Disability and Rehabilitation最新文献

Purpose: To assess the efficacy of pulmonary rehabilitation (PR) on fatigue in patients with post-COVID-19 syndrome (PCS).

Methods: A systematic review and a meta-analysis were performed until 21 October 2024 in 4 databases (CINAHL, Medline, Scopus and Web of Science). Inclusion criteria: Population: patients (≥18 years) with PCS; Intervention: PR; Comparison: control group (CG) vs. placebo; Outcome: fatigue assessed before and after the intervention; Study: randomized clinical trials. Methodological quality was assessed with Downs and Black scale and risk of bias with Cochrane risk-of-bias tool. Meta-analysis was conducted with RevMan 5.4.

Results: Thirteen studies were included in the systematic review and 10 in the meta-analysis. The meta-analysis showed a moderate effect size (SMD = -0.59, 95% CI = -0.89, -0.28; p = 0.0002, n = 973) in favor of PR compared to CG for fatigue, with significant differences. Compared to CG, fatigue in patients with PCS was reduced to a greater extent in PR group (both center-based PR and home-based PR, and both <12 weeks of PR and ≥12 weeks of PR), with significant differences.

Conclusion: This review demonstrates the efficacy of PR as a promising intervention for alleviating fatigue in patients with PCS, revealing a significantly greater reduction in fatigue in PR group compared to CG.

Prospero registration number: CRD42022310791.

Purpose: Young and middle-aged women engage in distinct occupations, facing unique post-stroke challenges that complicate their recovery. However, little is known about their experiences with occupational engagement following a stroke. This qualitative systematic review aimed to explore the post-stroke experiences of women aged 18-65 from an occupational perspective of health.

Methods: A comprehensive search of five databases identified qualitative studies on post-stroke experiences of women aged 18-65. Two reviewers independently appraised the methodological quality of eligible studies. Data were extracted and synthesised using the Joanna Briggs Institute (JBI) method of meta-aggregation.

Results: Seven studies were included. From 103 extracted findings, 18 aggregated categories and six synthesised findings emerged, relating to impacts on (1) daily life, domestic roles, self-efficacy and identity (2) work (3) relationships (4) health and recovery (5) adjustment and coping, and (6) experiences with healthcare.

Conclusion: Post-stroke occupational engagement in young and middle-aged women was disrupted across various life domains, reflecting its dynamic and intersectional nature with individual experiences of doing, being, belonging and becoming. Systematic barriers and societal attitudes posed additional challenges to recovery. These findings underscore the need for equitable, person-centred interventions to facilitate occupational engagement for health and well-being in this population.

Purpose: This scoping review aims to give an overview of the literature describing medical complications in children from 2 to 17 years, arising in the subacute and chronic phases after pediatric CNS injury, and to identify knowledge gaps on the subject.

Methods: Our scoping review of publications in databases Embase and Medline follows the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).

Results: We identified 11,497 articles published from 2000 to 2024. Initial screening reduced these to 1,220, which were reviewed in full-text, resulting in inclusion of 373 publications. Acquired brain injury was the most common CNS injury, with neoplastic etiology as the dominating subgroup. The majority of the articles were retrospective studies and case studies. Most publications reported one complication, and comprehensive approaches were scarce. Epilepsy and endocrine disturbances were the most frequently reported complications in brain injury patients, and scoliosis and pressure ulcers predominated in the spinal cord injury group.

Conclusion: Despite a broad literature on the current topic, more longitudinal studies are needed, especially studies with a comprehensive approach to the medical complications that can occur after the acute phase in children with CNS injury.

Background: Health care providers face many challenges with delivering care in rural areas. However, little is known about their experiences of providing care to marginalized populations, such as children with disabilities. The purpose of this study was to explore the experiences of health care providers serving rural children with disabilities.

Methods: We conducted a scoping review following the Joanna Briggs Institute methodology and an inductive thematic approach involving eight international databases (Embase, CINAHL, JBI EBP, Healthstar, Ovid Medline, PsycINFO, Scopus, Web of Science). Of the 2631 screened articles, 31 met the inclusion criteria.

Results: The studies spanned across seven countries over a 24-year period. Our findings involved the following themes: (1) training and knowledge of childhood-onset disabilities (i.e., lack of training; adequate training); (2) communication (i.e., communication concerns; effective communication and rapport building with local communities); and (3) lack of resources, services and supports (i.e., staff shortages; travel and accessibility issues; challenges of intersectional needs of rural patients).

