Biomedical subjects

S M Haley

Publications and source records attributed to S M Haley.

29 records · Page 2Linked to original sources

PubMed1989

Kappa coefficient calculation using multiple ratings per subject: a special communication.

The purpose of this special communication is to describe the application of the Kappa coefficient for the estimation of interobserver agreement. Kappa is a preferred statistic for the estimation of the accuracy of nominal and ordinal data in clinical research by physical therapists. A brief introduction to the properties of the Kappa coefficient is given, and a special case of Kappa for multiple ratings per subject is explained. A FORTRAN program, written specifically for the multiple-ratings situation, is described.

Electronic Data Processing↗

PubMed1988

Predicting long-term outcome among post-rehabilitation stroke patients.

This paper examines correlates of long-term outcome in a sample of 89 stroke patients discharged from medical rehabilitation. Patients in this study were recruited in 1984 and followed prospectively for a 12-month period postdischarge. This analysis builds on previous studies which have called researchers to move beyond single-outcome studies which use only bivariate analysis. Multivariate techniques are used to evaluate the influence of a number of predictor variables on three measures of long-term outcome: 1) a composite variable that includes functional status, mortality and discharge disposition (home v nursing home); 2) life satisfaction; and 3) medical charges. The results show that 1) multivariate analyses present a different picture from that obtained when using bivariate analysis; and 2) the same predictor variables are not equally important in predicting different outcome variables. From 30-42% of the variance in the three dependent variables is explained by severity of illness, function at admission, age, wheelchair use and in- and out-of-house social supports.

Cerebrovascular Disorders↗

PubMed1988

Description and interobserver reliability of the Tufts Assessment of Motor Performance.

This paper describes the conceptual basis for the development of a new clinical evaluation instrument, the Tufts Assessment of Motor Performance (TAMP). The TAMP is a 32-item, diagnosis-independent, criterion-referenced test that samples physical performance items in the areas of mobility, activities of daily living and physical aspects of communication. The administrative and scoring criteria of the TAMP are presented, and the multiple measurement dimensions are described. The documentation of patient status and progress, as described in the functional and performance profiles, is outlined. The paper also reports initial interobserver reliability on the intraitem tasks and the summary indexes of the two profiles. Forty individuals (20 adults and 20 children) with neurologic and musculoskeletal disorders comprised the reliability sample. Kappa and intraclass correlations were used to estimate the reliability of three independent raters on individual tasks and aggregate scores, respectively. Task reliability for the assistance and approach measurement dimensions were generally higher than for the more qualitative pattern and proficiency dimensions. Yet over 90% of all the tasks had acceptable reliability, while all the summary indexes had high interobserver reliability. Determination of interobserver reliability data is the initial phase of defining the most appropriate and technically valuable items, and will serve as a basis for item revision and reduction to enhance the clinical utility of the test.

Activities of Daily Living↗

PubMed1987

Sequence of development of postural reactions by infants with Down syndrome.

The sequential development of postural reactions was examined in 20 infants with Down syndrome aged two to 24 months, and was compared to the sequence for non-handicapped infants. Protective reactions appeared relatively earlier in the sequential pattern for infants with Down syndrome than for non-handicapped infants. The study documents dissimilar sequences of postural reaction development for the two infant groups. The data suggest that both the delay and the dissimilar sequence of postural reactions should be considered when evaluating the motor development and movement quality of infants with Down syndrome.

Down Syndrome↗

PubMed1986

Postural reactions in infants with Down syndrome. Relationship to motor milestone development and age.

I examined the emergence of automatic postural reactions (righting, equilibrium, and protective reactions) in a group of infants with Down syndrome and in a developmentally matched group of nonhandicapped infants. I assessed the relationship of postural reactions to chronological age and to motor milestone development (as measured by the Bayley Scales of Infant Development). The relationship of postural reactions to chronological age was weaker in the infants with Down syndrome; a regression analysis revealed a slower rate of postural reaction development evident at an age of about five months and older in infants with Down syndrome. The association between postural reactions and motor milestone performance was remarkably similar for both infant groups in degree of association and pattern across the span of motor development tested. The results indicated that, even though the rate of development differed, the association between postural reactions and motor milestones was similar in normal and delayed development. These results support the current rationale that promotes intervention efforts focusing on the facilitation of postural reactions to enhance motor milestone development in infants with Down syndrome.

Age Factors↗

PubMed1986

Independent sitting development and the emergence of associated motor components.

The purpose of this preliminary study was to examine the relationship between the emergence of independent sitting ability and the presence of underlying motor components (reflexes, automatic postural reactions, and flexion and extension movement patterns). Ten full-term, nonhandicapped infants were tested longitudinally for the presence of underlying motor components as they attained three performance levels of sitting ability between the ages of 4 and 7 months. A total of 26 observations was collected across the 10 infants. The time of each testing session was based on the infants' attainment of each successive sitting performance level. Underlying motor components were assessed at each testing session to determine whether a consistent sequence of component emergence developed and whether those components were associated with a specific performance level of sitting. The results indicated that no consistent sequential pattern of motor component emergence existed. The data showed that the pattern of underlying component emergence was highly variable across the infants at similar levels of sitting ability, although some components were associated highly with specific performance levels. The data suggest that the attainment of independent sitting in nonhandicapped infants is described best as a continuous developmental process, rather than a discontinuous "stage" phenomenon.

