Modeling Measurement as a Sequential Process: Autoregressive Confirmatory Factor Analysis (AR-CFA).

To model data from multi-item scales, many researchers default to a confirmatory factor analysis (CFA) approach that restricts cross-loadings and residual correlations to zero. This often leads to problems of measurement-model misfit while also ignoring theoretically relevant alternatives. Existing research mostly offers solutions by relaxing assumptions about cross-loadings and allowing residual correlations. However, such approaches are critiqued as being weak on theory and/or indicative of problematic measurement scales. We offer a theoretically-grounded alternative to modeling survey data called an autoregressive confirmatory factor analysis (AR-CFA), which is motivated by recognizing that responding to survey items is a sequential process that may create temporal dependencies among scale items. We compare an AR-CFA to other common approaches using a sample of 8,569 people measured along five common personality factors, showing how the AR-CFA can improve model fit and offer evidence of increased construct validity. We then introduce methods for testing AR-CFA hypotheses, including cross-level moderation effects using latent interactions among stable factors and time-varying residuals. We recommend considering the AR-CFA as a useful complement to other existing approaches and treat AR-CFA limitations.

Evaluation of postural stability in children with hemiplegic cerebral palsy.

[Purpose] Postural stability is the ability of to maintain the position of the body within the support area. This function is affected in cerebral palsy. The aim of the present study was to compare static and dynamic postural stability between children with hemiplegic cerebral palsy and healthy controls. [Subjects and Methods] Thirty-seven children between the ages of 5 and 14 diagnosed with hemiplegic cerebral palsy (19 right, 18 left) and 23 healthy gender- and age-matched controls were included in the study. Postural stability was evaluated in both of the groups using a Neurocom Balance. Sway velocity was measured both with the eyes open and closed. Sit to stand and turning abilities were also assessed. [Results] The sway velocities with the eyes open and closed were significantly different between the groups. The weight transfer time in the Sit to Stand test was also significantly slower in children with cerebral palsy. Children with cerebral palsy also showed slower turning times and greater sway velocities during the Step and Quick Turn test on a force plate compared with their healthy counterparts. [Conclusion] Both static and dynamic postural stability parameters are affected in hemiplegic cerebral palsy. Further research is needed to define rehabilitation interventions to improve these parameters in patients.

Evidence based rehabilitation in chronic pain syndromes.

Chronic pain syndrome (CPS) is a complex condition that presents a major challenge to physicians because of its unknown etiology and poor response to all kinds of therapies. It has been suggested that chronicity should be considered when pain persists longer than the acceptable healing time. The impact of chronic pain on patients' lives varies from minor limitations to complete loss of independence. The rehabilitation in CPSs is multi-disciplinary and involves physical, occupational, and manual therapy, aquatherapy, cognitive/behavioral therapy, biofeedback, psychotherapy, and some new therapies. In recent years, the point of view in chronic pain management has changed substantially and CPS is managed best with a multidisciplinary approach, including a rehabilitative process. The treatment protocol should be planned and modified individually. A combination of several methods has been tried, but long-term evidence-based studies are needed for new treatment modalities.