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Glegg S, Costello C, Barnaby S, Cassidy C, Sibley KM, Russell K, Kingsnorth S, Pritchard L, de Camargo OK, Andersen J, Bellefeuille S, Cross A, Curran J, Hesketh K, Layco J, Reynolds J, Robeson P, Straus S, Wittmeier K. Connecting for Care: a protocol for a mixed-method social network analysis to advance knowledge translation in the field of child development and rehabilitation. Implement Sci Commun 2022; 3:127. [PMID: 36457120 PMCID: PMC9713183 DOI: 10.1186/s43058-022-00372-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Connections between individuals and organizations can impact knowledge translation (KT). This finding has led to growing interest in the study of social networks as drivers of KT. Social networks are formed by the patterns of relationships or connections generated through interactions. These connections can be studied using social network analysis (SNA) methodologies. The relatively small yet diverse community in the field of child development and rehabilitation (CD&R) in Canada offers an ideal case study for applying SNA. The purposes of this work are to (1) quantify and map the structure of Canadian CD&R KT networks among four groups: families, health care providers, KT support personnel, and researchers; (2) explore participant perspectives of the network structure and of KT barriers and facilitators within it; and (3) generate recommendations to improve KT capacity within and between groups. Aligning with the principles of integrated KT, we have assembled a national team whose members contribute throughout the research and KT process, with representation from the four participant groups. METHODS A sequential, explanatory mixed-method study, within the bounds of a national case study in the field of CD&R. Objective 1: A national SNA survey of family members with advocacy/partnership experience, health care providers, KT support personnel, and researchers, paired with an anonymous survey for family member without partnership experience, will gather data to describe the KT networks within and between groups and identify barriers and facilitators of network connections. Objective 2: Purposive sampling from Phase 1 will identify semi-structured interview participants with whom to examine conventional and network-driven KT barriers, facilitators, and mitigating strategies. Objective 3: Intervention mapping and a Delphi process will generate recommendations for network and conventional interventions to strengthen the network and facilitate KT. DISCUSSION This study will integrate network and KT theory in mapping the structure of the CD&R KT network, enhance our understanding of conventional and network-focused KT barriers and facilitators, and provide recommendations to strengthen KT networks. Recommendations can be applied and tested within the field of CD&R to improve KT, with the aim of ensuring children achieve the best health outcomes possible through timely access to effective healthcare.
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Affiliation(s)
- Stephanie Glegg
- grid.17091.3e0000 0001 2288 9830Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, T325 – 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada ,grid.414137.40000 0001 0684 7788BC Children’s Hospital Research Institute, Vancouver, British Columbia Canada ,grid.414137.40000 0001 0684 7788Sunny Hill Health Centre at BC Children’s Hospital, Vancouver, British Columbia Canada ,Moms Against Racism, Victoria, British Columbia Canada
| | - Carrie Costello
- grid.460198.20000 0004 4685 0561Children’s Hospital Research Institute of Manitoba, Excellence in Neurodevelopment and Rehabilitation Research in Child Health (ENRRICH) Theme, Winnipeg, Manitoba Canada
| | | | - Christine Cassidy
- grid.55602.340000 0004 1936 8200School of Nursing, Dalhousie University, Halifax, Nova Scotia Canada ,grid.414870.e0000 0001 0351 6983IWK Health, Halifax, Nova Scotia Canada
| | - Kathryn M. Sibley
- grid.21613.370000 0004 1936 9609Community Health Sciences and George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Canada
| | - Kelly Russell
- grid.460198.20000 0004 4685 0561Children’s Hospital Research Institute of Manitoba, Excellence in Neurodevelopment and Rehabilitation Research in Child Health (ENRRICH) Theme, Winnipeg, Manitoba Canada ,grid.21613.370000 0004 1936 9609Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba Canada
| | - Shauna Kingsnorth
- grid.414294.e0000 0004 0572 4702Evidence to Care, Teaching & Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario Canada ,grid.414294.e0000 0004 0572 4702Bloorview Research Institute, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario Canada
| | - Lesley Pritchard
