1
|
Quamar AH, Schmeler MR, Collins DM, Schein RM. Development and content validation of the Electronic Instrumental activities of daily living Satisfaction Assessment (EISA) outcome tool. Assist Technol 2024; 36:360-365. [PMID: 34232842 DOI: 10.1080/10400435.2021.1953192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 10/20/2022] Open
Abstract
This study describes the development and content validation of the Electronic Instrumental activities of daily living Satisfaction Assessment (EISA), a self-report outcome measure for assessing satisfaction with completing instrumental Activities of Daily Living (IADL) for People With Disabilities (PWD) using internet-Connected Assistive Devices (iCAD). For this study, an iCAD is defined as any information communication technology/electronic device or software that assists with promoting, maintaining, and/or enhancing the ability of a PWD to live independently in society. Phase 1 of development involved generating an initial item pool based on a literature review. Content validity of the EISA was computed in Phase 2 using the Qualtrics on-line research platform. Utilizing the content validity index procedure, EISA demonstrated acceptable content validity: item level (I-CVI of 0.78 or higher) and scale level (S-CVI/Ave of 0.90 or higher). EISA version 1.0 was generated in Phase 3 where it is the first of its kind outcome measure specifically designed for assessing satisfaction with completing IADL for PWD using iCAD.
Collapse
Affiliation(s)
- Abbas H Quamar
- Department of Rehabilitation Counseling, University of Arkansas at Little Rock, Little Rock, Arkansas, USA
| | - Mark R Schmeler
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh Pennsylvania, USA
| | - Diane M Collins
- Department of Occupational Therapy, University of Texas Medical Branch, Galveston, Texas, USA
| | - Richard M Schein
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh Pennsylvania, USA
| |
Collapse
|
2
|
Morrow C, Schein R, Pramana G, McDonough C, Schmeler M. Falls in people with mobility limitations: a cross-sectional analysis of a US registry of assistive device users. Disabil Rehabil Assist Technol 2024:1-7. [PMID: 38958175 DOI: 10.1080/17483107.2024.2369654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/04/2024]
Abstract
Purpose of the Article: To (1) summarise the personal and clinical characteristics of persons with disabilities (PwDs) in the US who were evaluated for mobility assistive equipment (MAE) in the functional mobility assessment and uniform dataset (FMA/UDS) and (2) stratify subpopulations of PwD who reported falling versus those who do not report a fall. Materials and Methods: This study was a retrospective, descriptive cohort analysis of adults with disabilities using the FMA/UDS. Data are collected during a user's initial evaluation for a new mobility device. The sample is intentionally general to be inclusive of all mobility device users. The primary variable of interest was a patient-reported fall within the 3 months leading up to their evaluation for a new mobility device. Subpopulation characteristics were stratified by this binary fall variable. Results and Conclusions: This study provides descriptions of PwDs being evaluated for a new mobility device. There were 11,084 PwDs with 31 different primary diagnoses. During their new mobility device evaluation, 52.2% of PwDs reported at least one fall in the last 3 months. For those who reported a fall, 46.6% of PwDs were using a walking aid or no device at all before the new mobility device evaluation. Additionally, persons with progressively acquired disabilities (i.e., Parkinson's disease, osteoarthritis and cardiopulmonary disease) reported higher rates of falls than those with congenital disabilities (i.e., cerebral palsy and spina bifida). These findings will influence future studies comparing different types of devices and their influence on falls and user satisfaction.
Collapse
Affiliation(s)
- Corey Morrow
- Department of Occupational Therapy, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Richard Schein
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gede Pramana
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Christine McDonough
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark Schmeler
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
3
|
Jahan AM, Guitard P, Jutai JW. Psychosocial predictors of mobility assistive devices non-adherence among older adults. Disabil Rehabil Assist Technol 2024:1-9. [PMID: 38393746 DOI: 10.1080/17483107.2024.2320723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Background: Mobility assistive devices (MADs) provide support to older adults to improve their quality of life; however, research shows that as many as 75% of older adults are non-adherent to prescribed MADs. This study investigated the psychosocial factors that predict non-adherence to MADs among older adults.Methods: A sample of Canadian older adult MADs users who resided in a long-term care facility was included. The data was collected using the Psychosocial Impact of Assistive Devices Scale (PIADS), and the Medical Outcomes Study Social Support Survey (mMOS-SS). Data analysis was performed using SPSS 28. Descriptive statistics were used to describe the sample and the study variables. Pearson correlation coefficients were used to evaluate the association between the study variables. Variables that were associated with non-adherence in a univariate analysis were subsequently entered into a multiple regression analysis.Results: The sample comprised 48 residents (26 females and 22 males), with a mean age of 86.8. In the univariate analysis, scores from the three PIADS subscales, namely, Competence, Adaptability, and Self-esteem, and the Social Support scale were significantly correlated with non-adherence (p < 0.05). In the multiple regression analyses, only Self-esteem significantly predicted non-adherence (p < 0.05), and this model explained between 43.5 and 54.3% of the variance in non-adherence.Conclusion: This study revealed that the Self-esteem construct, which includes several concepts related to psychological well-being, was the only significant predictor of non-adherence among the studied sample of older adults. The clinical implications of the findings are subsequently discussed.
Collapse
Affiliation(s)
- Alhadi M Jahan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Paulette Guitard
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Jeffrey W Jutai
- School of Interdisciplinary Health Sciences and Life Research Institute, University of Ottawa, Ottawa, Canada
| |
Collapse
|
4
|
Borgnis F, Desideri L, Converti RM, Salatino C. Available Assistive Technology Outcome Measures: Systematic Review. JMIR Rehabil Assist Technol 2023; 10:e51124. [PMID: 37782310 PMCID: PMC10687703 DOI: 10.2196/51124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND The World Health Organization claimed that measuring outcomes is necessary to understand the benefits of assistive technology (AT) and create evidence-based policies and systems to ensure universal access to it. In clinical practice, there is an increasing need for standardized methods to track AT interventions using outcome assessments. OBJECTIVE This review provides an overview of the available outcome measures that can be used at the follow-up stage of any AT intervention and integrated into daily clinical or service practice. METHODS We systematically searched for original manuscripts regarding available and used AT outcome measures by searching for titles and abstracts in the PubMed, Scopus, and Web of Science databases up to March 2023. RESULTS We analyzed 955 articles, of which 50 (5.2%) were included in the review. Within these, 53 instruments have been mentioned and used to provide an AT outcome assessment. The most widely used tool is the Quebec User Evaluation of Satisfaction with Assistive Technology, followed by the Psychosocial Impact of Assistive Technology Scale. Moreover, the identified measures addressed 8 AT outcome domains: functional efficacy, satisfaction, psychosocial impact, caregiver burden, quality of life, participation, confidence, and usability. The AT category Assistive products for activities and participation relating to personal mobility and transportation was the most involved in the reviewed articles. CONCLUSIONS Among the 53 cited instruments, only 17 (32%) scales were designed to evaluate specifically assistive devices. Moreover, 64% (34/53) of the instruments were only mentioned once to denote poor uniformity and concordance in the instruments to be used, limiting the possibility of comparing the results of studies. This work could represent a good guide for promoting the use of validated AT outcome measures in clinical practice that can be helpful to AT assessment teams in their everyday activities and the improvement of clinical practice.
Collapse
|
5
|
Mesoros MJ, Schein RM, Pramana G, Schiappa VJ, Schmeler MR, Dicianno BE. Functional mobility, employment and safety benefits of seat elevating devices. Assist Technol 2023; 35:471-476. [PMID: 36112503 DOI: 10.1080/10400435.2022.2124469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 10/14/2022] Open
Abstract
STATUS OF RESEARCH PROCESS Study completed. INVOLVEMENT OF ASSISTIVE TECHNOLOGY USERS Participants were power wheelchair users.
Collapse
Affiliation(s)
- Matthew J Mesoros
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Richard M Schein
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gede Pramana
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Vince J Schiappa
- Center for Assistive Technology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mark R Schmeler
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Assistive Technology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Brad E Dicianno
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Center for Assistive Technology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
6
|
Alqahtani S, Cooper R, Cooper RA. Current state and conceptual framework of assistive technology provision in Saudi Arabia. Disabil Rehabil Assist Technol 2023; 18:1357-1363. [PMID: 34847331 DOI: 10.1080/17483107.2021.2008027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Assistive Technology (AT) devices provide essential means of mobility, employment, communication, social engagement for older adults and people with different disabilities, if prescribed correctly to match users' needs and goals. Regardless of the setting or location, a successful AT service delivery model includes the multidisciplinary collaboration of the people with disabilities and the specialists who have knowledge and expertise in the design and application of AT. In Saudi Arabia, unfortunately, the availability of AT devices is mainly limited to basic mobility and daily living aids such as wheelchairs and seating systems, prosthetics and orthotics, communication devices, low-vision devices, and adapted transportation equipment. The aim of this perspective is to provide clinicians and healthcare professionals in Saudi Arabia with a model for the optimisation of the provision of AT devices decision making regarding AT devices for people with disabilities by adhering to a user-centered team approach throughout the service delivery process. METHOD The policy, human, activity, assistance, technology, and environment (PHAATE) model is used as a conceptual framework and guideline for this paper. RESULTS AND CONCLUSION The PHAATE components could serve as a guideline for a wide range of stakeholders in Saudi Arabia (e.g., researchers, product developers, practitioners, clinicians, third-party reimbursement entities, consumers, and educators) when developing service delivery systems.IMPLICATION FOR REHABILITATIONDespite the support and funding resources of AT devices by the Saudi government, there is still the needs to increase awareness and knowledge about AT application and services, as well as optimal service delivery models of AT devices.AT service delivery provision models such as PHAATE model may help clinicians and other medical professionals in Saudi Arabia to make informed decisions about the provision of AT device services.
