlation between children's HiMAT scores and their age, height, weight, and BMI. Age explained the most variability in HiMAT scores for both boys and girls. LIMITATIONS The reliability, validity, and responsiveness of the HiMAT have not been tested across a broad range of children with mobility limitations. Normative data reported in this study are for Australian children only. CONCLUSIONS HiMAT scores for children in this study increased with age, height, weight, and BMI. Age was the most appropriate variable for developing a normative dataset of HiMAT scores for children of primary school age.
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Affiliation(s)
- Beverly J Eldridge
- Department of Allied Health, La Trobe University, Level 4, The Alfred Centre, Melbourne, Victoria, Australia
| | - Mary P Galea
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Anne L Kissane
- Victorian Paediatric Rehabilitation Service, North Geelong, Victoria, Australia
| | - Jonathan C Broder
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Rory Wolfe
- Department of Epidemiology and Preventive Medicine, Monash University
| | - Gavin Williams
- Department of Physiotherapy, Epworth Healthcare; and Department of Physiotherapy, The University of Melbourne, Victoria, Australia
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Connell T, Paterson J, Roberts RM, Raghavendra P, Sawyer M, Russo RN. Clinician modifiable factors associated with better quality of life in children with acquired brain injury undergoing rehabilitation. Brain Inj 2018; 32:423-430. [PMID: 29364024 DOI: 10.1080/02699052.2018.1429661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To identify clinician-modifiable factors related to quality of life (QOL) in children with acquired brain injury (ABI). PARTICIPANTS AND METHODS Thirty-nine children attending an ABI rehabilitation program (5-18 years) were assessed using the Personality Inventory for Children-2, Vineland Adaptive Behavior Scale-2, Handicap-Related Problems for Parents Inventory and Children's Assessment of Participation and Enjoyment. The Pediatric Quality of Life Inventory was completed by children and parents six months later. RESULTS Children with lower levels of internalising and externalising behaviours, health and social skill problems, and higher family functioning had significantly higher levels of total QOL (child and parent rated) (r = -.47 to -.79). In addition, children with higher levels of adaptive behaviour had significantly higher parent rated total QOL (r = .46). Measures of mother's stressors had moderate but not statistically significant relationships with the child's total QOL (r = -.31 to -.35). There were moderate and statistically significant relationships between measures of participation in physical activities and total QOL as rated by children (r = .42-.48) but not parents (r = .11-.30). CONCLUSIONS These findings suggest potential targets to be investigated in future clinical research in rehabilitation following ABI in children to optimise QOL.
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Affiliation(s)
- Tim Connell
- a Northern Adelaide Local Health Network, Adelaide, Australia
| | | | - Rachel M Roberts
- c Faculty of Health and Medical Sciences , University of Adelaide, Adelaide, Australia
| | | | - Michael Sawyer
- c Faculty of Health and Medical Sciences , University of Adelaide, Adelaide, Australia.,e Women's and Children's Health Network, North Adelaide, Australia
| | - Remo N Russo
- e Women's and Children's Health Network, North Adelaide, Australia.,f College of Medicine and Public Health , Bedford Park, Australia
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Austin D, Frater T, Wales L, Dunford C. Measuring changes in functional ability in older children and young people with acquired brain injury using the UK FIM + FAM. Br J Occup Ther 2017. [DOI: 10.1177/0308022617735036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction There is a need for validated and responsive measurement tools to demonstrate changes in functional ability. Existing outcome measurement tools have significant limitations for children and young people with acquired brain injury (ABI). Aim This study examines the potential of the UK Functional Independence Measure + Functional Assessment Measure (UK FIM + FAM) to detect clinical change in older children and young people with ABI. Method This is a secondary retrospective pretest–post test analysis of 72 children and young people age 8–17 years. Internal responsiveness was examined using Wilcoxon signed-rank tests and effect sizes indices; external responsiveness was examined in relation to the Neurological Impairment Scale (NIS) using Spearman’s correlation coefficient. Results Highly significant changes were detected from admission to discharge on motor, cognitive and total UK FIM + FAM scores ( p < 0.001). Medium to large effect sizes were found on the total scale indicating good internal responsiveness. There was a significant, negative correlation between UK FIM + FAM change scores and NIS change scores ( p < 0.01) indicating good external responsiveness. Conclusion The UK FIM + FAM was able to detect clinically meaningful change in functional ability in children and young people with ABI over 8 years. Further validity and reliability must be established before recommending its use in this client group.
