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Stendell L, Stubbs PW, Rivera E, Rogers K, Verhagen AP, Davis GM, Middleton JW, de Oliveira CQ. Are Middle- or Older-Aged Adults With a Spinal Cord Injury Engaging in Leisure-Time Physical Activity? A Systematic Review and Meta-Analysis. Arch Rehabil Res Clin Transl 2024; 6:100335. [PMID: 39006108 PMCID: PMC11240020 DOI: 10.1016/j.arrct.2024.100335] [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: 07/16/2024] Open
Abstract
Objectives To investigate the amount of Leisure-Time Physical Activity (LTPA) that people over 45 years with a spinal cord injury (SCI) performed and to determine the frequency, duration, intensity, and modality of LTPA performed. Data Sources We searched 5 major electronic databases (CINAHL, SCOPUS, EMBASE, MEDLINE, and PubMed) from inception to March 2023. Study Selection Cross-sectional, longitudinal studies and control arm of controlled trials that assessed LTPA in participants over 45 years old, with a SCI. We included 19 studies in the review and 11 in the meta-analysis. Data Extraction We followed the PRISMA checklist for Systematic Reviews. Two review authors independently assessed the risk of bias and extracted data on participants' demographics, injury characteristics, and LTPA participation of the included studies. Risk of bias was assessed using the Joanne Briggs Institute critical appraisal tool for cross-sectional studies. Any conflicts were resolved by a third author. Data Synthesis We found considerable variability in LTPA participation in adults 45 years and older with SCI. An estimated 27%-64% of participants did not take part in any LTPA. A random effects meta-analysis model was completed for studies that reported total or moderate-to-heavy LTPA scores in minutes per week. Overall, participants (n=1675) engaged in 260 [205;329] (mean [95% CI]) mins/week of total LTPA. Those participating in moderate-heavy intensity LTPA (n=364) completed 173 [118; 255] (mean [95% CI]) mins/week. LTPA modalities included walking, wheeling, hand-cycling, basketball, and swimming, among others. Conclusions While many older adults with SCI seem to be meeting the recommended weekly physical activity volume, many still remain sedentary. There was significant variation in reporting of frequency, intensity, and duration of LTPA and reporting on modality was limited. Because of differences in reporting, it was challenging to compare results across studies. Data constraints prevented subgroup analysis of LTPA disparities between paraplegia and tetraplegia.
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Affiliation(s)
- Laura Stendell
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Peter W. Stubbs
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Esminio Rivera
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Kris Rogers
- Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Arianne P. Verhagen
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Glen M. Davis
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - James W. Middleton
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
- The Kolling Institute, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Camila Quel de Oliveira
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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LaVela SL, Wu J, Harris AH, Frayne SM, Nevedal AL, Arnow KD, Barreto NB, Davis K, Eisenberg D. Physical and emotional consequences of excess weight as experienced by individuals with spinal cord injuries. J Spinal Cord Med 2024; 47:412-422. [PMID: 36448929 PMCID: PMC11044741 DOI: 10.1080/10790268.2022.2097994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
CONTEXT/OBJECTIVE Excess weight has the potential to carry a substantial physical and emotional burden. A better understanding of perceived consequences of excess weight may facilitate the development of patient-centered programs and interventions to promote weight management efforts in persons with spinal cord injury (SCI). The study objective was to describe consequences of excess weight from the personal perspectives of individuals with SCI. DESIGN Descriptive qualitative design using in-depth semi-structured interviews and thematic analysis. SETTING Veterans Health Administration (VHA) SCI System of Care. PARTICIPANTS Individuals with SCI (n-33). OUTCOME MEASURES Key themes from thematic analysis. RESULTS Participants were male (61%), ranged from 29 to 84 years of age, and about half had tetraplegia (55%). Five themes were identified that demonstrate negative consequences of excess weight experienced by individuals with SCI, including: (1) physical health conditions (including chronic conditions and SCI secondary conditions), (2) physical symptoms (such as pain, discomfort, and fatigue), (3) movement challenges, (4) appearance-related concerns, and (5) emotional impacts. CONCLUSIONS Carrying excess weight is concerning to individuals with SCI and in terms of consequences such onset or exacerbation of chronic conditions, SCI secondary conditions, physical symptoms, e.g. pain, movement impairment (including hampered mobility, difficult transfers and self-care), image/appearance concerns (e.g. body image, clothing misfit), and negative emotions (e.g. unhappy, sad, depressed). Our findings may inform SCI healthcare providers about the consequences of excess weight as experienced by individuals with SCI, highlighting what matters most to persons with SCI and guiding a patient-centered approach to weight management in this population.
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Affiliation(s)
- Sherri L. LaVela
- Center of Innovation for Complex Chronic Care, VA Edward Hines Jr., Hines, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Justina Wu
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Alex H.S. Harris
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California, USA
- Stanford-Surgery Policy Improvement Research & Education Center, Stanford University School of Medicine, Stanford, California, USA
| | - Susan M. Frayne
- Center of Innovation for Complex Chronic Care, VA Edward Hines Jr., Hines, Illinois, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Andrea L. Nevedal
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Katherine D. Arnow
- Stanford-Surgery Policy Improvement Research & Education Center, Stanford University School of Medicine, Stanford, California, USA
| | - Nicolas B. Barreto
- Stanford-Surgery Policy Improvement Research & Education Center, Stanford University School of Medicine, Stanford, California, USA
| | - Kristen Davis
- Stanford-Surgery Policy Improvement Research & Education Center, Stanford University School of Medicine, Stanford, California, USA
| | - Dan Eisenberg
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California, USA
- Stanford-Surgery Policy Improvement Research & Education Center, Stanford University School of Medicine, Stanford, California, USA
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Redepenning DH, Bell M, Adenaiye O, Dicianno BE. Relationship between employment and adaptive video gaming in individuals with physical disabilities. Disabil Rehabil Assist Technol 2024:1-8. [PMID: 38592947 DOI: 10.1080/17483107.2024.2339427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE The purpose of this study was to assess employment characteristics of individuals with physical disabilities who currently participate in adaptive gaming and determine if there is a positive association between adaptive gaming and employment. MATERIALS AND METHODS A survey was administered to individuals with disabilities who currently use adaptive video gaming equipment to gather information on demographics, gaming habits, employment characteristics, and subjective benefits of gaming on employment. RESULTS The study included 606 participants. Over 57% of participants reported full-time or part-time employment. Nearly half of the participants reported using their equipment either most or all of the time to complete tasks related to work. Participants using their equipment to complete work tasks most or all of the time were more likely to be employed full-time (p = 0.0021). Over 75% of participants reported subjective benefits of adaptive video gaming on their employment. CONCLUSION Participants in this study had higher rates of employment compared to national averages for individuals with physical disabilities. More frequent use of adaptive gaming equipment for work was associated with a higher likeliness of full-time employment. Most participants who were employed reported subjective benefits of adaptive gaming on employment through improvements in mental health, physical function, and cognition.
