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Motl RW, Foley FW, Picone MA, Lipton ML, Izzetoglu M, Hernandez ME, Holtzer R. Initial validation of the university of Alabama Birmingham study of aging life-space assessment in older adults with multiple sclerosis. Mult Scler Relat Disord 2024; 82:105354. [PMID: 38134603 PMCID: PMC10894523 DOI: 10.1016/j.msard.2023.105354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/21/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Older adults with multiple sclerosis (OAMS) have declines in walking and physical performance that may erode community mobility defined as the spatial extent of mobility in one's daily life and environment. OBJECTIVE This study provided the first application and validation of the University of Alabama Birmingham Study of Aging Life-Space Assessment (UAB LSA) as a measure of community mobility in OAMS. METHODS The sample included 97 OAMS and 108 healthy controls (HCs) who completed baseline assessments as part of an ongoing, longitudinal study. The primary assessments included the UAB LSA and timed 25-foot walk (T25FW), short physical performance battery (SPPB), global health score (GHS), and geriatric depression scale (GDS) in both OAMS and HCs, and patient determined disease steps (PDDS) scale in only OAMS. RESULTS OAMS had significantly lower UAB LSA scores than HCs (p < .001). UAB LSA scores had strong correlations with T25FW(rs = -.641) and SPPB(rs = 0.507) in OAMS, and moderate correlations in HCs (rs = -.300 & rs = 0.384). The correlations between UAB LSA and GHS and GDS scores were significant, but small in OAMS (rs = -.239 & rs = -.231), and not statistically significant in HCs (rs = -.009 & rs = -.166). There was a strong correlation between UAB LSA and PDDS scores in the OAMS sample (rs = -.605). CONCLUSION We provided initial evidence for UAB LSA scores as a measure of community mobility in OAMS.
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Affiliation(s)
- Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States
| | - Frederick W Foley
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States; Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, United States
| | - Mary Ann Picone
- Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, United States
| | - Michael L Lipton
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States; Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Meltem Izzetoglu
- Villanova University, Electrical and Computer Engineering, Villanova, PA, United States
| | - Manuel E Hernandez
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States; Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, Urbana, IL, United States
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States.
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Chippendale T, Albert SM, Mahmood A. Efficacy of the Stroll Safe Outdoor Fall Prevention Program: A Randomized Controlled Trial. Gerontologist 2023; 63:1556-1565. [PMID: 36148513 DOI: 10.1093/geront/gnac145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Outdoor falls can negatively affect the independence and well-being of community-dwelling older adults. Although there is some overlap, there are also differences in risk factors for indoor and outdoor falls. There are no existing community-based fall prevention programs that specifically target outdoor fall prevention. To fill this gap, the Stroll Safe program was developed. RESEARCH DESIGN AND METHODS A cluster-randomized controlled trial design was used with randomization at the site level. Participants (N = 86) were aged 60 and older, with a history of an outdoor fall or who had a fear of falling outdoors. Eight naturally occurring retirement community program sites were randomly assigned to the treatment or wait list control group. Outcome measures included the Outdoor Falls Questionnaire, the Falls Behavioral Scale for the Older Person, and the Falls Efficacy Scale-International to examine knowledge of risks, safe strategy use, protective behaviors, and fear of falling. An Analysis of Covariance (ANCOVA) was used to compare change scores between groups with covariates included for any initial differences between groups. A linear mixed model was also conducted to account for any clustering effects. RESULTS Significant differences (ps < .05) were found between groups for knowledge of outdoor fall risks and safe strategy use. Effect sizes were large (Cohen's d = 1.2-1.9). Results were retained at 6-week follow-up. DISCUSSION AND IMPLICATIONS Stroll Safe is effective in improving knowledge of outdoor fall risks and increasing safe strategy use for community mobility. Stroll Safe fills a gap in outdoor fall prevention programs. Clinical Trials Registration Number: NCT03624777.
