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Clanchy K, Mitchell J, Mulholland K, Jurd E, Kendall E, Lloyd DG, Palipana D, Pizzolato C, Shirota C. Towards co-design of rehabilitation technologies: a collaborative approach to prioritize usability issues. Front Rehabil Sci 2024; 5:1302179. [PMID: 38450206 PMCID: PMC10915061 DOI: 10.3389/fresc.2024.1302179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024]
Abstract
Introduction Early stakeholder engagement is critical to the successful development and translation of rehabilitation technologies, a pivotal step of which is usability testing with intended end-users. To this end, several methods employ end-user feedback to identify usability and implementation issues. However, the process of prioritizing identified issues seldom leverages the knowledge and expertise of the range of stakeholders who will ultimately affect the demand and supply of a device. This paper describes a novel method to prioritize end-user feedback using transdisciplinary stakeholder consultation and address it in subsequent product development. The proposed approach was demonstrated using a case study relating to the development of a novel technology for neural recovery after spinal cord injury. Method Feedback from five individuals with chronic spinal cord injury was collected during two-hour usability evaluation sessions with a fully functional high-fidelity system prototype. A think-aloud and semi-structured interview protocol was used with each participant to identify usability and acceptability issues relating to the system in a 3-phase approach. Phase 1 involved extracting usability issues from think-aloud and semi-structured interview data. Phase 2 involved rating the usability issues based on their significance, technical feasibility, and implementation priority by relevant internal and external stakeholders. Finally, Phase 3 involved aggregating the usability issues according to design and implementation elements to facilitate solution generation, and these solutions were then raised as action tasks for future design iterations. Results Sixty usability issues representing nine facets of usability were rated. Eighty percent of issues were rated to be of moderate to high significance, 83% were rated as being feasible to address, and 75% were rated as addressable using existing project resources. Fifty percent of the issues were rated to be a high priority for implementation. Evaluation of the grouped issues identified 21 tasks which were mapped to the product roadmap for integration into future design iterations. Discussion This paper presents a method for meaningful transdisciplinary stakeholder engagement in rehabilitation technology development that can extended to other projects. Alongside a worked example, we offer practical considerations for others seeking to co-develop rehabilitation technologies.
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Affiliation(s)
- K. Clanchy
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - J. Mitchell
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - K. Mulholland
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Advanced Design and Prototyping Technologies Institute, Menzies Health Institute Queensland, Southport, QLD, Australia
| | - E. Jurd
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Advanced Design and Prototyping Technologies Institute, Menzies Health Institute Queensland, Southport, QLD, Australia
| | - E. Kendall
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - D. G. Lloyd
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Advanced Design and Prototyping Technologies Institute, Menzies Health Institute Queensland, Southport, QLD, Australia
| | - D. Palipana
- Emergency Department, Gold Coast University Hospital, Southport, QLD, Australia
| | - C. Pizzolato
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Advanced Design and Prototyping Technologies Institute, Menzies Health Institute Queensland, Southport, QLD, Australia
| | - C. Shirota
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
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Clanchy K, Stanfield M, Smits E, Liimatainen J, Ritchie C. Calibration and validation of physical behaviour cut-points using wrist-worn ActiGraphs for children and adolescents: A systematic review. J Sci Med Sport 2024; 27:92-104. [PMID: 38087661 DOI: 10.1016/j.jsams.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVES To review cut-points calibrated and independently validated from wrist-worn ActiGraph accelerometers to measure moderate to vigorous physical activity (MVPA) and time spent sedentary (SED) in children and adolescents. DESIGN Systematic literature review. METHODS Five databases were searched for relevant cut-point calibration and independent validation studies relating to wrist worn ActiGraphs in children and adolescents from inception through 30 April 2022. Extracted data included: country of publication; study name; population; device model; wear location; sampling frequency; epoch length; activity protocol; criterion method and definitions used to classify PA intensity; statistical methods for calibration; statistical methods for validation/cross-validation; and MVPA and SED outcome. RESULTS Fourteen calibration studies and seven independent validation studies were identified. Calibrated cut-points for MVPA vector magnitude counts ranged from 7065 to 9204 counts per minute (cpm) and 63.5 to 201 milli-gravitational units (mg). For SED, calibrated cut-points ranged from <2556 cpm to 4350 cpm and 30.8 to 48.1 mg. Classification accuracy values determined by independent validation studies varied, with kappa values ranging from 0.31 to 0.60 and area under the curve statistics ranging from 0.51 to 0.84 for MVPA and kappa values ranging from 0.31 to 0.44 and area under the curve statistics ranging from 0.70 to 0.85 for SED. CONCLUSIONS The results of this systematic literature review support the use of the Crouter and colleagues cut-points for the measurement of MVPA and SED for children and adolescents aged 6-12 years. Further work is required to independently validate cut-points developed in younger children and older adolescents.
