Research methods in rehabilitation

A.Y. 2020/2021
6
Max ECTS
48
Overall hours
SSD
ING-INF/05 M-FIL/03 M-PSI/03 MED/04 MED/06
Language
Italian
Learning objectives
The course is aimed at providing students with knowledge about:
- medical ethics, in order to develop critical thinking and discussion skills on moral, legal and ethical issues related to health professions;
- theories and statistical-psychometric methods for the assessment of behaviors, perceptions, and attitudes;
- the use of computer and technological tools to support the work of rehabilitation professionals and the quality of life of persons with disability;
- research planning and implementation in the rehabilitation domain, taking into account its methodological peculiarities (variable definition, experimental design, statistics) and specific bioethical implications;
- general pathology in order to understand and describe inflammation and cancer as the two main causes of human diseases:
- techniques for the molecular investigation of the above described pathologies;
- programs and models for addressing cancer diseases
Expected learning outcomes
At the end of the course, the student will be able to:
- use computer, epidemiological and statistical methods and tools, as well as apply them to the organization of rehabilitation services, by assessing their appropriateness, effectiveness and efficiency
- plan and conduct research in the rehabilitation field, taking into account its methodological peculiarities (variable definition, experimental design, statistics) and specific bioethical implications
Course syllabus and organization

Single session

Responsible
Most lessons will take place synchronously through the Teams platforms. If possible, some lessons will be organized in presence, following the indications provided by the University as concerns safety and social distancing, with simultaneous activation of the remote mode via Teams. All lessons will be recorded and made available to students on the Ariel platform, together with additional learning materials.
The course program and materials will not change.
During the emergency phase exams will be performed orally through Teams. Whenever possible, written exams will be organized in presence, following the indications concerning safety and social distancing. The possibility to perform the exam orally in remote mode will be anyway guaranteed for students living in other regions or countries, as well as for students with serious pathologies.
Prerequisites for admission
No prior knowledge required
Assessment methods and Criteria
The assessment of learning outcomes consists of a written test, taking place during specific exam sessions, as per the Rules. The test includes multiple choice questions.
All the modules comprised in the teaching contribute equally to determining the final mark, expressed on a scale of 30.
No intermediate or early exam sessions are planned.
Teaching materials or notes are not allowed for consultation during testing.
The results are published on the ARIEL website of the master degree.
Moral philosophy
Course syllabus
Part 1: Ethics
- Philosophical ethics and role ethics
- content and function of ethical codes in the health professions.
Part 2 - Medical bioethics
- Health rights, informed consent
- role of Ethics Committees as concerns healthcare treatments and biomedical research
Teaching methods
The teaching consists of frontal classroom lessons, scheduled according to a timetable published on the ARIEL website of the master degree
Teaching Resources
- C. Del Bò, Etica del turismo, Carocci, 2017, limitatamente al capitolo 2.
-materiale distribuito a lezione
Psychometrics
Course syllabus
- Cumulative questionnaires: typical structures.
Visual analogues and mono-item questionnaires (numeric rating Scales); Multi-item scales like likert and Scales rating; Examples taken from current clinical and experimental practice; Different methods of administration.
- Main epistemological problems:
Latent and fully observable variables; "reflective" and"training"; Causal or co-variation relationship between latent variables and observed behaviours; Difference between evaluation (multidimensional decision-making) and true measure (one-dimensional process)
- Ideal properties of the measure: Unidimensionality; Discrimination (linearity, precision, targeting-accuracy, floor-to-ceiling effect); Estimation of missing scores; Not redundancy (cancellation of "Jackpot"); Invariance across sub-groups (including intra-inter-observer repeated measures); Possibility of correction according to the severity of the examiner
- The concept of the"validity"of the measure.
- Scores and measurements. Distortions induced by raw scores (raw scores).
- From counting to true measurements: from traditional test theory to modern item response theory: Observed scores (Observed-raw scores) and scores expected from the theoretical model (expected scores); difference between expected
and Observed scores: "residual" and data-model fit; maximum likelihood estimation: maximum does not mean great; Georg Rasch's original dichotomic model: prescriptive, non-descriptive Rasch-derivative models: scale rating (Andrich model), partial-credit (Masters model) and many-facets
- Solutions offered by Rasch models: Linearity; Single response error estimates; internal coherence estimates in response profiles; LAPMER scale; missing values estimates; data-model fit; stability of item challenge hierarchy among subgroups; differential item functioning and differential test functioning correction through item-split
In particular: solution to the problem of translation across different linguistic contexts (metric vs linguistic equivalence). McGill Pain Disability Questionnaire and BACKILL scale; Multiple examiners mis-fit: FISM-ProQual™ for research projects evaluation
- Examples of frequently used scales with limited validity
- Example of scale construction (ABILHAND) based on Rasch criteria
- Video Examples of manual performances; comparison between visual evaluation of abilities and measurement through ABILHAND
- Use of nomograms to graphically convert scores of linear measures; missing values; software freeware MINISTEP™.
- Evaluation profiles through scales; example with upper limb functioning
- Behavioral measures based on instrumental measures of performance (e.g.strength; balance): advantages and limits vs questionnaires. Subjectivity and objectivity in psychometric or behavioral measures
Basic statistics:
- Measurement scales and their features
- Central tendency and dispersion measure.
- Statistical hypothesis / Statistical hypothesis testing
- Test of association among variables: Independence test, correlation indices.
- Graphing variable relationships (level of association; shared variance)