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Affiliation(s)
- Tracy Chippendale
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York City, New York, USA
| | - Steven M Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Atiya Mahmood
- Gerontology Department, Simon Fraser University, Vancouver, British Columbia, Canada
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Choi C, Shing P, Wang S, Huszti E. Measuring vibration and shock in power wheelchairs for clinical application. Assist Technol 2023:1-8. [PMID: 37463511 DOI: 10.1080/10400435.2023.2230485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/20/2023] Open
Abstract
Research evidence demonstrates the negative effects of Whole-Body Vibration (WBV) and correlation between exposure to WBV and detriment to health. ISO Standard 2631-1 (1997) is the accepted standard for human exposure to WBV in vehicle vibration, and provides vibration guidelines for health and comfort. These standards have not been applied to power wheelchairs (PWC), and no clinical tool exists that measures vibration levels during live power wheelchair driving. This study measures WBV and shock levels during PWC driving, considering the impact of terrains, base configurations, and seat cushions. A sensor tag accelerometer was used to measure vibration and shock in three different PWC configurations driven over seven different terrains. Data was collected for two runs per wheelchair, per terrain type, per cushion type. Differences were significant (p < .001) for overall mean and median peak vibration compared across the seven terrains, and for overall mean vibration for basic and enhanced cushions. Differences were also noted in mean and peak vibration in the three different base configurations (p = .0052). Results were compared with ISO 2631-1 guidelines. Mechanical shock on certain terrains created peak vibration levels with likely health risk. Results from this study can inform PWC prescription process.
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Affiliation(s)
- Cathy Choi
- Seating Clinic, Hennick Bridgepoint Hospital - Sinai Health, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Paula Shing
- Professional Practice, Hennick Bridgepoint Hospital - Sinai Health, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Stella Wang
- Biostatistics Research Unit, University Health Network (UHN), Toronto, Canada
| | - Ella Huszti
- Biostatistics Research Unit, University Health Network (UHN), Toronto, Canada
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4
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Fristedt S, Kammerlind AS, Fransson EI, Ernsth Bravell M. Physical functioning associated with life-space mobility in later life among men and women. BMC Geriatr 2022; 22:364. [PMID: 35473475 PMCID: PMC9040227 DOI: 10.1186/s12877-022-03065-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background Life-space mobility is defined as the ability to access different areas extending from the room where the person sleeps to places outside one’s hometown. Life-space mobility is vital to support performance of daily life activities and autonomous participation in social life. However, there is a dearth of research that investigates a wider range of physical functions and functioning in relation to life-space mobility rather than just single aspects. Thus, the purpose of the present study was to identify and describe several measures of physical functioning associated with life-space mobility among older men and women. Methods Data used in this study was derived from the OCTO 2 study, a population-based study of health, functioning and mobility among older persons (n = 312) in Sweden. Associations between Life-Space Assessment (LSA) total score and age, sex, Short Physical Performance Battery (SPPB), dizziness, lung function i.e. Peak Expiratory Flow (PEF), grip strength, self-rated vision and hearing were analysed through bivariate and multivariate regression models. Results The bivariate models showed that life-space mobility was significantly associated with sex, but also age, SPPB, PEF and grip strength in the total group as well as among men and women. In addition, hearing was significantly associated with life-space mobility among women. Those factors that were statistically significant in the bivariate models were further analysed in multivariable models for the total group, and for men and women separately. In these models, sex, grip strength and SPPB remained significantly associated with life-space mobility in the total group, as well as SPPB among both men and women. Conclusion Sex, physical function in terms of physical performance measured by SPPB (balance, gait speed and chair stand), and grip strength are associated with life-space mobility. Consequently, these factors need to be considered in assessments and interventions aiming to maintain mobility in old age.
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Affiliation(s)
- Sofi Fristedt
- School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden. .,Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, Sweden.
