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Lyons FL, Martin Ginis KA. Multidimensionality of leisure-time physical activity behaviour in adults with spinal cord injury: implications for measurement. Spinal Cord 2024; 62:88-90. [PMID: 38151583 DOI: 10.1038/s41393-023-00947-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/25/2023] [Accepted: 12/06/2023] [Indexed: 12/29/2023]
Abstract
The Physical Activity Recall Assessment for People with SCI (PARA-SCI) has demonstrated the best test-retest reliability and validity of self-report measures of leisure-time physical activity (LTPA) for adults with SCI. However, the absence of internal consistency reliability data has been raised as a concern. Internal consistency is relevant only for unidimensional measures. In other populations, LTPA is known to be a multidimensional construct, evaluated with multidimensional measures. We tested for unidimensionality through secondary analysis of PARA-SCI data (n = 703). Cronbach's α was 0.227. Principal components analysis showed two components/dimensions ('Moderate and Heavy Intensity LTPA' and 'Mild Intensity LTPA') explained 73% of the variance. Binary logic crosstabulation produced no discernible patterns of behavioural interrelatedness across LTPA intensities. Together, these data demonstrate the multidimensionality of LTPA and the PARA-SCI is not unidimensional. Internal consistency should not be a criterion for evaluating LTPA questionnaires for use in studies of people with SCI.
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Affiliation(s)
- Fergus L Lyons
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
- Centre for Chronic Disease Prevention and Management, Kelowna, BC, Canada
| | - Kathleen A Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada.
- Centre for Chronic Disease Prevention and Management, Kelowna, BC, Canada.
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada.
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
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van der Slikke R, de Leeuw AW, de Rooij A, Berger M. The Push Forward in Rehabilitation: Validation of a Machine Learning Method for Detection of Wheelchair Propulsion Type. SENSORS (BASEL, SWITZERLAND) 2024; 24:657. [PMID: 38276350 PMCID: PMC10821488 DOI: 10.3390/s24020657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Within rehabilitation, there is a great need for a simple method to monitor wheelchair use, especially whether it is active or passive. For this purpose, an existing measurement technique was extended with a method for detecting self- or attendant-pushed wheelchair propulsion. The aim of this study was to validate this new detection method by comparison with manual annotation of wheelchair use. Twenty-four amputation and stroke patients completed a semi-structured course of active and passive wheelchair use. Based on a machine learning approach, a method was developed that detected the type of movement. The machine learning method was trained based on the data of a single-wheel sensor as well as a setup using an additional sensor on the frame. The method showed high accuracy (F1 = 0.886, frame and wheel sensor) even if only a single wheel sensor was used (F1 = 0.827). The developed and validated measurement method is ideally suited to easily determine wheelchair use and the corresponding activity level of patients in rehabilitation.
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Affiliation(s)
- Rienk van der Slikke
- Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands; (A.-W.d.L.); (M.B.)
- Department of BioMechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Arie-Willem de Leeuw
- Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands; (A.-W.d.L.); (M.B.)
| | - Aleid de Rooij
- Department of Innovation, Quality and Research, Basalt Revalidatie, 2545 AA The Hague, The Netherlands;
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Monique Berger
- Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands; (A.-W.d.L.); (M.B.)
- Department of Innovation, Quality and Research, Basalt Revalidatie, 2545 AA The Hague, The Netherlands;
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Alhumaid MM, Said MA, Adnan Y, Khoo S. Cross-Cultural Adaptation and Validation of the Arabic Version of the Physical Activity Scale for Individuals with Physical Disabilities in Saudi Arabia (PASIPD-AR). Healthcare (Basel) 2024; 12:179. [PMID: 38255068 PMCID: PMC10815588 DOI: 10.3390/healthcare12020179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
This study aimed to cross-culturally adapt and validate the Arabic version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) with Saudi Arabian participants. The study encompassed four distinct stages: (i) translation and subsequent back-translation; (ii) a preliminary assessment aimed at evaluating the quality of the translated scale; (iii) an assessment of the reliability of the measures employed; and (iv) a comprehensive examination of the validity of the measures. A sample of Saudi Arabian participants with physical disabilities (N = 206) took part, ranging in age from 18 to 70 years old, with an average age of 39.56 years and a standard deviation of 12.16. The findings obtained from the reliability tests indicated a notable level of internal consistency and stability. Experts and confirmatory factor analysis were employed to establish the face, content, and construct validity. The findings of the assessment of the Arabic version of PASIPD demonstrated a satisfactory degree of reliability and validity, rendering it suitable for implementation within the Saudi Arabian setting.
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Affiliation(s)
- Majed M. Alhumaid
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Mohamed A. Said
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Yuhanis Adnan
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Selina Khoo
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
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Almeida LDO, de Lima A, Sprizon GS, Ilha J. Measurement properties of assessment instruments of quality of life in people with spinal cord injury: A systematic review. J Spinal Cord Med 2024; 47:15-50. [PMID: 37707365 PMCID: PMC10795554 DOI: 10.1080/10790268.2023.2254878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
CONTEXT A spinal cord injury or disease (SCI/D) is a devastating condition that affects all areas of a person's life, including quality of life (QoL). Assessing this construct using clinical instruments with adequate measurement properties is fundamental for an effective multi-professional treatment. OBJECTIVE To identify the clinical instruments for assessing the QoL that present the best recommendation for use in people with SCI based on their measurement properties. METHODS The overall methodology was conducted according to Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) systematic review guidance and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted up to March 2023 on MEDLINE/PubMed, Web of Science, Scopus, CINAHL, and Embase databases. RESULTS Seventy-seven studies were included in this review, and 49 instruments were identified. The overall methodological quality of all studies ranged from insufficient to sufficient, and the level of evidence ranged from very low to high confidence. Twenty-six instruments may have the potential to be recommended, and the other 23 should not be recommended. CONCLUSION None of the QoL instruments can be highly recommended as the most suitable instrument for the construct and population of interest. The generic instruments SF-36, SF-12, QWB, WHOQOL-DIS, WHOQOL-BREF, QLI-SCI, QOLP-PD, LS Questions, Lisat-9, and BRFSS are the clinical instruments that have the best measurement properties tested and have the potential to be the current best recommendation for assessing QoL in individuals with SCI.
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Affiliation(s)
- Lorena de Oliveira Almeida
- Spinal Cord Injury Rehabilitation Research Group (SCIR-Group), Physiotherapy Graduate Program, Department of Physiotherapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Aline de Lima
- Spinal Cord Injury Rehabilitation Research Group (SCIR-Group), Physiotherapy Graduate Program, Department of Physiotherapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Giovana Silva Sprizon
- Spinal Cord Injury Rehabilitation Research Group (SCIR-Group), Physiotherapy Graduate Program, Department of Physiotherapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Jocemar Ilha
- Spinal Cord Injury Rehabilitation Research Group (SCIR-Group), Physiotherapy Graduate Program, Department of Physiotherapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
