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The application of robotic devices is being used as Assistive Technology (AT) for improving rehabilitation interventions. The purposes of this research were to (1) test a novel low-cost robotic AT to support interventions for people with Cerebral Palsy (CP); (2) determine its usability; and (3) analyze its impact. It was a pilot study with prospective, longitudinal and analytical cohorts was done. Intervention was developed in one association (NGO) of people with CP. Participants were 6 women and 3 men with CP, with a mean age of 51.67. Intervention with LOLA2 (a robotic platform, not wearable, equipped with artificial intelligence) was implemented for training some activities of daily life (ADL) of participants. Functional Independence Measure (FIM), Psychosocial Impact of Assistive Technology Scale (PIADS), and Assistive Technology Device Predisposition Assessment (ATPA) were used for outcome measures. Level of participants' independence was high (FIM = 98). Psychosocial impact of the robotic platform in terms of competence (M = 0.25), adaptability (M = 0.33), and self-esteem (M = 0.25), was positive, but low. The mean in ATDPA (M = 3) reflects a moderate match. No significant variations concerning the changes in functional independence were detected. The robotic platform is applicable and complementary AT for rehabilitation. This study leads to implementing some improvements in its design, proposed activities, human-robot interaction, and system for registering information. IMPLICATIONS FOR REHABILITATION: Robotic devices such as LOLA2 show promise as complementary tools in rehabilitation for individuals with Cerebral Palsy (CP), highlighting the potential for improved outcomes in clinical practice. There is a clear need for enhancements in the usability, universal design, and technical specifications of robotic platforms like LOLA2 to ensure their full functionality and quality, underscoring the importance of ongoing development and refinement. Utilizing specific outcome measures tailored to assess the efficacy and applicability of assistive technologies (AT), including robotic devices, is crucial for comprehensive evaluation and informed decision-making in rehabilitation interventions. Further research with higher validity is necessary to expand the evidence base surrounding the use of robotic devices in assistive technology, guiding specialized technical decisions and enhancing their integration into rehabilitation practices. [ABSTRACT FROM AUTHOR]

Purpose: To examine the reliability of ADL interview (ADL-I) ability measures when administered by different health professionals (HPs). Materials and methods: Older adults with stable ADL ability were invited to participate in three ADL-I interviews, administered by occupational therapists (OTs), physical therapists (PTs), and nursing staff (NS), respectively. Methods based on classic and modern test theory were applied. Results: Overall, n = 36 older adults and n = 11 HPs participated. Intraclass Correlation Coefficients were acceptable for research purposes (> 0.7), but not for clinical use. Mean differences in ADL ability measures were significant when comparing measures based on interviews by OTs to measures based on interviews by PTs and NS. Further, in 25 to 47% of the individuals, ADL-I ability measures differed significantly across HPs. Limits of Agreement revealed that measures based on interviews by OTs were systematically lower compared to measures based on interviews by PTs and NS. Four ADL-I items displayed Differential Item Functioning based on HP. Conclusion: When using the ADL-I, it is recommended to only involve one profession, to increase the reliability of measures. Results highlight the importance of evaluating reliability of measures based on instruments administered across HPs before implementation in rehabilitation practice and research. IMPLICATIONS FOR REHABILITATION: Evaluations of activities of daily living (ADL) ability conducted in rehabilitation practice by different health professionals may not generate comparable results. When using the ADL-Interview, it is recommended to only involve one profession, to increase reliability of measures. The results of the present study highlight the importance of evaluating if ADL instruments can produce reliable measures in terms of both interrater reliability and measurement error. [ABSTRACT FROM AUTHOR]

Persistent symptoms post-mild traumatic brain injury (mTBI) includes autonomic dysregulation (AD). The composite autonomic symptoms score, (COMPASS-31), was developed to quantify AD symptom severity in the last year, which limits clinical utility. The primary aim was to determine validity of a modified-COMPASS-31 measuring symptoms in the last month compared to the original, secondarily to compare both original and modified versions to the Neurobehavioral Symptom Inventory (NSI), and tertiarily to detect change post-treatment of the modified-COMPASS-31 compared to NSI and headache intensity (HI). Thirty-three military personnel with persistent headache post-mTBI. Total and domain scores for COMPASS-31 (original vs. modified) NSI and HI at baseline. Change in modified-COMPASS-31. NSI, and HI. Baseline COMPASS-31 versions were comparable and highly correlated (r = 0.72, p < 0.001), they were moderately correlated at best to the NSI (r < 0.6), which may suggest differences in measurement metrics. The mean change in modified-COMPASS-31 scores (15.4/100, effect size 0.8) was mild to moderately correlated to the change in HI (r = 0.39) score, but not to NSI (r = 0.28). The modified-COMPASS-31 appears to be valid, can measure change of AD symptom severity, and is recommended as an outcome measure. [ABSTRACT FROM AUTHOR]

Purpose: Over 240 million children worldwide experience inequities due to disablement/disability. Play is important for children's global development, to enable participation in life, and has been used in therapeutic settings. The purpose of this systematic review is to determine the effectiveness of play used in therapy for children with disabilities, to explore ways that play is used in therapy, and to classify and map outcome measures used in play-based interventions to the International Classification of Functioning. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The search yielded 22 articles eligible for inclusion. A meta-analysis found significant heterogeneity for play-based intervention outcomes, precluding estimates of effectiveness. Body function and structure outcomes accounted for 61% of reported outcome measures. Conclusion: There is a trend towards a small positive effect of play used in therapy for children with disabilities, but certainty of the effect is poor, and replication difficult due to heterogeneous reports of how play is used. Research aims and outcome measures focusing on meaningful aspects of activity and participation in addition to body function and structure domains of the International Classification of Functioning should be considered for play-based interventions for children with disabilities. IMPLICATIONS FOR REHABILITATION: Play-based interventions trend towards a positive effect on ICF outcomes, but the certainty of effect is limited. Play is used in diverse ways making it a versatile method to promote engagement or deliver therapy to a wide variety of children with disabilities. Play-based studies measuring outcomes solely related to body function and structure domains of the ICF may not capture the broader holistic benefits of play. When using play in clinical practice, professionals should consider the child's personal and environmental factors and the influence of play on activity and participation. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONHemiplegic shoulder pain (HSP) is reported in up to 40% of people with stroke. Causes of HSP are often multifactorial. To inform appropriate treatment, reliable/valid assessments are critical. The aim of this scoping review was to collate assessment approaches used in studies where the primary outcome was HSP, and to identify how frequently each assessment approach was used.A systematic search, including studies from 2000-2023 was conducted of the MEDLINE, EMBASE, CINAHL, AMED, Biomed Central, and Cochrane Library databases, with four key terms used: “assess”, “stroke”, “pain” and “shoulder”. All primary studies published in English language fulfilling the reviews inclusion criteria were included. Six reviewers extracted the data.A total of 29 assessment methods for HSP were identified from 124 studies. The common assessments were: Visual Analogue Scale (n = 75, 60%), Passive Range of Movement (n = 65, 52%), Fugl-Meyer Assessment (n = 32, 26%), glenohumeral subluxation (n = 30, 24%) and Numerical Rating Scale (n = 27, 22%).A wide range of assessment approaches was identified for HSP, and some are used more than others. A fully comprehensive assessment that considers different aspects of pain including severity and timing, functioning, and the psychological burden, is needed in this area of practice to be able to guide appropriate treatment.Hemiplegic shoulder pain is reported in up to 40% of people with stroke and a wide range of assessments approaches are reported in the literature.Simple questioning about shoulder pain may not be adequate for providing the best clinical care to patients and an ideal assessment approach would be one that takes into consideration both quantitative and qualitative information.Until a new measure is developed, the four common assessments reported (Visual Analogue Scale; Passive Range of Movement; Fugl-Meyer Assessment and Numerical Rating Scale) should be used in combination.Hemiplegic shoulder pain is reported in up to 40% of people with stroke and a wide range of assessments approaches are reported in the literature.Simple questioning about shoulder pain may not be adequate for providing the best clinical care to patients and an ideal assessment approach would be one that takes into consideration both quantitative and qualitative information.Until a new measure is developed, the four common assessments reported (Visual Analogue Scale; Passive Range of Movement; Fugl-Meyer Assessment and Numerical Rating Scale) should be used in combination. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTo evaluate the psychometric properties of the Arabic version of the Activities-Specific Balance Confidence Scale using the 5-option response categories for individuals with lower limb amputation (ABC-5/Ar).This was a methodological study on a convenience sample of individuals with unilateral lower-limb amputation attending outpatient rehabilitation centres in Saudi Arabia and Turkey (N = 155). Rasch analysis (WINSTEPS version 4.6.5) was used to examine the 5-categories rating scale structure, item fit, item difficulty hierarchy, person separation index, unidimensionality, local item dependency, and differential item functioning.The ABC-5/Ar 5-response option demonstrated an appropriate model fit. Most items fit the Rasch model, except for item #12 “walk in a crowded mall,” which showed an overfitting value of 0.63. The person separation indices 2.95 (Cronbach’s α = 0.96). Principal component analysis of residuals confirmed the unidimensionality of the scale; however, local dependency was detected between item #14 “Ride in escalator holding rail,” and item #15 “Ride in escalator not holding rail.”The findings suggest that the ABC-5/Ar shows promise in assessing balance confidence in Arabic-speaking lower-limb prosthesis users. However, further studies with larger sample sizes and in diverse clinical contexts are needed to confirm its effectiveness in various clinical settings.Overall, our Rasch-based study provides additional evidence to support the psychometric appropriateness of using the Activity-specific Balance Confidence scale with the 5-category options (ABC-5) of the Arabic version among lower prosthesis users.Clinicians and researchers should be mindful of cultural and contextual differences that exist among Arabic-speaking population which may influence how participants responded to certain items in the scale.It is essential to conduct a comprehensive psychometric evaluation to guide the implementation and interpretation of scales, particularly in Arabic-speaking countries due to the scarcity of validated and standardised outcome measures to assess prosthesis users’ confidenceOverall, our Rasch-based study provides additional evidence to support the psychometric appropriateness of using the Activity-specific Balance Confidence scale with the 5-category options (ABC-5) of the Arabic version among lower prosthesis users.Clinicians and researchers should be mindful of cultural and contextual differences that exist among Arabic-speaking population which may influence how participants responded to certain items in the scale.It is essential to conduct a comprehensive psychometric evaluation to guide the implementation and interpretation of scales, particularly in Arabic-speaking countries due to the scarcity of validated and standardised outcome measures to assess prosthesis users’ confidence [ABSTRACT FROM AUTHOR]

