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Sarsak HI. Patient Satisfaction with Occupational Therapy Services for Wheeled Mobility and Seating Devices. Occup Ther Health Care 2024; 38:890-903. [PMID: 36107489 DOI: 10.1080/07380577.2022.2121992] [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: 05/22/2022] [Revised: 08/08/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
Satisfaction of 81 patients was evaluated before and after receiving occupational therapy services. There was a statistically significant difference between patients' scores before and after receiving occupational therapy services (p < .05). Over 85% indicated a high satisfaction in relation to quality and health outcomes attributed to occupational therapy services, 44% reported barriers related to limited availability, accessibility, and knowledge of occupational therapy services, and 35% made suggestions for improvements. Patient-therapist communication and easy access to occupational therapy services can enhance occupational therapy knowledge, lead to positive patient experience and quality health outcomes, and higher patient satisfaction.
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Sarsak HI, von Zweck C, Ledgerd R. Wheeled and Seated Mobility Devices Provision: Quantitative Findings and SWOT Thematic Analysis of a Global Occupational Therapist Survey. Healthcare (Basel) 2023; 11:healthcare11081075. [PMID: 37107909 PMCID: PMC10137666 DOI: 10.3390/healthcare11081075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE To better understand the global role of occupational therapists and explore facilitators and barriers impacting user access to high quality, affordable wheeled and seated mobility device (WSMD) provision worldwide. METHODS Mixed-method approach utilizing quantitative findings and qualitative strengths, weaknesses, opportunities, and threats (SWOT) analysis of a global online survey. RESULTS A total of 696 occupational therapists from 61 countries completed the survey. Almost 49% had 10 or more years of experience with the provision of WSMDs. WSMD provision had positive, significant associations with attainment of certification (0.000), higher service funding (0.000), higher country income (0.001), standardized training (0.003), continuous professional development (0.004), higher experience (0.004), higher user satisfaction (0.032), custom-made device provision (0.038), higher staff capacity (0.040), and more time working with users (0.050); negative, significant associations were identified with high cost of WSMDs (0.006) and pre-made device provision (0.019). SWOT analysis identified high country income, funding, experience, training, certification from global partners, variety of roles and practice settings, and interdisciplinary teamwork as strengths and opportunities for professional growth, while low country income, lack of time/staff capacity/standardization/support services, and poor access to proper devices were indicated as weaknesses and threats. CONCLUSION Occupational therapists are skilled healthcare professionals and provide a variety of WSMD services. Efforts to build collaborative partnerships, enhance access to occupational therapists and funding options, improve service and standards for WMSD service delivery, and promote professional development will help to overcome challenges and facilitate WSMD provision globally. Promoting practices based on best available evidence for WSMD provision worldwide should be prioritized.
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Affiliation(s)
| | - Claudia von Zweck
- World Federation of Occupational Therapists, 1211 Geneva, Switzerland
| | - Ritchard Ledgerd
- World Federation of Occupational Therapists, 1211 Geneva, Switzerland
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Field DA, Livingstone RW. Parents' and Therapists' Satisfaction with Four Early Childhood Power Mobility Devices. Can J Occup Ther 2022; 89:364-375. [PMID: 35656731 PMCID: PMC9709530 DOI: 10.1177/00084174221098879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Little is known about satisfaction with power mobility devices used by young children. Purpose. Parents' and therapists' satisfaction with four early childhood power mobility devices were examined. Method. A two-phased study, comprising Trial Phase cross-sectional design and Loan Phase one-group pretest-posttest design. Parents and therapists of children 9 months to 6 years with mobility limitations completed the Quebec User Evaluation of Satisfaction of Assistive Technology 2.0 Device Subscale (QUEST8) plus an additional device Aesthetics rating. Findings. Seventy-four parents and 42 therapists from 18 child development and rehabilitation centres participated. Parent and therapist median QUEST8 and Aesthetics scores varied across devices when trialled and over the six-month loan. Favourable median ratings had no statistically significant differences between parents and therapists. Parent ratings decreased statistically over loan period although therapists' ratings did not. Device dimensions, safety, and aesthetics were highly rated. Implications. Similarities and differences exist among parent and therapist ratings.