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Brandenbarg P, Hoekstra F, Barakou I, Seves BL, Hettinga FJ, Hoekstra T, van der Woude LHV, Dekker R, Krops LA. Measurement properties of device-based physical activity instruments in ambulatory adults with physical disabilities and/or chronic diseases: a scoping review. BMC Sports Sci Med Rehabil 2023; 15:115. [PMID: 37735403 PMCID: PMC10512652 DOI: 10.1186/s13102-023-00717-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/22/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND People with physical disabilities and/or chronic diseases tend to have an inactive lifestyle. Monitoring physical activity levels is important to provide insight on how much and what types of activities people with physical disabilities and/or chronic diseases engage in. This information can be used as input for interventions to promote a physically active lifestyle. Therefore, valid and reliable physical activity measurement instruments are needed. This scoping review aims 1) to provide a critical mapping of the existing literature and 2) directions for future research on measurement properties of device-based instruments assessing physical activity behavior in ambulant adults with physical disabilities and/or chronic diseases. METHODS Four databases (MEDLINE, CINAHL, Web of Science, Embase) were systematically searched from 2015 to April 16th 2023 for articles investigating measurement properties of device-based instruments assessing physical activity in ambulatory adults with physical disabilities and/or chronic diseases. For the majority, screening and selection of eligible studies were done in duplicate. Extracted data were publication data, study data, study population, device, studied measurement properties and study outcome. Data were synthesized per device. RESULTS One hundred three of 21566 Studies were included. 55 Consumer-grade and 23 research-grade devices were studied on measurement properties, using 14 different physical activity outcomes, in 23 different physical disabilities and/or chronic diseases. ActiGraph (n = 28) and Fitbit (n = 39) devices were most frequently studied. Steps (n = 68) was the most common used physical activity outcome. 97 studies determined validity, 11 studies reliability and 6 studies responsiveness. CONCLUSION This scoping review shows a large variability in research on measurement properties of device-based instruments in ambulatory adults with physical disabilities and/or chronic diseases. The variability highlights a need for standardization of and consensus on research in this field. The review provides directions for future research.
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Affiliation(s)
- Pim Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands.
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands.
| | - Femke Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, V1V 1V7, Canada
| | - Ioulia Barakou
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Bregje L Seves
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, NE1 8ST, UK
| | - Trynke Hoekstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, 1081 BT, The Netherlands
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Rienk Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Leonie A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
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Cummings HC, Merkas J, Yaraskavitch J, Longmuir PE. Impact of Physical Activity Counselling on Children with Medical Conditions and Disabilities and Their Families. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1293. [PMID: 37628292 PMCID: PMC10453572 DOI: 10.3390/children10081293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/13/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023]
Abstract
Physical activity counselling can target cognitive-affective participation barriers, but counselling benefits for children with medical conditions/disabilities were unknown. This study investigated successes, challenges, and the impact of physical activity counselling on children and their families. One-on-one semi-structured interviews were completed with 7 patients (2 male/5 female, aged 13-17) and 4 parents who participated in 2-8 weekly counselling sessions (2015-2020). Interviews were recorded and transcribed verbatim for inductive thematic analyses. Counselling encouraged positive mindset changes (viewing physical activity more holistically, making it "more fun and manageable", helping them to "learn how to love moving and doing sports"). Participants felt strong support (feeling heard, validated, and provided with "hope… that we can still achieve things… even though it may seem like there's limitations"). Counselling was viewed positively. The intent to improve active lifestyle attitudes and confidence was reflected in positive, primarily cognitive-affective (motivation for activity, "more general skills of having a positive attitude towards physical activity and the willingness to try new things") outcomes. More sessions, additional resources to keep, and follow-up after counselling completion were recommended to support behaviour change. Future research should evaluate enhanced counselling services and comparing children who have and have not received such counselling.
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Affiliation(s)
- Hannah C. Cummings
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (H.C.C.); (J.M.)
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
| | - Jordan Merkas
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (H.C.C.); (J.M.)
