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Biomedical subjects

K Ottenbacher

Publications and source records attributed to K Ottenbacher.

At least 19 recordsLinked to original sources
PubMed2001

Rehabilitation outcomes for brain injured patients in Australia: functional status, length of stay and discharge destination.

This study describes the rehabilitation length of stay (LOS), discharge destination and discharge functional status of 149 patients admitted with traumatic brain injury (TBI) to an Australian hospital over a 5-year period. Hospital charts of patients admitted between 1993-1998 were reviewed. Average LOS over the 5-year time period was 61.8 days and only decreased nominally over this time. Longer LOS was predicted by lower admission motor FIM scores and presence of comorbidities. Mean admission and discharge motor FIM scores were 58 and 79, which represented a gain of 21 points. Higher discharge motor FIM scores were predicted by higher admission motor FIM scores and younger age. FIM gain was predicted by cognitive status and age. Most patients, 88%, were discharged back to the community, with 30% changing their living setting or situation. Changing living status was predicted by living alone and having poorer functional status on admission.

Activities of Daily Living↗
PubMed1999

Disability in older adults. 3: Policy implications.

Several models of disability proposed in recent years share many common elements and are helping to direct research and inform practice. One new development is that disablement, a concept that emphasizes the impairments--handicap continuum, is now being implemented by concepts related to enablement. Enablement focuses attention on the capacity for rehabilitation. Coincidentally, a new generation of functional assessment measures has evolved that allow greater sensitivity not only to levels of disability but also to levels of ability. Together, the new models and tools hold promise of providing a more sensitive evaluation of rehabilitation efforts and a more accurate forecasting of future needs.

Activities of Daily Living↗
PubMed1998

Task performance in virtual environments used for cognitive rehabilitation after traumatic brain injury.

OBJECTIVE: This report describes a reliability study using a prototype computer-simulated virtual environment to assess basic daily living skills in a sample of persons with traumatic brain injury (TBI). The benefits of using virtual reality in training for situations where safety is a factor have been established in defense and industry, but have not been demonstrated in rehabilitation. SUBJECTS: Thirty subjects with TBI receiving comprehensive rehabilitation services at a residential facility. METHODS: An immersive virtual kitchen was developed in which a meal preparation task involving multiple steps could be performed. The prototype was tested using subjects who completed the task twice within 7 days. RESULTS: The stability of performance was estimated using intraclass correlation coefficients (ICCs). The ICC value for total performance based on all steps involved in the meal preparation task was .73. When three items with low variance were removed the ICC improved to .81. Little evidence of vestibular optical side-effects was noted in the subjects tested. CONCLUSION: Adequate initial reliability exists to continue development of the environment as an assessment and training prototype for persons with brain injury.

Activities of Daily Living↗
PubMed1998

Competence in scientific inquiry and research.

The survival and expansion of the profession of occupational therapy depends on its ability to respond to continually changing environments. One of the most current and critical factors in this adaptation is the capacity of therapists to achieve competence in scientific inquiry and research. Competence in the role of researcher is necessary because it contributes to the development of the individual therapist, the profession, and the organization within which the therapist functions. The aim of this article is to review and elaborate on the competencies associated with the role of researcher and to propose a reconceptualization of the knowledge, skills, and attitudes that shape competence in scientific inquiry.

Evidence-Based Medicine↗
PubMed1992

Impact of random assignment on study outcome: an empirical examination.

Sixty research investigations published in the biomedical literature were analyzed to examine the effect of design attributes on outcome. All 60 studies included a controlled trial involving a pretest, a therapeutic intervention, and a posttest across at least two groups. Thirty of the trials used random assignment of participants to treatment or control conditions and 30 trials employed some nonrandom method of subject assignment. Trial results were aggregated and evaluated by comparing effect sizes for the primary statistical test of the hypothesis. Data analysis revealed that the trial results, as measured by effect size, did not vary across therapeutic trials using random assignment versus those using nonrandom allocation of subjects. The impact of design attributes in the interpretation of multiple clinical trials addressing a similar research question is examined. The argument is made that various design attributes frequently associated with methodological quality should be considered as important moderator variables and their influence on trial outcome should not be assumed a priori but rather examined empirically.

