Disability and Rehabilitation最新文献

Background: Stroke survivors exhibit sedentary behavior, and many do not engage in physical activity and exercise for a number of reasons. Secondary prevention through physical activity is a priority to avoid a new stroke or disease.

Objective: To describe the experience of stroke survivors with maintained walking ability living in Spain regarding physical activity and exercise.

Methods: A qualitative phenomenological study was conducted. Purposive sampling was carried out to include 35 stroke survivors who had stroke more than 6 months ago from 14 neurorehabilitation centers in 24 cities in Spain. Data were collected through semi-structured interviews and researchers' field notes. The Giorgi approach was used for the qualitative analysis of the data collected.

Results: Three themes emerged: a) Changes in the experience of physical activity and exercise adaptation; b) Reasons for and against the practice of physical activity and exercise; c) Experiencing tiredness and fatigue.

Conclusions: Our results show the individual post-stroke perception of each person, the reasons for and against the practice of physical activity and exercise, as well as the impact this has on their daily life and activity. These results will help health professionals to understand the needs of stroke survivors when prescribing physical activity and exercise included in intervention programs.

Purpose: To develop and validate an evidence-based observational tool to measure engagement in telepractice early intervention (EI).

Materials and methods: The Engagement in Telepractice Observational Tool (eTOT) was developed based on a previous e-Delphi study. Two independent raters used a set of 50 items to score 45 videorecorded telepractice EI sessions with young children with communication difficulties and their family. Principal component analysis (PCA) and reliability measures were conducted.

Results: PCA identified six key components related to the measurement of engagement in telepractice. The components representing professional behaviours were (1) interacting directly with the parent; (2) getting to know the child and family to keep them motivated; (3) maximising the telepractice environment; and (4) demonstrating and practising the parent's role as agent of therapy. The two remaining components represented family behaviours: (5) parent interacting and supporting their child; and (6) family collaborating directly with the professional. The eTOT was found to have good reliability (α = .86), with very good test-retest and inter-rater reliability scores (κ_w = .85 and .94 respectively).

Conclusion: There is preliminary evidence that the eTOT is a valid and reliable tool to measure engagement during telepractice EI. The eTOT can be used as a self-reflection tool to identify and provide engagement-building opportunities in family-centred telepractice EI.

Purpose: In 2023, the World Health Assembly endorsed a Resolution on Strengthening Rehabilitation in Health Systems. This study aims to explore the perspectives of Swiss rehabilitation stakeholders regarding the relevance, challenges, and opportunities of the Resolution for Switzerland.

Methods: A cross-sectional online survey was conducted among Swiss rehabilitation stakeholders. Purposive snowball sampling with a quota system ensured a representative sample. Survey development and reporting adhered to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Descriptive analysis was applied to quantitative data, while thematic analysis was used for free-text responses.

Results: A representative sample of 282 Swiss rehabilitation stakeholders completed the survey. Developing multidisciplinary rehabilitation skills emerged as the most relevant action in the Resolution. Primary challenges centred on financing and workforce issues and integrated care, while main opportunities included policy development and advocacy efforts.

Conclusion: This study enhances the understanding of current challenges and opportunities for rehabilitation in Switzerland. Leveraging this approach and related findings into national and international policy considerations can support policymakers responding in a contextualised manner to the urges of the Resolution.

Purpose: The aim of this study was to assess the translation, validation, and reliability of the Albanian ODI (ODI-A) version 2.1b.

Methods: Standardized guidelines for evaluation of psychometric properties were followed. Participants were recruited from a national center with orthopedic-traumatological specialty of an Albanian region. The construct validity, internal consistency, and the reliability of ODI-A measured by seven days test-retest method across two repeated measures were considered.

Results: In total, 200 patients completed the ODI-A 2.1b version: 43% had low back pain, 36% had rheumatoid arthritis as principal diagnosis and the other participants had trauma, luxation, discal hernia, and fractures as diagnosis accompanied by back pain. There were no missing items. The Kaiser-Meyer-Olkin was 0.613 and Bartlett's test of sphericity was found to be significant (p < 0.001). ODI-A showed excellent test-retest reliability of each item (ICC = 0.707-0.959). Cronbach's α for the first completion was 0.684, ICC for ODI-A was 0.629, the SEM was 1.701, and MDC_95% was 4.71.

Conclusions: ODI-A, adapted from a linguistic and cultural perspective, meets validity and reliability requirements necessary for its use in the Albanian population with back pain.

Purpose: To conduct the first known comprehensive examination of loneliness and its correlates in a diverse sample of people with spinal cord injury (SCI).

Methods: A cross-sectional sample of 343 people with SCI provided responses to the 20-item UCLA Loneliness Scale-Version 3. We examined the relation of loneliness to measures of demographic, disability, physical health, and social characteristics.

Results: The majority (56%) of respondents had scores indicating high levels of loneliness. At least a quarter of respondents indicated that they often felt alone, left out, isolated, and lacking in companionship. At least a quarter rarely or never felt there were people who really understood them, with whom they could talk, and with whom they had a lot in common. In univariate analyses, loneliness was associated with several demographic, disability, and health characteristics suggesting potential risk factors. In multiple regression analyses, social characteristics (social integration, social support, satisfaction with social roles) were the most strongly associated with loneliness.

Conclusions: Our findings underscore the high prevalence of loneliness among people with SCI. Given the adverse health consequences of loneliness documented in the general literature, there is an urgent need for researchers, healthcare providers, and policy makers to address the loneliness crisis in this population.

Aim: This study aimed to investigate the validity and reliability of the 2-Minute Step Test (2MST) in patients with lumbar spinal stenosis (LSS).