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
| | - Jenna Yaraskavitch
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
| | - Patricia E. Longmuir
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
- Faculties of Medicine and Health Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada
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de Freitas GR, Abou L, de Lima A, Rice L, Ilha J. Measurement Properties of Clinical Instruments for Assessing Manual Wheelchair Mobility in Individuals with Spinal Cord Injury: A Systematic Review. Arch Phys Med Rehabil 2022; 104:656-672. [PMID: 36272445 DOI: 10.1016/j.apmr.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To evaluate the measurement properties of clinical instruments used to assess manual wheelchair mobility in individuals with spinal cord injury (SCI). DATA SOURCES This systematic review was conducted according to the Consensus-Based Standards for the Selection of Health Measurement Instruments guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search was conducted up to December 2021 on MEDLINE/PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Biblioteca Regional de Medicina, and Cumulative Index to Nursing and Allied Health databases without time restriction. STUDY SELECTION Peer-reviewed original research articles that examined any clinical wheelchair mobility and/or skill assessment instrument among adults with SCI and reported data on at least one measurement property or described the development procedure were evaluated independently by two reviewers. DATA EXTRACTION Data were independently extracted according to Consensus-Based Standards for the Selection of Health Measurement Instruments methodology. Measurement property results from each study were independently rated by two reviewers as sufficient, insufficient, indeterminate, or inconsistent. The evidence for each measurement property was rated as high, moderate, low, or very low (Grading of Recommendations, Assessment, Development, and Evaluation). Recommendations for highly-rated instruments were performed. DATA SYNTHESIS Twenty-nine studies with 21 instruments were identified. The methodological quality of studies ranged from insufficient to sufficient, and the quality of evidence ranged from very low to high. Six instruments reported content validity. Reliability and construct validity were the most studied measurement properties. Structural validity and invariance for cross-cultural measurement were not reported. The highly rated instruments were the Wheelchair Outcome Measure and Wheelchair Skills Test Questionnaire. CONCLUSIONS Although numerous instruments for assessing wheelchair mobility and/or skills among individuals with SCI were identified, not many measurement properties have been sufficiently established. The Wheelchair Outcome Measure and Wheelchair Skills Test Questionnaire show the current best potential to be recommended for clinical and research use. Further studies are needed to strengthen or change these recommendations.
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Callupe Luna J, Martinez Rocha J, Monacelli E, Foggea G, Hirata Y, Delaplace S. WISP, Wearable Inertial Sensor for Online Wheelchair Propulsion Detection. SENSORS 2022; 22:s22114221. [PMID: 35684843 PMCID: PMC9185644 DOI: 10.3390/s22114221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 12/10/2022]
Abstract
Manual wheelchair dance is an artistic recreational and sport activity for people with disabilities that is becoming more and more popular. It has been reported that a significant part of the dance is dedicated to propulsion. Furthermore, wheelchair dance professionals such as Gladys Foggea highlight the need for monitoring the quantity and timing of propulsions for assessment and learning. This study addresses these needs by proposing a wearable system based on inertial sensors capable of detecting and characterizing propulsion gestures. We called the system WISP. Within our initial configuration, three inertial sensors were placed on the hands and the back. Two machine learning classifiers were used for online bilateral recognition of basic propulsion gestures (forward, backward, and dance). Then, a conditional block was implemented to rebuild eight specific propulsion gestures. Online paradigm is intended for real-time assessment applications using sliding window method. Thus, we evaluate the accuracy of the classifiers in two configurations: “three-sensor” and “two-sensor”. Results showed that when using “two-sensor” configuration, it was possible to recognize the propulsion gestures with an accuracy of 90.28%. Finally, the system allows to quantify the propulsions and measure their timing in a manual wheelchair dance choreography, showing its possible applications in the teaching of dance.
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Affiliation(s)
- Jhedmar Callupe Luna
- Versailles Engineering Systems Laboratory, University of Versailles Saint-Quentin-en-Yvelines, University of Paris-Saclay, 78140 Vélizy, France; (E.M.); (S.D.)
- Correspondence: (J.C.L.); (J.M.R.); Tel.: +33-01-3925-4958 (J.C.L. & J.M.R.)
| | - Juan Martinez Rocha
- Versailles Engineering Systems Laboratory, University of Versailles Saint-Quentin-en-Yvelines, University of Paris-Saclay, 78140 Vélizy, France; (E.M.); (S.D.)