IntroductionPurposeMethodResultsConclusionThe International Knee Documentation Committee (IKDC) and Anterior Cruciate Ligament – Quality of Life Questionnaire (ACL-QOL) are frequently used patient-reported instruments designed for individuals with anterior cruciate ligament reconstruction (ACL-R).To evaluate responsiveness and determine minimal important change (MIC) for the Persian-version of IKDC and ACL-QOL in athletes with ACL-R following physiotherapy intervention.One hundred athletes with ACL-R, undergoing 16-week physiotherapy completed IKDC and ACL-QOL at weeks 4 and 20 post ACL-R. Participants also rated their overall changes on a 7-point global rating of change at follow-up. Responsiveness was evaluated using the receiver operating characteristics (ROC) curve and correlation analysis. In addition, the minimal important change (MIC) was determined on the ROC curve.Acceptable responsiveness was reached by the IKDC and most of the subscales of ACL-QOL (area under the ROC curve (AUC) of 0.72–0.79). Also, the subscale of Lifestyle issues of ACL-QOL (AUC of 0.81 (95% CI = 0.72–0.89) and the overall of ACL-QOL (AUC of 0.87 (95% CI = 0.80–0.93) showed the good level of responsiveness. The MIC scores of IKDC and the Overall ACL-QOL were determined 25 and 26 points, respectively.The IKDC and ACL-QOL questionnaires have adequate responsiveness and are able to measure the change in athletes with ACL-R following a 16-week physiotherapy intervention. [ABSTRACT FROM AUTHOR]

The aim of this study was to translate the English version of the Foot Posture Index (FPI-6) into Turkish and to examine its psychometric properties. After the forward-backward translation process, the internal consistency and intra – and inter-rater reliability were evaluated by using Cronbach's α and Intraclass Correlation Coefficient (ICC2,k) (two-way random effects model with absolute agreement type), respectively. The agreement between reliability assessments was investigated by the standard error of measurement (SEM) and the minimal detectable change (MDC95%). Criterion validity was assessed in relationship between the Turkish FPI-6 and Foot Function Index (FFI) and the American Orthopedic Foot and Ankle Society (AOFAS). The study was completed with 45 patients with foot/ankle problems. The internal consistency (Cronbach's α = 0.85; 0.78, respectively), intra-reliability (ICC2,k = 0.96; 0.94, respectively), and inter-reliability (ICC2,k = 0.93; both of them) of the Turkish version of the FPI-6 were excellent for the dominant and non-dominant lower limb. The SEM was low, and the agreement was considered to have high absolute reliability, as demonstrated by the smallest change in measurement error. The Turkish FPI-6 also had moderate correlations with the FFI and AOFAS (p <.05). It has been proven that the Turkish FPI-6 is valid and reliable and can be used by Turkish-speaking researchers and clinicians in patients with various foot-ankle problems. [ABSTRACT FROM AUTHOR]

Rehabilitation outcomes are important for patients, professionals and policy makers. Most outcome measures (OMs) were developed for "Western" contexts and may be inadequate for low-resource and conflict settings, where the ability to demonstrate impact would be critical to strengthening the sector. This study aims to understand perspectives of physiotherapists from challenging environments regarding current practices, value, barriers, and facilitators of measuring rehabilitation outcomes. Focus group discussions were held in English with 35 physiotherapists from 18 countries. Audio recordings were transcribed verbatim, anonymised, and analysed using reflexive thematic analysis. Four themes emerged illustrating the levels at which outcomes and measures were discussed: User (patients, families), provider (physiotherapists, rehabilitation workers), application (OMs), and structure (management, health system). Participants discussed diversity in current practices and patient populations, utility of OMs and a neglected rehabilitation sector lacking investment. Barriers to progressing outcome measurement included lacking patient health literacy, rehabilitation provider training, valid OMs, and leadership. Participants suggested improved patient involvement, routine outcome measurement by using, developing, or adapting simple, context- and stakeholder-relevant OMs, and support from management. These insights illustrate the need of and provide robust recommendations for context-adapted development of rehabilitation outcome measurement in various challenging contexts. Rehabilitation outcomes are important to show impact in low-resource and conflict settings, but most outcome measures originate from "Western" contexts Experience of physiotherapists from low-resource and conflict settings reveals the barriers and facilitators to measuring rehabilitation outcomes in their workplaces Participants' suggest to use or develop simple scales that are contextualised and stakeholder-relevant for standard, routine measurement This study highlights the need to improve the measurement of rehabilitation outcomes in challenging contexts and provides guidance on how to do so [ABSTRACT FROM AUTHOR]

To test the hypotheses that, after the delivery of manual wheelchairs following the WHO 8-step service-delivery process, wheelchair-related health and quality of life, wheelchair skills, wheelchair use, and poverty probability would improve; and that the number of wheelchair repairs required, adverse events, caregiver burden, and the level of assistance provided would decrease. This was a longitudinal, prospective within-subject study including 247 manual wheelchair users, and 119 caregivers, in El Salvador who received a wheelchair following the WHO 8-step process as well as maintenance reminders. Outcome measurements were performed via structured questionnaires and dataloggers at the initial assessment, at wheelchair delivery, and at 3- and 6-month follow-up. Significant improvements in wheelchair-related health indicators (all with p < 0.004) and quality of life (p = 0.001), and a significant reduction in national and "extreme" poverty probability (p = 0.004 and p = 0.012) were observed by six months. Wheelchair use significantly decreased (p = 0.011 and p = 0.035) and wheelchair skills increased (p = 0.009). Caregiver burden did not change (p = 0.226) but the number of activities of daily living (ADLs) that required no assistance significantly increased (p = 0.001) by three months and those who required complete assistance decreased (p = 0.001). No changes were observed in wheelchair repairs (p = 0.967) and breakdowns over time with new wheelchairs. Wheelchair service delivery using the WHO 8-step process on manual wheelchair users in El Salvador has positive effects on health and quality of life, wheelchair skills, caregiver assistance levels, and poverty. Further research is needed to determine the relative contributions of the intervention components. Providing manual wheelchairs using the 8-step process of the WHO has benefits on health and quality of life, wheelchair skills, caregiver assistance levels, and poverty. The WHO 8-steps service delivery process for manual wheelchairs can be used in less-resourced settings. [ABSTRACT FROM AUTHOR]

Risks and benefits of spinal manipulations and mobilization in pediatric populations are a concern to the public, policymakers, and international physiotherapy governing organizations. Clinical Outcome Assessments (COA) used in the literature on these topics are contentious. The aim of this systematic review was to establish the quality of clinician-reported and performance-based COAs identified by a scoping review on spinal manipulation and mobilization for pediatric populations across diverse medical conditions. Electronic databases, clinicaltrials.gov and Ebsco Open Dissertations were searched up to 21 October 2022. Qualitative synthesis was performed using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines to select studies, perform data extraction, and assess risk of bias. Data synthesis used Grading of Recommendations, Assessment, Development and Evaluations (GRADE) to determine the certainty of the evidence and overall rating: sufficient (+), insufficient (-), inconsistent (±), or indeterminate (?). Four of 17 identified COAs (77 studies, 9653 participants) with supporting psychometric research were classified as: Performance-based outcome measures: AIMS – Alberta Infant Motor Scale (n = 51); or: Clinician-reported outcome measures: LATCH – Latch, Audible swallowing, Type of nipple, Comfort, Hold (n = 10), Cobb Angle (n = 15), Postural Assessment (n = 1). AIMS had an overall sufficient (+) rating with high certainty evidence, and LATCH had an overall sufficient (+) rating with moderate certainty of evidence. For the Cobb Angle and Postural Assessment, the overall rating was indeterminate (?) with low or very low certainty of evidence, respectively. The AIMS and LATCH had sufficient evidence to evaluate the efficacy of spinal manipulation and mobilization for certain pediatric medical conditions. Further validation studies are needed for other COAs. [ABSTRACT FROM AUTHOR]

