Marcel Dijkers

Wayne State University | WSU · Department of Physical Medicine and Rehabilitation

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...

Objective: To examine the utility of the sleep disturbance item of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for insomnia among individuals with moderate to severe traumatic brain injury (TBI). Setting: Telephone interview. Participants: A sample of 248 individuals with a history of moderate to severe TBI participated in a...

Peer reviewing is a key mechanism underlying science publishing, but during their graduate training clinicians and researchers are unlikely to be taught the skill. This paper sets forth the art of peer reviewing in general, and the types of reviews that are most useful to the Editors of Spinal Cord (SC). The topics addressed are: the SC editorial p...

Objective: To determine what factors determine the quality of rehabilitation Clinical Practice Guidelines (CPGs). Design: 6 Databases were searched for papers that had applied the Appraisal of Guidelines for Research & Evaluation II (AGREE II) quality assessment tool to rehabilitation CPGs. The 573 de-duplicated abstracts were independently scre...

Objective To evaluate the quality of descriptions of interventions in health care research reports, based on a synthesis of reviews that used the Template for Intervention Description and Replication (TIDieR) to rate the completeness and quality of intervention reporting. Design Overview of published reviews. In a systematic search of the literatu...

Clear reporting on rehabilitation treatments is critical for interpreting and replicating study results, and for translating treatment research into clinical practice. This article reports the recommendations of a working group on improved reporting on rehabilitation treatments. These recommendations are intended to be combined with the efforts of...

Objective To evaluate the quality of rehabilitation Clinical Practice Guidelines (CPGs), specifically with respect to their applicability. Data sources Medline, Embase, Web of Science, CINAHL, PsycINFO, the Cochrane Library Databases were searched for papers published in 2017-2019 that had applied the Appraisal of Guidelines for Research & Evaluat...

Objective To determine whether the 12 items of the Template for Intervention Description and Replication (TIDieR) can be combined into a single summary score reflecting intervention reporting completeness and quality Design Systematic review and reanalysis of published data. After a systematic search of the published literature, 16 review articles...

Objective: To examine the factors associated with the remission of insomnia by examining a sample of individuals who had insomnia within the first two years after traumatic brain injury (TBI) and assessing their status at a secondary time point. Design and Methods: Secondary data analysis from a multicenter longitudinal cohort study. A sample of 40...

Objective: To describe the authors who have contributed papers to the Archives of Physical Medicine and Rehabilitation (APM&R) over the 100 years of its existence. Design: Extraction of relevant information from a sample of APM&R papers; SETTING: N/A; PARTICIPANTS: 4933 authors contributing to 1787 articles; MAIN OUTCOME MEASURES: number of auth...

The Archives of Physical Medicine and Rehabilitation was born as a radiology journal, and over its century of existence has gone through various names and owners, while shifting its contents from radiology to physical medicine to physical medicine and rehabilitation. These developments are sketched in light of the growth and eventual merger of phys...

Objective: To evaluate the effect of family attendance at inpatient rehabilitation therapy sessions on traumatic brain injury (TBI) patient outcomes at discharge and up to 9 months postdischarge. Design: Propensity score methods are applied to the TBI Practice-Based Evidence database, a database consisting of multisite, prospective, longitudinal...

Objective To describe systematic reviews (SRs) of the use of exoskeletons for gait and mobility by persons with neurologic disorders and to evaluate their quality as guidance for research and clinical practice. Data Sources PubMed, EMBASE, Web of Science, CINAHL Complete, PsycINFO, Cochrane Database of Systematic Reviews, PEDro, and Google Scholar...

Objective: To evaluate the effect of providing a greater percentage of therapy as contextualized treatment on acute traumatic brain injury (TBI) rehabilitation outcomes. Design: Propensity score methods are applied to the TBI Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational...

Study design: A narrative review of principles, benefits and disadvantages, as well as methods of research data sharing. Objectives: To assist prospective Spinal Cord authors and others with understanding and implementing data sharing, so that various benefits of such sharing can accrue to all spinal cord injury research stakeholders. Setting:...

Objective To determine if patients’ level of effort (LOE) in therapy sessions during traumatic brain injury (TBI) rehabilitation modifies the effect of compliance with the 3-Hour Rule of the Centers for Medicare & Medicaid Services. Design Propensity score methodology applied to the TBI Practice-Based Evidence database, consisting of multisite, pr...

