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Myers, Jonathan, William Herbert, Paul Ribisl, and Barry Franklin. "Is new science driving practice improvements and better patient outcomes? Applications for cardiac rehabilitation." Clinical & Investigative Medicine 31, no. 6 (December 1, 2008): 400. http://dx.doi.org/10.25011/cim.v31i6.4928.
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Evidence from many clinical trials in recent years suggests that a large “treatment gap” exists between recommended therapies and the care that patients actually receive. This gap has been particularly apparent in the area of primary and secondary prevention of cardiovascular disease. In this article, three areas are discussed in which new scientific advances have not been adequately translated to clinical practice. These include: 1) the most appropriate measures to define the risks associated with obesity; 2) the under-diagnosis of obstructive sleep apnea and its relation to cardiovascular risk; and 3) the use and misuse of the exercise test and other functional status tools to predict health outcomes. Each is discussed in terms of how they should be quantified, their contribution to the estimation of cardiovascular disease risk, their response to interventions, and implications for cardiac rehabilitation. Clinical cardiac rehabilitation programs can benefit from routinely including these measures, both for their value in stratifying risk and for their importance in quantifying program efficacy. Physicians and allied health professionals should expand their routine medical evaluations and coronary risk factor profiling to include these measures.
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Aldhahir, Abdulelah M., Ahmed M. Al Rajeh, Yousef S. Aldabayan, Salifu Drammeh, Vanitha Subbu, Jaber S. Alqahtani, John R. Hurst, and Swapna Mandal. "Nutritional supplementation during pulmonary rehabilitation in COPD: A systematic review." Chronic Respiratory Disease 17 (January 1, 2020): 147997312090495. http://dx.doi.org/10.1177/1479973120904953.
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Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chronic obstructive pulmonary disease (COPD) has been limited by an absence of rigorous evidence-based studies supporting use. The objective was to report and summarise the current evidence supporting the use of nutritional supplementation to improve outcomes during PR in stable COPD patients. A systematic search was conducted up to 7 August 2019 (registration number CRD42018089142). The preferred reporting items for systematic reviews and meta-analyses guidelines were used. Six databases were included: Medical Literature Analysis and Retrieval System Online or MEDLARS Online, Allied and Complementary Medicine Database, the Cochrane Database of Systematic Reviews, Excerpta Medica dataBASE, Cumulative Index of Nursing and Allied Health Literature and Web of Science. This systematic search generated 580 initial matches, of which 22 studies (917 COPD participants) met the pre-specified criteria and were included. Sixteen of 19 studies that used nutritional supplements in addition to PR did not show additional benefit compared to PR alone when measuring exercise capacity. Nutritional supplements significantly increased body weight in 7 of 11 studies. Body mass index increased significantly in two of six studies. Handgrip strength did not improve, while quadriceps muscle strength significantly improved in 3 of 11 studies. Four of eight studies showed a significant improvement in inspiratory muscle function. Only 2 of 14 studies demonstrated a significant improvement in quality of life with supplementation in addition to PR. There remains insufficient evidence on the effect of nutritional supplementation on improving outcomes during PR in patients with COPD due to heterogeneity in supplements, outcome measures and PR programmes. Therefore, controversy remains and further research is needed.
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Moran, Anna, Susan A. Nancarrow, and Pamela Enderby. "Mechanisms to enhance the effectiveness of allied health and social care assistants in community-based rehabilitation services: a qualitative study." Health & Social Care in the Community 23, no. 4 (December 5, 2014): 389–98. http://dx.doi.org/10.1111/hsc.12158.
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Brown, Leanne J., Luke Wakely, Alexandra Little, Susan Heaney, Emma Cooper, Katrina Wakely, Jennifer May, and Julie M. Burrows. "Immersive Place-Based Attachments in Rural Australia: An Overview of an Allied Health Program and Its Outcomes." Education Sciences 13, no. 1 (December 20, 2022): 2. http://dx.doi.org/10.3390/educsci13010002.
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This paper describes a rural immersive attachment program for allied health students at an Australian University Department of Rural Health and its workforce outcomes. A mixed methods longitudinal cohort study, with data collected via end-of-placement and post-graduation surveys. Over 13 years, 311 allied health ‘year-long’ immersive rural attachments, as well as short-term placements, were supported. Pre- and post-placement rural practice intention ratings were paired (from 572 end of placement surveys) for 553 (96.7%) students. Students from metropolitan (49.4%, n = 273, p < 0.001), and rural origin (50.6%, n = 280, p < 0.001) showed a significant increase in rural practice intention. At 1 year post-graduation, 40.3% (n = 145) of graduates had worked in a rural or remote location in Australia, 39.9% at 3 years (n = 87) and 36.5% (n = 42) at 5 years. Longer-term rural attachments were found to be associated with rural practice location, independent of rural background. Those who had undertaken a longer rural attachment (≥18-weeks) were twice as likely to be working in a rural or remote area than those <18 weeks at 1 year (OR 2.018 95% CI 1.204–3.382) and 2.7 times as likely at 3 years (OR 2.727, 95% CI (1.325–5.614). Supporting students to undertake rural immersive attachments appears to be associated with greater rural practice intention and later rural practice.
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Joshi, Vicky L., Jan Christensen, Esben Lejsgaard, Rod S. Taylor, Ann Dorthe Zwisler, and Lars H. Tang. "Effectiveness of rehabilitation interventions on the secondary consequences of surviving a cardiac arrest: a systematic review and meta-analysis." BMJ Open 11, no. 9 (September 2021): e047251. http://dx.doi.org/10.1136/bmjopen-2020-047251.
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AimThe aim of this systematic review was to assess the effectiveness of rehabilitation interventions on the secondary physical, neurological and psychological consequences of cardiac arrest (CA) for adult survivors.MethodsA literature search of electronic databases (MEDLINE, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica database, Psychological Information Database, Web of Science and Cochrane Central Register of Controlled trials) was conducted for randomised controlled trials (RCTs) and observational studies up to 18 April 2021. The primary outcome was health-related quality of life (HRQoL) and main secondary outcome was neurological function with additional secondary outcomes being survival, rehospitalisation, safety (serious and non-serious adverse events), psychological well-being, fatigue, exercise capacity and physical capacity. Two authors independently screened studies for eligibility, extracted data and assessed risk of bias.ResultsThree RCTs and 11 observational studies were included (total 721 participants). Study duration ranged from 8 weeks to 2 years. Pooled data from two RCTs showed low-quality evidence for no effect on physical HRQoL (standardised mean difference (SMD) 0.19, (95% CI: −0.09 to 0.47)) and no effect on mental HRQoL (SMD 0.27 (95% CI: −0.01 to 0.55)).Regarding secondary outcomes, very low-quality evidence was found for improvement in neurological function associated with inpatient rehabilitation for CA survivors with acquired brain injury (SMD 0.71, (95% CI: 0.45 to 0.96)) from five observational studies. Two small observational studies found exercise-based rehabilitation interventions to be safe for CA survivors, reporting no serious or non-serious events.ConclusionsGiven the overall low quality of evidence, this review cannot determine the effectiveness of rehabilitation interventions for CA survivors on HRQoL, neurological function or other included outcomes, and recommend further high-quality studies be conducted. In the interim, existing clinical guidelines on rehabilitation provision after CA should be followed to meet the high burden of secondary consequences suffered by CA survivors.PROSPERO registration numberCRD42018110129.
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Bhattarai, Muna, Susan Miller Smedema, and Khomapak Maneewat. "An Integrative Review of Factors Associated With Resilience Post-Spinal Cord Injury." Rehabilitation Counseling Bulletin 64, no. 2 (July 9, 2020): 118–27. http://dx.doi.org/10.1177/0034355220938429.
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This study aimed to analyze factors associated with resilience among persons with spinal cord injury (SCI). An integrative review was conducted. Electronic databases including PubMed, ProQuest, Cumulative Index of Nursing and Allied Health Literature, and Web of Science were searched using relevant search terms and keywords. A total of two qualitative and nine quantitative studies were included in the review. Psychosocial factors such as social support, self-efficacy, spirituality, post-traumatic growth, life satisfaction, adaptive coping strategies, psychological strength, and being a role model were associated with higher resilience. Stress, anxiety, depression, external locus of control, and attachment avoidance correlated with lower resilience. Inconsistent results were reported for demographic and injury-related variables such as the age of the participants, gender, pain, and functional independence. The integrative review reported a number of factors associated with resilience in people with SCI. Rehabilitation counselors working with this population can design rehabilitation interventions targeting these variables to enhance the resilience of people with SCI. Consideration of cultural and contextual influences on resilience, as well as the design of effective interventions, are important directions for future research.
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Crawley, Rosie. "Cultural competence in occupational therapy to reduce health disparities: a systematic literature review." International Journal of Therapy and Rehabilitation 29, no. 10 (October 2, 2022): 1–14. http://dx.doi.org/10.12968/ijtr.2021.0011.
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Background/Aims Despite agreement about the relationship between cultural competence and health equality, there is a lack of clear guidance within occupational therapy about what it means to be culturally competent and how it can be achieved. This literature review aims to critically appraise qualitative research to explore occupational therapists' experience of working cross culturally. By comparing these experiences, this review aims to identify ways in which occupational therapists individually, and occupational therapy as a profession, can increase the efficacy of the interventions they provide within cross-cultural situations, so all clients can be supported to achieve equal health outcomes. Methods The following databases were searched between 2010 and 2020: ASSIA (Applied Social Science Index), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, Medline Pubmed. The resultant papers were appraised using the Critical Appraisal Skills Programme checklist and thematic analysis was used to identify three themes. Results The six papers included in this review present the experiences of occupational therapists and occupational therapy students working in cross-cultural situations in the UK, Canada, South Africa, USA, Australia and Ireland. Three major themes emerged that explore the relationship between client-centred practice and cultural competence, theory–practice links, and strategies and barriers to working in a culturally competent way. Conclusions Cultural competence is strongly aligned with some of the core principles of occupational therapy: occupational justice and occupational identity. However, theoretical knowledge and confidence among occupational therapists in this area is lacking, implying that their impact could be greater if there was a more concrete definition of cultural competence and standardised guidelines for practice. Further research is needed to build on the strategies and overcome barriers, so that occupational therapists can fulfil the professional obligation they have to work effectively with all populations.
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Tatham, Kate C., Daniel F. McAuley, Mark Borthwick, Neil G. Henderson, Gemma Bashevoy, and Stephen J. Brett. "The National Institute for Health Research Critical Care Research Priority Setting Survey 2018." Journal of the Intensive Care Society 21, no. 3 (July 8, 2019): 198–201. http://dx.doi.org/10.1177/1751143719862244.
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Introduction Defining research priorities in intensive care is key to determining appropriate allocation of funding. Several topics were identified from the 2014 James Lind Alliance priority setting exercise conducted with the Intensive Care Society. The James Lind Alliance process included significant (and vital) patient/public contribution, but excluded professionals without a bedside role. As a result it may have failed to identify potential early-stage translational research topics, which are more likely identified by medical and/or academic members of relevant specialist basic science groups. The objective of the present project was to complement the James Lind Alliance project by generating an updated list of research priorities by facilitating academic research input. Method A survey was conducted by the National Institute for Health Research (NIHR) to identify the key research priorities from intensive care clinicians, including allied health professionals and academics, along with any evolving themes arising from translational research. Feasibility of all identified topics were then discussed and allocated to themes by a joint clinical academics/NIHR focus group. Results The survey was completed by 94 intensive care clinicians (including subspecialists), academics and allied health professions. In total, 203 research questions were identified, with the top five themes focusing on: appropriate case selection (e.g. who and when to treat; 24%), ventilation (7%), sepsis (6%), delirium (5%) and rehabilitation (5%). Discussion Utilising a methodology distinct from that employed by the James Lind Alliance process, from a broad spectrum of intensive care clinicians/scientists, enabled identification of a variety of priority research areas. These topics can now inform not only the investigator-led research agenda, but will also be considered in due course by the NIHR for potential future funding calls.