BackgroundAimsMethods & ProceduresOutcomes & ResultsConclusionsResearch on aphasia treatments that directly target conversation skills have been on the rise in the recent past. Despite the ubiquitous nature of gestures in everyday conversations and their possible compensatory and/or supportive functions for adults with aphasia, the conversational treatment outcome measures continue to rely on spoken language alone.We aimed to explore the feasibility of using co-speech hand gestures as a treatment outcome measure in Clyde, an individual with chronic and severe Wernicke’s aphasia.Using a multiple-probe single-case experimental research, we examined data from one participant with aphasia (Clyde) who was a part of a larger study involving 3 people with aphasia (Devanga, 2020). 10-minute conversations between Clyde and clinician, and Clyde and his spouse, were completed during 3 baseline probes, 3 treatment probes and 3 maintenance probes. Clyde also completed a 15-session Collaborative Referencing Intervention (CRI; Devanga etal., 2021) with the clinician. The 18 conversation samples were videorecorded, transcribed, and analysed.The outcomes analysed included overall gesture frequency and type (i.e., referential vs. non-referential) across sessions (baseline – treatment – maintenance) and partner familiarity (clinician – spouse). We also compared the gesture outcomes with the spoken language measure, CIUconv (Correct Information Units). Overall gesture frequency was higher with the clinician than the spouse, and the frequency of referential gestures were higher than the non-referential gestures with both partners. With the onset of treatment, we found that overall gesture frequency decreased and #CIUconv increased with the clinician, however there were minimal variations across phases with the spouse. Additionally, with the onset of treatment, referential gestures decreased, and non-referential gestures increased with both partners.Findings from this exploratory study provide preliminary support to using co-speech hand gestures as treatment outcome measures for aphasia. Clinical implications including comparisons of gestural outcomes with spoken language outcomes and their implementation are discussed. Further research on differences in gesture use among aphasia types and severities and patterns of change in gesture use with aphasia treatment is warranted. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionTo examine the psychometric properties of the Spanish version of the 34-item Clinical Outcomes in Routine Evaluation—Outcome Measure questionnaire (CORE-OM).Psychometric exploration was conducted in two samples: non-clinical (n = 706) and clinical (n = 420) participants. The non-clinical sample comprised a subgroup of community members (n = 308) and students (n = 398). The clinical sample consisted of self-reported patients (n = 209) and outpatients (n = 211). The analysis included both internal and test-retest reliability, convergent validity, and principal component analysis. A reliable change index and clinical cut-off scores were established for assessing clinically significant change.The Spanish CORE-OM demonstrated good internal consistency and test-retest reliability, along with satisfactory convergent validity against the 45-item Outcome Questionnaire (OQ-45.2). There were strong differentiations between the clinical and non-clinical samples and the four sample subsets. The outpatient group reported the highest scores, while the community group exhibited the lowest scores. There were no marked gender effects. All observed patterns aligned closely with the established Spanish referential data.Our findings provide support for the utilization of the Spanish CORE-OM as a measure for tracking psychotherapeutic progress in the context of Chile. [ABSTRACT FROM AUTHOR]

Life balance is a new and important concept in occupational therapy. New measurements are needed to assess and evaluate life balance and interventions aimed to achieve this concept. This article describes the test-retest reliability of three life balance measures: the Activity Calculator (AC), Activity Card Sort (ACS-NL(18-64)) and Occupational Balance Questionnaire (OBQ11-NL). Data collection took place among 50 participants with neuromuscular diseases: facioscapulohumeral dystrophy (FSHD, n = 25) or mitochondrial myopathy (MM, n = 25). The AC, the ACS-NL(18–64) and the OBQ11-NL were assessed twice with an interval of one week. Intraclass correlation coefficients (ICC-agreement) were applied to examine test-retest reliability. The ICC of the AC-average total day score was.95 (95% CI.91-.97), whereas the ICC of the weights allocated to each activity was 0.80 (95% CI.77–0.82). The ICC of the ACS-NL(18–64) percentage retained activities was 0.92 (95% CI 0.86 − 0.96) and the ICC of the importance score per activity was-.76 (95% CI. 0.68–0.89). The ICC of the OBQ11-NL total score was.76 (95% CI 0.62–0.86). All three tools showed good to excellent test-retest reliability in a sample of patients with FSHD or MM, which is promising for its use in clinical practice and research. The AC, ACS-NL(18–64) and the OBQ11-NL are promising, reliable measures of life balance in patients with neuromuscular diseases. The development of three new instruments for life balance enlarges the possibility for health professionals to measure life balance in clinical practice and research. [ABSTRACT FROM AUTHOR]

IntroductionObjectiveMethodsResultsConclusionAssessing gait adaptation in children with cerebral palsy (CP) requires cost-effective and easily applicable methods.To evaluate the reliability and validity of the Walking Adaptability Ladder Test for Kids (WAL-K) in assessing gait adaptation in children with CP.Sixty-six participants (40 children with CP and 26 controls), aged 6–18 years, underwent WAL-K testing under single- and double-run conditions with video recording. Test-retest reliability, interrater reliability, concurrent validity, and known-group validity were assessed. Concurrent validity was assessed using the Timed Up and Go Test (TUGT), Four-Square Step Test (FSST), and Five Times Sit-to-Stand Test.Interrater intraclass correlation coefficients (ICC3,k) values were > 0.999 for the WAL-K single- and double-run tests. The test-retest reliability ICC3,k values were 0.988 for the WAL-K single-run, and 0.963, 0.962, and 0.963 for the WAL-K double-run (p < .05). WAL-K double-run showed a strong correlation with FSST (r = 0.791), while WAL-K single-run correlated weakly with TUGT (r = 0.394) (p < .01). Moderate correlations were observed between other tests (p < .01). Children with CP had higher scores in all WAL-K tests compared to controls (p < .001).The WAL-K test demonstrated validity and reliability, making it suitable for clinical use without requiring specialized laboratory settings. It enables repeated assessments of gait adaptation in children with CP. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionThe aims of this study were to adapt the Swedish version of the International Outcome Inventory for Hearing Aids (IOI-HA) to the International Outcome Inventory for Alternative Interventions (IOI-AI) in the context of ear surgery (IOI-AIop) and to test the psychometric properties.The validated Swedish questionnaire IOI-HA was adapted to the IOI-AIop by omitting the question about hearing aid use and changing the term “hearing aid” to “surgery” in the remaining items. The validity, component structure and reliability of the IOI-AIop were assessed.Subjects diagnosed with otosclerosis and undergoing stapedotomy were included in the study (n = 162).High mean scores were noted for all items. Ceiling effects were noted, most pronounced for the satisfaction item. Principal component analysis (PCA) yielded a two-component structure explaining 77.5% of the variance. The test-retest reliability measured by intra class correlation coefficient was >0.9, and the internal consistency coefficient measured by Cronbach’s alfa was >0.8.The IOI-AIop showed good psychometric properties. However, ceiling effects were observed. The two-component solution was in line with previous factor analyses of the IOI-HA and the IOI-AI. The comprehensive IOI-AIop is recommended as a useful tool to evaluate patient perspectives after ear surgery. [ABSTRACT FROM AUTHOR]

Touchscreen devices are widely used in modern life and have quickly become part of daily life for children, including during Occupational Therapy sessions for children with disabilities. Touchscreen Assessment Tool (TATOO) is a prototype application used to evaluate children's performance when using touchscreen devices. The purpose of this study, based on the logical user-centred interaction design framework, was to evaluate TATOO's usability for occupational therapists and typically developing children and to examine the correlations between their usability scores. A convenience sample of clinicians (N = 10) and children with typical development (N = 60) was recruited for this study. The usability assessment was conducted using the System Usability Scale (SUS) and semi-structured interviews for the clinicians, and the Short Feedback Questionnaire-Child (SFQ-Child) for the children. The SUS scores (M ± SD = 85.5 ± 8.04, range = 70–97.5) indicated good ratings of TATOO's usability by clinicians; the SFQ-Child results showed children also rated its usability very highly, including all ages (4–10 years) and all tasks. The clinicians all expressed positive attitudes towards using TATOO, and no bias was found between the clinicians' usability scores and the children's usability feedback. The TATOO is a user-friendly tool. Researchers and clinicians can benefit from the availability of an objective and low-cost assessment tool to promote their evaluation and intervention by providing more focussed individualized recommendations and adaptations. The study also suggests a model to follow when developing applications and evaluating their usability through a mixed-method approach to deepen understanding of the user's needs. Touchscreen Assessment Tool (TATOO) shows a user-friendly tool for assessing the different skills required to operate touchscreens interface. TATOO has the potential to become an essential objective and low-cost assessment tool for the clinician, in which the spread of touchscreens constantly increases. Researchers and clinicians can benefit from the availability of such tools to promote their evaluation and intervention by providing more focussed individualized recommendations and adaptations. TATOO will complement the assessment needs, as traditional fine motor assessment tools cannot capture the skills necessary to operate a touchscreen device The study suggests a model to follow when developing applications and evaluating their usability through a mixed-method approach in order to deepen understanding of the user's needs. [ABSTRACT FROM AUTHOR]

