Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Sep 2010
Clinical TrialEffect of pulmonary rehabilitation on balance in persons with chronic obstructive pulmonary disease.
To describe within-subject effects of pulmonary rehabilitation (PR) on balance in persons with chronic obstructive pulmonary disease (COPD) and to determine whether any observed changes in balance were associated with change in exercise tolerance or health-related quality of life. ⋯ PR contributed to minor improvements in balance and had no effect on balance confidence in subjects with COPD. Further work is warranted to determine the optimal intervention for improving balance in this population.
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Arch Phys Med Rehabil · Sep 2010
Issues affecting the selection of participation measurement in outcomes research and clinical trials.
The ever-growing number of participation measures without consensus on which is best makes it difficult to determine which measure to use in rehabilitation research and clinical trials. In an effort to address issues affecting the selection of a participation measure for a specific research purpose, this article (1) outlines the types and characteristics of participation measures, (2) enumerates various uses of participation measures in disability and rehabilitation research, (3) discusses appropriate matching of the type of participation measure with the research task, and (4) offers recommendations for future participation research. Participation instruments vary in terms of their degree of participation specificity, the conceptual model that underlies their development, whether they include multiple domains or take a more global approach, the extent to which they are objective versus subjective, whether they use general population norms, who is the respondent, the method of item and scale development, and their psychometric properties. ⋯ Selection of a participation measure for use in a specific study requires an understanding of the characteristics of available tools and the nature of the research design, but most importantly, it requires matching the instrument to the specific research question or hypothesis. Instruments assessing participation are currently appropriate as secondary outcomes in trials evaluating interventions targeting activity limitation, and they will become appropriate as primary outcomes when interventions are tested that target participation directly. It will be easier to apply participation measures appropriately to their many research uses once substantial progress is made in obtaining better participation measurements and consensus is reached about the best tools.
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Arch Phys Med Rehabil · Sep 2010
Suggestions for refinement of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH): a factor analysis and Rasch validation study.
To perform a comprehensive psychometric analysis of Disabilities of the Arm, Shoulder and Hand (DASH) to examine its properties and provide insights for an improved version. ⋯ Unidimensionality and the key domains identified by the original developers as the theoretic framework of DASH were not confirmed by our analyses. The response categories showed misfunctioning. "Sexual Activities" and "Tingling" misfit the Rasch model. Further detailed investigations of DASH are warranted, both to confirm these results in different health conditions and cultures, and to reanalyze in-depth content validity issues regarding the questionnaire.
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Arch Phys Med Rehabil · Sep 2010
Craniocervical orientation affects muscle activation when exercising the cervical extensors in healthy subjects.
To evaluate the activity of neck extensor muscles during different extension exercises with muscle functional magnetic resonance imaging (mfMRI). ⋯ The results of this study provide some preliminary insight into the impact of craniocervical orientation on the differential response of the deep and superficial cervical extensor muscles during the performance of cervical extensor exercises.