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Shah, Shraddha, Grace Dibben, Aditi Ketkar, David L. Hare, Jonathan Myers, Barry Franklin, Abraham Samuel Babu, and Rod S. Taylor. "Identifying the Optimal Exercise Prescription for Patients with Coronary Artery Disease Undergoing Cardiac Rehabilitation: Protocol for a Systematic Review and Network Meta-Analysis of Randomized Control Trials." International Journal of Environmental Research and Public Health 19, no. 19 (September 28, 2022): 12317. http://dx.doi.org/10.3390/ijerph191912317.
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Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity. Exercise-based cardiac rehabilitation (EBCR) has been shown to improve clinical outcomes in these patients, and yet clinicians are often challenged to prescribe the most effective type of exercise training. Therefore, this systematic review and network meta-analysis (NMA) aims to formally quantify the optimal dose of exercise training interventions to improve exercise capacity and quality of life by undertaking direct and indirect pooled comparisons of randomized controlled trials. A detailed search will be conducted on PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), EMBASE and Web of Science. Two reviewers will screen the existing literature and assess the quality of the studies. Disagreements will be resolved through consensus. We anticipate that the analysis will include pairwise and Bayesian network meta-analyses. Most of the trials have studied the impact of exercise training comparing one or two modalities. As a result, little evidence exists to support which interventions will be most effective. The current NMA will address this gap in the literature and assist clinicians and cardiac rehabilitation specialists in making an informed decision. Results will be disseminated through peer-reviewed journals. Ethical approval is not applicable, as no research participants will be involved. PROSPERO Registration number: CRD42022262644.
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Jones, Helen, Keith P. George, Andrew Scott, John P. Buckley, Paula M. Watson, David L. Oxborough, Dick H. Thijssen, et al. "Charter to establish clinical exercise physiology as a recognised allied health profession in the UK: a call to action." BMJ Open Sport & Exercise Medicine 7, no. 3 (September 2021): e001158. http://dx.doi.org/10.1136/bmjsem-2021-001158.
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The UK population is growing, ageing and becoming increasingly inactive and unfit. Personalised and targeted exercise interventions are beneficial for ageing and the management of chronic and complex conditions. Increasing the uptake of effective exercise and physical activity (PA) interventions is vital to support a healthier society and decrease healthcare costs. Current strategies for exercise and PA at a population level mostly involve self-directed exercise pathways, delivered largely via the fitness industry. Even for those who opt-in and manage to achieve the current recommendations regarding minimum PA, this generic ‘one-size-fits-all’ approach often fails to demonstrate meaningful physiological and health benefits. Personalised exercise prescription and appropriate exercise testing, monitoring and progression of interventions for individuals with chronic disease should be provided by appropriately trained and recognised exercise healthcare professionals, educated in the cognate disciplines of exercise science (eg, physiology, biomechanics, motor control, psychology). This workforce has operated for >20 years in the Australian public and private healthcare systems. Accredited exercise physiologists (AEPs) are recognised allied health professionals, with demonstrable health and economic benefits. AEPs have knowledge of the risks and benefits of distinct forms of exercise, skills in the personalised prescription and optimal delivery of exercise, and competencies to support sustained PA behavioural change, based on the established scientific evidence. In this charter, we propose a road map for the training, accreditation and promotion of a clinical exercise physiology profession in the UK.
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de Oliveira e Silva, Ana Cristina, Wynne Pereira Nogueira, Elucir Gir, Sandra Aparecida de Almeida, Bárbara Iansã de Lima Barroso, and Maria Eliane Moreira Freire. "Limiting factors of face shield use for health professionals during the COVID-19 pandemic." Work 70, no. 2 (October 26, 2021): 355–63. http://dx.doi.org/10.3233/wor-210542.
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BACKGROUND: Coronavirus disease (COVID-19) is caused by SARS-COV2, a highly transmissible and pathogenic viral infection, and was identified in December 2019 in Wuhan, China. Three months later, it became a severe pandemic. OBJECTIVE: To identify scientific evidence on the use of face shields by health professionals during the COVID-19 pandemic period. METHOD: An integrative literature review of articles obtained from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases was undertaken. For the search, controlled, non-controlled descriptors and specific keywords: “face shield,” “fluid resistance procedure,” “respiratory infections,” “healthcare workers,” “COVID-19,” “aerosols,” and “personal protection infection” were used. RESULTS: The sample comprised seven studies. The available evidence has shown that face shields do not have a defined standard for their production—their effectiveness depends on the quality of the visor, structure, and fixation system. They must be used as adjuvants to other personal protective equipment (PPE), and their isolated use is not recommended due to the fragilities of peripheral face sealing, especially during the COVID-19 pandemic period. CONCLUSION: Due to the shortage of this equipment, domestic face shields can be indicated if they meet production requirements, based on scientific evidence for their efficient use.
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Swartz, Erik E., and Gianluca Del Rossi. "Cervical Spine Alignment During On-Field Management of Potential Catastrophic Spine Injuries." Sports Health: A Multidisciplinary Approach 1, no. 3 (May 2009): 247–52. http://dx.doi.org/10.1177/1941738109334211.
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Context: When cervical spine injuries are suspected, the cervical spine should be immobilized in a neutral position and neck motion controlled in preparation for transport to an emergency facility. Protocols for emergency transport utilizing common devices (cervical collars) and methods (transfer techniques) during these procedures are not entirely evidence based. Evidence Acquisition: The medical literature search covered the time period of January 1966 to June 2008 using the following keywords, either alone or in combination: extrication collars, cervical collars, spine orthoses, spinal immobilization, spine board, spinal board, transfer techniques, and back board. Biomedical databases searched included Medline, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL [1982 to 2008]). The reference lists of all trials identified were also searched for additional trials. Methods: Only trials that directly compared the efficacy or safety of transfer methods and/or immobilization devices were included. Studies that measured voluntary head movement after the fitting of the cervical orthoses and those that did not evaluate motion across individual spinal segments were not included. Results: A lift-and-slide transfer method with a full body immobilization device creates less motion than a log-roll maneuver. Extrication-type cervical immobilization collars are limited in their ability to control neck motion in the injured cadaveric model. Conclusion: Allied health professionals responsible for the management of the cervical spine–injured patient should become familiar with and employ a lift-and-slide transfer technique in appropriate situations and should not rely exclusively on extrication-type collars to immobilize the neck.
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Tinning, Richard, David Jenkins, Jessie Collins, Tony Rossi, and Tania Brancato. "Major practicum as a learning site for exercise science professionals: A pilot study." European Physical Education Review 18, no. 2 (May 22, 2012): 239–44. http://dx.doi.org/10.1177/1356336x12440024.
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Exercise science is now an integral part of the allied health framework in Australia and graduates from accredited programmes are equipped with skills recognised as being important in the prevention and management of lifestyle-related diseases. This pilot study sought to determine the experiences of 11 final-year exercise science students in their major practicum and identify skills learned and developed while on placement. Analysis of the interview data established that the students worked with clients from a broad range of sociocultural and socioeconomic backgrounds, both within and between practicum sites; the students’ experiences and their preparedness to engage with clients from different backgrounds varied as a result. Although the students generally reported being technically skilled for their major placement, many reported being underprepared to deal with people from different backgrounds. However, all participants held that their interpersonal skills greatly improved in response to their placement and several remarked that they developed their problem-solving skills through watching and assisting their supervisors work with clients. The present study confirms the practicum as a critical learning site for improving communication and problem-solving skills with exercise science and exercise physiology students.
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O’Brien, Kyle H., and Victor Lushin. "Examining the Impact of Psychological Factors on Hospital Length of Stay for Burn Survivors: A Systematic Review." Journal of Burn Care & Research 40, no. 1 (July 18, 2018): 12–20. http://dx.doi.org/10.1093/jbcr/iry040.
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Abstract Recovery of burn patients may be impeded by mental health problems. By gaining a better understanding of the impact that psychological factors may have on hospital length of stay, providers may be better informed to address the complex needs of burn survivors through effective and efficient practices. This systematic review summarizes existing data on the adverse psychological factors for the length of burn patients’ hospitalization, and assesses the methodological quality of the extant literature on mental health conditions of burn survivors. A literature search was conducted in four electronic databases: PubMed, PsychINFO, Science Direct, and the Cumulative Index to Nursing and Allied Health Literature. Results yielded reports published between 1980 and 2016. Methodological quality was assessed by using an 11-item methodological quality score system. Seventy-four studies were identified by search; 19 articles were eligible for analysis. Findings demonstrate paucity of evidence in the area. Reports indicate longer hospital stay among burn patients with mental health problems. Substance use was the most consistent mental-health predictor of longer hospital stay. Heterogeneity in data on mental health conditions rendered impossible estimation of effect sizes of individual psychological factors on length of hospitalization. Many studies over-relied on retrospective designs, and crude indicators of psychological factors. Findings indicate that mental health problems do have an impact on the trajectory of burn recovery by increasing the length of hospital stay for burn survivors. Inpatient mental health services for burn patients are critically needed. Prospective designs, and more sensitive psychological indicators are needed for future studies.
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Blasco-Peris, Carles, Laura Fuertes-Kenneally, Tomas Vetrovsky, José Manuel Sarabia, Vicente Climent-Paya, and Agustín Manresa-Rocamora. "Effects of Exergaming in Patients with Cardiovascular Disease Compared to Conventional Cardiac Rehabilitation: A Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health 19, no. 6 (March 15, 2022): 3492. http://dx.doi.org/10.3390/ijerph19063492.
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Background: Exercise-based cardiac rehabilitation (CR) programs are used for improving prognosis and quality of life in patients with cardiovascular disease (CVD). Nonetheless, adherence to these programs is low, and exercise-based CR programs based on virtual reality (i.e., exergaming) have been proposed as an alternative to conventional CR programs. However, whether exergaming programs are superior to conventional CR programs in patients with CVD is not known. Objective: This systematic review with meta-analysis was conducted to explore whether exergaming enhances exercise capacity, quality of life, mental health, motivation, and exercise adherence to a greater extent than conventional CR programs in patients with CVD. Method: Electronic searches were carried out in PubMed, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases up to June 2021. Meta-analyses were performed using robust variance estimation with small-sample corrections. The effect sizes were calculated as the mean differences (MD) or standardized mean differences (SMD) as appropriate. The SMD magnitude was classified as trivial (<0.20), small (0.20–0.49), medium (0.50–0.79), or large (≥0.80). Heterogeneity was interpreted based on the I2 statistics as low (25%), moderate (50%), or high (75%). Results: Pooled analyses showed no differences between exergaming and conventional CR programs for enhancing exercise capacity (i.e., distance covered in the six-minute walk test) (MD+ = 14.07 m (95% confidence interval (CI) −38.18 to 66.32 m); p = 0.426) and mental health (SMD+ = 0.17 (95% CI −0.36 to 0.70); p = 0.358). The results showed a small, statistically nonsignificant improvement in quality of life in favor of exergaming (SMD+ = 0.22 (95% CI = −0.37 to 0.81); p = 0.294). Moderate heterogeneity was found for exercise capacity (I2 = 53.7%), while no heterogeneity was found for quality of life (I2 = 3.3%) and mental health (I2 = 0.0%). Conclusions: Exergaming seems not to be superior to conventional CR programs for improving exercise capacity, quality of life, or mental health in patients with CVD.