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Affiliation(s)
- Kelly Clanchy
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Menzies Health Institute of Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Matthew Stanfield
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia
| | - Esther Smits
- RECOVER Injury Research Centre and National Health and Medical Research Council (NHMRC) Centre for Research Excellence: Better Health Outcomes After Compensable Injury, University of Queensland, Australia
| | - Jenna Liimatainen
- RECOVER Injury Research Centre and National Health and Medical Research Council (NHMRC) Centre for Research Excellence: Better Health Outcomes After Compensable Injury, University of Queensland, Australia
| | - Carrie Ritchie
- RECOVER Injury Research Centre and National Health and Medical Research Council (NHMRC) Centre for Research Excellence: Better Health Outcomes After Compensable Injury, University of Queensland, Australia
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Chapman K, Dixon A, Kendall E, Clanchy K. Defining dignity at the intersection of disability: a scoping review. Disabil Rehabil 2024:1-11. [PMID: 38265032 DOI: 10.1080/09638288.2024.2302582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE This scoping literature review aimed to determine the definition of dignity in relation to disability. It also examined the extent to which inclusive research methods have been used to develop working definitions. MATERIALS AND METHODS A comprehensive search was conducted in five electronic databases, using a modified framework by Arksey and O'Malley. Narrative synthesis and qualitative content analysis were employed to examine definitions of dignity and the use of inclusive research methods. RESULTS 22 peer-reviewed studies were included. The majority of the studies were qualitative (72.72%) and examined various disability populations in diverse settings. Although 19 studies offered a definition of dignity, there was no clear consensus. Dignity was frequently defined from a utilitarian perspective, emphasising affordances and barriers. However, engagement with theoretical constructs was superficial and limited. Further, no studies mentioned the use of inclusive research methods. CONCLUSIONS The absence of inclusive research methods hinders the development of a comprehensive definition of dignity that is accepted by and relevant to people with disability. Engaging with both theoretical and empirical perspectives of dignity is crucial to develop a meaningful and inclusive definition, which can inform interventions and policies that enhance dignity for people with disability across diverse settings and contexts.
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Affiliation(s)
- Kelsey Chapman
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
| | - Angel Dixon
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
| | - Elizabeth Kendall
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
| | - Kelly Clanchy
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
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Mitchell J, Clanchy K, Shirota C. Towards Translation of Novel Neurorehabilitation Systems: A Practical Approach to Usability Testing. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941179 DOI: 10.1109/icorr58425.2023.10304770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Usability testing is important for the effective translation of neurorehabilitation technologies but is often overlooked and under-reported. The aim of this paper is to present a method of collecting and analyzing usability data, using a think-aloud and semi-structured interview protocol and qualitative analysis techniques. We present a worked case study of this method with a novel neurorehabilitation system that utilizes thought-controlled robotics to partially restore lower-limb function of people with spinal cord injury (SCI). Five male participants (mean age = 32.6 years) with SCI who identified as users of related neurorehabilitation technologies completed the usability study. Video-recorded usability sessions utilized a combination of concurrent and retrospective think-aloud methods as well as semi-structured interviews. Recordings were analyzed to identify verbal and behavioral feedback from participants regarding system performance and acceptability. In total, 538 data points were logged, which were aggregated into 60 usability issues, 44 positive evaluations, and 31 strategies for improvement. The approach undertaken was novel in that we sought to not only capture usability issues but also system elements that were positively evaluated by intended users and strategies for improvement from the perspective of intended users. These observations will be used to inform the further development of the neurorehabilitation system.
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Shirota C, Mitchell J, Clanchy K. End-User Perspectives of the Importance of Rehabilitation Technologies and Related Values for Implementation. IEEE Int Conf Rehabil Robot 2023; 2023:1-4. [PMID: 37941202 DOI: 10.1109/icorr58425.2023.10304808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Despite the increased availability of rehabilitation technologies (such as robotics) and evidence to support their use, their adoption is still limited in practice. To begin to address this issue, we sought to better understand the perspectives of end-users regarding the implementation of rehabilitation technologies through an online survey. Fifty unique responses across Client (e.g., people with disability and carers), Allied Health (e.g., occupational and physical therapists, podiatrists, psychologists, dieticians, audiologists, exercise physiologists), and Medical (i.e., physicians and nurses) groups were analyzed. Respondents considered rehabilitation technologies to be important (median across groups of 9 out of 10). Across groups, value statements related to the implementation of rehabilitation technologies ranked from most to least important related to: benefits of technology to its intended end-user with disability, practical use of technologies, the technologies themselves (e.g., innovative, established, stand-alone), and their impact on health professionals or the health system as a whole. There were similarities and differences in ranking within and across end-user groups. The prioritization of statements indicates where development efforts can be focused to address end-user goals, and disparity in results across groups supports rich stakeholder engagement during rehabilitation technology development.
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Clanchy K, Hill J, Fenning M, Tweedy S. Community-based physical activity promotion confers broad-spectrum benefits for military veterans with chronic and complex conditions: evidence from 4 years of rehabilitation consultant referrals. BMJ Mil Health 2023:e002375. [PMID: 37364900 DOI: 10.1136/military-2023-002375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Veterans experience a high incidence of chronic and complex health conditions requiring a holistic approach to health and well-being. The Adapted Physical Activity Program (APAP) is a theory-based programme developed to support the physical activity (PA) participation of community-dwelling people with disabilities. Although available to all people with disabilities, of the 214 clients referred between 2015 and 2019, two hundred and three were veterans. This study aimed to understand this unexpected predominance by describing the characteristics of the veterans referred to APAP, including client goals, as well as describing the characteristics of the rehabilitation consultants who made the referrals. METHODS Descriptive statistics were used to describe specific characteristics of the veterans and the rehabilitation consultants. Content analysis was used to analyse client goals. RESULTS Client data highlighted the complexity of this clinical population. All clients had been diagnosed with more than one health condition, with most experiencing both a physical injury and a mental health diagnosis. Content analysis revealed six overarching client goals, including supporting sustainable PA participation, mental health and well-being, participation in meaningful activities, community and social engagement, management of condition and physical health and fitness. Data from the referring organisations showed that each organisation had multiple health professionals that made repeated referrals to APAP. The most common health profession to make a referral to APAP was occupational therapy. CONCLUSION Veterans have a high incidence of chronic and complex health conditions including physical injury and mental illness. Programmes and services that look beyond addressing the diagnosis and treatment of specific conditions to supporting the overall health and well-being of the individual are required. Person-centred, community-based PA programmes such as APAP might offer this solution. Further research is required to assess the efficacy of such programmes with this population.
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Affiliation(s)
- Kelly Clanchy
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - J Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - M Fenning
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - S Tweedy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
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Mitchell J, Shirota C, Clanchy K. Factors that influence the adoption of rehabilitation technologies: a multi-disciplinary qualitative exploration. J Neuroeng Rehabil 2023; 20:80. [PMID: 37340496 DOI: 10.1186/s12984-023-01194-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/23/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Technological innovation is recognised as having the potential to enhance rehabilitation for people with disability. Yet, resistance to, and abandonment of, rehabilitation technology is prevalent and the successful translation of technology into rehabilitation settings remains limited. Therefore, the aim of this work was to develop an in-depth, multi-stakeholder perspective on what influences the adoption of rehabilitation technologies. METHODS Semi-structured focus groups were conducted as part of a larger research project aiming to facilitate the co-design of a novel neurorestorative technology. Focus group data were analysed using a five-phase hybrid deductive-inductive approach to qualitative data analysis. RESULTS Focus groups were attended by 43 stakeholders with expertise in one or more of the following fields: people with disability, allied health, human movement science, computer science, design, engineering, ethics, funding, marketing, business, product development, and research development. Six main themes influencing the adoption of technology in rehabilitation were identified: cost beyond the purchase price, benefits to all stakeholders, trust to be earned in technology, ease of technology operation, ability to access technology, and the 'co' in co-design. All six themes were found to be interrelated; in particular, the importance of direct stakeholder engagement in the development of rehabilitation technologies (the 'co' in co-design) was prevalent in all themes. CONCLUSIONS A range of complex and interrelated factors influence the adoption of rehabilitation technologies. Importantly, many of the issues that have the potential to negatively impact rehabilitation technology adoption may be addressed during development by utilising the experience and expertise of stakeholders who influence its supply and demand. Our findings state that a wider cohort of stakeholders needs to be actively engaged in the development of rehabilitation technologies to better address the factors that contribute to technology underutilisation and abandonment and facilitate better outcomes for people with disability.
