Showing papers on "Physical disability published in 2020"

Home and Community-Based Physical Therapist Management of Adults With Post-Intensive Care Syndrome.

Abstract: More than 4 million adults survive a stay in the intensive care unit each year, with many experiencing new or worsening physical disability, mental health problems, and/or cognitive impairments, known as post-intensive care syndrome (PICS). Given the prevalence and magnitude of physical impairments after critical illness, many survivors, including those recovering from COVID-19, could benefit from physical therapist services after hospital discharge. However, due to the relatively recent recognition and characterization of PICS, there may be limited awareness and understanding of PICS among physical therapists practicing in home health care and community-based settings. This lack of awareness may lead to inappropriate and/or inadequate rehabilitation service provision. While this perspective article provides information relevant to all physical therapists, it is aimed toward those providing rehabilitation services outside of the acute and postacute inpatient settings. This article reports the prevalence and clinical presentation of PICS and provides recommendations for physical examination and outcomes measures, plan of care, and intervention strategies. The importance of providing patient and family education, coordinating community resources including referring to other health care team members, and community-based rehabilitation service options is emphasized. Finally, this perspective article discusses current challenges for optimizing outcomes for people with PICS and suggests future directions for research and practice.

Prevalence of mental health conditions, sensory impairments and physical disability in people with co-occurring intellectual disabilities and autism compared with other people: a cross-sectional total population study in Scotland.

Abstract: Objectives To investigate prevalence of mental health conditions, sensory impairments and physical disability in children, adults and older adults with co-occurring intellectual disabilities and autism, given its frequent co-occurrence, compared with the general population. Design Whole country cohort study. Setting General community. Participants 5709 people with co-occurring intellectual disabilities and autism, compared with 5 289 694 other people. Outcome measures Rates and ORs with 95% CIs for mental health conditions, visual impairment, hearing impairment and physical disability in people with co-occurring intellectual disabilities and autism compared with other people, adjusted for age, sex and interaction between age and co-occurring intellectual disabilities and autism. Results All four long-term conditions were markedly more common in children, adults and older adults with co-occurring intellectual disabilities and autism compared with other people. For mental health, OR=130.8 (95% CI 117.1 to 146.1); visual impairment OR=65.9 (95% CI 58.7 to 73.9); hearing impairment OR=22.0 (95% CI 19.2 to 25.2); and physical disability OR=157.5 (95% CI 144.6 to 171.7). These ratios are also greater than previously reported for people with either intellectual disabilities or autism rather than co-occurring intellectual disabilities and autism. Conclusions We have quantified the more than double disadvantage for people with co-occurring intellectual disabilities and autism, in terms of additional long-term health conditions. This may well impact on quality of life. It raises challenges for staff working with these people in view of additional complexity in assessments, diagnoses and interventions of additional health conditions, as sensory impairments and mental health conditions in particular, compound with the persons pre-existing communication and cognitive problems in this context. Planning is important, with staff being trained, equipped, resourced and prepared to address the challenge of working for people with these conditions.

Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer

Abstract: Improved survival means that cancer is increasingly becoming a chronic disease. Understanding and improving functional outcomes are critical to optimising survivorship. We quantified physical and mental health-related outcomes in people with versus without cancer, according to cancer type. Questionnaire data from an Australian population-based cohort study (45 and Up Study (n = 267,153)) were linked to cancer registration data to ascertain cancer diagnoses up to enrolment. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for adverse person-centred outcomes—severe physical functional limitations (disability), moderate/high psychological distress and fair/poor quality of life (QoL)—in participants with versus without cancer, for 13 cancer types. Compared to participants without cancer (n = 244,000), cancer survivors (n = 22,505) had greater disability (20.6% versus 12.6%, respectively, PR = 1.28, 95%CI = (1.25–1.32)), psychological (22.2% versus 23.5%, 1.05 (1.02–1.08)) and poor/fair QoL (15.2% versus 10.2%; 1.28 (1.24–1.32)). The outcomes varied by cancer type, being worse for multiple myeloma (PRs versus participants without cancer for disability 3.10, 2.56–3.77; distress 1.53, 1.20–1.96; poor/fair QoL 2.40, 1.87–3.07), lung cancer (disability 2.81, 2.50–3.15; distress 1.67, 1.46–1.92; poor/fair QoL 2.53, 2.21–2.91) and non-Hodgkin’s lymphoma (disability 1.56, 1.37–1.78; distress 1.20, 1.05–1.36; poor/fair QoL 1.66, 1.44–1.92) and closer to those in people without cancer for breast cancer (disability 1.23, 1.16–1.32; distress 0.95, 0.90–1.01; poor/fair QoL 1.15, 1.05–1.25), prostate cancer (disability 1.11, 1.04–1.19; distress 1.09, 1.02–1.15; poor/fair QoL 1.15, 1.08–1.23) and melanoma (disability 1.02, 0.94–1.10; distress 0.96, 0.89–1.03; poor/fair QoL 0.92, 0.83–1.01). Outcomes were worse with recent diagnosis and treatment and advanced stage. Physical disability in cancer survivors was greater in all population subgroups examined and was a major contributor to adverse distress and QoL outcomes. Physical disability, distress and reduced QoL are common after cancer and vary according to cancer type suggesting priority areas for research, and care and support.

Development of the Pregnancy and Motherhood Evaluation Questionnaire (PMEQ) for evaluating and measuring the impact of physical disability on pregnancy and the management of motherhood: a pilot study

Abstract: The aim of this study was to develop a questionnaire that allows researchers to investigate and measure the impact of physical disability on pregnancy and the management of motherhood. Such a quest...

Frailty and the Burden of Concurrent and Incident Disability in Patients With Cirrhosis: A Prospective Cohort Study.

Abstract: Frailty results from the chronic effects of malnutrition and muscle wasting in patients with cirrhosis. It is well-established that frailty is strongly associated with mortality in this population. However, little is known of its relationship with physical disability, a critical patient-centered outcome. Adults with cirrhosis underwent outpatient testing of frailty using the Liver Frailty Index (LFI) and disability using activities of daily living (ADL; range 0-6) and Instrumental ADL (IADL; range 0-8) scales at one center between 2012 and 2016. We used adjusted multilevel logistic mixed-effects regression to test the association between frailty and current disability (impairment with ≥1 ADL or IADL) and incident disability at 6 months among those without baseline disability. Of the 983 participants, 20% were robust, 32% were less robust, 33% were prefrail, and 15% were frail; 587 (60%) had at least 1 assessment. The percentage of participants with at least 1 baseline ADL or IADL impairment was 28% and 37%, respectively. In adjusted regression models, each point LFI increase was associated with a 3.3 and 4.6 higher odds of current difficulty with at least 1 ADL and IADL (P < 0.001 for each), respectively. Among participants without baseline disability, each point LFI increase was associated with a 2.6 and 1.7 higher odds of having difficulty with at least 1 ADL and IADL at 6 months, respectively. Conclusion: Frailty is strongly associated with concurrent and incident disability in patients with cirrhosis. In the clinic, the LFI can be used to identify those in greatest need for additional support/resources to maintain functional independence. In research settings, the LFI may help to identify an enriched population for clinical trials of interventions aimed at those most vulnerable to disability.

Evidence-Based Physical Therapy for Individuals with Rett Syndrome: A Systematic Review

Abstract: Rett syndrome is a rare genetic disorder that affects brain development and causes severe mental and physical disability This systematic review analyzes the most recent evidence concerning the role of physical therapy in the management of individuals with Rett syndrome The review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses A total of 17319 studies were found in the main scientific databases Applying the inclusion/exclusion criteria, 22 studies were admitted to the final phase of the review Level of evidence of the included studies was assessed using the Oxford Centre for Evidence-Based Medicine—Levels of Evidence guide Nine approaches to physical therapy for patients with Rett syndrome were identified: applied behavior analysis, conductive education, environmental enrichment, traditional physiotherapy with or without aids, hydrotherapy, treadmill, music therapy, computerized systems, and sensory-based treatment It has been reported that patients had clinically benefited from the analysed approaches despite the fact that they did not have strong research evidence According to the results, a multimodal individualized physical therapy program should be regularly recommended to patients with Rett syndrome in order to preserve autonomy and to improve quality of life However, more high-quality studies are needed to confirm these findings