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Deepa S., Kumaresan Abathsagayam, Prathap Suganthirababu, Ramana K., Surya Vishnuram, and Vignesh Srinivasan. "A need to reconsider the rehabilitation protocol in patients with idiopathic Parkinson’s disease: Review analysis." Biomedicine 42, no. 4 (September 12, 2022): 657–60. http://dx.doi.org/10.51248/.v42i4.375.
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Idiopathic Parkinson’s disease is the second most debilitating and progressive neurodegenerative disease affecting the functional activities in day-to-day life. The motor and non-motor symptoms have shown to be a huge functional loss for the subject which has led to compromise their independence. There are varieties of treatment programs proposed as pharmacological, surgical, rehabilitation, allied therapies but none have proven to be the disease modifying treatments in managing the symptoms of Parkinson’s disease patients. Research has shown that discontinuity in the treatment and diminished effects of treatments have drained care givers physically, emotionally, and financially. In this study we explore the available physiotherapy treatment strategies highlighting the research gaps in articles (n=36). The articles were taken from the databases such as PubMed, Science Direct and Google Scholar by considering the inclusion and exclusion criteria. Though the present research has shown to be significant in improving the motor and non-motor symptoms there are still unanswered questions on the rehabilitation protocols whether they can modify the disease and improve the quality of life among Parkinson’s disease in long term. Exercise have proven to be beneficial, cost effective and low risk which improves the overall health and independence of the patient, however, the mechanism involved are less understood.
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Nicolau, Célia, Liliana Mendes, Mário Ciríaco, Bruno Ferreira, Cristina Lavareda Baixinho, César Fonseca, Rogério Ferreira, and Luís Sousa. "Educational Intervention in Rehabilitation to Improve Functional Capacity after Hip Arthroplasty: A Scoping Review." Journal of Personalized Medicine 12, no. 5 (April 19, 2022): 656. http://dx.doi.org/10.3390/jpm12050656.
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(1) Background: The prevalence of coxarthrosis associated with ageing is one of the main reasons for the increase in hip arthroplasty. Educational intervention in the pre- and postoperative period of hip arthroplasty can improve functionality and, consequently, quality of life. Therefore, we intend to map the educational interventions that improve the functional capacity of people undergoing hip arthroplasty on their rehabilitation process. (2) Methods: Scoping review. The search was carried out in the databases: CINAHL complete, MEDLINE Complete, Nursing and Allied Health Collection: Comprehensive, Cochrane Methodology Register, Library, Information Science and Technology Abstracts, MedcLatina, and Google Academic. We included studies that evaluated the implementation of educational rehabilitation interventions that enable the empowerment and teaching of people undergoing hip arthroplasty. (3) Results: Thirteen studies were analysed that met the eligibility criteria and allowed the research question to be answered. Education in the perioperative period promotes training to perform rehabilitation exercises, improves the hospitalisation experience, increases participation in the rehabilitation process, allows early mobilisation, and increases the functional potential, thus enabling faster reintegration into society. (4) Conclusion: Early mobilisation plays a very important role in a person′s functional recovery, as well as in the prevention of thromboembolic complications. Exercise produces benefits in relation to physical function, namely, in improving strength, balance, facilitating functional activities, and preventing complications.
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Jorge, Beatriz Maria, Alessandra Mazzo, Anamaria Alves Napoleão, and Anaísa Bianchini. "Evidências científicas das práticas de diagnóstico da retenção urinária: scoping review [Scientific evidence of urinary retention diagnostic practices: scoping review] [Evidencias científicas de las prácticas de diagnóstico de la retención urinaria: scoping review]." Revista Enfermagem UERJ 26 (September 28, 2018): e25840. http://dx.doi.org/10.12957/reuerj.2018.25840.
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Objetivo: identificar evidências científicas sobre as práticas para o diagnóstico da retenção urinária. Método: trata-se de uma Scoping Review. A busca foi realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library e SCOPUS. Das 2482 referências encontradas, 23 foram selecionadas. Resultados: os 23 artigos que foram agrupados de acordo com a clínica do paciente: clínica cirúrgica, clínica de reabilitação e clínica obstétrica. E as práticas utilizadas para o diagnóstico da retenção urinária: cateterismo urinário de alívio, por meio do ultrassom portátil de bexiga, com a associação do ultrassom portátil de bexiga e do cateterismo urinário e/ou com medidas não invasivas. Conclusão: o diagnóstico da retenção urinária é um assunto que vem sendo discutido há algum tempo, no entanto, ainda não há um consenso, e a sua prática é realizada muitas vezes sem eficácia.ABSTRACTObjective: to identify scientific evidence on urinary retention diagnostic practices. Method: this scoping review searched the Latin American & Caribbean Health Sciences Literature, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library and SCOPUS databases. Of the 2482 references found, 23 were selected. Results: the 23 articles were grouped by patient clinic (surgery, rehabilitation or obstetrics) and by urinary retention diagnostic practices (intermittent urinary catheterization, by portable bladder ultrasound, combination of portable bladder ultrasound and urinary catheterization and/or non-invasive measures). Conclusion: diagnosis of urinary retention is an issue that has been discussed for some time. However, there is still no consensus, and in practice it is often performed ineffectively.RESUMENObjetivo: identificar evidencias científicas sobre las prácticas para el diagnóstico de la retención urinaria. Método: se trata de una Scoping Review. Se realizó la búsqueda en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library y SCOPUS. De las 2482 referencias encontradas, se seleccionaron 23. Resultados: los 23 artículos se agruparon según la clínica del paciente: clínica quirúrgica, clínica de rehabilitación y clínica de obstetricia. Y las prácticas utilizadas para el diagnóstico de retención urinaria: cateterismo urinario de alivio, a través de ecografía (portátil) de vejiga, con la combinación de ecografía de vejiga y del cateterismo urinario y/o con medidas no invasivas. Conclusión: el diagnóstico de la retención urinaria es un tema que está siendo discutido desde hace algún tiempo, sin embargo, todavía no existe un consenso y su práctica se realiza a menudo ineficazmente.
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Yalnaz, Ushna, Usman Sarwar, Sumair Quresh, Hafiz Sulman Saeed, Imran Manzoor, and Nusrat Rasheed. "Effectiveness of Wobble Board Exercises on Dynamic Balance among Undergraduate Students." Journal of University Medical & Dental College 13, no. 2 (May 26, 2022): 391–95. http://dx.doi.org/10.37723/jumdc.v13i2.737.
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BACKGROUND & OBJECTIVE: Control of posture and balance is vital in mobility. Board exercise provides information about the motor strategies associated with muscle activation patterns that result when a person is standing on a wobble board surface that unexpectedly translates or tilts, which stimulates proprioception on the ankle.
METHODOLOGY: This study recruited 37 Undergraduate medical students of Allied health sciences (including males and females) of age between 17 to 25 years, conducted at skill lab of Shalamar Institute of Health Sciences. It is a Pre-test, Post-test Quasi-Experimental study in which balance was assessed by performing SEBT while maintaining single-limb stance. After 2 weeks of training, a dynamic balance was reassessed using Star Excursion Balance Test (SEBT).
RESULTS: A total of 37 patients are included in this study with the age of 22.0±1.65 years and BMI 20.9±3.02 are considered. The study includes 15 male and 22 female patients. This study shows significant differences in Pre-SEBT and Post-SEBT values of legs as p-value <0.05.
CONCLUSION: There were significant differences in Pre-exercising and Post-exercising SEBT. Study shows that wobble board-based rehabilitation training has a positive impact on improving balance of participants.
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Turville, Megan L., Liana S. Cahill, Thomas A. Matyas, Jannette M. Blennerhassett, and Leeanne M. Carey. "The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: a systematic review." Clinical Rehabilitation 33, no. 5 (February 25, 2019): 834–46. http://dx.doi.org/10.1177/0269215519829795.
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Objective: The aim of this study was to evaluate if somatosensory retraining programmes assist people to improve somatosensory discrimination skills and arm functioning after stroke. Data sources: Nine databases were systematically searched: Medline, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, Embase, Amed, Web of Science, Physiotherapy Evidence Database, OT seeker, and Cochrane Library. Review methods: Studies were included for review if they involved (1) adult participants who had somatosensory impairment in the arm after stroke, (2) a programme targeted at retraining somatosensation, (3) a primary measure of somatosensory discrimination skills in the arm, and (4) an intervention study design (e.g. randomized or non-randomized control designs). Results: A total of 6779 articles were screened. Five group trials and five single case experimental designs were included ( N = 199 stroke survivors). Six studies focused exclusively on retraining somatosensation and four studies focused on somatosensation and motor retraining. Standardized somatosensory measures were typically used for tactile, proprioception, and haptic object recognition modalities. Sensory intervention effect sizes ranged from 0.3 to 2.2, with an average effect size of 0.85 across somatosensory modalities. A majority of effect sizes for proprioception and tactile somatosensory domains were greater than 0.5, and all but one of the intervention effect sizes were larger than the control effect sizes, at least as point estimates. Six studies measured motor and/or functional arm outcomes ( n = 89 participants), with narrative analysis suggesting a trend towards improvement in arm use after somatosensory retraining. Conclusion: Somatosensory retraining may assist people to regain somatosensory discrimination skills in the arm after stroke.
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Lipson-Smith, Ruby, Luis Pflaumer, Marie Elf, Sarah-May Blaschke, Aaron Davis, Marcus White, Heidi Zeeman, and Julie Bernhardt. "Built environments for inpatient stroke rehabilitation services and care: a systematic literature review." BMJ Open 11, no. 8 (August 2021): e050247. http://dx.doi.org/10.1136/bmjopen-2021-050247.
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ObjectivesTo identify, appraise and synthesise existing design evidence for inpatient stroke rehabilitation facilities; to identify impacts of these built environments on the outcomes and experiences of people recovering from stroke, their family/caregivers and staff.DesignA convergent segregated review design was used to conduct a systematic review.Data sourcesOvid MEDLINE, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature were searched for articles published between January 2000 and November 2020.Eligibility criteria for selecting studiesQualitative, quantitative and mixed-methods studies investigating the impact of the built environment of inpatient rehabilitation facilities on stroke survivors, their family/caregivers and/or staff.Data extraction and synthesisTwo authors separately completed the title, abstract, full-text screening, data extraction and quality assessment. Extracted data were categorised according to the aspect of the built environment explored and the outcomes reported. These categories were used to structure a narrative synthesis of the results from all included studies.ResultsTwenty-four articles were included, most qualitative and exploratory. Half of the included articles investigated a particular aspect of the built environment, including environmental enrichment and communal areas (n=8), bedroom design (n=3) and therapy spaces (n=1), while the other half considered the environment in general. Findings related to one or more of the following outcome categories: (1) clinical outcomes, (2) patient activity, (3) patient well-being, (4) patient and/or staff safety and (5) clinical practice. Heterogeneous designs and variables of interest meant results could not be compared, but some repeated findings suggest that attractive and accessible communal areas are important for patient activity and well-being.ConclusionsStroke rehabilitation is a unique healthcare context where patient activity, practice and motivation are paramount. We found many evidence gaps that with more targeted research could better inform the design of rehabilitation spaces to optimise care.PROSPERO registration numberCRD42020158006.
