Necessary and sufficient causes of participation post-stroke: practical and philosophical perspectives

Mayo, Nancy E.; Bronstein, David; Scott, Susan C.; Finch, Lois; Miller, Sydney B.

doi:10.1007/s11136-013-0441-6

Cited by 44 publications

(57 citation statements)

References 36 publications

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“…In fact, rating of health as poor or fair is sufficient to indicate service needs; rating of health as good or better is neither necessary nor sufficient to indicate no need, and this group would need to be specifically evaluated. (42) In addition, self-rated health used as single item, had a high specificity and a moderate to low sensitivity. Studies had shown that only 30% of seniors discharged from acute care fully recover to similar levels prior hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Planning Health Services for Seniors: Can We Use Patient’s Own Perception?

et al. 2017

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ObjectivesThe objectives of this study were to identify needs and to estimate whether self-reported health can be used as an indicator of service needs among seniors.MethodsThis was a cross-sectional survey. Age- and sex-adjusted logistic regression was used to estimate the link between functional status indicators and fair or poor self-reported health. Forward stepwise logistic regression was performed to identify the strongest contributors of poor health. Positive predictive value (PPV), sensitivity, and specificity were calculated to identify whether health perception could be used to identify people in need of physical rehabilitation services.Results142 seniors agreed to answer the survey, yielding a response rate of 73%. Among the respondents (mean age 79±7; 60% women), 40% rated their health as fair or poor. Seniors perceiving their health as fair or poor had higher odds of reporting impairments, activity limitations, and participation restrictions (OR ranging from 2.37 95%CI: 1.03-5-45 to 12.22 95%CI: 2.68–55.78) in comparison to those perceiving their health as good or better. The strongest contributors for poor/fair health were depression, difficulty performing household tasks, pain, and dizziness (c-statistic = 0.91 and a maximum adjusted r-squared of 0.60). Self-rated health used as single-item showed a positive predictive value (PPV) of 1, sensitivity of 52%, and specificity of 100%.ConclusionOur results indicate that all seniors participating in this study and reporting fair or poor health have indicators of need for further rehabilitation services. Asking patients to rate their own health may be an alternate way of querying about need, as many older persons are afraid to report disability because of fear of further institutionalization.

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Section: Discussionmentioning

confidence: 99%

Planning Health Services for Seniors: Can We Use Patient’s Own Perception?

et al. 2017

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“…17 Recruitment for the original study was targeted to identify individuals with specific characteristics; 250 people with transtibial amputation from trauma, transtibial amputation from dysvascular causes, transfemoral amputation from trauma, transfemoral amputation from dysvascular causes, and bilateral amputation were sought.…”

Section: Methodsmentioning

confidence: 99%

Cross-Sectional Assessment of Factors Related to Pain Intensity and Pain Interference in Lower Limb Prosthesis Users

Morgan

Friedly

Amtmann

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective To determine relationships between pain site(s) and pain intensity/interference in people with lower limb amputations. Design Cross-sectional survey. Setting Community. Participants Lower limb prosthesis users with unilateral or bilateral amputations (n=1296, mean time since amputation = 14.1 years). Intervention Not applicable. Main Outcome Measures Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity (1-item to assess average pain), PROMIS Pain Interference (4-item short form to assess the consequences of pain in desired activities), and questions that asked participants to rate the extent to which each of the following were a problem: residual limb pain, phantom limb pain, knee pain on the non-amputated side, back pain, and shoulder pain. Results Nearly three-quarters of participants (72.1%) reported problematic pain in one or more of the listed sites. Problematic phantom limb, back, and residual limb pain were reported by 48.1%, 39.2%, and 35.1% of participants, respectively. Knee pain and shoulder pain were less commonly identified as problems (27.9% and 21.7%, respectively). Participants also reported significantly (p<.0001) higher pain interference (T score=54.7, SD=9.0) than the normative sample based on the U.S. population (T score=50.0, SD=10.0). Participants with lower limb amputations rated their pain intensity on average at 3.3 (SD=2.4) on a 0–10 scale. Pain interference (rho=.564, p<.0001) and intensity (rho=.603, p<.0001) were positively and significantly correlated with number of pain sites reported. Conclusion Problematic pain symptoms, especially residual limb, phantom limb, and back pain, affect the majority of prosthetic limb users and have the potential to greatly restrict participation in life activities.

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“…The Prosthetic Limb Users Survey of Mobility (PLUS-M™) 24 was developed using the rigorous methods proposed by Reeve and colleagues 23 to fulfill the need for a brief, accurate, and clinically meaningful self-report mobility instrument specific to people with LLA. Development of a new instrument using contemporary standards was intended to address barriers to routine use, including relevance of items, administration burden, and ease of interpretation.…”

Section: Introductionmentioning

confidence: 99%

Construct Validity of the Prosthetic Limb Users Survey of Mobility (PLUS-M) in Adults With Lower Limb Amputation

Hafner

Gaunaurd

Morgan

et al. 2017

Archives of Physical Medicine and Rehabilitation

147

185

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Objective To assess construct validity of the Prosthetic Limb Users Survey of Mobility (PLUS-M), a self-report mobility measure for people with lower limb amputation (LLA). Design Cross-sectional study. Setting Private prosthetic clinics (n=37). Participants Current lower limb prosthesis users (n=199, mean age=55.4±14.3 years, 71.4% male) were assessed before receiving a replacement prosthesis, prosthetic socket, and/or prosthetic knee. Intervention Not applicable. Main Outcome Measure(s) Convergent construct validity was examined using correlations between participants’ PLUS-M T-scores and measures of physical function, mobility, and balance, including the Amputee Mobility Predictor (AMP), Timed Up and Go (TUG), Patient Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), Prosthesis Evaluation Questionnaire-Mobility Subscale (PEQ-MS), and Activities-Specific Balance Confidence Scale (ABC). Known-groups construct validity was evaluated by comparing differences in PLUS-M T-scores among participants grouped by Medicare Functional Classification Level (MFCL). Results PLUS-M T-scores demonstrated a moderate positive relationship with AMP scores (rho=0.54, p<0.001) and a moderate negative relationship with TUG times (rho=- 0.56, p<0.001). The PLUS-M also showed a strong positive relationship with PEQ-MS scores (rho=0.78, p<0.001), ABC scores (rho=0.81, p<0.001), and PROMIS-PF T-scores (rho=0.81, p<0.001). Significant differences (p<0.05) in PLUS-M T-scores were found among groups of people classified by different MFCLs. Conclusion Study results support validity of the PLUS-M as a self-report measure of prosthetic mobility. Correlations between PLUS-M and measures of physical function, mobility, and balance indicate convergent construct validity. Similarly, significant differences in PLUS-M T-scores across MFCL groups provide evidence of known-groups construct validity. In summary, evidence indicates that PLUS-M has good construct validity among people with LLA.

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Necessary and sufficient causes of participation post-stroke: practical and philosophical perspectives

Abstract: Two treatable component causes of participation, walking capacity and mood, were identified; of these, only excellent walking capacity could be considered a sufficient cause.

Cited by 44 publications

References 36 publications

Planning Health Services for Seniors: Can We Use Patient’s Own Perception?

Planning Health Services for Seniors: Can We Use Patient’s Own Perception?

Cross-Sectional Assessment of Factors Related to Pain Intensity and Pain Interference in Lower Limb Prosthesis Users

Construct Validity of the Prosthetic Limb Users Survey of Mobility (PLUS-M) in Adults With Lower Limb Amputation

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