The Experts below are selected from a list of 70881 Experts worldwide ranked by ideXlab platform
Michael F Green - One of the best experts on this subject based on the ideXlab platform.
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neurocognitive Change Functional Change and service intensity during community based psychosocial rehabilitation for schizophrenia
Psychological Medicine, 2009Co-Authors: John S Brekke, Michael F GreenAbstract:BACKGROUND: This study examined the magnitude of neurocognitive Change during 1 year of community-based psychosocial intervention, whether neurocognitive Change and Functional Change were linked, and how neurocognitive Change combined with service intensity to facilitate Functional Change. METHOD: A total of 130 individuals diagnosed with schizophrenia were recruited upon admission to four community-based psychosocial rehabilitation programs. Subjects were assessed at baseline, 6 and 12 months on role functioning and symptom measures. Neurocognition was measured at baseline and 12 months. Service intensity was the number of days of treatment attendance during the study period. Latent mean difference tests and Latent Growth Curve Models (LCGMs) were used to examine the study hypotheses. RESULTS: There was statistically and clinically significant Functional improvement over 12 months. Neurocognition improved significantly over time. Seventy-six (58%) of the sample showed neurocognitive improvement and 54 (42%) did not. There was a significant rate of Functional enhancement in the neurocognitive improver group. There was a non-significant rate of Functional Change in the neurocognitive non-improver group. Neurocognitive improvers showed Functional improvement that was 350% greater than neurocognitive non-improvers. Service intensity did not vary between neurocognitive improvers and non-improvers but there was a strong interaction between neurocognitive improvement, service intensity and rate of Functional improvement such that service intensity was strongly related to Functional improvement for neurocognitive improvers but not for neurocognitive non-improvers. Medication usage and symptomatology did not confound these findings. CONCLUSIONS: These findings suggest that neurocognitive improvement may be a foundation for Functional Change and treatment responsiveness during community-based psychosocial rehabilitation for individuals with schizophrenia.
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neurocognitive Change Functional Change and service intensity during community based psychosocial rehabilitation for schizophrenia
Psychological Medicine, 2009Co-Authors: John S Brekke, Michael F GreenAbstract:Background This study examined the magnitude of neurocognitive Change during 1 year of community-based psychosocial intervention, whether neurocognitive Change and Functional Change were linked, and how neurocognitive Change combined with service intensity to facilitate Functional Change. Method A total of 130 individuals diagnosed with schizophrenia were recruited upon admission to four community-based psychosocial rehabilitation programs. Subjects were assessed at baseline, 6 and 12 months on role functioning and symptom measures. Neurocognition was measured at baseline and 12 months. Service intensity was the number of days of treatment attendance during the study period. Latent mean difference tests and Latent Growth Curve Models (LCGMs) were used to examine the study hypotheses. Results There was statistically and clinically significant Functional improvement over 12 months. Neurocognition improved significantly over time. Seventy-six (58%) of the sample showed neurocognitive improvement and 54 (42%) did not. There was a significant rate of Functional enhancement in the neurocognitive improver group. There was a non-significant rate of Functional Change in the neurocognitive non-improver group. Neurocognitive improvers showed Functional improvement that was 350% greater than neurocognitive non-improvers. Service intensity did not vary between neurocognitive improvers and non-improvers but there was a strong interaction between neurocognitive improvement, service intensity and rate of Functional improvement such that service intensity was strongly related to Functional improvement for neurocognitive improvers but not for neurocognitive non-improvers. Medication usage and symptomatology did not confound these findings. Conclusions These findings suggest that neurocognitive improvement may be a foundation for Functional Change and treatment responsiveness during community-based psychosocial rehabilitation for individuals with schizophrenia.
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how neurocognition and social cognition influence Functional Change during community based psychosocial rehabilitation for individuals with schizophrenia
Schizophrenia Bulletin, 2007Co-Authors: John S Brekke, Jeffrey D Long, Michael F GreenAbstract:The purpose of this study was to assess how neurocognition and social cognition were associated with initial Functional level and with rates of Functional Change in intensive community-based psychosocial rehabilitation interventions that have been shown to yield significant Functional Change for individuals diagnosed with schizophrenia. We also examined how service intensity was associated with rates of Change and whether it served as a moderator of the relationship between Functional Change and both neurocognition and social cognition. The sample consisted of 125 individuals diagnosed with schizophrenia or schizoaffective disorder who were recruited upon admission to 1 of 4 community-based psychosocial rehabilitation facilities and were followed prospectively for 12 months. One hundred and two subjects completed the 12-month protocol. The findings suggested that (i) the initial level of psychosocial functioning was related to both social cognition and neurocognition at baseline, (ii) when significant rehabilitative Change occurs, higher neurocognition and social cognition scores at baseline predicted higher rates of Functional Change over the subsequent 12 months, (iii) greater service intensity was related to higher rates of improvement in Functional outcome over time, and (iv) service intensity moderated the relationship between neurocognition and initial Functional level and moderated the relationship between social cognition and the rates of Functional Change at a trend level. These findings have relevance to our understanding of the heterogeneity in Functional rehabilitative outcomes, to our understanding of the conditions of rehabilitative Change and for the design of psychosocial interventions in the community.