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Affiliation(s)
- Debra A Field
- Debra Field, Clinical Associate Professor,
Department of Occupational Science & Occupational Therapy, University of
British Columbia, T325 - 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5.
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Ouellet B, Best KL, Wilson D, Miller WC. Exploring the Influence of a Community-Based Peer-Led Wheelchair Skills Training on Satisfaction with Participation in Children and Adolescents with Cerebral Palsy and Spina Bifida: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11908. [PMID: 36231211 PMCID: PMC9564843 DOI: 10.3390/ijerph191911908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Peer-led approaches improve satisfaction with participation, wheelchair skills and wheelchair use self-efficacy in adults, but the evidence is limited in children. This pilot study aimed to explore the influence of community-based, peer-led, group wheelchair training program (i.e., Seating To Go) on satisfaction with participation (primary outcome), wheelchair skills, and wheelchair use self-efficacy in children and adolescents with cerebral palsy and spina bifida. METHODS A single group pre-post design was used. Invitations were shared online and diffused by clinicians and advocacy and provider groups to recruit a convenience sample of eight pediatric wheelchair users. Participants completed the Seating To Go program in groups that were facilitated by adult wheelchair users. Satisfaction with participation (Wheelchair Outcome Measure-Young People), wheelchair skills (Wheelchair Skills Test), wheelchair use self-efficacy (Wheelchair Use Confidence Scale), and perceived wheelchair skills capacity (Wheelchair Skills Test Questionnaire; proxy rating: parents) were evaluated before and after the Seating To Go program. Descriptive statistics and nonparametric longitudinal data analysis were conducted to explore changes in all outcomes from baseline to post-intervention. RESULTS Pediatric wheelchair users (ranging in age from 5 to 15 years) and their parents reported statistically significant improvements in satisfaction with participation. The improvements in wheelchair skills and wheelchair confidence were also statistically significant, but not the parents' perception of their children's wheelchair skills. CONCLUSIONS A community-based peer-led approach to wheelchair skills training seems promising for improving wheelchair outcomes in pediatric wheelchair users. Further controlled studies with larger samples are warranted.
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Affiliation(s)
- Béatrice Ouellet
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Krista L. Best
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Deb Wilson
- Seating To Go—Geneva Healthcare, Hamilton 3204, New Zealand
| | - William C. Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- G.F. Strong Rehabilitation Centre—Rehabilitation Research Lab, Vancouver, BC V5Z 2G9, Canada
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Giesbrecht E, Faieta J, Best K, Routhier F, Miller WC, Laberge M. Impact of the TEAM Wheels eHealth manual wheelchair training program: Study protocol for a randomized controlled trial. PLoS One 2021; 16:e0258509. [PMID: 34644350 PMCID: PMC8513836 DOI: 10.1371/journal.pone.0258509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/20/2021] [Indexed: 12/05/2022] Open
Abstract
Background Variable, and typically inadequate, delivery of skills training following manual wheelchair (MWC) provision has a detrimental impact on user mobility and participation. Traditional in-person delivery of training by rehabilitation therapists has diminished due to cost, travel time, and most recently social distancing restrictions due to COVID-19. Effective alternative training approaches include eHealth home training applications and interactive peer-led training using experienced and proficient MWC users. An innovative TEAM Wheels program integrates app-based self-training and teleconference peer-led training using a computer tablet platform. Objective This protocol outlines implementation and evaluation of the TEAM Wheels training program in a randomized control trial using a wait-list control group. Setting The study will be implemented in a community setting in three Canadian cities. Participants Individuals ≥ 18 years of age within one year of transitioning to use of a MWC. Intervention Using a computer tablet, participants engage in three peer-led teleconference training sessions and 75–150 minutes of weekly practice using a video-based training application over 4 weeks. Peer trainers individualize the participants’ training plans and monitor their tablet-based training activity online. Control group participants also receive the intervention following a 1-month wait-list period and data collection. Measurements Outcomes assessing participation; skill capacity and performance; self-efficacy; mobility; and quality of life will be measured at baseline and post-treatment, and at 6-month follow-up for the treatment group. Impact statement We anticipate that TEAM Wheels will be successfully carried out at all sites and participants will demonstrate statistically significant improvement in the outcome measures compared with the control group.
