OBJECTIVE: An enduring problem in the field of rehabilitation has been the lack of standardization in the protocols of treatments and tests. To develop a process evaluation method to standardize the administration of rehabilitation procedures used in the Extremity Constraint Induced Therapy Evaluation (EXCITE) Trial, a randomized controlled trial of upper-extremity constraint-induced therapy implemented across 7 sites. DESIGN: Process evaluation. SETTING: Research laboratory. PARTICIPANTS: Convenience sample or research personnel. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Checklist scoring sheets were developed to rate videotapes using systematic application of prescribed steps for each of 5 procedures across 3 time periods. Time periods were immediately after training, and 1 and 2 years later. A performance score of at least 90% was required before individual research personnel were allowed to participate in the trial. RESULTS:Overall performance scores ranged from 85.8% to 95% of performance items correctly executed. There was a significant improvement in standard performance of procedures between the first time period (immediately after training) and each of the subsequent time periods for all but 1 procedure. The scoring of standardized performance when carried out with routine participant testing and training did not differ significantly from scoring from videotaped sessions submitted for standardization rating for 2 of the procedures, suggesting adequate validity of scoring from videotape. CONCLUSIONS: The present method was successful in assessing protocol fidelity for the EXCITE research personnel and represents 1 means of addressing the longstanding problem in rehabilitation of the lack of standardization in administering different treatments and tests.
RCT Entities:
OBJECTIVE: An enduring problem in the field of rehabilitation has been the lack of standardization in the protocols of treatments and tests. To develop a process evaluation method to standardize the administration of rehabilitation procedures used in the Extremity Constraint Induced Therapy Evaluation (EXCITE) Trial, a randomized controlled trial of upper-extremity constraint-induced therapy implemented across 7 sites. DESIGN: Process evaluation. SETTING: Research laboratory. PARTICIPANTS: Convenience sample or research personnel. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Checklist scoring sheets were developed to rate videotapes using systematic application of prescribed steps for each of 5 procedures across 3 time periods. Time periods were immediately after training, and 1 and 2 years later. A performance score of at least 90% was required before individual research personnel were allowed to participate in the trial. RESULTS: Overall performance scores ranged from 85.8% to 95% of performance items correctly executed. There was a significant improvement in standard performance of procedures between the first time period (immediately after training) and each of the subsequent time periods for all but 1 procedure. The scoring of standardized performance when carried out with routine participant testing and training did not differ significantly from scoring from videotaped sessions submitted for standardization rating for 2 of the procedures, suggesting adequate validity of scoring from videotape. CONCLUSIONS: The present method was successful in assessing protocol fidelity for the EXCITE research personnel and represents 1 means of addressing the longstanding problem in rehabilitation of the lack of standardization in administering different treatments and tests.
Authors: Michelle Woodbury; Craig A Velozo; Paul A Thompson; Kathye Light; Gitendra Uswatte; Edward Taub; Carolee J Winstein; David Morris; Sarah Blanton; Deborah S Nichols-Larsen; Steven L Wolf Journal: Neurorehabil Neural Repair Date: 2010-07-08 Impact factor: 3.919
Authors: Edward Taub; Gitendra Uswatte; Mary H Bowman; Victor W Mark; Adriana Delgado; Camille Bryson; David Morris; Staci Bishop-McKay Journal: Arch Phys Med Rehabil Date: 2012-08-21 Impact factor: 3.966