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Using the Rasch Model to Investigate Suggested Cut-off Score of the Berg Balance Scale
Research Posters Setting: Does not apply to this study. Participants: None. Interventions: None. Main Outcome Measure(s): The main outcomes were concept “linkability”, concept density, ICF category distribution, and item perspective. Results: Inter-observer agreement was 87% for linkability and 84% for code-agreement. PAQ (65%) and VQ (56%) were predominantly from the HS-disability perspective. PQ (68%) was predominantly QOL. One item out of 83 in the assessments represented the HS-function perspective. 221 concepts were identified among all assessments, with 126 (70%) linkable to ICF. PQ (40% of items) and VQ (37%) addressed mental functions by asking about patient perception of health status. PAQ (35%) and VQ (36%) addressed sensory/pain function more than PQ (5%). PQ (66%) represented the broadest array of activity/participation topics (44% for PAQ and PQ). A single item in PQ addressed environmental factors. Conclusion/Discussion: None of these PAD assessments comprehensively addresses disease-specific functional status or QOL. Their focus on disability may not effectively target aspects of community function that are important patient-centered outcomes for PAD treatment/rehabilitation/ research. This analysis should be used as a takeoff point to create a comprehensive disease-specific PAD assessment. Key Words: Peripheral Arterial Disease, Outcomes, Function, Limb Salvage Disclosures: None. Research Poster 309289 Using the Rasch Model to Investigate Suggested Cut-off Score of the Berg Balance Scale Sergio Romero (Center of Innovation on Disability and Rehabilitation Research (Veterans Adminstration)), Mi Jung Lee Research Objectives: To investigate the psychometric properties of the Berg Balance Scale (BBS) at suggested cut-off score and identify specific items that offer the most information for individuals at high risk of falling. Design: Retrospective analysis of item level data using the Rasch model. First, model assumptions were tested using factor analysis methods [1]. Then, the Rasch Partial Credit model was used to estimate item difficulty and person ability parameters [2]. Fit indices, ceiling/floor effects, item information, and estimated errors were used to investigate the psychometric properties of the scale. Setting: Data collected at the Gainesville VA outpatient Gait and Balance Clinic as part of a comprehensive intake evaluation. Participants: 218 community dwelling older Veterans (age 55 and older) with a history of falling. Primary causes for falling included neurological conditions, cardiopulmonary or musculoskeletal dysfunction, peripheral neuropathy, polypharmacy, orthostatic hypotension, and vestibulopathy. Interventions: N/A. Main Outcome Measure(s): N/A. Results: Data met model assumptions of unidimensionality (RMSEA < .08, SRMR < .08 and CFI >.90) [3]. All items showed adequate fit (meansquare ranges were 0.5 to 2.0) [4]. The 45 BBS score corresponded to an estimated 2.1 logits with a standard error of 0.4. A 95% confidence interval around this estimate indicates a range of 1.3 - 2.9 logits or 38-49 BBS points. Items: Standing on one foot, Placing alternate foot on stool, Turning 360, and Turning to look behind provided the most information at the suggested cut-off point. Conclusion/Discussion: Instrument met criteria for Rasch analysis. The Item/Person distribution suggests including more high level items would be beneficial. Currently, instrument reliably distinguishes roughly 3 levels of function. Given the significant amount of error associated with estimates clinicians might consider using ranges of scores to categorize patients. Key Words: Falls, Geriatrics, Evaluation, Gait Disclosures: None.