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Affiliation(s)
- Jessie Mitchell
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Camila Shirota
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kelly Clanchy
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
- School of Health Sciences and Social Work, Griffith University, Southport, Australia.
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Haynes A, Howard K, Johnson L, Williams G, Clanchy K, Tweedy S, Scheinberg A, Chagpar S, Wang B, Vassallo G, Ashpole R, Sherrington C, Hassett L. Physical Activity Preferences of People Living with Brain Injury: Formative Qualitative Research to Develop a Discrete Choice Experiment. Patient 2023:10.1007/s40271-023-00628-9. [PMID: 37204699 DOI: 10.1007/s40271-023-00628-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND OBJECTIVE The World Health Organization physical activity guidelines for people living with disability do not consider the needs of people living with moderate-to-severe traumatic brain injury. This paper describes the qualitative co-development of a discrete choice experiment survey to inform the adaption of these guidelines by identifying the physical activity preferences of people living with moderate-to-severe traumatic brain injury in Australia. METHODS The research team comprised researchers, people with lived experience of traumatic brain injury and health professionals with expertise in traumatic brain injury. We followed a four-stage process: (1) identification of key constructs and initial expression of attributes, (2) critique and refinement of attributes, (3) prioritisation of attributes and refinement of levels and (4) testing and refining language, format and comprehensibility. Data collection included deliberative dialogue, focus groups and think-aloud interviews with 22 purposively sampled people living with moderate-to-severe traumatic brain injury. Strategies were used to support inclusive participation. Analysis employed qualitative description and framework methods. RESULTS This formative process resulted in discarding, merging, renaming and reconceptualising attributes and levels. Attributes were reduced from an initial list of 17 to six: (1) Type of activity, (2) Out-of-pocket cost, (3) Travel time, (4) Who with, (5) Facilitated by and (6) Accessibility of setting. Confusing terminology and cumbersome features of the survey instrument were also revised. Challenges included purposive recruitment, reducing diverse stakeholder views to a few attributes, finding the right language and navigating the complexity of discrete choice experiment scenarios. CONCLUSIONS This formative co-development process significantly improved the relevance and comprehensibility of the discrete choice experiment survey tool. This process may be applicable in other discrete choice experiment studies.
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Affiliation(s)
- Abby Haynes
- Sydney Musculoskeletal Health: The University of Sydney and Sydney Local Health District, Gadigal Land, Sydney, NSW, Australia.
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Land, Sydney, NSW, Australia.
- Sydney Musculoskeletal Health, Level 10 KGV Building, Missenden Road, Camperdown (Gadigal land), NSW, 2050, Australia.
| | - Kirsten Howard
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Land, Sydney, NSW, Australia
| | - Liam Johnson
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Gavin Williams
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
- Physiotherapy Department, Epworth HealthCare, Melbourne, VIC, Australia
| | - Kelly Clanchy
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, QLD, Australia
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Adam Scheinberg
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Sakina Chagpar
- Sydney Musculoskeletal Health: The University of Sydney and Sydney Local Health District, Gadigal Land, Sydney, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Land, Sydney, NSW, Australia
| | - Belinda Wang
- Sydney Musculoskeletal Health: The University of Sydney and Sydney Local Health District, Gadigal Land, Sydney, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Land, Sydney, NSW, Australia
| | | | - Rhys Ashpole
- Insurance and Care (icare) NSW, Sydney, NSW, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health: The University of Sydney and Sydney Local Health District, Gadigal Land, Sydney, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Land, Sydney, NSW, Australia
| | - Leanne Hassett
- Sydney Musculoskeletal Health: The University of Sydney and Sydney Local Health District, Gadigal Land, Sydney, NSW, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Implementation Science Academy, Sydney Health Partners, Sydney, NSW, Australia
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Johnson L, Williams G, Sherrington C, Pilli K, Chagpar S, Auchett A, Beard J, Gil R, Vassallo G, Rushworth N, Tweedy S, Simpson G, Scheinberg A, Clanchy K, Tiedemann A, Hassett L. Correction to: the effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis. BMC Public Health 2023; 23:433. [PMID: 36879239 PMCID: PMC9987097 DOI: 10.1186/s12889-023-15240-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Affiliation(s)
- Liam Johnson
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Gavin Williams
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | - Catherine Sherrington
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Kavya Pilli
- Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Sydney, Australia
| | - Sakina Chagpar
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Aylish Auchett
- School of Health Sciences and Social Work, Grifth Health, Grifth University, Gold Coast, Australia
| | - Jack Beard
- Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | - Renee Gil
- School of Health Sciences and Social Work, Grifth Health, Grifth University, Gold Coast, Australia
| | | | | | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Grahame Simpson
- Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Sydney, Australia.,Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, The University of Sydney and Northern Sydney Local Health District, Sydney, Australia
| | - Adam Scheinberg
- Children's Research Institute, Melbourne, Australia.,School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Kelly Clanchy
- School of Health Sciences and Social Work, Grifth Health, Grifth University, Gold Coast, Australia.,Menzies Health Institute of Queensland, Grifth University, Gold Coast, Australia
| | - Anne Tiedemann
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. .,School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,University of Sydney, Susan Wakil Health Building, D19 Western Ave, 2006, Camperdown, NSW, Australia.