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Affiliation(s)
- Drew H Redepenning
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Mitch Bell
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Oluwasanmi Adenaiye
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Brad E Dicianno
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
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Patsakos EM, Bailey KA, Ditor DS. Exploring the Lived Experiences of Individuals With Spinal Cord Injury During the COVID-19 Pandemic. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241226827. [PMID: 38263725 PMCID: PMC10807388 DOI: 10.1177/00469580241226827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/09/2023] [Accepted: 01/02/2024] [Indexed: 01/25/2024]
Abstract
The global spread of severe acute respiratory syndrome coronavirus 2019 (COVID-19) has affected over 100 countries and has led to the tragic loss of life, overwhelmed health care systems and severely impacted the global economy. Specifically, individuals living with spinal cord injury (SCI) are particularly vulnerable during the COVID-19 pandemic as they often face adverse impacts on their health, emotional well-being, community participation, and life expectancy. The objective of this study was to investigate the lived experience of individuals with SCI during the COVID-19 pandemic in Ontario, Canada. An exploratory design with a qualitative descriptive approach was used to address the study objective. Nine semi-structured interviews were conducted with individuals with traumatic and non-traumatic SCI (37-69 years, C3-L5, AIS A-D, and 5-42 years post-injury). Using reflexive thematic analysis, the following themes were created: (1) Caregiver exposure to COVID-19; (2) Staying physically active in quarantine; (3) Living in social isolation; (4) Difficulty obtaining necessary medical supplies; (5) Access to health services and virtual care during COVID-19; and (6) Fighting COVID-19 misinformation. This is one of the first studies to explore the impact of COVID-19 on individuals living with SCI in Ontario. This study contributes to a greater understanding of the challenges faced by individuals living with SCI and provides insight into how to better support and respond to the specific and unique needs of individuals with SCI and their families during a national emergency or pandemic.
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Affiliation(s)
| | | | - David S. Ditor
- Brock University, St. Catharines, ON, Canada
- Brock-Niagara Centre for Health and Well-being, St. Catharines, ON, Canada
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Wu W, Kang Z, Mu D, Zhao H, Yang F. T2 mapping for quantitative assessment of ankle cartilage of weightlifters. Sci Rep 2023; 13:19160. [PMID: 37932324 PMCID: PMC10628267 DOI: 10.1038/s41598-023-46259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023] Open
Abstract
The research into the prevention of sports injuries among the population, particularly juveniles, has become crucial due to the increasing participation in physical exercises like fitness. To assess the difference in T2 values of ankle talar cartilage between weightlifters and healthy volunteers using quantitative magnetic resonance imaging (MRI) technique T2 mapping. Study design: Prospective. Prospective evaluation of T2 values of ankle cartilage of 50 weightlifters (30 adults and 20 juveniles) and 100 healthy volunteers (80 adults and 20 juveniles) using Siemens 3.0 T MRI with PDWI, T1WI, and T2 mapping sequences. Three physicians manually divided the talar cartilage of the ankle joint into six regions of interest. Three physicians utilized the anterior and posterior cut edges of the tibial cartilage as markers to identify the corresponding anterior and posterior cut edges of the talar cartilage on the sagittal MRI images. The medial and lateral sides were defined as half of the talar articular surface on the coronal plane. Differences in T2 values in each cartilage region were compared using independent sample T test or Mann-Whitney U test. The T2 values of talar cartilage were significantly increased in the athlete group relative to the volunteer group (35.11 and 31.99, P < 0.001), with the most significant difference observed in the juvenile athlete group compared to the volunteer group (34.42 and 28.73, P < 0.001). There was a significant difference in the T2 value of ankle talar cartilage between weightlifters and healthy volunteers, and juveniles may be more vulnerable to overuse sports injuries. This study contributes to understanding the cartilage health of juvenile athletes and the prevention of sports injuries.
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Affiliation(s)
- Weibiao Wu
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China
| | - Zhuanzhuan Kang
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China
| | - Di Mu
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China
| | - Huiyu Zhao
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China
| | - Feng Yang
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China.
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Zainudin MF, Ahmad Fauzi A. Factors associated with sports participation amongst people with spinal cord injury in a Malaysian tertiary hospital. J Spinal Cord Med 2023; 46:91-98. [PMID: 34292138 PMCID: PMC9897789 DOI: 10.1080/10790268.2021.1950454] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To identify factors that are associated with sports participation following spinal cord injury (SCI). STUDY DESIGN Case-control study. SETTING Spinal Rehabilitation outpatient clinic in a tertiary hospital in Kuala Lumpur, Malaysia. PARTICIPANTS Thirty-one sports participants (SP) and thirty-four non-sports participants (NSP) (N = 65) met the following inclusion criteria; chronic SCI more than one year, age between 18 and 50 years, both traumatic and non-traumatic SCI at C5 level and below, complete or incomplete SCI (AIS A-D) and mobilizing with either manual or motorized wheelchair independently. METHODS Face-to-face interviews were performed with a 22-item self-constructed questionnaire which contained four domains of variables; socio-demographic, SCI-related, environmental and sports-related factors. Data collection was done between June 2017 and May 2018. RESULTS Traumatic SCI, pre-injury interest in sports, pre-injury sports participation, ability to drive own vehicles, and being employed were significantly associated with sports participation post-SCI (p < 0.05). Multiple logistic regression revealed traumatic SCI (p = 0.012, OR 34.70, CI 2.21-545.90) and pre-injury interest in sports (p = 0.046, OR 29.10, CI 1.06-798.95) to be independent predictors of sports participation post-SCI. CONCLUSION Traumatic SCI and pre-injury interest in sports were predictors of sports participation post-SCI. Pre-injury sports participation, being employed, and the ability to drive own vehicles were positively associated with sports participation. Findings from this study suggest a few crucial differences in facilitators and barriers to sports participation in Malaysia compared to other countries.
