Πέμπτη 14 Ιουλίου 2016
Effect of sampling rate and filter settings on High Frequency Oscillation detections
High frequency oscillations (HFOs) are short, rare events with high power in approximately 80-500 Hz and have been suggested as a biomarker of epilepsy (Bragin et al., 2002; Engel et al., 2009; Wu et al., 2010; Blanco et al., 2011; Park et al., 2012; Haegelen et al., 2013; Kerber et al., 2014). Research often focuses on HFOs as a biomarker of ictal onset tissue (Cho et al., 2014; Dumpelmann et al., 2014; Malinowska et al., 2014; Okanishi et al., 2014; Gliske et al., 2016). HFOs have also been considered as a biomarker of a pre-ictal state (Pearce et al., 2013; Malinowska et al., 2014).
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Evaluation and treatment of mild traumatic brain injury through the implementation of clinical video telehealth: Provider perspectives from the Veterans Health Administration
Substantial numbers of U.S. military Veterans who served in recent conflicts experience mild traumatic brain injury. Data suggests that as many as 25% of Veterans do not have a comprehensive traumatic brain injury evaluation to determine a diagnosis and develop a plan to treat symptoms. Technologies like clinical video telehealth offer a potential means to overcome travel distance and other barriers that can impact Veteran receipt of a comprehensive traumatic brain injury evaluation after a positive screening; however, little is known about implementing clinical video telehealth in this context.
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Innovations with 3D Printing in Physical Medicine and Rehabilitation: An Analysis of the Literature
Created over 30 years ago, three dimensional printing (3DP) has recently seen a meteoric rise in interest within medicine, and the field of Physical Medicine and Rehabilitation is no exception. Also called additive manufacturing (AM), the recent increase in utilization of 3DP is likely due to lower cost printers as well as breakthroughs in techniques and processing. This thematic narrative review serves to introduce the rehabilitation professional to 3DP technology and how it is being applied to orthoses, prostheses, and assistive technology (AT).
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King Vision video laryngoscope versus Lightwand as an intubating device in adult patients with Mallampatti grade III and IV patients
Anticipated and unanticipated difficult airways are often encountered by anesthesiologists in their clinical practice. There are various devices available in such situations. We aim to compare King Vision video laryngoscope and Lightwand for their performance as an intubating device in predicted difficult intubation.
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Intraoperative cardiovascular collapse in a patient with epidermolysis bullosa
Epidermolysis bullosa (EB) is an autosomal recessive disorder that can arise in the skin and mucosal membranes spontaneously or after trauma. These patients may require anesthesia due to esophageal balloon dilatation, surgical release of contracture pseudosyndactyly, or dental procedures. However, clinicians may face with particular difficulty in these patients due to the formation of bullae followed by scar and contractures on the skin and airways. Furthermore, significant cardiovascular effects may also occur intraoperatively [1–4].
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Ultrasound-guided high-thoracic paravertebral block relieves referred pain caused by cervical spondylosis and provides stellate ganglion–blocking effect
A 71-year-old man visited our outpatient unit for pain around the back of the lower neck and scapular arch originating from cervical spondylosis, with some trigger points on the left side related to zygapophyseal joint. We obtained written informed consent and performed an ultrasound (US)–guided high-thoracic paravertebral block at the T1 level, using an M-turbo (Fujifilm Sonosite, Inc, Bothell, WA) and a microconvex array transducer (5-8 MHz, C11x; Fujifilm Sonosite, Inc). After placing the patient in a lateral decubitus position (with the side to be blocked on top), we confirmed the C7 spinous process as the most prominent point on the midline of the lower neck.
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Spinal Cord Injury - Quality of Life Self-Esteem
The SCI-QOL Self-esteem measure is an item response theory (IRT)-calibrated item bank with 23 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or 8 item short form (SF). 16 items were newly generated, 5 items were drawn from the Neuro-QOL measurement system and 2 items were drawn from the Traumatic Brain Injury-QOL measure.
The Short Form (SF) version requires only the printed form and a pencil. A CAT administration requires a desktop, laptop, or tablet computer with internet connection and login to AssessmentCenter.net.
Access to the short form, and administration of CATs through Assessment Center, is available through SCI-QOL@udel.edu.
- Full Item Bank: Mean SE= 0.22 (Range= 0.14--.51)
- 8-Item Fixed CAT: Mean SE= 0.27 (Range= 0.19-0.54)
- Variable Length CAT: Mean SE= 0.31 (0.24-0.53)
- Full Item Bank: MDC= 10.7
- 8-Item Fixed CAT: MDC= 10.62
- Variable Length CAT: MDC= 10.61
Traumatic SCI (Kalpakjian et al., 2015; n= 245)
- Excellent: (ICC= 0.84)
- Excellent: (ICC= 0.95)
- Floor Effect: Excellent (0.14%)
- Ceiling Effect: Adequate to Excellent (4.3%)
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Spinal Cord Injury - Quality of Life Positive Affect & Well Being
The SCI-QOL Positive Affect & Well-being instrument is an item response theory (IRT)-calibrated item bank with 28 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or 10 item short form (SF). 5 items were newly generated and 23 were drawn from the Neuro-QOL positive affect and well-being scale.
