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1.
Neurol Res ; : 1-11, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39087592

RESUMEN

OBJECTIVES: Stroke is a leading cause of death in Taiwan. Poor public knowledge of stroke may lead to delays in prehospital arrival, resulting in unfavorable prognoses. Studies have investigated public knowledge of stroke and highlighted the importance of stroke education, however, few such studies have been conducted in Taiwan. This study assessed the changes in public knowledge of stroke between 2012 and 2020 by conducting a survey during two World Stroke Day events. Furthermore, this study identified areas where educational efforts may have been insufficient. MATERIALS & METHODS: Questionnaires were distributed to the participants of 2012 and 2020 World Stroke Day events in Taiwan. In total, 328 and 336 questionnaires were completed, respectively. Stroke literacy and knowledge were analyzed between 2012 and 2020. Data were analyzed using the chi-square test or independent t-test. p < 0.05 indicates statistical significance. RESULTS: Hypertension was the most recognized risk factor for stroke in both years (p < 0.001), and recognition of most of the given risk factors significantly increased. In addition, recognition of more than half of the stroke warning signs significantly increased, awareness of the correct acute stroke response also increased (p < 0.001), and overall stroke literacy in Taiwan increased (p = 0.001). CONCLUSION: Stroke literacy and knowledge in Taiwan have improved significantly between 2012 and 2020, but many people still lack adequate stroke knowledge and awareness. Government health department must take this sort of intervention continually (campaigns) and novel approaches (e.g. board game…) to improve stroke literacy and knowledge in public health. REGISTRATION ID: N202109072, approved by the Joint Institutional Review Board of Taipei Medical University on 2021/11/02.

2.
Artículo en Inglés | MEDLINE | ID: mdl-38984531

RESUMEN

OBJECTIVE: Assess the effectiveness of transcranial direct current stimulation (tDCS) in knee osteoarthritis (OA). METHODS: Searched PubMed, Cochrane Library, Embase, and Scopus databases until August 3, 2023, and identified randomized controlled trials (RCTs) evaluating the effects of tDCS in knee OA whose outcomes using pain scores or functional scales. The selected RCTs were subjected to meta-analysis and risk of bias assessment. RESULTS: Seven RCTs involving 488 patients were included in this meta-analysis. Compared with the control group, the tDCS group exhibited significant improvement in pain scores after treatment (standardized mean difference [SMD] = 1.03; 95% confidence interval [CI]: 0.70 to 1.35; n = 359; I2 = 46%), pain scores during follow-up (SMD = 0.83; 95% CI: 0.21 to 1.45; n = 358; I2 = 86%), and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores after treatment (SMD = 4.76; 95% CI: 0.16 to 9.53; n = 319; I2 = 74%), but WOMAC scores during follow-up did not differ significantly between the groups (SMD = 0.06; 95% CI: -0.2 to 0.32; n = 225; I2 = 0%). CONCLUSION: tDCS is a promising therapy for knee OA. Further investigation using large-scale, high-quality RCTs is necessary for optimal tDCS approach in knee OA.

3.
PLoS One ; 19(5): e0303537, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38753671

RESUMEN

Various injectants are available for the treatment of carpal tunnel syndrome. This systematic review and network meta-analysis was conducted to investigate the effectiveness of different injection therapies in alleviating the symptoms of carpal tunnel syndrome. Various databases were searched for relevant studies from inception until May 10, 2023. Eligible studies were identified using the patient (P), intervention (I), comparison (C), and outcomes (O) model, which involved (P) participants with carpal tunnel syndrome, (I) an intervention based on injection therapy, (C) the use of placebo or another injectant as a control treatment, and (O) the measurement of clinical and electrodiagnostic outcomes of interest. A total of 18 studies were included in the analysis. The network meta-analysis revealed that platelet-rich plasma is effective in the treatment of carpal tunnel syndrome in terms of symptom and pain relief and functional improvement in both the short and long term, whereas steroids are effective only in the short term. Additionally, injections of dextrose solution may offer long-term pain relief as well as short- and long-term symptom alleviation and functional improvement. The study findings suggest that platelet-rich plasma should be used as the first-line treatment for carpal tunnel syndrome, with dextrose and steroids serving as alternative treatment options.


