This prospective, observational study of acute stroke survivors was completed to report our clinical application of the Penetration-Aspiration Scale (PAS), an 8-point multidimensional assessment, used in conjunction with the Video Fluoroscopic Swallow Study (VFSS). In addition, we were interested in determining the association of PAS scores at admission, demographics and clinical characteristics with functional recovery (measured by the Functional Independence Measure [FIM]) at discharge from an inpatient rehabilitation hospital. There were thirty-five patients that met inclusion and consented. Out of the 35, 34 (97%) were successfully assessed with the PAS with VFSS. Multivariate regression model revealed that the PAS scores, sex, length of stay, and admission FIM scores were significantly associated with functional recovery at hospital discharge (all p values < .05). We conclude that the PAS was feasible to administer with VFSS and implement in our inpatient setting. The PAS provided information about the depth of the airway invasion, material remaining after the swallow, and the response to aspiration, which were not reported in a standardized way prior to this study. The association between the PAS and functional recovery at discharge suggests that stroke survivors with swallowing impairment have less functional improvement noted at discharge than those with better swallowing scores. Therefore, people with dysphagia may need additional services and care. Future research should determine if using the PAS can improve clinical practice and ensure consistency across care transitions (expansion), as those with dysphagia may need additional services and care.

Objective: The Modified Barthel Index (MBI) measures individuals’ level of independence in performing activities of daily living. The purpose of this study was to examine the internal consistency and construct validity of the MBI for children with rare disorders. Methods: The study participants are children with rare disorders who have muscle weakness including Barth syndrome and congenital muscular dystrophy (N = 113). The MBI was completed by participants in either an online format utilizing the UF Qualtrics system or a pencil-and-paper format. Statistical analysis was conducted to examine the psychometric properties of the MBI. Results: The MBI showed excellent internal consistency for children with Barth syndrome (Cronbach’s α = .91) and congenital muscular dystrophy (Cronbach’s α = .93). Construct validity was supported by a significant difference in MBI scores among participants grouped by diagnoses. MBI score was significantly different between the unaffected group and congenital muscular dystrophy (p < .0001) as well as between the unaffected group and Barth syndrome (p < .0001). Conclusion: The psychometric properties of the MBI present good reliability and construct validity suggesting suitability for use as an outcome measure for children with rare disorders.

Objectives: Free Water Protocols (FWPs) are implemented selectively because of mixed evidence on the benefits associated with their use. This retrospective study examines the implementation a long-standing clinical program and descriptively reports rehabilitation and quality care outcomes. Methods: Data were collected over 6 years (n = 575). Inpatient rehabilitation setting. Variables included in this study were age, medical diagnoses, rate of acute care hospital transfers, discharge destinations, length of time on FWP. Results: Cohort consisted of older adults (M = 68.43, SD = 15.11), with diagnosis of stroke (60.2%), brain injury (19.1%), spinal cord injury (7.3%), cardiac (1%), orthopedics (5%), other (13.1%). Acute care hospital transfers occurred in 6% as descriptively compared to national average (14%). Additionally, participants tolerated FWP for days (M = 14.1, SD = 14.4) and most went home following rehabilitation Discussion: This retrospective study concludes the feasibility of implementing a FWP in a rehabilitation facility and reports descriptive outcomes. Experimental research is required for conclusions to be made regarding effectiveness of the FWP for dysphagia.

Objective: To evaluate item-factor structures of the 15 sensory items from the Survey of Pathways to Diagnosis and Services (Pathways) and examine the best fitting model. Methods: The study subjects were 1,968 children aged 6-17 years, who had ever been diagnosed with Autism Spectrum Disorder (ASD) and/or Intellectual Disability (ID). Factor analyses and item response theory models were used to determine the best fitting item-factor structure of the sensory items. The Strengths and Difficulties Questionnaires (SDQ) was used to test the concurrent validity of the sensory severity estimates. Results: A bifactor MIRT model (a general and four sensory factors) was selected as the best fitting model. All items statistically fitted to the bifactor model (p > .01) and showed moderate correlations with all five subscales of the SDQ (r s = .31 ~.51, p < .0001). The general sensory score differentiated the four different diagnostic groups (ASD, ID, ASD with ID, and no current symptoms) [F (3,1961) = 207.4, p < .0001]. Conclusion: The Pathways sensory items yielded reliable estimates of the general and each corresponding sensory factor by applying a bifactor MIRT model. The sensory score can be used as a valid sensory measure in the population survey.

The advance of information technology with governmental support allows researchers to utilize big data to conduct rigorous rehabilitation-related studies in both the United States and Korea. While big data research has been actively conducted in the United States, few Korean rehabilitation scientists currently conduct big data research. In this paper, we discuss the existing rehabilitation-related big data in Korea and introduce the current big data research trends in the United States. In addition, we provide potential research areas by discussing the previous big data studies in the United States, including 1) functional outcomes, 2) geographical variation, 3) linkage of a population-based cohort to hospital data, 4) cross-national comparison, and 5) scale development. We also discuss various statistical methods required in big data research and compare how these methods differ compared to the traditional research methods in rehabilitation research. Lastly, we discuss the importance of workforce development in rehabilitation-related big data research. We hope this paper will provide occupational therapy scientists and clinicians with practical and useful information about big data research and accelerate big data rehabilitation research communities in Korea.