Initial Psychometric Evaluation of the Arm Activity Measure (ArmA): A Measure of Activity in the Hemiparetic Arm.

Initial psychometric evaluation of the Arm Activity Measure (ArmA): a measure of activity in the hemiparetic arm.

Clin Rehabil. 2013 Feb 20;
Ashford S, Turner-Stokes L, Siegert R, Slade M

Objective:To evaluate the psychometric properties of the Arm Activity Measure (ArmA), a patient-reported measure of active and passive function in the paretic upper limb.Design:Psychometric evaluation study.Setting:Two specialist rehabilitation and spasticity management services.Method:Patients (n = 92) with upper limb paresis were recruited from two specialist neurorehabilitation centres. Mean age 44.5 (SD 16.7). Diagnostic distribution: stroke 48 (52%); other brain injury 28 (31%); or other neurological condition 16 (17%). Evaluation of convergent and divergent validity; unidimensionality, scaling, reliability (internal consistency and test-retest); responsiveness to change and feasibility of the ArmA were undertaken.Results:Expected convergent and divergent relationships were seen with the Leeds Adult Spasticity Impact Scale and the Disabilities of Arm Shoulder and Hand (DASH) (rho 0.5-0.63). Principal components analysis confirmed that active and passive function formed two separate constructs in each sub-scale. Mokken analysis corroborated the findings of the principal components analysis and demonstrated scaling using the monotone homogeneity model (Item H>0.5 for all items). Cronbach’s alpha was 0.85 and 0.96, respectively, for the passive and active function subscales. Item level test-retest agreement ranged from 92-97.5% (quadratic-weighted Kappa 0.71-0.94). In the subgroup treated for spasticity with botulinum toxin (n = 58), the ArmA passive function scale identified a significant difference between responder and non-responder groups (Mann Whitney U = 0.85, p < 0.01). Respondents reported the ArmA to be relevant (77%), easy to use (90%) and timely to complete (83% under 10 minutes).Conclusion:The ArmA is a valid and reliable tool feasible for use in the evaluation of upper limb function in the context of treatment for spasticity. HubMed – rehab

What effect does a structured home-based exercise programme have on people with Huntington’s disease? A randomized, controlled pilot study.

Clin Rehabil. 2013 Feb 20;
Khalil H, Quinn L, van Deursen R, Dawes H, Playle R, Rosser A, Busse M

Objective:The aim of this study was to explore feasibility, safety and outcome of an exercise intervention in people with Huntington’s disease.Design:A randomized controlled pilot trial.Setting:A home-based exercise programme.Subjects:A total of 25 subjects with early to mid-stage Huntington’s disease.Intervention:Subjects were randomly allocated to either an exercise intervention (n = 13) or a control group (n = 12). Subjects in the exercise intervention group were asked to perform exercises at home three times a week for eight weeks using an exercise DVD, specifically developed for this purpose. The control group received their usual care.Measures:Adherence in the intervention group was calculated from exercise diaries. Measures of gait, balance, function, level of physical activity and quality of life were evaluated. Analysis of covariance was used to compare follow-up scores across groups after adjustment for chance baseline differences. Effect sizes were calculated.Results:Eleven participants from the intervention and ten from the control group completed the study. Mean adherence was 29.4 SD 1.8 for the 32 prescribed sessions. There were no related adverse events. Differences between groups were observed in gait speed, balance, function and level of physical activity, but not quality of life as measured by the SF36. Effect sizes were large (>0.8) for the majority of the outcomes.Conclusions:Short-term structured home exercise programmes are feasible, beneficial and safe for people with early to mid-stage of Huntington’s disease. Our findings support the implementation of a larger trial of longer-term home exercise. HubMed – rehab

Test of Wheeled Mobility (TOWM) and a short wheelie test: a feasibility and validity study.

Clin Rehabil. 2013 Feb 20;
Fliess-Douer O, Van Der Woude LH, Vanlandewijck YC

Objective:To assess the feasibility and validity of both the Test of Wheeled Mobility (TOWM) and a wheelie test.Design:Cross-sectional study.Setting:KU Leuven gymnasium.Subjects:Thirty male manual wheelchair users (age range 23-53 years) with spinal cord injury.Interventions:Participants preformed both tests after completing a personal information form and a ‘Perceived self-efficacy in WM’ scale. The TOWM consists of 30 tasks reflecting functional wheeled mobility. The wheelie test consists of eight tasks measuring the ability to perform a ‘wheelie’ in challenging situations.Main measure:Ability, performance time, qualitative and anxiety scores were assessed. Convergent validity was tested by correlating the TOWM and the wheelie test scores. Construct validity was assessed by testing whether the four scores of both tests are significantly related to perceived self-efficacy in wheeled mobility, time since injury and sport participation.Results:TOWM average total testing time was 24.7 minutes (±5.93) and the wheelie test was 12.62 minutes (±5.08). Convergent validity was confirmed by the positive correlation between the TOWM and wheelie test total ability scores (r = 0.84; P < 0.001), quality scores (r = 0.88) and anxiety scores (r = 0.66). Moderate correlations were found between the total time scores of the TOWM and wheelie test (r = 0.47). Construct validity was confirmed by fair to moderate correlations between both test’s scores with time since injury, self-efficacy and sport participation after injury.Conclusion:The TOWM and the wheelie tests are feasible and valid instruments for assessing manual wheelchair mobility in persons with spinal cord injury. HubMed – rehab

Home-Based Secondary Prevention Programs for Patients With Coronary Artery Disease: A META-ANALYSIS OF EFFECTS ON ANXIETY.

J Cardiopulm Rehabil Prev. 2013 Feb 18;
McClure T, Haykowsky MJ, Schopflocher D, Hsu ZY, Clark AM

PURPOSE:: Anxiety is common among patients with coronary artery disease (CAD). Despite the benefits of home-based CAD prevention interventions on quality of life and atherosclerotic risk factors, the efficacy of home-based programs in reducing patient anxiety is unknown. METHODS:: We performed a systematic review and meta-analysis of all randomized trials that examined the effects of home-based interventions on anxiety reduction in patients with CAD published in 18 databases until December 2009. Analyses were based on changes in the standardized mean difference between treatment groups. RESULTS:: Eight trials containing intervention means and standard deviations on anxiety were reviewed. Overall quality of the trials was low to moderate. Compared with usual care or center-based cardiac rehabilitation, home-based interventions had a small but significant effect in reducing anxiety (total effect size: -0.13; 95% CI: -0.20 to -0.06; P < .001; I = 66%). CONCLUSIONS:: This meta-analysis provides evidence that home-based secondary prevention programs are effective in reducing anxiety level in CAD patients. However, because of the limited number of trials available and high degrees of heterogeneity in the data, further research needs to be done to provide a definitive answer on the benefits of home-based programs on anxiety management in CAD patients. HubMed – rehab