Showing papers in "Disability and Rehabilitation in 2019"
TL;DR: The refined ICF Linking Rules presented in this article outline the method to establish comparability of health information based on the ICF.
Abstract: Purpose The content of and methods for collecting health information often vary across settings and challenge the comparability of health information across time, individuals or populations. The International Classification of Functioning, Disability and Health (ICF) contains an exhaustive set of categories of information which constitutes a unified and consistent language of human functioning suitable as a reference for comparing health information. Methods and results In two earlier papers, we have proposed rules for linking existing health information to the ICF. Further refinements to these existing ICF Linking Rules are presented in this paper to enhance the transparency of the linking process. The refinements involve preparing information for linking, perspectives from which information is collected and the categorization of response options. Issues regarding the linking of information not covered or unspecified within the ICF are also revisited in this paper. Conclusion: The ICF Linking Rul...
335 citations
TL;DR: This scoping review shows that the need for rehabilitation considerably outstrips the provision of services, and there are substantial unmet needs for rehabilitation and numerous barriers to accessing services.
Abstract: Background: There is a global demand for rehabilitation services but to date little attention has been paid to rehabilitation as part of the health agenda, especially in low- and middle-income coun...
89 citations
TL;DR: Clinicians should determine both parent and young person commitment to a physical activity before enrolment and should be aware that teenagers may be more ready to be active as they develop greater independence and should raise awareness of the benefits of physical activity.
Abstract: Purpose: Existing research has explored the barriers and facilitators of physical activity participation for young people with disability from the perspective of young people and their families. However, little research has investigated the views of clinicians who facilitate access to physical activity programs and compared this with their child client’s perspectives.Method: Interviews were conducted with six allied health and sports development professionals associated with a programme which supports access to recreation and sporting activities. Interviews explored facilitators and barriers to physical activity experienced by their clients. Open-ended survey questions investigating barriers and facilitators of physical activity participation were also completed by 28 young people with disability aged 10–17 years who were clients of this programme.Results: The most salient facilitator of participation described by clinicians was “planning programs to promote success and inclusion.” Young people de...
78 citations
TL;DR: A systematic review and meta-analysis of randomized controlled trials concerning the effectiveness of walking interventions compared to other physical exercise on pain, disability, quality of life and fear-avoidance, in chronic low back pain found that walking may be considered as an alternative to otherphysical activity.
Abstract: Objective: Walking is commonly recommended to relieve pain and improve function in chronic low back pain. The purpose of this study was to conduct a systematic review and meta-analysis of randomize...
60 citations
TL;DR: The Godin Leisure-Time Exercise Questionnaire is an appropriate, simple, and effective tool for describing patterns of physical activity, examining correlates and outcomes of physicalactivity participation, and is an advantageous primary outcome for measuring change in physical activity in response to an intervention.
Abstract: Purpose: The Godin Leisure-Time Exercise Questionnaire has been a commonly applied measure of physical activity in research among persons with multiple sclerosis over the past decade. This paper pr...
59 citations
TL;DR: In this paper, the authors examined factors associated with quality of life among adults with autism spectrum disorder and found that improved quality-of-life is an important outcome for adults with ASD.
Abstract: Purpose: Improved quality of life is an important outcome for adults with autism spectrum disorder. However, little research has examined factors associated with quality of life among adults with a...
56 citations
TL;DR: The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge, Nevertheless, the field needs to mature.
Abstract: Aims: Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and pr...
55 citations
TL;DR: Specialised care focusing on the most relevant risk factors for each stage of recovery may enhance fall prevention during post-fall recovery, and people with a lower limb amputation are at increased risk of falling during all stages of recovery.
Abstract: Purpose: The objective of this study was to estimate fall incidence and describe associated risk factors among people with a lower limb amputation (LLA) during various stages of recovery: the surgi...
53 citations
TL;DR: The timing of when youth disclosed their disability to their employer depended on disability type and severity, comfort level, type of job, and industry, and youth’s strategies and reasons for disclosure.