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Vancampfort, Davy, Michel Probst, Liv Helvik Skjaerven, Daniel Catalán-Matamoros, Amanda Lundvik-Gyllensten, Antonia Gómez-Conesa, Rutger Ijntema, and Marc De Hert. "Systematic Review of the Benefits of Physical Therapy Within a Multidisciplinary Care Approach for People With Schizophrenia." Physical Therapy 92, no. 1 (January 1, 2012): 11–23. http://dx.doi.org/10.2522/ptj.20110218.
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BackgroundAlthough schizophrenia is the fifth leading cause of disability-adjusted life years worldwide in people aged 15 to 44 years, the clinical evidence of physical therapy as a complementary treatment remains largely unknown.PurposeThe purpose of this study was to systematically review randomized controlled trials (RCTs) evaluating the effectiveness of physical therapy for people with schizophrenia.Data SourcesEMBASE, PsycINFO, PubMed, ISI Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and the Cochrane Library were searched from their inception until July 1, 2011, for relevant RCTs. In addition, manual search strategies were used.Study SelectionTwo reviewers independently determined study eligibility on the basis of inclusion criteria.Data ExtractionReviewers rated study quality and extracted information about study methods, design, intervention, and results.Data SynthesisTen RCTs met all selection criteria; 6 of these studies addressed the use of aerobic and strength exercises. In 2 of these studies, yoga techniques also were investigated. Four studies addressed the use of progressive muscle relaxation. There is evidence that aerobic and strength exercises and yoga reduce psychiatric symptoms, state anxiety, and psychological distress and improve health-related quality of life, that aerobic exercise improves short-term memory, and that progressive muscle relaxation reduces state anxiety and psychological distress.LimitationsThe heterogeneity of the interventions and the small sample sizes of the included studies limit overall conclusions and highlight the need for further research.ConclusionsPhysical therapy offers added value in the multidisciplinary care of people with schizophrenia.
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Woolham, John, Paul Freddolino, Grant Gibson, and Sarah Daniels. "Telecare at a crossroads? Finding researchable questions." Journal of Enabling Technologies 15, no. 3 (May 25, 2021): 175–88. http://dx.doi.org/10.1108/jet-11-2020-0049.
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Purpose This paper aims to report on a structured attempt to develop new directions for research into telecare. Current research evidence suggests that telecare in the UK is not optimally cost-effective and does not deliver better outcomes than more traditional forms of care and support. To address this problem, an analysis of expert opinion about future directions for research is provided. Design/methodology/approach Two electronic surveys of UK based academic experts were conducted. Participants were drawn from a range of professional disciplines, including medicine, social care, occupational therapy and social policy and identified were by their contribution in this, or allied fields. The first survey included nine questions intended to identify at least one new research question that could form the basis of a funding proposal to the Nuffield Foundation, which provided “seedcorn” funding to support this work. Ten themes were identified following thematic analysis. The second survey asked participants to prioritise three of these themes. Findings Key themes emerging as priority areas for future research were as follows: the role of assessment in ensuring technology deployment meets the needs of service users; ethical implications of technology and how these might be addressed in the future; and the use of end user co-production/co-creation approaches in the development of new assistive technologies and digital enabled care. Research limitations/implications The findings are based on academic expert opinion; perspectives of practitioners, service users and family members are unrepresented. Practical implications The findings of this study could contribute to development of new directions for telecare research, and future strategic funding decisions in this rapidly changing field. Originality/value Evidence for sub-optimal outcomes for telecare requires new thinking. The authors are not aware of any other study that offers an analysis of expert opinion of fruitful areas for new research into telecare.
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Briani, Ronaldo Valdir, Amanda Schenatto Ferreira, Marcella Ferraz Pazzinatto, Evangelos Pappas, Danilo De Oliveira Silva, and Fábio Mícolis de Azevedo. "What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials." British Journal of Sports Medicine 52, no. 16 (March 16, 2018): 1031–38. http://dx.doi.org/10.1136/bjsports-2017-098099.
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ObjectiveTo systematically review evidence of primary outcomes from randomised controlled trials (RCTs) examining the effect of treatment strategies on quality of life (QoL) or psychosocial factors in individuals with knee osteoarthritis (OA).DesignSystematic review with meta-analysis.Data sourcesMedline, Embase, SPORTDiscus, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science were searched from inception to November 2017.Eligibility criteria for selecting studiesWe included RCTs investigating the effect of conservative interventions on QoL or psychosocial factors in individuals with knee OA. Only RCTs considering these outcomes as primary were included.ResultsPooled data supported the use of exercise therapy compared with controls for improving health-related and knee-related QoL. There was limited evidence that a combined treatment of yoga, transcutaneous electrical stimulation and ultrasound may be effective in improving QoL. Limited evidence supported the use of cognitive behavioural therapies (with or without being combined with exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress.Summary/ConclusionExercise therapy (with or without being combined with other interventions) seems to be effective in improving health-related and knee-related QoL or psychosocial factors of individuals with knee OA. In addition, evidence supports the use of cognitive behavioural therapies (with or without exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress in individuals with knee OA.PROSPERO registration numberCRD42016047602.
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Naeemabadi, MReza, Hesam Fazlali, Samira Najafi, Birthe Dinesen, and John Hansen. "Telerehabilitation for Patients With Knee Osteoarthritis: A Focused Review of Technologies and Teleservices." JMIR Biomedical Engineering 5, no. 1 (July 21, 2020): e16991. http://dx.doi.org/10.2196/16991.
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Background Telerehabilitation programs are designed with the aim of improving the quality of services as well as overcoming existing limitations in terms of resource management and accessibility of services. This review will collect recent studies investigating telerehabilitation programs for patients with knee osteoarthritis while focusing on the technologies and services provided in the programs. Objective The main objective of this review is to identify and discuss the modes of service delivery and technologies in telerehabilitation programs for patients with knee osteoarthritis. The gaps, strengths, and weaknesses of programs will be discussed individually. Methods Studies published in English since 2000 were retrieved from the EMBASE, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Physiotherapy Evidence Database (PEDro), and PsycINFO databases. The search words “telerehabilitation,” “telehealth,” “telemedicine,” “teletherapy,” and “ehealth” were combined with “knee” and “rehabilitation” to generate a data set of studies for screening and review. The final group of studies reviewed here includes those that implemented teletreatment for patients for at least 2 weeks of rehabilitation. Results In total, 1198 studies were screened, and the full text of 154 studies was reviewed. Of these, 38 studies were included, and data were extracted accordingly. Four modes of telerehabilitation service delivery were identified: phone-based, video-based, sensor-based, and expert system–based telerehabilitation. The intervention services provided in the studies included information, training, communication, monitoring, and tracking. Video-based telerehabilitation programs were frequently used. Among the identified services, information and educational material were introduced in only one-quarter of the studies. Conclusions Video-based telerehabilitation programs can be considered the best alternative solution to conventional treatment. This study shows that, in recent years, sensor-based solutions have also become more popular due to rapid developments in sensor technology. Nevertheless, communication and human-generated feedback remain as important as monitoring and intervention services.
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Sharififar, Sharareh, Heather K. Vincent, Jonathan Shuster, and and Mark Bishop. "Quantifying Poststroke Gait Deviations: A Meta-analysis of Observational and Cross-sectional Experimental Trials." Journal of Stroke Medicine 2, no. 1 (June 2019): 23–31. http://dx.doi.org/10.1177/2516608519856246.
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The hemiparetic walking pattern is a common feature of an upper motor neuron impairment caused by stroke. Previous studies have recorded deviations in hemiparetic walking patterns. We aimed to quantify gait alterations poststroke relative to healthy gait across a range of walking speeds by a systematic review and meta-analysis. We searched databases including MEDLINE via PubMed, Web of Science, SPORTDiscus, Cumulative Literature Index to Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials from 1927 to the end of July 2015 for all instrumented measured gait variables in (a) observational studies with stroke patients only and (b) interventional studies in healthy, age-matched (elderly) participants, and those with stroke published in English. We analyzed data using a patient-weighted random-effects method. The heterogeneity of methods and measures employed across studies limited the intended analyses. The search pooled 2,223 articles, of which we included 49 observational and 124 interventional studies involving 960 healthy elders and 4,691 participants with stroke. As expected, those with stroke have gait-speed-related statistical differences from those without stroke. Specifically, this meta-analysis determined that (a) only 2 spatial parameters consistently changed according to gait speed – step length and stride length – and (b) irrespective of speed, 9 spatiotemporal measures, 5 sagittal kinematic, and 3 kinetic measures from the analysis were statistically different from the healthy counterparts ( P < .05). These findings suggest the importance of using instrumented measurement techniques for evaluating stroke gait rehabilitation.
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Fakolade, Afolasade, Etienne J. Bisson, Julie Pétrin, Julie Lamarre, and Marcia Finlayson. "Effect of Comorbidities on Outcomes of Neurorehabilitation Interventions in Multiple Sclerosis." International Journal of MS Care 18, no. 6 (November 1, 2016): 282–90. http://dx.doi.org/10.7224/1537-2073.2016-015.
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Background: Interest in comorbidities has increased in the past few years, but the effect of comorbidities on outcomes of multiple sclerosis (MS) neurorehabilitation interventions is unclear. The aim of this review was to identify and summarize the existing evidence regarding the effect of comorbidities on outcomes of neurorehabilitation interventions targeting people with MS. Methods: Five databases (Embase, MEDLINE through Ovid, PubMed Central, Cumulative Index to Nursing and Allied Health Literature, and Web of Science) were searched using index terms and keywords relating to MS and a wide range of rehabilitation interventions. Studies screened were limited to English-language randomized controlled trials. Information related to included and excluded comorbidities and how they were reported and described was extracted from the included studies. Results: Fifty-four neurorehabilitation randomized controlled trials were included and were grouped into categories: robotics/technology-enhanced (n = 7), task-oriented training/neurorehabilitation principles (n = 7), electrical stimulation (n = 12), temperature regulation (n = 6), magnetic field therapy (n = 5), vibration (n = 9), and miscellaneous (n = 8). Although the issue of comorbidity was considered in 40 studies, it was limited to excluding individuals from participating in the trials. Only two studies reported on comorbidity, but neither examined the possible mediating or moderating effect of comorbidities on intervention outcomes. Conclusions: This review documents important knowledge gaps about the effect of comorbidity on neurorehabilitation outcomes and identifies a critical need for future studies to address this issue. Without this information, we limit our understanding of the mechanisms of comorbidity and its effects on relevant clinical and research outcomes specific to neurorehabilitation.
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Wasielewski, Noah J., Tonya M. Parker, and Kevin M. Kotsko. "Evaluation of Electromyographic Biofeedback for the Quadriceps Femoris: A Systematic Review." Journal of Athletic Training 46, no. 5 (September 1, 2011): 543–54. http://dx.doi.org/10.4085/1062-6050-46.5.543.
