Women with disabilities, body image, and wellbeing: Assessing the effectiveness of dance sessions.

INTRODUCTION: There is growing research evidence on bodily discourses and body image issues of women with disabilities. Within the art-based intervention repertoire for persons with disabilities, dance and movement-based therapies and interventions are gaining prominence. The aim of this study was to examine the impact of dance sessions (delivered online) on body image, body satisfaction/dissatisfaction, and wellbeing of women with disabilities. METHOD: A quasi-experimental waitlist control design study was conducted with data collected at two time points: baseline or pre-test and five-months later or post-test. Outcomes were measured using the Body Image Scale and the WHO-5-Wellbeing Index. RESULTS: The dance sessions were effective (Hedges' g = -0.56 -0.88; p < 0.01) and post-test body dissatisfaction scores were lower and wellbeing scores were higher for participants with a college degree or postgraduate degree, self-employed or students, and whose intervention compliance was above threshold (>50% dance sessions attended and corresponding homework sessions completed). Tobit regression models indicated that it was possible to estimate post-test outcomes due to dance sessions alone, controlling for significant socio-demographics. DISCUSSION: The domain knowledge of non-pharmacological art-based interventions for persons with disabilities, particularly women, is supported. CONCLUSIONS: Findings commend dance sessions as effective psychotherapeutic mechanisms to mitigate body dissatisfaction, improve body image and wellbeing of women with disabilities. Future research may focus on large-scale cross-sectional trials, variations in the repertoire for women with different disability types and histories, and qualitative narratives.

The Reliability and Validity of the OneStep Smartphone Application for Gait Analysis among Patients Undergoing Rehabilitation for Unilateral Lower Limb Disability.

An easy-to-use and reliable tool is essential for gait assessment of people with gait pathologies. This study aimed to assess the reliability and validity of the OneStep smartphone application compared to the C-Mill-VR+ treadmill (Motek, Nederlands), among patients undergoing rehabilitation for unilateral lower extremity disability. Spatiotemporal gait parameters were extracted from the treadmill and from two smartphones, one on each leg. Inter-device reliability was evaluated using Pearson correlation, intra-cluster correlation coefficient (ICC), and Cohen's d, comparing the application's readings from the two phones. Validity was assessed by comparing readings from each phone to the treadmill. Twenty-eight patients completed the study; the median age was 45.5 years, and 61% were males. The ICC between the phones showed a high correlation (r = 0.89-1) and good-to-excellent reliability (ICC range, 0.77-1) for all the gait parameters examined. The correlations between the phones and the treadmill were mostly above 0.8. The ICC between each phone and the treadmill demonstrated moderate-to-excellent validity for all the gait parameters (range, 0.58-1). Only 'step length of the impaired leg' showed poor-to-good validity (range, 0.37-0.84). Cohen's d effect size was small (d < 0.5) for all the parameters. The studied application demonstrated good reliability and validity for spatiotemporal gait assessment in patients with unilateral lower limb disability.

Impact of rehabilitation services on employment outcomes for individuals with physical disabilities: a propensity score matching analysis.

BACKGROUND: Choosing a suitable job and leading a fulfilling professional life is vital for individuals, regardless of disability. Governments provide rehabilitation services to promote employment for individuals with disabilities, but research on their effects is limited. This study aimed to examine the impact of rehabilitation services on employment among people with physical disabilities in South Korea using propensity score matching. METHODS: This study utilized an observational research design. Data were obtained from the 2020 National Survey of Disabled Persons, including 1,757 individuals aged 20 or older with physical disabilities. Descriptive statistics, chi-square and independent t-tests, logistic regression, and propensity score matching were employed. RESULTS: The results for employment of individuals with physical disabilities showed no difference between the with rehabilitation services and the without rehabilitation services group. Based on subgroup analysis, when individuals with physical disabilities who rated their subjective health status low received rehabilitation services, it had a positive effect on employment. CONCLUSIONS: The results of this study could serve as foundational data for future policies and educational directions concerning rehabilitation services for persons with disabilities.

[From immersion to inclusion, a learning experience]. / De l'immersion à l'inclusion, une expérience apprenante.

As part of their training, volunteer nursing students from the Gers healthcare training institute were invited to take part in a sports exchange with a handibasket team. The main aim of the project was to change their perceptions of disability. Here, four of the students share their experiences and the benefits of the experience.

Association between health insurance programs and rehabilitation services utilisation among people with disabilities: evidence from China.