Workplace difficulties, health-related quality of life, and perception of stigma from the perspective of patients with Multiple Sclerosis

Abstract: Introduction In Multiple Sclerosis (MS), withdrawal from employment is a critical problem. This study explores relationships between disease characteristics, work difficulties, health-related quality of life, depression, and stigma and how these factors affect employment status. Methods A multicenter, non-interventional, cross-sectional study was conducted in adults with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). Patient-reported questionnaires included: 23-item Multiple Sclerosis Work Difficulties Questionnaire, 29-item Multiple Sclerosis Impact Scale, Stigma Scale for Chronic Illness, and Beck Depression Inventory-Fast Screen. Results A total of 199 individuals (mean age = 43.9 ± 10.5 years, 60.8% female, 86.4% with RRMS) participated in the study. Mean time from diagnosis was 9.6 ± 7.2 years and median Expanded Disability Status Scale score was 2.0 (interquartile range: 1.0–3.5). Employment rate was 47.2% (n = 94). Mean physical and psychological MSIS-29 impact sub-scores were 40.38 ± 17.1 and 20.24 ± 7.8, respectively. Forty patients (19.9%) had at least one SSCI-8 item with a score of 4 or 5, suggesting the presence of stigma often or always. Eighty-one patients (40.7%) were depressed and 25 (12.6%) had moderate-to-severe depression. Work difficulties were higher in those with worse functional status, a diagnosis of PPMS, and lower educational levels. Employed participants had lower perceptions of stigma and depressive symptoms than those not employed. Higher perceptions of stigma were also strongly linked to higher physical and psychological impact on health-related quality of life and greater work difficulties. Depressive symptoms were also strongly related to work-related problems. Conclusions Work difficulties, stigma and poor quality of life are common in MS patients, even in a population with low physical disability. Evaluation of these dimensions in clinical practice would allow the development of targeted rehabilitation and specific work plans for MS employers.

Effectiveness of Home-based rehabilitation in improving physical function of persons with Stroke and other physical disability: A systematic review of randomized controlled trials.

Abstract: Background A significant number of people with physical disabilities in the world, especially in most developing countries face a lot of impediments. There is a dearth of literature describing the consensus of effectiveness of home-based rehabilitation programs designed specifically for people living with different types of physical disabilities resulting from stroke, Parkinson's and other musculoskeletal conditions. Objective To determine if home-based rehabilitation is effective in improving physical function of people with physical disabilities. Method A systematic review of randomized controlled trials was done. An electronic search of the literature was done by PubMed, Cochrane Library, the Physiotherapy Evidence Database and Cumulative Index to Nursing and Allied Health Literature from 1990 to March 2018 to identify full text, peer-reviewed randomized controlled trials, Published in English. Selected randomized controlled trials were critically appraised with 11 items Physiotherapy Evidence Database scale scores extracted from the Physiotherapy Evidence Database and studies were included if the cutoff of 5 points was reached on Physiotherapy Evidence Database scale score. Results Nine randomized controlled trials met the preset eligibility criteria. This systematic review found that there is the consistency of findings among the included studies which showed that home-based rehabilitation is an effective option for people with physical disabilities. Conclusion Home-based rehabilitation is not superior to hospital-based rehabilitation in improving nearly all patient outcomes assessed. However, home-based exercise programs require patient enthusiasm and regular follow-up to yield positive outcomes.

Psychological Quality of Life in People with Physical Disability: The Effect of Internalized Stigma, Collective Action and Resilience.

Abstract: Purpose: The main objective of this study was to examine the role of social identification, collective action and resilience in reducing the negative consequences of internalized stigma on the psychological quality of life of people with physical disability using path analysis. We propose a model with two paths: the first through social identification and collective action and the second via resilience. Method: A total of 288 Spanish people with physical disability aged between 18 and 82 years (46.4% males; mean [SD] of age = 45.1 [12.3] responded to the questionnaire. Data were collected for three months through an online survey. Results: The tested model adequately fit the data. We found that the relationship between internalized stigma and the psychological quality of life of people with physical disability was mediated by resilience. However, neither social identification nor collective action mediated the association between internalized stigma and quality of life among our participants. Conclusions: The results confirmed the negative association between internalized stigma and quality of life in the population with physical disability. The results show that some interactive processes, such as resilience, may contribute to decreasing the negative effects of internalized stigma. In contrast, no effects of identification with the group or collective action intention were found.