| | - Ann-Sofi Kammerlind
- Futurum, SE-551 85, Linköping, Region Jönköping County, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83, Linköping, Sweden
| | - Eleonor I Fransson
- School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden
| | - Marie Ernsth Bravell
- School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden
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Townley G, Brusilovskiy E, Klein L, McCormick B, Snethen G, Salzer MS. Community Mental Health Center Visits and Community Mobility of People with Serious Mental Illnesses: A Facilitator or Constraint? Community Ment Health J 2022; 58:420-428. [PMID: 33813724 DOI: 10.1007/s10597-021-00821-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/27/2021] [Indexed: 11/26/2022]
Abstract
Mental health services and interventions have increasingly focused on the importance of community participation and mobility for people with serious mental illnesses (SMI). This study examined the role that visits to community mental health centers (CMHCs) may play in increasing community mobility of people with SMI. Eighty-nine adults with SMI receiving services at three CMHCS were tracked with GPS-enabled phones over a 13-day period. Findings revealed that participants visited more destinations on days they went to a CMHC compared to days they did not. They also spent more time out of the home and traveled greater distances. Results suggest that the benefits of visiting a mental health center appear to go beyond treatment outcomes, but also point to the possibility that obligations, whether to a clinic appointment or possibly vocational, educational, leisure, faith, or social commitments, may be an important stepping stone to more mobility and intentional, sustained community participation.
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Affiliation(s)
- Greg Townley
- Department of Psychology, Portland State University, 317 Cramer Hall, 1721 SW Broadway, Portland, OR, 97207, USA.
| | - Eugene Brusilovskiy
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, USA
| | - Louis Klein
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, USA
| | - Bryan McCormick
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, USA
| | - Gretchen Snethen
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, USA
| | - Mark S Salzer
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, USA
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6
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Lawal O, Nwegbu C. Movement and risk perception: evidence from spatial analysis of mobile phone-based mobility during the COVID-19 lockdown, Nigeria. GeoJournal 2022; 87:1543-1558. [PMID: 33162644 PMCID: PMC7604547 DOI: 10.1007/s10708-020-10331-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 05/12/2023]
Abstract
The emergence of COVID-19 across the globe prompted many countries to institute total lockdown or other models of mobility restrictions to mitigate the spread of the disease. On March 29th, Nigeria instituted a nationwide lockdown. It is pertinent to understand the pattern created by this lockdown. This could offer insights into how people perceive the hazard and the level of compliance across the States in Nigeria. Mobile phone-based mobility data and the number of new cases from the beginning to the end of the lockdown were utilised. The study examines space-time trends across different place categories at the state level. Place categories witnessed mobility reduction as high as 56%, 57%, 65%, 75%, 38% for retail and recreation (RtRc), Grocery and Pharmacy (GrPh), Park, and Transport Hubs (Trst) respectively. Most States recorded mobility uptrend towards workplace, retail and recreational areas. Multiple correspondence analysis (MCA) identified two dimensions from the Space-time trends. The first dimension (D1) accounted for 66% of the variance. Examination of the Object Scores from the MCA showed that there are two classes-two risk perception groups. The pattern of mobility recorded shows that there is a variation in mobility restriction compliance across the States. The trend groupings identified captured an aspect of risk perception within each State. Thus, pointing to difference in levels of risk acceptance. With the level of misinformation currently being experienced worldwide, concerted efforts should be made on improving risk perception to prevent the re-emergence of the disease.
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Affiliation(s)
- Olanrewaju Lawal
- Department of Geography and Environmental Management, Faculty of Social Sciences, University of Port Harcourt, Port Harcourt, Nigeria
| | - Chidozie Nwegbu
- Department of Geography and Environmental Management, Faculty of Social Sciences, University of Port Harcourt, Port Harcourt, Nigeria
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Saha J, Mondal S, Chouhan P. Spatial-temporal variations in community mobility during lockdown, unlock, and the second wave of COVID-19 in India: A data-based analysis using Google's community mobility reports. Spat Spatiotemporal Epidemiol 2021; 39:100442. [PMID: 34774257 DOI: 10.1016/j.sste.2021.100442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/02/2021] [Accepted: 07/21/2021] [Indexed: 12/23/2022]
Abstract
COVID-19 has been altering all aspects of societal life including community mobility since December 2019. This study analyzes the spatial-temporal variations in human mobility patterns as the influence of COVID-19 during different periods at the state and union territory (UT) levels in India. From the spatial and temporal perspective, we find that change of mobility patterns and variations within states and UTs. The residential mobility has been increased because the mobility towards the home increased during the lockdown and the second wave but during the unlocking period reduced to some extent. There have spatial variations in mobility towards different places within states and UTs during the lockdown and second wave (lockdown to partial lockdown) but overall mobility towards different places like retail, parks, workplace, and transit stations have been reduced in India. During unlocking, mobility has been reduced all over the states and UTs in India but there have spatial-temporal variations within.
