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Vinge AFJ, Mondrup ME, Nielsen KT, Wæhrens EE. Assessment of motor and process skills in Danish occupational therapy practice. Scand J Occup Ther 2023; 30:1311-1329. [PMID: 37300535 DOI: 10.1080/11038128.2023.2220910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/30/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The demand for employment of standardized evaluations is increasing. In Denmark, approximately 25% of all occupational therapists (OTs) are trained to use the standardized occupational therapy instrument Assessment of Motor and Process Skills (AMPS). AIMS To investigate the use of AMPS within Danish occupational therapy practice and determine factors supporting or hindering the use. MATERIAL AND METHODS An online cross-sectional survey was conducted among OTs from various settings. RESULTS Overall, 844 calibrated OTs participated in the survey. Of these, 540 (64%) met the inclusion criteria and 486 (90%) completed the questionnaire. Forty percent of the participants used the AMPS in a standardized way during a one-month period and 56% reported being dissatisfied with the low number of AMPS evaluations completed. Five supporting and nine hindering factors were found to significantly influence the use of standardized AMPS evaluations. CONCLUSIONS/SIGNIFICANCE Despite demands for standardized evaluations, the AMPS is not regularly used in a standardized way within Danish occupational therapy practice. Use of AMPS in clinical practice seems to be facilitated by an acknowledgement from the management and the OT's ability to develop habits and routines. Time restraints were reported, however, time to conduct evaluations was not a statistically significant influencing factor.
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Affiliation(s)
- Annette Forsberg Jørgensen Vinge
- Occupation Science, User Perspectives and Community-based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mette Egelund Mondrup
- Occupation Science, User Perspectives and Community-based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
- Occupation-centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- Occupation Science, User Perspectives and Community-based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Occupation-centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Nielsen KT, Andersen U, Wæhrens EE, von Bülow C. Quality of ADL task performance in persons with schizophrenia: Looking beyond independence. Scand J Occup Ther 2023:1-10. [PMID: 36635973 DOI: 10.1080/11038128.2023.2165541] [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: 01/14/2023]
Abstract
BACKGROUND Persons with schizophrenia may experience decreased ability to perform activities of daily living (ADL) indicated by need for assistance in everyday life. Others are independent, but their quality of ADL task performance in terms of effort and efficiency may still be impacted. AIMS/OBJECTIVES The overall purpose of this study was to explore the quality of ADL task performance in subgroups with schizophrenia (independent/needing assistance). MATERIALS AND METHODS Participants were in- and outpatients at a Psychiatric Hospital diagnosed with schizophrenia (n = 83). Their quality of ADL task performance was evaluated using the Assessment of Motor and Process Skills (AMPS). Evaluations were conducted at the hospital. Two subgroups (A: independent and B: needing assistance) were created based on AMPS ADL ability measures. RESULTS The majority in both subgroups had AMPS ADL ability measures within the risk zones. Further, the majority in subgroup A had ADL ability measures within age expectations but below mean for well persons of the same age. Both ineffective motor and process skills were identified in both subgroups. CONCLUSIONS/SIGNIFICANCE Occupational therapy is indicated for persons with schizophrenia, both for independent persons and for persons needing assistance. This is to prevent decline in or to enhance ADL ability.
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Affiliation(s)
- Kristina Tomra Nielsen
- The Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark.,Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ulla Andersen
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,The Department of Occupational Therapy, Copenhagen University College, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, Occupational Science, User Perspectives and Community-Based Research, University of Southern Denmark, Odense, Denmark
| | - Cecilie von Bülow
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Fabricius J, Huynh MNM, Pedersen AR, Sampedro Pilegaard M. Predicting length of stay with assessment of motor and process skills in subjects with acquired brain injury. Brain Inj 2023; 37:1-6. [PMID: 36597272 DOI: 10.1080/02699052.2022.2163291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 09/30/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The Functional Independence Measure (FIM) is a well-established predictor of length of stay (LOS) for rehabilitation. The Assessment of Motor and Process Skills (AMPS) is a more in-depth construct for measuring activities of daily living (ADL) and may therefore be a valuable adjunct when predicting LOS. This paper aimed to investigate AMPS as a candidate predictor of LOS in a statistical model including FIM. METHODS A cohort study of 647 patients with acquired brain injuries admitted for rehabilitation. LOS was analyzed in a multiple regression model with the motor and process/cognitive domains of AMPS and FIM. RESULTS Independence in ADL process ability and FIM cognition were associated with 31% (p < 0.001) and 38% (p < 0.001) shorter LOS, respectively, relative to patients needing total assistance. Independence in ADL motor ability was associated with a 26% (p = 0.002) shorter LOS, whereas FIM motor was not a predictor. CONCLUSIONS The AMPS predicts LOS for rehabilitation at a level that is at least as good as that of FIM. Conducting the AMPS early in the course of inpatient rehabilitation provides clinicians and managers with valuable information for planning LOS.
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Affiliation(s)
- Jesper Fabricius
- Department of Research, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Martin Nhut Minh Huynh
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Asger Roer Pedersen
- Department of Research, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Marc Sampedro Pilegaard
- Department of Social Medicine and Rehabilitation, Gødstrup Hospital, Denmark
- DEFACTUM, Central Region Denmark, Aarhus, Denmark
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Lin LY, Chi IJ, Sung YS. Mediating effect of sequential memory on the relationship between visual-motor integration and self-care performance in young children with autism spectrum disorder. Front Psychol 2022; 13:988493. [PMID: 36275205 PMCID: PMC9583898 DOI: 10.3389/fpsyg.2022.988493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveVisual perception is a skill that contributes to the performance of self-care and important development tasks in early childhood. The relationship between self-care and visual perception is especially significant for young children with autism spectrum disorder (ASD), who have been described as visual learners. However, this relationship is not clearly understood among young children with ASD. We investigated the role of motor-free visual perception on the relationship between self-care and visual-motor integration in young children with ASD.MethodsA sample of 66 children with ASD aged 48 to 83 months were recruited. Measurements included the Assessment of Motor and Process Skills, the Developmental Test of Visual Perception—Third Edition, and Test of Visual-Perceptual Skills—Third Edition.ResultsThe results indicated that self-care performance had significant positive correlations with visual-motor integration, visual discrimination, visual memory, visual spatial relationships, and visual sequential memory. Of these, visual sequential memory and visual spatial relationships were the main factors related to self-care performance. Sequential memory was a mediator of the relationship between visual-motor integration and self-care performance.ConclusionThis study establishes a deeper understanding of self-care and motor-free visual perception among young children with ASD. Understanding the relationship between visual perception and self-care in young children with ASD may aid professionals in providing self-care interventions for this population.
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Affiliation(s)
- Ling-Yi Lin
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- *Correspondence: Ling-Yi Lin,
| | - I-Jou Chi
- Institute of Brain Science, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Shan Sung
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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5
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Garcia C, Collins R, McCabe D, Galvin R, Boland P. Impact of visual field loss post-stroke on activities of daily living: a prospective cohort study. Neuropsychol Rehabil 2022:1-16. [PMID: 35679176 DOI: 10.1080/09602011.2022.2081219] [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: 10/18/2022]
Abstract
This study investigated the ADL performances of people with VFL after an acute stroke using an observation-based evaluation of ADL skills, the Assessment of Motor and Process Skills. The AMPS was administered on initial assessment and at ≥11 weeks follow-up on 58 adults with a mild stroke, with (n = 16) and without VFL (n = 42), over a 13-month period. The AMPS guidelines on clinically relevant difference of 0.30 logits were used to determine the differences of the groups' ADL performance on initial assessment and follow-up. The study found that the ADL motor and process scores did not differ significantly on initial assessment. The study observed no clinically relevant difference between the ADL motor and process scores of between the VFL and non-VFL on initial assessment and follow-up but demonstrated clinically relevant improvements in ADL motor and process scores of both groups from initial assessment to follow-up. VFL does not have an additional negative impact on ADL performance of those with a mild stroke and does not impede improvement of ADL performance over time.
