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1.
Disabil Rehabil Assist Technol ; : 1-9, 2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38449447

RESUMEN

People with acquired brain injuries (ABI) face financial challenges that affect their daily lives. Managing finances is a crucial activity that can help avoid social isolation. However, this task becomes difficult for people with ABI because of their cognitive impairments. Recent advances in digital technology can help people with ABI manage their finances more effectively. This study aims to identify and describe available digital tools that can help ABI in budget management, and identify their effectiveness, barriers and facilitators to implementation. To address this issue, we conducted a rapid review of academic databases followed by a modified Google/Google Scholar search to identify the digital tools to support budgeting tasks (DBT) used and tested by people with ABI. Our rapid review included only two articles on the use of DBT. The first study showed that common portable electronic devices were acceptable and desirable as memory and organisational aids for people with ABI. The second study documented the development of a DBT and the perception of users (research participants) who found it appealing and user-friendly. However, for both articles, the technologies used are outdated and lack information on barriers and facilitators to using DBT. In conclusion, this literature review revealed that digital technologies have the potential to support budget management in people with ABI, but technology needs to be made available on the market to benefit the users. Further research and development are needed to create new ways to help people with brain injuries manage their budgets.


Our study showed limited literature involving appropriate digital tools to support budgeting task (DBT) to meet the needs of people with acquired brain injury (ABI) to manage their budgets. Therefore, further research is encouraged to develop digital tools adapted to the budgeting needs and cognitive impairments of people with ABI and their socio-cultural environment.Our paper provides recommendations to develop human-centred digital solutions to help people with ABI manage their budgets, that are accessible, reliable and sustainable. Mixed methods and mix of methods are highly recommended in this regard.

2.
J Pers Med ; 13(8)2023 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-37623481

RESUMEN

Stroke rehabilitation is a lengthy procedure that is necessary for stroke recovery. However, stroke rehabilitation may not be readily available for patients who live rurally due to barriers such as transportation and expenses. This shortage in wearable technology, in turn, causes health disparity among the rural population, which was exacerbated by the COVID-19 pandemic restrictions. Telerehabilitation (TR) is a potential solution for stroke rehabilitation in rural areas. This one-case study aimed to examine the feasibility and safety of a technology-enabled at-home TR program for stroke survivors living in a rural area in Canada. A VR setup was installed successfully in the home of our participant. A tablet was also supplied for the TR program. Each program consisted of 24 sessions to be completed over a 12-week period. Our participant was assessed on day one using the Fugl-Meyer assessment, the Modified Ashworth Scale, the 10 m walk test, and the Mini-Mental State Exam. Three questionnaires were also completed, including the Motor Activity Log (MAL), the Stroke Index Scale (SIS), and the Treatment Self-Regulation Questionnaire. These assessments were completed thrice, on day 1, at week 6, and at week 12. The participant found the tablet and its accompanying exercises easy to use, with a few limitations. The participant found the VR system more challenging to manage independently as a lack of comfortability, the visual contrast during the first trials, and certain technical aspects of the technology created several functional barriers. Although some limitations with the technology were noted, this case study indicates that telerehabilitation is feasible under certain circumstances when used in conjunction with traditional rehabilitation services.

3.
J Clin Med ; 12(13)2023 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-37445545

RESUMEN

While eHealth can help improve outcomes for older patients receiving geriatric rehabilitation, the implementation and integration of eHealth is often complex and time-consuming. To use eHealth effectively in geriatric rehabilitation, it is essential to understand the experiences and needs of healthcare professionals. In this international multicentre cross-sectional study, we used a web-based survey to explore the use, benefits, feasibility and usability of eHealth in geriatric rehabilitation settings, together with the needs of working healthcare professionals. Descriptive statistics were used to summarize quantitative findings. The survey was completed by 513 healthcare professionals from 16 countries. Over half had experience with eHealth, although very few (52 of 263 = 20%) integrated eHealth into daily practice. Important barriers to the use or implementation of eHealth included insufficient resources, lack of an organization-wide implementation strategy and lack of knowledge. Professionals felt that eHealth is more complex for patients than for themselves, and also expressed a need for reliable information concerning available eHealth interventions and their applications. While eHealth has clear benefits, important barriers hinder successful implementation and integration into healthcare. Tailored implementation strategies and reliable information on effective eHealth applications are needed to overcome these barriers.

