Abstract
Objectives
To examine the responsiveness and predictive validity of the Participation Measure–3
Domains, 4 Dimensions (PM-3D4D) in people receiving outpatient rehabilitation following
stroke.
Design
Prospective cohort observational study.
Setting
Outpatient rehabilitation settings.
Participants
Volunteer patients (N=269) with stroke (mean age ± SD [y], 55.36±12.46; 70.26% male).
Interventions
Not applicable.
Main Outcome Measures
The PM-3D4D was designed to measure 3 domains (Productivity, Social, and Community)
and 4 dimensions (Diversity, Frequency, Desire for change, and Difficulty) of participation
in individuals with rehabilitation needs. All participants completed the PM-3D4D,
the Participation Assessment with Recombined Tools-Objective (PART-O), the Participation
Measure for Post-Acute Care (PM-PAC), and the EuroQol-5-Dimension (EQ-5D) at the baseline
assessment and again following 3 months of outpatient rehabilitation.
Results
Significant mean changes in scores were observed for most of the PM-3D4D subscales,
with the largest score change observed in the Difficulty subscale (standardized response
mean=0.57∼0.88). The minimal detectable change and meaningful clinically important
differences were calculated for each subscale. The Frequency and Difficulty dimensions
of the PM-3D4D demonstrated significantly greater responsiveness than the PART-O and
PM-PAC, respectively. The baseline PM-3D4D scores, except for Desire for change subscales,
were significantly correlated with the PART-O, PM-PAC, and EQ-5D scores after 3 months
of rehabilitation.
Conclusions
This study provides evidence supporting the responsiveness and predictive validity
of the PM-3D4D in survivors of stroke. Among all subscales of the PM-3D4D, the Difficulty
dimensional scale demonstrated the greatest responsiveness. The Desire for change
dimension of the PM-3D4D showed less responsiveness, and we recommend that it be used
as a goal-setting tool rather than an outcome measure. The PM-3D4D can potentially
be used to predict participation outcomes and the health-related quality of life following
rehabilitation interventions.
Keywords
List of abbreviations:
CI (confidence interval), EQ-5D (EuroQol-5-Dimension), HRQoL (health-related quality of life), MDC (minimal detectable change), MDC90 (minimal detectable change with a confidence level of 90%), MCID (meaningful clinically important difference), PART-O (Participation Assessment with Recombined Tools-Objective), PM-3D4D (Participation Measure–3 Domains, 4 Dimensions), PM-PAC (Participation Measure for Post-Acute Care), SRM (standardized response mean), USER-Participation (Utrecht Scale for Evaluation of Rehabilitation Participation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 14, 2019
Footnotes
Supported by the Ministry of Science and Technology, Taiwan (grant no. MOST105-2628-B-038-003-MY3), the Ministry of Health and Welfare, Taiwan (grant no. MOHW105-TDU-B-212-133018), and National Health Research Institutes, Taiwan (grant no. NHRI-EX108-10819PC). The funding sources had no influence on the study design or findings.
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
