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Barradell S, Scholten I. How, and to what end, is the WHO-ICF framework represented in physiotherapy? Insights from a qualitative research synthesis. Physiother Theory Pract 2024:1-18. [PMID: 38938207 DOI: 10.1080/09593985.2024.2370345] [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: 11/13/2023] [Accepted: 06/14/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND It has been two decades since the World Health Organization's endorsement of the International Classification of Functioning, Disability and Health (ICF). It is timely to undertake a rigorous search that analyzes the discourses around the ICF's conceptual framework within physiotherapy, the kinds of enquiry to date and the professional areas where this is happening and how. PURPOSE The aim of this research is to synthesize the literature related to how the physiotherapy profession (practice, research and education) thinks about and puts to use the WHO ICF. RESULTS A final sample of 37 papers was agreed. Five overarching third-order interpretations were derived: (i) A way of thinking and practicing, (ii) Endorsed but not embedded, (iii) Striking a balance, (iv) Power of participation and (v) Moving forward. Together, these themes illustrate the evolving role of the ICF in physiotherapy over the previous two decades. They highlight the ICF's potential for shaping the future of physiotherapy practice, education and research. CONCLUSIONS Work is needed to connect existing literature about the ICF and related models and embed the ICF, its language and philosophy across physiotherapy education and practice. Re-representation of the model might help address misinterpretation of the ICF, but fundamentally, embedding the ICF in entry-level curriculum is likely to be the most significant driver of change in practice.
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Affiliation(s)
- Sarah Barradell
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Ingrid Scholten
- Speech Pathology & Audiology, Flinders University, Adelaide, SA, Australia
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Verpe IS, Thygesen KB, Escorpizo R, Mortensen OS, Korshøj M. Construct validity of the Danish version of the Work Rehabilitation Questionnaire (WORQ)-sensitivity and specificity of the objectively tested physical capacity items. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1115981. [PMID: 37168232 PMCID: PMC10165101 DOI: 10.3389/fresc.2023.1115981] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/31/2023] [Indexed: 05/13/2023]
Abstract
Objective The aim of this study was to examine the construct validity of the Danish version of the Work Rehabilitation Questionnaire (WORQ) and to compare the physical capacity items of WORQ to objective, standardized measures of physical capacity and selected SF-36 physical items. Methods The study took place at a job center in Holbæk municipality, and 40 clients of working age were enrolled. Participants completed the interviewer-administered version of WORQ, selected SF-36 items, and underwent objective, physical capacity testing, including a 30-s sit-to-stand-test, a hand-grip-strength test, and a 6-min walk test to estimate cardiorespiratory fitness. Correlations between variables were assessed using Spearman's correlation. Further, cross tabulations and chi-square tests were conducted, and sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) were calculated. Results We found a moderate to strong correlation between WORQ and SF-36 items and a weak to moderate correlation between physical capacity items of WORQ and objectively tested physical capacity measures. On the basis of cross tabulations, calculations yielded overall higher NPVs than PPVs, whereas sensitivity and specificity varied more, with not one parameter being overall better than the other. Conclusion We found evidence of construct validity of the WORQ-Danish. However, our study might also raise a question as to whether objective physical capacity tests are the gold standard for evaluating functioning. Our results are promising, and we suggest further investigations of the screening capabilities of WORQ, alongside other legacy measures or instruments, both self-reported and objective physical measures, to complement information-where specific answers to specific questions trigger work-related actions or interventions.
