Abstract：
:In clinical trials, the choice of the primary outcome affects the study design, the sample size calculations, the data analysis, and the interpretation of the study results. Most importantly, it may determine the future of the intervention being studied. In several clinical and rehabilitation settings, a single primary outcome measure is often not sufficient to reflect the effect of an intervention because attention is focused on multiple aspects of patients' recovery. In stroke and traumatic brain injuries trials, for example, functional recovery is as important as cognitive recovery. Thus, a trial with a functional scale alone as the primary outcome would not be informative about the effectiveness of the intervention on cognitive functions. From the methodologic point of view, the choice of multiple primary outcomes presents several challenges, including selecting a measure, among several, to be used for sample size calculations; dealing with multiple comparisons; and interpreting the results. In this article, we discuss a global test procedure that allows investigators to use several binary measures as primary outcomes in a clinical trial. This procedure offers an efficient solution under very reasonable assumptions, avoids loss of power caused by multiple comparisons, has greater statistical power than any single outcome measure, and is easily interpreted and of direct clinical interest.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Bagiella Edoi
10.1016/j.apmr.2009.08.133subject
Has Abstractpub_date
2009-11-01 00:00:00pages
S17-21issue
11 Suppleissn
0003-9993issn
1532-821Xpii
S0003-9993(09)00639-Xjournal_volume
90pub_type
杂志文章abstract：OBJECTIVE:To investigate the task dependence of elbow weakness in patients with hemiparesis. DESIGN:Descriptive study based on interlimb comparisons of maximum voluntary torques (MVTs) generated isometrically in elbow flexion and extension under four task conditions: without explicit control of the torques at adjacent...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(99)90225-3
更新日期：1999-07-01 00:00:00
abstract：:This self-directed learning module highlights advances in the management of pain. It is part of the chapter on physiatric therapeutics for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This section discusses neuroanatomy and neurophysiol...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1990-03-01 00:00:00
abstract：OBJECTIVE:To evaluate the change in the 6-minute walk test (6-MWT) distance relative to changes in key functional capacity measures after 16 weeks of exercise training in older patients (≥65y) who have heart failure with preserved ejection fraction (HFpEF). DESIGN:Prospective, randomized, single-blinded (by researcher...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2016.08.481
更新日期：2017-03-01 00:00:00
abstract：OBJECTIVES:To evaluate risk factors for respiratory morbidity in chronic spinal cord injury (SCI). SETTING:Model SCI care system based at an urban public rehabilitation medical center. DESIGN:Case series with evaluation of pulmonary function by conventional spirometric testing. PARTICIPANTS:Two hundred twenty-two ad...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(00)90107-2
更新日期：2000-06-01 00:00:00
abstract：OBJECTIVE:To determine whether an implanted neuroprosthesis for bladder and bowel management is less costly than conventional techniques. DESIGN:Retrospective cost-identification analysis with comparison before and after implantation of the neuroprosthesis. SETTING:Life-care planning interviews in patients' homes. P...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2001.25912
更新日期：2001-11-01 00:00:00
abstract：OBJECTIVE:To evaluate whether adding functional exercise training to standard physiotherapy during residential slow-stream rehabilitation (SSR) improves discharge outcomes and functional ability. DESIGN:Randomized controlled trial. SETTING:A regional hospital. PARTICIPANTS:Older people (N=60) admitted to SSR. INTER...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2014.12.012
更新日期：2015-05-01 00:00:00
abstract：:A case-control study was undertaken to see if symptoms of upper gastrointestinal (UGI) (oropharyngeal, esophageal, and gastric) dysfunction occurred more frequently in males afflicted with Duchenne muscular dystrophy (DMD) than healthy controls. Subjects included 55 children with confirmed DMD and 55 age-matched contr...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:This investigation focuses on the effect of vocational rehabilitation on persons with chronic disabilities who have epilepsy, heart disease, spinal cord injury, arthritis, or emphysema. A thesis is proposed that such rehabilitants might be more vulnerable to unemployment than others, and it is also hypothesized that t...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1976-06-01 00:00:00