- Correspondence: (J.C.L.); (J.M.R.); Tel.: +33-01-3925-4958 (J.C.L. & J.M.R.)
| | - Eric Monacelli
- Versailles Engineering Systems Laboratory, University of Versailles Saint-Quentin-en-Yvelines, University of Paris-Saclay, 78140 Vélizy, France; (E.M.); (S.D.)
| | - Gladys Foggea
- Compagnie Tatoo “Danse Contemporaine Inclusive”, 77185 Lognes, France;
| | - Yasuhisa Hirata
- Smart Robots Design Lab, Tohoku University, Sendai 980-8579, Japan;
| | - Stéphane Delaplace
- Versailles Engineering Systems Laboratory, University of Versailles Saint-Quentin-en-Yvelines, University of Paris-Saclay, 78140 Vélizy, France; (E.M.); (S.D.)
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Lankhorst K, Sol M, van den Berg-Emons R, Horemans H, de Groot J. The Preliminary Criterion Validity of the Activ8 Activity Monitor to Measure Physical Activity in Youth Using a Wheelchair. Pediatr Phys Ther 2021; 33:268-273. [PMID: 34417429 DOI: 10.1097/pep.0000000000000821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to assess the criterion validity of the Activ8 to detect "active wheelchair use" and to distinguish 6 types of wheelchair activities using video recordings as a gold standard. METHODS Ten participants who use a manual wheelchair were participants in this study. Data of 2 participants were used for adapting the algorithm and data of 7 participants were used for assessing the criterion validity. RESULTS Criterion validity for detecting "active wheelchair use" had a relative time difference of 7.4%, agreement of 96%, sensitivity of 98.3%, and positive predictive value of 90%. Results for distinguishing 6 types of wheelchair activities had an agreement of 73%, sensitivity of 67.1%, and positive predictive value of 65.5%. CONCLUSIONS The Activ8 is able to detect "active wheelchair use" in youth using a manual wheelchair. Further development of the algorithm is necessary to distinguish between different types of wheelchair activities.
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Affiliation(s)
- Kristel Lankhorst
- Research Group Lifestyle and Health (Drs Lankhorst, Sol, and de Groot), HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Institute for Human Movement Studies (Dr Lankhorst), HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine (Dr Sol), UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; Department of Rehabilitation Medicine (Drs Berg-Emons and Horemans), Erasmus University Medical Center, Rotterdam, the Netherlands; Knowledge Institute of the Federation of Medical Specialists (Dr de Groot), Utrecht, the Netherlands
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Martin Ginis KA, van der Ploeg HP, Foster C, Lai B, McBride CB, Ng K, Pratt M, Shirazipour CH, Smith B, Vásquez PM, Heath GW. Participation of people living with disabilities in physical activity: a global perspective. Lancet 2021; 398:443-455. [PMID: 34302764 DOI: 10.1016/s0140-6736(21)01164-8] [Citation(s) in RCA: 136] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/13/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022]
Abstract
Approximately 1·5 billion people worldwide live with a physical, mental, sensory, or intellectual disability, about 80% of which are in low-income and middle-income countries. This Series paper provides a global overview of the prevalence, benefits, and promotion policies for physical activity for people living with disabilities (PLWD). PLWD are 16-62% less likely to meet physical activity guidelines and are at higher risk of serious health problems related to inactivity than people without disabilities. Meta-analyses have shown that physical activity has beneficial effects on cardiovascular fitness (average standardised mean difference [SMD] 0·69 [95% CI 0·31-1·01]), musculoskeletal fitness (0·59 [0·31-0·87]), cardiometabolic risk factors (0·39 [0·04-0·75]), and brain and mental health outcomes (0·47 [0·21-0·73]). These meta-analyses also show that health benefits can be achieved even with less than 150 min of physical activity per week, and suggest that some physical activity is better than none. Meta-analyses of interventions to increase physical activity for PLWD have reported effect sizes ranging from SMD 0·29 (95% CI 0·17-0·41, k=10) to 1·00 (0·46-1·53, k=10). There is increasing awareness among policy makers of the needs of PLWD for full participation in physical activity. Physical activity action plans worldwide must be adequately resourced, monitored, and enforced to truly advance the fundamental rights of PLWD to fully participate in physical activity.
