Trunk muscle electromyographic activity with unstable and unilateral exercises
- Authors: Behm, David , Leonard, Allison , Young, Warren , Bonsey, Andrew , MacKinnon, Scott N.
- Date: 2005
- Type: Text , Journal article
- Relation: Journal of Strength and Conditioning Research Vol. 19, no. 1 (2005), p. 193-201
- Full Text:
- Reviewed:
- Description: The purpose of this cross-sectional study was to evaluate the effect of unstable and unilateral resistance exercises on trunk muscle activation. Eleven subjects (6 men and 5 women) between 20 and 45 years of age participated. Six trunk exercises, as well as unilateral and bilateral shoulder and chest presses against resistance, were performed on stable (bench) and unstable (Swiss ball) bases. Electromyographic activity of the upper lumbar, lumbosacral erector spinae, and lower-abdominal muscles were monitored. Instability generated greater activation of the lower-abdominal stabilizer musculature (27.9%) with the trunk exercises and all trunk stabilizers (37.7-54.3%) with the chest press. There was no effect of instability on the shoulder press. Unilateral shoulder press produced greater activation of the back stabilizers, and unilateral chest press resulted in higher activation of all trunk stabilizers, when compared with bilateral presses. Regardless of stability, the superman exercise was the most effective trunk-stabilizer exercise for back-stabilizer activation, whereas the side bridge was the optimal exercise for lower-abdominal muscle activation. Thus, the most effective means for trunk strengthening should involve back or abdominal exercises with unstable bases. Furthermore, trunk strengthening can also occur when performing resistance exercises for the limbs, if the exercises are performed unilaterally. © 2005 National Strength & Conditioning Association.
- Description: C1
- Description: 2003001184
What price early discharge? Informal caregiving in home-based rehabilitation
- Authors: Dow, Briony
- Date: 2003
- Type: Text , Conference paper
- Relation: Paper presented at the 7th National Rural Health Conference, Canberra : 1st - 4th March, 2003
- Full Text:
- Reviewed:
- Description: Over recent years there has been an international trend towards shorter hospital stays, and the provision of alternative health services in the home (Philp, 1996). This paper focuses on one example of this trend, home-based rehabilitation. Other examples are hospital in the home programs (Gunnel, Coast, Richards, Peters, Pounsford & Darlow, 2000) and domiciliary midwife services offered to women discharged early from maternity hospital (Thompson, Roberts, Currie & Ellwood, 2000). In Victoria, homebased rehabilitation has been available as an alternative to hospital-based care since 1995 when the first home-based rehabilitation program was established at the Greenvale campus of the North-West Hospital. Since then another ten programs have been established in Victoria as alternatives to in-patient care. Similar programs have also been established in other Australian states and overseas (for example, in Western Australia, Bairstow, Asche, Heavens & Lithgo, 1997; and in Sweden, Widén Holmqvist, de Pedro Cuesta, Holm & Kostulas, 1995).
- Description: E1
- Description: 2003000513
Development of the Workload Analysis Scale (WAS) for the assessment and rehabilitation services of Ballarat Health Services
- Authors: Gathercole, Michael , DeMello, Lesley
- Date: 2001
- Type: Text , Journal article
- Relation: Social Work in Health Care Vol. 34, no. 1-2 (2001), p. 143-160
- Full Text: false
- Reviewed:
- Description: This study describes the development of the Workload Analysis Scale (WAS), designed to predict the likely workload involved for social workers working with clients in the assessment and rehabilitation areas of Ballarat Health Services (BHS). Such a scale would allow more equitable case allocation, flagging of difficult cases, better work prioritisation, training of new staff and tracking changes over time. Items for the scale were developed in consultation with workers. Initially the scale consisted of 33 items divided into five subscales, relating respectively to treatment factors, demographics, psychosocial complexity, planned interventions and variable staff factors. Eight staff members of BHS contributed to the completion of the scale for 111 clients seen over a four month period on the rehabilitation and assessment wards. Initial analysis of the data led to a modification of the scale and subsequent satisfactory measures of reliability and validity. © 2001 by The Haworth Press, Inc. All rights reserved.