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Affiliation(s)
| | | | - Djh McCabe
- Tallaght University Hospital, Dublin, Ireland.,Vascular Neurology Research Foundation, Dept of Neurology, and Stroke Services, Tallaght University Hospital, Dublin, Ireland.,Department of Clinical Neurosciences, Royal Free Campus, UCL Queen Square Institute of Neurology, London, UK.,Academic Unit of Neurology School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Pauline Boland
- School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Mallinson T, Kozlowski AJ, Johnston MV, Weaver J, Terhorst L, Grampurohit N, Juengst S, Ehrlich-Jones L, Heinemann AW, Melvin J, Sood P, de Winckel AV. Rasch Reporting Guideline for Rehabilitation Research (RULER): The RULER Statement. Arch Phys Med Rehabil 2022; 103:1477-1486. [PMID: 35421395 DOI: 10.1016/j.apmr.2022.03.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
The application of Rasch Measurement (RM) Theory to rehabilitation assessments has proliferated in recent years. RM Theory helps design and refine assessments so that items reflect a unidimensional construct, in an equal interval metric that distinguishes among persons of different abilities in a manner that is consistent with the underlying trait. Rapid growth of RM in rehabilitation assessment studies has led to inconsistent results reporting. Clear, consistent, transparent reporting of RM Theory results is important for advancing rehabilitation science and practice based on precise measures. Precise measures, in turn, provide researchers, practitioners, patients, and other stakeholders with tools for effective decision-making. The goal of this Rasch Reporting Guideline for Rehabilitation Research (RULER) is to provide peer-reviewed, evidence-based, transparent, and consistent recommendations for reporting studies that apply RM Theory in a rehabilitation context. The purpose of the guideline is to ensure that authors, reviewers, and editors have uniform expectations about how to write and evaluate research on rehabilitation outcome assessments. A task force of rehabilitation researchers, clinicians, and editors met regularly between November 2018 and August 2020 to identify the need for the guideline, develop an organizing framework, identify content areas, and develop the recommendations. This RULER statement includes the organizing framework and a checklist of 59 recommendations. The guideline is supported by an Explanation & Elaboration manuscript that provides more detail about the framework and recommendations in the checklist. A glossary of key terms and a recommended iterations table are provided in supplemental, online only materials.
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Affiliation(s)
- Trudy Mallinson
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University
| | - Allan J Kozlowski
- Department of Epidemiology and Biostatistics, Michigan State University - College of Human Medicine and Mary Free Bed Rehabilitation Hospital
| | - Mark V Johnston
- Professor Emeritus, Department of Occupational Science & Technology, College of Health Sciences, University of Wisconsin-Milwaukee
| | - Jennifer Weaver
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University; Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh
| | - Namrata Grampurohit
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University
| | - Shannon Juengst
- Department of Physical Medicine and Rehabilitation, School of Health Professions, University of Texas Southwestern Medical Center
| | - Linda Ehrlich-Jones
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University and Shirley Ryan AbilityLab, Chicago, Illinois
| | - Allen W Heinemann
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University and Shirley Ryan AbilityLab, Chicago, Illinois
| | - John Melvin
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University
| | - Pallavi Sood
- Department of Aging & Geriatric Research, Institute of Aging, University of Florida
| | - Ann Van de Winckel
- Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota.
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Chi IJ, Lin LY. Using the Assessment of Motor and Process Skills and the Pediatric Evaluation of Disability Inventory to Assess Self-Care Performance Among Preschool Children With Autism Spectrum Disorder. Am J Occup Ther 2022; 76:23195. [PMID: 35143605 DOI: 10.5014/ajot.2022.046326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Caregiver rating scales often give an unclear picture of the actual self-care performance of preschool children with autism spectrum disorder (ASD). OBJECTIVE To assess self-care performance among preschool children with ASD using two standardized instruments. DESIGN Cross-sectional study. SETTING Clinics, hospitals, and early intervention centers in Tainan, Taiwan. PARTICIPANTS Sixty children with ASD (ages 48-71 mo). Outcomes and Measures: The Standard Version of the Childhood Autism Rating Scale-Second Edition, the Assessment of Motor and Process Skills (AMPS), and the Chinese version of the Pediatric Evaluation of Disability Inventory (PEDI-C). RESULTS About 53.3% of children with ASD scored below 1.5 logits for AMPS motor skills and below 1 logit for AMPS process skills, indicating difficulties performing activities of daily living tasks. The average PEDI-C self-care normative standard scores were moderately low (between -1 and -2 SDs), indicating poor self-care performance. The correlations between the two measures were also low (rs = .27-.44). Overall, the results for 36 children were consistent with AMPS and PEDI-C scores; however, those for 24 children (40.0%) were discrepant. CONCLUSIONS AND RELEVANCE These findings have implications for how preschool children with ASD perform their self-care activities and suggest that more than half of preschool children with ASD have a need for occupational therapy interventions that target self-care skills. Occupational therapy practitioners can work with preschool children with ASD and their families to help them improve their self-care performance. What This Article Adds: Many children with ASD need occupational therapy interventions that target self-care skills. Both the AMPS and the PEDI-C provide valuable information from different perspectives on the self-care performance of preschool children with ASD.
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Affiliation(s)
- I-Jou Chi
- I-Jou Chi, MS, is Occupational Therapist, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan. At the time this research was conducted, Chi was Graduate Student, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Yi Lin
- I-Jou Chi, MS, is Occupational Therapist, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan. At the time this research was conducted, Chi was Graduate Student, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Tan BL, Shi J, Yang S, Loh H, Ng D, Choo C, Medalia A. The use of virtual reality and augmented reality in psychosocial rehabilitation for adults with neurodevelopmental disorders: A systematic review. Front Psychiatry 2022; 13:1055204. [PMID: 36590624 PMCID: PMC9794993 DOI: 10.3389/fpsyt.2022.1055204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Virtual reality and augmented reality have been used in psychosocial rehabilitation for adults with neurodevelopmental disorders in recent years, to provide functional training in a scaffolded and appealing manner. This systematic review attempted to evaluate (1) how virtual reality or augmented reality technology was deployed, when used as an intervention for adults with neurodevelopmental disorders; and (2) how virtual or augmented reality-assisted psychosocial rehabilitation programs impacted on the functional domains of community living, employment and social participation. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was adopted and a search of publications between June 2012 and June 2022 was carried out. The target groups were adults with schizophrenia/schizoaffective disorders, autism spectrum disorder, intellectual disabilities and attention deficit hyperactivity disorder. Interventions that targeted at least one functional domain were included. RESULTS The database search generated 1,267 records and 38 studies met the inclusion criteria. Three studies utilized augmented reality while the rest utilized virtual reality. The virtual scenarios were displayed in various ways, such as head-mounted displays, computer screens, mobile devices and cave rooms. A few studies also used features such as speech recognition, eye tracking and motion-capture device to provide real-time feedback to participants during rehabilitation. Eleven studies reported interventions that addressed community living, 15 studies addressed vocational skills and nine studies trained participants in social skills or social cognition. Three studies sought to improve quality of life using virtual scenarios to expose participants to various situations. Majority of these studies reported preliminary promising results, with improvement in the functional domains addressed. However, several studies had small sample sizes and many single-arm pretest-posttest studies were assessed to be of serious or critical risk of bias. CONCLUSION Virtual reality and augmented reality are deployed in various ways to augment psychosocial rehabilitation for adults with neurodevelopmental disorders. Most interventions target skills training or strategy learning in the areas of community living, work and social participation. Preliminary positive findings of their effects on functional performance were reported. Larger and robust studies using ecologically valid outcome measures will be needed to establish their effects on real-world functional outcomes. SYSTEMATIC REVIEW REGISTRATION identifier: CRD42022335443.
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Affiliation(s)
- Bhing-Leet Tan
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore.,Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Jing Shi
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Suyi Yang
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Hannah Loh
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Desiree Ng
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Cherie Choo
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Alice Medalia
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
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Amris K, Bandak E, Kristensen LE, Wæhrens EE. Agreement between self-reported and observed functioning in patients with rheumatoid arthritis, osteoarthritis, and fibromyalgia, and the influence of pain and fatigue: a cross-sectional study. Scand J Rheumatol 2021; 51:452-460. [PMID: 34596488 DOI: 10.1080/03009742.2021.1952755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: To evaluate the relationship between self-reported and performance-based measures of functioning in rheumatoid arthritis (RA), knee osteoarthritis (OA), and fibromyalgia (FM), and the influence of pain and fatigue.Method: Self-reported functioning was assessed by the Stanford Health Assessment Questionnaire, Fibromyalgia Impact Questionnaire, and Knee injury and Osteoarthritis Outcome Score. Performance-based measures of task-related physical activity included grip strength and Six-Minute Walk Test (6MWT). Assessment of Motor and Process Skills (AMPS) was used to obtain performance-based measures of activities of daily living (ADL) ability. Pain and fatigue were assessed by 100 mm visual analogue scales. Spearman's rho correlation and regression modelling were applied.Results: Correlations between self-reported functioning and performance-based measures of ADL ability were weak to moderate, and strongest in OA (r = 0.57, p = 0.002), and AMPS ADL ability measures did not enter regression models as explanatory factors for self-reported functioning. Correlations between AMPS ADL ability measures and measures of task-related physical activity were weak, except for a strong correlation between AMPS ADL motor ability and 6MWT in OA (r = 0.63, p = 0.000). The 6MWT was the only performance-based test explaining variance in AMPS motor ability (OA = 42%; FM = 11%). Pain explained variance in self-reported ability and contributed to variance in AMPS ADL motor ability measures in OA.Conclusion: Self-reported and observed measures of functioning assess partly different aspects of functioning, and both approaches may therefore be relevant in a structured assessment of patients with musculoskeletal disorders.