John S Brekke - One of the best experts on this subject based on the ideXlab platform.
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neurocognitive Change Functional Change and service intensity during community based psychosocial rehabilitation for schizophrenia
Psychological Medicine, 2009Co-Authors: John S Brekke, Michael F GreenAbstract:BACKGROUND: This study examined the magnitude of neurocognitive Change during 1 year of community-based psychosocial intervention, whether neurocognitive Change and Functional Change were linked, and how neurocognitive Change combined with service intensity to facilitate Functional Change. METHOD: A total of 130 individuals diagnosed with schizophrenia were recruited upon admission to four community-based psychosocial rehabilitation programs. Subjects were assessed at baseline, 6 and 12 months on role functioning and symptom measures. Neurocognition was measured at baseline and 12 months. Service intensity was the number of days of treatment attendance during the study period. Latent mean difference tests and Latent Growth Curve Models (LCGMs) were used to examine the study hypotheses. RESULTS: There was statistically and clinically significant Functional improvement over 12 months. Neurocognition improved significantly over time. Seventy-six (58%) of the sample showed neurocognitive improvement and 54 (42%) did not. There was a significant rate of Functional enhancement in the neurocognitive improver group. There was a non-significant rate of Functional Change in the neurocognitive non-improver group. Neurocognitive improvers showed Functional improvement that was 350% greater than neurocognitive non-improvers. Service intensity did not vary between neurocognitive improvers and non-improvers but there was a strong interaction between neurocognitive improvement, service intensity and rate of Functional improvement such that service intensity was strongly related to Functional improvement for neurocognitive improvers but not for neurocognitive non-improvers. Medication usage and symptomatology did not confound these findings. CONCLUSIONS: These findings suggest that neurocognitive improvement may be a foundation for Functional Change and treatment responsiveness during community-based psychosocial rehabilitation for individuals with schizophrenia.
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neurocognitive Change Functional Change and service intensity during community based psychosocial rehabilitation for schizophrenia
Psychological Medicine, 2009Co-Authors: John S Brekke, Michael F GreenAbstract:Background This study examined the magnitude of neurocognitive Change during 1 year of community-based psychosocial intervention, whether neurocognitive Change and Functional Change were linked, and how neurocognitive Change combined with service intensity to facilitate Functional Change. Method A total of 130 individuals diagnosed with schizophrenia were recruited upon admission to four community-based psychosocial rehabilitation programs. Subjects were assessed at baseline, 6 and 12 months on role functioning and symptom measures. Neurocognition was measured at baseline and 12 months. Service intensity was the number of days of treatment attendance during the study period. Latent mean difference tests and Latent Growth Curve Models (LCGMs) were used to examine the study hypotheses. Results There was statistically and clinically significant Functional improvement over 12 months. Neurocognition improved significantly over time. Seventy-six (58%) of the sample showed neurocognitive improvement and 54 (42%) did not. There was a significant rate of Functional enhancement in the neurocognitive improver group. There was a non-significant rate of Functional Change in the neurocognitive non-improver group. Neurocognitive improvers showed Functional improvement that was 350% greater than neurocognitive non-improvers. Service intensity did not vary between neurocognitive improvers and non-improvers but there was a strong interaction between neurocognitive improvement, service intensity and rate of Functional improvement such that service intensity was strongly related to Functional improvement for neurocognitive improvers but not for neurocognitive non-improvers. Medication usage and symptomatology did not confound these findings. Conclusions These findings suggest that neurocognitive improvement may be a foundation for Functional Change and treatment responsiveness during community-based psychosocial rehabilitation for individuals with schizophrenia.