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Affiliation(s)
- Dalya Austin
- Occupational Therapist, Imperial College NHS Trust, London, UK
| | | | - Lorna Wales
- Research Professional Lead, The Children’s Trust, London, UK
| | - Carolyn Dunford
- Head of Therapy & Research, The Children’s Trust, London, UK
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Williams KS, Young DK, Burke GAA, Fountain DM. Comparing the WeeFIM and PEDI in neurorehabilitation for children with acquired brain injury: A systematic review. Dev Neurorehabil 2017; 20:443-451. [PMID: 28277891 DOI: 10.1080/17518423.2017.1289419] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION We sought to compare the suitability of the Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disability Inventory (PEDI) as outcome measures in rehabilitation of children with acquired brain injury (ABI). METHODS We performed a systematic review of the evidence base using five databases. PRISMA guidelines were adhered to and the review was registered with the PROSPERO international prospective register of systematic reviews (registration number CRD42015025370). RESULTS Twenty-six retrospective studies were included. Twelve studies utilized the PEDI, thirteen studies the WeeFIM, and one study included both. Statistically significant responsiveness was demonstrated for both the WeeFIM and PEDI, although significant ceiling effects were detected. Evidence of clinically significant responsiveness was limited to one center utilizing the PEDI. CONCLUSION Although requiring licensing to use, the WeeFIM is more suitable for the inpatient setting, is quicker to administer and showed minimal ceiling effects compared to the PEDI counterpart.
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Affiliation(s)
- Katie S Williams
- a Department of Paediatric Haematology, Oncology and Palliative Care , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK
| | - David K Young
- a Department of Paediatric Haematology, Oncology and Palliative Care , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK
| | - G A Amos Burke
- a Department of Paediatric Haematology, Oncology and Palliative Care , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK
| | - Daniel M Fountain
- a Department of Paediatric Haematology, Oncology and Palliative Care , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK
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Fragala-Pinkham MA, Dumas HM, Lombard KA, O'Brien JE. Responsiveness of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test in measuring functional outcomes for inpatient pediatric rehabilitation. J Pediatr Rehabil Med 2016; 9:215-22. [PMID: 27612081 DOI: 10.3233/prm-160382] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Responsiveness of the PEDI-CAT Mobility, Daily Activities, and Social/Cognitive domains and Wheelchair subdomain was evaluated for youth admitted to a pediatric post-acute care hospital. METHODS Inpatients ages 2-21 years, with a length of stay of ≥ 5 days and with both admission and discharge scores were included. The difference between mean admission and discharge PEDI-CAT scaled scores were analyzed using paired t-tests. Effect sizes, standard response means (SRMs), and minimal detectable change values were calculated. Score comparison between diagnostic subgroups (Traumatic Brain Injury, Neurological, Orthopedic, Medical) and age groups ( ≤ 5, > 5 but < 13, ≥ 13 years) were evaluated for the Mobility domain. RESULTS Sample size differed by domain with 66 Mobility, 30 Daily Activities, 19 Social/Cognitive and 9 Wheelchair subdomain pairs. Significant differences were found for all domains when mean admission and discharge scaled scores were compared. Moderate to large effect sizes and SRMs were found for the Mobility and Daily Activities domains and Wheelchair subdomain. Small effect size but large SRM was found for the Social/Cognitive domain. The Mobility domain was also responsive to changes in all diagnostic and age groups. CONCLUSION The PEDI-CAT was responsive to functional changes for youth discharged from an inpatient pediatric rehabilitation hospital.