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Affiliation(s)
- K Amris
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.,Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - E Bandak
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - L E Kristensen
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.,Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - E E Wæhrens
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.,Occupational Science & Occupational Therapy, User Perspectives and Community-Based Interventions, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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10
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Nielsen LM, Oestergaard LG, Kirkegaard H, Maribo T. Construct Validity and Clinical Utility of World Health Organization Disability Assessment Schedule 2.0 in Older Patients Discharged From Emergency Departments. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:710137. [PMID: 36188825 PMCID: PMC9397984 DOI: 10.3389/fresc.2021.710137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022]
Abstract
Introduction: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is designed to measure functioning and disability in six domains. It is included in the International Classification of Diseases 11th revision (ICD-11). The objective of the study was to examine the construct validity of WHODAS 2.0 and describe its clinical utility for the assessment of functioning and disability among older patients discharged from emergency departments (EDs). Material and Methods: This cross-sectional study is based on data from 129 older patients. Patients completed the 36-item version of WHODAS 2.0 together with the Barthel-20, the Assessment of Motor and Process Skills (AMPS), Timed Up and Go (TUG), and the 30-Second Chair Stand Test (30 s-CST). Construct validity was examined through hypothesis testing by correlating the WHODAS with the other instruments and specifically the mobility domain in WHODAS 2.0 with the TUG and 30 s-CST tests. The clinical utility of WHODAS 2.0 was explored through floor/ceiling effect and missing item responses. Results: WHODAS 2.0 correlated fair with Barthel-20 (r = -0.49), AMPS process skills (r = -0.26) and TUG (r=0.30) and correlated moderate with AMPS motor skills (r = -0.58) and 30s-CST (r = -0.52). The WHODAS 2.0 mobility domain correlated fair with TUG (r = 0.33) and moderate with 30s-CST (r = -0.60). Four domains demonstrated floor effect: D1 "Cognition," D3 "Self-care," D4 "Getting along," and D5 "Household." Ceiling effect was not identified. The highest proportion of missing item responses were present for Item 3.4 (Staying by yourself for a few days), Item 4.4 (Making new friends), and Item 4.5 (Sexual activities). Conclusion: WHODAS 2.0 had fair-to-moderate correlations with Barthel-20, AMPS, TUG, and 30s-CST and provides additional aspects of disability compared with commonly used instruments. However, the clinical utility of WHODAS 2.0 applied to older patients discharged from EDs poses some challenges due to floor effect and missing item responses. Accordingly, patient and health professional perspectives need further investigation.
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Affiliation(s)
- Louise Moeldrup Nielsen
- Department of Occupational Therapy, Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
| | - Hans Kirkegaard
- Research Centre for Emergency Medicine, Emergency Department, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
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Rawtaer I, Abdul Jabbar K, Liu X, Ying TTH, Giang AT, Yap PLK, Cheong RCY, Tan HP, Lee P, Wee SL, Ng TP. Performance-based IADL evaluation of older adults with cognitive impairment within a smart home: A feasibility study. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12152. [PMID: 33718585 PMCID: PMC7927161 DOI: 10.1002/trc2.12152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/25/2020] [Accepted: 01/06/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is characterized by subtle deficits that functional assessment via informant-report measures may not detect. Sensors can potentially detect deficits in everyday functioning in MCI. This study aims to establish feasibility and acceptability of using sensors in a smart home for performance-based assessments of two instrumental activities of daily living (IADLs). METHODS Thirty-five older adults (>65 years) performed two IADL tasks in a smart home laboratory equipped with sensors and a web camera. Participants' cognitive states were determined using published criteria including measures of global cognition and comprehensive neuropsychological test batteries. Selected subtasks of the IADL assessment were autonomously captured by the sensors. Total time taken for each task and subtask were computed. A point scoring system captured accuracy and number of attempts. Acceptability of the smart home setup was assessed. RESULTS Participants with MCI (n = 21) took longer to complete both tasks than participants with healthy cognition (HC; n = 14), with significant time differences observed only in "Cost calculation." Completion time for IADL tasks and scores correlated in the expected direction with global cognition. Over 95% of the participants found the smart home assessment acceptable and a positive experience. DISCUSSION We demonstrated the feasibility and acceptability of the use of unobtrusive commercially available sensors in a smart home for facilitating parts of the objective assessment of IADL in older adults. Future studies need to identify more IADLs that are suitable for semi-automated or automated assessments through the use of simple, low-cost sensors.
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Affiliation(s)
- Iris Rawtaer
- Geriatric Education and Research Institute (GERI)SingaporeSingapore
- Department of PsychiatrySengkang General HospitalSingaporeSingapore
| | | | - Xiao Liu
- Geriatric Education and Research Institute (GERI)SingaporeSingapore
| | | | - Anh Thuy Giang
- Rehabilitation DepartmentKhoo Teck Puat HospitalSingaporeSingapore
| | - Philip Lin Kiat Yap
- Geriatric Education and Research Institute (GERI)SingaporeSingapore
- Geriatric MedicineKhoo Teck Puat HospitalSingaporeSingapore
| | - Rachael Chin Yee Cheong
- Geriatric Education and Research Institute (GERI)SingaporeSingapore
- Geriatric MedicineKhoo Teck Puat HospitalSingaporeSingapore
| | - Hwee Pink Tan
- School of Information SystemsSingapore Management UniversitySingaporeSingapore
| | - Pius Lee
- School of Information SystemsSingapore Management UniversitySingaporeSingapore
| | - Shiou Liang Wee
- Geriatric Education and Research Institute (GERI)SingaporeSingapore
- Faculty of Health and Social SciencesSingapore Institute of TechnologySingaporeSingapore
| | - Tze Pin Ng
- Geriatric Education and Research Institute (GERI)SingaporeSingapore
- Department of Psychological MedicineNational University of SingaporeSingaporeSingapore
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12
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Kaptain RJ, Helle T, Patomella AH, Weinreich UM, Kottorp A. New Insights into Activities of Daily Living Performance in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2021; 16:1-12. [PMID: 33447024 PMCID: PMC7802487 DOI: 10.2147/copd.s264365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/11/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose There have been calls for more knowledge of activities of daily living (ADL) performance in order to address interventions in pulmonary rehabilitation effectively. Everyday technology (ET) has become an integrated dimension of ADL, impacting the ways in which ADL is performed. To improve everyday functioning and quality of life, the use of ADL and ET use needs to be evaluated and addressed effectively in interventions. Therefore, the aim of this study was twofold: 1) to explore the quality of ADL performance, and 2) to investigate the relationship between observation and self-reported ADL performance and ability to use everyday technologies in people living with COPD. Methods This cross-sectional study involved 84 participants aged 46–87 years. Participants were recruited through healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were collected using standardized assessments that investigated different ADL perspectives: self-reported ADL tasks and ET use, observed motor and process ability, and need for assistance. Data were analysed and presented using descriptive statistics and Pearson’s correlation coefficient. Results The most affected ADL tasks were mobility within or outside the home, lower dressing, bathing, pedicuring, cooking, shopping, cleaning and washing clothes. New insights into the quality of ADL performance in people living with COPD were presented in terms of detailed ADL motor skills and ADL process skills, as well as the predicted need for support to function in the community. Moreover, new insights into the relationship between observation and self-reported ADL performance (r=0.546, p<0.01; r=0.297, p<0.01) and between ADL performance and self-perceived ability to use ET (r=0.524, p<0.01; r=0.273, p<0.05; r=0.044, p=0.692) were presented. Conclusion Overall, the knowledge from the present study is valuable for focusing interventions that address challenging ADL performance and ET use through relevant and realistic activities. The ability to use ET is important to evaluate and target pulmonary rehabilitation.