Asunto(s)
Síndrome del Túnel Carpiano , Plasma Rico en Plaquetas , Ensayos Clínicos Controlados Aleatorios como Asunto , Síndrome del Túnel Carpiano/tratamiento farmacológico , Síndrome del Túnel Carpiano/terapia , Humanos , Resultado del Tratamiento , Metaanálisis en Red , Inyecciones , Glucosa/administración & dosificación
4.
Cureus ; 16(3): e55614, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38586637

RESUMEN

INTRODUCTION: The aim of the present study was to report on the prevalence of disability and its association with sociodemographic factors among welfare benefit applicants in Greece. The study also compared the disability scores between different health conditions using the WHODAS 2.0 (12-item version), a biopsychosocial-model-based measure. METHODS: The Greek WHODAS 2.0, 12-item version, was administered by interview. A three-member medical committee assessed the medical records of the applicants and assigned a disability percentage based on the biomedical measure of disability percentage determination (Barema scale). RESULTS: The majority of the participants were female (56.65%). Certain health conditions were presented more frequently among welfare benefit applicants (mental health disorders and neoplasms). The domains with the highest rate of difficulty were the "participation" and "life activities" domains. Significant differences were found between WHODAS 2.0 and Barema scores for all eight different health condition categories. The factorial ANOVA (8x2) showed a significant interaction effect between health condition category and gender with respect to the WHODAS 2.0 score (F = 19.033, p <.001, η2 = 0.13). The WHODAS 2.0 score was negatively correlated to gender, years of studies, and marital status and positively correlated to age, working status, and the Barema score. The results revealed that male participants with a partner who were younger, had more studies, were actively working, and had a lower Barema score would have lower WHODAS scores. CONCLUSION: Sociodemographic characteristics of welfare benefit applicants are associated with disability levels based on WHODAS 2.0. Certain health conditions, like mental health or neuromusculoskeletal conditions, are associated with higher disability scores. There are differences between the biopsychosocial and the biomedical approaches to disability assessment. The implementation of WHODAS 2.0 may contribute to a better understanding of the lived experience of patients and is a feasible and efficient tool. Combining biomedical and biopsychosocial approaches may enhance the procedures of disability assessment and help in the development of policies that support people with disabilities.

5.
Sci Rep ; 14(1): 3787, 2024 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-38360804

RESUMEN

We aim to clarify the relationship between low skeletal muscle mass and varying levels of adiposity and to identify the types of physical function impairments associated with sarcopenic obesity (SO). This study examined cross-sectional data from the National Health and Nutrition Examination Survey with whole-body dual-energy X-ray absorptiometry (DXA) scans. The data included age, gender, DXA-assessed body composition, and physical functional activity with performing daily tasks by questionnaire. We subdivided the data by body composition into a non-SO group and a SO group (ASMI 0-49.99% and FMI of 50-100%), after which the SO data were subdivided into three classes. A higher class indicated higher adiposity and lower muscle mass. The physical function impairment of the two groups was compared. Our study examined 7161 individuals, of which 4907 did not have SO and 2254 had SO, and their data were further divided into three classes (i.e., class I, 826 individuals; class II, 1300 individuals; and class III, 128 individuals). Significant differences in demographics and DXA parameters were identified between the non-SO and SO groups (P < 0.001); the individuals with SO were older, included more women, and exhibited high adiposity and less lean muscle mass. The individuals with class III SO exhibited greater differences and reported more difficulty in performing daily activities. The individuals with class III SO exhibited the most severe physical function impairment. Our study highlights the considerable difficulties encountered by individuals with SO in performing daily activities. Given this finding, customized rehabilitation strategies should be implemented to improve the quality of life of individuals with SO.


