Stroke rehabilitation. Outcome studies and guidelines for alternative levels of care.

This study was conducted to continue the construct validation of the occupational therapy Cerebral Vascular Accident (CVA) evaluation used at St. Marys Hospital Medical Center in Madison, Wisconsin. From the previous factor analysis of this battery, a perception factor emerged that is defined by high loadings on measures of body scheme, figure ground, position in space, spatial relations, and stereognosis. From the literature review it was hypothesized that scores on these tests should be related to patient discharge disposition. Results of this study supported the hypothesis, thus providing further evidence of the construct validity of the St. Marys CVA Evaluation Battery.

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“…continue to be published (11,12). the perceptual construct were Two studies considered the cri-valid, there would be a relation-…”

Section: Julia Van Deusenmentioning

confidence: 99%

Construct Validation of the St. Marys CVA Evaluation: Perceptual Measures

Harlowe

Deusen

1984

The American Journal of Occupational Therapy

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“…[5][6][7][8][9][10][11] Nevertheless, these data did not greatly improve outcome prediction in a group of 841 patients when multivariate techniques were used to mathematically predict outcome using a "medical model." 11 Other attempts to predict outcome using multivariate techniques, also based on medical data alone, have also failed. and can provide simple data for cost-effectiveness and cost-benefit analysis.…”

Section: To the Editormentioning

confidence: 99%

Toward a uniform assessment of "outcome".

Feigenson¹

1982

Stroke

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have recently highlighted the need for merging medical and functional outcome parameters and for the development of a standard instrument which measures outcome in stroke survivors. These issues were addressed by the group involved with the demonstration project for the National Stroke Data Base in 1977, a project sponsored by the Office of Biometry and Field Studies of NINCDS.2 . 3 A standardized data vocabulary was subsequently constructed and used during the pilot phase of the Data Base Project.Independently, other attempts to merge data from a large medical stroke data base with data from a comprehensive functional data base 4 and a simple demographic data base yielded some information about outcome predictions.5-11 Nevertheless, these data did not greatly improve outcome prediction in a group of 841 patients when multivariate techniques were used to mathematically predict outcome using a "medical model."11 Other attempts to predict outcome using multivariate techniques, also based on medical data alone, have also failed. >13 Experience suggests that psychosocial and socioeconomic variable must also be considered.11 ' 12 TABLEThe Outcome Index proposed by Spence and Donner does not include this information.' It also fails to adequately describe and/or delineate the differences between behavioral status, communication status, cognitive status, perceptual status, ability to walk, upper extremity function, self-care status, transfer status, homemaking abilities, ability to perform in real life situations, vocational/educational status, quality of life, living arrangements, amount of help needed to maintain the stroke patient, and the cost for care. By "lumping" all of these descriptors together, Spence and Donner decrease the sensitivity of their instrument while making it less useful to the clinician who cares for the patient and for the researcher who is attempting to see if various types of therapeutic intervention can change outcome in any of the categories listed. The Barthel's Index 14 has the same shortcomings.An alternative outcome assessment appears in the

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