Locomotor Disabilities Research Articles

Perceived Needs Related to Social Participation of People with Leprosy-related Disabilities and other People with Disabilities in Cambodia: A Qualitative Study

Purpose: The objective of this study was to describe the similarities and differences in perceived needs related to social participation of persons with leprosy-related disabilities and other persons with disabilities in Cambodia, and to suggest key interventions to promote participation in the community. Methods: A cross-sectional study was conducted. People with leprosy-related disabilities were selected at home during field visits or at the rehabilitation centre for people with leprosy in Phnom Penh. People with locomotor disabilities were selected at the rehabilitation centre for persons with disabilities in Phnom Penh and Prey Veng. A pilot-tested, face-to-face semi-structured interview, with open and closed questions, and focus group discussions were used to investigate the perceived needs related to social and economic participation in the community. The interview was based on the International Classification of Functioning, Disability and Health (ICF) model of the WHO. Results: Both groups of people with disabilities struggle with social exclusion in society. People with leprosy-related disabilities, in particular, live below the poverty line of US$ 0.5 per day. Most of the participants lived in rural areas. Participants raised the need for enhanced self-esteem and help in finding jobs. To overcome the difficulty in finding employment, they felt vocational training and microcredit to start businesses, were required. Conclusions: The study found that both groups of people with disabilities have similar needs to improve participation in social and economic life. Rehabilitation centres provide vocational training and microcredit. Self-help groups have also proven effective in reaching poor people with disabilities in rural areas and improving social participation. The authors suggest that it is best to form multi-disability self-help groups to empower all the affected people and help fight poverty.

Designing Functional Clothes for Persons with Locomotor Disabilities

Abstract The life quality improvement issue is a problem of national and international interest. This acquires total different values when it is to refer to a series of disadvantaged categories, that is the persons with locomotor disabilities. It is an inevitable social responsibility to create equal opportunities for disabled people, to prevent any intentional or unintentional discrimination that they face and apply positive discrimination if necessary to improve their living standards and to let them have an equal share from social development as productive individuals of society. A disability is any kind of restriction or inability to accomplish a certain activity, which belongs to the interval considered as “normal” for a human being. Disabilities are characterized by deficiencies or excesses in the activity or behaviour that is normally expected from a person; they can be temporary or permanent, reversible or irreversible, progressive or regressive. The physical disabilities that require the use of wheelchairs imply the manufacturing of special clothing products that meet certain needs at a functional and/or therapeutic level. The study presents the main aspects involved in designing and developing textile products for this category of users. Therefore, the apparel that is specially designed for persons with disabilities has to: allow more freedom and independence when is being worn, correspond to the aesthetic point of view, offer psychological benefits and help to socially integrate the individual who wears it. In addition, clothes should not hinder the individual’s mobility and must allow the use of the chest and of the superior limbs to the maximum, they must be durable, have a low level of electrostatic charge, be absorbent and comfortable, present the so-called “rehabilitation functions”, and last but not least, be beneficial for the wearer both from a physical and psychological point of view.

Effect of vitamin D3 intake on the onset of disease in a murine model of human Krabbe disease.

Low vitamin D level is a risk factor for various late-onset CNS demyelinating disorders. We investigated whether vitamin D deficiency influences disease in twitcher mice (GALC(twi/twi) ; twi), a murine model of Krabbe disease (KD), an inherited disorder caused by galactocerebrosidase (GALC) deficiency that leads to psychosine accumulation, oligodendrocyte (OL) loss, and CNS demyelination. We found that the in situ 1,25-dihydroxyvitamin D3 level was reduced, with a parallel increase in the expression of inflammatory cytokines and vitamin D-catabolizing enzymes in the brains of KD and twi mice compared with age-matched controls. Pups maintained on milk from lactating heterozygous (GALC(twi/+) ) mothers that were fed a vitamin D3-supplemented diet until weaning and then fed a vitamin D3-supplemented diet demonstrated delayed body weight loss and development of disease in twi mice. This delayed the onset of tremors and locomotor disabilities that eventually impacted the life span of twi mice (50 ± 2 days). Accordingly, the expression of antioxidant enzymes was increased with delayed psychosine accumulation, lipid peroxidation, and inflammatory response that eventually protected CNS myelin and axonal integrity in twi mice. In vitro studies revealed that 1,25-dihydroxyvitamin D3 enhances antioxidant defenses in OLs deficient for GALC or incubated with psychosine. Together these data provide the first evidence that vitamin D deficiency affects disease development in twi mice and that vitamin D3 supplementation has the potential to improve the efficacy of KD therapeutics.