Asunto(s)
Sarcopenia , Humanos , Femenino , Encuestas Nutricionales , Estudios Transversales , Calidad de Vida , Índice de Masa Corporal , Obesidad , Composición Corporal , Absorciometría de Fotón , Músculo Esquelético/diagnóstico por imagen
6.
J Occup Rehabil ; 34(1): 71-86, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37378718

RESUMEN

PURPOSE: Decisions to increase work participation must be informed and timely to improve return to work (RTW). The implementation of research into clinical practice relies on sophisticated yet practical approaches such as machine learning (ML). The objective of this study is to explore the evidence of machine learning in vocational rehabilitation and discuss the strengths and areas for improvement in the field. METHODS: We used the PRISMA guidelines and the Arksey and O'Malley framework. We searched Ovid Medline, CINAHL, and PsycINFO; with hand-searching and use of the Web of Science for the final articles. We included studies that are peer-reviewed, published within the last 10 years to consider contemporary material, implemented a form of "machine learning" or "learning health system", undertaken in a vocational rehabilitation setting, and has employment as a specific outcome. RESULTS: 12 studies were analyzed. The most commonly studied population was musculoskeletal injuries or health conditions. Most of the studies came from Europe and most were retrospective studies. The interventions were not always reported or specified. ML was used to identify different work-related variables that were predictive of return to work. However, ML approaches were varied and no standard or predominant ML approach was evident. CONCLUSIONS: ML offers a potentially beneficial approach to identifying predictors of RTW. While ML uses a complex calculation and estimation, ML complements other elements of evidence-based practice such as the clinician's expertise, the worker's preference and values, and contextual factors around RTW in an efficient and timely manner.


Asunto(s)
Empleo , Reinserción al Trabajo , Humanos , Estudios Retrospectivos , Rehabilitación Vocacional , Europa (Continente)
7.
Spinal Cord ; 62(3): 110-116, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38160224

RESUMEN

STUDY DESIGN: Cross-sectional study. OBJECTIVES: Work-related disability is common in persons with spinal cord injury (SCI). The aims of this study are to examine the associations of employment with self-perceived health (SPH) and quality of life (QoL) across 22 countries and to explore the covariates around employment and SPH and QoL. SETTING: Community. METHODS: We analyzed 9494 community-dwelling persons with SCI aged 18-65. We performed an adjusted regression and path analysis. The independent variable was 'employment' and the dependent variables were two single items: QoL (very poor to very good) and SPH (excellent to poor). Covariates included the Gross Domestic Product (GDP), education, time since SCI, age, gender, years of employment after SCI, SCI level (paraplegia, tetraplegia), and completeness of SCI. RESULTS: Participants' mean age was 47, 74% were male, and 63% had paraplegia. We found an association between employment and QoL and SPH. While the magnitude of the effect of employment on QoL did not differ across GDP quartiles, its perceived effect on QoL was found to be significant in the highest GDP quartile. Employment was predictive of good SPH in two GDP quartiles (Q1 and Q4), but significant across all quartiles when predicting poor perceptions, with the magnitude of effect varying significantly. CONCLUSIONS: Employment is closely related to QoL and SPH depending on the GDP. We may positively influence the QoL and SPH in the SCI population to promote better employment outcomes by considering the infrastructure and economy.


Asunto(s)
Calidad de Vida , Traumatismos de la Médula Espinal , Humanos , Masculino , Persona de Mediana Edad , Femenino , Estudios Transversales , Traumatismos de la Médula Espinal/epidemiología , Traumatismos de la Médula Espinal/complicaciones , Encuestas y Cuestionarios , Empleo , Paraplejía/complicaciones
8.
Cureus ; 15(11): e48588, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38084177

