bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pressure mapping systems: reliability of pressure map interpretation
Authors: Stinson M D , Porter-Armstrong A P , Eakin P A 
Published: November 2003

Background: Pressure mapping systems offer a new technology to assist with pressure care assessment. Data output from such systems can be presented in three forms: numerical data, a three-dimensional grid and a colour-coded pressure map. Objectives: To (1) investigate whether sole use of the pressure map was a reliable method of interpreting interface pressures when compared with use of the numerical data; (2) establish the inter and intra-rater reliability of using pressure maps to assess pressure and determine whether reliability depended upon system operator experience; and (3) examine whether reliability extended to the range of seating surfaces being tested. Design: A reliability study assessing the ranking of pressure maps recorded by the Force Sensing Array pressure mapping system. Setting: A university occupational therapy department and a community NHS trust. Subjects: Fifteen occupational therapists with experience in pressure mapping and 50 occupational therapy students with no practical experience of pressure mapping. Interventions: Two sets of pressure maps were pre-recorded with an able-bodied adult seated on a variety of surfaces, with maps on each individual surface recorded over a 20-minute period at 2-minute intervals. Subjects ranked both sets of maps in terms of ‘best to poorest’ distribution of pressure. Main outcome measures: Rank orders of (1) pressure maps; (2) average interface pressures (mmHg); (3) maximum interface pressures (mmHg). Results: The use of pressure maps to interpret interface pressures was a reliable method. Significant agreement existed within ( p < 0.001) and between groups of operators and reliability extended over the range of seating surfaces tested. Conclusions: The practice of using pressure maps to interpret interface pressures in seating as opposed to using the associated numerical data can be supported. This was shown to be a reliable method of assessment by both experienced and less experienced operators across a range of seating surfaces.
Prognostic factors in the subacute phase after stroke for the future residence after six months to one year. A systematic review of the literature
Authors: Meijer R , Ihnenfeldt D S , van Limbeek J , Vermeulen M , de Haan R J 
Published: November 2003

Objective: To identify evidence-based prognostic factors in the subacute phase after a stroke for future residence at six months to one year post stroke. Design: Systematic literature search designed in accordance with the Cochrane Collaboration criteria with the following data sources: (1) MEDLINE, EMBASE, CINAHL, Current Contents, Cochrane Database of Systematic Reviews, PsycLIT and Sociological Abstracts. (2) Reference lists, personal archives and consultation of experts in the field. (3) Guidelines. Methods: Inclusion criteria were: (1) cohort studies of patients with an ischaemic or haemorrhagic stroke; (2) inception cohort with assessment of prognostic factors within the first two weeks after stroke; (3) outcome measures for future residence; and (4) a follow-up of six months to one year. Internal, statistical and external validity of the studies were assessed using a checklist with 11 methodological criteria in accordance with the recommendations of the Cochrane Collaboration. Results: From 1027 potentially relevant studies 10 studies involving a total of 3564 patients met the inclusion criteria. No prognostic factor was identified in at least two level A (i.e., a good level of scientific evidence according to the methodological score) studies, our standard for scientific proof. The following factors were found in at least one level A study: low initial ADL functioning, high age, cognitive disturbance, paresis of arm and leg, not alert as initial level of consciousness, old hemiplegia, homonymous hemianopia, visual extinction, constructional apraxia, no transfer to the stroke unit, nonlacunar stroke type, visuospatial construction problems, urinary incontinence and female gender. Conclusions: At present there is insufficient evidence concerning possible predictors in the subacute stage of stroke to make an evidence-based prediction of the future residence. In the scientific research until now social factors and their contribution to the possibility of living independently have not been investigated, or at least less well. None of the studies in this review described a conceptual framework as basis for the choice of the examined prognostic factors.
A qualitative study of stroke patients' and carers' perceptions of the stroke family support organizer service
Authors: Lilley Steven A , Lincoln Nadina B , Francis Valerie M 
Published: November 2003

Objective: To investigate stroke patients’ and carers’ perceptions of the family support organizer (FSO) service in order to highlight its value for potential purchasers and to help shed light on findings from randomized controlled trials. Design and subjects: Twenty semi-structured interviews were undertaken with a sub sample of stroke patients and their primary informal carers after completion of nine-month outcome assessments as part of a randomized controlled trial. Setting: Community stroke services in North Nottinghamshire, UK. Results: Interviewees who received the service reported that the presence of an FSO was valuable in many respects, including helping to claim benefits, as a source of information on stroke, and providing continuity between stroke services. Emotional support was only described by a few. Interviewees who did not receive the service described feelings of isolation and being let down by other stroke services after discharge. They also reported problems accessing information. Help needed to address the practical problems after stroke was commonly reported. For those who did not receive the FSO service, access to support appeared to be found through other channels. Conclusion: The FSO service appeared to be an information service. In order to evaluate community stroke services, a mixture of qualitative and quantitative outcome measures are necessary.
Measurement of isometric wrist muscle strength – a systematic review of starting position and test protocol
Authors: Bialocerkowski Andrea E , Grimmer Karen A 
Published: November 2003