- Full Item Bank: Mean SEM= 0.14 (Range= 0.10-0.45)
- 10-Item Short Form: Mean SEM= 0.21 (Range= 0.14 - 0.48)
- 10-Item Fixed CAT: Mean SEM= 0.19 (Range= 0.13-0.47)
- Variable-length CAT: Mean SEM= 0.20 (Range= 0.15 - 0.46)
- Variable Length CAT (Min 4): Mean SEM= 0.25 (0.20-0.46)
- Full Item Bank: MDC= 0.39
- 10-Item Fixed CAT: MDC= 0.53
- Variable Length CAT (Min 4): MDC= 0.69
- Excellent: (Pearson's r= 0.78)
- Excellent: (ICC= 0.78)
- Full Item Bank - Excellent: (Cronbach's Alpha= 0.97)
- Floor Effect: Excellent (0.14%)
- Ceiling Effect: Adequate to Excellent (3.1%)
- Floor Effect: Excellent (0.14%)
- Ceiling Effect: Adequate to Excellent (9.9%)
- Floor Effect: Excellent (0.14%)
- Ceiling Effect: Adequate to Excellent (4.5%)
- Floor Effect: Excellent (0.14%)
- Ceiling Effect: Adequate to Excellent (3.49%)
- Floor Effect: Excellent (0.14%)
- Ceiling Effect: Adequate to Excellent (3.5%)
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Chedoke Arm and Hand Activity Inventory - 7
The CAHAI is a performance test using functional items. It is not designed to measure the client's ability to complete the task using only their unaffected hand, but rather to encourage bilateral function.
This test consists of 13 functional tasks to complete (open jar of coffee, call 911, draw a line with a ruler, put toothpaste on toothbrush, cut medium consistency putty, pour a glass of water, wring out washcloth, clean pair of eyeglasses, zip up a zipper, do up 5 buttons, dry back with towel, place container on table, carry bag upstairs).
- Jar of coffee
- Phone
- Ruler and pen
- Toothpaste and toothbrush
- Knife
- Fork
- Putty
- Glass of water
- Wet washcloth
- Eyeglasses
- Jacket and zipper
- Shirt with 5 buttons
- Towel
- Rubbermaid 38 liter container (50x37x27cm) with 10 lb. weight
- Plastic gorcery bag with 4 lb. weight
Stroke (inpatient and outpatient)
- MDC (90) = 6.3 points
- Excellent reliability (ICC = 0.96)
Stroke: (Schuster, 2010; n = 23 patients (Mean age 69.4, SD 12.9: 6 females; Mean time post-stroke: 1.5y (2.5y))
- Excellent reliability (ICC = ranges from 0.96-0.99 for CAHAI-G 13, 9, 8, 7)
Upper Extremity Paralysis:
- Excellent reliability (ICC = 0.98)
- Excellent reliability (ICC = 0.95)
Stroke:
- Excellent reliability (ICC = 0.967)
- Client should have some active movemtn capacity in the involved arm
- All three shortened versions of the CAHAI-13 demonstrated strong psychometric properties and can be used as a functional measure for assessment for UE function (especially with limited time and resources). The CAHAI-7 maintained the highest level of longitudinal validity and cross-sectional validity.
- CAHAI is inexpensive and transportable compared to the ARAT. Whereas the ARAT bilaterally examines upper limb function, the CAHAI takes a bilateral approach to analyzing basic functional tasks.
Barreca, S., Gowland, C. K., et al. (2004). "Development of the Chedoke Arm and Hand Activity Inventory: theoretical constructs, item generation, and selection." Top Stroke Rehabil 11(4): 31-42. Find it on PubMed
Barreca, S. R., Stratford, P. W., et al. (2005). "Test-retest reliability, validity, and sensitivity of the Chedoke arm and hand activity inventory: a new measure of upper-limb function for survivors of stroke." Arch Phys Med Rehabil 86(8): 1616-1622. Find it on PubMed
Schuster, C., Hahn, S. & Ettlin, T. (2010). Objectively-assessed outcome measures: a translation and cross-cultural adaptation procedure applied to the Chedoke McMaster Arm and Hand Activity Inventory (CAHAI). BMC Medical Research Methodology, 10, 106. Find it on PubMed
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Neck Disability Index
Originally developed in 1991, the NDI is now the most widely used instrument for assessing self-rated disability in patients with neck pain.
- The NDI consists of ten questions in the following domains: Pain Intensity, Personal Care, Lifting, Reading, Headaches, Concentration, Work, Driving, Sleeping, and Recreation.