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Affiliation(s)
| | - Helene M Dumas
- Research Center, Franciscan Hospital for Children, Brighton, MA, USA
| | - Kelly A Lombard
- Research Center, Franciscan Hospital for Children, Brighton, MA, USA.,Physical Therapy Department, Boston Children's Hospital, Boston, MA, USA
| | - Jane E O'Brien
- Research Center, Franciscan Hospital for Children, Brighton, MA, USA
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10
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Baque E, Barber L, Sakzewski L, Boyd RN. Test–re-test reproducibility of activity capacity measures for children with an acquired brain injury. Brain Inj 2016; 30:1143-9. [DOI: 10.3109/02699052.2016.1165869] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Janssens A, Rogers M, Gumm R, Jenkinson C, Tennant A, Logan S, Morris C. Measurement properties of multidimensional patient-reported outcome measures in neurodisability: a systematic review of evaluation studies. Dev Med Child Neurol 2016; 58:437-51. [PMID: 26661333 PMCID: PMC5031226 DOI: 10.1111/dmcn.12982] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 12/15/2022]
Abstract
AIM To identify and appraise the quality of studies that primarily assessed the measurement properties of English language versions of multidimensional patient-reported outcome measures (PROMs) when evaluated with children with neurodisability, and to summarize this evidence. METHOD MEDLINE, Embase, PsycINFO, CINAHL, AMED, and the National Health Service Economic Evaluation Database were searched. The methodological quality of the papers was assessed using the COnsensus-based Standards for selection of health Measurement INstruments checklist. Evidence of content validity, construct validity, internal consistency, test-retest reliability, proxy reliability, responsiveness, and precision was extracted and judged against standardized reference criteria. RESULTS We identified 48 studies of mostly fair to good methodological quality: 37 papers for seven generic PROMs (CHIP, CHQ, CQoL, KIDSCREEN, PedsQL, SLSS, and YQOL), seven papers for two chronic-generic PROMs (DISABKIDS and Neuro-QOL), and four papers for three preference-based measures (HUI, EQ-5D-Y, and CHSCS-PS). INTERPRETATION On the basis of this appraisal, the DISABKIDS appears to have more supportive evidence in samples of children with neurodisability. The overall lack of evidence for responsiveness and measurement error is a concern when using these instruments to measure change, or to interpret the findings of studies in which these PROMs have been used to assess change.
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Affiliation(s)
- Astrid Janssens
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Morwenna Rogers
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Rebecca Gumm
- Royal Devon and Exeter NHS Foundation TrustExeterUK
| | - Crispin Jenkinson
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Alan Tennant
- Department of Rehabilitation MedicineUniversity of LeedsLeedsUK
| | - Stuart Logan
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Christopher Morris
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
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12
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Kissane AL, Eldridge BJ, Kelly S, Vidmar S, Galea MP, Williams GP. High-level mobility skills in children and adolescents with traumatic brain injury. Brain Inj 2015; 29:1711-6. [DOI: 10.3109/02699052.2015.1075174] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Polinder S, Haagsma JA, van Klaveren D, Steyerberg EW, van Beeck EF. Health-related quality of life after TBI: a systematic review of study design, instruments, measurement properties, and outcome. Popul Health Metr 2015; 13:4. [PMID: 25722656 PMCID: PMC4342191 DOI: 10.1186/s12963-015-0037-1] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/02/2015] [Indexed: 12/03/2022] Open
Abstract
Measurement of health-related quality of life (HRQL) is essential to quantify the subjective burden of traumatic brain injury (TBI) in survivors. We performed a systematic review of HRQL studies in TBI to evaluate study design, instruments used, methodological quality, and outcome. Fifty-eight studies were included, showing large variation in HRQL instruments and assessment time points used. The Short Form-36 (SF-36) was most frequently used. A high prevalence of health problems during and after the first year of TBI was a common finding of the studies included. In the long term, patients with a TBI still showed large deficits from full recovery compared to population norms. Positive results for internal consistency and interpretability of the SF-36 were reported in validity studies. The Quality of Life after Brain Injury instrument (QOLIBRI), European Brain Injury Questionnaire (EBIQ), Child Health Questionnaire (CHQ), and the World Health Organization Quality of Life short version (WHOQOL-BREF) showed positive results, but evidence was limited. Meta-analysis of SF-36 showed that TBI outcome is heterogeneous, encompassing a broad spectrum of HRQL, with most problems reported in the physical, emotional, and social functioning domain. The use of SF-36 in combination with a TBI-specific instrument, i.e., QOLIBRI, seems promising. Consensus on preferred methodologies of HRQL measurement in TBI would facilitate comparability across studies, resulting in improved insights in recovery patterns and better estimates of the burden of TBI.
