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M Dijkers

Publications and source records attributed to M Dijkers.

27 records · Page 2Linked to original sources
PubMedDate not supplied

Characteristics in addition to size of the contralateral hand predict hand volume but are not clinically useful.

Traditionally, therapists who treat hand edema have used the volume of the contralateral hand to estimate normal or pre-injury hand volume. This presupposes that for the average person the difference in volumes between the two hands is so small that it is clinically insignificant. Left and right hand volumes, as well as a number of other hand characteristics, and health history were collected for a sample of 512 persons. Over 15% of the subjects had a measured volume difference of 30 ml or more. The difference in absolute and relative volumes between hands was minimally affected by gender, age, lifestyle, hand dominance, size of the largest hand, health problems, or previous hand injuries. Regression analysis uncovered a number of characteristics, including gender, handedness, and age, that predicted hand volume over and above the contralateral hand, but they boosted the proportion of variance explained only from 0.968 to 0.973, a clinically insignificant increase. It was concluded that the traditional methods of estimating pre-injury volume are still useful.

Adolescent↗
PubMedDate not supplied

Measuring quality of life: methodological issues.

Quality of life is a term used in a number of disciplines, and definitions and conceptualizations vary from utility of health states to life satisfaction and from possession of socially desirable characteristics to positive affect. This article offers a taxonomy of measures of quality of life based on measurement characteristics, which are shown to closely parallel definitions and their underlying assumptions. The fact that basic philosophical issues and ethical assumptions underlie quality of life measurement is stressed. Clinimetric characteristics of quality of life measures (validity, reliability, responsiveness, sensitivity, practicality, face validity, interpretability) are reviewed. This article concludes with a discussion of a number of additional methodological issues, including the following: measurement of change in the quality of life; generic v disease-specific measures; the use of self-reports by persons with mental health or cognitive-communicative problems; and the use of proxy reporters of quality of life.

Activities of Daily Living↗
PubMedDate not supplied

Randomized clinical trials in medical rehabilitation research.

The purpose of this article is to provide researchers and clinicians with a basic understanding of randomized clinical trials and to discuss their potential application to and limitations in the field of physical medicine and rehabilitation. A brief history of the development of randomized clinical trials, definitions of clinical trials, types of trials, and overview of methodological issues related to design are offered. Information is provided about the need to establish clear and concise study objectives and to explicitly define interventions and expected outcomes. Recommendations for developing clinical protocols and determining adequate sample size are presented, and various statistical considerations, including power, are discussed. Issues related to sampling strategies, and recruitment are reviewed. Importance of randomization and blinding is emphasized. Readers are also referred to other resources available on this topic. Finally, the authors describe shortfalls associated with the use of this design in rehabilitation research. These are further explored and discussed in terms of the actual benefits and limitations of randomized clinical trials in physical medicine and rehabilitation research. Recommendations are made regarding the use of this methodology to address relevant needs in clinical practice.

Bias↗
PubMedDate not supplied

Traumatic brain injury registries in the United States: an overview.

In the United States, injuries account for more death and disability in the one to 44 year age group than all communicable diseases and other conditions combined. Concerns about this, about the cost of acute and rehabilitation care after injury, and about quality of life for survivors are mounting, as epitomized by Federal Government initiatives. Public health surveillance of injuries such as traumatic brain injury has recently begun to evolve, following decades of experience with similar methods for infectious and chronic disease conditions. In 1985, the Centers for Disease Control began to promote the development of surveillance systems for 'sentinel injuries' at both the state and national level. Many states have developed, or are in the process of developing, statewide registries for traumatic brain injury. The rationale behind the establishment of these registries is fourfold: 1) to identify injured persons in order to facilitate and coordinate their rehabilitation and other needed services; 2) to gather data for injury prevention and control; 3) to gather data for health care planning; and 4) to evaluate services provided to injured persons. Purpose, content, and scope of these registries are presented in detail.

Brain Injuries↗
PubMedDate not supplied

Use of the Recognition Memory Test in traumatic brain injury: preliminary findings.

The suitability of Warrington's Recognition Memory Test (RMT) for detecting memory impairment after traumatic brain injury was investigated in a pilot study of 36 patients with moderate and severe brain injuries. The patients showed significant memory deficits on both RMT subtests, Words and Faces, with greater impairment on the Faces subtest. No significant gender differences were found. The left hemisphere lesion group obtained the lowest mean score on the Words subtest, and the right hemisphere lesion group had the lowest mean score on the Faces subtest, although these differences did not reach statistical significance. At the 90-94% specificity level the sensitivity of the Faces and Words subtests for the detection of memory impairment after traumatic brain injury was 81% and 63%, respectively. The RMT appears to be a promising instrument for measuring and describing patterns of memory impairment after brain injury.

Adolescent↗
PubMedDate not supplied

The Joint Protection Behavior Assessment: a reliability study.

OBJECTIVE: Of the various measures developed for studying persons with rheumatoid arthritis, only one that focuses on joint protection has undergone extensive testing, the Joint Protection Behavior Assessment (JPBA). The purpose of the present study was to examine the interrater and intrarater reliability of the JPBA. METHOD: Six healthy participants performed the JPBA under three test conditions (uninformed, informed, completely guided joint protection behavior). The 18 test performances were videotaped and scored by nine independent raters. RESULTS: Analysis of these data showed that interrater reliability (intraclass correlation coefficient [ICC]) was .90 or higher, and intrarater reliability was .95 or higher (ICC). The correlation between the JPBA and its two shortened versions was .95 or higher (ICC). Internal consistency was also high, with a coefficient alpha of 0.95 for the complete JPBA. Kappa values showed that for most subtasks, there was fair to excellent agreement between raters and consistency of raters over time. CONCLUSION: Our data suggest that the complete JPBA has excellent clinimetric properties and that the shortened versions are adequate for clinical situations. Some improvements in the test manual suggested by the present study may further improve the measure. A repeat of this study under real-world circumstances would provide an estimate of JPBA reliability in clinical practice.

Activities of Daily Living↗