Effectiveness of the capability approach in rehabilitation for persons with neuromuscular diseases: A controlled before-after study
Bibliographic record
Abstract
BACKGROUND: Rehabilitation of persons with neuromuscular diseases (NMD) requires a personalised approach that focuses on achieving and maintaining a level of functioning that enables them to be in a state of well-being. The capability approach states that well-being should be understood in terms of capabilities, which are the opportunities that people have to be and do things they have reason to value. The aim of this study is to investigate whether providing care inspired by the capability approach (capability care) has an effect on the well-being of persons with NMD. METHODS: In the Rehabilitation and Capability care for persons with NeuroMuscular Diseases (ReCap-NMD) study, 64 adults with facioscapulohumeral muscular dystrophy or myotonic dystrophy type 1 were included in two groups, using a before-after controlled design with 6 months between the measurement moments. The first group received rehabilitation as usual, the second received capability care. This article reports on the primary outcome measure, the Canadian Occupational Performance Measure (COPM) and secondary quantitative outcome measures (questionnaires on participation, capability well-being and health-related quality of life). RESULTS: There was no difference between capability care and usual care on the COPM and the secondary outcome measures. There was a similar improvement for both capability care and usual rehabilitation on the COPM at 6-month follow-up. This means that the effect of capability care is similar to usual rehabilitation. CONCLUSION: This is the first study that explicitly developed, implemented and evaluated a clinical healthcare intervention inspired by the capability approach. We found no difference on the COPM between persons with NMD receiving capability care compared to usual rehabilitation. There is a need for further research on the clinical relevance and added value of the capability approach for rehabilitation and other fields in healthcare. TRIAL REGISTRATION: Trialregister.nl NL8946.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".