Collapse
Affiliation(s)
| | - Rosemarie Cooper
- Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rory A Cooper
- Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
7
|
Sheng B, Zhao J, Zhang Y, Xie S, Tao J. Commercial device-based hand rehabilitation systems for stroke patients: State of the art and future prospects. Heliyon 2023; 9:e13588. [PMID: 36873497 PMCID: PMC9982629 DOI: 10.1016/j.heliyon.2023.e13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
Various hand rehabilitation systems have recently been developed for stroke patients, particularly commercial devices. Articles from 10 electronic databases from 2010 to 2022 were extracted to conduct a systematic review to explore the existing commercial training systems (hardware and software) and evaluate their clinical effectiveness. This review divided the rehabilitation equipment into contact and non-contact types. Game-based training protocols were further classified into two types: immersion and non-immersion. The results of the review indicated that the majority of the devices included were effective in improving hand function. Users who underwent rehabilitation training with these devices reported improvements in their hand function. Game-based training protocols were particularly appealing as they helped reduce boredom during rehabilitation training sessions. However, the review also identified some common technical drawbacks in the devices, particularly in non-contact devices, such as their vulnerability to the effects of light. Additionally, it was found that currently, there is no commercially available game-based training protocol that specifically targets hand rehabilitation. Given the ongoing COVID-19 pandemic, there is a need to develop safer non-contact rehabilitation equipment and more engaging training protocols for community and home-based rehabilitation. Additionally, the review suggests the need for revisions or the development of new clinical scales for hand rehabilitation evaluation that consider the current scenario, where in-person interactions might be limited.
Collapse
Affiliation(s)
- Bo Sheng
- School of Mechatronic Engineering and Automation, Shanghai University, 99 Shangda Road, Baoshan, Shanghai, China
| | - Jianyu Zhao
- School of Mechatronic Engineering and Automation, Shanghai University, 99 Shangda Road, Baoshan, Shanghai, China
| | - Yanxin Zhang
- Department of Exercise Sciences, The University of Auckland, 4703906, Newmarket, Auckland, New Zealand
| | - Shengquan Xie
- School of Electronic and Electrical Engineering, University of Leeds, 3 LS2 9JT, Leeds, United Kingdom
| | - Jing Tao
- School of Mechatronic Engineering and Automation, Shanghai University, 99 Shangda Road, Baoshan, Shanghai, China
| |
Collapse
|
8
|
Söke F, Ataoğlu NEE, Öztekin MF, Koçer B, Karakoç S, Gülşen Ç, Çomoğlu SS, Bora HA. Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. Turk J Med Sci 2023; 53:405-412. [PMID: 36945943 PMCID: PMC10388090 DOI: 10.55730/1300-0144.5597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/30/2022] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Impaired trunk control is common in neurological disorders; however, trunk control has not been examined in patients with cervical dystonia (CD). Therefore, the primary aim was to compare trunk control between patients with CD and healthy people. The secondary aim was to investigate the relationship between trunk control and balance, functional mobility, and disease severity in patients with CD. METHODS ]This cross-sectional study included 32 patients with CD and 32 healthy people. Trunk control was compared using the trunk impairment scale (TIS) that consists of three subscales: static sitting balance, dynamic sitting balance, and trunk coordination between two groups. Balance was assessed using Berg Balance Scale, four square step test, and one-leg stance test. The Timed Up and Go Test was measured to determine functional mobility. Toronto Western Spasmodic Torticollis Rating Scale was used to evaluate disease severity.]></AbstractText> <AbstractText Label="RESULTS"><![CDATA[ Patients with CD demonstrated worse performance on the TIS-total with TIS-dynamic sitting subscale and TIS-trunk coordination subscale (p < 0.001, p < 0.001, and p < 0.001), except for TIS-static sitting subscale (p = 0.078) compared to healthy people. TIS-total scores had moderate to strong correlations with balance, functional mobility, and disease severity (range r between 0.786 and 0.536, p < 0.05 for all). There was no correlation between TIS-total scores and disease severity (p = 0.102). DISCUSSION Patients with CD had impaired trunk control, especially in dynamic sitting balance and trunk coordination. Impaired trunk control was also associated with balance and functional mobility but not disease severity. These findings suggest that trunk control deficits should receive attention in the assessment and treatment of patients with CD.
Collapse
Affiliation(s)
- Fatih Söke
- Department of Physiotherapy and Rehabilitation, Gülhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | | | - Mehmet Fevzi Öztekin
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Bilge Koçer
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Selda Karakoç
- Department of Physiotherapy and Rehabilitation, Gülhane Institute of Health Science, University of Health Sciences, Ankara, Turkey
| | - Çağrı Gülşen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Selim Selçuk Çomoğlu
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Hatice Ayşe Bora
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
| |
Collapse
|
9
|
DiGiovine CP, Donahue M, Bahr P, Bresler M, Klaesner J, Pagadala R, Burkhardt B, Grott R. Rehabilitation engineers, technologists, and technicians: Vital members of the assistive technology team. Assist Technol 2023; 35:23-34. [PMID: 29953331 DOI: 10.1080/10400435.2018.1454713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The rehabilitation engineering professions include rehabilitation engineers, rehabilitation technologists / assistive technologists and rehabilitation technicians. The purpose of this white paper is to define the rehabilitation engineering professions, describe educational pathways for the field of rehabilitation engineering, and describe the role of the rehabilitation engineering professions in a multitude of professional settings. An ad-hoc committee was convened by the Rehabilitation Engineering and Technologists (RE&T) Professional Standards Group (PSG) at the 2013 annual meeting, RESNA Conference in Seattle, Washington. The ad-hoc committee reviewed over 80 different sources in preparing the white paper, which included peer reviewed journal articles, conference proceedings, professional organization websites. Based on this review, in addition to expert opinion and stakeholder feedback, the committee developed the following definitions.Rehabilitation Engineer (RE) uses the innovative and methodical application of scientific knowledge and technology to design and develop a device, system or process, which is intended to satisfy the human needs of an individual with a disability.Rehabilitation Technologist / Assistive Technologist (RT/AT) combines scientific and engineering knowledge and methods with technical skills to complement engineering activities for an individual with a disability.Rehabilitation Technician (RTn) works with equipment, primarily assembling and testing component parts of devices or systems that have been designed by others for individuals with disabilities; usually under direct supervision of a rehabilitation engineer or rehabilitation technologist / assistive technologist. Their preferences are given to assembly, repair, or evolutionary improvements to technical equipment by learning its characteristics, rather than by studying the scientific or engineering basis for its original design.This whitepaper provides a framework for future discussions on the advancement of the rehabilitation engineering professions with the goal of improving the quality of life of individuals with disabilities through the application of science and technology.
Collapse
Affiliation(s)
- Carmen P DiGiovine
- Occupational Therapy Division,The Ohio State University, Columbus, Ohio, USA
| | - Meghan Donahue
- Stout Vocational Rehabilitation Institute,University of Wisconsin - Stout, Menomonie, Wisconsin, USA
| | - Patricia Bahr
- College of Education,The University of Iowa, Iowa City, USA
| | - Mark Bresler
- AWT Rehabilitation Engineer East Quadrant,Georgia Vocational Rehabilitation Agency, Macon, Georgia, USA
| | - Joseph Klaesner
- Department of Radiology,Washington University School of Medicine, St. Louis, Missouri, USA
| | - Raj Pagadala
- AWT Rehabilitation Engineer East Quadrant,Georgia Vocational Rehabilitation Agency, Macon, Georgia, USA
| | - Brian Burkhardt
- Department of Veterans Affairs, McGuire VA Medical Center, Richmond, Virginia, USA
| | - Ray Grott
- The Rehabilitation Engineering and Assistive Technology (RET) Project, San Francisco State University, San Francisco, California, USA
| |
Collapse
|
10
|
Sarsak HI. Validation of an Arabic translation of the Functional Mobility Assessment (FMA) tool for assistive mobility device users. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2022. [DOI: 10.1186/s43161-022-00100-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
Background
Functional mobility assessment (FMA) tool is a self-report questionnaire developed to measure users’ satisfaction with assistive mobility devices while performing activities of daily living.
Purpose
To validate an Arabic translation of the FMA tool for Arabic-speaking assistive mobility devices users.
Methods
A committee of 2 bilingual qualified occupational therapists translated the English version into Arabic which was verified by back translation. The final versions were administered to bilingual assistive mobility devices users. The participants were randomly assigned to answer either the English or Arabic version of the FMA first, followed by answering the FMA in the other language. The scores obtained were tested for agreement using the kappa statistic.
Results
Participants’ (n=52), 28 were males and 24 were females, average participant age was 39.4 years old and had used an assistive mobility device for 6.4 years. We found a significant moderate agreement between the scores obtained from the two versions (p<0.000). The kappa measurement of agreement was 0.59 (95% confidence interval, 0.48–0.70).
Conclusion
The FMA is now available in Arabic, and it is an appropriate measure for use in research and clinical practice to quantify satisfaction with a functional mobility among assistive mobility device users. Further studies should test its psychometric properties.
Collapse
|
11
|
Xia Y, Xu Y, Li Y, Lu Y, Wang Z. Comparative Efficacy of Different Repetitive Transcranial Magnetic Stimulation Protocols for Stroke: A Network Meta-Analysis. Front Neurol 2022; 13:918786. [PMID: 35785350 PMCID: PMC9240662 DOI: 10.3389/fneur.2022.918786] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background Although repetitive transcranial magnetic stimulation (rTMS) has been proven to be effective in the upper limb motor function and activities of daily living (ADL), the therapeutic effects of different stimulation protocols have not been effectively compared. To fill this gap, this study carried out the comparison of the upper limb motor function and ADL performance of patients with stroke through a network meta-analysis. Methods Randomized controlled trials (RCTs) on the rTMS therapy for stroke were searched from various databases, including PubMed, web of science, Embase, Cochrane Library, ProQuest, Wanfang database, the China National Knowledge Infrastructure (CNKI), and VIP information (www.cqvip.com). The retrieval period was from the establishment of the database to January 2021. Meanwhile, five independent researchers were responsible for the study selection, data extraction, and quality evaluation. The outcome measures included Upper Extremity Fugl-Meyer Assessment (UE-FMA), Wolf Motor Function Test (WMFT), Modified Barthel Index (MBI), the National Institute of Health stroke scale (NIHSS), and adverse reactions. The Gemtc 0.14.3 software based on the Bayesian model framework was used for network meta-analysis, and funnel plots and network diagram plots were conducted using Stata14.0 software. Results Ninety-five studies and 5,016 patients were included ultimately. The intervention measures included were as follows: placebo, intermittent theta-burst stimulation (ITBS), continuous theta-burst stimulation (CTBS),1 Hz rTMS,3–5 Hz rTMS, and ≥10 Hz rTMS. The results of the network meta-analysis show that different rTMS protocols were superior to placebo in terms of UE-FMA, NIHSS, and MBI outcomes. In the probability ranking results, ≥10 Hz rTMS ranked first in UE-FMA, WMFT, and MBI. For the NIHSS outcome, the ITBS ranked first and 1 Hz rTMS ranked the second. The subgroup analyses of UE-FMA showed that ≥10 Hz rTMS was the best stimulation protocol for mild stroke, severe stroke, and the convalescent phase, as well as ITBS was for acute and subacute phases. In addition, it was reported in 13 included studies that only a few patients suffered from adverse reactions, such as headache, nausea, and emesis. Conclusion Overall, ≥10 Hz rTMS may be the best stimulation protocol for improving the upper limb motor function and ADL performance in patients with stroke. Considering the impact of stroke severity and phase on the upper limb motor function, ≥10 Hz rTMS may be the preferred stimulation protocol for mild stroke, severe stroke, and for the convalescent phase, and ITBS for acute and subacute phases. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier [CRD42020212253].
Collapse
Affiliation(s)
- Yuan Xia
- School of Health Sciences, Wuhan Sports University, Wuhan, China
| | - Yuxiang Xu
- School of Life Sciences, Henan University, Kaifeng, China
| | - Yongjie Li
- Department of Rehabilitation Medicine, Guizhou Provincial Orthopedics Hospital, Guiyang, China
- *Correspondence: Yongjie Li
| | - Yue Lu
- School of Health Sciences, Wuhan Sports University, Wuhan, China
| | - Zhenyu Wang
- School of Health Sciences, Wuhan Sports University, Wuhan, China
| |
Collapse
|
12
|
Boccardi A, Wu F, Pearlman J, Mhatre A. Elderly wheelchair users recommend age-friendly design improvements to a mHealth wheelchair maintenance application in a mixed-methods study (Preprint). JMIR Aging 2022; 5:e39301. [PMID: 36256830 PMCID: PMC9627462 DOI: 10.2196/39301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 11/22/2022] Open
Abstract
Background Wheelchair part failures have doubled over the past decade. Preventative wheelchair maintenance reduces wheelchair failures and prevents user consequences. We are developing a smartphone app called WheelTrak, which alerts users when maintenance is required, to encourage maintenance practices and compliance. Objective This mixed methods study aimed to develop a wheelchair maintenance app using broad stakeholder advice and investigate older adults’ interaction experience with the app and their perceived barriers to and facilitators of maintenance. Methods Interviews were conducted with stakeholders, including mobility device users, to generate needs statements and app specifications. The app was designed in 2 stages. Stage 1 involved the development of the app according to the specifications and evaluation of the app interface by lead users. Stage 2 included the revision of the app screens and manual functionality testing. Usability testing and semistructured interviews were conducted with older wheelchair and scooter users. The System Usability Scale was used to measure app usability. Results Interviews with power and manual wheelchair users (37/57, 65%), wheelchair service providers (15/57, 26%), manufacturers (2/57, 4%), seating and mobility researchers (1/57, 2%), and insurance plan providers (2/57, 4%) informed the needs and specifications of the app technology. The 2-stage development process delivered a fully functional app that met the design specifications. In total, 12 older adults (mean age 74.2, SD 9.1 years; n=10, 83% women; and n=2, 17% men) participated in the usability testing study. Of the 12 participants, 9 (75%) agreed to use WheelTrak for preventative maintenance. WheelTrak scored an average System Usability Scale score of 60.25 (SD 16). Four overarching themes were identified: WheelTrak app improvements, barriers to maintenance, consequences related to mobility device failure, and smart technology use and acceptance. Older adults preferred the simplicity, readability, personalization, and availability of educational resources in the app. Barriers to maintenance pertained to health issues and lack of maintenance knowledge among older adults. Facilitators of maintenance included notification for maintenance, app connectivity with the service provider, reporting of device failure, and the presence of a caregiver for maintenance. Conclusions This study highlighted age-friendly design improvements to the app, making it easy to be used and adopted by older wheelchair users. The WheelTrak app has close to average system usability. Additional usability testing will be conducted following app revision in the future.
Collapse
Affiliation(s)
- Alyssa Boccardi
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Fangzheng Wu
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anand Mhatre
- Occupational Therapy Division, Ohio State University Wexner Medical Center, Columbus, OH, United States
| |
Collapse
|
13
|
Lu Y, Xia Y, Wu Y, Pan X, Wang Z, Li Y. Repetitive transcranial magnetic stimulation for upper limb motor function and activities of daily living in patients with stroke: a protocol of a systematic review and Bayesian network meta-analysis. BMJ Open 2022; 12:e051630. [PMID: 35273041 PMCID: PMC8915325 DOI: 10.1136/bmjopen-2021-051630] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Patients with stroke usually suffer from varying degrees of movement dysfunction, which seriously affects their quality of life, especially for the upper limb dysfunction. Therefore, this study aims to compare the effects of different repetitive transcranial magnetic stimulation (rTMS) modalities on upper limb motor function and daily activities in patients with stroke. METHODS AND ANALYSIS Relevant research will be collected systematically from PubMed, Web of Science, Embase, Cochrane Library, ProQuest, Wanfang Database, China National Knowledge Infrastructure and Chinese Scientific and Journal Database (VIP) about randomised controlled trials of rTMS in the stroke treatment range from the establishment to November 2020. Primary outcomes will be obtained from scales measuring the upper limb motor function like Upper Extremity Fugl-Meyer Assessment Scale, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Action Research Arm Test and Box and Block Test. The secondary outcomes include modified Barthel Index and adverse events (such as vertigo, headache and epilepsy), with the goal of assessing patients' activities of daily living and the safety of treatment. In order to avoid personal bias in the included studies, two reviewers will conduct the data extraction and quality evaluation independently, and all data analyses will be performed by Generate Mixed Treatment comparison software V.0.14.3 and Stata V.16.0. ETHICS AND DISSEMINATION The network meta-analysis (NMA) in this study does not require ethical approval because the data analysis will be used only to evaluate the rTMS treatment efficacy without patients' private information. In addition, the results will be disseminated in international conference reports and peer-reviewed manuscripts. PROSPERO REGISTRATION NUMBER CRD42020212253.
Collapse
Affiliation(s)
- Yue Lu
- Department of Health Sciences, Wuhan Sports University, Wuhan, Hubei, China
| | - Yuan Xia
- Department of Health Sciences, Wuhan Sports University, Wuhan, Hubei, China
| | - Yue Wu
- Department of Health Sciences, Wuhan Sports University, Wuhan, Hubei, China
| | - Xinyong Pan
- Department of Health Sciences, Wuhan Sports University, Wuhan, Hubei, China
| | - Zhenyu Wang
- Department of Health Sciences, Wuhan Sports University, Wuhan, Hubei, China
| | - Yongjie Li
- Department of Rehabilitation Medicine, Guizhou Orthopedics Hospital, Guiyang, Guizhou, China
| |
Collapse
|
14
|
Semancik B, Schmeler MR, Schein RM, Hibbs R. Face validity of standardized assessments for wheeled mobility & seating evaluations. Assist Technol 2021:1-9. [PMID: 34591750 DOI: 10.1080/10400435.2021.1974980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 10/20/2022] Open
Abstract
A problem in the Complex Rehabilitation Technology industry is the lack of standardization in the assessment for wheeled mobility and seating (WMS). The aim of this paper was to identify assessment tools commonly used by clinicians during WMS evaluations. After the tools were identified by a panel of 12 subject matter experts, a presentation at the 2018 International Seating Symposium in Vancouver, Canada and the 2018 European Seating Symposium in Dublin, Ireland polled attendees via the Sli.do polling application to determine professional opinions of each tool, resulting in face validity for use in wheelchair evaluations. The Lawshe Content Validity Ratio was used to convert this anecdotal data into numerical data, indicating which tools were most and least used by attendees. Finally, a literature search was conducted to determine the reliability, validity, and International Classification of Functioning, Disability, & Health domain for each measure. The findings indicate that while there are many standardized and reliable assessment tools available for wheeled mobility and seating evaluations, most clinicians use only a few standardized assessment tools during WMS evaluations.
Collapse
Affiliation(s)
- Bethany Semancik
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mark R Schmeler
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Richard M Schein
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rachel Hibbs
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
15
|
Lee-Hauser CR, Schein RM, Schiappa VJ, Pruziner AL, Tostenrude D, Goedhard KE, Nelson LM, Schmeler MR. Demographic and Functional Characteristics of National Veterans Wheelchair Games Participants: A Cross-sectional Study. Mil Med 2021; 186:e749-e755. [PMID: 33242063 DOI: 10.1093/milmed/usaa398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/13/2020] [Accepted: 09/23/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Although many studies report the impact of adaptive sports and recreation on quality of life for people with disabilities across several age groups, few have focused on the Veteran population. The purpose of this study was to establish a baseline of common characteristics of the Veteran population that participated in the National Veterans Wheelchair Games (NVWG) in 2017 and 2018, including their perception on how their participation is associated with function and social factors. MATERIALS AND METHODS A cross-sectional study was implemented as part of a quality assurance collaboration between the University of Pittsburgh and the Veterans Administration National Veterans Sports Programs and Special Events. Demographic and quality-of-life data were collected through the Functional Mobility Assessment (FMA) and associated Uniform Dataset as well as the Sports Participation Outcome Research Tool and Comprehensive Uniform Survey (SPORTACUS). This report provides and discusses the descriptive analyses that were performed on the data and establishes a framework to assess the impact of sports and exercise for Veterans with disabilities. RESULTS A sample of 426 Veterans, 87% who were male and an average population age of 56 years old, reported high FMA scores on each of 10 items (daily routine, comfort, health, operate, reach, transfer, personal care, indoor mobility, outdoor mobility, and transportation) along with SPORTACUS scores scoring above 5, based on a 1-6 scoring scale (1 being "completely disagree" and 6 being "completely agree"), on each domain indicating sports participation is associated with their ability to function and participate in the community. CONCLUSION Based on these results, it can be concluded for this military Veteran population that participation in a large, organized adaptive sports programs such as the NVWG has a positive association with daily function, quality of life, community participation, and use of higher quality assistive technology.