Pain Anxiety as a Mechanism Linking Pain Severity and Opioid Misuse and Disability Among Individuals With Chronic Pain.

Abstract: OBJECTIVE Chronic pain affects a significant number of individuals in the United States and is associated with several negative health-related outcomes, including possibility of opioid misuse and disability. The identification of factors associated with both opioid misuse and disability is of critical public health importance, and significant research suggests that pain severity has been shown to be associated with both. Pain-related anxiety has been uniquely associated with both opioid misuse and disability, yet little research has examined pain-related anxiety as a potential mechanism linking pain severity with opioid misuse and disability. METHOD Therefore, the current study examined whether pain-related anxiety explains, in part, the relationship between pain severity, opioid misuse, and disability among 396 adults with chronic pain (55.8% female, Mage 36.61, SD 11.40). RESULTS Cross-sectional analyses indicated that pain-related anxiety significantly mediated the relationship between pain severity, opioid misuse outcomes, and psychosocial disability, but not physical disability. CONCLUSIONS These results build upon the literature indicating the importance of pain-related anxiety in those with chronic pain by suggesting this construct may account, in part, for the relation of pain intensity to opioid misuse and psychosocial disability. Future research should longitudinally examine these associations.

Role of Perceived Social Support on the Association between Physical Disability and Symptoms of Depression in Senior Citizens of Pakistan

Abstract: An emerging body of literature has implied that perceived social support is known as an upstream element of cognitive health. Various dimensions of perceived social support may have divergent influence on physical and cognitive health in later life. The present study aimed to investigate the mediating role of perceived social support on the relationship between physical disability and symptoms of depression in senior citizens of Pakistan. The data were collected from three metropolitan cities (Lahore, Faisalabad, Multan) in the Punjab province of Pakistan and 100 participants were approached from each city with a total sample size of 300. The results demonstrated that family support, friends’ support, and significant others’ support mediated the association between physical disability and symptoms of depression, with an indirect effect of 0.024, 0.058, and 0.034, respectively. The total direct and indirect effect was 0.493. Physical disability was directly associated with symptoms of depression and greater physical disability predicted a higher level of symptoms of depression. Perceived social support, including family support, friends’ support, and significant others’ support, showed an indirect association with symptoms of depression. Furthermore, family support and friends’ support were more significantly associated with symptoms of depression as compared to significant others’ support. The research discoveries have better implications for health care professionals, hospice care workers, and policy makers. A holistic approach is required to prevent senior citizens from late-life mental disorders.

Working ability in individuals with different disease courses of multiple sclerosis: Factors beyond physical impairment.