Abstract: Purpose: Many youths with disabilities find it challenging to disclose their medical condition and request workplace accommodations. Our objective was to explore when and how young people with disabilities disclose their condition and request workplace accommodations. Methods: We conducted 17 in-depth interviews (11 females, six males) with youth with disabilities aged 15-34 (mean age 26). We analyzed our data using an interpretive, qualitative, and thematic approach. Results: Our results showed the timing of when youth disclosed their disability to their employer depended on disability type and severity, comfort level, type of job, and industry. Youth's strategies and reasons for disclosure included advocating for their needs, being knowledgeable about workplace rights, and accommodation solutions. Facilitators for disclosure included job preparation, self-confidence, and self-advocacy skills, and having an inclusive work environment. Challenges to disability disclosure included the fear of stigma and discrimination, lack of employer's knowledge about disability and accommodations, negative past experiences of disclosing, and not disclosing on your own terms. Conclusions: Our findings highlight that youth encounter several challenges and barriers to disclosing their condition and requesting workplace accommodations. The timing and process for disclosing is complex and further work is needed to help support youth with disclosing their condition. Implications for rehabilitation Clinicians, educators, and employers should emphasize the importance of mentoring and leadership programs to give youth the confidence and self-advocacy skills needed to disclose and ask for accommodations in the workplace. Clinicians should advocate for the inclusion of youth with disabilities in the workforce and educate employers on the importance of doing so. Youth with disabilities need more opportunities for employment training and particularly how to disclose their disability and request workplace accommodations.
48 citations
TL;DR: The results show that elite athletes with disability are less visible in the media than their nondisabled counterparts; female athletes received less coverage than male; the media favored domestic athletes and certain types of disability; and, although there was a focus on athleticism, this was underpinned by a “supercrip” narrative and a medicalised description of disability.
Abstract: Background: The media plays an important role in shaping society’s beliefs about disability and sport. The aim of this systematic review is to identify how elite athletes with disability are portra...
47 citations
TL;DR: Active, performance-focused exercise with variable practice opportunities improves gross motor function in ambulant/semi-ambulant children with cerebral palsy.
Abstract: Purpose: Evaluate effectiveness of active exercise interventions for improving gross motor activity/participation of school-aged, ambulant/semi-ambulant children with cerebral palsy (CP).Method: A ...
TL;DR: Although center of pressure measures were nonhomogeneous, subjects with chronic low back pain had poorer performance overall compared to healthy controls and implications for rehabilitation Static balance is affected in individuals with chronicLow back pain.
Abstract: Purpose: To examine the static standing balance of individuals with chronic low back pain when compared to a healthy control group.Methods: A search of available literature was done using PubMed, S...
TL;DR: It is shown that the Eating Assessment Tool has deficits in its construct validity and a need to improve the instrument to support its frequent use in clinical practice and research.
Abstract: Purpose: We aimed to evaluate the construct validity of the Eating Assessment Tool (EAT-10) by determining its dimensionality, rating scale integrity, item-person match, precision and relationship with the degree of airway invasion and functional oral intake.Methods: We conducted a retrospective analysis of patients’ EAT-10 scores. We used the Rasch rating scale model. We investigated correlations between the EAT-10 and scores on the Penetration-Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS).Results: The median score of the EAT-10 from 127 patients was 16 of 40 (range 0–40). Confirmatory factor analysis supported unidimensionality. The 5-point rating scale categories met published criteria. Two items misfit the Rasch model and two other items displayed differential item functioning. Rasch person reliability was 0.79. Our patient cohort was divided into three person-strata. Correlations between the EAT-10 and the PAS and FOIS were weak to moderate in strength (respectively: r = 0.26...
TL;DR: The current use of robotic exoskeletons in rehabilitation and home settings is presented and the benefits and limitations of the devices are discussed and ways that these devices fall short of fulfilling the promise of reengage in everyday activities in real-world life contexts are suggested.