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Affiliation(s)
- Suzanne Polinder
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - Juanita A Haagsma
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - David van Klaveren
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - Ewout W Steyerberg
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - Ed F van Beeck
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
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14
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Wong RKY, McEwan J, Finlayson D, Chung S, Wan L, Salbach NM, Kirkwood G, Meschino C, Wright FV. Reliability and validity of the acquired brain injury challenge assessment (ABI-CA) in children. Brain Inj 2014; 28:1734-43. [DOI: 10.3109/02699052.2014.947620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Morris C, Janssens A, Allard A, Thompson Coon J, Shilling V, Tomlinson R, Williams J, Fellowes A, Rogers M, Allen K, Beresford B, Green C, Jenkinson C, Tennant A, Logan S. Informing the NHS Outcomes Framework: evaluating meaningful health outcomes for children with neurodisability using multiple methods including systematic review, qualitative research, Delphi survey and consensus meeting. HEALTH SERVICES AND DELIVERY RESEARCH 2014. [DOI: 10.3310/hsdr02150] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BackgroundThe identification of suitable outcome measures will improve the evaluation of integrated NHS care for the large number of children affected by neurodisability, and has the potential to encourage the provision of more appropriate and effective health care. This research sought to appraise the potential of patient-reported outcome measures (PROMs) for children and young people with neurodisability.AimThis research aimed (i) to identify key outcomes of health care for children with neurodisability, beyond morbidity and mortality, from the perspectives of children, parents and professionals; (ii) to critically appraise existing generic multidimensional PROMs; and (iii) to examine whether or not the key outcomes might be measured by existing PROMs. We also sought agreement on a definition of neurodisability.MethodsData were gathered in three main ways, (i) a systematic review identified eligible generic multidimensional PROMs and peer-reviewed studies evaluating psychometric performance using English-language questionnaires. Studies were appraised for methodological quality and psychometric performance was appraised using standard criteria. (ii) Focus groups and interviews with children and young people with neurodisability, and separately with parents, sought to identify important outcomes of NHS care, and their feedback on example PROM questionnaires. (iii) An online Delphi survey was conducted with a multidisciplinary sample of health professionals to seek agreement on appropriate NHS outcomes. In addition, we convened a consensus meeting with a small nominal group of young people, parents and professionals; the group sought agreement on a core set of important health outcomes.ResultsFrom the systematic review, we identified 126 papers that reported eligible evidence regarding the psychometric performance of 25 PROMs. Evidence of psychometric robustness was more favourable for a small number of PROMs: KIDSCREEN (generic), DISABKIDS (chronic-generic) and Child Health Utility 9D (preference-based measure). The Pediatric Quality of Life Inventory and KINDL offer both self-report and a proxy report version for a range of age bands, but evidence of their psychometric performance was weaker. Evidence was lacking in one or more respects for all candidate PROMs, in both general populations and those with neurodisability. Proxy reporting was found generally to be poorly correlated with self-report. Focus groups and interviews included 54 children and young people, and 53 parents. The more important health outcomes were felt to be communication, emotional well-being, pain, mobility, independence/self-care, worry/mental health, social activities and sleep. In addition, parents of children with intellectual impairment identified behaviour, toileting and safety as important outcomes. Participants suggested problems with the face validity of example PROM questionnaires for measuring NHS care. In the Delphi survey, 276 clinicians from a wide range of professions contributed to at least one of four rounds. Professionals rated pain, hearing, seeing, sleep, toileting, mobility and communication as key goals for the NHS but also identified treating neurological symptoms as important. Professionals in the Delphi survey and parents working with the research team agreed a proposed definition for neurodisability. The consensus meeting confirmed overlap between the outcomes identified as important by young people, parents and professionals, but not complete agreement.ConclusionsThere was agreement between young people, parents and professionals regarding a core suite of more important health outcomes: communication, emotional well-being, pain, mobility, independence/self-care, worry/mental health, social activities and sleep. In addition, behaviour, toileting and safety were identified as important by parents. This research suggests that it would be appropriate to measure these constructs using PROMs to assess health care. None of the candidate PROMs in the review adequately captures all of the identified constructs, and there is inadequate evidence that candidate PROMs are psychometrically robust for use across children with neurodisability. Further consultation with young people, families and professionals is warranted to support the use of PROMs to measure NHS outcomes. Research to test potential PROMs with different age groups and conditions would be valuable.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
