ORCID Profile
0000-0002-8632-094X
Current Organisations
Epworth HealthCare
,
Alfred Health
,
Austin Hospital
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.APMR.2017.10.015
Abstract: To evaluate reproducibility (reliability and agreement) of the Brachial Assessment Tool (BrAT), a new patient-reported outcome measure for adults with traumatic brachial plexus injury (BPI). Prospective repeated-measure design. Outpatient clinics. Adults with confirmed traumatic BPI (N=43 age range, 19-82y). People with BPI completed the 31-item 4-response BrAT twice, 2 weeks apart. Results for the 3 subscales and summed score were compared at time 1 and time 2 to determine reliability, including systematic differences using paired t tests, test retest using intraclass correlation coefficient model 1,1 (ICC BrAT. Test-retest reliability was excellent (ICC These findings support the use of the BrAT as a reproducible patient-reported outcome measure for adults with traumatic BPI with evidence of appropriate reliability and agreement for both in idual and group comparisons. Further psychometric testing is required to establish the construct validity and responsiveness of the BrAT.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Whitehouse Publishing
Date: 03-2020
DOI: 10.47795/CQZF2655
Abstract: Loss of arm and hand function is a devastating consequence of cervical spinal cord injury. Tendon transfer surgery has traditionally been used to restore key functions including elbow extension, wrist extension and grasp and pinch. The more recent development of nerve transfer surgery enables direct restoration of voluntary control of these functions. While both types of surgery are safe and effective, nerve transfer surgery results in a more open, flexible and natural hand, with more subtle control for a range of activities of daily living.
Publisher: SAGE Publications
Date: 10-10-2014
Abstract: To determine whether the revised High-Level Mobility Assessment Tool (HiMAT) was valid for measuring mobility for people with multi-trauma orthopaedic lower limb injuries. Cross-sectional study. Participants with lower limb multi-trauma orthopaedic injuries. One complete revised HiMAT was obtained for 106 people within 12 weeks of being allowed to fully weight bear. Rasch analysis was used to assess the overall fit of the model for in iduals and items, differential item functioning, local dependency, targeting of items and dimensionality. The mean revised HiMAT score was 10.5 (SD = 6.8) with a range of 5–30. Rasch analysis of revised HiMAT showed adequate overall fit to the model ( P = 0.29) with no misfitting items (fit residual SD = 0.69) or persons (fit residual SD = 0.62). The scale showed good internal consistency (Person Separation Index = 0.91). One item (hopping) demonstrated disordered thresholds, however this item had good fit to the model in all other aspects. The revised HiMAT was unidimensional, and no differential item functioning was detected for gender or age. The revised HiMAT was well targeted for this group with a range of items across all ability levels. The results of this study support the internal construct validity of the revised HiMAT as a well-targeted, unidimensional measure of high-level mobility with no ceiling or floor effect for males and females recovering from multi-trauma orthopaedic lower limb injuries.
Publisher: Elsevier BV
Date: 08-2019
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.APMR.2017.11.004
Abstract: To evaluate construct validity and responsiveness of the Brachial Assessment Tool (BrAT), a new patient-reported outcome measure for people with traumatic brachial plexus injury (BPI), and to compare it to the Disabilities of the Arm, Shoulder and Hand (DASH) and the Upper Extremity Functional Index (UEFI). Cross-sectional study. Outpatient clinics. Adults (N=29 age range, 20-69y) with confirmed traumatic BPI. Participants completed the BrAT 3 times over an 18-month period together with 16 DASH activity items and the UEFI. Evaluations were undertaken of construct validity, known-groups validity, 1-way repeated analysis of variance, and effect size. BrAT, DASH, and UEFI. The BrAT demonstrated a moderate to low correlation with the DASH activity items ( 0.7). According to known-groups validity, only the BrAT was able to discriminate between people who stated they could use their hand versus those who were unable to use their hand to perform activities. All measures indicated a significant effect for time with the exception of BrAT subscale 1. The effect size was highest for the BrAT but lower than expected (BrAT, .52-.40 DASH, .15 UEFI, .36). These preliminary findings support the BrAT as a valid and responsive patient-reported outcome measure for adults with traumatic BPI. The BrAT activity items appear to be more targeted than the DASH or UEFI particularly for people with more severe BPI. The BrAT also appears to be measuring a different activity construct than the DASH and the UEFI. Further work is required to confirm these results with larger s le sizes.
