Comprehensive rehabilitation at Beitostølen Healthsports Centre: Influence on mental and physical functioning

What fits me? Procurement of adapted tricycle for activity and participation

PURPOSE

To determine which factors are relevant when applying for the most appropriate adapted tricycle for people with disabilities.

METHODS

Patients participating in a rehabilitation programme and planning to apply for an adapted tricycle were invited to participate in an observational study. Measurements used were watts when pedalling, 6-minute walk test, the Trunk Impairment Scale, 30 s sit-to-stand test, Oxford Scale of muscle strength and range of motion testing. Participants answered questions about important factors for choice of tricycle. Nonparametric correlation tests were performed using SPSS to investigate relevant associations between test results and tricycle type.

RESULTS

The study included 37 participants with a large variety of complex disabilities who applied for 9 different adapted tricycles. Participants ranged in age from 5 to 79 years (M = 24 years, SD = 20), with almost half (49%) under 18 years of age. More than half of the participants (57%) were women. Most participants chose an assistive motor. Participants over 50 years applied for a recumbent tricycle. Answers on questionnaire revealed safety, comfort and mastery as important factors for tricycle choice.

CONCLUSIONS

Large variations in personal characteristics and needs indicate that individually tailored assessments are necessary to find the most appropriate tricycle.Implications for rehabilitationLarge variations of characteristics and needs among people with disabilities and tricycle types indicate individual-level analyses are necessary to find the most appropriate one.A large selection of tricycles and support from an experienced professional when testing are success factors for finding the most appropriate tricycle.

One-year trajectories of mental and physical functioning during and after rehabilitation among individuals with disabilities

Purpose

First, to evaluate the trajectories of physical and mental functioning in individuals with chronic disabilities receiving adapted physical activity-based rehabilitation. Second, to determine whether demographic factors, disability group, pain, fatigue and self-efficacy at baseline influenced these trajectories.

Research design

A prospective intervention study.

Methods

The study included 214 subjects with chronic disabilities who were admitted to a four-week adapted physical activity-based rehabilitation stay at Beitostølen Healthsports Centre. The subjects completed written questionnaires eight and four weeks before the rehabilitation, at admission to and discharge from the rehabilitation centre and again four weeks and 12 months after discharge. Multilevel models were performed to examine the trajectories of SF-12 physical and mental functioning with possible predictors.

Results

Time yielded a statistically significant effect on physical and mental functioning (p < 0.001). Low age (p = 0.002), no more than 2 h of personal assistance per week (p = 0.023), non-nervous system disability (p = 0.019), low pain level (p < 0.001) and high chronic disease-efficacy (p = 0.007) were associated with higher physical functioning. There was a greater improvement in physical functioning for subjects with lower chronic disease-efficacy at baseline (p = 0.036) and with a disability not associated with the nervous system (p = 0.040). Low fatigue (p = 0.001) and high chronic disease-efficacy (p = 0.004) predicted higher mental functioning. There was also a greater improvement in mental functioning for subjects with high fatigue (p =0.003) and low chronic disease efficacy at baseline (p = 0.032).

Conclusion

Individuals with chronic disabilities who participated in an adapted physical activity-based intervention showed statistically significant increases in both physical and mental functioning across the 12 months after the intervention. The greatest improvement was among subjects with a high level of fatigue and low chronic disease-efficacy, as well as disabilities not associated with the nervous system, which has implications for the target groups in future rehabilitation.

Implementation of ICF in goal setting in rehabilitation of children with chronic disabilities at Beitostolen Healthsports Centre

PURPOSE

Develop an International Classification of Functioning, Disability and Health (ICF) Code Set, useful in goal oriented rehabilitation of a study population of children with chronic disabilities.

METHOD

A triangulation of methods, using an interview to identify the main needs and goals of the study population, and a questionnaire to identify the main problems, with a registration of the frequency within each category. After qualitative and quantitative analyses this resulted in two sets of ICF categories. These two sets were then compared and merged into a proposed ICF Code Set for goal setting.

RESULTS

Thirty categories were identified from the interviews and the following linking process. Problems were reported in all suggested categories within the ICF questionnaire, resulting in 49 categories. The comparison of the two sets of categories resulted in a proposed ICF Code Set of 40 categories.

CONCLUSIONS

Through a triangulation of methods, we developed a tailored code set for the goal setting process in rehabilitation for children with a disability, taking into account both individual preferences and the health professionals' perspective. Although the external validity is limited, our methodological procedures may have relevance for the implementation of ICF in other clinical settings and populations.