Biomedical subjects

K E Roach

Publications and source records attributed to K E Roach.

22 records · Page 2Linked to original sources

PubMed1988

Interrater reliability of a clinical scale of rigidity.

The purposes of this study were 1) to describe a clinical scale of rigidity and testing procedure for use in patients with Parkinson's disease and 2) to examine the scale's interrater reliability. Twenty subjects (3 women, 17 men; mean age = 64 years, s = 16.3) participated in the study. Criteria for participation were 1) diagnosis of Parkinson's disease, 2) physician-documented rigidity, 3) ability to follow one-step verbal directions, and 4) ability to attain at least 75% of the standard passive-range-of-motion measurements of the elbow, forearm, and wrist of the tested upper extremity. Each of two raters used a standardized set of instructions and test procedures. The degree of rigidity was assessed using a four-point scale ranging from 0 (absent) to 3 (severe). The observed agreement between raters was 16 out of 20 trials. A Cohen's weighted Kappa was used to analyze the data (Kw = .636, p = .20). Factors were identified that may have contributed to the discrepancy between agreement and the agreement beyond chance.

Female↗

PubMed1988

Reliability and validity of the Acute Care Index of Function for patients with neurologic impairment.

The Acute Care Index of Function (ACIF), developed to standardize the assessment of functional status in patients with acute neurologic deficits, was tested for interrater reliability and concurrent validity. Interrater reliability was tested on 91 patients in a five-week study. After a two-week training period, six physical therapists were paired so that each therapist was paired with each other therapist for one week. All patients were rated weekly with the ACIF by a pair of physical therapists. A total of 166 assessments were conducted. Concurrent validity was tested using descriptions of function of 10 hypothetical patients. Each patient description was assigned a score based on the ACIF. Ten experienced therapists were then asked to rank order the functional status of each patient based on the patient's description. The average of the physical therapists' rankings was correlated with the ranking determined with the ACIF scores. Reliability data were analyzed using Cohen's weighted Kappa. The weighted Kappa values ranged from .60 to .98. Validity data were analyzed with the Spearman rank-order correlation coefficient (rs = .81, p less than .01). The results of this study indicate that the ACIF is reliable between raters and valid in its ability to rank order functional status for patients with acute neurologic deficits.

Adolescent↗

PubMed1988

Development of an Acute Care Index of Functional status for patients with neurologic impairment.

The Acute Care Index of Function (ACIF) was developed to standardize the functional status assessment of patients with acute neurologic impairment. The ACIF was used to collect patient data for a six-month period. A scoring system was then developed for the ACIF using data from 75 randomly selected patients in three discharge categories: 1) home (n = 25), 2) nursing home (n = 25), and 3) rehabilitation center (n = 25). After a scoring system was established, the ACIF was examined to determine whether it met the design criteria. The average amount of time required to administer the ACIF was 12 minutes, demonstrating feasibility for use in acute care. Data from 28 patients with a cerebrovascular accident from the discharge categories of nursing home and rehabilitation center demonstrated that the ACIF was precise enough to detect functional status changes in patients with an acute neurologic impairment. Data from the original 75 patients were examined to determine the ability of the ACIF to separate patients by score into groups consistent with their discharge placement. A 1 x 3 analysis of variance and a Scheffé post hoc analysis demonstrated that the mean ACIF scores of patients in the three discharge categories were significantly different.

Activities of Daily Living↗

PubMedDate not supplied

Effect of a combined walking and conversation intervention on functional mobility of nursing home residents with Alzheimer disease.

Assisted walking and walking combined with conversation were compared to a conversation-only intervention in nursing home residents with Alzheimer disease. Sixty-five subjects randomly assigned to treatment group were tested at baseline and end of treatment. Subjects' mean Mini-Mental State Examination score was 10.83; mean age was 87. Treatment was given for 30 minutes three times a week for 16 weeks. Subjects in the assisted walking group declined 20.9% in functional mobility; the conversation group declined 18.8%. The combined walking and conversation treatment group declined only 2.5%. These differences in outcome were significant and appear to have been affected by differences in treatment fidelity. Subjects in the conversation treatment group completed 90% of intended treatment compared with 75% in the combined group and only 57% in the assisted walking group. Failure to treat was due to subject refusal and physical illness. The conversation component of the combined walking and conversation treatment intervention appears to have improved compliance with the intervention, thereby improving treatment outcome. Results indicate that assisted walking with conversation can contribute to maintenance of functional mobility in institutionalized populations with Alzheimer disease. Staff assigned to this task should be prepared to use effective communication strategies to gain acceptance of the intervention.

Aged↗