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Background: Telerehabilitation is emerging in Saudi Arabia. This study investigated occupational therapy professionals’ perspectives on using telerehabilitation in their practice. Method: Data were collected through semi-structured phone interviews conducted with nine Saudi occupational therapists. A pragmatic qualitative evaluation approach was used. Findings: Experience and perceptions of participants regarding telerehabilitation were represented as follows: awareness and knowledge of telerehabilitation; how telerehabilitation increases occupational therapy availability and access in Saudi Arabia; telerehabilitation in the pandemic; telerehabilitation is preferred; suitability of telerehabilitation in Saudi Arabia; telerehabilitation care pathways; telerehabilitation readiness in Saudi Arabia; and telerehabilitation willingness by Saudi occupational therapists. Conclusion: Saudi occupational therapists have good knowledge and awareness of telerehabilitation, and some had used it during the pandemic. They showed positive attitudes and a willingness to use telerehabilitation if appropriate technology infrastructure, official policy standards and guidelines, training, data security, and financial resources could be provided to support implementation.

This article is a simultaneous joint publication in Journal of Rehabilitation Medicine, Annals of Physical and Rehabilitation Medicine, American Journal of Physical Medicine & Rehabilitation, Developmental Neurorehabilitation, European Journal of Physical and Rehabilitation Medicine, Journal of Occupational Rehabilitation, Musculoskeletal Science & Practice and Neurorehabilitation and Neural Repair. The articles are identical except for stylistic changes in keeping with each journal's style. Either version may be used in citing this article.

A structured review using the PRISMA guidelines, MeSH keywords and eight health databases was conducted (1990 to March 2021). Telerehabilitation research evidence from the Middle East and North Africa region (MENA) was summarized. Twelve studies from Iran, Israel, Morocco, and Saudi Arabia met inclusion criteria; nearly all had been published within the past five years. Methodological quality was moderate to good in the four randomized controlled trials, five cohort-studies and three cross-section surveys. There were seven intervention studies in cardiovascular, musculoskeletal, neurology or burn rehabilitation and three patient perception and two practitioner perception studies. Narrative synthesis revealed content themes relating to rehabilitation availability and accessibility; patient/practitioner perceptions of telerehabilitation; telerehabilitation to augment traditional services; and barriers to telerehabilitation. Telerehabilitation practice in MENA has been demonstrated as feasible, acceptable to patients, and effective in practitioner-designed cohort specific programs. Practitioners are generally positive but lack experience and need training, enabling technological systems, and policy frameworks. &nbsp

This study used a scoping review methodology to identify, collate and summarise published literature relating to people with disability in Libya. Most sources came from peak international agencies, some from humanitarian agency media releases, a few were Libyan government reports and very little from scholarly journals. Four themes summarize findings and provide a means to examine assumptions regarding people with disability in Libya: (1) scant data and information gaps are the norm; (2) disability is a medical problem to be managed; (3) acquisition context matters: conflict versus non-conflict disability; and (4) disability human rights - social model on paper but not yet in practice. Findings reveal gaps in knowledge, promising signs of change and areas for action. People with disability in Libya need: a stable and secure community; visibility in reporting, planning and evaluation of services that are inclusive in design and delivery; and measures, technical definitions and socio-cultural understandings of disability that value function, activity and participation in everyday life as much as medical conditions, impairments and expert treatment. These actions will help provide people with disability in Libya an opportunity to actively contribute in rebuilding their communities in a post-conflict future.

Background Academic and professional drivers have stimulated interest in self-directed learning of students in pre-certification health professional programs. Particular attention has focussed on factors which may influence a students¿ readiness for self-directed learning. Method A five stage structured scoping review of published literature was conducted to identify measures of self-directed learning readiness used with students in pre-certification health professional programs and those factors that have been investigated as potential determinants. Relevant articles were identified in six databases using key search terms and a search strategy. Two independent reviewers used criteria to cull irrelevant sources. Articles which met eligibility criteria were charted. Results The final analysis included 49 articles conducted in nursing, medicine, physiotherapy, pharmacy, occupational therapy and dentistry cohorts. Twenty-one potential determinants had been investigated with gender, year level, age program delivery and previous education level the most common. Self-directed learning readiness has been of interest globally, mostly in medicine and nursing, and studies have nearly exclusively used one of two instruments. Conclusion There is nascent evidence that age, year level and previous education level may have positive influence. These factors have in common the passing of time and may in fact be proxy for more encompassing developmental or social constructs. Further research is needed particularly in the allied health professions where there is limited research in very few disciplines. Studies in interprofessional contexts may be an efficient approach to increasing the knowledge base. Further work is also warranted to determine appropriate use of the two instruments across the range of health disciplines.