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Affiliation(s)
- Kathleen A Martin Ginis
- Department of Medicine and Centre for Chronic Disease Prevention and Management and International Collaboration on Repair Discoveries, Faculty of Medicine, School of Health and Exercise Sciences, Faculty of Health and Social Development, and Reichwald Health Sciences Centre, University of British Columbia, Kelowna, BC, Canada.
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Byron Lai
- Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland; Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Michael Pratt
- Institute for Public Health and Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Celina H Shirazipour
- Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Brett Smith
- School of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Priscilla M Vásquez
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
| | - Gregory W Heath
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, USA
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11
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Bekteshi S, Nica IG, Gakopoulos S, Konings M, Maes R, Cuyvers B, Aerts JM, Hallez H, Monbaliu E. Exercise load and physical activity intensity in relation to dystonia and choreoathetosis during powered wheelchair mobility in children and youth with dyskinetic cerebral palsy. Disabil Rehabil 2021; 44:4794-4805. [PMID: 33970729 DOI: 10.1080/09638288.2021.1921064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore the relation between exercise load, physical activity intensity, and movement disorders during powered wheelchair (PW) mobility in people with severe dyskinetic cerebral palsy (DCP). METHODS Ten participants with DCP, 6-21 years old, users of a head/foot steering system were included. Dystonia and choreoathetosis were assessed using the Dyskinesia Impairment Mobility Scale (DIMS), heart rate (HR) was used to assess the exercise load of the tasks on the participants, and the accelerometry-based activity index (AI) to measure the physical activity intensity and energy expenditure during mobility task performance. RESULTS Neck- and distal arm dystonia showed significant correlations with HR (0.64 < rs < 0.77; 0.009 < p < 0.048), whereas neck- and proximal arm choreoathetosis with AI (0.64 < rs < 0.76, 0.011 < p < 0.044). Total-body AI was strongly correlated to the AI of the arms (0.66 < rs < 0.90, < 0.001 < p < 0.038), but not to the AI of the head. CONCLUSIONS During PW mobility tasks, dystonia is associated to exercise load and choreoathetosis to physical activity intensity and energy expenditure. Findings highlight the difficulties in measuring exercise load and activity intensity in PW users with DCP due to the involuntary hypertonic and/or hyperkinetic hallmark of the movement disorders. Nevertheless, a relaxed surrounding with minimal distractions during PW training may increase learning efficiency. Future studies with a bigger sample size are highly recommended to fully establish the relationship between the variables and to allow generalizability of results.Implications for rehabilitationDystonia is positively related to heart rate during powered mobility, which may be explained by the hypertonic hallmark of dystonia causing an increase in exercise load.Choreoathetosis is positively related to the physical activity index during powered mobility where the hyperkinetic hallmark of choreoathetosis may lead to an increase in physical activity intensity and energy expenditure.Arm overflow movements are the component which contribute the most to total-body activity index, thus, minimizing these movements may lower the overall energy expenditure during powered mobility.Mobility training in a relaxed surrounding with minimal distractions and minimized arm overflow movements may lead to a less-demanding powered wheelchair mobility experience and increased learning efficiency.