The invisible contract: Shifting care from the hospital to the home
- Authors: Dow, Briony , McDonald, John
- Date: 2007
- Type: Text , Journal article
- Relation: Australian Health Review Vol. 31, no. 2 (May 2007), p. 193-202
- Full Text:
- Reviewed:
- Description: The ageing population and associated burgeoning health care costs have resulted in a shift of care from institutional settings to home and community-based care. As one example, rehabilitation-in-the-home (RITH) programs are becoming increasingly prevalent. These programs either substitute or supplement in-hospital treatment by providing multidisciplinary rehabilitation and support services in the client's own home. This paper investigates the impact of RITH programs on informal carers. Semi-structured interviews carried out with caregivers and staff revealed a complex and contradictory interpretation of informal caring. Analysis of carers' interviews revealed: an assumption by themselves and others (including RITH staff) that they would provide care; the intimate, arduous and relentless work of caring; lack of consultation about discharge; lack of recognition and reimbursement; and low levels of program support for them as carers. Carers are integral to the successful rehabilitation of the client, but they occupy a marginal status within the program. An invisible contract consigns to them substantial care-work that was previously provided by the hospital. Informal carers in RITH programs can be seen as disenfranchised care contractors. This has implications for policy makers, program managers and researchers.
- Description: C1
- Description: 2003005828
Lower limb amputation in Northern Netherlands: Unchanged incidence from 1991-1992 to 2003-2004
- Authors: Fortington, Lauren , Rommers, Gerardus , Postema, Klaas , Van Netten, Jaap , Geertzen, Jan , Dijkstra, Pieter
- Date: 2013
- Type: Text , Journal article
- Relation: Prosthetics and Orthotics International Vol. 37, no. 4 (August 2013 2013), p. 305-310
- Full Text: false
- Reviewed:
- Description: Background: Investigating population changes gives insight into effectiveness and need for prevention and rehabilitation services. Incidence rates of amputation are highly varied, making it difficult to meaningfully compare rates between studies and regions or to compare changes over time. Study Design: Historical cohort study of transtibial amputation, knee disarticulation, and transfemoral amputations resulting from vascular disease or infection, with/without diabetes, in 2003-2004, in the three Northern provinces of the Netherlands. Objectives: To report the incidence of first transtibial amputation, knee disarticulation, or transfemoral amputation in 2003-2004 and the characteristics of this population, and to compare these outcomes to an earlier reported cohort from 1991 to 1992. Methods: Population-based incidence rates were calculated per 100,000 person-years and compared across the two cohorts. Results: Incidence of amputation was 8.8 (all age groups) and 23.6 (≥45 years) per 100,000 person-years. This was unchanged from the earlier study of 1991-1992. The relative risk of amputation was 12 times greater for people with diabetes than for people without diabetes. Conclusions: Investigation is needed into reasons for the unchanged incidence with respect to the provision of services from a range of disciplines, including vascular surgery, diabetes care, and multidisciplinary foot clinics. Clinical relevance: This study shows an unchanged incidence of amputation over time and a high risk of amputation related to diabetes. Given the increased prevalence of diabetes and population aging, both of which present an increase in the population at risk of amputation, finding methods for reducing the rate of amputation is of importance.
