Biomedical subjects

Wayne Dite

Publications and source records attributed to Wayne Dite.

3 recordsLinked to original sources

PubMed2004

Additional task-related practice improves mobility and upper limb function early after stroke: a randomised controlled trial.

The purpose of this study was to investigate whether additional practice of either upper limb or mobility tasks improved functional outcome during inpatient stroke rehabilitation. This prospective, randomised, single blind clinical trial recruited 30 stroke subjects into either an Upper Limb or a Mobility Group. All subjects received their usual rehabilitation and an additional session of task-related practice using a circuit class format. Independent assessors, blinded to group allocation, tested all subjects. Outcome measures used were three items of the Jebsen Taylor Hand Function Test (JTHFT), two arm items of the Motor Assessment Scale (MAS), and three mobility measures, the Timed Up and Go Test (TUGT), Step Test, and Six Minute Walk Test (6MWT). Both groups improved significantly between pre- and post-tests on all of the mobility measures, however only the Upper Limb Group made a significant improvement on the JTHFT and MAS upper arm items. Following four weeks training, the Mobility Group had better locomotor ability than the Upper Limb Group (between-group differences in the 6MWT of 116.4 m, 95% CI 31.4 to 201.3 m, Step Test 2.6 repetitions, 95% CI -1.0 to 6.2 repetitions, and TUGT -7.6 sec, 95% CI -15.5 to 0.2 sec). The JTHFT dexterity scores in the Upper Limb Group were 6.5 sec (95% CI -7.4 to 20.4 sec) faster than the Mobility Group. Our findings support the use of additional task-related practice during inpatient stroke rehabilitation. The circuit class format was a practical and effective means to provide supervised additional practice that led to significant and meaningful functional gains.

Arm↗

PubMed2002

A clinical test of stepping and change of direction to identify multiple falling older adults.

OBJECTIVES: To establish the reliability and validity of a new clinical test of dynamic standing balance, the Four Square Step Test (FSST), to evaluate its sensitivity, specificity, and predictive value in identifying subjects who fall, and to compare it with 3 established balance and mobility tests. DESIGN: A 3-group comparison performed by using 3 validated tests and 1 new test. SETTING: A rehabilitation center and university medical school in Australia. PARTICIPANTS: Eighty-one community-dwelling adults over the age of 65 years. Subjects were age- and gender-matched to form 3 groups: multiple fallers, nonmultiple fallers, and healthy comparisons. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Time to complete the FSST and Timed Up and Go test and the number of steps to complete the Step Test and Functional Reach Test distance. RESULTS: High reliability was found for interrater (n=30, intraclass correlation coefficient [ICC]=.99) and retest reliability (n=20, ICC=.98). Evidence for validity was found through correlation with other existing balance tests. Validity was supported, with the FSST showing significantly better performance scores (P<.01) for each of the healthier and less impaired groups. The FSST also revealed a sensitivity of 85%, a specificity of 88% to 100%, and a positive predictive value of 86%. CONCLUSION: As a clinical test, the FSST is reliable, valid, easy to score, quick to administer, requires little space, and needs no special equipment. It is unique in that it involves stepping over low objects (2.5cm) and movement in 4 directions. The FSST had higher combined sensitivity and specificity for identifying differences between groups in the selected sample population of older adults than the 3 tests with which it was compared.

Accidental Falls↗

PubMed2002

Development of a clinical measure of turning for older adults.

OBJECTIVE: The purpose of this study was to identify the characteristics present and observable when older adults safely and efficiently turn while walking and to develop and evaluate a clinical measure of turning based on these characteristics. DESIGN: This was a validation study of balance and mobility tests using a three-group sample of convenience. RESULTS: The reliability of a turn measure consisting of nine movement items was identified. Five of the turn measure items were able to discriminate between multiple faller and the other two groups. The two items dichotomously rated as yes or no were "seems steady throughout the turn" and "moves fluently without hesitation between turn and walk when exiting the turn." Three other items were, total turn score, the time taken to turn, and turn step number. These last two items also achieved strong correlation with existing balance measures and high sensitivity for identifying multiple fallers. These items form an easy-to-use clinical measure of turning for older adults. CONCLUSIONS: The turn measure developed in this investigation was found to be a reliable and valid clinical measure of turning while walking for older adults. Specific turn items were found to discriminate between groups of healthy and impaired older adults and had good sensitivity for identifying multiple fallers. The turn measure is relatively quick to administer and score and uses equipment readily available in most clinical settings.

Accidental Falls↗