Assessment of gait nonlinear dynamics by inhomogeneous point-process models.

Point-process linear models of stride intervals have been recently proven to provide a unique characterization of human gait dynamics through instantaneous time domain features. In this study we propose novel instantaneous measures characterizing nonlinear gait dynamics using a quadratic autoregressive inhomogeneous point-process model recently devised for the instantaneous assessment of physiological, natural, and physical discrete dynamical systems. Our mathematical framework accounts for long-term information given by the past events of non-stationary non-Gaussian time series, expressed by a Laguerre expansion of the Wiener-Volterra terms. Here, we present a study of gait variability from data gathered from physionet.org, including 15 recordings from young and elderly healthy volunteers, and patients with Parkinson's disease. Results show that our instantaneous polyspectral characterization provides an informative tracking of the inherent nonlinear dynamics of human gait, which is significantly affected by aging and locomotor disabilities.

Study of menstrual patterns in adolescent girls with disabilities in a residential institution.

The gynecological health needs of girls with disabilities is an issue related to their rights as individuals. The objective of this study is to describe the menstrual pattern of girls with disabilities. A descriptive study was undertaken on thirty girls with different types of disabilities in a residential institution. The diagnosis, type of disability, secondary sexual characters, age at menarche, menstrual pattern and practice of menstrual hygiene was noted. The girls with intellectual disabilities had later age of menarche, irregular cycles and more behaviour problems. The girls with hearing impairment and locomotor disabilities had normal menstrual pattern. The girl with low vision had earlier menarche and regularized cycles. Girls with normal intelligence and mild intellectual disabilities were independent in maintaining menstrual hygiene. The menstrual disorders are managed conservatively in accordance with latest guidelines. Onset of menarche is towards the extremes of normal age range in girls with intellectual disabilities or visual impairment but not in girls with hearing impairments or locomotor disabilities. Girls with disabilities have potential for independent menstrual care. Menstrual disorders were managed conservatively.

Structural barriers at the workplace for employees with vision and locomotor disabilities in New Delhi, India.

India, a signatory to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), has 2.21% of people with disabilities to the total population of which 26% are employed (Census 2011 and 2001). Accessibility was introduced for the first time in 1995 under The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act. Article 9 of UNCRPD promotes barrier-free environment on an equal basis with others. Despite the legislation and the UN convention, structural barriers continue to be one of the largest barriers posing concern for PwDs at their workplace. To identify various physicall barriers limiting accessibility of PWDs in the formal sector in Delhi. Quantitative descriptive research design. Random sample was drawn. Structural barriers create difficulty in accessing basic amenities such as canteens, toilets etc. Disability is a human rights issue. An employee with disability is entitled to dignified life. Effective implementation of Article 9 and 27 of UNCRPD will pave a way for removing structural barriers at workplace.

Intellectual disability in India: Charity to right based.