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Affiliation(s)
- Ida Skovborg Verpe
- Department of Occupational and Social Medicine, Holbæk Hospital, Part of Copenhagen University Hospital, Holbæk, Denmark
| | - Katrine Baltzer Thygesen
- Department of Occupational and Social Medicine, Holbæk Hospital, Part of Copenhagen University Hospital, Holbæk, Denmark
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, UnitedStates
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Holbæk Hospital, Part of Copenhagen University Hospital, Holbæk, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
- Correspondence: Ole Steen Mortensen
| | - Mette Korshøj
- Department of Occupational and Social Medicine, Holbæk Hospital, Part of Copenhagen University Hospital, Holbæk, Denmark
- TheNational Research Centre for the Working Environment, Copenhagen, Denmark
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Dalboni GL, Garcêz RL, Assis ÍC, Vaz DV. Conceptions of disability among physiotherapists: an exploratory qualitative study. Physiother Theory Pract 2022:1-10. [DOI: 10.1080/09593985.2022.2042757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gláucia L Dalboni
- Universidade Federal de Minas Gerais, Programa de Pós Graduação Em Ciências da Reabilitação, Belo Horizonte, Brazil
| | - Regiane L Garcêz
- Universidade Federal de Minas Gerais, Departamento de Comunicação Social, Belo Horizonte, Brazil
| | - Ítalo C Assis
- Universidade Federal de Minas Gerais, Departamento de Comunicação Social, Belo Horizonte, Brazil
| | - Daniela V Vaz
- Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Belo Horizonte, Brazil
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Sharp A, Herrman D. Disability and Physical Therapy: A Complicated Relationship, an Uncertain Path Forward. Phys Ther 2021; 101:6158007. [PMID: 33682881 DOI: 10.1093/ptj/pzab085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/21/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Amanda Sharp
- Division of Physical Therapy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Deana Herrman
- Department of Disability and Human Development, University of Illinois, Chicago, Illinois, USA
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Bulhões ÉRFN, Dantas THDM, Dantas JH, Souza ÍND, Castaneda L, Dantas DDS. Functioning of women in the postpartum period: an International Classification of Functioning, Disability and Health-based consensus of physical therapists. Braz J Phys Ther 2020; 25:450-459. [PMID: 33386254 DOI: 10.1016/j.bjpt.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physical therapists provide treatment for pain and other common complaints for women in the postpartum period, thereby contributing to the improvement of their functioning. However, before applying any interventions, physical therapists should assess their patients to identify the desired therapeutic goals. In this context, the International Classification of Functioning, Disability and Health (ICF) may be a useful tool for documenting functioning data and operationalizing collaborative goal setting. OBJECTIVE To identify ICF categories and the respective domains that should be considered in the evaluation of women postpartum. METHODS A consensus-building, three-round e-mail survey was conducted using the Delphi method. The sample included Brazilian physical therapists with expertise in women's health. Meaningful content was analyzed in accordance to the ICF linking rules. The kappa coefficient and content validity index (CVI) were calculated. RESULTS The panel consisted of 45 participants with a median age of 33 years and more than 10 years of experience in women's health. A total of 1261 meaningful contents were identified from the responses in the first round. After consensus was achieved, a final list of 62 items was prepared, including 53 categories (11 were on structures; 15 on body functions; 12 on activities and participation; 15 on environmental factors) and nine personal factors (CVI=0.89). CONCLUSION From the perception of physical therapists, an ICF-based postpartum assessment to describe functioning and disability must comprise 53 ICF categories and nine personal factors.
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Affiliation(s)
| | - Thaissa Hamana De Macedo Dantas
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN, Brazil
| | - Jardelina Hermecina Dantas
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN, Brazil
| | - Íris Nascimento De Souza
- Federal Institute of Education, Sciences and Technology of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana Castaneda
- Federal Institute of Education, Sciences and Technology of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Diego De Sousa Dantas
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN, Brazil; Programa de pós-graduação em Fisioterapia, Universidade Federal de Pernambuco, Recife, PE, Brazil.