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Affiliation(s)
- Ed Giesbrecht
- Department of Occupational Therapy, University of Manitoba, Winnipeg, Manitoba, Canada
- * E-mail:
| | - Julie Faieta
- Department of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Krista Best
- Department of Rehabilitation, Université Laval, Quebec City, Quebec, Canada
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec City, Quebec, Canada
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec, Canada
| | - William C. Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maude Laberge
- Département d’opérations et systèmes de décision, Université Laval, Quebec City, Quebec, Canada
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Understanding the Global Challenges to Accessing Appropriate Wheelchairs: Position Paper. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073338. [PMID: 33804868 PMCID: PMC8036353 DOI: 10.3390/ijerph18073338] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/18/2021] [Indexed: 11/17/2022]
Abstract
Introduction: Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. Approach: To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. Conclusion: The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us.
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Tracking and Characterization of Spinal Cord-Injured Patients by Means of RGB-D Sensors. SENSORS 2020; 20:s20216273. [PMID: 33158050 PMCID: PMC7663008 DOI: 10.3390/s20216273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 11/25/2022]
Abstract
In physical rehabilitation, motion capture solutions are well-known but not as widespread as they could be. The main limit to their diffusion is not related to cost or usability but to the fact that the data generated when tracking a person must be elaborated according to the specific context and aim. This paper proposes a solution including customized motion capture and data elaboration with the aim of supporting medical personnel in the assessment of spinal cord-injured (SCI) patients using a wheelchair. The configuration of the full-body motion capturing system is based on an asymmetric 3 Microsoft Kinect v2 sensor layout that provides a path of up to 6 m, which is required to properly track the wheelchair. Data elaboration is focused on the automatic recognition of the pushing cycles and on plotting any kinematic parameter that may be interesting in the assessment. Five movements have been considered to evaluate the wheelchair propulsion: the humeral elevation, the horizontal abduction of the humerus, the humeral rotation, the elbow flexion and the trunk extension along the sagittal plane. More than 60 volunteers with a spinal cord injury were enrolled for testing the solution. To evaluate the reliability of the data computed with SCI APPlication (APP) for the pushing cycle analysis, the patients were subdivided in four groups according to the level of the spinal cord injury (i.e., high paraplegia, low paraplegia, C7 tetraplegia and C6 tetraplegia). For each group, the average value and the standard deviation were computed and a comparison with similar acquisitions performed with a high-end solution is shown. The measurements computed by the SCI-APP show a good reliability for analyzing the movements of SCI patients’ propulsion wheelchair.
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Field DA, Miller WC. The Wheelchair Outcome Measure for Young People (WhOM-YP): modification and metrics for children and youth with mobility limitations. Disabil Rehabil Assist Technol 2020; 17:192-200. [PMID: 32536333 DOI: 10.1080/17483107.2020.1774811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Wheelchairs enhance children's mobility and participation in daily life, yet few participation measures are used to evaluate wheeled mobility interventions. The Wheelchair Outcome Measure for Young People (WhOM-YP) addresses this gap, evaluating importance of and satisfaction with client-identified participation outcomes inside and outside home for children aged 18 years and younger who need wheeled mobility interventions.Methods: Mixed methods study using semi-structured interviews with nine experienced therapists and nine wheelchair users (11-18 years) evaluated the appropriateness of adult Wheelchair Outcome Measure for younger ages. Four key informants reviewed findings and offered additional modifications. Two-week test-retest reliability and construct validity were examined with children and parents; Spearman correlations were estimated among child and parent scores and Mann-Whitney U Test analyzed difference in outside home participation mean weighted satisfaction scores between new and experienced power mobility users.Results: Modifications