Research Methods in Rehabilitation

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

- 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

- Technological tools and equipment that can assess and quantify functional damage: motion analysis, inertial
Sensors
Examples of clinical studie with technologies for the assessment of human movements in Infantile cerebral Palsy and in Parkinsons's Disease
The system of European research organization in rehabilitation.

Natural immunity response
- Natural immunity cells
- Cell modifications during the response of natural immunity: Cellular activation;
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
- Techniques described: Cell cultures; Western blot, qualitative and quantitative analysis of protein

- 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