- Description: C1
Benefits of pilates in Parkinson's Disease : A systematic review and meta-analysis
- Authors: Suarez-Iglesias, David , Miller, Kyle , Seijo-Martinez, Manuel , Ayan, Carlos
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Medicina-Lithuania Vol. 55, no. 8 (2019), p. 1-14
- Full Text:
- Reviewed:
- Description: Pilates may be a beneficial method of exercise for people with Parkinson's disease (PD). However, no studies have critically reviewed the scientific evidence in this regard. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of Pilates as a rehabilitation strategy for PD. A systematic search of the electronic databases PubMed, PEDro, Scopus, and SPORTDiscus was conducted to identify studies related to the effect of Pilates on PD. The search timeframe ranged from the inception of each database to March 2019. The search resulted in the identification of four randomized controlled trials (RCTs) and four non-RCT studies. The methodological quality of the investigations ranged from poor to fair. The descriptive analysis of the eight investigations showed that Pilates resulted in beneficial effects on fitness, balance and functional autonomy. A subsequent meta-analysis on the four RCTs indicated that Pilates was more effective than traditional training programmes in improving lower limb function. Pilates can be safely prescribed for people with mild-to-moderate PD. Preliminary evidence indicates that its practice could have a positive impact on fitness, balance and physical function. Its benefits on lower-body function appear to be superior to those of other conventional exercises. Future randomized studies with greater samples are needed to confirm these observations.
Mobility in Elderly People With a Lower Limb Amputation: A Systematic Review
- Authors: Fortington, Lauren , Rommers, Gerardus , Geertzen, Jan , Postema, Klaas , Dijkstra, Pieter
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of the American Medical Directors Association Vol. 13, no. 4 (May 2012 2012), p. 319-325
- Full Text: false
- Reviewed:
- Description: Elderly people with a lower limb amputation impose a heavy burden on health resources, requiring extensive rehabilitation and long term care. Mobility is key to regaining independence; however, the impact of multiple comorbidities in this patient group can make regaining mobility a particularly challenging task. An evidence-based prognosis for mobility is needed for rehabilitation and long term care planning. This systematic review summarizes the prosthetic and nonprosthetic mobility outcomes achieved by elderly people with a lower limb amputation, to determine whether an accurate prognosis for mobility can be made. MEDLINE, EMBASE, and CINAHL were searched for studies published before May 2010 in English, German, Dutch, or French, using keywords and synonyms for elderly, mobility, rehabilitation, and amputation. Mobility focused on actual movement (moving from one place to another) and was limited to long-term measurements, 6 months after amputation or 3 months after discharge from rehabilitation. The 15 included studies featured a diversity of objective outcome measures and mobility grades that proved difficult to compare meaningfully. In general, studies that included selected populations of prosthetic walkers showed that advanced prosthetic mobility skills can be achieved by the elderly person with a lower limb amputation, including outdoor/community walking. Studies that included all subjects undergoing a lower limb amputation reported that less than half of the elderly population achieved a household level of prosthetic mobility. The predominant findings from the included studies were incomplete reporting of study populations and poor reporting of the reliability of the mobility measures used. The strength of conclusions from this review was therefore limited and the prognosis for mobility in elderly people after lower limb amputation remains unclear. Further research into mobility outcomes of this population is needed to provide evidence that enables more informed choices in rehabilitation and long term care.
- Description: C1
Spinifex-mallee revegetation : Implications for restoration after mineral-sands mining in the Murray-Darling Basin
- Authors: Sluiter, Ian , Schweitzer, Andrew , Mac Nally, Ralph
- Date: 2016
- Type: Text , Journal article
- Relation: Australian Journal of Botany Vol. 64, no. 6 (2016), p. 547-554
- Full Text: false
- Reviewed:
- Description: Mineral-sands mining in the semiarid and arid zone of south-eastern Australia is now a widespread disturbance that may adversely affect large areas of remnant vegetation, including mallee (Eucalyptus spp.) with hummock grass or spinifex (Triodia scariosa) understorey. No broad-scale restoration projects have been undertaken to revegetate mallee Eucalyptus species with spinifex. We report on the survivorship and relative importance (spatial coverage) of hand-planted tubestock 10 years after establishment in 2001, which included mallee Eucalyptus, Triodia scariosa, Acacia spp. and Hakea spp. These taxa are the dominant plants in a semiarid dune-swale system on a former mineral-sands mine licence area in semiarid, north-western Victoria. Mean survivorship of tubestock was 0.58±0.04. Spinifex (Triodia scariosa), needlewood (Hakea) and several mallee species (Eucalyptus spp.) survived substantially better than the average of all tubestock-planted species, although Acacia spp. had low survivorships. Although the plantings were undertaken in the early stages of the most severe drought in the instrumental record (the 'Millennium drought'), several taxa survived well and species such as spinifex established and developed ground coverage greater than the benchmark values for the ecological vegetation class of the location. We conclude that hand-planting of tubestock can achieve restoration objectives for this component of spinifex-mallee vegetation, even under extremely arduous conditions associated with long-term drought. We also herald the importance of taking a long-term view to the assessment of revegetation success, in this case 10 years. © CSIRO 2016.