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Objective: To critically review evidence for the effectiveness of electromyographic biofeedback (EMGB) of the quadriceps femoris muscle in treating various knee conditions. Data Sources: Databases used to locate randomized controlled trials included PubMed (1980–2010), Cumulative Index of Nursing and Allied Health Literature (CINAHL, 1995–2007), Web of Science (1986–2010), SPORTDiscus (1990–2007), and Physiotherapy Evidence Database (PEDro). Key words were knee and biofeedback. Study Selection: The criteria for selection were clinical randomized controlled trials in which EMGB of the quadriceps femoris was used for various knee conditions of musculoskeletal origin. Trials were excluded because of research designs other than randomized controlled trials, articles published in a non-English language, inclusion of healthy research participants, inability to identify EMGB as the source of clinical improvement, and lack of pain, functional outcome, or quadriceps torque as outcome measures. Data Extraction: Twenty specific data points were abstracted from each clinical trial under the broad categories of attributes of the patient and injury, treatment variables for the EMGB group, treatment variables for the control group, and attributes of the research design. Data Synthesis: Eight trials yielded a total of 319 participants with patellofemoral pain syndrome (n = 86), anterior cruciate ligament reconstruction (n = 52), arthroscopic surgery (n = 91), or osteoarthritis (n = 90). The average methodologic score of the included studies was 4.6/10 based on PEDro criteria. Pooled analyses demonstrated heterogeneity of the included studies, rendering the interpretation of the pooled data inappropriate. The EMGB appeared to benefit short-term postsurgical pain or quadriceps strength in 3 of 4 postsurgical investigations but was ineffective for chronic knee conditions such as patellofemoral pain and osteoarthritis in all 4 studies. Because the findings are based on limited data, caution is warranted until more randomized controlled trials are conducted to support or refute the general trends observed in this report.
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Georlee, Gifty M., Abiram U, Pham Ngoc Dat, Nguyen Khac Tuan, and Shashank Mehrotra. "Home-modification interventions addressing falls and participation in activities of daily living among older adults: a scoping review protocol." BMJ Open 10, no. 9 (September 2020): e039742. http://dx.doi.org/10.1136/bmjopen-2020-039742.
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IntroductionFalls are the second leading reason for incidental or unexpected deaths worldwide. Many older adults who fall, regardless of whether they are injured or not, tend to experience fear of fall and this can lead to decreased participation in activities of daily living (ADLs). Subsequent falls lead to weakness, a decline in physical functioning, increased chances of falling and a negative impact on the instrumental ADLs. Here, we present our scoping review protocol to appraise the literature to describe and explain the home-modification interventions used by occupational therapists to address falls and participation in ADLs among community-dwelling older adults. We are aiming to review the available home-modification intervention protocols, facilitators and barriers to such interventions, and the experiences of occupational therapists and clients after receiving these interventions.Methods and analysisThis scoping review protocol follows existing guidelines for scoping reviews with a particular attention on Arksey and O’Malley (2005) and Colquhoun et al (2014). We will include the following databases: Scopus, Web of Science, PubMed, ProQuest, Cumulative Index to Nursing and Allied Health Literature and Google Scholar. We plan to conduct the literature search from August 16, 2020 to September 15, 2020. Two reviewers will independently screen eligible studies for inclusion. We will extract the bibliographic data, study design, details of the intervention provided, outcomes and experiences of occupational therapists and clients, and further organise them for better understanding.Ethics and disseminationAs secondary data analysis, this scoping review does not require ethics approval. Results will summarise and disseminate the existing literature related to home-modification interventions provided by occupational therapists addressing falls and participation in ADLs among community-dwelling older adults. We plan to disseminate the results through peer-reviewed journals and conferences, targeting occupational therapists, other rehabilitation workers, researchers and policy makers.
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Duncan, Morvwen, Elisavet Moschopoulou, Eldrid Herrington, Jennifer Deane, Rebecca Roylance, Louise Jones, Liam Bourke, et al. "Review of systematic reviews of non-pharmacological interventions to improve quality of life in cancer survivors." BMJ Open 7, no. 11 (November 2017): e015860. http://dx.doi.org/10.1136/bmjopen-2017-015860.
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ObjectivesOver two million people in the UK are living with and beyond cancer. A third report diminished quality of life.DesignA review of published systematic reviews to identify effective non-pharmacological interventions to improve the quality of life of cancer survivors.Data sourcesDatabases searched until May 2017 included PubMed, Cochrane Central, EMBASE, MEDLINE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO.Study selectionPublished systematic reviews of randomised trials of non-pharmacological interventions for people living with and beyond cancer were included; included reviews targeted patients aged over 18. All participants had already received a cancer diagnosis. Interventions located in any healthcare setting, home or online were included. Reviews of alternative therapies or those non-English reports were excluded. Two researchers independently assessed titles, abstracts and the full text of papers, and independently extracted the data.OutcomesThe primary outcome of interest was any measure of global (overall) quality of life.Analytical methodsQuality assessment assessing methdological quality of systematic reviews (AMSTAR) and narrative synthesis, evaluating effectiveness of non-pharmacological interventions and their components.ResultsOf 14 430 unique titles, 21 were included in the review of reviews. There was little overlap in the primary papers across these reviews. Thirteen reviews covered mixed tumour groups, seven focused on breast cancer and one focused on prostate cancer. Face-to-face interventions were often combined with online, telephone and paper-based reading materials. Interventions included physical, psychological or behavioural, multidimensional rehabilitation and online approaches. Yoga specifically, physical exercise more generally, cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR) programmes showed benefit in terms of quality of life.ConclusionsExercise-based interventions were effective in the short (less than 3–8 months) and long term. CBT and MBSR also showed benefits, especially in the short term. The evidence for multidisciplinary, online and educational interventions was equivocal.
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Kit, O. I., A. I. Shikhlyarova, E. M. Frantsiyants, and G. V. Zhukova. "Celebrating 10 Years in research publishing: scientific traditions of Open-Access Journal CARDIOMETRY as the mirror of fundamental and applied biomedical problems." CARDIOMETRY, no. 23 (August 20, 2022): 17–30. http://dx.doi.org/10.18137/cardiometry.2022.23.1730.
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The 10th anniversary of the international journal CARDIOMETRY is a good opportunity to summarize achievements and highlight the important milestones in the life of the journal with respect to the contents of the journal associated with most advanced research information about the topical issues in cardiology and allied sciences biology and medicine. The ideas on a system-related approach and an integrative assessment of the actual organism status as a whole, which lay the foundation of the journal philosophy, allows covering as wide as possible a great variety of the aspect what is the norm and what is pathology that is a substantial prerequisite for delineating clearly structured themes treated by each issue of the journal and for making in such a manner a collection of the journal issues, with cardiology as a common thread, that distinguishes CARDIOMETRY from all other profiled scientific journals.
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Mountjoy, Margo, Celia Brackenridge, Malia Arrington, Cheri Blauwet, Andrea Carska-Sheppard, Kari Fasting, Sandra Kirby, et al. "International Olympic Committee consensus statement: harassment and abuse (non-accidental violence) in sport." British Journal of Sports Medicine 50, no. 17 (April 26, 2016): 1019–29. http://dx.doi.org/10.1136/bjsports-2016-096121.
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Despite the well-recognised benefits of sport, there are also negative influences on athlete health, well-being and integrity caused by non-accidental violence through harassment and abuse. All athletes have a right to engage in ‘safe sport’, defined as an athletic environment that is respectful, equitable and free from all forms of non-accidental violence to athletes. Yet, these issues represent a blind spot for many sport organisations through fear of reputational damage, ignorance, silence or collusion. This consensus statement extends the 2007 IOC Consensus Statement on Sexual Harassment and Abuse in Sport, presenting additional evidence of several other types of harassment and abuse—psychological, physical and neglect. All ages and types of athletes are susceptible to these problems but science confirms that elite, disabled, child and lesbian/gay/bisexual/trans-sexual (LGBT) athletes are at highest risk, that psychological abuse is at the core of all other forms and that athletes can also be perpetrators. Harassment and abuse arise from prejudices expressed through power differences. Perpetrators use a range of interpersonal mechanisms including contact, non-contact/verbal, cyber-based, negligence, bullying and hazing. Attention is paid to the particular risks facing child athletes, athletes with a disability and LGBT athletes. Impacts on the individual athlete and the organisation are discussed. Sport stakeholders are encouraged to consider the wider social parameters of these issues, including cultures of secrecy and deference that too often facilitate abuse, rather than focusing simply on psychopathological causes. The promotion of safe sport is an urgent task and part of the broader international imperative for good governance in sport. A systematic multiagency approach to prevention is most effective, involving athletes, entourage members, sport managers, medical and therapeutic practitioners, educators and criminal justice agencies. Structural and cultural remedies, as well as practical recommendations, are suggested for sport organisations, athletes, sports medicine and allied disciplines, sport scientists and researchers. The successful prevention and eradication of abuse and harassment against athletes rests on the effectiveness of leadership by the major international and national sport organisations.
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O’Connor, Joanne, Dorothy McCaughan, Catriona McDaid, Alison Booth, Debra Fayter, Roccio Rodriguez-Lopez, Roy Bowers, et al. "Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis." Health Technology Assessment 20, no. 55 (July 2016): 1–262. http://dx.doi.org/10.3310/hta20550.
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BackgroundPatients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee–ankle–foot orthoses (KAFOs).ObjectivesTo assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs.MethodsQualitative study of views of orthoses users – a qualitative in-depth interview study was undertaken. Data were analysed for thematic content. A coding scheme was developed and an inductive approach was used to identify themes. Systematic review – 18 databases were searched up to November 2014: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health, EMBASE, PASCAL, Scopus, Science Citation Index, BIOSIS Previews, Physiotherapy Evidence Database, Recal Legacy, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment database, Cochrane Central Register of Controlled Trials, Conference Proceedings Citation Index: Science, Health Management Consortium, ClinicalTrials.gov, International Clinical Trials Registry Platform and National Technical Information Service. Studies of adults using an orthosis for instability of the knee related to NMD or a CNS disorder were included. Data were extracted and quality was assessed by two researchers. Narrative synthesis was undertaken. Survey and costing analysis – a web survey of orthotists, physiotherapists and rehabilitation medicine physicians was undertaken. Telephone interviews with orthotists informed a costing analysis.ResultsQualitative study – a total of 24 people participated. Potential for engagement in daily activities was of vital importance to patients; the extent to which their device enabled this was the yardstick by which it was measured. Patients’ prime desired outcome was a reduction in pain, falls or trips, with improved balance and stability. Effectiveness, reliability, comfort and durability were the most valued features of orthoses. Many expressed frustration with perceived deficiencies in service provision relating to appointment and administrative systems and referral pathways. Systematic review – a total of 21 studies (478 participants) were included of people who had post-polio syndrome, inclusion body myositis, were post stroke or had spinal cord injury. The studies evaluated KAFOs (mainly carbon fibre), stance control KAFO and hip KAFOs. All of the studies were at risk of bias and, in general, were poorly reported. Survey and costing analysis – in total, 238 health-care professionals responded. A range of orthoses is prescribed for knee instability that is related to NMD or CNS conditions, approximately half being custom-made. At least 50% of respondents thought that comfort and confidence in mobility were extremely important treatment outcomes. The cost of individual KAFOs was highly variable, ranging from £73 to £3553.ConclusionsVarious types of orthoses are used in the NHS to manage patients with NMD/CNS conditions and knee instability, both custom-made and prefabricated, of variable cost. Evidence on the effectiveness of the orthoses is limited, especially in relation to the outcomes that are important to orthoses users.LimitationsThe population included was broad, limiting any in-depth consideration of specific conditions. The response rate to the survey was low, and the costing analysis was based on some assumptions that may not reflect the true costs of providing KAFOs.Future workFuture work should include high-quality research on the effectiveness and cost-effectiveness of orthoses; development of a core set of outcome measures; further exploration of the views and experiences of patients; and the best models of service delivery.Study registrationThis study is registered as PROSPERO CRD42014010180. The qualitative study is registered as Current Controlled Trials ISRCTN65240228.FundingThe National Institute for Health Research Health Technology Assessment programme.