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Affiliation(s)
- Muhamad Faizal Zainudin
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,Corresponding to: Muhamad Faizal Zainudin, Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur50603, Malaysia.
| | - Aishah Ahmad Fauzi
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Watson PK, Arora M, Middleton JW, Quel de Oliveira C, Heard R, Nunn A, Geraghty T, Marshall R, Davis GM. Leisure-Time Physical Activity in People With Spinal Cord Injury-Predictors of Exercise Guideline Adherence. Int J Public Health 2022; 67:1605235. [PMID: 36579138 PMCID: PMC9790928 DOI: 10.3389/ijph.2022.1605235] [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: 07/21/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives: This study described leisure-time physical activity (LTPA) for people in Australia with spinal cord injury (SCI) and whether certain sociodemographic and psychosocial variables might be associated with LTPA uptake and guidelines adherence. Methods: The Physical Activity Scale for Individuals with a Physical Disability was used to measure the intensity and volume of LTPA of 1,579 individuals with SCI. Summary statistics were calculated for LTPA guidelines adherence. Analyses included regression modelling. Results: Of the 1,579 participants, 58% performed LTPA and 13% adhered to recommended guidelines for weekly LTPA. There was an association with being an "exerciser" based on the time since injury (OR = 1.02 [95% 1.01-1.03]), a traumatic injury (OR = 1.53 [95% CI 1.13-2.08]) and a higher self-rating of health (OR = 1.10 [95% CI 0.95-1.27]). Where LTPA guidelines were met, adherence was most related to a traumatic injury (OR = 1.75 [95% CI 1.02-3.02]) and being unemployed (OR = 1.53 [95% CI 1.03-2.25]). Conclusion: Of those who performed LTPA with SCI, one in four met population-specific LTPA guidelines. Sociodemographic variables were moderately associated with being an "exerciser" or LTPA "guideline-adherent."
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Affiliation(s)
- Paul K. Watson
- Discipline of Exercise and Sport Sciences, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia,*Correspondence: Paul K. Watson,
| | - Mohit Arora
- Northern Sydney Local Health District, John Walsh Centre for Rehabilitation Research, The Kolling Institute, Sydney, NSW, Australia,Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - James W. Middleton
- Northern Sydney Local Health District, John Walsh Centre for Rehabilitation Research, The Kolling Institute, Sydney, NSW, Australia,Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Camila Quel de Oliveira
- Department of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Robert Heard
- Discipline of Behavioural and Social Sciences in Health, Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Andrew Nunn
- Victorian Spinal Cord Service, Austin Health, Heidelberg, VIC, Australia
| | - Timothy Geraghty
- Queensland Spinal Cord Injuries Service, Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, QLD, Australia,The Hopkins Centre, Griffith University, Brisbane, QLD, Australia
| | - Ruth Marshall
- South Australian Spinal Cord Injury Service, Central Adelaide Local Health Network, Adelaide, SA, Australia,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Glen M. Davis
- Discipline of Exercise and Sport Sciences, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Soo Hoo JA, Kim H, Fram J, Lin YS, Page C, Easthausen I, Jayabalan P. Shoulder pain and ultrasound findings: A comparison study of wheelchair athletes, nonathletic wheelchair users, and nonwheelchair users. PM R 2022; 14:551-560. [PMID: 34028204 PMCID: PMC9444331 DOI: 10.1002/pmrj.12648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/08/2021] [Accepted: 05/14/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Shoulder pain is one of the most common musculoskeletal concerns in manual wheelchair users including among athletes. However, there is a paucity of research characterizing both shoulder pain and shoulder pathology in this population. OBJECTIVE To characterize and compare the prevalence of current shoulder pain and ultrasound metrics of shoulder pathology between wheelchair athletes, nonathletic wheelchair users, and nonwheelchair users. DESIGN Cross-sectional. SETTING Chicago-area adaptive sport teams/programs and musculoskeletal clinics. PARTICIPANTS Thirty-four wheelchair athletes, six nonathletic wheelchair users, and 12 nonwheelchair users. METHODS Self-reported shoulder pain was assessed by questionnaire and Wheelchair User Shoulder Pain Index (WUSPI). Shoulder physiology and pathology were assessed by physical and ultrasound evaluation of both shoulders by a sports medicine physician. MAIN OUTCOME MEASURES Questionnaire outcomes: Prevalence of current shoulder pain, total WUSPI score. Physical examination outcomes: total Physical Examination of Shoulder Scale (PESS) score. Sonographic outcomes: Acromiohumeral distance (AHD) and presence of shoulder pathology. RESULTS The majority of wheelchair athletes (68%) and nonathletic wheelchair users (67%) experienced shoulder pain since using a manual wheelchair. Wheelchair basketball players had a mean WUPSI score of 17.2 (SD = 21.8), and athletes participating in handcycling, sled hockey, and quad rugby had mean scores of 4.91 (SD = 8.32), 7.76 (SD = 13.1), and 4.29 (SD = 7.75), respectively. Shoulder pathology was observed in 14 of 31 (45%) wheelchair athletes and 4 of 6 (67%) nonathletic wheelchair users (p = .41). CONCLUSIONS Although wheelchair use is a risk factor for shoulder pain, participation in amateur wheelchair sports may not be associated with increased risk of shoulder pain. It is possible that overhead sports such as wheelchair basketball may define a unique high-risk group. Further study is needed to examine this relationship and to determine whether there are differences between specific wheelchair sports.