RESUMEN

INTRODUCTION: The International Classification of Functioning, Disability, and Health (ICF) provides a framework for the biopsychosocial model of disability and was developed by the World Health Organization (WHO). The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is an ICF-based tool that measures health and disability at the population level or in clinical practice. The aim of the study was to examine the psychometric properties of the Greek version of the WHODAS 2.0 (12-item) administered to 10,163 adults who had applied for welfare benefits in three regions of Greece. METHODS: The WHODAS 2.0, administered by interview was the primary outcome variable. Principal axis factoring (PAF) and confirmatory factor analysis (CFA) assessed the data fit to the model (construct validity). The correlation between Barema disability percentage (assessed by a three-member medical committee) and WHODAS 2.0 score and the correlation between WHODAS 2.0 score and the number of comorbidities were also examined (concurrent validity). Cronbach's alpha was used to assess the internal consistency of the questionnaire. Floor and ceiling effects were also examined. RESULTS: Internal consistency was acceptable (Cronbach's alpha=0.918). A significant association was found between Barema disability percentage and the WHODAS 2.0 score. Factor analysis showed a clear two-factor solution (PAF and CFA), while no floor or ceiling effects were evident. CONCLUSION: The Greek version of the 12-item WHODAS 2.0 was found to be reliable and valid in a wide sample of applicants for welfare benefits.

9.
J Occup Rehabil ; 2023 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-38102368

RESUMEN

PURPOSE: Assessing work functioning in patients with persistent low back pain (LBP) is important for understanding their ability to engage in work-related activities. This study aims to evaluate the item characteristics, factor structure, and internal consistency of the Work Rehabilitation Questionnaire (WORQ) in patients with persistent LBP. METHODS: Four hundred and twenty-five individuals with LBP completed the WORQ. Item characteristics, exploratory factor analysis (EFA), and consistency were performed to identify the underlying factors. RESULTS: Missing responses were < 2% for each item. The analysis revealed three factors: psychological wellbeing, physical functioning, and cognitive ability. The factors demonstrated strong internal consistency, with Cronbach's alpha values ranging from 0.88 to 0.93 and McDonald's Omega from 0.92 to 0.96. Fifteen items did not fit into any identified factors, suggesting their potential value in screening functioning levels beyond the factors. CONCLUSIONS: The WORQ is a valid instrument for evaluating work limitations in individuals with persistent LBP. Further research should assess its responsiveness to changes from interventions that target workability. Advancing this knowledge has the potential to promote work rehabilitation and improve the quality of life for patients with persistent LBP.

11.
Sci Rep ; 13(1): 20018, 2023 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-37973838

RESUMEN

The combination of mirror therapy (MT) and neuromuscular electrical stimulation (NMES) has been devised as an intervention method in stroke rehabilitation; however, few studies have investigated its efficacy in lower extremity motor function recovery. In this systematic review and meta-analysis, we examined the effectiveness of combined MT and NMES therapy in improving poststroke walking speed, spasticity, balance and other gait parameters. Randomized controlled trials (RCTs) were selected from PubMed, Cochrane Library, EMBASE, and Scopus databases. In total, six RCTs which involving 181 participants were included. Our findings indicate that MT combined with NMES elicits greater improvement relative to control group in walking speed (SMD = 0.67, 95% confidence interval [CI] 0.26-1.07, P = 0.001), Berg Balance Scale (SMD = 0.72; 95% CI 0.31-1.13; P = 0.0007), cadence (SMD = 0.59, 95% CI 0.02-1.16, P = 0.04), step length (SMD = 0.94, 95% CI 0.35-1.53, P = 0.002), and stride length (SMD = 0.95, 95% CI 0.36-1.54, P = 0.002) but not in modified Ashworth scale (SMD = - 0.40, 95% CI - 1.05 to 0.26, P = 0.23). Our findings suggest that MT combined with NMES may be a suitable supplemental intervention to conventional therapy in stroke survivors.