Background: Isometric strength of the wrist musculature is frequently used in the clinical setting as a primary outcome measure following a wrist disorder. Objective: A systematic search of the literature was undertaken to review published starting positions and test protocols used in assessing isometric strength of the wrist musculature. Methods: AMED, CINAHL, Current Contents, EMBASE and MEDLINE computerized databases were searched for literature published between January 1980 and September 2002 that described the methodologies used to assess isometric wrist muscle strength. Papers were excluded if they explored motor unit recruitment, strength was assessed via manual muscle testing or no information regarding starting position or test protocol was included. Results: A total of 15 papers met the inclusion criteria. Starting position varied between papers, with little justification for the positions assumed. Test protocols used also were variably described, with some not meeting accepted standards for the assessment of isometric strength. Many of the reports lacked information regarding starting position and test protocol used, which precluded replication of the methodology. Conclusions: Further research is required to determine the optimum starting position and test protocol for the assessment of isometric wrist muscle strength. These should subsequently be assessed for reliability, to ensure that consistent results are produced over different occasions of testing.
Is the repetitive training of complex hand and arm movements benefi cial for motor recovery in stroke patients?
Authors: Woldag Hartwig , Waldmann Guido , Heuschkel Gabriele , Hummelsheim Horst 
Published: November 2003

Objective: To determine whether a repetitive training of complex movements of arm and hand contributes to functional recovery in stroke patients. Design: Prospective, longitudinal, multiple baseline design across individuals. Setting: Neurological rehabilitation centre. Subjects: Twenty-one patients with stroke in the middle cerebral artery territory. Interventions: Baseline phase: ‘house-typical’ occupational and physiotherapy; training phase: ‘house-typical’ therapy supplemented by repetitive training of (1) grasping and transport movements and (2) sawing movements of the affected arm over 10 minutes each, twice daily, five days per week. Main outcome measures: Rivermead Motor Assessment (RMA, arm section), grip strength, rapid isotonic hand extension, three-dimensional motion analysis. Results: Patients experienced a continuous functional improvement of the affected arm (RMA score from initial 4.9 ± 2.1 to 8.0 ± 4.6, p < 0.001) and an increase of grip strength during the baseline and the training phase (from initial 102.4 ± 43.3 N to 150.6 ± 118.9 N, p < 0.05). Movement analysis revealed a trend to a more precise movement execution. The repetitive training of complex movements did not result in an additional benefit. Conclusion: The repetitive training of complex movements does not further enhance the functional recovery of the affected arm and hand in stroke patients compared with functionally based occupational and physiotherapy.
Bobath or Motor Relearning Programme? A follow-up one and four years post stroke
Authors: Langhammer Birgitta , Stanghelle Johan K 
Published: November 2003

Objective: The purpose of this follow-up one and four years post stroke was to find out whether the initial physiotherapy approach had had any long-term effects on mortality, motor function, postural control, activities of daily living, life quality, follow-up from community services and living conditions. Design: A randomized controlled trial of first time ever stroke patients. Group 1 ( n = 33) and group 2 ( n = 28) had initial physiotherapy according to the Motor Relearning Programme and Bobath, respectively. Main outcome measures: The Motor Assessment Scale (MAS), the Sødring Motor Evaluation Scale (SMES), the Barthel ADL Index, the Nottingham Health Profile (NHP) and Berg Balance Scale were used. The following parameters were also registered: incidence of new strokes, other diseases, use of assistive devices, the patient's accommodation and use of services from the community. Results: The mortality rates were similar in the two groups. In both groups the motor function, postural control and ADL had decreased rapidly, leaving many of the patients dependent and with a high risk of falling. Life quality had increased compared to the acute stage, but was still low in comparison with healthy persons. Patients in both groups lived at home, but were dependent on help from relatives and community services. Physiotherapy as follow-up service was seldom used. The initial physiotherapy approach did not seem to have a major in‘uence on the patients' ability to cope in the long term. Conclusion: This follow-up at one and four years post stroke showed no major in‘uence of two different initial physiotherapy regimens on long-term function. The study confirmed a rapid deterioration of ADL and motor function and an increased dependence on relatives. The study reveals a gap between the intense treatment in the acute phase and little or no follow-up of physiotherapy treatment or other rehabilitation activities later.
Programme evaluation of a geriatric rehabilitation day hospital
Authors: Hershkovitz Avital , Gottlieb Daniel , Beloosesky Yichayaou , Brill Shai 
Published: November 2003

