PubMed HealthSearch

Biomedical subjects

K Ottenbacher

Publications and source records attributed to K Ottenbacher.

At least 19 recordsLinked to original sources

Impact of random assignment on study outcome: an empirical examination.

Sixty research investigations published in the biomedical literature were analyzed to examine the effect of design attributes on outcome. All 60 studies included a controlled trial involving a pretest, a therapeutic intervention, and a posttest across at least two groups. Thirty of the trials used random assignment of participants to treatment or control conditions and 30 trials employed some nonrandom method of subject assignment. Trial results were aggregated and evaluated by comparing effect sizes for the primary statistical test of the hypothesis. Data analysis revealed that the trial results, as measured by effect size, did not vary across therapeutic trials using random assignment versus those using nonrandom allocation of subjects. The impact of design attributes in the interpretation of multiple clinical trials addressing a similar research question is examined. The argument is made that various design attributes frequently associated with methodological quality should be considered as important moderator variables and their influence on trial outcome should not be assumed a priori but rather examined empirically.

Data Interpretation, Statistical

Use of applied behavioral techniques and an adaptive device to teach lip closure to severely handicapped children.

The effectiveness of applied behavioral programming in teaching lip closure was investigated with 3 severely retarded male students who had oral motor dysfunction. A multiple-baseline design across subjects was employed. The results revealed dramatic increases in the level of functional lip closure for all 3 students when an appropriate adaptive device was combined with behavioral intervention. Follow-up results indicated that functional lip closure generalized to other feeding tasks. Findings suggest that applied behavioral management may be successfully used to teach specific oral motor skills and facilitate integration of these skills into a normalized feeding pattern.

Adolescent

Efficacy of spinal manipulation/mobilization therapy. A meta-analysis.

A quantitative review (meta-analysis) was undertaken to synthesize existing evidence on the efficacy of joint mobilization and manipulation and expose consumers of rehabilitation research to the methods and procedures of quantitative reviewing. Potentially relevant studies were obtained through a computer-assisted bibliographic search of the Index Medicus data base and through examination of references contained in retrieved studies. A total of 57 titles were potentially relevant to manipulation/mobilization, but only nine met the prespecified criteria for inclusion in the quantitative review. Data analysis indicated that studies not employing random assignment were more likely to produce results supporting the use of manipulation/mobilization therapies. The effects in favor of manipulation and mobilization were greater when manual therapy was provided in conjunction with other forms of treatment and were also greater when the treatment effects were measured immediately following therapy. In addition, hypotheses tests appearing in journals published in the United States showed manipulation/mobilization less effective in comparison with reports appearing in English language journals published outside the United States. The results provided only limited empirical support for spinal mobilization and manipulation when used to treat pain, flexibility limitations, and impairment in physical activity.

Back Pain

Quantitative trends in occupational therapy research: implications for practice and education.

Articles that appeared in The American Journal of Occupational Therapy (vol 27, 1973 and vol 37, 1983) were reviewed and categorized according to the quantitative procedures employed. Data analysis revealed that the proportion of articles reporting no statistical information decreased from 57% in 1973 to 31% in 1983. Conversely, there was a significant increase in articles containing quantitative methods that were categorized as advanced, from 8% (vol 27) to 29% (vol 37). A trend was also revealed toward multiple authorship of articles over the ten-year period. In addition, the senior authors of articles appearing in 1983 were much more likely to possess graduate degrees than were senior authors of articles published in 1973. This paper discusses the implications of the increased use of quantitative procedures in the occupational therapy literature.

Occupational Therapy

Reliability of the Behavioral Assessment Scale of Oral Functions in Feeding.

Interrater and test-retest reliability of the Behavioral Assessment Scale of Oral Functions in Feeding were computed for two separate samples of severely and profoundly handicapped students having oral-motor and feeding disorders. Reliability was assessed using the intraclass correlation-generalizability theory approach and resulted in coefficients ranging from .68 to .84. These values were considered only marginally acceptable by current standards of instrument development advocated in the behavioral sciences. This paper discusses the difficulty in developing psychometrically satisfactory assessment instruments for use with the severely and profoundly developmentally disabled and gives implications for practice and future research.