- Scoring: Each question contains six answer choices, scored from 0 (no disability) to 5 (complete disability). All section scores are then totaled. Scoring is reported on a 0-50 scale, 0 being the best possible score and 50 being the worst. Alternately, the score can be reported from 0-100. The score is often reported as a percentage (0-100%)
- Cervical Radiculopathy (CR)
- Mechanical Neck Pain (MNP)
- Neck pain: Chronic, non-specific
- Neck pain: Chronic, non-traumatic
- Neck pain: Chronic, uncomplicated
- Neck pain: Degenerative, post-traumatic and other
- Neck pain: Mechanical
- Neck pain: With or without arm pain
- Patients undergoing cervical fusion surgery for degenerative disc disease
- Symptomatic cervical disc disease involving one vertebral level between C3 and C7
- Subacute whiplash
- Whiplash Associated Disorders (WAD)
Cervical Radiculopathy:
(Cleland et al, 2006; n = 38; mean age = 51.2 (10.6) years
- SEM = 4.4 (on a scale of 0 - 50)
(Young et al, 2010; n = 165; mean age = 49 (9.7) years)
- SEM = 5.7 (on a scale of 0 - 50)
Mechanical Neck Disorder:
(Cleland et al, 2008; n = 138; mean age = 42.5 (11.9) years
- SEM = 8.4 (on a scale of 0 - 50)
(Young et al, 2009; n = 91; mean age = 47.8 (14.6) years
- SEM = 4.3 (on a scale of 0 - 50)
Non-Specific Neck Pain:
(Jorristsma et al, 2012; n = 76; mean age = 38.5 years)
- SEM = 3.0 (on a scale of 0 - 50)
(Vos C.J., Verhagen A.P., Koes B.W., 2006; n = 187)
- SEM = 0.60 (WAD, arm pain, shoulder pain, headaches)
(Westaway M.D., Stratford P.W., Binkley J.M., 1998; n = 31, average age = 40.4)
- SEM = 1.80 (torticollis, radiologically confirmed osteoarthritis, radicular findings, history of MVA)
Mechanical Neck Disorders
(Cleland et al, 2008)
- MDC = 19.6% (on a scale of 0 - 100%)
(Young et al, 2009)
- MDC = 10.2 (on a scale of 0 - 50)
Cervical Radiculopathy:
(Cleland et al, 2006)
- MDC = 10.2 (on a scale of 0 - 50)
(Young et al, 2010)
- MDC = 13.4 (on a scale of 0 - 50)
Non-specific Neck Pain:
(Pool et al, 2007; n = 183; mean age = 45.8 (11.6) years)
- MDC = 10.5 calculated (on a scale of 0 - 50)
(Jorristsma et al, 2012)
- MDC = 8.4 (on a scale of 0 - 50)
CR:
(Young I.A., Cleland J.A., Michener L.A., Brown C., 2010)
- MDC = 13.4
(Cleland J.A., Fritz J.M., Whitman J.M., Palmer J.A., 2006; n = 38)
- MDC = 10.2
Mixed NSNP:
(Pool J.J., Ostelo R.W., Hoving J.L., Bouter L.M., de Vet H.C., 2007; n = 183)
- MDC = 10.5
(Vos C.J., Verhagen A.P., Koes B.W., 2006)
- MDC = 1.66 (WAD, arm pain, shoulder pain, headaches)
(Westaway M.D., Stratford P.W., Binkley J.M., 1998)
- MDC = 4.20 (torticollis, radiologically confirmed osteoarthritis, radicular findings, history of MVA)
Mechanical Neck Disorders:
(Young et al, 2009)
- MCID = 7.5 (on a scale of 0 - 50)
(Cleland et al, 2008)
- MCID = 19% (on a scale of 0 - 100%)
(Stratford P.W., Riddle D.L., Binkley J.M., Spadoni G., Westaway M.D., Padfield B., 1999)
- MCID = 5.0
Cervical Radiculopathy:
(Young et al, 2010)
- MCID = 8.5 (on a scale of 0 - 50)
(Cleland et al, 2006)
- MCID = 7.0 (on a scale of 0 - 50)
Non-specific Neck Pain:
(Pool et al, 2007)
- MCID = 3.5
(Jorristsma et al, 2012)
- MCID = 3.5 (on a scale of 0 - 50)
Cervical Spine Fusion:
(Carreon et al, 2010; n = 505; mean age = 52.6 (10.2) years)
- MCID = 7.5 (on a scale of 0 - 50)
Mechanical neck disorders:
(Stratford P.W., Riddle D.L., Binkley J.M., Spadoni G., Westaway M.D., Padfield B., 1999)
- r = 0.94
(Ackelman B.H., Lindgren U., 2002; n = 97)
- r = 0.81 – 0.99
(Vernon H., Mior S., 1991)
- r = 0.89
(Young et al, 2009)
- Adequate test retest reliability (ICC = 0.64)
- According to Hogg-Johnson (2009), the low test retest reliability in this study, when compared to other studies, could be due to the inclusion criteria or due to methodological problems. Precision of the estimate could also have been affected by small sample size or the study's definition of a 'stable' sample.