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Milanović, Zoran, Saša Pantelić, Nedim Čović, Goran Sporiš, Magni Mohr, and Peter Krustrup. "Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis." British Journal of Sports Medicine 53, no. 15 (January 25, 2018): 926–39. http://dx.doi.org/10.1136/bjsports-2017-097885.
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BackgroundA previous meta-analysis showed that maximal oxygen uptake increased by 3.51 mL/kg/min (95% CI 3.07 to 4.15) during a recreational football programme of 3–6 months in comparison with continuous moderate-intensity running, strength training or a passive control group. In addition, narrative reviews have demonstrated beneficial effects of recreational football on physical fitness and health status.ObjectiveThe purpose of this systematic review and meta-analysis was to evaluate the magnitude of effects of recreational football on blood pressure, body composition, lipid profile and muscular fitness with reference to age, gender and health status.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PubMed, SPORTDiscus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were searched prior to 1 February 2017. In addition, Google Scholar alerts were set up in January 2012 to identify potential papers with the following key terms: recreational football, recreational soccer, street football and street soccer.Eligibility criteria for selecting studiesRandomised and matched controlled trials with participants allocated to a recreational football group or any other type of exercises or passive control group were included. Training programmes had to last at least 2 weeks to meet the inclusion criteria. The primary outcome measures were blood pressure, resting heart rate, body composition, muscular fitness, and blood lipids and glucose tolerance. A total of 31 papers met the inclusion criteria and were included.ResultsThe effect of recreational football on systolic blood pressure (SBP) versus no-exercise controls was most likely extremely largely beneficial (effect size (ES)=4.20 mm Hg; 95% CI 1.87 to 6.53). In addition, a most likely very large beneficial (ES=3.89 mm Hg; 95% CI 2.33 to 5.44) effect was observed for diastolic blood pressure (DBP), when compared with non-active groups. Furthermore, a most likely extremely large beneficial effect was shown for SBP and DBP in participants with mild hypertension (11 and 7 mm Hg decrease, respectively) and participants with prehypertension (10 and 7 mm Hg decrease, respectively). Meta-analysis of recreational football determined the impact on resting heart rate as most likely extremely largely beneficial (ES=6.03 beats/min; 95% CI 4.43 to 7.64) when compared with non-active groups. The observed recreational football effect on fat mass was most likely largely beneficial (ES=1.72 kg; 95% CI 0.86 to 2.58) and the effect on countermovement jump (CMJ) performance was most likely very largely beneficial (ES=2.27 cm; 95% CI 1.29 to 3.25) when compared with non-active groups. Possibly beneficial decreases were found in low-density lipoprotein levels (ES=0.21 mmol/L; 95% CI 0.06 to 0.36). Possibly largely beneficial effect was observed for DBP in comparison with continuous running training. Small harmful and unclear results were noted for SBP, fat and lean body mass, body mass index, as well as muscular fitness when compared with running and Zumba training.ConclusionThe present meta-analysis demonstrated multiple broad-spectrum benefits of recreational football on health-related physical fitness compared with no-exercise controls, including improvements in blood pressure, resting heart rate, fat mass, low-density lipoprotein cholesterol and CMJ performance. Additionally, recreational football is efficient and effective as Zumba and continuous running exercise regimens with highlighted social, motivational and competitive components.
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De Miguel-Rubio, Amaranta, M. Dolores Rubio, Alvaro Alba-Rueda, Alejandro Salazar, Jose A. Moral-Munoz, and David Lucena-Anton. "Virtual Reality Systems for Upper Limb Motor Function Recovery in Patients With Spinal Cord Injury: Systematic Review and Meta-Analysis." JMIR mHealth and uHealth 8, no. 12 (December 3, 2020): e22537. http://dx.doi.org/10.2196/22537.
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Background Patients with spinal cord injury (SCI) usually present with different motor impairments, including a deterioration of upper limb motor function (ULMF), that limit their performance of activities of daily living and reduce their quality of life. Virtual reality (VR) is being used in neurological rehabilitation for the assessment and treatment of the physical impairments of this condition. Objective A systematic review and meta-analysis was conducted to evaluate the effectiveness of VR on ULMF in patients with SCI compared with conventional physical therapy. Methods The search was performed from October to December 2019 in Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Physiotherapy Evidence Database (PEDro), PubMed, and Cochrane Central Register of Controlled Trials. The inclusion criteria of selected studies were as follows: (1) comprised adults with SCI, (2) included an intervention with VR, (3) compared VR intervention with conventional physical therapy, (4) reported outcomes related to ULMF, and (5) was a controlled clinical trial. The Cochrane Collaboration’s tool was used to evaluate the risk of bias. The RevMan 5.3 statistical software was used to obtain the meta-analysis according to the standardized mean difference (SMD) and 95% CIs. Results Six articles were included in this systematic review. Four of them contributed information to the meta-analysis. A total of 105 subjects were analyzed. All of the studies used semi-immersive or nonimmersive VR systems. The statistical analysis showed nonsignificant results for the Nine-Hole Peg Test (SMD –0.93, 95% CI –1.95 to 0.09), muscle balance test (SMD –0.27, 95% CI –0.82 to 0.27), Motricity Index (SMD 0.16, 95% CI −0.37 to 0.68), Jebsen-Taylor Hand Function Test (JTHFT) subtests (writing, SMD –0.10, 95% CI –4.01 to 3.82; simulated page turning, SMD –0.99, 95% CI –2.01 to 0.02; simulated feeding, SMD –0.64, 95% CI –1.61 to 0.32; stacking checkers, SMD 0.99, 95% CI –0.02 to 2.00; picking up large light objects, SMD –0.42, 95% CI –1.37 to 0.54; and picking up large heavy objects, SMD 0.52, 95% CI –0.44 to 1.49), range of motion of shoulder abduction/adduction (SMD –0.23, 95% CI –1.48 to 1.03), shoulder flexion/extension (SMD 0.56, 95% CI –1.24 to 2.36), elbow flexion (SMD –0.36, 95% CI –1.14 to 0.42), elbow extension (SMD –0.21, 95% CI –0.99 to 0.57), wrist extension (SMD 1.44, 95% CI –2.19 to 5.06), and elbow supination (SMD –0.18, 95% CI –1.80 to 1.44). Favorable results were found for the JTHFT subtest picking up small common objects (SMD –1.33, 95% CI –2.42 to –0.24). Conclusions The current evidence for VR interventions to improve ULMF in patients with SCI is limited. Future studies employing immersive systems to identify the key aspects that increase the clinical impact of VR interventions are needed, as well as research to prove the benefits of the use of VR in the rehabilitation of patients with SCI in the clinical setting.
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Richter, Randy R., Tricia M. Austin, and Mark F. Reinking. "Foot Orthoses in Lower Limb Overuse Conditions: A Systematic Review and Meta-Analysis—Critical Appraisal and Commentary." Journal of Athletic Training 46, no. 1 (January 1, 2011): 103–6. http://dx.doi.org/10.4085/1062-6050-46.1.103.
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Abstract Reference/Citation: Collins N, Bisset L, McPoil T, Vicenzino B. Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Foot Ankle Int. 2007;28(3):396–412. Clinical Question: Among patients with or at risk for musculoskeletal overuse conditions, (1) do foot orthoses provide clinically meaningful improvements, and (2) are foot orthoses cost-effective? Data Sources: Studies published through September 28, 2005, were identified by using MEDLINE, EMBASE, CINAHL and Pre-CINAHL, Physiotherapy Evidence Database (PEDro), PubMed, SPORTDiscus, Biological Abstracts, Web of Science, Allied Health and Complementary Medicine Database, and the full Cochrane Library. The authors did not provide the search strategy used. Reference lists of included randomized controlled trials (RCTs) and identified systematic reviews were searched by hand. Study Selection: Studies were included if (1) they were RCTs that included the use of foot orthoses (either custom or prefabricated) in 1 of the intervention groups, (2) the clinical problem was an overuse condition as defined by the American College of Foot and Ankle Orthopedics and Medicine guidelines for which foot orthoses were recommended, and (3) at least 1 clinically relevant outcome was measured for a minimum of 1 week. Limits were not placed on year of publication, status of publication, or language. Data Extraction: The journal, authors, and author affiliations of included RCTs were masked from 2 of the reviewers who independently assessed the included RCTs for methodologic quality using a modified PEDro scale plus 3 additional items (justification of sample size, use of outcome measures with known validity and reliability, and reporting of adverse or side effects). Disagreements on methodologic quality were resolved with consensus or by a third reviewer. The effect sizes for the included RCTs were represented by relative risk (RR) for dichotomous outcomes and standardized mean difference (SMD) for continuous data. Confidence intervals (CIs) were reported for RR and SMD. Study data were extracted directly from each of the included studies. If provided, data from intention-to-treat analysis were extracted. Study authors were contacted when insufficient data were reported. A meta-analysis (random-effects model) was conducted using Review Manager (version 4.2; The Nordic Cochrane Centre, Copenhagen, Denmark). Main Results: The search identified 3192 potentially relevant studies. Full articles were retrieved for 327 studies. Twenty-two of the 327 studies met the inclusion criteria. Because the authors of 1 study used the same methods to report on 2 populations, a total of 23 RCTs were included in the systematic review. Prevention of lower limb overuse conditions with the use of foot orthoses was reported in 8 RCTs (7 studies). The effect of foot orthoses in the treatment of lower limb overuse conditions was reported in 15 RCTs. Of the 23 RCTs, the cost-effectiveness of foot orthoses was reported in 2 and the adverse effects of foot orthoses were reported in 8. Across the prevention RCTs, data were available for analysis for a range of 47 to 417 participants with 8 to 16 weeks of follow-up. Based on 4 RCTs in which the researchers examined prevention of lower limb overuse conditions with foot orthoses versus control in military personnel, the RR was 1.49 (95% CI = 1.07, 2.08). A clinically beneficial effect size was set a priori at 1.5 or greater for the foot-orthoses group or at 0.7 or less for the comparison group. Based on 2 RCTs reported in 1 study of the use of custom versus prefabricated foot orthoses for prevention of lower limb overuse conditions, no significant difference in risk was found (RR = 1.14, 95% CI = 0.90, 1.44). In their calculating and reporting of RR, the authors do not appear to have followed convention. Across the treatment RCTs, data were available for analysis for a range of 18 to 133 participants with 8 to 52 weeks of follow-up. The authors of the treatment RCTs reported a variety of outcome measures. Two of these, patient-perceived treatment effect (PPE) and pain on the visual analog scale (VAS), were used to calculate an overall treatment effect (PPE as RR and VAS as SMD). Based on 2 RCTs examining foot orthoses versus control, no significant difference in PPE was found (RR = 1.01, 95% CI = 0.61, 1.68). Based on 2 RCTs in which custom versus prefabricated foot orthoses were examined, no significant difference in PPE was found (RR = 0.88, 95% CI = 0.42, 1.81). The VAS data reported in the text appear to contradict the VAS data reported in Figure 2 for foot orthoses versus control for the treatment of lower limb overuse conditions. Specifically, the lower limit of the CI in the text was negative (−0.28) and in Figure 2 was positive. Because of this apparent contradiction, we did not interpret these data. Authors of 2 RCTs reported cost-effectiveness, but the data could not be pooled. Adverse events were reported in 8 of the 22 studies. The most common adverse effect reported was discomfort, which was the main reason for discontinuing foot-orthoses use in 2 studies. Conclusions: The evidence supports the use of foot orthoses to prevent a first occurrence of lower limb overuse conditions and shows no difference between custom and prefabricated foot orthoses. The evidence was insufficient to recommend foot orthoses (custom or prefabricated) for the treatment of lower limb overuse conditions.
