Examination of the relevance of the ICF cores set for stroke by comparing with the Stroke Impact Scale

Paanalahti, Markku; Bērziņa, Guna; Lundgren‐Nilsson, Åsa; Arndt, T.; Sunnerhagen, Katharina S.

doi:10.1080/09638288.2017.1396368

Cited by 7 publications

(2 citation statements)

References 35 publications

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“…Patients' responses on the ICF five-point scale were dichotomized into 0 = "no impairment" and 1-4 = "impairment". This dichotomization process is in accordance with published recommendations [8,26,27]. The two additional responses for the assessment of ICF categories ("not specified" and "not applicable") were treated as missing.…”

Section: Data Preparation and Selection Of Classifiermentioning

confidence: 99%

Machine Learning Based Linking of Patient Reported Outcome Measures to WHO International Classification of Functioning, Disability, and Health Activity/Participation Categories

Habenicht,

Fehrmann,

Blohm

et al. 2023

JCM

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Background: In the primary and secondary medical health sector, patient reported outcome measures (PROMs) are widely used to assess a patient’s disease-related functional health state. However, the World Health Organization (WHO), in its recently adopted resolution on “strengthening rehabilitation in all health systems”, encourages that all health sectors, not only the rehabilitation sector, classify a patient’s functioning and health state according to the International Classification of Functioning, Disability and Health (ICF). Aim: This research sought to optimize machine learning (ML) methods that fully and automatically link information collected from PROMs in persons with unspecific chronic low back pain (cLBP) to limitations in activities and restrictions in participation that are listed in the WHO core set categories for LBP. The study also aimed to identify the minimal set of PROMs necessary for linking without compromising performance. Methods: A total of 806 patients with cLBP completed a comprehensive set of validated PROMs and were interviewed by clinical psychologists who assessed patients’ performance in activity limitations and restrictions in participation according to the ICF brief core set for low back pain (LBP). The information collected was then utilized to further develop random forest (RF) methods that classified the presence or absence of a problem within each of the activity participation ICF categories of the ICF core set for LBP. Further analyses identified those PROM items relevant to the linking process and validated the respective linking performance that utilized a minimal subset of items. Results: Compared to a recently developed ML linking method, receiver operating characteristic curve (ROC-AUC) values for the novel RF methods showed overall improved performance, with AUC values ranging from 0.73 for the ICF category d850 to 0.81 for the ICF category d540. Variable importance measurements revealed that minimal subsets of either 24 or 15 important PROM variables (out of 80 items included in full set of PROMs) would show similar linking performance. Conclusions: Findings suggest that our optimized ML based methods more accurately predict the presence or absence of limitations and restrictions listed in ICF core categories for cLBP. In addition, this accurate performance would not suffer if the list of PROM items was reduced to a minimum of 15 out of 80 items assessed.

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Section: Data Preparation and Selection Of Classifiermentioning

confidence: 99%

Machine Learning Based Linking of Patient Reported Outcome Measures to WHO International Classification of Functioning, Disability, and Health Activity/Participation Categories

Habenicht,

Fehrmann,

Blohm

et al. 2023

JCM

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“…of working age) (3). A variety of impairments may occur after stroke, including sensorimotor and cognitive impairments as well as fatigue (4)(5)(6). Fatigue can be a persistent problem even among those who have otherwise recovered well (7)(8)(9).…”

mentioning

confidence: 99%

Factors associated with fatigue among people who have returned to work after stroke: an exploratory study

Norlander,

Lindgren,

Brogårdh

2024

JRM

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Objective: To explore the associations between fatigue impact and (a) personal and stroke-related characteristics, (b) functional impairments and (c) work-related factors among individuals who have returned to work after stroke. Design: A cross-sectional exploratory study. Subjects: 87 working stroke survivors. Methods: This study comprises data from a postal survey targeting work ability and perceived stroke-related consequences 1 year after stroke. Fatigue was evaluated using the Fatigue Severity Scale (FSS). Factors associated with having fatigue (FSS total score ≥ 4) were identified using univariable and multivariable logistic regression analyses. Three domain-specific multivariable models and 1 final combined model were created. Results: Fatigue was reported by 43% of the participants. Several factors representing all the investigated domains were associated with fatigue. In the final combined regression model, self-perceived low cognitive functioning, low decision control at work and high quantitative job demands had the strongest independent effects on the odds of having fatigue. Conclusion: Among people who were working 1 year after stroke, fatigue was associated with both personal and stroke-related characteristics as well as functional impairments and work-related factors. This highlights the complex nature of post-stroke fatigue. Fatigue management interventions should have a comprehensive approach and also consider the work environment.

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Task-Oriented Circuit Training for Mobility in Outpatient Stroke Rehabilitation in Germany and Austria: A Contextual Transferability Analysis

et al. 2020

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People with stroke cite mobility deficits as one of the most burdensome limitations. National and international stroke guidelines recommend physical therapy based on task-oriented practice, with high numbers of repetitions to improve mobility. In the outpatient setting in Germany and Austria, these principles have not yet been established. The purpose of this study was to identify an evidence-based intervention that could help reduce this research-practice gap. A stepwise approach proposed by Voigt-Radloff et al and Cochrane Germany was used. First, the specific health service problem in the German and Austrian physical therapy outpatient context was identified. Second, a promising intervention was identified using a systematic search in the Cochrane Library and grading the quality of the evidence using GRADE. Finally, the transferability of the promising intervention into the local context was evaluated using predefined questions from the Cochrane guide and reports from health insurances, professional organizations, and national stroke guidelines. Task-oriented circuit training reviewed by English et al was chosen. The review showed clinically important improvements in walking distance and speed. The quality of the evidence was graded high for these 2 outcomes. We identified contextual challenges for implementation at the setting level (eg, insufficient reimbursement for group therapy by insurance companies), the participant and therapist level (eg, unknown motivation for group therapy due to the established 1:1 patient-therapist ratio), and the outcome measure level (eg, lack of standardized, cross-culturally translated manuals). While task-oriented circuit training is scientifically well established, barriers to implementation into routine care in Germany and Austria can be expected. In a next step, research using knowledge translation methodology will focus on the detailed evaluation of barriers and facilitators with the relevant stakeholders.

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Examination of the relevance of the ICF cores set for stroke by comparing with the Stroke Impact Scale

Cited by 7 publications

References 35 publications

Machine Learning Based Linking of Patient Reported Outcome Measures to WHO International Classification of Functioning, Disability, and Health Activity/Participation Categories

Machine Learning Based Linking of Patient Reported Outcome Measures to WHO International Classification of Functioning, Disability, and Health Activity/Participation Categories

Factors associated with fatigue among people who have returned to work after stroke: an exploratory study

Task-Oriented Circuit Training for Mobility in Outpatient Stroke Rehabilitation in Germany and Austria: A Contextual Transferability Analysis

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