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how neurocognition and social cognition influence Functional Change during community based psychosocial rehabilitation for individuals with schizophrenia
Schizophrenia Bulletin, 2007Co-Authors: John S Brekke, Jeffrey D Long, Michael F GreenAbstract:The purpose of this study was to assess how neurocognition and social cognition were associated with initial Functional level and with rates of Functional Change in intensive community-based psychosocial rehabilitation interventions that have been shown to yield significant Functional Change for individuals diagnosed with schizophrenia. We also examined how service intensity was associated with rates of Change and whether it served as a moderator of the relationship between Functional Change and both neurocognition and social cognition. The sample consisted of 125 individuals diagnosed with schizophrenia or schizoaffective disorder who were recruited upon admission to 1 of 4 community-based psychosocial rehabilitation facilities and were followed prospectively for 12 months. One hundred and two subjects completed the 12-month protocol. The findings suggested that (i) the initial level of psychosocial functioning was related to both social cognition and neurocognition at baseline, (ii) when significant rehabilitative Change occurs, higher neurocognition and social cognition scores at baseline predicted higher rates of Functional Change over the subsequent 12 months, (iii) greater service intensity was related to higher rates of improvement in Functional outcome over time, and (iv) service intensity moderated the relationship between neurocognition and initial Functional level and moderated the relationship between social cognition and the rates of Functional Change at a trend level. These findings have relevance to our understanding of the heterogeneity in Functional rehabilitative outcomes, to our understanding of the conditions of rehabilitative Change and for the design of psychosocial interventions in the community.
John Whyte - One of the best experts on this subject based on the ideXlab platform.
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advancing rehabilitation practice through improved specification of interventions
Archives of Physical Medicine and Rehabilitation, 2019Co-Authors: Jeanne M Zanca, Lyn S Turkstra, Christine C Chen, Andrew Packel, Mary Ferraro, Tessa Hart, Jarrad H Van Stan, John Whyte, Marcel P. DijkersAbstract:Abstract Rehabilitation clinicians strive to provide cost-effective, patient-centered care that optimizes outcomes. A barrier to this ideal is the lack of a universal system for describing, or specifying, rehabilitation interventions. Current methods of description vary across disciplines and settings, creating barriers to collaboration, and tend to focus mostly on Functional deficits and anticipated outcomes, obscuring connections between clinician behaviors and Changes in functioning. The Rehabilitation Treatment Specification System (RTSS) is the result of more than a decade of effort by a multidisciplinary group of rehabilitation clinicians and researchers to develop a theory-based framework to specify rehabilitation interventions. The RTSS describes interventions for treatment components, which consist of a target (Functional Change brought about as a direct result of treatment), ingredients (actions taken by clinicians to Change the target), and a hypothesized mechanism of action, as stated in a treatment theory. The RTSS makes explicit the connections between Functional Change and clinician behavior, and recognizes the role of patient effort in treatment implementation. In so doing, the RTSS supports clinicians’ efforts to work with their patients to set achievable goals, select appropriate treatments, adjust treatment plans as needed, encourage patient participation in the treatment process, communicate with team members, and translate research findings to clinical care. The RTSS may help both expert and novice clinicians articulate their clinical reasoning processes in ways that benefit treatment planning and clinical education, and may improve the design of clinical documentation systems, leading to more effective justification and reimbursement for services. Interested clinicians are invited to apply the RTSS in their local settings.
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contributions of treatment theory and enablement theory to rehabilitation research and practice
Archives of Physical Medicine and Rehabilitation, 2014Co-Authors: John WhyteAbstract:Abstract Scientific theory is crucial to the advancement of clinical research. The breadth of rehabilitation treatment requires that many different theoretical perspectives be incorporated into the design and testing of treatment interventions. In this article, the 2 broad classes of theory relevant to rehabilitation research and practice are defined, and their distinct but complementary contributions to research and clinical practice are explored. These theory classes are referred to as treatment theories (theories about how to effect Change in clinical targets) and enablement theories (theories about how Changes in a proximal clinical target will influence distal clinical aims). Treatment theories provide the tools for inducing clinical Change but do not specify how far reaching the ultimate impact of the Change will be. Enablement theories model the impact of Changes on other areas of function but provide no insight as to how treatment can create Functional Change. Treatment theories are more critical in the early stages of treatment development, whereas enablement theories become increasingly relevant in specifying the clinical significance and practical effectiveness of more mature treatments. Understanding the differences in the questions these theory classes address and how to combine their insights is crucial for effective research development and clinical practice.
Weihsien Hong - One of the best experts on this subject based on the ideXlab platform.
