Biomedical subjects

Luc Noreau

Publications and source records attributed to Luc Noreau.

14 recordsLinked to original sources

PubMed2006

Measurement of participation in myotonic dystrophy: reliability of the LIFE-H.

Person-perceived social participation is an important aspect to measure in rehabilitation in neuromuscular disorders. The objective was to document the test-retest and inter-rater reliability of the Assessment of Life Habits (LIFE-H), in a sample of individuals with myotonic dystrophy (DM1). Twenty-eight participants with myotonic dystrophy aged between 29 and 75 years (mean: 52.7) were recruited. The LIFE-H questionnaire was administered at three different occasions. The LIFE-H demonstrates high test-retest and inter-rater reliability (ICCs: 0.80-0.92) for the total score and subscores (daily activities and social roles). Moderate to high test-retest reliability (ICCs: 0.76-0.92) was found for most categories (8/10) of the LIFE-H. Similar results were obtained for inter-rater reliability (ICCs: 0.68-0.93). Moderate to high agreement using the Bland and Altman method was obtained for most categories. The LIFE-H, a measure of person-perceived social participation, demonstrates adequate test-retest and inter-rater reliability for clinical and research purposes in myotonic dystrophy.

Activities of Daily Living↗

PubMed2006

Predictors of long-term participation after stroke.

PURPOSE: (1) To explore factors that predict long-term participation after stroke (2-4 years after discharge from rehabilitation), and (2) to determine factors that predict both short- and long-term participation. METHODS: Biopsychosocial data of people who had had a stroke were measured at discharge from an intensive rehabilitation unit using valid instruments. Six months later (n=102) as well as 2-4 years later (n=66), social participation of the survivors was measured in their living environments. Participation was estimated with the Assessment of Life Habits (LIFE-H), which includes 12 categories of daily activities and social roles. RESULTS: From multivariate regression analyses, the best predictors of long-term participation after stroke appear to be age, comorbidity, motor coordination, upper extremity ability and affect. Age, comorbidity, affect and lower extremity coordination are the best predictors of participation after stroke at both measurement times. CONCLUSIONS: With the exception of age, these factors may be positively modified and thus warrant special attention in rehabilitation interventions.

Activities of Daily Living↗

PubMed2006

Long-term changes in participation after stroke.

BACKGROUND AND PURPOSE: People who have had a stroke may have difficulty resuming some of their previous activities, which leads to a decline in their participation in daily activities and social roles. The purposes of this study were to compare participation 6 months (T1) and between 2 and 4 years (T2) after discharge from a rehabilitation unit and to verify if any changes were associated with changes in personal and environmental factors. METHOD: Participation of people who had had a stroke was measured at T1 and T2 with the Assessment of Life Habits. RESULTS: A significant reduction (p < .001) in participation in daily activities was observed, specifically in the following categories: nutrition, p < .001; fitness, p = .004; personal care, p < .001; and housing, p = .001. However, participation in social roles was maintained during this period (p = .10). The increased perception of technology as a facilitator (environmental factor) over time explained a part of the decline in participation (R2 = 0.13). CONCLUSION: Factors associated with the reduction in participation in daily activities should be further studied in order to prevent this decline.

Activities of Daily Living↗

PubMed2005

Reliability of the seated postural control measure for adult wheelchair users.

PURPOSE: To evaluate the test-retest and interrater reliability of the Seated Postural Control Measure for Adults 1.0 (SPCMA 1.0). METHOD: The participants were evaluated first by two raters and then, 3 weeks later, by one rater. Section 1 (one item, seven-point scale) evaluates the adult's overall ability to control its posture in a sitting position. Sections 2 and 3 (22 items each, scored on a seven-point scale), evaluate the adult's postural alignment in a static position and the changes in postural alignment induced by a dynamic activity. RESULTS: For the test-retest reliability, the intraclass correlation coefficient (ICC) of section 1 was excellent (0.95) and moderate to good for sections 2 and 3 (0.60 - 0.62) and their subsections (0.47 - 0.78). For interrater reliability, the three sections had good to excellent ICCs (0.68 - 0.93) and their subsections had moderate to good ICCs (0.41 - 0.69). A large range was observed in Kappa coefficients (test-retest and interrater reliability) for the item analysis of the sections 2 and 3, due to a lack of variability in some items. CONCLUSIONS: The results confirm that the SPCMA is reliable as a whole. Suitable information has been obtained for the development of the SPCMA 2.0 and, although further psychometric testing is needed, the latter should improve clinical evaluation of seated postural control in adult wheelchair users.

