scholarly journals Performance-based outcome measures are associated with cadence variability during community ambulation among individuals with a transtibial amputation

2020 ◽  
Vol 44 (4) ◽  
pp. 215-224
Author(s):  
Emma Haldane Beisheim ◽  
Elisa Sarah Arch ◽  
John Robert Horne ◽  
Jaclyn Megan Sions
Keyword(s):  
Physical Performance ◽  
Outcome Measures ◽  
Gait Speed ◽  
The United States ◽  
Clinical Settings ◽  
Walk Test ◽  
Community Based ◽  
Transtibial Amputation ◽  
Community Ambulation ◽  
10 Meter Walk Test

Background: In the United States, Medicare Functional Classification Level (K-level) guidelines require demonstration of cadence variability to justify higher-level prosthetic componentry prescription; however, clinical assessment of cadence variability is subjective. Currently, no clinical outcome measures are associated with cadence variability during community ambulation. Objectives: Evaluate whether physical performance, i.e. 10-meter Walk Test (10mWT)-based walking speeds, L-Test, and Figure-of-8 Walk Test scores, is associated with community-based cadence variability among individuals with a transtibial amputation. Study design: Cross-sectional. Methods: Forty-nine participants, aged 18–85 years, with a unilateral transtibial amputation were included. Linear regression models were conducted to determine whether physical performance was associated with cadence variability (a unitless calculation from FitBit® OneTM minute-by-minute step counts), while controlling for sex, age, and time since amputation ( p ⩽ .013). Results: Beyond covariates, self-selected gait speed explained the greatest amount of variance in cadence variability (19.2%, p < .001). Other outcome measures explained smaller, but significant, amounts of the variance (11.1–17.1%, p = .001–.008). For each 0.1 m/s-increase in self-selected and fast gait speeds, or each 1-s decrease in L-Test and F8WT time, community-based cadence variability increased by 1.76, 1.07, 0.39, and 0.79, respectively ( p < .013). Conclusions: In clinical settings, faster self-selected gait speed best predicted increased cadence variability during community ambulation. Clinical relevance The 10-meter Walk Test may be prioritized during prosthetic evaluations to provide objective self-selected walking speed data, which informs the assessment of cadence variability potential outside of clinical settings.

scholarly journals Evaluation of Gait Speed after Applying Kinesio Tape on Quadriceps Femoris Muscle in Patients with Knee Osteoarthritis

2018 ◽  
Vol 6 (8) ◽  
pp. 1394-1398 ◽  
Author(s):  
Klejda Tani ◽  
Irena Kola ◽  
Vjollca Shpata ◽  
Fregen Dhamaj
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Diagnosis ◽  
Gait Speed ◽  
Quadriceps Femoris ◽  
Walk Test ◽  
Kinesio Tape ◽  
Quadriceps Femoris Muscle ◽  
Increased Risk ◽  
Femoris Muscle ◽  
10 Meter Walk Test

BACKGROUND: Knee osteoarthritis is a chronic degenerative disease, known as the most common cause of difficulty walking in older adults and subsequently is associated with slow walking. Functional decline, increased risk of falls and the presence of pain are, in many studies, related to the muscle weakness caused by osteoarthritis especially weakness of the quadriceps muscles. Many studies have shown that the strength of the quadriceps femoris muscle can affect gait, by improving or weakening it. Kinesio Tape is a physiotherapeutic technique, which reduces pain and increases muscular strength by irritating the skin receptors.AIM: This study aimed to verify if the application of Kinesio Tape on quadriceps femoris muscle increases gait speed while decreasing the time needed to accomplish the 10-meter walk test in patients with knee osteoarthritis and also in subjects without knee osteoarthritis.METHOD: In this study, we observed the change of gait speed with the help of the 10-meter walk test before, one day and three days after the application of Kinesio Tape in quadriceps femoris muscle. We compared the results of the time needed to perform the 10-meter walk in two groups. In the first group, the Patients group, participated 102 out-patients with a clinical diagnosis of primary knee osteoarthritis, while in the second group, the Control group, participated 73 subjects with a main excluding criterion a clinical diagnosis of primary knee osteoarthritis.RESULTS: Our results indicated that there was a significant decrease of time needed to perform the 10-meter walk test in both groups three days after application of Kinesio Tape on quadriceps femoris muscle. However, there was not a significant change one day after the application of Kinesio Tape compared before its application in both groups.CONCLUSIONS: Our results indicated that there was a significant decrease in time needed to accomplish the 10-meter walk test. Kinesio Tape is a technique that can be used especially when changing walking stereotypes is a long-term goal of the treatment.

