Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-25T16:08:11.121Z Has data issue: false hasContentIssue false

Development and Preliminary Validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA)

Published online by Cambridge University Press:  13 August 2014

Janelle M. Gesch*
Affiliation:
Brain Injury Rehabilitation Unit, Physiotherapy Department, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane 4102, Australia
Nancy L. Low Choy
Affiliation:
Australian Catholic University, (McAuly Campus), Brisbane, Australia The Prince Charles Hospital, Brisbane, Australia
Benjamin K. Weeks
Affiliation:
Griffith Health Institute, Griffith University, Gold Coast, Australia
Leanne L. Passier
Affiliation:
Brain Injury Rehabilitation Unit, Physiotherapy Department, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane 4102, Australia
Margarida Nascimento
Affiliation:
Brain Injury Rehabilitation Unit, Physiotherapy Department, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane 4102, Australia
Terrence P. Haines
Affiliation:
Brain Injury Rehabilitation Unit, Physiotherapy Department, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane 4102, Australia Southern Physiotherapy Clinical School, Physiotherapy Department, Monash University, Melbourne, Australia
Suzanne S. Kuys
Affiliation:
The Prince Charles Hospital, Brisbane, Australia Griffith Health Institute, Griffith University, Gold Coast, Australia
*
Address for correspondence: Janelle Gesch, Physiotherapy Department, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane 4102, Australia. E-mail: [email protected]
Get access

Abstract

Background and aims: For patients with a severe brain injury there is no objective physiotherapy assessment tool that is responsive to the incremental changes in motor recovery in the acute stage. The aims of this study were to identify the items of neuro-motor recovery and scoring criteria for the Acute Brain Injury Physiotherapy Assessment (ABIPA) and determine responsiveness to change and concurrent validity against accepted standard measures of consciousness and physical function in the severe brain injury population.

Method: The literature was searched and an expert consensus panel of experienced clinical physiotherapists informed item selection and developed practical assessment guidelines. The ABIPA was investigated for responsiveness to change and concurrent validity against the Glasgow Coma Scale (GCS), Clinical Outcome Variable Scale (COVS) and Motor Assessment Scale (MAS). Eleven patients (9 males; cohort 41 ± 18 years) with moderate/severe brain injury were recruited, and assessed on days 1, 3, 7 and then weekly until discharge.

Results: The ABIPA demonstrated good to excellent correlations overall with the GCS (rho > .76, p ≤ .001), COVS (rho > .82, p ≤ .001) and MAS (rho > 0.66, p ≤ .001). On day 3, the ABIPA showed the greatest responsiveness to change (standardised response means (SRM) > .83) compared to other measures (SRMs < .77). At discharge all tools demonstrated change in neuro-motor recovery.

Conclusions: The ABIPA is a promising tool for detecting incremental changes in neuro-motor recovery early after severe brain injury.