Activities of Daily Living↗

PubMed2005

Adaptation of a seated postural control measure for adult wheelchair users.

PURPOSE: Clinical measures of seated postural control in adults are not standardized and most are derived from in-house tools. The purpose of this study is to adapt a pediatric instrument to evaluate seated postural control in adult wheelchair users. METHOD: The new instrument is called the Seated Postural Control Measure for Adults (SPCMA) 1.0. Five preliminary versions were pretested with some 20 adults by two raters and a group of experts. RESULTS: This instrument comprises three sections: Section 1, level of sitting scale for adults (1 item, 7-point ordinal scale); Section 2, static postural alignment (22 items, 7-point ordinal scale); and Section 3, postural alignment after a dynamic activity, propulsion of the wheelchair on flat terrain and an incline (22 items, 7-point ordinal scale). CONCLUSIONS: The SPCMA for Adults 1.0 improves the quality and uniformity of evaluations done by different raters, which facilitates more rigorous follow-up of clients over time, communication between professionals, and objective verification of the attainment of intervention objectives.

Activities of Daily Living↗

PubMed2005

Participation after stroke compared to normal aging.

OBJECTIVE: To examine the reduction in participation of people who have had a stroke compared with healthy people with normal aging. DESIGN: Participation of people who had a stroke was compared with participation of healthy subjects. SUBJECTS/PATIENTS: Forty-six people who had a stroke for 2-4 years and 46 healthy participants matched on age, sex and living environment. MEASUREMENTS: Participation was estimated with the Assessment of Life Habits (LIFE-H). The LIFE-H (short version 2.1) is composed of 58 daily activities and social roles associated to the 12 categories of the Disability Creation Process model. The LIFE-H gives separate scores for each category, for 2 main subsections "Daily activities" and "Social roles" and a total score. RESULTS: Scores of healthy subjects did not reach the maximum value (9/9) of the LIFE-H, their mean scores varying from 6.3 to 8.6, according to the categories. These scores are higher than of the participants with stroke for all categories (scores varying from 3.9 to 6.5; p-values from 0.002 to <0.001), except the interpersonal relationships category (score of 7.8 vs 8.0) where no difference was found (p=0.49). The disruption in participation after stroke varies according to the categories of the LIFE-H, but is more important in the daily activities categories. CONCLUSION: The comparison of the scores obtained by the 2 groups suggests that a part of the reduction in participation in daily activities and social roles after stroke is attributable to normal aging and not entirely to the stroke itself. It helps to focus interventions on activities and roles disruption domains that are really attributable to stroke.

Activities of Daily Living↗

PubMed2005

Quality of life after spinal cord injury.

Quality of life (QOL) is an often-used but it remains an ill-understood concept in medicine. Literature suggests 3 important approaches to operationalize and measure QOL: Health-related quality of life (HRQOL), well-being, and QOL as a superordinate construct. To measure the various instruments of HRQOL (SF-36 and Sickness Impact Profile) and well-being (Satisfaction With Life Scale and Life Satisfaction Questionnaire LiSat) are used. Domains on which QOL of persons with SCI lag behind QOL of the general population are identified. Overall, this paper suggests: (1) that inspection of the QOL measure used in a particular study is necessary to identify the domains of QOL that are measured, (2) that most measures lack sufficient evidence of reliability and validity, and (3) that longitudinal studies starting in the early phase of rehabilitation are necessary to reveal the course and predictors of QOL of persons with SCI.

Activities of Daily Living↗

PubMed2005

Participation after spinal cord injury: the evolution of conceptualization and measurement.

The increasing life expectancy after spinal cord injury has given social participation a new recognition as one of the ultimate goals of a comprehensive rehabilitation process. Recent evolution of the concept suggests 2 different approaches to document participation after spinal cord injury and a careful appraisal of the related outcome measures is important as discrepancies of results between the 2 approaches can be significant. Literature on objective participation reports a large variability in several dimensions that are particularly influenced by intrinsic factors such as severity of injury and secondary impairments. The direct influence of the environmental factors remains to be demonstrated by empirical studies. There are fewer tools available to evaluate subjective impressions of participation but recent investigations support the importance of taking account of the person's perceived restrictions participation in order to get better understandings of an individual's specific needs and problems. The aim of this article is to present the evolution of the conceptualization and measurement of the two approaches and to describe the level of participation of individuals with SCI.

