scholarly journals Responsiveness and Minimal Clinically Important Difference of the Five Times Sit-to-Stand Test in Patients with Stroke

2021 ◽  
Vol 18 (5) ◽  
pp. 2314
Author(s):  
Rodrigo Martín-San Agustín ◽  
Mª José Crisostomo ◽  
Mª Piedad Sánchez-Martínez ◽  
Francesc Medina-Mirapeix
Keyword(s):  
Gait Speed ◽  
Global Rating ◽  
External Criterion ◽  
Functional Changes ◽  
Sit To Stand ◽  
Clinically Important Difference ◽  
Stage 1 ◽  
Two Stages ◽  
Degree Of Severity ◽  
Responsiveness To Change

This study aimed to analyze the responsiveness of the 5STS test among stroke patients and to estimate the MCIDs (minimal clinically important differences) for different severity levels of community ambulation and stages of recovery. The 5STS and comparator instruments (gait speed and Functional Ambulatory Category (FAC)) were evaluated at baseline. These measures were repeated at 4 (Stage 1) and 8 weeks (Stage 2), together with the Global Rating of Change (GROC). The MCIDs were calculated with two anchor-based methods using the GROC as the external criterion. Responsiveness to change for the 5STS was estimated analyzing the correlation with changes in the two comparator instruments and their capacity to discriminate improvement. For the 5STS test, while the MCIDs of the limited community ambulators were similar in the two stages (around 3 s), those of the household ambulators decreased from 1.9 s to 0.72 s. Spearman’s rho coefficients showed an acceptable correlation between changes in 5STS and changes for both the FAC and gait speed changes in both stages of recovery. Our study revealed that the 5STS is responsive to functional changes in patients with stroke and that their degree of severity and stage of recovery influence the MCID values of the 5STS.

scholarly journals Responsiveness and Minimal Clinically Important Difference of the Five Times Sit-To-Stand Test in Patients with Stroke

2021 ◽  
Author(s):  
Rodrigo Martín San Agustín ◽  
Mª José Crisostomo ◽  
Mª Piedad Sánchez-Martínez ◽  
Francesc Medina-Mirapeix
Keyword(s):  
Gait Speed ◽  
Global Rating ◽  
External Criterion ◽  
Functional Changes ◽  
Sit To Stand ◽  
Clinically Important Difference ◽  
Stage 1 ◽  
Two Stages ◽  
Degree Of Severity ◽  
Responsiveness To Change

This study aimed to analyze the responsiveness of the 5STS test among stroke patients and to estimate the MCIDs for different severity levels of community ambulation and stages of recovery. The 5STS and comparator instruments [gait speed and Functional Ambulatory Category (FAC)] were evaluated at baseline. These measures were repeated at 4 (Stage 1) and 8 weeks (Stage 2), together with the Global Rating of Change (GROC). The MCIDs were calculated with two anchor-based methods using the GROC as the external criterion. Responsiveness to change for the 5STS was estimated analyzing the correlation with changes in the two comparator instruments and their capacity to discriminate improvement. For the 5STS test, while the MCIDs of the limited community ambulators were similar in the two stages (around 3 s), those of the household ambulators decreased from 1.9 s to 0.72 s. Spearman's rho coefficients showed an acceptable correlation between changes in 5STS and changes for both the FAC and gait speed changes in both stages of recovery. Our study revealed that the 5STS is responsive to functional changes in patients with stroke and that their degree of severity and stage of recovery influence the MCID values of the 5STS.

scholarly journals A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke

2021 ◽  
pp. 026921552110251
Author(s):  
Marla K Beauchamp ◽  
Rudy Niebuhr ◽  
Patricia Roche ◽  
Renata Kirkwood ◽  
Kathryn M Sibley
Keyword(s):  
Stroke Rehabilitation ◽  
Minimal Clinically Important Difference ◽  
Clinical Importance ◽  
Minimal Detectable Change ◽  
Global Rating ◽  
Detectable Change ◽  
Clinically Important Difference ◽  
Before And After ◽  
Small Change ◽  
A Prospective Study