Method: This cross-sectional study involved 55 volunteers, aged 18-80, diagnosed with lumbar spinal stenosis. The participants were assessed using the 2MST, the 2-Minute Walk Test (2MWT), the 6-Minute Walk Test (6MWT), the Visual Analogue Scale (VAS), and the Oswestry Disability Index (ODI). To evaluate the reliability of the 2MST, test-retest reliability was determined by administering the 2MST again after a 7-day interval. The reliability analysis included the intraclass correlation coefficient (ICC) with a 95% confidence interval (CI), standard error of measurement (SEM), and minimum detectable change at the 95% confidence level (MDC₉₅). For concurrent validity, the correlations of the 2MST with the 2MWT, 6MWT, and ODI were assessed.

Results: The 2MST exhibited excellent test-retest reliability (ICC = 0.94, SEM = 5.56, MDC₉₅=15.41) in LSS patients. Additionally, the 2MST showed significant correlations with the 2MWT (r = 0.842, p < 0.001), 6MWT (r = 0.819, p < 0.001), and ODI score (r = -0.722, p < 0.001).

Conclusion: This study demonstrated that the 2MST is a valid and reliable tool for assessing exercise capacity in individuals with LSS.

Clinicaltrials.gov id: NCT06060821.

Background and aims: Clinical practice guidelines for rehabilitation in musculoskeletal oncology are lacking. Guidelines should include recommendation statements aimed at optimising care to enhance recovery and quality of life. The project aim was to provide a foundation of best practice based upon expert consensus and evidence.

Design: Consensus-based guidelines supported by systematic literature search.

Methods: This was a consensus-based guideline developed with the support of the British Sarcoma Group (BSG). A group of national rehabilitation experts working within bone or soft tissue sarcoma centres across the UK met from December 2019. Evidence was gathered from a narrative literature review. Recommendations were developed with a variety of stakeholders to achieve consensus.

Results: During the face to face consultation event and literature review seven themes were identified which should guide rehabilitation: (1) access to specialist Allied Health Professionals (AHPs) for treatment; (2) documented referral pathway for specialist AHP care; (3) assessment of individual issues, personal and multi-dimensional (holistic) needs; (4) patient centred care; (5) evidence-based rehabilitation treatment; (6) effective communication and provision of information; (7) patient support through access to other services.

Conclusions: Development of consensus-based, evidence-informed rehabilitation guidelines for those treated for primary malignant musculoskeletal tumours, provides rationale and evidence-based recommendations.

Purpose: As the group of technology-dependent children with long-term tracheostomy continues to expand, we aimed to explore parents' lived experience of everyday life with a child dependent on long-term tracheostomy.

Materials and methods: Six parents of four children were interviewed and the transcripts analyzed using Giorgi's descriptive phenomenology.

Results: All aspects of everyday life, parent-child interaction, and interaction with the surrounding outside world were affected by technology dependency. Parents played an active role by acting both as a protective shield between the outside world and the child and as an enabling bridge to help the child interact with the outside world. The active and involved role of parents is interwoven in all aspects, levels, and directions of interaction and everyday life. The lived experiences can be described in four themes: caution and risk awareness due to technology, meeting the demands of technology dependence, strained and constrained by technology dependence, and conflicted feelings about technology dependence.

Conclusions: Long-term tracheostomy and technology-dependency affect and shape everyday life. Practical implications from the study suggest that re-design and co-design between all stakeholders involved are needed to support parental well-being, coping and enhance patient safety for this growing population and their parents.

Background: Several Patient Reported Outcome Measurements (PROMs) can be used to quantify participation in rehabilitation patients, yet there is limited comparative research on their content and psychometric properties to make an informed decision between them.

Objective: To compare the content and several psychometric properties of the Restriction and Satisfaction subscales of the Utrecht Scale for Evaluation of Rehabilitation - Participation (USER-P) with the Patient-Reported Outcomes Measurement Information System Ability to Participate in Social Roles and Activities (PROMIS-APS) and Satisfaction with Social Roles and Activities (PROMIS-SPS) v2.0 8-item short forms.

Methods: A cross-sectional survey among patients who received rehabilitation treatment (N = 563). Coverage of participation domains, distributions, inter-item correlations, internal consistency, construct validity, and discriminative validity were compared between the PROMs.

Results: The USER-P subscales cover more participation domains than the PROMIS short forms. All PROMs demonstrated adequate internal consistency (α > 0.82) and each had >75% of the hypotheses regarding construct validity confirmed.

Conclusions: The internal consistency, construct and discriminative validity were similar between the USER-P subscales and the PROMIS short forms. It appeared that the USER-P offers more broad information about participation on item level and the total scores of PROMIS short forms offer more precise general information regarding participation.

Background: Individuals with spinal cord injury (SCI) are dissatisfied with their bowel care, but 71% have not changed their care for at least 5 years. Recently, individuals with SCI expressed a need for knowledge about bowel care options. Healthcare providers (HCP) play a crucial role in supporting bowel care changes.

Objective: We aimed to understand the barriers and facilitators HCP face when discussing changes in bowel care with individuals with SCI.

Methods: Semi-structured interviews were conducted with HCP in partnership with Spinal Cord Injury British Columbia and key community stakeholders. Barriers and facilitators were extracted, deductively coded using the Theoretical Domains Framework, then inductively analysed for themes.

Results: Themes highlighted that effective bowel care requires diverse knowledge from a multidisciplinary team. Lack of time to prioritise bowel care and limited healthcare resources were barriers to improving care, which may be augmented through regular bowel care review of both medical and person-centered priorities. Facilitators were accessible and tailored knowledge sharing of care options, complemented by peer support.

Conclusion: This study highlights the need for targeted interventions that reduce barriers and enhance facilitators to changing care routines, supporting individuals with SCI to change bowel care when needed, and improving quality of life.