Mayo-Portland Adaptability Inventory: Comparing Psychometrics in Cerebrovascular Accident to Traumatic Brain Injury

Malec, James F.; Kean, Jacob; Altman, Irwin; Swick, Shannon

doi:10.1016/j.apmr.2012.06.013

Cited by 36 publications

(27 citation statements)

References 11 publications

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“…Our previous analyses comparing MPAI-4 responses between two major diagnostic categories (TBI vs. stroke) in post-inpatient brain injury rehabilitation samples revealed differential item functioning for some items; however, examination of differential test functioning showed very similar metrics between the two groups at the test level, i.e., test characteristic curves were virtually identical. 4 This finding supports combining diagnostic groups in this and other types of analyses in which the focus is on evaluating measures of function rather than measures of diagnostic signs and symptoms.…”

Section: Methodssupporting

confidence: 70%

“…5 This value is very similar to the value of .91 obtained in prior analyses with large data sets. 3–4 Values for these indicators were very similar for both the total sample and for the subset that showed zero or greater change on the MPAI-4 from first to second assessment.…”

Section: Resultsmentioning

confidence: 84%

“…For example, in a prior study, we examined for potential differences between the two largest populations of ABI, stroke and TBI. 4 Differences were found on some items between these two groups that reflected expected differences between more lateralized and more diffuse/frontal brain injury. However, any two participants in either diagnostic group will also differ in their item profiles depending on the specific brain regions affected by ABI, premorbid characteristics and other factors that create individual patterns of functional impairment.…”

Section: Discussionmentioning

confidence: 94%

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The Minimal Clinically Important Difference for the Mayo-Portland Adaptability Inventory

Malec

Kean

Monahan

2017

Journal of Head Trauma Rehabilitation

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Objectives To determine the Minimal Clinically Important Difference (MCID) and Robust Clinically Important Difference (RCID) of the Mayo-Portland Adaptability Inventory (MPAI-4) as measures of response to intervention. Methods Retrospective analysis of existing data. Both distribution- and anchor-based methods were used to triangulate on the MCID and to identify a moderate, i.e., more robust, level of change (RCID) for the MPAI-4. These were further evaluated with respect to clinical provider ratings. Participants Data for individuals with acquired brain injury in rehabilitation programs throughout the U.S. in the OutcomeInfo Database (n=3087) with two MPAI-4 ratings. Main Measures MPAI-4, Supervision Rating Scale (SRS), Clinician Rating of Global Clinical Improvement (CRGCI). Results Initial analyses suggested 5 T-score points (5T) as the MCID and 9T as the RCID. 81–87% of clinical raters considered a 5T change and 99% considered a 9T change to indicate meaningful improvement. Conclusions 5T represents the MCID for the MPAI-4 and 9T, the RCID. Both values are notably less than the Reliable Change Index (RCI). While the RCI indicates change with a high level of statistical confidence, it may be insensitive to change that is considered meaningful by providers and participants as indicated by the MCID.

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Section: Methodssupporting

confidence: 70%

Section: Resultsmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 94%

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The Minimal Clinically Important Difference for the Mayo-Portland Adaptability Inventory

Malec

Kean

Monahan

2017

Journal of Head Trauma Rehabilitation

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“…The measure yields a total score reflecting overall disability, as well as three subscale scores for the Ability Index (e.g., mobility, cognitive functioning, communication), Adjustment Index (e.g., pain, mood, fatigue), and Participation Index (e.g., social contact, independent living, employment). Prior studies have demonstrated satisfactory internal consistency and construct validity, as well as concurrent and predictive validity, for the full measure and its indices ( Wilde et al, 2010 ; Kean et al, 2011 ; Malec et al, 2012 ). The MPAI-4 has been shown to be sensitive to clinical change in studies of rehabilitation interventions ( Eicher et al, 2012 ), and that all 30 items could be mapped to components and categories in the WHO-ICF ( Lexell et al, 2012 ).…”