CFRP Shear Strengthening of Reinforced-Concrete T-Beams with Corroded Shear Links
- Authors: Qin, Shunde , Dirar, Samir , Yang, Jian , Chan, Andrew , Elshafie, Mohammed
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Composites for Construction Vol. 19, no. 5 (2015), p.
- Full Text:
- Reviewed:
- Description: This paper investigates the structural behavior of uncorroded as well as corroded RC T-beams strengthened in shear with either externally bonded (EB) carbon fiber-reinforced polymer (CFRP) sheets or embedded CFRP rods. Nine tests were carried out on RC T-beams having an effective depth of 295 mm and a shear span to effective depth ratio of 3.05. The investigated parameters are the shear link corrosion level (uncorroded, 7% corroded, or 12% corroded) and type of CFRP strengthening system (EB CFRP sheets or embedded CFRP rods). The unstrengthened beams with shear link corrosion levels of 7 and 12% had shear strengths that were 11 and 14%, respectively, less than the shear strength of the uncorroded unstrengthened beam. Both the embedded CFRP rods and EB CFRP sheets were effective in enhancing the shear strength of tested beams but the effectiveness of both strengthening systems decreased with increasing shear link corrosion level. The shear strength enhancement provided by the embedded CFRP rods and EB CFRP sheets decreased from 19 and 15%, respectively, to 12 and 11%, respectively, with an increase in shear link corrosion level from 7 to 12%. Corrosion of the shear links did not have a significant effect on the beam stiffness. Premature debonding limited the effectiveness of the EB CFRP sheets whereas the embedded CFRP rods did not exhibit signs of debonding and therefore showed higher effectiveness.
Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India : A qualitative inquiry
- Authors: Jagnoor, Jagnoor , Bekker, Sheree , Chamania, Shobha , Potokar, Tom , Ivers, Rebecca
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 3 (2018), p. 1-11
- Full Text:
- Reviewed:
- Description: Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks.
Greater understanding of normal hip physical function may guide clinicians in providing targeted rehabilitation programmes
- Authors: Kemp, Joanne , Schache, Anthony , Makdissi, Michael , Sims, Kevin , Crossley, Kay
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 16, no. 4 (2013), p. 292-296
- Full Text: false
- Reviewed:
- Description: Objectives: This study investigated tests of hip muscle strength and functional performance. The specific objectives were to: (i) establish intra- and inter-rater reliability; (ii) compare differences between dominant and non-dominant limbs; (iii) compare agonist and antagonist muscle strength ratios; (iv) compare differences between genders; and (v) examine relationships between hip muscle strength, baseline measures and functional performance. Design: Reliability study and cross-sectional analysis of hip strength and functional performance. Methods: In healthy adults aged 18-50. years, normalised hip muscle peak torque and functional performance were evaluated to: (i) establish intra-rater and inter-rater reliability; (ii) analyse differences between limbs, between antagonistic muscle groups and genders; and (iii) associations between strength and functional performance. Results: Excellent reliability (intra-rater ICC = 0.77-0.96; inter-rater ICC = 0.82-0.95) was observed. No difference existed between dominant and non-dominant limbs. Differences in strength existed between antagonistic pairs of muscles: hip abduction was greater than adduction (p < 0.001) and hip ER was greater than IR (p < 0.001). Men had greater ER strength (p = 0.006) and hop for distance (p < 0.001) than women. Strong associations were observed between measures of hip muscle strength (except hip flexion) and age, height, and functional performance. Conclusions: Deficits in hip muscle strength or functional performance may influence hip pain. In order to provide targeted rehabilitation programmes to address patient-specific impairments, and determine when individuals are ready to return to physical activity, clinicians are increasingly utilising tests of hip strength and functional performance. This study provides a battery of reliable, clinically applicable tests which can be used for these purposes. © 2012 Sports Medicine Australia.
