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Beattie C, Streetman AE, Heinrich KM. Empowering Personal Trainers to Work with Individuals with Disabilities to Improve Their Fitness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:999. [PMID: 39200610 PMCID: PMC11353939 DOI: 10.3390/ijerph21080999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/22/2024] [Accepted: 07/28/2024] [Indexed: 09/02/2024]
Abstract
The benefits of regular physical activity for individuals with disabilities (IWDs) are well recognized. Nonetheless, IWDs report several barriers to physical activity participation, including limited access to qualified and experienced personal trainers. Limited research exists from personal trainers' perspective. This qualitative study aimed to examine the experiences of personal trainers who successfully improve the fitness of IWDs. Individual interviews were conducted with ten personal trainers, focusing on educational and occupational background, experiences training IWDs, and experiences training IWDs within gyms. Thematic analysis produced five themes: (1) personal trainers working with IWDs need specialized education and extensive, often multidisciplinary, experience; (2) personal trainers are most successful when they have the opportunity to work with IWDs who have a diverse range of disabilities and differing expressions of each; (3) a robust network between personal trainers and allied healthcare providers is necessary to support IWDs; (4) access to physical activity is enhanced when trainers manage resources appropriately; and (5) personal trainers can empower IWDs to be advocates for their physical activity needs. Future research could examine the effects of an adaptive hands-on educational intervention among personal trainers to enhance IWDs' health and fitness.
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Affiliation(s)
- Cassandra Beattie
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA; (A.E.S.); (K.M.H.)
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Anderson E, Baker A, Borisoff J, Mattie J, Sawatzky B, Sparrey C, Mortenson WB. Accessible exercise for wheelchair users: comparing the usability of two adapted exercise machines. Disabil Rehabil Assist Technol 2024; 19:2065-2075. [PMID: 37695264 DOI: 10.1080/17483107.2023.2256380] [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: 12/23/2022] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Exercise is an important occupation for wheelchair users. Limited access to adapted aerobic exercise equipment in the community and lack of knowledge on how to exercise are barriers to exercise participation among wheelchair users. To address these barriers, the adapted rower (aROW) and adapted skier (aSKI) exercise machines and educational materials were created. PURPOSE 1) To compare wheelchair users' perspectives of the effectiveness and usability of the aROW and aSKI. 2) To explore perceptions of educational materials to support use of the machines. MATERIALS AND METHODS A sequential, mixed-methods study design was used. Six wheelchair users trialled the machines, and completed an interview and two usability questionnaires. Qualitative data were analysed using thematic and conventional content analysis. Usability scores of both machines were compared using the Wilcoxon Signed Ranks Test. RESULTS Data show high usability of the aROW and aSKI. More set up challenges were reported for the aROW than the aSKI. Participants perceived both machines provided effective cardiovascular workouts, and each met their exercise goals differently. Participants preferred the instructional videos over instructional sheets and provided suggestions for improving both. The Wilcoxon Signed Ranks Test showed no statistically significant difference in usability between the aROW and aSKI. CONCLUSION Implementing the aROW and aSKI in the community may address some equity issues that wheelchair users face by providing more aerobic exercise options. Results will inform educational material revisions to support use of the machines.
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Affiliation(s)
- Elisabeth Anderson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Abigail Baker
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Jaimie Borisoff
- International Collaboration on Repair Discoveries (iCORD), Vancouver, Canada
- Rehabilitation Engineering Design Lab, British Columbia Institute of Technology, Burnaby, Canada
| | - Johanne Mattie
- Rehabilitation Engineering Design Lab, British Columbia Institute of Technology, Burnaby, Canada
| | - Bonita Sawatzky
- International Collaboration on Repair Discoveries (iCORD), Vancouver, Canada
- Faculty of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Carolyn Sparrey
- International Collaboration on Repair Discoveries (iCORD), Vancouver, Canada
- Mechatronic Systems Engineering, Simon Fraser University, Burnaby, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
- International Collaboration on Repair Discoveries (iCORD), Vancouver, Canada
- Rehabilitation Research Program, Vancouver, Canada
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Celebi M, Cheng A, Sawatzky B, Mattie J, Borisoff J, Laskin JJ, Mortenson WB. Should I stay or should I go? An exploratory study comparing wheelchair-adapted rowing at home vs. in community gyms. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38949081 DOI: 10.1080/17483107.2024.2362895] [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: 09/13/2023] [Accepted: 05/25/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Wheelchair users experience many barriers to physical activity as affordable and accessible exercise equipment options are limited. Thus, the home-based adapted rower (aROW) and gym-based aROW were developed. The objectives were to determine: 1) wheelchair users' preferences, perspectives, facilitators, and barriers to using the home-based versus the gym-based aROW, 2) perceived usability of the home and gym aROWs, and 3) recommendations to adapt the aROW further for home and community use. MATERIALS AND METHODS In this two-phase exploratory mixed-methods study, participants completed one month of using a home aROW, followed by one month of using a community gym aROW. After each phase, participants completed a semi-structured interview and the System Usability Scale (SUS) questionnaire. Interview data were analyzed using conventional content analysis and effect size comparing SUS data was calculated. RESULTS AND CONCLUSIONS Four categories were identified: what worked well, barriers to using the aROWs, what could be improved and important considerations. There was a large effect size in perceived usability between the aROWs with participants preferring the home aROW. Overall, rowing was enjoyable, and participants achieved positive physical outcomes. As preferences are individual, the home aROW provides wheelchair users with a potential choice between home or gym exercise.