We conducted a series of tests on the FORensic oUtcome Measure (FORUM), a novel tool for measuring outcomes in forensic mental health services, which consists of complementary patient-reported (FORUM-P) and clinician-reported instruments (FORUM-C). Inpatients and outpatients at a UK forensic psychiatric regional service completed the FORUM-P and members of their clinical teams completed the FORUM-C. Patients and clinicians also provided qualitative feedback on the instruments. We assessed test-retest and inter-rater reliability in standard ways. Sixty-two patients participated with a mean age of 41.0 years (standard deviation 11.3). Thirty-five clinicians provided information about these patients. For internal consistency, Cronbach's alpha for FORUM-P was 0.87 (95% confidence interval 0.80–0.93) and for FORUM-C was 0.93 (95% confidence interval 0.91–0.96). For test-retest reliability, weighted kappa for FORUM-P was 0.44 (95% confidence interval 0.24–0.63) and for FORUM-C was 0.78 (95% confidence interval 0.73–0.85). For inter-rater reliability, Spearman correlation coefficient for overall FORUM-C score between the first rating by clinician 1 and clinician 2 was 0.47 (95% confidence interval 0.18–0.69). For comprehensiveness, comprehensibility, and relevance FORUM-P and FORUM-C were both rated as good. FORUM-P and FORUM-C provide a novel, robust set of complementary instruments with promising psychometric properties for monitoring outcomes in forensic mental health. [ABSTRACT FROM AUTHOR]

The "Test Adaptation Reporting Standards" (TARES), or "TARES statement" was developed to alleviate the problems arising from inadequate reporting of test adaptation procedures. The TARES contains a short preamble and a checklist, that comprises an evidence-based minimum set of information for reporting in test adaptations. The TARES statement was developed by an international group of experts, under the umbrella of the International Test Commission (ITC) to support an increase in the accuracy, transparency, and usefulness of test adaptations documentation. This paper reports on the context and motivation for generating the TARES statement, describes the development process, discusses the TARES checklist structure and components, and suggests potential uses. [ABSTRACT FROM AUTHOR]

To synthesize and critically appraise available interventions in the conservative management of hand impairment for children and adolescents with heritable disorders of connective tissue (HDCT). A search of peer-reviewed literature and online platforms were included with data regarding hand impairment and function, conservative management and outcome measures extracted and appraised. Levels of evidence were applied to published literature. Ten peer-reviewed papers, eleven webpages and YouTube videos met the inclusion criteria. Reported interventions included: strengthening, orthoses, assistive equipment, education and pacing. Evidence of intervention effectiveness and evidence-based guidance on dosage were absent, with no consistency of outcome measures monitoring intervention effectiveness. Online platforms posted by health professionals predominantly provided advice for families without clinical detail of interventions. There is a consistent suite of interventions identified in both peer-reviewed literature and online platforms used by clinicians and families to manage hand impairment for children and adolescents with HDCT. Clear dosage parameters and outcome measures are needed in future intervention studies to determine the effectiveness of interventions and guide clinicians in how best to treat hand impairment. Increasing accountability and quality of online resources posted by health professionals for families is warranted to ensure dosage details and precautions are provided. [ABSTRACT FROM AUTHOR]

Examine and identify the breadth of definitions and measures of objective and subjective spinal stiffness in the literature, with a focus on clinical implications. A scoping review was conducted to determine what is known about definitions and measures of the specific term of spinal stiffness. Following the framework by Arksey and O'Malley, eligible peer-reviewed studies identified using PubMed, Ebsco health, and Scopus were included if they reported definitions or measures of spinal stiffness. Using a data abstraction form, the studies were classified into four themes: biomechanical, surgical, pathophysiological, and segmental spinal assessment. To identify similarities and differences between studies, sixteen categories were generated. In total, 2426 records were identified, and 410 met the eligibility criteria. There were 350 measures (132 subjective; 218 objective measures) and 93 indicators of spinal stiffness. The majority of studies (n = 69%) did not define stiffness. This review highlights the breadth of objective and subjective measures that are both clinically and methodologically diverse. There is no consensus regarding a standardised definition of stiffness in the reviewed literature. There is a need for a consensus definition of stiffness, as we did not find a consensus definition of stiffness in the reviewed literature. Definitions of stiffness should be included alongside self-reported or patient-reported outcome measures. There is a need to establish the relationship between subjective and objective measures in future studies. Clinicians should be aware that stiffness is a symptom that may indicate the presence of underlying pathophysiology. [ABSTRACT FROM AUTHOR]

Fatigue is a major symptom of ABI. Greater fatigue is associated with cognitive impairment. Our aim was to systematically review, describe and analyse the literature on the extent of this relationship. Five databases were searched from inception. Studies were included where: participants had a defined clinical diagnosis of ABI which included TBI, stroke or subarachnoid haemorrhage; a fatigue measure was included; at least one objective cognitive measure was used. Three reviewers individually identified studies and determined quality using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Sixteen of the 412 identified studies, investigating the relationship between cognitive dysfunction and fatigue, comprising a total of 1,745 participants, were included. Quality ranged from fair to good. Meta-analysis found fatigue was significantly associated with an overall pattern of cognitive slowing on tasks of sustained attention. A narrative synthesis found weak associations with fatigue and information processing, attention, memory and executive function. Analysis found sustained attentional performance had stronger associations with fatigue after ABI. Whereas, weak associations were found between fatigue and information processing, attention and to some extent memory and executive function. More focused research on specific cognitive domains is needed to understand the mechanisms of fatigue. Cognitive dysfunction is associated with higher fatigue levels after stroke, traumatic brain injury or subarachnoid haemorrhage. Management of cognitive dysfunction may improve fatigue and participation in meaningful activities after stroke, traumatic brain injury or subarachnoid haemorrhage. Intervention strategies that reduce cognitive load during everyday activities (e.g., grading the burden on attentional resources), may potentially be effective in managing post-ABI fatigue. Agreement on core measures could facilitate integration of findings into clinical practice. [ABSTRACT FROM AUTHOR]

Outcome measures are highly recommended in stroke physical therapy, however, most of the existing research has been performed from the provider perspective. Understanding the patient perspective of outcome measures in conjunction with the therapist perspective may help to better support patient engagement and autonomy. The purpose of this study was to explore patient and therapist perspectives on physical therapy outcome measures post-stroke. This qualitative case study of a Canadian rehabilitation facility is based on patient-oriented research principles, with three patient partners embedded in the research team. Data collection included chart reviews, observations of physical therapy sessions, patient interviews, and therapist interviews. Field notes of observations and interview transcripts were analyzed using thematic analysis. Ten patients and seven therapists participated. Analysis revealed the following two themes: 1) tracking progress; and 2) partnership. Tracking progress included the expectations patients had for improvement, the importance of objectively measuring change and the functional improvement observed day by day. Partnership described the relationship between therapist and patient including communication, encouragement and affirmation, the therapist as expert and the gradual shift in autonomy from therapist to patient. Patients valued the objective results of outcome measures and were encouraged by measurable changes. Maximizing the use of physical therapy outcome measures may improve patient engagement and support relational autonomy. [ABSTRACT FROM AUTHOR]

The Patient-Specific Functional Scale (PSFS) is among the most used measures to evaluate physical function. The PSFS has not been translated into Turkish for patients with low back pain to date. The purpose of the present study was to translate and cross-culturally adapt the PSFS into Turkish (PSFS-T) and to assess its reliability and validity in patients with low back pain. A total of 105 participants completed the PSFS-T, Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Visual Analogue Scale (VAS) for pain. Sixty-nine participants completed the PSFS-T questionnaire twice in 7 days. The internal consistency of the PSFS-T was assessed using Cronbach's alpha while the Intraclass Correlation Coefficient (ICC) was used to evaluate test-retest reliability. The convergent validity of PSFS-T was determined with ODI, RMDQ, and VAS questionnaires by using Pearson's correlation coefficient analysis. The PSFS-T demonstrated acceptable internal consistency (Cronbach's α = 0.79) and good test-retest reliability (ICC2,1 = 0.75) with no floor or ceiling issues. The PSFS-T showed a moderate correlation with ODI (Rp =0.49, p<0.001) and RMDQ (Rp =0.46, p<0.001). A poor correlation was found between PSFS-T and VAS (Rp = 0.36, p< 0.001). Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) for the PSFS-T scores were 0.69 and 1.91 respectively The Turkish version of PSFS is a valid and reliable instrument for the assessment of low back patients. It may be considered a preferable scale for clinical assessment of Turkish-speaking patients with low back pain. [ABSTRACT FROM AUTHOR]

This study aimed to describe the tinnitus severity in patients with chronic otitis media (COM) and describe the sociodemographic and clinical variables associated with tinnitus severity. Cross-sectional study. Two otology-referral centers in Bogotá (Colombia) were included. Sociodemographic, clinical associated factors and quality of life questionnaires were applied. Otoscopic evaluation and audiometric data were collected. About 231 adults with COM. Up to 51.5% of the patients reported severe tinnitus discomfort, 21.7% moderate discomfort, and 26.8% minor discomfort. Factor associated with increased tinnitus severity in patients with COM were older age (aOR: 1.02; 95% CI: 1.01–1.05), higher education (aOR: 2.24; 95% CI: 1.03–4.87), ear discharge during childhood (aOR: 1.88; 95% CI: 1.02–3.45), cholesteatoma in one ear (aOR: 2.26; 95% CI: 1.05–4.88), and pure-tone air average over 15 dB (aOR: 2.08; 95% CI: 1.28–3.36). Differences of 10-points in symptoms severity and 15-points in the total score of the "Chronic Suppurative Otitis Media Questionnaire-12" were found between the tinnitus severity groups. Our results highlight the need for further research on the associated factors of tinnitus severity on COM patients. COM patients with higher tinnitus severity presented worse audiometric results and worse quality of life outcomes. [ABSTRACT FROM AUTHOR]