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Affiliation(s)
- Jennifer A. Soo Hoo
- Division of Rehabilitation Medicine, Weill Cornell Medicine/NYP, New York, New York, USA
| | - Hyungtaek Kim
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Julia Fram
- Shirley Ryan Ability Lab, Chicago, Illinois, USA,Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yen-Sheng Lin
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA,Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | | | - Imaani Easthausen
- Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, New York, USA
| | - Prakash Jayabalan
- Shirley Ryan Ability Lab, Chicago, Illinois, USA,Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
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Varahra A, Ahmed H, Lindsay S. Exploring Direct and Indirect Associations of Exercise and Sport Participation with Employment among Individuals with Disabilities: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:44-54. [PMID: 33956265 DOI: 10.1007/s10926-021-09962-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
Purpose Exercise and sports have many positive benefits for persons with or without a disability. Despite this, the contribution of exercise and sport participation to employment is less documented. The purpose of this scoping review was to provide insight into the direct and indirect associations of exercise and sport participation with employment among persons with disabilities. Methods Six databases were searched (MEDLINE, Embase, Scopus, PsychINFO, CINAHL, and HealthStar) from their inception date to March 20, 2020. Peer-reviewed English and French articles were included if at least one outcome measure on employment or work-related outcomes as a result of participation in, or benefits of exercise and sport participation was the focus of the study. Results The research identified 2796 hits. Of which, 23 published between 1992 and 2019 met eligibility criteria. Seven studies identified a direct association between exercise and sport participation with employment and full-time positions. Sixteen studies reported on improved health/work-related outcomes such as occupational performance (i.e., self-care, functional independence), physical fitness (i.e., upper extremity strength, endurance) and psychological well-being (i.e., self-efficacy). Conclusions This scoping review highlights that exercise and sport participation have associations with employment and work-related outcomes. Benefits of exercise and sports may be considered to a greater extent, than in the past, in programs that facilitate employment for persons with disabilities. Additional research using longitudinal design should be conducted to further understand the strength of these associations and evaluate whether exercise and sport participation should be incorporated more intensely in vocational programs.
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Affiliation(s)
- Azar Varahra
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
| | - Hiba Ahmed
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
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10
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Hansen RK, Samani A, Laessoe U, Larsen RG, Cowan RE. Sociodemographic characteristics associated with physical activity barrier perception among manual wheelchair users. Disabil Health J 2021; 14:101119. [PMID: 34099418 DOI: 10.1016/j.dhjo.2021.101119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/19/2021] [Accepted: 05/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Individuals with disabilities are sub-optimally active and at increased risk for chronic diseases. Limited knowledge exists about how differences among wheelchair-dependent individuals may affect their perception of physical activity barriers. OBJECTIVE We examined whether the perception of physical activity barriers are associated with wheelchair user sociodemographic characteristics. METHODS Danish manual wheelchair users (MWCUs) (N = 181; 52.5% females, mean ± SD: age 48 ± 14 yrs) completed the 'Barriers to Physical Activity Questionnaire for People with Mobility Impairments' (BPAQ-MI) online. The BPAQ-MI queries physical activity barriers in four domains (intrapersonal, interpersonal, organizational, and community) and eight subdomains. Participant characteristics evaluated as potentially associated with physical activity barriers included age, sex, years in chair, body mass index (BMI), spinal cord injury (SCI) (if any), education, employment, and resident city size. Simple linear regression (step 1) and multiple regression models (step 2) were created to assess associations between MWCU characteristics and barriers. RESULTS Multiple regression models revealed that MWCUs who were obese, who did not complete high school, or were unemployed rated physical activity barriers higher across several subdomains (all r2≤0.226, p<0.05). Resident city size was associated with safety subdomain barrier impact (r2=0.039, p<0.05). Sex, age, years in chair and SCI were not associated with any barrier domains (all p ≥ 0.064). CONCLUSIONS Our results provide new evidence that MWCUs with BMI ≥30; who are not employed; or who only have completed high school, may need special consideration and resources to overcome distinct physical activity barriers. Behavioral strategies and interventions focusing on reducing physical activity barriers should be tailored to the individuals above.
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Affiliation(s)
- Rasmus K Hansen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Department of Research and Development, University College of Northern Jutland (UCN), Aalborg, Denmark.
| | - Afshin Samani
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Uffe Laessoe
- Department of Research and Development, University College of Northern Jutland (UCN), Aalborg, Denmark; Physical Therapy Department, University College of Northern Jutland (UCN), Aalborg, Denmark
| | - Ryan G Larsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Rachel E Cowan
- Department of Physical Medicine and Rehabilitation, The University of Alabama at Birmingham, Birmingham, AL, USA
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11
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Blauwet CA, Robinson D, Riley A, MacEwan K, Patstone M, Dubon ME. Developing a Virtual Adaptive Sports Program in Response to the
COVID
‐19 Pandemic. PM R 2020; 13:211-216. [DOI: 10.1002/pmrj.12481] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/09/2020] [Accepted: 08/24/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Cheri A. Blauwet
- Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital/Harvard Medical School Boston, MA
- Department of Physical Medicine and Rehabilitation and Kelley Adaptive Sports Research Institute Spaulding Rehabilitation Hospital, Harvard Medical School Boston, MA
| | - David Robinson
- Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital/Harvard Medical School Boston, MA
| | | | | | | | - Mary E. Dubon
- Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital/Harvard Medical School Boston, MA
- Department of Physical Medicine and Rehabilitation and Kelley Adaptive Sports Research Institute Spaulding Rehabilitation Hospital, Harvard Medical School Boston, MA
- Department of Orthopedics Boston Childrenʼs Hospital Boston, MA
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12
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Lawrason SVC, Todd KR, Shaw RB, Martin Ginis KA. Physical activity among individuals with spinal cord injury who ambulate: a systematic scoping review. Spinal Cord 2020; 58:735-745. [DOI: 10.1038/s41393-020-0460-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/27/2022]
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Ponti A, Berardi A, Galeoto G, Marchegiani L, Spandonaro C, Marquez MA. Quality of life, concern of falling and satisfaction of the sit-ski aid in sit-skiers with spinal cord injury: observational study. Spinal Cord Ser Cases 2020; 6:8. [PMID: 32034122 PMCID: PMC7007432 DOI: 10.1038/s41394-020-0257-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Observational study. OBJECTIVE To describe (1) user satisfaction, (2) the Quality of Life (QoL) and (3) fear of falling in individuals with tetraplegia or paraplegia who used a mono-ski for sit-skiing. SETTING Spinal units and Sport associations. METHODS An observational study of people with spinal cord injury (SCI) who used a sit-ski. Participants were recruited in various SCI rehabilitation centers and sport associations. Participants completed three assessment tools: the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0); the World Health Organization Quality of Life (WHOQoL-BREF); the Spinal Cord Injury Fall Concern Scale (SCI-FCS). Results were evaluated with chi-squared test and Kolmogorov-Smirnov's test and the significance was set for p values < 0.05. RESULTS Fifteen participants were included. Results showed positive and statistically significant values for all the items of the SCI-FCS related to fear of falling, and for most of the items of the WHOQoL-BREF related to QoL and the QUEST 2.0 related to satisfaction with the device. CONCLUSIONS This study highlights that sit skiing is correlated with high levels of satisfaction with the mono-ski, increases in QoL, and low levels of fear of falling. In adding these findings to the existent literature, it can be stated with more certainty that sit-skiing is a sport that can be recommended in rehabilitation and sports therapy programs.