Abstract: Background Experiencing a decrease in working ability or even becoming unemployed is common in patients with multiple sclerosis (MS) and has a detrimental impact on the individual's quality of life, self-esteem, and on society's economic burden. Physical disability is still considered the most important predictor for patients’ inability to work. This study aims to confirm and extend findings from prior studies indicating the additional importance of other demographical and clinical information accessible within a routine patient evaluation, placing particular emphasis on the inclusion of cognitive and neuropsychiatric measures, as well as on potential disease course differences. Methods 159 MS patients (84 with a relapsing disease course (RMS); 75 with a progressive disease course (PMS)) were examined with the Brief International Cognitive Assessment for MS (BICAMS) battery, mood and fatigue questionnaires, and screened for subjectively experienced cognitive problems as well as for various person- and disease-related information (age, sex, education, age at diagnosis, disease duration, immunotherapy, number and nature of comorbidities, smoking and alcohol intake, sleep disturbances). These measures, along with Expanded Disability Status Scale (EDSS) scores were compared between unemployed, part- and full-time working patients. Significant variables were further entered into hierarchical regression models predicting employment status (employed vs. unemployed) as well as weekly hours at work in each disease subtype, respectively. Results In patients with RMS, unemployed patients had higher EDSS scores, reported a higher number of comorbidities, more frequent past depressive episodes, a higher level of fatigue, and performed worse on the Symbol-Digit Modalities Test (SDMT) and the Brief Visuospatial Memory Test revised (BVMT-R). Besides EDSS, unemployment was predicted by SDMT, while weekly hours at work were further determined by the number of comorbidities, BVMT-R, and disease duration. In patients with PMS, unemployed patients also had higher EDSS scores, were younger at diagnosis, and showed a decreased performance in SDMT and the Rey Verbal Learning and Memory Test German version (Verbaler Lern- und Merkfaehigkeitstest; VLMT). Employment status as well as weekly working hours were both predicted by VLMT, educational level, and disease duration beyond EDSS in patients with PMS, while depressive episodes additionally impacted on employment status. Conclusions Objectively assessed cognitive functions, neuropsychiatric symptoms (i.e. a history of depressive episodes, fatigue) as well as some specific clinical data (disease duration, comorbidities) add substantial value in the evaluation of working ability beyond physical disability. Since unemployment is associated with different major factors among disease courses, more comprehensive and customized assessments are needed to refine characterization of individual work ability and to adjust interventional strategies targeting employment maintenance.

Acceptance and commitment therapy for the treatment of depression in persons with physical disability: a randomized controlled trial.

Abstract: Objective:To evaluate the effectiveness of acceptance and commitment therapy (ACT) on depressive symptoms in physically disabled persons.Design:Randomized controlled trial.Setting:State welfare org...

Reproductive Health in Women with Physical Disability: A Conceptual Framework for the Development of New Patient-Reported Outcome Measures.

Abstract: Background: Barriers in the built environment, enduring stereotypes and biases, and limited disability competency of health care providers compromise access to and quality of reproductive health ca...

Minor sex trafficking of girls with disabilities

Abstract: The purpose of this paper is to investigate the associations between minor women’ (girls’) disability status and victimization via minor sex trafficking.,This investigation used data from the National Longitudinal Study of Adolescent to Adult Health, a large, nationally-representative sample of in-school adolescents in the USA that began in 1994. The analysis included bivariate associations between physical disability status or low cognitive ability and minor sex trafficking among female survey respondents (n = 5,430).,Girls with any disability had a higher prevalence of minor sex trafficking than their peers without disabilities. Odds of minor sex trafficking were significantly higher for those with severe physical disabilities (5.83) and for those with low cognitive abilities (4.86) compared to the odds of their peers without their respective disabilities. Results for girls with mild or moderate physical disabilities were not statistically significant compared to peers without disabilities.,These nationally-representative survey data reinforce the trends present in smaller populations and case study research: female adolescents with disabilities are at a heightened risk for sex trafficking. On both a national and global scale, the human rights gaps in policy and practice must be addressed to adequately reach, intervene and protect this vulnerable population.,Research about minor sex trafficking typically relies on small-scale surveys and/or convenience samples. This study used a nationally-representative survey to demonstrate the link between disability status and women’s experiences with minor sex trafficking.

The relative influence of intellectual disabilities and autism on sensory impairments and physical disability: A whole‐country cohort of 5.3 million children and adults

Abstract: Background: Intellectual disabilities and autism are lifelong and often co‐occur. Little is known on their extent of independent association with sensory impairments and physical disability. Methods: For Scotland's population, logistic regressions investigated age–gender‐adjusted odds ratios (OR) of associations, independently, of intellectual disabilities and autism with sensory impairments and physical disability. Results: 1,548,819 children/youth, and 3,746,584 adults. In children/youth, the effect size of intellectual disabilities and autism, respectively, was as follows: blindness (OR = 30.12; OR = 2.63), deafness (OR = 13.98; OR = 2.31), and physical disability (OR = 43.72; OR = 5.62). For adults, the effect size of intellectual disabilities and autism, respectively, was as follows: blindness (OR = 16.89; OR = 3.29), deafness (OR = 7.47; OR = 2.36), and physical disability (OR = 6.04; OR = 3.16). Conclusions: Intellectual disabilities have greater association with the population burden of sensory impairments/physical disability, but autism is also associated regardless of overlap with intellectual disabilities. These may impact further on communication limitations due to autism and intellectual disabilities, increasing complexity of assessments/management of other health conditions. Clinicians need to be aware of these important issues.

