Biomedical subjects

Barbara Mazer

Publications and source records attributed to Barbara Mazer.

12 recordsLinked to original sources

PubMed2006

Validity and reliability of the modified shuttle walk test in patients with chronic obstructive pulmonary disease.

OBJECTIVES: (1) To examine the concurrent criterion validity of the modified shuttle walk test (MSWT) by using the 6- (6MWT) and 12-minute walk test (12MWT), (2) to examine the concurrent criterion validity of the estimated maximum oxygen uptake (Vo2max) of the MSWT with actual Vo2max, and (3) to determine test-retest reliability of the MSWT in patients with chronic obstructive pulmonary disease (COPD). DESIGN: Validation study. SETTING: Outpatient pulmonary rehabilitation program. PARTICIPANTS: Thirty clinically stable adults with COPD. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Subjects were randomly assigned to receive either the 6MWT and 12MWT or the MSWT first. The MSWT was repeated 1 week later (N = 30). Estimated Vo2max was calculated, and actual Vo2max was conducted by using the Jones test. Validity of the MSWT was assessed by comparing endurance scores and Vo2max with results from the 6MWT and 12MWT and Jones test, respectively. RESULTS: There was a moderately high correlation between the MSWT and the 6MWT and 12MWT at initial testing (.82 and .74, respectively). Correlation between estimated and actual Vo2max was r equal to .68. Test-retest reliability for the entire sample was high (intraclass correlation coefficient, .88). Results remained quite stable across severity, age, and sex subgroups. CONCLUSIONS: The MSWT is a standardized externally paced submaximal endurance walking test. The results indicate that the MSWT has high concurrent validity and test-retest reliability for patients with COPD.

Aged↗

PubMed2006

Diagnosing Sotos syndrome in the setting of global developmental delay and macrocephaly.

Sotos syndrome (cerebral gigantism) is characterized by macrocephaly, global developmental delay, characteristic facial dysmorphology, and a markedly advanced bone age. The purpose of this study was to describe the prevalence of Sotos syndrome in a consecutive series of patients with global developmental delay, which might modify our laboratory evaluation approach to this particular clinical situation. For a 10-year inclusive interval, the case records of all consecutive patients referred for global developmental delay in a single pediatric neurology practice were reviewed. Patients with macrocephaly were defined by an age- and gender-adjusted head circumference greater than or equal to the 98th percentile. Possible clinical factors associated with eventual diagnosis of Sotos syndrome in this group of macrocephalic children were tested with a two-tailed Fisher exact test. Of 261 children with global developmental delay, 18 (7%) had documented macrocephaly. Of these 18 children, 3 (17%) had an advanced bone age and were diagnosed with Sotos syndrome. In patients with global developmental delay and concomitant macrocephaly, Sotos syndrome is not uncommon. Assessment of bone age is a simple screening test for diagnosis of this entity and should be undertaken routinely in children with macrocephaly and global developmental delay even in the absence of other distinctive syndromic clinical features.

Abnormalities, Multiple↗

PubMed2006

Analysis of clinical features predicting etiologic yield in the assessment of global developmental delay.

OBJECTIVE: Global developmental delay is a common reason for presentation for neurologic evaluation. This study examined the role of clinical features in predicting the identification of an underlying cause for a child's global developmental delay. METHODS: Over a 10-year inclusive interval, the case records of all consecutive children <5 years of age referred to a single ambulatory practice setting for global developmental delay were systematically reviewed. The use of clinical features in predicting the identification of a specific underlying cause for a child's delay was tested using chi2 analysis. RESULTS: A total of 261 patients eventually met criteria for study inclusion. Mean age at initial evaluation was 33.6 months. An underlying cause was found in 98 children. Commonest etiologic groupings were genetic syndrome/chromosomal abnormality, intrapartum asphyxia, cerebral dysgenesis, psychosocial deprivation, and toxin exposure. Factors associated with the ability to eventually identify an underlying cause included female gender (40 of 68 vs 58 of 193), abnormal prenatal/perinatal history (52 of 85 vs 46 of 176), absence of autistic features (85 of 159 vs 13 of 102), presence of microcephaly (26 of 40 vs 72 of 221), abnormal neurologic examination (52 of 71 vs 46 of 190), and dysmorphic features (44 of 84 vs 54 of 177). In 113 children without any abnormal features identified on history or physical examination, routine screening investigations (karyotype, fragile X molecular genotyping, and neuroimaging) revealed an underlying etiology in 18. CONCLUSIONS: Etiologic yield in an unselected series of young children with global developmental delay is close to 40% overall and 55% in the absence of any coexisting autistic features. Clinical features are readily apparent that may enhance an expectation of a successful etiologic search. Screening investigations may yield an underlying cause.

Child, Preschool↗

PubMed2006

Adjustment to community residential settings over time among older adults with serious mental illnesses.