scholarly journals Proposing Development and Utility of a Mobility Composite Measure in Patients with a Neurologic Disorder

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Chad Swank ◽  
Sattam Almutairi ◽  
Ann Medley
Keyword(s):  
Outcome Measures ◽  
Walk Test ◽  
Composite Measure ◽  
Balance Confidence ◽  
Sit To Stand ◽  
Neurologic Disorders ◽  
The Individual ◽  
Abc Scale ◽  
A Prospective Study ◽  
10 Meter Walk Test

Background. Outcome measures typically assess single domains making holistic assessment difficult. Our purpose was to develop a mobility composite measure (MCM) based on four commonly used outcome measures and compare this composite score to the individual measures in patients with neurologic disorders.Methods. We retrospectively reviewed 148 medical records for inclusion of primary neurologic diagnosis and scoring for 5 times sit-to-stand test (5TSST), 10-meter walk test (10MWT), 2-minute walk test (2MWT), and activities-specific balance confidence (ABC) scale.Results. After establishing that a single concept was being assessed with interitem correlations, raw scores were converted to percentage of normal and combined into the MCM for analysis from admission to discharge. Scores on each measure significantly improved after intervention (5TSST,p<.001; 10MWT,p<.001; 2MWT,p<.001; ABC,p=.02). Mean MCM (n=93) admission scores were67.55±31.88% and discharge scores were74.81±34.39% (p=.002). On average, patients improved 7.26% on the MCM exceeding the threshold of expected error (MDC95= 3.59%).Conclusions. MCM detected change in patient outcomes statistically and clinically and appears to capture a holistic picture of functional status. We recommend a prospective study to further investigate a “composite measure” incorporating measures from several functional domains.

scholarly journals Reliability and Minimal Detectable Change of Physical Performance Measures in Individuals With Pre-manifest and Manifest Huntington Disease

2013 ◽  
Vol 93 (7) ◽  
pp. 942-956 ◽  
Author(s):  
Lori Quinn ◽  
Hanan Khalil ◽  
Helen Dawes ◽  
Nora E. Fritz ◽  
Deb Kegelmeyer ◽  
...  
Keyword(s):  
Physical Performance ◽  
Outcome Measures ◽  
Physical Functioning ◽  
Huntington Disease ◽  
Step Test ◽  
Minimal Detectable Change ◽  
Walk Test ◽  
Detectable Change ◽  
Retest Reliability ◽  
Test Retest Reliability

BackgroundClinical intervention trials in people with Huntington disease (HD) have been limited by a lack of reliable and appropriate outcome measures.ObjectiveThe purpose of this study was to determine the reliability and minimal detectable change (MDC) of various outcome measures that are potentially suitable for evaluating physical functioning in individuals with HD.DesignThis was a multicenter, prospective, observational study.MethodsParticipants with pre-manifest and manifest HD (early, middle, and late stages) were recruited from 8 international sites to complete a battery of physical performance and functional measures at 2 assessments, separated by 1 week. Test-retest reliability (using intraclass correlation coefficients) and MDC values were calculated for all measures.ResultsSeventy-five individuals with HD (mean age=52.12 years, SD=11.82) participated in the study. Test-retest reliability was very high (&gt;.90) for participants with manifest HD for the Six-Minute Walk Test (6MWT), 10-Meter Walk Test, Timed “Up & Go” Test (TUG), Berg Balance Scale (BBS), Physical Performance Test (PPT), Barthel Index, Rivermead Mobility Index, and Tinetti Mobility Test (TMT). Many MDC values suggested a relatively high degree of inherent variability, particularly in the middle stage of HD. Minimum detectable change values for participants with manifest HD that were relatively low across disease stages were found for the BBS (5), PPT (5), and TUG (2.98). For individuals with pre-manifest HD (n=11), the 6MWT and Four Square Step Test had high reliability and low MDC values.LimitationsThe sample size for the pre-manifest HD group was small.ConclusionsThe BBS, PPT, and TUG appear most appropriate for clinical trials aimed at improving physical functioning in people with manifest HD. Further research in people with pre-manifest HD is necessary.