Objective: To use causal inference methods to determine if receipt of a greater proportion of inpatient rehabilitation treatment focused on higher level functions, for example, executive functions, ambulating over uneven surfaces (advanced therapy [AdvTx]), results in better rehabilitation outcomes. Design: A cohort study using propensity score...

The Traumatic Brain Injury Model Systems Center (TBIMSC) program was established by the National Institute on Disability, Independent Living, and Rehabilitation Research in 1987, with the goal of conducting research to improve the care and outcomes for individuals with moderate-to-severe traumatic brain injury (TBI). This article provides an update...

Rehabilitation clinicians strive to provide cost-effective, patient-centered care that optimizes outcomes. A barrier to this ideal is the lack of a universal system for describing, or specifying, rehabilitation interventions. Current methods of description vary across disciplines and settings, creating barriers to collaboration, and tend to focus m...

Despite significant advances in measuring the outcomes of rehabilitation interventions, little progress has been made in specifying the therapeutic ingredients and processes that cause the measured changes in patient functioning. The general approach to better clarifying the process of treatment has been to develop reporting checklists and guidelin...

The field of rehabilitation remains captive to the black-box problem: our inability to characterize treatments in a systematic fashion across diagnoses, settings, and disciplines, so as to identify and disseminate the active ingredients of those treatments. In this paper we describe the Rehabilitation Treatment Specification System (RTSS), by which...

The majority of rehabilitation treatments are volitional in nature, meaning that they require the patient's active engagement and effort. Volitional treatments are particularly challenging to define in a standardized fashion, since the clinician is not in complete control of the patient's role in enacting these treatments. Current recommendations f...

Several guidelines have been published with the goal of increasing the usefulness of reports of clinical research. Although such guidelines may clarify key features of study design, the way in which rehabilitation treatments, themselves, are described continues to be problematic and to limit the ability to replicate research, synthesize evidence ac...

Study design: Secondary analysis of prospectively collected observational data. Objectives: To assess the representativeness of the Spinal Cord Injury Model Systems National Database (SCIMS-NDB) of all adults aged 18 years or older receiving inpatient rehabilitation in the United States (US) for new onset traumatic spinal cord injury (TSCI). Se...

Objective: To determine whether antispasmodic medications are associated with neurological and functional outcomes during the first year after traumatic spinal cord injury (SCI). Design/Methods: Retrospective analysis of prospectively collected data from six inpatient SCI rehabilitation centers. Baseline-adjusted outcomes at discharge and one-year...

Marcel P Dijkers,1 Katherine G Akers,2 Sujay S Galen,3 Diane E Patzer,4 Phuong T Vu41Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, 2Shiffman Medical Library, Wayne State University, Detroit, 3Physical Therapy Program, Wayne State University, Detroit, 4Center for Spinal Cord Injury Recovery, Rehabilitation Inst...

Objective. To systematically review the literature on the effectiveness of ear acupuncture (EA) for immediate pain relief. Data sources. AMED, CINAHL, Cochrane Reviews, Embase, PsycINFO, PubMed, Scopus Web of Science, from inception through March 2015. Study selection. English publications, randomized controlled trials on human subjects involving E...

Post-traumatic brain injury fatigue (PTBIF) is a major problem in the years after traumatic brain injury (TBI), yet little is known about its persistence and resolution. The objective of the study was to identify factors related to PTBIF remission and resolution. TBI Model System registrants at five centres participated in interviews at either one...

Purpose: The purpose of this clinical focus article is to describe the conceptual framework of the multidisciplinary rehabilitation treatment taxonomy (RTT) and illustrate its potential use in speech-language pathology (SLP) clinical practice and research. Method: The method used was a critical discussion. Results: Current methods of defining...

Spinal Cord is the official journal of the International Spinal Cord Society. It provides complete coverage of all aspects of spinal injury and disease.

Background: Few studies have investigated prostate cancer patients' experiences of cognitive functioning or neurobehavioral symptoms (i.e., behavioral changes associated with neurological dysfunction) following androgen deprivation therapy (ADT). Methods: Semi-structured interviews conducted from the US by phone and in-person were used to explor...

Background: Individuals with traumatic brain injury (TBI) often develop sleep disorders post-injury. The most common one is insomnia, which can exacerbate other post-injury symptoms, including fatigue, impaired cognition, depression, anxiety, and pain. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a manualized treatment that effectively tre...

Objectives: (a) Identify life satisfaction trajectories after moderate to severe traumatic brain injury (TBI); (b) establish a predictive model for these trajectories across the first 5 years postinjury; and (c) describe differences in these life satisfaction trajectory groups, focusing on age, depressive symptoms, disability, and participation in...