Objective: To determine the minimal clinically important difference of the Mini-BESTest in individuals’ post-stroke. Design: Prospective cohort study. Setting: Outpatient stroke rehabilitation. Subjects: Fifty outpatients with stroke with a mean (SD) age of 60.8 (9.4). Intervention: Outpatients with stroke were assessed with the Mini-BESTest before and after a course of conventional rehabilitation. Rehabilitation sessions occurred one to two times/week for one hour and treatment duration was 1.3–42 weeks (mean (SD) = 17.4(10.6)). Main measures: We used a combination of anchor- and distribution-based approaches including a global rating of change in balance scale completed by physiotherapists and patients, the minimal detectable change with 95% confidence, and the optimal cut-point from receiver operating characteristic curves. Results: The average (SD) Mini-BESTest score at admission was 18.2 (6.5) and 22.4 (5.2) at discharge (effect size: 0.7) ( P = 0.001). Mean change scores on the Mini-BESTest for patient and physiotherapist ratings of small change were 4.2 and 4.3 points, and 4.7 and 5.3 points for substantial change, respectively. The minimal detectable change with 95% confidence for the Mini-BESTest was 3.2 points. The minimally clinical importance difference was determined to be 4 points for detecting small changes and 5 points for detecting substantial changes. Conclusions: A change of 4–5 points on the Mini-BEST is required to be perceptible to clinicians and patients, and beyond measurement error. These values can be used to interpret changes in balance in stroke rehabilitation research and practice.

scholarly journals Effect of 2CaO·SiO2 particles addition on dephosphorization behavior

2020 ◽  
Vol 39 (1) ◽  
pp. 219-227
Author(s):  
Aijun Deng ◽  
Yunjin Xia ◽  
Jie Li ◽  
Dingdong Fan
Keyword(s):  
Liquid Slag ◽  
Solid Phase ◽  
Solid Particles ◽  
Hot Metal ◽  
Liquid Silicate ◽  
Phase Complex ◽  
Dephosphorization Slag ◽  
Stage 1 ◽  
Two Stages ◽  
Complex Liquid

AbstractThe effect of the addition of 2CaO·SiO2 solid particles on dephosphorization behavior in carbon-saturated hot metal was investigated. The research results showed that the addition of 2CaO·SiO2 particles have little influence on desilication and demanganization, and the removal of [Si] and [Mn] occurred in the first 5 min with different conditions where the contents of 2CaO·SiO2 particles addition for the conditions 1, 2, 3, 4, and 5 are 0, 2.2, 6.4, 8.6, and 13.0 g, respectively. The final dephosphorization ratios for the conditions 1, 2, 3, 4, and 5 are 61.2%, 66.9%, 79.6%, 63.0%, and 78.1%, respectively. The dephosphorization ratio decreases with the increase of 2CaO·SiO2 particles in the first 3 min. The reason for this is that the dephosphorization process between hot metal and slag containing C2S phase consisted of two stages: Stage 1, [P] transfers from hot metal to liquid slag and Stage 2, the dephosphorization production (3CaO·P2O5) in liquid slag reacts with 2CaO·SiO2 to form C2S–C3P solid solution. The increase of 2CaO·SiO2 particles increases the viscosity of slag and weakens the dephosphorization ability of the stage 1. The SEM and XRD analyses show that the phase of dephosphorization slag with the addition of different 2CaO·SiO2 particles is composed of white RO phase, complex liquid silicate phase, and black solid phase (C2S or C2S–C3P). Because the contents of C2S–C3P and 2CaO·SiO2 in slag and the dephosphorization ability of the two stages are different, the dephosphorization ability with different conditions is different.

scholarly journals Archaeological studies In theIlmeny state reserve, South Urals

2020 ◽  
pp. 112-122
Author(s):  
V.S. Mosin
Keyword(s):  
Bronze Age ◽  
Iron Age ◽  
Early Iron Age ◽  
South Urals ◽  
Stone Age ◽  
Stage 1 ◽  
Two Stages

