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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 2000 Dicembre;35(4):171-82
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.