Background: Self-directed learning (SDL) is expected of health science graduates; it is thus a learning outcome in many pre-certification programs. Previous research identified age, gender, discipline and prior education as associated with variations in students' self-directed learning readiness (SDLR). Studies in other fields also propose personality as influential. Method: This study investigated relationships between SDLR and age, gender, discipline, previous education, and personality traits. The Self-Directed Learning Readiness Scale and the 50-item 'big five' personality trait inventory were administered to 584 first-year undergraduate students (n = 312 female) enrolled in a first-session undergraduate interprofessional health sciences subject. Results: Students were from health promotion, health services management, therapeutic recreation, sports and exercise science, occupational therapy, physiotherapy, and podiatry. Four hundred and seven responses (n = 230 females) were complete. SDLR was significantly higher in females and students in occupational therapy and physiotherapy. SDLR increased with age and higher levels of previous education. It was also significantly associated with 'big five' personality trait scores. Regression analysis revealed 52.9% of variance was accounted for by personality factors, discipline and prior experience of tertiary education. Conclusion: Demographic, discipline and personality factors are associated with SDLR in the first year of study. Teachers need to be alert to individual student variation in SDLR.

Background/aim Assistive technologies have the potential to increase the amount of movement practice provided during inpatient stroke rehabilitation. The primary aim of this study was to investigate the feasibility of using the Saebo-Flex™ device in a subacute stroke setting to increase task-specific practice for people with little or no active hand movement. The secondary aim was to collect preliminary data comparing hand/upper limb function between a control group that received usual rehabilitation and an intervention group that used, in addition, the Saebo-Flex™ device. Methods Nine inpatients (mean three months (median six weeks) post-stroke) participated in this feasibility study conducted in an Australian rehabilitation setting, using a randomised pre-test and post-test design with concealed allocation and blinded outcome assessment. In addition to usual rehabilitation, the intervention group received eight weeks of daily motor training using the Saebo-Flex™ device. The control group received usual rehabilitation (task-specific motor training) only. Participants were assessed at baseline (pre-randomisation) and at the end of the eight-week study period. Feasibility was assessed with respect to ease of recruitment, application of the device, compliance with the treatment programme and safety. Secondary outcome measures included the Motor Assessment Scale (upper limb items), Box and Block Test, grip strength and the Stroke Impact Scale. Results Recruitment to the study was very slow because of the low number of patients with little or no active hand movement. Otherwise, the study was feasible in terms of being able to apply the Saebo-Flex™ device and compliance with the treatment programme. There were no adverse events, and a greater amount of upper limb rehabilitation was provided to the intervention group. While there were trends in favour of the intervention group, particularly for dexterity, no between-group differences were seen for any of the secondary out

Context: Little is known about Libyan disability and rehabilitation services. Objectives: To describe workforce characteristics of the only functioning disability rehabilitation service in 2012 Libya. This was the Benghazi Rehabilitation and Handicap Center. The focus of the case study was the physical disability services including amputee care. Method: Organizational case study involving site visit, self-report workforce survey, and review of relevant policy, government and peak agency reports relevant to disability services. Results: The case study revealed that disability regulations in Libya focussed on social security entitlements and impairment focussed treatment. Community based rehabilitation or initiatives for social inclusion and participation were scant, creating problems for people requiring long term rehabilitation in the community. The center workforce continued to function in spite of conflict and in difficult circumstances. While expatriate staff left in the 2011 conflict, local staff retention was high. These workers were mono-lingual, had longevity of tenure, and a lack of qualification mobility. Some such as therapists and prosthetic technicians, had highly specialised skills requiring center facilities. The case study revealed: escalating patient demand; bed-block; and problems in supplies, capital and equipment maintenance. There were opportunities to increase capacity through: clinical and administrative staff training; development of inpatient facilities for women; discharge options for long-term male inpatients; and coordinated information systems. Of 232 eligible, n=72 staff, who participated in the survey (mean age was 39.4 years; n=40 males). Most therapists/ prosthetic technicians were male; most nurses/ administrative workers were female (p=.0001). The most common qualification across occupations was secondary school; 28.2% had intermediate secondary and 22.5% university degrees as their highest qualification. A third had been employed a