abstract：OBJECTIVE:To assess the efficacy of extracorporeal shockwave therapy (ESWT) and provide clinicians with an evidence base for their clinical decision making. DATA SOURCES:PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Evidence-Based Medicine Reviews. STUDY SELECTION:All randomized or quas...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.apmr.2014.01.033
更新日期：2014-08-01 00:00:00
abstract：OBJECTIVE:To compare postural balance between patients who have had either a large diameter head total hip arthroplasty or surface replacement arthroplasty. DESIGN:Observational study. SETTING:Outpatient biomechanical laboratory. PARTICIPANTS:Two groups of 14 patients with surface replacement or large diameter head ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2009.01.033
更新日期：2009-09-01 00:00:00
abstract：:Knowledge of upper limb activity in the natural environment is critical for evaluating the effectiveness of rehabilitation services. Wearable sensors allow efficient collection of these data and have the potential to be less burdensome than self-report measures of activity. Sensors can capture many different variables...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2019.01.004
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:To examine the effects of communication skills training on physiotherapists' supportive behavior during clinical practice. DESIGN:Randomized trial. SETTING:Hospital outpatient physiotherapy clinics. PARTICIPANTS:Physiotherapists (N=24) and patients (N=24) with chronic low back pain. INTERVENTIONS:Two hosp...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.apmr.2014.11.007
更新日期：2015-05-01 00:00:00
abstract：:Limited guidelines exist for rehabilitation programs for individuals with diabetes mellitus, blindness, and associated autonomic neuropathy. Abnormalities in autonomic function have been postulated to interfere with exercise conditioning and may predispose individuals to exercise-induced hypoglycemia. Twenty-nine indi...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1989-08-01 00:00:00
abstract：OBJECTIVE:To investigate the changes in muscle oxygen consumption (mV˙O2) using near-infrared spectroscopy (NIRS) after 4 weeks of training with functional electrical stimulation (FES) cycling in nonambulatory people with multiple sclerosis (MS). DESIGN:Four-week before-after trial to assess changes in mV˙O2 after an ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2014.10.010
更新日期：2015-04-01 00:00:00
abstract：:Chronic pain is a common clinical finding in spinal cord injury (SCI), with a reported incidence of between 45% and 90%. This figure was obtained by using nonstandardized pain evaluation and for mostly inpatient populations. Because of the shortcomings of previous investigations and the wide range of reported incidenc...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1985-11-01 00:00:00
abstract：OBJECTIVE:To examine the responsiveness and validity of the Action Research Arm Test (ARAT) in a population of subjects with mild-to-moderate hemiparesis within the first few months after stroke. DESIGN:Data were collected as part of the Very Early Constraint-Induced Therapy for Recovery from Stroke trial, an acute, s...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2006.09.003
更新日期：2006-12-01 00:00:00
abstract：:Unilateral brachial plexus injury is a rare complication of thoracoscopic sympathectomy, which is generally considered to be a simple and safe procedure. We report on a 26-year-old man who developed weakness and numbness of the right arm after thoracoscopic sympathectomy for hyperhidrosis. Electromyographic study reve...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(03)00135-7
更新日期：2003-09-01 00:00:00
abstract：OBJECTIVE:To determine the validity of the 6-minute walk test (6MWT) as an outcome measure to evaluate walking capacity in ambulatory patients with amyotrophic lateral sclerosis (ALS). DESIGN:Observational study. SETTING:Multidisciplinary ALS clinic at an academic medical center. PARTICIPANTS:Patients with ALS (N=18...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2017.04.004
更新日期：2017-11-01 00:00:00