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Affiliation(s)
- Rina Juel Kaptain
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark.,Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Tina Helle
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark.,Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Ann-Helen Patomella
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Ulla Møller Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark.,The Clinical Institute, Aalborg University, Aalborg, Denmark
| | - Anders Kottorp
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.,Faculty of Health and Society, Malmö University, Malmö, Sweden
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13
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Gartz R, Dickerson A, Radloff JC. Comparing Component-Based and Occupation-Based Interventions of a Person with Visual Deficits' Performance. Occup Ther Health Care 2020; 35:40-56. [PMID: 33347359 DOI: 10.1080/07380577.2020.1862443] [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: 10/22/2022]
Abstract
This study aimed to compare the effectiveness of component-based, occupation-based, and a combined intervention for visual-scanning to improve occupational performance. This exploratory case study used a 55-year-old female, seven years post-stroke with visual field deficits, who completed a component-based intervention (Vision Coach), an occupation-based intervention (IADL activities that incorporated scanning tasks), and a combined intervention. The Assessment of Motor and Process Skills (AMPS) was completed prior to and after each intervention. Participant's data was compared between interventions and AMPS standardization sample, with observable improvements in motor skills and process skills. Visual-scanning training as a compensatory method appears to be effective for chronic visual field deficits post-stroke, particularly using component-based and occupation-based interventions in combination.
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Affiliation(s)
- Rachel Gartz
- Rehabilitation - SCI/GR, Vidant Medical Center, Greenville, NC, USA
| | - Anne Dickerson
- Occupational Therapy, East Carolina University, Greenville, NC, USA
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14
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Chi IJ, Lin LY. Relationship Between the Performance of Self-Care and Visual Perception Among Young Children With Autism Spectrum Disorder and Typical Developing Children. Autism Res 2020; 14:315-323. [PMID: 32881415 DOI: 10.1002/aur.2367] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 11/06/2022]
Abstract
Studies investigating the performance of self-care and visual perception in young children with autism spectrum disorder (ASD) are limited. The relationship between self-care performance and visual perception ability in young children with ASD is not yet clearly understood. Here, self-care performance was evaluated by the caregivers and therapists of children with ASD. The differences in self-care performance and visual perception ability were investigated in 66 children with ASD and 66 typically developing (TD) children between the ages of 48-83 months. The relationships between self-care and visual perception were tested in both two groups. The Assessment of Motor and Process Skills (AMPS) and the Chinese version of the Pediatric Evaluation of Disability Inventory (PEDI-C) were used to assess the children's self-care performance. The Test of Visual Perceptual Skills-Third Edition (TVPS-3) and the Developmental Test of Visual Perception-Third Edition (DTVP-3) were used to evaluate visual perception ability. Young children with ASD obtained significantly lower scores for self-care performance (AMPS and PEDI-C) and visual perception ability (TVPS-3 and DTVP) compared with TD children. Additionally, positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD. The findings of this research highlight the need for pediatric practitioners to include self-care and visual-motor integration evaluations for young children with ASD. LAY SUMMARY: Young children with ASD obtained significantly lower scores for self-care performance and visual perception ability compared with TD children. Positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD.
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Affiliation(s)
- I-Jou Chi
- Departments of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Yi Lin
- Departments of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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15
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Cuesta-Vargas A, Martin-Martin J, Gonzalez-Sanchez M, Merchan-Baeza JA, Perez-Cruzado D. Identification of Tools for the Functional and Subjective Assessment of Patients in an Aquatic Environment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165690. [PMID: 32781711 PMCID: PMC7460483 DOI: 10.3390/ijerph17165690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/16/2022]
Abstract
Aquatic therapy is one of the most common treatments for alleviating musculoskeletal pathologies. Its effectiveness has been evaluated with functional tests and questionnaires. Functional tests are used in aquatic therapy; however, in most cases, they are carried out in a non-aquatic environment and, as such, their results may differ from those of tests performed in an aquatic environment. A systematic review was performed to assess the accuracy of functional tests and patient-reported outcomes to assess aquatic therapy interventions. The authors conducted a literature search in July 2019. In total, 70,863 records were identified after duplicates removed. Of these, 14 records were included about functional tests assessment in aquatic environment and 725 records for questionnaires. The majority of the tests had also been assessed in a dry environment, allowing differences and similarities between the tests in the two environments to be observed. Different variables have been assessed in tests included in the present systematic review (cardiorespiratory, neuromuscular, kinematic, physiological, kinetic responses and rating of perceived exertion) which are included in the manuscript. Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and the 12-item Short Form Health Survey were the assessments most commonly used by the different authors.
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Affiliation(s)
- Antonio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Malaga, Spain; (A.C.-V.); (M.G.-S.)
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
| | - Jaime Martin-Martin
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Legal Medicine Area, Department of Human Anatomy, Legal Medicine and History of Science, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain
- Correspondence:
| | - Manuel Gonzalez-Sanchez
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Malaga, Spain; (A.C.-V.); (M.G.-S.)
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
| | - Jose Antonio Merchan-Baeza
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - David Perez-Cruzado
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Department of Occupational Therapy, Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
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16
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Nielsen LM, Maribo T, Kirkegaard H, Bjerregaard MK, Oestergaard LG. Identifying elderly patients at risk of readmission after discharge from a short-stay unit in the emergency department using performance-based tests of daily activities. BMC Geriatr 2020; 20:217. [PMID: 32571229 PMCID: PMC7310017 DOI: 10.1186/s12877-020-01591-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/21/2020] [Indexed: 11/21/2022] Open
Abstract
Background Readmission is a serious and adverse event for elderly patients. Despite efforts, predicting the risk of readmission remains imprecise. The objective of this study is to examine if performance-based tests of daily activities can identify elderly patients at risk of readmission within 26 weeks after discharge from a short-stay unit in the emergency department. Methods The current study is an observational study based on data from 144 elderly patients included in a previous non-randomised controlled trial. Before discharge, patients were assessed for limitations in performing daily activities using three performance-based tests with predetermined cut-off values: the Assessment of Motor and Process Skills, Timed Up and Go and the 30s-Chair Stand Test. Outcome was risk of readmission within 26 weeks after discharge. Results Limitations in performing daily activities were associated with risk of readmission as measured by the Assessment of Motor and Process Skills motor scale (Crude OR = 4.38 [1.36; 14.12]), (Adjusted OR = 4.17 [1.18; 14.75]) and the 30s-Chair Stand Test (Adjusted OR = 3.36 [1.42; 7.93]). No significant associations were found in regards to other measures. Conclusion The Assessment of Motor and Process Skills motor scale and the age, gender and comorbidity adjusted 30s-Chair Stand Test can identify elderly patients at increased risk of readmission after discharge from the emergency department. The results were limited by one-third of the patients did not perform the Assessment of Motor and Process Skills and the association between 30s-Chair Stand Test and risk of readmission were only positive when adjusted for age, gender and comorbidity.
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Affiliation(s)
- Louise Moeldrup Nielsen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Arhus, Denmark. .,Department of Occupational Therapy, VIA University College, Aarhus, Denmark.
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Hans Kirkegaard
- Research Centre for Emergency Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | | | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Arhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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17
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Eriksson BM, Ekström AB, Peny-Dahlstrand M. Daily activity performance in congenital and childhood forms of myotonic dystrophy type 1: a population-based study. Dev Med Child Neurol 2020; 62:723-728. [PMID: 31701525 DOI: 10.1111/dmcn.14395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2019] [Indexed: 11/28/2022]
Abstract
AIMS To identify and describe the profile characterizing motor and process skills during daily activity performance in individuals with congenital and childhood forms of myotonic dystrophy type 1 (DM1) and to investigate differences in performance between subgroups. METHOD Sixty participants (34 males, 26 females, mean age=17y 8mo, SD=6y 0mo, range 5y 8mo-29y 0mo) were divided into severe congenital (n=9), mild congenital (n=20), and childhood (n=31) DM1 subgroups. Daily activity performance was evaluated using a standardized observational instrument: the Assessment of Motor and Process Skills. RESULTS Deficits in performance were more pronounced in process than motor skills. Performance more than 2 SDs below age-specific norms was seen in 65% of participants for process skills and 33% of participants for motor skills. The cut-off scores indicated a potential need for assistance in daily activities for 79% of participants older than 18 years of age (n=28) due to deficient process skills. INTERPRETATION Extensive deficits in daily activity performance were found in congenital and childhood forms of DM1, mainly owing to deficient process skills. Such skills impact on the ability to perform daily activities and could explain dependency in individuals with DM1. Process skills should be considered when evaluating daily activity performance. WHAT THIS PAPER ADDS Young people with myotonic dystrophy type 1 show deficits in motor and process skills when performing daily activities, compared with normative data. Deficits in process skills were more pronounced than deficits in motor skills.
