Disability and Rehabilitation最新文献

Purpose: Loss of upper extremity (UE) function impacts almost every aspect of daily life and upper limb recovery is reported to be a major priority of individuals living with tetraplegia. Surgical peripheral nerve transfer (PNT) offers the potential to restore volitional control of elbow, wrist and hand function of individuals with C5-C8 tetraplegia AIS A-C. Unfortunately, while there is growing evidence supporting the role of PNT in spinal cord injury (SCI) rehabilitation, there are currently no internationally-recognized consensus-derived best practices for provision of PNT following spinal cord injury (SCI) and few programs have focused on interdisciplinary collaboration during patient selection, surgical decision making, management of medical comorbidities and postoperative rehabilitation. This quality improvement initiative aimed to establish a novel, interdisciplinary PNT program with the goal of optimizing UE recovery and function in individuals with tetraplegia in Canada.

Materials and methods: An interprofessional team assembled to complete a detailed exploration of care segments, organizing and sequencing care delivery.

Results and conclusions: As a result of this initiative, a care map of planned interprofessional services, their optimal timing across the continuum of care, and clinical functional and community integration outcomes were developed. Data collection and program evaluation are ongoing, and further work to mitigate barriers and develop educational materials around PNT surgery are intended to improve medical decision making and best practice implementation.

Purpose: To investigate the concurrent validity of the telephone-based assessment of the Fatigue Severity Scale (FSS) and Medical Research Council (MRC) dyspnea scale in individuals with Parkinson's disease (PD).

Methods: The FSS and MRC Dyspnea Scale were applied twice, with an interval of one to two weeks between the assessments. The first assessment was carried out face-to-face and the second was via a telephone call. Intraclass correlation coefficient (ICC) (FSS score) and weighted Kappa statistic (FSS item score and MRC score) were used to investigate the agreement between face-to-face and telephone-based assessments (α = 5%).

Results: Sixty-seven individuals (66.8 ± 8.4 years) with PD were included. Significant agreement of very high magnitude was found for the FSS total score (ICC = 0.90; 95%CI = 0.84-0.94; p ≤ 0.001). Significant agreement from substantial to almost perfect magnitude was found for all FSS item scores (Kappa coefficients = 0.68-0.85; SE = 0.12; 95%CI = 0.44-1.09). A significant and almost perfect agreement was found for the MRC score (Kappa coefficients = 0.87; SE = 0.12; 95%CI = 0.64-1.11).

Conclusions: The telephone-based assessment of the FSS and MRC Dyspnea Scale showed adequate concurrent validity for evaluating dyspnea and fatigue in individuals with PD. Therefore, telephone-based assessments of fatigue and dyspnea can be performed in these individuals using the FSS and MRC scale.Implications for rehabilitationThe Fatigue Severity Scale (FSS) is a nine-item self-report measurement tool that measures the impact of fatigue on activities of daily living.The Medical Research Council (MRC) Dyspnea Scale consists of five statements, which measure how much dyspnea limits daily activities.Fatigue and dyspnea are common non-motor symptoms in individuals with Parkinson's disease (PD), affecting their health and quality of life.Telephone administration of the FSS and MRC Dyspnea Scale has adequate validity in individuals with PD, supporting their use in both clinical practice and research.

Purpose: Translation and cross-cultural adaptation of the Low Back Pain Treatment Belief Questionnaire (LBP-TBQ) into the Persian language.

Methods and materials: This cross-sectional study was conducted on 120 patients with LBP. The translation procedure followed Beaton's guidelines. To assess the Persian LBP-TBQ's psychometric properties, the questionnaires were administered twice to all participants at intervals of 5-7 days. The Persian versions of the Brief Illness Perception Questionnaire (BIPQ) and Pain Self-Efficacy Beliefs Questionnaire (PSEQ) were used to assess construct validity.

Results: The efficacy of sampling ranged from 0.855 to 0.893 for the investigated therapeutic approaches. The Cronbach's alpha was in the range of 0.91 to 0.95. The intraclass correlation coefficients for the total item scores for all four treatment methods were high (0.87-0.91) and their standard errors of measurement ranged from 3.8 to 15.9. No significant correlation was found for BIPQ and PSEQ with the scores of various subscales of the investigated treatments. However, significant correlations, ranging from 0.50 to 0.96, were found between the subscales and total scores for all four treatment approaches.

Conclusion: The Persian version of the LBP-TBQ is a reliable and valid instrument that could be practically used for identifying LBP treatment preferences in the Persian-speaking population.