Objective: To evaluate the rehabilitation programme in a geriatric day hospital. Design: An observational study. Setting: An urban geriatric rehabilitation day hospital. Subjects: Three hundred and fifty-three older patients admitted to a rehabilitation day hospital during 2000: 163 post stroke, 113 with deconditioning and 77 post orthopaedic surgery (hip fracture and joint replacement). Main outcome measures: Functional Independence Measure (FIM), Nottingham Extended ADL Index, timed ‘get up and go’ test. Results: The mean discharge scores of all FIM items were significantly higher than the mean admission scores. Mean score change, however, for each item was less than one point. Most of the patients (70%) improved by less than 5 points, regardless of main admission diagnoses. Patients with a lower admission FIM score improved more than those with a higher admission score. The majority of the enrolled patients (92%) showed an improvement in their Nottingham Extended ADL Index score. The mean (SD) score on admission was 21 (11.9) and at discharge 31 (14.6). In all but three items (self-feeding, using a telephone and driving a car), mean scores at discharge were significantly higher than admission scores ( p < 0.001). A significant improvement in timed ‘get up and go’ score was found for all patients regardless of main diagnosis. Performance time decreased by 33% and discharge scores for all patient groups were approximately 20 seconds. Conclusions: The notable improvement in mobility and instrumental activities of daily living on the one hand, and the minor improvements achieved in basic activities of daily living on the other, suggests a need to revise treatment goals of day hospitals.
Verbal fluency assessment of patients with multiple sclerosis: test–retest and inter-observer reliability
Authors: Vlaar A M M , Wade D T 
Published: November 2003

Objective: To establish the reliability and validity of verbal ‘uency testing in patients with multiple sclerosis (MS). Design: Each patient was assessed twice 7–14 days apart on a test of phonological ‘uency and again 7–14 days later when half of the patients were assessed for phonological ‘uency by a second assessor while the other half was assessed by the first assessor using a test of semantic ‘uency. Setting: A specialist young disabled unit. Subjects: Thirty-five patients with multiple sclerosis. Measures: Phonological ‘uency (PF) was tested giving the patient 60 seconds to generate words starting with ‘F’ ‘A’ and ‘S’; semantic ‘uency (SF) with names of animals and fruits. Also used were the Short Orientation–Memory–Concentration Test and the Barthel ADL Index. Results: On the first occasion 31/35 patients could be tested, and the average (SD) score of the PF was 21.9 (12.1), median 18. The test–retest reliability ( n = 30/35) of the PF was good (Pearson r = 0.85). The score difference between the first two occasions ranged from +17 to –15 (median –3, mean –2.9, SD 6.7). The inter-observer reliability ( n = 13/16) of the PF was good (Pearson r = 0.90). The difference of the score between the two assessors ranged from –9 to +6 (median 0, mean –1.2, SD 4.9). The correlation (Pearson) of the PF score with the SF, Barthel and SOMC was respectively r = 0.59, r = 0.27 and r = 0.63. Conclusions: Phonological ‘uency testing is reliable in people with MS.
Medial–lateral postural stability in communitydwelling women over 40 years of age
Authors: Nitz J C , Choy N L Low , Isles R C 
Published: November 2003

Objective: To document the change in medial–lateral balance in women aged between 40 and 80 years. Design: A cross-sectional study of six measures of medial–lateral balance was undertaken. Setting: The Betty Byrne Henderson Centre for Women and Ageing, Royal Women's Hospital, Australia. Subjects: Five hundred and three community-dwelling women between 40 and 80 years of age were randomly recruited from a large metropolitan region with 366 subjects admitted after applying exclusion criteria. Measurements: The clinical measurements included the lateral reach and step tests while laboratory measurements were gathered from the Balance Master software programs for unilateral stance and limits of stability. Results: A significant decline in all measures ( p < 0.02) was evident between the forties and sixties age decade cohorts. The clinical step test showed a significant ( p < 0.001) decline between the forties and fifties groups. A significant correlation was shown between step test and unilateral stance ( p < 0.001) and movement velocity, reaction time and end-point excursion centre of gravity (COG) on the limits of stability test ( p < 0.001). Conclusions: This new evidence demonstrates that there is a significant decline in medial–lateral balance in women that occurs between their forties and sixties. Suggestions for further study were made.
Inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury
Authors: van Loo M A , Moseley A M , Bosman J M , de bie R A , Hassett L 
Published: November 2003