This exploratory cross-sectional study examined adjustment over time of three groups of seniors with serious mental illnesses (N=33), who were transferred from a psychiatric hospital to a community residential facility from 1995-1998. The study participants had lived in the community for 6-41 months. Outcomes included measures of global, social, cognitive and ADL functioning, quality of life and rehospitalizations. Analyses revealed no significant deterioration in symptomatology, cognitive and ADL functioning between groups and a significant change in social functioning. Five participants were readmitted for short hospitalizations. Participants in all groups expressed a positive quality of life in their current community residence.

Activities of Daily Living↗

PubMed2005

Eliciting information on differential sensation of heat in those with and without poststroke aphasia using a visual analogue scale.

BACKGROUND AND PURPOSE: Aphasia can result in an inability to communicate the presence, location, or intensity of pain. Although visual analogue scales (VASs) exist, it is unknown whether they are useful in assessing pain in individuals with aphasia. The objective was to determine whether those with poststroke aphasia could respond differentially to thermal stimuli of varying intensities using a standardized VAS. METHODS: Five groups of participants were assessed: those without stroke, those with stroke but without aphasia, and 3 groups with varying degrees of aphasia. A 10-cm vertical VAS was used to measure responses to varying thermal intensities delivered on the participant's forearm. RESULTS: Across all 5 groups, a similar proportion demonstrated ability to discriminate between 2 temperatures (chi2=1.899; P=0.75). When presented with 4 temperatures, all groups performed more poorly, yet with similar success rates across groups (chi2=0.1267; P=0.88). The repeated-measures ANOVA revealed no effect of group but a significant effect of temperature (P<0.0001). CONCLUSIONS: A VAS may be useful in clinical identification of differing intensities of stimuli in a substantial proportion of those with aphasia.

Adult↗

PubMed2005

Static wrist splint use in the performance of daily activities by individuals with rheumatoid arthritis.

OBJECTIVE: In individuals with rheumatoid arthritis (RA), to identify the influence of wrist splint wear on pain, work performance, endurance, perceived task difficulty, and perceived splint benefit while performing various upper limb tasks. METHODS: This crossover study included 30 individuals with wrist involvement. Pain, work performance, endurance, and perceived task difficulty were assessed with the splint on and off. Using a work simulator, participants performed 14 tasks, 10 assessing work performance and 4 assessing endurance. A visual analog scale (VAS) was used to rate pain, task difficulty, and perceived splint benefit. RESULTS: With the splint on, pain was significantly lower in 5 tasks, as was perceived difficulty in task performance. Work performance did not differ significantly with the splint on versus off. While mean endurance scores were always better with the splint on, differences reached significance on only one task. The task with greatest overall perceived splint benefit was "chopping with a knife." CONCLUSION: Results revealed that for most tasks, there was generally a positive effect of splint use on hand function; however, perceived splint benefit was marginal. For most tasks splint use improved or did not change pain levels, did not interfere with work performance, increased or maintained endurance, and did not increase perceived task difficulty. The findings suggest that wrist splint prescription is not a simple process; clinicians and clients need to work together to determine the daily wear pattern that maximizes benefit and minimizes inconvenience according to the client's individual needs.

Activities of Daily Living↗

PubMed2004

New directions in the outcome evaluation of children with cerebral palsy.

This article addresses newly emerging concepts regarding the examination of outcomes in children with cerebral palsy (CP). Three important factors have prompted a change toward a broader approach to outcome measurement: (1) the recent endorsement of the World Health Organization classification scheme of functioning, disability, and health; (2) recognition of the importance of the role of child and environmental factors in modifying outcome; and (3) appreciation of the challenges faced at key transitions during development. Comparison of the literature on outcomes in children with CP published in 2002 with studies published 10 years earlier demonstrates an increased number of studies and a wider range of outcome measures used to characterize the functioning of these children. A better understanding of the extent and nature of the outcomes and their determinants is critical to guide clinical decision making and program planning to maximize community integration, social participation, and overall well-being of the child and family.

Activities of Daily Living↗

PubMed2002

Discharging older adults with a severe and chronic mental illness in the community.

In recent years, a deinstitutionalization movement has been occurring in Canadian psychiatric institutions. Occupational therapists, experts in evaluating occupational performance, are key contributors to the selection of appropriate community housing environments. This study describes the global functioning, performance in activities of daily living, social behavior, cognitive status, and quality of life of 33 older adults with a severe and chronic mental illness, who were transferred from a psychiatric hospital to community facilities between 1995 and 1998. Evaluations were repeated five times, twice before discharge and three times after the transfer. Participants demonstrated stability in their global, social and ADL functioning over time. In general, participants required occasional intervention for management of social behaviors, moderate assistance in activities of daily living, and were highly satisfied with their community accommodation. The transfer to community settings did not lead to a significant deterioration in the participants' levels of global functioning and quality of life.