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Affiliation(s)
- Mine Celebi
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anika Cheng
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bonita Sawatzky
- International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Johanne Mattie
- MAKE+ Applied Research, British Columbia Institute of Technology (BCIT), Burnaby, British Columbia, Canada
| | - Jaimie Borisoff
- International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- MAKE+ Applied Research, British Columbia Institute of Technology (BCIT), Burnaby, British Columbia, Canada
| | - James J Laskin
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute (VCHRI), Vancouver, British Columbia, Canada
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Kapsalis E, Jaeger N, Hale J. Disabled-by-design: effects of inaccessible urban public spaces on users of mobility assistive devices - a systematic review. Disabil Rehabil Assist Technol 2024; 19:604-622. [PMID: 35984675 DOI: 10.1080/17483107.2022.2111723] [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: 11/04/2021] [Revised: 06/21/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Despite the increase of users of Mobility Assistive Devices (MobAD), there has been a lack of accessibility in urban environments in many parts of the world. We present a systematic review of how the inaccessible design of public spaces affects quality-of-life - including aspects of health and safety, independence, and social participation - of MobAD users. MATERIALS AND METHODS We conducted a literature search in three databases (i.e., Scopus, Web of Science, and PubMed) and initially discovered 3980 publications. We analysed 48 peer-reviewed journal articles published in English from 2005 to 2021 and assessed their quality of evidence via the Mixed Methods Appraisal Tool. RESULTS Findings indicated a substantial number of inaccessible elements for MobAD users in public spaces. Pathway characteristics, boarding ramps, entrance features, confined spaces, and service surfaces were deemed to be the least accessible elements. These barriers had multifaceted effects on MobAD users' quality of life with aspects of physical health, mobility, and use of public transport being most affected. CONCLUSIONS Notwithstanding that the reviewed studies mostly ocused on wheelchair users residing in high-income countries, this review outlines the critical role of the design of the built environment as a factor of disablement for MobAD users. We conclude by highlighting a few recommendations for future research and practice, especially inclusive approaches and adaptive techniques to assist MobAD users with performing tasks in public spaces independently.Implications for RehabilitationUsers of Mobility Assistive Devices experience a lack of accessibility provisions in public open spaces and buildings internationally.Physical barriers in public spaces substantially diminish the health and safety, autonomy, and social participation of users of Mobility Assistive Devices.There is a definite need for the adoption of inclusive strategies and adaptive techniques in placemaking processes so that users of Mobility Assistive Devices can have equitable access to public spaces.
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Affiliation(s)
- Efthimis Kapsalis
- Department of Architecture and Built Environment, University of Nottingham, Nottingham, United Kingdom
| | - Nils Jaeger
- Department of Architecture and Built Environment, University of Nottingham, Nottingham, United Kingdom
| | - Jonathan Hale
- Department of Architecture and Built Environment, University of Nottingham, Nottingham, United Kingdom
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Willingham TB, Stowell J, Collier G, Backus D. Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:79. [PMID: 38248542 PMCID: PMC10815484 DOI: 10.3390/ijerph21010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.
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Affiliation(s)
- T. Bradley Willingham
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - Julie Stowell
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - George Collier
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
| | - Deborah Backus
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
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Seemüller S, Beck F, Reimers AK. Physical activity of children and adolescents who use a wheelchair: a systematic review. BMC Public Health 2023; 23:2479. [PMID: 38082282 PMCID: PMC10714460 DOI: 10.1186/s12889-023-17201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/09/2023] [Indexed: 12/18/2023] Open
Abstract
Physical activity has numerous health benefits for people with physical disabilities. Nevertheless, activity levels are often below recommended levels. To promote physical activity among children and adolescents who use a wheelchair as their primary source of mobility, this systematic review explores the physical activity patterns of this group. A systematic search of PubMed, Sports Medicine & Education Index, Web of Science, and SPORTDiscus was performed, included articles were synthesized in terms of duration, intensity, and settings in which physical activity occurred, as well as the physical activity measurement methods. Nine articles were included. The mean overall physical activity level across the included studies was 98 minutes per day (range: 78-115 minutes per day). Two articles analysed the duration of physical activity at different intensities (very light physical activity, light physical activity (LPA), moderate to vigorous physical activity (MVPA) and intensities near to maximum). Within the included articles, both subjective and objective measurement methods were used. Due to the small number of articles, combined with small sample sizes, there is not enough evidence to answer the research questions sufficiently. Nevertheless, the review provides an overview of actual research and clearly shows that the physical activity values are insufficiently researched. There is a need for further research on the scope, types and settings of physical activity in the target group.
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Affiliation(s)
- Selina Seemüller
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Franziska Beck
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anne Kerstin Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Herbert AS, Welk B, Elliott CS. Internal and External Barriers to Bladder Management in Persons with Neurologic Disease Performing Intermittent Catheterization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6079. [PMID: 37372666 DOI: 10.3390/ijerph20126079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
People living with neurogenic lower urinary tract dysfunction (NLUTD) often have to use clean intermittent catheters (CIC) to manage their bladder function. The use of catheters presents multiple unique challenges, based on both the person's inherent characteristics and on the external limitations imposed by public toilets. We review the impact of age, sex, upper limb function, caregiver assistance, time required to perform CIC, and urinary incontinence on CIC in NLUTD, with special reference to their interaction with societal and public health factors. Public toilet limitations, such as lack of availability, adequate space and special accommodation for CIC, cleanliness, and catheter design are also reviewed. These potential barriers play a significant role in the perception and performance of bladder care in people living with NLUTD.