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Affiliation(s)
- Jay Saha
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India.
| | - Sabbir Mondal
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India.
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India.
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8
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Chan HY, Chen A, Ma W, Sze NN, Liu X. COVID-19, community response, public policy, and travel patterns: A tale of Hong Kong. Transp Policy (Oxf) 2021; 106:173-184. [PMID: 33846671 PMCID: PMC8026218 DOI: 10.1016/j.tranpol.2021.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/28/2021] [Accepted: 04/01/2021] [Indexed: 05/05/2023]
Abstract
The COVID-19 outbreak has necessitated a critical review of urban transportation and its role in society against the backdrop of an exogenous shock. This article extends the transportation literature regarding community responses to the COVID-19 pandemic and what lessons can be obtained from the case of Hong Kong in 2020. Individual behavior and collective responsibility are considered crucial to ensure both personal and community wellbeing in a pandemic context. Trends in government policies, the number of infectious cases, and community mobility are examined using multiple data sources. The mobility changes that occurred during the state of emergency are revealed by a time-series analysis of variables that measure both the epidemiological severity level and government stringency. The results demonstrate a high response capability of the local government, inhabitants, and communities. Communities in Hong Kong are found to have reacted faster than the implementation of health interventions, whereas the government policies effectively reduced the number of infection cases. The ways in which community action are vital to empower flexible and adaptive community responses are also explored. The results indicate that voluntary community involvement constitutes a necessary condition to help inform and reshape future transport policy and response strategies to mitigate the pandemic.
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Affiliation(s)
- Ho-Yin Chan
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Anthony Chen
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wei Ma
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Nang-Ngai Sze
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Xintao Liu
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Suri A, Rosso AL, VanSwearingen J, Coffman LM, Redfern MS, Brach JS, Sejdić E. Mobility of Older Adults: Gait Quality Measures are associated with Life-Space Assessment Scores. J Gerontol A Biol Sci Med Sci 2021; 76:e299-e306. [PMID: 34038537 DOI: 10.1093/gerona/glab151] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The relation of gait quality to real-life mobility among older adults is poorly understood. This study examined the association between gait quality, consisting of step variability, smoothness, regularity, symmetry and gait speed with the Life-Space Assessment (LSA). METHODS In community-dwelling older adults (N=232, age 77.5±6.6, 65% females), gait quality was derived from: a) an instrumented walkway: gait speed, variability and walk-ratio; and b) accelerometer: signal variability, smoothness, regularity, symmetry, and time-frequency spatiotemporal variables during 6-minute walk. In addition to collecting LSA scores, cognitive functioning, walking-confidence, and falls were recorded. Spearman correlations (speed as covariate) and Random Forest Regression were used to assess associations between gait quality and LSA, and Gaussian-mixture modeling (GMM) was used to cluster participants. RESULTS Spearman correlations of ρp=0.11 (signal amplitude variability ML), ρp=0.15, ρp=-0.13 (symmetry AP-V, ML-AP), ρp=0.16 (power V) and ρ=0.26 (speed), all p<0.05 and marginally related, ρp=-0.12 (regularity V), ρp=0.11 (smoothness AP) and ρp=-0.11 (step-time variability), p<0.1 were obtained. The cross-validated Random Forest model indicated good fit LSA prediction error of 17.77; gait and cognition were greater contributors than age and gender. GMM indicated two clusters. Group-1(N=189) had better gait quality than Group-2(N=43): greater smoothness AP (2.94±0.75 vs 2.30±0.71); greater similarity AP-V (0.58±0.13 vs 0.40±0.19); lower regularity V (0.83±0.08 vs 0.87±0.10); greater power V (1.86±0.18 vs 0.97±1.84); greater speed (1.09±0.16 vs 1.00±0.16 m/s); lower step time CoV (3.70±1.09 vs 5.09±2.37) and better LSA (76±18 vs 67±18), padjusted<0.004. CONCLUSIONS Gait quality measures taken in the clinic are associated with real-life mobility in the community.
