Activity limitations, use of assistive devices, and mortality and clinical events in 25 high-income, middle-income, and low-income countries: an analysis of the PURE study

From Makerspaces to Practice: 3D Printing Expansion to Improve Assistive Technology Access

The rising demand for assistive technology (AT) highlights the potential of 3D printing as an innovative occupational therapy (OT) tool. This cost-effective technology enables the creation of customized AT devices that enhance client participation and well-being through remediation and adaptive approaches. However, adoption in OT practice faces several barriers, including limited practitioner awareness, insufficient training, and time and maintenance challenges. This commentary proposes a tiered approach focused on expanding education and integrating 3D printing into OT training and practice settings. In addition, it advocates for developing and using validated outcome measures to evaluate the effectiveness of 3D-printed devices. Client-reported satisfaction and participation metrics should be prioritized across practice settings to ensure that 3D-printed devices meet occupational goals and user needs. Expanding educational opportunities and developing validated assessment tools focusing on participatory outcomes will support broader integration of 3D printing in OT practice, improving AT access through client and practitioner collaboration.

Exercise and Fitness Quantification in Clinical Practice: Why and How; and Where Are We Going?

Exercise and fitness quantification is increasingly recognized as a critical component in clinical practice, particularly within preventive cardiology. In this article we explore the multifaceted importance of exercise quantification in clinical settings, addressing preventive care, cost-effectiveness, psychosocial benefits, treatment planning, and monitoring progress. Quantifying exercise habits allows clinicians to evaluate risk profiles, prescribe tailored interventions, and monitor patient progress. The methodologies for exercise quantification are discussed. In preventive cardiology, adherence to guidelines from organizations such as the American Heart Association, the European Society of Cardiology, and the Canadian Cardiovascular Society is emphasized, with particular focus on high-intensity interval training and the central role of physical therapists/kinesiologists. Special populations, such as weekend warriors, those reflecting the "fat and fit" concept, athletes, and those at risk of overtraining syndrome, are considered in prescribing exercise. Future directions in exercise and fitness quantification include the integration of advanced wearable technology, personalized medicine, telemedicine, and promotion of active, walkable communities. The incorporation of behavioral science is highlighted as a missing component that can enhance long-term adherence to exercise regimens through motivation, behavior change techniques, patient-centered approaches, and continuous monitoring and feedback. This comprehensive approach aims to optimize cardiovascular health and overall well-being through individualized, evidence-based exercise interventions that are both effective and sustainable.

Multimorbidity and Multiple Disabilities: Present Status and the Roles of Rehabilitation

The world is aging, and an increasing number of countries are becoming aged or super-aged societies. Japan has already become the world's first super-aged society, with an aging rate of 29.1% of the entire population of the country. As of 15 September 2021, there were approximately 36.40 million people aged 65 years and over. The advent of the super-aged society has increased the possibility of multimorbidity and multiple disabilities (MMDs) in the elderly population. According to a survey by the Ministry of Health, Labour and Welfare, the percentage of people with multiple disabilities of all people with physical disabilities has fluctuated between 4.0 and 7.0%, but rapidly increased to 8.9% in 2006 and 17.7% in 2016. This review aimed to establish the present status of MMDs and the rehabilitation for MMDs. In rehabilitation settings, patients with MMDs are more common than patients with a single disease or disability; however, evidence on MMD rehabilitation is insufficient. Inexperienced and unconfident medical professionals are overly cautious in providing rehabilitation; therefore, adequate rehabilitation is not provided. Furthermore, to respond to the rehabilitation needs of patients with MMDs, human resources need to be cultivated, and a scientific basis needs to be built. It is expected that MMD guidelines will soon be developed based on various case studies and surveys. In MMD rehabilitation, it is important to provide "wider, earlier, more intimate, and more connected rehabilitation"; for this, the training and cooperation of rehabilitation medical professionals is necessary.