Marieke Coussens

Updating the Evidence on Functional Capacity Evaluation Methods: A Systematic Review

Objectives To synthesize the evidence on the psychometrics functional capacity evaluation (FCE) methods. Methods A systematic literature search in nine databases. The resulting articles were screened based on predefined in- and exclusion criteria. Two reviewers independently performed this screening. Included studies were appraised based on their methodological quality. Results The search resulted in 20 eligible studies about nine different FCE methods. The Baltimore Therapeutic Equipment work simulator showed a moderate predictive validity. The Ergo-Kit (EK) showed moderate variability and high inter- and intra-rater reliability. Low discriminative abilities and high convergent validity were found for the EK. Concurrent validity of the EK and the ERGOS Work Simulator was low to moderate. Moderate to high test–retest, inter- and intra-reliability was found in the Isernhagen Work-Systems (IWS) FCE. The predictive validity of the IWS was low. The physical work performance evaluation (PWPE) showed moderate test–retest reliability and moderate to high inter-rater reliability. Low internal and external responsiveness were found for the PWPE, predictive validity was high. The predictive validity of the short-form FCE was also high but need to be further examined on several psychometric properties. Low discriminative and convergent validity were found for the work disability functional assessment battery. The WorkHab showed moderate to high test–retest, inter- and intra-rater reliability. Conclusion Well-known FCE methods have been rigorously studied, but some of the research indicates weaknesses in their reliability and validity. Future research should address how these weaknesses can be overcome.

Motivation in pediatric motor rehabilitation: A systematic search of the literature using the self-determination theory as a conceptual framework

ABSTRACT Objective: Motivation is suggested as an important factor in pediatric motor rehabilitation. Therefore, we reviewed the existing evidence of (motivational) motor rehabilitation paradigms, and how motivation influences rehabilitation outcome using self-determination theory as conceptual framework. Methods: PubMed and Web-of-Science databases were systematically searched until June 2015. Data were independently extracted and critiqued for quality by three authors. Studies reporting motivational aspects were included. Most studies examined new technology (e.g., virtual reality [VR]). Results: Out of 479 records, three RCT, six case-control, and six non-comparative studies were included with mixed quality. Motivation was rarely reported. Training individualization to the child’s capabilities with more variety seemed promising to increase motivation. Motivation increased when the exercises seemed helpful for daily activities. Conclusions: Motivation in pediatric rehabilitation should be comprehensively assessed within a theoretical framework as there are indications that motivated children have better rehabilitation outcomes, depending on the aspect of motivation.

Enquête naar kennis, gebruik en perceptie van richtlijnen betreffende cerebrovasculair accident (CVA) bij Vlaamse SP-diensten en CVA-revalidatie-eenheden

Abstract Enquiry towards knowledge on, use ofand perception of guidelines for strokein the various categories of care practitionersin Flemish (Belgian) specialized servicesfor stroke care The need for quality within medical and paramed-ical acts has actually become more determinate andurgent. This search for quality of care canbe found in „evidence-based medecine” (EBM). Oneway to implement this in practice is to develop instru-ments such as (clinical) guidelines.Since the rehabilitative care for patients after strokeis complex as well as multidisciplinary, the rele-vance of paramedical guidelines for this group ofpatients is obviously considerable. Guidelines leadindeed to a more uniform and transparent care.Through an enquiry in specialized services forstroke care in Flanders (Belgium), the authors havetried to detect the existing knowledge as well as theuse and perception of guidelines for stroke patientsof diverse categories of care practitioners.This enquiry by letter of 49 Flemish hospitals withspecialised services (SP neurological / SP locomo-torical) or with RIZIV-rehabilitation convention(National institute for health insurance) revealed thatin the respondents’ group (n = 83), physicians andnurses are most familiar with guidelines. Moreover,their knowledge increases with ascending age andexperience in stroke care. Still a lot of other practi-tioners do not know what guidelines exactly repre-sent. Thus the need for information and educationremains substantial.From all disciplines questioned, physicians useguidelines most frequently.None of the interrogated caretakers was dismissivetowards guidelines; the better their knowledge andthe more frequent their use of guidelines, the moreopen and compliant they are towards this care struc-ture.Literatuur