Study design: Consensus decision-making process. Objectives: The objective of this study was to develop an International Spinal Cord Injury (SCI) Activities and Participation (A&P) Basic Data Set. Setting: International working group. Methods: A committee of experts was established to select and define A&P data elements to be included in thi...

To describe patients' level of effort in occupational, physical, and speech therapy sessions during traumatic brain injury (TBI) inpatient rehabilitation and to evaluate how age, injury severity, cognitive impairment, and time are associated with effort. Prospective, multicenter, longitudinal cohort study. Acute TBI rehabilitation programs. Patient...

To describe the use of occupational therapy (OT), physical therapy (PT), and speech therapy (ST) treatment activities throughout the acute rehabilitation stay of patients with traumatic brain injury. Multisite prospective observational cohort study. Inpatient rehabilitation settings. Patients (N=2130) admitted for initial acute rehabilitation after...

This supplement of the Archives of Physical Medicine and Rehabilitation is devoted to the Traumatic Brain Injury-Practice Based Evidence study, the first practice-based evidence study, to our knowledge, of traumatic brain injury rehabilitation. The purpose of this preface is to place this study in the broader context of comparative effectiveness re...

To describe study design, patients, centers, treatments, and outcomes of a traumatic brain injury (TBI) practice-based evidence (PBE) study and to evaluate the generalizability of the findings to the U.S. TBI inpatient rehabilitation population. Prospective, longitudinal, observational study. Ten inpatient rehabilitation centers. Patients (N=2130)...

To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and to assess the relations of group therapy with patient, injury, and treatment factors and outcomes. Prospective observational cohort. Inpatient rehabilitation. Consecutive admissions (N=2130) for initial TBI rehabilita...

Persons with neurologic conditions such as spinal cord injury, stroke, and multiple sclerosis often lose the ability to stand and walk. Robotic hip-knee-ankle-foot exoskeletal orthoses have become commercially available and may allow some of these people to stand and walk again. These devices may also have applications beyond mobility, such as exer...

Background: Powered exoskeletons have been demonstrated as being safe for persons with spinal cord injury (SCI), but little is known about how users learn to manage these devices. Objective: To quantify the time and effort required by persons with SCI to learn to use an exoskeleton for assisted walking. Methods: A convenience sample was enroll...

Observers commonly note the poor reporting of research, including rehabilitation research. The CONSORT checklist (supplemented by the CONSORT extension for non-pharmacologic interventions) has been published for improving the reporting of intervention research. However, the items on these checklists are considered to be inadequate to guide authors...

Research has noted poor psychosocial outcomes among individuals with traumatic brain injury (TBI) who are involved in litigation. While part I of this two-part qualitative study report examined litigation-related stressors that constitute barriers to recovery, part II explores ways litigants facilitated well-being and recovery both during and after...

Prior studies have frequently noted elevated symptom endorsement among traumatic brain injury (TBI) litigants compared to nonlitigants with TBI, with little examination of potential litigation-related stressors. This qualitative study using semi-structured interviews with eight current and nine past litigants was designed to improve our understandi...

Objective: To conduct a systematic review of the evidence on interventions for posttraumatic brain injury fatigue (PTBIF). Methods: Systematic searches of multiple databases for peer-reviewed studies published in English on interventions targeting PTBIF as a primary or secondary outcome through January 22, 2014. Reference sections were also revi...

Objective: To provide an overview of a series of projects that used a structured self-report screening tool in diverse settings and samples to screen for lifetime history of traumatic brain injury (TBI). Setting: Diverse community settings. Participants: Homeless persons (n = 111), individuals with HIV seeking vocational rehabilitation (n = 17...

Background: Sleep disturbances are common following traumatic brain injury (TBI). The Pittsburgh Sleep Quality Index (PSQI) is a widely used measure of sleep quality that has been used in numerous populations. Although this measure has been used in TBI research, there are few studies examining the psychometric properties in this population. Objec...

Objective: To examine the effectiveness of gabapentin and pregabalin in diminishing neuropathic pain and other secondary conditions in individuals with spinal cord injury (SCI). Data sources: A systematic search was conducted using multiple databases for relevant articles published from 1980 to June 2013. Study selection: Controlled and uncont...

Objective To identify baseline participant variables in the domains of demographics, medical/psychosocial history, injury characteristics, and postinjury functional status associated with longitudinal follow-up completeness in persons with traumatic brain injury (TBI) using the TBI Model Systems (TBIMS) National Database (NDB). Design Exhaustive c...