Byline: B. Chavan, Abhijit. Rozatkar According to the Census 2001, [sup][1] there are 21 million people with disabilities in India who constitute 2.13% of the total population. In contrast, the National Sample Survey Organization (NSSO) estimated that the number of persons with disabilities in India is 1.8% of the Indian population; [sup][2] of which 75% of persons with disabilities live in rural areas, 49% of them are literate and only 34% are employed. Both the surveys included the persons with visual, hearing, speech, locomotor, and mental disabilities, but the distribution in each category according to the two surveys differs drastically. However, experts working in the field of developmental disabilities feel that prevalence of mental disability is much higher. [sup][3] Intellectual disability (ID) is characterized by significant impairment in cognitive and adaptive behavior. The term used to describe this condition has gone under constant change over the years due to social and political compulsions. The main reason to search for a new term is to find a least stigmatizing terminology. Thus, mental retardation, which was in use world over till late 20 [sup]th century, has now been replaced with ID in most English speaking countries. Diagnostic and Statistical Manual 5 [sup]th Revision (DSM-V) has replaced it with ID and the much anticipated 11 [sup]th revision of International Classification of Disease is likely to do so. [sup][4],[5] The history of ID has passed through a very turbulent phase and can be briefly summarized under: i) Pre-industrialization phase: From the dawn of civilization to the beginning of industrialization period, people born with "abnormal" physiognomy were treated with fear or ridicule (and perhaps continue to do so in many societies). ii) Industrialization phase: Although industrial revolution is associated with increasing wealth and productivity, it also brought in many ill effects. Migration to bigger cities led to development of slums, poverty, diseases, and crimes. Families started valuing those with vocational ability and started neglecting members who were not able to work. The individual who had low intelligence were left out and were labeled as feeble-minded, degrading, and stigmatizing. iii) Humanitarian approach: In 1846, Dr Samuel Gridley Howe from Boston persuaded Massachusetts Legislature to appoint a commission to inquire into the condition of 'idiots'. After survey and close study, he for the first time observed, "These are the proper subjects of education, they can be taught to do some kind of labor and they can be made self-sufficient". [sup][6] It led to many state run schools for these persons. However, these schools were a failure because Howe and his fellows (Sequin and Wilbur) were too optimistic, unrealistic in expectations as they expected to restore all 'idiots' to normal functioning. iv) Demonology of the defectives: The scientific developments of Darwinism, sociological approach, Mendelian theory of genetics, and Binet psychometric tests advocated, directly or indirectly that feeble minded individuals, who could be easily identified and quantified, are risk to the society. Thus, the society started thinking ways to prevent feeble mindedness from occurring and working on ways how to control those in whom it did occur. The segregation seemed to be the best method where feeble minded could be cheaply and wisely cared for along with prevention and societal protection. v) Period of John F Kennedy: In 1963, based on recommendations of President's Panel on Mental Retardation, JF Kennedy made a speech to the Congress of United States and asked for new resources to address the needs for people with mental retardation. Soon, virtually every state launched special educational programs for these persons. [sup][6] Currently, the term ID is being used instead of mental retardation. This transition in terminology is supported by organization like the American Association on Intellectual and Developmental Disabilities (AAIDD), International Association for the Scientific Study of Intellectual Disabilities (IASSID), and President's Committee for People with Intellectual Disabilities. …

Functional Independence and Quality of Life for Persons with Locomotor Disabilities in Institutional Based Rehabilitation and Community Based Rehabilitation - A Comparative Study

Purpose: To compare the functional independence and quality of life of persons with locomotor disabilities who undergo Institutional Based Rehabilitation (IBR) and similar persons who undergo Community Based Rehabilitation (CBR). Methods: Purposive sampling was done. Thirty males with locomotor disabilities -15 from IBR and 15 from CBR- were selected. Both the groups were first administered the Functional Independence Measure (FIM) questionnaire, followed by the Quality of Life (WHOQOL-BREF) questionnaire. Results: There were no significant differencse between IBR and CBR with regard to functional independence (t value = -1.810, P < 0.05), and with regard to Quality of Life (QOL) (t value of 0.468, P < 0.05). doi: 10.5463/dcid.v23i3.147

Cholinergic Receptor Alterations in the Brain Stem of Spinal Cord Injured Rats

Cholinergic receptors in upper motor neurons of brain stem control locomotion and coordination. Present study unravels cholinergic alterations in brain stem during spinal cord injury to understand signalling pathway changes which may be associated with spinal cord injury mediated motor deficits. We evaluated cholinergic function in brain stem by studying the expression of choline acetyl transferase and acetylcholine esterase. We quantified metabotropic muscarinic cholinergic receptors by receptor assays for total muscarinic, muscarinic M1 and M3 receptor subunits, gene expression studies using Real Time PCR and confocal imaging using FITC tagged secondary antibodies. The gene expression of ionotropic nicotinic cholinergic receptors and confocal imaging were also studied. The results from our study showed metabolic disturbance in cholinergic pathway as choline acetyl transferase is down regulated and acetylcholine esterase is up regulated in spinal cord injury group. The significant decrease in muscarinic receptors showed by decreased receptor number along with down regulated gene expression and confocal imaging accounts for dysfunction of metabotropic acetylcholine receptors in spinal cord injury group. Ionotropic acetylcholine receptor alterations were evident from the decreased gene expression of alpha 7 nicotinic acetylcholine receptors and confocal imaging. The motor coordination was analysed by Grid walk test which showed an increased foot slips in spinal cord injured rats. The significant reduction in brain stem cholinergic function might have intensified the motor dysfunction and locomotor disabilities.