ICU discharge screening for prediction of new-onset physical disability-A multinational cohort study.

Abstract: BackgroundMethods to identify patients at risk for incomplete physical recovery after intensive care unit (ICU) stay are lacking. Our aim was to develop a method for prediction of new-onset physica ...

The Impact of a summer sports camp for children with visual impairments on the self-efficacy of physical education pre-service teachers: A pilot study

Abstract: Training and self-confidence of the instructor are important components in the success of any inclusive physical education (PE) or recreation program. The purpose of this study was to determine if the self-efficacy toward teaching students with intellectual disabilities, physical disabilities or visual impairment in PE would increase in PE pre-service teachers working at a one-week intensive sports camp for youth with visual impairments. PE pre-service teachers (n=18) filled out the Self-Efficacy Scale for Physical Education Teacher Education Majors towards Children with Disabilities (SE-PETE-D) pre- and post-camp. SE-PETE-D measured participants’ self-efficacy toward including students with disabilities. Participant’s self-efficacy for teaching youth with a visual impairment scores significantly increased during camp, t(17) = 3.75, p = .002, d = 0.88. A similar pattern was observed in self-efficacy for teaching youth with an intellectual disability and physical disability, with scores also significantly increasing, t(17) = 5.32, p < .001, d = 1.25 and, t(17) = 3.83, p = .001, d = .90, respectively. Results from this study suggest teaching and learning experiences that are both practical and disability-orientated can be quite effective in increasing PE pre-service teacher’s confidence working with youth with disabilities

Attitudes towards inclusion of refugee girls with and without disabilities in Austrian primary schools

Abstract: This study addressed the concept of ‘intersectionality’ relating to refugee status and disability. It examined whether differences in attitudes depending on disability type (physical disability vs....

Using the ICF framework to evaluate the effects of environmental factors on physical disability among people with diabetes mellitus.

Abstract: Objective: This study aimed to analyze the influence of environmental factors on the ICF activity–participation outcome, controlling for body function and personal factor dimensions of 75 diabetes ...

Relationships between stroke, depression, generalized anxiety disorder and physical disability: some evidence from the Canadian Community Health Survey-Mental Health.

Abstract: The objective of this study is to evaluate associations between stroke, depression, anxiety and physical disability. The sample of 19,159 participants aged ≥30 was obtained from the 2012 Canadian Community Health Survey-Mental Health. Depression or anxiety was defined as major depressive disorder (MDD) or generalized anxiety disorder (GAD) within the past 12 months. The history of anxiety was defined as GAD at any time point during the respondent's lifetime. Physical disability was assessed by the past 14-day disability in daily-living activities. For statistical analysis, two logistic regression models (crude and adjusted models) were presented. The results showed that subjects with stroke had greater likelihoods of MDD-GAD comorbidity and GAD only compared those without stroke. People with GAD only had higher likelihood of physical disability than those with neither of the two conditions. Among participants with stroke, lifetime GAD was associated with a greater likelihood of MDD. In conclusion, individuals with stroke may be vulnerable to comorbid depression-anxiety as well as anxiety only. Additionally, subjects with anxiety were more likely to have physical disability. The history of anxiety increased the risk for developing post-stroke depression.

