scholarly journals Examining minimal important change of the Canadian Occupational Performance Measure for subacute rehabilitation hospital inpatients

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Kanta Ohno ◽  
Kounosuke Tomori ◽  
Tatsunori Sawada ◽  
Ryuji Kobayashi
Keyword(s):  
Confidence Interval ◽  
Important Change ◽  
Performance Measure ◽  
Initial Assessment ◽  
Minimal Important Change ◽  
Occupational Performance ◽  
External Criterion ◽  
Canadian Occupational Performance Measure ◽  
Patient Reported ◽  
Transition Index

Abstract Background The Canadian Occupational Performance Measure (COPM) is an individualized patient-reported outcome designed to evaluate the self-perceptions of a patient’s occupational performance. Our study aimed to examine the minimal important change (MIC) in inpatients undergoing subacute rehabilitation. The MIC values were calculated using the three different anchor-based analyses with the transition index as an external criterion; the mean change method (MICMeanChange), the receiver operating characteristic (MICROC) analysis, and the predictive modeling method adjusted for the proportion of improved patients (MICadjust). In this study, the MICadjust value was considered as the most valid statistical method. We recruited 100 inpatients with various health conditions from subacute rehabilitation hospitals. Data were collected twice: an initial assessment and a reassessment one month later. The systematic interview format (Five Ws and How) was used for both the initial and second assessments to prevent information bias (response shift). Results Three patients who indicated deterioration on the transition index were excluded from all analyses, and 97 patients were analyzed in this study. The MICadjust values were 2.20 points (95% confidence interval 1.80–2.59) for the COPM performance score and 2.06 points (95% confidence interval 1.73–2.39) for the COPM satisfaction score. The MICMeanChange and MICROC values were considered less reasonable to interpret because the proportions of the improved patients subgroup were more than 50% (82.5%). Conclusions The MICadjust value estimates from this study can help detect whether the patients’ perceived occupational performance improved or did not change. The results support the multidisciplinary use of COPM in clinical practice and research on subacute rehabilitation inpatients.

scholarly journals Effectiveness of sensor monitoring in a rehabilitation programme for older patients after hip fracture: a three-arm stepped wedge randomised trial

2019 ◽  
Vol 48 (5) ◽  
pp. 650-657 ◽  
Author(s):  
Margriet C Pol ◽  
Gerben ter Riet ◽  
Margo van Hartingsveldt ◽  
Ben Kröse ◽  
Bianca M Buurman
Keyword(s):  
Hip Fracture ◽  
Occupational Therapy ◽  
Older Patients ◽  
Performance Measure ◽  
Daily Functioning ◽  
Occupational Performance ◽  
Canadian Occupational Performance Measure ◽  
Patient Reported ◽  
The Mean ◽  
Sensor Monitoring

AbstractObjectivesto test the effects of an intervention involving sensor monitoring-informed occupational therapy on top of a cognitive behavioural treatment (CBT)-based coaching therapy on daily functioning in older patients after hip fracture.Design, setting and patientsthree-armed randomised stepped wedge trial in six skilled nursing facilities, with assessments at baseline (during admission) and after 1, 4 and 6 months (at home). Eligible participants were hip fracture patients ≥ 65 years old.Interventionspatients received care as usual, CBT-based occupational therapy or CBT-based occupational therapy with sensor monitoring. Interventions comprised a weekly session during institutionalisation, followed by four home visits and four telephone consultations over three months.Main outcomes and measuresthe primary outcome was patient-reported daily functioning at 6 months, assessed with the Canadian Occupational Performance Measure.Resultsa total of 240 patients (mean[SD] age, 83.8[6.9] years were enrolled. At baseline, the mean Canadian Occupational Performance Measure scores (range 1–10) were 2.92 (SE 0.20) and 3.09 (SE 0.21) for the care as usual and CBT-based occupational therapy with sensor monitoring groups, respectively. At six months, these values were 6.42 (SE 0.47) and 7.59 (SE 0.50). The mean patient-reported daily functioning in the CBT-based occupational therapy with sensor monitoring group was larger than that in the care as usual group (difference 1.17 [95% CI (0.47-1.87) P = 0.001]. We found no significant differences in daily functioning between CBT-based occupational therapy and care as usual.Conclusions and relevanceamong older patients recovering from hip fracture, a rehabilitation programme of sensor monitoring-informed occupational therapy was more effective in improving patient-reported daily functioning at six months than to care as usual.Trial registrationDutch National Trial Register, NTR 5716.