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Affiliation(s)
- Anisha Suri
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh
| | - Andrea L Rosso
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh
| | - Jessie VanSwearingen
- Department of Physical Therapy, School of Rehabilitation Sciences, University of Pittsburgh, Pittsburgh
| | - Leslie M Coffman
- Department of Physical Therapy, School of Rehabilitation Sciences, University of Pittsburgh, Pittsburgh
| | - Mark S Redfern
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh
| | - Jennifer S Brach
- Department of Physical Therapy, School of Rehabilitation Sciences, University of Pittsburgh, Pittsburgh
| | - Ervin Sejdić
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh.,Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh
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Pfeiffer B, Brusilovskiy E, Hallock T, Salzer M, Davidson AP, Slugg L, Feeley C. Impact of COVID-19 on Community Participation and Mobility in Young Adults with Autism Spectrum Disorders. J Autism Dev Disord 2021. [PMID: 33988774 DOI: 10.1007/s10803-021-05054-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 01/31/2023]
Abstract
Transportation and mobility for community participation is difficult for persons with Autism Spectrum Disorders (ASD) under normal circumstances, but the impact of COVID-19 made access even more challenging. Researchers used a single-subject design to examine patterns of change from before and after the COVID-19 pandemic in community mobility and participation as measured by GPS and daily participation questionnaires. Participants were young adults with ASD between the ages of 21 and 27 (4 males, 2 females) who were enrolled in a subsequent study. Community mobility and participation decreased for all participants in both essential and non-essential activities. Additionally, the number of trips for participants decreased substantially in the after COVID-19 periods, as did the variability in modes of transit.
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Vindin P, Cordier R, Wilson NJ, Lee H. A Driver Training Program Intervention for Student Drivers with Autism Spectrum Disorder: A Multi-site Randomised Controlled Trial. J Autism Dev Disord 2021. [PMID: 33389302 DOI: 10.1007/s10803-020-04825-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
The purpose of this multi-site randomised controlled trial was to evaluate the effectiveness of a Driving Training Program, an intervention designed for student drivers with autism spectrum disorder (ASD). Participants were 72 student drivers with ASD (ages 16-31) who were randomly assigned to an intervention or control group. Student drivers received ten driving lessons with a professional driving instructor via a standardised driving route. The Driving Performance Checklist was used as the outcome measure to evaluate the driving performance of student drivers during on-road pre- and post-observational drives. Both groups showed an improvement in driving performance, however, the extent of improvement between groups was not significant. Findings showed promising intervention efficacy for training student drivers with ASD to drive.
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12
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Brusilovskiy E, Klein LA, Townley G, Snethen G, McCormick B, Hiremath SV, Salzer MS. Examining the relationship between community mobility and participation using GPS and self-report data. Soc Sci Med 2020; 265:113539. [PMID: 33234453 DOI: 10.1016/j.socscimed.2020.113539] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/20/2020] [Accepted: 11/16/2020] [Indexed: 01/17/2023]
Abstract
Higher levels of community mobility have been shown to be associated with better physical health, mental health, and quality of life. The ability to move about one's community is also expected to facilitate community participation, which is an aspect of health functioning. This study uses Global Positioning Systems (GPS) technology to track various dimensions of community mobility, such as destinations, time outside the home, and distance traveled, and examine the relationship between these variables and community participation in a sample of individuals with serious mental illnesses (SMI). This population was selected because they are known to have diminished health functioning in terms of their community participation, and the goal is to explore the extent to which mobility limitations may account for this. A total of 103 individuals with serious mental illnesses were recruited from mental health agencies and consented to having their mobility tracked using GPS for 13 days and answering questions about their community-based activities. Greater amount of participation was associated with having more destinations and spending more time out of the house, but not with traveling larger distances and having a greater activity space. None of the mobility variables were related to the number of important participation areas or sufficiency of participation. The findings support the hypothesis that greater mobility is related to more participation, although satisfaction with the degree to which one participates does not appear to be impacted, suggesting that other factors need to be accounted for. Health policymakers and providers should pay attention to community mobility as a factor that affects health outcomes such as participation, in individuals with serious mental illnesses, and other populations. In particular, attending to access to personal transport, public transportation, and other mobility options appears to be important, as well as interventions aimed at encouraging greater community mobility.
