OBJECTIVE: To examine the utility of decision analysis methods for examining the dynamic nature of impairment-activity interactions following stroke. DESIGN: Decision analyses (Chi-squared Automatic Interaction Detector) of a prospective cohort study. SETTING: Community and institutional settings based on the location of participants three months after stroke. PARTICIPANTS: Individuals were recruited from consecutive admissions to a regional academic health center and were assessed three months after stroke (N= 67). MAIN OUTCOME MEASURES: Neurological impairment was measured with the National Institutes of Health Stroke Scale (NIHSS). Mobility, self-care and instrumental activities of daily living (instrumental ADL) performance were assessed with a performance observation measure, the Performance Assessment of Self-care Skills (PASS). Decision analysis methods were used to examine interactions between neurological impairments and activity outcomes. RESULTS: Unique neurological impairments were associated with each activity outcome (bowel and bladder urgency interacted with mobility; hand function interacted with self-care; mental functions interacted with instrumental ADL), and these findings are supported by previous studies. The predictive validity of mobility and self-care analyses was stronger than the instrumental ADL analyses. CONCLUSIONS: Decision analysis methods show promise for understanding dynamic impairment--activity interactions. This understanding may enhance methods for informing rehabilitation decisions.
OBJECTIVE: To examine the utility of decision analysis methods for examining the dynamic nature of impairment-activity interactions following stroke. DESIGN: Decision analyses (Chi-squared Automatic Interaction Detector) of a prospective cohort study. SETTING: Community and institutional settings based on the location of participants three months after stroke. PARTICIPANTS: Individuals were recruited from consecutive admissions to a regional academic health center and were assessed three months after stroke (N= 67). MAIN OUTCOME MEASURES: Neurological impairment was measured with the National Institutes of Health Stroke Scale (NIHSS). Mobility, self-care and instrumental activities of daily living (instrumental ADL) performance were assessed with a performance observation measure, the Performance Assessment of Self-care Skills (PASS). Decision analysis methods were used to examine interactions between neurological impairments and activity outcomes. RESULTS: Unique neurological impairments were associated with each activity outcome (bowel and bladder urgency interacted with mobility; hand function interacted with self-care; mental functions interacted with instrumental ADL), and these findings are supported by previous studies. The predictive validity of mobility and self-care analyses was stronger than the instrumental ADL analyses. CONCLUSIONS: Decision analysis methods show promise for understanding dynamic impairment--activity interactions. This understanding may enhance methods for informing rehabilitation decisions.
Authors: David F Schneider; Adrian Dobrowolsky; Irshad A Shakir; James M Sinacore; Michael J Mosier; Richard L Gamelli Journal: J Burn Care Res Date: 2012 Mar-Apr Impact factor: 1.845
Authors: Ryanne J M Lemmens; Annick A A Timmermans; Yvonne J M Janssen-Potten; Rob J E M Smeets; Henk A M Seelen Journal: BMC Neurol Date: 2012-04-12 Impact factor: 2.474