4.
JMIR Rehabil Assist Technol ; 10: e44498, 2023 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-37463040

RESUMEN

BACKGROUND: Owing to demographic trends and increasing health care costs, quick discharge with geriatric rehabilitation at home is advised and recommended for older adults. Telerehabilitation has been identified as a promising tool to support rehabilitation at home. However, there is insufficient knowledge about how to implement a validated home telerehabilitation system in other contexts. One of the major challenges for rehabilitation professionals is transitioning to a blended work process in which human coaching is supplemented via digital care. OBJECTIVE: The study aimed to gain an in-depth understanding of the factors that influence the implementation of an evidence-based sensor monitoring intervention (SMI) for older adults by analyzing the perspectives of rehabilitation professionals working in 2 different health ecosystems and mapping SMI barriers and facilitators. METHODS: We adopted a qualitative study design to conduct 2 focus groups, 1 in person in the Netherlands during winter of 2017 and 1 on the web via Zoom (Zoom Video Communications; owing to the COVID-19 pandemic) in Canada during winter of 2022, to explore rehabilitation providers' perspectives about implementing SMI. Qualitative data obtained were analyzed using thematic analysis. Participants were a group of rehabilitation professionals in the Netherlands who have previously worked with the SMI and a group of rehabilitation professionals in the province of Manitoba (Canada) who have not previously worked with the SMI but who were introduced to the intervention through a 30-minute web-based presentation before the focus group. RESULTS: The participants expressed different characteristics of the telerehabilitation intervention that contributed to making the intervention successful for at-home rehabilitation: focus on future participation goals, technology support provides the rehabilitation professionals with objective and additional insight into the daily functioning of the older adults at home, SMI can be used as a goal-setting tool, and SMI deepens their contact with older adults. The analysis showed facilitators of and barriers to the implementation of the telerehabilitation intervention. These included personal or client-related, therapist-related, and technology-related aspects. CONCLUSIONS: Rehabilitation professionals believed that telerehabilitation could be suitable for monitoring and supporting older adults' rehabilitation at home. To better guide the implementation of telerehabilitation in the daily practice of rehabilitation professionals, the following steps are needed: ensuring that technology is feasible for communities with limited digital health literacy and cognitive impairments, developing instruction tools and guidelines, and training and coaching of rehabilitation professionals.

5.
Arch Phys Med Rehabil ; 104(9): 1371-1377, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37209934

RESUMEN

OBJECTIVES: To evaluate the effectiveness of a home-based simulator training, in comparison with a videogame-based training, in terms of powered wheelchair driving skills, skills use in a real-world setting, and driving confidence. DESIGN: Single-blinded randomized controlled trial. SETTING: Community. PARTICIPANTS: New powered wheelchair users (N=47) randomly allocated to simulator group (n=24, 2 drop-out) and control group (n=23, 3 drop-out). INTERVENTIONS: The miWe wheelchair simulator (simulator group) or a kart driving videogame (control group) was setted-up at participants' homes (computer + joystick). They were instructed to use it at least 20 minutes every 2 days, during a period of 2 weeks. PRIMARY OUTCOME MEASURE(S): Assessments were done at baseline (T1) and post-training (T2) using the Wheelchair Skills Test Questionnaire (WST-Q, version 4.1), Wheelchair Confidence Scale (WheelCon), Assistive Technology Outcomes Profile for Mobility, and Life-Space Assessment (LSA). The time necessary to complete 6 WST tasks was measured with a stopwatch. RESULTS: Participants of the simulator group significantly increased their WST-Q capacity score at T2 by 7.5% (P<.05), whereas the control group remained at the same score (P=.218). Participants of both groups rolled backward and went through a door significantly faster at T2 (P=.007; P=.016), but their speed did not change for the other skills. The WheelCon score significantly increased after training (+4% for the control group and +3.5% for the simulator group, P=.001). There was no T1-T2 difference between groups for the WST-Q performance scores (P=.119), the ATOP-Activity (P=.686), the ATOP-Participation scores (P=.814), and the LSA score (P=.335). No adverse events or side effects were reported during data collection or training. CONCLUSIONS: Participants of both groups improved some skills and their wheelchair driving confidence. The simulator training group also demonstrated a modest post-training gain in their WST-Q capacity, but more studies would be needed to explore the long-term effects of the McGill immersive wheelchair simulator (miWe) simulator on driving skills.