OBJECTIVES: Rehabilitation is crucial to improve the health status of people with disabilities. Previous studies mainly analysed the impact of health insurance on utilisation of general health services; the relationship between health insurances and rehabilitation services utilisation among Chinese people with disabilities has been long neglected. This study aimed to analyse the association between health insurance programs and rehabilitation services utilisation among disabled people. STUDY DESIGN: This was a cross-sectional study. METHODS: The data used in this study were derived from 2021 National Household Income Survey of Disabled People and National Basic Database of People with Disabilities conducted by China Disabled Persons' Federation. Logistic regression model was used to analyse the relationship between health insurance and rehabilitation services utilisation, and the propensity score matching method was used to check the robustness of the results. RESULTS: (1) Disabled people insured by the Basic Medical Insurance System for Urban Employees (BMISUE) and the Basic Medical Insurance System for Urban and Rural Residents (BMISURR) were positively associated with rehabilitation service utilisation (odds ratio [OR] = 1.852, 95% confidence interval [CI]:1.268, 2.707; OR = 1.375, 95% CI: 0.962, 1.966). (2) The utilisation level of rehabilitation service among disabled people insured by BMISUE was significantly higher than those insured by BMISURR (OR = 1.355, 95% CI: 1.161, 1.581). (3) The supply of rehabilitation services at the community level was positively correlated with the utilisation by people with disabilities. CONCLUSION: Health insurance can improve the financial accessibility of using rehabilitation services, and the utilisation level will increase as the benefits level of health insurance increase.

Theories, models and frameworks to understand barriers to the provision of mobility-assistive technologies: a scoping review.

OBJECTIVES: There is strong evidence that mobility-assistive technologies improve occupational performance, social participation, educational and employment access and overall quality of life in people with disabilities. However, people with disabilities still face barriers in accessing mobility products and related services. This review aims to summarise and synthesise: (1) theories, models and frameworks that have been used to understand mobility-assistive technology access, (2) determinants of access and (3) gaps in knowledge. DESIGN: A scoping review using the five-step framework by Arksey and O'Malley. DATA SOURCES: We searched the MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and SCOPUS databases for publications published between 2000 and 2024. We searched for articles published up to 20 March 2024. ELIGIBILITY CRITERIA: We included English-published literature in peer-reviewed journals that reported (a) barriers to the provision of mobility-assistive technologies, (b) including at least one theory, model or framework and (c) between 2000 and 2024. DATA EXTRACTION AND SYNTHESIS: We extracted the study characteristics, theories, models, framework usage, research recommendations, key findings on mobility-assistive technology barriers and theoretical propositions. We conduct a theoretical synthesis guided by Turner's approach. RESULTS: We included 18 articles that used 8 theories, models and frameworks, synthesised into 9 propositions. The synthesised theory emphasises that mobility is essential for human flourishing, and that certain health conditions may impose restrictions on mobility. This impact can be alleviated by two direct determinants: (1) the provision of suitable services and (2) their comprehensive provision. Policies and costs influence these services indirectly. Environmental and personal factors also affect the use of these services. Ineffectively addressing these determinants can limit access to mobility-assistive technologies and subsequent disabilities. CONCLUSION: Our synthetic model describes the logic of providing evidence-based mobility-assistive technologies, and we identify the determinants of access that can act as targets for future work to improve the provision of mobility-assistive technologies.

Effectiveness assessment of a home-based exercise intervention in mitigating HTLV-1 associated disabilities: A validation study.

To evaluate the effectiveness of a home exercise program called Home Exercise Booklet for People Living with Human T Lymphotropic Virus 1 (HTLV-1). This is a methodological study of content validation with expert judges. A questionnaire with a Likert scale was applied, containing 16 items referring to the content domain. Descriptive statistics were used to obtain the content validity index. In total, 46 judges participated, 24 physiotherapists (PG) and 22 professionals from other health areas specializing in methodological studies and HTLV-1 (EG). In the validation process, each evaluator judged the technology and scored their considerations. In the end, we obtained the following results for the Content Validity Index (CVI): PG CVI: 94.3%, GE CVI: 93.4%. Although the index was sufficient to consider the technology validated, modifications were made to the second and final version of the booklet, considering the judges' observations and suggestions, which we consider relevant. The technology proved to be valid for use with the target audience. The development and validation of this product provides support to help prevent functional decline in people living with HTLV-1; standardize guidelines for physiotherapy professionals who monitor these issues; start a home exercise program aimed at other comorbidities; open the possibility of creating and validating home exercise programs with other comorbidities.

Employers' perceptions of supports provided to their employees with disabilities.

The employment of individuals with disabilities is significantly low. Many factors are associated with this issue; however, support and accommodations that can be provided to such individuals can improve their employment rate and outcomes. This study aimed to examine the support provided to employees with disabilities in Saudi Arabia. The descriptive approach was utilized, and a survey was used to collect the data. The sample consisted of 86 employer participants to examine the support of their employees with disabilities. Findings revealed that the support provided was high, and the participants reported that such support facilitates finding and maintaining a job. In addition, the variables were all found to have no significant differences. Providing needed and necessary support is an effective strategy that leads to competitive employment for individuals with disabilities, especially for the long term. Implications and recommendations are also discussed.