Activities of Daily Living↗

PubMed2004

Is social participation associated with quality of life of older adults with physical disabilities?

PURPOSE: To explore the relationships between subjective quality of life and social participation of older adults with physical disabilities. METHOD: A cross-sectional design was used with a convenience sample of 46 people aged 60 to 90 living in the community. Subjective quality of life was estimated with the Quality of Life Index and social participation with the Assessment of Life Habits. RESULTS: Only a weak relationship was found between total scores of quality of life and social participation. Interpersonal relationships, responsibilities, fitness and recreation were the categories of social participation most associated with quality of life. Social roles were more associated with quality of life than daily activities. Finally, satisfaction with the accomplishment of life habits was also more associated with quality of life than the performance itself. CONCLUSIONS: The importance of social participation in regard to the quality of life of older persons with physical disabilities living in the community is partially supported by these findings. Other studies are needed to clarify how social participation influences quality of life in this population.

Aged↗

PubMed2004

Measuring social participation: reliability of the LIFE-H in older adults with disabilities.

PURPOSE: Much more attention should be paid to instruments documenting social participation as this area is increasingly considered a pivotal outcome of a successful rehabilitation. The purpose of this study was to document the reliability of a participation measure, the Assessment of Life Habits (LIFE-H), in older adults with functional limitations. METHODS: Eighty-four individuals with physical disabilities living in three different environments were assessed twice with the LIFE-H, an instrument that documents the quality of social participation by assessing a person's performance in daily activities and social roles (life habits). RESULTS: The intraclass correlation coefficients (ICC) computed for intrarater reliability exceeded 0.75 for seven out of the 10 life habits categories. For interrater reliability, the total score and daily activities subscore are highly reliable (ICC </=0.89), and the social roles subscore is moderately reliable (ICC = 0.64). 'Personal care' is the category with the highest ICC, and for five other categories ICCs are moderate to high (< 0.60). CONCLUSION: LIFE-H is a valuable addition to instruments that mostly emphasize the concepts of function or functional independence. It is particularly meaningful to evaluate the participation of older adults in significant social role domains such as recreation and community life. It may be considered among the instruments having the best fit with the ICF definition of participation (the person's involvement in a life situation) and a majority of its related domains.

Activities of Daily Living↗

PubMed2004

Social participation of older adults in Quebec.

BACKGROUND AND AIMS: Measuring social participation of older adults is an important issue, since this concept includes not only daily activities (e.g.: feeding, personal care, mobility) but also social roles (e.g.: interpersonal relationships, leisure). The purpose of this study was to determine whether or not increased age is associated with a decrease in social participation. The study also explored relationships between social participation and some personal and environmental characteristics. METHODS: The Assessment of Life Habits (LIFE-H) was used to document social participation in 189 community-dwelling people aged 55 and over. The LIFE-H (short version 3.1) is composed of 77 daily activities and social roles associated with the 12 categories of the Disability Creation Process model. RESULTS: Social participation significantly decreases with advancing age (p < 0.001). Scores are reported for each category of the LIFE-H, by mean and standard deviation and also by percentiles for each of the following age groups: 55-64, 65-74, 75-84 and 85+. Gender is associated with participation in four LIFE-H categories, with women obtaining significantly higher scores in Nutrition (p < 0.001) and Interpersonal relationships (p = 0.007) and men in Housing (p = 0.002) and Mobility (p = 0.03). Lastly, participation is poorly associated with personal and environmental characteristics. CONCLUSION: This study will help clinicians and researchers to better understand the concept of participation, and particularly to distinguish between changes in participation due to normal aging and those attributable to pathological aging.

Aged↗

PubMed2004

Validity of the Assessment of Life Habits in older adults.

OBJECTIVE: To study the construct validity of a participation scale, the Assessment of Life Habits, with older adults having functional limitations. More specifically, the study aimed to verify the ability of the Assessment of Life Habits to discriminate between clienteles in 3 living environments, and to compare participation scores to functional independence scores obtained with the Functional Autonomy Measurement System (Système de mesure de l'autonomie fonctionnelle). DESIGN: Participants were evaluated once with the Assessment of Life Habits and the Functional Autonomy Measurement System. SUBJECTS: Eighty-seven older adults (mean age 78.0 years (8.2)) living in 3 types of environment: own home, private nursing home or long-term care centre. RESULTS: Results suggest that the Assessment of Life Habits scores discriminate between different levels of participation according to the living environments of the participants. The Assessment of Life Habits measures some similar aspects to the Functional Autonomy Measurement System scale but also additional concepts not included in the Functional Autonomy Measurement System. CONCLUSION: This study supports the validity of the Assessment of Life Habits as a participation measure. It suggests the importance of going beyond disability measures to evaluate the overall functioning of older adults correctly.