- grid.17089.370000 0001 2190 316XDepartment of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta Canada ,grid.481529.30000 0004 6093 6169Women and Children’s Health Research Institute, Edmonton, Alberta Canada
| | - Olaf Kraus de Camargo
- grid.25073.330000 0004 1936 8227CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227Department of Pediatrics, School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - John Andersen
- grid.17089.370000 0001 2190 316XDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta Canada ,grid.413574.00000 0001 0693 8815Alberta Health Services, Edmonton, Alberta Canada
| | - Samantha Bellefeuille
- grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario Canada
| | - Andrea Cross
- grid.25073.330000 0004 1936 8227CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227Department of Pediatrics, School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Janet Curran
- grid.55602.340000 0004 1936 8200School of Nursing, Dalhousie University, Halifax, Nova Scotia Canada
| | - Kim Hesketh
- Children’s Treatment Network, Richmond Hill, Ontario Canada
| | - Jeremy Layco
- grid.460198.20000 0004 4685 0561Children’s Hospital Research Institute of Manitoba, Excellence in Neurodevelopment and Rehabilitation Research in Child Health (ENRRICH) Theme, Winnipeg, Manitoba Canada
| | - James Reynolds
- grid.410356.50000 0004 1936 8331Faculty of Health Sciences, Queen’s University, Kingston, Ontario Canada ,Kids Brain Health Network, Burnaby, British Columbia Canada
| | - Paula Robeson
- Children’s Healthcare Canada, Ottawa, Ontario Canada
| | - Sharon Straus
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Kristy Wittmeier
- grid.460198.20000 0004 4685 0561Children’s Hospital Research Institute of Manitoba, Excellence in Neurodevelopment and Rehabilitation Research in Child Health (ENRRICH) Theme, Winnipeg, Manitoba Canada ,grid.21613.370000 0004 1936 9609Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba Canada ,Rehabilitation Centre for Children, Winnipeg, Manitoba Canada
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Itakussu EY, Morita AA, Kakitsuka EE, Pitta F, Cavalheri V, Hernandes NA. Instruments to assess function or functionality in adults after a burn injury: A systematic review. Burns 2021; 47:999-1011. [PMID: 33896659 DOI: 10.1016/j.burns.2021.04.003] [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: 09/18/2020] [Revised: 02/22/2021] [Accepted: 04/06/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Assessment of functionality or function, through valid and reliable instruments, is essential during rehabilitation of adults after a burn injury. Currently, there is no consensus in the literature regarding the most appropriate tool that should be used to assess function or functionality; there is also no synthesis of the current studies published in this area. OBJECTIVES To investigate and report the instruments used to assess function or functionality in adults after a burn injury; to identify the characteristics and evidence on their measurement properties; and to evaluate their clinical utility. METHODS We systematically searched the literature via six electronic databases and via screening reference lists of relevant studies. The review was registered in PROSPERO (CRD42016048065) and reported according to the PRISMA statement. Studies in which function or functionality of upper and/or lower limbs of adults after a burn injury was assessed were included. Exclusion criteria comprised studies in pediatric populations and conference abstracts. RESULTS Thirty-four studies were included. Twelve questionnaires and seven objective tests for function or functionality were identified. Three specific tools were found; four generic instruments have been validated in burns. Nine studies evaluated the instruments' measurement properties, presenting at least one property classified as 'fair' quality. Finally, 18 instruments demonstrated clinical utility. CONCLUSION This systematic review demonstrated that most instruments used to assess function or functionality in adults with a burn injury have not been specifically developed for this population and had their measurement properties poorly studied. Conversely, almost all instruments had clinical utility.
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Affiliation(s)
- Edna Yukimi Itakussu
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil; Burn Treatment Center, University Hospital of State University of Londrina (HU-UEL), Londrina, Brazil.
| | - Andrea Akemi Morita
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil.
| | - Emely Emi Kakitsuka
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil.
| | - Fabio Pitta
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil.
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Australia; Allied Health, South Metropolitan Health Service, Perth, Australia.
| | - Nidia Aparecida Hernandes
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil.
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Research on rehabilitation interventions for adults living with HIV: a scoping review. Int J Rehabil Res 2017; 39:106-16. [PMID: 27028287 DOI: 10.1097/mrr.0000000000000166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this paper is to use a scoping review to investigate the extent, range, and nature of research on rehabilitation interventions for adults living with HIV. Electronic databases (MEDLINE, EMBASE, CINAHL, AMED, and PsychINFO) and reference lists of the included articles were searched. Authors were emailed when possible for unavailable articles. A total of 897 titles and abstracts were retrieved. Thirty-three articles were included. There were 27 different rehabilitation interventions delivered by 18 professions. The studies were completed in four different countries. Most studies were published in 2008. A randomized-controlled trial was the most used method. The nature of the studies was analyzed according to the three-core concepts of the International Classification of Functioning, Disability and Health: 28 studies addressed impairments; six studies addressed activity limitations; and 14 studies addressed participation restrictions. This scoping study advances the knowledge of research on rehabilitation interventions for adults living with HIV. More research on rehabilitation interventions is needed in sub-Saharan Africa and other low-income and middle-income countries to ensure that these individuals are receiving the best possible care. There is a need for the HIV field to recognize the important contribution of rehabilitation toward the HIV care continuum.
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Masterson-Algar P, Burton CR, Rycroft-Malone J. Process evaluations in neurological rehabilitation: a mixed-evidence systematic review and recommendations for future research. BMJ Open 2016; 6:e013002. [PMID: 28186944 PMCID: PMC5129134 DOI: 10.1136/bmjopen-2016-013002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/23/2016] [Accepted: 10/13/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To systematically review how process evaluations are currently designed, what methodologies are used and how are they developed alongside or within neurological rehabilitation trials. METHODS This mixed-methods systematic review had two evidence streams: stream I, studies reporting process evaluations alongside neurorehabilitation trials research and stream II, methodological guidance on process evaluation design and methodology. A search strategy was designed for each evidence stream. Data regarding process evaluation core concepts and design issues were extracted using a bespoke template. Evidence from both streams was analysed separately and then synthesised in a final overarching synthesis proposing a number of recommendations for future research. RESULTS A total of 124 process evaluation studies, reporting on 106 interventions, were included in stream I evidence. 30 studies were included as stream II evidence. Synthesis 1 produced 9 themes, and synthesis 2 identified a total of 8 recommendations for process evaluation research. The overall synthesis resulted in 57 'synthesis recommendations' about process evaluation methodology grouped into 9 research areas, including the use of theory, the investigation of context, intervention staff characteristics and the delivery of the trial intervention. CONCLUSIONS There remains no consensus regarding process evaluation terminology within the neurological rehabilitation field. There is a need for process evaluations to address the nature and influence of context over time. Process evaluations should clearly describe what intervention staff bring to a trial, including skills and experience prior to joining the research. Process evaluations should monitor intervention staff's learning effects and the possible impact that these may have on trial outcomes.
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Ferrazzi P, Krupa T. Re: Mental health rehabilitation in therapeutic jurisprudence: Theoretical improvements. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 46:42-49. [PMID: 27107821 DOI: 10.1016/j.ijlp.2016.02.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Legal scholarship relevant to criminal court mental health initiatives that divert people with mental illness from prosecution to treatment has created the concept of therapeutic jurisprudence (TJ), an approach that seeks to maximize the law's potential for therapeutic outcomes. Despite recognition that TJ includes a rehabilitative response as a key animating principle and that it advocates for interdisciplinary synthesis, TJ has developed mainly from within the practice and discipline of law and without reference to the discipline of rehabilitation science, in which approaches to mental health rehabilitation (MHR) have witnessed significant developments in recent decades. In particular, concepts of MHR have shifted from a biomedical focus to a psychosocial approach, such as the recovery model, that incorporates values of self-determination, independence, and empowerment. It is argued that greater consideration of MHR will improve the theoretical validity of TJ by 1) helping define what 'therapeutic' means; 2) constructing a normative framework; and 3) broadening the scope of TJ as an interdisciplinary approach. More research is needed to ensure concepts from MHR rehabilitation science are considered in TJ legal scholarship and criminal court mental health initiatives.
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Affiliation(s)
- Priscilla Ferrazzi
- University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.
| | - Terry Krupa
- Queen's University, 31 George Street, Kingston, ON, K7L 3N6, Canada.
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Some reflections on the past, present, and future of Physical and Rehabilitation Medicine (on the occasion of the 30th SOFMER congress). Ann Phys Rehabil Med 2016; 59:79-82. [DOI: 10.1016/j.rehab.2016.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 02/12/2016] [Indexed: 11/30/2022]
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Giesbrecht EM, Miller WC, Jin BT, Mitchell IM, Eng JJ. Rehab on Wheels: A Pilot Study of Tablet-Based Wheelchair Training for Older Adults. JMIR Rehabil Assist Technol 2015; 2:e3. [PMID: 28582240 PMCID: PMC5454553 DOI: 10.2196/rehab.4274] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/04/2015] [Accepted: 03/22/2015] [Indexed: 11/27/2022] Open
Abstract
Background Alternative and innovative strategies such as mHealth and eLearning are becoming a necessity for delivery of rehabilitation services. For example, older adults who require a wheelchair receive little, if any, training for proficiency with mobility skills. This substantive service gap is due in part to restricted availability of clinicians and challenges for consumers to attend appointments. A research team of occupational therapists and computer scientists engaged clinicians, consumers, and care providers using a participatory action design approach. A tablet-based application, Enhancing Participation In the Community by improving Wheelchair Skills (EPIC Wheels), was developed to enable in-chair home training, online expert trainer monitoring, and trainee-trainer communication via secure voice messaging. Objective Prior to undertaking a randomized controlled trial (RCT), a pilot study was conducted to determine the acceptability and feasibility of administering an mHealth wheelchair skills training program safely and effectively with two participants of different skill levels. The findings were used to determine whether further enhancements to the program were indicated. Methods The program included two in-person sessions with an expert trainer and four weeks of independent home training. The EPIC Wheels application included video instruction and demonstration, self-paced training activities, and interactive training games. Participants were provided with a 10-inch Android tablet, mounting apparatus, and mobile Wi-Fi device. Frequency and duration of tablet interactions were monitored and uploaded daily to an online trainer interface. Participants completed a structured evaluation survey and provided feedback post-study. The trainer provided feedback on the training protocol and trainer interface. Results Both participants perceived the program to be comprehensive, useful, and easily navigated. The trainer indicated usage data was comprehensive and informative for monitoring participant progress and adherence. The application performed equally well with multiple devices. Some initial issues with log-in requests were resolved via tablet-specific settings. Inconsistent Internet connectivity, resulting in delayed data upload and voice messaging, was specific to individual Wi-Fi devices and resolved by standardizing configuration. Based on the pilot results, the software was updated to make content download more robust. Additional features were also incorporated such as check marks for completed content, a more consumer-friendly aesthetic, and achievement awards. The trainer web interface was updated to improve usability and provides both a numerical and visual summary of participant data. Conclusions The EPIC Wheels pilot study provided useful feedback on the feasibility of a tablet-based home program for wheelchair skills training among older adults, justifying advancement to evaluation in an RCT. The program may be expanded for use with other rehabilitation interventions and populations, particularly for those living in rural or remote locations. Future development will consider integration of built-in tablet sensors to provide performance feedback and enable interactive training activities. Trial Registration ClinicalTrials.gov NCT01644292; https://clinicaltrials.gov/ct2/show/NCT01644292 (Archived by WebCite at http://www.webcitation.org/6XyvYyTUf).
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Affiliation(s)
- Edward Mark Giesbrecht
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Department of Occupational Therapy, University of Manitoba, Winnipeg, MB, Canada
| | - William C Miller
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Department of Occupational Therapy and Occupational Science, University of British Columbia, Vancouver, BC, Canada
| | - Boyang Tom Jin
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Ian M Mitchell
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Janice J Eng
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
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Silva CC, Silva A, Sousa A, Pinheiro AR, Bourlinova C, Silva A, Salazar A, Borges C, Crasto C, Correia MV, Vilas-Boas JP, Santos R. Co-activation of upper limb muscles during reaching in post-stroke subjects: an analysis of the contralesional and ipsilesional limbs. J Electromyogr Kinesiol 2014; 24:731-8. [PMID: 24882699 DOI: 10.1016/j.jelekin.2014.04.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 04/01/2014] [Accepted: 04/15/2014] [Indexed: 10/25/2022] Open
Abstract
The purpose of this study was to analyze the change in antagonist co-activation ratio of upper-limb muscle pairs, during the reaching movement, of both ipsilesional and contralesional limbs of post-stroke subjects. Nine healthy and nine post-stroke subjects were instructed to reach and grasp a target, placed in the sagittal and scapular planes of movement. Surface EMG was recorded from postural control and movement related muscles. Reaching movement was divided in two sub-phases, according to proximal postural control versus movement control demands, during which antagonist co-activation ratios were calculated for the muscle pairs LD/PM, PD/AD, TRIlat/BB and TRIlat/BR. Post-stroke's ipsilesional limb presented lower co-activation in muscles with an important role in postural control (LD/PM), comparing to the healthy subjects during the first sub-phase, when the movement was performed in the sagittal plane (p<0.05). Conversely, the post-stroke's contralesional limb showed in general an increased co-activation ratio in muscles related to movement control, comparing to the healthy subjects. Our findings demonstrate that, in post-stroke subjects, the reaching movement performed with the ipsilesional upper limb seems to show co-activation impairments in muscle pairs associated to postural control, whereas the contralesional upper limb seems to have signs of impairment of muscle pairs related to movement.
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Affiliation(s)
- Cláudia C Silva
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal.
| | - Augusta Silva
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| | - Andreia Sousa
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| | - Ana Rita Pinheiro
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| | - Catarina Bourlinova
- Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ana Silva
- INESC-TEC and Faculty of Engineering, University of Porto, Porto, Portugal
| | - António Salazar
- INESC-TEC and Faculty of Engineering, University of Porto, Porto, Portugal
| | - Carla Borges
- INESC-TEC and Faculty of Engineering, University of Porto, Porto, Portugal
| | - Carlos Crasto
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| | | | - João Paulo Vilas-Boas
- CIFI2D, Faculty of Sport, and Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
| | - Rubim Santos
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
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A Systematic Review of Randomized Controlled Trials in the Field of Dysphagia Rehabilitation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2013. [DOI: 10.1007/s40141-013-0030-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stevens M, Kirsh B, Nixon SA. Rehabilitation interventions for children living with HIV: a scoping review. Disabil Rehabil 2013; 36:865-74. [DOI: 10.3109/09638288.2013.821184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abdul Latif L, Daud Amadera JE, Pimentel D, Pimentel T, Fregni F. Sample size calculation in physical medicine and rehabilitation: a systematic review of reporting, characteristics, and results in randomized controlled trials. Arch Phys Med Rehabil 2011; 92:306-15. [PMID: 21272730 DOI: 10.1016/j.apmr.2010.10.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 09/02/2010] [Accepted: 10/01/2010] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To assess systematically the reporting of sample size calculation in randomized controlled trials (RCTs) in 5 leading journals in the field of physical medicine and rehabilitation (PM&R). DATA SOURCES The data source was full reports of RCTs in 5 leading PM&R journals (Journal of Rehabilitation Medicine, Archives of Physical Medicine and Rehabilitation, American Journal of Physical Medicine and Rehabilitation, Clinical Rehabilitation, and Disability and Rehabilitation) between January and December of 1998 and 2008. Articles were identified in Medline. STUDY SELECTION A total of 111 articles met our inclusion criteria, which include RCTs of human studies in the 5 selected journals. DATA EXTRACTION Sample size calculation reporting and trial characteristics were collected for each trial by independent investigators. DATA SYNTHESIS In 2008, 57.3% of articles reported sample size calculation as compared with only 3.4% in 1998. The parameters that were commonly used were a power of 80% and alpha of 5%. Articles often failed to report effect size or effect estimates for sample size calculation. Studies reporting sample size calculation were more likely to describe the main outcome and to have a sample size greater than 50 subjects. The study outcome (positive vs negative) was not associated with the likelihood of sample size reporting. Trial characteristics of the 2 periods (1998 vs 2008) were similar except that in 1998 there were more negative studies compared with 2008. CONCLUSIONS Although sample size calculation reporting has improved dramatically in 10 years and is comparable with other fields in medicine, it is still not adequate given current publication guidelines.
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Affiliation(s)
- Lydia Abdul Latif
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
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Phillips M, Lin X. Rehabilitation in practice: Learning about research--how can trainees in rehabilitation medicine become competent in appraising and conducting research? Clin Rehabil 2010; 24:1059-71. [PMID: 21115684 DOI: 10.1177/0269215510375900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is 'The trainee is able to critically appraise scientific, clinical and sociological research literature' and 'The trainee is able to complete a clinical audit study from the planning to final report stage'.
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Affiliation(s)
- Margaret Phillips
- University of Nottingham Division of Rehabilitation Medicine, Royal Derby Hospital.
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Chapter 53: rehabilitation therapies. HANDBOOK OF CLINICAL NEUROLOGY 2009. [PMID: 19892156 DOI: 10.1016/s0072-9752(08)02153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
This chapter retraces the history and evolution of rehabilitative efforts by physicians and other health professionals to alleviate the symptoms and disabilities associated with neurological disorders. Rehabilitation therapies often provide interventions that go beyond traditional medical treatment aimed at treating impairments, and help those with neurological injuries and illness to re-establish themselves as productive and socially-integrated citizens by reducing their functional disabilities. The chapter considers the early history of practical treatments developed in Greek and Roman times, reviews the scattered attempts at treatment during the Middle Ages and Renaissance, examines the more recent development of specific rehabilitative techniques and disciplines in the 20th century, and also provides discussion of the contemporary application of empirically validated rehabilitation strategies and techniques that emphasize treatment efficacy. The evolution of medical and physical rehabilitation, occupational and vocational rehabilitation, aphasia and cognitive rehabilitation, are all discussed, with additional review of the influence of some of the military conflicts and wars in history that have stimulated the advancement of the clinical practice of rehabilitation. A critique of the benefits of comprehensive rehabilitative programs for traumatic brain injury and stroke is specifically included. The varied skepticism and optimism of treating neurological disorders throughout history is also highlighted.
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Kroll T, Morris J. Challenges and Opportunities in Using Mixed Method Designs in Rehabilitation Research. Arch Phys Med Rehabil 2009; 90:S11-6. [DOI: 10.1016/j.apmr.2009.04.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Revised: 03/20/2009] [Accepted: 04/14/2009] [Indexed: 10/20/2022]
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Ng L, Khan F, Mathers S. Multidisciplinary care for adults with amyotrophic lateral sclerosis or motor neuron disease. Cochrane Database Syst Rev 2009:CD007425. [PMID: 19821416 DOI: 10.1002/14651858.cd007425.pub2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Multidisciplinary care (MDC) is increasingly thought to be an important means of symptomatic and supportive management for motor neuron disease (MND) but the evidence base for its effectiveness is unclear. OBJECTIVES To assess the effectiveness of MDC in adults with MND, especially the types of approaches that are effective (settings, intensity) and the outcomes that are affected. SEARCH STRATEGY We searched The Cochrane Neuromuscular Disease Group Specialized Register (11 May 2009), and The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2009), MEDLINE (1966 to April 2009), EMBASE (1980 to April 2009), CINAHLPlus (1937 to April 2009), AMED (1985 to April 2009) and LILACS (1982 to April 2009). SELECTION CRITERIA Randomised and controlled clinical trials that compared MDC in MND with either routinely available local services or lower levels of intervention; or studies that compared MDC in different settings or at different levels of intensity.Studies of 'other designs' (such as observational studies) were included only in the Discussion since such studies could only be of limited contribution to the best evidence synthesis. DATA COLLECTION AND ANALYSIS We performed a 'best evidence' synthesis based on methodological quality. We grouped studies in terms of setting and intensity (high or low) of therapy. MAIN RESULTS No randomised controlled trials or controlled clinical trials were identified. We summarised the results of five observational studies (including one with two reports) in the Discussion section of this review. AUTHORS' CONCLUSIONS In the absence of randomised controlled trials or controlled clinical trials, the 'best' evidence to date is based on three 'low' and two 'very low quality' observational studies. These suggest 'very low quality evidence' for an advantage for mental health domains (only) of quality of life without increasing healthcare costs, and 'low level quality' evidence for reduced hospitalisation for MDC in low-intensity outpatient settings; and 'very low quality' evidence for improved disability in high-intensity settings. The evidence for survival is conflicting. These conclusions are tentative and the gap in current research should not be interpreted as proof that MDC is ineffective. Further research is needed into appropriate study designs; outcome measurement; caregiver needs; and the evaluation of optimal settings, type, intensity or frequency and cost-effectiveness of MDC in the MND population. Future research should focus on observational designs to assess care and outcomes in 'real-life' settings. The interface between neurology, rehabilitation and palliative care should be explored to provide long-term support for MND.
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Affiliation(s)
- Louisa Ng
- Rehabilitation, Royal Melbourne Hospital, Royal Park Campus, Poplar Road, Parkville, Victoria, Australia, 3052
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Demers L, Poissant L. Connecting with clinicians: opportunities to strengthen rehabilitation research. Disabil Rehabil 2008; 31:152-9. [PMID: 18720124 DOI: 10.1080/09638280802037936] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This article examines the distinctive opportunities and challenges involved in connecting with clinicians to strengthen rehabilitation research. METHOD The relevant literature on various factors that link researchers and clinicians is summarized and discussed. RESULTS Links between researchers and clinicians are demonstrated by evidence-based practice, common conceptual background and the development of research capacity. Sustainable partnerships can evolve throughout the research process by using various enduring strategies such as experts' committee as well as novel approaches like communities of practice. CONCLUSION This paper reflects the conviction that reducing the gap between research and clinical practice will be facilitated by implementing partnerships originating from both researchers and clinicians.
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Affiliation(s)
- Louise Demers
- Research Centre of the Montreal Geriatric University Institute, Canada.
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Dunn DS, Elliott TR. The Place and Promise of Theory in Rehabilitation Psychology. Rehabil Psychol 2008; 53:254-267. [PMID: 19649146 PMCID: PMC2600846 DOI: 10.1037/a0012962] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE: Although rehabilitation psychology is more focused on empirical evidence and clinical application than theory development, we argue for the primacy of theory, and explain why theories are needed in and useful for rehabilitation psychology. Impediments to theory development are discussed, including the difficulties of applying psychological theories in multidisciplinary enterprises, and the difficulties in developing a theory-driven research program. We offer suggestions by reviewing research settings, knowledge gained through controlled studies, grantsmanship, and then identify topical areas where new theories are needed. We remind researcher-practitioners that rehabilitation psychology benefits from a judicious mix of scientific rigor and real-world vigor. CONCLUSIONS: We close by advocating for theory-driven research programs that embrace a methodological pluralism, which will in turn advance new theory, produce meaningful research programs that inform practice, and realize the goals of this special issue of Rehabilitation Psychology-advances in research and methodology.
