A computer adaptive testing approach for assessing physical functioning in children and adolescents.
ABSTRACT The purpose of this article is to demonstrate: (1) the accuracy and (2) the reduction in amount of time and effort in assessing physical functioning (self-care and mobility domains) of children and adolescents using computer-adaptive testing (CAT). A CAT algorithm selects questions directly tailored to the child's ability level, based on previous responses. Using a CAT algorithm, a simulation study was used to determine the number of items necessary to approximate the score of a full-length assessment. We built simulated CAT (5-, 10-, 15-, and 20-item versions) for self-care and mobility domains and tested their accuracy in a normative sample (n=373; 190 males, 183 females; mean age 6y 11mo [SD 4y 2m], range 4mo to 14y 11mo) and a sample of children and adolescents with Pompe disease (n=26; 21 males, 5 females; mean age 6y 1mo [SD 3y 10mo], range 5mo to 14y 10mo). Results indicated that comparable score estimates (based on computer simulations) to the full-length tests can be achieved in a 20-item CAT version for all age ranges and for normative and clinical samples. No more than 13 to 16% of the items in the full-length tests were needed for any one administration. These results support further consideration of using CAT programs for accurate and efficient clinical assessments of physical functioning.
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ABSTRACT: Children and youth with cerebral palsy receive ongoing physical and occupational therapy services to improve their functional performance and participation in activities at home, school, and in the community. Over the past 2 decades, rehabilitation interventions have become more functional and goal oriented. In this article, we discuss factors that have influenced emerging intervention approaches. These factors include greater involvement of families in decision making, changing conceptual frameworks and theories underlying skill development and improved outcome measures. New research findings indicate that rehabilitation interventions embracing family-centered services and focusing on functional improvement can be more effective in promoting participation. This knowledge can serve as the platform for further examination of the most effective rehabilitation interventions for children and youth with cerebral palsy.Journal of child neurology 05/2014; · 1.59 Impact Factor
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ABSTRACT: OBJETIVO: Identificar as escalas utilizadas para avaliação funcional na doença de Pompe (DP) e descrever seu nível de evidência e recomendação.FONTES DE DADOS: Revisão sistemática sobre as escalas de avaliação funcional na DP. Pesquisa realizada nos bancos de dados Medline, Lilacs, Registro Cochrane de Ensaios Controlados Central (CCTR) e SciELO com artigos (exceto artigos de revisão) publicados entre 2000 e 2010. As palavras-chave utilizadas nos idiomas português e inglês foram: doença de depósito de glicogênio tipo II, atividades cotidianas, avaliação. Os artigos foram classificados em nível de evidência e recomendação.SÍNTESE DOS DADOS: Foram incluídos 14 estudos que avaliaram desde recém-nascidos a adultos (amostra total=449). Foram encontradas as seguintes escalas na literatura: Pediatric Evaluation of Disability Inventory (PEDI) e sua forma adaptada para DP (Pompe-PEDI), Alberta Infant Motor Scale (AIMS), Rotterdam Handiscap Scale (RHS), Functional Independence Measure (FIM), Gross Motor Function Measure (GMFM) e Peabody Developmental Motor Scales (PDMS-II). A maioria dos estudos apresentou nível de evidência III, por serem não randomizados. Grau de recomendação das escalas: C para AIMS e Pompe-PEDI; D para GMFM e PDMS-II; E para RHS e FIM.CONCLUSÕES: A maioria das escalas utilizadas para avaliação funcional na DP apresenta baixo nível de evidência e recomendação. As que apresentam melhor grau de recomendação (C) são as escalas AIMS e Pompe-PEDI aplicadas em Pediatria.Revista Paulista de Pediatria 06/2012; 30(2):272-277.
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ABSTRACT: The overall goal was to perform a systematic literature search and structured review of the state of outcome measurement in the field of upper limb prosthetics and to propose future directions for research in this area. The review is based on systematic searches of Medline, Cumulative Index to Nursing and Allied Health Literature, and RECAL electronic databases from 1970 to March 2009 and on subsequent review of the reference lists of the identified publications (citation tracking), as well as articles in the author's personal collection. Each article was independently reviewed by two readers. Publications were initially screened for relevance, and then fully reviewed to extract relevant data and review the methodological quality of the study. A quality rating form, based on guidelines provided by Terwee et al. (J Clin Epidemiol. 2006;60:34-42), was devised for evaluation of the clinimetric properties of the identified outcome measures. The search identified 660 peer-reviewed publications related to outcome measurement with upper limb amputees of which 25 met all of the author's inclusion criteria for full review. In the adult literature, seven outcome measures (4 amputees specific and 3 generic) were revealed. This compares with 25 measures identified in the lower limb adult amputee outcomes review by Condie et al. (J Prostht Orthot. 2006;18:13-45). In the pediatric review, nine distinct outcome measures (5 amputees specific and 4 generic) were found. Two of the pediatric measures also have younger child versions. There was overlap of one measure, the Assessment of Capacity for Myoelectric Control (ACMC), between adult and pediatric studies. The use of standardized outcome measures with adult upper limb amputees is sparse in the published studies with this clinical population, and upper limb prosthetic-specific measures are few in number. Attention needs to be paid to all aspects of measurement development and validation across the International Classification of Functioning, Disability, and Health. The measures with greatest psychometric promise for use in upper limb prosthetics are the ACMC, the Upper Extremity Functional Status Module of the Orthotics and Prosthetics User Survey, the Disabilities of Arm, Shoulder, and Hand Questionnaire, and the Trinity Amputation and Prosthesis Experience Scales. Greater strides toward measure development and validation have been made with pediatric upper limb amputees. The emphasis that is currently needed is on the determination of the test-retest reliability and responsiveness of the most promising measures (ACMC, University of New Brunswick Test, the Assisting Hand Assessment, Prosthetic Upper Extremity Functional Index, and the ABILHAND-Kids) and discussion on how best to approach the measurement of participation and quality of life.JPO Journal of Prosthetics and Orthotics 09/2009; 21(9):P3-P63.