The paper describes two stages of archeological studies at the territory of the Ilmeny State Reserve. Stage 1 is related to expedition of L.Ya. Krizhevskaya in 1961–1970, which resulted in fn-ding of more than 40 settlements and sites of the Stone Age, Bronze Age and Early Iron Age. Seven settlements were excavated. Stage 2 studies began in 2010 and are continued at present. These works allowed us to fnd about 40 sites and settlements of the Stone Age and to excavate of the Stone Age sites and Bronze Ages burials.

scholarly journals The King’s Brief Interstitial Lung Disease (KBILD) questionnaire: an updated minimal clinically important difference

2019 ◽  
Vol 6 (1) ◽  
pp. e000363 ◽  
Author(s):  
Aish Sinha ◽  
Amit Suresh Patel ◽  
Richard J Siegert ◽  
Sabrina Bajwah ◽  
Toby M Maher ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Minimal Clinically Important Difference ◽  
Scale Transformation ◽  
Global Rating ◽  
Longitudinal Assessment ◽  
Hrqol Questionnaire ◽  
Clinically Important Difference ◽  
The Mean ◽  
Small Change

IntroductionThe King’s Brief Interstitial Lung Disease (KBILD) is a 15-item validated health-related quality of life (HRQOL) questionnaire. The method of scoring the KBILD has recently changed to incorporate a logit-scale transformation from one that used raw item responses, as this is potentially a more linear scale. The aim of this study was to re-evaluate the KBILD minimal clinically important difference (MCID) using the new logit -transformed scoring.Methods57 patients with interstitial lung disease (17 idiopathic pulmonary fibrosis, IPF) were asked to complete the KBILD questionnaire on two occasions in outpatient clinics. At the second visit, patients also completed a 15-item global rating of change of health status questionnaire (GRCQ). The MCID was calculated as the mean of four different methods: the change in KBILD for patients indicating a small change in GRCQ, patients with a 7%–12% change in FVC, 1 SE of measurement of baseline KBILD and effect size (ES) of 0.3.ResultsThe mean (SD) KBILD total score for all patients was 55.3 (15.6). 16 patients underwent a therapeutic intervention. 36 patients reported a change in their condition on the GRCQ; 22 deteriorated, 14 improved and 21 were unchanged. There was a significant change in KBILD total score in patients reporting a change in GRCQ; mean (SD) 57.0 (13.6) versus 50.0 (9.7); mean difference 7.0; 95% CI of difference 3.0 to 11.0; p<0.01. The change in KBILD total score correlated with the GRCQ scale; r=−0.49, p<0.01. The mean KBILD total score MCID was 5. The MCID of KBILD domains were 6 for Psychological, 7 for Breathlessness and Activities, and 11 for Chest Symptoms.ConclusionThe KBILD is a responsive tool for longitudinal assessment of HRQOL in patients with ILD. The MCID of the KBILD total score is a 5-unit change.

scholarly journals Apical Debris Extrusion by Adaptive Root Canal Instrumentation in Oval Canals: Full-Sequence SAF System vs. the XP-Endo Shaper Plus Sequence

2020 ◽  
Vol 10 (16) ◽  
pp. 5684 ◽  
Author(s):  
Ajinkya M. Pawar ◽  
Bhaggyashri A. Pawar ◽  
Anuj Bhardwaj ◽  
Alexander Maniangat Luke ◽  
Zvi Metzger ◽  
...  
Keyword(s):  
Root Canal ◽  
Significance Level ◽  
Full Sequence ◽  
Apical Extrusion ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Stage 1 ◽  
Two Stages ◽  
Root Canal Instrumentation

Apical extrusion of debris (AED) by the full sequence of the self-adjusting file (SAF) system was compared with that of the XP-endo shaper plus sequence. Sixty permanent mandibular incisors were randomly assigned to two groups (n = 30) for root canal instrumentation: Group A: Stage 1—pre-SAF OS, pre-SAF 1 and pre-SAF 2 files, followed by Stage 2—1.5 mm SAF; and Group B: Stage 1— hand K-file 15/0.02, followed by Stage 2—XP-endo shaper and Stage 3—XP-endo finisher. The AED produced during instrumentation at each stage was collected in pre-weighed Eppendorf tubes. The weights of AED by the two methods were compared using t tests with significance level set at 5%. Group A produced significantly less total AED than Group B (p < 0.001), with no significant difference in debris extrusion between the two stages (p = 0.3014). Conversely, in Group B, a significant difference was noted between Stage 1 and Stages 2 and 3 (p < 0.01), with no significant difference between Stages 2 and 3 (p = 0.488). Both sequences resulted in measurable amounts of AED. Each phase, in either procedure, made its own contribution to the extrusion of debris.

