International journal of rehabilitation research. Internationale Zeitschrift für Rehabilitationsforschung. Revue internationale de recherches de réadaptation
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The aim of this study was to analyze the course of reduction of disability during a pain rehabilitation program (PRP) and factors influencing this course. A prospective cohort study was carried out. All patients with chronic musculoskeletal pain treated in a PRP between March 2010 and December 2010 were eligible for this study. ⋯ Disability reduces during the PRP. Initial PDI, treatment week, average pain, and interaction between initial PDI and treatment week influence the course of disability reduction during the PRP. These results could aid in predicting the required duration of a PRP at the start.
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We aimed to validate the translated and cross-culturally adapted Persian version of the Shoulder Pain and Disability Index (SPADI). The final Persian SPADI was administered to 190 patients, out of whom 83 patients returned for the retest. We administered the Persian version of the SF-36 quality-of-life inventory and the disabilities of the arm shoulder and hand (DASH) questionnaires at the first visit to assess the convergent validity. Cronbach's α was 0.94 for the total SPADI, which showed excellent internal consistency. The intraclass correlation coefficient was 0.84 for the total SPADI, which showed good reliability between the test and retest. Convergent validity was confirmed, as the Spearman correlation between total SPADI and DASH was 0.61. Moreover, there was significant correlation between the subscales of the SPADI and SF-36 scales. The Persian version of the SPADI proved to be a reliable and valid instrument to be implemented in the Persian population with shoulder disorders. ⋯ level II.
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New treatments are being investigated for spinal cord injury (SCI), and any improvement may result in incremental cost savings. The objective of this study was to determine the direct costs of care 2 years after an SCI, stratifying for completeness and level of injury. A retrospective database analysis was carried out using data from the Quebec Trauma Registry, the Quebec Medical Insurance Board, and the Quebec Automobile Insurance Corporation between 1997 and 2007. ⋯ For incomplete lesions, costs did not differ significantly between groups during the first or the second year. Incomplete spinal cord injuries result in lower healthcare costs compared with complete injuries across all groups during the first 2 years after injury. As less severe levels of injury result in measurably lower costs, the funds spent to reduce the severity or level of SCI could at least partially be recouped through healthcare savings.
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Translating, culturally adapting and validating the Italian version of the Pain Stages of Change Questionnaire (PSOCQ-I) to allow its use with Italian-speaking patients with low back pain. The PSOCQ-I was developed by forward-backward translation, a final review by an expert committee and a test of the prefinal version to establish its correspondence with the original English version. Psychometric testing included confirmatory factor analysis, reliability by internal consistency (Cronbach's α) and test-retest reliability (intraclass coefficient correlation), and construct validity by comparing PSOCQ-I with the Pain Catastrophising Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Roland Morris Disability Scale (RMDQ), a pain Numerical Rating Scale (NRS), and the Hospital Anxiety and Depression Scale (Pearson's correlation). ⋯ Low correlations were found between the PSOCQ-I subscales and anxiety (r=-0.132; 0.150) and depression (r=-0.113; 0.186). The PSOCQ was translated successfully into Italian, and proved to have a good factorial structure and psychometric properties that replicated the results of other versions. Its use is recommended for research purposes.
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We carried out a prospective study to determine whether stroke patients' functional status or health-related quality of life would predict whether they lived at home 2.5 years after discharge from neurological inpatient rehabilitation. We carried out a single-center prospective cohort study. The outcome 'home care' versus 'death' or 'institutionalization' (nursing home admission) was evaluated 30 months after discharge. ⋯ In total, 30 months after discharge, 75% of the stroke survivors were still living at home. Multivariate analysis showed that patients continued to live at home significantly more frequently when they had fewer mortality-relevant comorbidities (P=0.001), a higher BMI (P=0.040), a higher increase in functional independence during inpatient rehabilitation (P=0.017), and above all, a better health-related quality of life, measured using the EQ-5D (P<0.001), at discharge. Stroke survivors' health-related quality of life measured with the EQ-5D and the change in functional status during multimodal neurological rehabilitation appear to be the strongest clinically relevant long-term predictors of staying at home.