Research training should facilitate effective researcher role development. While researcher roles require the performance of specialised knowledge and skill, they also require development of personal research identities within social contexts. Interaction with research peers can provide opportunities for reflective role development. Ad-hoc cohort-specific peer interventions are relatively common in research training, but these can lack standardisation and clear conceptual frameworks to underpin strategies. Peer Assisted Study Sessions (PASS) provide a structured approach to peer support for learning. As such, we aimed to develop, implement and evaluate a PASS program for research trainees. Participants (N = 21; (9 male, 12 female; exercise science n = 5, biomedical science n = 7, science n = 2, public health n = 4, nutrition n = 3) were post-bachelor honours students and PASS was provided on a weekly basis. Demographic, academic, and PASS data were collected from institutional records. Students completed standardised PASS satisfaction evaluations. Standard undergraduate PASS administrative, funding, and reporting strategies were successfully applied. Leader selection, training, and PASS resource development processes were adapted for the research training context. Attendance and student satisfaction was high as was timely completion of research related assessments. PASS has been shown to provide methodological consistency and a transparent conceptual framework to frame expectations about the process, leader and participant roles, and mechanisms to evaluate impact. PASS enables institutionally sanctioned but peer driven opportunities for social exchange wherein reflective interpretive approaches to research role development can be considered.

Research training should facilitate effective researcher role development. While researcher roles require the performance of specialised knowledge and skill, they also require development of personal research identities within social contexts. Interaction with research peers can provide opportunities for reflective role development. Ad-hoc cohort-specific peer interventions are relatively common in research training, but these can lack standardisation and clear conceptual frameworks to underpin strategies. Peer Assisted Study Sessions (PASS) provide a structured approach to peer support for learning. As such, we aimed to develop, implement and evaluate a PASS program for research trainees. Participants (N = 21; (9 male, 12 female; exercise science n = 5, biomedical science n = 7, science n = 2, public health n = 4, nutrition n = 3) were post-bachelor honours students and PASS was provided on a weekly basis. Demographic, academic, and PASS data were collected from institutional records. Students completed standardised PASS satisfaction evaluations. Standard undergraduate PASS administrative, funding, and reporting strategies were successfully applied. Leader selection, training, and PASS resource development processes were adapted for the research training context. Attendance and student satisfaction was high as was timely completion of research related assessments. PASS has been shown to provide methodological consistency and a transparent conceptual framework to frame expectations about the process, leader and participant roles, and mechanisms to evaluate impact. PASS enables institutionally sanctioned but peer driven opportunities for social exchange wherein reflective interpretive approaches to research role development can be considered.

Research training should facilitate effective researcher role development. While researcher roles require the performance of specialised knowledge and skill, they also require development of personal research identities within social contexts. Interaction with research peers can provide opportunities for reflective role development. Ad-hoc cohort-specific peer interventions are relatively common in research training, but these can lack standardisation and clear conceptual frameworks to underpin strategies. Peer Assisted Study Sessions (PASS) provide a structured approach to peer support for learning. As such, we aimed to develop, implement and evaluate a PASS program for research trainees. Participants (N = 21; (9 male, 12 female; exercise science n = 5, biomedical science n = 7, science n = 2, public health n = 4, nutrition n = 3) were post-bachelor honours students and PASS was provided on a weekly basis. Demographic, academic, and PASS data were collected from institutional records. Students completed standardised PASS satisfaction evaluations. Standard undergraduate PASS administrative, funding, and reporting strategies were successfully applied. Leader selection, training, and PASS resource development processes were adapted for the research training context. Attendance and student satisfaction was high as was timely completion of research related assessments. PASS has been shown to provide methodological consistency and a transparent conceptual framework to frame expectations about the process, leader and participant roles, and mechanisms to evaluate impact. PASS enables institutionally sanctioned but peer driven opportunities for social exchange wherein reflective interpretive approaches to research role development can be considered.

Research training should facilitate effective researcher role development. While researcher roles require the performance of specialised knowledge and skill, they also require development of personal research identities within social contexts. Interaction with research peers can provide opportunities for reflective role development. Ad-hoc cohort-specific peer interventions are relatively common in research training, but these can lack standardisation and clear conceptual frameworks to underpin strategies. Peer Assisted Study Sessions (PASS) provide a structured approach to peer support for learning. As such, we aimed to develop, implement and evaluate a PASS program for research trainees. Participants (N = 21; (9 male, 12 female; exercise science n = 5, biomedical science n = 7, science n = 2, public health n = 4, nutrition n = 3) were post-bachelor honours students and PASS was provided on a weekly basis. Demographic, academic, and PASS data were collected from institutional records. Students completed standardised PASS satisfaction evaluations. Standard undergraduate PASS administrative, funding, and reporting strategies were successfully applied. Leader selection, training, and PASS resource development processes were adapted for the research training context. Attendance and student satisfaction was high as was timely completion of research related assessments. PASS has been shown to provide methodological consistency and a transparent conceptual framework to frame expectations about the process, leader and participant roles, and mechanisms to evaluate impact. PASS enables institutionally sanctioned but peer driven opportunities for social exchange wherein reflective interpretive approaches to research role development can be considered.