Asunto(s)
Silla de Ruedas , Humanos , Encuestas y Cuestionarios , Destreza Motora
6.
JMIR Ment Health ; 10: e40330, 2023 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-36630174

RESUMEN

BACKGROUND: Digital health technology is a promising way of supporting health care providers and family caregivers as they care for patients with cognitive impairment. OBJECTIVE: This scoping review aimed to portray the use of digital health technology to assist health care providers and family caregivers in caring for patients with cognitive impairment who live in the community or in a facility. METHODS: We conducted a scoping review of peer-reviewed scientific articles available in MEDLINE, PsycINFO, Scopus, and CINAHL with Full Text, as well as gray literature available in preprint servers, theses depositories, and various national and international dementia organizations' websites. The search yielded 975 articles, of which we included 7 (0.7%) in the review. RESULTS: Of the 7 interventions included in the retrieved manuscripts, 2 (29%) were digital calendar reminder systems to support activities of daily living and medication management; 2 (29%) were apps on tablet devices to simulate the presence of family before therapy interventions; 1 (14%) was a social robot used in therapeutic sessions to include elements of musicotherapy, reminiscence, cognitive games, and relaxation; 1 (14%) was a commercially available computer system that provides access to various recreational leisure activities; and 1 (14%) was a web-based self-management support system that helps family caregivers to deal with behavior changes in a relative with dementia. Of the 7 articles, only 1 (14%) reported on the use of a behavior change theory, namely a comprehensive process model of engagement coupled with cognitive stimulation therapy. CONCLUSIONS: Literature on the topic is scarce, recent, and heterogeneous. There is a clear need for a theoretical framework to conceptualize and govern the use of behavior change models that incorporate technology for patients with cognitive impairment.

7.
Assist Technol ; 35(6): 497-505, 2023 11 02.
Artículo en Inglés | MEDLINE | ID: mdl-36701417

RESUMEN

This study aimed to investigate clinical stakeholders' acceptance of an immersive wheelchair simulator as a potential powered wheelchair skills training tool. Focus groups, conducted in four rehabilitation centers, were used to obtain a rich understanding of participants' experiences and beliefs. Then, a cross-sectional survey of the simulator acceptability for clinical practice was created. Twenty-three rehabilitation therapists and clinical program directors participated in the focus groups and thirty-three responded to the survey. Participants generally expressed that use of the simulator would be complementary to training in an actual powered wheelchair, and that it could be useful for challenging situations in rehabilitation centers (e.g. anxious clients; when there is uncertainty around their potential to drive a powered wheelchair; tasks that cannot be assessed in a real-life environment). They also provided suggestions to improve the simulator (e.g. more feedback during tasks; possibility of adjusting control settings such as speed and sensitivity; possibility of adding varied control interfaces). Feedback received from key stakeholders clearly indicated that the wheelchair simulator would be complementary to training provided in a real context of use. However, some important limitations must be addressed to improve the simulator and promote its adoption by clinical programs, therapists and clients.


Asunto(s)
Silla de Ruedas , Humanos , Estudios Transversales , Encuestas y Cuestionarios , Retroalimentación
8.
Artículo en Inglés | MEDLINE | ID: mdl-36554640

RESUMEN

Adoption of Ambient Assisted Living (AAL) technologies for geriatric healthcare is suboptimal. This study aims to present the AAL Adoption Diamond Framework, encompassing a set of key enablers/barriers as factors, and describe our approach to developing this framework. A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. SCOPUS, IEEE Xplore, PubMed, ProQuest, Science Direct, ACM Digital Library, SpringerLink, Wiley Online Library and grey literature were searched. Thematic analysis was performed to identify factors reported or perceived to be important for adopting AAL technologies. Of 3717 studies initially retrieved, 109 were thoroughly screened and 52 met our inclusion criteria. Nineteen unique technology adoption factors were identified. The most common factor was privacy (50%) whereas data accuracy and affordability were the least common factors (4%). The highest number of factors found per a given study was eleven whereas the average number of factors across all studies included in our sample was four (mean = 3.9). We formed an AAL technology adoption framework based on the retrieved information and named it the AAL Adoption Diamond Framework. This holistic framework was formed by organising the identified technology adoption factors into four key dimensions: Human, Technology, Business, and Organisation. To conclude, the AAL Adoption Diamond Framework is holistic in term of recognizing key factors for the adoption of AAL technologies, and novel and unmatched in term of structuring them into four overarching themes or dimensions, bringing together the individual and the systemic factors evolving around the adoption of AAL technology. This framework is useful for stakeholders (e.g., decision-makers, healthcare providers, and caregivers) to adopt and implement AAL technologies.