Publisher: Wiley
Date: 18-09-2014
DOI: 10.1016/J.PMRJ.2013.09.007
Abstract: To investigate the concurrent validity, responsiveness, and ceiling effect of the revised High-Level Mobility Assessment Tool (HiMAT) in persons after orthopedic multitrauma. Cross-sectional s le of convenience. A large tertiary rehabilitation hospital. Forty-three participants with orthopedic multitrauma lower limb injuries that resulted from motor vehicle accidents. This study compared the concurrent validity, responsiveness, and ceiling effects of the revised HiMAT, motor subsection of the Functional Independence Measure (FIM) instrument. Performances for all participants were concurrently scored on the motor FIM, revised HiMAT, and the Lower Extremity Functional Scale (LEFS) at initial testing, and 6 and 12 weeks after the decision to fully bear weight. Revised HiMAT, motor FIM, and LEFS. The correlation between the revised HiMAT and the motor FIM was moderate (r = 0.49 P <.001) and partly induced by a ceiling effect in the motor FIM. After 12 weeks of full weight bearing, 51.2% of participants achieved the maximum score on the motor FIM. The correlation between the revised HiMAT and LEFS was weak (r = 0.39 P = .012), which indicated a weak relationship between self-reported mobility problems and actual performance. The revised HiMAT was more responsive than the motor FIM and the LEFS, based on the proportion of persons who exceeded the minimal detectable change score over a period of 6 and 12 weeks. The revised HiMAT is more responsive to change than the LEFS and motor FIM, and less susceptible to a ceiling effect than the motor FIM for persons with orthopedic multitrauma. It has poor-to-moderate concurrent validity with the LEFS and motor FIM, which suggests that it may be measuring a different aspect of mobility.
Publisher: SAGE Publications
Date: 05-03-2021
Abstract: We report a retrospective series of 44 transfers in 26 patients in whom a functioning supinator nerve was transferred to a paralyzed posterior interosseous nerve through a single, anterior approach to re-animate hand opening in mid-cervical tetraplegia. Eighteen patients underwent concurrent nerve or tendon transfers to re-animate grasp and/or pinch through the same anterior incision. We evaluated the strength of the innervated muscle at mean follow-up of 24 months (range 12–27). The strength attained in our patients was equivalent to the strength after the transfer through a posterior approach reported in the literature. Nineteen of our patients were satisfied with the hand opening procedure. First webspace opening was the only variable to correlate with patient satisfaction. We conclude that the anterior approach yields similar results to the posterior approach and has the advantage of allowing easier access for simultaneously performing nerve or tendon transfers to reconstruct grasp and pinch. Level of evidence: IV
Publisher: Informa UK Limited
Date: 04-01-2022
Publisher: Informa UK Limited
Date: 10-2019
DOI: 10.1080/09638288.2019.1668970
Abstract: Traumatic, pan-brachial plexus injuries result in major functional disability. Surgical advancements, such as free-functioning muscle transfers, are restoring physical capacity that was not achieved 3-4 decades ago. Despite reconstructive procedures, brachial plexus injury patients report chronic pain, changes in work circumstances, concerns about their appearance, increased reliance on others, and difficulty completing daily activities. This suggests that recovery needs to be considered to better deliver post-injury health services. Investigate the lived-experience of patients following free-functioning muscle transfers for management of traumatic, pan-brachial plexus injuries.Better understand issues during recovery and implications for rehabilitation with this population. A phenomenological, qualitative design was employed that involved 5 participants who underwent surgery between 2007 and 2015. In-depth, semi-structured interviews were conducted and data were analyzed using interpretative phenomenological analysis. Three interrelated themes were generated from the data. The first theme 'Experience of health care systems' captures the participants' reflections of their post-injury experience and health care received. The second 'Psychosocial considerations' consists of emotional responses, relationship disturbance, and coming to terms with the permanence of their changed arm. The last theme, 'Creating a new self-identity', relates to the participants experience of adjustment to their new circumstances. The findings of this study demonstrate that comprehensive medical coverage and access to expert brachial plexus injury health providers support patients following injury. However, recovery also requires the need for the patient to adjust and establish a new self-concept. Health care providers can assist patients by establishing positive therapeutic relationships, as well as, reducing the number of care providers by providing a continuity of care from the same health professionals.IMPLICATIONS FOR REHABILITATIONIn iduals with pan-brachial plexus injuries felt it was beneficial to work with health care providers with extensive brachial plexus injury knowledge.Stable, long-term relationships with health providers during rehabilitation were reported as beneficial to recovery.Greater consideration of the process of adjustment and creating a new self-identity following pan-brachial plexus injury needs to be considered during rehabilitation.