Feasibility and acceptability of a volunteer-mediated diversional therapy program for older patients with cognitive impairment
- Authors: Shee, Anna Wong , Phillips, Bev , Hill, Keith , Dodd, Karen
- Date: 2014
- Type: Text , Journal article
- Relation: Geriatric Nursing Vol. 35, no. 4 (2014), p. 300-305
- Full Text: false
- Reviewed:
- Description: Understanding the perceptions of stakeholders is critical for determining acceptability and feasibility of volunteer-mediated programs. This study evaluated the feasibility and acceptability for staff, volunteers, patients and their carers, of a volunteer diversional therapy program for patients with cognitive impairment undergoing inpatient rehabilitation. Post-program structured interviews were conducted with the volunteers (n = 10), patients (n = 30) and their carers (n = 3); and nursing staff (n = 6) participated in a focus group. Thematic analysis identified five themes (values, attitudes, knowledge, purpose, support) in two dimensions (personal, team culture). Overall, patients, carers, staff and volunteers were satisfied with the volunteer program and perceived benefits for quality of care. Recommendations for improvements to the program related to staff engagement with the program and the volunteers' education and training. The volunteer diversional therapy pilot program for patients with cognitive impairment on a sub-acute ward was acceptable and feasible for patients, carers, staff and volunteers. (C) 2014 Mosby, Inc. All rights reserved.
How much is enough in rehabilitation? High running workloads following lower limb muscle injury delay return to play but protect against subsequent injury
- Authors: Stares, Jordan , Dawson, Brian , Peeling, Peter , Drew, Michael , Heasman, Jarryd , Rogalski, Brent , Colby, Marcus
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 10 (2018), p. 1019-1024
- Full Text:
- Reviewed:
- Description: Objectives: Examine the influence of rehabilitation training loads on return to play (RTP) time and subsequent injury in elite Australian footballers. Design: Prospective cohort study. Methods: Internal (sessional rating of perceived exertion: sRPE) and external (distance, sprint distance) workload and lower limb non-contact muscle injury data was collected from 58 players over 5 seasons. Rehabilitation periods were analysed for running workloads and time spent in 3 rehabilitation stages (1: off-legs training, 2: non-football running, 3: group football training) was calculated. Multi-level survival analyses with random effects accounting for player and season were performed. Hazard ratios (HR) and 95% confidence intervals (CI) for each variable were produced for RTP time and time to subsequent injury. Results: Of 85 lower limb muscle injuries, 70 were rehabilitated to RTP, with 30 cases of subsequent injury recorded (recurrence rate = 11.8%, new site injury rate = 31.4%). Completion of high rehabilitation workloads delayed RTP (distance: >49,775 m [reference: 34,613–49,775 m]: HR 0.12, 95%CI 0.04–0.36, sRPE: >1266 AU [reference: 852–1266 AU]: HR 0.09, 95%CI 0.03–0.32). Return to running within 4 days increased subsequent injury risk (3–4 days [reference: 5–6 days]: HR 25.88, 95%CI 2.06–324.4). Attaining moderate-high sprint distance (427–710 m) was protective against subsequent injury (154–426 m: [reference: 427–710 m]: HR 37.41, 95%CI 2.70–518.64). Conclusions: Training load monitoring can inform player rehabilitation programs. Higher rehabilitation training loads delayed RTP; however, moderate-high sprint running loads can protect against subsequent injury. Shared-decision making regarding RTP should include accumulated training loads and consider the trade-off between expedited RTP and lower subsequent injury risk.
