Élisabeth Dutil

The Purdue Pegboard Test: Normative data for people aged 60 and over

Manual dexterity is frequently evaluated in rehabilitation services to estimate hand function. Several tests have been developed for this purpose, including the Purdue Pegboard, which measures fine manual dexterity. The goals of the study were to verify the test-retest reliability with subjects aged 60 and over without upper limb impairment, and to develop normative data based on a random sample of healthy older community-living individuals. The results show that the test-retest reliability is good (intra-class correlation coefficients from 0.66 to 0.90, depending on the subtest). Norms are presented to help clinicians involved in rehabilitation services to better differentiate real dexterity deficits from those that may be attributed to normal ageing.

Development and Reliability of an Upper Extremity Function Test for the Elderly: The TEMPA

Accurate assessment of upper extremity performance is a critical element in determinimg the potential independance of the physically impaired person. An upper extremity function test for the elderly, the TEMPA (Test Évaluant les Membres supérieurs des Personnes Âgées), was developed, involving nine tasks related to routine daily activities. Each task is measured by three sub-scores: speed of execution, functional rating and task analysis. A test-retest and interrater reliability study was conducted with a sample of 29 subjects, aged 62 to 82 years, with various upper extremity impairments and varying degrees of functional independance. Intraclass correlation coefficients ranged from moderate to high (0.70 to 1.0), demonstrating temporal stability and sound agreement between evaluators. A preliminary construct validity study was conducted by correlating score of the TEMPA with functional independance to basic personal care (Spearmans Rho = 0.74). The TEMPA is a reliable instrument that appears to fill a void in the evaluation of the elderly. More psychometric studies are required to confirm its validity.

Hand Sensibility of Healthy Older People

OBJECTIVE: To develop normative data for four hand sensibility modalities in older subjects.

Factors affecting leisure participation after a traumatic brain injury: an exploratory study.

ObjectiveTo explore leisure participation by people with traumatic brain injury (TBI) and reasons underlying changes after the trauma. ParticipantsTwenty-six individuals with mild to severe TBI. Main MeasureLeisure Profile, a semi-structured questionnaire measuring involvement in leisure activities before and after TBI (frequency of activities, degree of interest, and desire to modify ones leisure activities), attitudes toward leisure, and difficulties that might influence leisure activities (impairments and environmental obstacles). ResultsLeisure participation was greatly disrupted after TBI, with 92% of the participants reporting a reduction posttrauma. Less severe injuries, more time since the injury, and the presence of social obstacles in the environment were positively correlated with leisure participation. Motor impairments had a negative impact on leisure participation. ConclusionTBI has a significant negative effect on leisure participation. Leisure activities should be evaluated and included in a therapy program designed to promote reintegration into society and work.

The criterion-related validity of the IADL Profile with measures of executive functions, indices of trauma severity and sociodemographic characteristics

Primary objective: To examine relationships between classical measures of executive functions (EF) and indices of traumatic brain injury (TBI) severity with the IADL Profile, a new performance-based measure of independence in instrumental activities of daily living (IADL) based on EF. This study hypothesized the presence of correlations between classical tests of EF and the IADL Profile, as the latter aims to establish whether the subjects main difficulties pertain to goal formulation, planning, carrying out the task and/or attaining the initial task goal; all important components of EF. Methods and procedures: One hundred subjects with a moderate/severe TBI aged 16–65 years (convenience sample) were recruited. Subjects were tested with the IADL Profile and three measures of EF within their home environment. Data was analysed using Pearson correlations, t-tests and multiple stepwise regressions. Results: Post-traumatic amnesia and working memory emerged as the major determinants of IADL Profile scores. Together, indices of injury severity, measures of EF, education, age and environmental factors accounted for 12–28% of the variance in IADL Profile scores. Conclusions: This study has shown that the IADL Profiles non-structured approach permits the observation of a broad range of behaviours related to EF deficits and thus provides a closer approximation of the persons independence in IADL. Further study is required to demonstrate the IADL Profiles ability to inform more targeted treatment interventions.

