The Functional Independence Measure is a mandated measure for all rehabilitation units in Canada. As the cognitive subscale of the Assessment of Motor and Process Skills is more sensitive to change than the Functional Independence Measure, we recommend also administering the Assessment of Motor and Process Skills to better detect changes in the cognitive aspect of function. Implications for rehabilitation When deciding between the Functional Independence Measure or the Assessment of Motor and Process Skills, it is important to consider whether patients' functional status is expected to change similarly or differently. The difference in sensitivity to change between the subscales of the two outcome measures varies with the characteristics of change (similar or different) in patients' functional status. We recommend using the Assessment of Motor and Process Skills, along with the Functional Independence Measure, for patients who are expected to make similar amounts of change in functional status, as the cognitive subscale of the Assessment of Motor and Process Skills is more sensitive to change and can better detect changes in the cognitive aspect of functioning. For patients whose functional status are expected to change differently (diverse diagnoses), the Functional Independence Measure may be more useful as the motor subscale was more sensitive to change when comparing between rehabilitation populations.
The Singapore version of the CAHAI demonstrated good validity and reliability, similar to the properties of the original CAHAI. Implications for rehabilitation The Singapore version of the Chedoke Arm and Hand Activity Inventory demonstrates evidence of construct validity and inter-rater reliability. The Singapore version of the Chedoke Arm and Hand Activity Inventory can be used by clinicians and researchers to evaluate function in the affected upper extremity for persons with stroke in Singapore.
Purpose: To determine the cost-effectiveness of physiotherapy (PT) to manage individuals with chronic conditions. Method: Design: Systematic review of randomized controlled trials (RCTs). Eligibility: RCTs with adult participants diagnosed with ≥1 chronic condition, an intervention delivered or supervised by a physiotherapist, including an economic evaluation of the intervention provided. Procedure: Eight databases were searched. Title/abstract screening, full-text review, and data extraction were performed in duplicate. The quality of included studies was assessed using Cochrane's Risk of Bias Assessment 2.0. Results: Fifty-three articles were included in this review. Fifteen compared PT to no PT, 38 compared novel PT to conventional PT. Of the studies comparing PT to no PT, 53% found PT to be cost-effective. Of the studies comparing novel to conventional PT, 55% found novel interventions were cost-effective. Overall, PT was cost-effective in most studies related to arthritis, chronic LBP, and chronic neck pain. The heterogeneity of study characteristics limited the ability to perform a meta-analysis. Conclusions: Over half of included studies reported PT to be cost-effective. Future high quality RCTs performing rigorous economic evaluations are needed to determine the cost-effectiveness of different interventions delivered or supervised by a PT to prevent disability for those with chronic conditions.
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