Research training should facilitate effective researcher role development. While researcher roles require the performance of specialised knowledge and skill, they also require development of personal research identities within social contexts. Interaction with research peers can provide opportunities for reflective role development. Ad-hoc cohort-specific peer interventions are relatively common in research training, but these can lack standardisation and clear conceptual frameworks to underpin strategies. Peer Assisted Study Sessions (PASS) provide a structured approach to peer support for learning. As such, we aimed to develop, implement and evaluate a PASS program for research trainees. Participants (N = 21; (9 male, 12 female; exercise science n = 5, biomedical science n = 7, science n = 2, public health n = 4, nutrition n = 3) were post-bachelor honours students and PASS was provided on a weekly basis. Demographic, academic, and PASS data were collected from institutional records. Students completed standardised PASS satisfaction evaluations. Standard undergraduate PASS administrative, funding, and reporting strategies were successfully applied. Leader selection, training, and PASS resource development processes were adapted for the research training context. Attendance and student satisfaction was high as was timely completion of research related assessments. PASS has been shown to provide methodological consistency and a transparent conceptual framework to frame expectations about the process, leader and participant roles, and mechanisms to evaluate impact. PASS enables institutionally sanctioned but peer driven opportunities for social exchange wherein reflective interpretive approaches to research role development can be considered.

Background: Spasticity in the upper limb is common after acquired brain impairment and may have a significant impact on the ability to perform meaningful daily activities. Traditionally, outcome measurement in spasticity rehabilitation has focused on impairment, however, improvements in impairments do not necessarily translate to improvements in an individual's ability to perform activities or engage in life roles. There is an increasing need for outcome measures that capture change in activity performance and life participation. Methods/Design: We will conduct a systematic review of the psychometric properties of instruments used to measure upper limb functional outcomes (activity performance and participation) in patients with spasticity. Assessments (n = 27) will be identified from a recently published systematic review of assessments that measure upper limb function in neurological rehabilitation for adults with focal spasticity, and a systematic review of each assessment will then be conducted. The databases MEDLINE, CINAHL and EMBASE will be searched from inception. Search strategies will include the name of the assessment and the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) published search strategy for identifying studies of measurement properties. The methodological rigour of the testing of the psychometric quality of instruments will be undertaken using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. International Classification of Functioning, Disability and Health (ICF) definitions of impairment, activity and participation will be used for content analysis of items to determine the extent to which assessments are valid measures of activity performance and life participation. We will present a narrative synthesis on the psychometric properties and utility of all instruments and make recommendations for assessment selection in practice. Discussion: This s

Social science research training is de-facto occupational socialisation to researcher-roles. To do research, trainees need to develop and demonstrate advanced scholarship that complies with disciplinary norms and perform tasks to pre-determined standards. Functionalist approaches to occupational socialization underpin the performative and standardised approach to research training common in universities. But there is more to research training than doing research. If truly successful, trainees will become researchers. They will take on the researcher-role and make it their own. Interpretive approaches to occupational socialization help illuminate intra- and inter-personal dimensions of role-taking and role-making, however this approach is rarely used to inform research training strategies. Occasional scholarship reveals ad-hoc application on interpretive approaches to research trainee experience (eg., "the journey") supervisor experience (eg., "emotional burden of supervision"), research training methods such as peer-learning (eg., informal or fabricated groups, research micro-climates), or research training pedagogy (eg., collaborative learning, co-production). Recently, interpretive approaches have been used to inform career-planning strategies for PhD graduates (eg., "Vitae") but this is yet to systematically inform institutional strategies for research-training. To more effectively and efficiently facilitate researcher-role development, research training should consider occupational socialization as an organizing framework, and utilize performative and interpretive approaches to role development.

Background/aim To describe Australian physiotherapy and occupational therapy practice for patients who receive upper-limb Botulinum Toxin-A (BoNT-A). Method Anonymous online survey asking about practice experience. Convenience sample of 128 BoNT-A experienced occupational therapists and physiotherapists. Results The primary work setting was multidisciplinary inpatient or outpatient rehabilitation services where therapists had automatic referral to BoNT-A patients. Patients expected BoNT-A to improve functional movement, reduce hypertonicity, increase passive range, reduce pain, improve appearance and hand hygiene. Most patients were injected in multidisciplinary public hospital clinics and had median 2 pre-injection (range 0-30) and 8 post-injection (range 0-50) therapy sessions. Biceps, flexor digitorum profundus/superficialis and brachoradialis were most frequently injected. Injectors used therapist assessment information to select sites 68% of the time; only 44% of services had assessment protocols. Standardised therapy assessments examined motor performance, pain and function in that order of frequency. The greater the awareness and perceived relevance of an assessment the more often therapists used it. All therapists set goals, most collaboratively, and these mirrored patient expectations. The most common treatments were stretch, task-specific functional training, strength training and home programmes. Conclusion While trends in Australian assessment, goals and treatment practice were observed, greater consistency could be achieved if therapy practice guidelines existed. The gap is exacerbated by the absence of Australian BoNT-A organisation and process of care spasticity management guidelines. This creates an environment where practice variability is inevitable. Recommendations to improve local service quality are made.