included age-appropriate changes, adding visuals to rating scales, and separate child and adult ratings dependent on child's age and abilities. Two week test-retest reliability estimates were as hypothesized; WhOM-YP mean satisfaction and mean weighted satisfaction summary scores for inside and outside home participation demonstrated intraclass correlation coefficient (ICC(2,1)) > 0.70. Discrimination between groups was as predicted; mean weighted satisfaction outside participation difference (p < 0.0001) demonstrated between experienced (median 74.2, n = 22) and inexperienced (median 32.9, n = 10) users. Revised format was conducive for individuals with diverse needs; images helped those with emerging numeracy and literacy skills, and proxy rating could be accommodated.Conclusion: Evidence supports WhOM-YP reliability and validity for measuring participation outcomes in daily life for young people.Implications for rehabilitationThe WhOM-YP offers a client-centred, individualized, participation focused outcome measure for young people who use wheeled mobility. Therapists, children, youth and parents were consulted throughout its development to ensure that the measure is relevant to their needs.The WhOM-YP can be used with children 18 years-of-age and younger. Consistent ratings over a two-week period of time (when no change was expected) were stronger for those 8 years and older. Children as young as 5 years of age can use this measure to share their views but caution is needed in score interpretation for those below 8 years-of-age.The option of parent-report to augment or provide a proxy measure increases WhOM-YP usefulness in rating individualized participation outcomes for a more age and ability diverse population.This is the first study to examine reliability and validity evidence in regards to using the Wheelchair Outcome Measure for Young People (WhOM-YP) with children who have mobility limitations and their parents.
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Affiliation(s)
- Debra A Field
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Sunny Hill Health Centre for Children, Vancouver, Canada
| | - William C Miller
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.,International Collaboration on Regenerative Discoveries, University of British Columbia, and the Vancouver Coastal Health Research Institute, Vancouver, Canada
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Bray N, Spencer LH, Tuersley L, Edwards RT. Development of the MobQoL patient reported outcome measure for mobility-related quality of life. Disabil Rehabil 2020; 43:3395-3404. [PMID: 32208059 DOI: 10.1080/09638288.2020.1741701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE To examine how mobility and mobility impairment affect quality of life; to develop a descriptive system (i.e., questions and answers) for a novel mobility-related quality of life outcome measure. MATERIALS AND METHODS Data were collected through semi-structured interviews. Participants were recruited predominantly from NHS posture and mobility services. Qualitative framework analysis was used to analyse data. In the first stage of analysis the key dimensions of mobility-related quality of life were defined, and in the second stage a novel descriptive system was developed from the identified dimensions. RESULTS Forty-six interviews were conducted with 37 participants (aged 20-94 years). Participants had a wide range of conditions and disabilities which impaired their mobility, including cerebral palsy, multiple sclerosis, and arthritis. Eleven dimensions of mobility-related quality of life were identified: accessibility, safety, relationships, social inclusion, participation, personal care, pain and discomfort, independence, energy, self-esteem, and mental-wellbeing. A new outcome measure, known as MobQoL, was developed. CONCLUSIONS Mobility and mobility impairment can have significant impacts on quality of life. MobQoL is the first outcome measure designed specifically to measure the impact of mobility on quality of life, and therefore has utility in research and practice to measure patient outcomes related to rehabilitation.Implications for RehabilitationMobility impairment affects many different aspects of health and quality of life.The impact of mobility impairment on quality of life is related to processes of physical, emotional, and behavioural adaptation.MobQoL is the first patient-reported outcome measure designed specifically to measure the quality of life impacts of mobility impairment and assistive mobility technology use.MobQoL has potential to be used by rehabilitation professionals to measure and monitor mobility-related quality of life as part of routine clinical practice.