Dance-based interventions/programs are gaining popularity; however, interventions are rarely explicitly described, including the role of dance facilitators, and their effects can be difficult to measure.

Methods: To address these issues, our intersectoral team collected quantitative and qualitative data. via a non-randomized pre-post study for six dance groups (teenagers with cerebral palsy, children with cerebral visual impairment, adults receiving outpatient physical rehabilitation, adults with Parkinson's disease, women who were formerly unsheltered, and community-dwelling older adults) outcome measures (heart rate variability-HRV, Multidimensional Outcome Expectation for Exercise Scale, Physical Activity Enjoyment Scale, Flow Sate Scale, and an in-house questionnaire) were collected with 34 participants up to five times to explore changes over time. Interviews, ethnographic observations, video recording and a qualitative thematic analysis were also conducted to describe the pedagogical strategies of one dance facilitator.

Results: HRV data were deemed unusable and other quantitative outcomes did not demonstrate statistically significant trends. Qualitative thematic analysis revealed important information about the adaptive verbal and non-verbal interactions between the facilitator and participants, linking to pleasure, effort, and body engagement.

Discussion/conclusion: Even without significant trends quantitatively, results were encouraging, and qualitative analyses were illuminating. Lessons learned and recommendations for future dance research and policymakers are included.

Purpose: Traumatic Brain Injury (TBI) can result in reduced social participation due to changes in cognition and communication. This study explored Instagram #TraumaticBrainInjury posts to determine how the platform was being used by people with brain injury and how TBI was discussed.

Materials and methods: Exploratory, qualitatively-driven, mixed-methods research design. Content analysis was conducted on the top 100 #TraumaticBrainInjury posts that met the study criteria. From each category identified in content analysis, two-three posts were further analysed using visual data analysis, then reflexive thematic analysis was used on this data to gain deeper understanding.

Results: Content analysis generated four categories: Promotional, Motivational, Educational, and Life Experiences. Thematic analysis of nine visual data narratives generated four themes: Sharing their Stories, Navigating Challenge, Anticipating More, and Building Community.

Conclusions: Community groups and people with TBI facilitated social connections and exchange about symptoms, recovery, struggles, and day-to-day life. Organisations and health professionals used the platform to provide information and promote their services to people with TBI. However, health professionals are under-utilised Instagram to promote social interactions and advocacy. The overall sentiment of the #TraumaticBrainInjury community was supportive and positive, suggesting integration of the platform into TBI rehabilitation would be beneficial for targeting social isolation.

Purpose: To assess the validity of the Fitbit ChargeHR versus a research-grade accelerometer (ActiGraph GT3X) for estimating daily step counts in free-living conditions in ambulatory children and youth living with physical and non-physical disabilities.

Materials and methods: Children and youth living with disability (n = 29; median age 10 years (IQR: 8-13), 55% boys; n = 2 with mobility aid) wore the GT3X ActiGraph accelerometer (hip) and the Fitbit ChargeHR (wrist) for seven days. Inter-device agreement in steps/day was assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots. A receiver operating curve (ROC) was used to determine a Fitbit step-count cut-point that corresponds to meeting physical activity guidelines (defined as ≥60 min of moderate-to-vigorous physical activity per day).

Results: Overall, we found an ICC = 0.861 (p < 0.001) between daily step counts measured by the two devices. Bland-Altman analyses revealed a mean difference ("bias") between the devices with the Fitbit recording, on average, 1,388 more steps/day than the accelerometer (Limits of Agreement (LoA) 1,741 to -4,518 steps per day). The ROC revealed a Fitbit cut-point of 12,272 steps/day corresponding to meeting guidelines.

Conclusions: Fitbit ChargeHR devices tend to overestimate daily step counts, but may still provide useful estimates of step counts and patterns in children and youth living with disability.

Purpose: Action observation (AO) and motor imagery (MI) are two forms of mental practice that can facilitate motor learning. We investigated if mental practice techniques (AO vs. combined AO+MI) can improve entry-level healthcare students' ability to locate anatomical structures in the immediate and short-term.

Materials and methods: Within a randomised control trial design, participants received a traditional anatomy lecture (Control, n = 13), or lecture plus AO (n = 13), or lecture plus combined AO+MI (n = 12). Mental practice involved either watching a physiotherapist's demonstration of (AO), or watching and imagining the feeling of (AO+MI) locating upper-limb anatomical points on a human model. Post intervention, participants located these points on a human model, assessed by diagnostic ultrasound, immediately and at one-week follow-up.