This newspaper article describes factors prospective higher degree research students should consider when deciding whether or not to commence PhD studies, where and with whom. The conceptual framework underpinning the advice provided is that of occupational socialization as applied to the development of research roles. The factors identified are those that have been demonstrated to enable, impede and accelerate acquisition of productive and engaged research roles.

Research training should facilitate effective researcher role development. While researcher roles require the performance of specialised knowledge and skill, they also require development of personal research identities within social contexts. Interaction with research peers can provide opportunities for reflective role development. Ad-hoc cohort-specific peer interventions are relatively common in research training, but these can lack standardisation and clear conceptual frameworks to underpin strategies. Peer Assisted Study Sessions (PASS) provide a structured approach to peer support for learning. As such, we aimed to develop, implement and evaluate a PASS program for research trainees. Participants (N = 21; (9 male, 12 female; exercise science n = 5, biomedical science n = 7, science n = 2, public health n = 4, nutrition n = 3) were post-bachelor honours students and PASS was provided on a weekly basis. Demographic, academic, and PASS data were collected from institutional records. Students completed standardised PASS satisfaction evaluations. Standard undergraduate PASS administrative, funding, and reporting strategies were successfully applied. Leader selection, training, and PASS resource development processes were adapted for the research training context. Attendance and student satisfaction was high as was timely completion of research related assessments. PASS has been shown to provide methodological consistency and a transparent conceptual framework to frame expectations about the process, leader and participant roles, and mechanisms to evaluate impact. PASS enables institutionally sanctioned but peer driven opportunities for social exchange wherein reflective interpretive approaches to research role development can be considered.

Background/aim The Western Neuro Sensory Stimulation Profile (WNSSP) is designed to measure disorders of consciousness in people with severe traumatic brain injury who are slow-to-recover. This study explores internal consistency reliability and concurrent validity of the WNSSP with function and two other consciousness measures. Method Retrospective chart audit of all severe traumatic brain injury patients admitted to a specialist neurological rehabilitation centre from January 2001 to December 2006 in a vegetative or minimally conscious state. Medical record of demographical, clinical and Glasgow Coma Scale (GCS) data were recorded. To be included in the study, patients needed admission and discharge WNSSP results; plus Functional Independence Measure™ (FIM™) and Rancho Los Amigos Scale (RLAS) scores. Results Of 37 potential participants, 33 had required WNSSP results (mean age 28 years; 27 male participants). Internal consistency reliability was very high (α = 0.933). Concurrent validity in relation to function was significant but weak at admission for FIM™ Total-scale but not subscales (rs = −0.146, P = 0.0424). At discharge, there was a modest relationship with FIM™ Motor-subscale (rs = 0.374; P = 0.045), and FIM™ Cognition-subscale (rs = 0.412; P = 0.026) scores, but not the FIM™ Total-scale. Concurrent validity in relation to the RLAS was strong at admission (rs = 0.693, P = 0.01) and discharge (rs = 0.788, P = 0.01). The WNSSP and GCS scores were not associated. Conclusion The WNSSP is sensitive to behavioural change in slow-to-recover patients with severe traumatic brain injury. It demonstrates very high internal consistency reliability, and positive evidence of concurrent validity with FIM™ and the RLAS providing detailed description of cognitive-sensory behaviour within RLAS-levels.

of a poster presentation that was presented at Health Services Research: Evidence-Based Practice Meeting, London, UK, 1-3 July, 2014.

of a poster presentation that was presented at Health Services Research: Evidence-Based Practice Meeting, London, UK, 1-3 July, 2014.

of a poster presentation that was presented at Health Services Research: Evidence-Based Practice Meeting, London, UK, 1-3 July, 2014.