Abstract: Purpose: Media images and marketing materials suggest a future in which individuals with spinal cord injury (SCI) can utilize robotic exoskeletons to reengage in everyday activities, yet these narratives may not align with the current technological realities. The purpose of this paper is to present and describe the current use of robotic exoskeletons in rehabilitation and home settings and discuss the benefits and limitations of the devices.Materials and methods: We provide an overview of the features and limitations of the four robotic exoskeleton products (EKSO Bionics, ReWalk, Rex Bionics, and Indego) that are currently being used in in the United States in rehabilitation settings. We follow by suggesting ways that these devices fall short of fulfilling the promise of reengage in everyday activities in real-world life contexts.Results and discussion: Available devices appear to be better suited for rehabilitation settings than for home use. Device weight, the need for upper extremity supports, ...
TL;DR: Investigation of factors influencing Australian speech pathologists’ guideline recommended aphasia management practices found a number of key factors influencing their practice, which differ in how they influence behaviours depending on the behaviour and clinical setting.
Abstract: Purpose: To explore factors influencing Australian speech pathologists’ guideline recommended aphasia management practices.Methods: Semi-structured interviews were conducted with hospital-based spe...
TL;DR: The circumstances surrounding falls reported by full-time wheelchair users living with multiple sclerosis and spinal cord injuries were found to be multifactorial and must be taken into consideration in the development of fall prevention programs.
Abstract: Purpose: The purpose of this study is to (1) explore and (2) compare circumstances of falls among full-time wheelchair users with spinal cord injury (SCI) and multiple sclerosis (MS).Methods: A mix...
TL;DR: The performances of licensed drivers with autism spectrum disorders appeared to be safer in respect to car-following distance but were poorer in their response to challenging traffic situations, particularly in traffic scenarios requiring critical response.
Abstract: Purpose: The aim of this study was to investigate the driving performance of drivers with autism spectrum disorders under complex driving conditions.Method: Seventeen drivers with autism spectrum d...
TL;DR: Some non-pharmacological interventions may be beneficial for reducing RLS severity and enhancing sleep and rehabilitation professionals should control for this possibility in future investigations.
Abstract: Introduction: Restless legs syndrome (RLS) is a sensorimotor disorder characterised by an uncomfortable urge to move the legs. Management is primarily pharmacological. Effects for non-pharmacological, non-surgical options are published but lack systematic examination. Objectives: To synthesise results of non-pharmacological/non-surgical treatment compared to no-treatment controls or alternative treatment for RLS on any relevant outcome. Methods: Databases and reference lists of reviews were searched for randomised controlled trials (RCTs) comparing non-pharmacological treatment to alternative or no treatment controls for idiopathic RLS. Search results were independently screened for inclusion by two researchers; disagreements regarding eligibility were resolved with discussion. Outcomes were summarised, and pooled where possible in meta-analysis. Results: The search yielded 442 articles. Eleven trials met inclusion criteria. Repetitive transcranial magnetic stimulation, exercise, compression devices, counterstrain manipulation, infrared therapy, and standard acupuncture were significantly more effective for RLS severity than control conditions. Vibration pads, cryotherapy, and transcranial direct current stimulation were ineffective in reducing RLS severity. Vibration pads, cryotherapy, yoga, compression devices, and acupuncture significantly improved some sleep-related outcomes. Conclusions: Few studies were identified and quality of evidence was not high. Some non-pharmacological interventions may be beneficial for reducing RLS severity and enhancing sleep. Implications for Rehabilitation The current management of restless leg syndrome is primarily pharmacological, and medications can have unwanted side effects. Repetitive transcranial magnetic stimulation, exercise, compression devices, counterstrain manipulation, infrared therapy, and standard acupuncture may reduce restless leg syndrome severity. Vibration pads, cryotherapy, yoga, compression devices, and acupuncture may improve some sleep-related outcomes in restless leg syndrome. Non-pharmacological interventions for RLS may cause placebo effects and rehabilitation professionals should control for this possibility in future investigations.
TL;DR: An infographic to communicate physical activity is highlighted and insights offered on some of the messages co-produced in it, including a focus on pleasure, amounts of physical activity, strength, sedentariness, visual images, language, and different impairments.
Abstract: Aim: The purpose of this paper is to share insights from an ongoing project that seeks to promote physical activity to disabled people.Method: Narrative commentary.Results: An overlooked yet import...