Cervical Radiculopathy:
(Young et al, 2010)
- Adequate test retest reliability (ICC = 0.55)
Neck Pain: Mechanical:
(Cleland et al, 2008)
- Adequate test retest reliability (ICC = 0.50)
Neck Pain:
(Westaway M.D., Stratford P.W., Binkley J.M., 1998)
- ICC = 0.89 (included torticollis, radiologically confirmed osteoarthritis, radicular findings ,and patients with a history of MVA)
(Vos C.J., Verhagen A.P., Koes B.W., 2006)
- ICC = 0.90 (23% had WAD, 37% had 'arm pain', 56% had 'shoulder pain', and 62% had headaches)
(Shaheen et al, 2013; n = 65, mean age = 41.3 (10.2) years)
- Excellent test retest reliability (ICC = 0.96)
Cervical Radiculopathy:
(Cleland et al, 2006)
- Adequate test retest reliability (ICC = 0.68)
Neck Pain: Degenerative, post-traumatic and other:
(McCarthy et al, 2007; n = 160 patients attending the Spinal Out-Patients Department at Queen's Medical Centre in Nottingham, UK; mean age = 51.2 (14-93 years); sex = 64 males and 96 females; 34 patients completed a survery 2 weeks later; average NDI score = 46%)
- Excellent test retest reliability (ICC = 0.93)
Neck Pain: Chronic, non-specific:
(Jorristsma et al, 2012)
- Excellent test retest reliability (ICC = 0.86)
Patients who underwent cervical fusion for degenerative disorders:
(Carreon et al, 2010)
- Excellent test retest reliability (ICC = 0.90 to 0.93)
Neck pain: Chronic, uncomplicated:
(Gay et al, 2007; n = 23; mean age = 49.6 (14.6) years)
- Adequate internal consistency (Cronbach alpha= 0.72 pretreatment and 0.77 post-treatment)
Neck Pain:
(Shaheen et al, 2013)
- Excellent internal consistency (Cronbach alpha= 0.89)
Neck Pain: Degenerative, post-traumatic and other:
(McCarthy et al, 2007; n = 160; mean age = 51.2 years)
- Excellent internal consistency (Cronbach alpha= 0.864)
Patients who underwent cervical fusion for degenerative disorders:
(Carreon et al, 2010)
- Adequate to Excellent internal consistency (Cronbach alpha ranged from 0.74 – 0.93)
Subacute whiplash patients with neck pain:
(Nieto et al, 2008; n =150; mean age = 35 (11.13) years)
- Excellent internal consistency (Cronbach alpha= 0.87)
Neck pain: Mechanical, non-specific:
(Van Der Velde et al, 2009; n = 521 subjects with neck pain; mean age = 44.95 (11.50 years); sex = 338 women and 183 men; mean neck pain intensity in week prior to study = 5.17 (1.87); mean NDI score = 13.57 (5.75))
- Adequate internal consistency (Cronbach alpha ranged from 0.73 - 0.80)
- Cronbach's alpha = 0.92
Whiplash
(Vernon H., Mior S., 1991)
- Cronbach's alpha = 0.80
Cervical Fusion for Degenerative Disorders Population:
(Carreon et al, 2011; n = 2080 patients undergoing cervical fusion for degenerative disorders; NDI scores were collected before surgery and 12 and 24 months after surgery; sex = 33% male; mean age = 50.4 (11.0) years)
- Excellent concurrent validity with SF - 6D (r = 0.82)
- Excellent predictive validity with SF - 6D (r = 0.81)
General Neck Pain Population:
(McCarthy et al, 2007)
- Adequate to Excellent concurrent validity with SF - 36 (r = 0.45 to 0.74)
Subacute Whiplash Patients with Neck Pain:
(Nieto et al, 2008)
- Adequate concurrent validity with pain intensity (r = 0.51)
- Adequate concurrent validity with pain interference index (r = 0.50)
- Adequate concurrent validity with depression scale (r = 0.51)
Mechanical Neck Disorders:
(Young et al, 2009)
- Adequate construct validity with global rating of change (r = 0.52)
Young (2010):
- Examined by comparing baseline scores and follow-up scores for stable and unstable groups using 2-way ANOVA. Showed significant change (P<0.001) in disability among self-rating patients.
(Shaheen A.A., Omar M.T., Vernon H., 2013)
- Strong correlation with GRC: r = 0.81
Cervical Radiculopathy (CR)
(Cleland J.A., Fritz J.M., Whitman J.M., Palmer J.A., 2006)
- Poor construct validity
Neck pain: Chronic, uncomplicated:
Gay (2007):
- Adequate construct validity with the VAS (r=0.45)
- Excellent construct validity with the NBQ on pre and posttest respectively (r=0.8 and 0.77 respectively)
(McCarthy M.J., Grevitt M.P., Silcocks P., Hobbs G., 2007)
- Correlation with SF-36 (each of the eight domains): r = -0.45 to -0.76 (spinal surgery outpatient setting)
(Riddle D.L., Stratford P.W., 1998; n = 146)
- Adequate correlation with Mental Component Summary (MCS) of SF-36: r = 0.47
- Adequate correlation with Physical Component Summary (PCS) of SF-36: r = 0.53
(Westaway M.D., Stratford P.W., Binkley J.M., 1998)
- Correlation with Patient-Specific Functional Scale (PSFS): r = 0.73 (at admission)
- r = 0.81 (at discharge)
Neck Pain: Chronic, non-traumatic:
Chan Ci En (2009, n = 20; mean age = 64.5 (12.8) years):
- Excellent construct validity with the NPAD (r= 0.86)
Neck Pain: With or without radiation to arm:
Alliet (2013; n = 338; mean age = 41.3 (11.8) years):
- Excellent construct validity with the DASH (r= 0.75)
Whiplash-associated disorders:
Hoving (2003, n = 71; mean age = 40.1 (14.3) years)
- Excellent construct validity with the NPQ (r =0.88)
Symptomatic cervical disc disease:
Richardson (2011, n = 430; mean age = 43.2 (7.9) years):
- Excellent construct validity with the SF-6D for all tested algorithms (r= >0.82).