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Middlebrook A, Bekker S, Middlebrook N, Rushton AB. Physical prognostic factors predicting outcome following anterior cruciate ligament reconstruction: protocol for a systematic review. BMJ Open 2020; 10:e033429. [PMID: 32217559 PMCID: PMC7170562 DOI: 10.1136/bmjopen-2019-033429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 03/01/2020] [Accepted: 03/09/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Injuries of the anterior cruciate ligament (ACL) are a common musculoskeletal complication and can cause significant reduction in patient function and quality of life. Many undergo ACL reconstruction, with high-quality rehabilitation key to successful outcome. Knowledge of physical prognostic factors, such as quadriceps strength, is crucial to inform rehabilitation and has important implications for outcome following ACL reconstruction. However, these factors predicting outcome are poorly defined. Therefore, the aim of this systematic review is to establish physical prognostic factors predictive of outcome in adults following ACL reconstruction. Outcome will be subdivided into two groups of outcome measures, patient-reported and performance-based. Physical prognostic factors of interest will reflect a range of domains and may be modifiable/non-modifiable. Results will help decide most appropriate management and assist in planning and tailoring preoperative and postoperative rehabilitation. METHODS AND ANALYSIS This systematic review protocol is reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. MEDLINE, CINAHL and EMBASE databases, key journals and grey literature will be searched from inception to July 2019. Prospective cohort studies including participants aged ≥16 years who have undergone ACL reconstruction will be included, with articles focusing on multi-ligament reconstructions and ACL repair surgery, or not published in English excluded. Two independent reviewers will conduct searches, assess study eligibility, extract data, assess risk of bias (Quality in Prognostic Studies tool) and quantify overall quality of evidence (modified Grading of Recommendations, Assessment, Development and Evaluation guidelines). If possible, a meta-analysis will be conducted, otherwise a narrative synthesis will ensue focusing on prognostic factors, risk of bias of included studies and strength of association with outcomes. ETHICS AND DISSEMINATION Findings will be published in a peer-reviewed journal, presented at conferences and locally to physiotherapy departments. Ethical approval is not required for this systematic review. PROSPERO REGISTRATION NUMBER CRD42019127732.
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Affiliation(s)
| | | | - Nicola Middlebrook
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham, UK
| | - Alison B Rushton
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham, UK
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Fleming AM, Ribeiro CT, Horovitz DG, Ribeiro LC, Corrêa APC. Description of Functioning in Children and Adolescents with Mucopolysaccharidosis - Case series. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2020. [DOI: 10.1590/2326-4594-jiems-2019-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Mitra S, Shakespeare T. Remodeling the ICF. Disabil Health J 2019; 12:337-339. [PMID: 30910583 DOI: 10.1016/j.dhjo.2019.01.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 01/21/2019] [Indexed: 12/01/2022]
Affiliation(s)
| | - Tom Shakespeare
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, UK
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Scrutinio D, Giardini A, Chiovato L, Spanevello A, Vitacca M, Melazzini M, Giorgi G. The new frontiers of rehabilitation medicine in people with chronic disabling illnesses. Eur J Intern Med 2019; 61:1-8. [PMID: 30389274 DOI: 10.1016/j.ejim.2018.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/18/2018] [Accepted: 10/24/2018] [Indexed: 01/01/2023]
Abstract
Because of the demographic shift and the increased proportion of patients surviving acute critical illnesses, the number of people living with severely disabling chronic diseases and, consequently, the demand for rehabilitation are expected to increase sharply over time. As underscored by the World Health Organization, there is substantial evidence that the provision of inpatient rehabilitation in specialized rehabilitation units to people with complex needs is effective in fostering functional recovery, improving health-related quality of life, increasing independence, reducing institutionalization rate, and improving prognosis. Recent studies in the real world setting reinforce the evidence that patients with ischemic heart disease or stroke benefit from rehabilitation in terms of improved prognosis. In addition, there is evidence of the effectiveness of rehabilitation for the prevention of functional deterioration in patients with complex and/or severe chronic diseases. Given this evidence of effectiveness, rehabilitation should be regarded as an essential part of the continuum of care. Nonetheless, rehabilitation still is underdeveloped and underused. Efforts should be devoted to foster healthcare professional awareness of the benefits of rehabilitation and to increase referral and participation.