Child Development↗

PubMed1986

Spinal mobility in young children. A normative study.

The purpose of this study was to collect values of back mobility on healthy children between the ages of 5 and 9 years. Normative values of back mobility have not been established for children under 10 years of age. Measurements of anterior and lateral spinal flexion were obtained from 282 children, using a standard flexion measurement procedure. Intraclass correlation estimates of reliability ranged from .77 to .89, indicating acceptable agreement and stability across and within raters. Girls demonstrated greater mobility than boys in all three measurements. Post hoc trend analyses revealed consistent increases in left and right lateral flexion with increasing age. No linear trend existed for anterior flexion. Using these data, we developed normative values of back mobility for each sex and age grouping. These measures of back mobility will provide the clinician with an empirically validated comparison to help identify early restrictions in back mobility in children with juvenile arthritis and other pediatric populations who are at risk for restrictions in back mobility. Early identification may lead to better prevention and more timely and effective treatment programs.

Back↗

PubMed1986

Sequential analyses of postural reactions in nonhandicapped infants.

The purpose of this study was to identify an empirically validated sequence of automatic postural reactions in a sample of 40 nonhandicapped infants. Using a cross-sectional design, we tested infants between the ages of 2 and 10 months for the presence of full and partial righting, equilibrium, and protective reactions. Two types of sequential analyses were performed. The Thurstone absolute scaling technique identified an age-related sequence, and the scalogram technique yielded a measure of the variability of the sequence. The sequence of postural reactions defined in this study is in general agreement with the sequence reported in previous clinical reports, although some differences in ordering are noted. A consistency index of .727 indicated that the sequence of postural reactions had fairly good predictive ability. This study contributes a data-based sequential model of postural reactions and an indication of the degree of sequential variability in the order of emergence of postural reactions in nonhandicapped infants. Definition of the sequence and the observed variability in nonhandicapped infants is an initial step in the understanding of the processes underlying the development of postural reactions.

Child Development↗

PubMed1984

Reliability of observational measures of the Movement Assessment of Infants.

This study was conducted to examine the reliability of the Movement Assessment of Infants (MAI), a recently published neuromotor assessment tool. Interobserver and test-retest reliability data were collected on 27 full-term and 26 preterm 4-month-old infants. Reliability coefficients (Pearson r) were calculated for both the total-risk scores and the section-risk scores on the MAI. The total-risk score was calculated by summing the questionable or abnormal ratings on each of the 65 test items. For each of the four sections of the test, tone, primitive reflexes, automatic reactions, and volitional movement, an individual section-risk score was computed in a similar manner. Fair reliability was demonstrated for the total-risk scores (interobserver: r = .72; test-retest: r = .76). Section-risk score coefficients yielded a wide range of values for both interobserver and test-retest reliabilities (poor to good reliability). These measures provide needed technical data for therapists using this test and will assist the authors of the MAI in their attempts to improve the clinical validity of this assessment tool.

Evaluation Studies as Topic↗

PubMedDate not supplied

Social function changes in children and adolescents with acquired brain injury during inpatient rehabilitation.

OBJECTIVE: To examine changes in social function capabilities between and within groups of children with six subtypes of acquired brain injury during inpatient rehabilitation. MEASURE: The Pediatric Evaluation of Disability Inventory (PEDI) Social Functional Skills Scale was administered to 139 children with acquired brain injury (mean age=9.28 years; SD = 5.27). METHODS: Scaled summary score changes from hospital admission to discharge for the total group and six diagnostic sub-groups were calculated. One-way ANOVAs were performed for the total group and six sub-groups to determine between group differences in amount of change. Within-group changes were examined by paired t-tests, effect sizes and the proportion of children who made a clinically meaningful change (> or = 10 points). RESULTS: Children with traumatic brain injury demonstrated the greatest amount of change during inpatient rehabilitation, but only significantly greater than children with seizures. Scores were significantly higher at discharge for the total group (p < 0.001) and all sub-groups except for the anoxia group. Forty-five per cent of all children made clinically meaningful changes. CONCLUSIONS: Children with acquired brain injury made significant changes in social functioning from admission to discharge. Varying degrees of change existed for diagnostic sub-groups. Further research is needed to examine clinically meaningful changes and in which areas of social functioning children are changing during inpatient rehabilitation.

Adolescent↗

PubMedDate not supplied

Use of the Children's Orientation and Amnesia Test at hospital discharge for children with neurological and non-neurological traumatic injuries.

The measurement of post-traumatic amnesia in children is a common clinical index of the extent of brain injury. The only published paediatric test, the Children's Orientation and Amnesia Test (COAT), has been standardized on a sample of children in a school setting who had not been injured or hospitalized. Two questions arise in the use of this test: are the published norms valid for hospitalized children with non-neurological trauma? and does the COAT offer better discriminative power or clinical utility over the adult test, the Galveston Orientation and Amnesia Test (GOAT)? This paper describes scores on the COAT for 28 children hospitalized with non-neurological injuries and compares them with the published scores. The hospitalized children scored within normal limits when compared with the school sample. In addition, 23 children with neurological traumatic injuries were given both the COAT and the GOAT. Failure rate was higher for the COAT. Some implications for the use of the COAT in paediatric trauma are discussed.

Adolescent↗