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Affiliation(s)
- Amber S Herbert
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94304, USA
| | - Blayne Welk
- Department of Surgery and Epidemiology and Biostatistics, Western University, Ontario, ON N6G 2M1, Canada
| | - Christopher S Elliott
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94304, USA
- Division of Urology, Santa Clara Valley Medical Center, San Jose, CA 95128, USA
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Dolbow DR, Gorgey AS, Johnston TE, Bersch I. Electrical Stimulation Exercise for People with Spinal Cord Injury: A Healthcare Provider Perspective. J Clin Med 2023; 12:jcm12093150. [PMID: 37176591 PMCID: PMC10179213 DOI: 10.3390/jcm12093150] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/05/2023] [Accepted: 04/15/2023] [Indexed: 05/15/2023] Open
Abstract
Electrical stimulation exercise has become an important modality to help improve the mobility and health of individuals with spinal cord injury (SCI). Electrical stimulation is used to stimulate peripheral nerves in the extremities to assist with muscle strengthening or functional activities such as cycling, rowing, and walking. Electrical stimulation of the peripheral nerves in the upper extremities has become a valuable tool for predicting the risk of hand deformities and rehabilitating functional grasping activities. The purpose of this paper is to provide healthcare providers perspective regarding the many rehabilitation uses of electrical stimulation in diagnosing and treating individuals with SCI. Electrical stimulation has been shown to improve functional mobility and overall health, decrease spasticity, decrease the risk of cardiometabolic conditions associated with inactivity, and assist in the diagnosis/prognosis of hand deformities in those with tetraplegia. Studies involving non-invasive stimulation of the spinal nerves via external electrodes aligned with the spinal cord and more invasive stimulation of electrodes implanted in the epidural lining of the spinal cord have demonstrated improvements in the ability to stand and enhanced the stepping pattern during ambulation. Evidence is also available to educate healthcare professionals in using functional electrical stimulation to reduce muscle spasticity and to recognize limitations and barriers to exercise compliance in those with SCI. Further investigation is required to optimize the dose-response relationship between electrical stimulation activities and the mobility and healthcare goals of those with SCI and their healthcare providers.
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Affiliation(s)
- David R Dolbow
- Department of Physical Therapy, College of Osteopathic Medicine, William Carey University, Hattiesburg, MS 39401, USA
| | - Ashraf S Gorgey
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, VA 23249, USA
- College of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Therese E Johnston
- Department of Physical Therapy, Arcadia University, Glenside, PA 19038, USA
| | - Ines Bersch
- International FES Centre®, Swiss Paraplegic Center, CH-6207 Nottwil, Switzerland
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Cunningham C, O'Donoghue G, Cosgrave S, Sands T, Leacy B, Markievicz I, Monaghan A, Shields N. Gym staff perspectives on disability inclusion: a qualitative study. Disabil Rehabil 2023; 45:441-448. [PMID: 35191365 DOI: 10.1080/09638288.2022.2036826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To explore gym staff perspectives on the inclusion of people with disability in the gym setting. MATERIALS AND METHODS Semi-structured interviews were conducted with 16 staff at four urban gym facilities, exploring perspectives on disability inclusion. An interpretive descriptive approach was adopted with reflexive thematic analysis of interview data and subsequent mapping of themes to the socioecological model. RESULTS Consistent with the socioecological model, the themes identified were "people with disability benefit from participation in gym settings" (personal); "positive interactions with people with disability" (interpersonal); "managing expectations of other gym users" (interpersonal); "inclusion is supported by a positive ethos, staff training and accessible facilities" (organisational); "people with disability lack awareness of inclusive exercise opportunities" (community); "desire to increase collaboration with healthcare professionals" (community); "access to transport can facilitate gym attendance" (community) and "local gym policy" (policy). CONCLUSION Although an overall ethos of inclusion was apparent, areas identified for enhancement were: awareness of gym services in the community; inter-sectoral collaboration with healthcare and disability organisations; comprehensive disability inclusion training; transport systems and accessibility; engaging people with disability in gym service planning. Implications for rehabilitationGym staff value collaboration with healthcare and rehab professionals to support inclusion of people with disability in exercise.Standardised disability inclusion training for gym staff is recommended.Individuals with disability should be empowered to contribute to the development of inclusive gym facilities and services.Rehab professionals have a role to play in raising awareness and advocating for inclusive exercise opportunities.
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Affiliation(s)
- Caitríona Cunningham
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Grainne O'Donoghue
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Sinead Cosgrave
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Tiarna Sands
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Brendan Leacy
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Igor Markievicz
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Andrew Monaghan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Nora Shields
- Department of Physiotherapy, La Trobe University, Melbourne, Australia
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Nalla S, Huang K, Spangenberg J, Chen L, Jayabalan P. The demographic and disability characteristics of individuals who regularly attend an urban adaptive fitness center: An observational study. PM R 2022; 14:1454-1460. [PMID: 34617406 PMCID: PMC8983785 DOI: 10.1002/pmrj.12720] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 09/06/2021] [Accepted: 09/24/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION While it is well known that regular physical activity provides significant physical and psychosocial health benefits, people with disabilities have disproportionately lower rates of exercise compared to the able-bodied population. Reduced levels of physical activity can put this population at an increased risk of chronic health conditions, highlighting the importance of ensuring that our communities have accessible adaptive fitness opportunities. OBJECTIVES To evaluate the demographic and disability characteristics in individuals who regularly attend a specialized urban adaptive fitness center, to provide foundational understanding about the population that uses such resources. DESIGN Cross-sectional study SETTING: Specialized urban adaptive fitness center PARTICIPANTS: Sixty-three (n = 63) participants who regularly attend an urban Adaptive Sports and Fitness Center INTERVENTION: Not applicable MAIN OUTCOME MEASURE: World Health Organization (WHO) Disability Assessment Schedule (WHODAS) 2.0, evaluating disability in six domains: cognition, mobility, self-care, getting along, life activities, and participation. Results were converted into scores ranging from 0 (no disability) to 100 (total disability) and compared to WHO published norms for the general population and a demographics intake form. RESULTS Participants with mean age of 52.9 ±14.3 years were grouped into three diagnostic categories: spinal cord injury (30.2%), traumatic brain injury/stroke (36.5%), and other neurologic disease/chronic medical disease (33.3%). A total of 45.9% live alone, 96.8% exercise at least twice/week, and 43.5% participate in adaptive sports. Participants travel 8.0 miles on average for attendance. WHODAS disability summary score was 26.48 (86th percentile). CONCLUSIONS Although adaptive fitness center participants had a higher level of disability than 80% to 90% of the general population, regular participation was realistic and feasible. Further understanding of the barriers in those who do not engage in such facilities is needed.
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Affiliation(s)
- Sindhoori Nalla
- Shirley Ryan AbilityLab, Chicago, Illinois, USA.,Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kevin Huang
- Shirley Ryan AbilityLab, Chicago, Illinois, USA.,Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Liqi Chen
- Biostatistics Collaboration Center, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - Prakash Jayabalan
- Shirley Ryan AbilityLab, Chicago, Illinois, USA.,Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
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Wheelchair-modified ergometer rowing exercise in individuals with spinal cord injury: a feasibility, acceptability, and preliminary efficacy study. Spinal Cord Ser Cases 2022; 8:48. [PMID: 35487894 PMCID: PMC9054742 DOI: 10.1038/s41394-022-00518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 11/08/2022] Open
Abstract
STUDY DESIGN Exploratory clinical investigation. OBJECTIVES To assess the feasibility, acceptability, and preliminary efficacy of upper-body rowing exercise adapted to wheelchair users with spinal cord injury (SCI). SETTING University exercise laboratory. METHODS Eight individuals with SCI exercised on a rowing ergometer modified for wheelchair users (REMW), three times weekly, for up to 30 min per session. Participants completed feasibility and acceptability questionnaire (1-5 Likert scale), and the Wheelchair Users Shoulder Pain Index (WUSPI) before and after six weeks of exercise. Average power output (POAVG), distance rowed, percent peak heart rate (%HRpeak), and rating of perceived exertion (RPE) (6-20 scale) were monitored throughout the 18 exercise sessions and analyzed to evaluate preliminary efficacy of the exercise modality. RESULTS All eight participants completed the study (97% adherence). Participants rated the exercise high on the feasibility and acceptability scale; median (interquartile range) = 5.0 (4.0-5.0), where higher numbers indicated greater feasibility. Shoulder pain was reduced by 21% yet not significantly different from baseline (p = 0.899). Physiological measures (%HRpeak = 80-83%; RPE = 15.0-16.0) indicated a high cardiovascular training load. From week 1 to week 6, POAVG and distance rowed increased by 37 and 36%, respectively (both p ≤ 0.001). CONCLUSIONS Data from six weeks of exercise on the REMW suggests that upper-body rowing is a feasible and acceptable exercise modality for wheelchair users with SCI. Session data on %HRpeak, RPE, and shoulder pain indicate that REMW evoked moderate to vigorous intensity exercise without exacerbation of shoulder pain. Future research is required to quantify potential training-induced changes in cardiorespiratory fitness.
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The Gatekeepers to Fitness: A Correspondence Study to Examine Disabling Practices Among Fitness Center Personnel. Adapt Phys Activ Q 2022; 39:214-229. [PMID: 35065534 DOI: 10.1123/apaq.2021-0136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 11/18/2022] Open
Abstract
Fitness centers may be an ideal setting for physical activity, yet qualitative findings suggest social-level barriers constrain access for people with disabilities. To further test this, I employed an online message correspondence study to investigate the effect of impairment status on the responsiveness of a national sample of fitness centers to requests for services. Email requests were sent to 800 fitness centers, of which 200 were tailored to each of the four investigative conditions (i.e., control, vision loss, spinal cord injury, or being autistic). The odds of receiving a positive response were 40.5% lower for individuals with vision loss (p = .011) and 33.3% lower for individuals with spinal cord injury (p = .055), as compared with individuals without an impairment. Specifically, the odds of receiving a positive response for personal training were 58.8% lower among individuals with vision loss (p = .003) and 41.1% lower for individuals with spinal cord injury (p = .065).
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Malik SA, Aburahmah L, Azuddin M. An Exploratory Study on the Use of Social Companion Robot for Adults with Motor Disabilities. ADVANCES ON INTELLIGENT INFORMATICS AND COMPUTING 2022:616-629. [DOI: 10.1007/978-3-030-98741-1_51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Carlsson G, Slaug B, Schmidt SM, Norin L, Ronchi E, Gefenaite G. A scoping review of public building accessibility. Disabil Health J 2021; 15:101227. [PMID: 34716114 DOI: 10.1016/j.dhjo.2021.101227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The built environment needs to be designed so that all people can participate in the activities they want and need to do. Yet, accessibility is difficult to put into practice, and accessibility issues tend to be overlooked in the building and planning processes. OBJECTIVES The aim of this scoping review was to summarize the research front in the area of accessibility to public buildings. Specific aims were to identify knowledge gaps, to identify access activities in relation to environmental features and to link to predominant activities in terms of the International Classification of Functioning, Disability and Health (ICF). METHODS A literature search was performed in PubMed, PsycINFO, Inspec, Embase and Cochrane databases. Articles in English based on original empirical studies investigating accessibility of public buildings for adults aged ≥18 years with functional limitations were considered. RESULTS Of the 40 articles included, ten involved study participants, while 30 only examined buildings using instruments to assess accessibility. In addition, the psychometric properties were only tested for a few of them. All articles concerned mobility and several visual limitations, while few addressed cognitive or hearing limitations. Ten main access activities were identified, from using parking/drop-off area to exiting building. CONCLUSIONS By using the ICF and theoretically relating the accessibility problems to activities, the results revealed that there are large knowledge gaps about accessibility to public buildings for older people and people with functional limitations and that there is a need for more methodological considerations in this area of research.
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Affiliation(s)
- G Carlsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - B Slaug
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - S M Schmidt
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - L Norin
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - E Ronchi
- Department of Fire Safety Engineering, Lund University, Sweden.
| | - G Gefenaite
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
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15
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Nikolajsen H, Richardson EV, Sandal LF, Juul-Kristensen B, Troelsen J. Fitness for all: how do non-disabled people respond to inclusive fitness centres? BMC Sports Sci Med Rehabil 2021; 13:81. [PMID: 34330328 PMCID: PMC8325230 DOI: 10.1186/s13102-021-00303-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 07/01/2021] [Indexed: 11/17/2022]
Abstract
Background Representation of people with disabilities in fitness centres is lacking, despite initiatives to promote inclusion mainly in the UK and USA. Success creating these inclusive spaces is mixed and few were crafted taking into account attitudes and biases of non-disabled co-members. Inclusive fitness centres have not gained much attention in Denmark, and the campaign ‘Fitness for All - fitness for people with physical disabilities’ was initiated. The aim of this study was shaped by two key questions; 1) what is the ideal fitness space from the perception of non-disabled fitness users? and 2) how might their dis/ableist attitudes negate inclusion in three future pilot inclusive fitness centres across Denmark? Method Three focus groups involving 5–7 (total n = 18) adult non-disabled participants were conducted. Aged ranged between 19 and 75 years, both men and women were involved, with fitness centre experiences ranging from 0 to 20+ years. Interviews were transcribed and analysed using Malterud’s four-step method of systematic text condensation. Results Of most importance was a pleasant atmosphere which should make them feel welcome and comfortable. Good social relations within the space were also highly valued. Participants welcomed people with physical disabilities but predicted many challenges with an inclusive fitness centre and expressed unconscious ableist attitudes. Conclusion The current study adds essential knowledge regarding how non-disabled people perceive the ideal inclusive fitness centre. A welcoming and inviting atmosphere is essential whereas social skills, ableism, ignorance, and preconceptions are important barriers that may hinder inclusion of participants with disabilities in inclusive fitness centres. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00303-2.
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Affiliation(s)
- Helene Nikolajsen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark. .,Department of Physiotherapy, Institute of Health Studies, University College South Denmark, Esbjerg-Haderslev, Denmark.
| | | | - Louise Fleng Sandal
- Research Unit for Physical Activity and Health in Work Life, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgit Juul-Kristensen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark
| | - Jens Troelsen
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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16
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Nikolajsen H, Sandal LF, Juhl CB, Troelsen J, Juul-Kristensen B. Barriers to, and Facilitators of, Exercising in Fitness Centres among Adults with and without Physical Disabilities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147341. [PMID: 34299792 PMCID: PMC8304633 DOI: 10.3390/ijerph18147341] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/15/2022]
Abstract
Fitness centres are an obvious arena for performing physical activity for the general population but representation of adults with physical disabilities (AwPD) is lacking. To increase possibilities for AwPD to exercise in fitness centres together with adults without physical disabilities (AwoPD), the aim of this study was to identify, synthesise, and compare barriers to, and facilitators of, exercising in fitness centres for each group. A scoping review was conducted and data extraction of the barriers and facilitators was performed independently by two researchers on six categories of contextual factors based on the framework of Di Blasi: (1) The fitness centre setting; (2) The fitness centre user characteristics; (3) The fitness instructor/staff characteristics; (4) The fitness centre user–instructor/management relationship; and (5) The fitness/exercise characteristics. An extra category, (6) Other relationships, was added. The PRISMA Extension for Scoping Reviews was used for reporting. Of the 102 included papers, only 26 (25%) of the papers were on AwPD, which focused mainly on physical barriers (category 1: inaccessible settings). In contrast, the remaining 76 papers involving AwoPD focused primarily on facilitators (category 2: motivational factors and exercising effects). In categories 3–6, the two groups had similar results, as both groups preferred skilled instructors, a welcoming and comfortable fitness centre environment, an ability to exercise at their preferred type and level, and good social connections. Since most data were based on AwoPD, more studies on actual experiences from AwPD are needed, to reveal the facilitators/motivational factors for fitness centre use.
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Affiliation(s)
- Helene Nikolajsen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
- Department of Physiotherapy, Institute of Health Studies, University College South Denmark, 6705 Esbjerg Ø, Denmark
- Correspondence:
| | - Louise Fleng Sandal
- Research Unit for Physical Activity and Health in Work Life, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Carsten Bogh Juhl
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, 2900 Hellerup, Denmark
| | - Jens Troelsen
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Birgit Juul-Kristensen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
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17
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Wong RN, Stewart AL, Sawatzky B, Laskin JJ, Borisoff J, Mattie J, Sparrey CJ, Mortenson WB. Exploring exercise participation and the usability of the adaptive rower and arm crank ergometer through wheelchair users' perspectives. Disabil Rehabil 2021; 44:3915-3924. [PMID: 33730952 DOI: 10.1080/09638288.2021.1894245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Arm crank ergometry and adaptive rowing are existing exercise options for wheelchairs users, but not commonly available. This study was conducted to explore exercise participation of wheelchair users, as well as the usability of the adaptive rowing ergometer (aROW) and arm crank ergometer (ACE). METHODS This mixed-methods study used a concurrent triangulation design. Following completion of both exercise sessions (5 min each), participants (n = 14) with spinal cord injury/disease (SCI/D) completed the System Usability Scale (SUS), and a semi-structured interview. Participants were asked about the use of both exercise modalities, and general exercise participation. SUS data were analyzed using a paired sample t-test and qualitative data were analyzed through conventional content analysis. RESULTS Wheelchair users exercised for improved physical and mental health, as well as for functional independence, and community participation; however, lack of accessible equipment was a prominent barrier. Both the aROW and ACE have high usability, but the aROW was perceived as more enjoyable and effective for cardiovascular exercise. CONCLUSIONS The implementation of the aROW into community gyms has the potential to help close the existing gap in inclusive equipment and may help people with disabilities to be more fully included in their community and lead healthier lives.Implications for rehabilitationWheelchair users perceive exercise as a meaningful activity that enhances physical health and risk of disease, functional independence, community participation, and overall social and emotional health.The adapted rowing machine was perceived as highly usable and was felt to be more enjoyable and effective for cardiovascular exercise compared to traditional arm crank ergometers.The adaptive rower provides an additional accessible equipment option for wheelchair users to obtain effective cardiovascular exercise.More available equipment may increase community participation and promote inclusion for wheelchair users.
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Affiliation(s)
- Rachel N Wong
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Ashley L Stewart
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Bonita Sawatzky
- International Collaboration of Repair Discoveries (ICORD), Vancouver, Canada.,Orthopaedics, University of British Columbia, Vancouver, Canada
| | - James J Laskin
- School of Physical Therapy & Rehabilitation Sciences, University of Montana, Missoula, MT, USA
| | - Jaimie Borisoff
- International Collaboration of Repair Discoveries (ICORD), Vancouver, Canada.,Rehabilitation Engineering Design Lab, British Columbia Institute of Technology, Burnaby, Canada
| | - Johanne Mattie
- Rehabilitation Engineering Design Lab, British Columbia Institute of Technology, Burnaby, Canada
| | - Carolyn J Sparrey
- International Collaboration of Repair Discoveries (ICORD), Vancouver, Canada.,Mechatronics Engineering, Simon Fraser University, Burnaby, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.,International Collaboration of Repair Discoveries (ICORD), Vancouver, Canada.,Rehabilitation Research Program, Vancouver, Canada
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18
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Carroll NW, Hall AG, Feldman S, Thirumalai M, Wade JT, Rimmer JH. Enhancing Transitions From Rehabilitation Patient to Wellness Participant for People With Disabilities: An Opportunity for Hospital Community Benefit. Front Public Health 2020; 8:105. [PMID: 32322569 PMCID: PMC7156537 DOI: 10.3389/fpubh.2020.00105] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/17/2020] [Indexed: 11/13/2022] Open
Abstract
Pressure is increasing on not-for-profit hospitals to demonstrate that they provide sufficient benefit to the community to justify their tax-exempt status. Many industry observers have suggested that this community benefit should address unmet medical needs within the community, deficits in the social determinants of health, or health disparities within communities. We argue that one area of clear unmet need is assistance in helping bridge the transition that people with disabilities (PWD) must make from rehabilitation patient to wellness participant. Programs to bridge this transition are necessary because many PWD struggle to identify strategies to maintain and maximize their own well-being after discharge from the healthcare system. As a result, PWD have worse health outcomes than non-disabled individuals. To address these needs, we propose hospitals take a leading role in establishing new, community-based efforts to provide PWD with benefits that will support their effort to self-manage health. Hospitals are well-suited to lead the creation of these programs because of the important role they play in providing services to PWD and because of their ability to bring together multiple stakeholders required to make supportive programs sustainable.
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Affiliation(s)
- Nathan W Carroll
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States.,School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Allyson G Hall
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States.,School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sue Feldman
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States.,School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mohanraj Thirumalai
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States.,School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jamie Tinker Wade
- Spain Rehabilitation Center, University of Alabama at Birmingham Hospital, Birmingham, AL, United States
| | - James H Rimmer
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
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19
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The accessibility of fitness centers for people with disabilities: A systematic review. Disabil Health J 2018; 11:525-536. [DOI: 10.1016/j.dhjo.2018.04.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/09/2018] [Accepted: 04/28/2018] [Indexed: 11/23/2022]
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20
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Rimmer JH, Herman C, Wingo B, Fontaine K, Mehta T. Methodological and clinical implications of a three-in-one Russian doll design for tracking health trajectories and improving health and function through innovative exercise treatments in adults with disability. BMC Med Res Methodol 2018. [PMID: 29540164 PMCID: PMC5853027 DOI: 10.1186/s12874-018-0480-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hybrid research designs targeting adults with neurologic disability are critical for improving the efficiency of models that can identify, track and intervene on identified health issues. METHODS Our Russian doll framework encompasses three study phases. Phase 1 involves prospectively following a cohort of participants with disability to examine the relationships between rates of health and functional deficits (e.g., pain, fatigue, deconditioning), functional measures (e.g., cardiorespiratory endurance, strength, balance), and environmental and sociocultural factors. In Phase 2, eligible participants with neurologic disability from Phase 1 (in our example, individuals with multiple sclerosis) are screened and randomized to a clinical exercise efficacy trial. In Phase 3, study participants are enrolled in a home-based teleexercise trial to test the feasibility and replicability of delivering the clinical exercise study in the home. DISCUSSION This unique three-in-one Russian doll framework serves as a foundation for informing and guiding researchers and clinicians in treating certain health and functional deficits in people with neurologic disability using exercise as a primary treatment modality in both the clinical and home settings. It offers a unique perspective for understanding the critical issues of functioning, health maintenance and quality of life for people with neurologic disability across a longitudinal framework. TRIAL REGISTRATION Study 2 ClinicalTrials.gov identifier NCT02533882 (retroactively registered 03/06/2015). Study 3 ClinicalTrials.gov identifier NCT03108950 (retroactively registered 04/05/2017).