Outcome measurement is recommended in stroke clinical practice guidelines, however there is considerable variability in how this activity is performed in clinical practice. Factors driving clinician behaviour have been explored in English-speaking countries, but little is known about the factors influencing clinical practice in non-English-speaking populations. (1) To explore barriers and facilitators to aphasia outcome measurement from the perspective of international aphasia clinicians. (2) To determine whether barriers and facilitators to outcome measurement differ in English- and non-English- speaking countries. The primary hypothesis was that clinicians working with people with aphasia in non-English-speaking countries would experience more barriers to outcome measurement than those in English-speaking countries. An international sample of aphasia clinicians completed an online survey informed by the Theoretical Domains Framework. Quantitative data were analysed using descriptive statistics and a Mann-Whitney U Test to compare English- and non-English- speaking groups. TDF domains identified as influencing clinician behaviour were mapped to the Behaviour Change Wheel, producing theory-informed strategies to improve practice. A total of 208 clinicians from 25 countries completed the survey. Almost all (93.7%) reported measuring outcomes to some extent, most commonly to measure client progress. Facilitators to outcome measurement included "social/professional role and identity" (understanding that measuring outcomes is part of the clinicians' role), "optimism" (feeling positive about measuring outcomes), and "emotion" (enjoying, and feeling comfortable measuring outcomes). Barriers were "environmental context and resources" (time and resource limitations, and competing caseload priorities), "behavioural regulation" (a lack of personal and workplace systems to measure outcomes) and "skills" (having insufficient training and experience in outcome measurement). There was no significant difference between the barriers and facilitators experienced by clinicians in English- and non-English- speaking countries. Implementation strategies, informed by Behaviour Change Techniques, were created to improve clinical practice. Internationally, clinicians working with people with aphasia measure outcomes and believe that this is part of their role, and a positive aspect of their work. Common barriers to outcome measurement included insufficient time and access to resources, inadequate personal and workplace systems, and insufficient skills necessary for performing outcome measurement. Preliminary, theory-informed strategies (e.g., improving access to culturally and linguistically appropriate measurement instruments; developing protocols, templates or checklists guided by recommended practice; and providing training in outcome measurement) would assist with uptake of clinical practice guidelines in this area. [ABSTRACT FROM AUTHOR]

Clinical trials in uveitis have led to the expansion of therapeutic options for the management of non-infectious uveitis. The purpose of this systematic review is to investigate why some clinical trials have yielded successful results and regulatory approval of new therapies, and some have not. A systematic literature search of the Pubmed/MEDLINE database and clinicaltrials.gov was performed from 2006 to 2021, according to the PRISMA guidelines. Phase III clinical trials of systemic and local therapies in adults with non-infectious intermediate, posterior, and panuveitis were included. A total of 79 clinical trials were collected from ClinicalTrials.gov and PubMed/MEDLINE database search. Based on the inclusion and exclusion criteria, 14 clinical trials were included. This review summarizes the study design, outcome measures, and results of recent phase III trials in non-infectious uveitis, in the interest of understanding limitations and rethinking new methods of defining endpoints in clinical trial design. [ABSTRACT FROM AUTHOR]

The use of outcome measures (OMs) is a hallmark of contemporary physical therapy in the USA. The effect of OM utilization on patient care decisions and the results of PT services remain poorly understood. The purpose of this study is to explore PTs perceptions about the relationship between balance OMs and decision-making and how that interaction impacts patient outcomes, particularly for patients with acquired brain injury. This qualitative study used semi-structured phone interviews with an interview guide. Maximum variation sampling was used. Thematic analysis was situated in a priori determined theory-based categories. Twenty-three physical therapists (PTs) from diverse geographic areas and practice settings participated. Therapists expressed diverse views on the impact of OM use on patient outcomes, but the majority perceived that using OMs improved rehabilitation outcomes. The use of OMs was related to the selection of optimal intervention type and intensity and justified continued high-frequency rehabilitation services. OMs were important to therapists' decision-making. In the present study, PTs reported that they believe the use of validated, clinically useful OMs may improve patient outcomes. Balance outcome measures are considered an important tool to the optimal management of the profound impact of balance impairments after brain injury. Most physical therapists in this study believe that using balance outcome measures results in better outcomes for patients with brain injury. In this study, physical therapists reported using outcome measures in wide-ranging ways to guide clinical decisions about balance in those with brain injury. [ABSTRACT FROM AUTHOR]

To provide a research review of the components and outcomes of routine outcome monitoring (ROM) and recommendations for research and therapeutic practice. A narrative review of the three phases of ROM – data collection, feeding back data, and adapting therapy – and an overview of patient outcomes from 11 meta-analytic studies. Patients support ROM when its purpose is clear and integrated within therapy. Greater frequency of data collection is more important for shorter-term therapies, and use of graphs, greater specificity of feedback, and alerts are helpful. Overall effects on patient outcomes are statistically significant (g ≈ 0.15) and increase when clinical support tools (CSTs) are used for not-on-track cases (g ≈ 0.36–0.53). Effects are additive to standard effects of psychological therapies. Organizational, personnel, and resource issues remain the greatest obstacles to the successful adoption of ROM. ROM offers a low-cost method for enhancing patient outcomes, on average resulting in an ≈ 8% advantage (success rate difference; SRD) over standard care. CSTs are particularly effective for not-on-track patients (SRD between ≈ 20% and 29%), but ROM does not work for all patients and successful implementation is a major challenge, along with securing appropriate cultural adaptations. [ABSTRACT FROM AUTHOR]

The objectives of this study were to translate the Pain Self-Efficacy Questionnaire (PSEQ) into Canadian French (PSEQ-F) and to evaluate its validity, reliability and responsiveness in a French-Canadian sample of patients with persistent rotator cuff related shoulder pain (RCRSP). Translation and cross-cultural adaptation of the original English version of the PSEQ into Canadian French were performed according to standard procedures. Thereafter, 78 adults with RCRSP completed the PSEQ-F on three occasions: baseline, 2 days later to evaluate the reliability and 6 weeks later to evaluate responsiveness. Cross-cultural adaptation was performed without problems with content or language. The PSEQ-F was found to be reliable (Intraclass Correlation Coefficient = 0.96; Minimal Detectable Change = 3 points [5%]), valid (moderate correlations with an abbreviated version of Disability of the Arm, Shoulder and Hand [QuickDASH] and Brief Pain Inventory [BPI] Questionnaires) and responsive (Standardized Response Mean = 0.96; Effect Size = 0.81; Minimal Clinically Important Difference = 6 points [10%]). The PSEQ-F is a reliable, valid and responsive questionnaire that can be used to assess pain self-efficacy in French-speaking individuals with RCRSP. Further studies should use a self-efficacy-specific Global Rating of Change scale to estimate its responsiveness more thoroughly. Higher levels of pain self-efficacy have been associated with increased odds of symptom resolution in those with persistent rotator cuff related shoulder pain (RCRSP). The Pain Self-Efficacy Questionnaire (PSEQ) has been identified as the most frequently used tool by clinicians to assess pain self-efficacy in patients at risk of developing persistent musculoskeletal pain. The Canadian French version of the PSEQ (PSEQ-F) is a reliable, valid and responsive questionnaire that can be used to assess pain self-efficacy in French-speaking individuals with RCRSP. [ABSTRACT FROM AUTHOR]

Little evidence exists regarding an integrated multidimensional evaluation methodology to analyze the within-patient effects of medical treatment for chronic rhinosinusitis with nasal polyps (CRSwNP). We aimed to use an integrated evaluation model to analyze the effects of short-course oral corticosteroid (OCS) followed by intranasal corticosteroid spray (INCS) therapy in patients with severe CRSwNP. In all, 32 patients with severe CRSwNP received oral methylprednisolone for three weeks followed by intranasal budesonide spray for nine weeks in this prospective single-arm study. An evaluation model integrating the concepts of the core outcome set (COS), clinical control and minimum clinically important difference (MCID) was longitudinally evaluated. All uncontrolled patients at baseline showed similar progressive improvements from baseline and more than 1 MCID response across core outcomes during the OCS period, with severe CRSwNP being partly controlled in 31 (96.9%) patients and uncontrolled in 1 (3.1%) patient at 3 weeks. During the subsequent INCS period, 14 (43.8%) patients gradually deteriorated to an uncontrolled status at 12 weeks, whereas 18 (56.2%) exhibited partly controlled CRSwNP until 12 weeks. In more than half of the patients, severe CRSwNP was partly controlled with the initial OCS followed by INCS therapy. An integrated evaluation model was used to facilitate the comprehensive evaluation of within-patient response, especially in patients with different responses to the same treatment. ChiCTR1900024287. [ABSTRACT FROM AUTHOR]