Background Botulinum toxin A (BoNT-A) injections are increasingly used to treat muscle spasticity and are often complemented by adjunctive rehabilitation therapies; however, little is known about the effect of therapy after injection. Purpose The aim of this study was to identify and summarize evidence on rehabilitation therapies used after BoNT-A injections to improve motor function in adults with neurological impairments. Data Sources Searches were conducted in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, National Research Register, metaRegistry of Controlled Trials, PEDro, and OTseeker. Study Selection Randomized and quasi-randomized controlled trials were considered for inclusion. Participants with neurological impairments received BoNT-A to treat focal spasticity in limbs, with rehabilitation interventions provided to experimental groups only. Primary outcome measures were joint mobility, function of the affected limb, and spasticity. Eleven studies with 234 participants, most of whom had stroke, were included in the review. Data Extraction Two reviewers extracted study details and data. Data Synthesis Methodological quality was rated using the PEDro scale. Both fixed-effects and random-effects models were used to calculate effect size. Results Studies were of variable quality: 3 were poor (PEDro score 1 to 4), and 8 were moderate (PEDro score 6 to 7). No study investigated effects for longer than 24 weeks (6 months). Included trials presented 9 therapy types, including ergometer cycling, electrical stimulation, stretch (casting, splinting, taping, or manual or exercise-induced stretch), constraint-induced movement therapy, task-specific motor training, and exercise programs. Statistical findings suggest that combined therapy and BoNT-A is slightly more effective than BoNT-A alone. Conclusion Evidence relating to impact of adjunct therapy is available, but the heterogeneity of studies limits the opportunity to demonstrate ov

Poster presented at Health Services Research: Evidence-based practice, 1-3 July 2014, London, United Kingdom.

Poster presented at Health Services Research: Evidence-based practice, 1-3 July 2014, London, United Kingdom

Over the last 20 years Australia has seen a huge growth in new occupational therapy programs. Each new program is an historic event that changes occupational therapy’s national profile. Each new course raises expectations. Governments fund universities expecting a civic and economic return on public investment through teaching, community engagement and research. Universities expect occupational therapy academic staff to fulfil this institutional obligation and bring a return on staffing and infrastructure costs. Students expect their employability, life and career opportunities will be enhanced. The profession expects the program will be high quality and will add to occupational therapy’s esteem. Clients and the community expect ethical, safe and competent graduates will help them.

presented at the 7th Biennial Conference of the Australasian Academy of Cerebral Palsy and Developmental Medicine, 11-14 March 2014, Hunter Valley, Australia

presented at the 7th Biennial Conference of the Australasian Academy of Cerebral Palsy and Developmental Medicine, 11-14 March 2014, Hunter Valley, Australia

of a poster presentation that was presented at Health Services Research: Evidence-Based Practice Meeting, London, UK, 1-3 July, 2014.

OBJECTIVE. The Western Neuro Sensory Stimulation Profile (WNSSP) presents a hierarchy of items suggestive of a sequence of recovery. The aim of this study was to understand the sequence of recovery of neurobehavioral function in patients with brain injury and determine whether this sequence was consistent with the WNSSP test item order. METHOD. We conducted a retrospective clinical chart audit of 37 adult inpatients (mean age = 29 yr; 31 men, 6 women) with a diagnosis of traumatic brain injury and a minimum of two medical record entries on the WNSSP. The sequence of recovery was statistically derived from the content and structure of the WNSSP. RESULTS. Our analysis did not support the current item ordering of the WNSSP as a function of the sequence of recovery from coma, with the exception of the Arousal/Attention subscale. CONCLUSION. WNSSP item performance suggested a sequence of recovery; clinicians may consider a revised item order that reflects this observed order.

Background: functional assessment is an important component of the management of older adults in the emergency department (ED) as the function level has been identified as a predictor of adverse events including ED re-presentation. A systematic review (SR) of all functional assessments utilised in EDs has not been undertaken making assessment selection, on the basis of evidence, difficult for staff. Objective: this SR: (i) identified functional assessments that have been utilised in ED settings, (ii) examined what psychometric properties analysis has been completed and (iii) established recommendations for practice. Methods: electronic database searching was completed utilising key search terms. Articles were reviewed using pre-determined inclusion criteria. Each study was appraised using quality criteria for aspects of validity and reliability in addition to clinical utility, interpretability and responsiveness. Recommendations for practice were determined on the basis of the extent of psychometric data generated in ED settings and whether or not the assessment was specifically developed for ED use. Results: a total of 332 articles were identified of which 43 articles utilising 14 functional assessments were retained. Psychometric testing was scarce. Functional assessment has been reported internationally and only with older adults. Following appraisal four assessments [the Identification of Seniors at Risk (ISAR), Triage Risk Stratification Tool (TRST), Older Adult Resources and Services (OARS) and Functional Status Assessment of Seniors in Emergency Departments (FSAS-ED)] were recommended for practice with moderate reservations. Conclusion: the ISAR or TRST are suitable for fast screening, whereas the OARS or FSAS-ED are more suitable for a comprehensive understanding of functional performance. Further research is warranted and recommendations for ED assessment may change as more becomes known about psychometric properties and clinical applications of other asses

OBJECTIVE. The Western Neuro Sensory Stimulation Profile (WNSSP) presents a hierarchy of items suggestive of a sequence of recovery. The aim of this study was to understand the sequence of recovery of neurobehavioral function in patients with brain injury and determine whether this sequence was consistent with the WNSSP test item order. METHOD. We conducted a retrospective clinical chart audit of 37 adult inpatients (mean age = 29 yr; 31 men, 6 women) with a diagnosis of traumatic brain injury and a minimum of two medical record entries on the WNSSP. The sequence of recovery was statistically derived from the content and structure of the WNSSP. RESULTS. Our analysis did not support the current item ordering of the WNSSP as a function of the sequence of recovery from coma, with the exception of the Arousal/Attention subscale. CONCLUSION. WNSSP item performance suggested a sequence of recovery; clinicians may consider a revised item order that reflects this observed order.