Type
Articles
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ansari, N., Haghdi, S., Moammeri, H., & Jalaie, S. (2006). Ashworth Scales are unreliable for the assessment of muscle spasticity. Physiotherapy Theory & Practice, 22 (3), 119125.CrossRefGoogle ScholarPubMed
Barker, R., Amsters, D., Kendall, M., Pershouse, K., & Haines, T. (2007). Reliability of the clinical outcome variables scale when administered via telephone to assess mobility in people with spinal cord injury. Archives of Physical Medicine and Rehabilitation, 88 (5), 632637.Google Scholar
Canedo, A., Grix, M.C., & Nicoletti, J. (2002). An analysis of assessments for the minimally responsive patient. Brain Injury, 16 (5), 453461.Google Scholar
Carr, J.H., Shepherd, R.B., & Nordholm, L. (1985). Investigation of a new motor assessment scale for stroke patients. Physical Therapy, 65, 175180.Google Scholar
Charness, A. (1986). Stoke/head injury: A guide to functional outcome in physical therapy management. Rockville: Aspens Systems Corporation.Google Scholar
Chestnut, R.M. (1990). Evidence for the effectiveness of rehabilitation for persons with traumatic brain injury. Journal of Head Trauma Rehabilitation, 14, 176188.Google Scholar
Chieregato, A., Martino, C., Pransani, V., Nori, G., Russo, E., Nato, A., & Simini, B. (2010). Classification of a traumatic brain injury: the Glasgow Coma scale is not enough. Acta Anaesthesiologica Scandinavica, 54, 696702.Google Scholar
Chua, K.S., & Kong, K.H. (2002). Rehabilitation outcome following traumatic brain injury – the Singapore experience. International Journal of Rehabilitation Research, 22 (3), 189197.CrossRefGoogle Scholar
Cifu, D.X., Kreutzer, J.S., Kolakowsky-Hayner, S.A., Marwitz, J.H., & Englander, J. (2003). The relationship between therapy intensity and rehabilitative outcomes after traumatic brain injury: A multicenter analysis. Archives of Physical Medicine and Rehabilitation, 84, 14411448.CrossRefGoogle ScholarPubMed
Cohen, J. (1977). Statistical power for the behavioural sciences. New York: Academic Press.Google Scholar
Crooks, C.Y., Zumsteg, J.M., & Bell, K.R. (2007). Traumatic brain injury: A review of practice management and recent advances. Physical Medicine and Rehabilitation Clinics of North America, 18, 681710.CrossRefGoogle ScholarPubMed
Demeurisse, G., Demol, O., & Roboye, E. (1980). Motor evaluation in vascular hemiplegia. European Neurology, 19, 382389.CrossRefGoogle ScholarPubMed
Duncan, P.W. (1990). Rehabilitation of the adult and child with traumatic brain injury (2nd ed.). Philadelphia: F.A. Davis.Google Scholar
Fischer, M., Rüegg, S., Czaplinski, A., Strohmeier, M., Lehmann, A., Tschan, F., . . . Marsch, S.C. (2010). Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients: a prospective observational study. Critical Care, 14, R64.Google Scholar
Fortune, N., & Wen, X. (1999). The definition, incidence and prevalence of acquired brain injury in Australia. Canberra: Australian Institute of Health and Welfare.Google Scholar
Gray, S.D. (2000). Slow to recover severe traumatic brain injury: a review of outcomes and rehabilitation effectiveness. Brain Injury, 14 (11), 10031014.Google Scholar
Guttman, L. (2004). A basis for Scaling Qualitive Data. American Sociological Review, 9 (2), 139150.Google Scholar
Guyatt, G.H., Krishner, B., & Jaeschke, R. (1992). Measuring health status: What are the necessary measurement properties? Clinical Epidemiology, 45 (12), 13411345.Google Scholar
Hagerty, C.G. (2002). Data abstraction and analysis using qualitative scaling. PhD thesis, The State University of New Jersey, New Brunswick, United States.Google Scholar
Haigh, R., Tennant, A., Biering-Sorensen, F., Grimby, G., Marincek, C., Phillips, S., . . . Thonnard, J. L. (2001). The use of outcome measures in physical medicine and rehabilitation within Europe. Journal of Rehabilitation Medicine, 33 (6), 273278.Google Scholar