Asunto(s)
Terapia por Estimulación Eléctrica , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Terapia del Movimiento Espejo , Recuperación de la Función , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/terapia , Terapia por Estimulación Eléctrica/métodos , Extremidad Inferior , Estimulación Eléctrica
12.
Front Rehabil Sci ; 4: 1134039, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37363810

RESUMEN

Purpose: This study aimed to translate and cross-culturally adapt the work rehabilitation questionnaire (WORQ) into Danish to examine the internal consistency and test-retest reliability of the Danish WORQ and, second, to test the feasibility of WORQ in the Danish context of vocational rehabilitation. Methods: The translation was performed in a dual-panel approach. The panel consisted of a bilingual physician, a university student in psychology, a layperson, a specialist in social work and rehabilitation, and a professor in social medicine. The international classification of functioning, disability, and health (ICF) codes were cross-evaluated to secure that there was a high level of agreement of ICF codes for each specific WORQ item in the Danish and English version. The content validity was evaluated by the clinical physicians at an outpatient clinic in social medicine and by the case managers at a municipality job center. Data for the examination of the internal consistency and test-retest reliability were collected at the Holbæk municipality from citizens in the working age. The test-retest took place 14 days apart. The internal consistency and test-retest reliability were tested conducting Cronbach's alpha, intraclass correlation, and Spearman's correlation analyses. Results: The panel experienced only minor challenges in the translation process, leading to minor modifications. The cross-evaluation of coding in the Danish WORQ compared with the initial English version only found small deviations, while the remaining coding agreed between the initial English and the Danish items. The panel argued to add sub-codes to culturally adapt to the transportation forms generally used in Denmark. The general perception among the participating patients and citizens at the job center as well as the clinical physicians and case managers was that the WORQ was easy, understandable, and meaningful. Conclusions: This study showed that the Danish WORQ have a high content validity and usability. Nonetheless, the Danish WORQ needs to be validated against well-acknowledged tools for assessing functional ability specific to work and in general.

13.
Front Rehabil Sci ; 4: 1115981, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37168232

RESUMEN

Objective: The aim of this study was to examine the construct validity of the Danish version of the Work Rehabilitation Questionnaire (WORQ) and to compare the physical capacity items of WORQ to objective, standardized measures of physical capacity and selected SF-36 physical items. Methods: The study took place at a job center in Holbæk municipality, and 40 clients of working age were enrolled. Participants completed the interviewer-administered version of WORQ, selected SF-36 items, and underwent objective, physical capacity testing, including a 30-s sit-to-stand-test, a hand-grip-strength test, and a 6-min walk test to estimate cardiorespiratory fitness. Correlations between variables were assessed using Spearman's correlation. Further, cross tabulations and chi-square tests were conducted, and sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) were calculated. Results: We found a moderate to strong correlation between WORQ and SF-36 items and a weak to moderate correlation between physical capacity items of WORQ and objectively tested physical capacity measures. On the basis of cross tabulations, calculations yielded overall higher NPVs than PPVs, whereas sensitivity and specificity varied more, with not one parameter being overall better than the other. Conclusion: We found evidence of construct validity of the WORQ-Danish. However, our study might also raise a question as to whether objective physical capacity tests are the gold standard for evaluating functioning. Our results are promising, and we suggest further investigations of the screening capabilities of WORQ, alongside other legacy measures or instruments, both self-reported and objective physical measures, to complement information-where specific answers to specific questions trigger work-related actions or interventions.

14.
Int J Equity Health ; 22(1): 56, 2023 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-36998015

RESUMEN

BACKGROUND: Inequality in health is a prevalent and growing concern among countries where people with disabilities are disproportionately affected. Unmet healthcare needs explain a large part of the observed inequalities between and within countries; however, there are other causes, many non-modifiable, that also play a role. AIM: This article explores the difference in health across income levels in populations with spinal cord injury (SCI). SCI is of special interest in the study of health systems, as it is an irreversible, long-term health condition that combines a high level of impairment with subsequent comorbidities. METHODS: We estimated the importance of modifiable and non-modifiable factors that explain health inequalities through a direct regression approach. We used two health outcomes: years living with the injury and a comorbidity index. Data come from the International Spinal Cord Injury Survey (InSCI), which has individual data on people with SCI in 22 countries around the world. Due to the heterogeneity of the data, the results were estimated country by country. RESULTS: On average, the results exhibit a prevalence of pro-rich inequalities, i.e., better health outcomes are more likely observed among high-income groups. For the years living with the injury, the inequality is mostly explained by non-modifiable factors, like the age at the time of the injury. In contrast, for the comorbidity index, inequality is mostly explained by unmet healthcare needs and the cause of the injury, which are modifiable factors. CONCLUSIONS: A significant portion of health inequalities is explained by modifiable factors like unmet healthcare needs or the type of accident. This result is prevalent in low, middle, and high-income countries, with pervasive effects for vulnerable populations like people with SCI, who, at the same time are highly dependent on the health system. To reduce inequity, it is important not only to address problems from public health but from inequalities of opportunities, risks, and income in the population. HIGHLIGHTS: • Better health status is evident among high-income groups, which is reflected in pro-rich inequalities. • Age at the time of the injury is the most important factor to explain inequalities in years living with the injury. • Unmet health care needs are the most important factor to explain inequalities in comorbidities. • The inequality in health varies by country dependent upon socioeconomic factors.