Background: functional assessment is an important component of the management of older adults in the emergency department (ED) as the function level has been identified as a predictor of adverse events including ED re-presentation. A systematic review (SR) of all functional assessments utilised in EDs has not been undertaken making assessment selection, on the basis of evidence, difficult for staff. Objective: this SR: (i) identified functional assessments that have been utilised in ED settings, (ii) examined what psychometric properties analysis has been completed and (iii) established recommendations for practice. Methods: electronic database searching was completed utilising key search terms. Articles were reviewed using pre-determined inclusion criteria. Each study was appraised using quality criteria for aspects of validity and reliability in addition to clinical utility, interpretability and responsiveness. Recommendations for practice were determined on the basis of the extent of psychometric data generated in ED settings and whether or not the assessment was specifically developed for ED use. Results: a total of 332 articles were identified of which 43 articles utilising 14 functional assessments were retained. Psychometric testing was scarce. Functional assessment has been reported internationally and only with older adults. Following appraisal four assessments [the Identification of Seniors at Risk (ISAR), Triage Risk Stratification Tool (TRST), Older Adult Resources and Services (OARS) and Functional Status Assessment of Seniors in Emergency Departments (FSAS-ED)] were recommended for practice with moderate reservations. Conclusion: the ISAR or TRST are suitable for fast screening, whereas the OARS or FSAS-ED are more suitable for a comprehensive understanding of functional performance. Further research is warranted and recommendations for ED assessment may change as more becomes known about psychometric properties and clinical applications of other asses

Aim: To investigate Quality of Upper Extremity Skills Test (QUEST) construct validity for children with cerebral palsy (CP). Method: 170 QUEST assessments from a convenience sample of 94 children with CP involved in clinical and research treatment programs (2 to 16 years; 54 male, 40 female; mean age 6 years 10 months, SD 2 years 11 months; GMFCS I-V). Results: The QUEST was not unidimensional; many items demonstrated poor fit when total scores were analyzed; goodness of fit improved when domains were considered independently and limbs separately examined. QUEST items involving elbow flexion and/or forearm in pronation were easily achieved thus reducing test sensitivity. Postures items in the grasp domain behaved erratically with little total score relationship. Implications: Calculating total scores is discouraged. Reporting QUEST results separately for domains and each limb is recommended. Posture items in the grasp domain had little relationship with total score and it is recommended that they be removed from the test.

Aim: To investigate Quality of Upper Extremity Skills Test (QUEST) construct validity for children with cerebral palsy (CP). Method: 170 QUEST assessments from a convenience sample of 94 children with CP involved in clinical and research treatment programs (2 to 16 years; 54 male, 40 female; mean age 6 years 10 months, SD 2 years 11 months; GMFCS I-V). Results: The QUEST was not unidimensional; many items demonstrated poor fit when total scores were analyzed; goodness of fit improved when domains were considered independently and limbs separately examined. QUEST items involving elbow flexion and/or forearm in pronation were easily achieved thus reducing test sensitivity. Postures items in the grasp domain behaved erratically with little total score relationship. Implications: Calculating total scores is discouraged. Reporting QUEST results separately for domains and each limb is recommended. Posture items in the grasp domain had little relationship with total score and it is recommended that they be removed from the test.

Aim: To investigate Quality of Upper Extremity Skills Test (QUEST) construct validity for children with cerebral palsy (CP). Method: 170 QUEST assessments from a convenience sample of 94 children with CP involved in clinical and research treatment programs (2 to 16 years; 54 male, 40 female; mean age 6 years 10 months, SD 2 years 11 months; GMFCS I-V). Results: The QUEST was not unidimensional; many items demonstrated poor fit when total scores were analyzed; goodness of fit improved when domains were considered independently and limbs separately examined. QUEST items involving elbow flexion and/or forearm in pronation were easily achieved thus reducing test sensitivity. Postures items in the grasp domain behaved erratically with little total score relationship. Implications: Calculating total scores is discouraged. Reporting QUEST results separately for domains and each limb is recommended. Posture items in the grasp domain had little relationship with total score and it is recommended that they be removed from the test.

