PMID- 31738892
OWN - NLM
STAT- MEDLINE
DCOM- 20200629
LR  - 20200629
IS  - 1532-821X (Electronic)
IS  - 0003-9993 (Linking)
VI  - 101
IP  - 4
DP  - 2020 Apr
TI  - Minimal Clinically Important Differences in Functional Independence After a 
      Knowledge Translation Intervention in Stroke Rehabilitation.
PG  - 587-591
LID - S0003-9993(19)31371-1 [pii]
LID - 10.1016/j.apmr.2019.10.185 [doi]
AB  - OBJECTIVE: To examine the odds of persons with stroke achieving minimal 
      clinically important difference (MCID) in functional independence during 
      inpatient rehabilitation relative to cognitive impairment (CI) severity, site, 
      and rehabilitation teams' exposure to a Cognitive Orientation to daily 
      Occupational Performance (CO-OP) knowledge translation (KT) intervention. DESIGN: 
      A pre-post observational study was conducted using data from a centralized 
      referral system. Our research team implemented a CO-OP KT intervention as part of 
      a larger study aimed at training teams to use the CO-OP approach. SETTING: Five 
      inpatient rehabilitation units. PARTICIPANTS: Cases extracted from a centralized 
      referral system from the 5 participating units. INTERVENTIONS: Not applicable. 
      MAIN OUTCOME MEASURES: The FIM instrument data from 12 months preintervention and 
      6 months postintervention were analyzed. A logistic regression was performed to 
      determine the odds ratios (ORs) for achieving MCID based on sample cohort 
      (historical control not exposed to CO-OP KT vs post-CO-OP KT intervention), 
      controlling for site and severity of CI. RESULTS: A model that considered the 
      intervention, admission score, CI severity, and site was the best fit for the 
      cases analyzed. Those with severe CI were less likely to achieve FIM total MCID 
      compared to those with no CI (P=<.001; OR=.18; 95% confidence interval, .09-.39). 
      Taking site and CI into account, cases post CO-OP KT intervention were 
      significantly more likely to achieve MCID on FIM motor (P=.048; OR=1.4; 95% 
      confidence interval, 1.00-1.98) than historical controls. CONCLUSION: The CO-OP 
      KT intervention is associated with increased odds of achieving MCID in the FIM 
      motor subscale in inpatient stroke rehabilitation.
CI  - Copyright (c) 2019 American Congress of Rehabilitation Medicine. Published by 
      Elsevier Inc. All rights reserved.
FAU - Linkewich, Elizabeth
AU  - Linkewich E
AD  - Regional Stroke Centre, Sunnybrook Health Sciences Centre, Toronto, ON; 
      Practice-Based Research, Sunnybrook Research Institute, Toronto, ON; Department 
      of Occupational Science and Occupational Therapy, University of Toronto, Toronto, 
      ON. Electronic address: beth.linkewich@sunnybrook.ca.
FAU - Avery, Lisa
AU  - Avery L
AD  - Avery Information Services Ltd., Orillia, ON.
FAU - Rios, Jorge
AU  - Rios J
AD  - St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, ON.
FAU - McEwen, Sara E
AU  - McEwen SE
AD  - St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, ON; 
      Department of Physical Therapy, University of Toronto, Toronto, ON; 
      Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT02597569
GR  - CIHR/Canada
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20191115
PL  - United States
TA  - Arch Phys Med Rehabil
JT  - Archives of physical medicine and rehabilitation
JID - 2985158R
SB  - IM
MH  - Aged
MH  - *Cognitive Dysfunction
MH  - *Disability Evaluation
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - *Minimal Clinically Important Difference
MH  - Problem Solving
MH  - Self Efficacy
MH  - Severity of Illness Index
MH  - Stroke Rehabilitation/*methods
OTO - NOTNLM
OT  - Cognitive impairment
OT  - Knowledge translation
OT  - Rehabilitation
EDAT- 2019/11/19 06:00
MHDA- 2020/07/01 06:00
CRDT- 2019/11/19 06:00
PHST- 2019/09/12 00:00 [received]
PHST- 2019/10/05 00:00 [accepted]
PHST- 2019/11/19 06:00 [pubmed]
PHST- 2020/07/01 06:00 [medline]
PHST- 2019/11/19 06:00 [entrez]
AID - S0003-9993(19)31371-1 [pii]
AID - 10.1016/j.apmr.2019.10.185 [doi]
PST - ppublish
SO  - Arch Phys Med Rehabil. 2020 Apr;101(4):587-591. doi: 10.1016/j.apmr.2019.10.185. 
      Epub 2019 Nov 15.