Adolescent

Human figure drawing ability and vestibular processing dysfunction in learning-disabled children.

Explored the relationship between vestibular function as measured by duration of postrotary nystagmus and human figure drawing ability in 40 children labeled as learning disabled. Regression analysis revealed that the variable of chronological age shared the most variance with human figure drawing scores. Postrotary nystagmus durations also shared a significant amount of variance with human figure drawing scores, while the variables of IQ and sex were nonsignificant. The results provide additional support for the assertion that some learning-disabled children evidence deficits in vestibular processing ability and that these deficits may affect performance on cognitive-perceptual tasks.

Child

Strategies for evaluating clinical change: implications for practice and research.

The methods and procedures of evaluation research using single-system or small-N designs are defined and described. Various components of single-system evaluation research, including specifying the problem, measuring and recording the data, selecting an appropriate design, and analyzing the data, are presented and discussed. The argument is made that single-system evaluation research methods are ideally suited to document clinical change on an individual basis and can provide a mechanism for establishing therapeutic accountability. The relationship between single-system evaluation research and the more traditional experimental procedures is briefly explored, and the implications for establishing an empirically derived basis for clinical practice are discussed.

Clinical Trials as Topic

Effects of vibratory, edible, and social reinforcement on performance of institutionalized mentally retarded individuals.

The relative effectiveness of verbal praise, vibration, and edible reward as methods of enhancing and maintaining performance on a perceptual-motor task was investigated. Sixty-six mentally retarded students were divided into high- and low-MA groups and randomly assigned to reinforcement conditions. Data analysis revealed that response rates for the low-MA students in the verbal condition reinforcement and the nonreinforcement phases were significantly lower than the response rates for the low-MA students in any phase of the edible or vibratory conditions. No significant difference in reinforcer effectiveness was observed across various phases for students in the high-MA groups.

Adolescent

Developmental implications of clinically applied vestibular stimulation.

Recent research has promoted the development of several techniques that use various forms of sensory stimulation to improve the neuromotor development of high-risk infants and developmentally delayed children. One of the newest and most popular adjuncts to therapy for developmentally delayed children is vestibular stimulation. The applied clinical research using vestibular stimulation activities with healthy human infants, infants at risk, and young children with developmental delay disorders is reviewed. The literature discussed indicates that controlled vestibular stimulation has had positive effects on arousal level, visual exploratory behavior, motor development, and reflex integration. Also discussed is the need for continued applied clinical research to further substantiate the most effective type of vestibular stimulation and the population for which such stimulation is most beneficial.

Cerebral Palsy

Vestibular-proprioceptive functions in 4 year olds: normative and regression analyses.

Normative data were obtained for 156 pre-school children's performances on measures of muscle tone, muscle co-contraction, standing balance, prone extension posture, flexion supine posture, asymmetrical tonic neck reflex, and postrotary nystagmus. Regression analysis indicated that these combined variables accounted for only 13.5 percent of the variance of postrotary nystagmus of 145 four year olds. However, if the data are examined only for children exhibiting nystagmus that is lower than 1 standard deviation below the mean, then these variables account for 50 percent of the variance of nystagmus. Prone extension posture, standing balance-eyes closed, and muscle tone account for 37 percent of the variance within this low-nystagmus population. These results are considered in light of the authors' previous studies demonstrating that, in learning-disabled children, vestibular-proprioceptive measures can be used clinically to predict which children will respond to sensory integration therapy with changes in postrotary nystagmus. These changes, according to sensory integration theory, reflect positive responses to therapy.

Child, Preschool

Quantitative reviewing: the literature review as scientific inquiry.

The literature review process is conceptualized as a form of scientific inquiry that involves methodological requirements and inferences similar to those employed in primary research. Five stages of quantitative reviewing that parallel stages in primary investigation are identified and briefly described. They include problem formation, data collection, data evaluation, analysis and interpretation, and reporting the results. The first two stages provide information and guidelines relevant to reviewers' employing traditional narrative procedures or conducting reviews of qualitative research literature. The final three stages relate specifically to the methodology of quantitative reviewing. The argument is made that quantitative reviewing procedures represent a paradigm shift that can assist researchers and clinicians in occupational therapy to establish a scientific data base that will serve to guide theory development and validate clinical practice.

