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Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici

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

lingua: Inglese

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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