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Swinkels ICS, Hart DL, Deutscher D, van den Bosch WJH, Dekker J, de Bakker DH, van den Ende CHM. Comparing patient characteristics and treatment processes in patients receiving physical therapy in the United States, Israel and the Netherlands: cross sectional analyses of data from three clinical databases. BMC Health Serv Res 2008; 8:163. [PMID: 18667062 PMCID: PMC2533658 DOI: 10.1186/1472-6963-8-163] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Accepted: 07/30/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many assume that outcomes from physical therapy research in one country can be generalized to other countries. However, no well designed studies comparing outcomes among countries have been conducted. In this exploratory study, our goal was to compare patient demographics and treatment processes in outpatient physical therapy practice in the United States, Israel and the Netherlands. METHODS Cross-sectional data from three different clinical databases were examined. Data were selected for patients aged 18 years and older and started an episode of outpatient therapy between January 1st 2005 and December 31st 2005. Results are based on data from approximately 63,000 patients from the United States, 100,000 from Israel and 12,000 from the Netherlands. RESULTS Age, gender and the body part treated were similar in the three countries. Differences existed in episode duration of the health problem, with more patients with chronic complaints treated in the United States and Israel compared to the Netherlands. In the United States and Israel, physical agents and mechanical modalities were applied more often than in the Netherlands. The mean number of visits per treatment episode, adjusted for age, gender, and episode duration, varied from 8 in Israel to 11 in the United States and the Netherlands. CONCLUSION The current study showed that clinical databases can be used for comparing patient demographic characteristics and for identifying similarities and differences among countries in physical therapy practice. However, terminology used to describe treatment processes and classify patients was different among databases. More standardisation is required to enable more detailed comparisons. Nevertheless the differences found in number of treatment visits per episode imply that one has to be careful to generalize outcomes from physical therapy research from one country to another.
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Affiliation(s)
- Ilse C S Swinkels
- NIVEL - Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
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Clark FA, Jackson JM, Scott MD, Carlson ME, Atkins MS, Uhles-Tanaka D, Rubayi S. Data-based models of how pressure ulcers develop in daily-living contexts of adults with spinal cord injury. Arch Phys Med Rehabil 2006; 87:1516-25. [PMID: 17084129 DOI: 10.1016/j.apmr.2006.08.329] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2006] [Revised: 08/17/2006] [Accepted: 08/22/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To examine the daily-lifestyle influences on the development of pressure ulcers in adults with spinal cord injury (SCI). DESIGN Qualitative investigation using in-depth interviewing and participant observation. SETTING Participants were studied in their homes and other naturalistic contexts. PARTICIPANTS Twenty men and women of diverse ethnicities with paraplegia or tetraplegia who were recruited at a pressure ulcer management clinic in a large rehabilitation facility. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Detailed descriptive information pertaining to the development of recurring pressure ulcers in relation to participants' daily routine and activity, personal choices, motivating influences, lifestyle challenges, and prevention techniques and strategies. RESULTS The daily-lifestyle influences on pressure ulcer development in adults with SCI can be described through various models that vary in complexity, depending on whether they incorporate individualization, interrelations among modeled elements, situational specificity, and/or temporal comprehensiveness. Ulcers are most likely to develop when a person with a relatively high-risk background profile is exposed to an equilibrium-disrupting change event that culminates in a specific pressure ulcer risk episode. CONCLUSIONS The results underscore the significant degree of complexity and individualization that characterize the emergence of pressure ulcers in daily-life contexts. Prevention efforts should therefore incorporate attention to the unique constellation of circumstances that comprise a person's everyday life.
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Affiliation(s)
- Florence A Clark
- Division of Occupational Science & Occupational Therapy, University of Southern California, Los Angeles, CA 90089-9003, USA.
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Affiliation(s)
- Walter R Frontera
- Department of Physical Medicine and Rehabilitation, University of Puerto Rico School of Medicine in San Juan, Puerto Rico
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Handoll HH. Systematic reviews on rehabilitation interventions. Arch Phys Med Rehabil 2006; 87:875. [PMID: 16731227 DOI: 10.1016/j.apmr.2006.04.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Accepted: 04/18/2006] [Indexed: 01/01/2023]
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