Asunto(s)
Inteligencia Ambiental , Instituciones de Vida Asistida , Dispositivos de Autoayuda , Humanos , Anciano , Atención a la Salud , Instituciones de Salud
9.
J Telemed Telecare ; : 1357633X221122124, 2022 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-36045633

RESUMEN

BACKGROUND: Telemonitoring and telerehabilitation can support home-based pulmonary rehabilitation (PR) and benefit patients with lung diseases or COVID-19. This study aimed to (1) identify which telemonitoring and telerehabilitation interventions (e.g. videoconferencing) are used to provide telehealth care for people with chronic respiratory conditions or COVID-19, and (2) provide an overview of the effects of telemonitoring and telerehabilitation on exercise capacity, physical activity, health-related QoL (HRQoL), and healthcare use in patients with lung diseases or COVID-19. METHODS: A search was performed in the electronic databases of Ovid MEDLINE, EMBASE, and Cinahl through 15 June 2021. Subject heading and keywords were used to reflect the concepts of telemonitoring, telerehabilitation, chronic lung diseases, and COVID-19. Studies that explored the effect of a telerehabilitation and/or telemonitoring intervention, in patients with a chronic lung disease such as asthma, chronic obstructive pulmonary diseases (COPD), or COVID-19, and reported the effect of the intervention in one or more of our outcomes of interest were included. Excluding criteria included evaluation of new technological components, teleconsultation or one-time patient assessment. RESULTS: This scoping review included 44 publications reporting the effect of telemonitoring (25 studies), telerehabilitation (8 studies) or both (11 studies) on patients with COPD (35 studies), asthma (5 studies), COPD and asthma (1 study), and COVID-19 (2 studies). Patients who received telemonitoring and/or telerehabilitation had improvements in exercise capacity in 9 out of 11 (82%) articles, better HRQoL in 21 out of 25 (84%), and fewer health care use in 3 out of 3 (100%) articles compared to pre-intervention. Compared to controls, no statistically significant differences were found in the intervention groups' exercise capacity in 5 out 6 (83%) articles, physical activity in 3 out of 3 (100%) articles, HRQoL in 21 out of 25 (84%) articles, and healthcare use in 15 out of 20 (75%) articles. The main limitation of the study was the high variability between the characteristics of the studies, such as the number and age of the patients, the outcome measures, the duration of the intervention, the technological components involved, and the additional elements included in the interventions that may influence the generalization of the results. CONCLUSION: Telemonitoring and telerehabilitation interventions had a positive effect on patient outcomes and appeared to be as effective as standard care. Therefore, they are promising alternatives to support remote home-based rehabilitation in patients with chronic lung diseases or COVID-19.

10.
Digit Health ; 8: 20552076221076927, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35223076

RESUMEN

BACKGROUND: People from lower and middle socioeconomic classes and vulnerable populations are among the worst affected by the COVID-19 pandemic, thus exacerbating disparities and the digital divide. OBJECTIVE: To draw a portrait of e-services as a digital approach to support digital health literacy in vulnerable populations amid the COVID-19 infodemic, and identify the barriers and facilitators for their implementation. METHODS: A scoping review was performed to gather published literature with a broad range of study designs and grey literature without exclusions based on country of publication. A search was created in Medline (Ovid) in March 2021 and translated to Medline, PsycINFO, Scopus and CINAHL with Full Text (EBSCOhost). The combined literature search generated 819 manuscripts. To be included, manuscripts had to be written in English, and present information on digital intervention(s) (e.g. social media) used to enable or increase digital health literacy among vulnerable populations during the COVID-19 pandemic (e.g. older adults, Indigenous people living on reserve). RESULTS: Five articles were included in the study. Various digital health literacy-enabling e-services have been implemented in different vulnerable populations. Identified e-services aimed to increase disease knowledge, digital health literacy and social media usage, help in coping with changes in routines and practices, decrease fear and anxiety, increase digital knowledge and skills, decrease health literacy barriers and increase technology acceptance in specific groups. Many facilitators of digital health literacy-enabling e-services implementation were identified in expectant mothers and their families, older adults and people with low-income. Barriers such as low literacy limited to no knowledge about the viruses, medium of contamination, treatment options played an important role in distracting and believing in misinformation and disinformation. Poor health literacy was the only barrier found, which may hinder the understanding of individual health needs, illness processes and treatments for people with HIV/AIDS. CONCLUSIONS: The literature on the topic is scarce, sparse and immature. We did not find any literature on digital health literacy in Indigenous people, though we targeted this vulnerable population. Although only a few papers were included, two types of health conditions were covered by the literature on digital health literacy-enabling e-services, namely chronic conditions and conditions that are new to the patients. Digital health literacy can help improve prevention and adherence to a healthy lifestyle, improve capacity building and enable users to take the best advantage of the options available, thus strengthening the patient's involvement in health decisions and empowerment, and finally improving health outcomes. Therefore, there is an urgent need to pursue research on digital health literacy and develop digital platforms to help solve current and future COVID-19-related health needs.

