Research, Objective Measures, & Mental Health

• Title

• Abstract

• Intro

• Methods

• Results

• Discussion

• Conclusion

• References

Parts of a Research Article

• background, purpose, main findings

Abstract

• states clinical question, purpose/hypothesis 

Intro

• independent/dependent variables

Methods

• data outcomes, does not include interpretation 

Results

• clinical implications 

Discussion

• most pertinent findings in a clinical context

Conclusion

• Meta Analysis

• Systematic Review

• Critically Appraised Topics

• RCT

• Cohort Studies

• Case Control Studies

• Case Series

• Expert Opinion

Levels of Evidence

• established statistical significance with studies with conflicting results 

Meta Analysis

• collects evidence from previous studies to answer a specific question 

Systematic Review

• comparing new treatment vs existing treatment

RCT

• group of participants that share similar characteristics 

Cohort Studies

• looks at two groups → control + experimental 

Case Control Studies

• follows subjects with similar diagnoses receiving same procedure

Case Series

•  yearly average of citations of articles published in last 2 years 

  • 10+ is great 

Impact Factor

• define role of specific diagnostic and treatment modalities 

  • Gold standard for APTA treatment option, does not take place of clinical judgement 

Clinical Practice Guidelines

• depression and/or mania

Mood Disorders

• don’t think about consequences of their actions

Mania

•  “turned down” mania

Hypomania

• not triggered by life events 

  • Each depressive episode confers brand new risks of chronicity, disability, suicide 

Major Depression Disorder

• early stages of major depressive disorder → substance abuse 

Dysthymia

• Type I; mania + depression 

• Type II: hypomania + depression 

Bipolar Disorder

• Tricyclic antidepressants (TCAs): 1st gen, fatal with OD

• Selective serotonin reuptake inhibitors (SSRIs) + Monoamine oxidase inhibitors (MAOIs): fewer side effects 

• Bupropion: increases seizure risk 

Depression Tx

• Anticonvulsants: mood stabilizers too

• Electroconvulsive therapy (ECT): briefs seizures induced with e-stim

Mania Tx

• visual/auditory hallucinations, delusions

  • Physical SS: uncoordinated, 

Schizophrenia

• tool/test used to assess and track pt status 

Subjective

• Score 

  • 0-6

  • 6-13

  • 13+  

Fall Risk Assessment Tool

• 0-6

Low Fall Rish

• 6-13

Medium Fall Risk

• 13+

High Fall Risk

• low back + referred leg pain 

  • Score: 0-5 → 0 = no disability | 5 = major disability 

  • Minimal detectable change (MDC) = 11

  • Minimally clinically important difference (MCID) = 13  

Oswestry Disability Index (ODI)

• disability of arm, shoulder hand

  • MDC = 11

  • MCID = 9-11.3

Quick DASH

• ability to perform ADLs

  • Score: 0-80 → 0 = major disability | 80 = no disability 

  • MDC + MCID = 9 

LEFS (lower extremity functional scale)

• clinician measurements

  • ROM, MMT, dynamometer 

  • 10 Meter Walk Test

  • TUG Test

  • Berg Balance Scale

    • 0-29

    • 21-40

    • 41-56

Objective

• walking speed, balance, bodily functions

10 Meter Walk Test

• mobility, balance, fall risk assessment 

TUG Test

• static + dynamic balance

Berg Balance Scale

• 0-29

High Risk (BBS)

• 21-40

Medium Risk (BBS)

• 41-56

Low Risk (BBS)

• significant number of pts score lowest possible 

Floor Effect

• significant number of pts score highest possible

Ceiling Effect

• Floor Effect

• Ceiling Effect

Errors of Measurement