Socio-demographic and injury-related factors contributing to activity limitations and participation restrictions in people with spinal cord injury in Bangladesh
- Authors: Kader, Manzur , Perera, Nirmala , Hossain, Mohammad , Islam, Redwanul
- Date: 2018
- Type: Text , Journal article
- Relation: Spinal Cord Vol. 56, no. 3 (2018), p. 239-246
- Full Text: false
- Reviewed:
- Description: Study design: Cross-sectional study. Objectives: To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh. Setting: Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. Methods: This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25-43) years and 5 (2-10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-Administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0-100; a high score indicates greater activity limitations and participation restrictions). Independent variables included socio-demographic factors (i.e., age, sex, marital status, educational level, monthly household income, employment status, and place of residence) and injury-related factors (i.e., injury duration, cause of injury, injury severity, and type of paralysis). Multivariable linear regression analyses were performed to identify the factors that independently contributed to activity limitations and participation restrictions. Results: Three significant independent variables explained 20.7% of the variance in activity limitations and participation restrictions (WHODAS 2.0 score), in which tetraplegia was the strongest significant contributing factor, followed by rural residence and complete injury. Conclusions: This study would indicate that tetraplegia, complete injury, and residing in a rural area are the major contributions in limiting the activity and participation following SCI in Bangladesh.
An adaptive and flexible brain energized full body exoskeleton with IoT edge for assisting the paralyzed patients
- Authors: Jacob, Sunil , Alagirisamy, Mukil , Menon, Varun , Kumar, B. Manoj , Balasubramanian, Venki
- Date: 2020
- Type: Text , Journal article
- Relation: IEEE Access Vol. 8, no. (2020), p. 100721-100731
- Full Text:
- Reviewed:
- Description: The paralyzed population is increasing worldwide due to stroke, spinal code injury, post-polio, and other related diseases. Different assistive technologies are used to improve the physical and mental health of the affected patients. Exoskeletons have emerged as one of the most promising technology to provide movement and rehabilitation for the paralyzed. But exoskeletons are limited by the constraints of weight, flexibility, and adaptability. To resolve these issues, we propose an adaptive and flexible Brain Energized Full Body Exoskeleton (BFBE) for assisting the paralyzed people. This paper describes the design, control, and testing of BFBE with 15 degrees of freedom (DoF) for assisting the users in their daily activities. The flexibility is incorporated into the system by a modular design approach. The brain signals captured by the Electroencephalogram (EEG) sensors are used for controlling the movements of BFBE. The processing happens at the edge, reducing delay in decision making and the system is further integrated with an IoT module that helps to send an alert message to multiple caregivers in case of an emergency. The potential energy harvesting is used in the system to solve the power issues related to the exoskeleton. The stability in the gait cycle is ensured by using adaptive sensory feedback. The system validation is done by using six natural movements on ten different paralyzed persons. The system recognizes human intensions with an accuracy of 85%. The result shows that BFBE can be an efficient method for providing assistance and rehabilitation for paralyzed patients. © 2013 IEEE. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Venki Balasubramanian” is provided in this record**
Barriers and enablers to aligning rehabilitation goals to patient life roles following acquired brain injury
- Authors: Sansonetti, Danielle , Nicks, Rebecca , Unsworth, Carolyn
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Occupational Therapy Journal Vol. 65, no. 6 (2018), p. 512-522
- Full Text: false
- Reviewed:
- Description: Background/aim: Life roles are integral to occupational therapy practice. Goal setting is a method of establishing priorities to measure outcomes. While acquired brain injury can impact a person's ability to fulfil meaningful life roles, the alignment of goals set in rehabilitation to life roles, is unclear. This study aimed to (i) explore the alignment of goals with life roles for people with an acquired brain injury participating in inpatient rehabilitation; and (ii) identify barriers and enablers to life role discussions within a patient-directed goal setting framework. Method: A mixed-methods study was conducted on an inpatient rehabilitation unit in Victoria, Australia. Quantitative data were obtained from a retrospective file audit of randomly selected medical records. Qualitative data were collected through: a) interviews with patients and their families; and b) A focus group with occupational therapists. Thematic analysis of both audit data and narrative data was undertaken. Results: Thirty files were examined and demonstrated 33% alignment between goals and life roles. Four interviews were completed with patients, with a family member participating in two of these. Themes identified were: readiness, role concept, recovery concept and goal review. Five therapists attended the focus group. Themes identified were: Patient factors, goal review, expectations, role change and environment. Interview and focus group data identified that barriers to life role discussions included: lack of patient and family readiness, patients’ difficulty understanding role concept, focus on impairments and lack of family/ significant others support. Enablers included: having early conversations involving family, regular goal review and use of standardised tools. Conclusion: Goal setting in alignment with life roles is important in acquired brain injury rehabilitation, but may be limited. This process can be enhanced by including patients and their significant others in early goal setting conversations, along with regular goal review across the rehabilitation process. © 2018 Occupational Therapy Australia
Engaging patients with moderate to severe acquired brain injury in goal setting
- Authors: D’Cruz, Kate , Unsworth, Carolyn , Roberts, Karen , Morarty, Jacqui , Turner-Stokes, Lynne
- Date: 2016
- Type: Text , Journal article
- Relation: International Journal of Therapy and Rehabilitation Vol. 23, no. 1 (2016), p. 20-31
- Full Text: false
- Reviewed:
- Description: Background/Aims: An exploratory study of a novel approach to using the Goal Engagement Scale to examine patients’, families’ and health professionals’ perceptions of patient engagement in goal setting. Methods: This mixed methods study was conducted from September 2013 to April 2014 in both inpatient trauma and rehabilitation units at an Australian health care service. Participants were 22triads (patients with moderate to severe traumatic brain injury or stroke, their family member(s) and a treating health professional) participating in routine goal setting interviews. Goal setting interviews were audio recorded, transcribed and thematically analysed, drawing upon an iterative process of qualitative data analysis, while the Goal Engagement Scale scores were analysed descriptively, drawing comparison between triad participant findings. Findings: Perception of patient’s level of engagement in goal setting differed between health professionals, patients and families. Health professionals’ views dominated the goal setting process. Goal setting interview data revealed four main themes, highlighting the importance of reflective listening skills to build a trusting relationship with patients and families to support engagement in goal setting. Conclusions: The findings of this exploratory study both affirm the suitability of future research into goal setting engagement and provide clinically useful strategies to support engagement of patients and families in goal setting. © 2016 MA Healthcare Ltd. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Carolyn Unsworth” is provided in this record**
IoT-powered deep learning brain network for assisting quadriplegic people
- Authors: Vinoj, P. , Jacob, Sunil , Menon, Varun , Balasubramanian, Venki , Piran, Md Jalil
- Date: 2021
- Type: Text , Journal article
- Relation: Computers and Electrical Engineering Vol. 92, no. (2021), p.