| | - Astrid Janssens
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Amanda Allard
- Council for Disabled Children, National Children’s Bureau, London, UK
| | | | - Valerie Shilling
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Richard Tomlinson
- Department of Child Health, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Jane Williams
- Department of Child Health and Paediatrics, Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Andrew Fellowes
- Council for Disabled Children, National Children’s Bureau, London, UK
| | - Morwenna Rogers
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Karen Allen
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Colin Green
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Alan Tennant
- Department of Rehabilitation Medicine, University of Leeds, Leeds, UK
| | - Stuart Logan
- University of Exeter Medical School, University of Exeter, Exeter, UK
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McArthur C, Venkatesh S, Warren D, Pringle D, Doerr T, Salbach NM, Kirkwood G, Wright V. Further development of the response scales of the Acquired Brain Injury Challenge Assessment (ABI-CA). Brain Inj 2013; 27:1271-80. [PMID: 24020440 DOI: 10.3109/02699052.2013.809551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To revise the scaling of the response sets of the Acquired Brain Injury Challenge Assessment (ABI-CA) through expert input and determination of empirically based cut-points. RESEARCH DESIGN A measurement development study with a content validity focus. METHODS Response option wording was revised through consultation with six physiotherapists with paediatric ABI expertise. Twenty-nine typically-developing children performed the ABI-CA and empirically-based cut-points for item-specific response options were derived from their time/distance/repetition results (SD values) as benchmark values. Movement quality considerations (compensatory movements) were identified from expert consultation/ABI-CA video observation and built into revised response options. The revised ABI-CA was pilot-tested with four children with ABI, aged 7-15 years, for a feasibility check. RESULTS Nineteen of the 23 items' response scales were revised based on experts' feedback and empirically-based cut-points replaced the previous arbitrarily-determined cut-points. Compensatory movement considerations were re-defined in nine items. The mean score of the refined ABI-CA was 70.0% (SD = 18.5) with four children with ABI. CONCLUSION The new response options in the ABI-CA appeared suitable for testing high-functioning children with ABI and the mid-range mean score in this pilot sample indicates its potential to measure change. Recommendations are outlined for final ABI-CA amendments before large-scale validation.
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Affiliation(s)
- Caitlin McArthur
- Department of Physical Therapy, Faculty of Medicine, University of Toronto , Toronto, Ontario , Canada
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Kertoy MK, Russell DJ, Rosenbaum P, Jaffer S, Law M, McCauley D, Gorter JW. Development of an outcome measurement system for service planning for children and youth with special needs. Child Care Health Dev 2013; 39:750-9. [PMID: 22845889 PMCID: PMC3842109 DOI: 10.1111/j.1365-2214.2012.01409.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2012] [Indexed: 11/27/2022]
Abstract
AIM This study described the process used in developing an outcome measurement framework for system planning to improve services for children and youth with special needs and their families in a Canadian province. The study reports the results of several parent-completed measures, which would be useful in service planning as well as the acceptability and utility of these measures for use by families and service centres. METHODS/RESULTS Development of a theoretical framework, consultation with key stakeholders, testing the utility of selected outcome measures and initial dissemination of results were critical elements in the successful development of an outcome system. Consultation with stakeholders confirmed use of the International Classification of Functioning, Disability and Health and the child-within-family-within community model as theoretical frameworks while building valuable partnerships and identifying potential barriers to implementation. Pilot testing showed three outcome measures were feasible for families to complete and the measures provided information about services for children that was valuable to families as well as service providers. Gaps in service delivery were identified and the need for better communication between service providers and communities to facilitate integrated services was highlighted. CONCLUSION The findings from this study can be used to implement an outcome measurement system for children with special needs and may serve as a resource for international researchers who are working to develop valid tools as well as outcome systems that are useful for system planning.