The use of balance outcome measures (OM) is proposed to enhance physical therapy services and patient outcomes. Explore current practices of balance OM use and OM's role in United States physical therapists' decision-making with patient's acquired brain injury (ABI). Cross-sectional survey utilizing snowball sampling, n = 373. Survey items required ranking agreement with statements on Likert scale. Multinomial logistic regression used to determine the relationship between survey answers and participant characteristics. Ninety-three percent of therapists reported using outcome measures with patients with ABI. Those who reported not using outcome measures with patients with ABI were significantly different on setting, primary patient population, APTA section membership, and ANPT membership. All respondents who primarily treated neurologic diagnoses used outcome measure with clients with ABI, compared to 87% of respondents who worked primarily with orthopedic clients. Comfort, equipment availability, and psychometric properties were the most frequent reasons for choosing a measure. Therapist decision-making was impacted by outcome measures; this frequency was dependent on practice setting, primary patient population, and specialty certifications. Physical therapists use a low diversity of outcome measures to assess balance. Respondents rated psychometric properties as more important than past published research. This is the first study to demonstrate that outcome measures play a role for most United States PTs in decision-making in all stages of the patient management model including identification of problems, diagnosis, prognosis, intervention selection, termination of services, and discharge planning, as well justifying service delivery. [ABSTRACT FROM AUTHOR]

This paper covers considerations in using criterion measures based on administrative data. We begin with a conceptual framework for understanding and evaluating administrative criterion measures as "objective" rather than (ratings-based) assessments of job performance. We then describe the associated advantages (e.g., availability) and disadvantages (e.g., contamination) of using administrative data for criterion-related validation purposes. Best practices in the use of administrative data for validation purposes, including procedures for (a) handling missing data, (b) performing data checks, and (c) reporting detailed decision rules so future researchers can replicate the analyses are also described. Finally, we discuss "modern data management" approaches for improving administrative data for supporting organizational decision-making. [ABSTRACT FROM AUTHOR]

There is a growing literature on the importance of cultural adaptation of research-supported social work interventions. Few studies have however offered systematic methods for the a priori assessment of intervention fit in a new context. The current study explores the use of measurement invariance analyses to help identify whether key theoretical constructs in an intervention's theory of change may fit differently in a new context. We draw on data on 13 measures of key constructs in an intervention for youth leaving out-of-home care designed and trialed in the US context (N = 295; 53.1% girls, mean age 17.3) compared to Swedish adolescents (N = 104; 41% girls, mean age 17.5). In general, the results found all the measures to be invariant between US and Swedish samples. The original intervention (US) is likely to have a good fit in the new (Swedish) context in terms of the measurement and functionality of its key constructs. There are, however, some indications that certain aspects of the original key constructs may function differently in the Swedish context, highlighting a need to review either measurement or intervention design. A broader conclusion is that measurement invariance can provide a useful tool for research-supported social work practice, namely the systematic a priori assessment of the transferability of an intervention's theory of change. Some limitations and methodological issues are discussed. [ABSTRACT FROM AUTHOR]

The ALS Functional Rating Scale-Revised (ALSFRS-R) is the most frequent primary outcome measure in ALS trials. The reliable and accurate performance of this instrument is critical. The Barrow Neurological Institute Clinical Research Organization (BNI-CRO) has been performing evaluator training and certification for the ALSFRS-R since 2011. Here we evaluate the impact of evaluator training and participant practice. Training records were reviewed for evaluators trained and certified by the BNI-CRO at least twice since 2011. We determined the impact of training intervals on ease of recertification. We also assessed whether the mode of training impacted successful vignette scoring. For self-reported participant assessment, remote training was provided by BNI CRO personnel; we determined whether there was a practice effect on reliable assessment. 117 evaluators completed at least two training sessions either via interactive in-person training, interactive remote training, or by completing a self-training module. Poorer performance on retraining was noted when the interval between pieces of training was 2 years or greater. Mode of training also impacted performance; interactive in-person and remote sessions were associated with better performance than the use of self-training modules. For participant self-assessment, week–week variability in ALSFRS-R scores declined over time as the study progressed. Standard training of evaluators has an impact on the performance of the ALSFRS-R, with shorter intervals between training positively impacting performance. Interactive training sessions allowing for real-time questions also are associated with better performance. Continued training is important to maintain a high-quality ALSFRS-R assessment. [ABSTRACT FROM AUTHOR]

To investigate clinically meaningful change for ROADS and ALSFRS-R using a patient-defined approach. Data were reviewed from participants assessed at the Emory ALS Center from 2019–2022 with two assessments using both ROADS and ALSFRS-R and a completed patient-reported global impression of change scale at the second visit. Minimal important difference (MID), or the smallest amount of change that is clinically relevant, was assessed based on patient reported impression of change for ROADS and ALSFRS-R. Minimal detectable change (MDC), the smallest amount of change exceeding the threshold for measurement error, was assessed for ROADS and ALSFRS-R using standard deviations for participants self-rated as "unchanged". Data were included from 162 participants. For ROADS (total possible normed score = 146), MID = 5.81 and MDC = 2.83 points. For ALSFRS-R (total possible sum-score = 48), MID = 3.24 and MDC = 1.59 points. Clinically meaningful decline during the assessment period was observed in 98/162 (60.49%) participants on ROADS and 75/162 (46.30) participants on ALSFRS-R (OR = 1.63, 95% CI [1.0009, 2.66]). Changes that are on average less than 5.81 points (3.98%) on the normed ROADS score or less than 3.24 points (6.75%) on the ALSFRS-R sum-score may not be clinically meaningful according to a patient-defined approach. Understanding the clinical and statistical limitations of these scales is crucial when designing and interpreting ALS research studies. [ABSTRACT FROM AUTHOR]

To estimate the prevalence of bilateral vestibulopathy (BV) and evaluate the association with, and concurrent validity of the Dynamic Gait Index (DGI) and the Dizziness Handicap Inventory (DHI) in diagnosing BV based on video head impulse test (vHIT) among older adults ≥65 years referred to a geriatric falls clinic on suspicion of vestibular impairment. The vHIT was applied as a reference standard of BV to estimate diagnostic parameters for optimal cut-off scores of DGI and DHI applied separately and in combination. Two-hundred medical records were reviewed (70% women, mean age 79.4 years). The prevalence of BV was 9%. DGI was weakly associated with BV: Odds Ratio (OR) 1.15 (95% confidence interval (CI): 1.01; 1.31), with a 93% sensitivity and 47% specificity of a cut-off score of 16. The total score of DHI showed no association with BV: OR 1.01 (95% CI: 0.98; 1.04). The concurrent validity for BV and DGI and/or DHI were found to be inadequate. A prevalence of 9% underlines the relevance for assessment of BV. Only a weak association between DGI and/or DHI and BV was found. Thus, vHIT remains the preferred test for detecting BV in geriatric fall assessments. Bilateral vestibulopathy (BV) has numerous negative consequences for older adults and the prevalence is high among older adults referred to a geriatric falls clinic on suspicion of vestibular impairment. The Dynamic Gait Index (DGI) and the Dizziness Handicap Inventory (DHI) are not valid alternatives to the Video Head Impulse Test (vHIT) when assessing BV among geriatric outpatients. [ABSTRACT FROM AUTHOR]

There remain barriers to securing robust and complete datasets from counselling embedded in Higher Education (HE). This study aimed to provide the first step towards developing a national dataset of student counselling outcomes drawn from differing outcome measures, platforms and reporting on all clients. Data from four counselling services using two clinical outcome measures and two platforms were pooled and analysed. Students presented to counselling with low levels of wellbeing and functioning, and high levels of depression, anxiety, academic distress and trauma. Counselling was particularly effective for improving depression, anxiety, wellbeing, hostility, social anxiety and academic distress. Results demonstrate value in pooling complete data from HE counselling services and we argue for developing a national dataset of university counselling data. [ABSTRACT FROM AUTHOR]

To measure and compare progression in children's power mobility skill among process and task-based measures following a loan of one of four early power mobility devices. Additionally, to explore different power mobility learner groups and skill development trajectories. In this pre-post study, children were purposefully sampled and power mobility skill was measured from video taken pre-post several months' experience (mean 192.40; SD 42.79 days) using the Assessment of Learning Powered mobility use (ALP) and two task-based measures. Associations among power mobility skill measures were examined. Child and environmental factors influencing ALP phase at loan-end were explored. Forty-six children aged 13 − 68 months (mean 40.40; SD 15.60) participated, with cerebral palsy being the most common condition (n = 33; 71.74%). ALP change scores ranged from −2 to +4 ALP phases (median 1.0). Wilcoxon signed rank test was significant for pre-post differences with a large effect size (z = 5.50, p < 0.001; r = 0.57). End-of-loan Spearman correlations between ALP and two task-based paediatric measures were excellent (rs = 0.92). Kruskal-Wallis test revealed significant effect of device, access method, diagnostic group and communication abilities on loan-end ALP phase. Positive change was demonstrated with most children (n = 39; 84.78%) changing at least one ALP phase during the study. Positive change was seen with children at all phases of tool-use, using all devices and access methods. Process and task-based measures were highly correlated, but differed in application for different learner groups. Different trajectories of skill development may be associated with different child profiles and access abilities. Children at all phases of tool-use can demonstrate positive change in power mobility skill using different devices and switch as well as joystick access methods The Assessment of Learning Powered mobility use (ALP) is useful for assessing tool-use and learning process skills for young children across the power mobility skill continuum. Task-based measures may also be helpful for guiding training and recording progress; The Power Mobility Training Tool (PMTT) is most useful for children exploring cause-effect and direction (ALP Phases 1–5), while the Power Mobility Program (PMP) is most useful for functional learners and those progressing from exploring direction to functional use (ALP Phases 5–8). Access method may influence power mobility learning trajectory and training [ABSTRACT FROM AUTHOR]