Publisher: Medical Journals Sweden AB
Date: 2015
Abstract: To identify the range of activities limited following adult traumatic brachial plexus injury and triangulate these with existing patient-reported outcome measures identified from the literature. A qualitative cross-sectional design. Adults with traumatic brachial plexus injury and expert clinicians. Using an International Classification of Functioning, Disability and Health (ICF) framework, participants identified day-to-day activities that are limited following traumatic brachial plexus injury. Two independent reviewers classified all reported activities into the Comprehensive ICF Core Set of Hand Conditions (CCS-HC) activity domains. Reported activities were triangulated with patient-reported outcome measures identified from the brachial plexus injury literature. Fifty-one participants (21 adults with brachial plexus injury, 30 expert clinicians) generated a total of 522 items. The inter-rater reliability for classification to CCS-HC domains was excellent (k = 0.94, 95% confidence interval (95% CI) 0.92-0.96). Activities reported by patients and clinicians represented all 29 CCS-CH activity domains. Five activities (2%) could not be classified to any ICF domain. Fifteen CCS-HC activity domains were represented in the Disabilities of Arm, Shoulder and Hand (DASH) and ABILHAND, 2 measures currently used in the brachial plexus injury literature. Adults with a brachial plexus injury report a range of activities that are limited following injury, and are under-represented in currently used patient-reported outcome measures. The activities reported in this study could be used to inform the development of a new brachial plexus injury targeted questionnaire.
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.APMR.2011.07.188
Abstract: To identify upper limb questionnaires used in the brachial plexus injury (BPI) literature to assess activities and to evaluate their clinimetric properties. DATA SOURCES STUDY SELECTION This systematic review was undertaken in 2 stages. In stage 1, 10 electronic databases and 1 Internet journal were searched for quantitative studies (ie, randomized controlled trials, comparative studies, case series, and case studies) that evaluated outcome after BPI, irrespective of language or date of publication, from date of database inception to September 2010. All outcome instruments used were extracted and classified using the International Classification of Functioning, Disability and Health framework. Questionnaires were identified that apportioned >50% of the total score to the assessment of upper limb activity. In stage 2, 4 electronic databases were searched for papers that evaluated the clinimetric properties of all identified activity questionnaires with respect to peripheral nerve injuries of the upper limb. Two independent reviewers assessed the clinimetric properties of identified questionnaires according to standardized criteria. Stage 1 identified 4324 papers, of which 265 met the inclusion criteria. One hundred and three outcome measures were identified, the majority of which assess body function or body structure. Twenty-nine questionnaires assessed upper limb activity. Two questionnaires, the ABILHAND and Disability of the Arm, Shoulder and Hand (DASH), attributed >50% of the overall score to activity of the upper limb. The DASH had some published evidence of clinimetric properties in in iduals with peripheral nerve injuries. Neither had been clinimetrically evaluated for BPI, nor met all quality criteria. Day-to-day activities of the upper limb are infrequently evaluated after BPI. While attempts have been made to measure activity, there is a paucity of clinimetric evidence on activity questionnaires for in iduals with BPI. We recommend that a core set of items be developed which evaluate activity, as well a body structure, body function, and participation.
