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- Nilsson, Maria H, et al.
(författare)
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Fatigue in Parkinson's Disease: Measurement Properties of a Generic and a Condition-specific Rating Scale.
- 2013
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Ingår i: Journal of Pain and Symptom Management. - : Elsevier BV. - 1873-6513 .- 0885-3924. ; 46:5, s. 737-746
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: High-quality fatigue rating scales are needed to advance the understanding of fatigue and determine the efficacy of interventions. Several fatigue scales are used in Parkinson's disease, but few have been tested using modern psychometric methodology (Rasch analysis). OBJECTIVES: To examine the measurement properties of the generic Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale and the condition-specific 16-item Parkinson Fatigue Scale (PFS-16) using Rasch analysis. METHODS: Postal survey data (n=150; 47% women; mean age 70 years) were Rasch analyzed. The PFS-16 scores were tested according to both the original polytomous and the suggested alternative dichotomized scoring methods. RESULTS: The PFS-16 showed overall Rasch model fit, whereas the FACIT-F showed signs of misfit, which probably was the result of a sleepiness-related item and mixing of positively/negatively worded items. There was no differential item functioning by disease duration but by fatigue status (greater likelihood of needing to sleep or rest during the day among people classified as nonfatigued) in the PFS-16 and FACIT-F. However, this did not impact total score-based estimated person measures. Targeting and reliability (≥0.86) were good, but the dichotomized PFS-16 showed compromised measurement precision. Polytomous and dichotomized PFS-16 and FACIT-F scores identified six, three, and four statistically distinct sample strata, respectively. CONCLUSION: We found general support for the measurement properties of both scales. However, polytomous PFS-16 scores exhibited advantages compared with dichotomous PFS-16 and FACIT-F scores. Dichotomization of item responses compromises measurement precision and the ability to separate people, and should be avoided.
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- Jonasson, Stina, et al.
(författare)
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Content Analysis of Four Fear of Falling Rating Scales by Linking to the International Classification of Functioning, Disability and Health.
- 2013
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Ingår i: PM&R. - : Wiley. - 1934-1563 .- 1934-1482. ; 5:7, s. 573-582
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To gain a deeper understanding of the content of 4 fear of falling (FOF) rating scales by linking them to the International Classification of Functioning, Disability and Health (ICF). DESIGN: Linking study according to the ICF linking rules. SETTING: Not applicable. PATIENTS: Not applicable. METHODS: The rating scales were the Falls Efficacy Scale-International (FES-I), the Swedish version of the Falls Efficacy Scale (FES[S]), the Activities-specific Balance Confidence Scale (ABC), and the modified Survey of Activities and Fear of Falling in the Elderly (SAFFE). The process followed the established and updated linking rules. Three linkers independently identified all meaningful concepts in the rating scales and linked them to the most precise ICF categories. The linkers then discussed their results to reach consensus. If consensus was not attained, the linkers pursued the discussions with a fourth person to reach consensus. MAIN OUTCOME MEASUREMENTS: Not applicable. RESULTS: Most meaningful concepts from the overall questions were linked to the ICF component of body functions. Of the 62 items, all but one meaningful concept were linked to the component of activities and participation. All 4 rating scales covered the chapters of mobility and domestic life and had most linkages to the mobility chapter. CONCLUSIONS: The linking process revealed similarities and differences between the 4 FOF rating scales, as well as methodologic challenges in linking instruments to the ICF. By providing a content description that allows for a direct comparison of the rating scales, the results may be helpful when choosing an appropriate rating scale assessing FOF in clinical practice and research. A further head-to-head comparison through psychometric analyses is required to recommend appropriate FOF rating scales. Studies are also needed to investigate how the overall question and response categories of a rating scale affect respondents' answers.
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- Lindholm, Beata, et al.
(författare)
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The clinical significance of 10-m walk test standardizations in Parkinson’s disease
- 2018
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Ingår i: Journal of Neurology. - : Springer Science and Business Media LLC. - 0340-5354 .- 1432-1459. ; 265:8, s. 1829-1835
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Tidskriftsartikel (refereegranskat)abstract
- Background: The 10-m walk test (10MWT) is a widely used measure of gait speed in Parkinson’s disease (PD). However, it is unclear if different standardizations of its conduct impact test results. Aim of the study: We examined the clinical significance of two aspects of the standardization of the 10MWT in mild PD: static vs. dynamic start, and a single vs. repeated trials. Implications for fall prediction were also explored. Methods: 151 people with PD (mean age and PD duration, 68 and 4 years, respectively) completed the 10MWT in comfortable gait speed with static and dynamic start (two trials each), and gait speed (m/s) was recorded. Participants then registered all prospective falls for 6 months. Results: Absolute mean differences between outcomes from the various test conditions ranged between 0.016 and 0.040 m/s (effect sizes, 0.06–0.14) with high levels of agreement (intra-class correlation coefficients, 0.932–0.987) and small standard errors of measurement (0.032–0.076 m/s). Receiver operating characteristic curves showed similar discriminate abilities for prediction of future falls across conditions (areas under curves, 0.70–0.73). Cut-off points were estimated at 1.1–1.2 m/s. Conclusions: Different 10MWT standardizations yield very similar results, suggesting that there is no practical need for an acceleration distance or repeated trials when conducting this test in mild PD.