Inclusion of people with intellectual disabilities in judo: a systematic review of literature

Abstract: Background and Study Aim: What do we know about the inclusion of judokas with disabilities? We find many different types of disability in judo and also diverse expressions in professional literature such as: judo for blind, judo for hearing imperative, judo for the deaf, g-judo, judo for disabled people, adaptive judo, special needs judo, judo for all, ID (intellectual disability) judo, inclusive judo, special judo, modified judo etc. An important division of disability is noticed considering mental or physical disability according to the disability medical model. Since judo for the blind is a Paralympic discipline, there are some more professional and scientific articles about judokas with a physical disability, especially blind, visually impaired and deaf athletes, but there are only a few about judokas with mental disability. The cognitive aim of our research of literature is problem the necessity of the inclusion of people with intellectual disabilities, which, according to the disability social model and human rights model, includes those who need more decision-making help in everyday activities. Material and Methods: We used the EBSCO Discovery Service (EDS) in the National and University Libraries (NUK) in Ljubljana, which used data from entire text databases such as: Academic Search Complete, JSTOR, ScienceDirect, Oxford Academic Journals, SpringerLink, Taylor and Francis, SAGE, Wiley Online Library, PsycArticles, Emerald and data from the bibliographic collections MEDLINE, SCOPUS and Web of Science. Databases were searched by following the PRISMA guidelines for systematic reviews. Additional articles from other sources were identified by examining the reference lists of the studies located via the database search. A total of 24 articles met the final inclusion criteria. Results: The authors of the selected articles examined various aspects of the judo impact on people with diverse abilities. Articles address: 4 topics related to judokas with autism, 1 to judokas with attention deficit hyperactivity disorder (ADHD), 1 to judokas with down syndrome, 16 to intellectual disabilities and 2 to judokas with behavioural disorders. Research relates to: quality of life; motor abilities and movement skills; measurements of grip strength; a level of hyperactivity and of impulsivity; health and physical activity promotion; analysis of judo matches; effects on psychosocial factors; ethics of inclusion; the impact of judo on aggressive behaviours; effects on cortisol and stress; physical and psychosocial benefits of modified judo practice; effects of controlled intensity on the basis of lactate threshold on the blood oxidative stress status and motor coordination; the effectiveness of judo sessions as a supplementary therapeutic method; balance; possibilities and limitations of judo and innovative agonology in the therapy; reports from festivals and championships and popularization of judo. Conclusions: Due to the small number of subjects and the small number of similar surveys, the results cannot be generalized to the broader population. Research varies greatly by type of research and is therefore not comparable. Judo for people with intellectual disabilities is on the rise and is practiced as a therapy, as for recreation with an emphasis on inclusion, or as a sport with competitions at the level of the World Championships.

Aging With a Physical Disability, Duration of Disability, and Life Satisfaction: A 5-Year Longitudinal Study Among People Aged 40 to 79 Years:

Abstract: Studies show that having physical disabilities is associated with lower life satisfaction (LS). People with disabilities have reduced opportunities and welfare compared with people without disabili...

Experiences accessing and using rehabilitation services for people with physical disabilities in Sierra Leone.

Abstract: Purpose: To explore the experiences of persons with physical disabilities accessing and using rehabilitation services in Sierra Leone.Materials and methods: Interviews of 38 individuals with differing physical disabilities in three locations across Sierra Leone. An inductive approach was applied, and qualitative content analysis used.Results: Participants faced several barriers to accessing and using rehabilitation services. Six themes emerged: The initial and ongoing need for rehabilitation throughout life; challenges with the cost of rehabilitation and transportation to reach rehabilitation services; varied experiences with rehabilitation staff; coming to terms with disability and encountering stigma; the struggles without and opportunities with rehabilitation services; and limited knowledge and availability of rehabilitation services.Conclusions: There is a continued need to address the barriers associated with the affordability of rehabilitation through the financing of rehabilitation and transportation and exploring low-cost care delivery models. Rehabilitation services, assistive devices, and materials need to be available in existing rehabilitation centres. A national priority list is recommended to improve the availability and coordination of rehabilitation services. Improved knowledge about disability and rehabilitation services in the wider community is needed. Addressing discriminatory health beliefs and the stigma affecting people with disabilities through community interventions and health promotion is recommended.Implications for RehabilitationFinancing for rehabilitation, transportation to services and low-cost delivery models of care areneeded to reduce financial barriers and increase affordability of access and use.Community interventions and health promotion can provide information about the utility and availability of rehabilitation services, while addressing health beliefs and stigma towards persons with disabilities.The availability of both rehabilitation services and information, that is relevant and accessible is required to facilitate improved access and use of rehabilitation services.