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Affiliation(s)
| | - Anna Giardini
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Luca Chiovato
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy; Dipartimento di Medicina Interna e Terapia Medica, Università di Pavia, Italy
| | - Antonio Spanevello
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy; Università degli Studi dell'Insubria, Varese, Italy
| | | | | | - Gianni Giorgi
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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Goselink RJ, Schreuder TH, van Alfen N, de Groot IJ, Jansen M, Lemmers RJ, van der Vliet PJ, van der Stoep N, Theelen T, Voermans NC, van der Maarel SM, van Engelen BG, Erasmus CE. Facioscapulohumeral Dystrophy in Childhood: A Nationwide Natural History Study. Ann Neurol 2018; 84:627-637. [PMID: 30179273 PMCID: PMC6282793 DOI: 10.1002/ana.25326] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/29/2018] [Accepted: 08/29/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Facioscapulohumeral dystrophy (FSHD) is one of the most frequent heritable muscular dystrophies, with a large variety in age at onset and disease severity. The natural history and molecular characteristics of FSHD in childhood are incompletely understood. Our objective is to clinically and genetically characterize FSHD in childhood. METHODS We performed a nationwide, single-investigator, natural history study on FSHD in childhood. RESULTS Multiple-source recruitment resulted in 32 patients with FSHD (0-17 years), leading to an estimated prevalence of 1 in 100,000 children in The Netherlands. This series of 32 children with FSHD revealed a heterogeneous phenotype and genotype in childhood. The phenotypic hallmarks of FSHD in childhood are: facial weakness with normal or only mildly affected motor performance, decreased functional exercise capacity (6-minute walk test), lumbar hyperlordosis, and increased echo intensity on muscle ultrasonography. In addition, pain and fatigue were frequent and patients experienced a lower quality of life compared to healthy peers. In contrast to the literature on early-onset FSHD, systemic features such as hearing loss and retinal and cardiac abnormalities were infrequent and subclinical, and epilepsy and intellectual disability were absent. Genotypically, patients had a mean D4Z4 repeat array of 5 units (range, 2-9), and 14% of the mutations were de novo. INTERPRETATION FSHD in childhood is more prevalent than previously known and the genotype resembles classic FSHD. Importantly, FSHD mainly affects functional exercise capacity and quality of life in children. As such, these results are paramount for counseling, clinical management, and stratification in clinical research. Ann Neurol 2018;84:635-645.
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Affiliation(s)
- Rianne J.M. Goselink
- Department of Neurology, Donders Centre for NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands
| | - Tim H.A. Schreuder
- Department of Neurology, Donders Centre for NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands
| | - Nens van Alfen
- Department of Neurology, Donders Centre for NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands
| | - Imelda J.M. de Groot
- Department of Rehabilitation, Donders Centre for NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands
| | - Merel Jansen
- Department of Rehabilitation, Donders Centre for NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands
| | | | | | - Nienke van der Stoep
- Department of Clinical GeneticsLeiden University Medical CentreLeidenThe Netherlands
| | - Thomas Theelen
- Department of OphthalmologyRadboud University Medical CentreNijmegenThe Netherlands
| | - Nicol C. Voermans
- Department of Neurology, Donders Centre for NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands
| | | | - Baziel G.M. van Engelen
- Department of Neurology, Donders Centre for NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands
| | - Corrie E. Erasmus
- Department of Neurology, Donders Centre for NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands
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Binda AC, Fréz AR, Daniel CR, Bertolini GRF, Ruaro JA, Baroni MP. Functioning of active postmenopausal women with osteoporosis. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.004.ao15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The multiple aspects of disability in patients with osteoporosis require comprehensive tool for their assessment. The International Classification of Functioning, Disability and Health (ICF) is designed to describe the experience of such patients with theirs functioning. Objective: This study aimed to describe the functioning in a sample of active postmenopausal women with osteoporosis according to the brief ICF core set for osteoporosis. Methods: This cross-sectional study was conducted among active community-dwelling older adults in a southern Brazilian city. Participants were enrolled by convenience sampling from a group conducting supervised aquatic and land-based exercises. Active postmenopausal women with osteoporosis were included. Thirty-two women (mean age 68.0 ± 5.1 years old) participated in the evaluation. The brief ICF core set for osteoporosis was used to establish functional profiles. The categories were considered valid when ≥20% of participants showed some disability (according to ICF qualifiers). Results: No category showed a high level of disability, as >50% of women rated by qualifiers .3 or .4. Only the category e580 was considered by all participants as a facilitator. Conclusion: The brief ICF core set for osteoporosis results demonstrated that this classification system is representative to describe the functional profile of the sample. Active postmenopausal women with osteoporosis presented few impairments related to body functions and structures, activities and participation and environmental factors.
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Covelli V, Raggi A, Paganelli C, Leonardi M. Family members and health professionals' perspectives on future life planning of ageing people with Down syndrome: a qualitative study. Disabil Rehabil 2017; 40:2867-2874. [PMID: 28789572 DOI: 10.1080/09638288.2017.1362595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To address the way in which primary caregivers of people over 45 with Down syndrome describe daily life activities and context and foresee their future. METHODS Thirteen family members and 15 health professionals participated to four focus groups. Meaningful concepts were identified and linked to the International Classification of Functioning, Disability and Health using established linking rules. RESULTS A total of 258 relevant concepts were identified and linked to 75 categories of the classification: 38 were from activity and participation and 17 from environmental factors domains. The most commonly reported issues were mental functions (b117-intellectual functions and b152-emotional functions), community life activities (d910-community life and d920-recreation and leisure) and environmental factors (e310-support of immediate family, e355-support from health professionals and e555-associations and organizational services). CONCLUSIONS Information on the daily life and health of ageing people with Down syndrome is important to plan social and health care interventions tailored to deal with problems that they may encounter in older age. Considering the interaction between health and environment and maintaining a continuity of daily routines were reported as the most relevant topics for managing daily lives of persons with Down syndrome in older ages. Implications for rehabilitation Pay more attention to the interaction between environmental factors and health condition in ageing people with Down syndrome. Information about the life contest are important in order to plan present and future social-health care interventions. Future planning for people with Down syndrome is a great concern for family members.
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Affiliation(s)
| | - Alberto Raggi
- b Neurology, Public Health and Disability Unit - Scientific Directorate , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Chiara Paganelli
- b Neurology, Public Health and Disability Unit - Scientific Directorate , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Matilde Leonardi
- b Neurology, Public Health and Disability Unit - Scientific Directorate , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
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Anåker A, von Koch L, Sjöstrand C, Bernhardt J, Elf M. A comparative study of patients' activities and interactions in a stroke unit before and after reconstruction-The significance of the built environment. PLoS One 2017; 12:e0177477. [PMID: 28727727 PMCID: PMC5519004 DOI: 10.1371/journal.pone.0177477] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/27/2017] [Indexed: 01/19/2023] Open
Abstract
Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients' activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole. The data were collected using a behavioral mapping technique at three different time points: in the original unit, in the temporary unit and in the new unit. A total of 59 patients were included. The analysis included field notes from observations of the physical environment and examples from planning and design documents. The findings indicated that in the new unit, the patients spent more time in their rooms, were less active, and had fewer interactions with staff and family than the patients in the original unit. The reconstruction involved a change from a primarily multi-bed room design to single-room accommodations. In the new unit, the patients' lounge was located in a far corner of the unit with a smaller entrance than the patients' lounge in the old unit, which was located at the end of a corridor with a noticeable entrance. Changes in the design of the stroke unit may have influenced the patients' activities and interactions. This study raises the question of how the physical environment should be designed in the future to facilitate the delivery of health care and improve outcomes for stroke patients. This research is based on a case study, and although the results should be interpreted with caution, we strongly recommend that environmental considerations be included in future stroke guidelines.
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Affiliation(s)
- Anna Anåker
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
- Dalarna University, School of Education, Health and Social Studies, Falun, Sweden
| | - Lena von Koch
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
- Karolinska University Hospital, Department of Neurology, Stockholm, Sweden
| | - Christina Sjöstrand
- Karolinska University Hospital, Department of Neurology, Stockholm, Sweden
- Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden
| | - Julie Bernhardt
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Marie Elf
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
- Dalarna University, School of Education, Health and Social Studies, Falun, Sweden
- Chalmers University of Technology, School of Architecture, Gothenburg, Sweden
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Heerkens YF, de Weerd M, Huber M, de Brouwer CPM, van der Veen S, Perenboom RJM, van Gool CH, Ten Napel H, van Bon-Martens M, Stallinga HA, van Meeteren NLU. Reconsideration of the scheme of the international classification of functioning, disability and health: incentives from the Netherlands for a global debate. Disabil Rehabil 2017; 40:603-611. [PMID: 28129712 DOI: 10.1080/09638288.2016.1277404] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE The ICF (International Classification of Functioning, Disability and Health) framework (used worldwide to describe 'functioning' and 'disability'), including the ICF scheme (visualization of functioning as result of interaction with health condition and contextual factors), needs reconsideration. The purpose of this article is to discuss alternative ICF schemes. METHOD Reconsideration of ICF via literature review and discussions with 23 Dutch ICF experts. Twenty-six experts were invited to rank the three resulting alternative schemes. RESULTS The literature review provided five themes: 1) societal developments; 2) health and research influences; 3) conceptualization of health; 4) models/frameworks of health and disability; and 5) ICF-criticism (e.g. position of 'health condition' at the top and role of 'contextual factors'). Experts concluded that the ICF scheme gives the impression that the medical perspective is dominant instead of the biopsychosocial perspective. Three alternative ICF schemes were ranked by 16 (62%) experts, resulting in one preferred scheme. CONCLUSIONS There is a need for a new ICF scheme, better reflecting the ICF framework, for further (inter)national consideration. These Dutch schemes should be reviewed on a global scale, to develop a scheme that is more consistent with current and foreseen developments and changing ideas on health. Implications for Rehabilitation We propose policy makers on community, regional and (inter)national level to consider the use of the alternative schemes of the International Classification of Functioning, Disability and Health within their plans to promote functioning and health of their citizens and researchers and teachers to incorporate the alternative schemes into their research and education to emphasize the biopsychosocial paradigm. We propose to set up an international Delphi procedure involving citizens (including patients), experts in healthcare, occupational care, research, education and policy, and planning to get consensus on an alternative scheme of the International Classification of Functioning, Disability and Health. We recommend to discuss the alternatives for the present scheme of the International Classification of Functioning, Disability and Health in the present update and revision process within the World Health Organization as a part of the discussion on the future of the International Classification of Functioning, Disability and Health framework (including ontology, title and relation with the International Classification of Diseases). We recommend to revise the definition of personal factors and to draft a list of personal factors that can be used in policy making, clinical practice, research, and education and to put effort in the revision of the present list of environmental factors to make it more useful in, e.g., occupational health care.
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Affiliation(s)
- Yvonne F Heerkens
- a Dutch Institute of Allied Health Care , Amersfoort , The Netherlands.,b Research Group Occupation & Health , HAN University of Applied Sciences , Nijmegen , The Netherlands
| | | | - Machteld Huber
- d Institute for Positive Health , Amersfoort , The Netherlands
| | - Carin P M de Brouwer
- e Department of Epidemiology, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Sabina van der Veen
- f Innovation Health Care Professions & Education , Dutch Health Care Institute , Diemen , The Netherlands
| | | | - Coen H van Gool
- g WHO Collaborating Centre for the Family of International Classifications in The Netherlands, National Institute for Public Health and the Environment , Bilthoven , The Netherlands
| | - Huib Ten Napel
- g WHO Collaborating Centre for the Family of International Classifications in The Netherlands, National Institute for Public Health and the Environment , Bilthoven , The Netherlands
| | - Marja van Bon-Martens
- h The Trimbos Institute, Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands
| | - Hillegonda A Stallinga
- i School of Nursing & Health, University Medical Center, University of Groningen , Groningen , The Netherlands
| | - Nico L U van Meeteren
- j Topsector Life Sciences and Health (Health ∼ Holland) , The Hague , The Netherlands.,k CAPHRI, Maastricht University , Maastricht , The Netherlands
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Rasch analysis supported the construct validity of self-report measures of activity and participation derived from patient ratings of the ICF low back pain core set. J Clin Epidemiol 2017; 84:161-172. [PMID: 28108353 DOI: 10.1016/j.jclinepi.2016.12.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 12/05/2016] [Accepted: 12/16/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate whether measures of activity limitations and participation restrictions with sound internal construct validity could be derived from patient ratings of the International Classification of Functioning, Disability and Health Low Back Pain Core Set (LBP-CS). STUDY DESIGN AND SETTING The LBP-CS Self-Report Checklist (LBP-CS-SRC) was developed to permit patients to self-rate their functioning according to an extended set of activity and participation categories from the LBP-CS. Rasch analysis was used to examine the validity of the LBP-CS-SRC with a sample of 308 adults with chronic low back pain attending two tertiary-referral outpatient services in Brisbane, Australia. RESULTS The activity limitations and participation restrictions qualifier scales functioned satisfactorily, and the LBP-CS-SRC person response validity was good. After deletion of six misfitting items, the dimensionality results supported using the instrument as distinct measures of activity limitations (17 items) and participation restrictions (10 items). The activity and participation measures both had good person separation reliability, and no component items exhibited meaningful differential item functioning. CONCLUSION The results demonstrate that measures of activity and participation with sound internal construct validity can be derived from patient ratings of LBP-CS categories. The LBP-CS-SRC can be used in clinical practice and epidemiologic research to support understanding of patients' perspectives on functioning.