Collapse
Affiliation(s)
- Cecelia Rose Lee-Hauser
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Richard M Schein
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Vince J Schiappa
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Alison L Pruziner
- U.S. Department of Veterans Affairs, National Veterans Sports Programs & Special Events, Washington, DC 20420, USA
| | - Dave Tostenrude
- U.S. Department of Veterans Affairs, National Veterans Sports Programs & Special Events, Washington, DC 20420, USA
| | - Kristine E Goedhard
- U.S. Department of Veterans Affairs, National Veterans Sports Programs & Special Events, Washington, DC 20420, USA
| | - Leif M Nelson
- U.S. Department of Veterans Affairs, National Veterans Sports Programs & Special Events, Washington, DC 20420, USA
| | - Mark R Schmeler
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, PA 15206, USA
| |
Collapse
|
16
|
Tasiemski T, Wilski M, Urbański P. One World Project's Wheelchair Skills Training Camp in Morocco - effects of a community peer-based programme. Disabil Rehabil Assist Technol 2021:1-7. [PMID: 34000212 DOI: 10.1080/17483107.2021.1914756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to assess wheelchair skills of persons with physical disabilities who attended the first Wheelchair Skills and Empowerment Camp in Morocco and their satisfaction with manual wheelchairs provided for the camp activities. MATERIALS AND METHODS 19 persons (13 male and 6 female) with physical disabilities took part in the project. The average time since injury or illness was 24 years. To assess wheelchair skills/user satisfaction, the researchers used the Queensland Evaluation of Wheelchair Skills test and the Quebec User Evaluation of Satisfaction with assistive Technology. RESULTS Study participants improved their overall wheelchair mobility skills (p = 0.002; d = 0.20), especially their ability to ascend and descend a ramp (p = 0.012; d = 0.67). The participants reported significantly greater satisfaction with the new provided wheelchairs in comparison to their own wheelchairs in regard to five satisfaction items; i.e., ease in adjusting (p = 0.011; d = 0.96), safety and security (p = 0.014; d = 0.97), durability (p = 0.037; d = 0.81), ease to use (p = 0.045; d = 0.87), and comfort (p = 0.006; d = 1.03). CONCLUSIONS Findings of this study indicate that persons with physical disabilities in Morocco need structured training in wheelchair skills and better-quality wheelchairs. The study also confirmed that community peer-based programmes in low-resource countries can play a significant role in rehabilitation of persons with physical disabilities, even many years after their injury or illness.IMPLICATIONS FOR REHABILITATIONThe One World project educated local persons with disabilities and government officials about the need for buying appropriate wheelchairs and for providing them according to the World Health Organization guidelines.19 persons who use wheelchairs participated in 6-days of wheelchair skills training sessions, which were led by three peer mentors who use a wheelchair: two with spinal cord injury, and one with polio complications.The 19 participants, who had lived with their disabilities on average for 24 years, advanced their general wheelchair mobility skills, which was assessed through a practical test.The results confirmed that community peer-based programmes in low-resource countries are important for improving wheelchair skills not only when beginning rehabilitation but even after individuals live many years with a disability.
Collapse
Affiliation(s)
- Tomasz Tasiemski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Piotr Urbański
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| |
Collapse
|
17
|
Schein RM, Yang A, McKernan GP, Mesoros M, Pramana G, Schmeler MR, Dicianno BE. Effect of the Assistive Technology Professional on the Provision of Mobility Assistive Equipment. Arch Phys Med Rehabil 2021; 102:1895-1901. [PMID: 33891909 DOI: 10.1016/j.apmr.2021.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to examine factors associated with variability in satisfaction with functional mobility (as measured by the Functional Mobility Assessment [FMA]) in users of mobility devices. Our primary hypothesis was that device type and Assistive Technology Professional (ATP) involvement will be the most significant predictors of FMA score. Our secondary hypothesis was that ATP involvement is associated with use of more custom-fitted manual wheelchairs and group 3 and 4 power wheelchairs. DESIGN Retrospective cohort study. SETTING Data were collected from equipment suppliers who collaborate with clinicians to administer the FMA and associated Uniform Data Set within various settings (ie, rehabilitation clinic, school, supplier place of business). PARTICIPANTS A data set of 4743 cases was included in the analysis (N=4743). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES FMA questionnaire collected at baseline, client age, gender, primary diagnosis, years since disability onset, device type, device age, living situation, ATP involvement, and geographic area. RESULTS Ordinal logistic regression modeling showed that geographic area, device type, ATP involvement, primary diagnosis, gender, age, device age, and years since onset of disability significantly predicted the variance in FMA scores at P<.05. Device type was the most significant predictor of variance in FMA score. Involvement of an ATP had a significant effect on the type of device that participants used (χ220=1739.18, P<.001; odds ratio, 0.589; 95% confidence interval, 0.49-0.708). If an ATP was involved, there were significantly higher proportions (all P<.05) of individuals using custom-fitted manual wheelchair and high-end groups 3 and 4 power wheelchairs prescribed compared with when no ATP was involved or when involvement was uncertain. CONCLUSIONS The relationship between ATP involvement and functional outcome supports the concept that ATP certification recognizes demonstrated competence in analyzing the needs of consumers with disabilities and selection of appropriate mobility assistive equipment with improved functional outcomes.
Collapse
Affiliation(s)
- Richard M Schein
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Anthony Yang
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Gina P McKernan
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Matthew Mesoros
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Gede Pramana
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Mark R Schmeler
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Brad E Dicianno
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.
| |
Collapse
|
18
|
Ott KK, Schein RM, Straatmann J, Schmeler MR, Dicianno BE. Development of a Home-Based Telerehabilitation Service Delivery Protocol for Wheelchair Seating and Mobility Within the Veterans Health Administration. Mil Med 2021; 187:e718-e725. [PMID: 33647955 DOI: 10.1093/milmed/usab091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/06/2021] [Accepted: 02/22/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The provision of seating and wheeled mobility devices is a complex process that requires trained professionals and multiple appointments throughout the service delivery process. However, this can be inconvenient and burdensome for individuals with mobility limitations or for individuals who live in rural areas. Rural areas often present unique difficulties regarding the provision of healthcare services including lengthy travel times to medical facilities and lack of specialized providers and medical technology. The purpose of this article is to provide a comprehensive overview of the development and implementation of a service delivery protocol for a home-based telerehabilitation assessment for wheelchair seating and mobility. MATERIALS AND METHODS The telerehabilitation team consists of a trained wheelchair seating and mobility therapist and a telehealth clinical technician (TCT). In order to determine veterans that are appropriate for a home-based telerehabilitation assessment, a three-phase pre-assessment screening process was conducted by the therapist and TCT, including consult, chart, and phone review. Veterans that met all of the predetermined eligibility criteria were recommended for a telerehabilitation wheelchair assessment. The TCT traveled to the veteran's residence with necessary evaluation and safety equipment and connected with the therapist remotely using the VA Video Connect platform. Assessment and veteran data were collected during the initial evaluation and then during a 21-day follow-up. RESULTS Forty-three veterans were successfully seen via telerehabilitation for a seating and wheeled mobility assessment between November, 2017 and July, 2018. The average travel distance between the veteran's residence and the clinic was 34.1 miles. The total telerehabilitation encounter times ranged from 45 min to 145 min. CONCLUSIONS The implementation of this service delivery protocol for wheelchair seating and mobility assessments demonstrated the benefits of using telehealth services including reaching rural veterans, reducing distance traveled, maximizing efficiency of provider schedules, and conducting realistic assessments in veterans' home environments. Success can be attributed to being able to deliver best practice remotely and to the rapport of the TCT with the providers. Cultivating provider buy-in, selecting appropriate outcome measures, and restructuring workflows were additional lessons learned. The VA Video Connect platform is an accessible tool that can be easily learned by both veterans and providers and used beyond initial wheelchair seating evaluations for improved access to follow-up healthcare services.
Collapse
Affiliation(s)
- Kaila K Ott
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Richard M Schein
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Joseph Straatmann
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Mark R Schmeler
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Brad E Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Kaufmann Medical Building, Pittsburgh, PA 15213, USA
| |
Collapse
|
19
|
Taylor J, Forgeron P, Vandyk A, Finley A, Lightfoot S. Pediatric Health Outcome Evaluation in Low-and Middle-Income Countries: A Scoping Review of NGO Practice. Glob Pediatr Health 2021; 8:2333794X21991011. [PMID: 33614849 PMCID: PMC7868502 DOI: 10.1177/2333794x21991011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/03/2021] [Accepted: 01/09/2021] [Indexed: 11/17/2022] Open
Abstract
Objective. The purpose of this study was to explore the research on the delivery and evaluation of pediatric health services by non-governmental organizations in low-and middle-income countries to better understand how they contribute to positive and sustainable health outcomes. Methods. A scoping review was completed using a 2-step study selection procedure. Results. Of the 5742 studies, 17 met criteria, including quantitative and mixed method designs, representing 10 different non-governmental organizations with programs in 33 low-and middle-income countries. Health outcomes were reported 89 times across the studies. A total of 56 different outcomes were identified in total, of which 24 were positive, 27 were negative, and 5 were unchanged. Conclusions. Widespread variation between non-governmental organizations exist, however, comprehensive pediatric health outcome evaluation is growing. Further emphasis should be given to adolescent specific research and robust measurement of quality of life.
Collapse
Affiliation(s)
| | | | | | - Allen Finley
- Dalhousie University & IWK Health Centre, Halifax, NS, Canada
| | | |
Collapse
|
20
|
Bell M, Schein RM, Straatmann J, Dicianno BE, Schmeler MR. Functional Mobility Outcomes in Telehealth and In-Person Assessments for Wheeled Mobility Devices. Int J Telerehabil 2020; 12:27-34. [PMID: 33520092 PMCID: PMC7757644 DOI: 10.5195/ijt.2020.6335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to compare telehealth and in-person service delivery models for wheeled mobility devices in terms of functional outcomes. We hypothesized that clinically significant improvements in functional mobility measured by the Functional Mobility Assessment (FMA) will occur in individuals receiving both telehealth and in-person clinic evaluations. A total of 27 Veterans receiving telehealth visits were compared to 27 individuals seen in clinic, selected from a database, matching for age, gender, and primary diagnosis. All mean individual item and total FMA scores in both groups increased from Time 1 to Time 2. Within the telehealth group, all changes in individual item and total FMA scores were statistically significant, with changes in 8 of 10 items meeting threshold for clinical significance (change >1.85 points). Within the clinic group, changes in 7 of 10 individual items and total FMA scores were statistically significant, and these same 7 items met threshold for clinical significance. Change scores for individual item and total FMA scores did not differ significantly between the two groups. A larger and clinically significant change in transfer score was seen in the telehealth group, suggesting telehealth visits may confer an advantage in being able to assess and address transfer issues in the home.
Collapse
Affiliation(s)
- Mitchell Bell
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Richard M. Schein
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joseph Straatmann
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brad E. Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mark R. Schmeler
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
21
|
Toro-Hernández ML, Augustine N, Kankipati P, Karg P, Rispin K, Schein RM, Kandavel K, D’Innocenzo ME, Goldberg M, Pearlman J. Preliminary steps of the development of a Minimum Uniform Dataset applicable to the international wheelchair sector. PLoS One 2020; 15:e0238851. [PMID: 32915874 PMCID: PMC7485892 DOI: 10.1371/journal.pone.0238851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 08/25/2020] [Indexed: 11/21/2022] Open
Abstract
Assistive products outcomes are needed globally to inform policy, practice, and drive investment. The International Society of Wheelchair Professionals developed a Minimum Uniform Dataset (MUD) for wheelchair services worldwide with the intent to gather data that is comparable globally. The MUD was developed with the participation of members from around the globe and its feasibility piloted at 3 sites. Three versions of the MUD are now available—a short form with 29 data points (available in English, Spanish, and French) and a standard version with 38 data points in English. Future work is to validate and complete the translation cycles followed by promoting the use of the MUD globally so that the data can be leveraged to inform policy, practice and direct investments.
Collapse
Affiliation(s)
| | - Nancy Augustine
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Padmaja Kankipati
- Specialized Mobility Operations and Innovation Pvt. Ltd, Bangalore, India
- Member of the International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
| | - Patricia Karg
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Karen Rispin
- Member of the International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Arts and Science, Letourneau University, Longview, Texas, United States of America
| | - Richard M. Schein
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Member of the International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
| | - Krithika Kandavel
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Megan E. D’Innocenzo
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Mary Goldberg
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jonathan Pearlman
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| |
Collapse
|
22
|
Field DA, Miller WC. The Wheelchair Outcome Measure for Young People (WhOM-YP): modification and metrics for children and youth with mobility limitations. Disabil Rehabil Assist Technol 2020; 17:192-200. [PMID: 32536333 DOI: 10.1080/17483107.2020.1774811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Wheelchairs enhance children's mobility and participation in daily life, yet few participation measures are used to evaluate wheeled mobility interventions. The Wheelchair Outcome Measure for Young People (WhOM-YP) addresses this gap, evaluating importance of and satisfaction with client-identified participation outcomes inside and outside home for children aged 18 years and younger who need wheeled mobility interventions.Methods: Mixed methods study using semi-structured interviews with nine experienced therapists and nine wheelchair users (11-18 years) evaluated the appropriateness of adult Wheelchair Outcome Measure for younger ages. Four key informants reviewed findings and offered additional modifications. Two-week test-retest reliability and construct validity were examined with children and parents; Spearman correlations were estimated among child and parent scores and Mann-Whitney U Test analyzed difference in outside home participation mean weighted satisfaction scores between new and experienced power mobility users.Results: Modifications included age-appropriate changes, adding visuals to rating scales, and separate child and adult ratings dependent on child's age and abilities. Two week test-retest reliability estimates were as hypothesized; WhOM-YP mean satisfaction and mean weighted satisfaction summary scores for inside and outside home participation demonstrated intraclass correlation coefficient (ICC(2,1)) > 0.70. Discrimination between groups was as predicted; mean weighted satisfaction outside participation difference (p < 0.0001) demonstrated between experienced (median 74.2, n = 22) and inexperienced (median 32.9, n = 10) users. Revised format was conducive for individuals with diverse needs; images helped those with emerging numeracy and literacy skills, and proxy rating could be accommodated.Conclusion: Evidence supports WhOM-YP reliability and validity for measuring participation outcomes in daily life for young people.Implications for rehabilitationThe WhOM-YP offers a client-centred, individualized, participation focused outcome measure for young people who use wheeled mobility. Therapists, children, youth and parents were consulted throughout its development to ensure that the measure is relevant to their needs.The WhOM-YP can be used with children 18 years-of-age and younger. Consistent ratings over a two-week period of time (when no change was expected) were stronger for those 8 years and older. Children as young as 5 years of age can use this measure to share their views but caution is needed in score interpretation for those below 8 years-of-age.The option of parent-report to augment or provide a proxy measure increases WhOM-YP usefulness in rating individualized participation outcomes for a more age and ability diverse population.This is the first study to examine reliability and validity evidence in regards to using the Wheelchair Outcome Measure for Young People (WhOM-YP) with children who have mobility limitations and their parents.
Collapse
Affiliation(s)
- Debra A Field
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Sunny Hill Health Centre for Children, Vancouver, Canada
| | - William C Miller
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.,International Collaboration on Regenerative Discoveries, University of British Columbia, and the Vancouver Coastal Health Research Institute, Vancouver, Canada
| |
Collapse
|
23
|
Tao G, Charm G, Kabacińska K, Miller WC, Robillard JM. Evaluation Tools for Assistive Technologies: A Scoping Review. Arch Phys Med Rehabil 2020; 101:1025-1040. [PMID: 32059944 DOI: 10.1016/j.apmr.2020.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/02/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Assistive technologies (ATs) support independence and well-being in people with cognitive, perceptual, and physical limitations. Given the increasing availability and diversity of ATs, evaluating the usefulness of current and emerging ATs is crucial for informed comparison. We aimed to chart the landscape and development of AT evaluation tools (ETs; ATETs) across disparate fields in order to improve the process of AT evaluation and development. DATA SOURCES We performed a scoping review of ATETs through database searching of MEDLINE, Embase, CINAHL, HaPI, PsycINFO, Cochrane Reviews, and Compendex as well as citation mining. STUDY SELECTION Articles explicitly referencing ATETs were retained for screening. We included ETs if they were designed to specifically evaluate ATs. DATA EXTRACTION We extracted 5 attributes of ATETs: AT category, construct evaluated, conceptual frameworks, type of end user input used for ATET development, and presence of validity testing. DATA SYNTHESIS From screening 23,434 records, we included 159 ATETs. Specificity of tools ranged from single to general ATs across 40 AT categories. Satisfaction, functional performance, and usage were the most common constructs of 103 identified. We identified 34 conceptual frameworks across 53 ETs. Finally, 36% incorporated end user input and 80% showed validation testing. CONCLUSIONS We characterized a wide range of AT categories with diverse approaches to their evaluation based on varied conceptual frameworks. Combining these frameworks in future ATETs may provide more holistic views of AT usefulness. ATET selection may be improved with guidelines for conceptually reconciling results of disparate ATETs. Future ATET development may benefit from more integrated approaches to end user engagement.
Collapse
Affiliation(s)
- Gordon Tao
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia
| | - Geoffrey Charm
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Integrated Sciences, The University of British Columbia, Vancouver, British Columbia
| | - Katarzyna Kabacińska
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia
| | - William C Miller
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia
| | - Julie M Robillard
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia; British Columbia Women's and Children's Hospital, Vancouver, British Columbia, Canada.
| |
Collapse
|
24
|
Paulisso DC, Cruz DMC, Allegretti ALC, Schein RM, Costa JD, Campos LCB, Schmeler MR. Cross-Cultural Adaptation and Face Validity of the Functional Mobility Assessment into Brazilian Portuguese. Occup Ther Int 2020; 2020:8150718. [PMID: 32110165 PMCID: PMC7029273 DOI: 10.1155/2020/8150718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/18/2019] [Accepted: 01/25/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction. The Functional Mobility Assessment (FMA) measures satisfaction with mobility devices in daily life. However, in Brazil, there is a lack of instruments which measure functional mobility. OBJECTIVE We aim to report the cross-cultural adaptation process and face validity of the FMA for use in Brazil. METHODS Two international guidelines were used in the cross-cultural adaptation process. Two independent translators translated the instrument from English to Brazilian Portuguese, and the two versions were reconciled. Two different translators back translated this reconciled version, and an expert committee analysed the resulting synthesis. For face validity, the FMA was applied with 24 participants, divided into two groups, users with disabilities (n = 12) and occupational therapy students (n = 12) and occupational therapy students (. RESULTS The cross-cultural adaptation of the FMA was concluded, and its face validity presented that both groups understood most or completely all instrument items. CONCLUSION The Brazilian version of FMA is now available in Brazilian Portuguese and has face validation. Further studies should test its psychometric properties.