Whiplash associated disorders:
(Hoving et al, 2003)
- The NDI and NPQ do not assess the full range of disabilities indicated as important to the patient in the PET. Of the 9 problems most frequently identified by the PET, only 3 are measured by the NDI (work, driving, and sleeping) and 4 by the NPQ (work, driving, sleeping, and social activities.) Other problems such as emotional and social functioning are not addressed by the NDI or NPQ
Neck Pain: Chronic, non-traumatic:
(Chan Ci En et al, 2009)
- Of the 11 problems identified by the majority of subjects in the PET, the NDI contained 6 of these problems and the NPAD contained 7
Neck Pain: With or without radiation to arm:
(Ailliet et al, 2013)
- Review of the literature and personal communication with the developer of the NDI confirmed that the NDI was based on the concept of disability; 11 neck pain experts and 10 patients commented on the construct, comprehensiveness, and relevance of the NDI
Subacute whiplash patients with neck pain:
(Nieto et al, 2008)
- Based on factor analysis the NDI can be viewed as a two-factor instrument. It can be broken down to pain intensity and interference with the level of cognitive functioning as well as interference with the level of physical functioning
Neck Pain: With or without radiation to arm:
(Ailliet et al, 2013)
- Reviewed with 10 patients, who commented on construct, comprehensiveness, and relevance of NDI
Neck Pain: With or without radiation to arm:
(Ailliet et al, 2013)
- Propose that a 10 - item computerized adaptive test can make it so that ceiling and floor effects are very unlikely to occur in the clinical applications (alternative to NDI)
Neck pain: Chronic, uncomplicated:
(Gay et al, 2007)
- There were no apparent floor or ceiling effects for either the NDI or the NBQ
Whiplash associated disorders:
(Hoving et al, 2003)
- The overall scores for the NDI and NPQ showed no floor/ceiling effects. However, ceiling effects existed for some individual items on the NDI
Symptomatic cervical disc disease:
(Richardson et al, 2011)
- Ceiling and floor effects were generated in the utility scores: >0.9 or <0.2
Neck Pain:
(Shaheen et al, 2013)
- No floor/ceiling effects as less than 15% of patients achieved the minimum possible scores
Mechanical Neck Pain
(Cleland J.A., Childs J.D., Whitman J.M., 2008)
- AUC = 0.83, acceptable
(Stratford P.W., Riddle D.L., Binkley J.M., Spadoni G., Westaway M.D., Padfield B., 1999)
- AUC = 0.9, acceptable
(Jorritsma W., Dijkstra P.U., de Vries G.E., Geertzen J.H., Reneman M.F., 2012)
- AUC = 0.75, acceptable
(Young B.A., Walker M.J., Strunce J.B., Boyles R.E., Whitman J.M., Childs J.D., 2009)
- AUC = 0.79, acceptable
Neck pain: Chronic, uncomplicated:
(Gay et al, 2007)
- Large effect size = 1.12
Mechanical Neck Disorders:
(Cleland et al, 2008)
- Moderate responsiveness; NDI and GRCS (r = 0.58), NDI and NRS (r = 0.57)
Neck Pain:
(Shaheen et al, 2013)
- Responsiveness was calculated by comparing change in NDI scores between improved and stable patients 1 week post treatment
- The results were statistically significant (P < 0.05)
Cervical Radiculopathy:
(Young I.A., Cleland J.A., Michener L.A., Brown C., 2010)
- AUC = 0.74, acceptable
(Cleland et al, 2006)
- AUC = 0.57 indicating an "inability to identify changes in patient's perceived levels of disability when such a change had occurred"
- Correlation between change scores on NDI and GROC and NPRS was not significant
Cervical Fusion for Degenerative Disorders Population:
(Carreon et al, 2010)
- Excellent responsiveness (Effect size = 0.85)
(Young et al, 2009)
Consider NDI changes of 10 points to be clinically meaningful for patients presenting with mechanical neck pain both with and without concurrent UE symptoms.
(Young et al, 2010)
Consider NDI changes of 13 points to be clinically meaningful for patients presenting with cervical radiculopathy.
(Richardson et al, 2011)
Translational healthcare economic models demonstrate that NDI scores are predictive of SF-6D utility scores in patients receiving either a total disc arthroplasty or anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease involving one vertebral level between C3 and C7. Utility scores derived from the NDI may be useful in making cost-effective choices in guiding evidence based care among and between healthcare disciplines.
(Jorritsma et al, 2012)
Clinicians should be aware that choosing either the minimal detectable change (MDC) or the minimal important change (MIC) gives different cut-off values and amounts of certainty on whether the observed change is relevant in patients with non-specific neck pain of duration greater than 3 months. Of the two options, application of the MDC is the more conservative choice. Thus, the use of MDC over the MIC increases the certainty that the observed change score is relevant and larger than measurement error.
(Aillet et al, 2013)
Sports and computer work are important aspects to consider in regards to the modern disablement process of neck pain. These components are not addressed by the NDI, which suggests the NDI may be an incomplete primary outcome measure.
(Alliet et al, 2013)
Medication use can have an impact on the scoring of the different items of the NDI and also on the interpretation of the score. Medication use is not addressed by the NDI, which suggests the NDI may be an incomplete primary outcome measure.
(Hoving et al, 2003, Neito et al, 2008, Chan Ci En et al, 2009)
Several relevant items, such as social and emotional items, of whiplash-associated disorders are out of the scope of the NDI. This suggests the NDI may be an incomplete primary outcome measure in the whiplash-associated disorder population.
(Carreon et al, 2010)
The change in NDI score at which a cervical spine fusion patient will perceive a marked improvement, compared to before surgery, is a 10 point decrease.
(Shaheen et al, 2013)
Missing data for driving (item 8) occurs with a high frequency. This may be due to the fact that driving is restricted to certain genders in certain cultures. Cultural factors should be considered when selecting the NDI as a primary outcome measure.
(Nieto et al, 2008)
The NDI demonstrates a two factor structure in the whiplash-associated disorder population. The first factor, referred to as "pain and interference with cognitive functioning", encompasses the following items: neck pain intensity, reading, headaches, concentration, and sleeping. This factor alludes to the extent to which neck pain interferes with a person's cognitive functioning. The second factor, referred to as "functional disability", encompasses the following items: personal care, lifting, work, driving, and recreation. This second factor refers to the extent to which neck pain influences the performance of a person's usual physical activity.
Ailliet, L., Knol, D. L., et al. (2013). "Definition of the construct to be measured is a prerequisite for the assessment of validity. The Neck Disability Index as an example." J Clin Epidemiol 66(7): 775-782 e772. Find it on PubMed
Carreon, L. Y., Anderson, P. A., et al. (2011). "Predicting SF-6D utility scores from the neck disability index and numeric rating scales for neck and arm pain." Spine (Phila Pa 1976) 36(6): 490-494. Find it on PubMed
Carreon, L. Y., Glassman, S. D., et al. (2010). "Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion." Spine J 10(6): 469-474. Find it on PubMed
Childs, J. D., Cleland, J. A., et al. (2011). "Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association." Journal of Women's Health Physical Therapy 35(2): 57-90.
Cleland, J. A., Childs, J. D., et al. (2008). "Psychometric properties of the Neck Disability Index and Numeric Pain Rating Scale in patients with mechanical neck pain." Arch Phys Med Rehabil 89(1): 69-74. Find it on PubMed
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Richardson, S. S. and Berven, S. (2012). "The development of a model for translation of the Neck Disability Index to utility scores for cost-utility analysis in cervical disorders." Spine J 12(1): 55-62. Find it on PubMed
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Frenchay Activities Index
Assesses a broad range of activities of daily living in patients recovering from stroke
- The items included move beyond the scope of ADL scales, which tend to focus on issues related to self care and mobility
- Can be separated into 3 factors:
- Domestic chores
- Leisure/work
- Outdoor activities
- Lower Limb Amputation
- Stroke
- Venous Leg Ulcers
- Chronic Low Back Pain
- High Utilizers of Health Care
- Mild Cognitive Impairment
- Traumatic Limb Injury
Stroke:
(Lu et al, 2012; n = 52, mean age = 59.4 (11.6) years, minimum 6 months post stroke, Taiwanese sample, Chronic Stroke)
- SEM = 2.4
(Lin et al, 2012; n = 127, mean age = 55.27 (11.23) years, time post stroke = 16.82 (16.05) months, Taiwanese sample)
- Standard Error of Measurement of individual items:
Item | Item Difficulty (Standard Error) |
The domain of domestic chores | |
Preparing meals | 0.08 |
Washing dishes | 0.08 |
Washing clothes | 0.08 |
Dusting/vacuum cleaning | 0.07 |
Cleaning (heavy housework) | 0.08 |
Local shopping | 0.17 |
The domain of work/leisure | |
Social activities | 0.07 |
Walking outside >15 min | 0.08 |
Hobby/sport | 0.07 |
Car/bus travel | 0.07 |
Outings | 0.08 |
Gardening | 0.09 |
Household/car maintenance | 0.10 |
Reading books | 0.08 |
Employment | 0.23 |
Elderly:
(Imam & Miller, 2012; n = 66, mean age = 79.03 (8.50) years, Chinese/Canadian sample, Elderly)
- MDC value = 8.64
Stroke:
(Lu et al, 2012, Chronic Stroke)
- MDC value = 6.7 (14.9%)
General Population:
(Turnbull et al. 2000, n = 602, aged 16 and older, General Population)
Age Band (yrs) | n | Median (IQR) (yrs) | Range (yrs) |
Male | |||
16-24 | 24 | 23.5 (17.5 to 30.3) | 10.0 to 37.0 |
25-34 | 28 | 28.5 (26.0 to 33.0) | 8.0 to 39.0 |
35-44 | 33 | 27.0 (24.0 to 34.0) | 3.0 to 40.0 |
45-54 | 34 | 27.0 (23.0 to 30.3) | 16.0 to 42.0 |
55-64 | 45 | 28.0 (24.0 to 33.5) | 0.0 to 40.0 |
65-74 | 41 | 24.0 (19.0 to 28.0) | 0.0 to 39.0 |
75-84 | 44 | 23.0 (12.3 to 30.0) | 1.0 to 38.0 |
85+ | 32 | 15.0 (4.3 to 26.0) | 0.0 to 39.0 |
All ages | 281 | 26.0 (19.0 to 31.0) | 0.0 to 42.0 |
Female | |||
16-24 | 38 | 23.0 (20.0 to 28.3) | 10.0 to 35.0 |
25-34 | 39 | 32.0 (30.0 to 35.0) | 24.0 to 40.0 |
35-44 | 42 | 32.0 (29.0 to 34.0) | 17.0 to 40.0 |
45-54 | 41 | 33.0 (30.0 to 37.5) | 17.0 to 41.0 |
55-64 | 48 | 31.5 (28.0 to 34.0) | 14.0 to 39.0 |
65-74 | 47 | 30.0 (24.0 to 33.0) | 7.0 to 39.0 |
75-84 | 32 | 29.0 (21.3 to 32.0) | 2.0 to 38.0 |
