Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, June 26, 2020

Interrater Reliability of the Wolf Motor Function Test-Functional Ability Scale: Why It Matters

I see absolutely no reason why this matters. Nothing here is going to get survivors better recovery.

Interrater Reliability of the Wolf Motor Function Test-Functional Ability Scale: Why It Matters

2014, Neurorehabilitation and neural repair
 Susan Duff, EdD, PT, OTR/L 1, 
Jiaxiu He, PhD 2, 
Monica Nelsen, DPT, PT 3, 
Christianne J. Lane, PhD 3, 
Veronica T. Rowe, MS, OTR/L 4 5, 
Steve L. Wolf, PhD, PT 6, 
Alexander W. Dromerick, MD 7, 
and Carolee J. Winstein, PhD, PT 3

Abstract

Background.
 One important objective for clinical trialists in rehabilitation is determining efficacy of interventions to enhance motor behavior. In part, limitation in the precision of measurement presents a challenge. The few valid, low-cost observational tools available to assess motor behavior cannot escape the variability inherent in test administration and scoring. This is especially true when there are multiple evaluators and raters, as in the case of multisite randomized controlled trials (RCTs). One way to enhance reliability and reduce variability is to implement rigorous quality control (QC) procedures.
Objective.
 This article describes a systematic QC process used to refine the administration and scoring procedures for the Wolf Motor Function Test (WMFT)–Functional Ability Scale (FAS).
 Methods.
 The QC process, a systematic focus-group collaboration, was developed and used for a phase III RCT, which enlisted multiple evaluators and an experienced WMFT-FAS rater panel.
Results.
 After 3 staged refinements to the administration and scoring instructions, we achieved a sufficiently high interrater reliability (weighted K=0.8).
Conclusions and Implications.
 A systematic focus-group process was shown to be an effective method to improve reliability of observational assessment tools for motor behavior in neurorehabilitation. A reduction in noise-related variability in performance assessments will increase power and potentially lower the number needed to treat. Improved precision of measurement can lead to more cost-effective and efficient clinical trials. Finally, we suggest that improved precision in measures of motor behavior may provide more insight into recovery mechanisms than a single measure of movement time alone.

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