scholarly journals Efeitos da Prática baseada em ocupações sobre o desempenho ocupacional e a função motora de sobreviventes de AVE/Effects of occupation-based practice on occupational performance and motor function in survivors of stroke

2021 ◽  
Vol 5 (3) ◽  
pp. 306-319
Author(s):  
Lorena Costa Branco ◽  
Ana Aline Nogueira Da Silva ◽  
Amanda Amorim De Souza ◽  
Albert Patrick Borcem Alho ◽  
Glenda Miranda Da Paixão
Keyword(s):  
Occupational Therapy ◽  
Social Science ◽  
Motor Function ◽  
Rating Scale ◽  
Therapeutic Process ◽  
Performance Measure ◽  
Initial Assessment ◽  
Occupational Performance ◽  
Canadian Occupational Performance Measure ◽  
And Performance

Introdução: O Acidente Vascular Encefálico é uma das causas de maior incapacidade em adultos e o processo de reabilitação em Terapia Ocupacional tem preconizado a prática centrada no cliente e a prática baseada em ocupações, a partir das quais o cliente torna-se ativo na escolha das metas e seu engajamento em ocupações é primordial no processo terapêutico. Objetivo: Verificar os efeitos da reabilitação pautada na prática baseada nas ocupações no desempenho ocupacional e a funcionalidade de sobreviventes de Acidente Vascular Encefálico. Métodos: Participaram do estudo seis indivíduos, submetidos a avaliação inicial e reavaliação a cada dez sessões. Foram utilizadas para coleta de dados a Escala de Avaliação de Fugl-Meyer e a Medida Canadense de Desempenho Ocupacional. Os atendimentos ocorreram duas vezes por semana com duração de 60 minutos nos quais eram realizadas simulações e treinos de atividades que compunham as ocupações dos indivíduos. A análise dos dados foi   realizada com o teste de Friedman por meio do website Social Science Statistics. Resultados: Através das avaliações foram observadas diferenças na satisfação e no desempenho de Autocuidado e Produtividade. Com os resulados da escala de Fugl Meyer, observou-se diferença especialmente na Função Motora. Conclusões: Os resultados reforçam que a reabilitação baseada nas ocupações, podem melhorar o desempenho ocupacional e as habilidades motoras de sobreviventes de Acidente Vascular Encefálico.Palavras-chave: Terapia Ocupacional. Hemiplegia. Acidente Vascular Cerebral. AbstractIntroduction: Stroke is one of the causes of greater disability in adults and the rehabilitation process in Occupational Therapy has advocated the client-centered practice and the practice based on occupations, from which the client becomes active in negotiating goals and their engagement in occupations is essential in the therapeutic process. Objective: To verify the effects of rehabilitation guided by occupation-based practice on occupational performance and functionality of stroke survivors. Method: Six individuals participated in the study, who were submitted to initial assessment and were reassessed in every ten sessions. The Fugl-Meyer Rating Scale and the Canadian Occupational Performance Measure were used for data collection. The interventions took place twice a week, lasting 60 minutes, in which simulations and training of activities that were part of the individuals' occupations were carried out. Data analysis was performed using the Friedman test through the Social Science Statistics website. Results: Through the assessments, differences were observed in the satisfaction and performance of Self-Care and Productivity. With the results of the Fugl Meyer scale, a difference was observed especially in the Motor Function. Conclusion: The results reinforce that occupation-based rehabilitation can improve the occupational performance and motor skills of stroke survivors.Keywords: Occupational Therapy. Hemiplegia. Stroke.  ResumenIntroducción: El accidente cerebrovascular es una de las causas de mayor discapacidad en los adultos y el proceso de rehabilitación en Terapia Ocupacional ha propugnado la práctica centrada en el cliente y la práctica basada en ocupaciones, a partir de la cual el cliente se vuelve activo en la elección de las metas y su participación en las ocupaciones es esencial en el proceso terapéutico. Objetivo: Verificar los efectos de la rehabilitación fundamentada en la práctica basada en las ocupaciones sobre el desempeño ocupacional y la funcionalidad de los supervivientes de accidente cerebrovascular. Método: Seis individuos participaron en el estudio, quienes fueron sometidos a evaluación inicial y reevaluación cada diez sesiones. Para la recopilación de datos se utilizaron la Escala Fugl-Meyer y la Medida canadiense de desempeño ocupacional. Las sesiones se realizaban dos veces por semana, con una duración de 60 minutos, en las que se realizaban simulaciones y entrenamiento de actividades que integraban las ocupaciones de los individuos. El análisis de los datos se realizó mediante la prueba de Friedman a través del sitio web de Estadísticas de Ciencias Sociales. Resultados: Através de las evaluaciones se observaron diferencias en la satisfacción y desempeño del Autocuidado y Productividad. Con los resultados de la escala de Fugl Meyer, se observó una diferencia especialmente en la Función Motora. Conclusión: Los resultados refuerzan que la rehabilitación basada en la ocupación puede mejorar el desempeño ocupacional y las habilidades motoras de los sobrevivientes de accidente cerebrovascular.Palabras clave: Terapia Ocupacional. Hemiplejia.  Accidente Cerebrovascular. 

A gaming system with haptic feedback to improve upper extremity function: A prospective case series

2021 ◽  
pp. 1-12
Author(s):  
Hamilton Hernandez ◽  
Isabelle Poitras ◽  
Linda Fay ◽  
Ajmal Khan ◽  
Jean-Sébastien Roy ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Haptic Feedback ◽  
Low Cost ◽  
Case Series ◽  
Performance Measure ◽  
Occupational Performance ◽  
Canadian Occupational Performance Measure ◽  
Prospective Case Series ◽  
Paediatric Rehabilitation ◽  
Therapeutic Settings

BACKGROUND: Video games can be used to motivate repetitive movements in paediatric rehabilitation. Most upper limb videogaming therapies do not however include haptic feedback which can limit their impact. OBJECTIVE: To explore the effectiveness of interactive computer play with haptic feedback for improving arm function in children with cerebral palsy (CP). METHODS: Eleven children with hemiplegic CP attended 12 therapist-guided sessions in which they used a gaming station composed of the Novint Falcon, custom-built handles, physical supports for the child’s arm, games, and an application to manage and calibrate therapeutic settings. Outcome measures included Quality of Upper Extremity Skills Test (QUEST) and Canadian Occupational Performance Measure (COPM). The study protocol is registered on clinicaltrials.gov (NCT04298411). RESULTS: Participants completed a mean of 3858 wrist extensions and 6665 elbow/shoulder movements during the therapist-guided sessions. Clinically important improvements were observed on the dissociated and grasp dimensions on the QUEST and the performance and satisfaction scales of the COPM (all p< 0.05). CONCLUSION: This study suggests that computer play with haptic feedback could be a useful and playful option to help improve the hand/arm capacities of children with CP and warrants further study. The opportunities and challenges of using low-cost, mainstream gaming software and hardware for therapeutic applications are discussed.

Cognitive orientation to daily occupation group in the adult day rehabilitation setting: A feasibility study Cognitive Orientation to daily Occupational Performance in day rehabilitation

2021 ◽  
pp. 030802262110087
Author(s):  
Sarah M Zera ◽  
Kathy Preissner ◽  
Heidi Fischer ◽  
Ashley Stoffel
Keyword(s):  
Feasibility Study ◽  
Performance Measure ◽  
Group Model ◽  
Occupational Performance ◽  
Subjective Data ◽  
Group Format ◽  
Cognitive Orientation ◽  
Canadian Occupational Performance Measure ◽  
Occupation Group ◽  
Daily Occupation

Introduction The Cognitive Orientation to daily Occupational Performance (CO-OP) ApproachTM is a leading approach in occupational therapy. Implementing the CO-OP ApproachTM in a group format in day rehabilitation has not yet been explored. Method In day rehabilitation, a barrier to implementing the CO-OP ApproachTM is the group model. To address these challenges, this feasibility study involved the development, implementation, and evaluation of a CO-OP group for adults. Four patients participated in six group sessions. Pre- and post-measures included the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS). Subjective data were collected to reflect the participant’s experiences during the group. Results 80% of participants recruited completed the group. All participants demonstrated improvement in goals addressed within the group and goals not addressed within the group on the COPM. AMPS findings were inconclusive. Subjective findings indicated participants appreciated the group learning environment, valued the CO-OP process, were motivated to participate, and would have liked more groups. Conclusion To our knowledge, this is the first adult CO-OP group in a clinical setting. Results support the feasibility of a CO-OP group in day rehabilitation and the need for further examination of the effectiveness of this intervention.

scholarly journals Effectiveness of Home-Based Occupational Therapy on COPM Performance and Satisfaction Scores in Patients with COPD

2020 ◽  
pp. 000841742097112
Author(s):  
Eleonore H. Koolen ◽  
Martijn A. Spruit ◽  
Marianne de Man ◽  
Jeanine C. Antons ◽  
Elieke Nijhuis ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Integrated Management ◽  
Performance Measure ◽  
Occupational Performance ◽  
Post Intervention ◽  
Canadian Occupational Performance Measure ◽  
Home Based ◽  
Copd Patients ◽  
The Mean ◽  
Mean Differences

Background. Occupational therapy (OT) may be an important intervention in patients with COPD, but studies show conflicting results. Purpose. To evaluate the effectiveness of home-based monodisciplinary OT in COPD patients Method. We conducted an observational clinical study. Main outcomes were the mean differences in the Canadian Occupational Performance Measure (COPM) performance and satisfaction scores, pre and post intervention. Findings. Pre- and postintervention data were obtained from 41 patients. Statistically significant increases were observed in COPM performance (5.0 ± 1.1 versus 6.9 ± 0.9; P<0.001) and satisfaction (4.6 ± 1.3 versus 6.9 ± 1.0; P<0.001). The most frequently reported occupational performance problems were found in the domains of productivity (47%) and mobility (40%), fewer in self-care (10%) and the least in leisure (3%). Implications. Home-based monodisciplinary OT can contribute significantly to the improvement of daily functioning of patients with COPD. OT should therefore be considered more often as part of the integrated management of these patients.

scholarly journals Assessing baseline dependency of anchor-based minimal important change (MIC): don’t stratify on the baseline score!

2021 ◽  
Author(s):  
Berend Terluin ◽  
Ewa M. Roos ◽  
Caroline B. Terwee ◽  
Jonas B. Thorlund ◽  
Lina H. Ingelsrud
Keyword(s):  
Real Data ◽  
Patient Reported Outcome ◽  
Health Condition ◽  
Important Change ◽  
Alternative Methods ◽  
Minimal Important Change ◽  
Baseline Score ◽  
Patient Reported ◽  
Before And After ◽  
Parallel Tests

Abstract Purpose The minimal important change (MIC) of a patient-reported outcome measure (PROM) is often suspected to be baseline dependent, typically in the sense that patients who are in a poorer baseline health condition need greater improvement to qualify as minimally important. Testing MIC baseline dependency is commonly performed by creating two or more subgroups, stratified on the baseline PROM score. This study’s purpose was to show that this practice produces biased subgroup MIC estimates resulting in spurious MIC baseline dependency, and to develop alternative methods to evaluate MIC baseline dependency. Methods Datasets with PROM baseline and follow-up scores and transition ratings were simulated with and without MIC baseline dependency. Mean change MICs, ROC-based MICs, predictive MICs, and adjusted MICs were estimated before and after stratification on the baseline score. Three alternative methods were developed and evaluated. The methods were applied in a real data example for illustration. Results Baseline stratification resulted in biased subgroup MIC estimates and the false impression of MIC baseline dependency, due to redistribution of measurement error. Two of the alternative methods require a second baseline measurement with the same PROM or another correlated PROM. The third method involves the construction of two parallel tests based on splitting the PROM’s item set. Two methods could be applied to the real data. Conclusion MIC baseline dependency should not be tested in subgroups based on stratification on the baseline PROM score. Instead, one or more of the suggested alternative methods should be used.

scholarly journals Evaluation of performance and personal satisfaction of the patient with spastic hand after using a volar dorsal orthosis

2010 ◽  
Vol 68 (3) ◽  
pp. 385-389 ◽  
Author(s):  
Danielle dos Santos Cutrim Garros ◽  
Rubens José Gagliardi ◽  
Regina Aparecida Rossetto Guzzo
Keyword(s):  
Patient Satisfaction ◽  
Functional Performance ◽  
Leisure Activities ◽  
Performance Measure ◽  
Personal Satisfaction ◽  
Occupational Performance ◽  
Daily Life Activities ◽  
Evaluation Of Performance ◽  
Productive Activities ◽  
Canadian Occupational Performance Measure

The performance and the satisfaction of the patient were quantitatively compared with the use of the volar dorsal orthosis in order to position the spastic hand. Thirty patients wearing the orthosis for eight hours daily were evaluated by the Canadian Occupational Performance Measure and the box and blocks test, for a three-month period. Five activities were selected (among daily life activities, productive activities, and leisure activities) by the patients, which were impaired by spasticity. There was an improvement related to performance after use of orthosis, with an average of 1.4±0.5 to 6.3±0.8 (p<0.01). Patient satisfaction average after wearing the orthosis was of 1.7±0.4 to 6.3±0.6 (p<0.01). In this casuistic, the use of orthosis for wrist and finger spasticity has shown an improvement in the functional performance and patient satisfaction.

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