scholarly journals Qualitative Interviewing: Testing Health Surveys Among Vietnam War Veterans at the Age of 70 Years

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983269
Author(s):  
April S. Fales ◽  
Yasmin S. Cypel ◽  
Marsha E. Dunn ◽  
Ann L. Truelove ◽  
Erick K. Ishii ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Vietnam War ◽  
Questionnaire Development ◽  
Usability Testing ◽  
Cognitive Interviewing ◽  
Item Recall ◽  
Subject Recruitment ◽  
Vietnam Era ◽  
Stage 1 ◽  
Two Stages

The Vietnam Era Health Retrospective Observational Study (VE-HEROeS) is a nationwide study designed to compare the health of U.S. Vietnam era veterans to age- and sex-matched U.S. residents. Two self-administered mail questionnaires, one for veterans and the other for the U.S. nonmilitary population, were developed using already validated and newly developed items. A pretest was conducted to evaluate item recall and comprehension, new-item response validity, and the overall survey experience (usability of survey materials including the screener questionnaire for nonveterans). Subject recruitment was completed using convenience sampling and a $50 incentive. Cognitive interviewing and usability interviewing, two qualitative research methods, were implemented. Interviews were conducted in two stages (Stage 1, cognitive interviewing, n = 12; Stage 2, usability testing, n = 8) by three experienced methodologists. Concurrent probing techniques, unscripted probes, and retroactive probing were used to elicit response from 14 veterans and six nonveterans (mostly male, White, and aged 65-70 years). Information about the overall survey process was also obtained through observation during usability testing. Results signify that qualitative research is an important part of questionnaire development targeting older veterans due to issues involving comprehension, interpretability, and recall.

Efficient two-stage sequential arrays of proof of concept studies for pharmaceutical portfolios

2020 ◽  
pp. 096228022095817
Author(s):  
Linchen He ◽  
Linqiu Du ◽  
Zoran Antonijevic ◽  
Martin Posch ◽  
Valeriy R Korostyshevskiy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit ◽  
Cost Effective ◽  
Cost Ratio ◽  
Proof Of Concept ◽  
Type Iii ◽  
Benefit Cost Ratio ◽  
Stage 1 ◽  
Two Stages ◽  
Benefit Cost

Previous work has shown that individual randomized “proof-of-concept” (PoC) studies may be designed to maximize cost-effectiveness, subject to an overall PoC budget constraint. Maximizing cost-effectiveness has also been considered for arrays of simultaneously executed PoC studies. Defining Type III error as the opportunity cost of not performing a PoC study, we evaluate the common pharmaceutical practice of allocating PoC study funds in two stages. Stage 1, or the first wave of PoC studies, screens drugs to identify those to be permitted additional PoC studies in Stage 2. We investigate if this strategy significantly improves efficiency, despite slowing development. We quantify the benefit, cost, benefit-cost ratio, and Type III error given the number of Stage 1 PoC studies. Relative to a single stage PoC strategy, significant cost-effective gains are seen when at least one of the drugs has a low probability of success (10%) and especially when there are either few drugs (2) with a large number of indications allowed per drug (10) or a large portfolio of drugs (4). In these cases, the recommended number of Stage 1 PoC studies ranges from 2 to 4, tracking approximately with an inflection point in the minimization curve of Type III error.

scholarly journals Comparison of difficulty with activities of daily living in elderly adults undergoing hemodialysis and community-dwelling individuals: a cross-sectional study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Toshiki Kutsuna ◽  
Yusuke Isobe ◽  
Takaaki Watanabe ◽  
Yusuke Matsunaga ◽  
Satomi Kusaka ◽  
...  
Keyword(s):  
Physical Function ◽  
Grip Strength ◽  
Gait Speed ◽  
Community Dwelling ◽  
Test Time ◽  
Control Group ◽  
Elderly Adults ◽  
Sit To Stand ◽  
Difficulty Score ◽  
Usual Gait Speed

