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- Andersson, Eleonor I., et al.
(author)
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Performance Tests in People With Chronic Low Back Pain Responsiveness and Minimal Clinically Important Change
- 2010
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In: Spine. - : J B Lippincott Co. - 0362-2436 .- 1528-1159. ; 35:26, s. E1559-E1563
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Journal article (peer-reviewed)abstract
- Study Design. Cohort study. Objective. To assess the responsiveness and minimal clinically important change (MCIC) of 6 commonly-used performance tests (5-minute walking, 50-ft walking, sit-to-stand, 1 minute stair climbing, loaded forward reach, Progressive Isoinertial Lifting Evaluation). Summary of Background Data. Performance tests are used to evaluate physical function in people with low back pain. Little is known about their clinimetric properties. Methods. Performance tests were administered in people with chronic nonspecific low back pain (n = 198) before and after 10 weeks of treatment. At 10 weeks, the global perceived effect scale was used to determine if participants judged themselves as worsened, unchanged, or improved. The mean change scores for each performance test were calculated. A performance test was considered responsive if the area under the receiver operating characteristic curve (AUC) was equal to or greater than 0.70. We used 2 methods to evaluate MCIC: the optimal cut-off point based on the receiver operating characteristic curve, which takes into account both sensitivity and specificity, and the minimal detectable change for improvement, which considers test specificity only. Results. In general, the mean change scores were the smallest in participants who judged themselves worsened and largest in those reporting to be improved. Sit-to-stand (AUC = 0.75) and stair climbing (AUC = 0.72) were the only performance tests that showed adequate responsiveness. For sit-to-stand, the MCIC ranged from 4.1 to 9.8 seconds (19%-45% of the mean baseline score). For stair climbing, the MCIC ranged from 14.5 to 23.9 steps (19%-31% of the mean baseline score). Conclusion. Only 2 of the 6 performance tests were responsive. Both had acceptable MCIC values. Developing individualized performance tests might partly overcome the general lack of responsiveness of performance tests. Future research should focus on the clinimetric testing of performance tests in subgroups.
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| 2. |
- Piskur, Barbara, et al.
(author)
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Parents actions, challenges, and needs while enabling participation of children with a physical disability: a scoping review
- 2012
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In: BMC Pediatrics. - : BioMed Central. - 1471-2431. ; 12:177
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Research review (peer-reviewed)abstract
- Background: Pediatric rehabilitation considers Family-centered service (FCS) as a way to increase participation of children with a physical disability in daily life. An important principal is that parents greatly contribute to their childs participation at school, at home, and in the community. However, it is unclear what kind of information is available from literature about what parents actually do to support their childs participation and what problems and needs they experience? Hence, the aim of this study was to provide an overview of the actions, challenges, and needs of parents in enabling participation of their child with a physical disability that is neurological and non-progressive in nature. less thanbrgreater than less thanbrgreater thanMethods: Scoping review with extensive literature search (September 2011) and a thematic analysis to synthesize findings. less thanbrgreater than less thanbrgreater thanResults: Fourteen relevant articles revealed two major themes: parents enable and support performance of meaningful activities and parents enable, change and use the environment. Each theme holds a number of actions (e. g. choosing the right type of meaningful activities for facilitating social contacts) and challenges (e. g. negative attitudes of other people). Less information is available about the needs of parents. less thanbrgreater than less thanbrgreater thanConclusions: This study indicates that parents apply a broad range of strategies to support participation of their children. They experience many challenges, especially as a result of constraints in the social and physical environments. However, this review also shows that little is known about needs of parents in facilitating participation. As Family-centered service (FCS) philosophy is all about the needs of the child and the family, it is essential to further investigate the needs of the parents and to understand if and to what extent they wish to be supported in enabling their childs participation in daily life.
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