Section: Methodsmentioning

confidence: 96%

Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation

et al. 2015

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Post-acute community-based rehabilitation is effective in reducing disability. However, while social participation and quality of life are valued as distal outcomes of neurorehabilitation, it is often not possible to observe improvements on these outcomes within the limited time-frames used in most investigations of rehabilitation. The aim of the current study was to examine differences in the sequence of attainments for people with acquired brain injury (ABI) undergoing longer term post-acute neurorehabilitation. Participants with ABI who were referred to comprehensive home and community-based neurorehabilitation were assessed at induction to service, at 6 months and again at 1.5 years while still in service on the Mayo-Portland Adaptability Index (MPAI-4), Community Integration Questionnaire, Hospital Anxiety and Depression Scale, and World Health Organisation Quality of Life measure. At 6 months post-induction to service, significant differences were evident in MPAI abilities, adjustment, and total neurodisability; and in anxiety and depression. By contrast, there was no significant effect at 6 months on more socially oriented features of experience namely quality of life (QoL), Community Integration and Participation. Eighteen month follow-up showed continuation of the significant positive effects with the addition of QoL-related to physical health, Psychological health, Social aspects of QoL and Participation at this later time point. Regression analyses demonstrated that change in QoL and Participation were dependent upon prior changes in aspects of neurodisability. Age, severity or type of brain injury did not significantly affect outcome. Results suggest that different constructs may respond to neurorehabilitation at different time points in a dose effect manner, and that change in social aspects of experience may be dependent upon the specific nature of prior neurorehabilitation attainments.

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“…Client profiles were included if clients were living in the community (i.e., not in residential or other institutional care), over the age of 12 years at the time of injury, and had sustained a TBI (e.g., vehicular, falls, assaults, sporting injuries), hypoxia, anoxia, or anesthetic accident, or a limited range of vascular events (e.g., subarachnoid hemorrhage). Clients were excluded if they had sustained a stroke, or brain injury associated with a cardiac event, as these diagnostic groups were considered to have different patterns of cognitive and functional outcomes from those seen in TBI (22). Individuals were not excluded on the grounds of substance abuse or psychiatric impairment.…”

Section: Study Populationmentioning

confidence: 99%

The interrelationship of functional skills in individuals living in the community, following moderate to severe traumatic brain injury

Giles

Clark-Wilson²,

Baxter³

et al. 2018

Brain Injury

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Objective: The Adaptive Behaviour and Community Competency Scale was used to investigate the interrelationship of 22 basic and instrumental activities of daily living (ADL/IADL) in individuals with moderate to severe traumatic brain injury (TBI). The relationship of self-awareness to task performance was also investigated. Research design: Prospective descriptive study. Method: The profiles of 100 community dwelling individuals were used to compare the degree to which independence in each ADL/IADL was associated with independence in every other ADL/IADL. The interrelationship of these skills was further explored in a factor analysis, and comparisons made between the degree of self-awareness of those who could and could not complete IADL independently. Results: We found evidence of a hierarchy of skills: individuals who were independent in IADL were more able to perform ADL, than vice versa. Factor analysis supported a two-factor solution distinguishing ADL and IADL. Self-awareness was more strongly associated with IADL than with ADL independence. Conclusions: A subset of individuals with moderate to severe TBI are able to perform a range of IADL. This group appears to have higher levels of self-awareness than those who are limited to performing only ADL skills. Implications for the applications of functional retraining interventions are discussed.

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Mayo-Portland Adaptability Inventory: Comparing Psychometrics in Cerebrovascular Accident to Traumatic Brain Injury

Cited by 36 publications

References 11 publications

The Minimal Clinically Important Difference for the Mayo-Portland Adaptability Inventory

The Minimal Clinically Important Difference for the Mayo-Portland Adaptability Inventory

Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation

The interrelationship of functional skills in individuals living in the community, following moderate to severe traumatic brain injury

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