11.
Artículo en Inglés | MEDLINE | ID: mdl-33800257

RESUMEN

The number of Canadians with dementia is expected to rise to 674,000 in the years to come. Finding ways to monitor behavioural disturbance in patients with dementia (PwDs) is crucial. PwDs can unintentionally behave in ways that are harmful to them and the people around them, such as other residents or care providers. Current practice does not involve technology to monitor PwD behaviours. Events are reported randomly by nonstaff members or when a staff member notices the absence of a PwD from a scheduled event. This study aims to explore the potential of implementing a novel detector of behavioural disturbances (DBD) in long-term care homes by mapping the perceptions of healthcare professionals and family members about this technology. Qualitative information was gathered from a focus group involving eight healthcare professionals working in a tertiary care facility and a partner of a resident admitted in the same facility. Thematic analysis resulted in three themes: (A) the ability of the DBD to detect relevant dementia-related behavioural disturbances that are typical of PwD; (B) the characteristics of the DBD and clinical needs and preferences; (C) the integration of the DBD into daily routines. The results tend to confirm the adequacy of the DBD to the day-to-day needs for the detection of behavioural disturbances and hazardous behaviours. The DBD was considered to be useful and easy to use in the tertiary care facility examined in this study. The participants intend to use the DBD in the future, which means that it has a high degree of acceptance.


Asunto(s)
Demencia , Cuidados a Largo Plazo , Canadá , Demencia/diagnóstico , Personal de Salud , Humanos , Casas de Salud
12.
Int J Med Inform ; 150: 104461, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33892446

RESUMEN

OBJECTIVES: Ambient assisted living technologies (AALTs) are being used to help community-dwelling older adults (OAs) age in place. Although many AALT are available, their acceptance (perceived usefulness, ease of use, intention to use and actual usage) is needed to improve their design and impact. This study aims to 1) identify AALTs that underwent an acceptance evaluation in rehabilitation contexts, 2) identify methodological tools and approaches to measure acceptance in ambient assisted living (AAL) in rehabilitation research, and 3) summarize AALT acceptance results in existing rehabilitation literature with a focus on peer-reviewed scientific articles. METHODS: A scoping review was conducted in the following databases: Medline, Embase, Cinahl, and PsycInfo, following the Arksey and O'Malley framework (2009). Four acceptance attributes were extracted: 'user acceptance', 'perceived usefulness', 'ease of use', and 'intention to use'. Data regarding AALT, participants, acceptance evaluation methods and results were extracted. RESULTS: A total of 21 articles were included among 634 studies retrieved from the literature. We identified 51 AALTs dedicated to various rehabilitation contexts, most of which focused on monitoring OAs' activities and environmental changes. Acceptance of AALT was evaluated using interviews, questionnaires, focus groups, informal feedback, observation, card sort tasks, and surveys. Although OAs intend to use - or can perceive the usefulness of - AALTs, they are hesitant to accept the technology and have concerns about its adoption. DISCUSSION AND CONCLUSIONS: The assessment of AALT acceptance in contexts of rehabilitation requires more comprehensive and standardized methodologies. The use of mixed-methods research is encouraged to cover the needs of particular studies. The timing of acceptance assessment should be considered throughout technology development phases to maximize AALT implementation.