Data Interpretation, Statistical↗
PubMed1986

Use of applied behavioral techniques and an adaptive device to teach lip closure to severely handicapped children.

The effectiveness of applied behavioral programming in teaching lip closure was investigated with 3 severely retarded male students who had oral motor dysfunction. A multiple-baseline design across subjects was employed. The results revealed dramatic increases in the level of functional lip closure for all 3 students when an appropriate adaptive device was combined with behavioral intervention. Follow-up results indicated that functional lip closure generalized to other feeding tasks. Findings suggest that applied behavioral management may be successfully used to teach specific oral motor skills and facilitate integration of these skills into a normalized feeding pattern.

Adolescent↗
PubMed1985

Efficacy of spinal manipulation/mobilization therapy. A meta-analysis.

A quantitative review (meta-analysis) was undertaken to synthesize existing evidence on the efficacy of joint mobilization and manipulation and expose consumers of rehabilitation research to the methods and procedures of quantitative reviewing. Potentially relevant studies were obtained through a computer-assisted bibliographic search of the Index Medicus data base and through examination of references contained in retrieved studies. A total of 57 titles were potentially relevant to manipulation/mobilization, but only nine met the prespecified criteria for inclusion in the quantitative review. Data analysis indicated that studies not employing random assignment were more likely to produce results supporting the use of manipulation/mobilization therapies. The effects in favor of manipulation and mobilization were greater when manual therapy was provided in conjunction with other forms of treatment and were also greater when the treatment effects were measured immediately following therapy. In addition, hypotheses tests appearing in journals published in the United States showed manipulation/mobilization less effective in comparison with reports appearing in English language journals published outside the United States. The results provided only limited empirical support for spinal mobilization and manipulation when used to treat pain, flexibility limitations, and impairment in physical activity.

Back Pain↗
PubMed1985

Quantitative trends in occupational therapy research: implications for practice and education.

Articles that appeared in The American Journal of Occupational Therapy (vol 27, 1973 and vol 37, 1983) were reviewed and categorized according to the quantitative procedures employed. Data analysis revealed that the proportion of articles reporting no statistical information decreased from 57% in 1973 to 31% in 1983. Conversely, there was a significant increase in articles containing quantitative methods that were categorized as advanced, from 8% (vol 27) to 29% (vol 37). A trend was also revealed toward multiple authorship of articles over the ten-year period. In addition, the senior authors of articles appearing in 1983 were much more likely to possess graduate degrees than were senior authors of articles published in 1973. This paper discusses the implications of the increased use of quantitative procedures in the occupational therapy literature.

Occupational Therapy↗
PubMed1985

Reliability of the Behavioral Assessment Scale of Oral Functions in Feeding.

Interrater and test-retest reliability of the Behavioral Assessment Scale of Oral Functions in Feeding were computed for two separate samples of severely and profoundly handicapped students having oral-motor and feeding disorders. Reliability was assessed using the intraclass correlation-generalizability theory approach and resulted in coefficients ranging from .68 to .84. These values were considered only marginally acceptable by current standards of instrument development advocated in the behavioral sciences. This paper discusses the difficulty in developing psychometrically satisfactory assessment instruments for use with the severely and profoundly developmentally disabled and gives implications for practice and future research.

Adolescent↗
PubMed1984

Human figure drawing ability and vestibular processing dysfunction in learning-disabled children.

Explored the relationship between vestibular function as measured by duration of postrotary nystagmus and human figure drawing ability in 40 children labeled as learning disabled. Regression analysis revealed that the variable of chronological age shared the most variance with human figure drawing scores. Postrotary nystagmus durations also shared a significant amount of variance with human figure drawing scores, while the variables of IQ and sex were nonsignificant. The results provide additional support for the assertion that some learning-disabled children evidence deficits in vestibular processing ability and that these deficits may affect performance on cognitive-perceptual tasks.