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Affiliation(s)
- Nathan Bray
- School of Health Sciences, Bangor University, Bangor, UK.,Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Llinos Haf Spencer
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Lorna Tuersley
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
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Lo L, Hebert D, Colquhoun H. Measuring practice gaps in the delivery of evidence-based seating assessments: a retrospective chart review. Disabil Rehabil Assist Technol 2019; 16:255-261. [DOI: 10.1080/17483107.2019.1672814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Lorna Lo
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Debbie Hebert
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Rocket Family Upper Extremity Clinic, Toronto Rehab, Toronto, Ontario, Canada
| | - Heather Colquhoun
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
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Abstract
PURPOSE Children who use manual wheelchairs encounter pain and injury risks to the upper body. Current literature does not describe how propulsion pattern and physiotherapeutic training methodologies impact response to treatment. METHODS This study assesses the effect of community-based intensive physical and occupational therapy on functional outcomes over a 7-week period in pediatric manual wheelchair users. RESULTS Key results include significant joint and musculotendon kinematic differences at the shoulder, improved speed and propulsion effectiveness, and changed propulsion pattern. CONCLUSIONS Statistics also revealed that propulsion pattern was a predictor of response to therapy, as was weekly therapeutic duration, wheelchair-specific focus by the therapists, and stretching.
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Gowran RJ, Goldberg M, Comanescu G, Ungureanu C, Garcia FDS, Xavier CA, Pearlman J. Developing country-specific wheelchair service provision strategic plans for Romania and the Philippines. Disabil Rehabil Assist Technol 2019; 14:612-627. [PMID: 30822183 DOI: 10.1080/17483107.2018.1539131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background: Achieving appropriate wheelchair provision at a national level is complex, requiring regulations, funding and policies established through governments. Understanding wheelchair provision within different countries is key. This paper describes the process used to support the development of wheelchair service strategic plans in Romania and the Philippines. It considers the influences, meaning, challenges and developments when producing strategic priorities within two different contexts. Methods: The International Society of Wheelchair Professionals (ISWP) sponsored affiliates Motivation Foundation Romania and the Philippine Society of Wheelchair Philippine Society of Wheelchair Professionals (PSWP), to conduct organizational ethnographic mixed method stakeholder centred studies, to develop robust strategic plans. An affiliate coordinator for wheelchair provision in less resourced settings supported this process. Results: Diversity between the two-affiliate sites was evident, influencing value placed within both societies towards equality and participation. Common components to address included: advocacy; wheelchair service infrastructure; capacity building; education; training and research. Research process facilitation supported by affiliate coordinator is important. Conclusion: Understanding contextual dimensions, which sharp a countries wheelchair service, is essential. Member states should take action by conducting in-country wheelchair sector analysis, to create wheelchair provision strategies for sustainable development, to meet personal posture and mobility needs, primary for daily living, as a basic human right. Implications for rehabilitation Understanding the complexity of providing appropriate wheelchairs within different countries is essential to meet the diverse needs of citizens. Conducting situational analysis of the wheelchair sector involving key stakeholders in the process is important to understand different perspectives and develop strategic priorities towards sustainable development. Producing context specific wheelchair sector reports and strategic plans strengthens the evidence base when informing governments regarding the importance of developing sustainable wheelchair provision infrastructures. The affiliate coordinator role is important to support affiliates to produce robust documentation that clearly and objectively outlines the wheelchair sector issues and plans, to provide solutions.
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Affiliation(s)
- Rosemary Joan Gowran
- a School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick , Limerick , Ireland.,b Occupational Therapy, School of Health and Sport Science, University of Sunshine Coast , Queensland , Australia
| | - Mary Goldberg
- c Department of Rehabilitation Science & Technology , University of Pittsburgh , Pittsburgh , PA , USA
| | | | | | | | - Cheryl Ann Xavier
- e Philippine Society of Wheelchair Professionals, Inc , Manila , Philippines
| | - Jon Pearlman
- c Department of Rehabilitation Science & Technology , University of Pittsburgh , Pittsburgh , PA , USA
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Rammer J, Slavens B, Krzak J, Winters J, Riedel S, Harris G. Assessment of a markerless motion analysis system for manual wheelchair application. J Neuroeng Rehabil 2018; 15:96. [PMID: 30400917 PMCID: PMC6219189 DOI: 10.1186/s12984-018-0444-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Wheelchair biomechanics research advances accessibility and clinical care for manual wheelchair users. Standardized outcome assessments are vital tools for tracking progress, but there is a strong need for more quantitative methods. A system offering kinematic, quantitative detection, with the ease of use of a standardized outcome assessment, would be optimal for repeated, longitudinal assessment of manual wheelchair users' therapeutic progress, but has yet to be offered. RESULTS This work evaluates a markerless motion analysis system for manual wheelchair mobility in clinical, community, and home settings. This system includes Microsoft® Kinect® 2.0 sensors, OpenSim musculoskeletal modeling, and an automated detection, processing, and training interface. The system is designed to be cost-effective, easily used by caregivers, and capable of detecting key kinematic metrics involved in manual wheelchair propulsion. The primary technical advancements in this research are the software components necessary to detect and process the upper extremity kinematics during manual wheelchair propulsion, along with integration of the components into a complete system. The study defines and evaluates an adaptable systems methodology for processing kinematic data using motion capture technology and open-source musculoskeletal models to assess wheelchair propulsion pattern and biomechanics, and characterizes its accuracy, sensitivity and repeatability. Inter-trial repeatability of spatiotemporal parameters, joint range of motion, and musculotendon excursion were all found to be significantly correlated (p < 0.05). CONCLUSIONS The system is recommended for use in clinical settings for frequent wheelchair propulsion assessment, provided the limitations in precision are considered. The motion capture-model software bridge methodology could be applied in the future to any motion-capture system or specific application, broadening access to detailed kinematics while reducing assessment time and cost.
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Affiliation(s)
- Jacob Rammer
- Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University, Olin Engineering Suite 323, Milwaukee, WI, 53201-1881, USA. .,Department of Biomedical Engineering, Marquette University, Olin Engineering Suite 323, Milwaukee, WI, 53201-1881, USA. .,Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53201-1881, USA.
| | - Brooke Slavens
- University of Wisconsin-Milwaukee, 2400 E Hartford Ave, Rm. 983, Milwaukee, WI, 53211, USA
| | - Joseph Krzak
- Shriners Hospitals for Children, Chicago, IL, USA.,Midwestern University, Physical Therapy Program, 555 31st St., Alumni Hall 340C, Downers Grove, IL, 60515, USA
| | - Jack Winters
- Marquette University, Biomedical Engineering, Milwaukee, WI, 53201-1881, USA
| | - Susan Riedel
- Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University, Olin Engineering Suite 323, Milwaukee, WI, 53201-1881, USA.,Department of Biomedical Engineering, Marquette University, Olin Engineering Suite 323, Milwaukee, WI, 53201-1881, USA.,Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53201-1881, USA
| | - Gerald Harris
- Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University, Olin Engineering Suite 323, Milwaukee, WI, 53201-1881, USA.,Department of Biomedical Engineering, Marquette University, Olin Engineering Suite 323, Milwaukee, WI, 53201-1881, USA.,Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53201-1881, USA.,Shriners Hospitals for Children, Chicago, IL, USA
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Field DA, Livingstone RW. Power mobility skill progression for children and adolescents: a systematic review of measures and their clinical application. Dev Med Child Neurol 2018. [PMID: 29542110 DOI: 10.1111/dmcn.13709] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIM To identify and critically appraise standardized measures of power mobility skill used with children (18y or younger) with mobility limitations and explore the measures' application for 'exploratory', 'operational', and 'functional' learners. METHOD Five electronic databases were searched along with hand-searching for peer-reviewed articles published in English to July 2017 (updated 31st August 2017). Key terms included power(ed) mobility, power(ed) wheelchair, and database-specific terms. Studies included at least one child with a disability, and a detailed description of the measure of power mobility skill. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed with inclusion criteria set a priori. Two reviewers independently screened titles, abstracts, and full-text articles. RESULTS Of 96 titles, 24 articles met inclusion criteria, describing nine measures of power mobility skill. The Wheelchair Skills Checklist, the Powered Mobility Program (PMP), and the Power Mobility Training Tool were augmented by three adaptations of the PMP. Two additional measures were further developed to create a third, the Assessment of Learning Powered mobility use. Validity evidence related primarily to content development while reliability evidence was reported on only two measures. INTERPRETATION All measures are in the initial stages of development and testing. Research investigating the measures' appropriateness for different types of learners and environments is warranted. WHAT THIS PAPER ADDS There are four distinct measures of paediatric power mobility skill: three task-based, one process-based. Power mobility learners may be divided into three groups: exploratory, operational, and functional. Application of measures of power mobility skill differs for these three groups.