Asunto(s)
Inteligencia Ambiental , Anciano , Humanos , Vida Independiente , Encuestas y Cuestionarios , Tecnología
13.
Int J Med Inform ; 148: 104408, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33609927

RESUMEN

BACKGROUND: Telehealth implementation is a great solution for Indigenous older adults (OAs) due to the rise of chronic disease and other age-related health disorders. Telehealth is a promising option to increase quality of life, decrease healthcare costs, and offer more independent living. OBJECTIVES: This scoping review investigated existing telehealth solutions that have been implemented to serve Indigenous OAs. METHODS: A structured search strategy was performed on 6 electronic databases: Ovid Medline, Ovid PsycINFO, Ovid Embase, EBSCOhost, Scopus and Cochrane. Studies were included in the review if they contained information on telehealth technologies for Indigenous OAs (aged 65 years and older). Grey literature was also explored in ProQuest Theses and Dissertations, ERIC, Google Advanced and various government websites from Canada, Australia/New Zealand and the USA. RESULTS: Twenty six articles were included and reviewed by two assessors. Analysis of the results from five countries revealed eight different types of telehealth solutions for Indigenous OAs. No documented telerehabilitation technologies were available to OAs in Indigenous Communities. Analysis of a broad range of Indigenous OAs with different chronic diseases revealed that they are seeking telehealth technologies for ease of access to health care, increased health equity and cost-effectiveness. Results revealed various advantages of telehealth for Indigenous OAs and barriers for implementing such technologies in Indigenous communities. CONCLUSION: The use of telehealth technologies among OAs is expected to rise, but effective implementation will be successful only if the patient's acceptance and culture are kept at the forefront, and if healthcare services are provided by telehealth-trained healthcare professionals.


Asunto(s)
Atención a la Salud , Calidad de Vida , Anciano , Tecnología Biomédica , Canadá , Enfermedad Crónica , Humanos
14.
Assist Technol ; 33(2): 72-86, 2021 03 04.
Artículo en Inglés | MEDLINE | ID: mdl-31135278

RESUMEN

Manual wheelchair (MWC) users face a variety of obstacles limiting their participation. Different MWC models and new add-on components intended to improve propulsion may impact users' function and participation, although there is a lack of research on this topic. The aims of this study were to: 1) identify MWC propelling aids (PA) that are reported in the literature; 2) classify the outcomes used to evaluate the influence of PA according to the International Classification of Functioning, Disability and Health (ICF); and 3) summarize evidence for the influence of PA. A scoping review was conducted in 2017 using Pubmed, Medline, Embase, CINAHL, Compendex, IEEE Xplore, RESNA and ISS proceedings, Google, and Google Scholar. The content of each manuscript was assessed by two independent reviewers. A total of 28 PA (19 human-powered; 9 power-assisted) were identified from 163 manuscripts. The three most cited ICF subdomains were "Activity & Participation" (n = 125), "Body Function" (n = 100), and "Personal Factors" (n = 55). The findings suggest an overall positive influence of PA on various ICF domains/subdomains, but initial findings should be interpreted with caution. Confirmation of the effect and safety of PA requires higher levels of evidence.


Asunto(s)
Personas con Discapacidad , Silla de Ruedas , Humanos
15.
Top Spinal Cord Inj Rehabil ; 25(1): 1-22, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30774286

RESUMEN

Objectives: To identify and classify tools for assessing the influence of neurogenic bowel dysfunction (NBD) on quality of life (QoL) after spinal cord injury (SCI). Methods: In this systematic review, MEDLINE/PubMed, CINAHL, and PsycInfo were searched to identify studies assessing the influence of NBD on QoL (or related construct) after SCI. Two independent reviewers screened titles and abstracts, and both reviewers classified tools as subjective or objective according to Dijkers' theoretical QoL framework. Results: Seventy-two studies were identified, and 35 studies met the inclusion criteria. Five objective measures assessed the influence of NBD on QoL, which were validated for use in SCI, but no measure was condition-specific to NBD. Eight measures were classified as subjective tools; two had an established reliability and validity for SCI while six had some psychometric evidence for use in the SCI population. Five subjective measures (NBD score, Burwood QoL Questionnaire, Impediments to Community Integration [ICI] Scale, SCI-QoL Bowel Management Difficulties, and Survey of Neurogenic Bowel Characteristics) were developed specifically for SCI. The NBD score showed sensitivity to the influence of NBD on QoL in experimental trials. Conclusion: Thirteen tools assessed the influence of NBD on QoL in SCI. Although not developed specifically for SCI, the Health Utility Index (HUI-III) was the only tool identified that provided data on "QoL as utility" on the impact of NBD. The validated NBD score was the only condition-specific tool to assess QoL as "subjective well-being." Further validation of existing tools could help to inform practice and policy related to resource allocation for bowel care post SCI.


