The reliability and validity of the International Classification of Functioning, Disability and Health′s Rehabilitation Set for multidisciplinary inpatients / 中华物理医学与康复杂志

Objective:To explore the reliability and validity of the International Classification of Functioning, Disability and Health′s 17-item Rehabilitation Set (ICF-RS-17) when used to evaluate multidisciplinary inpatients.Methods:A total of 359 inpatients in the departments of rehabilitation, orthopedics, neurology, and neurosurgery of three hospitals in Jiangsu province were assessed with the ICF-RS-17 at admission and at discharge, and the internal consistency of the tool was calculated. Inter-rater and intra-rater reliability were quantified using interclass correlation coefficients (ICCs). Structural validity was analyzed using factor analysis.Results:The tool′s Cronbach′s α was 0.945. The overall inter-rater ICC was 0.946 with the ICCs of all of the items except b280 sensation of pain within the range from 0.630 to 0.948. The overall intra-rater ICCs ranged from 0.471 to 0.947. The factor analysis found three factors with eigenvalues greater than 1, accounting for 74% of the variation, without double-loaded items. The three influential factors were exercise ability, sleep perception communication ability and self-care ability.Conclusion:The ICF-RS-17 has good internal consistency, inter-rater and intra-rater reliability and structural validity in the evaluation of multidisciplinary inpatients.

A clinical outcomes assessment tool based on the International Classification of Functioning, Disability and Health / 中华物理医学与康复杂志

Objective:To confirm items included in a tool for assessing clinical outcomes based on International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set.Methods:The item pool was established based on the ICF Rehabilitation Set. Then 15 experts were invited to participate in three rounds of expert Delphi consensus-building to choose items with high importance in assessing clinical outcomes. The reliability of the tool was examined by analyzing the experts′ positive coefficients, authority coefficients and degree of agreement.Results:The assessment tool which emerged from the three rounds comprised 17 items, including 8 Body Functions items (b130 Energy and drive functions, b134 Sleep functions, b152 Emotional functions, b280 Sensation of pain, b455 Exercise tolerance functions, b620 Urination functions, b710 Mobility of joint functions and b730 Muscle power functions), d230 Carrying out daily routine from General Tasks and Demands, 3 Mobility items (d410 Changing basic body position, d450 Walking and d465 Moving around using equipment), 4 Self-care items (d510 Washing oneself, d530 Toileting, d540 Dressing and d550 Eating) and 1 item of Interpersonal Interactions and Relationships (d710 Basic interpersonal interactions). All had 100% positive coefficients after the three rounds, with an authority coefficient of 0.81 and coefficients of variation between 0.054 and 0.412.Conclusion:The assessment tool constructed in this study provides a new direction for quality control in clinical practice and medical insurance assessments.

The reliability of a functioning assessment tool based on the International Classification of Functioning, Disability and Health / 中华物理医学与康复杂志

Objective:To investigate the reliability of a tool based on the International Classification of Functioning, Disability and Health (ICF) in the assessment of functioning despite disability.Methods:A total of 371 patients were assessed using a tool based on the ICF rehabilitation set combined with a numerical rating scale ranging from 0 to 10. The internal consistency, inter-rater reliability and intra-rater reliability were analyzed.Results:The scale′s Cronbach′s alpha coefficient was 0.89. The inter-rater correlation coefficient was 0.85, and the correlations among the items ranged from 0.78 to 0.94. The intra-rater correlation coefficient with the scale was 0.95, with the item correlations ranging from 0.72 to 0.97. Only item b230 Hearing function did not correlate well.Conclusions:The functioning assessment tool based on the ICF rehabilitation set when combined with a numerical rating scale has internal consistency, inter-rater reliability and intra-rater reliability sufficient for use in clinical practice.

The validity of the rehabilitation set of the International Classification of Functioning, Disability and Health in assessing aging-related disability / 中华物理医学与康复杂志

Objective:To explore the validity of a function assessing tool based on the International Classification of Functioning, Disability and Health′s (ICF′s) rehabilitation set in assessing aging-related disability.Methods:A total of 1610 elderly people from 15 nursing homes across China were assessed using the tool based on the ICF′s rehabilitation set and with the 12-item short form health survey (SF-12). The structural validity of the responses was analyzed using factor analysis, and criterion-related validity was also evaluated.Results:The factor analysis yielded three factors with eigenvalues greater than 1. Their cumulative explanatory power was 74.4%. Item d550 eating had double loading in the factor analysis. The item scores and the total scores of the disability assessment tool were significantly negatively correlated with the physiological function domain scores and the psychological function domain scores.Conclusion:The function assessment tool based on the ICF′s rehabilitation set when combined with a numerical rating scale has good structural and criterion-related validity in the assessment of disability due to aging.

The effectiveness and cost-effectiveness of clinical rehabilitation for subacute cerebral infarction patients / 中华物理医学与康复杂志

Objective To determine the effectiveness and medical cost-effectiveness of clinical rehabilitation for promoting the functional recovery of sub-acute cerebral infarction patients.Methods Totally 247 sub-acute patients with cerebral infarction were randomly divided into a clinical rehabilitation group of 129 and a routine rehabilitation group of 118.The clinical group received a standardized rehabilitation intervention and drug treatment,while the routine rehabilitation group received routine rehabilitation therapy and drug treatment.The Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI) were used to compare the two groups after the treatment and 3 and 6 weeks later.The hospital cost for six weeks was also compared between the 2 groups.Results At 3 and 6 weeks,improvement in the average FMA and MBI scores was observed in both groups but the inter-group differences were not significant.The total hospital cost of the clinical group was,however,significantly less than that of the others.Conclusion Clinical rehabilitation can improve the motor function and ability in the activities of daily living of stroke patients.It also has economic benefits.

The construct validity of ICF generic set as a measure of functioning in clinical practice of China / 中国康复医学杂志

Objective:To explore the construct validity of ICF generic set as a functioning measure tool in routine clinical practice of China.Method:Totally 4510 patients covering departments of rehabilitation,neurology or cerebral surgery,cardiology,pneumology and orthopedics from 50 hospitals in 21 provinces of mainland China were enrolled in this multicenter study.Each patient was assessed by the same rater with ICF generic set at the time of baseline and discharge.Result:At the time of discharge,with exception of the scores of item d850,the scores of ICF generic set is (15.25±13.48),which is lower than that of the baseline (23.76±15.15).Two common factors which come from factor analysis are almost consisted with theoretic structure,and the contributing rate of cumulative sums was 78.018％.Confirmatory factor analysis indicated that the model was consistent with the theoretical assumption,and the fitness indexes were RMSEA=0.026,NFI=0.999,CFI=0.999,AGFI=0.994.Conclusion:The construct validity of ICF generic set is good,The ICF generic is a useful functioning measure tool in routine clinical practice.

The construct validity of ICF generic set as a measure of functioning in clinical practice of China / 中国康复医学杂志

Objective:To explore the construct validity of ICF generic set as a functioning measure tool in routine clinical practice of China.Method:Totally 4510 patients covering departments of rehabilitation,neurology or cerebral surgery,cardiology,pneumology and orthopedics from 50 hospitals in 21 provinces of mainland China were enrolled in this multicenter study.Each patient was assessed by the same rater with ICF generic set at the time of baseline and discharge.Result:At the time of discharge,with exception of the scores of item d850,the scores of ICF generic set is (15.25±13.48),which is lower than that of the baseline (23.76±15.15).Two common factors which come from factor analysis are almost consisted with theoretic structure,and the contributing rate of cumulative sums was 78.018％.Confirmatory factor analysis indicated that the model was consistent with the theoretical assumption,and the fitness indexes were RMSEA=0.026,NFI=0.999,CFI=0.999,AGFI=0.994.Conclusion:The construct validity of ICF generic set is good,The ICF generic is a useful functioning measure tool in routine clinical practice.

Effects of muscle energy technique combined with joint mobilization in the management of frozen shoulder / 中华物理医学与康复杂志

Objective To observe the therapeutic effects of muscle energy technique combined with joint mobilization on frozen shoulder.Methods Thirty-six patients with frozen shoulder were randomly assigned to:group A (treated with muscle energy technique plus joint mobilization),group B (treated with passive stretching with joint mobilization),and group C (treated with joint mobilization merely),and each had 12 patients.All the patients were treated accordingly for 3 times a week,totally for 4 weeks.The American Shoulder and Elbow Surgeons evaluation system (ASES) was adopted to evaluate clinical effects before and at the end of treatment.Results After 4 weeks of treatment,all patients' ASES scores were improved significantly (P ＜ 0.05).The improvement in the shoulder score index and shoulder range of motion were to a significantly better extent in group A than in the other two groups.Conclusion Muscle energy technique plus joint mobilization could effectively relieve pain increase the shoulder ROM and improve performance in activities of daily living in patients suffering from frozen shoulder.

The quality of life of earthquake victims with nonunion fracture in limbs after medical rehabilitation / 中华物理医学与康复杂志

Objective To analyze factors contributing to the quality of life of earthquake victims with nonunion fracture in limbs after medical rehabilitation and to provide a clinical reference for future disasters.Methods Thirty-one wounded who sustained their injuries in the Sichuan earthquake completed the short form-36(SF-36)questionnaire 2 weeks before their amputation,and after 3,6 and 12 months of medical rehabilitation.The SF-36scores were compared with Sichuan population norms.Stepwise multiple linear regression was used to highlight variables which influenced their functional recovery and their physical and mental health.Results The physical and mental health composite scores of the 31 victims were significantly lower than Sichuan population norms before medical rehabilitation,but they had a significant increasing trend after 3,6 and 12 months of treatment.Their scores on all the domains remained significantly lower than Sichuan population norms at a later follow-up.Smoking,external fixations and chronic diseases were related to their recovery of physical function.Age,permanent housing,family income and casualties among family members were related to their mental health recovery.Conclusion The quality of life of patients with nonunion fracture caused by earthquake can be improved significantly through medical rehabilitation.But social factors should be considered in addition to medical rehabilitation after an earthquake.