Absolutely useless! 'Measurements' DO NOTHING UNLESS THEY ARE DIRECTLY MAPPED TO RECOVERY PROTOCOLS! I'd have you all fired! This proves the absolute fucking stupidity of the stroke medical world!
Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHAT GOOD 'measurements' do to get survivors recovered with NO EXCUSES! Your definition of competence in stroke is obviously much lower than stroke survivors' definition of your competence! Swearing at me is allowed, I'll return the favor. Don't even attempt to use the excuse that brain research is hard.
Responsiveness and validity of three dexterous function measures in stroke rehabilitation
Keh-chung Lin, ScD, OTR;1–2 Li-ling Chuang, PhD, PT;1 Ching-yi Wu, ScD, OTR;3* Yu-wei Hsieh, MS;1Wan-ying Chang, BS41School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; 2Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei,Taiwan; 3Graduate Institute of Clinical Behavioral Science and Department of Occupational Therapy, Chang Gung
University, Taoyuan, Taiwan; 4Rehabilitation Department, Taipei Hospital, Department of Health, Taipei, Taiwan
Abstract
In this study, we compared the responsiveness and validity of the Box and Block Test (BBT), the Nine-Hole Peg Test (NHPT), and the Action Research Arm Test (ARAT). We randomized 59 patients with stroke into one of three rehabilitation treatments for 3 weeks. We administered six outcome measures (BBT, NHPT, ARAT, Fugl-Meyer Assessment [FMA], Motor Activity Log [MAL], and Stroke Impact Scale [SIS]hand function domain) pretreatment and posttreatment. We used the standardized response mean (SRM) to examine responsiveness and the Spearman rank correlation coefficient(rho) to examine concurrent validity. The BBT, NHPT, and ARAT were moderately responsive to change and not significantly different (SRM = 0.64–0.79). The correlations within the BBT, NHPT, and ARAT were moderate to good at pretreatment(rho = –0.55 to –0.80) and posttreatment (rho = –0.57 to –0.71). The BBT and ARAT showed fair to moderate correlations with the FMA, MAL, and SIS hand function domain at pretreatment and posttreatment (rho = 0.31–0.59), whereas the NHPT demonstrated low to fair correlations with the FMA and MAL (rho = –0.16 to –0.33) and moderate correlations with the SIS hand function domain (rho = –0.58 to –0.66). Our results indicate that the BBT, NHPT, and ARAT are suitable to detect changes over time. While simultaneously considering the responsiveness and validity attributes, the BBT and ARAT can be considered more appropriate for evaluating dexterous function than the NHPT. Further studies with larger samples are needed to validate these findings. Clinical Trial Registration: ClinicalTrials.gov; Relative Effects and Predictive Models of Contemporary Upper Limb Training Programs in Stroke Patients; NCT00778453; http://clinicaltrials.gov/ct2/show/NCT00778453?term=NCT00778453&rank=1. Key words: bootstrapping, cerebrovascular accident, clinimetrics, dexterity, function, outcome, rehabilitation, responsiveness, upper limb, validity. Abbreviations: ADL = activity of daily living, AOU = amountof use, ARAT = Action Research Arm Test, BAT = bilateral arm training, BBT = Box and Block Test, CIT = constraint-induced therapy, dCIT = distributed CIT, FMA = Fugl-Meyer Assessment, MAL = Motor Activity Log, NHPT = Nine-Hole Peg Test, SIS = Stroke Impact Scale, SRM = standardized response mean, UL = upper limb, WMFT = Wolf Motor Function Test.* Address all correspondence to Ching-yi Wu, ScD, OTR; Department of Occupational Therapy, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333,Taiwan; 886-3-2118800, ext 5761; fax: 866-3-2118800, ext3163. Email: cywu@mail.cgu.edu.tw DOI:10.1682/JRRD.2009.09.0155
No comments:
Post a Comment