Jette AM, Haley SM 2005. Contemporary measurement techniques for rehabilitation outcomes assessment

Health and Disability Research Institute, Boston University, 53 Bay State Road, Boston, MA 02215, USA.
Journal of Rehabilitation Medicine (Impact Factor: 1.68). 12/2005; 37(6):339-45. DOI: 10.1080/16501970500302793
Source: PubMed


In this article, we review the limitations of traditional rehabilitation functional outcome instruments currently in use within the rehabilitation field to assess Activity and Participation domains as defined by the International Classification of Function, Disability, and Health. These include a narrow scope of functional outcomes, data incompatibility across instruments, and the precision vs feasibility dilemma. Following this, we illustrate how contemporary measurement techniques, such as item response theory methods combined with computer adaptive testing methodology, can be applied in rehabilitation to design functional outcome instruments that are comprehensive in scope, accurate, allow for compatibility across instruments, and are sensitive to clinically important change without sacrificing their feasibility. Finally, we present some of the pressing challenges that need to be overcome to provide effective dissemination and training assistance to ensure that current and future generations of rehabilitation professionals are familiar with and skilled in the application of contemporary outcomes measurement.

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    • "There is a need to understand the functional characteristics of CCRC residents that might guide the development of the CCRC environment to enhance function and quality of life [4]. Despite these caveats, the greater oversight and community of caregivers in CCRCs provides a unique opportunity to track physical and cognitive function across time and ultimately develop and test interventions that target both physical and cognitive function relative to older adults residing in the community-at-large [14] [15] [16] [17] [18]. Such research is critical to identifying and overcoming barriers to the implementation of physical activity and promoting programs that are designed to sustain independence in CCRCs. "
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    ABSTRACT: In partnership with six Continuing Care Retirement Communities (CCRCs), the current study focused on the feasibility of recruiting a representative sample of residents and then assessing their functional health. With our guidance, each of the six CCRCs recruited a volunteer (V-Group) and random (R-Group) sample of independent living residents. We provided face-to-face training and ongoing remote electronic support to the CCRC staff on the testing battery and the web-based data entry system. The testing battery was consisted of demographic, physical function, and psychosocial assessments. After training, CCRC staff were receptive to the study goals and successfully used the data entry website. In the V-Group (N=189), 76% were already participating in CCRC wellness programs. We attempted to recruit a random, unbiased (R-Group) sample of 20% (n=105) of eligible residents; however, only 30 consented to be tested and 70% of this group (21/30) was also already participating in a wellness program. Mean age of all participants was 82.9 years. The V-Group had a higher Short Physical Performance Battery (SPPB) total score (least squares mean[SE], 9.4[0.2] vs 8.2[0.4], p=0.014) and SPPB gait speed component score (3.5[0.1] vs 3.0[0.2], p=0.007) and spent more time doing moderate-to-vigorous physical activity (300[21] vs 163[49] min/week, p=0.013) compared to the R-Group. While it is feasible to recruit, assess and transmit data on residents' functional health in partnership with CCRCs, population validity was severely compromised. Attention needs to be given to the development of more effective methods to recruit less interested residents. Copyright © 2014 Elsevier Inc. All rights reserved.
    Contemporary Clinical Trials 12/2014; 40. DOI:10.1016/j.cct.2014.12.003 · 1.94 Impact Factor
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    • "Assistive device properties can be mechanically measured using testing devices, they can be assessed by clinicians, or they can be assessed from the wheelchair users' perspective utilizing questionnaires and physiological or timed tests that look at the impact of the wheelchair's properties on the user's mobility (Burke, Kennedy, Miskala, Papadopoulos, & Trentacosti, 2008; Chow & Levy, 2011; Gailey, 2006; Giesbrecht, Ripat, Quanbury, & Cooper, 2009). Objective timed and physiological outcomes metrics can highlight the impact of the wheelchair on the subjects' mobility; however, most validated assessment tools available to evaluate wheelchair skills seemed to be primarily designed to assess the wheelchair users rather than the wheelchairs themselves (Fliess-Douer, Vanlandewijck, Manor, & Van der Woude, 2010; Haisma et al., 2006; Jette & Haley, 2005; Mortenson, Miller, & Auger, 2008). Some researchers have used skills tests of various sorts to investigate the functionality of wheelchairs or specific parts of wheelchairs (Algood, Cooper, Fitzgerald, Cooper, & Boninger, 2005; Kirby, Corkum, et al., 2008; Kirby, MacDonald, Smith, MacLeod, & Webber, 2008). "
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    ABSTRACT: This comparative study of two similar wheelchairs designed for less-resourced settings provides feedback to manufacturers, informing ongoing improvement in wheelchair design. It also provides practical familiarity to clinicians in countries where these chairs are available, in their selection of prescribed wheelchairs. In Kenya, 24 subjects completed 3 timed skills and assessments of energy cost on 2 surfaces in each of 2 wheelchairs: the Regency pediatric chair and a pediatric wheelchair manufactured by the Association of the Physically Disabled of Kenya (APDK). Both wheelchairs are designed for and distributed in less-resourced settings. The Regency chair significantly outperformed the APDK chair in one of the energy cost assessments on both surfaces and in one of three timed skills tests.
    Assistive technology: the official journal of RESNA 05/2014; 26(2). DOI:10.1080/10400435.2013.837847 · 0.51 Impact Factor
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    • "With this technology, a small number of items can be selected from the item bank which are most relevant for a person of a particular ability level (Velozo et al, 1999). The IRT in combination with CAT method has recently become an alternative to conventional fixed-format disability measurement (Jette and Haley, 2005; Kopec, 2000). The ICF Activity Measure (ICF-AM) has recently been developed to create an efficient and precise measurement system based on the activity dimension of World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF). "
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    ABSTRACT: The aim of the present study was to compare measurement precisions of the Oswestry Back Pain Disability Questionnaire (ODQ) and a computer adaptive testing (CAT) method. The ODQ has been regarded as one of the most reliable condition-specific measure for back pain for decades. Cross-sectional study was carried out with two independent convenient samples from two out-patient rehabilitation clinics for back pain () and non-back pain group (). Participants were asked to fill out the ODQ and CAT of International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM). A series of Rasch analyses were performed to calculate person ability measures. The CAT measures had greater relative precision in discriminating the groups than did the ODQ measure in comparisons of the relative precision. The CAT measure appears to be more effective than did the ODQ measure in terms of measurement precision. By administering test items calibrated in a way, CAT measures using item response theory may promise a means with measurement precision as well as efficiency.
    11/2013; 20(4). DOI:10.12674/ptk.2013.20.4.022
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