The Development and Preliminary Validation of the Taiwanese Manual Ability Measure for Burns.

The development and preliminary validation of the Taiwanese Manual Ability Measure for Burns.

Filed under: Rehab Centers

Burns. 2013 Jan 21;
Lin SY, Chen CC, Mao HF, Hsiao FY, Tu VY

OBJECTIVE: To develop and validate the Taiwanese Manual Ability Measure for Burns (T-MAM for Burns), a task-oriented functional evaluation tool to assess self-reported manual ability in burn patients. DESIGN: A longitudinal study. PARTICIPANTS: A sample of 45 burn patients from burn rehabilitation centers with varying degrees of hand involvement. METHODS: The preliminary testing version was formed by adding burn specific items to the Taiwanese version of the Manual Ability Measure. A field test was then conducted for item reduction and psychometric properties testing. RESULTS: Out of 55 initial items, 20 were selected into the final version of the T-MAM for Burns. Psychometric analyses indicated that it was reliable (test-retest ICC=.99), with adequate concurrent validity with various other hand function tests (r=-.79 with the short form Disabilities of the Arm, Shoulder, and Hand, or, the QuickDASH) and discriminative validity (significant difference (t=2.99, P=.005) between groups with unilateral vs. bilateral hand burns), and responsive (ES=.24 and .44 at one- and 3-month evaluations). CONCLUSION: This study shows that the T-MAM for Burns has great potential to be a functional outcome measure for burn rehabilitation. Additional research with a larger sample should be conducted to further confirm its validity and reliability.
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Team size in spinal cord injury inpatient rehabilitation and patient participation in therapy sessions: The SCIRehab Project.

Filed under: Rehab Centers

J Spinal Cord Med. 2012 Nov; 35(6): 624-34
Dijkers MP, Faotto RM

Context/objective: Rehabilitation teams generally are described as consisting of a single representative of 6-8 disciplines, but research suggests that the number of individuals involved may be much larger. This study aimed to determine the size of teams in spinal cord injury (SCI) rehabilitation, and the effect of team size on patients’ active participation in their treatment sessions.Prospective observational study.Six SCI rehabilitation centers.A total of 1376 patients with traumatic SCI admitted for first rehabilitation.Not applicable.Number of treatment sessions, by discipline and overall clinician rating of active participation of the patient; Treatment Concentration Index (TCI) calculated as ?p(k)(2) (where p refers to the proportion of treatment sessions delivered by team member k).The average patient was treated by 39.3 different clinicians. The numbers were especially high for physical therapy (mean: 8.8), occupational therapy (7.2), and nursing (16.1). TCI was 0.08 overall; it varied by discipline. TCI was negatively correlated with length of stay, except for psychology. Participation ratings were minimally affected by the number of sessions the patient and the therapist had worked together.In SCI rehabilitation, teams are at least as large as suggested by previous research. However, this may not mean lack of familiarity of patient and therapist with one another, or alternatively, the possibly weak therapeutic alliance does not affect the patients’ active participation in their sessions. Further research is needed to determine whether there are negative effects on rehabilitation outcomes.
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Outcomes of social work and case management services during inpatient spinal cord injury rehabilitation: The SCIRehab project.

Filed under: Rehab Centers

J Spinal Cord Med. 2012 Nov; 35(6): 611-23
Hammond FM, Gassaway J, Abeyta N, Freeman ES, Primack D, Kreider SE, Whiteneck G

To investigate associations of social work/case management (SW/CM) services during inpatient rehabilitation following spinal cord injury (SCI) and patient characteristics with outcomes.Prospective observational cohort of individuals with SCI receiving inpatient rehabilitation.Six inpatient rehabilitation centers.1032 individuals with traumatic SCI.Not applicable. Main outcome measure(s): Type of residence at the time of rehabilitation discharge. Employment/school status, presence of a pressure ulcer, Patient History Questionnaire, Satisfaction with Life Scale, Craig Handicap Assessment and Reporting Technique (CHART) subscales, and rehospitalization at 1-year post-injury.The intensity of specific SW/CM services is associated with multiple outcomes examined. More sessions dedicated to discharge planning for a home discharge and financial planning were associated positively with more discharge to home, while more sessions focused on planning for discharge to a location other than home, e.g. nursing home or long-term acute care facilities, have negative associations with societal participation outcomes (CHART Social Integration, Occupation, and Mobility scores) as well as with residing at home at the time of the 1-year injury anniversary. Conclusion(s): The intensity and type of SW/CM services are associated with outcomes at rehabilitation discharge and at 1-year post-injury. Discharge to home may require assistance from SW/CM in the area of discharge planning and financial planning, while discharge to non-home residence demands directed SW/CM services for such placement. Note: This is the eighth of nine articles of this SCIRehab series.
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