Collapse
Affiliation(s)
- Debora C. Paulisso
- Department of Occupational Therapy, Universidade Federal de São Carlos, São Carlos 13565905, Brazil
| | - Daniel M. C. Cruz
- Department of Occupational Therapy, Universidade Federal de São Carlos, São Carlos 13565905, Brazil
| | - Ana Luiza C. Allegretti
- Department of Occupational Therapy, University of Texas Health Science Center San Antonio, San Antonio 78229, USA
| | - Richard M. Schein
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh 15260, USA
| | - Jacqueline D. Costa
- Department of Occupational Therapy, Universidade Federal de São Carlos, São Carlos 13565905, Brazil
| | - Lays C. B. Campos
- Department of Occupational Therapy, Universidade Federal de São Carlos, São Carlos 13565905, Brazil
| | - Mark R. Schmeler
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh 15260, USA
| |
Collapse
|
25
|
Cambetis S, Richmond J, Chew A. Motorized Mobility Scooter Use and Knowledge of the Rules And Etiquette: A Survey. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2019. [DOI: 10.1080/02703181.2019.1699634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sophie Cambetis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Janet Richmond
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Angela Chew
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| |
Collapse
|
26
|
Faieta JM, Hand BN, Berner T, Schmeler MR, DiGiovine C. Evaluation of the Functional Mobility Assessment Through Rasch Analysis. Arch Phys Med Rehabil 2019; 101:712-716. [PMID: 31809752 DOI: 10.1016/j.apmr.2019.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the effectiveness of the Functional Mobility Assessment (FMA) when measuring an individual's satisfaction with functional mobility. DESIGN Secondary analysis of cross-sectional self-report data. SETTING Assistive technology center within an academic medical center in the Midwestern United States. PARTICIPANTS Individuals with a disability that use or plan to use a mobility device (N=871). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES FMA. RESULTS All FMA items (10/10) contributed to a single unidimensional construct with good to strong fit to a unidimensional confirmatory factor model. Rasch analysis revealed that the rating scale, majority of persons (>90%), and all items fit the Rasch measurement model. The FMA demonstrated adequate reliability (person reliability=0.85) and separated persons into 3 strata: those with high, medium, and low satisfaction with functional mobility. CONCLUSIONS The FMA is an appropriate measure for use in research and clinical settings to quantify satisfaction with functional mobility among mobility device users.
Collapse
Affiliation(s)
- Julie M Faieta
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, Ohio.
| | - Brittany N Hand
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, Ohio
| | - Theresa Berner
- Assistive Technology Center, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Mark R Schmeler
- Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Carmen DiGiovine
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, Ohio; Assistive Technology Center, Ohio State University Wexner Medical Center, Columbus, Ohio; Occupational Therapy Division, Ohio State University, Columbus, Ohio; Biomedical Engineering Department, Ohio State University, Columbus, Ohio
| |
Collapse
|
27
|
Faieta J, Schmeler MR, Schiappa VJ, Hand BN, Schein RM, Saptono A, Berner T, DiGiovine CP. Evaluation of Service Delivery Effectiveness Through Patient-Reported Outcome Measures. Am J Phys Med Rehabil 2019; 98:1072-1078. [DOI: 10.1097/phm.0000000000001245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
28
|
Schmeler MR, Schein RM, Saptono A, Schiappa VJ. Development and Implementation of a Wheelchair Outcomes Registry. Arch Phys Med Rehabil 2019; 100:1779-1781. [DOI: 10.1016/j.apmr.2019.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
|
29
|
Rice LA, Yarnot R, Mills S, Sonsoff J. A pilot investigation of anterior tilt use among power wheelchair users. Disabil Rehabil Assist Technol 2019; 16:152-159. [PMID: 31348680 DOI: 10.1080/17483107.2019.1644676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To examine the influence of use of the anterior tilt-in-space power seat function on performance of functional activities, physical health, and user satisfaction on among power wheelchair users. MATERIALS AND METHODS Ten full-time power wheelchair users with a seat elevator on their current chair participated in a mixed-methods, repeated measures study. At Visit 1 participants completed the Wheelchair Outcome Measure, Functional Mobility Assessment, Wheelchair Users Shoulder Pain Index, Fatigue Severity Scale, and the Spinal Cord Injury Secondary Conditions Scale. Physical assessments were performed to examine transfer quality (transfer assessment instrument), functional reach, activities of daily living (performance assessment of self-care skills), seated balance (function in sitting test), spasticity, respiratory function, and speech production. Approximately 3 days later (Visit 2), participants were trained on use and provided a power wheelchair with anterior tilt to trial for two weeks. After two weeks (Visit 3), the Visit 1 protocol was repeated and a semistructured interview conducted. RESULTS Participants lived with disabilities of cerebral palsy, spinal muscular atrophy and multiple sclerosis. With use of anterior tilt, significant improvements were seen among safety of meal preparation, p = 0.033, dz = 0.91 and functional reach in the vertical direction, p = 0.000, dz = 2.62. Subjectively, participants found anterior tilt helpful in performance of reaching tasks in but found the safety equipment restrictive. CONCLUSION Preliminary results indicate that use of the anterior tilt may help to improve performance of functional activities. Additional research is needed to examine the long-term influence of the technology.Implications for rehabilitationThe anterior tilt seat function changes the seat angle orientation in relation to the ground in the sagittal plane and angles the seat forward. As a result, the individual using the assistive technology is positioned in a semistanding position.Preliminary results of this study indicate that with use of anterior tilt, safety of meal preparation and functional reach in the vertical direction significantly improved. Subjectively, participants found anterior tilt helpful in performance of reaching tasks but found the safety equipment restrictive.Additional research is needed to examine the long-term influence of anterior tilt on functional activities, physical health and user satisfaction on among a large and diverse group of power wheelchair users.
Collapse
Affiliation(s)
- Laura A Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Rebecca Yarnot
- Department of Kinesiology and Community Health, College of Applied Health Sciences University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sarah Mills
- Department of Human Development and Family Studies, College of Agricultural, Consumer and Environmental Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jacob Sonsoff
- Department of Kinesiology and Community Health, College of Applied Health Sciences University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Center on Health, Aging and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| |
Collapse
|
30
|
Paulisso DC, Schmeler MR, Schein RM, Allegretti ALC, Campos LCB, Costa JD, Fachin-Martins E, Cruz DMCD. Functional mobility assessment is reliable and correlated with satisfaction, independence and skills. Assist Technol 2019; 33:264-270. [DOI: 10.1080/10400435.2019.1629125] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Debora Caires Paulisso
- Department of Occupational Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
| | - Mark R. Schmeler
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Richard M. Schein
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | - Emerson Fachin-Martins
- Program in Science of Rehabilitation, Universidade de Brasília, Distrito Federal, Brazil
| | - Daniel Marinho Cezar da Cruz
- Department of Occupational Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
- Occupational Therapist
| |
Collapse
|
31
|
Ossada VAY, Souza JG, Cruz DMC, Campos LCB, Medola FO, Costa VDSP. Cross-cultural adaptation of wheelchair skills test (version 4.3) for wheelchair users and caregivers to the Portuguese language (Brazil). Disabil Rehabil Assist Technol 2019; 15:491-498. [PMID: 31145013 DOI: 10.1080/17483107.2019.1604826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To perform cross-cultural adaptation of the Wheelchair Skills Test of manual wheelchair users and their caregivers into the Brazilian Portuguese language.Methods: The study was composed of translation, synthesis of translations, back-translation, review by an expert committee and pre-test, when the test was applied in the target population. Included were translators, subject specialists and coordinators to carry out the cross-cultural adaptation process, and manual wheelchair users and their caregivers with at least six months of wheelchair experience for the pre-test.Results: Forty-three people participated in the study, 30 for the pre-test and 13 for the stages that preceded the pre-test. The mean age of manual wheelchair users was 40.2 (±10.7) years and of caregivers was 44.2 (±15.7) years. Of the 47 phrases translated in the first stage, 36 discrepancies were found and resolved. During the analysis by the committee of experts the instrument underwent 13 modifications in order to achieve the best possible equivalence between the original version and the final version and was understandable by the people evaluated. The total pre-test scores of wheelchair users and their caregivers were 66.2 (±24.6) and 88.7 (±14.2), respectively.Conclusions: This instrument was able to evaluate the abilities of wheelchair users and their caregivers in Brazil, as well as being useful for training in rehabilitation programs.Implications for rehabilitationThe need to use wheelchair (WC) properly has made clinicians and rehabilitation professionals more concerned with assessing and training users' abilities with their WC.Cross-cultural adaptation allows for the linguistic modification of the original language of the evaluation tool into a new language and enables the comparison of research results in different countries.Immediate use of the instrument for WC users and caregivers in Brazil, both for evaluation and for training, is necessary and may be a means for rehabilitation professionals to improve their evaluations, their treatments and optimize the skills that aim at independence.
Collapse
Affiliation(s)
- Vinícius Aparecido Yoshio Ossada
- Department of Physiotherapy, Universidade Pitágoras Unopar (UNOPAR), Londrina, Brazil.,Department of Physiotherapy, Centro Universitário Filadélfia (UniFil), Londrina, Brazil
| | - Jônatas Garcia Souza
- Department of Physiotherapy, Universidade Pitágoras Unopar (UNOPAR), Londrina, Brazil
| | | | | | - Fausto Orsi Medola
- Department of Design, Universidade Estadual Paulista (UNESP), Bauru, Brazil
| | | |
Collapse
|
32
|
Rispin K, Davis AB, Sheafer VL, Wee J. Development of the Wheelchair Interface Questionnaire and initial face and content validity. Afr J Disabil 2019; 8:520. [PMID: 31049310 PMCID: PMC6489171 DOI: 10.4102/ajod.v8i0.520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/27/2018] [Indexed: 11/18/2022] Open
Abstract
Background Because resources are limited in low- and middle-income countries (LMIC), the development of outcome measures is of interest. Wheelchair outcome measures are useful to support evidence-based practice in wheelchair provision. Objectives The Wheelchair Interface Questionnaire (WIQ) is being developed to provide a professional perspective on the quality of the interface between a wheelchair and its user. This article discusses the development of the WIQ and its face and content validity. Method During field studies in Kenya, we sought to include professional report data on the wheelchair–user interface that could be analysed to inform design changes. None of the existing measures was focused on the interface between users and their wheelchairs. The WIQ was developed to meet this need. To investigate face and content validity, 24 experienced wheelchair professionals participated in a study that included two rounds of an online survey and a focus group in Kenya. Results Responses were categorised by topic and the WIQ was modified following each iteration. Participants affirmed the usefulness of a brief professional report measure to provide a snapshot of the user–wheelchair interface. Participants emphasised the importance of brevity, wide applicability and provision of specific feedback for wheelchair modification or design changes. The focus group agreed that the final version provided useful data and was applicable to virtually all wheelchair users in LMIC. Conclusion These preliminary studies indicate initial face and content validity of the WIQ as a method for providing a professional perspective on the interface between a user and his or her wheelchair. Keywords Outcome measure; wheelchair assessment; user–wheelchair interface; wheelchair appropriateness; professional report.