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van Dulmen SA, van der Wees PJ, Bart Staal J, Braspenning JCC, Nijhuis-van der Sanden MWG. Patient reported outcome measures (PROMs) for goalsetting and outcome measurement in primary care physiotherapy, an explorative field study. Physiotherapy 2016; 103:66-72. [PMID: 27033783 DOI: 10.1016/j.physio.2016.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 01/05/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Routine use of patient reported outcome measures (PROMs) may provide an effective way of monitoring patient valued outcomes. In this study we explored (1) the current use of PROMs; (2) to what extent the goals correspond with the selected PROMs; (3) the health outcomes based on PROMs. DESIGN Observational clinical cohort study. SETTING Dutch primary care physiotherapy practices (n=43). PARTICIPANTS Patients (n=299) with neck pain or low back pain. MAIN OUTCOME MEASURES The number of PROMs used per patient were calculated. The International Classification of Functioning, Disability and Health was used to map the patients' goals and the percentages of PROMS selected that match the domains of the goals were calculated. Health outcomes were assessed using two approaches for estimating the minimal clinically important difference (MCID). RESULTS Repeated measurements with the Visual Analogue Scale, the Patient Specific Complaints questionnaire, the Quebec Back Pain Disability Scale, or the Neck Disability Index were completed by more than 60% of the patients. The PROMs used matched in 46% of the cases with goals for pain improvement, and in 43% with goals set at activity/participation level. The mean differences between baseline and follow up scores for all PROMs were statistically significant. Improvements of patients based on MCID varied from 57% to 90%. CONCLUSIONS PROMs were used in the majority of the patients, showed improved health outcomes and fitted moderately with goals. The results of this study can be used for future research assessing the routine use of outcome measurements with PROMs.
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Affiliation(s)
- Simone A van Dulmen
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.
| | - Philip J van der Wees
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands
| | - J Bart Staal
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands; School for Physical Therapy, University of Applied Sciences Nijmegen, The Netherlands
| | - J C C Braspenning
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands
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Hammond R, Anttila H. Profession's Identity Challenged by the Language it Uses. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2015; 20:197-9. [PMID: 26639391 DOI: 10.1002/pri.1657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 10/05/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Ralph Hammond
- Adult Rehabilitation, Somerset Partnership NHS Foundation Trust, Bridgwater, UK. .,International Neurological Physical Therapy Association, www.wcpt.org/INPA.
| | - Heidi Anttila
- Welfare Department; Ageing, Disability and Functioning Unit, National Institute for Health and Welfare (THL), PO Box 30, Helsinki, FIN-00271, Finland
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18
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Escorpizo R. Summary and Way Forward: Doing more of ICF in physical therapy. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2015; 20:251-3. [DOI: 10.1002/pri.1656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 10/04/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Reuben Escorpizo
- Department of Rehabilitation and Movement Science; The University of Vermont; Burlington VT USA
- Swiss Paraplegic Research; Nottwil Switzerland
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