Asunto(s)
Renta , Traumatismos de la Médula Espinal , Humanos , Factores Socioeconómicos , Encuestas y Cuestionarios , Disparidades en el Estado de Salud , Atención a la Salud , Traumatismos de la Médula Espinal/epidemiología
16.
Clin Rehabil ; 37(1): 3-16, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35730135

RESUMEN

OBJECTIVE: To investigate whether neuromuscular electrical stimulation improves mobility in children with spastic cerebral palsy. METHODS: PubMed, Cochrane, EMBASE, and Scopus were searched for randomized controlled trials studying the effects of NMES on the lower limbs in children with spastic CP. Randomized controlled trials comparing the effect of neuromuscular electrical stimulation with that of placebo or conventional therapy on mobility in children with cerebral palsy were eligible for inclusion. Two reviewers independently screened studies, extracted data, and examined the risk of bias and quality of evidence by using the revised Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2.0) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method. The final search was conducted on May 23, 2022. RESULTS: A total of 14 randomized controlled trials (2 crossover studies and 12 parallel studies including 421 patients) were included in this meta-analysis. Compared with the control group (conventional physical therapy), the treatment group exhibited greater improvement in walking speed (standardized mean difference = 0.29; 95% confidence interval = 0.02-0.57) and the standing, walking, running, and jumping dimension of the Gross Motor Function Measure (standardized mean difference = 1.24; 95% confidence interval = 0.64-1.83). CONCLUSION: Neuromuscular electrical stimulation improved mobility in children with spastic cerebral palsy, particularly in standing, running, and jumping function, and it is safe for children with spastic cerebral palsy.


Asunto(s)
Parálisis Cerebral , Terapia por Estimulación Eléctrica , Niño , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Espasticidad Muscular/terapia , Caminata , Estimulación Eléctrica , Terapia por Estimulación Eléctrica/métodos
17.
Clin Rehabil ; 37(4): 516-533, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36330696

RESUMEN

OBJECTIVE: There are different upper limb manual training protocols, namely constraint-induced movement therapy, modified constraint-induced movement therapy, hand-arm bimanual intensive training, hand-arm bimanual intensive training including lower extremity, action observation training, and mirror therapy, available for improving functional outcomes in children with cerebral palsy. However, the effect and priority of these strategies remain unclear. DATA SOURCES: We searched the PubMed, Cochrane Library, and Embase databases for relevant articles from inception to October 12, 2022. REVIEW METHODS: To assess the effect and priority of different strategies of upper limb manual training protocols through a systematic review and network meta-analysis of randomized controlled trials. RESULTS: We included 22 randomized controlled trials in this network meta-analysis. The ranking probability and standard mean differences with 95% credible intervals of the comparison between placebo and other forms of upper limb manual training were as follows: mirror therapy = 2.83 (1.78, 3.88), hand-arm bimanual intensive training including the lower extremity = 0.53 (0.09, 0.96), constraint-induced movement therapy = 0.44 (0.18, 0.71), hand-arm bimanual intensive training = 0.41 (0.15, 0.67), modified constraint-induced movement therapy = 0.39 (0.03, 0.74), and action observation training = 0.18 ( - 0.29, 0.65). No significant inconsistency was noted between the results of direct and indirect comparisons. CONCLUSION: We suggest that mirror therapy could be the upper limb manual training protocol of choice for improving functional outcomes in patients with cerebral palsy.