Data Collection

Oral sensorimotor therapy in the developmentally disabled: a multiple baseline study.

The efficacy of a program of sensorimotor facilitation procedures to improve oral motor function and feeding behaviors in students with severe developmental delay was explored. Four severely handicapped students were administered the oral habilitation program using a multiple baseline across-subjects design with staggered introduction of the treatment. Graphic analysis and the split middle method of trend estimation revealed that one subject evidenced an increase in weight and improved oral motor evaluation as a result of the intervention. Two other subjects displayed partial improvement. The correlates of treatment effectiveness are briefly discussed and the need for continued investigation is emphasized.

Adult

Patterns of postrotary nystagmus in three learning-disabled children.

This study explores the effect of a program of sensory integration therapy, with emphasis on vestibular stimulation activities, on the duration of postrotary nystagmus in three learning-disabled children. The single-subject methodology employed allowed a more individualistic and longitudinal investigation of nystagmus patterns in the three subjects. The graphic and statistical analysis of the data revealed that two of the three subjects evidenced significant changes in postrotary nystagmus durations over the 25-week period of the study. Subject 1, with initially low nystagmus durations, displayed an increase in duration, whereas subject 2, with initially normal postrotary nystagmus durations, exhibited a response decline in nystagmus durations. The postrotary nystagmus durations of subject 2 remained relatively stable across both the baseline and intervention periods. The therapeutic implications of the findings are discussed, and areas in need of additional investigation are highlighted.

Child

Occupational therapy and special education: some issues and concerns related to Public Law 94-142.

Because of the evolving nature of the professions involved in providing services to the developmentally disabled as mandated by PL 94-142, the potential of theoretical and programmatic conflict exists. Some of the philosophical differences and similarities between occupational therapy and special education are reviewed. Two conceptual approaches to therapy and education are identified. The first approach is based on the medical model, which emphasized diagnostic evaluation to determine the cause of a disorder and the prescription of remedial activities to alleviate the dysfunction. The second approach is the task analysis model, which emphasized task content and behaviorally based teaching strategies and objectives. It is proposed that, through a mutual understanding and cooperative effort on the part of all professionals, the two models may be combined to provide comprehensive services to the developmentally disabled.

Adolescent

Sensory integration therapy: affect or effect.

The results of studies examining the effectiveness of sensory integration therapy were reviewed, using recently developed quantitative methods that treat the literature review process as a unique type of research. Forty-nine studies were located initially. Eight of these studies met the following criteria: (a) they investigated the effect of sensory integration therapy; (b) they included dependent measures of academic achievement, motor or reflex performance, and/or language function; (c) they included a comparison between at least two groups; and (d) they reported quantitative results of the effect of sensory integration therapy. The 8 studies contained a total of 47 statistical hypothesis tests that evaluated the effectiveness of sensory integration therapy. An analysis of these tests, using quantitative reviewing methods, revealed that subjects participating in sensory integration therapy performed significantly better than members in the control groups who did not receive sensory integration therapy. The application of sensory integration therapy to various client populations is discussed in relation to the existing empirical support revealed in the studies reviewed. The advantages of quantitative reviewing procedures are discussed, and use of the procedures with the developing occupational therapy research literature is recommended.

Developmental Disabilities

An investigation of self-concept and body image in the mentally retarded.

Explored the relationship of self-drawings to scores on a measure of self-concept in a sample of 31 mentally retarded Ss. Five variables hypothesized to be related to self-concept including overall self-drawing score, size of self-drawing, age, sex, and IQ were subjected to forward (stepwise) multiple regression analysis. Data analysis revealed that four of the five variables shared significant variance with self-concept scores. It is suggested that these variables can provide additional information in evaluating the self-concept of the mentally retarded.

Adolescent