Results: Immediately post, accuracy was greater for AO+MI (M = 2.0, 95% CI = 1.6-2.4) and AO (M = 2.13, 95% CI = 1.7-2.6), than Control (M = 1.43, 95% CI = 1.0-1.8; ps < 0.05). At the follow-up, AO+MI (M = 2.23, 95% CI = 1.8-2.7) was significantly more accurate than AO (M = 1.30, 95% CI = 0.8-1.8; p < 0.01).

Conclusions: While mental practice groups out-performed the Control immediately post, only the AO+MI group retained this advantage. Educators should therefore consider augmenting traditional anatomy lectures with mental practice as a low-cost resource for enhancing learning.

Background: In 2020, clinical services noted an unexpected increase in functional tic disorders, which coincided with the timing of the COVID-19 pandemic. Evidence suggests that functional symptoms and tic disorders have a significant impact on family functioning and child and parent quality of life. However, little is currently known of the impact of a functional tics (FTs) diagnosis in adolescence, both on the young person and their family.

Methods: The current qualitative study explores adolescent and parent experiences of a FTs diagnosis, associated symptoms, and post-diagnostic support. Seven females aged between 12 and 18 years with a formal FTs diagnosis and eight parents were recruited through Tourette's Action, a UK-based charity concerning Tourette syndrome. Participants took part in individual semi-structured interviews via Microsoft Teams. Transcribed interviews were analysed using a reflexive Thematic Analysis.

Results: Themes generated from adolescent and parent interviews included (1) blamed, disbelieved, discounted, (2) fighting for help, (3) professional and community support and (4) changes in identity and relationships.

Conclusions: The findings emphasise the importance of psychoeducation encompassing FTs and young peoples' holistic needs, support to develop personalised strategies for management of FTs and interacting additional needs, alongside an increased public and professional understanding of FTs to aid stigma reduction.

Purpose: Return to work (RTW) after a major traumatic injury (MTI; traumatic brain injury, spinal cord injury, multi-trauma orthopaedic injury) is an important rehabilitation outcome. This study aimed to explore the experience of early vocational rehabilitation (EVR) after MTI, and RTW barriers/facilitators.

Methods: Adopting a qualitative design, 24 people with MTI were interviewed about participating in the Early Intervention Vocational Rehabilitation Service (EIVRS). Perceptions of EIVRS timing and RTW barriers/facilitators were explored. Data were analysed using reflexive thematic analysis.

Results: Participants experienced EIVRS as positive. The intervention's early timing was mostly appropriate, determined by individual factors. RTW barriers included injury impairments; difficulties adapting work roles and unstable employment; and psychological difficulties. RTW facilitators included ongoing recovery, employer flexibility, and feeling supported. Reported EIVRS benefits centred around three themes: gaining optimism and motivation through increased understanding; having a sense of control through the individualised program and vocational expertise; and feeling less worry and stress. Participants recommended long-term EIVRS availability.

Conclusions: Participants experienced EIVRS as an important component of their rehabilitation. Timing of vocational interventions needs to be individualised according to medical, cognitive, psychological, and employment factors. Embedding EVR within rehabilitation teams would facilitate this individualisation and may improve long-term rehabilitation outcomes.

Purpose: This study assessed the impact of refractive error (RE) correction on health-related quality of life (HRQoL) among nursing home residents.

Materials/methods: This quasi-experimental study with comparison group enrolled 249 participants for baseline and follow-up assessments in August 2021 and January 2022, respectively. Ophthalmic examination was conducted and visual acuity was assessed at baseline. Spectacles were distributed at three months before the follow-up. The interviewer-administered questionnaire assessed participants' socio-demographics and HRQoL using a 36-item Short-Form Health Survey (SF-36). Patient compliance with wearing spectacles was measured.

Results: The mean age of participants was 72.6. About 42.0% had mild to severe visual impairment (VI), while 5.0% were blind. At the follow-up, the normal vision improved from 52.8% to 64.9%, while mild to severe VI decreased from 42.3% to 30.3%. In the RE correction group, 83.3% of visually impaired people improved their vision to normal after receiving spectacles and 70.8% had corrected presbyopia. At the follow-up, those who had corrected their vision reported significantly better physical (PHC) and mental health component (MHC) scores of SF-36, particularly in physical functioning, emotional well-being, and pain. Those who had not corrected their vision reported no significant improvement in both PHC and MHC. There were no significant differences in baseline to follow-up mean change scores for PHC and MHC between those who corrected their vision and those who had not.

Conclusion: Access to comprehensive eye care services including regular eye screenings, provision of spectacles, and interventions facilitating spectacle-wearing compliance might improve ophthalmic health and HRQoL in this population.