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Affiliation(s)
- Debra A Field
- Sunny Hill Health Centre for Children, Vancouver, BC, Canada
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Moye J, Boyle P. Occupational therapists' experiences of community seating provision for patients following a stroke. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.5.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jennifer Moye
- Occupational Therapy Lead, Community Neuro Rehabilitation Team, First Community Health and Care, Oxted Therapies Unit, Oxted, UK
| | - Paul Boyle
- Senior Lecturer in Occupational Therapy, School of Health Sciences, University of Brighton, Eastbourne, UK
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Understanding the association between pressure ulcers and sitting in adults what does it mean for me and my carers? Seating guidelines for people, carers and health & social care professionals. J Tissue Viability 2018; 27:59-73. [DOI: 10.1016/j.jtv.2017.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 09/04/2017] [Indexed: 11/17/2022]
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McSweeney E, Gowran RJ. Wheelchair service provision education and training in low and lower middle income countries: a scoping review. Disabil Rehabil Assist Technol 2017; 14:33-45. [PMID: 29092684 DOI: 10.1080/17483107.2017.1392621] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Improving access to education and training for those providing wheelchair and seating assistive technology to meet personal posture and mobility requirements, as a basic human right, is a priority. This review considers education and training available to personnel within low and lower middle income countries (LLMIC), to ascertain where gaps in knowledge exist and identify human resource education priorities. METHOD A scoping review, mapping out existing scientific and grey literature within the field between 1993 and 2017 was conducted. The search strategy included use of online databases, manual analogue searches and key stakeholder informant advice. A content analysis process was applied to organize the literature retrieved and extract key themes. RESULTS Education and training in LLMIC appears ad hoc and limited, however, there is growing recognition as to its importance, notably by the World Health Organization and nongovernmental organizations, delivering education initiatives to a number of countries, along with the development of a credentialing test. Inconsistency exists regarding personnel responsible for wheelchair provision, with no specific professional clearly recognized to oversee the system within many LLMIC. CONCLUSIONS Education and training is required for all stakeholders involved in wheelchair provision. Advocating for programme development to enhance personnel skills, build capacity and ensure best practice is a priority. Pilot sites, delivering and credentialing appropriate wheelchair provision education and training within context should be considered. Measuring outcomes and transferable skills should be part of education programme delivery structures. Considering a new discipline responsible for oversight of wheelchair provision should be investigated. Implications for rehabilitation Education and training is an essential step in the wheelchair provision process in the bid to obtain an appropriate wheelchair via appropriate provision services. However, it is more than education and training; its a human rights issue. Mandatory education and training needs to be a requirement for all stakeholders involved in wheelchair provision. Key wheelchair personnel need to establish their central role in this arena. The study raises awareness as to the importance of working with governments to commit to building sustainable wheelchair provision infrastructures.
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Affiliation(s)
- Elizabeth McSweeney
- a Department of Clinical Therapies , Faculty of Education and Health Sciences, University of Limerick , Ireland
| | - Rosemary Joan Gowran
- a Department of Clinical Therapies , Faculty of Education and Health Sciences, University of Limerick , Ireland.,b School of Health & Sport Sciences , Faculty of Science, Health, Education & Engineering, University of the Sunshine Coast , Australia
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Stephens M, Bartley C, Betteridge R, Samuriwo R. Developing the tissue viability seating guidelines. J Tissue Viability 2017; 27:74-79. [PMID: 28919021 DOI: 10.1016/j.jtv.2017.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 09/01/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Costs for the prevention and management of pressure ulcers have increased significantly with limited published advice from health and social care organisations on seating and preventing pressure ulcers. At the request of the UK Tissue Viability Society the aim of the publication was to develop a practical guide for people, carers and health and social care professionals on how the research and evidence base on pressure ulcer prevention and management can be applied to those who remain seated for extended periods of time. METHODS AND FINDINGS The evidence base informing the guidelines was obtained by applying a triangulation of methods: a literature review, listening event and stakeholder group consultation. The purpose was to engage users and carers, academics, clinicians, inspectorate and charities, with an interest in seating, positioning and pressure management to: gather views, feedback, stories, and evidence of the current practices in the field to create a greater awareness of the issue. CONCLUSION The new guidelines are inclusive of all people with short and long-term mobility issues to include all population groups. The document includes evidence on where pressure ulcers develop when seated, risk factors, best possible seated position and what seat adjustments are required, the ideal seating assessment, interventions, self-help suggestions and key seating outcomes. The updated TVS CPGs have been informed by the best available evidence, the insights and wisdom of experts, stakeholders and people who spend extended periods of time sitting.