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Turner J, Clanchy K, Vincze L. Telehealth interventions for physical activity and exercise participation in postpartum women: A quantitative systematic review. Prev Med 2023; 167:107413. [PMID: 36603606 DOI: 10.1016/j.ypmed.2022.107413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/14/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
Postpartum women are one of the least physically active vulnerable populations globally and telehealth has been proposed as a potential method of delivering effective exercise interventions for this population. However, clinical practice guidelines are based upon the recommendations for the general population and therefore, the most efficacious exercise dose and the delivery method for this population is unclear. This quantitative systematic review will examine the implementation and outcomes of telehealth exercise interventions in the postpartum population to synthesise the degree to which these outcomes have been assessed and evaluated. Five databases were searched from January 2001 to March 2022. Studies implementing synchronous telehealth exercise interventions for postpartum women were included. Interventions were examined against the Template for Intervention Description and Replication (TIDieR) checklist that assesses intervention reporting completeness and replicability. Of the 1036 records identified, 16 studies progressed to data extraction. Six interventions provided individualised exercise prescription, and only four were delivered by university-level exercise practitioners. Physical activity participation was well reported, however health-related outcomes (i.e., muscular strength and aerobic capacity) were very minimally assessed. Only one intervention utilised modern video conferencing as the primary telehealth communication method. With the minimal assessment of health-related outcomes, there is limited scope to assess the effectiveness of these interventions for postpartum women. Future research interventions need to be reported according to a validated trial reporting system and focus on relevant health related outcomes including postpartum depressive symptoms, quality of life, cardiovascular fitness, muscular strength and body composition.
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Affiliation(s)
- Jemma Turner
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Kelly Clanchy
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia.
| | - Lisa Vincze
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
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Johnson L, Williams G, Sherrington C, Pilli K, Chagpar S, Auchettl A, Beard J, Gill R, Vassallo G, Rushworth N, Tweedy S, Simpson G, Scheinberg A, Clanchy K, Tiedemann A, Hassett L. The effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis. BMC Public Health 2023; 23:63. [PMID: 36624502 PMCID: PMC9830875 DOI: 10.1186/s12889-022-14935-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In 2020, the World Health Organization (WHO) released the first global physical activity and sedentary behaviour guidelines for children and adults living with disability. The evidence informing the guidelines though is not specific to people living with traumatic brain injury (TBI), but rather comes from other disabling conditions such as Parkinson's disease, and stroke. There remains a clear lack of direct evidence of the effects of physical activity for people living with TBI. The objective of this rapid review was to identify direct evidence of the effect of physical activity on health outcomes in people with moderate-to-severe TBI to inform adaptation of the WHO physical activity guidelines into clinical practice guidelines. METHODS We conducted a rapid systematic review with meta-analysis of randomised controlled trials, including people of any age with moderate-to-severe TBI, investigating physical activity interventions compared to either usual care, a physical activity intervention with different parameters, or a non-physical activity intervention. Four databases (CENTRAL, SPORTDiscus, PEDro, Ovid MEDLINE) were searched from inception to October 8, 2021. The primary outcomes were physical function, cognition, and quality of life. RESULTS Twenty-three studies were included incorporating 812 participants (36% females, majority working-age adults, time post-TBI in studies ranged from 56 days (median) to 16.6 years (mean)). A range of physical activity interventions were evaluated in rehabilitation (n = 12 studies), community (n = 8) and home (n = 3) settings. We pooled data from the end of the intervention for eight outcomes. Participation in a virtual reality physical activity intervention improved mobility, assessed by the Community Balance and Mobility Scale (range 0 to 96; higher score indicates better mobility) more than standard balance training (two studies, 80 participants, Mean Difference = 2.78, 95% CI 1.40 to 4.16; low certainty evidence). There was uncertainty of effect for the remaining outcomes, limited by small sample sizes, diverse comparators and a wide range of outcome measures. CONCLUSION This review consolidates the current evidence base for the prescription of physical activity for people with moderate-to-severe TBI. There remains a pressing need for further rigorous research in order to develop practice guidelines to support clinical decision-making when prescribing physical activity in this population.