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Affiliation(s)
- James H Rimmer
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, 1716 9th Ave. South, Birmingham, AL, 35294-1212, USA.,UAB-Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, 1716 9th Ave. South, Birmingham, AL, 35294-1212, USA
| | - Cassandra Herman
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35294-0022, USA.,UAB-Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, 1716 9th Ave. South, Birmingham, AL, 35294-1212, USA
| | - Brooks Wingo
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, 1716 9th Ave. South, Birmingham, AL, 35294-1212, USA
| | - Kevin Fontaine
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35294-0022, USA
| | - Tapan Mehta
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, 1716 9th Ave. South, Birmingham, AL, 35294-1212, USA. .,UAB-Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, 1716 9th Ave. South, Birmingham, AL, 35294-1212, USA.
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21
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Investigating the Efficacy of Web-Based Transfer Training on Independent Wheelchair Transfers Through Randomized Controlled Trials. Arch Phys Med Rehabil 2018; 99:9-16.e10. [DOI: 10.1016/j.apmr.2017.06.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/02/2017] [Accepted: 06/19/2017] [Indexed: 11/23/2022]
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22
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Tolle H, Rapacz A, Weintraub B, Shogren C, Harkema SJ, Gibson JL. Establishing the NeuroRecovery Network Community Fitness and Wellness facilities: multi-site fitness facilities provide activity-based interventions and assessments for evidence-based functional gains in neurologic disorders. Disabil Rehabil 2017; 40:3086-3093. [PMID: 28814123 DOI: 10.1080/09638288.2017.1365178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Physical fitness is a necessity for those living with a spinal cord injury, yet access to fitness facilities, equipment, and specially trained fitness experts are limited. METHODS This article introduces the concept of a network of fitness facilities specially geared towards individuals with spinal cord injury and other neurological disorders. RESULTS The Community Fitness and Wellness branch of the NeuroRecovery Network was created to provide a continuum of care after traditional rehabilitation for individuals living with a spinal cord injury and other neurological disorders. Community Fitness and Wellness facilities translate activity-based interventions performed during rehabilitation into a community setting as well as provide other fitness and wellness opportunities. Community Fitness and Wellness facilities are staffed by professionals with training on the specialized needs of individuals living with spinal cord injury or other neurological disorders. Standardized assessments evaluate functional, health, and quality of life gains at regular intervals. A national database gathers information on standardized interventions and assessment outcomes providing a mechanism for evaluation of interventions performed in the community setting. CONCLUSIONS The establishment of Community Fitness and Wellness facilities allows for the quick translation and evaluation of novel, effective approaches from research to individuals in the community. Implications for Rehabilitation Fitness needs of individuals with spinal cord injury living in the community necessitate the use of special equipment and trained staff. Community Fitness and Wellness Programs offer specially trained staff and adaptive equipment providing a continuity of care for those with spinal cord injuries and other neurological disorders.
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Affiliation(s)
- Heather Tolle
- a Department of Neurological Surgery , University of Louisville , Louisville , KY , USA
| | - Andrew Rapacz
- b Courage Kenny Rehabilitation Institute , Minneapolis , MN , USA
| | - Barry Weintraub
- b Courage Kenny Rehabilitation Institute , Minneapolis , MN , USA
| | - Carrie Shogren
- b Courage Kenny Rehabilitation Institute , Minneapolis , MN , USA
| | - Susan J Harkema
- a Department of Neurological Surgery , University of Louisville , Louisville , KY , USA.,c Frazier Rehabilitation Institute , Louisville , KY , USA
| | - Jeremy L Gibson
- a Department of Neurological Surgery , University of Louisville , Louisville , KY , USA
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23
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Rimmer JH, Padalabalanarayanan S, Malone LA, Mehta T. Fitness facilities still lack accessibility for people with disabilities. Disabil Health J 2017; 10:214-221. [DOI: 10.1016/j.dhjo.2016.12.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 12/05/2016] [Accepted: 12/23/2016] [Indexed: 11/25/2022]
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24
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Eliason MJ, McElroy JA, Garbers S, Radix A, Toms Barker L. Comparing women with and without disabilities in five-site "Healthy Weight" interventions for lesbian/bisexual women over 40. Disabil Health J 2016; 10:271-278. [PMID: 28025087 DOI: 10.1016/j.dhjo.2016.12.005] [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: 07/13/2016] [Revised: 10/18/2016] [Accepted: 12/11/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lesbian/bisexual women with physical disabilities (LBPD) are an under-studied population. OBJECTIVES This study compared LBPD to LB women without physical disabilities as defined by the Americans with Disabilities Act on socio-demographic variables, health characteristics, and quality of life, physical activity, weight, and nutrition outcomes following a health intervention. METHODS Data came from the Healthy Weight in Lesbian and Bisexual Women Study (HWLB) where 376 LB women were recruited into five geographically dispersed interventions. Baseline data were examined to compare women with and without physical disabilities as defined by the ADA, and pre/post intervention data were analyzed for differences in treatment outcomes including quality of life, physical activity, nutrition, and body size. RESULTS Compared to women without disability, LBPD were more likely to be bisexual or another sexual identity than lesbian, single, report poor or fair health status, postmenopausal, and had a higher body mass index and waist circumference to height ratio. LBPD women were less likely to work and to drink heavily, and reported reduced physical and mental health quality of life. In spite of these differences, after the intervention, LBPD had similar outcomes to women without disabilities on most measures, and were more likely to show improvements in physical quality of life and consumption of fruits/vegetables. CONCLUSIONS Although different from women without disabilities on many socio-demographic and health variables at baseline, the study suggests that LBPD have similar outcomes to women without disabilities, or may even do better, in group health interventions.