Collapse
Affiliation(s)
- Karen Rispin
- Department of Biology and Kinesiology, LeTourneau University, Longview, United States
| | - Abigail B Davis
- Department of Biology and Kinesiology, LeTourneau University, Longview, United States
| | - Vicki L Sheafer
- Department of Psychology, LeTourneau University, Longview, United States
| | - Joy Wee
- Canadian Association of Physical Medicine and Rehabilitation, Kingston, Canada
| |
Collapse
|
33
|
Abstract
Soft-tissue deficits in amputation stumps can lead to significant pain and disability. An emerging treatment option is stem cell-enriched fat grafting. This is the first study assessing the potential for this treatment modality in lower extremity amputation sites. In this prospective cohort study, five injured military personnel suffering from pain and limited function at amputation sites were recruited. Fat grafting enriched with stromal vascular fraction was performed at amputation sites to provide additional subcutaneous tissue padding over bony structures. Outcomes measures included complications, demographic data, physical examination, cellular subpopulations, cell viability, graft volume retention, pain, Lower Extremity Functional Scale, Functional Mobility Assessment, 36-Item Short-Form Health Survey, and rates of depression. Follow-up was 2 years. There were no significant complications. Volume retention was 61.5 ± 24.0 percent. Overall cell viability of the stromal vascular fraction was significantly correlated with volume retention (p = 0.016). There was no significant correlation between percentage of adipose-derived stem cells or number of cells in the stromal vascular fraction and volume retention. There was a nonsignificant trend toward improvement in pain scores (3.0 ± 2.5 to 1.2 ± 1.6; p = 0.180 at 2 years). There were no significant changes in disability indexes. Results from this pilot study demonstrate that stromal vascular fraction-enriched fat grafting is a safe, novel modality for the treatment of symptomatic soft-tissue defects in traumatic lower extremity amputations. Volume retention can be anticipated at slightly over 60 percent. Further studies are needed to assess efficacy. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.
Collapse
|
34
|
Martini DN, Zeeboer E, Hildebrand A, Fling BW, Hugos CL, Cameron MH. ADSTEP: Preliminary Investigation of a Multicomponent Walking Aid Program in People With Multiple Sclerosis. Arch Phys Med Rehabil 2018; 99:2050-2058. [PMID: 29958906 DOI: 10.1016/j.apmr.2018.05.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/05/2018] [Accepted: 05/14/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the effect of the Assistive Device Selection, Training and Education Program (ADSTEP) on falls and walking and sitting activity in people with multiple sclerosis (PwMS). DESIGN Randomized controlled trial. SETTING Veterans affairs medical center. PARTICIPANTS PwMS (N=40) using a walking aid at baseline who had fallen in the previous year. INTERVENTIONS Participants were randomly assigned to ADSTEP or control. ADSTEP had 6 weekly, 40-minute, 1-on-1 sessions with a physical therapist, starting with walking aid selection and fitting, followed by task-oriented progressive gait training. Control was usual medical care with the option of ADSTEP after the study. MAIN OUTCOME MEASURES The following were assessed at baseline, intervention completion, and 3 months later: falls, timed Up and Go, timed 25-foot walk, 2-minute walk, Four Square Step Test, International Physical Activity Questionnaire, Quebec User Evaluation of Satisfaction with Assistive Technologies, Multiple Sclerosis Walking Scale-12, Activities-Specific Balance Confidence Scale, and Multiple Sclerosis Impact Scale-29. Effect on these outcomes was estimated by a 2-by-2 repeated measures general linear model. RESULTS Fewer ADSTEP than control participants fell (χ2=3.96, P<.05. number needed to treat =3.3). Time spent sitting changed significantly differently with ADSTEP than with control from baseline to intervention completion (F=11.16, P=.002. ADSTEP: reduced 87.00±194.89min/d; control: increased 103.50±142.21min/d; d=0.88) and to 3-month follow-up (F=9.25, P=.004. ADSTEP: reduced 75.79±171.57min/d; control: increased 84.50±149.23min/d; d=0.79). ADSTEP yielded a moderate effect on time spent walking compared to control at 3-month follow-up (P>.05. ADSTEP 117.53±148.40min/d; control 46.43±58.55min/d; d=0.63). CONCLUSIONS ADSTEP prevents falls, reduces sitting, and may increase walking in PwMS.
Collapse
Affiliation(s)
- Douglas N Martini
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Eline Zeeboer
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | | | - Brett W Fling
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO
| | - Cinda L Hugos
- Department of Neurology, Oregon Health & Science University, Portland, OR; Veterans Affairs Portland Health Care System, Portland, OR
| | - Michelle H Cameron
- Department of Neurology, Oregon Health & Science University, Portland, OR; Veterans Affairs Portland Health Care System, Portland, OR.
| |
Collapse
|
35
|
Efficacy of Elastic Resistance Training Program for the Institutionalized Elderly. TOPICS IN GERIATRIC REHABILITATION 2018. [DOI: 10.1097/tgr.0000000000000179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Zhao N, Zhang J, Qiu M, Wang C, Xiang Y, Wang H, Xie J, Liu S, Wu J. Scalp acupuncture plus low-frequency rTMS promotes repair of brain white matter tracts in stroke patients: A DTI study. J Integr Neurosci 2018. [DOI: 10.3233/jin-170043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Ning Zhao
- Department of Rehabilitation Medicine, Shenzhen Nanshan Hospital, Shenzhen University, Shenzhen, 518052, China
- Department of Rehabilitation Medicine, Shenzhen Nanshan District People’s Hospital, Shenzhen, 518052, China
| | - Jingna Zhang
- College of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China
| | - Mingguo Qiu
- College of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China
| | - Chunrong Wang
- Department of Radiology, Shenzhen Nanshan District People’s Hospital, Shenzhen, 518052, China
| | - Yun Xiang
- Department of Rehabilitation Medicine, Shenzhen Nanshan Hospital, Shenzhen University, Shenzhen, 518052, China
- Department of Rehabilitation Medicine, Shenzhen Nanshan District People’s Hospital, Shenzhen, 518052, China
| | - Hui Wang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Jingwen Xie
- Department of Radiology, Shenzhen Nanshan District People’s Hospital, Shenzhen, 518052, China
| | - Shu Liu
- Hunan University of Chinese Medicine, Changsha, 410007, China
| | - Jing Wu
- Hunan University of Chinese Medicine, Changsha, 410007, China
| |
Collapse
|
37
|
Bouça-Machado R, Maetzler W, Ferreira JJ. What is Functional Mobility Applied to Parkinson's Disease? JOURNAL OF PARKINSON'S DISEASE 2018; 8:121-130. [PMID: 29480225 PMCID: PMC5836402 DOI: 10.3233/jpd-171233] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 12/17/2022]
Abstract
Although yet poorly defined and often misused, the concept of functional mobility has been used in research studies as a more global and ecological outcome of patients' health status. Functional mobility is a person's physiological ability to move independently and safely in a variety of environments in order to accomplish functional activities or tasks and to participate in the activities of daily living, at home, work and in the community. Parkinson's disease (PD) has a direct impact on patients' motor control and on mobility in general. Even with optimal medical management, the progression of PD is associated with mounting impairments at different levels of body function, causing marked limitations in a wide variety of activities, as well as a severe disability and loss of autonomy. Despite this, for everyday functioning PD patients need to have a good functional mobility that allow them to get around effortlessly in a reasonable amount of time to access to the same environments as others. This paper reviewed the concept of functional mobility applied to PD. This was done through an International Classification of Functioning and Disability (ICF) perspective. Recommendations to address the known factors that contribute to a poor functional mobility were outlined while suggestions for clinical practice and research were made.
Collapse
Affiliation(s)
- Raquel Bouça-Machado
- Instituto de Medicina Molecular, Lisbon, Portugal
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Joaquim J. Ferreira
- Instituto de Medicina Molecular, Lisbon, Portugal
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal
| |
Collapse
|
38
|
Rispin KL, Hamm E, Wee J. Discriminatory validity of the Aspects of Wheelchair Mobility Test as demonstrated by a comparison of four wheelchair types designed for use in low-resource areas. Afr J Disabil 2017; 6:332. [PMID: 28936413 PMCID: PMC5594268 DOI: 10.4102/ajod.v6i0.332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 05/02/2017] [Indexed: 11/19/2022] Open
Abstract
Background Comparative effectiveness research on wheelchairs available in low-resource areas is needed to enable effective use of limited funds. Mobility on commonly encountered rolling environments is a key aspect of function. High variation in capacity among wheelchair users can mask changes in mobility because of wheelchair design. A repeated measures protocol in which the participants use one type of wheelchair and then another minimises the impact of individual variation. Objectives The Aspects of Wheelchair Mobility Test (AWMT) was designed to be used in repeated measures studies in low-resource areas. It measures the impact of different wheelchair types on physical performance in commonly encountered rolling environments and provides an opportunity for qualitative and quantitative participant response. This study sought to confirm the ability of the AWMT to discern differences in mobility because of wheelchair design. Method Participants were wheelchair users at a boarding school for students with disabilities in a low-resource area. Each participant completed timed tests on measured tracks on rough and smooth surfaces, in tight spaces and over curbs. Four types of wheelchairs designed for use in low-resource areas were included. Results The protocol demonstrated the ability to discriminate changes in mobility of individuals because of wheelchair type. Conclusion Comparative effectiveness studies with this protocol can enable beneficial change. This is illustrated by design alterations by wheelchair manufacturers in response to results.