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Esmaeili V, Juneau A, Dyer JO, Lamontagne A, Kairy D, Bouyer L, Duclos C. Intense and unpredictable perturbations during gait training improve dynamic balance abilities in chronic hemiparetic individuals: a randomized controlled pilot trial. J Neuroeng Rehabil 2020; 17:79. [PMID: 32552850 PMCID: PMC7298869 DOI: 10.1186/s12984-020-00707-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/08/2020] [Indexed: 11/26/2022] Open
Abstract
Background Previous studies have assessed the effects of perturbation training on balance after stroke. However, the perturbations were either applied while standing or were small in amplitude during gait, which is not representative of the most common fall conditions. The perturbations were also combined with other challenges such as progressive increases in treadmill speed. Objective To determine the benefit of treadmill training with intense and unpredictable perturbations compared to treadmill walking-only training for dynamic balance and gait post-stroke. Methods Twenty-one individuals post-stroke with reduced dynamic balance abilities, with or without a history of fall and ability to walk on a treadmill without external support or a walking aid for at least 1 min were allocated to either an unpredictable gait perturbation (Perturb) group or a walking-only (NonPerturb) group through covariate adaptive randomization. Nine training sessions were conducted over 3 weeks. NonPerturb participants only walked on the treadmill but were offered perturbation training after the control intervention. Pre- and post-training evaluations included balance and gait abilities, maximal knee strength, balance confidence and community integration. Six-week phone follow-ups were conducted for balance confidence and community integration. Satisfaction with perturbation training was also assessed. Results With no baseline differences between groups (p > 0.075), perturbation training yielded large improvements in most variables in the Perturb (p < 0.05, Effect Size: ES > .46) group (n = 10) and the NonPerturb (p ≤ .089, ES > .45) group (n = 7 post-crossing), except for maximal strength (p > .23) in the NonPerturb group. Walking-only training in the NonPerturb group (n = 8, pre-crossing) mostly had no effect (p > .292, ES < .26), except on balance confidence (p = .063, ES = .46). The effects of the gait training were still present on balance confidence and community integration at follow-up. Satisfaction with the training program was high. Conclusion Intense and unpredictable gait perturbations have the potential to be an efficient component of training to improve balance abilities and community integration in individuals with chronic stroke. Retrospective registration: ClinicalTrials.gov. March 18th, 2020. Identifier: NCT04314830.
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Affiliation(s)
- Vahid Esmaeili
- School of Rehabilitation, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation-Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, in CIUSSS du Centre-Sud-de-l'ile-de-Montréal, Montreal, Canada
| | - Andréanne Juneau
- Centre for Interdisciplinary Research in Rehabilitation-Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, in CIUSSS du Centre-Sud-de-l'ile-de-Montréal, Montreal, Canada.,Lethbridge-Layton-MacKay Rehabilitation Centre, Montréal, Canada
| | - Joseph-Omer Dyer
- School of Rehabilitation, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada
| | - Anouk Lamontagne
- Centre for Interdisciplinary Research in Rehabilitation-Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, in CIUSSS du Centre-Sud-de-l'ile-de-Montréal, Montreal, Canada.,School of Physical and Occupationnal Therapy, McGill University, Montréal, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation-Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, in CIUSSS du Centre-Sud-de-l'ile-de-Montréal, Montreal, Canada
| | - Laurent Bouyer
- Department of Rehabilitation, Faculty of Medicine, Université Laval and Center for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, Quebec City, Canada
| | - Cyril Duclos
- School of Rehabilitation, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada. .,Centre for Interdisciplinary Research in Rehabilitation-Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, in CIUSSS du Centre-Sud-de-l'ile-de-Montréal, Montreal, Canada.
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14
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Hellinger N, Lipskaya-Velikovsky L, Weizman A, Ratzon NZ. Comparing executive functioning and clinical and sociodemographic characteristics of people with schizophrenia who hold a driver's license to those who do not. Can J Occup Ther 2019; 86:70-80. [PMID: 30991831 DOI: 10.1177/0008417419831399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND. Community engagement requires driving. However, there is paucity of research focusing on the potential to drive for people with schizophrenia. PURPOSE. This study aimed to characterize people with schizophrenia by comparing clinical signs, executive functions (EF), and sociodemographic aspects of those holding a driver's license to those without one. METHOD. This cross-sectional study used convenience sampling to select 60 ambulatory individuals to participate: 31 with a driver's license and 29 without one. They completed the Wisconsin Card Sorting Test (WCST) for evaluation of EF and the Positive and Negative Syndrome Scale (PANSS) for symptoms severity evaluation. Data were analyzed using multivariate analyses of covariance and logistic regression models. FINDINGS. Participants with a license had less severe negative symptoms and general psychopathology and better EF and sociodemographic aspects compared to those without a license. Logistic regression revealed significant odds ratios (OR) in general psychopathology (PANSS; OR = 0.963, p = .011) and in the WCST (OR = 0.504, p = .027). IMPLICATIONS. This study offers occupational therapists a data-driven perspective on evaluating potential fitness to drive to enable participation in daily life and well-being of people with schizophrenia.
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Patterson L, Mullen N, Stinchcombe A, Weaver B, Bédard M. Measuring the impact of driving status: The Centre for Research on Safe Driving-Impact of Driving Status on Quality of Life (CRSD-IDSQoL) tool. Can J Occup Ther 2019; 86:30-39. [PMID: 30786747 DOI: 10.1177/0008417418824980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND. Driving an automobile is often considered an activity of daily living and is crucial to quality of life for many individuals. Following driving cessation, quality of life may become compromised. PURPOSE. The Centre for Research on Safe Driving-Impact of Driving Status on Quality of Life (CRSD-IDSQoL) was designed to measure various elements of quality of life and how those elements are affected by driving status. METHOD. The CRSD-IDSQoL was cross-sectionally administered to a convenience sample of 114 individuals (mean age 65.8 years). Exploratory factor analysis was used to examine the factor structure. FINDINGS. The results supported three factors. Following adjustments for conceptual fit, Cronbach's alphas for the Community Mobility, Emotional, and Resources and Safety domains were .82, .84, and .74, respectively. Community Mobility was positively associated with distance driven per week. IMPLICATIONS. The CRSD-IDSQoL may be a useful tool to study quality-of-life impacts of driving cessation. Further evaluation of the tool is warranted.
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Hatchett PE, Mulroy SJ, Eberly VJ, Haubert LL, Requejo PS. Body mass index changes over 3 years and effect of obesity on community mobility for persons with chronic spinal cord injury. J Spinal Cord Med 2016; 39:421-32. [PMID: 26781601 PMCID: PMC5102291 DOI: 10.1080/10790268.2015.1133482] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To identify the prevalence of obesity in persons with chronic spinal cord injury (SCI), determine change in body mass index (BMI) over time, and identify impact of obesity on community mobility. DESIGN Prospective three year longitudinal study. SETTING Outpatient clinic of rehabilitation center. PARTICIPANTS Convenience sample of 222 persons with paraplegia between 2-20 years post SCI. OUTCOME MEASURES BMI at baseline and three years; community mobility (daily wheelchair propulsion distance and velocity, average number of daily transfers and depression raises). RESULTS Participants were 34.1 (27.3, 40.3) years of age and median duration of SCI was 8.7 (3.2, 15.1) years. The SCI adjusted BMI classification identified 44% of participants as obese. BMI increased over time with 13% moving into a higher weight category. Median change in BMI was 0.46 (-0.92, 1.50) kg/m (2) (z = -2.684, P = 0.007), and increased at a rate of 0.15 kg/m(2)/yr. Average BMI was negatively correlated with daily wheelchair propulsion distance (r = -0.179, P = 0.009), however there was no significant relationship with velocity, number of daily transfers or depression raises. CONCLUSION The majority of participants with chronic SCI were overweight (23%) or obese (44%) and BMI increased by 0.46 kg/m(2) over three years. Those with higher BMIs pushed their wheelchairs shorter distances, but other mobility measures were not impacted by body weight. Continued mobility activities with increasing body weight can increase risk for shoulder injury. Identifying persons who are obese allows for directed and timely health and mobility intervention.
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Affiliation(s)
- Patricia E. Hatchett
- Rancho Los Amigos National Rehabilitation Center, Pathokinesiology Laboratory, Downey, CA, USA,Correspondence to: Patricia E. Hatchett, Rancho Los Amigos National Rehabilitation Center Pathokinesiology Laboratory, Trailer 600 7601 East Imperial Highway Downey, CA 90242, USA.
| | - Sara J. Mulroy
- Rancho Los Amigos National Rehabilitation Center, Pathokinesiology Laboratory, Downey, CA, USA
| | - Valerie J. Eberly
- Rancho Los Amigos National Rehabilitation Center, Pathokinesiology Laboratory, Downey, CA, USA
| | - Lisa Lighthall Haubert
- Rancho Los Amigos National Rehabilitation Center, Pathokinesiology Laboratory, Downey, CA, USA
| | - Philip S. Requejo
- Rancho Los Amigos National Rehabilitation Center, Rehabilitation Engineering, Downey, CA, USA
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Abstract
We all do this. We personalize things. We buy leopard-printed seat covers and fuzzy dice for our cars, and display action figures and photographs in our offices. Studying older adults who have extended this process of personalization to their mobility devices, the purpose of the mobility aid personalization (MAPx) project is to examine MAPx and its impact on the health and mobility of older adults. Using a qualitative research design, field observations and interviews were conducted with 72 older adults to gain an in-depth understanding of device customization from an emic (insider's) perspective. Findings illustrate that older adults personalize their devices for reasons of fun, function and fashion. MAPx - the process of purposefully selecting or modifying a mobility device to suit individual needs and preferences - was also found to promote health and mobility by encouraging device acceptance, increasing social participation, enhancing joy and preserving identity. MAPx makes an important contribution to our understanding of the complex relationship between older adults and assistive devices and provides a new approach to some old problems including falls, inactivity and social isolation. Encouraging MAPx is a promising rehabilitation strategy for promoting health and community mobility among the older adult population. Implications for Rehabilitation Personalizing an assistive device facilitates device acceptance, promotes health and well-beingand should be supported and encouraged in rehabilitative care. Choice, variety and access are critical aspects of assistive devices; vendors, manufacturers andpractitioners should work together to provide clients with a greater range of affordable optionsfor new devices. Function is more than mechanical or physical; social factors including social identity, stigma andsocial roles must be adequately considered and explicit in rehabilitative practice.
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Affiliation(s)
- Paula Gardner
- a Department of Health Sciences , Brock University , St. Catharines , ON , Canada.,b Affiliate Scientist Bridgepoint Collaboratory for Research and Innovation , Toronto , ON , Canada
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Abstract
Community mobility supports occupational participation among older adults and promotes active ageing. This study aimed to explore community mobility of older adults within an urban Indian context in view of the limited available literature in this area. A cross-sectional survey was conducted on a convenience sample of 75 older adults residing in Chennai city using a questionnaire and a non-retrospective, open format, two-day time diary. Participants engaged in community mobility and activities outside home for 10% of time over two days. Activities and roles related to religious and spiritual activities and expression, social participation, leisure and informal personal education participation occupied most time and were engaged in most frequently. Walking was the most frequently used mode of transportation and participants reported numerous road-related hazards (lack of proper pavements, disobedience of traffic rules, difficulty crossing roads, crowded roads, and poor condition of roads). Participants used public transport less often. Public transport-related barriers (difficulty boarding and alighting buses/trains due to high steps/insufficient time, inadequate seat reservation for older adults, overcrowding and increased expense on auto rickshaws/taxis) were also expressed as concerns. Participants linked their ability to use public transport with independence and assigned relatively less value to driving. The findings emphasize the significance of community mobility to promote participation in older adults and recommend age-friendly environments in Indian cities.
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Affiliation(s)
- Meena Ramachandran
- Department of Occupational Therapy, School of Allied Health Sciences, Manipal University, Manipal, 576104, Karnataka, India.
| | - Sebestina A D'Souza
- Department of Occupational Therapy, School of Allied Health Sciences, Manipal University, Manipal, 576104, Karnataka, India.
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