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Objective: The responsiveness of a new participation measure, the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was compared with that of the Impact on Particpation and Autonomy (IPA). Furthermore, the concurrent validity of these two measures was assessed., Method: Participants were patients with brain injury or neuromuscular disease, who received occupational therapy as part of a multidisciplinary outpatient rehabilitation programme. They completed the IPA and the USER-Participation at the start and end of the programme, and at three-month follow-up. Responsiveness was analysed using the effect size (ES) and the standardized response mean (SRM)., Results: Responsiveness figures were small to moderate (-0.4 to 0.5) and similar for the IPA and the USER-Participation. The USER-Participation showed a consistent result, with Frequency scores declining and Restriction and Satisfaction scores inclining over time, and the IPA showed mixed results, with the different domain scores both inclining and declining over time. Correlations between IPA and USER-Participation scales were all significant, but by far strongest for the USER-Participation Satisfaction scale (-0.64 to -0.81)., Conclusion: The USER-Participation was at least as responsive as the IPA. Further, satisfaction with participation as measured with the USER-Participation is highly similar to the concept of autonomy in participation as measured with the IPA.

Objective: To assess the responsiveness of 4 participation measures., Design: Longitudinal study with repeated measurements at the start (t1) and at the end (t2) of a multidisciplinary out-patient rehabilitation programme, and at 4 months follow-up (t3)., Subjects: Outpatients with different diagnoses (n=395) from 5 rehabilitation centres in The Netherlands., Methods: Measures were the Frenchay Activities Index (FAI), the Participation subscale of the ICF Measure of Participation and Activities Screener (IMPACT-SP), the Participation Scale, and the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation). Responsiveness was analysed using the effect size and the standardized response mean., Results: Comparing scores at t1 and t2, the standardized response mean was 0.54 for the USER-Participation Restriction scale, 0.41 for the FAI, 0.40 for the IMPACT-SP, 0.39 for the USER-Participation Satisfaction scale, -0.36 for the Participation Scale, and 0.21 for the USER-Participation Frequency scale. Effect size values were generally somewhat smaller than standardized response mean values. Effect size and standardized response mean values were negligible between t2 and t3. Responsiveness parameters varied between diagnostic groups, with participants with acquired brain injury showing the largest change and participants with neuro-muscular disease or chronic pain showing least change., Conclusion: Overall and across the different diagnostic groups, the USER-Participation Restriction scale showed the best responsiveness.

Abstract: Objective: To validate the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) in persons with spinal cord injury (SCI) using 2 International Classification of Functioning, Disability and Health (ICF)-based instruments: the ICF Measure of Participation and Activities-Screener (IMPACT-S) and the World Health Organization Disability Assessment Schedule II (WHODAS II). Design: Validation study. Score distributions, internal consistency, and concurrent and discriminant validity were evaluated. Setting: The community. Participants: Convenience sample of persons (N=157) with long-term SCI living in The Netherlands. Interventions: Not applicable. Main Outcome Measures: USER-Participation, IMPACT-S, and WHODAS II. Results: No instruments showed floor effects, and 3 out of 6 WHODAS II domains showed ceiling effects. Most scores showed adequate internal consistency (α≥.70), except for the USER-Participation frequency scale (.51) and 2 WHODAS II domains (.58–.60). Spearman correlation coefficients between the segregate USER-Participation scales were <.60 (range, .39–.46), showing that they cover separate aspects of participation. Concurrent validity of the USER-Participation was shown because >75% (83.3%) of the 24 hypotheses (Spearman correlation coefficients above or below .60) with the other measurement instruments were confirmed. Concurrent validity between the IMPACT-S and WHODAS II was not shown (53.8% of 13 hypotheses confirmed). All scores except 4 WHODAS II domains showed significant differences in participation between persons with paraplegia and tetraplegia. Conclusions: The USER-Participation showed generally satisfactory psychometric properties in Dutch persons with long-term SCI living in the community. The IMPACT-S showed the best psychometric properties, and the WHODAS II showed less favorable results. Future research on the USER-Participation should focus on validation in other languages and different diagnostic groups. [Copyright &y& Elsevier]

Background: Participation is a multidimensional concept, consisting of an objective and a subjective dimension. Many studies have focused on determinants of only 1 dimension of participation post stroke. Objective: To describe participation (both objective and subjective) and to determine how physical and cognitive independence and subjective complaints (pain, fatigue, and mood) influence participation in community-dwelling stroke survivors in the Netherlands. Methods: The Utrecht Scale for Evaluation of Rehabilitation (USER) measures physical and cognitive independence and subjective complaints. USER-Participation measures 3 dimensions of participation: frequency (objective perspective), restrictions (subjective perspective), and satisfaction (subjective perspective). Spearman correlations and backward linear regression analyses were used to analyze associations between the 3 USER-Participation scores with demographics, stroke characteristics, physical and cognitive independence, and subjective complaints. Results: Of the 111 participants, 48.5% returned to work post stroke, but mostly for only 1 to 16 hours a week. Experienced participation restrictions were most prevalent in physical exercise, chores in/around the house, housekeeping, and outdoor activities. On average, participants were relatively satisfied with their participation, but dissatisfaction occurred in cognition, activities outdoors, and work/housekeeping. Regression analysis revealed that objective participation was determined by physical and cognitive independence, age, and education, whereas subjective participation was determined by physical and cognitive independence, fatigue, and mood. Conclusions: Most participants experienced participation problems, despite relatively good physical recovery. In addition to physical and cognitive factors, subjective complaints of persons with stroke should be addressed in the rehabilitation program. [ABSTRACT FROM AUTHOR]