TL;DR: The main caregiver of a hip fracture patient is usually a woman who is the daughter of the patient, and reducing her burden of care should be included as one of the objectives of rehabilitation treatment.
Abstract: Purpose: To determine the profile of the main informal caregivers, the evolution of the caregiver burden, and the influencing factors of caregiver burden at 1-year after hip fracture surgery.Method...
TL;DR: It is shown that muscle amplitude is generally low during Lokomat guided walking, and that treadmill Speed is the main training parameter to influence muscular output in stroke patients during LokOMat walking.
Abstract: Purpose: The Lokomat is a commercially available robotic gait trainer, applied for gait rehabilitation in post-stroke hemiparetic patients. Selective and well-dosed clinical use of the Lokomat trai...
TL;DR: Overall, the sample in the present study demonstrated a moderate decline in participation following a stroke and only the “social roles” domain was severely affected.
Abstract: Objective: Evaluate, code and qualify the participation of Brazilian stroke survivors based on the international classification of functioning, disability and health (ICF) and identify predictors o...
TL;DR: The burden of undernutrition is high among children with cerebral palsy in rural Bangladesh which is augmented by both poverty and clinical severity; hence, these vulnerable groups should be focused in designing nutrition intervention and rehabilitation programs.
Abstract: Purpose: To assess the nutritional status and underlying risk factors for malnutrition among children with cerebral palsy in rural Bangladesh. Materials and methods: We used data from the Bangladesh Cerebral Palsy Register; a prospective population based surveillance of children with cerebral palsy aged 0-18 years in a rural subdistrict of Bangladesh (i.e., Shahjadpur). Socio-demographic, clinical and anthropometric measurements were collected using Bangladesh Cerebral Palsy Register record form. Z scores were calculated using World Health Organization Anthro and World Health Organization AnthroPlus software. Results: A total of 726 children with cerebral palsy were registered into the Bangladesh Cerebral Palsy Register (mean age 7.6 years, standard deviation 4.5, 38.1% female) between January 2015 and December 2016. More than two-third of children were underweight (70.0%) and stunted (73.1%). Mean z score for weight for age, height for age and weight for height were -2.8 (standard deviation 1.8), -3.1 (standard deviation 2.2) and -1.2 (standard deviation 2.3) respectively. Moderate to severe undernutrition (i.e., both underweight and stunting) were significantly associated with age, monthly family income, gross motor functional classification system and neurological type of cerebral palsy. Conclusions: The burden of undernutrition is high among children with cerebral palsy in rural Bangladesh which is augmented by both poverty and clinical severity. Enhancing clinical nutritional services for children with cerebral palsy should be a public health priority in Bangladesh. Implications for Rehabilitation Population-based surveillance data on nutritional status of children with cerebral palsy in Bangladesh indicates substantially high burden of malnutrition among children with CP in rural Bangladesh. Children with severe form of cerebral palsy, for example, higher Gross Motor Function Classification System (GMFCS) level, tri/quadriplegic cerebral palsy presents the highest proportion of severe malnutrition; hence, these vulnerable groups should be focused in designing nutrition intervention and rehabilitation programs. Disability inclusive and focused nutrition intervention programme need to be kept as priority in national nutrition policies and nutrition action plans specially in low- and middle-income countries. Community-based management of malnutrition has the potential to overcome this poor nutritional scenario of children with disability (i.e., cerebral palsy). The global leaders such as World Health Organization, national and international organizations should take this in account and conduct further research to develop nutritional guidelines for this vulnerable group of population.
TL;DR: A family-directed approach to brain injury model is introduced, which provides a theoretical framework for educating and training family members as facilitators in the management process: promoting competence rather than dependency on service systems.
Abstract: Purpose: This article proposes a theoretical framework to help professionals include family as active members in brain injury rehabilitation. A trend towards greater family involvement has lead to ...
TL;DR: Investigation of an adapted version of a commercially available, virtual-reality gaming system for upper-limb rehabilitation with community dwelling stroke-survivors suggested that the system is feasible and acceptable for use with a group of community-dwelling stroke- survivors including those with moderately-severe disability.