Results of Forensic Assertive Community Treatment in Belgium After 33 Months

2016 ◽  
Vol 33 (S1) ◽  
pp. S460-S461
Author(s):  
T. Marquant ◽  
K. Goethals
Keyword(s):  
United States ◽  
Outcome Measures ◽  
Assertive Community Treatment ◽  
Psychiatric Hospitals ◽  
The United States ◽  
Community Treatment ◽  
Mentally Ill Offenders ◽  
Control Group ◽  
Community Based ◽  
Community Tenure

IntroductionForensic adaptations of assertive community treatment (ACT) remain understudied in Europe, whereas promising results emerge from the United States. There is a need for research into the effectiveness of ForACT outside the United States, as Europe differs greatly in terms of organisation of mental health and judicial system.ObjectiveInvestigating effectiveness of forensic adaptations of ACT in the area of Flanders, Belgium. Outcome measures are divided into forensic, like arrests or incarcerations, and non-forensic, like admissions and length of stay.AimsInvestigating effectiveness of ForACT on forensic and non-forensic outcome measures as well as factors related to outcome. A third outcome is community tenure, which is the actual number of days divided by the potential number of days spent in the community.MethodsA controlled cohort study was designed over with first results at 33 months. The experimental group consists of a new ForACT team in the area of Flanders, Belgium (n = 70). Patients are admitted from prison, psychiatric hospitals or other community-based care. The control group consists of mentally ill offenders in community-based treatment after release from prison (n = 56).ResultsResults on forensic measures and community tenure are promising in favour of the ForACT team. In contrast, clients are often, though shortly, readmitted into psychiatric residential care. Substance use emerges as the main reason for admissions.ConclusionsA local forensic adaptation of ACT reveals promising results on forensic outcome measures, yet suffers a large number of admissions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Avaliação do Tempo Atribuído à Travessia de Peões: Contributo para uma Lisboa Mais Inclusiva

2020 ◽  
Vol 33 (6) ◽  
pp. 401
Author(s):  
Sílvia Boaventura ◽  
Jorge Rodrigues ◽  
Teresa Plancha ◽  
Mariana Martins ◽  
Marta Silva ◽  
...  
Keyword(s):  
Public Transport ◽  
Gait Speed ◽  
Walk Test ◽  
Physical Medicine ◽  
Portuguese Population ◽  
Balance Confidence ◽  
The Disabled ◽  
Pedestrian Crossing ◽  
10 Meter Walk Test ◽  
Confidence Scale

Introduction: With progressive ageing of the Portuguese population, it is paramount that the conditions of outdoor accessibility and safety are adapted to this age group. The aim of this study was to assess whether the time allocated to pedestrian crossing in the crosswalks with pedestrian crossing lights between Curry Cabral Hospital and local public transport is enough to allow safe passage of the elderly.Material and Methods: We evaluated 100 ambulatory care patients from the Physical Medicine and Rehabilitation department. All of them answered a questionnaire, the Activities-Specific Balance Confidence Scale (Portuguese version) and performed a 10-meter walk test. All crosswalks with pedestrian crossing lights between the hospital and local public transport were analyzed, in a total of 26, and the gait speed required to perform a safe crossing was calculated.Results: Mean age of patients was 75 years and the majority (73%) were female. The study showed that all patients could safely cross 17 (65%) crosswalks. The nine remaining crosswalks (35%) represented an obstacle to our sample.Discussion: If the required gait speed as currently set in legislation for the disabled was implemented, 99% of the patients would have been able to cross the crosswalks safely.Conclusion: It is essential to apply the gait speed set in legislation, since non-compliance endangers elderly patients in Curry Cabral Hospital, increasing the likelihood of accidents and the feeling of insecurity on the streets.