abstract：:Based on the author's experience with more than 20 cases of immobilization hypercalcemia following spinal cord injury, current concepts of this condition are presented. Symptoms may be mild or severe: laboratory findings are essential for differential diagnosis in older individuals, in whom preinjury Paget's disease a...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：:A standardized method of obtaining distal motor latencies of the medial and lateral plantar nerves over fixed distances with temperature correction in 37 normal subjects is presented. The posterior tibial nerve was supramaximally stimulated 6, 8, 10, 12 and 14cm proximal to the active electrode over the motor point of...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1980-06-01 00:00:00
abstract：:Median nerve responses in 13 patients and 9 normal subjects were evaluated using surface bipolar stimulation. The M response from surface electrodes placed upon the thenar eminence was recorded on a fiberoptic chart recorder and simultaneously subjected to true electronic integration. Comparison between the integrated...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1981-08-01 00:00:00
abstract：BACKGROUND AND PURPOSE:Patients with low back pain are often administered a Functional Capacity Evaluation (FCE) to determine levels of physical functioning at the conclusion of their rehabilitation program. The purpose of this study was to examine the relationship between psychological factors (ie, self-reported disab...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(96)90161-6
更新日期：1996-02-01 00:00:00
abstract：:Visual imperception denotes the disorders of perceptual functioning commonly associated with unilateral brain injury. Typically the same half of the visual fields of both eyes are affected on the side opposite to that of the brain injury. The disorder may have a sensory or an attentional basis or both, moreover, the p...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1983-10-01 00:00:00
abstract：OBJECTIVE:To determine if constraint-induced movement therapy (CIMT) is more effective than bimanual training to improve occupational performance and participation in children with congenital hemiplegia. DESIGN:Single-blind randomized comparison trial with evaluations at baseline, 3, and 26 weeks. SETTING:Community f...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.apmr.2010.11.022
更新日期：2011-04-01 00:00:00
abstract：:This study was conducted to establish the concurrent validity and interrater reliability of the Motor Assessment Scale (MAS) for stroke patients. Thirty hemiplegic subjects were tested with the MAS and the Fugl-Meyer Assessment (FMA), a reliable and validated test of motor function in stroke patients. The high correla...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：OBJECTIVES:To investigate whether extra physical therapy intervention reduces length of stay and improves patient outcomes in people with acute or subacute conditions. DATA SOURCES:Electronic databases CINAHL, MEDLINE, AMED, PEDro, PubMed, and EMBASE were searched from the earliest date possible through May 2010. Addi...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,评审
doi：10.1016/j.apmr.2011.04.005
更新日期：2011-09-01 00:00:00
abstract：OBJECTIVES:To determine whether there is a postprandial increase of rectal pressure in patients with spinal cord injury (SCI) and to compare their rectal pressures with those of healthy volunteers. DESIGN:A before-after trial comparing SCI and control subjects. SETTING:Patients were recruited from the register of an ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2003.50071
更新日期：2003-01-01 00:00:00
abstract：OBJECTIVE:To identify adaptive changes within the motor network for internally and externally paced finger movements in the acute and chronic phase after ischemic stroke. DESIGN:A functional magnetic resonance imaging study of internally and externally paced thumb-index-finger opposition 4 to 7 days and 3 months after...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2010.07.217
更新日期：2010-10-01 00:00:00
abstract：OBJECTIVE:To review systematically the evidence for the management of orthostatic hypotension (OH) in patients with spinal cord injuries (SCIs). DATA SOURCES:A key word literature search was conducted of original and review articles as well as practice guidelines using Medline, CINAHL, EMBASE, and PsycInfo, and manual...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,评审
doi：10.1016/j.apmr.2009.01.009
更新日期：2009-05-01 00:00:00
abstract：:This case documents a patient with lumbosacral radiculopathy, reflex sympathetic dystrophy, and tarsal tunnel syndrome affecting one extremity. After lumbar laminectomy for L5-S1 radiculopathy, the patient developed foot pain diagnosed as secondary to reflex sympathetic dystrophy. Because of increasing foot pain despi...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1985-03-01 00:00:00