Abstract: Purpose: To establish feasibility, acceptability, and preliminary efficacy of an adapted version of a commercially available, virtual-reality gaming system (the Personalised Stroke Therapy ...
TL;DR: There is sufficient scientific evidence for the beneficial effects of exercise on the cardiovascular and muscular fitness of adults with mild/moderate ID, but no firm conclusion can be made regarding the effects of aerobic, muscular, and combined training programs on the body composition of Adults with intellectual disabilities.
Abstract: Purpose: To systematically review the existing scientific evidence regarding the effects of physical exercise on the fitness level of people with intellectual disabilities.Methods: Following the ch...
TL;DR: Advice from a physiotherapist and beliefs about the benefits of exercise influenced the reported exercise behaviours of individuals with Ehlers–Danlos syndrome – hypermobility type in this survey.
Abstract: Purpose: To explore exercise beliefs and behaviours of individuals with Joint Hypermobility syndrome/Ehlers–Danlos syndrome – hypermobility type and to explore patient experiences of physiotherapy.Methods: A cross sectional questionnaire survey design was used to collect quantitative and qualitative data from adult members of the Hypermobility Syndromes Association and Ehlers–Danlos Syndrome Support UK. Descriptive and inferential statistics were used to analyse the data. Qualitative data was analysed thematically.Results: 946 questionnaires were returned and analysed. Participants who received exercise advice from a physiotherapist were 1.75 more likely to report high volumes of weekly exercise (odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.30–2.36, p < 0.001) than those with no advice. Participants who believed that exercise is important for long-term management were 2.76 times more likely to report a high volume of weekly exercise compared to the participants who did not hold this be...
TL;DR: Analysis of trends in quality of life (QoL) development among older stroke patients within the first year after rehabilitation discharge and the impact of including proxy interviews in research and practice found that including severely impaired patients via proxies reduces the risk of overestimating QoL outcomes.
Abstract: To analyse trends in quality of life (QoL) development among older stroke patients within the first year after rehabilitation discharge, and to investigate the impact of including proxy interviews ...
TL;DR: Coaching in early physiotherapy intervention is described, taking the specific coaching approach of the family-centered program “COPing with and CAring for infants with special needs” (COPCA) as a case in point to recommend applying coaching methods that are based on explicit theoretical background and clinical knowledge.
Abstract: Background: Coaching is en vogue in pediatric physiotherapy, but often applied rather unspecific and undefined. Methods: This paper aims to describe coaching in early physiotherapy intervention, taking the specific coaching approach of the family-centered program "COPing with and CAring for infants with special needs" (COPCA) as a case in point. Results: The theoretical underpinnings of coaching in COPCA, including a meta-model, family-centered practice, the Neuronal Group Selection Theory and the goal-oriented coaching approach, are discussed. Next, the translation of theory into practical ingredients for coaching of families of a child with special needs is presented. The latter includes the appreciation of family autonomy and attitudes, and the creativity to ask specific questions to support the families in making their own decisions to promote their child's development during daily care-giving routines. Conclusion: It is concluded that the approach of coaching is demanding for both families and pediatric physiotherapists. It requires an active role of the family members in the intervention process and for therapists that they incorporate the attitude of a coach that largely differs from the attitude of the traditional therapist. For families and pediatric physiotherapists appreciating these changes in attitude, COPCA's coaching offers a promising form of early intervention. Implications for rehabilitation We recommend the implementation of the promising approach of goal-oriented and solution-focused coaching in pediatric rehabilitation and/or early intervention. We recommend applying coaching methods that are based on explicit theoretical background and clinical knowledge. We recommend formal training in coaching before professionals apply coaching in pediatric rehabilitation and/or early intervention.
TL;DR: There is a need to address barriers which people with disabilities experience in accessing health care services in Malawi through the expansion of the provision of assistive devices, implementing comprehensive outreach services targetingPeople with disabilities and strengthening the links between key component of access to quality health care.
Abstract: Purpose: This paper explores the barriers which people with disabilities experience in accessing health care services in Malawi.Methodology: Fifty-two in-depth interviews were conducted with people...