To investigate: (1) the interrater, and test–retest reliability of the coin rotation test (CRT) in people with Parkinson's Disease (PwPD); (2) the minimum detectable change in the CRT; (3) the concurrent and known-groups validity of the CRT; and (4) the cut-off times that best discriminate PwPD from healthy people and functionally dependent PwPD from functionally independent PwPD. Forty-eight PwPD and 33 healthy people were included. The CRT was administered with the nine-hole peg test, Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Scale, Parkinson's Disease Questionnaire-8, and Schwab and England Scale. The CRT had excellent interrater and test–retest reliability. Minimal detectable changes were 5.96 and 8.23 s for the dominant and non-dominant hand, respectively. The CRT correlated with other outcome measures. Significant differences in the CRT times were found between PwPD and healthy people, and between functionally dependent PwPD and functionally independent PwPD. The cut-off times of 12.66 s on the dominant hand and 15.76 s on the non-dominant best discriminated PwPD from healthy people, while 22.99 s on the dominant hand and 23.48 s on the non-dominant best discriminated functionally dependent PwPD from functionally independent PwPD. The CRT is a reliable, and clinically available tool for assessing manual dexterity in PwPD. The coin rotation test is a reliable, valid, and clinically available tool for assessing manual dexterity in Parkinson's Disease. The minimal detectable changes of the coin rotation test are 5.96 s for dominant hand and 8.23 s for the non-dominant hand, which may useful for clinicians and researchers to detect in any true change in manual dexterity after any intervention. The coin rotation test correlated with Parkinson's Disease-specific measurement tools. The coin rotation test times may detect impaired manual dexterity between people with Parkinson's Disease and healthy people, and between functionally dependent and functionally independent in Parkinson's Disease population. [ABSTRACT FROM AUTHOR]

Adults with lower-limb amputation walk with an asymmetrical gait and exhibit poor functional outcomes, which may negatively impact quality-of-life. To evaluate associations between gait asymmetry and performance-based physical function among adults with lower-limb amputation. A cross-sectional study involving 38 adults with a unilateral transtibial (N = 24; 62.5 ± 10.5 years) or transfemoral amputation (N = 14; 59.9 ± 9.5 years) was conducted. Following gait analysis (capturing step length and stance time asymmetry at self-selected (SSWS) and fast walking speeds (FWS)), participants completed performance-based measures (i.e. Timed Up and Go (TUG), the 10-Meter Walk Test (10mwt), and the 6-Minute Walk Test (6MWT)). Step length and stance time asymmetry (at SSWS and FWS) were significantly correlated with each performance-based measure (p <.001 to p =.035). Overall, models with gait measures obtained at SSWS explained 40.1%, 46.8% and 40.1% of the variance in TUG-time (p =.022), 10mwt-speed (p =.003) and 6MWT-distance (p =.010), respectively. Models with gait measures obtained at FWS explained 70.0%, 59.8% and 51.8% of the variance in TUG-time (p <.001), 10mwt-speed (p <.001), and 6MWT-distance (p <.001), respectively. Increases in step length or stance time asymmetry are associated with increased TUG-time, slower 10mwt-speed, and reduced 6MWT-distance. Findings suggest gait asymmetry may be a factor in poor functional outcomes following lower-limb amputation. [ABSTRACT FROM AUTHOR]

Limits of stability (LOS) is a major component of balance dysfunction in people with multiple sclerosis (MS). The functional reach test (FRT) is a clinical LOS assessment; however, its psychometric properties have not been investigated in people with MS yet. Objectives: To investigate: (1) the intrarater, interrater, and test–retest reliability of the FRT in people with MS; (2) the minimum detectable change (MDC) in the FRT distances; (3) the concurrent and discriminant validity of the FRT; and (4) the cutoff distance that best discriminates people with MS from healthy people and fallers from non-fallers with MS. Forty-three people with MS and 36 healthy people participated in this study. The FRT was administered along with the instrumented LOS test, Berg Balance Scale, Four Square Step Test, Timed Up and Go Test, and Expanded Disability Status Scale. The FRT was repeated by the same rater after 2 min from the first test session to determine the intrarater reliability and was simultaneously conducted by two independent raters to determine the interrater reliability. The FRT was also repeated after 7–10 days to determine the test–retest reliability. The reliability was quantified using intraclass correlation coefficients (ICC), Bland-Altman plots, and the MDC. The validity was assessed by correlating the FRT distances with the scores of other measures and by comparing the FRT distances between the MS group and healthy people, and between the fallers and non-fallers in the MS group. The FRT demonstrated good to excellent intrarater, interrater, and test–retest reliability with an ICC (3,1) of 0.80–0.88 (p <.001), an ICC (3,2) of 0.94–0.97 (p <.001), an ICC (2,3) of 0.84–0.86 (p <.001), respectively. Bland–Altman analyses showed no systematic bias between the assessments. The MDC was 8.28 centimeters. The FRT was correlated with the other outcome measures (correlation coefficients ranged from 0.31 to 0.79, p <.05 for all). Significant differences in the FRT distances were found between people with MS and healthy people; however, no significant difference was found between the fallers and non-fallers with MS (p <.001 and p =.09, respectively). The cutoff distance of 35.5 centimeters best discriminates healthy people from people with MS while of 28.5 centimeters did not discriminate between the fallers and non-fallers with MS. The FRT is a reliable, valid, and easy-to-administer tool for assessing LOS in people with MS. [ABSTRACT FROM AUTHOR]

Outcome measures (OMs) have been emphasized by healthcare professions to optimize patient examination; however, a lack of regular use of OMs exists. The purpose of this study was to describe the outcome of a knowledge translation (KT) intervention to increase the use of OMs by physical therapists in an inpatient rehabilitation setting. A quasi-experimental pre-post study design was used. A multi-component KT intervention including education, organizational support, documentation, and environmental changes to increase the use of five OMs was implemented. Audit and feedback (A&F) was added to the KT intervention at month 6. Documented use of OMs was determined through manual chart audit (n = 864) and electronically (n = 2599). Regression analyses were used to identify factors associated with OMs use across time and diagnoses. Following the addition of A&F to the KT intervention at month 6, there was a significant increase in the odds of OMs use across all time intervals (months 6–12, 12–18, 18–24)(Odds Ratio (OR) 5.9, 95% Confidence Interval (CI) 4.1–8.5; OR 8.5, 95% CI 6.0–12.1; OR 10.8, 95% CI 7.6–15). There was also a significant increase in the odds of documenting OMs on individuals with neurological diagnoses (OR 0.3, 95% CI 0.5–0.8). This KT intervention increased and sustained OMs use over 24-months. This intervention can be replicated to improve the evidence-based practices of physical therapists. [ABSTRACT FROM AUTHOR]

The aim was to investigate how structured assessment of physical function can be performed in people with musculoskeletal disorders in arm-shoulder-hand. Specifically, we aimed to determine: • Which questionnaires are available for structured assessment of physical function in people with musculoskeletal disorders in arm-shoulder-hand? • What aspects of physical function do those questionnaires measure? • What are the psychometric properties of the questionnaires? By means of a systematic review, questionnaires and psychometric tests of those were identified. ICF was used to categorise the content of the questionnaires, and the COSMIN checklist was used to assess the psychometric evaluations. Nine questionnaires were identified. Most items focused on activities rather than functions. Commonly, a couple of psychometric measurements had been tested, most often reported being adequate. Only one questionnaire had been tested for all aspects. Variation in scope and insufficient reports regarding validity and reliability make comparisons and decisions on use difficult both in clinical practice and for research purposes. The level of psychometric evaluation differs, and often only a few aspects of validity and reliability have been tested. The questionnaires address activity issues to a higher extent than function. This review investigates the content and quality of nine ASH questionnaires. The questionnaires addressed activity issues to a higher extent than function. The level of psychometric testing of the questionnaires differed. DASH, Quick-DASH, and SPADI were the questionnaires that were most often evaluated with various psychometric tests, and with adequate results. [ABSTRACT FROM AUTHOR]