Aim: To investigate Quality of Upper Extremity Skills Test (QUEST) construct validity for children with cerebral palsy (CP). Method: 170 QUEST assessments from a convenience sample of 94 children with CP involved in clinical and research treatment programs (2 to 16 years; 54 male, 40 female; mean age 6 years 10 months, SD 2 years 11 months; GMFCS I-V). Results: The QUEST was not unidimensional; many items demonstrated poor fit when total scores were analyzed; goodness of fit improved when domains were considered independently and limbs separately examined. QUEST items involving elbow flexion and/or forearm in pronation were easily achieved thus reducing test sensitivity. Postures items in the grasp domain behaved erratically with little total score relationship. Implications: Calculating total scores is discouraged. Reporting QUEST results separately for domains and each limb is recommended. Posture items in the grasp domain had little relationship with total score and it is recommended that they be removed from the test.

Aim: To investigate Quality of Upper Extremity Skills Test (QUEST) construct validity for children with cerebral palsy (CP). Method: 170 QUEST assessments from a convenience sample of 94 children with CP involved in clinical and research treatment programs (2 to 16 years; 54 male, 40 female; mean age 6 years 10 months, SD 2 years 11 months; GMFCS I-V). Results: The QUEST was not unidimensional; many items demonstrated poor fit when total scores were analyzed; goodness of fit improved when domains were considered independently and limbs separately examined. QUEST items involving elbow flexion and/or forearm in pronation were easily achieved thus reducing test sensitivity. Postures items in the grasp domain behaved erratically with little total score relationship. Implications: Calculating total scores is discouraged. Reporting QUEST results separately for domains and each limb is recommended. Posture items in the grasp domain had little relationship with total score and it is recommended that they be removed from the test.

Aim: To investigate reliability of the Quality of Upper Extremity Skills Test (QUEST) scores for children with cerebral palsy (CP) aged 212 years. Method: Thirty-one QUESTs from 24 children with CP were rated once by two raters and twice by one rater. Internal consistency of total scores, inter- and intra-rater reliability findings for total, domain, and item scores were calculated. Results: Total scores inter-rater reliability, Intra-class Correlation Coefficient (ICC) was 0.86, and for intra-rater reliability, ICC was 0.96. Domains had high reliability (ICC > 0.80) within raters and between raters except for grasp (moderate at ICC = 0.67). Item inter-rater reliability was moderate or better for 80% of items; item intra-rater reliability was moderate or better for 87% of items. Total score internal consistency was high (¿ = 0.97). Implications: The QUEST has proven reliability for children with CP aged 18 months to 8 years. This study demonstrates strong reliability for children aged 212 years

Aim: To investigate reliability of the Quality of Upper Extremity Skills Test (QUEST) scores for children with cerebral palsy (CP) aged 212 years. Method: Thirty-one QUESTs from 24 children with CP were rated once by two raters and twice by one rater. Internal consistency of total scores, inter- and intra-rater reliability findings for total, domain, and item scores were calculated. Results: Total scores inter-rater reliability, Intra-class Correlation Coefficient (ICC) was 0.86, and for intra-rater reliability, ICC was 0.96. Domains had high reliability (ICC > 0.80) within raters and between raters except for grasp (moderate at ICC = 0.67). Item inter-rater reliability was moderate or better for 80% of items; item intra-rater reliability was moderate or better for 87% of items. Total score internal consistency was high (¿ = 0.97). Implications: The QUEST has proven reliability for children with CP aged 18 months to 8 years. This study demonstrates strong reliability for children aged 212 years

Closing keynote address from the Occupational Therapy Australia 24th National Conference and Exhibition, 29 June - 1 July 2011, Gold Coast, Australia

Aim: To investigate reliability of the Quality of Upper Extremity Skills Test (QUEST) scores for children with cerebral palsy (CP) aged 212 years. Method: Thirty-one QUESTs from 24 children with CP were rated once by two raters and twice by one rater. Internal consistency of total scores, inter- and intra-rater reliability findings for total, domain, and item scores were calculated. Results: Total scores inter-rater reliability, Intra-class Correlation Coefficient (ICC) was 0.86, and for intra-rater reliability, ICC was 0.96. Domains had high reliability (ICC > 0.80) within raters and between raters except for grasp (moderate at ICC = 0.67). Item inter-rater reliability was moderate or better for 80% of items; item intra-rater reliability was moderate or better for 87% of items. Total score internal consistency was high (¿ = 0.97). Implications: The QUEST has proven reliability for children with CP aged 18 months to 8 years. This study demonstrates strong reliability for children aged 212 years

from the 22nd Stroke Society of Australasia Annual Scientific Meeting, 14-16 September 2011, Adelaide, Australia.