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Affiliation(s)
- Michele J Eliason
- Department of Health Education, HSS 110, San Francisco State University, 1600 Holloway, San Francisco, CA 94132, USA.
| | - Jane A McElroy
- University of Missouri, Department of Family & Community Medicine, MA306, Medical Sciences Building, Columbia, MO 65212, USA.
| | - Samantha Garbers
- Population & Family Health at Columbia University's Mailman School of Public Health, USA.
| | - Asa Radix
- Callen Lorde Community Health Center, New York, NY, USA.
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25
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Martin Ginis KA, Ma JK, Latimer-Cheung AE, Rimmer JH. A systematic review of review articles addressing factors related to physical activity participation among children and adults with physical disabilities. Health Psychol Rev 2016; 10:478-494. [PMID: 27265062 DOI: 10.1080/17437199.2016.1198240] [Citation(s) in RCA: 212] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Dozens of published papers cite factors related to leisure-time physical activity (LTPA) participation among people with physical disabilities. Unfortunately, there has been little effort to synthesise this literature in a manner that is accessible and useful to the sectors (e.g., health care, recreation) responsible for LTPA promotion in disability populations. In this systematic review, over 200 factors were extracted from 22 review articles addressing barriers and facilitators to LTPA in children and adults with physical disabilities. Factors were grouped according to common themes, classified into five levels of a social ecological model, and coded according to whether they could be affected by the health-care and/or recreation sectors. Findings are discussed with regard to key factors to target in LTPA-enhancing interventions, relevant theories and models in which to frame interventions, the levels at which the interventions can be implemented, and intervention priorities. The synthesis provides a blueprint and a catalyst for researchers and practitioners to shift focus from conducting studies that merely describe LTPA barriers and facilitators, to developing and delivering strategies to increase LTPA among persons with physical disabilities.
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Affiliation(s)
| | - Jasmin K Ma
- a Department of Kinesiology , McMaster University , Hamilton , Ontario , Canada L8S 4K1
| | - Amy E Latimer-Cheung
- b Queen's University, School of Kinesiology and Health Studies , Kingston , Ontario , Canada K7L 3N6
| | - James H Rimmer
- c University of Alabama at Birmingham and Lakeshore Foundation , Birmingham , AL , USA
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26
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Rimmer JH, Lai B, Young HJ. Bending the Arc of Exercise and Recreation Technology Toward People With Disabilities. Arch Phys Med Rehabil 2016; 97:S247-51. [DOI: 10.1016/j.apmr.2016.02.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 02/09/2016] [Accepted: 02/15/2016] [Indexed: 10/21/2022]
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27
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Associations with being physically active and the achievement of WHO recommendations on physical activity in people with spinal cord injury. Spinal Cord 2016; 55:235-243. [DOI: 10.1038/sc.2016.126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 11/09/2022]
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28
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Schüssler-Fiorenza Rose SM, Stineman MG, Pan Q, Bogner H, Kurichi JE, Streim JE, Xie D. Potentially Avoidable Hospitalizations among People at Different Activity of Daily Living Limitation Stages. Health Serv Res 2016; 52:132-155. [PMID: 26990312 DOI: 10.1111/1475-6773.12484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine whether higher activity of daily living (ADL) limitation stages are associated with increased risk of hospitalization, particularly for ambulatory care sensitive (ACS) conditions. DATA SOURCE Secondary data analysis, including 8,815 beneficiaries from 2005 to 2006 Medicare Current Beneficiary Survey (MCBS). STUDY DESIGN ADL limitation stages (0-IV) were determined at the end of 2005. Hospitalization rates were calculated for 2006 and age adjusted using direct standardization. Multivariate negative binomial regression, adjusting for baseline demographic and health characteristics, with the outcome hospitalization count was performed to estimate the adjusted rate ratio of ACS and non-ACS hospitalizations for beneficiaries with ADL stages > 0 compared to beneficiaries without limitations. DATA COLLECTION Baseline ADL stage and health conditions were assessed using 2005 MCBS data and count of hospitalization determined using 2006 MCBS data. PRINCIPAL FINDINGS Referenced to stage 0, the adjusted rate ratios (95 percent confidence interval) for stage I to stage IV ranged from 1.9 (1.4-2.5) to 4.1 (2.2-7.8) for ACS hospitalizations compared with from 1.6 (1.3-1.9) to 1.8 (1.4-2.5) for non-ACS hospitalizations. CONCLUSIONS Hospitalization rates for ACS conditions increased more dramatically with ADL limitation stage than did rates for non-ACS conditions. Adults with ADL limitations appear particularly vulnerable to potentially preventable hospitalizations for conditions typically manageable in ambulatory settings.
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Affiliation(s)
- Sophia Miryam Schüssler-Fiorenza Rose
- Department of Veterans Affairs Palo Alto Health Care System, Spinal Cord Injury and Disorders Center, Palo Alto, CA.,Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - Margaret G Stineman
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA.,Perelman School of Medicine University of Pennsylvania, Philadelphia, PA
| | - Qiang Pan
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
| | - Hillary Bogner
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
| | - Jibby E Kurichi
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
| | - Joel E Streim
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA.,Mental Illness Research Education and Clinical Center Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
| | - Dawei Xie
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
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