James E. Graham, PhD, DC, Amol M. Karmarkar, PhD, OTR, Kenneth J

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Presentation transcript:

Small Sample Research Designs for Evidence-Based Rehabilitation: Issues and Methods  James E. Graham, PhD, DC, Amol M. Karmarkar, PhD, OTR, Kenneth J. Ottenbacher, PhD, OTR  Archives of Physical Medicine and Rehabilitation  Volume 93, Issue 8, Pages S111-S116 (August 2012) DOI: 10.1016/j.apmr.2011.12.017 Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions

Fig. 1 A-B design with follow-up for 1 person. The y axis presents time to complete the Timed Up & Go test; the x axis presents the sequence of observations across 6 baseline (A), 6 intervention (B), and 2 follow-up (FU) sessions. The dashed horizontal line indicates the value that is 2 SDs below the mean of baseline phase scores. Marklund I, Klassbo M. Clinical Rehabilitation. Volume 20, Issue Number 7. pp. 568-76, copyright © 2006 by SAGE Publications. Reprinted by Permission of SAGE.14 Archives of Physical Medicine and Rehabilitation 2012 93, S111-S116DOI: (10.1016/j.apmr.2011.12.017) Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions

Fig. 2 Multiple baseline design across outcomes with follow-up for 1 person. The y axis is the magnitude of error in perceived joint position; the x axis is the sequence of observations across consecutive phases. Vertical lines indicate the transitions from baseline to stimulus-specific intervention, to follow-up phases, respectively. Abbreviations: Flex-ent, flexion-extension; Uln-rad, ulnar-radial. Adapted from Carey LM, Matyas TA. Training of somatosensory discrimination after stroke: facilitation of stimulus generalization. Am J Phys Med Rehabil 2005;84(6):428-42.18 Archives of Physical Medicine and Rehabilitation 2012 93, S111-S116DOI: (10.1016/j.apmr.2011.12.017) Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions

Fig. 3 Alternating treatment design with follow-up for 1 person. Upper chart: y axis presents the step length (m); the x axis presents the sequence of observations across consecutive phases. Solid vertical lines indicate phase transitions: baseline, intervention, and follow-up. Lower chart: illustrates potential patterns of randomly assigned intervention sequences applied during each session. NOTE. The lower chart does not show all 12 alternating intervention sequences. Adapted from Diamond MF, Ottenbacher KJ, Effect of a tone-inhibiting dynamic ankle-foot orthosis on stride characteristics of an adult with hemiparesis, Physical Therapy, 1990, vol. 70, pp. 423-30, with permission of the American Physical Therapy Association. This material is copyrighted, and any further reproduction or distribution requires written permission from APTA.19 Archives of Physical Medicine and Rehabilitation 2012 93, S111-S116DOI: (10.1016/j.apmr.2011.12.017) Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions