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Malone LA, Mehta T, Mendonca CJ, Mohanraj S, Thirumalai M. A prospective non-randomized feasibility study of an online membership-based fitness program for promoting physical activity in people with mobility impairments. Pilot Feasibility Stud 2024; 10:104. [PMID: 39095876 PMCID: PMC11295342 DOI: 10.1186/s40814-024-01528-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 07/08/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND People with mobility limitations have a disproportionately higher rate of acquiring secondary conditions such as obesity, cardiovascular comorbidity, pain, fatigue, depression, deconditioning, and type 2 diabetes. These conditions often result from poor access to home and community-based health promotion/wellness programs. The aim of this project was to determine the feasibility of delivering an online community membership-based fitness program for individuals with mobility impairments. METHODS For this prospective single-arm study, participants were recruited from members of a community fitness facility that serves people with physical disabilities and chronic health conditions. While all members had access to the online platform, individuals had to opt-in to participate in the research component. Activity options included 16 pre-recorded videos and 9 live exercise classes. During the 8-week program, participants had an opportunity to earn three exercise incentives for reaching certain activity milestones. Enrollment percentage, attendance, and attrition were tracked to assess program feasibility and acceptability. Changes in participant-reported outcomes including self-reported physical activity, psychosocial outcomes, and health-related quality of life (HRQOL) were examined using non-parametric analyses. RESULTS A total of 146 eligible individuals were screened of which 33 enrolled (22.6%). Two participants withdrew from the study, so a total of 31 were used for analyses. Participants included 29 women and 12 Black people with an average age of 60 (± 15.9) years. Health conditions included stroke, post-polio, arthritis, neuropathy, cerebral palsy, and obesity. Ten participants used an assistive device to get around inside the home. Twenty-six participants (78.8%) completed the online program, and 5 participants earned all 3 participation incentives. The mean number of live Zoom exercise classes attended by the participants was 12.8 (range = 0-43) over 8 weeks; 3 of 31 participants did not attend any classes. On average, participants watched 128 min (range = 0-704 min) of pre-recorded videos; 6 of 31 participants did not view any pre-recorded videos. Self-reported physical activity showed the largest improvement (11.15 units; 95% CI, 3.08, 19.56) with an effect size of 0.51 (Cohen's d). CONCLUSIONS This pilot study of an online membership-based fitness program for people with mobility impairments demonstrated preliminary effectiveness in increasing physical activity and was found to be feasible and acceptable. Feasibility endpoints do indicate potential to improve retention. These results suggest that online delivery of exercise programs can broaden the reach of specialized community fitness programs and is a promising direction for future work and fully powered trials are warranted to assess intervention efficacy. TRIAL REGISTRATION ClinicalTrials.gov, NCT05138809. Registered September 2, 2021, ClinicalTrials.gov PRS: Record Summary NCT05138809.
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Affiliation(s)
- Laurie A Malone
- Department of Occupational Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Tapan Mehta
- Department of Family and Community Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christen J Mendonca
- School of Health Professions, UAB Research Collaborative, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sangeetha Mohanraj
- School of Health Professions, UAB Research Collaborative, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mohanraj Thirumalai
- Division of Preventive Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
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Hoevenaars D, Holla JFM, de Groot S, Weijs PJM, Kraaij W, Janssen TWJ. Lifestyle and health changes in wheelchair users with a chronic disability after 12 weeks of using the WHEELS mHealth application. Disabil Rehabil Assist Technol 2024; 19:648-657. [PMID: 36165036 DOI: 10.1080/17483107.2022.2115563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE The aim of this study was to determine changes in physical activity, nutrition, sleep behaviour and body composition in wheelchair users with a chronic disability after 12 weeks of using the WHEELS mHealth application (app). METHODS A 12-week pre-post intervention study was performed, starting with a 1-week control period. Physical activity and sleep behaviour were continuously measured with a Fitbit charge 3. Self-reported nutritional intake, body mass and waist circumference were collected. Pre-post outcomes were compared with a paired-sample t-test or Wilcoxon signed-rank test. Fitbit data were analysed with a mixed model or a panel linear model. Effect sizes were determined and significance was accepted at p < .05. RESULTS Thirty participants completed the study. No significant changes in physical activity (+1.5 √steps) and sleep quality (-9.7 sleep minutes; -1.2% sleep efficiency) were found. Significant reduction in energy (-1022 kJ, d = 0.71), protein (-8.3 g, d = 0.61) and fat (-13.1 g, d = 0.87) intake, body mass (-2.2 kg, d = 0.61) and waist circumference (-3.3 cm, d = 0.80) were found. CONCLUSION Positive changes were found in nutritional behaviour and body composition, but not in physical activity and sleep quality. The WHEELS app seems to partly support healthy lifestyle behaviour.Implications for RehabilitationHealthy lifestyle promotion is crucial, especially for wheelchair users as they tend to show poorer lifestyle behaviour despite an increased risk of obesity and comorbidity.The WHEELS lifestyle app seems to be a valuable tool to support healthy nutrition choices and weight loss and to improve body satisfaction, mental health and vitality.
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Affiliation(s)
- Dirk Hoevenaars
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
| | - Jasmijn F M Holla
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
- Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, The Netherlands
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands
| | - Sonja de Groot
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
- Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, The Netherlands
| | - Peter J M Weijs
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Wessel Kraaij
- Leiden Institute of Advanced Computer Science, Leiden University, Leiden, The Netherlands
| | - Thomas W J Janssen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
- Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, The Netherlands
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Giesbrecht E, Faieta J, Best K, Routhier F, Miller WC, Laberge M. Impact of the TEAM Wheels eHealth manual wheelchair training program: Study protocol for a randomized controlled trial. PLoS One 2021; 16:e0258509. [PMID: 34644350 PMCID: PMC8513836 DOI: 10.1371/journal.pone.0258509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/20/2021] [Indexed: 12/05/2022] Open
Abstract
Background Variable, and typically inadequate, delivery of skills training following manual wheelchair (MWC) provision has a detrimental impact on user mobility and participation. Traditional in-person delivery of training by rehabilitation therapists has diminished due to cost, travel time, and most recently social distancing restrictions due to COVID-19. Effective alternative training approaches include eHealth home training applications and interactive peer-led training using experienced and proficient MWC users. An innovative TEAM Wheels program integrates app-based self-training and teleconference peer-led training using a computer tablet platform. Objective This protocol outlines implementation and evaluation of the TEAM Wheels training program in a randomized control trial using a wait-list control group. Setting The study will be implemented in a community setting in three Canadian cities. Participants Individuals ≥ 18 years of age within one year of transitioning to use of a MWC. Intervention Using a computer tablet, participants engage in three peer-led teleconference training sessions and 75–150 minutes of weekly practice using a video-based training application over 4 weeks. Peer trainers individualize the participants’ training plans and monitor their tablet-based training activity online. Control group participants also receive the intervention following a 1-month wait-list period and data collection. Measurements Outcomes assessing participation; skill capacity and performance; self-efficacy; mobility; and quality of life will be measured at baseline and post-treatment, and at 6-month follow-up for the treatment group. Impact statement We anticipate that TEAM Wheels will be successfully carried out at all sites and participants will demonstrate statistically significant improvement in the outcome measures compared with the control group.
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Affiliation(s)
- Ed Giesbrecht
- Department of Occupational Therapy, University of Manitoba, Winnipeg, Manitoba, Canada
- * E-mail:
| | - Julie Faieta
- Department of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Krista Best
- Department of Rehabilitation, Université Laval, Quebec City, Quebec, Canada
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec City, Quebec, Canada
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec, Canada
| | - William C. Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maude Laberge
- Département d’opérations et systèmes de décision, Université Laval, Quebec City, Quebec, Canada
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Hoevenaars D, Holla JFM, Te Loo L, Koedijker JM, Dankers S, Houdijk H, Visser B, Janssen TWJ, de Groot S, Deutekom M. Mobile App (WHEELS) to Promote a Healthy Lifestyle in Wheelchair Users With Spinal Cord Injury or Lower Limb Amputation: Usability and Feasibility Study. JMIR Form Res 2021; 5:e24909. [PMID: 34379056 PMCID: PMC8386360 DOI: 10.2196/24909] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 03/01/2021] [Accepted: 05/08/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Maintaining a healthy lifestyle is important for wheelchair users' well-being, as it can have a major impact on their daily functioning. Mobile health (mHealth) apps can support a healthy lifestyle; however, these apps are not necessarily suitable for wheelchair users with spinal cord injury or lower limb amputation. Therefore, a new mHealth app (WHEELS) was developed to promote a healthy lifestyle for this population. OBJECTIVE The objectives of this study were to develop the WHEELS mHealth app, and explore its usability, feasibility, and effectiveness. METHODS The WHEELS app was developed using the intervention mapping framework. Intervention goals were determined based on a needs assessment, after which behavior change strategies were selected to achieve these goals. These were applied in an app that was pretested on ease of use and satisfaction, followed by minor adjustments. Subsequently, a 12-week pre-post pilot study was performed to explore usability, feasibility, and effectiveness of the app. Participants received either a remote-guided or stand-alone intervention. Responses to semistructured interviews were analyzed using content analysis, and questionnaires (System Usability Score [SUS], and Usefulness, Satisfaction, and Ease) were administered to investigate usability and feasibility. Effectiveness was determined by measuring outcomes on physical activity, nutrition, sleep quality (Pittsburgh Sleep Quality Index), body composition, and other secondary outcomes pre and post intervention, and by calculating effect sizes (Hedges g). RESULTS Sixteen behavior change strategies were built into an app to change the physical activity, dietary, sleep, and relaxation behaviors of wheelchair users. Of the 21 participants included in the pilot study, 14 participants completed the study. The interviews and questionnaires showed a varied user experience. Participants scored a mean of 58.6 (SD 25.2) on the SUS questionnaire, 5.4 (SD 3.1) on ease of use, 5.2 (SD 3.1) on satisfaction, and 5.9 (3.7) on ease of learning. Positive developments in body composition were found on waist circumference (P=.02, g=0.76), fat mass percentage (P=.004, g=0.97), and fat-free mass percentage (P=.004, g=0.97). Positive trends were found in body mass (P=.09, g=0.49), BMI (P=.07, g=0.53), daily grams of fat consumed (P=.07, g=0.56), and sleep quality score (P=.06, g=0.57). CONCLUSIONS The WHEELS mHealth app was successfully developed. The interview outcomes and usability scores are reasonable. Although there is room for improvement, the current app showed promising results and seems feasible to deploy on a larger scale.
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Affiliation(s)
- Dirk Hoevenaars
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands.,Amsterdam Rehabilitation Research Center, Reade, Amsterdam, Netherlands
| | - Jasmijn F M Holla
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, Netherlands.,Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, Netherlands.,Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, Netherlands
| | - Leonie Te Loo
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, Netherlands
| | - Johan M Koedijker
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, Netherlands
| | - Sarah Dankers
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Han Houdijk
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, Netherlands
| | - Bart Visser
- Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, Netherlands.,Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Thomas W J Janssen
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands.,Amsterdam Rehabilitation Research Center, Reade, Amsterdam, Netherlands.,Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, Netherlands
| | - Sonja de Groot
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands.,Amsterdam Rehabilitation Research Center, Reade, Amsterdam, Netherlands.,Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, Netherlands
| | - Marije Deutekom
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, Netherlands.,Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, Netherlands.,Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
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Greenhalgh M, Kulich H, Blaauw E, Turner R, Peterson S, Cooper RA, Songer T. Health Outcomes Used to Determine Facets of Health-related Quality of Life for Post-9/11 Veterans Using Assistive Technology for A Combat-related Mobility Impairment: A Literature Review. Mil Med 2021; 186:1106-1114. [PMID: 33538791 DOI: 10.1093/milmed/usab028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/11/2020] [Accepted: 01/21/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Novel rehabilitation methods, including distribution and adoption of assistive technology for lower extremity impairments, are becoming crucial to ensure positive quality of life in all individuals. The quality of life of post-9/11 combat veterans is not well understood, in comparison to research on other populations. The following essay describes a review on health outcomes used to determine health-related quality of life (HR-QoL) among combat-injured service members who require mobility-related assistive technology. MATERIALS AND METHODS Reviews pooled data from research on PubMed, EMBASE, CINAHL, and PsycINFO published after September 11, 2001, and included service members who sustained a mobility impairment because of involvement in a post-9/11 combat operation. Basic descriptors were extracted in addition to health outcomes used, which were then categorized and summarized by six domains for HR-QoL as defined by the World Health Organization. RESULTS This review found health outcomes that fit in the pain and discomfort, negative emotions, mobility, social relations, access to and quality of healthcare services, and religious/spiritual/personal beliefs subdomains. The categorized results detailed their application to track and model HR-QoL health states in those with mobility impairments using mobility-based assistive technology. CONCLUSIONS The research on combat-induced mobility impairments indicates assistive technology improves otherwise poor health states. The results model these domains and subdomains to determine overall HR-QoL and the quality of a healthcare intervention, though additional research is needed as only one study was identified to be experimental in design.
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Affiliation(s)
- Mark Greenhalgh
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA.,School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA.,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Hailee Kulich
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA.,School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Eline Blaauw
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA
| | - Rose Turner
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA.,Health Sciences Library, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Sara Peterson
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA.,Department of Prosthetics and Orthotics, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Rory A Cooper
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA.,School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Thomas Songer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
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Betts AC, Ochoa C, Hamilton R, Sikka S, Froehlich-Grobe K. Barriers and Facilitators to Lifestyle Intervention Engagement and Weight Loss in People Living With Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2021; 27:135-148. [PMID: 33814891 PMCID: PMC7983639 DOI: 10.46292/sci20-00025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Individuals living with spinal cord injury (SCI) have a high prevalence of obesity and unique barriers to healthy lifestyle. Objective: To examine barriers and facilitators to engagement and weight loss among SCI participants enrolled in the Group Lifestyle Balance Adapted for individuals with Impaired Mobility (GLB-AIM), a 12-month intensive lifestyle intervention. Methods: SCI participants (N = 31) enrolled in a wait-list, randomized controlled trial where all participants received intervention between August 2015 and February 2017. Analyses of pooled data occurred in 2020 to examine cross-sectional and prospective associations of hypothesized barriers and facilitators with (1) intervention engagement, comprised of attendance and self-monitoring, and (2) percent weight change from baseline to 12 months. We performed multivariable linear regression on variables associated with outcomes at p < .05 in bivariate analyses and controlled for intervention group. Results: Participants were middle-aged (mean age, 48.26 ± 11.01 years), equally male (50%) and female, White (80.7%), and unemployed (65.6%). In participants who completed baseline surveys (n = 30), dietary self-efficacy explained 26% of variance in engagement (p < .01); among the 12-month study completers (n = 22, 71.0%), relationship issues explained 23% of variance in engagement (p < .01). Money problems, health issues unrelated to SCI, lack of motivation, and experimental group explained 57% of variance in weight loss (p for model < .01), with lack of motivation uniquely explaining 24% of variance (p < .01). Conclusion: Improving engagement and weight loss for persons with SCI in the GLBAIM program may be achieved by addressing lack of motivation, relationship issues, and nutrition self-efficacy.
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Affiliation(s)
- Andrea C. Betts
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Dallas, Texas
| | - Christa Ochoa
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas
| | - Rita Hamilton
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas
| | - Seema Sikka
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas
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Ertzgaard P, Nene A, Kiekens C, Burns AS. A review and evaluation of patient-reported outcome measures for spasticity in persons with spinal cord damage: Recommendations from the Ability Network - an international initiative. J Spinal Cord Med 2020; 43:813-823. [PMID: 30758270 PMCID: PMC7808317 DOI: 10.1080/10790268.2019.1575533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Context: Patient-reported outcome measures (PROMs) are valuable for capturing the impact of spasticity on health-related quality of life (HRQoL) in persons with spinal cord damage (SCD) and evaluating the efficacy of interventions. Objective: To provide practical guidance for measuring HRQoL in persons with spasticity following SCD. Methods: Literature reviews identified measures of HRQoL and caregiver burden, utilized in studies addressing spasticity in SCD. Identified measures were evaluated for clinical relevance and practicality for use in clinical practice and research. The PRISM, SCI-SET, EQ-5D and SF-36 instruments were mapped to the International Classification of Functioning, Disability and Health (ICF). The PRISM and SCI-SET were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Results: Two spasticity-specific, five generic, and four preference-based measures were identified. ICF mapping and the COSMIN checklist supported the use of the PRISM and SCI-SET in SCD. The SF-36 is considered the most useful generic measure; disability-adapted versions may be more acceptable but further studies on psychometric properties are required. The SF-36 can be converted to a preference-based measure (SF-6D), or alternatively the EQ-5D can be used. While no measures specific to caregivers of people with SCD were identified, the Caregiver Burden Scale and the Zarit Burden Interview are considered suitable. Conclusion: Recommended measures include the PRISM and SCI-SET (condition-specific), SF-36 (generic), and Caregiver Burden Scale and Zarit Burden Interview (caregiver burden). Consideration should be given to using condition-specific and generic measures in combination; the PRISM or SCI-SET combined with SF-36 is recommended.
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Affiliation(s)
- Per Ertzgaard
- Rehabiliteringsmedicinska Kliniken, University Hospital, Linköping, Sweden,Correspondence to: Per Ertzgaard Rehabiliteringsmedicinska Kliniken, University Hospital, SE-582 85, Linköping, Sweden; phone +46 707955853. E-mail:
| | - Anand Nene
- Formerly, Roessingh Centre for Rehabilitation, Roessingh Research & Development, Enschede, The Netherlands
| | - Carlotte Kiekens
- Department of Development and Regeneration, KU Leuven – University of Leuven, Leuven, Belgium,Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Anthony S. Burns
- Division of Physiatry, Division of Medicine, University of Toronto, Toronto, Canada
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Washburn RA, Ptomey LT, Gorczyca AM, Smith PR, Mayo MS, Lee R, Donnelly JE. Weight management for adults with mobility related disabilities: Rationale and design for an 18-month randomized trial. Contemp Clin Trials 2020; 96:106098. [PMID: 32768682 DOI: 10.1016/j.cct.2020.106098] [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: 02/28/2020] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
Adults with mobility related disabilities (MRDs) represent an underserved group with a high prevalence of overweight/obesity and limited options for weight management. We previously demonstrated clinically meaningful 12-month weight loss in adults with MRDs (-6.2%, 36% ≥5% of baseline weight) using an enhanced Stop Light Diet (eSLD) delivered using at home face-to-face behavioral sessions and optional physical activity. However, the costs/logistics associated with intervention delivery by individual home visits limits the potential for scaling and implementation of this approach. Thus, we will conduct a two-arm randomized trial in 128 overweight/obese adults with MRDs to compare weight loss (6 mos.) and maintenance (12 mos.) between interventions utilizing the eSLD, behavioral counseling, and increased physical activity delivered to individual participants in their homes or delivered to groups of participants in their homes remotely via video conferencing. The primary aim will compare weight loss between interventions arms across 6 months. Secondarily, we will compare weight loss (0-18 mos.), the proportion of participants who achieve clinically meaningful weight loss (≥5%) from 0 to 6 and 0 to18 months, and changes in quality of life from 0 to 6 and 0 to 18 months between interventions arms. We will also conduct cost, cost-effectiveness and contingent valuation comparisons and explore the influence of behavioral session attendance, compliance with the recommendations for diet and physical activity, self-monitoring of diet and physical activity, barriers to physical activity, sleep quality, and medications on weight change across 6 and 18 months. NCT REGISTRATION: NCT04046471.
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Affiliation(s)
- Richard A Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Lauren T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Anna M Gorczyca
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Patricia R Smith
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Matthew S Mayo
- Department of Biostatistics and Data Science, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Robert Lee
- Department of Population Health, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Joseph E Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
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Walker LO, Becker H, Andrews EE, Phillips CS. Adapting a health behavioral change and psychosocial toolkit to the context of physical disabilities: Lessons learned from disabled women with young children. Disabil Health J 2020; 14:100977. [PMID: 32778452 DOI: 10.1016/j.dhjo.2020.100977] [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: 04/13/2020] [Revised: 06/10/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Mothers with physical disabilities (MPDs) face the behavioral and psychosocial changes of the motherhood transition with fewer resources, additional barriers, and higher risks than nondisabled mothers. In this study we sought guidance from MPDs on adaptations needed to a health promotion toolkit for behavioral and psychosocial health that was originally developed for nondisabled, primarily low-income, women. OBJECTIVE To identify general themes for adaptations that would increase the suitability of the toolkit for MPDs. METHODS 11 MPDs were interviewed by videoconferencing in a mixed-methods study about their perspectives on improving relevance of the existing toolkit for this population. The toolkit contained three components: assessment scale, feedback template on assessment results, and a decision aid related to behavior change. Interviews were analyzed using qualitative content analysis. RESULTS Nine themes for improving suitability of the toolkit for MPDs were identified. Themes covered: Using non-judgment language; including strengths, not just risks; using exercise items applicable to persons with physical disabilities; being aware that functional ability was the key body image concern; considering motivational stages of behavioral change; providing choice in goal-setting for change; including suggestions for social support; identifying resources for health and adaptive parenting; and making health promotion resources available in alternative platforms (paper, electronic). CONCLUSIONS The MPDs' feedback revealed ways that our toolkit for behavioral and psychosocial health could be improved to be inclusive of MPDs. The participatory methods utilized here are also recommended in designing new or revising existing materials aimed at enhancing health promotion for people with disabilities.
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Affiliation(s)
- Lorraine O Walker
- School of Nursing, The University of Texas at Austin, Austin, TX, USA.
| | - Heather Becker
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Erin E Andrews
- Dell Medical School, University of Texas at Austin, Austin, TX, USA; Texas Valley Coastal Bend Health Care System, Veterans Health Administration, Harlingen, TX, USA
| | - Carolyn S Phillips
- School of Nursing, The University of Texas at Austin, Austin, TX, USA; Dana-Farber Cancer Institute, Boston, MA, USA
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Vancini RL, Gomes AA, de Paula-Oliveira H, de Lira C, Rufo-Tavares W, Andrade MS, Sarro KJ, Sampaio MM, Viana RB, Nikolaidis PT, Rosemann T, Knechtle B. Quality of Life, Depression, Anxiety Symptoms and Mood State of Wheelchair Athletes and Non-athletes: A Preliminary Study. Front Psychol 2019; 10:1848. [PMID: 31456720 PMCID: PMC6700361 DOI: 10.3389/fpsyg.2019.01848] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/26/2019] [Indexed: 11/17/2022] Open
Abstract
The present study aims to compare quality of life, depression, anxiety symptoms, and profile of mood state of wheelchair athletes and non-athletes. Thirty-nine basketball and rugby wheelchair athletes (n = 23, nine women, age 36.0 ± 10.0 years; body mass 66.2 ± 13.8 kg; height 170.0 ± 8.5 cm) and non-athletes (n = 16, 4 women, 39.0 ± 14.2 years; body mass 79.6 ± 17.2 kg; height 170.0 ± 6.4 cm) were recruited. Quality of life, anxiety and depressive symptoms and mood disorders were evaluated by the Medical Outcomes Short-Form Health Survey (SF-36), State-Trait Anxiety Inventory, Beck Depression Inventory and Profile of Mood State questionnaire, respectively. Comparison between groups (non-athletes vs. athletes) was performed using Student's t-test for independent samples. No differences (p > 0.05) were found between non-athletes vs. athletes regards to quality of life, depressive and anxiety symptoms and profile of mood state. Overall, non-athletes and athletes presented medium anxiety symptoms and mild to moderate depressive symptoms. In conclusion, the wheelchair athletes and non-athletes presented similar quality of life, depressive and anxiety symptoms, and profile of mood state.
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Affiliation(s)
- Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Laboratório de Força e Condicionamento, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Andressa Amato Gomes
- Centro de Educação Física e Desportos, Laboratório de Força e Condicionamento, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Hudson de Paula-Oliveira
- Centro de Educação Física e Desportos, Laboratório de Força e Condicionamento, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Claudio de Lira
- Setor de Fisiologia Humana e do Exercício, Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Weverton Rufo-Tavares
- Centro de Educação Física e Desportos, Laboratório de Força e Condicionamento, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Karine Jacon Sarro
- Faculdade de Educação Física, Universidade Estadual de Campinas, Campinas, Brazil
| | | | - Ricardo Borges Viana
- Setor de Fisiologia Humana e do Exercício, Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
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11
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Lanig IS, New PW, Burns AS, Bilsky G, Benito-Penalva J, Bensmail D, Yochelson M. Optimizing the Management of Spasticity in People With Spinal Cord Damage: A Clinical Care Pathway for Assessment and Treatment Decision Making From the Ability Network, an International Initiative. Arch Phys Med Rehabil 2018; 99:1681-1687. [PMID: 29428347 DOI: 10.1016/j.apmr.2018.01.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 01/08/2018] [Accepted: 01/17/2018] [Indexed: 11/28/2022]
Abstract
The recognition, evaluation, and management of disabling spasticity in persons with spinal cord damage (SCD) is a challenge for health care professionals, institutions, health systems, and patients. To guide the assessment and management of disabling spasticity in individuals with SCD, the Ability Network, an international panel of clinical experts, developed a clinical care pathway. The aim of this pathway is to facilitate treatment decisions that take into account the effect of disabling spasticity on health status, individual preferences and treatment goals, tolerance for adverse events, and burden on caregivers. The pathway emphasizes a patient-centered, individualized approach and the need for interdisciplinary coordination of care, patient involvement in goal setting, and the use of assessment and outcome measures that lend themselves to practical application in the clinic. The clinical care pathway is intended for use by health care professionals who provide care for persons with SCD and disabling spasticity in various settings. Barriers to optimal spasticity management in these people are also discussed. There is an urgent need for the clinical community to clarify and overcome barriers (knowledge-based, organizational, health system) to optimizing the management of spasticity in people with SCD.
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Affiliation(s)
- Indira S Lanig
- Northern Colorado Rehabilitation Hospital, Johnstown, CO, Australia.
| | - Peter W New
- Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Caulfield, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Epworth-Monash Rehabilitation Medicine Unit, Southern Medical School, Monash University, Clayton, Victoria, Australia; Rehabilitation and Aged Care Service, Kingston Centre, Monash Health, Cheltenham, VIC, Australia
| | - Anthony S Burns
- Division of Physiatry, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Jesus Benito-Penalva
- Institut Guttmann, Neurorehabilitation Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Djamel Bensmail
- Department of Physical Medicine and Rehabilitation, R. Poincaré Hospital, AP-HP, University of Versailles Saint Quentin, Garches, France
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12
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Michel YA, Engel L, Rand-Hendriksen K, Augestad LA, Whitehurst DG. "When I saw walking I just kind of took it as wheeling": interpretations of mobility-related items in generic, preference-based health state instruments in the context of spinal cord injury. Health Qual Life Outcomes 2016; 14:164. [PMID: 27894349 PMCID: PMC5127051 DOI: 10.1186/s12955-016-0565-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 11/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In health economic analyses, health states are typically valued using instruments with few items per dimension. Due to the generic (and often reductionist) nature of such instruments, certain groups of respondents may experience challenges in describing their health state. This study is concerned with generic, preference-based health state instruments that provide information for decisions about the allocation of resources in health care. Unlike physical measurement instruments, preference-based health state instruments provide health state values that are dependent on how respondents interpret the items. This study investigates how individuals with spinal cord injury (SCI) interpret mobility-related items contained within six preference-based health state instruments. METHODS Secondary analysis of focus group transcripts originally collected in Vancouver, Canada, explored individuals' perceptions and interpretations of mobility-related items contained within the 15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index (HUI), Quality of Well-Being Scale Self-Administered (QWB-SA), and the 36-item Short Form health survey version 2 (SF-36v2). Ritchie and Spencer's 'Framework Approach' was used to perform thematic analysis that focused on participants' comments concerning the mobility-related items only. RESULTS Fifteen individuals participated in three focus groups (five per focus group). Four themes emerged: wording of mobility (e.g., 'getting around' vs 'walking'), reference to aids and appliances, lack of suitable response options, and reframing of items (e.g., replacing 'walking' with 'wheeling'). These themes reflected item features that respondents perceived as relevant in enabling them to describe their mobility, and response strategies that respondents could use when faced with inaccessible items. CONCLUSION Investigating perceptions to mobility-related items within the context of SCI highlights substantial variation in item interpretation across six preference-based health state instruments. Studying respondents' interpretations of items can help to understand discrepancies in the health state descriptions and values obtained from different instruments. This line of research warrants closer attention in the health economics and quality of life literature.
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Affiliation(s)
- Yvonne Anne Michel
- Department of Health Management and Health Economics, Institute of Health and Society, Medical Faculty, University of Oslo, Postboks 1089, Blindern, 0318, Oslo, Norway
| | - Lidia Engel
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Kim Rand-Hendriksen
- Department of Health Management and Health Economics, Institute of Health and Society, Medical Faculty, University of Oslo, Postboks 1089, Blindern, 0318, Oslo, Norway.,Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway
| | - Liv Ariane Augestad
- Department of Health Management and Health Economics, Institute of Health and Society, Medical Faculty, University of Oslo, Postboks 1089, Blindern, 0318, Oslo, Norway
| | - David Gt Whitehurst
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada. .,Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada. .,International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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13
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Pettersson I, Hagberg L, Fredriksson C, Hermansson LN. The effect of powered scooters on activity, participation and quality of life in elderly users. Disabil Rehabil Assist Technol 2015; 11:558-63. [DOI: 10.3109/17483107.2015.1027301] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ingvor Pettersson
- School of Health and Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden and
| | - Lars Hagberg
- School of Health and Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden and
| | - Carin Fredriksson
- School of Health and Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden and
| | - Liselotte N Hermansson
- School of Health and Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden and
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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14
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Whitehurst DGT, Engel L, Bryan S. Short Form health surveys and related variants in spinal cord injury research: a systematic review. J Spinal Cord Med 2014; 37:128-38. [PMID: 24559417 PMCID: PMC4066421 DOI: 10.1179/2045772313y.0000000159] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
CONTEXT 'Short Form' health surveys - such as the SF-36 and SF-12 - are widely used in medical research. Spinal cord injury (SCI) is no exception, despite oft-cited concerns regarding measurement properties for populations with physical impairment. OBJECTIVE To provide a comprehensive overview of the use of Short Form health surveys and their variants within the SCI literature. METHODS Papers published between database inception and September 2012 were identified from 11 electronic databases; a supplementary reference list search was also conducted. Data extraction focused on details regarding the range of different Short Form surveys and variants used in SCI research, the respective frequency of use, the nature of reporting (complete versus partial reporting) and the method of survey administration. RESULTS One hundred seventy-four papers were identified. Thirty-six-item Short Form health surveys were frequently administered as complete instruments (n = 82); in 69 of these 82 studies (84%), it was not clearly stated which 36-item version had been used (e.g. SF-36v1, SF-36v2, RAND-36). Data for individual items and domains were often reported (29% of identified studies), indicating significant partial use of standardized measures. Modified variants of standardized health surveys were administered in 12 studies. CONCLUSION Although standardized Short Form health surveys are common within SCI research, attempts to add, delete, or modify items have resulted in a number of variants, often with minimal supportive psychometric evidence. Using established, generic outcome measures is appealing for a number of reasons. However, validity is paramount and requires further explicit consideration within the SCI research community.
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Affiliation(s)
- David G. T. Whitehurst
- Correspondence to: David G. T. Whitehurst, Faculty of Health Sciences, Blusson Hall 10504, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada.
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15
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McPherson A, Martin CR. A review of the measurement properties of the 36-item short-form health survey (SF-36) to determine its suitability for use in an alcohol-dependent population. J Psychiatr Ment Health Nurs 2013; 20:114-23. [PMID: 22458774 DOI: 10.1111/j.1365-2850.2012.01896.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A psychometric evaluation of the 36-item short-form health survey (SF-36) was undertaken in contemporary studies to assess its suitability for use in an alcohol-dependent population. Three criteria were used to try and determine this: factor analysis, internal consistency reliability and test-retest reliability. Factor analysis revealed that it is mainly consistent with a bidimensional model, internal consistency reliability showed that it consistently provided scores above the recommended threshold and test-retest reliability of the SF-36 highlights that it too provided higher than suggested scores. A conclusion was reached recommending the SF-36 as a reliable screening tool in an alcohol-dependent population, but this is given in caution as no studies were found analysing the instrument in this population.
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Affiliation(s)
- A McPherson
- School of Health, Nursing and Midwifery PhD Student, University of the West of Scotland, Ayr, UK
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16
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Kerfeld CI, Dudgeon BJ, Engel JM, Kartin D. Development of items that assess physical function in children who use wheelchairs. Pediatr Phys Ther 2013; 25:158-66; discussion 167. [PMID: 23542193 PMCID: PMC3613779 DOI: 10.1097/pep.0b013e318288d239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the content, format, and comprehension of the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric physical function related to mobility items for children who use wheelchairs (WCs). METHODS During a cognitive interview, 14 children, aged 8 to 12 years, who use WCs, verbalized their thoughts when answering PROMIS items. The questionnaire appraisal system was used to code summarized text from the interviews. RESULTS The children requested items be more specific and include options for reporting adaptive ways of performing and participating. How they would answer the item depended on the situation and specific environmental supports and constraints they may have experienced. CONCLUSIONS As rehabilitation professionals develop and use self-reported outcome measures, they should explore what is important to children who use WCs regarding their views on physical functioning, the influences of the environment, and variability in the use of devices to assist with functional mobility.
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Affiliation(s)
- Cheryl I Kerfeld
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle 98195, USA.
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17
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Khoury AJ, Hall A, Andresen E, Zhang J, Ward R, Jarjoura C. The association between chronic disease and physical disability among female Medicaid beneficiaries 18-64 years of age. Disabil Health J 2012; 6:141-8. [PMID: 23507165 DOI: 10.1016/j.dhjo.2012.11.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 11/06/2012] [Accepted: 11/30/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Rates of physical disability are higher in women than in men, and economically disadvantaged women are at greater risk for physical disability than women with higher incomes. Chronic diseases increase the risk of physical disability, and people with physical disability experience some added risks of secondary conditions including chronic disease. Yet, little is known about the prevalence of chronic disease among women living with a physical disability who use Medicaid, a particularly disadvantaged population. OBJECTIVE This study described the prevalence of chronic disease among adult (18-64 years), female, Florida Medicaid beneficiaries living with a physical disability between 2001 and 2005. METHODS Using Medicaid eligibility and claims files, we extracted ICD-9 codes for physically-disabling conditions and Current Procedure Terminology codes for mobility-assistive devices to define three levels of physical disability. RESULTS Participants appeared to be at high risk for both physical disability and chronic diseases. Close to half of the women had been diagnosed with one or more physically-disabling conditions, and 5.3% used mobility devices. One-third of the women had hypertension and sizeable proportions had other chronic diseases. Women with physical disability were more likely to have co-morbid chronic diseases than their able-bodied counterparts. DISCUSSION Our findings support the need for improved chronic disease prevention among female Medicaid beneficiaries, particularly those with physical disability. Strategies to improve prevention, screening and treatment in this population may mitigate the trends toward higher physical disability rates in the low-income, working-age population and may prevent high Medicare and Medicaid costs in the long-run.
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Affiliation(s)
- Amal J Khoury
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.
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Magnusson JE, Riess CM, Becker WJ. Modification of the SF-36 for a headache population changes patient-reported health status. Headache 2012; 52:993-1004. [PMID: 22553950 DOI: 10.1111/j.1526-4610.2012.02156.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Using standard quality of life and disability measures may not accurately capture these constructs in specific health populations such as headache patients. Modifying the wording of standard measures such as the Short-Form 36 (SF-36) should be considered in order to make them more applicable to specific patient populations. OBJECTIVE To investigate the possibility that headache patients may not consider their headaches when responding to SF-36 questions pertaining to health, physical health, pain, and bodily pain. METHODS The wording of several SF-36 questions were adapted for a headache population by making specific reference to "headaches" when asking people to rate the impact of health issues on their life. The results of the modified "Headache" SF-36 were compared with a similar population of transformed migraine patients who had completed the "Standard" SF-36. RESULTS Significant differences were found between scores for the "Standard" SF-36 group and the "Headache" SF-36 group across all SF-36 variables except for "General Health." CONCLUSIONS Misinterpretation of the concepts of "health,""physical health,""pain," and "bodily pain," although commonly used by the SF-36 in many populations, could influence responses on this measure, as respondents may not relate their head/headaches to these constructs. To ensure that accurate data are obtained in relation to the quality of life of headache patients, consideration should be given to using a form of the SF-36 that has been modified to allow appropriate interpretation of the questions completed by headache patients.
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Affiliation(s)
- Jane E Magnusson
- Department of Sport and Exercise Science, University of Auckland, Auckland, New Zealand.
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Salvador-Carulla L, Garcia-Gutierrez C. The WHO construct of health-related functioning (HrF) and its implications for health policy. BMC Public Health 2011; 11 Suppl 4:S9. [PMID: 21624195 PMCID: PMC3104222 DOI: 10.1186/1471-2458-11-s4-s9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The International Classification of Functioning (ICF) has acquired a central role in the WHO Family of International Classifications and it has been extensively adopted as the reference framework for health-related functioning (HrF). This review aims to provide a description of the ICF/HrF to contextualise ICF/HrF in relation to other approaches to health functioning and to describe its application in policy and legislation with a special focus on Spain. METHODS Narrative review based on the scientific literature and prior expert knowledge. RESULTS ICF is both a coding system and a conceptual framework of HrF, which is framed as a unidimensional, bipolar and asymmetric construct with a negative pole (disability) and a positive pole (good functioning) with higher complexity. Other models of HrF include health promotion, quality of life and activities of daily living (ADL). The curtailed taxonomy of ICF and its unclear distinction from other approaches have had significant implications for research, policy and legislation, as illustrated by the case of the legislation and services for functional dependency in Spain and other examples. CONCLUSIONS The ICF model of functioning is more comprehensive and usable than previous alternatives, but a full taxonomy of the HrF construct is needed to avoid further confusions in this field. This should also comprise harmonization with other classifications of the WHO Family of International Classifications and other models of health functioning.
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20
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Cerniauskaite M, Quintas R, Boldt C, Raggi A, Cieza A, Bickenbach JE, Leonardi M. Systematic literature review on ICF from 2001 to 2009: its use, implementation and operationalisation. Disabil Rehabil 2010; 33:281-309. [PMID: 21073361 DOI: 10.3109/09638288.2010.529235] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To present a systematic literature review on the state of the art of the utilisation of the International Classification of Functioning, Disability and Health (ICF) since its release in 2001. METHOD The search was conducted through EMBASE, MEDLINE and PsychInfo covering the period between 2001 and December 2009. Papers were included if ICF was mentioned in title or abstract. Papers focussing on the ICF-CY and clinical research on children and youth only were excluded. Papers were assigned to six different groups covering the wide scenario of ICF application. RESULTS A total of 672 papers, coming from 34 countries and 211 different journals, were included in the analysis. The majority of publications (30.8%) were conceptual papers or papers reporting clinical and rehabilitation studies (25.9%). One-third of the papers were published in 2008 and 2009. CONCLUSIONS The ICF contributed to the development of research on functioning and on disability in clinical, rehabilitation as well as in several other contexts, such as disability eligibility and employment. Diffusion of ICF research and use in a great variety of fields and scientific journals is a proof that a cultural change and a new conceptualisation of functioning and disability is happening.
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Affiliation(s)
- Milda Cerniauskaite
- Neurology, Public Health and Disability Unit-Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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Horner-Johnson W, Krahn GL, Suzuki R, Peterson JJ, Roid G, Hall T. Differential Performance of SF-36 Items in Healthy Adults With and Without Functional Limitations. Arch Phys Med Rehabil 2010; 91:570-5. [DOI: 10.1016/j.apmr.2009.12.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 12/15/2009] [Accepted: 12/16/2009] [Indexed: 10/19/2022]
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Drum CE, Peterson JJ, Culley C, Krahn G, Heller T, Kimpton T, McCubbin J, Rimmer J, Seekins T, Suzuki R, White GW. Guidelines and criteria for the implementation of community-based health promotion programs for individuals with disabilities. Am J Health Promot 2009; 24:93-101, ii. [PMID: 19928482 DOI: 10.4278/ajhp.090303-cit-94] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Health promotion programs for people with disabilities are in the early stages of development. This critical review utilizes a credentialed expert panel to develop a set of guidelines for community-based health promotion programs for individuals with disabilities. The procedures include a review of background material, systematic literature review with drafted guidelines consisting of operational, participation and accessibility recommendations. The role that those with disabilities can play is addressed and includes program planning, implementation and evaluation, physical and programmatic accessibility of programs, and importance of evidence-based practices.
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Affiliation(s)
- Charles E Drum
- Rehabilitation Research and Training Center on Health and Wellness/Center on Community Accessibility, Oregon Health & Science University, Portland, OR 97207-0574, USA.
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23
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Krahn GL, Suzuki R, Horner-Johnson W. Self-rated health in persons with spinal cord injury: relationship of secondary conditions, function and health status. Qual Life Res 2009; 18:575-84. [DOI: 10.1007/s11136-009-9477-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 04/02/2009] [Indexed: 10/20/2022]
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Krahn GL, Fujiura G, Drum CE, Cardinal BJ, Nosek MA. The dilemma of measuring perceived health status in the context of disability. Disabil Health J 2009; 2:49-56. [DOI: 10.1016/j.dhjo.2008.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 12/30/2008] [Accepted: 12/31/2008] [Indexed: 11/29/2022]
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