Rehab Centers: Age and Sex Differences Between Patient and Physician-Derived Outcome Measures in the Foot and Ankle.

Age and sex differences between patient and physician-derived outcome measures in the foot and ankle.

Filed under: Rehab Centers

J Bone Joint Surg Am. 2013 Feb 6; 95(3): 209-14
Baumhauer JF, McIntosh S, Rechtine G

Traditionally, physicians have identified which outcome factors are important to measure in order to determine the success or failure of treatment without any input from patients. The purpose of the present study was to ascertain the five outcome factors that are most important to the patient and the impact that age and sex have on these factors. These five most important patient-derived outcome factors were then compared with factors within two of the most commonly used outcome instruments for the foot and ankle.Informant interviews, pre-testing, consistency analysis, and pilot testing led to the construction of a twenty-item survey of outcome factors that patients identified as being important in the treatment of their foot or ankle problem. Subjects selected the top five factors and rank ordered them from 1 to 5 (with 1 representing extreme importance and 5 representing least importance). One thousand computer simulations identified the top five factors, and these were subsequently stratified for sex and age. Wilcoxon rank-sum and Benjamini-Hochberg tests were used to compare the data between groups.The survey was completed by 783 subjects. The five most important factors were limited walking (p < 0.05), activity-related pain (p < 0.05), constant pain (p < 0.05), difficulty with prolonged standing (p = 0.754), and inability to do one’s job or housework (p = 0.995). Shoe-related issues and foot and ankle weakness were significantly different between the sexes. Constant pain, inability to play sports, inability to participate in a job or housework, and recurrent foot or ankle skin sores or infections were significantly different between age groups. Between 38% and 50% of the outcome points found on two commonly used foot and ankle instruments included factors not of primary importance to the patient.There are sex and age-related differences regarding outcome factors following the treatment of disorders affecting the foot and ankle. As many as 50% of the factors in currently used foot and ankle outcome instruments are not of primary importance to patients.
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Health-related quality of life and socioeconomic situation among diastrophic dysplasia patients in Finland.

Filed under: Rehab Centers

J Rehabil Med. 2013 Feb 6;
Krüger L, Pohjolainen T, Kaitila I, Kautiainen H, Arkela-Kautiainen M, Hurri H

Objective: The purpose of the present study was to gain a comprehensive view of the quality of life and socio-economic conditions in a more representative sample of patients with diastrophic dysplasia than previously presented. Methods: The study sample comprised 115 patients with diastrophic dysplasia, aged over 18 years. The patients were contacted, and 68 patients (59%) agreed to participate in the study. They answered a structured questionnaire, which included the items of RAND-36 and Finn-Health Assessment Questionnaire (Finn-HAQ) questionnaires. The Finn-HAQ items were linked to the categories of the International Classification of Functioning, Disability and Health (ICF). Population controls for matching the participating patients for age and sex were identified in the Finnish population registry. Demographic and social factors (educational status, employment status and household income) were collected in separated questions. Results: RAND-36 showed significantly lower physical functioning in the group of diastrophic dysplasia patients than in the control group. Also, the differences in scores for energy and social functioning were significant. In the mental component scales, no significant difference was found between the groups. When compared with the controls, we found significantly lower levels in all 3 ICF components of functioning in the group of patients when Finn-MDHAQ items linked to ICF were used. Almost 75% of patients with diastrophic dysplasia belonged to the group of people with minor/low income. Some or clear worsening of economic situation due to diastrophic dysplasia was reported by 25 (58%) female and 17 (68%) male patients. Conclusion: In their daily living, patients with diastrophic dysplasia have marked physical difficulties, which affect their quality of life, participation in society and their financial situation. It seems that the mental situation is not greatly affected, but a more detailed study is needed to evaluate and illuminate the psychological consequences of this severe skeletal dysplasia. Overall, the pieces of information in the present study are of high importance when designing and reorganizing rehabilitation and in supportive therapy and treatment of patients with diastrophic dysplasia.
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Applying the Comprehensive International Classification of Functioning, Disability and Health Core Sets for stroke framework to stroke survivors living in the community.

Filed under: Rehab Centers

J Rehabil Med. 2013 Feb 6;
Paanalahti M, Lundgren-Nilsson A, Arndt A, Sunnerhagen KS

Objective: The aims of this study were to explore the perspective of functioning in community-dwelling people with prior stroke and to confirm, if possible, the Comprehensive International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for stroke. Methods: Qualitative interviews were analysed (using the content analysis method and established ICF linking rules) from 22 persons following stroke (age range 59-87 years), as well as their spouses/partners, where relevant. Results: Ninety-nine (76%) of 130 second-level ICF categories in the existing Comprehensive ICF Core Set for stroke were confirmed: 31 categories (of 41) in the component of body functions, 38 categories (of 51) in the component of activities and participation, 26 (of 33) in the component of environmental factors and 4 (of 5) in the component of body structures. Eleven additional ICF categories and one personal factor, a coping style of “I take it as it comes” were also identified in the transcribed text. Conclusion: The Comprehensive ICF Core Set for stroke was largely confirmed.
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Engaging the disengaged: strategies in dealing with the return to work grump!

Filed under: Rehab Centers

Prof Case Manag. 2013 Mar; 18(2): 100-3
Mitchel K

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Taking Care of Tootsie.

Filed under: Rehab Centers

Prof Case Manag. 2013 Mar; 18(2): 86-88
Owen M, Bellot J

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