Traumatic Stress and Depression Risk Screening at an ACS Verified Trauma Center.

BACKGROUND: Physiological trauma that requires admission to an emergency department may result in psychological distress. As many as 20%-40% of civilians who experience trauma develop traumatic stress disorders and depression postinjury. Yet, less than 10% of trauma centers implement screening for traumatic stress and depression risk. OBJECTIVE: This project aimed to develop, implement, and evaluate a traumatic stress and depression risk screening policy. METHODS: Twelve trauma advanced practice providers implemented the newly developed traumatic stress and depression risk screening policy at an American College of Surgeons verified Level II trauma center. Trauma patients admitted for greater than 24 hr, 14 years of age or older, with a Glasgow Coma Scale score greater than 13 were eligible for screening using the Injured Trauma Survivor Screen. RESULTS: During the 6-week data collection period, 114 trauma patients presented to the emergency department. Of those, 82 (72%) met inclusion criteria, 77 (94%) eligible trauma patients were screened, and seven (9%) patients screened positive. Patients not eligible for screening were discharged within 24 hr or were too confused to answer questions. An evaluation survey revealed that the advanced practice providers thought that the screening policy was easy to use, feasible, not very time-consuming, and should be continued in the future. CONCLUSION: This project demonstrated the ease and effectiveness of implementing a traumatic stress and depression risk screening policy and that only minor changes are needed to make it sustainable.

Reliability of the Revised Motor Learning Strategies Rating Instrument and Its Role in Describing the Motor Learning Strategy Content of Physiotherapy Sessions in Paediatric Acquired Brain Injury.

Purpose: Documenting the use of motor learning strategies (MLS) in physiotherapy is a foundational step in understanding the effectiveness of motor skills-based treatments in paediatric acquired brain injury (ABI). The purpose of this study was to estimate the inter- and intrarater reliability of the revised Motor Learning Strategies Rating Instrument (MLSRI-22) in physiotherapy for children and youth with ABI when administered by trained student physiotherapists. The MLSRI-22 was then used to describe the MLS content of traditional and robotic treadmill training physiotherapy sessions for children with ABI to demonstrate its application. Method: Thirty videos of children with ABI receiving Lokomat or traditional physiotherapy were rated using the MLSRI-22. Inter- and intrarater reliability were estimated using intra-class correlation coefficients (ICCs). Mean MLSRI-22 item scores described the MLS session content. Results: MLSRI-22 total score inter- and intrarater ICCs were 0.81 (95% CI: 0.61, 0.91) and 0.95 (95% CI: 0.90, 0.98), respectively. There were similarities and differences in MLS content between treatment approaches. Conclusions: Trained assessors can reliably administer the MLSRI-22 in physiotherapy for children with ABI. Research using MLSRI-22 scores to explore and systematically compare MLS across treatment approaches may provide insight into their effectiveness and contribute to MLS practice guidelines for children with ABI.

Objectif : il est essentiel de répertorier les stratégies d'apprentissage moteur (SAM) utilisées en physiothérapie pour comprendre l'efficacité des traitements pédiatriques reposant sur les habiletés motrices en cas de lésions cérébrales acquises (LCA). La présente étude visait à évaluer la fiabilité interévaluateur et intraévaluateur de l'instrument d'évaluation révisé des stratégies d'apprentissage moteur (MLSRI­22) en physiothérapie chez les enfants et les adolescents ayant des LCA, lorsqu'il était utilisé par des étudiants en physiothérapie. Le MLSRI­22 a ensuite été utilisé pour décrire le contenu des SAM de séances de formation sur tapis roulant classique et robotique chez des enfants ayant des LCA et ainsi en démontrer l'application. Méthodologie : les chercheurs ont classé 30 vidéos d'enfants ayant des LCA recevant des services Lokomat ou de physiothérapie classique au moyen du MLSRI­22. Ils ont évalué la fiabilité interévaluateur et intraévaluateur à l'aide des coefficients de corrélation intraclasse (CCI). Les scores moyens du MLSRI­22 décrivaient le contenu de la séance de SAM. Résultats : les CCI interévaluateurs et intraévaluateurs du score total du MLSRI­22 s'élevaient à 0,81 (IC à 95 % : 0,61, 0,91) et à 0,95 (IC à 95 % : 0,90, 0,98), respectivement. Il y avait des similarités et des différences dans les démarches thérapeutiques des SAM. Conclusion : des évaluateurs formés peuvent utiliser le MLSRI­22 en toute fiabilité en physiothérapie auprès des enfants ayant des LCA. Les recherches faisant appel aux scores du MLSRI­22 pour explorer et comparer systématiquement les diverses démarches thérapeutiques des SAM peuvent donner un aperçu de leur efficacité et contribuer à la préparation de directives cliniques sur les SAM chez les enfants ayant des LCA.