Conclusions: Our findings emphasize the extent of the challenges that rural health care providers encounter in delivering care to children with disabilities. There is a critical need for further supports, resources and targeted interventions to recruit and retain rural health care providers.

Purpose: Children with incomplete recovery from Brachial Plexus Birth Injury (BPBI) experience varying degrees of upper limb impairment, and 20-30% require interventions to optimize function. A psychometrically validated measure of upper limb activity capacity is essential to guide shared clinical decisions for surgical and rehabilitation interventions.

Materials and methods: Following the Joanna Briggs Institute Manual for Evidence Synthesis, this systematic review included studies on the measurement properties of the Brachial Plexus Outcome Measure (BPOM) - Activity Scale, a performance-based outcome measure of upper limb activity capacity in children with BPBI. Three databases were searched from inception to October 2023. Methodological quality was assessed and summarized using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN)'s Risk of Bias checklist.

Results: Of 11 screened, 6 studies were included. The quality of measurement property studies was very good (27%, n = 4), adequate (7%, n = 1), doubtful (20%, n = 3) and inadequate (47%, n = 7). The BPOM - Activity Scale demonstrated strong internal consistency, with good reliability and construct validity. Additional evidence on its content validity and reliability is necessary.

Conclusions: Overall, the BPOM - Activity Scale has the potential to provide evidence-based information to support the rehabilitation of children with BPBI.

Purpose: To identify and prioritise key activities to promote functional independence and reduce the risk of hospital-associated deconditioning for older adults admitted to our acute care wards.

Materials and methods: A local, stand-alone evaluation and planning project using group concept mapping methodology. Multidisciplinary healthcare workers took part in a statement generation activity, individually sorted these statements into themes, and rated each statement for perceived importance and current success. Applying multidimensional scaling and hierarchical cluster analysis to the sorted data produced visual representations of the statements (concept maps), and rating scores enabled identification of agreed priorities for improvement.

Results: Seventy-eight participants took part in ideas generation, 25 in sorting, and 86 in rating. An eight-item cluster map was agreed upon, with the following named clusters: optimising nutrition and hydration; facilitating independence, especially at mealtimes; creating an enabling 'rehabilitative' culture; get up, get dressed, get moving; inclusion and engagement for patient wellbeing; understanding and managing risk; working together, preparing for home; and organisation of care in an acute hospital setting.

Conclusion: The findings from this group concept mapping project highlight the importance of adopting a multidimensional approach to promoting functional independence and reducing the risk of hospital-associated deconditioning for hospitalised older adults.

Purpose: Parenting a child with a disability can be overwhelming, can increase family conflicts, and reduce quality of life. Limited resources and support intensify these challenges. We aimed to assess the extent of parental stress, social support, and their correlates among parents of children with physical disabilities (PDs) in Nepal.

Methods: A cross-sectional analytical study was conducted among 280 parents at the Hospital and Rehabilitation Center for Disabled Children (HRDC) in Nepal. Face-to-face interviews were conducted using the parental stress scale (PSS) and the multidimensional scale for perceived social support (MSPSS).

Results: The results revealed a negative correlation between parental stress and social support. Fathers, high-income families (>25000 NPR), or those having children with musculoskeletal disabilities, experienced less parental stress. Parents with a primary education faced high parental stress. Parents in nuclear families or with primary education were less likely to perceive high social support.

Conclusion: Fathers, those with higher income or education, or those caring for children with musculoskeletal disabilities, suffered less parental stress. With the increased perception of social support, the parental stress decreased. Support systems should be expanded and strengthened, targeting mothers, nuclear families, and parents with low education and income.

Purpose: This study aimed to develop a tailored International Classification of Functioning, Disability and Health (ICF) Core Set for driving rehabilitation in South Korea, addressing the functional needs of individuals with disabilities and the gaps in the current rehabilitation system.

Materials and methods: An initial item pool was created based on focus group interviews with 13 individuals with disabilities who use assistive driving technologies. This was followed by two Delphi rounds with 12 occupational therapy experts. Items were rated for relevance using Lawshe's content validity ratio (CVR), with a threshold of 0.54. Additional items were proposed during the process and reviewed in the second round.

Results: The final Core Set included 55 ICF categories: 17 body functions, 21 activities and participation items, and 17 environmental factors. These categories reflect key cognitive, sensory, and physical demands of driving, as well as social and environmental conditions that influence driving performance.

Conclusions: The developed ICF Core Set provides a function-based framework for driving rehabilitation that is applicable to the Korean context. It offers a foundation for assessment, service design, and policy development. Future research should examine its clinical utility and cross-disciplinary applicability.