A recent clinical practice guideline set forth recommendations for the administration of the 6 Minute Walk Test, including course set-up and using mathematical calculation to obtain the distance walked. In clinical practice and research, however, deviations from these protocols exist. To assess for differences in total distance walked between use of mathematical calculation and a measuring wheel during three different course configurations of the 6 Minute Walk Test. Fifty healthy adults (18 males, 32 females) completed this study. The mean age was 37.04 (13.76) years ranging from 23 to 61 years. Each participant completed three course configurations of the 6 Minute Walk Test: a 12-meter straight walkway representing the Academy of Neurologic Physical Therapy Core Set of Outcome Measures Clinical Practice Guideline protocol, a 30-meter straight walkway, representing the American Thoracic Society's recommended protocol, and a 1.2-meter by 12-meter rectangular walkway, of which the Core Set of Outcome Measures Clinical Practice Guideline was derived. For mathematical calculation, the total number of laps counted, and this total number was multiplied by the distance of one lap with any partial lap added. Additionally, a research assistant followed behind each participant with a measuring wheel to capture distance walked. For all configurations, there were statistically significant differences between mathematical calculation and a measuring wheel, with mathematical calculation producing significantly less total distance. Additionally, there were statistically significant differences between all course configurations, despite the method of measurement. Adhering to 6 Minute Walk Test protocols, including the method of measuring the distance, is imperative to accurately interpret results and compare to existing data. Despite recommendations for standardized administration of the 6 Minute Walk Test, deviations exist, including the method of which to obtain the total distance walked; either by use of mathematical calculation or a measuring wheel. In three different 6 minute walk test course configurations, including the American Thoracic Society's recommended protocol and the Academy of Neurologic Physical Therapy recommended protocol, the measuring wheel resulted in significantly larger distances than use of the mathematical calculation. Despite the measuring wheel able to account for the turns during the 6 Minute Walk Test, it is imperative for clinicians to utilize standardized procedures such as using mathematical calculation, in order to accurately track progress and compare to existing data, of which mathematical calculation was used to derive. [ABSTRACT FROM AUTHOR]

To determine the intra-rater and inter-rater reliability of the Powered Mobility Program (PMP) and the Israel Ministry of Health Powered Mobility Proficiency Test (PM-PT); to test inter-rater reliability of the Assessment of Learning Powered Mobility (ALP) tool; to determine the convergent validity of these measures for children with physical disabilities. Participants included 30 children (mean 10 years, 6 months [SD 3 years, 7 months]; range: 6–18 years) with cerebral palsy and other neuromuscular disorders. Participants were non-proficient powered wheelchair drivers. Two blinded raters assessed the driving ability by viewing videos of the participants twice as they drove a pre-designed route at ALYN Hospital, Israel. They were assessed via the PMP, ALP and PM-PT outcome measures. Intra-class correlation coefficients (ICC2,1) were used to test intra-rater and inter-rater reliability and Spearman correlation coefficients were used to assess convergent validity. The PMP intra-rater reliability revealed ICCs2,1 of coefficients were 0.97/0.98 for both raters. For the PM-PT the ICC2,1 was 0.89/0.96 for both raters. The PMP inter-rater reliability ICC2,1 was 0.94/0.87 for the two tests, for the PM-PT the ICC2,1 was 0.91/0.87 for the two tests and for the ALP the ICC2,1 was 0.83. The convergent validity between the PMP and the PM-PT was rs=0.96, between the PMP and ALP was rs=0.89 and between the PM-PT and ALP was rs=0.87. The PMP and PM-PT intra and interrater reliability were good to excellent, the ALP inter-rater reliability was good and the convergent validity between all three measures was good to excellent. There is evidence of validity and reliability for three tests of powered wheelchair proficiency (PMP, PM-PT and ALP). Children using powered mobility, aged 6–18 years, now have outcome measures with empirical evidence that was previously lacking. When time for assessment is limited, the shorter PM-PT can be used instead of the more comprehensive PMP. [ABSTRACT FROM AUTHOR]

Traditional face-to-face learning is often replaced by virtual learning because it can be more feasible and cost-effective, and more recently due to the need for social distancing. The objective was to evaluate the effectiveness of two innovative knowledge translation (KT) interventions; in-person stakeholder-hosted, interactive, problem-based seminars (SHIPS) versus online problem-based tutorials (e-PBL) in changing knowledge, readiness to change, and self-efficacy with respect to the use of rehabilitation outcome measures. Physical and occupational therapists (n = 124) were recruited from four sites across Canada to participate in either an e-PBL or SHIPS. Evaluations of KT impact measured knowledge, self-efficacy to implement outcome measures in practice, and readiness to change. There were 112 participants who completed the study. Following the intervention, the mean knowledge scores for both groups improved, but there was greater improvement in participants who completed SHIPS. For self-efficacy and readiness to change, there was no significant difference between groups six months following the interventions. E-PBL was as good as a SHIPS for improving and retaining self-efficacy and readiness to change. Knowledge improved more with workshops than online delivery, while improvements in self-efficacy and readiness to change improved similarly regardless of delivery. This study compared the relative efficacy of internet and workshop-based education, focusing specifically on the use of outcome measures in physical and occupational therapy practice. Improvements in the self-efficacy of rehabilitation professionals with respect to outcome measure use had lasting effects regardless of KT intervention type, as it was retained six months following the intervention. Results from this study show that online interventions may be as effective as face-to-face workshops for improving readiness to change and self-efficacy for using outcome measures in practice by rehabilitation professionals. This is valuable information given the recent global pandemic, the need for social distancing, and the potential for learning interventions to focus within the online environment in the future. [ABSTRACT FROM AUTHOR]

Abdominal pain (AP) is a common feature in the general population. However, in patients with juvenile idiopathic arthritis (JIA) AP has scantily been studied. Among other reasons, gastrointestinal symptoms may present as side effects due to the medical treatment of JIA. The aim of the study was to explore the frequency of AP and its relationship to disease components and health-related quality of life (HRQoL) among young adults with JIA. This study included a cohort of 97 Finnish patients belonging to the population-based Nordic JIA cohort at their 17-year follow-up study visit. Mean age of the patients was 23 years. AP, functional status, fatigue, HRQoL, disease characteristics of JIA, and comorbidities were evaluated. AP was classified into three categories according to frequency: (1) never, (2) seldom (one to three times a month) and (3) frequent (at least once a week). About 48 (50%) young adults with JIA reported AP. Seldom AP was reported by 37 (38%), and frequent AP by 11 (11%) patients. AP was significantly associated with fatigue, female gender, functional status and arthritis-related pain. Patients having frequent AP reported lower HRQoL. AP was associated with the use of methotrexate and sulfasalazine, but not with nonsteroidal anti-inflammatory drugs (NSAIDs). AP is an important complaint in young adults with JIA and is associated with fatigue, female gender, methotrexate and sulfasalazine use. Patients with JIA reporting frequent AP with lower functional status and higher arthritis-related pain values have lower HRQoL. [ABSTRACT FROM AUTHOR]

Intensive Comprehensive Aphasia Programs (ICAPs) implement evidence-based, holistic therapies in a short-duration cohort model. ICAPs are growing in popularity, yet there are still relatively few programs, partially due to the high cost of running an ICAP. ICAPs implemented by graduate student clinicians can reduce the overall cost of an ICAP, but Phase I efficacy data for cognitive-linguistic outcomes for an ICAP carried out by graduate students has yet to be reported. To investigate the impact of a graduate student-run ICAP on measures of cognitive-linguistic change, and to identify relationships between individual and treatment variables and cognitive-linguistic function across pre- and post-ICAP administration. Fifty-three stroke survivors with chronic aphasia (33 males, 20 females; 32 first-time participants and 21 repeat participants; mean age = 65 years; mean time post-onset = 34 months) participated in an ICAP implemented by graduate students across eight cohorts. Cognitive-linguistic outcome measures included: Western Aphasia Battery, Revised (WAB-R); Boston Naming Test, Second Edition (BNT-2); and Raven's Coloured Progressive Matrices (RCPM). Paired samples t-tests were used to compare pre- and post-ICAP performance for each measure, and Pearson's r correlation coefficients were used to evaluate relationships between measures, as well as individual and treatment variables. Statistically significant change was observed on all three measures post-treatment, with small to no effect size. Participants who had completed a previous ICAP showed greater change on the WAB-R and RCPM, but no other individual or treatment variables significantly predicted change on outcome measures. Results provide Phase I, proof-of-concept evidence of positive cognitive-linguistic change in stroke survivors with aphasia following ICAP participation. An ICAP implemented by graduate student clinicians produced significant improvements for persons with chronic aphasia. [ABSTRACT FROM AUTHOR]

This study reports on the development of an outcome measure designed to evaluate pre-registration physiotherapy students' ability in performing core cardiorespiratory skills. A four round, e- Delphi study using an international panel of expert cardiorespiratory physiotherapists involved in pre-registration student education was undertaken. In round one participants identified what they look for in students competently performing core cardio-respiratory physiotherapy assessment and treatment skills. These items were refined in rounds two and three. Item content validity score (iCVI) of ≥ 0.8 at round four identified consensus. Scale content validity index (SCVI) was calculated. Response rate for round one was 46% (6/13). Additional experts were invited to participate and response rates increased to 71% (round 2), 88% (round 3) and 100% (round 4). Of the 207 items across the seven skills identified in round one, 140 were presented in round four. Of these, consensus was achieved for 128 items, with 12 being excluded. The SCVI was 0.907. This e-Delphi study enabled the development of a draft outcome measure, which aims to assess performance of seven cardiorespiratory physiotherapy skills. This tool will enable rigorous evaluation of different education methods to establish their effectiveness. However, it is first necessary to establish construct validity and assess inter and intra-rater reliability. [ABSTRACT FROM AUTHOR]