A New Process Model for Relationship-Centred Shared Decision-Making in Physical Medicine and Rehabilitation Settings.

Introduction: We present a relationship-centred shared-decision-making (RCSDM) process model to explicate factors that shape decision-making processes during physical medicine and rehabilitation (PMR) encounters among patients, their care partners and practitioners. Existing shared decision-making (SDM) models fall short in addressing the everyday decisions routinely made regarding persons with chronic disabilities who require high levels of support, their care partners and rehabilitation practitioners. In PMR, these everyday decisions are small scale, immediate and in service to a larger therapeutic goal.

Using Electronic Health Record Data for Occupational Therapy Health Services Research: Invited Commentary.

Health services research (HSR) is a field of study that examines how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care, the quality and cost of health care, and health and well-being. HSR approaches can help build the occupational therapy evidence base, particularly in relation to population health. Data from electronic health record (EHR) systems provide a rich resource for applying HSR approaches to examine the value of occupational therapy services.

Exploratory examination of the scale structure of the Moorong Self-Efficacy Scale: Application of Rasch Measurement Theory.

Objective: Exploratory application of the Rasch Measurement (RM) Model for evidence for reproducibility, conceptual/content validity, and structural validity of the Moorong Self-Efficacy Scale (MSES).

Study Design: Secondary RM analysis of data collected in a randomized controlled trial comparing two exercise interventions for persons living with spinal cord injury (SCI).

Setting: Community-dwelling persons living with SCI enrolled in an exercise study.

Comparing indices of responsiveness for the Coma Near-Coma Scale with and without pain items: An Exploratory study.

Introduction: This study aimed to establish the indices of responsiveness for the Coma/Near-Coma (CNC) scale without (8 items) and with (10 items) pain test stimuli. A secondary purpose was to examine whether the CNC 8 items and 10 items differ when detecting change in neurobehavioral function.

Methods: We analyzed CNC data from three studies of participants with disorders of consciousness: one observational study and two intervention studies.

Pressure Injury Data Reconciliation in a Randomized Controlled Trial.

Objective: To advance pressure injury (PrI) research in individuals with spinal cord injury (SCI) by describing lessons learned and recommendations for future research, ultimately promoting PrI prevention and more effective wound care. This paper describes the detailed procedures undertaken to collect and reconcile PrI data and summarizes the types of discrepancies identified.

Design: Secondary analyses of PrI data collected between 2009 and 2014 in a randomized controlled trial (parent study).

Association of Cognitive Impairment With Rate of Functional Gain Among Older Adults With Stroke.

Objectives: This study explored the association between cognitive impairment at admission with self-care and mobility gain rate (amount of change per week) during a post-acute care stay (admission to discharge) for older adults with stroke.

Design: Retrospective cohort study.

Setting And Participants: Four inpatient rehabilitation and 6 skilled nursing facilities.

Mapping outcomes for recovery of consciousness in studies from 1986 to 2020: a scoping review protocol.

Introduction: Historically, heterogeneous outcome assessments have been used to measure recovery of consciousness in patients with disorders of consciousness (DoC) following traumatic brain injury (TBI), making it difficult to compare across studies. To date, however, there is no comprehensive review of clinical outcome assessments that are used in intervention studies of adults with DoC. The objective of this scoping review is to develop a comprehensive inventory of clinical outcome assessments for recovery of consciousness that have been used in clinical studies of adults with DoC following TBI.

Determining the Hierarchy of Coma Recovery Scale-Revised Rating Scale Categories and Alignment with Aspen Consensus Criteria for Patients with Brain Injury: A Rasch Analysis.

This study aimed to empirically evaluate the hierarchical structure of the Coma Recovery Scale-Revised (CRS-R) rating scale categories and their alignment with the Aspen consensus criteria for determining disorders of consciousness (DoC) following a severe brain injury. CRS-R data from 262 patients with DoC following a severe brain injury were analyzed applying the partial credit Rasch Measurement Model. Rasch Analysis produced logit calibrations for each rating scale category.

"Fluctuation is the norm": Rehabilitation practitioner perspectives on ambiguity and uncertainty in their work with persons in disordered states of consciousness after traumatic brain injury.

The purpose of this study is to describe the clinical lifeworld of rehabilitation practitioners who work with patients in disordered states of consciousness (DoC) after severe traumatic brain injury (TBI). We interviewed 21 practitioners using narrative interviewing methods from two specialty health systems that admit patients in DoC to inpatient rehabilitation. The overarching theme arising from the interview data is "Experiencing ambiguity and uncertainty in clinical reasoning about consciousness" when treating persons in DoC.

Reporting Guideline for RULER: Rasch Reporting Guideline for Rehabilitation Research: Explanation and Elaboration.

The Rasch Reporting Guideline for Rehabilitation Research (RULER) provides peer-reviewed, evidence-based, transparent, and consistent recommendations for reporting studies that apply Rasch Measurement (RM) Theory in a rehabilitation context. The purpose of the guideline is to ensure that authors, reviewers, and editors have uniform guidance about how to write and evaluate research on rehabilitation outcome assessments. The RULER statement includes an organizing framework and a checklist of 59 recommendations.

Rasch Reporting Guideline for Rehabilitation Research (RULER): the RULER Statement.

The application of Rasch Measurement (RM) Theory to rehabilitation assessments has proliferated in recent years. RM Theory helps design and refine assessments so that items reflect a unidimensional construct in an equal interval metric that distinguishes among persons of different abilities in a manner that is consistent with the underlying trait. Rapid growth of RM in rehabilitation assessment studies has led to inconsistent results reporting.