Asunto(s)
Parálisis Cerebral , Niño , Humanos , Parálisis Cerebral/terapia , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto , Modalidades de Fisioterapia , Extremidad Superior , Resultado del Tratamiento
18.
Pain ; 164(2): 252-257, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-35975878

RESUMEN

ABSTRACT: Understanding chronic pain and disability requires a consideration of the lived experience of the patient. There is limited evaluation of the content validity of patient-reported outcome measures (PROMs) in chronic pain using a comprehensive biopsychosocial view of the patient's experience. To address this gap, this study aimed to evaluate the content validity of PROMs for patients with chronic pain. A literature review was performed to identify PROMs for patients with chronic pain. Concepts from PROMs were linked to the International Classification of Functioning, Disability, and Health (ICF); the ICF Core Set for Chronic Widespread Pain; and the International Classification of Diseases-11 Functioning Properties of Chronic Pain (FP). Concepts were compared with published "attributes'' of chronic pain. 62 PROMs (1336 items total) were identified and linked to 560 unique second-level ICF categories. The greatest number of items across PROMs were represented in the activities and participation category (44% of all total items), followed by body functions (41%), environmental factors (9%), personal factors (5%), and body structures (0.3%). There was a 41% to 78% match with the Core Set for Chronic Widespread Pain and the International Classification of Diseases-11 FP, respectively. 20% of items reflected the pain-experience attributes with the most items reflecting the concept of "control over pain." Content validity analysis suggests chronic widespread pain patient-reported outcome measures poorly address attributes of living with chronic pain that matter most to patients. Future development or refinement should consider a more comprehensive view of the patients' lived experience.


Asunto(s)
Dolor Crónico , Personas con Discapacidad , Humanos , Dolor Crónico/diagnóstico , Dolor Crónico/terapia , Evaluación de la Discapacidad , Personas con Discapacidad/psicología , Clasificación Internacional de Enfermedades , Medición de Resultados Informados por el Paciente , Actividades Cotidianas
20.
Artículo en Inglés | MEDLINE | ID: mdl-36498067

RESUMEN

A hip fracture is a major adverse event for older individuals that has extremely high rates of mortality and morbidity, specifically functional decline. Thus, effective post-hip fracture rehabilitation is crucial to enable patients to regain function and improve their quality of life. Most post-hip fracture rehabilitation programs focus only on physical functioning, but rehabilitation goals related to the quality of life, social participation, and environmental issues are also crucial considerations. This study aimed to develop a core set of considerations based on the International Classification of Functioning, Disability, and Health (ICF) for use as a reference in designing comprehensive rehabilitation programs for patients with hip fractures. For this purpose, we recruited 20 experts from related fields working at a university hospital to complete a three-round Delphi-based questionnaire. Before beginning this process, a literature review related to ICF category selection was conducted. Next, a 5-point Likert scale was employed to rate the importance of each proposed category, and Spearman's rank correlation coefficient and semi-interquartile range indices were analyzed to rate the consensus status. Categories for the ICF core set of considerations for post-hip-fracture rehabilitation were chosen on the basis of a high level of consensus and a mean score of ≥4.5 in the third Delphi-based questionnaire round. After selection, the ICF core set comprised 34 categories, namely 15 for bodily functions, 5 for bodily structures, 13 for activities and participation, and 1 for environmental factors. The proposed post-hip-fracture rehabilitation ICF core set can serve as a reference for developing effective rehabilitation strategies and goal setting by interdisciplinary teams. However, further feasibility evaluation is recommended for individualized rehabilitation program design.


Asunto(s)
Personas con Discapacidad , Fracturas de Cadera , Humanos , Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud , Actividades Cotidianas , Calidad de Vida , Personas con Discapacidad/rehabilitación , Fracturas de Cadera/cirugía , Evaluación de la Discapacidad , Técnica Delphi
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