Activities of Daily Living↗

PubMed2003

Biomechanical analysis of a posterior transfer maneuver on a level surface in individuals with high and low-level spinal cord injuries.

OBJECTIVE: The purpose of this study was to determine the movement patterns and the muscular demand during a posterior transfer maneuver on a level surface in individuals with spinal cord injuries. DESIGN: Six participants with high-level spinal cord injury (C7 to T6) were compared to five participants with low-level spinal cord injury (T11 to L2) with partial or complete control of abdominal musculature. BACKGROUND: Developing an optimal level of independence for transfer activities figures among the rehabilitation goals of individuals with spinal cord injury. There has been no biomechanical study which specifically describes the posterior transfer maneuver. METHODS: Tridimensional kinematics at the elbow, shoulder, head and trunk, as well as surface electromyographic data of the biceps, triceps, anterior deltoid, posterior deltoid, pectoralis major, latissimus dorsi, trapezius and rectus abdominus muscles were recorded during the posterior transfer. To quantify the muscular demand, the electromyographic data were amplitude normalized to the peak value obtained from maximum voluntary contractions. The transfer was divided into pre-lift, lift, and post-lift phases for analysis. RESULTS: The duration of the lift phase was significantly shorter (P<0.05) for the high-level spinal cord injury (1.24; SD, 0.37 s) when compared to the low-level spinal cord injury (1.74; SD, 0.39 s). The patterns and magnitudes of the angular displacements were found similar between groups (P values: 0.45-0.98). However, the high-level spinal cord injury initiated the task from a forward flexed posture, whereas the low-level spinal cord injury adopted an almost upright alignment of the trunk. Higher muscular demands were calculated for all muscles among high-level spinal cord injury participants during the transfer when compared to the low-level spinal cord injury. However, only the anterior deltoid (high level=92.4%; low level=34.2%) and the pectoralis major (high level=109.8%; low level=25.6%) reached statistical significance during the lift phase.Conclusions. Participants with high-level spinal cord injury presented different movement characteristics and higher muscular demands during the posterior transfer than low-level spinal cord injury ones. This is probably to compensate for the additional trunk and upper limb musculature impairment. RELEVANCE: The findings of this study may help to develop guidelines of specific strengthening programs for the thoracohumeral, scapulothoracic and shoulder muscles designed to restore optimal transfer capacity in individuals with spinal cord injury. Furthermore, innovative rehabilitation programs targeting the ability to control the trunk could be beneficial for these individuals.

Abdominal Muscles↗

PubMedDate not supplied

Comparison of two functional independence scales with a participation measure in post-stroke rehabilitation.

The objectives of the study were to compare the association and responsiveness of the functional autonomy measurement system (SMAF) and functional independence measure (FIM) as outcome measures addressing functional independence in stroke patients involved in an intensive rehabilitation program and to compare their relationships with a social participation measure after rehabilitation period. One hundred and thirty-two people who had a stroke were evaluated with the SMAF and FIM during the rehabilitation period (T1: admission; T2: discharge; n=132) and twice after discharge (T3=2 weeks; n=118; T4=6 months later; n=102). At T3 and T4, a participation measure, the assessment of life habits (LIFE-H), was added. The main findings are: (1) the total scores on the SMAF and FIM are strongly correlated together (r=0.93 to 0.95; p<0.001); 2) the responsiveness of both functional independence scales is similar even though the SMAF total score is more responsive to change than the FIM total score (standardized response mean: 1.20 vs. 0.97; p<0.01); (3) the SMAF and FIM are related similarly to the daily activities domain of the participation scale; and finally (4) the social roles domain of the participation scale is less related to the SMAF and MIF than the daily activities domain; however, the SMAF score is more related to the social roles domain than the MIF. Our results support the need to use supplementary measures, such as participation measure, that cover not only physical function but also the other domains of participation, such as interpersonal relationships and leisure, that can be disrupted following a stroke.

Activities of Daily Living↗