Leisure repertoire among persons with a spinal cord injury: interests, performance, and well-being.

OBJECTIVE: To explore and describe the leisure repertoire of persons with traumatic spinal cord injury (SCI) and how the repertoire is related to interest, performance, and well-being. DESIGN: Cross-sectional study. SETTING: A total of 97 persons with traumatic SCI were recruited from the non-profit national organization, RG Active Rehabilitation in Sweden. OUTCOME MEASURE: Data were collected through a two-part postal survey. The first comprised of questions investigating socio-demographic variables and injury characteristics; the second part included an interest checklist with 20 areas of leisure activities. RESULTS: The participants were mostly interested in, performed, and experienced well-being from social and culture activities and TV/DVD/movies. The areas of leisure activities in which they had most likely experienced changes after the SCI were outdoor activities, exercise, and gardening. Sex, age, and to some extent, time since injury were related to interest, performance, well-being, and changed performance. CONCLUSIONS: The results provided an explanation and limited description of a changed leisure repertoire among persons after a traumatic SCI. The study showed that sex, age, and time since injury were more closely related to the choice of leisure activities to include in the leisure repertoire than the level of injury. This knowledge can be of importance when professionals in the field of rehabilitation are planning and implementing interventions concerning leisure activities for persons with SCI.

The Assessment of Awareness of Ability (A3) in a Japanese context: a Rasch model application.

The overall aim of this study was to evaluate the validity of the Assessment of Awareness of Ability (A3) in a Japanese context. The A3 (formerly known as the Assessment of Awareness of Disability, AAD) is a standardized 11-question interview used to explore the discrepancy between observed strengths and limitations in the performance of activities of daily living (ADL) according to the Assessment of Motor and Process Skills (AMPS) and the limitations described by the client. In this study, 259 matched Swedish and Japanese A3 data records were analyzed using a Rasch partial credit model (PCM). The analysis of rater consistency and items demonstrated acceptable goodness-of-fit according to the PCM, indicating rater consistency and internal scale validity. The A3 can help clients and therapists understand discrepancies between observed and self-reported performance aspects of various everyday tasks within Japanese and Swedish contexts.

Psychometric evaluation of an assessment of awareness using two different Rasch models.

OBJECTIVE: The aim of this study was to evaluate the psychometric properties of the Assessment of Awareness of Disability (AAD), applied to a sample of clients with a variety of diagnoses, using two different Rasch models. METHODS: The sample consisted of 245 clients admitted to occupational therapy services in Sweden. The psychometric properties of the AAD measures were analysed and compared using both Rasch partial credit (PCM) and rating scale (RSM) models. RESULTS: In relation to rating scale properties and person response validity, the RSM yielded better results. However, the PCM demonstrated better item goodness-of-fit statistics than the RSM, supporting the internal scale validity of the AAD. Some systematic indications of sample-dependent misfit were also found in the data. CONCLUSION: The results support the validity of the AAD in a sample of clients with various diagnoses, although some limitations of the tool are addressed. The outcomes also demonstrate the importance of making cautious choices when selecting a Rasch model for investigating psychometric properties, as the choice has a substantial impact on the interpretation of the findings.

Semi-conducting properties of titanium dioxide surfaces on titanium implants.