- Full Text: false
- Reviewed:
- Description: Brain-Computer Interface (BCI) systems have recently emerged as a prominent technology for assisting paralyzed people. Recovery from paralysis in most patients using the existing BCI-based assistive devices is hindered due to the lack of training and proper supervision. The system's continuous usage results in mental fatigue, owing to a higher user concentration required to execute the mental commands. Moreover, the false-positive rate and lack of constant control of the BCI systems result in user frustration. The proposed framework integrates BCI with a deep learning network in an efficient manner to reduce mental fatigue and frustration. The Deep learning Brain Network (DBN) recognizes the patient's intention for upper limb movement by a deep learning model based on the features extracted during training. DBN correlates and maps the different Electroencephalogram (EEG) patterns of healthy subjects with the identified pattern's upper limb movement. The stroke-affected muscles of the paralyzed are then activated using the obtained superior pattern. The implemented DBN consisting of four healthy subjects and a quadriplegic patient achieved 94% accuracy for various patient movement intentions. The results show that DBN is an excellent tool for providing rehabilitation, and it delivers sustained assistance, even in the absence of caregivers. © 2021
Survey of occupational therapy driver assessors’ rehabilitation interventions with older drivers
- Authors: Unsworth, Carolyn , Baker, Anne , Morton-Kehle, Dana , Darzins, Susan
- Date: 2022
- Type: Text , Journal article
- Relation: OTJR Occupation, Participation and Health Vol. 42, no. 2 (2022), p. 115-126
- Full Text: false
- Reviewed:
- Description: The rehabilitation strategies used by occupational therapy driver assessors with older drivers with age-related decline or health conditions are not well understood. The objective of the study was to describe driver rehabilitation interventions used by Australian driver assessors, identify factors that guide rehabilitation choices, and identify barriers and facilitators encountered. An online survey was emailed to 300 driver assessors. Descriptive statistics were used to summarize and to rank order participant responses. A total of 148 respondents selected from a combined total of 655 interventions. The four most common rehabilitation methods were (a) graded driving (18%, n = 118), (b) practicing specific maneuvers (17.7%, n = 116), (c) using a modified vehicle (16.9%, n = 111), and (d) graded driving in local areas only (15.1%, n = 99). The most common barrier limiting driver rehabilitation was cost (M = 2.92, SD = 1.24). The most frequently used driver rehabilitation method was on-road training. Practice can be enhanced by collating and evaluating resources, and ensuring effective interventions are more accessible. © The Author(s) 2021.
SAfety and feasibility of EArly resistance training after median sternotomy : the SAFE-ARMS study
- Authors: Pengelly, Jacqueline , Boggett, Stuart , Bryant, Adam , Royse, Colin , Royse, Alistair , Williams, Gavin , El-Ansary, Doa El
- Date: 2022
- Type: Text , Journal article
- Relation: Physical Therapy Vol. 102, no. 7 (2022), p.
- Full Text:
- Reviewed:
- Description: Objective: The purpose of this study was to determine the safety and feasibility of subacute upper limb resistance exercise on sternal micromotion and pain and the reliability of sternal ultrasound assessment following cardiac surgery via median sternotomy. Methods: This experimental study used a pretest-posttest design to investigate the effects of upper limb resistance exercise on the sternum in patients following their first cardiac surgery via median sternotomy. Six bilateral upper limb machine-based exercises were commenced at a base resistance of 20 lb (9 kg) and progressed for each participant. Sternal micromotion was assessed using ultrasound at the mid and lower sternum at 2, 8, and 14 weeks postsurgery. Intrarater and interrater reliability was calculated using intraclass correlation coefficients (ICCs). Participant-reported pain was recorded at rest and with each exercise using a visual analogue scale. Results: Sixteen adults (n = 15 males; 71.3 [SD = 6.2] years of age) consented to participate. Twelve participants completed the study, 2 withdrew prior to the 8-week assessment, and 2 assessments were not completed at 14 weeks due to assessor unavailability. The highest median micromotion at the sternal edges was observed during the bicep curl (median = 1.33 mm; range = -0.8 to 2.0 mm) in the lateral direction and the shoulder pulldown (median = 0.65 mm; range = -0.8 to 1.6 mm) in the anterior-posterior direction. Furthermore, participants reported no increase in pain when performing any of the 6 upper limb exercises. Interrater reliability was moderate to good for both lateral-posterior (ICC = 0.73; 95% CI = 0.58 to 0.83) and anterior-posterior micromotion (ICC = 0.83; 95% CI = 0.73 to 0.89) of the sternal edges. Conclusion: Bilateral upper limb resistance exercises performed on cam-based machines do not result in sternal micromotion exceeding 2.0 mm or an increase in participant-reported pain. Impact: Upper limb resistance training commenced as early as 2 weeks following cardiac surgery via median sternotomy and performed within the safe limits of pain and sternal micromotion appears to be safe and may accelerate postoperative recovery rather than muscular deconditioning. © 2022 The Author(s). Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved.