Treatment of Functional Gait Abnormality in a Rehabilitation Setting: Emphasizing the Physical Interventions for Treating the Whole Child.

Objective: Conversion disorder has a significant impact on families and the healthcare system. A recent review suggests there is little uniformity in treating this population. This paper describes an inpatient treatment program emphasizing physical conditioning and less time uncovering the psychological underpinnings of the presentation. Design: This study included 100 pediatric patients admitted to an inpatient rehabilitation setting with lower extremity weakness/dysfunction not explained by a medical cause. Patients followed a 16-step goal hierarchy to increase physical function. Patients participated in three hours of therapy and met with a psychologist and teacher daily. Patient functioning was assessed at three time periods using the mobility items of the Functional Independence Measure for Children (WeeFIM). Results: Ninety-four patients completed the program. The average length of stay was 10 days. There were no significant differences between gender, length of stay, or insurance. Data was collected from 73 participants at a two-month follow-up. A repeated measures analysis of variance (ANOVA), using time points at admission, discharge, and follow-up, revealed significant improvements over time. Post-hoc contrasts showed differences with admission and discharge but no differences between discharge and follow-up, suggesting gains in mobility remained. Conclusion: This paper describes an inpatient program that effectively treats patients with conversion disorder in a relatively short period. The physical gains made during hospitalization persisted over time and suggest inpatient rehabilitation focusing on physical mobility could be a more financially beneficial approach than outpatient treatment. Future considerations include identifying a more robust assessment process for patients to determine other psychological characteristics that might impact successful, more short-term treatment.

Using the Internet to prescreen participants for research on interpersonal violence: experimental design considerations.

Internet-based testing has become increasingly popular in recent years due largely to the availability of computers and the Web to research participants. For researchers studying interpersonal violence, Internet-based methodologies can also be used as a prescreening device to identify a population of interest, such as individuals reporting violence in their relationships. However, several challenges exist with this approach. This article evaluates the use of an Internet-based prescreening device to identify potential participants for a study on interpersonal violence, highlighting challenges encountered with this methodology, and offers suggestions for improvement in experimental design when conducting Internet-based screenings of interpersonal violence.