Feasibility of Physical Therapy Evaluation Symptom Provocation Tests in Older Adults With Mild Traumatic Brain Injury: Mixed Methods Study
Notice bibliographique
Résumé
Background: Early standard assessment protocols have decreased costs and better identified treatment strategies in individuals with mild traumatic brain injury (mTBI). Clinical practice guidelines contained strong recommendations for the use of provocation tests in evaluating younger adults (<65 y of age). Currently, the recommended protocols and literature regarding tolerance to self-reported and physical exertion outcome testing in older adults (>65 y of age) with mTBI have been limited. To start bridging some of these shortcomings and aid the development of practice guidelines for older adults, this study explored the feasibility of physical therapy evaluation protocols for individuals aged >65 years. Objective: The study aimed to (1) assess the feasibility and tolerance of using evidence-based physical therapy evaluation outcome tests, and (2) apply the International Classification of Health, Disability, and Function (ICF) domains to an emergent thematic analysis of research protocols involving older adults with and without mTBI. Methods: The feasibility study was a mixed methods design that included 13 community participants (>65 y) with and without mTBI. Investigators documented completion of the health form, participant-reported outcomes including the Patient-Specific Function Scale (PSFS) and Post Concussion Symptom Scale, and physical performance measures using the Motion Sensitivity Quotient (MSQ) and a submaximal recumbent stepper test, modified from the Buffalo Concussion Bike Test. Emergent contextual themes were identified within the study protocol, testing space, and participant responses. Results: The sample included 13 participants (aged 65-91 y; 7 females, 6 males), 4 with mTBI and 9 without mTBI. All completed the health form, PSFS, and Post Concussion Symptom Scale, with moderate verbal cues required in 15% (PSFS) of the cases. The Motion Sensitivity Quotient and Buffalo Concussion Bike Test-Modified were completed to the participants' maximum safe effort. No participants experienced adverse mTBI symptoms. The categories for the theme of study protocol were time, communication, and logistics coordination. The categories for the theme of study environment were assessment, documentation, and safety. Unanticipated positive emotions were evoked with comments such as feedback, including participation was "fun" and "I didn't know I could do all this." Conclusions: Older adults were able to tolerate the collection of participant-reported and physical outcome measures that allowed for individual maximal safe efforts without mTBI symptom provocation. The contextual themes using the ICF model of study protocol and environment were categorized and coded for future research consideration. Positive emotion participant responses were captured at the end of data collection. Clinical Relevance: This study applied standard physical therapy assessment protocols, which were safely tolerated by older adults with mTBI. The study used ICF domains from a research procedure perspective for protocol and environment considerations. The findings included participants' positive emoted responses, which may inform future large-sample trials in the evaluation of older adults with mTBI.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,088 | 0,095 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,005 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».