Validity:
- Construct validity
- Validity associated with construct operationalization
- Face validity
- Content validity
- Structural Validity
- Exploratory Factor Analysis / Principal Component Analisis
- Common / Unique / Latent factors
- Correlation matrix
- Explained variance (Factors / Components)
- Factor solutions
- Varimax / Oblimin rotations
- Number of factors to be retained: employed criteria
- Graphing variable relationships in the context of Factor Analysis
- Confirmatory Factor Analysis
- Latent factors
- Fit indices (absolute, comparative, parsimonious)
- Criterion validity
- Predictive validity
- Cuncurrent validity
- Congruent validity
- Convergent / divergent / discriminant / differential validity

Reliability:
- Measurement error (systematic / random)
- Measurement precision / stability
- Split-half reliability
- Cronbach alpha
- Test-retest reliability
Teaching methods
The teaching consists of frontal classroom lessons, scheduled according to a timetable published on the ARIEL website of the master degree
Teaching Resources
- Nunnally J.C, Bernstein I. Psychometric theory. Mcgraw hill, New York, 3rd edition 1994
- Bond T, Fox C,M. Applying the rasch model. Routledge publisher,Oxford, 3rd edition 2015
- Penta M, Arnould C, Decruynaère C. Analisi di Rasch e questionari di misura. Trad it a cura di L.Tesio: Springer Italia, 2008
- Tesio L. Measuring behaviours and perceptions: Rasch analysis as a tool for rehabilitation research. J Rehabil Med 2003; 35:105-115
Information processing systems
Course syllabus
- Technological tools and equipment that can assess and quantify functional damage: motion analysis, inertial
sensors, sensor prostheses; Robotics and virtual reality in rehabilitation; Skeletal muscle modelling: simulation of
movement based on data collected by the patient.
- Planning of functional surgery, applications of neuromuscular electrical stimulation
The system of European research organisation in rehabilitation.
Teaching methods
The teaching consists of frontal classroom lessons, scheduled according to a timetable published on the ARIEL website of the master degree
Teaching Resources
Slides and learning material provided by the teacher
Clinical pathology
Course syllabus
Natural immunity response
- Natural immunity cells
- Cell modifications during the response of natural immunity: Cellular activation (prr, nfkb and its adjustment);
Macrophage activation (m1, m2)
- Vascular changes during natural immunity: Vasodilation; Increased permeability
- Leucocitary recruitment: Membership (molecules involved)
ChemotaxIs
- Mediators
- Chronic inflammatory response
- Adenosine; Functions of adenosine
Tumors
- Benign tumor and malignant tumor; Genes involved in the genesis of cancer; Molecular bases of oncology;
Characteristics of the cancer cell: neoplastic progression; Angiogenesis; TranscriptIon Factor hypoxia
inducible factor 1: adjustment
- Techniques described: Cell cultures; Western blot, qualitative and quantitative analysis of protein
Teaching methods
The teaching consists of frontal classroom lessons, scheduled according to a timetable published on the ARIEL website of the master degree
Teaching Resources
Pontieri, Elementi di patologia generale. Per i corsi di laurea in professioni sanitarie. Piccin, 2018
Rubin, Reisner, Rizzuto, Ausoni, Patologia generale: l'essenziale. Piccin 2015
Cairo, Recalcati, Tacchini, Quick review: patologia. Edises 2011
Medical oncology
Course syllabus
- Basic principles of scientific research (hypothesis, experimental phase, discussion of results)
- Overview of epidemiology, risk factors and nomenclature of cancer pathology
- Overview of the diagnostic procedure of cancer pathology, screening tests and new diagnostic and screening methodologies
-Clinical studies and their value, observational/experimental, cohort studies, case-control studies, randomized studies
-Phase I studies in oncology: goals, methods, interpretation of results
-Phase II studies in oncology: goals, methods, interpretation of results
-Phase III studies in oncology: objectives, methods, interpretation of results
- Phase IV studies
- Study with historical controls, limits and applicability
- Studies of non-inferiority
- Metanalysis, limits and applicability
-Planning a clinical trial (inclusion/exclusion criteria, informed consent, ethics committee)
-The impact on the clinical practice of studies in oncology
Teaching methods
The teaching consists of frontal classroom lessons, scheduled according to a timetable published on the ARIEL website of the master degree
Teaching Resources
Texts and in-depth learning materials will be indicated by the teacher during the lessons
Clinical pathology
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 1
Lessons: 8 hours
Professor: Tacchini Lorenza
Information processing systems
ING-INF/05 - INFORMATION PROCESSING SYSTEMS - University credits: 1
Lessons: 8 hours
Medical oncology
MED/06 - MEDICAL ONCOLOGY - University credits: 1
Lessons: 8 hours
Professor: Guidetti Anna
Moral philosophy
M-FIL/03 - MORAL PHILOSOPHY - University credits: 1
Lessons: 8 hours
Professor: Poggi Francesca
Psychometrics
M-PSI/03 - PSYCHOMETRICS - University credits: 2
Lessons: 16 hours
Professors: Negri Luca, Tesio Luigi