Assessing pain severity and treatment outcomes in patients with low back pain: A Structural equation modeling approach at the center for the rehabilitation of the Paralysed, Bangladesh.

OBJECTIVES: This study aims to observe the associated risk factors of lower back pain and the factors that increase the pain severity. So, the main objective of this research is to identify the factors which may cause the lower back pain and the causal effect on the pain severity and respective treatment. This study also tries to determine the demographical characteristics of the low back pain patients and determine the inter relationship of psychological health, work stress and treatment effect with the pain disability index. STUDY DESIGN: In this cross-sectional study, 200 patients with lower back pain were interviewed who were taking treatments from the physiotherapy department at the Center for the Rehabilitation of the Paralysed, Savar, Dhaka, Bangladesh. METHODS: A quantitative research model has been performed to observe the relationship between different causes of low back pain effects on the patients. Different statistical analysis including structural equation modeling have been performed to observe their pain severity and treatment effect. RESULTS: The study found 64% (128) of the total participants as male and 36% (72) as female among 200 patients of low back pain. The study also observed the highest portion of the patients belong to the age group 39 to 45 years (21.5%). On the basis of BMI, obese weight respondents were 26.5% (53), overweight respondents were 37% (74), normal weight respondents were 33% (66), and underweight respondents were only 3.5% (7). Here, sex, body mass index (BMI), living place and educational status have significant association with pain disability index (PDI). On the other hand, smoking tendency of patients has insignificant relationship (p>0.05) with pain disability index (PDI). The path coefficients of the structural equation model identified that all the null hypotheses of no significant relationship have been rejected for 5% level of significance. The hypothesis of psychological health is positively related to pain severity of a patient has an acceptable strength (ß = 0.745, p<0.001) and a positive direction. Another hypothesis (Psychological health is positively related to the treatment of a patient) shows an acceptable strength (ß = 0.401, p <0.001) and a positive direction. Work stress is also found to be positively related to pain severity of a patient with an acceptable strength (ß = 0.544, p < 0.001) and a positive direction. The hypothesis (Work stress is positively related to the treatment of a patient) has an acceptable strength (ß = 0.322, p< 0.05) and a positive direction. The hypothesis (pain severity is positively related to the treatment of patients) shows an acceptable strength (ß = 0.801, p < 0.001) and a positive direction. CONCLUSION: The research found out the psychological health situation and work stress of patients are significantly related with pain severity with acceptable strength. Also, Pain severity is significantly associated with treatment scheme intensity.

Accuracy of Video-Based Hand Tracking for People With Upper-Body Disabilities.

Utilization of hand-tracking cameras, such as Leap, for hand rehabilitation and functional assessments is an innovative approach to providing affordable alternatives for people with disabilities. However, prior to deploying these commercially-available tools, a thorough evaluation of their performance for disabled populations is necessary. In this study, we provide an in-depth analysis of the accuracy of Leap's hand-tracking feature for both individuals with and without upper-body disabilities for common dynamic tasks used in rehabilitation. Leap is compared against motion capture with conventional techniques such as signal correlations, mean absolute errors, and digit segment length estimation. We also propose the use of dimensionality reduction techniques, such as Principal Component Analysis (PCA), to capture the complex, high-dimensional signal spaces of the hand. We found that Leap's hand-tracking performance did not differ between individuals with and without disabilities, yielding average signal correlations between 0.7-0.9. Both low and high mean absolute errors (between 10-80mm) were observed across participants. Overall, Leap did well with general hand posture tracking, with the largest errors associated with the tracking of the index finger. Leap's hand model was found to be most inaccurate in the proximal digit segment, underestimating digit lengths with errors as high as 18mm. Using PCA to quantify differences between the high-dimensional spaces of Leap and motion capture showed that high correlations between latent space projections were associated with high accuracy in the original signal space. These results point to the potential of low-dimensional representations of complex hand movements to support hand rehabilitation and assessment.

Let the records speak: an exploration of rehabilitation services offered in primary healthcare, Johannesburg metropolitan district.

