Prediction of hospitalization time and independence level with functional outcomes for patients with acute stroke: a retrospective study

OBJECTIVES

The objective of this study was to develop predictive models for estimating the length of stay (LOS) with standardized clinical outcome measures (Functional Independence Measure, Trunk Impairment Scale, Postural Assessment Scale for Stroke Patients, Fugl Meyer Assessment Scale, and Functional Ambulation Category) during acute care setting.

METHODS

One hundred sixty-nine patients were included in the retrospective study. Predictors chosen for the LOS included scores of functional outcome measures at admission. We used Spearman's rank correlation coefficients to calculate correlations among clinical outcome measures and LOS, stepwise multiple regression analysis to develop a predictive model, and receiver operating characteristics curve to analyze the predictive value of explanatory factors obtained from the previous model for discharge Functional Independence Measure score.

RESULTS

The predictive equation explained 81% of the variance in LOS. The most important predictors were trunk impairment, motor function of the upper extremity, walking ability, and independence level at admission. The receiver operating characteristic curve was obtained with a cut-off score of 13 points for the Trunk Impairment Scale, 47 points for Fugl Meyer Assessment-Upper Extremity, and 2 points for Functional Ambulation Category, demonstrating the highest percentage of the accurately predicted ability of independence level at discharge.

DISCUSSION

The models presented in this study could help clinicians and researchers to predict the LOS and discharge independence level of clinical outcomes for patients with acute stroke enrolled in an acute care setting.

DEVELOPMENT OF THE POSTURAL HABITS AND AWARENESS SCALE (PHAS): A RELIABILITY AND VALIDITY STUDY

Objectives. The aim of this study was to develop a scale that assesses postural awareness and habits, as well as to establish the validity and reliability thereof. Methods. The 19-item Postural Habits and Awareness Scale was developed. The scale has a score range of 0-95, with a higher score indicating good posture and awareness. 278 healthy adults with an age range of 18-65 years were included in the study. The sociodemographic form, Short Form 36 Health Survey (SF-36), and Body Awareness Questionnaire (BAQ) were used to test the validity and reliability of this newly developed scale. Results. From factor analyses, it was observed that the items clustered in 4 factors, which explained 55.99% of the variance. The Cronbach's α for each factor of the scale varied between 0.619 and 0.832. A high correlation was observed regarding test-retest reliability of the scale (r: 0.905). Conclusion. This newly developed self-reported scale allows for the comprehensive determination of both postural habits and awareness together. The PHAS is a valid and reliable scale that can be used by professionals who are interested in posture.

Effect of Kinesio taping on wrist kinematics and functional performance: A randomized controlled trial

BACKGROUND

Kinesio taping (KT) is a popular adjunct treatment modality for musculoskeletal injuries, hand and wrist injuries. The effectiveness of KT on wrist kinematics has been analyzed during single plane movements in general, and no study has investigated its effectiveness during dart throwing motion (DTM).

PURPOSE

To compare the effects of different KT techniques on wrist kinematics during DTM and functional performance of hand in healthy participants.

STUDY DESIGN

Randomized, double-blind, placebo-controlled, crossover study.

METHODS

Seventy-two healthy participants were included. Dominant wrist kinematics during DTM was evaluated by a Leap motion controller and wrist functional performance was evaluated by Minnesota Manual Dexterity Test. In order to compare the effects of KT on different muscles and also the effects of KT and placebo taping (PT), wrists of participants were evaluated under 5 conditions: without any taping, KT on flexor carpi ulnaris (FCU), KT on extensor carpi radialis brevis and longus (ECRB/L), PT on FCU and PT on ECRB/L. Means of outcome measures without any taping and with different 4 tapings were compared by repeated measures analysis of variance. PT and KT effects were compared by Wilcoxon signed rank test.

RESULTS

DTM range increased (P = .0) and Minnesota Manual Dexterity Test time decreased (P = .0) after KT and PT applications on FCU and ECRB/L muscles. Amount of change in wrist kinematics (P = .0; effect size = 0.2 and 0.3) and functional performance (P = .0; effect size = 0.6 and 0.8) were more obvious with KT applications, independent from the muscles they were applied on (P = .2 for wrist kinematics and P = .7 for functional performance).

CONCLUSIONS

KT on either FCU or ECRB/L muscles improve wrist kinematics and functional performance, significantly. Further studies should investigate if these findings apply for the patients with different wrist injuries, for both immediate- and long-term effectiveness.

Reliability and validity of Five Times Sit to Stand Test in pregnancy-related pelvic girdle pain

BACKGROUND

Pelvic girdle pain (PGP) is a common musculoskeletal disorder during pregnancy, and functional mobility evaluation is very important in reflecting the treatment effects.

OBJECTIVES

To investigate reliability and validity of Five Times Sit-to-Stand (5TSS) test in pregnant women with and without PGP.

DESIGN

A cross-sectional observational study.

METHODS

One hundred sixty-seven women in the second or third trimester of pregnancy participated in two assessments one week apart. The 5TSS and Timed Up & Go (TUG) tests were used to assess functional mobility, in a randomized sequence, by two independent raters. Time to complete the tests were recorded. Perceived pain and difficulty during functional mobility tests were marked on two Visual Analogue Scales. Following tests of functional mobility, seven clinical tests were used to classify the subjects as with or without PGP.

RESULTS

The 25% of subjects had PGP. Inter-rater reliability of 5TSS was excellent for subjects with and without PGP (ICC = 0.999, 95% CI = 0.999-1.000; ICC = 0.999, 95% CI = 0.999-0.999, respectively). Test-retest reliability of 5TSS was also very high for subjects with and without PGP (ICC = 0.986, 95% CI = 0.959-0.995; ICC = 0.828, 95% CI = 0.632-0.920, respectively). The 5TSS scores were positively correlated with TUG scores (r = 0.420, p = 0.006 and r = 0.404, p = 0.000, respectively). The subjects reported higher pain (95% CI = 0.322-0.824) and difficulty (95%Cl = 0.500-1.042) during 5TSS than the TUG test.

CONCLUSIONS

The 5TSS test is a reliable and valid functional mobility outcome measure in pregnant women with and without PGP. Further psychometric properties of the measure such as responsiveness, should be investigated in the future.