Objective: To assess the inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury. Design: Twelve subjects each completed five comfortably paced and five fast-paced walking trials. Walking speed was measured simultaneously by five observers using a stopwatch (clinical procedure) and by infrared timing gates (gold standard). Setting: Brain injury rehabilitation unit. Subjects: People with traumatic brain injury who could walk independently and were participating in a rehabilitation programme. Main outcome measures: Walking speed over a 10-metre distance. Results: The inter-rater reliability of walking speed measured using a stopwatch was very high, with an intraclass correlation coefficient of at least 0.998 for both comfortable and fast-paced tests. Concurrent validity was excellent for comfortable and fast tests, with perfect correlations between the stopwatch and infrared timing gate measurement procedures. Conclusions: Physiotherapists can use a stopwatch as a reliable and valid measurement tool to quantify walking speed over a short distance at both comfortable and fast paces in people who have sustained traumatic brain injuries.
Changes in life goals of people with neurological disabilities
Authors: Nair K P Sivaraman , Wade Derick T 
Published: November 2003

Objective: To investigate the relationship between changes in life goals and progression of disabilities among subjects with neurological disorders over a period of four years. Design: Retrospective study. Setting: A centre for continuing disability management in the UK. Subjects: Patients with static or progressive neurological disabilities. Interventions: Review of rehabilitation team notes. Main outcome measures: Barthel ADL Index and Rivermead Life Goals Questionnaire from four consecutive annual assessments from 1997 to 2000. Results: Thirty-two subjects had progressive disabilities and 24 had static disabilities. In subjects with static disabilities there was no significant change in grades of any of the life goals over a period of four years. Among subjects with progressive disabilities, significant reductions were noted in importance given to partner ( p = 0.034), work ( p = 0.008) and leisure ( p = 0.028) over four years. While there was no significant change in number of life goals considered as extremely important in subjects with static disabilities, there was a significant reduction in number of goals considered as extremely important in subjects with progressive disabilities ( p = 0.022) Conclusion: People with progressive disabilities tend to downgrade the significance attached to goals related to partner, work and leisure. They also reduce number of goals graded as extremely important. This change is not seen in people with static disability.
Assessing advanced locomotor recovery after total hip arthroplasty with the timed stair test
Authors: Perron Marc , Malouin Francine , Moffet Hélène 
Published: November 2003

Objective: To assess advanced locomotor performance with the timed stair test (TST) and to determine if the level of performance of a group of women one year after hip replacement changed with the functional demands of the tasks. Design: Comparison of the performance of two groups of women. Setting: General community. Participants: A convenient sample including 18 women who had had a total hip replacement 11 months earlier (patients) and 15 healthy age-matched women (comparison group). Main outcome measures: Three tests were administered: the 10-m walk test, the unloaded TST and the loaded TST (10 kg). The duration of each test was recorded and transformed into speed and the level of performance was assessed by calculating percentage deficit using corresponding values from the comparison group. The TST is made of four subtasks: (1) standing up and walking, (2) ascending stairs, (3) turning and descending stairs, (4) walking back, turning and sitting down. Results: Significant differences in performance were found for all three tests with the patients showing a slower performance. The percentage deficits increased significantly from the less difficult (walking: 18%) to the more difficult conditions (unloaded TST: 23% and loaded TST: 28%), with the greatest deficits found during stair descent. Strong correlations were also found between walking deficits and TST deficits (loaded: r = 0.82; unloaded: r = 0.88). Conclusions: By combining mobility, walking and stair activities, the TST can be used to assess various components of advanced locomotor performance. The progressive level of difficulty of the TST subtasks as well as the addition of a load make it useful to detect subtle locomotor disabilities.
Depressive symptoms in advanced cancer. Part 1. Assessing depression: the Mood Evaluation Questionnaire
Authors: Meyer H A Martine , Sinnott Claire , Seed Paul T 
Published: November 2003

Objective: A prospective cohort study evaluated the performance and acceptability of the cognitive based Mood Evaluation Questionnaire (MEQ) in assessing depressive symptoms over time in patients with advanced cancer. The structured clinical interview for DSM-III-R (SCID) and the single-item interview screening question were also administered. Method: Forty-five advanced cancer patients were followed monthly for up to six interviews (108 interviews in total). Results: The MEQ and SCID had moderate agreement (weighted kappa 0.52 over all interviews). At first interview, 26 (58%) patients were depressed using MEQ, seven (16%) of these severely. Attrition rates were high for subsequent interviews. The assessment process was considered positive by 92% patients, and acceptable as a single and repeat measure. Positive responses to MEQ questions about worthlessness, death and self-harm were strong predictors of current depressed mood. Conclusion: The MEQ has potential as a useful alternative to SCID in assessing depressive symptoms in a palliative care population, and can be used by nonpsychiatric trained professionals. It is positively received by patients and acceptable as a repeat measure. Most patients appreciate being asked about their mood in depth, including questions around death and self harm.