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Affiliation(s)
- Britt-Marie Eriksson
- Regional Pediatric Rehabilitation Center, Silvia Children's Hospital, Queen, Gothenburg
| | - Anne-Berit Ekström
- Regional Pediatric Rehabilitation Center, Silvia Children's Hospital, Queen, Gothenburg
| | - Marie Peny-Dahlstrand
- Regional Pediatric Rehabilitation Center, Silvia Children's Hospital, Queen, Gothenburg.,Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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18
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Walsh RJ, Lee J, Drasga RM, Leggett CS, Shapnick HM, Kottorp AB. Everyday Technology Use and Overall Needed Assistance to Function in the Home and Community Among Urban Older Adults. J Appl Gerontol 2019; 39:1115-1123. [PMID: 31578898 DOI: 10.1177/0733464819878620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Older adults manage increasing numbers of everyday technologies to participate in home and community activities. Purpose: We investigated how assessing use of everyday technologies enhanced predictions of overall needed assistance among urban older adults. Method: We used a cross-sectional design to analyze responses from 114 participants completing the Everyday Technology Use Questionnaire, the Montreal Cognitive Assessment, and a sociodemographic questionnaire. We estimated overall needed assistance based on definitions in the Assessment of Motor and Process Skills. We created logistic regression models and receiver operator characteristic curves to analyze variables predicting overall needed assistance. Findings: With high specificity and sensitivity, the Everyday Technology Use Questionnaire and the Montreal Cognitive Assessment were the strongest predictors of overall needed assistance. Implications: Assessing everyday technology use enhanced predictions of overall needed assistance among urban older adults.
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Affiliation(s)
- Ryan J Walsh
- School of Medicine, Washington University, St. Louis, MO, USA
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19
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Brekke MF, la Cour K, Brandt Å, Peoples H, Wæhrens EE. The Association between ADL Ability and Quality of Life among People with Advanced Cancer. Occup Ther Int 2019; 2019:2629673. [PMID: 31531007 PMCID: PMC6745094 DOI: 10.1155/2019/2629673] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/09/2019] [Accepted: 08/06/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Occupational therapy and occupational science are founded on the theoretical core assumption that occupation and quality of life (QoL) are closely related. However, such theoretical core assumptions must be supported through empirically based research. OBJECTIVE To investigate the association between QoL and occupation, here self-reported and observed ADL abilities as a part of occupation, among people with advanced cancer, including determining whether self-reported or observed ADL ability had the stronger association with QoL. METHODS The study was nested in a cross-sectional study. The association between ADL ability and QoL among 108 people with advanced cancer was investigated using the ADL Interview (ADL-I), the Assessment of Motor and Process Skills (AMPS), and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-C30). RESULTS AND CONCLUSIONS Results showed that high observed ADL motor ability was associated with high QoL. In contrast, observed ADL process ability and self-reported ADL ability were not significantly associated with QoL. Oppositely expected, observed ADL ability had a stronger association with QoL than self-reported ADL ability. Thereby, the study to some extent contributes knowledge confirming the theoretical core assumptions about the relation between occupation, here performance of ADL, and QoL.
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Affiliation(s)
- Mette Falk Brekke
- Department of Occupational Therapy, University College Absalon, Næstved, Denmark
| | - Karen la Cour
- Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
- The Danish Knowledge Center for Rehabilitation and Palliative Care, REHPA, Vestergade 17, 5800 Nyborg, Denmark
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
| | - Åse Brandt
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- Centre for Disability and Mental Vulnerability, The National Board of Social Services, Odense, Denmark
| | - Hanne Peoples
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- Faculty of Health Sciences, Health Sciences Research Center, University College Lillebaelt, Odense, Denmark
| | - Eva Ejlersen Wæhrens
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- The Parker Institute, Copenhagen University Hospital Bispebjerg & Frederiksberg, Copenhagen, Denmark
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20
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Miller KK, Lin SH, Neville M. From Hospital to Home to Participation: A Position Paper on Transition Planning Poststroke. Arch Phys Med Rehabil 2018; 100:1162-1175. [PMID: 30465739 DOI: 10.1016/j.apmr.2018.10.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/18/2018] [Accepted: 10/27/2018] [Indexed: 12/25/2022]
Abstract
Based on a review of the evidence, members of the American Congress of Rehabilitation Medicine Stroke Group's Movement Interventions Task Force offer these 5 recommendations to help improve transitions of care for patients and their caregivers: (1) improving communication processes; (2) using transition specialists; (3) implementing a patient-centered discharge checklist; (4) using standardized outcome measures; and (5) establishing partnerships with community wellness programs. Because of changes in health care policy, there are incentives to improve transitions during stroke rehabilitation. Although transition management programs often include multidisciplinary teams, medication management, caregiver education, and follow-up care management, there is a lack of a comprehensive and standardized approach to implement transition management protocols during poststroke rehabilitation. This article uses the Transitions of Care (TOC) model to conceptualize how to facilitate a comprehensive patient-centered hand off at discharge to maximize patient functioning and health. Specifically, this article reviews current guidelines and provides an evidence summary of several commonly cited approaches (Early Supported Discharge, planned predischarge home visits, discharge checklists) to manage TOC, followed by a description of documented barriers to effective transitions. Patient-centered and standardized transition management may improve community integration, activities of daily living performance, and quality of life for stroke survivors while also decreasing hospital readmission rates during the transition from hospital to home to community.
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Affiliation(s)
- Kristine K Miller
- Department of Physical Therapy, Indiana University, Indianapolis, IN.
| | - Susan H Lin
- Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, MA
| | - Marsha Neville
- School of Occupational Therapy, Texas Woman's University, Dallas, TX
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21
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Nielsen LM, Maribo T, Kirkegaard H, Petersen KS, Oestergaard LG. Development of a complex intervention aimed at reducing the risk of readmission of elderly patients discharged from the emergency department using the intervention mapping protocol. BMC Health Serv Res 2018; 18:588. [PMID: 30055597 PMCID: PMC6064169 DOI: 10.1186/s12913-018-3391-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 07/15/2018] [Indexed: 11/10/2022] Open
Abstract
Background Limitations in performing daily activities and a incoherent discharge are risk factors for readmission of elderly patients after discharge from the emergency department. This paper describes the development and design of a complex intervention whose aim was to reduce the risk of readmission of elderly patients discharged from the emergency department. Methods The intervention was described using the Intervention Mapping approach. In step 1, a needs assessment was conducted to analyse causes of readmission. In steps 2 and 3, expected improvements in terms of intervention outcomes, performance objectives and change objectives were specified and linked to selected theory- and evidence-based methods. In step 4, the specific intervention components were developed; and in step 5, an implementation plan was described. Finally, in step 6, a plan for evaluating the effectiveness of the intervention was described. The intervention was informed by input from a literature search, informal interviews and an expert steering group. Results A three-phased theory- and evidence-based intervention was developed. The intervention consisted of 1) assessment of performance of daily activities, 2) defining a rehabilitation plan and 3) a follow-up home visit the day after discharge with focus on enhancing the patients’ performance of daily activities. Conclusion The intervention mapping protocol was found to be a useful method to describe and systemize this theory- and evidence-based intervention. Electronic supplementary material The online version of this article (10.1186/s12913-018-3391-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louise Moeldrup Nielsen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark. .,Department of Occupational Therapy, VIA University College, Aarhus, Denmark.
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region , Aarhus, Denmark
| | - Hans Kirkegaard
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark.,Centre of Research in Rehabilitation (CORIR) Department of Clinical Medicin, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
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22
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Nielsen LM, Maribo T, Kirkegaard H, Petersen KS, Lisby M, Oestergaard LG. Effectiveness of the "Elderly Activity Performance Intervention" on elderly patients' discharge from a short-stay unit at the emergency department: a quasi-experimental trial. Clin Interv Aging 2018; 13:737-747. [PMID: 29731615 PMCID: PMC5927350 DOI: 10.2147/cia.s162623] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose To examine the effectiveness of the Elderly Activity Performance Intervention on reducing the risk of readmission in elderly patients discharged from a short-stay unit at the emergency department. Patients and methods The study was conducted as a nonrandomized, quasi-experimental trial. Three hundred and seventy-five elderly patients were included and allocated to the Elderly Activity Performance Intervention (n=144) or usual practice (n=231). The intervention consisted of 1) assessment of the patients’ performance of daily activities, 2) referral to further rehabilitation, and 3) follow-up visit the day after discharge. Primary outcome was readmission (yes/no) within 26 weeks. The study was registered in ClinicalTrial.gov (NCT02078466). Results No between-group differences were found in readmission. Overall, 44% of the patients in the intervention group and 42% in the usual practice group were readmitted within 26 weeks (risk difference=0.02, 95% CI: [−0.08; 0.12] and risk ratio=1.05, 95% CI: [0.83; 1.33]). No between-group differences were found in any of the secondary outcomes. Conclusion The Elderly Activity Performance Intervention showed no effectiveness in reducing the risk of readmission in elderly patients discharged from a short-stay unit at the emergency department. The study revealed that 60% of the elderly patients had a need for further rehabilitation after discharge.