Abstract Background Elderly adults undergoing hemodialysis (HD) have multiple comorbidities, physical frailty, and functional dependence with activities of daily living (ADL). ADL difficulty is an early predictor of ADL dependency in community-dwelling elderly adults. However, the characteristics of ADL difficulty in patients undergoing HD have not yet been reported. The present study aimed to examine the current status and characteristics of physical function and ADL difficulty in ambulatory elderly patients undergoing HD. Methods In all, 136 elderly outpatients undergoing HD and 40 community-dwelling controls participated in the present study. The characteristics, physical function (SARC-F score, grip strength, five-times sit-to-stand test time, usual gait speed, maximum gait speed, and short physical performance battery score), and scores from the ADL difficulty questionnaires [difficulty related to upper limb (U/L) and lower limb (L/L) functions] were compared between the HD and control groups. Multiple regression analysis was performed to examine whether the characteristics of physical function were able to discriminate ADL difficulty in the HD group. Results The HD group had a significantly greater SARC-F score, lower grip strength, longer five-times sit-to-stand test time, slower usual gait speed, slower maximum gait speed, lower short physical performance battery score, and lower U/L and L/L ADL difficulty scores compared to the control group (all P < 0.001). The distribution of U/L and L/L ADL difficulty scores showed a wider variation in the HD group than in the control group. The U/L ADL difficulty score was independently associated with the SARC-F score (β = −0.52, P < 0.001) and grip strength (β = 0.21, P = 0.02). The L/L ADL difficulty score was independently associated with the SARC-F score (β = −0.56, P < 0.001) and usual gait speed (β = 0.35, P < 0.001). Conclusions The elderly HD group had a poorer physical function and experienced stronger ADL difficulty than the control group. There was an association between ADL difficulty and sarcopenia or poor physical function among patients undergoing HD. These findings provide useful data for effective clinical management to prevent decline of ADL in ambulatory elderly patients undergoing HD.

scholarly journals Determining Ergonomic Smartphone Forms With High Grip Comfort and Attractive Design

2018 ◽  
Vol 61 (1) ◽  
pp. 90-104 ◽  
Author(s):  
Songil Lee ◽  
Gyouhyung Kyung ◽  
Jihhyeon Yi ◽  
Donghee Choi ◽  
Sungryul Park ◽  
...  
Keyword(s):  
Potential Effect ◽  
Hand Length ◽  
Stage 1 ◽  
Two Stages

Objective: The authors aimed to identify ergonomic smartphone forms by investigating the effects of hand length, four major smartphone dimensions (height, width, thickness, and edge roundness), and smartphone mass on grip comfort and design attractiveness. Background: Despite their potential effect on grip comfort and design attractiveness, the dimensions specified above have never been simultaneously considered in a study investigating smartphone gripping. Method: Seventy-two young individuals participated in a three-stage study. Stage 1 determined the ranges of the four smartphone dimensions suitable for grip comfort and identified the strengths of their influences. Stage 2 investigated the effects of width and thickness (determined to have the greatest influence) on grip comfort and design attractiveness. Mock-ups of varying masses were fabricated using the dimensions determined during the first two stages to investigate the effect of mass on grip comfort and design attractiveness in Stage 3. Results: Phone width was found to significantly influence grip comfort and design attractiveness, and the dimensions of 140 × 65 (or 70) × 8 × 2.5 mm (height × width × thickness × edge roundness) provided high grip comfort and design attractiveness. The selected dimensions were fit with a mass of 122 g, with masses in the range of 106–137 g being comparable. Conclusion: The findings of this study contribute to ergonomic smartphone design developments by specifying dimensions and mass that provide high grip comfort and design attractiveness. Application: The dimensions and mass determined in this study should be considered for improving smartphone design grip comfort and attractiveness.

Sign in / Sign up

Export Citation Format

Share Document