85+ | 34 | 14.0 (3.0 to 24.8) | 0.0 to 35.0 |
All ages | 321 | 30.0 (24.0 to 33.0) | 0.0 to 41.0 |
Stroke:
(Schepers et al, 2006; n = 163; mean age = 56 (11) years; 6 to 12 months post stroke, Chronic Stroke)
6 months post stroke | 12 months post stroke | |||||
Measure (scale range) | Mean (SD) | Sample range | IQR | Mean (SD) | Sample range | IQR |
FAI (0–45) | 18.0 (8.5) | 0–36 | 12–25 | 20.9 (8.7) | 2–42 | 15–28 |
BI (0–20) | 18.7 (1.6) | 13–20 | 18–20 | 18.9 (1.5) | 14–20 | 18–20 |
FIM total (18–126) | 111.7 (8.3) | 81 124 | 107–118 | 112.2 (8.3) | 83–125 | 109–11 |
FIM motor (13–91) | 80.3 (6.4) | 58–91 | 77–85 | 80.9 (7.0) | 57–91 | 77–86 |
FIM cognitive (5–35) | 31.4 (3.6) | 18–35 | 29–34 | 31.2 (3.2) | 16–35 | 30–34 |
FAI, Frenchay Activities Index |
Elderly:
(McPhail et al, 2009; n = 40, mean age = 79 (7.3) years, Australian sample)
- Excellent test-retest reliability (ICC = 0.94 with CI 0.89 - 1.00)
(Imam & Miller, 2012)
- Excellent test-retest reliability (ICC = 0.86)
General Population
(Turnbull et al, 2000, General Population)
Excellent test-retest reliability (r = 0.96)
Lower Limb Amputation
(Miller et al, 2004, n = 84, mean age = 56.5 (13) years, Lower Limb Amputation)
- Excellent test-retest reliability (ICC = 0.79)
Stroke:
(Lu et al, 2012)
- Excellent test-retest reliability (ICC= 0.89)
(Sarker et al, 2012; n = 238, mean age = 68.6 (14.2) years, 3 months post stroke, severe (NIHSS score > 13) = 23)
- ICC= 0.27 (CI: -0.09 to 0.60) with Barthel Index
- ICC= 0.75 (CI: 0.06 to 0.91) with Nottingham Extended ADL scale
(Green et al, 2001; n = 22; mean age = 71.6 (6.8) years; mean time since stroke onset = 15 months; median time between assessments = 7 days, Chronic Stroke)
Test-rest agreement | ||
FAI Domain: | % agreement | Kappa |
main meals | 100 | 1.00 |
washing up | 77 | 0.75 |
washing clothes | 86 | 0.82 |
light housework | 86 | 0.84 |
heavy housework | 82 | 0.25 |
local shopping | 73 | 0.55 |
social outing | 77 | 0.81 |
walking outside >15 m | 68 | 0.53 |
hobby | 64 | 0.50 |
drive car/travel on bus | 82 | 0.77 |
outings car rides | 77 | 0.82 |
gardening | 82 | 0.74 |
household /car maintenance | 96 | 0.69 |
read books | 73 | 0.73 |
paid work | 100 | * |
*= kappa value uncertain |
Stroke:
(Piercy et al, 2000; n = 59; 35 = stroke survivors, 24 = caregivers; 15.2 days between assessments; mean age = 71.1 (14.8) years; stroke onset 6 to 12 months, Chronic Stroke)
- Excellent inter-rater reliability (r = 0.93; FAI total)
- Excellent item level inter-rater reliability (Kappa range = 0.64-0.80; 9/15 items)
(Post & de Witte, 2003; n = 45; mean age = 55.6 (10.9) years; 3 to 9 days between assessments, Chronic Stroke)
- Excellent interrater reliability (ICC = 0.90; FAI total)
- Adequate to excellent interrater reliability (Kappa range = 0.41 - 0.90; at item level)
(Wendel et al, 2013; n=31; mean age=75 (range 54-94); >18 months post stroke (mean =27 months), Swedish population, Swedish version)
Distribution of FAI agreement of two raters | |
FAI Domain | Weighted kappa |
Main meals | 0.976 |
Washing up | 0.908 |
Washing clothes | 1.000 |
Light housework | 0.956 |
Heavy housework | 0.844 |
Local shopping | 0.819 |
Social outings | 0.975 |
Walking outdoors (>15 mins) | 1.000 |
Pursing active interest in hobby | 0.930 |
Outings/car rides | 0.851 |
Gardening | 0.939 |
Household and/or car maintenance | 0.923 |
Reading books | 0.873 |
Gainful work | 1.000 |
Lower Limb Amputation:
(Miller et al, 2001; n = 435; mean age = 62.0 (15.7) years, Lower Limb Amputation)
· Excellent internal consistency, (Cronbach's alpha = 0.87 post amputation)
Traumatic Limb Injury:
(Chern et al, 2014; three months post injury, n=342, mean age=43.7(18.5) years; 6 months post injury, n=1010, mean age=45.3(18.6) years; 12 months post injury, n=987, mean age=45.7(18.5); Traumatic Limb Injury, Taiwanese population, Chinese Version)
- Excellent internal consistency for three time points (Chronbach's alpha = 0.91 post injury)
Stroke:
(Lin et al, 2012, Stroke)
- Excellent internal consistency for whole test (r = 0.99)
- Cronbach's alpha = 0.81 for domestic chores domain
- Cronbach's alpha = 0.73 for work/leisure domain
Stroke & Normals:
(Schuling et al, 1993; stroke sample = 185; mean age = 76 (10.4) years; mean time since stroke onset = 26 weeks, Stroke and Normals)
- Excellent internal consistency
- (Cronbach's alpha = 0.83 - controls/normal)
- (Cronbach's alpha = 0.87 - post-stroke)