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e129 Research Poster 310689 Utility of Using the NSI With Mild TBI Patients in an Urban Trauma Center Christina Weyer Jamora (University of California-San Francisco/Zuckerberg San Francisco General Hospital), Serana Chester, Michele Diaz, Jary Larsen, Ronald Ruff Research Objectives: To examine the utility of using the Neurobehavioral Symptom Inventory as a measure of postconcussive symptoms, guide treatment planning, and treatment outcome in an urban level 1 trauma center. Design: Retrospective single group design of individuals with mild traumatic brain injury with follow up at 6 months. Setting: The study setting was at Zuckerberg San Francisco General Hospital. This is an outpatient multidisciplinary mild traumatic brain injury clinic in a urban level 1 trauma center that primary serves a diverse public health populations. Participants: A total of 33 participants with mild traumatic brain injury were selected based on their participation in the outpatient mild traumatic brain injury clinic. Interventions: The participants were administered the Neurobehavioral Symptom Inventory, PHQ-2, PCL-2, AUDIT-C, and psychosocial questions. Based on the participant’s responses, the patient was then assigned to the appropriate discipline for assessment and intervention-Physical Therapy, Nurse Practitioner, Social Work, and Neuropsychologist. Participants were provided neuropsychological screening, education, medication recommendations, vestibular rehabilitation interventions, and psychosocial brief intervention and resource linkage. Participants were followed up 1 month and 6 months post visit. Main Outcome Measure(s): Glasgow Outcome Scale Extended, Neurobehavioral Symptom Inventory, patient experience. Results: Participants NSI scores decreased from 26.42 to 9.13 at 6 months. GOSE scores at 6 months were 7.45. All but one participant was back to work at full or partial capacity. Participants reflected high satisfaction with their clinic experience of 8.42 out of 10 being the best. Conclusion/Discussion: NSI is a potentially useful measure for assessing and tracking mild TBI outcomes in public health populations. Additional study is warranted to validate these findings. Key Words: Mild TBI, Concussion, Outpatient Clinic, Assessment and Management, Public Health Disclosures: None. Research Poster 305228 Validation of Gait Cycle Timing Using Wearable Sensors in Individuals with Cerebral Palsy Richard Pimentel (Children’s Hospital Colorado), Colton Sauer, James Carollo Research Objectives: To compare gait cycle stride times between wearable inertial sensors (IMUs) to Optical Motion Capture (OMC) in individuals with cerebral palsy (CP) and age and gender matched controls. Design: Criterion standard. Setting: Hospital based, Accredited, Clinical Motion Laboratory. Participants: Following local IRB approval, a convenience sample of 14 individuals with CP and 14 age and gender-matched subjects free of gait pathology participated in this study. Interventions: N/A. Main Outcome Measure(s): Gait cycle duration (stride time) averaged across multiple steps for each subject between two sequential ipsilateral foot strikes, and total number of gait cycles measured by each measurement system. Results: Seventy trials were captured simultaneously with OMC (Vicon) and IMU (APDM Inc.) systems for each group. The IMUs initially detected 57 CP and 63 AMN trials, however the gait cycle intervals were
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e129 Research Poster 310689 Utility of Using the NSI With Mild TBI Patients in an Urban Trauma Center Christina Weyer Jamora (University of California-San Francisco/Zuckerberg San Francisco General Hospital), Serana Chester, Michele Diaz, Jary Larsen, Ronald Ruff Research Objectives: To examine the utility of using the Neurobehavioral Symptom Inventory as a measure of postconcussive symptoms, guide treatment planning, and treatment outcome in an urban level 1 trauma center. Design: Retrospective single group design of individuals with mild traumatic brain injury with follow up at 6 months. Setting: The study setting was at Zuckerberg San Francisco General Hospital. This is an outpatient multidisciplinary mild traumatic brain injury clinic in a urban level 1 trauma center that primary serves a diverse public health populations. Participants: A total of 33 participants with mild traumatic brain injury were selected based on their participation in the outpatient mild traumatic brain injury clinic. Interventions: The participants were administered the Neurobehavioral Symptom Inventory, PHQ-2, PCL-2, AUDIT-C, and psychosocial questions. Based on the participant’s responses, the patient was then assigned to the appropriate discipline for assessment and intervention-Physical Therapy, Nurse Practitioner, Social Work, and Neuropsychologist. Participants were provided neuropsychological screening, education, medication recommendations, vestibular rehabilitation interventions, and psychosocial brief intervention and resource linkage. Participants were followed up 1 month and 6 months post visit. Main Outcome Measure(s): Glasgow Outcome Scale Extended, Neurobehavioral Symptom Inventory, patient experience. Results: Participants NSI scores decreased from 26.42 to 9.13 at 6 months. GOSE scores at 6 months were 7.45. All but one participant was back to work at full or partial capacity. Participants reflected high satisfaction with their clinic experience of 8.42 out of 10 being the best. Conclusion/Discussion: NSI is a potentially useful measure for assessing and tracking mild TBI outcomes in public health populations. Additional study is warranted to validate these findings. Key Words: Mild TBI, Concussion, Outpatient Clinic, Assessment and Management, Public Health Disclosures: None. Research Poster 305228 Validation of Gait Cycle Timing Using Wearable Sensors in Individuals with Cerebral Palsy Richard Pimentel (Children’s Hospital Colorado), Colton Sauer, James Carollo Research Objectives: To compare gait cycle stride times between wearable inertial sensors (IMUs) to Optical Motion Capture (OMC) in individuals with cerebral palsy (CP) and age and gender matched controls. Design: Criterion standard. Setting: Hospital based, Accredited, Clinical Motion Laboratory. Participants: Following local IRB approval, a convenience sample of 14 individuals with CP and 14 age and gender-matched subjects free of gait pathology participated in this study. Interventions: N/A. Main Outcome Measure(s): Gait cycle duration (stride time) averaged across multiple steps for each subject between two sequential ipsilateral foot strikes, and total number of gait cycles measured by each measurement system. Results: Seventy trials were captured simultaneously with OMC (Vicon) and IMU (APDM Inc.) systems for each group. The IMUs initially detected 57 CP and 63 AMN trials, however the gait cycle intervals were