Posts Tagged Questionnaire
[Abstract] Improving the acceptability to enhance the efficiency of stroke rehabilitation procedures based on brain-computer interfaces: General public results – Poster
Posted by Kostas Pantremenos in REHABILITATION on March 29, 2022
Abstract : Stroke leaves around 40% of surviving patients dependent in their activities of daily living, notably due to severe motor disabilities [Inserm, 2019]. Brain-Computer Interfaces (BCIs) have been shown to be efficient for improving motor recovery after stroke [Cervera et al., 2018], but this efficiency is still far from the level required to achieve the clinical breakthrough expected by both clinicians and patients. While technical levers of improvement have been identified, they are insufficient: fully optimised BCIs are pointless if patients and clinicians do not want to use them [Blain-Moraes et al., 2012]. We hypothesise that improving BCI acceptability and acceptance, by better informing stakeholders about BCI functioning and by personalising the BCI-based rehabilitation procedures to each patient, respectively, will favour engagement in the rehabilitation process and result in an increased efficiency. Our first objective was to identify the factors influencing the intention to use (IU) BCIs [Davis, 1989]. Based on the literature, we constructed a model of BCI acceptability and adapted it in questionnaires addressed to the general population (n=753) and post-stroke patients (n=33). Videos were included, one about the general functioning of BCIs, the second about their relevance for rehabilitation. We used random forest algorithms to explain IU based on our model’s factors. After the first video, IU was mainly explained by subjective and personal factors, i.e., perceived usefulness (PU), perceived ease of use (PEOU) and BCI playfulness for the general population, and PU, autonomy and engagement in the rehabilitation for the patients. After the second video, the explanatory factors became more scientific/rational, with PU, cost-benefits ratio and scientific relevance for the general population, and PU, scientific relevance and ease of learning for patients. The shift of main explanatory factors (before/after second video) from subjective representations to scientific arguments highlights the impact of providing patients with clear information regarding BCIs.
[Abstract] Aerobic Training in Canadian Stroke Rehabilitation Programs
Posted by Kostas Pantremenos in REHABILITATION on September 28, 2018
Background and Purpose: Aerobic training (AT) is recommended for people after stroke, yet uptake and operationalization of AT in clinical practice in Canada have not been measured. We surveyed inclusion of structured AT and barriers to implementation in public inpatient/outpatient stroke rehabilitation programs across Canada.
Methods: A Web-based questionnaire was sent to 89 stroke rehabilitation program leads.
Results: Forty-six programs from 7 of 9 eligible Canadian provinces/territories completed the questionnaire. Seventy-eight percent of programs reported including AT, with most (75%) excluding participants with severe physical impairments, and 28% excluding those with coexisting cardiac conditions. A greater proportion of dedicated stroke rehabilitation programs prescribed AT, compared to nondedicated stroke units (68.8% vs 31.3%, P = 0.02). The top 2 challenges for programs that included and did not include AT were “insufficient time within therapy sessions” and “length of stay in rehabilitation.” Programs that did not include AT ranked “not a goal of most patients” and “not an organizational/program priority” as third and fourth, whereas they were ranked eighth and thirteenth by programs with AT. Best practice recommendations were inconsistently followed for conducting preparticipation exercise testing (36.1%) and for monitoring patients from higher-risk populations, specifically people with diabetes at risk for hypoglycemia (78.8%) and hypertension (36.6%). Of programs conducting preparticipation exercise testing, 91% did not monitor electrocardiography.
Discussion and Conclusions: Most stroke rehabilitation programs across Canada include AT. People with severe physical impairment and those with cardiac, metabolic, and hemodynamic comorbidities may be excluded or not appropriately monitored during exercise. More detailed guidelines and training practices are needed to address these challenges.
Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A233).
via Aerobic Training in Canadian Stroke Rehabilitation Programs : Journal of Neurologic Physical Therapy
[ARTICLE] Development and validation of a novel questionnaire for self-determination of the range of motion of wrist and elbow – Full Text
Posted by Kostas Pantremenos in Paretic Hand on August 3, 2016
Abstract
Background
The aim of this study was to develop and validate a novel self-administered questionnaire for assessing the patient’s own range of motion (ROM) of the wrist and the elbow.
Methods
In a prospective clinical study from January 2015 to June 2015, 101 consecutive patients were evaluated with a novel, self-administered, diagram-based, wrist motion assessment score (W-MAS) and elbow motion assessment score (E-MAS). The questionnaire was statistically evaluated for test-retest reliability, patient-physician agreement, comparison with healthy population, and influence of covariates (age, gender, affected side and involvement in workers’ compensation cases).
Results
Assessment of patient-physician agreement demonstrated almost perfect agreement (k > 0.80) with regard to six out of eight items. There was substantial agreement with regard to two items: elbow extension (k = 0.76) and pronation (k = 0.75). The assessment of the test-retest reliability revealed at least substantial agreement (k = 0.70). The questionnaire revealed a high discriminative power when comparing the healthy population with the study group (p = 0.007 or lower for every item). Age, gender, affected side and involvement in workers’ compensation cases did not in general significantly influence the patient-physician agreement for the questionnaire.
Conclusion
The W-MAS and E-MAS are valid and reliable self-administered questionnaires that provide a high level of patient-physician agreement for the assessments of wrist and elbow ROM.
Level of evidence: Diagnostic study, Level II
Background
Assessing the patient’s outcome and satisfaction is important in modern orthopedic practice [1, 2, 3]. Using questionnaires to evaluate patients with wrist and elbow disorders is widespread and has been shown to be valid and reproducible [4, 5, 6, 7, 8, 9]. Self-reported outcome measures allow outcomes to be assessed from the patient’s perspective and do not require time in clinic or medical staff for data collection.
Common self-administered questionnaires for the determination of hand- and upper limp specific results of the wrist (e.g. patient-rated wrist evaluation, PRWE [8]) and of the elbow (e.g. The American Shoulder and Elbow Surgeons-Elbow, ASES-E [1]) enable the patient to assess the functional impairment of the joint, but they do not formally assess the range of motion, and patients have to attend clinic for this to be measured [10]. Therefore important data regarding the ROM would be lost in patients who are unable or unwilling to come to the outpatient clinic at the regular follow-up or for clinical research.
To our knowledge no validated self-assessment questionnaire for the ROM of the wrist or the elbow exists, which compares the agreement of the patient’s outcome with the examination by a physician.
Therefore, the aim of the current study was to develop a self-administered, diagram-based wrist motion assessment score (W-MAS) and elbow motion assessment score (E-MAS) to enable the patients to assess their own ROM of the wrist and the elbow. We further evaluated validity and reliability of this novel questionnaire with respect to the accuracy of self-determination of the wrist and elbow ROM.