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Affiliation(s)
- M K Kertoy
- Western UniversityLondon, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster UniversityHamilton, Ontario, Canada
| | - D J Russell
- CanChild Centre for Childhood Disability Research, McMaster UniversityHamilton, Ontario, Canada
| | - P Rosenbaum
- Department of Pediatrics, McMaster UniversityHamilton, Ontario, Canada
| | - S Jaffer
- CanChild Centre for Childhood Disability Research, McMaster UniversityHamilton, Ontario, Canada
| | - M Law
- CanChild Centre for Childhood Disability Research, McMaster UniversityHamilton, Ontario, Canada
| | - D McCauley
- CanChild Centre for Childhood Disability Research, McMaster UniversityHamilton, Ontario, Canada
| | - J W Gorter
- Department of Pediatrics, McMaster UniversityHamilton, Ontario, Canada
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Adair B, Said CM, Rodda J, Morris ME. Psychometric properties of functional mobility tools in hereditary spastic paraplegia and other childhood neurological conditions. Dev Med Child Neurol 2012; 54:596-605. [PMID: 22524640 DOI: 10.1111/j.1469-8749.2012.04284.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To evaluate studies on the psychometric properties of measurement tools used to quantify functional mobility in children with hereditary spastic paraplegia (HSP) and other childhood neurological conditions. METHOD Two independent reviewers identified measures previously used by clinicians to quantify functional mobility. Because our primary interest was HSP, the first search identified measurement tools in studies that included those with HSP. To enhance the generalizability, the second search examined the reliability, validity, and responsiveness of tools in children with a range of neurological conditions such as cerebral palsy, spinal muscular atrophy, Down syndrome, and traumatic brain injury. The Consensus-based Standards for the Selection of Health Measurement Instruments was used to rate the methodological quality of identified articles. RESULTS The Gillette Functional Assessment Questionnaire (FAQ), the Functional Mobility Scale (FMS), the Gross Motor Function Measure (GMFM), the Rivermead Motor Assessment, and the Walking Index for Spinal Cord Injury II were identified for quantifying functional mobility. The FMS and GMFM were reliable, valid, and responsive to changes across a range of childhood neurological conditions. The FAQ was reliable and valid for measuring functional mobility in similar populations. INTERPRETATION The FAQ, FMS, and GMFM are valid, reliable, and responsive measures in children with a range of neurological conditions.
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Affiliation(s)
- Brooke Adair
- Department of Physiotherapy, The University of Melbourne, Victoria, Australia
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Foo WS, Galvin J, Olsen J. Participation of children with ABI and the relationship with discharge functional status. Dev Neurorehabil 2012; 15:1-12. [PMID: 22256829 DOI: 10.3109/17518423.2011.623142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To investigate the relationship between children's functional status at discharge from inpatient rehabilitation and participation in home, school and community life following paediatric acquired brain injury (ABI). METHODS The Child and Adolescent Scale of Participation (CASP) was mailed to 60 families of school-aged children who had sustained an ABI. Functional status data was obtained from the hospital database. Twenty-eight families participated in the study. RESULTS No statistically significant correlations between functional status at discharge and participation levels were found. CONCLUSIONS The lack of correlation raised questions regarding the sensitivity of the PEDI and the CASP. Therapists should consider the implication that children who perform well in functional tasks on the PEDI at discharge may not necessarily participate at age-expected levels upon return home. Environmental and child factors that hinder or support participation, such as physical infrastructure and impairments resulting from paediatric ABI, need to be considered when planning services.
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Affiliation(s)
- Wendy Shuhua Foo
- School of Occupational Therapy, Latrobe University, Melbourne, Australia
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McCauley SR, Wilde EA, Anderson VA, Bedell G, Beers SR, Campbell TF, Chapman SB, Ewing-Cobbs L, Gerring JP, Gioia GA, Levin HS, Michaud LJ, Prasad MR, Swaine BR, Turkstra LS, Wade SL, Yeates KO. Recommendations for the use of common outcome measures in pediatric traumatic brain injury research. J Neurotrauma 2012; 29:678-705. [PMID: 21644810 PMCID: PMC3289848 DOI: 10.1089/neu.2011.1838] [Citation(s) in RCA: 229] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup's recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from each identified domain including academics, adaptive and daily living skills, family and environment, global outcome, health-related quality of life, infant and toddler measures, language and communication, neuropsychological impairment, physical functioning, psychiatric and psychological functioning, recovery of consciousness, social role participation and social competence, social cognition, and TBI-related symptoms. In the second tier, supplemental measures were recommended for consideration in TBI research focusing on specific topics or populations. In the third tier, emerging measures included important instruments currently under development, in the process of validation, or nearing the point of published findings that have significant potential to be superior to measures in the core and supplemental lists and may eventually replace them as evidence for their utility emerges.
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Affiliation(s)
- Stephen R McCauley
- Department of Physical Medicine and Rehabilitation, Neurology, and Pediatrics, Baylor College of Medicine, and the Michael E. DeBakey Veterans Administration Medical Center, Houston, Texas 77030, USA.