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Affiliation(s)
| | - Carol Bartley
- School of Health Sciences, University of Salford, UK
| | | | - Ray Samuriwo
- School of Healthcare Sciences, Cardiff University, UK; Wales Centre for Evidence Based Care, Cardiff University, UK; Cardiff Institute for Tissue Engineering and Repair (CITER), Cardiff University, UK
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Kitajima E, Moriuchi T, Iso N, Sagari A, Kikuchi Y, Higashi T. Actual use of and satisfaction associated with rollators and "shopping carts" among frail elderly Japanese people using day-service facilities. Disabil Rehabil Assist Technol 2016; 12:519-525. [PMID: 27049353 DOI: 10.3109/17483107.2016.1159738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose This study aimed at clarifying the actual use of and satisfaction with rollators and "shopping carts" (wheeled walkers with storage) among frail elderly people, who were certified by a long-term care insurance system as users of facilities that provide day-service nursing care and rehabilitation. Methods We identified 1247 frail elderly people who used day-service facilities, and evaluated their actual use of, and satisfaction with, rollators and shopping carts. Results Forty-four (3.5%) individuals used rollators, and 53 (4.3%) used shopping carts. The shopping cart group contained more individuals who were certified as care level 1 (26.4%), than the rollator group (20.5%), and 52.8% of the shopping cart group was certified as care levels 1-3. The scores for "repairs and services" and "follow-up" from the Quebec User Evaluation of Satisfaction with assistive Technology second version (QUEST 2.0) survey were significantly higher in the rollator group than in the shopping cart group. Conclusions The QUEST 2.0 scores revealed that shopping cart users exhibit insufficient "repairs and services" and "follow-up" scores. As frail elderly people with poor care status accounted for >50% of the shopping cart group, these individuals urgently need walking aids that are tailored to their care status. Implications for Rehabilitation We conclude that walking aid fitting must be tailored to each persons care status, and suggest that a system should be established to allow occupational or physical therapists to provide this fitting Moreover, our analysis of the QUEST2.0 service scores revealed that repairs, services, and follow-up are insufficient to meet the needs of shopping cart users.
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Affiliation(s)
- Eiji Kitajima
- a Unit of Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,b Center for Industry , University and Government Cooperation, Nagasaki University , Nagasaki , Japan
| | - Takefumi Moriuchi
- a Unit of Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,c Medical Corporation , Tojinkai Miharadai Hospital , Nagasaki , Japan
| | - Naoki Iso
- a Unit of Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,c Medical Corporation , Tojinkai Miharadai Hospital , Nagasaki , Japan
| | - Akira Sagari
- a Unit of Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,d Japanese Red Cross Society , Nagasaki Genbaku Hospital , Nagasaki , Japan
| | - Yasuyuki Kikuchi
- e Unit of Physical and Occupational Therapy , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Toshio Higashi
- a Unit of Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
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Baum C, Cox D. Special Issue: Occupational Performance Measures for Health and Wellbeing — Research and Practice. Br J Occup Ther 2014. [DOI: 10.4276/030802214x13916969446912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Carolyn Baum
- Guest editor and member of BJOT's International Advisory Board; Elias Michael Director of the Program in Occupational Therapy and Professor of Occupational Therapy and Neurology, Washington University School of Medicine, St Louis, MO, United States
| | - Diane Cox
- Guest editor and Chair BJOT's Editorial Board; Director of Research and Head of the Graduate School, Professor of Occupational Therapy, University of Cumbria, Lancaster
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