Study design: Cross-sectional. Objective: To preliminarily evaluate the validity of an interview-based spinal cord injury (SCI) neuropathic pain screening instrument. Setting: Six university-based SCI centers in the United States. Methods: Clinician diagnoses of neuropathic pain (NP) and non-neuropathic pain subtypes were collected independe...

To evaluate the psychometric properties of the Spinal Cord Injury Functional Index (SCI-FI) short forms (Basic Mobility, Self-Care, Fine Motor, Ambulation, Manual Wheelchair, and Power Wheelchair) based on internal consistency, correlations between short- and full item bank forms, and a 10-item compute adaptive test version, magnitude of ceiling an...

This article introduces the Archives supplement presenting a conceptual framework for the creation of a rehabilitation treatment taxonomy (RTT). It describes the key theoretical and empirical articles and their role, and the commentaries that were solicited. More importantly, based on feedback received to date, it sketches what the RTT is proposed...

Many rehabilitation treatment interventions, unlike pharmacologic treatments, are not operationally defined, and the labels given to such treatments do not specify the active ingredients that produce the intended treatment effects. This, in turn, limits the ability to study and disseminate treatments, to communicate about them clearly, or to train...

Rehabilitation is in need of an organized system or taxonomy for classifying treatments to aid in research, practice, training, and interdisciplinary communication. In this article, we describe a work-in-progress effort to create a rehabilitation treatment taxonomy (RTT) for classifying rehabilitation interventions by the underlying treatment theor...

In relation to the conceptual framework for a rehabilitation treatment taxonomy (RTT), which has been proposed in other articles in this supplement, this article discusses a number of issues relevant to its further development, including creating distinctions within the major target classes; the nature and quantity of allowable targets of treatment...

To gain an understanding of clinical thought processes about treatment classification and description, and to identify desired characteristics of and challenges to be addressed by a future rehabilitation treatment taxonomy. Qualitative analysis of data collected via focus groups and semistructured interviews. Inpatient rehabilitation programs. Clin...

The idea of constructing a taxonomy of rehabilitation interventions has been around for quite some time, but other than small and mostly ad hoc efforts, not much progress has been made, in spite of articulate pleas by some well-respected clinician scholars. In this article, treatment taxonomies used in health care, and in rehabilitation specificall...

With funding from a cooperative agreement from the National Institute on Disability and Rehabilitation Research, we have worked for the past 5 years on the development of a rehabilitation treatment taxonomy, a system of classifying all treatments delivered by all rehabilitation disciplines for all diagnostic groups of patients, whatever the setting...

Context Over the last four decades, the focus of spinal cord injury (SCI) rehabilitation has shifted from medical management to issues that affect quality of life and community participation. Physical therapists (PTs) need to design and implement interventions that result in maximal participation to provide an individual with SCI an effective rehab...

To determine whether the Short-Term Executive Plus (STEP) cognitive rehabilitation program improves executive dysfunction after traumatic brain injury (TBI). Randomized, wait-list controlled clinical trial with minimization and blinded outcome assessment. Community. 98 participants with TBI and executive dysfunction (TBI severity 50% moderate/sever...

Objective To describe pain during inpatient rehabilitation and its impact on delivery of inpatient rehabilitation services for persons with spinal cord injury (SCI).DesignProspective observational study and retrospective chart review.SettingSix inpatient rehabilitation facilities participating in the SCIRehab Study.ParticipantsPatients (N=1357) rec...

Comparative effectiveness research (CER) has been receiving much attention (and government funding) in recent years, stemming from dissatisfaction with much medical and health care research, which does not produce actionable evidence that can be used by clinicians, patients, and policymakers. Rehabilitation research has been characterized by simila...

Objective To investigate the amount of variation in short- and medium-term spinal cord injury (SCI) rehabilitation outcomes explained by various comorbidity measures, over and above patient preinjury characteristics and neurologic and functional status.DesignProspective observational cohort study of traumatic SCI patients receiving inpatient rehabi...

Objective To describe group therapy utilization in spinal cord injury (SCI) inpatient rehabilitation.DesignProspective observational study.SettingSix inpatient rehabilitation facilities.ParticipantsPatients (N=1376) receiving initial rehabilitation after traumatic SCI.InterventionsNot applicable.Main Outcome MeasureTime spent in group versus indivi...

