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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    • "In client-oriented management, the conceptual framework of the ICF helps to facilitate and guide communication and care for the client, clarify roles of team members, and aid in clinical reasoning[20,45]. In this case, the ICF-based documentation tools encouraged inter-professional communication in that they required the rehabilitation professionals involved to identify relevant functioning domains based on discipline-specific assessments (ICF Assessment Sheet), to decide on a mutual rating for each ICF category and set shared goals (ICF Categorical Profile), to determine the appropriate interventions and allocate the respective responsibilities for conducting the interventions (ICF Intervention Sheet), and to discuss and conclude goal achievement (ICF Evaluation Display). "
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    ABSTRACT: An important goal of rehabilitation with regard to community integration is return-to-work, and vocational rehabilitation plays a key role in return-to-work efforts as well as encouraging employment retention. For vocational rehabilitation to be successful, a comprehensive, client-oriented, and inter-professional rehabilitation management approach is essential. The International Classification of Functioning, Disability, and Health (ICF), specifically ICF-based documentation tools that correspond to the “Rehab-Cycle” model, can guide the inter-professional rehabilitation management process by providing the rehabilitation team tools for structuring and coordinating their tasks from the identification of the problem to the planning of rehabilitation services, thereby promoting inter-professional communication and facilitating comprehensive client-oriented documentation. This chapter outlines the ICF-based documentation tools – ICF Assessment Sheet, ICF Categorical Profile, ICF Intervention Table, and the ICF Evaluation Display – and illustrates the use of these tools in a case example of Martin, a 26-year-old male with paraplegia, who participated in vocational rehabilitation program.
    No preview · Article · Jan 2015
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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.
    Full-text · Article · Dec 2014 · Contemporary Clinical Trials
    • "The paucity of information describing these outcomes may be directly related to the availability of valid and reliable participation outcome measures in speech-language pathology (Eadie et al., 2006; Yorkston et al., 2008). A critical component in establishing these outcomes is the use of measures with established reliability and validity that reflect current, relevant theoretical frameworks (Jette and Haley, 2005). The Focus on the Outcomes of Communication Under Six (FOCUS © ; Thomas-Stonell et al., 2013) is a new, free, 50-item outcome measure that assesses communicative-participation outcomes based on parent or speech-language pathologist (SLP) reports. "
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    ABSTRACT: The purpose of this article is to describe communicative-participation outcomes measured by the Focus on the Outcomes of Communication Under Six (FOCUS©; Thomas-Stonell et al., 2013) for interventions provided by speech-language pathologists (SLPs) in different community settings for preschoolers with speech-language impairments (Sp/LI) with and without developmental mobility impairments (MI). The predictive relationships between communicative-participation and (1) functioning-and-disability, and (2) contextual factors, was also investigated. Sixty-one preschoolers with Sp/LI and their parents participated. Twenty-six preschoolers were identified with Sp/LI and received speech-language interventions (Group 1), 20 preschoolers were identified with Sp/LI and MI and received speech-language interventions (Group 2), and 15 preschoolers with Sp/LI awaiting intervention served as waitlist controls (Group 3). Parents completed structured interviews about children’s communicative-participation outcomes using the FOCUS© at three time points (pre-intervention, post-intervention, and 3-months post-intervention) with an SLP. Only Groups 1 and 2 experienced statistically and clinically meaningful communicative-participation outcomes over time as measured by the FOCUS©. Pre- to post-intervention communicative-participation was predicted by functioning-and-disability and contextual factors, initial social skills and intervention status, respectively. Post-intervention to 3-month post-intervention scores were also predicted by functioning-and-disability and contextual factors, risk status (Sp/LI only, Sp/LI+developmental MI) and intervention status, respectively. Significant and clinically meaningful changes in communicative-participation over time are associated with speech-language interventions for preschoolers with Sp/LI.
    No preview · Article · May 2014 · Child Language Teaching and Therapy
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