Activities of Daily Living↗

PubMedDate not supplied

Concurrent validity of the Neurobehavioural Assessment for Pre-term Infants (NAPI) at term age.

BACKGROUND: Accurate measurement of neonatal neurological integrity is critical for early identification of pre-term and full-term infants at-risk for developmental disability. The Neurobehavioural Assessment for Pre-term Infants (NAPI) was developed to measure the progression of neurobehavioural development in pre-term infants born between 32 weeks post-conceptional age (PCA) and term. This instrument has many unique advantages; however, criterion validity is unknown and results are subsequently difficult to interpret. OBJECTIVES: This study examined the concurrent validity of the NAPI against a criterion instrument, the Einstein Neonatal Neurobehavioural Assessment Scale (ENNAS), which measures similar constructs and has demonstrated excellent reliability and validity. METHODS: A sample of 41 pre-term and full-term infants (40 +/- 2 weeks) was assessed with the NAPI and ENNAS on the same day. RESULTS: The findings demonstrated that correlations between similar NAPI clusters and ENNAS clusters ranged from 0.35-0.65 and correlations between many similar individual NAPI and ENNAS items ranged from 0.40-0.60. Two NAPI clusters also discriminated between normal, abnormal and suspect performance on the ENNAS. CONCLUSION: The NAPI has many unique advantages as a tool. It examines neonates serially, has established weekly normative data and requires minimal infant handling. This study provides new validation of the NAPI instrument.

Awareness↗

PubMedDate not supplied

Rehabilitation services for children: therapists' perceptions.

The objective of this study was to examine occupational therapists' (OT) and physiotherapists' (PT) perceptions regarding waiting time and the quality and quantity of the services they provide for children with disabilities. A survey was sent by post to all paediatric OTs and PTs in Quebec, Canada. A Service Delivery Questionnaire included questions regarding therapist/client characteristics, waiting times and quality and quantity of services provided. The Measure of Processes of Care for Service Providers (MPOC-SP) rated use of family-centred care by responding clinicians. Waiting times were longest for OT services (p<0.0001), speech/language interventions (p<0.0001) and services in rehabilitation and community health centres (p<0.0001). Quality of services was rated higher by PTs, experienced therapists and those using more methods of keeping up-to-date. The frequency and duration of services varied according to profession, type of clientele and setting. According to clinicians directly involved in the provision of rehabilitation services, long delays exist for children waiting for rehabilitation services, and perceived quality of services differs according to specific therapist and client characteristics. These findings will assist those involved in planning the distribution of co-ordinated rehabilitation services for children.

Adolescent↗

PubMedDate not supplied

Development of a standardized instrument to assess computer task performance.

OBJECTIVE: The purpose of this study was to determine the psychometric properties of the Assessment of Computer Task Performance, specifically, the test-retest reliability, internal consistency, construct validity, and ability to discriminate between known groups. METHOD: This assessment comprises 14 standardized and timed tasks. It was administered to 24 persons with upper-extremity impairments and 30 with no impairments by a trained occupational therapist. To assess the test-retest reliability, participants in the impaired group were retested within 2 to 7 days. Intraclass correlation coefficients were calculated to determine test-retest reliability. Internal consistency was assessed with Cronbach's alpha, and factor analysis was conducted to examine construct validity. The Mann Whitney U Test was used to assess the test's ability to discriminate between the groups. RESULTS: Results indicated that the tool has excellent reliability and internal consistency, can discriminate between groups, and has appropriate construct validity. CONCLUSION: The Assessment of Computer Task Performance provides occupational therapists with an accurate test to measure computer performance and can assist them in providing computer access services.

Adolescent↗

PubMedDate not supplied

Validity of the Cognitive Behavioral Driver's Inventory in predicting driving outcome.

OBJECTIVE: This study seeks to (a) compare Cognitive Behavioral Driver's Inventory (CBDI) scores for clients who passed and failed a driving evaluation and for diagnostic groups (left cerebrovascular accident [CVA], right CVA, traumatic brain injury [TBI], and cognitive decline); (b) determine sensitivity, specificity, and positive and negative predictive values of the CBDI; (c) compare validity of the CBDI with other tools; and (d) identify factors associated with outcome. PARTICIPANTS: This historical cohort study included clients with neurological conditions who completed a driving evaluation. MEASURES: CBDI, Motor-Free Visual Perception Test (MVPT), Bells test, and driving results were extracted from the charts. RESULTS: Mean CBDI (p < 0.0001) and MVPT (p < 0.0001) scores were significantly worse for those failing compared to passing the driving evaluation. Sensitivity of the CBDI was 62%, specificity was 81%, positive predictive values were 73%, and negative predictive values were 71%. Results varied according to diagnostic group. CONCLUSIONS: The CBDI is not sufficiently predictive of outcome to replace a driving evaluation, and is predictive only for clients with R-CVA and TBI. Evaluation of driving should vary according to diagnosis.

Automobile Driver Examination↗