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- Thordardottir, Björg, et al.
(författare)
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"You plan, but you never know" - participation among people with different levels of severity of Parkinson's disease.
- 2014
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 36:26, s. 2216-2224
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Purpose: The aim of this study was to improve our understanding of important aspects of participation in everyday life for people with different levels of severity of Parkinson's disease (PD). Methods: A qualitative design was used, with empirical data obtained from focus groups. The participants had all been diagnosed with PD at least one year prior to the start of the study. Purposeful sampling was used to ensure that both sexes, with variations in age, marital status, living arrangements, education and employment, were represented. Recruitment continued until saturation was reached and resulted in 29 participants. Homogeneity within each focus group was based on self-rated PD severity (mild, moderate or severe). Findings: The aspects that influence participation at different stages of PD are that those with PD stand out in public, as a result of disease-specific features, and that the disease is unpredictable. Planning was highlighted as a strategy that is required to support participation and cope with stress and to compensate for the fact that everyday activities demanded a great deal of time and energy. Conclusion: These findings are of importance to the development of rehabilitation interventions that support people with PD in maintaining their participation in everyday life, throughout the course of the disease. Implications for Rehabilitation PD severity and disease-specific problems (e.g. freezing of gait) need to be taken into account when tackling restrictions that affect participation. Interventions that aim to facilitate participation require different components and expertise depending on PD severity, as well as on individual preferences and needs. Structuring and planning everyday life might not facilitate participation for all those with PD, but concrete measures, such as making a schedule in order to structure daily life, may benefit those with milder PD.
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- Andersson, Nilla, et al.
(författare)
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Environmental barriers and housing accessibility problems for people with Parkinson’s disease : A three-year perspective
- 2023
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 30:5, s. 661-672
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although housing accessibility is associated with important health outcomes in other populations, few studies have addressed this in a Parkinson’s disease population. Aim: To determine the most severe environmental barriers in terms of housing accessibility problems and how these evolved over 3 years among people with Parkinson’s disease. Material and Methods: 138 participants were included (men = 67%; mean age = 68 years). The most severe environmental barrier were identified by the Housing Enabler instrument and ranked in descending order. The paired t-test was used to analyse changes in accessibility problems over time. Results: The top 10 barriers remained largely unchanged over 3 years, but with notable changes in order and magnitude. ‘No grab bar in hygiene area’ and ‘Stairs only route’ were top-ranked in generating accessibility problems at baseline but decreased significantly (p = 0.041; p = 0.002) at follow-up. ‘Difficulties to reach refuse bin’ was top-ranked at follow-up, with a significant increase (p < 0.001) of related accessibility problems. Conclusions and Significance: The new knowledge about how accessibility problems evolve over time could be used by occupational therapists to recommend more effective housing adaptations taking the progressive nature of Parkinson’s disease into account. On societal level, the results could be used to address accessibility problems systematically.
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| 8. |
- Carlsson, Gunilla, et al.
(författare)
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Falls and Fear of Falling among Persons Who Receive Housing Adaptations-Results from a Quasi-Experimental Study in Sweden
- 2017
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Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- While health might deteriorate through the ageing and disablement process, the impacts of disability can be reduced by adapting the environment. This study aimed to investigate the effects of applying a standardized research-based strategy to housing adaptation as compared to ordinary practice with respect to falls and fear of falling. Another aim was to investigate the overall effects of housing adaptations on fall-related outcomes over time. In total, 196 clients were included at baseline, with follow-up at 3 and 6 months after the housing adaptation was implemented. The only significant difference between the two approaches was identified with respect to fear of falling at 3 months after the housing adaptation, but not after 6 months. The number of clients reporting actual falls increased over time in both sites, whereas the number of reported near-falls decreased most in the intervention site, but without significant differences. Thus, the patterns of differences between the sites are inconsistent, as are the patterns of change in fall-related outcomes. An overall conclusion is that if the goal is to improve fall-related outcomes, housing adaptation should be complemented with other interventions preventing falls and explicitly address the clients' activity limitations. In addition, longer follow-up times are necessary.
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