- Adequate internal consistency
- (Cronbach's alpha = 0.78 - pre-stroke retrospective reports)
Elderly:
(Imam & Miller, 2012, Elderly)
- Adequate concurrent validity with Reintegration into Normal Living index (r = 0.61)
- Adequate concurrent validity with Activities-specific Balance Confidence scale (r = 0.55)
- Adequate concurrent validity with Timed Up & Go test (r = -0.68)
Stroke:
(Wade et al, 1985; Schuling et al, 1993; Cup et al, 2003; Wu et al, 2011; n = 70; mean age = 55.5 (12.1) years; mean time post stroke = 19.9 (12.5) months, Stroke)
- Excellent concurrent validity with the Barthel Index (r = 0.66; disability scores)
- Excellent concurrent validity with the Barthel (r = 0.79)
- Excellent concurrent validity with the Euroqol (r = 0.65)
- Excellent concurrent validity with the Rankin (r = -0.80)
- Adequate concurrent validity with the Stoke Adapted Sickness Impact Profile-30 (r = -0.43)
- Excellent concurrent validity with the Modified Nottingham Extended ADL scale (r = 0.80)
- Adequate concurrent validity with the Stroke Impact Scale Total (r = 0.50)
(Sarker et al, 2012, Stroke)
- Excellent concurrent validitiy with Barthel Index (r = 0.80)
- Excellent concurrent validity with Nottingham Extended ADL scale (r = 0.90)
Traumatic Limb Injury:
(Chern et al, 2014, Traumatic Limb Injury, Chinese Version)
- Adequate predictive validity at 3, 6, and 12 months with WHOQOL-BREF domains:
- at 3 months with WHOQOL-BREF - Physical domain (r = .39)
- at 3 months with WHOQOL-BREF - Psychology domain (r = .38)
- at 3 months with WHOQOL-BREF - Environment domain (r = .39)
- at 6 months with WHOQOL-BREF - Physical domain (r = .41)
- at 6 months with WHOQOL-BREF - Environment domain (r = .31)
- at 6 months with WHOQOL-BREF - Physical domain (r = .50)
- at 12 months with WHOQOL-BREF - Psychology domain (r = .37)
- at 12 months with WHOQOL-BREF - Social Relations domain (r = .35)
- at 12 months with WHOQOL-BREF - Environment domain (r = .37)
- Poor discriminant validity with the Emotional and Alertness Scales of Sickness Impact Profile (r = -0.15, Emotional and r = -0.14, Alertness)
- Excellent convergent validity with the Sickness Impact Profile-Home Management (r = -0.73)
- Excellent convergent validity with the Sickness Impact Profile-Body Care (r = -0.70)
- Excellent convergent validity with the Sickness Impact Profile- Mobility (r = -0.68)
- Excellent convergent validity with FIM Motor subscale (r = 0.63)
- Adequate convergent validity with the Sickness Impact Profile-Ambulation (r = -0.56)
- Adequate convergent validity with the Sickness Impact Profile-Recreation/pastimes (r = -0.47)
- Adequate convergent validity with the Sickness Impact Profile-Communication (r = -0.42)
- Adequate convergent validity with the Sickness Impact Profile-Eating (r = -0.42)
- Adequate convergent validity with the Sickness Impact Profile-Rest/Sleep (r = -0.42)
- Adequate convergent validity with the Sickness Impact Profile- Social Interaction (r = -0.39)
Stroke:
(Pedersen et al, 1997; n = 437; mean age = 73.6 (10) years; assessed 6 months post-stroke, Chronic Stroke)
- FAI and Barthel Index (BI) are complementary measures that both assess Activities of Daily Life (ADL)
- Each measure assesses different aspects of ability, the BI assesses movement and motor power functioning, the FAI assessed progressively more difficult aspects of ADL
- FAI floor effects were observed at approximately 57.5 points (FAI mean = 30.0 (11.6) points)
(Sarker et al, 2012, Stroke)
- Significantly large floor effect (19%)
Venous Leg Ulcers:
(Walters et al, 1999; n = 233, median age = 75 (range = 67-82) years, Venous Leg Ulcers)
Adequate floor effect (2.1%)- Adequate Ceiling Effect at 3 months (0.3%)
- Adequate Ceiling Effect at 6 months (3.5%)
- Adequate Ceiling Effect at 12 months (2.5%)
- Adequate Floor Effect at 3 months (7.3%)
- Adequate Floor Effect at 6 months (4.3%)
- Adequate Floor Effect at 12 months (2.4%)
- FAI (coupled with Stroke Adapted Sickness Impact Profile) detected the most patient change and had moderate effect sizes (d = 0.59) for chronic stroke patients between 6 and 12 months post stroke)
- FAI was also noted to change in the expected direction from pre-stroke, 6 months, and 12 months post-stroke
Frenchay Activities Index translations:
French (p26):
http://ift.tt/29GPVmo
Spanish (p288):
http://ift.tt/29GmchF
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