Collapse
Affiliation(s)
- Karen L Rispin
- Department of Biology, Tourneau University, United States
| | - Elisa Hamm
- Kinesiology Department, LeTourneau University, United States
| | - Joy Wee
- School of Rehabilitation Therapy, Queens University, Canada
| |
Collapse
|
39
|
Sund T, Brandt Å, Anttila H, Iwarsson S. Psychometric properties of the NOMO 1.0 tested among adult powered-mobility users. The Canadian Journal of Occupational Therapy 2016; 84:34-46. [DOI: 10.1177/0008417416652909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. The Nordic Mobility Related Outcome Evaluation of Assistive Device Intervention (NOMO 1.0) instrument evaluates the effectiveness of mobility devices in assessing mobility-related participation, captured by three scales (Need for Assistance, Frequency, and Ease/Difficulty) and one index (Participation Repertoire). Purpose. This study aimed to investigate a range of psychometric properties of the NOMO 1.0 in a sample of adult powered mobility device (PMD) users. Method. Data collected from PMD users ( N = 248) in Denmark, Finland, and Norway as part of a larger study were analyzed using state-of-the-art statistical methods. Findings. The acceptability and applicability of the NOMO 1.0 items were generally within recommended values. Some floor/ceiling effects were found and the reliability was acceptable for only the Frequency scale. The factor analysis identified one component for the Need for Assistance scale and six components of the Frequency scale. Implications. The NOMO 1.0 should be used for research purposes and not for clinical practice. Better reliability should be established for the Need for Assistance and Ease/Difficulty scales prior to further psychometric testing to establish the validity of the NOMO 1.0.
Collapse
|
40
|
Toro ML, Eke C, Pearlman J. The impact of the World Health Organization 8-steps in wheelchair service provision in wheelchair users in a less resourced setting: a cohort study in Indonesia. BMC Health Serv Res 2016; 16:26. [PMID: 26801984 PMCID: PMC4722611 DOI: 10.1186/s12913-016-1268-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/12/2016] [Indexed: 11/28/2022] Open
Abstract
Background For people who have a mobility impairment, access to an appropriate wheelchair is an important step towards social inclusion and participation. The World Health Organization Guidelines for the Provision of Manual Wheelchairs in Less Resourced Settings emphasize the eight critical steps for appropriate wheelchair services, which include: referral, assessment, prescription, funding and ordering, product preparation,fitting and adjusting, user training, and follow-up and maintenance/repairs. The purpose of this study was to investigate how the provision of wheelchairs according to the World Health Organization’s service provision process by United Cerebral Palsy Wheels for Humanity in Indonesia affects wheelchair recipients compared to wait-listed controls. Methods This study used a convenience sample (N = 344) of Children, Children with proxies, Adults, and Adults with proxies who were on a waiting list to receive a wheelchair as well as those who received one. Interviews were conducted at baseline and a 6 month follow-up to collect the following data: Demographics and wheelchair use questions, the World Health Organization Quality of Life-BREF, Functional Mobility Assessment, Craig Handicap Assessment Recording Technique Short Form. The Wheelchair Assessment Checklist and Wheelchair Skills Test Questionnaire were administered at follow up only. Results 167 participants were on the waiting list and 142 received a wheelchair. Physical health domain in the World Health Organization Quality of Life-BREF improved significantly for women who received a wheelchair (p = 0.044) and environmental health improved significantly for women and men who received a wheelchair as compared to those on the waiting list (p < 0.017). Satisfaction with the mobility device improved significantly for Adults with proxies and Children with proxies as compared to the waiting list (p < 0.022). Only 11 % of Adults who received a wheelchair reported being able to perform a “wheelie”. The condition of Roughrider wheelchairs was significantly better than the condition of kids wheelchairs for Children with proxies as measured by the Wheelchair Assessment Checklist (p = 0.019). Conclusions Wheelchair provision according to World Health Organization’s 8-Steps in a less-resourced setting has a range of positive outcomes including increased satisfaction with the mobility device and better quality of life. Wheelchair provision service could be improved by providing more hours of wheelchair skills training. There is a need for outcome measures that are validated across cultures and languages.
Collapse
Affiliation(s)
- Maria L Toro
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.,Programa de Ingenieria Biomedica, Escuela de Ingeniería de Antioquia y Universidad CES, Envigado, Antioquia, Colombia
| | - Chika Eke
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jonathan Pearlman
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. .,Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
41
|
Jenkins GR, Vogtle LK, Yuen HK. Factors Associated With the Use of Standardized Power Mobility Skills Assessments Among Assistive Technology Practitioners. Assist Technol 2015; 27:219-25. [DOI: 10.1080/10400435.2015.1030515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Gavin R. Jenkins
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Laura K. Vogtle
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Hon K. Yuen
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
42
|
Carver J, Ganus A, Ivey JM, Plummer T, Eubank A. The impact of mobility assistive technology devices on participation for individuals with disabilities. Disabil Rehabil Assist Technol 2015; 11:468-77. [PMID: 25815679 DOI: 10.3109/17483107.2015.1027295] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM This study aims to address the gap in research and contribute to the body of knowledge on the perspectives assistive technology device users have toward their devices. METHOD Mixed methods were used to better understand the impact of mobility assistive technology devices (MATDs) on participation for individuals with disabilities. The Functional Mobility Assessment was administered in conjunction with two qualitative questions developed by the research team allowing participants to expound on the impact of their MATD experience. Participants were recruited online via the National Spinal Cord Injury Association website and in-person at Abilities Expo in Atlanta, Georgia, and the International Seating Symposium in Nashville, Tennessee. RESULTS Results are consistent with findings from prior research regarding accessibility for individuals with disabilities. Corresponding findings were found in both the quantitative and qualitative data and are categorized into several major themes: environment (indoor and outdoor), surface heights, transportation, dependence, independence, quality of life and participation. CONCLUSION Quantitative data from this study indicate that users of MATD are satisfied with the way in which their devices enable maneuvering indoors, while qualitative data suggest otherwise. Implications for healthcare practitioners are described and future recommendations are provided. Implications for Rehabilitation Healthcare professionals should advocate for proper mobility assistive technology devices (MATDs) for their patients in order to enable increased independence, safety and efficiency. Healthcare professionals must be cognizant of the impact of the environment and/or environmental barriers when prescribing MATD. Additional areas of interest for future research may include investigating the impact of MATD in association with date of onset of disability, according to diagnoses, or specific to length of time since acquiring the device.
Collapse
Affiliation(s)
- Jordan Carver
- a School of Occupational Therapy, Belmont University , Nashville , TN , USA
| | - Ashley Ganus
- a School of Occupational Therapy, Belmont University , Nashville , TN , USA
| | - Jon Mark Ivey
- a School of Occupational Therapy, Belmont University , Nashville , TN , USA
| | - Teresa Plummer
- a School of Occupational Therapy, Belmont University , Nashville , TN , USA
| | - Ann Eubank
- a School of Occupational Therapy, Belmont University , Nashville , TN , USA
| |
Collapse
|
43
|
Sund T, Iwarsson S, Anttila H, Brandt Å. Effectiveness of Powered Mobility Devices in Enabling Community Mobility-Related Participation: A Prospective Study Among People With Mobility Restrictions. PM R 2015; 7:859-870. [PMID: 25677008 DOI: 10.1016/j.pmrj.2015.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 01/22/2015] [Accepted: 02/01/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the effectiveness of powered mobility device (ie, powered wheelchair and scooter) interventions over a 1-year period in Nordic countries. DESIGN Prospective design. SETTING The study involved community-dwelling participants from Denmark, Finland, and Norway. PARTICIPANTS In all, 180 participants with different self-reported impairments participated in the study. The mean age was 68.7 years (95% confidence interval [CI] = 39.9-97.5 years), and 47.8% of the participants were men. METHODS Two face-to-face interviews about mobility and mobility-related participation were conducted with participants in their homes. The first interview took place shortly before the participants received their powered mobility device, and the second took place about 1 year later (mean, 386.9 days; standard deviation = 52.78). MAIN OUTCOME MEASURES Changes in frequency, ease/difficulty, and number of mobility-related aspects of participation in daily life were investigated in the total sample and in subgroups by means of the NOMO 1.0 instrument, applying a structured interview format. RESULTS In the total sample, the frequency of shopping for groceries (P < .001, effect size = 0.29, 95% CI = 0.08-0.50) and going for a walk/ride (P < .001, effect size = 0.62, 95% CI = 0.41-83) increased, whereas the number of aspects of participation performed (P < .001) increased only slightly. Going to a restaurant/café/pub, shopping for groceries, doing other shopping, posting letters, going to the bank or the chemist's, going for a walk/ride, and visiting family/friends became easier (P < .001 to P = .001); effect sizes varied between 0.50 (95% CI = 0.29-0.71) and 0.85 (95% CI = 0.63-1.07). Men, persons who used scooters, and persons with poor self-reported health seem to benefit the most from the intervention. CONCLUSIONS Powered mobility device interventions mainly contribute to mobility-related participation by making participation easier for people with mobility restrictions and by increasing the frequency of aspects of participation such as shopping for groceries and going for a walk/ride. The effects varied with regard to the subgroups. The present study further strengthens the current evidence that powered mobility devices increase mobility-related participation in daily life among certain subgroups of adults with mobility restrictions.
Collapse
Affiliation(s)
- Terje Sund
- Department of Assistive Technology, The Norwegian Labour and Welfare Service, Oslo, Norway.,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Susanne Iwarsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Heidi Anttila
- Health and Social Services Development Unit, Service System Department, National Institute for Health and Welfare, Helsinki, Finland
| | - Åse Brandt
- Department of Disability and Technology, The National Board of Social Services, Odense, Denmark.,Institute of Public Health, University of Southern Denmark, Odense, Denmark
| |
Collapse
|