Hall, K.M., & Cope, N.D. (1995). The benefit of rehabilitation in traumatic brain injury: A literature review. Journal of Head Trauma Rehabilitation, 10 (1), 113.Google Scholar
Harms-ringdahl, K. (1993). Muscle strength (vol. 8). Edinburgh: Churchill Livingstone.Google Scholar
Hellweg, S., & Johannes, S. (2008). Physiotherapy after traumatic brain injury: A systematic review of the literature. Brain Injury, 22 (5), 365373.CrossRefGoogle ScholarPubMed
Kidd, D., Stewart, G., & Baldry, J. (1996). The Functional Independence Measure: A comparative validity and reliability study. Disability and Rehabilitation, 17 (1), 1014.CrossRefGoogle Scholar
Laxe, S., Tschiesner, U., Zasler, N., López-Blazquez, R., Tormos, J.M., & Bernabeu, M. (2012). What domains of the International Classification of Functioning, Disability and Health are covered by the most commonly used measurement instruments in traumatic brain injury research? Clinical Neurology and Neurosurgery, 114 (6), 645650.Google Scholar
Low Choy, N., Kuys, S., Richards, M., & Isles, R. (2002). Measurement of functional ability following traumatic brain injury using the Clinical Outcomes Variable Scale: A reliability study. Australian Journal of Physiotherapy, 48 (1), 3539.Google Scholar
Mayo, N., Sullivan, J., & Swaine, B. (1991). Observer variation in assessing neurophysical signs among patients with head injuries. American Journal of Physical Medicine and Rehabilitation, 70 (3), 118123.Google Scholar
McNett, M. (2007). A review of the predictive ability of Glasgow Coma Scores in head injury. Journal of Neurosciences Nursing, 39 (2), 68.Google Scholar
Mittrach, R., Grill, E., Walchner-Bonjean, M., Scheuringer, M., Boldt, C., Huber, E.O., & Stucki, G. (2008). Goals of physiotherapy interventions can be described using the International Classification of Functioning, Disability and Health. Physiotherapy, 94 (2), 150157.Google Scholar
Nelson, A. (1984). Rehabilitation of the adult and child with traumatic brain injury (2nd ed.). Philadelphia: F.A. Davis.Google Scholar
New Zealand Guidelines Group. (2007). Traumatic brain injury: Diagnosis, acute management and rehabilitation. Evidence- based best practice guideline summary. Wellington: New Zealand Guidelines Group.Google Scholar
Nichol, A.D., Higgins, A.M., Gabbe, B.J., Murray, L.J., Cooper, D.J., & Cameron, P.A. (2011). Measuring functional and quality of life outcomes following major head injury: Common scales and checklists. Injury, 42 (3), 281287.Google Scholar
O’Dell, M.W., Jasin, P., Stivers, M., Lyons, N., Schmidt, S., & Moore, D.E. (1996). Interrater reliability of the coma recovery scale. Journal of Head Trauma Rehabilitation, 11 (3), 6166.Google Scholar
Pape, T.L., Lundgren, S., Heinemann, A.W., Guernon, A., Giobbie-Hurder, A., Wang, J., . . . Williams, V. (2006). Establishing a prognosis for functional outcome during coma recovery. Brain Injury, 20 (7), 743758.Google Scholar
Pilon, M., Sullivan, S.J., & Coulombe, J. (1995). Persistent vegetative state: which sensory–motor variables should the physiotherapsit measure? Brain Injury, 9 (4), 365376.Google Scholar
Pollock, A., Morris, J., Wijck, F. van, Coupar, F., & Langhorne, P. (2011). Response to Cauraugh, J.H. et al. Bilateral movement training and stroke motor recovery progress: a structured review and meta-analysis. Human Movement Science, 30 (1), 143146.Google Scholar
Pomeroy, V.M., Dean, D., Sykes, L., Faragher, B., Yates, M., Tyrrell, P, . . . Tallis, R. (2000). The unreliability of clinical measures of muscle tone: implications for stroke therapy. Age and Aging, 29, 229233.Google Scholar
Poole, J., & Whitney, S. (1988). Motor assessment scale for stroke patients: concurrent validity and interrater reliability. Archives of Physical Medicine and Rehabilitation, 69, 195197.Google Scholar
Portney, L., & Watkins, M., (2000). Foundations of clinical research: Applications to practice (2nd ed.). Upper Saddle River, New Jersey: Prentice Hall.Google Scholar