scholarly journals Use of Standardized Outcome Measures in Physical Therapist Practice: Perceptions and Applications

2009 ◽  
Vol 89 (2) ◽  
pp. 125-135 ◽  
Author(s):  
Diane U Jette ◽  
James Halbert ◽  
Courtney Iverson ◽  
Erin Miceli ◽  
Palak Shah
Keyword(s):  
Outcome Measures ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Management Strategies ◽  
The United States ◽  
Clinical Settings ◽  
Rehabilitation Professionals ◽  
Participation Restrictions ◽  
Specialty Certification ◽  
American Physical

Background Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. Objective The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. Design The study used an observational design. Methods A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Results Forty-eight percent of participants used standardized outcome measures. The majority of participants (&gt;90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. Limitations The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Conclusions Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.

scholarly journals Enhancement of a prosthetic knee with a microprocessor-controlled gait phase switch reduces falls and improves balance confidence and gait speed in community ambulators with unilateral transfemoral amputation

2017 ◽  
Vol 42 (2) ◽  
pp. 228-235 ◽  
Author(s):  
Sara Agueda Fuenzalida Squella ◽  
Andreas Kannenberg ◽  
Ângelo Brandão Benetti
Keyword(s):  
Outcome Measures ◽  
Gait Speed ◽  
Standard Of Care ◽  
Walking Distance ◽  
Walk Test ◽  
Transfemoral Amputation ◽  
Prosthetic Knee ◽  
Balance Confidence ◽  
Highly Active ◽  
Prosthetic Knees

Background:Despite the evidence for improved safety and function of microprocessor stance and swing-controlled prosthetic knees, non-microprocessor-controlled prosthetic knees are still standard of care for persons with transfemoral amputations in most countries. Limited feature microprocessor-control enhancement of such knees could stand to significantly improve patient outcomes.Objectives:To evaluate gait speed, balance, and fall reduction benefits of the new 3E80 default stance hydraulic knee compared to standard non-microprocessor-controlled prosthetic knees.Study design:Comparative within-subject clinical study.Methods:A total of 13 young, high-functioning community ambulators with a transfemoral amputation underwent assessment of performance-based (e.g. 2-min walk test, timed ramp/stair tests) and self-reported (e.g. falls, Activities-Specific Balance Confidence scale, Prosthesis Evaluation Questionnaire question #1, Satisfaction with the Prosthesis) outcome measures for their non-microprocessor-controlled prosthetic knees and again after 8 weeks of accommodation to the 3E80 microprocessor–enhanced knee.Results:Self-reported falls significantly declined 77% ( p = .04), Activities-Specific Balance Confidence scores improved 12 points ( p = .005), 2-min walk test walking distance increased 20 m on level ( p = .01) and uneven ( p = .045) terrain, and patient satisfaction significantly improved ( p < .01) when using the 3E80 knee. Slope and stair ambulation performance did not differ between knee conditions.Conclusion:The 3E80 knee reduced self-reported fall incidents and improved balance confidence. Walking performance on both level and uneven terrains also improved compared to non-microprocessor-controlled prosthetic knees. Subjects’ satisfaction was significantly higher than with their previous non-microprocessor-controlled prosthetic knees. The 3E80 may be considered a prosthetic option for improving gait performance, balance confidence, and safety in highly active amputees.Clinical relevanceThis study compared performance-based and self-reported outcome measures when using non-microprocessor and a new microprocessor-enhanced, default stance rotary hydraulic knee. The results inform rehabilitation professionals about the functional benefits of a limited-feature, microprocessor-enhanced hydraulic prosthetic knee over standard non-microprocessor-controlled prosthetic knees.

