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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 2000 December;35(4):171-82

language: English

Comparison ­among func­tion­al out­come meas­ures for trau­mat­ic ­brain inju­ry: assess­ment in the Ital­ian com­mu­nity

Cantagallo A. 1, Maietti A. 2, Hall K. M. 3, Bushnik T. 3

1 Department of Rehabilitation, Hospital of Ferrara, Italy;
2 Department of Psychology, University of Aberdeen, UK;
3 Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San José, CA, USA


BACKGROUND: The aim of ­this ­study is to inves­ti­gate sta­tis­ti­cal and clin­i­cal char­ac­ter­is­tics ­across meas­ures, espe­cial­ly sen­si­tiv­ity to out­come ­issues in the com­mu­nity and rela­tion­ships ­between meas­ures.
METHODS: We ­assessed for­ty Italian ­adult indi­vid­u­als ­with ­prior mod­er­ate to ­severe Traumatic Brain Injury (TBI), who had ­received inpa­tient reha­bil­i­ta­tion two to ­nine ­years pre­vi­ously, in a com­mu­nity in Northern Italy. The out­come meas­ures ­were: The Community Integration Questionnaire (CIQ), Neurobehavioural Functioning Inventory (NFI), Patient Competency Rating Scale (­PCRS), Level of Cognitive Functioning Scale (­LCFS), Functional Independence Measure (FIM)™, Functional Assessment Measure (FIM+FAM), Supervision Rating Scale (SRS), Disability Rating Scale (DRS), Revised Craig Handicap Assessment and Reporting Technique (R-­CHART), and Glasgow Outcome Scale (GOS).
RESULTS: Measures ­with the few­est max­i­mum ­scores ­were the DRS, CIQ Home Integration and Social Integration sub­scales, and R-­CHART Cognition and Occupation sub­scales. Measures ­with the great­est num­bers of max­i­mum ­scores, indi­cat­ing func­tion­al inde­pen­dence, ­were the FIM Motor, Cognition and Total Score, R-­CHART Physical Independence, FIM+FAM Cognition and Total ­score, the NFI Somatic Difficulties and Aggression sub­scales, the ­LCFS, and the SRS. The ­items/sub­scales/­total ­scores ­that ­showed ­good var­i­abil­ity ­were: FAM Total, CIQ Social Integration and Total, ­PCRS Total, R-­CHART Cognition and Occupation and NFI (all sub­scales). Among meas­ures ­that ­showed ade­quate var­i­abil­ity, the ­only ­items/sub­scales/­total ­scores ­that ­were high­ly inter­cor­re­lat­ed ­were the ­PCRS ­with the NFI Memory/Attention and Motor sub­scales. The pro­por­tion of indi­vid­u­als obtain­ing max­i­mum ­scores on ­some meas­ures ­were sub­stan­tial, reflect­ing the attain­ment of func­tion­al inde­pen­dence, at ­least as meas­ured by ­those ­scales.
CONCLUSIONS: These ceil­ing ­effects ­could indi­cate ­that the meas­ure is inap­pro­pri­ate for the ­high lev­el of func­tion­ing of the sam­ple test­ed in the com­mu­nity.

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