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Affiliation(s)
| | | | - Giovanni Galeoto
- Department of Public Health and Infectious Disease, "Sapienza" University of Rome, Rome, Italy.
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14
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Abstract
The health benefits of regular recreational physical activity are well known in reducing secondary health consequences of a sedentary lifestyle in the general population. However, individuals with physical disabilities participate less frequently in recreational activity compared with those without disabilities. Although evidence on the impact of recreational physical activity on quality of life in this population is in its infancy, regular recreational and sports activity participation has shown to have a positive association with improvements in quality of life, life satisfaction, community reintegration, mood, and employment in those with disabilities. Facilitators of participating in adaptive sports include a desire to improve social support, physical fitness, health, and fun. Unfortunately, those with disabilities face numerous barriers to participate in adaptive sports including accessibility, transportation, awareness, finances, and physical and cognitive impairments. Further studies are needed to investigate facilitators and barriers to participating in adaptive sports to capitalize on the physical and psychosocial benefits of regular recreational activity. The aim of this article is to review the available literature on the effects of adaptive sports participation on quality of life.
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15
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Klenk C, Albrecht J, Nagel S. Social participation of people with disabilities in organized community sport. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2019. [DOI: 10.1007/s12662-019-00584-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
The benefit of sport for athletes with impairments is well established. However, sport participation is not without risk. The existing literature informs us that injury patterns are sport and disability specific. Further research is needed to study injuries in this population.
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Abstract
Shoulder pain is one of the most common complaints amongst wheelchair athletes. There are many debated potential risk factors for shoulder pain in this population including inherent anatomy, increased loading forces, overuse, age, wheelchair use duration, trunk control, and sport played. Proper identification of etiology of shoulder pain with a thorough history and physical examination is important for management purposes. Treatment can be challenging as complete rest from exacerbating activities is often difficult as upper extremity use is necessary for everyday life activities such as mobility and transfers. Addition of shoulder maintenance strengthening program focusing on strengthening adductors, external rotators, and scapular retractors is important to keep shoulder muscles well-balanced to prevent injury.
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Dorsett P, McLennan V. Exploring the ‘status quo’ in vocational rehabilitation and employment outcomes following spinal cord injury. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-180995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Pat Dorsett
- School of Human Services and Social Work, Griffith University, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Vanette McLennan
- School of Allied Health Sciences, Griffith University, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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19
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Blauwet CA. More Than Just a Game: The Public Health Impact of Sport and Physical Activity for People With Disabilities (The 2017 DeLisa Lecture). Am J Phys Med Rehabil 2019; 98:1-6. [PMID: 30286017 DOI: 10.1097/phm.0000000000001063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although people with disabilities make up a large proportion of our global population and are known to be disproportionately impacted by sedentary lifestyles leading to chronic disease, programs promoting physical activity often fail to address their unique needs. Both environmental and attitudinal factors also act as barriers to full participation. In this context, increasing evidence shows the positive impact of physical activity and sport on outcomes related to physical health, mental health, community participation, and, in some cases, neurorecovery for people with disabilities. Thus, participation should be seen not only as a medical intervention but also as a rights-based issue. We, as physiatrists, can be agents of change by promoting concepts of universal design and inclusion in physical activity and sport programs.
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Affiliation(s)
- Cheri A Blauwet
- From the Harvard Medical School, Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
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20
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Alve YA, Bontje P. Factors Influencing Participation in Daily Activities by Persons With Spinal Cord Injury: Lessons Learned From an International Scoping Review. Top Spinal Cord Inj Rehabil 2019; 25:41-61. [PMID: 30774289 PMCID: PMC6368111 DOI: 10.1310/sci2501-41] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: It is important to develop further understanding regarding the facilitating and constraining factors that influence participation in daily activities, including social and human rights issues faced by persons with spinal cord injury (SCI) that affect their opportunities to lead full social lives. Objectives: To identify, describe, and compare factors that influence participation in daily activities by persons with SCI living in high-income countries (HICs) and in low- and middle-income countries (LMICs). Method: We performed a scoping review of 2,406 articles published between 2001 and 2016 that were identified from electronic databases. From these, 58 remained after checking inclusion and exclusion criteria. Analyses included (a) identifying factors that facilitate and constrain participation in daily activities; (b) categorizing the identified factors as issues related to medical, social, and human rights models; and (c) comparing determinants between LMICs and HICs. Results: The medical model factors pertained to long-term physical health and functional capacities, self-efficacy and adjustment skills, relearning capacities for performing daily activities, and availability of cost-effective adaptive equipment. The social model factors pertained to developing accommodating communities (accessible environments and mutual understanding). The factors of the human rights model pertained to autonomy (empowerment) and development of social justice (application of policies, advocacy, and negotiation). Conclusion: Eight lessons are proposed to enhance health and functional abilities, ensure disability friendly environments, develop social justice, and provide empowerment to enhance participation in daily activities among person with SCI living in LMICs.
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Affiliation(s)
- Yeasir Arafat Alve
- Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Department of Occupational Therapy, BHPI, Centre for the Rehabilitation of the Paralysed (CRP), Dhaka, Bangladesh
| | - Peter Bontje
- Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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21
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Lape EC, Katz JN, Losina E, Kerman HM, Gedman MA, Blauwet CA. Participant-Reported Benefits of Involvement in an Adaptive Sports Program: A Qualitative Study. PM R 2017; 10:507-515. [PMID: 29111464 DOI: 10.1016/j.pmrj.2017.10.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/16/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although participation in adaptive sports offers numerous benefits for persons with disabilities, a substantial number of eligible persons do not take part. Previous studies have identified personal and environmental factors that promote or inhibit adaptive sports participation. However, these studies have considered a relatively narrow range of factors. OBJECTIVE To use qualitative research techniques to identify novel factors that influence participation in a community-based adaptive sports program. DESIGN Qualitative focus group study. SETTING Community-based adaptive sports programs affiliated with a rehabilitation hospital network. PARTICIPANTS Participants were recruited from among 134 adults who registered for the sports program in 2013-2014. Participants with mobility or sensory impairment, absence of cognitive impairment, and English proficiency were included. The 90 former participants with adequate contact information were contacted, and 17 participated in the focus groups. METHODS Two moderators led each of 3 audio-recorded focus groups using a moderator's guide. We conducted a thematic analysis of transcript data to identify perceived benefits, barriers, and facilitators of participation. RESULTS Our analysis identified 5 themes: physical well-being and health/safety; interpersonal and social relationships; intrapersonal and beliefs/attitudes; physical environment; and access. Participants experienced participation both as physically beneficial and as transformative in terms of how they view themselves. However, programs drew on limited personal resources and sometimes presented a perceived risk of injury. Finding information about and transportation to programs was a challenge. Participants formed an informal community that modeled what athletes with disabilities are capable of, helping to overcome initial doubts. CONCLUSIONS To gain the benefits of participation, athletes overcame significant barriers, several of which may be modifiable, including transportation and difficult-to-find information about program offerings. The importance of community and raising awareness of athletes' own abilities suggests a key role for mentorship. Our study contributes to the understanding of experiential aspects that motivate participation in adaptive sports. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Emma C Lape
- Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, 75 Francis St, BTM 5016, Boston, MA 02115.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Boston, MA
| | - Jeffrey N Katz
- Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, 75 Francis St, BTM 5016, Boston, MA 02115.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Boston, MA
| | - Elena Losina
- Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, 75 Francis St, BTM 5016, Boston, MA 02115.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Boston, MA
| | - Hannah M Kerman
- Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, 75 Francis St, BTM 5016, Boston, MA 02115.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Boston, MA
| | - Marissa A Gedman
- Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, 75 Francis St, BTM 5016, Boston, MA 02115.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Boston, MA
| | - Cheri A Blauwet
- Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, 75 Francis St, BTM 5016, Boston, MA 02115.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA.,Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Boston, MA
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Rojhani S, Stiens SA, Recio AC. Independent sailing with high tetraplegia using sip and puff controls: integration into a community sailing center. J Spinal Cord Med 2017; 40:471-480. [PMID: 27415644 PMCID: PMC5537965 DOI: 10.1080/10790268.2016.1198548] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND We are continually rediscovering how adapted recreational activity complements the rehabilitation process, enriches patients' lives and positively impacts outcome measures. Although sports for people with spinal cord injuries (SCI) has achieved spectacular visibility, participation by high cervical injuries is often restricted due to poor accessibility, safety concerns, lack of adaptability, and high costs of technology. METHODS We endeavor to demonstrate the mechanisms, adaptability, accessibility, and benefits the sport of sailing creates in the rehabilitative process. Our sailor is a 27-year-old man with a history of traumatic SCI resulting in C4 complete tetraplegia. RESULTS The participant completed an adapted introductory sailing course, and instruction on the sip-and-puff sail and tiller control mechanism. With practice, he navigated an on-water course in moderate winds of 5 to 15 knots. DISCUSSION Despite trends toward shorter rehabilitation stays, aggressive transdisciplinary collaboration with recreation therapy can provide community and natural environment experiences while inpatient and continuing post discharge. Such peak physical and psychological experiences provide a positive perspective for the future that can be shared on the inpatient unit, with families and support systems like sailing clubs in the community. CONCLUSION Rehabilitation theory directs a team process to achieve patient self-awareness and initiate self-actualization in spite of disablement. Utilization of local community sailing centers that have provided accessible assisted options provides person-centered self-realization of goals as assisted by family and natural supports. Such successful patients become native guides for others seeking the same experience.
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Affiliation(s)
- Solomon Rojhani
- Department of Physical Medicine & Rehabilitation, The Johns Hopkins School of Medicine, Baltimore, MD, USA,Correspondence to: Solomon Rojhani, Chief Resident 2016-2017, The Johns Hopkins University School of Medicine, Department of Physical Medicine & Rehabilitation, 600 North Wolfe Street Phipps 160, Baltimore, MD, USA, 21287. E-mail:
| | - Steven A. Stiens
- Department of Rehabilitation Medicine, University of Washington, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Albert C. Recio
- International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger & Department of Physical Medicine & Rehabilitation, The Johns Hopkins School of Medicine, Baltimore, MD, USA
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23
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Jörgensen S, Martin Ginis KA, Lexell J. Leisure time physical activity among older adults with long-term spinal cord injury. Spinal Cord 2017; 55:848-856. [PMID: 28322241 DOI: 10.1038/sc.2017.26] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVES To describe participation in leisure time physical activity (LTPA) (amount, intensity and type) among older adults with long-term spinal cord injury (SCI), and to investigate the associations with sociodemographics, injury characteristics and secondary health conditions (SHCs). SETTING Home settings in southern Sweden. METHODS Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS). The physical activity recall assessment for people with SCI was used to assess LTPA among 84 men and 35 women (mean age 63.5 years, mean time since injury 24 years, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D). Associations were analyzed statistically using hierarchical multivariable regression. RESULTS Twenty-nine percent reported no LTPA, whereas 53% performed moderate-to-heavy intensity LTPA. The mean minutes per day of total LTPA was 34.7 (±41.5, median 15, range 0-171.7) and of moderate-to-heavy LTPA 22.5 (±35.1, median 5.0, range 0-140.0). The most frequently performed activities were walking and wheeling. Sociodemographics, injury characteristics and SHCs (bowel-related and bladder-related problems, spasticity and pain) explained 10.6% and 13.4%, respectively, of the variance in total and moderate-to-heavy LTPA. Age and wheelchair use were significantly, negatively associated with total LTPA. Women, wheelchair users and employed participants performed significantly less moderate-to-heavy LTPA than men, those using walking devices/no mobility device and unemployed participants. CONCLUSION Many older adults with long-term SCI do not reach the amount or intensity of LTPA needed to achieve fitness benefits. Research is needed on how to increase LTPA and to identify modifiable factors that could enhance their participation.