Characterizing Standardized Functional Data at Inpatient Rehabilitation Facilities.

Objective: The Improving Medicare Post-Acute Care Transformation Act of 2014 mandates using standardized patient functional data across post-acute settings. This study characterized similarities and differences in clinician-observed scores of self-care and transfer items for the standardized section GG functional domain and the functional independent measure (FIM) at inpatient rehabilitation facilities.

Design: We conducted secondary analyses of 2017 Uniform Data System for Medical Rehabilitation national data.

Psychometric Properties and Sex Differences on the Mayo-Portland Adaptability Inventory Participation Subscale (M2PI) in Veterans With Traumatic Brain Injury.

Objective: To evaluate the structural validity of the Mayo-Portland Adaptability Inventory Participation Index (M2PI) in a sample of veterans and to assess whether the tool functioned similarly for male and female veterans.

Design: Rasch analysis of M2PI records from the National Veterans Traumatic Brain Injury Health Registry database from 2012-2018.

Setting: National VA Polytrauma System of Care outpatient settings.

Association of Therapy Time and Cognitive Recovery in Stroke Patients in Post-Acute Rehabilitation.

Objectives: Cognitive impairment is highly prevalent after stroke, with 77% of people having impairment in at least 2 cognitive domains. The purpose of this study is to describe the association between therapy minutes per length of stay (LOS) day and cognitive recovery in patients receiving rehabilitation services in inpatient post-acute care facilities following a stroke.

Design: Secondary analyses of data collected in inpatient rehabilitation and skilled nursing facilities from 2005 to 2010 for an observational cohort study.

Association of Therapy Time Per Day With Functional Outcomes and Rate of Recovery in Older Adults After Elective Joint Replacement Surgery.

Objectives: To explore the association between therapy minutes per length of stay (LOS) day (TMLD), functional outcomes, and rate of functional recovery among older adults after elective hip or knee replacement surgery across postacute (PAC) settings.

Design: Secondary analysis of data collected for an observational cohort study from 2005 to 2010.

Setting: Four inpatient rehabilitation facilities (IRF) and 7 skilled nursing facilities (SNF).

A Pilot Trial Examining the Merits of Combining Amantadine and Repetitive Transcranial Magnetic Stimulation as an Intervention for Persons With Disordered Consciousness After TBI.

Objective: Report pilot findings of neurobehavioral gains and network changes observed in persons with disordered consciousness (DoC) who received repetitive transcranial magnetic stimulation (rTMS) or amantadine (AMA), and then rTMS+AMA.

Participants: Four persons with DoC 1 to 15 years after traumatic brain injury (TBI).

Design: Alternate treatment-order, within-subject, baseline-controlled trial.

Psychometric Properties of the Coma Near-Coma Scale for Adults in Disordered States of Consciousness: A Rasch Analysis.

Objectives: To examine the construct validity and measurement precision of the Coma Near-Coma scale (CNC) in measuring neurobehavioral function (NBF) in patients with disorders of consciousness receiving postacute care rehabilitation.

Design: Rasch analysis of retrospective data.

Participants: Participants (N=48) with disordered consciousness who were admitted to postacute care rehabilitation.

Neural Connectivity Changes Facilitated by Familiar Auditory Sensory Training in Disordered Consciousness: A TBI Pilot Study.

For people with disordered consciousness (DoC) after traumatic brain injury (TBI), relationships between treatment-induced changes in neural connectivity and neurobehavioral recovery have not been explored. To begin building a body of evidence regarding the unique contributions of treatments to changes in neural network connectivity relative to neurobehavioral recovery, we conducted a pilot study to identify relationships meriting additional examination in future research. To address this objective, we examined previously unpublished neural connectivity data derived from a randomized clinical trial (RCT).

Cognition and Other Predictors of Functional Disability Among Veterans With Mild Traumatic Brain Injury and Posttraumatic Stress Disorder.

Background: Limitations in everyday functioning are frequently reported by veterans with a history of mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). Multiple factors are associated with functional disability among veterans, including depression, poor social support, cognition, and substance use. However, the degree to which these factors, particularly cognitive capacities, contribute to functional limitations remains unclear.

Self-reported Participation Restrictions Among Male and Female Veterans With Traumatic Brain Injury in Veterans Health Administration Outpatient Polytrauma Programs.

Objectives: To identify areas of most restricted self-reported participation among veterans with traumatic brain injury (TBI), explore associations among participation restriction and clinical characteristics, and examine differences in participation restrictions by sex.

Design: Retrospective cross-sectional design.

Setting: National VA Polytrauma System of Care outpatient settings.

Combining Items From 3 Federally Mandated Assessments Using Rasch Measurement to Reliably Measure Cognition Across Postacute Care Settings.

Objective: To combine items from the Functional Independence Measure, Minimum Data Set (MDS) 2.0, and the Outcome and Assessment Information Set (OASIS)-B to reliably measure cognition across postacute care settings and facilitate future studies of patient cognitive recovery.

Design: Rasch analysis of data from a prospective, observational cohort study.

A comparison of three methods in categorizing functional status to predict hospital readmission across post-acute care.

Background: Methods used to categorize functional status to predict health outcomes across post-acute care settings vary significantly.

Objectives: We compared three methods that categorize functional status to predict 30-day and 90-day hospital readmission across inpatient rehabilitation facilities (IRF), skilled nursing facilities (SNF) and home health agencies (HHA).

Research Design: Retrospective analysis of 2013-2014 Medicare claims data (N = 740,530).