Child↗
PubMed1984

Strategies for evaluating clinical change: implications for practice and research.

The methods and procedures of evaluation research using single-system or small-N designs are defined and described. Various components of single-system evaluation research, including specifying the problem, measuring and recording the data, selecting an appropriate design, and analyzing the data, are presented and discussed. The argument is made that single-system evaluation research methods are ideally suited to document clinical change on an individual basis and can provide a mechanism for establishing therapeutic accountability. The relationship between single-system evaluation research and the more traditional experimental procedures is briefly explored, and the implications for establishing an empirically derived basis for clinical practice are discussed.

Clinical Trials as Topic↗
PubMed1984

Effects of vibratory, edible, and social reinforcement on performance of institutionalized mentally retarded individuals.

The relative effectiveness of verbal praise, vibration, and edible reward as methods of enhancing and maintaining performance on a perceptual-motor task was investigated. Sixty-six mentally retarded students were divided into high- and low-MA groups and randomly assigned to reinforcement conditions. Data analysis revealed that response rates for the low-MA students in the verbal condition reinforcement and the nonreinforcement phases were significantly lower than the response rates for the low-MA students in any phase of the edible or vibratory conditions. No significant difference in reinforcer effectiveness was observed across various phases for students in the high-MA groups.

Adolescent↗
PubMed1983

Developmental implications of clinically applied vestibular stimulation.

Recent research has promoted the development of several techniques that use various forms of sensory stimulation to improve the neuromotor development of high-risk infants and developmentally delayed children. One of the newest and most popular adjuncts to therapy for developmentally delayed children is vestibular stimulation. The applied clinical research using vestibular stimulation activities with healthy human infants, infants at risk, and young children with developmental delay disorders is reviewed. The literature discussed indicates that controlled vestibular stimulation has had positive effects on arousal level, visual exploratory behavior, motor development, and reflex integration. Also discussed is the need for continued applied clinical research to further substantiate the most effective type of vestibular stimulation and the population for which such stimulation is most beneficial.

Cerebral Palsy↗
PubMed1983

Vestibular-proprioceptive functions in 4 year olds: normative and regression analyses.

Normative data were obtained for 156 pre-school children's performances on measures of muscle tone, muscle co-contraction, standing balance, prone extension posture, flexion supine posture, asymmetrical tonic neck reflex, and postrotary nystagmus. Regression analysis indicated that these combined variables accounted for only 13.5 percent of the variance of postrotary nystagmus of 145 four year olds. However, if the data are examined only for children exhibiting nystagmus that is lower than 1 standard deviation below the mean, then these variables account for 50 percent of the variance of nystagmus. Prone extension posture, standing balance-eyes closed, and muscle tone account for 37 percent of the variance within this low-nystagmus population. These results are considered in light of the authors' previous studies demonstrating that, in learning-disabled children, vestibular-proprioceptive measures can be used clinically to predict which children will respond to sensory integration therapy with changes in postrotary nystagmus. These changes, according to sensory integration theory, reflect positive responses to therapy.

Child, Preschool↗
PubMed1983

Quantitative reviewing: the literature review as scientific inquiry.

The literature review process is conceptualized as a form of scientific inquiry that involves methodological requirements and inferences similar to those employed in primary research. Five stages of quantitative reviewing that parallel stages in primary investigation are identified and briefly described. They include problem formation, data collection, data evaluation, analysis and interpretation, and reporting the results. The first two stages provide information and guidelines relevant to reviewers' employing traditional narrative procedures or conducting reviews of qualitative research literature. The final three stages relate specifically to the methodology of quantitative reviewing. The argument is made that quantitative reviewing procedures represent a paradigm shift that can assist researchers and clinicians in occupational therapy to establish a scientific data base that will serve to guide theory development and validate clinical practice.

Data Collection↗