To investigate the frequency of and reasons for missed therapy sessions during inpatient rehabilitation after traumatic spinal cord injury (SCI), and to assess the influence of demographic, medical, and injury factors on the missing of therapy sessions.DesignProspective cohort study.SettingSix inpatient rehabilitation centers.ParticipantsIndividual...

Introduction: Although there has been a decline in the incidence of TBI in the general population, the rate of TBI in older adults has increased. Increased age has been long recognized as a predictor of worse outcomes after TBI. Despite the growing number of TBI in the elderly, our understanding of the long-term consequences of TBI is quite limite...

Background: Elderly persons with traumatic brain injury (TBI) are increasingly admitted to inpatient rehabilitation, but we have limited knowledge of their characteristics, the treatments they receive, and their short-term and medium-term outcomes. This study explored these issues by means of comparisons between age groups. Methods: Data on 1419...

Study design: Literature review. Objective: To critically review all publications/internet sites that have described/used the Walking Index for Spinal Cord Injury (WISCI II), as a measure of impairment of walking function after spinal cord injury (SCI), in order to identify its psychometric properties, clarify its nature, specify misuse and inco...

Objective: To describe therapist-reported factors affecting therapy sessions in spinal cord injury (SCI) inpatient rehabilitation and explore their impact on the patient's rehabilitation program. Design: Prospective observational longitudinal cohort design. Data were obtained from systematic recordings of interventions by clinicians and from med...

Change and growth are the bread and butter of rehabilitation research, but to date most researchers have used inferior statistical methods to quantify change, its nature, speed and form. Hierarchical linear modeling (HLM) (random/mixed effects or latent growth or multi-level modeling, individual/latent growth curve analysis) is superior to analysis...

Primary objective: To examine mortality rates among older adults (≥60 years) post-traumatic brain injury (TBI). Research design: Systematic review and meta-analysis. Methods and procedures: Using multiple databases, a literature search was conducted for articles on mortality after TBI published up to July 2011. Information on patient characteristic...

Objective: To determine the prevalence of insomnia and posttraumatic brain injury (TBI) fatigue (PTBIF) in individuals with moderate to severe TBI, to explore the relationship between PTBIF and insomnia and their association with outcomes. Design: Cross-sectional study. Setting: Five National Institute of Disability and Rehabilitation Research...

Objective: To investigate the psychometric properties of the Multidimensional Assessment of Fatigue (MAF) scale in a traumatic brain injury (TBI) sample. Design: Prospective survey study. Setting: Community. Participants: One hundred sixty-seven individuals with TBI admitted for inpatient rehabilitation, enrolled into the TBI Model Systems n...

Objective: To characterize overall and cause-specific mortality and life expectancy among persons who have completed inpatient traumatic brain injury rehabilitation and to assess risk factors for mortality. Design: Prospective cohort study. Setting: The Traumatic Brain Injury Model Systems. Participants: A total of 8573 individuals injured b...

Background/objective: To examine associations of patient characteristics along with treatment quantity delivered by seven clinical disciplines during inpatient spinal cord injury (SCI) rehabilitation with outcomes at rehabilitation discharge and 1-year post-injury. Six inpatient SCI rehabilitation centers enrolled 1376 patients during the 5-year SC...

To investigate associations of nursing bedside education and care management activities during inpatient rehabilitation with functional, participation, and quality-of-life outcomes for patients with traumatic spinal cord injury (SCI). In a prospective observational study, data were obtained by means of systematic recording of nursing activities by...

Context/objective: Rehabilitation teams generally are described as consisting of a single representative of 6-8 disciplines, but research suggests that the number of individuals involved may be much larger. This study aimed to determine the size of teams in spinal cord injury (SCI) rehabilitation, and the effect of team size on patients' active par...

Study design: Qualitative study to identify themes and explore mechanisms underlying recovery of hand function post stroke for individuals discharged from rehabilitation services. Purpose of the study: Post-stroke hemiparesis frequently results in persistent hand dysfunction; the mechanisms of functional recovery are however poorly understood. W...

To investigate the predictive value of preinjury factors for satisfaction with life (SWL) at 1-year posttraumatic brain injury (TBI). Secondary analysis of prospective, longitudinal registry using data collected during inpatient rehabilitation and at 1-year post-TBI. Fifteen specialized brain injury units providing acute rehabilitation care as part...

To determine whether use of neighborhood characteristics derived from U.S. Census Bureau information contributes to the prediction of outcomes after traumatic brain injury (TBI) beyond the variance accounted for by individual characteristics. Cross-sectional analysis of follow-up interviews conducted 1, 2, and 5 years postinjury. Twelve Traumatic B...