scholarly journals A INFLUÊNCIA DA REALIDADE VIRTUAL SOBRE A VELOCIDADE DA MARCHA E AVALIAÇÃO DA SATISFAÇÃO DE INDIVÍDUOS COM DOENÇA DE PARKINSON

2020 ◽  
Vol 12 (3) ◽  
pp. 01-09
Author(s):  
Mariana da Cruz Souza ◽  
Paola Larissa de Araujo Biazini ◽  
Débora Toshimi Furuta ◽  
Alice Haniuda Moliterno ◽  
Nicoly Ribeiro Uliam ◽  
...  
Keyword(s):  
Mental Health ◽  
Experimental Study ◽  
Virtual Reality ◽  
Gait Speed ◽  
Initial Assessment ◽  
Walk Test ◽  
Patients Satisfaction ◽  
Promising Tool ◽  
Significant Difference ◽  
10 Meter Walk Test

Virtual Reality (VR) is a promising tool used in the rehabilitation of individuals with Parkinson's Disease(PD) as it promotes motor learning through multisensory feedback in real time. This is an experimental study with a single arm whose objective was to analyze the influence of VR on gait speed and satisfaction assessment of individuals with PD. In the initial assessment (IA1) a 10-Meter Walk Test (10MWT) was applied, followed by the protocol of 10 sessions with VR using Nintendo WiiTM console. In the final evaluation (FE2), the 10MWT was reapplied, followed by the Abbreviated Patients’ Satisfaction with Mental Health Services Scale (SATIS-BR). The 10MWT showed 0.91 ± 0.20 in IA1 and 1 ± 0.22 in FE2 with no significant difference (p= 0.187) while SATIS-BR scored 4.8 ± 0.22 out of 5. It is concluded that despite the non-significant result, the gait speed was maintained, exposing expressive values of the participants' satisfaction.

Hiring Practices of Exercise Physiologist in Cardiac Rehabilitation Programs among Mid-Atlantic States in the United States

2016 ◽  
Vol 5 (3) ◽  
pp. 32-36 ◽  
Author(s):  
Allison Hope Bowersock ◽  
William Alexander Breeding ◽  
Carmel Alexander Sheppard
Keyword(s):  
United States ◽  
Patient Education ◽  
Cardiac Rehabilitation ◽  
Science Curriculum ◽  
Exercise Physiology ◽  
Clinical Skill ◽  
The United States ◽  
Hiring Practices ◽  
Clinical Settings ◽  
Rehabilitation Programs

Purpose: The purpose of this survey was to identify factors that may be influencing the appreciation of exercise physiology as a discipline as demonstrated by hiring practices in regional clinical settings. Methods: A telephone survey was administered to 33 cardiac rehabilitation programs in 5 states in the Mid-Atlantic region of the United States (Kentucky, North Carolina, Tennessee, Virginia, and West Virginia). Results: The distribution of nurses and exercise physiologists (EPs) employed by the 33 facilities varied by state, but overall there were 86 nurses and 55 EPs working among the surveyed facilities. Of the 33 surveyed facilities, 12 (36%) reported a preference for hiring nurses over EPs; only 4 (12%) reported a preference for hiring EPs over nurses. The remaining facilities (n = 17; 52%) reported no preference (n = 12; 36%) or that the decision depends on a variety of factors (n = 5; 15%). Several common themes were identified from respondents. These included that, compared to nurses, EPs have greater expertise in exercise prescription and better understanding of safe exercise progression for patients. However, nurses were believed to possess greater assessment and clinical skill with an emphasis on emergency response preparedness and greater general patient education skills. Conclusion: Academic programs that prepare students for careers as EPs employed in clinical settings may benefit from additional coursework and internship site selection that focus on clinical assessment skills, emergency preparedness, and patient education to reinforce their work in an exercise science curriculum.

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