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Affiliation(s)
- Saranda Bekteshi
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Ioana Gabriela Nica
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Sotirios Gakopoulos
- KU Leuven, Bruges Campus, Department of Computer Science, Mechatronics Research Group, Bruges, Belgium
| | - Marco Konings
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Rozanne Maes
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Benoit Cuyvers
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Jean-Marie Aerts
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Hans Hallez
- KU Leuven, Bruges Campus, Department of Computer Science, Mechatronics Research Group, Bruges, Belgium
| | - Elegast Monbaliu
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
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12
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Seves BL, Hoekstra F, Schoenmakers JW, Brandenbarg P, Hoekstra T, Hettinga FJ, Dekker R, van der Woude LH, van der Schans CP. Test-retest reliability and concurrent validity of the Adapted Short QUestionnaire to ASsess Health-enhancing physical activity (Adapted-SQUASH) in adults with disabilities. J Sports Sci 2020; 39:875-886. [DOI: 10.1080/02640414.2020.1850983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Bregje L. Seves
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - Femke Hoekstra
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | - Jorrit W.A. Schoenmakers
- University of Groningen, University Medical Center Groningen, Department of Orthopedics, Groningen, The Netherlands
| | - Pim Brandenbarg
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Trynke Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Lucas H.V. van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise & Health Sciences, Loughborough University, UK
| | - Cees P. van der Schans
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
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13
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Candoni G, Coronel E, Sanchez-Correa C, Tomadín R, Valdez M. [Psychometric properties of observational instruments to evaluate wheelchair skills in persons with a spinal cord injury: A systematic review]. Rehabilitacion (Madr) 2020; 55:125-137. [PMID: 33272607 DOI: 10.1016/j.rh.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/18/2022]
Abstract
A total of 60% of people with a spinal cord injury are completely dependent on a wheelchair. There is a wide variety of instruments that assess wheelchair skills, but they are not specific for this population. OBJECTIVE: To identify, assess, compare and summarize the psychometric properties of instruments that assess wheelchair skills in persons with a spinal cord injury. A systematic review was conducted and observational instruments were included that assessed wheelchair skills in persons with spinal cord injury. Eleven articles were identified that evaluated eight instruments. Most of them reported activities according to the International Classification of Functioning, Disability and Health. Reliability was the most frequently evaluated psychometric property. The Queensland Evaluation of Wheelchair Skills and the Adapted Manual Wheelchair Circuit had the best degrees of confidence in the evidence, and their application could guide the selection of pertinent therapeutic strategies. PROSPERO registration: CRD42020161430.
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Affiliation(s)
- G Candoni
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina.
| | - E Coronel
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina
| | - C Sanchez-Correa
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina
| | - R Tomadín
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina
| | - M Valdez
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina
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14
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Construct validation of the leisure time physical activity questionnaire for people with SCI (LTPAQ-SCI). Spinal Cord 2020; 59:311-318. [PMID: 33040086 DOI: 10.1038/s41393-020-00562-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional construct validation study. OBJECTIVES To test the construct validity of the Leisure Time Physical Activity Questionnaire for People with Spinal Cord Injury (LTPAQ-SCI) by examining associations between the scale responses and cardiorespiratory fitness (CRF) in a sample of adults living with spinal cord injury (SCI). SETTING Three university-based laboratories in Canada. METHODS Participants were 39 adults (74% male; M age: 42 ± 11 years) with SCI who completed the LTPAQ-SCI and a graded exercise test to volitional exhaustion using an arm-crank ergometer. One-tailed Pearson's correlation coefficients were computed to examine the association between the LTPAQ-SCI measures of mild-, moderate-, heavy-intensity and total minutes per week of LTPA and CRF (peak volume of oxygen consumption [V̇O2peak] and peak power output [POpeak]). RESULTS Minutes per week of mild-, moderate- and heavy-intensity LTPA and total LTPA were all positively correlated with V̇O2peak. The correlation between minutes per week of mild intensity LTPA and V̇O2peak was small-medium (r = 0.231, p = 0.079) while all other correlations were medium-large (rs ranged from 0.276 to 0.443, ps < 0.05). Correlations between the LTPAQ-SCI variables and POpeak were also positive but small (rs ranged from 0.087 to 0.193, ps > 0.05), except for a medium-sized correlation between heavy-intensity LTPA and POpeak (r = 0.294, p = 0.035). CONCLUSIONS People with SCI who report higher levels of LTPA on the LTPAQ-SCI also demonstrate greater levels of CRF, with stronger associations between moderate- and heavy-intensity LTPA and CRF than between mild-intensity LTPA and CRF. These results provide further support for the construct validity of the LTPAQ-SCI as a measure of LTPA among people with SCI.