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Affiliation(s)
- S Jörgensen
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - K A Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, BC, Canada
| | - J Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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24
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Rohatinsky N, Goodridge D, Rogers MR, Nickel D, Linassi G. Shifting the balance: conceptualising empowerment in individuals with spinal cord injury. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:769-779. [PMID: 27400830 DOI: 10.1111/hsc.12370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 06/06/2023]
Abstract
Empowerment is believed to be an essential element in self-management of disease and the promotion of self-efficacy, and can be defined as the ability of individuals to increase control over aspects of their lives. In contrast, powerlessness in individuals with chronic illness can occur when they perceive that they lack the capacity, authority or resources to affect an outcome. Individuals with spinal cord injuries (SCIs) are at risk for powerlessness and have the potential to become empowered, but these concepts have not been explored within their context. The purpose of this study was to explore how individuals with SCI enact the empowerment process using Lord's (1991) process of empowerment framework. This study used a secondary analysis of a data set obtained from a mixed methods study exploring access to health and social care for 23 persons with SCI in Saskatchewan, Canada. The primary study data were collected from September 2012 to January 2013. The secondary analysis of data utilised a deductive thematic analysis approach and findings were conceptualised and applied to a model that represents the shift in balance between powerlessness and empowerment in individuals with SCI.
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Affiliation(s)
- Noelle Rohatinsky
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna Goodridge
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Marla R Rogers
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Darren Nickel
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Clinical Lead Spinal Cord Injury and Amputation Programs, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
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25
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Blauwet CA, Yang HY, Cruz SA, Collins JE, Smith KC, Losina E, Katz JN. Functional and Environmental Factors Are Associated With Sustained Participation in Adaptive Sports. PM R 2016; 9:668-675. [PMID: 27810582 DOI: 10.1016/j.pmrj.2016.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/16/2016] [Accepted: 10/21/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although community-based adaptive sports have become a popular means of rehabilitation for individuals with disabilities, little is known regarding the factors that lead to sustained participation. OBJECTIVE To determine the demographic, environmental, disability-related, and functional factors associated with sustained participation in a community-based adaptive sports program. DESIGN Retrospective cohort study. SETTING Community-based adaptive sports program. PARTICIPANTS Adults with mobility-related disabilities. METHODS Data were collected from registration forms and participation logs. Participants were described as "sustainers" if they attended ≥2 sessions, or as "nonsustainers" if they attended 0 or 1 session. We examined the associations between sustained participation and demographic, environmental, disability-related, and functional factors in bivariate and multivariable analyses. MAIN OUTCOME MEASUREMENT Sustained participation in the adaptive sports program. RESULTS Of the 134 participants, 78 (58%) were sustainers and 56 (42%) were nonsustainers. In multivariable analyses, participants who ambulated independently had lower odds of being sustainers (odds ratio [OR] = 0.33, 95% confidence interval [CI] = 0.11, 0.96), and those who used an ambulatory assistive device had twice the odds of being sustainers (OR = 2.0, 95% CI = 0.65, 6.2) compared to those who used a manual wheelchair. Moreover, participants who lived within 5.3 miles of the program site (OR = 3.8, 95% CI = 1.1, 13.0) and those who lived between 5.3 and 24.4 miles from the program site (OR = 2.8, 95% CI = 1.0, 7.7) had significantly higher odds of sustained participation than those who lived more than 24.4 miles from the program site. CONCLUSION Sustained participation in community-based adaptive sports is associated with living closer to the program site and the presence of a moderate level of functional impairment. These findings suggest that programs might consider increasing the number of satellite sites and expanding offerings for individuals with mild or more significant mobility-related disabilities to effectively increase program participation. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Cheri A Blauwet
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital and the Brigham and Women's Hospital, 300 First Ave, Charlestown, MA 02129(∗).
| | - Heidi Y Yang
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA(†)
| | | | - Jamie E Collins
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA(§)
| | - Karen C Smith
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA(‖)
| | - Elena Losina
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA(¶)
| | - Jeff N Katz
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, MA(#)
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Garshick E, Mulroy S, Graves DE, Greenwald K, Horton JA, Morse LR. Active Lifestyle Is Associated With Reduced Dyspnea and Greater Life Satisfaction in Spinal Cord Injury. Arch Phys Med Rehabil 2016; 97:1721-7. [PMID: 26951870 PMCID: PMC4802491 DOI: 10.1016/j.apmr.2016.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/25/2016] [Accepted: 02/13/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the relations between measures of activity with dyspnea and satisfaction with life in chronic spinal cord injury (SCI). DESIGN Cross-sectional survey. SETTING Five SCI centers. PARTICIPANTS Between July 2012 and March 2015, subjects (N=347) with traumatic SCI ≥1 year after injury who used a manual wheelchair or walked with or without an assistive device reported hours spent away from home or yard on the previous 3 days, sports participation, and planned exercise. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Satisfaction with Life Scale (SWLS) and dyspnea. Dyspnea was defined as shortness of breath when hurrying on the level or going up a slight hill, going slower than people the same age on the level because of breathlessness, or stopping for breath when going at your own pace, or after about 100yd (or after a few minutes) on the level. RESULTS Dyspnea prevalence was 30%. Adjusting for asthma or chronic obstructive pulmonary disease, mobility mode, race, and season, there was a significant linear trend between greater SWLS scores and quartiles of time spent away from the home or yard (P=.0002). SWLS score was greater if participating in organized sports (P=.01), although was not significantly greater with planned exercise (P=.093). Planned exercise was associated with a reduced odds ratio (OR) of dyspnea (.57; 95% confidence interval [CI], .34-.95; P=.032), but organized sports was not (P=.265). Dyspnea was not significantly increased in persons who spent the fewest hours outside their home or yard (≤7h) compared with people who spent the most hours outside their home or yard (>23h) (OR=1.69; 95% CI, 0.83-3.44; P=.145). CONCLUSIONS In SCI, a planned exercise program is associated with less dyspnea. An active lifestyle characterized by greater time spent away from home or yard and sports participation is associated with greater SWLS scores.
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Affiliation(s)
- Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Veterans Affairs Boston Healthcare System, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | - Sara Mulroy
- Rancho Los Amigos National Rehabilitation Center, Downey, CA
| | - Daniel E Graves
- Frazier Rehabilitation Institute, University of Louisville, Louisville, KY
| | - Karen Greenwald
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - John A Horton
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Leslie R Morse
- Spaulding-Harvard Spinal Cord Injury Model System, Spaulding Rehabilitation Hospital, Boston, MA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
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Performance-Focussed Sport – An Avenue to Gold-Medal Clinical Outcomes for People with Neurological Impairments? BRAIN IMPAIR 2016. [DOI: 10.1017/brimp.2016.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper investigates the premise that long-term engagement in performance-focussed sports training may lead to significantly enhanced clinical outcomes for people with neurological impairments (NI). The minimum volume of moderate-intensity activity recommended for good health is 450 MET.minutes/week, although evidence from the general population indicates that outcomes may be enhanced by completing up to five times this volume (2250 MET.minutes/week) at vigorous (rather than moderate) intensity. Most studies evaluating physical activity interventions for people with NI deliver low volumes (<450 MET.minutes/week), which may explain why evidence for some clinical outcomes is weak. Athletes (with or without NI) who aim to achieve high-level sports performance undertake an increasingly large volume of vigorous intensity physical activity over several seasons. Evidence that people with NI may enhance clinical outcomes through performance-focussed sports training includes: evidence from studies investigating the benefits of high-intensity and/or high volume clinical exercise; scientific evidence from elite/high-level athletes; and anecdotal evidence from Paralympic athlete testimonials. Additionally, sports participants with NI may also accrue an important array of psychosocial benefits, including higher rates of employment, and higher satisfaction with life and social integration. Rigorous, prospective, longitudinal clinical monitoring of people with NI undertaking performance-focussed sports training are required to evaluate its clinical utility.
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Trenaman L, Miller WC, Querée M, Escorpizo R. Modifiable and non-modifiable factors associated with employment outcomes following spinal cord injury: A systematic review. J Spinal Cord Med 2015; 38:422-31. [PMID: 25989899 PMCID: PMC4612197 DOI: 10.1179/2045772315y.0000000031] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
CONTEXT Employment rates in individuals with spinal cord injury (SCI) are approximately 35%, which is considerably lower than that of the general population. In order to improve employment outcomes a clear understanding of what factors influence employment outcomes is needed. OBJECTIVE To systematically review factors that are consistently and independently associated with employment outcomes in individuals with SCI, and to understand the magnitude of their influence. METHODS Through an electronic search of MEDLINE/PubMed, EMBASE, CINAHL, PsycINFO, Social Science Abstracts and Social Work databases, we identified studies published between 1952-2014 that investigated factors associated with employment outcomes following SCI. Exclusion criteria included: (1) reviews (2) studies not published in English (3) studies not controlling for potential confounders through a regression analysis, or (4) studies not providing an effect measure in the form of OR, RR, or HR. Data were categorized based on the International Classification of Functioning, Disability and Health framework, with each domain sub-categorized by modifiability. First author, year of publication, sample size, explanatory and outcome variables, and effect measures were extracted. RESULTS Thirty-nine studies met the inclusion criteria. Twenty modifiable and twelve non-modifiable factors have been investigated in the context of employment following SCI. Education, vocational rehabilitation, functional independence, social support, and financial disincentives were modifiable factors that have been consistently and independently associated with employment outcomes. CONCLUSION A number of key modifiable factors have been identified and can inform interventions aimed at improving employment outcomes for individuals with SCI. Future research should focus on determining which factors have the greatest effect on employment outcomes, in addition to developing and evaluating interventions targeted at these factors.
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Affiliation(s)
| | - William C Miller
- Correspondence to: William C Miller, FCAOT, Department of Occupational Science and Occupational Therapy, University of British Columbia, T325–2211 Wesbrook Mall, Vancouver, BC, Canada V6 T 2B5. E-mail:
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Sahlin KB, Lexell J. Impact of Organized Sports on Activity, Participation, and Quality of Life in People With Neurologic Disabilities. PM R 2015; 7:1081-1088. [DOI: 10.1016/j.pmrj.2015.03.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 03/22/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
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Sport participation among individuals with acquired physical disabilities: group differences on demographic, disability, and Health Action Process Approach constructs. Disabil Health J 2014; 8:216-22. [PMID: 25458978 DOI: 10.1016/j.dhjo.2014.09.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 09/20/2014] [Accepted: 09/27/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Despite numerous physical, social, and mental health benefits of engaging in moderate and vigorous intensity physical activities (e.g., sport), few individuals with acquired physical disabilities currently participate in adapted sport. Theory-based sport promotion interventions are one possible way to increase the amount of individuals who engage in sport. OBJECTIVES The primary objective of this study was to examine the profiles of three different sport participation groups with respect to demographic, injury, and Health Action Process Approach (HAPA) constructs. METHODS ANOVAs and Chi-square tests were used to determine group differences on demographic and disability-related constructs. A MANCOVA was conducted to determine differences between three sport participation groups (non-intenders, intenders, and actors) with age, years post-injury, mode of mobility, and sex included as covariates. RESULTS A cohort of 201 individuals was recruited; 56 (27.9%) were non-intenders, 21 (10.4%) were intenders, and 124 (61.7%) were actors. The MANCOVA revealed significant differences between groups on the HAPA constructs, F(22,370) = 9.02, p < .0001, Pillai's trace = .70, demonstrating that individuals with acquired physical disabilities will rate important health behavior constructs differently based on their sport intentions. CONCLUSION These results provide an important framework that adapted sport organizations can use to tailor their sport promotion programs.
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