Salter, K., Jutai, J., Foley, N., & Teasell, R. (2010). Clinical Outcome Variables Scale : A retrospective validation study in patients after stroke. Journal of Rehabilitation Medicine, 42 (7), 609613.Google Scholar
Seaby, L., & Torrance, G. (1989). Reliability of a physiotherapy functional assessment used in a rehabilitation setting. Physiotherapy Canada, 41 (5), 264271.Google Scholar
Shukla, D., Devi, B.I., & Agrawal, A. (2011). Outcome measures for traumatic brain injury. Clinical Neurology and Neurosurgery, 113 (6), 435441.Google Scholar
Slade, A., Tennant, A., & Chamberlain, M.A. (2002). A randomised controlled trial to determine the effect of intensity of therapy upon length of stay in a neurological rehabilitation setting. Journal of Rehabilitation Medicine, 34 (6), 260266.Google Scholar
Sodring, K.M., Bantz-Holter, E., Ljunggren, A.E., & Wytter, T. (1995). Description and validation of a test of motor function and activities in stroke patients. Scandinavian Journal of Rehabilitation, 27, 211217.Google Scholar
Spivack, G., Spettell, C.M., Ellis, D.W., & Ross, S.E. (1992). Effects of intensity of treatment and length of stay on rehabilitation outcomes. Brain Injury, 6, 419434.Google Scholar
Swaine, B., & Sullivan, S. (1996). Reliability of early motor function testing in persons following severe traumatic brain injury. Brain Injury, 10 (4), 263276.CrossRefGoogle ScholarPubMed
Swaine, B.R., & Sullivan, S.J. (1999). Interpreting reliability of early motor function measurement following head injury. Physiotherapy Theory and Practice, 15 (3), 155164.Google Scholar
Swaine, B.R., Sullivan, S.J., & Sicotte, D. (1994). Expert opinion in the identification of variables for the measurement of early recovery in adults with traumatic brain injury. Brain Injury, 8 (4), 323334.Google Scholar
Tardieu, G., Rondot, P., Mensch, J., Dalloz, J.C., Monfraix, C., & Tabary, J.C. (1957). Responses electromyographiques à l’étirement musculaire chez l’homme normal. Revue Neurologie, 97 (1), 6061.Google Scholar
Teasdale, G., & Jennet, B. (1974). Assessment of coma and impaired consciousness. A practical scale. The Lancet, 300 (2), 8184.Google Scholar
Teasell, R., Bayona, N., Marshall, S., Cullen, N., Bayley, M., Chundamala, J., . . . Tu, L. (2007). A systematic review of the rehabilitation of moderate to severe acquired brain injuries. Brain Injury, 21 (2), 107112.Google Scholar
Tolfts, A., & Stiller, K. (1997). Do patients with traumatic brain injury benefit from physiotherapy? A review of the evidence. Physiotherapy Theory and Practice, 13 (3), 197206.Google Scholar
Turner-Stokes, L., Nair, A., Sedki, I., Disler, P.B., & Wade, D.T. (2005). Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database of Systematic Reviews 2005, Issue 3.Google Scholar
Walker, W., & Pickett, T.C. (2007). Motor impairment after severe traumatic brain injury: A longitudinal multicenter study. Journal of Rehabilitation Research & Development, 44 (7), 975982.Google Scholar
Weir, J., Steyerberg, E.W., Butcher, I., Lu, J., Lingsma, H.F., McHugh, G. S., . . . Murray, G.D. (2012). Does the extended Glasgow Outcome Scale add value to the conventional Glasgow Outcome Scale? Journal of Neurotrauma, 29 (1), 5358.CrossRefGoogle Scholar
Wright, J., Bushnik, T., & O’Hare, P. (2000). The Centre for Outcome Measurement in Brain Injury (COMBI): An internet resource you should know about. Journal of Head Trauma Rehabilitation, 15 (8), 734738.Google Scholar
Zhu, X.L., Poon, W.S., Chan, C.C., & Chan, S.S. (2007). Does intensive rehabilitation improve the functional outcome of patients with traumatic brain injury (TBI)? A randomized controlled trial. Brain Injury, 21 (7), 681690.Google Scholar
Zitnay, G.A., Zitnay, K. M., Povlishock, J.T., Hall, E.D., Marion, D.W., Trudel, T., . . . Barth, J.T. (2008). Traumatic brain inury research priorities: The Conemaugh International Brain Injury Symposium. Journal of Neurotrauma, 25(October), 11351152.CrossRefGoogle Scholar