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Meunier P, Joussain C, Gremeaux V, Carnet D, Bastable P, Ruet A, Drigny J. Transcultural adaptation and validation of a French version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD-Fr). Ann Phys Rehabil Med 2020; 64:101423. [PMID: 32763488 DOI: 10.1016/j.rehab.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/08/2020] [Accepted: 07/05/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Pierre Meunier
- Service de Médecine Physique et de Réadaptation, CHU de Caen Normandie, Normandie Univ, UNICAEN, Caen, France
| | - Charles Joussain
- Université de Versailles St-Quentin en Yvelines, INSERM UMR 1179, Montigny-le-Bretonneux, France
| | - Vincent Gremeaux
- Swiss Olympic Medical Center, Division de médecine physique et réadaptation, CHUV, 1011 Lausanne, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Didier Carnet
- Department of Medical English, Medical School of Dijon, University of Burgundy, France
| | - Philip Bastable
- Department of Medical English, Medical School of Dijon, University of Burgundy, France
| | - Alexis Ruet
- Service de Médecine Physique et de Réadaptation, CHU de Caen Normandie, Normandie Univ, UNICAEN, CHU de Caen Normandie, INSERM UMR-SU1077, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Joffrey Drigny
- Service de Médecine Physique et de Réadaptation, Service de Médecine du Sport, CHU de Caen Normandie, Normandie Univ, UNICAEN, INSERM, COMETE, GIP CYCERON, Caen, France.
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Bombardier CH, Dyer JR, Burns P, Crane DA, Takahashi MM, Barber J, Nash MS. A tele-health intervention to increase physical fitness in people with spinal cord injury and cardiometabolic disease or risk factors: a pilot randomized controlled trial. Spinal Cord 2020; 59:63-73. [PMID: 32694748 DOI: 10.1038/s41393-020-0523-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Clinical trial. OBJECTIVES We used a single-blind parallel-group design to test the feasibility and preliminary efficacy of a telehealth-based physical activity counseling intervention to increase physical fitness in people with SCI. SETTING Seattle, Washington, United States. METHODS We recruited under-active, manual wheelchair-using adults at least 1-year post-SCI who had at least two cardiometabolic risk factors/diseases. Participants underwent baseline tests of peak cardiorespiratory fitness; lipids, glucose and insulin; muscle and fat mass; self-reported physical activity, depression, pain and other factors. Participants were assigned 1:1 to treatment vs. usual care (UC) control conditions via concealed computerized randomization. Treatment was delivered via telephone and adapted from the 16-session Diabetes Prevention Program. All baseline tests were repeated at 6 months. Prespecified feasibility goals were to recruit at least nine participants/quarter and retain 85% with complete fitness testing at 6 months. Prespecified efficacy goals were to demonstrate at least a medium treatment effect size (0.50) on fitness, self-reported physical activity, and other outcomes. RESULTS Seven participants were randomized to treatment, 8 to UC over 15 months. Maximum recruitment was only 5.4 participants/quarter. Thirteen (87%) of participants were retained. The effects of treatment on fitness and most cardiometabolic risk factors did not meet expectations, whereas the effects on self-reported physical activity, depression, and pain did meet expectations. CONCLUSIONS The study did not meet key efficacy and feasibility objectives, yet there were some promising effects on self-report measures and lessons to be learned for designing future trials.
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Affiliation(s)
- Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
| | | | - Patricia Burns
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Deborah A Crane
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | | | - Jason Barber
- Department of Neurosurgery, University of Washington, Seattle, WA, USA
| | - Mark S Nash
- Departments of Neurological Surgery, Physical Medicine & Rehabilitation and Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, USA
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