Publisher: Research, Society and Development
Date: 17-08-2022
DOI: 10.33448/RSD-V11I11.33455
Abstract: Objective: Present the translation and cultural adaptation of the BrAT for the Brazilian population. Methodology: This translation and cross-cultural adaptation study involved ten steps proposed by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR): preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing – which comprised: a Delphi study involving Brazilian physiotherapists that should answer a 7-item form, ided into 3 central axes: questionnaire content, structure and cross-cultural adaptation and a Pilot study involving patients with BPI that were questioned regarding their comprehension on each question of Brazilian version of BrAT -, review of cognitive debriefing, proofreading and final report. Results: The translation process generated the first Brazilian Portuguese version of BrAT. On cognitive debriefing, ten physiotherapists from the five Brazilian regions provided answers on Delphi study, and a consensus ≥ 80% was achieved in all items, with no amendments proposed. The pilot study involved twenty-one patients with BPI who showed full understanding of the translated version of BrAT and did not suggest any changes. After proofreading the instrument, the final Brazilian version of BrAT (BrAT-Brasil) was developed. Conclusion: BrAT-Brasil version proved to be well adapted to the cultural scenario of the Brazilian population. It exhibited successful results in all stages recommended by the international guideline on translation and cultural adaptation of patient-reported outcome measures.
Publisher: Public Library of Science (PLoS)
Date: 03-07-2017
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.APMR.2022.02.024
Abstract: This study aims to develop a patient-reported outcome measure that focuses on relevant daily activities relying on upper extremity for in iduals with tetraplegia. Cross-sectional study. Spinal cord injury units in 2 countries. Ninety-nine in iduals (N=99) with C2-C8, American Spinal Injury Association Impairment Scale A-D tetraplegia, mean age 46 years, 1- 43 years post injury. Thirteen items included in the initial testing were chosen from 708 activity limitations identified by in iduals with tetraplegia. Items were pilot tested for wording, response options, and relevance for both performance and satisfaction. Items were analyzed and reselected using exploratory factor analysis and Rasch analysis for local dependency, dimensionality, differential item functioning (DIF), threshold response, and targeting. Not applicable. Exploratory factor analysis supported a 2-factor solution for both performance and satisfaction. While data fit the Rasch model, there was evidence of local dependency and multiple disordered thresholds. Three items were removed because of high interitem correlation and DIF and the scale rescored to 5 response options. The remaining 10 items demonstrated fit to the Rasch model, with no local dependency, no multidimensionality, no item or person misfit, and minimal disordered thresholds. Results support the internal construct validity and unidimensionality of the Tetraplegia Upper Limb Activities Questionnaire (TUAQ), a 10-item, 5-response patient-reported outcome measure assessing performance and satisfaction with activities targeted to the upper extremity for in iduals with tetraplegia. Further testing is required and ongoing to evaluate reliability and responsiveness of the TUAQ.
Publisher: Springer Science and Business Media LLC
Date: 25-11-2019
DOI: 10.1038/S41393-019-0386-X
Abstract: Prospective cohort study. To validate a Clinical Prediction Rule (CPR) for ambulation in a non-traumatic spinal cord injury population (NTSCI). Tertiary spinal rehabilitation inpatient service, Melbourne, Australia. Adults with confirmed NTSCI were recruited between April 2013 and July 2017. Data based on the original van Middendorp CPR (age and four neurological variables) were collected from participant's medical records and by interview. The Spinal Cord Independence Measure item 12 was used to quantify the ability to walk at 6 and 12 months. A receiver operator curve (ROC) was utilised to determine the performance of the CPR. Ambulatory outcomes were compared for AIS A, B, C and D and aetiology groups. The area under the ROC curve (AUC) was 0.94 with 95% confidence interval (CI) 0.86-1.0 (n = 52). Overall accuracy was 75% at 6 months and 82% at 12 months. For the whole cohort the sensitivity at 12 months was 95% and specificity 73%. However, specificity for AIS C and D was only 50%. The CPR correctly predicted those who did not walk at 6 and 12 months following NTSCI, but was less accurate in predicting those who would walk particularly those with an AIS C or D classification. This CPR may be useful to inform planning for future care in in iduals with NTSCI, particularly for those who are not expected to walk. Further research with larger s le sizes is required to determine if the trends identified in this study are generalisable.
Publisher: Oxford University Press (OUP)
Date: 09-06-2022
DOI: 10.1093/PTJ/PZAC076
Abstract: The aim of this project was to evaluate the construct validity of the high-level mobility assessment tool (HiMAT) for children who are developing typically with no underlying condition that may affect mobility. The HiMAT is a revised 8-item measure of high-level mobility. Rasch analysis was used to assess fit to the Rasch model indicating unidimensionality, person separation index local dependency, targeting of items, and differential item functioning. Children with typical development aged 5 to 12 years (n = 1091 554 girls and 537 boys) were recruited from 8 schools. The mean HiMAT score was 22.4/32 (range, 8–32). Data fit the Rasch model, indicating that the HiMAT was a unidimensional scale assessing a single construct (high-level mobility). The person separation index was .86, indicating good reliability. The skip item exhibited differential item functioning by sex. Although items were well targeted, the fit residual mean for persons was 2.40, indicating most found the tasks easy to complete. Unlike in adult populations, 2 items (walk and walk over obstacle) exhibited local dependency & .2. The HiMAT is a unidimensional targeted performance measure of high-level mobility for children with typical development aged 5 to 12 years. Further examination of the relationship between the test items “walk” and “walk over an obstacle” may be required to ensure that scores on these items are truly independent of one another.
Publisher: Informa UK Limited
Date: 05-06-2022
DOI: 10.1080/09638288.2020.1769207
Abstract: To identify and appraise the existing clinical practice guidelines, consensus statements and Cochrane systematic reviews for the management of adult and paediatric focal spasticity to generate a single synthesized guideline. Systematic review of 12 electronic databases. Clinical practice guidelines, consensus statements and Cochrane systematic reviews for focal spasticity in adults and children. Included studies were appraised according to the AGREE II criteria. A total of 25 papers were included in this review, comprising 12 clinical practice guidelines, nine consensus statements and four Cochrane systematic reviews. The areas most strongly endorsed were: (1) management to be provided by a multi-disciplinary team, (2) therapy should be goal-directed, (3) goals to be developed in conjunction with the patient and family, and (4) importance of follow-up evaluations. There was a greater focus on activity outcomes and classification in the paediatric papers. The guidelines varied considerably in their quality, with AGREE II scores ranging from 52.8 to 97.1%. This systematic review has synthesized the key elements regarding principles of focal spasticity management, outcome measures, physical interventions and educational recommendations into a single, readily applied guideline available for clinical use. Despite considerable variability in the quality of the guidelines, several strong themes emerged.Implications for rehabilitationFocal spasticity management should be multi-disciplinary, patient-centred and goal-directed.Routine measurement of impairment and activity are strongly endorsed.Botulinum toxin A injection should only be provided as part of an integrated approach to focal spasticity management.
Publisher: SAGE Publications
Date: 16-11-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2008
Publisher: Elsevier BV
Date: 10-2012
Publisher: Mark Allen Group
Date: 02-12-2014
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.JHT.2022.01.006
Abstract: Traumatic, brachial plexus injuries (BPI) result represent a significant cost to the in idual and society. Recovery involves multiple surgeries, takes years, and often results in permanent physical dysfunction. While the last couple of decades have seen advancements in surgical management, the BPI rehabilitation literature has not kept pace with these developments. We aim to explore the experience of public and privately employed hand therapists' in delivering effective long-term rehabilitation services to inviduals with BPI in Australia. An interpretative qualitative study. Two focus groups were conducted with Australian hand therapists' (n = 10). Data were analyzed using an inductive thematic approach. Three key themes were generated from the data. The first theme 'Falling through the gaps: overlooked components of therapy for BPI' captures participants' thoughts on postinjury health care and rehabilitation services. The second 'Developing a therapeutic alliance: underpinned by time and trust' relates to the relationship building challenges and opportunities following trauma that will withstand the long-term recovery of in iduals following BPI. The last theme, 'Factors required for professional development: knowledge and support,' considers the variation seen with these clients in relation to therapy needs and outcomes. The findings of this study highlight the need to better equip hand therapists' skills and knowledge in responding to pain and psychological management post BPI. Our results reinforce the benefit of interdisciplinary models of care in the management of in iduals with BPI.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.APMR.2016.06.021