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Affiliation(s)
- Louise Moeldrup Nielsen
- Department of Occupational Therapy, VIA University College.,Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital
| | - Thomas Maribo
- Department of Public Health, Aarhus University, DEFACTUM
| | - Hans Kirkegaard
- Department of Clinical Medicine, Research Centre for Emergency Medicine, Aarhus University Hospital, Aarhus
| | | | - Marianne Lisby
- Department of Clinical Medicine, Research Centre for Emergency Medicine, Aarhus University Hospital, Aarhus
| | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital.,Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
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23
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Nielsen LM, Kirkegaard H, Østergaard LG, Bovbjerg K, Breinholt K, Maribo T. Comparison of self-reported and performance-based measures of functional ability in elderly patients in an emergency department: implications for selection of clinical outcome measures. BMC Geriatr 2016; 16:199. [PMID: 27899065 PMCID: PMC5129645 DOI: 10.1186/s12877-016-0376-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 11/23/2016] [Indexed: 11/10/2022] Open
Abstract
Background Assessment of functional ability in elderly patients is often based on self-reported rather than performance-based measures. This study aims to compare self-reported and performance-based measures of functional ability in a population of elderly patients at an emergency department (ED). Methods Participants were 61 patients aged 65 years and above admitted to an ED. The self-reported measure used was the Barthel-20; the performance-based measures were Timed Up and Go (TUG); 30s-Chair Stand Test (30s-CST) and Assessment of Motor and Process Skills (AMPS) with the two scales; motor and process. Correlation analyses were conducted to examine the relationships between the self-reported and performance-based measures of functional ability. Results The correlation between the Barthel-20 and the TUG was moderate (r = −0.64). The correlation between the Barthel-20 and the AMPS motor was also moderate (r = 0.53). The correlation between the Barthel-20 and the 30s-CST was fair (r = 0.45). The correlation between Barthel-20 and the AMPS process was non-significant. The results were affected by high ceiling effect (Barthel-20). Conclusion Self-reported and performance-based measures seem to assess different aspects of functional ability. Thus, the two methods provide different information, and this highlight the importance of supplementing self-reported measures with performance-based measures when assessing functional ability in elderly patients. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0376-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louise M Nielsen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark. .,School of Occupational Therapy at VIA University College, Aarhus N, Denmark.
| | - Hans Kirkegaard
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus C, Denmark
| | - Lisa G Østergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark
| | - Karina Bovbjerg
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark
| | - Kasper Breinholt
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark
| | - Thomas Maribo
- MarselisborgCentret, DEFACTUM, Central Denmark Region, Department of Public Health, Aarhus University, Aarhus C, Denmark
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Rasmussen MU, Amris K, Rydahl-Hansen S, Danneskiold-Samsoe B, Mortensen EL, Christensen R, H Sjölund B. Are the changes in observed functioning after multi-disciplinary rehabilitation of patients with fibromyalgia associated with changes in pain self-efficacy? Disabil Rehabil 2016; 39:1744-1752. [PMID: 27632051 DOI: 10.1080/09638288.2016.1211179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the hypothesis that change in pain self-efficacy is associated with observed and self-reported activity, pain intensity, catastrophizing, and quality of life after multi-disciplinary rehabilitation of fibromyalgia patients. DESIGN In-depth analyses of secondary outcomes of a randomized-controlled trial. SUBJECTS Women (N = 187) with fibromyalgia. METHODS Outcomes were Pain Self-Efficacy, Assessment of Motor and Process Skills (AMPS), SF-36 Physical Function (SF-36-PF), pain intensity, and SF-36 Mental Composite Score (SF-36-MCS) to assess quality of life and pain catastrophizing. Individual and group associations between outcomes were examined. RESULTS Individual changes in pain self-efficacy were not associated with changes in observed activity: AMPS motor (rs = 0.08, p = 0.27) and process (rs = 0.12, p = 0.11), not even in those patients with a clinically relevant improvement in observed functioning (38.5%), and only weakly or moderatly with changes in SF-36-PF; (rs = 0.31, p < 0.0001), SF-36-MSC; (rs = 0.41, p < 0.0001), and pain catastrophizing (rs = -0.31, p < 0.0001). No differences in pain self-efficacy were observed between the rehabilitated group and controls (difference: 1.61; 95% CI: -0.84 to 4.06; p = 0.24). However, a subgroup (34%) had a clinically relevant improvement in pain self-efficacy. This group was younger (mean age 41.4 vs. 45.8, p = 0.01), more recently diagnosed (1.8 vs. 2.8 years, p = 0.003), but had an unresolved welfare situation (59% vs. 40%, p = 0.02). CONCLUSION The main hypothesis was falsified, as there was no association between pain self-efficacy and actual performance of activity. The relation to functioning may be limited to perceived, cognitive-emotional aspects, as indicated by the weak to moderate correlations to the self-reported measures. Implications for Rehabilitation Improvement in observed activity post multi-disciplinary rehabilitation was not associated with change in pain self-efficacy. Patients performed better after rehabilitation, but did not perceive to have improved their capacity. The relationship between pain self-efficacy and functioning may be limited to cognitive-emotional aspects rather than actual activity. Both observational and self-reported measures should be included in evaluating outcomes of rehabilitation for patients with fibromyalgia.
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Affiliation(s)
- Marianne Uggen Rasmussen
- a The Parker Institute , Department of Rheumatology , Bispebjerg and Frederiksberg Hospital , Capital Region of Copenhagen , Frederiksberg , Denmark.,b Institute of Public Health, University of Southern Denmark , Odense C , Denmark
| | - Kirstine Amris
- a The Parker Institute , Department of Rheumatology , Bispebjerg and Frederiksberg Hospital , Capital Region of Copenhagen , Frederiksberg , Denmark
| | - Susan Rydahl-Hansen
- c Research Unit of Clinical Nursing , Bispebjerg and Frederiksberg Hospital , Capital Region of Copenhagen , København , Denmark.,d Section for Nursing Department of Public Health , Aarhus University , Aarhus , Denmark
| | - Bente Danneskiold-Samsoe
- a The Parker Institute , Department of Rheumatology , Bispebjerg and Frederiksberg Hospital , Capital Region of Copenhagen , Frederiksberg , Denmark
| | - Erik Lykke Mortensen
- e Department of Public Health and Center for Healthy Aging , University of Copenhagen , København K , Denmark
| | - Robin Christensen
- a The Parker Institute , Department of Rheumatology , Bispebjerg and Frederiksberg Hospital , Capital Region of Copenhagen , Frederiksberg , Denmark
| | - Bengt H Sjölund
- b Institute of Public Health, University of Southern Denmark , Odense C , Denmark
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Norup A, Guldberg AM, Friis CR, Deurell EM, Forchhammer HB. An interdisciplinary visual team in an acute and sub-acute stroke unit: Providing assessment and early rehabilitation. NeuroRehabilitation 2016; 39:451-61. [PMID: 27589515 DOI: 10.3233/nre-161376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe the work of an interdisciplinary visual team in a stroke unit providing early identification and assessment of patients with visual symptoms, and secondly to investigate frequency, type of visual deficits after stroke and self-evaluated impact on everyday life after stroke. METHODS For a period of three months, all stroke patients with visual or visuo-attentional deficits were registered, and data concerning etiology, severity and localization of the stroke and initial visual symptoms were registered. One month after discharge patients were contacted for follow-up. RESULTS Of 349 acute stroke admissions, 84 (24.1%) had visual or visuo-attentional deficits initially. Of these 84 patients, informed consent was obtained from 22 patients with a mean age of 67.7 years(SD 10.1), and the majority was female (59.1%). Based on the initial neurological examination, 45.4% had some kind of visual field defect, 27.2% had some kind of oculomotor nerve palsy, and about 31.8% had some kind of inattention or visual neglect. The patients were contacted for a phone-based follow-up one month after discharge, where 85.7% reported changes in their vision since their stroke. CONCLUSION In this consecutive sample, a quarter of all stroke patients had visual or visuo-attentional deficits initially. This emphasizes how professionals should have increased awareness of the existence of such deficits after stroke in order to provide the necessary interdisciplinary assessment and rehabilitation.