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Improvement of Upper Extremity Motor Control and Function After Home-Based Constraint Induced Therapy in Children With Unilateral Cerebral Palsy: Immediate and Long-Term Effects
Archives of Physical Medicine and Rehabilitation, 2014Co-Authors: Hsiehching Chen, Ching-yi Wu, Fei-chuan Chen, Lin-ju Kang, Chia-ling Chen, Weihsien HongAbstract:Objective: To investigate the long-term effects of home-based constraint induced therapy (CIT) on motor control underlying Functional Change in children with unilateral cerebral palsy (CP). Design: Randomized controlled trial. Setting: Home based. Participants: Children with unilateral CP (NZ45; aged 6e12y) were randomly assigned to receive home-based CIT (nZ23) or traditional rehabilitation (TR) (nZ22). Interventions: Both groups received a 4-week therapist-based intervention at home. The home-based CIT involved intensive Functional training of the more affected upper extremity during which the less affected one was restrained. The TR involved Functional unimanual and bimanual training. Main Outcome Measures: Allchildrenunderwentkinematicandclinicalassessmentsatbaseline,4weeks(posttreatment),and3and6months(followup).Thereach-to-graspkinematicswerereactiontime(RT),normalizedmovementtime,normalizedmovementunit,peakvelocity(PV),maximumgrip aperture (MGA), and percentage of movement where MGA occurs. The clinical measures were the Peabody Developmental Motor Scales, Second Edition (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), and Functional Independence Measure for children (WeeFIM). Results: The home-based CIT group showed a shorter RT (P
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effects of modified constraint induced movement therapy on movement kinematics and daily function in patients with stroke a kinematic study of motor control mechanisms
Neurorehabilitation and Neural Repair, 2007Co-Authors: Ching-yi Wu, Hsiehching Chen, Ihsuen Chen, Weihsien HongAbstract:Background and Objective. Motor control of the upper extremity during unilateral and bimanual Functional tasks and Functional Change during daily activities were evaluated in patients with stroke treated with modified constraint-induced movement therapy (mCIMT). Methods. In a pre-post randomized, controlled trial, 30 stroke patients received 2 hours of mCIMT or traditional rehabilitation (TR) for 3 weeks. Motor control of the upper extremity was evaluated using kinematic analysis in unilateral and bilateral tasks. Kinematic variables included spatial and temporal movement efficiency and type of movement control (preplanned control, representing well-learned movement, or feedback-guided control). Functional outcomes were evaluated using the Motor Activity Log (MAL) and the Functional Independence Measure (FIM). Results. Patients receiving mCIMT showed more temporally (P = .013) and spatially (P = .011) efficient movement and more preplanned movement control (P = .009) during the bimanual task, and greater ...
Marcel P. Dijkers - One of the best experts on this subject based on the ideXlab platform.
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advancing rehabilitation practice through improved specification of interventions
Archives of Physical Medicine and Rehabilitation, 2019Co-Authors: Jeanne M Zanca, Lyn S Turkstra, Christine C Chen, Andrew Packel, Mary Ferraro, Tessa Hart, Jarrad H Van Stan, John Whyte, Marcel P. DijkersAbstract:Abstract Rehabilitation clinicians strive to provide cost-effective, patient-centered care that optimizes outcomes. A barrier to this ideal is the lack of a universal system for describing, or specifying, rehabilitation interventions. Current methods of description vary across disciplines and settings, creating barriers to collaboration, and tend to focus mostly on Functional deficits and anticipated outcomes, obscuring connections between clinician behaviors and Changes in functioning. The Rehabilitation Treatment Specification System (RTSS) is the result of more than a decade of effort by a multidisciplinary group of rehabilitation clinicians and researchers to develop a theory-based framework to specify rehabilitation interventions. The RTSS describes interventions for treatment components, which consist of a target (Functional Change brought about as a direct result of treatment), ingredients (actions taken by clinicians to Change the target), and a hypothesized mechanism of action, as stated in a treatment theory. The RTSS makes explicit the connections between Functional Change and clinician behavior, and recognizes the role of patient effort in treatment implementation. In so doing, the RTSS supports clinicians’ efforts to work with their patients to set achievable goals, select appropriate treatments, adjust treatment plans as needed, encourage patient participation in the treatment process, communicate with team members, and translate research findings to clinical care. The RTSS may help both expert and novice clinicians articulate their clinical reasoning processes in ways that benefit treatment planning and clinical education, and may improve the design of clinical documentation systems, leading to more effective justification and reimbursement for services. Interested clinicians are invited to apply the RTSS in their local settings.