The properties of the TiO2 layer on titanium implant surfaces are decisive for good contact with the surrounding tissue. The oxide properties can be deliberately changed by for example chemical etching, ion incorporation or anodisation. In the present study impedance spectroscopy was used to study the semi-conducting properties of the naturally formed oxide for different pre-treatment of the surface. A turned surface was used as a reference and both physical (blasting) and chemical (hydrofluoric acid etching) treatments were investigated. Blasting of a titanium sample introduces defects in the metal surface and the study clearly shows that also the oxide layer contains defects leading to a higher number of charge carriers (increased conductivity) compared with the oxide on the turned surface. The hydrofluoric acid etching of the blasted surface results in an oxide film with even higher conductivity. Indication of the defect oxide structure for fluoride treated samples was also seen when analysing the TiO+/Ti+ ratio from ToF-SIMS data. The lowest value of this ratio was obtained for the HF etched sample, indicating a less stoichiometric oxide compared to the other surfaces. This is a result of incorporation of fluoride ions in the oxide, as proven by adsorption studies on a TiO2 suspension. The results were treated in the context of surface complexation and two surface complexes were identified. Our results are discussed in relation to pull-out data on rabbit. The pull-out forces depend primarily on surface roughness but the contribution from the hydrofluoric acid etching might be explained by fluoride ion incorporation and the resulting increase in oxide conductivity.

Longitudinal changes in everyday life after home modifications for people aging with disabilities.

OBJECTIVE: To investigate longitudinal impacts of home modifications on the difficulty of performing everyday life tasks for people aging with disabilities, and to investigate whether other factors had any additional impacts on difficulty in everyday life tasks for people receiving home modifications. METHODS: The sample consisted of 103 persons aging with disabilities and in need of home modifications, divided into an intervention group and a comparison group. The data were first subjected to Rasch analysis and a random coefficient model was used. RESULTS: Participants in the intervention group reported a significantly lower level of difficulty in everyday life tasks compared with those in the comparison group. One confounding factor, number of months waiting for home modification, had an impact on difficulty in everyday life. CONCLUSION: Home modifications are effective in decreasing difficulty in performing everyday life tasks up to six months after the installation. Furthermore, to be effective home modifications need to be installed in a timely fashion. For each consecutive month the person waited for their home modification the difficulty of performing everyday life tasks increased. Therefore, it is important that home modifications be installed as soon as possible after the need has been identified.

Impact of home modification services on ability in everyday life for people ageing with disabilities.

OBJECTIVE: To examine the impact of home modifications on self-rated ability in everyday life from various aspects for people ageing with disabilities. METHODS: The study sample was recruited from an agency providing home modification services in Sweden and comprised 73 subjects whose referrals had been approved and who were scheduled to receive home modifications (intervention group) and 41 subjects waiting for their applications to be assessed for approval (comparison group). The subjects rated their ability in everyday life using the Client-Clinician Assessment Protocol Part I on 2 occasions: at baseline and follow-up. The Client-Clinician Assessment Protocol Part I provides data on the clients' self-rated independence, difficulty and safety in everyday life. The data were first subjected to Rasch analysis in order to convert the raw scores into interval measures. Further analyses to investigate changes in self-rated ability were conducted with parametric statistics. RESULTS: Subjects who had received home modifications reported a statistically significant improvement in their self-rated ability in everyday life compared with those in the comparison group. Subjects who had received home modifications reported less difficulty and increased safety, especially in tasks related to self-care in the bathroom and transfers, such as getting in and out of the home. CONCLUSION: Home modifications have a positive impact on self-rated ability in everyday life, especially on decreasing the level of difficulty and increasing safety.

Performance of activities of daily living in a sample of applicants for home modification services.

Home modification services are provided to support persons with functional limitations to live independently at home. It is not well known what causes individuals to apply for home modifications, or in what kind of life situation this need appears. The aim of this study was to examine the relationship between performance of activities of daily living, housing and living situation, and the home modification applied for in a sample of home modification applicants. Further, the aim was to examine differences in performance of activities of daily living between subgroups with different social support. A total of 102 participants were included in the study. Data on performance of activities of daily living was collected through interviews in the participants' homes, using structured instruments. The participants reported high levels of independence in activities of daily living, and were using assistive devices to a large extent. However, the applicants clearly experienced difficulties in performing activities related to the applied home modification. The study indicates that the main reason for applying for Home Modification Grants was perceived difficulties in performance of activities of daily living. This stresses the importance of including other aspects besides independence when trying to understand persons' activity performance and planning for occupational therapy interventions.