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Affiliation(s)
- Anne Norup
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne-Mette Guldberg
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Claus Radmer Friis
- Department of Occupational Therapy and Physiotherapy, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eva Maria Deurell
- Department of Occupational Therapy and Physiotherapy, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Ryd C, Nygård L, Malinowsky C, Öhman A, Kottorp A. Can the everyday technology use questionnaire predict overall functional level among older adults with mild cognitive impairment or mild-stage alzheimer's disease? - a pilot study. Scand J Caring Sci 2016; 31:201-209. [DOI: 10.1111/scs.12330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 12/21/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Charlotta Ryd
- Division of Occupational Therapy; Department of Neurobiology, Care sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Louise Nygård
- Division of Occupational Therapy; Department of Neurobiology, Care sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Camilla Malinowsky
- Division of Occupational Therapy; Department of Neurobiology, Care sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Annika Öhman
- Division of Health Activity and Care; National Institute for the Study of Ageing and Later Life (NISAL); Department of Social and Welfare studies; Linköping University; Norrköping Sweden
| | - Anders Kottorp
- Division of Occupational Therapy; Department of Neurobiology, Care sciences and Society; Karolinska Institutet; Stockholm Sweden
- Department of Occupational Therapy; Zurich University of Applied Sciences; Winterthur Switzerland
- Department of Occupational Therapy; University of Illinois at Chicago; Chicago IL USA
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Huertas Hoyas E, Pedrero Pérez EJ, Águila Maturana AM, Rojo Mota G, Martínez Piédrola R, Pérez de Heredia Torres M. Outcomes of a multicomponent intervention on occupational performance in persons with unilateral acquired brain injury. FUNCTIONAL NEUROLOGY 2016; 31:109-15. [PMID: 27358224 DOI: 10.11138/fneur/2016.31.2.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Complications after unilateral acquired brain injury (ABI) can affect various areas of expertise causing (depending on the location of the lesion) impairment in occupational performance. The aim of this study was to analyze and compare the concepts of occupational performance and functional independence, both before and after a multicomponent intervention including occupational therapy, in persons with unilateral brain damage. This was a longitudinal quasi-experimental pretest post-test study in a sample of 58 patients with unilateral brain injury (28 with traumatic brain injury and 30 with ischemic stroke). The patients' level of independence was measured using the short version of the International Classification of Functioning, Disability and Health. We also measured quality of performance using the Assessment of Motor and Process Skills. The findings of this study showed that patients with injury in the right hemisphere improved more than those with left hemisphere damage (p<0.001). All the patients with ABI, especially those with right-sided injury, derived benefit from the multicomponent intervention, except in the area of motor skills. More research is needed on the specific techniques that might address such skills.
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MacKenzie DE, Westwood DA. Investigating visual attention during scene perception of safe and unsafe occupational performance. The Canadian Journal of Occupational Therapy 2015; 82:224-34. [PMID: 26502017 DOI: 10.1177/0008417414568010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Occupational therapists routinely use observation for evaluation, intervention planning, and prediction of a client's occupational performance and/or safety within the environment. Perception of safety contributes to the decision-making process for discharge or placement recommendations. PURPOSE The purpose of this study was to determine if differences exist in safety ratings and eye movements between occupational therapists and nontrained matched individuals while viewing domain-specific versus non-domain-specific images. METHOD Ten licensed occupational therapists and 10 age-, gender-, and education level-matched participants completed this eye-tracking study. FINDINGS For all image exposure durations, occupational therapists had more polarized safety ratings for stroke-related image content but little evidence of differences in eye movements between groups. Eye movement group differences did not emerge in the regions of interest identified by an independent expert panel. IMPLICATIONS The results point to a complex relationship between decision making and observational behaviour in occupational assessment and highlight the need to look beyond image features.
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Von Bülow C, Amris K, La Cour K, Danneskiold-Samsøe B, Wæhrens EE. Ineffective ADL skills in women with fibromyalgia: a cross-sectional study. Scand J Occup Ther 2015; 23:391-7. [PMID: 26468666 DOI: 10.3109/11038128.2015.1095237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Subgroups of women with fibromyalgia likely show different activity of daily living (ADL) skill deficits. Identifying ineffective ADL skills of significance in the 'typical' woman with fibromyalgia will promote the planning of targeted occupational therapy interventions aiming at improving ADL ability. OBJECTIVE To identify frequently reported ADL skill deficits of significance in subgroups of women with fibromyalgia who have decreased ADL motor ability in combination with decreased or competent ADL process ability. METHOD Women with fibromyalgia were evaluated with the Assessment of Motor and Process Skills (AMPS). If they demonstrated decreased ADL motor ability, the calibrated AMPS raters identified and reported ineffective ADL skills of significance. Descriptive comparisons were made between subgroups displaying either decreased or competent ADL process ability. RESULTS Moves, calibrates, bends, reaches, and paces were identified as the most frequently reported ineffective ADL skills of significance within the total sample (n = 188). The ADL process skills items organise and accommodate were identified as ineffective only in the subgroup with decreased ADL process ability (n = 105). CONCLUSION It is suggested that clinicians modify the individual's tasks and environments to compensate for identified ineffective ADL skills and to use the AMPS to differentiate interventions in women with fibromyalgia.
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Affiliation(s)
- Cecilie Von Bülow
- a The Parker Institute, Department of Rheumatology , Copenhagen University Hospital , Bispebjerg and Frederiksberg , Denmark .,b The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark , and.,c Metropolitan University College , Copenhagen , Denmark
| | - Kirstine Amris
- a The Parker Institute, Department of Rheumatology , Copenhagen University Hospital , Bispebjerg and Frederiksberg , Denmark
| | - Karen La Cour
- b The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark , and
| | - Bente Danneskiold-Samsøe
- a The Parker Institute, Department of Rheumatology , Copenhagen University Hospital , Bispebjerg and Frederiksberg , Denmark
| | - Eva Ejlersen Wæhrens
- a The Parker Institute, Department of Rheumatology , Copenhagen University Hospital , Bispebjerg and Frederiksberg , Denmark .,b The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark , and
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Ayres H, Panickacheril John A. The Assessment of Motor and Process Skills as a measure of ADL ability in schizophrenia. Scand J Occup Ther 2015; 22:470-7. [DOI: 10.3109/11038128.2015.1061050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Baird K, Comis LE, Joe GO, Steinberg SM, Hakim FT, Rose JJ, Mitchell SA, Pavletic SZ, Figg WD, Yao L, Flanders KC, Takebe N, Sarantopoulos S, Booher S, Cowen EW. Imatinib mesylate for the treatment of steroid-refractory sclerotic-type cutaneous chronic graft-versus-host disease. Biol Blood Marrow Transplant 2015; 21:1083-90. [PMID: 25771402 DOI: 10.1016/j.bbmt.2015.03.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/09/2015] [Indexed: 11/19/2022]
Abstract
Sclerotic skin manifestations of chronic graft-versus-host disease (ScGVHD) lead to significant morbidity, including functional disability from joint range of motion (ROM) restriction. No superior second-line therapy has been established for steroid-refractory disease. Imatinib mesylate is a multikinase inhibitor of several signaling pathways implicated in skin fibrosis with in vitro antifibrotic activity. We performed an open-label pilot phase II trial of imatinib in children and adults with corticosteroid-refractory ScGVHD. Twenty patients were enrolled in a 6-month trial. Eight received a standard dose (adult, 400 mg daily; children, 260 mg/m(2) daily). Because of poor tolerability, 12 additional patients underwent a dose escalation regimen (adult, 100 mg daily initial dose up to 200 mg daily maximum; children, initial dose 65 mg/m(2) daily up to 130 mg/m(2) daily). Fourteen patients were assessable for primary response, improvement in joint ROM deficit, at 6 months. Primary outcome criteria for partial response was met in 5 of 14 (36%), stable disease in 7 of 14 (50%), and progressive disease in 2 of 14 (14%) patients. Eleven patients (79%), including 5 with partial response and 6 with stable disease, demonstrated a positive gain in ROM (range of 3% to 94% improvement in deficit). Of 13 patients with measurable changes at 6 months, the average improvement in ROM deficit was 24.2% (interquartile range, 15.5% to 30.5%; P = .011). This trial is registered at http://clinicaltrials.gov as NCT007020689.