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Halls, Dayna, Carolyn Murray, and Ben Sellar. "Why allied health professionals use evidence-based clinical guidelines in stroke rehabilitation: A systematic review and meta-synthesis of qualitative studies." Clinical Rehabilitation, April 28, 2021, 026921552110123. http://dx.doi.org/10.1177/02692155211012324.
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Objective: To capture qualitative research about the perspectives and reasoning of allied health professionals about variability in the use of clinical guidelines in stroke rehabilitation. Data sources: Ovid Medline, Psychinfo, Cochrane, Ovid Emcare, Scopus and Web of Science. Method: The review protocol followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Qualitative or mixed methods research that provided qualitative data about use of clinical guidelines delivered by allied health professionals in stroke rehabilitation was included. Clinical guidelines included any evidence-based documents that guided allied health stroke rehabilitation practice. All studies were screened in duplicate at title and abstract and then at full text. Included studies were appraised using the McMaster Critical Appraisal Tool. Results: Data from 850 allied health professionals in 22 qualitative research studies from seven different countries were analysed and synthesised. Four themes were developed including: context necessitates strategy, all clients are different, systemic changes are needed and need a good reason to change something. The findings aligned with the four arms of evidence-base practice. Allied health professionals use clinical guidelines when they align with their reasoning and match the ‘sweet spot’ for client goals and circumstance. Clinical guideline use is attributed to sufficient resourcing, time and motivation and a strong research culture within health systems. Conclusions: Variabilities in clinical guideline use by allied health professionals are due to their clinical reasoning, contextual factors, client characteristics and enabling health systems.
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Matthews, James, Amanda M. Hall, and Alison Keogh. "Evaluating the effects of behavior change training on the knowledge, confidence and skills of sport and exercise science students." BMC Sports Science, Medicine and Rehabilitation 12, no. 1 (October 6, 2020). http://dx.doi.org/10.1186/s13102-020-00209-5.
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Abstract Background Behavior change interventions have the potential to have a transformative effect on the health of populations. Allied health professionals have a key role to play in delivering these interventions. However, traditionally undergraduate allied health professional programs have not had a behavior change focus. The aim of this study was to assess the effectiveness of a training program on sport and exercise science students’ knowledge, confidence and skills in the provision of behavior change support. Method A mixed method convergent design was used to address the research question. Fifteen sport and exercise science students took part in a training program consisting of seven 90-min weekly face to face group sessions. Student satisfaction with training methods was assessed. Pre-to-post training changes in students’ confidence and knowledge in the provision of behavior change support was evaluated. Delivery of behavior change support was assessed by an audio recorded role-play rated by an expert using the Health Care Climate Questionnaire, and an adapted version of the Communication Evaluation in Rehabilitation Tool. Students also completed a reflective assignment. Results Students were satisfied with the training. There were increases in students’ confidence and knowledge of certain behavior change components post-training but not behavior change techniques. Students delivered behavior change support in a broadly needs supportive manner. The reflective assignment showed that students found particular behavior change strategies difficult to implement. Conclusion It is feasible to train undergraduate students in particular components of behavior change support. Academic institutions should embed behavior change training into the allied health professional curriculum to ensure graduates are job ready with the knowledge, confidence and skills to support health related behavior change within the wider health system.
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Beaupre, Justin, Sam W. Meske, and Meghan Buckley. "Athletic Training and Population Health Science." Journal of Athletic Training, February 24, 2021. http://dx.doi.org/10.4085/314-19.
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Objective: To define and discuss the role of population health as a framework to improve care and clinical decision making in athletic training practice. Background: Athletic trainers are allied health professionals who are uniquely suited to provide preventative and educational health and wellness programs to improve health outcomes across a physically active population. Athletic trainers are often the first touch point for high school athletes seeking health and wellness education which may allow them to be the first intervention or prevention point for reducing or eliminating negative health behaviors and outcomes among their patients. Conclusions: Integrating a population health framework into the athletic training setting prepares athletic trainers to address complex health issues that exist in communities as a result of factors that influence determinants of health. The field of athletic training could benefit from the use of a population health approach to care by creating a broader consideration of the factors that impact the health of homogenous groups of populations that are served by athletic trainers.
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White, Jennifer, Kellie Grant, Mitchell Sarkies, Terrence Haines, Meg E. Morris, Leeanne Carey, Nicholas F. Taylor, et al. "Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making." Health Research Policy and Systems 19, no. 1 (March 18, 2021). http://dx.doi.org/10.1186/s12961-020-00662-1.
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Abstract Background Health policy and management decisions rarely reflect research evidence. As part of a broader randomized controlled study exploring implementation science strategies we examined how allied health managers respond to two distinct recommendations and the evidence that supports them. Methods A qualitative study nested in a larger randomized controlled trial. Allied health managers across Australia and New Zealand who were responsible for weekend allied health resource allocation decisions towards the provision of inpatient service to acute general medical and surgical wards, and subacute rehabilitation wards were eligible for inclusion. Consenting participants were randomized to (1) control group or (2) implementation group 1, which received an evidence-based policy recommendation document guiding weekend allied health resource allocation decisions, or (3) implementation group 2, which received the same policy recommendation document guiding weekend allied health resource allocation decisions with support from a knowledge broker. As part of the trial, serial focus groups were conducted with a sample of over 80 allied health managers recruited to implementation group 2 only. A total 17 health services participated in serial focus groups according to their allocated randomization wave, over a 12-month study period. The primary outcome was participant perceptions and data were analysed using an inductive thematic approach with constant comparison. Thematic saturation was achieved. Results Five key themes emerged: (1) Local data is more influential than external evidence; (2) How good is the evidence and does it apply to us? (3) It is difficult to change things; (4) Historically that is how we have done things; and (5) What if we get complaints? Conclusions This study explored implementation of strategies to bridge gaps in evidence-informed decision-making. Results provide insight into barriers, which prevent the implementation of evidence-based practice from fully and successfully occurring, such as attitudes towards evidence, limited skills in critical appraisal, and lack of authority to promote change. In addition, strategies are needed to manage the risk of confirmation biases in decision-making processes. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12618000029291). Universal Trial Number (UTN): U1111-1205-2621.
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Ross, Megan H., Andrea Whitehead, Lauren Jeffery, Nicole Hartley, and Trevor Russell. "Supervising Students During a Global Pandemic: Clinical Educators’ Perceptions of a Student-Led Telerehabilitation Service During COVID-19." International Journal of Telerehabilitation 14, no. 1 (May 25, 2022). http://dx.doi.org/10.5195/ijt.2022.6464.
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Scope: In March 2020, COVID-19 restrictions prompted services delivered by student-led clinics in the university sector to transition to telehealth. This provided a unique opportunity to explore the challenges and opportunities faced by clinical educators when supervising students to deliver telehealth. Methodology: Semi-structured interviews were conducted with allied health clinical educators who supervised students on clinical placement who were required to provide services via telehealth. Clinical educators across the disciplines of audiology, occupational therapy, physiotherapy, and speech pathology were asked to reflect on their experiences and perceptions of the rapid transition to a telehealth model for student clinical placements. A content analysis approach was used to analyse qualitative data. Conclusions: From the perspective of clinical educators, student-led telehealth services can effectively meet client needs while achieving student learning outcomes. This study highlights many opportunities for student learning via telehealth in the clinical education environment and the role of the clinical educator in the learning experience.
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Ahmed, Aamna, Ping Guo, and Zahraa Jalal. "A systematic review investigating the role and impact of pharmacist interventions in cardiac rehabilitation." International Journal of Clinical Pharmacy, November 19, 2022. http://dx.doi.org/10.1007/s11096-022-01517-1.
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Abstract Background Cardiovascular disease (CVD) is a predominant cause of mortality. Pharmacists play an important role in secondary prevention of CVD, however, their role in cardiac rehabilitation is under-reported and services are under-utilised. Aim To explore the role of pharmacists in cardiac rehabilitation, the impact of their interventions on patient outcomes, and prospects of future role development. Method Databases searched were PubMed, Embase, Medline, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO from January 2006 to October 2021. Randomised and non-randomised controlled trials were selected if they assessed the role of pharmacists in cardiac rehabilitation. Cochrane risk of bias tool, Joanna Briggs Institute (JBI) Critical Appraisal Tool for Quasi-Experimental Studies and the National Heart, Lung and Blood Institute (NIH) quality assessment tool, were used to assess quality and a narrative synthesis was conducted. Results The search yielded 786 studies, only five met the inclusion criteria. The pharmacist-led interventions included patient education, medication review and reconciliation, and medication adherence encouragement. Four out of the five studies showed that pharmacist-led interventions in cardiac rehabilitation significantly improved patient clinical and non-clinical outcomes. One study showed a statistically significant reduction in low density lipoprotein-cholesterol (LDL-C) levels to optimal target of < 70 mg/dL (80% vs 60%, p = 0.0084). Two studies reported better medication adherence, and two studies showed greater improvement in all domains of health-related quality of life observed in the intervention group. Conclusion Pharmacist-led interventions in cardiac rehabilitation could lower CVD risk factors and hence recurrence. Although these findings support pharmacists’ involvement in cardiac rehabilitation, larger intervention studies are needed to evaluate the feasibility of pharmacist-led interventions and their impact on hospital admissions and mortality risk.
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Chimatiro, George Lameck, and Anthea J. Rhoda. "Scoping review of acute stroke care management and rehabilitation in low and middle-income countries." BMC Health Services Research 19, no. 1 (November 4, 2019). http://dx.doi.org/10.1186/s12913-019-4654-4.
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Abstract Background Stroke is a major public health concern, affecting millions of people worldwide. Care of the condition however, remain inconsistent in developing countries. The purpose of this scoping review was to document evidence of stroke care and service delivery in low and middle-income countries to better inform development of a context-fit stroke model of care. Methods An interpretative scoping literature review based on Arksey and O’Malley’s five-stage-process was executed. The following databases searched for literature published between 2010 and 2017; Cochrane Library, Credo Reference, Health Source: Nursing/Academic Edition, Science Direct, BioMed Central, Cumulative Index to Nursing and Allied Health Literature (CINNAHL), Academic Search Complete, and Google Scholar. Single combined search terms included acute stroke, stroke care, stroke rehabilitation, developing countries, low and middle-income countries. Results A total of 177 references were identified. Twenty of them, published between 2010 and 2017, were included in the review. Applying the Donebedian Model of quality of care, seven dimensions of stroke-care structure, six dimensions of stroke care processes, and six dimensions of stroke care outcomes were identified. Structure of stroke care included availability of a stroke unit, an accident and emergency department, a multidisciplinary team, stroke specialists, neuroimaging, medication, and health care policies. Stroke care processes that emerged were assessment and diagnosis, referrals, intravenous thrombolysis, rehabilitation, and primary and secondary prevention strategies. Stroke-care outcomes included quality of stroke-care practice, functional independence level, length of stay, mortality, living at home, and institutionalization. Conclusions There is lack of uniformity in the way stroke care is advanced in low and middle-income countries. This is reflected in the unsatisfactory stroke care structure, processes, and outcomes. There is a need for stroke care settings to adopt quality improvement strategies. Health ministry and governments need to decisively face stroke burden by setting policies that advance improved care of patients with stroke. Stroke Units and Recombinant Tissue Plasminogen Activator (rtPA) administration could be considered as both a structural and process necessity towards improvement of outcomes of patients with stroke in the LMICs.