BACKGROUND: Primary healthcare in South Africa aims to transform the national health system by emphasising community-based care and preventive strategies. However, rehabilitation services, particularly for individuals with disabilities and chronic non-communicable diseases, are often overlooked in primary healthcare. This study aimed to investigate the provision of primary healthcare rehabilitation services in the Johannesburg Metropolitan District by exploring client sociodemographics and variations in services provided by rehabilitation professionals. METHODS: A retrospective review of clinic rehabilitation records from 2011 to 2020 was conducted at nine provincially funded community health centres (CHCs) offering rehabilitation services. Stratified sampling facilitated record selection based on rehabilitation service type and year. A specifically designed data extraction tool captured demographics, disabilities, rehabilitation received, and referral sources. Descriptive analysis used means, standard deviations, and frequencies. RESULTS: The findings show a diverse client population with a wide age range, with a significant proportion falling into the < 5 years and 30-49 years age groups. Neuromusculoskeletal and movement-related disabilities were most prevalent, affecting approximately two-thirds of clients. Referral sources were often undocumented, and inconsistent discharge information with no record of patient follow up, highlighted the need for improved documentation practices. Clinic visits were the primary service delivery mode, followed by limited home visits and outreach services. Occupational therapy and physiotherapy were the most used services. Speech and language therapy services were underused, and some CHCs lacked audiology services. There were variations in the number of individual and group sessions provided by the different rehabilitation services, and there were age- and disability-specific differences in service use. CONCLUSION: This study offers insights into rehabilitation service provision in the Johannesburg Metropolitan District and enhances our understanding of rehabilitation services in primary healthcare settings. It underscores the importance of a multidisciplinary rehabilitation team to address diverse rehabilitation needs, improving documentation and discharge practices, expanding service delivery models, and reducing disparities in service use. The findings inform strategies for optimising service delivery, workforce, resource allocation, and intersectoral collaboration to ultimately enhance the quality and accessibility of integrated rehabilitation services.

Care-receivers with physical disabilities' perceptions on having humanoid assistive robots as assistants: a qualitative study.

BACKGROUND: People with physical disabilities due to disease or injury face barriers to their daily activities and participation in society. Many depend on formal or informal caregivers for assistance to live independently. However, future healthcare challenges due to demographic changes threaten access to home care and assistants. Assistive technologies, such as robots for physical assistance, can support the independence and autonomy of people with physical disabilities. This study explore Norwegian care-receivers' perceptions of using robot assistance in their homes, including preferences for tasks acceptable or unacceptable for robot assistance and the underlying reasons. METHOD: Purposive sampling was employed to recruit 18 participants, aged between 18 and 77 years, with differences in physical function including diagnoses such as stroke, spinal cord injury, amputations, and muscular dystrophy. Qualitative data were gathered through four focus group interviews wherein participants watched videos featuring a humanoid assistive robot, EVEr3. The collected data underwent analysis using reflexive thematic analysis. RESULTS: Three themes with associated sub-themes were constructed: (a) How a robot could assist in daily life, (b) The robot's appearance and functionality, and (c) Concerns about having a robot as an assistant. The participants welcomed the idea of a future robotic assistant in areas that may contribute to an increased feeling of independence and autonomy. CONCLUSION: A robot assisting in activities of daily living would need to be individually customized to meet the needs of each user in terms of which tasks to assist with, how to assist in these defined tasks, and how it is controlled.

Mixed-Methods Study of Disability Self-Management in Mexican Americans With Osteoarthritis.

BACKGROUND: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives. OBJECTIVE: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. METHODS: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. RESULTS: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. DISCUSSION: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.

Development of the assessment standards of the International Classification of Functioning, Disability, and Health (ICF) Geriatric Core Set through a modified Delphi method.

BACKGROUND: There is currently a lack of functional assessment tools based on the International Classification of Functioning, Disability, and Health (ICF) theoretical framework that are specific for older adults. OBJECTIVE: The aim of the present study was to develop Chinese assessment standards of the ICF Geriatric Core Set for functional evaluation of older adults. METHODS: A two-stage study process was conducted to develop the assessment standards of the ICF Geriatric Core Set: establishment of candidate assessment standards, and a modified Delphi consensus process including a pilot survey and two-round formal expert survey. Thirty participants in the field of ICF and geriatric rehabilitation were recruited. The suitability of the assessment standards in the questionnaires was rated using a Likert 5-level scoring method. The arithmetic mean, the full mark ratio and the coefficient of variation (CV) were used as screening indicators for the assessment standards, and modification was made for several standards, in line with the Delphi results and the expert panel discussion. RESULTS: Thirty-three candidate assessment standards belonging to 17 categories were generated. A total of 26 and 24 experts in the field of ICF and geriatric rehabilitation participated in the two-round survey, respectively. Five standards belonging to four categories entered into the second-round survey directly, five standards belonged to five categories entered with minor modification, and nine standards belonging to seven categories were redesigned based on the literature and discussion of the expert panel. In the second-round survey,15 assessment standards belonging to 15 categories met the screening requirements and four assessment standards belonged to the two remaining categories that needed a criterion and which the expert panel discussed for the final decision. CONCLUSIONS: Using the modified Delphi method, the assessment standards of the ICF Geriatric Core Set have been developed.Future work should focus on the reliability and validity of the the assessment standards and their application to the health management of older adults.