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Field DA, Roxborough LA. Responsiveness of the Seated Postural Control Measure and the Level of Sitting Scale in children with neuromotor disorders. Disabil Rehabil Assist Technol 2011; 6:473-82. [DOI: 10.3109/17483107.2010.532285] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wright FV, Ryan J, Brewer K. Reliability of the Community Balance and Mobility Scale (CB&M) in high-functioning school-aged children and adolescents who have an acquired brain injury. Brain Inj 2010; 24:1585-94. [PMID: 20973626 DOI: 10.3109/02699052.2010.523045] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To examine inter-rater, intra-rater and test-re-test reliability of the Community Balance and Mobility Scale (CB&M) and compare reliability in live vs videotape rating contexts for children with acquired brain injury (ABI). RESEARCH DESIGN Repeated measures design. METHODS AND PROCEDURES Seven physiotherapists (PTs) were trained as assessors. The primary assessor administered and scored baseline CB&M while the second assessor observed and scored independently (inter-rater reliability). Re-assessment occurred 3-10 days later by primary assessor (test-re-test reliability). Assessments were videotaped. MAIN OUTCOMES AND RESULTS There were 32 participants with ABI (mean age = 14 years 1 month (SD = 2 years 1 month)). Baseline mean scores were 67.4% (18.2) and 66.7% (18.3) for primary and second assessor, respectively. Primary assessors' re-test mean score was 69.3%. Inter-rater reliability ICC was 0.93 (95% confidence interval (CI) = 0.87-0.97). Test-re-test ICC was 0.90 (95%CI = 0.81-0.95) and Bland-Altman plot indicated greatest test-re-test differences for mid-range CB&M scores. Minimum detectable change (MDC₉₀) was 13.5% points. CONCLUSIONS The CB&M showed excellent reliability in youth. Reliability was comparable for live and videotape rating approaches, meaning that the easier and less expensive live-rating can be recommended. Future work should focus on evaluation of responsiveness to change in rehabilitation centre and community intervention contexts.
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Fournier CJ, Davis MJ, Patnaik A, Elliott TR, Dyer JA, Jasek EE, Phillips CD. Modeling caregivers' perceptions of children's need for formal care: Physical function, intellectual disability, and behavior. Disabil Health J 2010; 3:213-21. [DOI: 10.1016/j.dhjo.2009.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2009] [Revised: 10/06/2009] [Accepted: 10/09/2009] [Indexed: 10/20/2022]
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Abstract
PURPOSE To examine functional recovery in mobility and self-care measured using the Pediatric Evaluation of Disability Inventory (PEDI) in children with spinal cord injury (SCI) during an inpatient rehabilitation stay and to identify how demographic and clinical variables relate to functional recovery. METHODS PEDI scores were collected through retrospective chart review for 32 children and adolescents with SCI (mean age, 10.6 +/- 6.2 years; range, 1-19 years) admitted to an inpatient physical rehabilitation program between 1995 and 2007. RESULTS Children with SCI showed significantly improved functional skill recovery and reduced caregiver assistance for the PEDI mobility and self-care domains after rehabilitation. Item analyses suggested more recovery in mobility than in self-care skills. Children with incomplete injury gained more independence in self-care than those with complete injury. CONCLUSIONS Children with SCI showed improved functional skills and reduced need for caregiver assistance as measured by the PEDI during inpatient rehabilitation.
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Abstract
BACKGROUND Rehabilitation professionals strive to provide high-quality evidence-based services for children. Developing systems to measure and monitor the benefits of our services, and health outcomes for children is complex and challenging. The Community Outcome Project aims to introduce systematic outcome measurement across the network of paediatric community-based brain injury services within the New South Wales Brain Injury Rehabilitation Program (BIRP) to support clinical practice and service evaluation. METHODS A literature review informed the development of the evaluative framework and identified available paediatric outcome measures which may be appropriate. Extensive consultation with clinicians supported project planning and identified clinical priorities that the outcome measures needed to capture. Outcome measures were shortlisted by matching them to identified clinical priorities, and then trialled in clinical practice. Qualitative feedback regarding clinical utility and feasibility was obtained from clinical staff. The process has utilized change management strategies to ensure the success of the project and keep staff engaged. RESULTS The process identified the three main clinical priorities for outcome measurement - family functioning, school performance and participation. Three outcome measures were chosen for the pilot project that is currently underway. They are Family Burden of Injury Interview, Academic Competence and Evaluation Scales and Child and Adolescent Scale of Participation. Plans for analyses of outcome data within the paediatric BIRP services are discussed. CONCLUSIONS Extensive preparation is required to optimize staff engagement in a project that systematically introduces outcome measures that are useful to clinicians, clients and service providers. Managing the change required is a key focus of the project. Benefits and costs to clinicians and services will be discussed.
