Properties of a brief assessment tool for longitudinal measurement of cognition in people living with HIV.

Background: Mild cognitive impairment is common in chronic HIV infection and there is concern that it may worsen with age. Distinguishing static impairment from on-going decline is clinically important, but the field lacks well-validated cognitive measures sensitive to decline and feasible for routine clinical use. Measures capable of detecting improvement are also needed to assess interventions.

Further validation of the Preference-Based Stroke Index three months after stroke.

Objective: To estimate the construct validity of the Preference-Based Stroke Index and its value added over a generic measure, the EuroQol-5D-3L at three months after stroke.

Design: This is a secondary analysis of an existing inception cohort. Pearson correlation coefficients were estimated to test construct validity and Generalized Estimating Equation analysis was conducted to compare the strength of the correlations of the Preference-Based Stroke Index and EuroQol-5D-3L with other measures.

Toward a Meaningful Definition of Recovery After Hip Fracture: Comparing Two Definitions for Community-Dwelling Older Adults.

Objectives: To examine the course of recovery and resulting health-related quality of life (HRQL) after low-trauma hip fracture using 2 different definitions of recovery.

Design: Inception cohort with 8 assessments over 1 year.

Setting: Participants were recruited from a tertiary-care hospital and followed up in the community.

How have research questions and methods used in clinical trials published in Clinical Rehabilitation changed over the last 30 years?

Research in rehabilitation has grown from a rare phenomenon to a mature science and clinical trials are now common. The purpose of this study is to estimate the extent to which questions posed and methods applied in clinical trials published in Clinical Rehabilitation have evolved over three decades with respect to accepted standards of scientific rigour. Studies were identified by journal, database, and hand searching for the years 1986 to 2016.

Quantifying cognition at the bedside: a novel approach combining cognitive symptoms and signs in HIV.

Background: Up to half of all people with HIV infection have some degree of cognitive impairment. This impairment is typically mild, but nonetheless often disabling. Although early detection of cognitive impairment offers the greatest hope of effective intervention, there are important barriers to this goal in most clinical settings.

Using existing data to identify candidate items for a health state classification system in multiple sclerosis.

Purpose: In multiple sclerosis (MS), the use of preference-based measures is limited to generic measures such as Health Utilities Index Mark 2 and 3, the EQ-5D and the SF-6D. However, the challenge of using such generic preference-based measures in people with MS is that they may not capture all domains of health relevant to the disease. Therefore, the main aim of this paper is to describe the development of a health state classification system for MS patients.

Necessary and sufficient causes of participation post-stroke: practical and philosophical perspectives.

Introduction: Participation, a construct within the disability/functioning framework, is evaluated on a person's involvement in life situations including family, community, work, social, and civic life. In the context of recovering from a major health event, participation is a treatment goal and it is known to correlate with the quality of life.

Objective: The purpose of this study is to track the dynamics of participation post-stroke in relationship to the dynamics of walking capacity, social support, and mood.

Nordic walking for geriatric rehabilitation: a randomized pilot trial.

Purpose: There is a need to identify effective interventions to promote walking capacity in seniors. This study compares nordic walking (NW) and usual overground walking (OW) and estimates the relative efficacy in improving walking capacity (endurance and gait speed) of the elderly.

Method: Single blind, site-stratified, randomized, pilot trial designed to estimate the amount of change with NW and OW.

Development and initial psychometric evaluation of the Stroke Arm Ladder: a measure of upper extremity function post stroke.

Objective: To develop an adaptive measure, the Stroke Arm Ladder, to parsimoniously quantify upper extremity function post stroke.

Setting: Various studies conducted in Montreal and elsewhere in Canada.

Subjects: A total of 4058 persons with stroke who participated in various studies were assessed on different occasions post stroke.

Relationship between muscle strength and functional walking capacity among people with stroke.

The purpose of this study was to estimate, using the Position-Specific Global Index (PSGI) of Lower-Limb Muscle Strength, the extent to which muscle strength is independently associated with functional walking capacity. We performed an observational, cross-sectional study with 63 patients poststroke (onset between 3 and 12 months) at a major teaching hospital in an urban Canadian city. We assessed functional walking capacity with the six-minute walk test (6MWT) and muscle strength with handheld dynamometry.

The extent to which common health-related quality of life indices capture constructs beyond symptoms and function.

