
Kimberly ErlerMassachusetts General Hospital | MGH
Kimberly Erler
About
58
Publications
2,978
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
462
Citations
Publications
Publications (58)
Objective
Patient‐reported outcome measures (PROMs), which capture patients' perspectives on the consequences of health and disease, are widely used in neurological care and research. However, it is unclear how PROMs relate to performance‐rated impairments. Sociodemographic factors are known to affect PROMs. Direct damage to brain regions critical...
Objectives
To identify personal, clinical, and environmental factors associated with 4 previously identified distinct multidimensional participation profiles of individuals following traumatic brain injury (TBI).
Setting
Community.
Participants
Participants ( n = 408) enrolled in the TBI Model Systems (TBIMS) Participation Module, all 1 year or m...
Objective
Patient-reported outcome measures provide valuable insights into health status after neurologic disease, but their relationships with function-based outcome measures remain incompletely understood. Here we evaluate the relationship between these two classes of measure using dimensionality-reduction techniques in patients after acute strok...
Purpose. To characterize societal participation profiles after moderate-severe traumatic brain injury (TBI) along objective (Frequency) and subjective (Satisfaction, Importance, Enfranchisement) dimensions.Materials and Methods. We conducted secondary analyses of a TBI Model Systems sub-study (N = 408). Multiaxial assessment of participation includ...
Background and Objectives
The classic and singular pattern of distal greater than proximal upper extremity motor deficits after acute stroke does not account for the distinct structural and functional organization of circuits for proximal and distal motor control in the healthy CNS. We hypothesized that separate proximal and distal upper extremity...
Introduction
Traditional methods for obtaining outcomes for patients after acute stroke are resource-intensive. This study aimed to examine the feasibility, reliability, cost, and acceptability of collecting outcomes after acute stroke with a short message service (SMS)-text messaging program.
Methods
Patients were enrolled in an SMS-text messagin...
Objectives: To examine the relationship between medications prescribed during the first 6-months post-stroke and functional outcome. Materials and Methods: A retrospective analysis of ischemic stroke survivors enrolled in an observational stroke recovery study from June-2017 to July-2019 was performed. Survivors with favorable outcomes (modified ra...
Objective(s)
To characterize the concepts, perspectives, and response options of participation outcome measures conceptualized with input from individuals with acquired brain injury (ABI).
Data Sources
PubMed, Shirley Ryan Ability Lab-Rehab Measures Database, NINDS Common Data Elements.
Study Selection
Measures were eligible for inclusion if they...
Objective: In rehabilitation research and practice, participation is defined as involvement in life situations and most often measured as frequency of engaging in these life situations. This narrow measurement approach overlooks that individuals perceive importance of and satisfaction with participation in activities in various life areas different...
Background
The return to participation in meaningful life roles for persons with acquired brain injury (pwABI) is a goal shared by pwABI, their families, clinicians, and researchers. Synthesizing how pwABI define participation will help to identify the aspects of participation important to pwABI and can inform a person-centered approach to particip...
Objective
To determine whether consistent command-following (CCF) should be added to the diagnostic criteria for emergence from the minimally conscious state (eMCS)
Design
Retrospective cohort study
Setting
Inpatient rehabilitation hospital
Participants
Patients (n=214) with acquired brain injury resulting in disorders of consciousness (DoC) adm...
While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this tim...
Background
Precise measurement of outcomes is essential for stroke trials and clinical care. Prior research has highlighted conceptual differences between global outcome measures such as the Modified Rankin Scale (mRS) and domain-specific measures (e.g. motor, sensory, language or cognitive function). This study related motor phenotypes to the mRS,...
Critical care society guidelines recommend that ethics committees mediate intractable conflict over potentially inappropriate treatment, including Do Not Resuscitate (DNR) status. There are, however, limited data on cases and circumstances in which ethics consultants recommend not offering cardiopulmonary resuscitation (CPR) despite patient or surr...
Research Objectives
To develop, refine, and implement strategies for virtual qualitative research in individuals with brain injury (BI) using the Knowledge to Action Framework.
Design
To design a standard operating procedure (SOP) for remote qualitative data collection in BI populations, we conducted a literature review, adapted the intervention t...
Research Objectives
To determine whether consistent command following (CCF) may be a sign of emergence from the minimally conscious state (MCS).
Design
Retrospective cohort study.
Setting
Specialized disorders of consciousness (DoC) program in an inpatient rehabilitation hospital.
Participants
Patients with severe acquired brain injury and DoC....
Introduction: Robust outcome data collection is critical for stroke care and clinical trials. However, reaching patients after discharge from acute care is challenging. This study examined the feasibility, acceptability, and accuracy of collecting outcomes through a text message-based program after stroke.
Methods: Patients discharged between June...
Introduction: Patient-reported outcome measures (PROMs) provide valuable insights into health status and function, but their relationships with performance-based outcomes remain incompletely understood. Here we compared these two classes of measures using dimensionality-reduction techniques with longitudinal data and examined their relationships wi...
The Coronavirus-2019 (COVID-19) pandemic has disproportionally affected communities of color and older adults in the United States. Nursing homes (NHs) have reported over 130,000 COVID-19 deaths (or one-fourth of all US deaths) circa March 2021, a high share of the nation’s total death count (CMS COVID-19 NH Data). These inequities partially driven...
Objective: To determine whether consistent command-following (CCF) should be added to the diagnostic criteria for emergence from the minimally conscious state (MCS)
Design: Retrospective cohort study
Setting: Inpatient rehabilitation hospital
Participants: Patients with severe acquired brain injury and disorders of consciousness (DoC) admitted to a...
Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
In acute care, discharge planning is a primary role of OT for clients with arm impairment after stroke. Discharge planning accounts for many factors, including impairments, function, social supports, insurance, and the input of other discipline...
Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Participation is the overarching goal of neurorehabilitation and OT interventions. Despite this emphasis on participation, evidence suggests that people with traumatic brain injury (TBI) have poor participation. It is clear that socioeconomic s...
Objective
To test the hypothesis that cognitive demands influence motor performance during recovery from acute stroke, we tested acute stroke patients on two motor tasks with different cognitive demands and related task performance to cognitive impairment and neuroanatomic injury.
Methods
We assessed the contralesional and ipsilesional upper extre...
Objectives
The COVID-19 pandemic has disproportionately affected racial and ethnic minorities in the United States and has been devastating for residents of nursing homes (NHs). However, evidence on racial and ethnic disparities in COVID-related mortality rates within NHs, and how that has changed over time has been limited. This study examines the...
Advances in data science and timely access to health informatics provide a pathway to integrate patient-reported outcome measures (PROMs) into clinical workflows and optimize rehabilitation service delivery. With the shift toward value-based care in the US healthcare system, as highlighted by the recent Centers for Medicare and Medicaid Services in...
Date Presented 03/28/20
Participation is a primary focus of OT and neurorehabilitation; however, there is a gap in understanding the association of depression and aging with participation. Therefore, this study aimed to (1) determine differences in participation between individuals with and without depression within the same age groups and (2) dete...
Introduction: Injury to the corticospinal tract (CST) has been shown to have a major effect on upper extremity motor recovery after stroke. This study aimed to examine how well CST injury, measured from neuroimaging acquired during the acute stroke workup, predicts upper extremity motor recovery.
Methods: Patients (N = 48) with upper extremity weak...
Severe traumatic brain injury (TBI) may result in a disorder of consciousness (DoC) and lead to substantial long-term disability. While level of independence with activities of daily living, especially for persons who recover consciousness during inpatient rehabilitation, generally improves over time, the degree of change in participation remains u...
As acute stroke treatments advance, more people survive the initial stroke event and live with long-term neurological impairments that impact functional outcomes and quality of life. In accordance with International Classification of Functioning (ICF), living with long-term neurological impairments can limit survivors' activity performance and rest...
During telehealth encounters, care partners may assist with physical maneuvers or examinations. These care partners may be friends or family members of the patient. There are unique ethical considerations in the use of care partners during telehealth examinations, yet there is limited guidance for such interactions. Evidence-based guidelines should...
Background:
The opioid epidemic has resulted in an increased number of patients with opioid use disorder (OUD) hospitalized for serious medical conditions. The intersection between hospital ethics consultations and the opioid crisis has not received significant attention.
Objective:
The aim of this study was to characterize ethics consult questi...
Background and Purpose—
Injury to the corticospinal tract (CST) has been shown to have a major effect on upper extremity motor recovery after stroke. This study aimed to examine how well CST injury, measured from neuroimaging acquired during the acute stroke workup, predicts upper extremity motor recovery.
Methods—
Patients with upper extremity we...
Participation is a primary goal of neurorehabilitation; however, most individuals post stroke experience significant restrictions in participation as they attempt to resume their everyday roles and routines. Despite this emphasis on participation, there is a paucity of evidence-based interventions for optimizing this outcome and a limited understan...
Participation restrictions, including restrictions in employment, recreational activities, and social interactions, and depression are common after traumatic brain injury (TBI) and can profoundly affect individuals. Participation and depression demonstrate complex relationships with each other and over time as individuals age. This study (1) identi...
Date Presented 04/05/19
Primary Author and Speaker: Kimberly Erler
Additional Authors and Speakers: Sarah McKinnon, Virginia Sullivan
Contributing Authors: Rebecca Inzana
Objective:
To determine whether rehospitalization during the first 2 years after moderate to severe traumatic brain injury (TBI) is associated with poor participation at 5 years post-TBI, after controlling for demographic and severity factors.
Setting:
TBI Model Systems Program.
Participants:
Community-dwelling individuals with TBI, 16 years o...
Participation is often considered a primary goal of traumatic brain injury (TBI) rehabilitation, but little is known about the influence of driving on participation after TBI. The objective of this study was to examine the independent contribution of driving status to participation at 5 years post TBI, after controlling for demographic, psychosocia...
Objective:
To identify factors that predict trajectories of participation over the first 5 years after moderate to severe traumatic brain injury (TBI).
Setting:
TBI Model System Programs.
Participants:
Community-dwelling individuals with TBI, 16 years of age or older (n = 1947).
Design:
Secondary analysis of a prospective, nonrandomly sample...
We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation's first hospital ethics committees, this committee has primarily focused on the optimum use of life-sus...