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Affiliation(s)
- H Badge
- University of Sydney, Outcomes Manager, GMCT Brain Injury Rehabilitation Directorate, Liverpool Hospital, Liverpool, UK
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Ibey RJ, Chung R, Benjamin N, Littlejohn S, Sarginson A, Salbach NM, Kirkwood G, Wright V. Development of a challenge assessment tool for high-functioning children with an acquired brain injury. Pediatr Phys Ther 2010; 22:268-76. [PMID: 20699774 DOI: 10.1097/pep.0b013e3181ea8ff6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To develop a performance-based challenge assessment to evaluate gross motor abilities of high-functioning youth with an acquired brain injury (ABI). METHODS Potential items were identified from the literature. A panel of 4 expert physical therapists selected items on the basis of 3 criteria: safety to test, feasibility to administer, and importance to perform. Item reduction was completed using ratings from a physical therapist web survey. The Acquired Brain Injury-Challenge Assessment (ABI-CA) was created and pilot tested with youth with an ABI. RESULTS Seventy-eight items were identified and reduced to 47 items following expert panel discussion. Web-survey item reduction by 75 pediatric physical therapists yielded a 24-item ABI-CA that was administered to 6 youth with an ABI, aged 8 to 17 years. The ABI-CA mean score was 50.7/81.0 (SD = 17.4). CONCLUSION The ABI-CA was feasible to administer and demonstrated gross motor activity challenges beyond the Gross Motor Function Measure. Response option refinement and measure validation are required prior to clinical/research use.
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Affiliation(s)
- Robyn J Ibey
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Linder-Lucht M, Othmer V, Walther M, Vry J, Michaelis U, Stein S, Weissenmayer H, Korinthenberg R, Mall V. Validation of the Gross Motor Function Measure for use in children and adolescents with traumatic brain injuries. Pediatrics 2007; 120:e880-6. [PMID: 17908744 DOI: 10.1542/peds.2006-2258] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Motor function recovery is a key goal during rehabilitation of children and adolescents with traumatic brain injury. To evaluate how well treatment strategies improve motor function, we need validated outcome measures that are responsive to change in pediatric patients with traumatic brain injury. The Gross Motor Function Measure has demonstrated excellent psychometric properties in children with cerebral palsy and Down syndrome, yet its responsiveness in patients with pediatric traumatic brain injury has not been proven irrefutably. Our aim was to validate the Gross Motor Function Measure for this patient group. METHODS Seventy-three patients (mean age: 11.4 years; range: 0.8-18.9 years) with moderate-to-severe traumatic brain injury were recruited in 12 rehabilitation centers and assessed twice with the Gross Motor Function Measure-88 over 4 to 6 weeks. As an external standard, we used judgements of change made independently by parents, physiotherapists, and 2 video assessors who were not familiar with the patients. We formulated and statistically investigated a priori hypotheses of how Gross Motor Function Measure change scores would correlate with those judgements of change. Both Gross Motor Function Measure versions, the original Gross Motor Function Measure-88 and the more recently developed Gross Motor Function Measure-66, were evaluated. RESULTS Both Gross Motor Function Measure change scores correlated significantly with all of the clinical judgements of change. The degree of correlation that we postulated, that the Gross Motor Function Measure change score would correlate highest with the video rating followed by physiotherapists and parents, was fully confirmed by the Gross Motor Function Measure-88 and largely confirmed by the Gross Motor Function Measure-66. Both Gross Motor Function Measure versions revealed convincing discriminative capability. Test-retest reliability was excellent. CONCLUSIONS We demonstrate convincing evidence of responsiveness and validity to support the use of both Gross Motor Function Measure versions as evaluative measures of gross motor function in children and adolescents with traumatic brain injury.
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Affiliation(s)
- Michaela Linder-Lucht
- Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, Mathildenstrasse 1, D-79106 Freiburg, Germany.
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