Asunto(s)
Intestino Neurogénico/psicología , Calidad de Vida/psicología , Traumatismos de la Médula Espinal/psicología , Actividades Cotidianas , Adolescente , Adulto , Anciano , Femenino , Indicadores de Salud , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Pronóstico , Encuestas y Cuestionarios/clasificación , Adulto Joven
16.
Foot Ankle Spec ; 6(5): 352-5, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23966260

RESUMEN

UNLABELLED: Prescriptions for functional ankle instability are generally oriented to taping, which need to be validated as an efficient treatment. Therefore, the aim of this study was to investigate the effectiveness of ankle taping on the subject's foot pressure and gait pattern, including mediolateral analysis, according to tape application side. A sample of 20 right-handed healthy subjects volunteered to participate in this study, which was composed of 3 taping conditions: "with taping of the right ankle," "with taping of both ankles," and "with taping of the left ankle." Participants were asked to perform a walk on the walkway to get 2 footprints repeated 6 times. The variables measured were step length, step duration, double stance, and swing. The results clearly showed significant change in step duration and double phase when tape was applied to the left ankle, F(2, 54) = 12.03; P < .05. Significant changes were also observed for step length and swing when tape was applied to the both ankles, F(2, 54) = 10.71; P < .05]. This study showed that double stance and swing phase duration increases, and that the pressure is equalized on both feet when taping the unstable ankle. Taping a functionally unstable ankle is more likely to improve its stability. LEVELS OF EVIDENCE: Therapeutic Level II: Prospective comparative trial.


Asunto(s)
Cinta Atlética , Adulto , Traumatismos del Tobillo/fisiopatología , Traumatismos del Tobillo/terapia , Fenómenos Biomecánicos , Femenino , Marcha , Humanos , Inestabilidad de la Articulación/fisiopatología , Inestabilidad de la Articulación/terapia , Masculino , Equilibrio Postural , Presión , Propiocepción , Resultado del Tratamiento , Caminata , Adulto Joven
17.
Eur J Appl Physiol ; 112(4): 1557-68, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21853307

RESUMEN

The aim of this study was to investigate human adaptations to fatigue induced by track sprint repetitions. Eight male sprinters were asked to run 4 × 100 m as quickly as possible with 3 min of recovery. Subjects were filmed (50 Hz) in order to measure stride length and frequency. Velocity was measured by means of radar (250 Hz) while contact and flight times were registered wirelessly by two pressure sensors (400 Hz) embedded under the insole of the subjects' shoes. Contact and flight times were used to calculate stiffness. In addition, blood samples were taken prior to warm-up, 1 min after each 100-m sprint and every 2 min after the last repetition until a lactate peak ([BLa]) was reached. [BLa] did not affect mechanical and stride parameters. Inter-series ANOVA showed that velocity decreased significantly (-3.55%) between Repetition 1 (8.18 ± 0.29 m s(-1)) and Repetition 4 (7.89 ± 0.42 m s(-1)), while [BLa] increased from 6.74 ± 1.15 to 13.58 ± 1.48 mmol l(-1) (p < 0.05). The first main result was that leg stiffness remained constant until Repetition 3 and then dramatically increased at Repetition 4, whereas vertical stiffness remained constant throughout all four repetitions. This behavior could be considered to be a neuromuscular adaptation to fatigue used by skilled athletes. The second main result was that velocity decreased during the second phase (30-80 m) of the entire 100 m. In addition, a PCA revealed three different sprint profiles explaining 88.2% of the total variance: the contact-time-pattern (39.46%), force-pattern (27.96%) and stride-pattern (20.77%). Two different motor signatures were identified with fatigue. In the first, athletes switch from the key variable to another when exhausted without changing their motor behavior (during Repetition 3 and/or Repetition 4). In the second, athletes do not change their motor behavior with fatigue.


Asunto(s)
Contracción Muscular , Fatiga Muscular , Músculo Esquelético/fisiología , Carrera , Adaptación Fisiológica , Adolescente , Análisis de Varianza , Biomarcadores/sangre , Fenómenos Biomecánicos , Francia , Humanos , Ácido Láctico/sangre , Extremidad Inferior , Masculino , Modelos Biológicos , Análisis de Componente Principal , Análisis y Desempeño de Tareas , Factores de Tiempo , Transductores de Presión , Grabación en Video , Adulto Joven
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