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Affiliation(s)
- Liam Johnson
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Gavin Williams
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | - Catherine Sherrington
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Kavya Pilli
- Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Sydney, Australia
| | - Sakina Chagpar
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Aylish Auchettl
- Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | - Jack Beard
- Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | - Renee Gill
- Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | | | | | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Grahame Simpson
- Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Sydney, Australia.,John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, The University of Sydney and Northern Sydney Local Health District, Sydney, Australia
| | - Adam Scheinberg
- Murdoch Children's Research Institute, Melbourne, Australia.,School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Kelly Clanchy
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Australia.,Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Anne Tiedemann
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. .,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,The University of Sydney, Susan Wakil Health Building, D19 Western Ave, Camperdown, NSW, 2006, Australia.
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Ritchie C, Clanchy K, Sterling M, Tate R, Smits EJ, Day M, Nikles J, Liimatainen J, Tweedy SM. Evaluation of a physical activity promotion intervention for adults with whiplash associated disorders: a single-case experimental design study. Disabil Rehabil 2022; 44:7255-7268. [PMID: 34651525 DOI: 10.1080/09638288.2021.1989062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE There is considerable variation in the physical and psychological presentations of people with whiplash-associated disorder (WAD). Optimal treatment continues to be a challenge. This research evaluated the efficacy of a community-located, theory-based intervention designed to promote physically active behaviour in people with persistent WAD, and thereby improve perceptions of pain interference and confidence completing activities in the presence of neck pain. MATERIALS AND METHODS A multiple-baseline, single-case experimental design was used to evaluate the 16-week intervention across six participants. RESULTS Weighted Tau-U showed significantly increased accelerometer-measured physical activity in three participants with large effect sizes (>0.5), with increased confidence in one participant (ES > 0.5), and reduced pain interference in another participant (ES > 0.7). Changes in other behaviours included clinically important improvements in quality of life for five participants and, in those participants with baseline symptom levels outside threshold levels, improvements in pain catastrophizing and pain self-efficacy. CONCLUSIONS Participation in a theory-based intervention resulted in significant improvements in physical and psychological health for five of six participants. Providing this type of community-located physical activity promotion strategy, to individuals with persistent WAD, may help address physical impairments and psychological distress commonly experienced in WAD. Trial registration: The trial was registered with the Australia and New Zealand Clinical Trials Registry (ACTRN: ACTRN12617001261303p) and ClinicalTrials.gov (Protocol Number: 2018000349/2017/743).Implications for rehabilitationRehabilitation professionals should consider recommending theory-based physical activity promotion strategies to reduce physical impairments and psychological distress in individuals with persistent WAD.Individually tailored physical activity promotion strategies may help individuals with persistent WAD become more physically active thereby reducing their risk of diseases associated with inactivity which may compound the effects of WADImprovements in physical and psychological health may occur independently of increasing habitual physical activity.Rehabilitation professionals may find that other community-located strategies which aim to promote physically active behaviour confer similar benefits for individuals with persistent WAD.
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Affiliation(s)
- Carrie Ritchie
- RECOVER Injury Research Centre and National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Recovery after Road Traffic Injury, The University of Queensland, Queensland, Australia
| | - Kelly Clanchy
- School of Health Sciences and Social Work, Menzies Health Institute, Griffith University, Queensland, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre and National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Recovery after Road Traffic Injury, The University of Queensland, Queensland, Australia
| | - Robyn Tate
- Emeritus Professor, John Walsh Centre for Rehabilitation Research, The University of Sydney, New South Wales, Australia
| | - Esther J Smits
- RECOVER Injury Research Centre, The University of Queensland, Queensland, Australia
| | - Melissa Day
- School of Psychology, The University of Queensland, Queensland, Australia.,Department of Rehabilitation Medicine, University of Washington, Washington, USA
| | - Jane Nikles
- RECOVER Injury Research Centre and National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Recovery after Road Traffic Injury, The University of Queensland, Queensland, Australia
| | - Jenna Liimatainen
- School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, Australia
| | - Sean M Tweedy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, Australia
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