The factorial validity and internal consistency of the Instrumental Activities of Daily Living Profile in individuals with a traumatic brain injury

The objective of the study was to investigate the factorial validity and internal consistency of the Instrumental Activities of Daily Living (IADL) Profile. A group of 96 patients aged 16 to 65 years, with moderate to severe traumatic brain injuries, was recruited from 12 rehabilitation hospitals in Quebec. The IADL Profile was administered by an occupational therapist in each subjects home and community environment. Principal axis factoring and confirmatory factor analysis provide preliminary support for six correlated factors (F): (F1) going to grocery store/shopping for groceries, (F2) having a meal with guests/cleaning up, (F3) putting on outdoor clothing, (F4) obtaining information, (F5) making a budget, (F6) preparing a hot meal for guests. Total explained variance was 73.6%. Cronbachs alpha analysis revealed high to very high internal consistency for all scales ranging from .81 to .98; internal consistency of the total scale was very high (0.95). The findings suggest that the IADL Profile is a promising means of documenting both IADL independence and the repercussions of executive function deficits on everyday tasks in real-world environments.

Validity of the TEMPA: A Measurement Instrument for Upper Extremity Performance

Motivated by the important role played by the upper extremities in daily activities and the limitations of existing tests for measurement of upper extremity performance for the elderly, an evaluation instrument, the TEMPA, was developed. Reliability studies having been previously reported, this study investigates two types of validity for the TEMPA. Concurrent validity was tested by examining the instruments agreement with two tests measuring similar concepts: the Action Research Armtest (ARA) and the Box and Block Test (B&BT). The TEMPAs construct validity was simultaneously explored by testing two hypotheses relating the concept of upper limb performance to that of functional independence. One hundred four men and women, aged between 60 and 94 years old, with various living arrangements and presenting different types of upper limb impairment, participated in the study. The TEMPA correlated significantly with the ARA and the B&BT. Correlation with independence was significantly higher with the TEMPA than with the ARA.

Development of the ADL Profile.

This article presents a new instrument, the ADL Pcofile, which is designed specifically for the head injured adult. The instrument is based on the model of occupational performance and on Lurias model of cerebral and motor functioning. It divides the concept of activities of daily living (ADL) into 3 dimensions: personal environment, home environment and community environment. It further delineates a number of activities, tasks and operations under each of these dimensions. The article presents a rationale for the instruments development, a description of the development process and the preliminary validation work, and details of the instrument itself.

Model of Competence: A Conceptual Framework for Understanding the Person-Environment Interaction for Persons with Motor Disabilities

The “Model of Competence” has been recently elaborated to help expand our understanding relating to a persons interaction with the environment. Specifically, it seeks to deal with the issues related to the home adaptation (the home layout and equipment) for a person living with motor disabilities. This theoretical model takes into account various characteristics of the person as well as of the environment, by re-grouping six concepts: person, environment, activity, role, competence and handicap situation. The “Model of Competence” is distinct because it includes: (1) both the human and the nonhuman dimension of the environment; (2) personal characteristics other than the strictly physical ones; (3) a clear identification of the interaction between the person and the environment; and (4) a means of operationalizing it via an assessment instrument. This model proposes an innovative approach to the person-environment relation in terms of personalizing accessibility, and thereby offers a new approach to understanding the concept of universal access. It has been developed for research and application, and addresses several disciplines.

The construct validity of the Functional Independence Measure as applied to stroke patients

The aim of this study was to examine the construct validity of the Functional Independence Measure (FIM) as related to the assessment of the functional independence of stroke patients during their stay in an acute care hospital following a cerebrovascular accident (CVA). Volunteer patients (n = 152) suffering from a stroke participated in the study. A number of functional, physical and neuropsychological indicators were measured upon the admission of a patient. Factor analysis was used to examine the dimensions included in the FIM. Two factors, life habits and ability, were obtained from a 14-item version of the FIM, which accounted for 76.2% of the total variance. Pearson product-moment correlation coefficients were then computed in order to examine the associations between physical and neuropsychological indicators, as well as with each sub-scale of the FIM. The results of this study show that the FIM measures the concept of life habits and is not solely restricted to the concept of ability as postulate...