Showing papers by "Transitional Learning Center published in 2012"
TL;DR: The 6MWT provides a good estimate of peak aerobic capacity, and some measures are more responsive to change than others in patients recovering from TBI, establishing an acceptable level of criterion-related (concurrent) validity.
Abstract: Background A simple test of aerobic fitness for patients with traumatic brain injury (TBI) that is valid, reliable, and responsive to change is needed to provide clinicians a functional measure of cardiorespiratory capacity.
Objective The purpose of this study was to examine the validity and responsiveness to change of the Six-Minute Walk Test (6MWT) in individuals with TBI.
Design A cohort, pretest-posttest, comparison study was conducted.
Methods Twenty-one patients performed the 6MWT upon admission to and prior to discharge from a postacute rehabilitation facility. Heart rate and distance traveled were recorded. A physiologic cost index (PCI) (beats per meter) was calculated based on steady-state heart rate. At discharge, all participants were able to perform a graded treadmill exercise test to exhaustion during which peak oxygen consumption (Vo2) was measured.
Results Between admission and discharge, mean total distance increased from 342.6 m (SD=127.0) to 408.9 m (SD=124.2), and work increased from 27,185 kg·m (SD=10,528) to 34,114 kg·m (SD=12,057). The effect size indexes were 1.10 and 1.12 for distance and work, respectively. Correlations ( r ) between the discharge peak Vo2 and the discharge 6MWT distance, PCI, and work were .58, −.61, and .47, respectively.
Limitations Stratification by gait speed may have improved responsiveness, especially for the slow ambulators.
Conclusions All measures correlated well with peak Vo2, establishing an acceptable level of criterion-related (concurrent) validity. The addition of heart rate and calculating the PCI was only slightly better at predicting peak Vo2, albeit nonsignificant, than a simple measure of total distance. The 6MWT provides a good estimate of peak aerobic capacity, and some measures are more responsive to change than others in patients recovering from TBI.
52 citations
TL;DR: The assessment of positive affect during in-patient medical rehabilitation may identify those at risk for poor social participation post-discharge and may lead to the design of innovative interventions aimed at the re-integration of stroke individuals into the community.
Abstract: Purpose: To examine the association between positive affect and social participation in adults with first-time stroke after in-patient medical rehabilitation. Methods: A prospective cohort design using information from the Stroke Recovery in Underserved Populations database (SRUP) for the years 2005–2006. Data were collected at discharge from in-patient medical rehabilitation and 3 months post-discharge. Participants were aged 50 and older with first-time stroke (n = 605) and admitted to 1 of 11 in-patient medical rehabilitation facilities across the United States. Primary measures included a positive affect scale and a home and community social participation instrument. Results: The mean age was 71.6 years, 50.3% were women, and 56.5% were married. Results of cumulative logit models showed each 1 point increase in positive affect was significantly associated with a 17% odds of higher social participation (OR: 1.17, 95% CI 1.10, 1.25), after adjusting for demographics, clinical characteristics, and negati...
47 citations
TL;DR: A more thorough understanding of blast injury mechanisms will result in novel and more effective therapeutic and rehabilitative strategies designed to reduce injury and facilitate recovery, thereby improving long-term outcomes in patients suffering from the devastating and often lasting effects of BINT.
Abstract: Blast injury is the most prevalent source of mortality and morbidity among combatants in Operations Iraqi and Enduring Freedom. Blast-induced neurotrauma (BINT) is a common cause of mortality, and even mild BINT may be associated with chronic cognitive and emotional deficits. In addition to military personnel, the increasing use of explosives by terrorists has resulted in growing numbers of blast injuries in civilian populations. Since the medical and rehabilitative communities are likely to be faced with increasing numbers of patients suffering from blast injury, the 2010 Galveston Brain Injury Conference focused on topics related to the diagnosis, treatment, and mechanisms of BINT. Although past military actions have resulted in large numbers of blast casualties, BINT is considered the signature injury of the conflicts in Iraq and Afghanistan. The attention focused on BINT has led to increased financial support for research on blast effects, contributing to the development of better experimenta...
37 citations
TL;DR: The tests of cognition and physical function are reviewed and proposed as the minimal tests that are feasible for a physician to perform in a clinical setting for subjects with brain injury and GH deficiency.
Abstract: There are scant prospective studies defining improvements in critical outcome measures with hormone replacement in hypopituitarism secondary to brain injury. We review the tests of cognition and physical function and summarize their use for subjects that are deficient in anterior hormone production during anterior pituitary hormone replacement in brain injury and propose these as the minimal tests that are feasible for a physician to perform in a clinical setting. We summarize the studies conducted to assess outcome measures after brain injury and also report preliminary findings for improvements in cognition and physical function in subjects with brain injury and GH deficiency.
8 citations