Purpose: This study proposes to identify for 5 widely used generic HRQL and QOL measures the extent to which function and global feelings of well-being are represented in their content.

Methods: The 5 indices were the EQ-5D, the HUI, the SF-36, SF-12, and the WHOQOL-Bref. A total of 15 raters with a variety of health and research backgrounds mapped the items.

Preliminary evidence for the development of a stroke specific geriatric depression scale.

Unlabelled: Measuring depression among persons with stroke faces many challenges; diagnostic tools are lengthy and do not measure the extent of depression; screening tools are not stroke-specific; and metrics from the available indices do not provide a value that is mathematically or clinically meaningful.

Purpose: To provide evidence for the development of a stroke specific Geriatric Depression Scale screening measure (SS-GDS) through Rasch methodology.

Methods: Secondary analyses of a randomized controlled trial post-stroke.

The disutility of restenosis--the impact of repeat percutaneous coronary intervention on quality of life.

Background: Percutaneous coronary intervention (PCI) with coronary stenting is a common medical procedure that is used to treat the symptoms of both stable angina and acute coronary syndromes. Drugeluting stents (DES) decrease restenosis and repeat revascularization procedures but are more expensive than bare-metal stents. A proper cost-effectiveness analysis of DES requires an understanding of the health value patients place on the avoidance of restenosis accompanied by a repeat PCI.

Development and initial psychometric evaluation of an item bank created to measure upper extremity function in persons with stroke.

Objective: To create and illustrate the development of a method to parsimoniously and hierarchically assess upper extremity function in persons after stroke.

Design: Data were analyzed using Rasch analysis.

Setting: Re-analysis of data from 8 studies involving persons after stroke.

A measure of physical functioning to define stroke recovery at 3 months: preliminary results.

Objective: To develop a physical functioning measure through Rasch analysis conceptualized using the International Classification of Functioning, Disability and Health (ICF).

Design: Observational cohort study.

Setting: Acute-hospital and community-based study.

Measuring cognition in a geriatric outpatient clinic: Rasch analysis of the Montreal Cognitive Assessment.

Objective: To evaluate the psychometric properties of the Montreal Cognitive Assessment as a quantitative measure of cognitive ability.

Data Analyzed: A total of 222 cases extracted from a clinical database (57-91 years) of patients screened for cognitive impairment in outpatient geriatric assessment clinics.

Data Collected: Demographic information and individual item responses to Montreal Cognitive Assessment.

A measure of early physical functioning (EPF) post-stroke.

Objective: To develop a comprehensive measure of Early Physical Functioning (EPF) post-stroke quantified through Rasch analysis and conceptualized using the International Classification of Functioning Disability and Health (ICF).

Design: An observational cohort study.

Subjects: A cohort of 262 subjects (mean age 71.

Validation of the Charlson Comorbidity Index for predicting functional outcome of stroke.

Objective: To determine whether a separate comorbidity index is needed to predict functional outcome after stroke, we compared the predictability of the Charlson Comorbidity Index (CMI) and the Functional Comorbidity Index (FCI) to that of a stroke-specific comorbidity index with function quantified with a measure developed with a Rasch model as outcome.

Design: Two prospective inception cohort studies, in 1996 through 1998 and in 2002 through 2005, with up to 9 months of follow-up.

Setting: Participants enrolled in 2 studies were recruited from acute care hospitals in the Montreal area.

Development of a measure of functioning for stroke recovery: the functional recovery measure.

Purpose: To develop a parsimonious measure of functioning for persons after stroke.

Method: A sub-set of 206 community-dwelling subjects with a first stroke from a larger cohort was interviewed within 9 months using 39 items from five indices assessing functioning. Information was collected on influencing variables: age, stroke type and severity, and previous health.

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.

Effort-limited treadmill walk test: reliability and validity in subjects with postpolio syndrome.

Objective: To determine the reliability and construct validity of an effort-limited treadmill walk test to measure functional ability in subjects with postpolio syndrome in an outpatient postpolio clinic.

Design: Functioning and distance walked on a treadmill to a Borg "hard" effort level were measured three times, a week apart, by two blinded raters in 15 subjects with postpolio syndrome, aged 37-67 yrs, with new weakness, fatigue, and pain but with no other cause of symptomatology or condition-limiting walking. One rater tested them twice.

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.