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Affiliation(s)
- Kristin Baird
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Leora E Comis
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Galen O Joe
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Seth M Steinberg
- Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Fran T Hakim
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jeremy J Rose
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Sandra A Mitchell
- Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Steven Z Pavletic
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - William D Figg
- Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Lawrence Yao
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Kathleen C Flanders
- Laboratory of Cancer Biology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Naoko Takebe
- Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Stefanie Sarantopoulos
- Division of Hematologic Malignancy and Cell Therapy and Duke Cancer Institute, Department of Medicine, Duke University, Durham, North Carolina
| | - Susan Booher
- Autoimmunity and Mucosal Immunology Branch, National Institute of Allergy and Infectious Diseases, Rockville, Maryland
| | - Edward W Cowen
- Dermatology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
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Nielsen KT, Wæhrens EE. Occupational therapy evaluation: use of self-report and/or observation? Scand J Occup Ther 2014; 22:13-23. [PMID: 25327781 DOI: 10.3109/11038128.2014.961547] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Occupational Therapy Intervention Process Model (OTIPM) serves to guide occupational therapists in their professional reasoning. The OTIPM prescribes evaluation of task performance based on both self-report and observation. Although this approach seems ideal, many clinicians raise the issue that time to perform evaluations is limited. It is, therefore, relevant to examine whether similar information concerning task performance can be obtained using self-report or observation. OBJECTIVE The aims were to investigate what information can be obtained regarding the quality of ADL task performance based on self-report and observation, respectively, and to examine the relationship between measures of self-reported and observed quality of ADL task performance. METHODS The quality of ADL task performance among 20 adults with depression was evaluated using the ADL Interview (ADL-I) and the Assessment of Motor and Process Skills (AMPS). RESULTS AND CONCLUSIONS Results indicated that participants both reported and demonstrated increased effort and/or fatigue, increased use of time, need for assistance, and safety problems. However, little relationship was found between measures of self-reported and observed quality of ADL task performance, supporting the use of both self-report and observation as part of the evaluation phase outlined in the OTIPM.
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Affiliation(s)
- Kristina Tomra Nielsen
- Occupational Therapy Department, University College of Northern Denmark , Aalborg , Denmark
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Amris K, Wæhrens EE, Christensen R, Bliddal H, Danneskiold-Samsøe B. Interdisciplinary rehabilitation of patients with chronic widespread pain: Primary endpoint of the randomized, nonblinded, parallel-group IMPROvE trial. Pain 2014; 155:1356-1364. [DOI: 10.1016/j.pain.2014.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 04/07/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022]
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Albert SM, Bear-Lehman J, Anderson SJ. Declines in mobility and changes in performance in the instrumental activities of daily living among mildly disabled community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2014; 70:71-7. [PMID: 24952575 DOI: 10.1093/gerona/glu088] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gait speed is as an important predictor of mortality, volume of medical care, hospitalization, onset of activities of daily living (ADL) disability, and nursing home placement. We examined associations between change in gait speed and change in observed performance in the instrumental ADL (IADL) in a sample of mild-to-moderately disabled older adults. METHODS Participants in the Sources of Independence in the Elderly project (n = 375) were approached to complete a 4-m gait assessment and a performance test of IADL competency at three points over 2 years. IADL competency was assessed by occupational therapists, who rated participants using the Assessment of Motor and Process Skills (AMPS) and who also made a global rating of need for help or supervision. Linear mixed models were developed to assess change in motor AMPS score relative to baseline status and change in gait speed and AMPS process scores. RESULTS Baseline gait and change in gait were significant correlates of change in the AMPS motor ability measures in models that adjusted for cognitive status and AMPS process ability. Even respondents with gait speeds of 1 m/s at baseline were at risk of declining AMPS motor ability and an occupational therapist rating of IADL disability if gait speed declined. CONCLUSIONS Slowing in gait speed is an important risk factor for IADL disability in mild to moderately disabled older adults.
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Affiliation(s)
- Steven M Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pennsylvania.
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Yuen HK, Austin SL. Systematic Review of Studies on Measurement Properties of Instruments for Adults Published in the American Journal of Occupational Therapy, 2009–2013. Am J Occup Ther 2014; 68:e97-106. [DOI: 10.5014/ajot.2014.011171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. We describe the methodological quality of recent studies on instrument development and testing published in the American Journal of Occupational Therapy (AJOT).
METHOD. We conducted a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist to appraise 48 articles on measurement properties of assessments for adults published in AJOT between 2009 and 2013.
RESULTS. Most studies had adequate methodological quality in design and statistical analysis. Common methodological limitations included that methods used to examine internal consistency were not consistently linked to the theoretical constructs underpinning assessments; participants in some test–retest reliability studies were not stable during the interim period; and in several studies of reliability and convergent validity, sample sizes were inadequate.
CONCLUSION. AJOT’s dissemination of psychometric research evidence has made important contributions to moving the profession toward the American Occupational Therapy Association’s Centennial Vision. This study’s results provide a benchmark by which to evaluate future accomplishments.
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Affiliation(s)
- Hon K. Yuen
- Hon K. Yuen, PhD, OTR/L, is Professor and Director of Research, Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, 1530 Third Avenue South, Birmingham, AL 35294;
| | - Sarah L. Austin
- Sarah L. Austin, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Chicago State University, College of Health Sciences, Chicago, IL
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Parkinson S, Cooper JR, de las Heras de Pablo CG, Forsyth K. Measuring the Effectiveness of Interventions When Occupational Performance is Severely Impaired. Br J Occup Ther 2014. [DOI: 10.4276/030802214x13916969447155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There has been a call for conceptually valid assessments to measure occupational performance with greater sensitivity. This opinion piece reasons that a broad-based tool is required to relate subtle shifts in occupational participation to changes in the therapeutic environment. It includes case vignettes from learning disability and dementia services to illustrate the progress that can be made in occupational participation. Improvements in participation were matched to indicators of change in existing assessment and intervention manuals, leading to the development of a new assessment. Future research will investigate the assessment's potential to measure progress when a person's occupational performance is severely impaired.
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Affiliation(s)
| | - John R Cooper
- Senior Occupational Therapist, 2gether NHS Foundation Trust, Gloucester
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McNulty TC, Fisher AG. Comparison of Activities of Daily Living Ability of Older Adults Who Are Homebound and Nonhomebound. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2013. [DOI: 10.3109/02703181.2013.794186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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HIV and disability: a pilot study exploring the use of the Assessment of Motor and Process Skills to measure daily life performance. J Int AIDS Soc 2013; 16:17339. [PMID: 23336724 PMCID: PMC3551982 DOI: 10.7448/ias.16.1.17339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 12/05/2012] [Accepted: 12/10/2012] [Indexed: 01/19/2023] Open
Abstract
Introduction Limitations in performing activities of daily living (ADL) are important indicators of health and overall wellness, yet relatively few studies specifically identify the ADL abilities of people living with HIV/AIDS (PHAs). Given the wide range of abilities and ages of PHAs, there is an urgent need to utilize an assessment of ADL ability that can validly evaluate those who are very able, as well as those who are very disabled, without the presence of ceiling or floor effects, to provide sensitive measures to detect change. Purpose The purpose of this study was to gather preliminary evidence of the validity of using the Assessment of Motor and Process Skills (AMPS) with PHAs. Methods By utilizing existing data records of PHAs from the international AMPS database, we explored (a) demographic factors; (b) person response validity by examining person and individual item goodness-of-fit to the AMPS measurement model; and (c) trends in ADL abilities of PHAs. Findings There were 137 data records in the international AMPS database (0.08% of the database). Goodness-of-fit analyses revealed that >90% of the individuals in the sample fit AMPS measurement model and >99% of the individual item ratings fit the model. More than 80% of the data record had ADL motor abilities that were significantly lower than age expectations, and 67% had ADL process ability measures that were significantly lower than age expectations. Conclusions The findings indicate that the AMPS is a valid measure of ADL ability for PHAs. Coupled with the lower than expected number of AMPS data records for PHAs and the significant ADL ability challenges that were encountered by this sample, this pilot study may indicate that PHAs encounter barriers to accessing rehabilitation services and/or may not receive referrals until significant ADL challenges are encountered.
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