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Doddoli, Suchitra, Gururaj Doddoli, and Smita Lokhande. "An Integrated Approach of Yoga and Ayurveda in Cancer Rehabilitation: A Systematic Review." Journal of Complementary and Alternative Medical Research, December 26, 2022, 1–17. http://dx.doi.org/10.9734/jocamr/2022/v20i3415.
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Aims: In this comprehensive evaluation of literature, body-mind practices of Yoga and Ayurveda during cancer rehabilitation are summarized.
Methodology: Through a methodical searching of PubMed, Embase, Scopus, Web of Science, and Allied Health Plus with a timescale of January 2007 to April 2021, appropriate research papers were identified. Data about study design, method of recruiting, subjects, interventions, and findings were taken out. Retrospective data analysis, pilot or feasibility studies were eliminated, whereas preliminary, controlled studies involving one- and multiple equipped samples, examining rehabilitating therapies for cancer patients at any phase with in-care spectrum had been included.
Results: The study included fifteen papers as outcome of PRISM model, wherein, breast carcinoma cases are predominant. Majority of therapies involved herbal and yoga-based regimens that enhanced psycho-physiological indicators and quality of life.
Conclusion: Preliminary research suggests that integrating Yoga and Ayurveda remedies with lifestyle-relied intervention is possible to improve self-healing capacity and sustainability in cancer patients, however methodical constraints of investigations in this growing field should be addressed. To progress the discipline, new research with robust research approaches seems to be necessary.
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Meira, Isabella Felix de Araújo, Fernanda Rios da Silva, Anderson Reis de Sousa, Evanilda Souza de Santana Carvalho, Darci de Oliveira Santa Rosa, and Álvaro Pereira. "Repercussions of intestinal ostomy on male sexuality: an integrative review." Revista Brasileira de Enfermagem 73, no. 6 (2020). http://dx.doi.org/10.1590/0034-7167-2019-0245.
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ABSTRACT Objective: To analyze scientific productions about the repercussions of intestinal ostomy on male sexuality and discuss its implications for planning nursing care. Method: Integrative literature review conducted in the databases Scientific Electronic Library Online, Latin American and Caribbean Literature in Health Sciences, Sciverse Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature and National Library of Medicine and National Institutes of Health, with no pre-established time frame and using the descriptors “sexuality,” “ostomy,” “colostomy,” “men” and “nursing.” Results: 21 articles were included to compose the interpretative analysis. Studies have shown that intestinal ostomy can affect male sexuality and reflect negatively on biophysiological, psychoemotional, and sociocultural dimensions. Final Considerations: Through education strategies in programs that follow-up ostomized men from preoperative to rehabilitation, the nurse can assist in adapting to reality, as well as in the quality of life.
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Halfpenny, Rhiannon, Alexandra Stewart, Paula Kelly, Eleanor Conway, and Christina Smith. "Dysphagia rehabilitation following acquired brain injury, including cerebral palsy, across the lifespan: a scoping review protocol." Systematic Reviews 10, no. 1 (December 2021). http://dx.doi.org/10.1186/s13643-021-01861-9.
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Abstract Background Swallowing impairment (dysphagia) following brain injury can lead to life-threatening complications such as dehydration, aspiration pneumonia and acute choking episodes. In adult therapeutic practice, there is research and clinical evidence to support the use of swallowing exercises to improve swallowing physiology in dysphagia; however, the use of these exercises in treating children with dysphagia is largely unexplored. Fundamental questions remain regarding the feasibility and effectiveness of using swallowing exercises with children. This review aims to outline the published literature on exercise-based treatment methods used in the rehabilitation of dysphagia secondary to an acquired brain injury across the lifespan. This will allow the range and effects of interventions utilised to be mapped alongside differential practices between adult and child populations to be formally documented, providing the potential for discussions with clinicians about which rehabilitative interventions might be appropriate for further trial in paediatrics. Methods This study will use a scoping review framework to identify and systematically review the existing literature using Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews (PRISMA) scoping review guidelines. Electronic databases (MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine Database (AMED)), grey literature and the reference lists of key texts including systematic reviews will be searched. Information about the rehabilitation design, dosage and intensity of exercise programmes used as well as demographic information such as the age of participants and aetiology of dysphagia will be extracted. The number of articles in each area and the type of data source will be presented in a written and visual format. Comparison between the literature in adult and child populations will be discussed. Discussion This review is unique as it directly compares dysphagia rehabilitation in adults with that of a paediatric population in order to formally identify and discuss the therapeutic gaps in child dysphagia rehabilitation. The results will inform the next stage of research, looking into the current UK-based speech and language therapy practices when working with children with acquired dysphagia. Systematic review registration Open science framework osf.io/ja4dr
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Shannon, Nicholas, and Jon Patricios. "Sports-related concussion: assessing the comprehension, collaboration, and contribution of chiropractors." Chiropractic & Manual Therapies 30, no. 1 (December 27, 2022). http://dx.doi.org/10.1186/s12998-022-00471-z.
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AbstractOver the last 2 decades, sports-related concussion (SRC) awareness and management have evolved from an emphasis on complete cognitive and physical rest to evidence-based protocols and interventions. Chiropractors are primary care providers with exposure to athletes and teams in collision sports and, in addition, manage patients with concussion-like symptoms including neck pain, dizziness, and headache. With SRC frequently occurring in the absence of a medical practitioner, the role of allied health practitioners like chiropractors should be emphasised when it comes to the recognition, assessment, and management of SRC. This commentary discusses the potential contribution of chiropractors in SRC and the specific role their expertise in the cervical spine may play in symptom evaluation and management. A PubMed and Google scholar review of the chiropractic SRC literature suggests that the chiropractic profession appears under-represented in concussion research in athletic populations compared to other medical and allied health fields. This includes an absence of chiropractic clinicians with a focus on SRC participating in the Concussion in Sport Group (CISG) and the International Consensus Conferences on Concussion. Furthermore, with evolving evidence suggesting the importance of cervicogenic manifestations in SRC, there is an opportunity for chiropractors to participate in SRC diagnosis and management more fully and contribute scientifically to an area of specialised knowledge and training. With a dearth of chiropractic orientated SRC science, clinical SRC expertise, and clinical chiropractic representation in the CISG; it is incumbent on chiropractic clinicians and scientists to take up this opportunity through meaningful contribution and involvement in the SRC field.
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Morillo, Hannah, Sophie Lowry, and Claire Henderson. "Exploring the effectiveness of family-based interventions for psychosis in low- and middle-income countries: a systematic review." Social Psychiatry and Psychiatric Epidemiology, June 14, 2022. http://dx.doi.org/10.1007/s00127-022-02309-8.
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Abstract Purpose Of the 80% people with psychosis living in low- and middle-income countries (LMICs), up to 90% are left to the care of families. The World Health Organization has recommended the inclusion of families in community-based rehabilitation and while there is evidence of its implementation in LMICs, this has not been reviewed yet. This study aims to describe the key features and implementation strategies of family-based interventions in LMICs, and appraise their effectiveness. Methods Included are people with psychosis in LMICs who receive any form of family-based intervention, compared to their usual or absence of treatment, with patient outcome measures. We searched (August 2021) through Embase, MEDLINE, Global Health, PsycInfo, Social Policy and Practice, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as from grey literature and hand-searched records. Risk of bias was assessed through the Integrated Quality Criteria for Review of Multiple Study Designs (ICROMS) and Consolidated Health Economic Evaluation Reporting Standards (CHEERS), then analyzed narratively. Results 27 studies were included from the 5254 records. Psychotherapeutic features, systems approach and task-sharing were key intervention elements. Delivery strategies included preliminary research, sustained family engagement, and cultural adaptation. There were positive health impacts across four outcome domains. Conclusion All studies recommended family-based interventions, with limitations in heterogeneity and 70% of them rated high risk of bias. Other Review was registered in PROSPERO (CRD42021256856). The authors did not receive funding for this research.
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Nelson, Luke, Henry Pollard, Rick Ames, Brett Jarosz, Pete Garbutt, and Cliff Da Costa. "A descriptive study of sports chiropractors with an International Chiropractic Sport Science Practitioner qualification: a cross-sectional survey." Chiropractic & Manual Therapies 29, no. 1 (December 2021). http://dx.doi.org/10.1186/s12998-021-00405-1.
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Abstract Background This paper describes the education and case management profile of sports chiropractors with the Federation of International Sports Chiropractors (FICS) postgraduate qualification: International Chiropractic Sport Science Practitioner (ICSSP). The ICSSP is the predominant international sports chiropractic qualification. Methods A cross-sectional survey, carried out between 22/10/2014 and 22/12/2014,was utilized with a 39-item web-based survey examining practitioner, practice and clinical management characteristics, and was distributed via email to all sports chiropractors who held an ICSSP qualification (n = 240) in 2014. Results The survey response rate was 64% (n = 154). 36% of chiropractors were aged between 31 and 40 years, just over three quarters were male, and 27% had been in practice for 5–10 years. The majority of respondents were based in North America. All sports chiropractors surveyed reported treating neuromusculoskeletal conditions outside of the spine. 91% utilized a multimodal approach in most of their treatments, prescribing rehabilitative exercises in 76% of consultations. Almost 64% of respondents reported current treatment of professional athletes, and 78% reported current treatment of semi-professional athletes, whilst the vast majority of those surveyed endorsed past treatment of professional (91%) and semi-professional (95%) athletes. All respondents reported referring to a range of conventional and allied health providers. Conclusions This study of ICSSP-qualified sports chiropractors describes a small but well-educated workforce treating high-level athletes, managing a wide range of spine and non-spinal neuromusculoskeletal conditions, utilising multimodal approaches (including active and passive strategies), and referring to and co-managing with other health practitioners.
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Li, Xin, Jie Shen, Juping Liang, Xuan Zhou, Yuqi Yang, Dexuan Wang, Shanshan Wang, Lixia Wang, Hong Wang, and Qing Du. "Effect of core-based exercise in people with scoliosis: A systematic review and meta-analysis." Clinical Rehabilitation, December 27, 2020, 026921552097510. http://dx.doi.org/10.1177/0269215520975105.
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Objective: To systematically assess the effectiveness of core-based exercise for correcting a spinal deformity and improving quality of life in people with scoliosis. Data sources: The PubMed, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science databases were searched from inception up to September 30, 2020. Methods: Clinical controlled trials were eligible if they compared the effectiveness of core-based exercise to other nonsurgical interventions in people with scoliosis. The revised Cochrane risk of bias assessment tool for randomized trials and the methodological index for non-randomized studies scale were used to assess the risk of bias. The outcomes included the Cobb angle, the angle of trunk rotation and quality of life. RevMan 5.3 was used, and intergroup differences were determined by calculating mean differences (MD) and 95% confidence intervals (CIs). Results: After screening 1348 studies, nine studies with 325 participants met the inclusion criteria. The exercise group had significantly lower Cobb angles (MD = −2.08, 95% CI: −3.89 to −0.28, P = 0.02) and significantly better quality of life as measured by the Scoliosis Research Society-22 questionnaire (MD = 0.25, 95% CI: 0.02 to 0.49, P = 0.03) than the control groups. However, no significant difference was observed regarding the angle of trunk rotation between groups (MD = −0.69, 95% CI: −2.61 to 1.22, P = 0.48). Furthermore, no serious adverse events were reported. The overall quality of evidence ranged from low to very low. Conclusion: Core-based exercise may have a beneficial role in reducing the Cobb angle and improving quality of life in people with scoliosis in the short term. PROSPERO registration number: CRD42020160509 (Available at http://www.crd.york.ac.uk/prospero/ )