Biomedical subjects

Johanne Higgins

Publications and source records attributed to Johanne Higgins.

4 recordsLinked to original sources

PubMed2006

The effect of a task-oriented intervention on arm function in people with stroke: a randomized controlled trial.

OBJECTIVE: To evaluate the efficacy of a task-oriented intervention in enhancing arm function in people with stroke. DESIGN: Two-centre, observer-blinded, stratified, block-randomized controlled trial. SETTING: General community. PATIENTS: Ninety-one individuals within one year of a first or recurrent stroke consented to participate between May 2000 and February 2003. INTERVENTIONS: The experimental intervention involved practice of functional, unilateral and bilateral tasks that were designed to improve gross and fine manual dexterity whereas the control intervention was composed of walking tasks. Members in both groups participated in three sessions a week for six weeks. MAIN OUTCOME MEASURE(S): The primary test of arm function was the Box and Block Test. Secondary tests included the Nine-Hole Peg Test, maximal grip strength, the Test d'Evaluation des Membres supérieurs des Personnes Agées (TEMPA) and the Stroke Rehabilitation Assessment of Movement. RESULTS: Results are for the more affected arm. Baseline performance on the Box and Block Test was an average of 26 blocks (standard deviation (SD) = 16) in the experimental group (n = 47) and 26 blocks (SD = 18) in the control group (n = 44). These values represent approximately 40% of age-predicted values. Values for the postintervention evaluation were an average of 28 (SD = 17) and 28 (SD = 19) blocks for the experimental and control group respectively. No meaningful change on other measures of arm function was observed. CONCLUSIONS: A task-oriented intervention did not improve voluntary movement or manual dexterity of the affected arm in people with chronic stroke.

Activities of Daily Living↗

PubMed2004

Incorporating the International Classification of Functioning, Disability, and Health (ICF) into an electronic health record to create indicators of function: proof of concept using the SF-12.

OBJECTIVE: The purpose of this proof-of-concept study was to assess the feasibility of using a generic health measure to create coded functional status indicators and compare the characterization of a stroke population using coded functional indicators and using health-related quality-of-life summary measures alone. DESIGN: Multiple raters assigned International Classification of Functioning, Disability, and Health (ICF) codes to the items of the 12-Item Short Form Health Survey (SF-12). Data for comparing the information from the SF-12 and from ICF codes were derived from the Montreal Stroke Cohort Study that was set up to examine the long-term impact of stroke. Available for analysis were data from 604 persons with stroke, average age 69 years, and 488 controls, average age 62 years. MEASUREMENT: The SF-12 provides two summary scores, one for physical health and one for mental health. Domains of the ICF are coded to three digits, before the decimal; specific categorizations of impairments, activity limitations, and participation restrictions are coded to four digits before the decimal. RESULTS: Persons with stroke scored, on average, approximately 10 points lower than controls on physical and mental health. The ICF coding indicated that this was attributed, not surprisingly, to greater difficulty in doing moderate activities including housework, climbing stairs, and working and was not attributed to differences in pain. Differences in mental health were attributed most strongly to greater fatigue (impairment in energy), but all areas of mental health were affected to some degree. CONCLUSION: The ICF coding provided enhanced functional status information in a format compatible with the structure of administrative health databases.

Activities of Daily Living↗

PubMed2003

The Stroke Rehabilitation Assessment of Movement (STREAM): a comparison with other measures used to evaluate effects of stroke and rehabilitation.

BACKGROUND AND PURPOSE: The Stroke Rehabilitation Assessment of Movement (STREAM) is a relatively new measure of voluntary movement and basic mobility. The main objectives of this study were: (1) to examine the relationship of the STREAM to other measures of impairment and disability and (2) to compare its usefulness for evaluating effects of stroke and rehabilitation and for assessing change over time with that of other measures of impairment and disability. SUBJECTS AND METHODS: The performance of 63 patients with acute stroke on the STREAM and other measures of impairment and disability was evaluated during the first week after stroke and 4 weeks and 3 months later. RESULTS: Scores on the STREAM were associated with scores on the Box and Block test, Balance Scale, Barthel Index, gait speed, and the Timed "Up Go" Test (with Pearson correlation coefficients ranging from .57 to .80) and were associated with categories of the Barthel Index and Balance Scale. The STREAM's ability to predict discharge destination from the acute care hospital, as well as to predict gait speed and Barthel Index scores at 3 months poststroke, was comparable to that of other commonly used measures. Standardized response mean estimates provided supporting evidence for the ability of the STREAM to reflect change over time. DISCUSSION AND CONCLUSION: The results obtained with the STREAM, as compared with other measures of impairment and disability in people with stroke, suggest that it may be useful in clinical practice and research.

Adult↗

PubMedDate not supplied

Upper-limb function and recovery in the acute phase poststroke.

This study evaluates stroke patients with upper-limb (UL) motor deficits using measures of impairment and "activity limitation" to quantify recovery of UL function poststroke and to identify predictors of UL function and predictors of UL recovery following stroke. The study also compares the recovery of UL function with that of the lower limb (LL). Measures of impairment and "activity limitation" of the UL and LL improved over the first 5 weeks. The Box and Block Test performance improved the most over 5 weeks (standardized response mean [SRM] = 1.34), followed closely by the 5-meter walk test (SRM = 0.97). Performances on measures of UL "activity limitation" measured at 1 week poststroke were the most important predictors of UL function 5 weeks poststroke. The results of this study do not support the belief that recovery of LL function is faster than that of UL.

Aged↗