Abstract: To evaluate the internal construct validity and dimensionality of a new patient-reported outcome measure for people with traumatic brachial plexus injury (BPI) based on the International Classification of Functioning, Disability and Health definition of activity. Cross-sectional study. Outpatient clinics. Adults (age range, 18-82y) with a traumatic BPI (N=106). There were 106 people with BPI who completed a 51-item 5-response questionnaire. Responses were analyzed in 4 phases (missing responses, item correlations, exploratory factor analysis, and Rasch analysis) to evaluate the properties of fit to the Rasch model, threshold response, local dependency, dimensionality, differential item functioning, and targeting. Not applicable, as this study addresses the development of an outcome measure. Six items were deleted for missing responses, and 10 were deleted for high interitem correlations >.81. The remaining 35 items, while demonstrating fit to the Rasch model, showed evidence of local dependency and multidimensionality. Items were ided into 3 subscales: dressing and grooming (8 items), arm and hand (17 items), and no hand (6 items). All 3 subscales demonstrated fit to the model with no local dependency, minimal disordered thresholds, no unidimensionality or differential item functioning for age, time postinjury, or self-selected dominance. Subscales were combined into 3 subtests and demonstrated fit to the model, no misfit, and unidimensionality, allowing calculation of a summary score. This preliminary analysis supports the internal construct validity of the Brachial Assessment Tool, a unidimensional targeted 4-response patient-reported outcome measure designed to solely assess activity after traumatic BPI regardless of level of injury, age at recruitment, premorbid limb dominance, and time postinjury. Further examination is required to determine test-retest reliability and responsiveness.
Publisher: SAGE Publications
Date: 03-08-2022
DOI: 10.1177/17531934221113739
Abstract: We report a retrospective study of 112 nerve transfers in 39 participants to investigate predictors of strength outcomes after nerve transfer surgery for upper limb reanimation in tetraplegia. We measured clinical and pre- and intraoperative neurophysiological assessment variables and compared them with strength outcomes 2 years after nerve transfer surgery. We found statistically significant improvement in Medical Research Council strength grades after nerve transfer surgery with lower cervical spine injuries (between one and two grades), lower donor nerve stimulation thresholds (half of a grade), greater motor evoked potential activity in recipient nerves (half of a grade) and greater muscle responses to intraoperative stimulation of donor (half of a grade) and recipient nerves (half of a grade). Level of evidence: III
Publisher: SAGE Publications
Date: 15-12-2011
Abstract: The High-level Mobility Assessment Tool (HiMAT) was developed to measure high-level mobility limitations following traumatic brain injury. The aim of this study was to investigate if the revised HiMAT is valid for use with adults with neurological conditions other than traumatic brain injury. Cross-sectional study. Ninety-five participants with neurological conditions. HiMAT score sheets were retrieved from the central medical files of people who had attended a major rehabilitation facility for a neurological condition from January 2006 to October 2007. Additional HiMAT score sheets were submitted by therapists who participated in the HiMAT User’s Group. Rasch analysis (RUMM2030 software) was used to determine the overall fit of the model, in idual item fit and differential item functioning. Rasch analysis supported the internal validity of the revised eight-item HiMAT for in iduals with neurological conditions. It showed good overall fit ( P = 0.74), no misfitting items and excellent internal consistency (Person Separation Index = 0.91). The HiMAT is unidimensional with no evidence of response dependency and no differential item functioning for age or sex. Further development of the revised HiMAT is required to investigate other aspects of validity, reliability and responsiveness in different neurological populations. However, the results support the internal validity of the revised HiMAT when used for people with neurological conditions who are able to walk without gait aids.
Publisher: Public Library of Science (PLoS)
Date: 07-2014
Publisher: Springer Science and Business Media LLC
Date: 19-01-2013
Publisher: Elsevier BV
Date: 12-2022
Publisher: Elsevier BV
Date: 07-2015
No related grants have been discovered for Bridget Hill.