Clinical Global Impression of Change in Physical Frailty: Development of a Measure Based on Clinical Judgment

Studenski, Stephanie; Hayes, Risa P.; Leibowitz, Ruth Q.; Bode, Rita; Lavery, Lawrence A.; Walston, Jeremy D.; Duncan, Pamela W.; Perera, Subashan

doi:10.1111/j.1532-5415.2004.52423.x

Cited by 226 publications

(172 citation statements)

References 26 publications

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“…Rather than asking patients to rate every aspect and implication of an intervention, patients are asked to provide a global impression of change. 12 There are however very comprehensive questionnaires that capture all aspects of users' satisfaction with equipment. 13 The most commonly used are the Quebec User Evaluation of Satisfaction with Assistive Technology 7,14,15 and the Psychosocial Impact of Assistive Devices.…”

Section: Discussionmentioning

confidence: 99%

How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

et al. 2012

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Background and purpose: The purpose of this study was to determine the amount and type of equipment prescribed to aid mobility and self-care for patients with spinal cord injuries (SCI) in Australia and to determine how frequently the equipment is used 1 year later and whether patients are satisfied with it. Methods: A consecutive series of 61 patients admitted for rehabilitation to two Sydney SCI units were recruited. All mobility and self-care equipment worth more than $AU50 prescribed by therapists before patients' discharge was recorded. This included wheelchairs, commodes, shower chairs, hoists, electric beds, pressure-relieving cushions, bed mattresses, slideboards, walking aids, orthoses, electrical stimulation systems and other pieces of notable exercise equipment. Patients were interviewed 1 year later and asked about each piece of equipment they had been prescribed. Specifically, they were asked about how frequently they had used each piece of equipment and whether they were satisfied with it. Data were analysed using descriptive statistics. Results: Three hundred and fourteen pieces of equipment, including 68 wheelchairs, were prescribed for the 61 patients. Most of the equipment (226/314) was used more than 20 times in the 2 months preceding the 1-year review. Most patients were satisfied or highly satisfied with the majority of equipment prescribed, although patients were very dissatisfied or only partly dissatisfied with 18/314 pieces of equipment. Discussion: Patients were generally satisfied with the equipment they were prescribed. There was a small amount of equipment prescribed that was not used 1 year later or with which patients were dissatisfied.

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Section: Discussionmentioning

confidence: 99%

How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

et al. 2012

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“…The above mentioned parameters (e.g., muscle strength in lower limbs, handgrip strength and body weight) were frequently included in the ageing-related literature as operational definitions of frailty (Fried 2001;Gobbens et al 2010;Studenski et al 2004). In fact, researchers reported a significant difference in terms of frailty between fallers and nonfallers among older adults.…”

Section: Medell and Alexandermentioning

confidence: 99%

The contribution of postural balance analysis in older adult fallers: A narrative review

Pizzigalli

Cremasco

Mulasso

et al. 2016

Journal of Bodywork and Movement Therapies

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“…A possible solution is to ask clinicians and patients to rate their overall impressions of change over time on a 15-point global impression of change scale anchored with 'a very great deal better' at one end ( þ 7) and 'a very great deal worse' (À7) at the other. 3,4 Impressions of change are commonly used as part of clinical trials in gerontology [5][6][7] and psychiatry, 6,8 but only rarely in SCI. 9,10 Although clinicians' and patients' impressions of change are subjective, they are nonetheless valuable and reflect the way clinical decisions are made in practice about ceasing, commencing or changing therapy.…”

Section: Introductionmentioning

confidence: 99%

“…9,10 Although clinicians' and patients' impressions of change are subjective, they are nonetheless valuable and reflect the way clinical decisions are made in practice about ceasing, commencing or changing therapy. 5 Presumably, when clinicians or patients rate overall impressions of change in motor performance, they take into account neurological status as well as the time and effort devoted to therapy and implications of change on real life. Arguably, clinicians' impressions of change are particularly valuable because they draw on clinical judgement, 6 which involves assessing the quality and speed of movement, and reflecting on the real-life implications of change in performance for people with SCI.…”

Section: Introductionmentioning

confidence: 99%

Clinicians’ and patients’ impressions of change in motor performance as potential outcome measures for clinical trials

et al. 2010

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Study design: A cross-sectional descriptive study was undertaken. Objectives: The overall objective was to explore the potential usefulness of clinicians' and patients' impressions of change in motor performance for clinical trials. Specifically, the aim was to compare clinicians' and patients' impressions of change in motor performance with standardized outcome measures in people with spinal cord injury (SCI). Setting: Spinal injury units, Sydney, Australia. Methods: Thirty people undergoing rehabilitation after recent SCI were recruited. They were assessed on two occasions separated by between 1 and 5 months. On both occasions, patients were assessed sitting unsupported (n ¼ 25), transferring (n ¼ 23) and walking (n ¼ 12) using standardized outcome measures. On the second occasion, patients rated their impressions of change in each of the three motor tasks since their initial assessment. A 15-point scale was used. In addition, patients were videoed performing the three motor tasks on the two occasions. Two clinicians with SCI experience independently viewed the pairs of videos and rated their impressions of change using the same 15-point scale. Clinicians' and patients' impressions of change were compared with each other and to the standardized objective measures. Results: Clinicians' and patients' impressions of change were greater than change measured with standardized objective measures for all three motor tasks (Po0.01). In addition, patients' impressions of change were greater than clinicians' impressions of change for transferring, but comparable for unsupported sitting and walking. Conclusion: Clinicians' and patients' impressions of change in motor performance may have potential for evaluating treatment effectiveness in clinical trials.

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Clinical Global Impression of Change in Physical Frailty: Development of a Measure Based on Clinical Judgment

Abstract: The CGIC-PF is a structured assessment of change in physical frailty with defined content and process. It has strong face validity, reliability, and feasibility for use in clinical research. It may be useful as one criterion of change and as an anchor for change in other measures.

Cited by 226 publications

References 26 publications

How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

The contribution of postural balance analysis in older adult fallers: A narrative review

Clinicians’ and patients’ impressions of change in motor performance as potential outcome measures for clinical trials

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