Individual-Level Responsiveness of the Original and Short-Form Postural Assessment Scale for Stroke Patients.

Individual-Level Responsiveness of the Original and Short-Form Postural Assessment Scale for Stroke Patients.

Phys Ther. 2013 May 30;
Hsueh IP, Chen KL, Chou YT, Wang YH, Hsieh CL

BACKGROUND: The group-level responsiveness of the Postural Assessment Scale for Stroke Patients (PASS) is similar to that of the short form PASS (SFPASS). This result is counterintuitive because the PASS has more items (12) and response levels (4) than does the SFPASS (5 items and 3 response levels). OBJECTIVE: To compare individual-level responsiveness between both measures to determine whether the SFPASS can detect change as sensitively as the PASS. STUDY DESIGN AND SETTING: 251 patients were assessed using the PASS at 14 and 30 days after stroke onset in a medical center. METHODS: The SFPASS scores were calculated from the patients’ responses on the PASS. We calculated individual-level responsiveness on the basis of the value of minimal detectable change (MDC). If a patient’s change score was greater than the MDC of the PASS or SFPASS, his/her improvement was considered significant. We examined the difference of the number of patients scoring greater than the MDC and the units of MDC (the MDC ratio) improved by the patients on both measures. RESULTS: 53.0% of the patients scored greater than the MDC of the PASS, while 43.0% of the patients scored greater than the MDC of the SFPASS. The difference was significant. The mean MDC ratio of the PASS (1.8±1.7) was significantly higher than that of the SFPASS (1.2±1.3). LIMITATIONS: The scores of the SFPASS were retrieved from those of the PASS, which limits the generalization of our findings. CONCLUSION: The PASS has better individual-level responsiveness than does the SFPASS. To comprehensively report effects of clinical trials, future studies using the PASS should report the individual-level effect (e.g., number of patients scoring greater than the MDC). HubMed – rehab

Acupuncture in Subacute Stroke: No Benefits Detected.

Phys Ther. 2013 May 30;
Zhu Y, Zhang L, Ouyang G, Meng D, Qian K, Wang T

BACKGROUND: There is debate around the effect of acupuncture on stroke with key reviews unable to find evidence of effect. This may be due to poor study design, small sample size and insufficient theoretical background. OBJECTIVE: The present study was designed to determine if acupuncture combined with conventional physical therapy improves motor function and activities of daily living in subacute stroke patients compared to conventional physical therapy alone. DESIGN: Multicenter, single-blinded, randomized study. SETTING: Four rehabilitation centers in the Jiangsu province of China participated in this study. PATIENTS: One hundred and eighty-eight patients with subacute stroke admitted to the hospital were randomized into an acupuncture group and a conventional rehabilitation group. INTERVENTIONS: A combination of body and scalp acupuncture was used for three months in the acupuncture group. All patients underwent conventional stroke rehabilitation. MEASUREMENTS: The Fugl-Meyer Assessment(FMA) and Barthel Index(BI) were performed at baseline, 1 month, 3 months and 6 months after inclusion in the study. RESULTS: No statistically significant differences were found at baseline between the groups. No statistically significant differences were found between the groups using the FMA motor scores and the BI scores at baseline, 1 month, 3 months and 6 months. Significant improvements were found in each group following treatment. CONCLUSIONS: In patients with subacute stroke, the addition of body and scalp acupuncture to a regimen of conventional physical therapy does not result in further improvement in either motor function or activities of daily living beyond the effect of conventional physical therapy alone. HubMed – rehab

The Association Between Correctional Orientation and Organizational Citizenship Behaviors Among Correctional Staff.

Int J Offender Ther Comp Criminol. 2013 May 29;
Lambert EG, Barton-Bellessa SM, Hogan NL

This study sought to examine the relationship between correctional orientation (support for rehabilitation or punishment) and organizational citizenship behaviors (going above and beyond what is expected at work). All available staff at a Midwestern, high-security prison that housed juvenile offenders sentenced as adults were surveyed. Regression results suggest that correctional orientation does have a direct impact on organizational citizenship. Those staff indicating greater support for rehabilitation were more likely to report engagement in organizational citizenship behaviors. Support for punishment, however, had a nonsignificant association. Even among custody staff (i.e., correctional officers) and staff who spent half or more of their day interacting with inmates, support for rehabilitation had a significant positive association with organizational behaviors and support for punishment was not a significant predictor. In addition to the benefits of increased support for rehabilitation, such as better inmate relations, job satisfaction, and lower job stress, the current results suggest that another benefit of increasing support for rehabilitation among staff could result in greater engagement in organizational citizenship behaviors. Correctional administrators should explore different ways to promote support for rehabilitation among staff. HubMed – rehab

Quadriceps isometric strength as a predictor of exercise capacity in coronary artery disease patients.

Eur J Prev Cardiol. 2013 May 30;
Kamiya K, Mezzani A, Hotta K, Shimizu R, Kamekawa D, Noda C, Yamaoka-Tojo M, Matsunaga A, Masuda T

BACKGROUND: Quadriceps strength is related to exercise capacity in normal subjects and different patient populations, but the relationship between maximal quadriceps isometric strength (QIS) and different exercise capacity levels in coronary artery disease (CAD) patients has not been systematically evaluated yet. METHOD: We studied 621 patients (60.6?±?9.9 years, 538 males) with recent coronary artery bypass grafting or myocardial infarction, who underwent treadmill exercise testing, maximal QIS measurement (hand-held dynamometry), and coronary arteriography. Maximal QIS was expressed as absolute value (kg), %bodyweight, and %predicted maximum. Logistic regression was used to assess the relationship of maximal QIS, age, sex, number of diseased coronary vessels, peak systolic blood pressure, peak heart rate, brain natriuretic peptide, and left ventricular ejection fraction with 5, 7, and 10 estimated metabolic equivalents (eMETs) exercise capacity levels. RESULTS: Maximal QIS %bodyweight was the strongest predictor of exercise capacity in each eMETs category. Receiver-operating characteristics curves identified maximal QIS of 46, 51, and 59 % bodyweight as the best predictive cut offs for 5, 7 and 10?eMETs, respectively, with positive predictive values of 0.72, 0.66, and 0.67, respectively. CONCLUSIONS: Maximal QIS is related with eMETs levels reached at exercise testing in CAD patients, and identified maximal QIS cut-off values for eMETs prediction may be used to set strength training goals according to patients’ needs with regard to habitual physical activity level. Hand-held dynamometry may meet the need of easiness of use and low cost required for strength evaluation in large-scale clinical trials. HubMed – rehab