Conceptual Foundations of Occupational Therapy

Study design Cross-sectional study of 63 patients with chronic low back pain (CLBP). Objectives To determine the relationship between the SF-36 physical functioning (PF) scale and physical performance on a modified symptom limited treadmill test, and to determine the effect of disability status and SF-36 mental health (MH) scores on self-reported physical functioning and on physical performance. Summary of background data Patients with CLBP report low levels of physical functioning. Because self-report measures are influenced by psychosocial factors, such as disability and low MH, a common recommendation is to supplement self-report with objective or physical performance testing. Little information exists regarding whether performance testing is also influenced by disability and low MH. Materials and methods Patients completed the SF-36 and performed a maximal, symptom-limited, modified treadmill test. Total walking time and heart rate on the treadmill were registered. The effects of disability and low MH on self-report and performance testing were calculated by unpaired Student's t-testing and effect size estimation. Results A strong relationship between the PF scale of the SF-36 and treadmill walking time was found, but there was little evidence of overlap between these physical functioning domains. Both disability status and low MH had a much larger effect on self-report measures than on physical performance. Conclusions Self-report measurements and performance-based assessments provide information about distinct, although related, domains of physical functioning. Disability and low MH are associated with lower SF-36 PF scores. Our results confirm that self-report measures require supplementation with objective performance testing to provide optimal assessment for patients with CLBP.

Physical functioning: self-report and performance measures are related but distinct.

12-Year within-wound study of the effectiveness of custom pressure garment therapy

Handbook of behavioral medicine

To define resilience and its components for individuals with severe burns, the authors integrated findings of a general literature review with opinions offered by 39 burn survivors through individual interviews. Results indicate that core factors influencing resiliency include social support (cultural influences and community, school, personal, and familial support,), cognitive skills (intelligence, coping style, personal control, and assignment of meaning), and psychological resources. Counseling strategies to strengthen resilience are suggested.

Resilience and Severe Burns

This study examined the pressure volumetric characteristics (compliance) of Jobst (Jobst Institute, Toledo, Ohio), Barton-Carey (Barton-Carey Co., Perrysburg, Ohio), and Tubigrip (SePro Healthcare Inc., Moorestown, N.J.) pressure garments for arms after repeated saturation with lubricating substances and repeated washing/drying cycles. The three treatment groups were each composed of one sleeve from each of the manufacturers and were subjected to 20 washing/drying cycles. In addition, the sleeves in treatment groups 2 and 3 were saturated with cocoa butter and Lubriderm moisturizer, respectively, before each cycle. Circumferential measurements were taken on the proximal forearm of the sleeve at varying degrees of pressure with a Grafco standard sphygmomanometer (Graham Field Inc., Hauppauge, N.Y.) and a Gulick anthropometric tape measure (Creative Engineering, Plymouth, Mich.). Measurements were taken initially and after every fifth washing/drying cycle. Analysis of variance revealed significant results for the main effects and some interactions at the 0.01 level. Overall results showed little change in the Jobst and Barton-Carey garments, whereas the Tubigrip garments displayed an inconsistent pattern.

Compliance and durability in pressure garments.

This study examined the relationship between perceived (stated) levels of function and the measured (observed) performance in squatting and stair climbing activities of 20 patients with chronic low back pain (CLBP) and 20 healthy volunteers. Subjects were asked through an interview to self-assess their ability to comfortably perform stair climbing and squatting as well as other tolerances. The subjects were then asked to perform the activities and their performance levels were recorded. Results revealed that patients' estimate of squatting and stair climbing abilities as well as their demonstrated levels were significantly lower (p < 0.001) than those of the healthy subjects. There was a significant difference between groups in terms of the time required to perform squatting but not stair climbing. Both groups underestimated their physical capabilities. Findings indicate that the use of actual performance measurement combined with self-report of functional abilities is needed when assessing performance le...

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Gail Hills Maguire

Papers

Compliance and durability in pressure garments.

Stated versus Observed Performance Levels in Patients with Chronic Low Back Pain.