Study of Factors Affecting Progress of Locomotor Disability in a Slum in Mumbai

Abstract Locomotor disability is one of the most commonly prevailing type of disability in India. This study was conducted with the aim of assessing the severity and to study the factors affecting progress of locomotor disability. A community based cross-sectional observation study was conducted in an urban slum of Mumbai. Total sample of 3665 individuals were screened; 205 were identified with locomotor disabilities who were subjected to a structured questionnaire and physical examination. The prevalence of locomotor disabilities is found to be 5.59 %. Females are affected more than the males and unemployment was observed to be very high. Awareness about rehabilitative services was found to be very low and very few individuals had ever taken any treatment. Majority of the individuals detected with locomotor disability were ambulatory, showed good IADL score and muscle power as well as single joint involvement. Advancing age and longer duration of disability have been associated with low scores of IADL, low muscular power, multiple joint involvement and increased duration of disability. Treatment started at young age, on immediate diagnosis will halt the progress of the disease. Availability and awareness of rehabilitation facilities will go a long way in improving the quality of life of individuals with locomotor disabilities.

Quality of life among the elderly with locomotor disabilities in Sweden and Poland in the 1990s

To estimate the proportion of locomotor disabilities in two elderly populations in Sweden and Poland, respectively. To estimate the perceived quality of life (QoL) in the disabled groups in samples from each country using a model developed by Carol Estwing Ferrans. The study comprised three parts: an epidemiological screening test for identification of individuals with a locomotor disability, an analysis of background data of importance and home visits with evaluations of quality of life and functional capacity. Home visits were made using the Quality of Life Index, (QLI) of Ferrans and Powers and a functional scale, the Standardized Practical Equipment (SPE). Data were collected for the period 1991-1996. In the population part of the study, with 1,380 respondents (78%) comprising elderly Swedish persons, 288 reported a locomotor disability. This can be compared with 425 among 1,045 respondents (52%) in a Polish elderly group. The tests at the home visits (Sweden, n=89; Poland, n=84) showed that both men and women in the Swedish group reported significantly higher scores for the total QLI (max. 30.00) with men reporting 26.68 points compared to 19.73 and women reporting 21.39 points compared to 19.40 and for three of the four subscales. Also, the Polish group scored lower for balance and mobility (SPE). The study provides an important view of the life situation measured with the QLI tool and the SPE for elderly persons with locomotor disorders in Sweden and Poland during the mid-1990s. The results are congruent with epidemiological reports on the poor health situation in Poland, particularly during that time. A new investigation among the elderly with locomotor disorders in the two countries today might provide different results.

Polysialic Acid Glycomimetic Promotes Functional Recovery and Plasticity After Spinal Cord Injury in Mice

Regeneration after injury of the central nervous system is poor due to the abundance of molecules inhibiting axonal growth. Here we pursued to promote regeneration after thoracic spinal cord injury in young adult C57BL/6J mice using peptides which functionally mimic polysialic acid (PSA) and human natural killer cell-1 (HNK-1) glycan, carbohydrate epitopes known to promote neurite outgrowth in vitro. Subdural infusions were performed with an osmotic pump, over 2 weeks. When applied immediately after injury, the PSA mimetic and the combination of PSA and HNK-1 mimetics, but not the HNK-1 mimetic alone, improved functional recovery as assessed by locomotor rating and video-based motion analysis over a 6-week observation period. Better outcome in PSA mimetic-treated mice was associated with higher, as compared with control mice, numbers of cholinergic and glutamatergic terminals and monaminergic axons in the lumbar spinal cord, and better axonal myelination proximal to the injury site. In contrast to immediate post-traumatic application, the PSA mimetic treatment was ineffective when initiated 3 weeks after spinal cord injury. Our data suggest that PSA mimetic peptides can be efficient therapeutic tools improving, by augmenting plasticity, functional recovery when applied during the acute phase of spinal cord injury.

Intensity And Energy Expenditure Of Sports In Elite Paralympic Athletes With Locomotor Disabilities

Intensity And Energy Expenditure Of Sports In Elite Paralympic Athletes With Locomotor Disabilities

Acupuncture for Locomotor Disabilities in a South American Red-Footed Tortoise (Geochelone Carbonaria) – a Case Report

The literature contains numerous reports of the effect of acupuncture on domestic or experimental animals, but only a few involving wild animals. This paper reports on acupuncture treatment for locomotor disabilities in a South American red-footed tortoise (Geochelone carbonaria, SPIX, 1824), an endangered land tortoise found in Brazils Cerrado region. The animal was captured and kept in an aquatic pen, subsequently developing respiratory symptoms and locomotor disabilities. The respiratory symptoms resolved in response to antibiotic treatment. However, despite the use of nutritional supplements, the motor symptoms remained unchanged. After 16 months, the tortoise was given six acupuncture sessions. No other changes were made to its environment or management. The location of the acupuncture points was transposed from canine charts. After acupuncture, the animals motor functions, which had remained unchanged during the preceding 16 months, were restored, enabling it to eat and walk unaided. The improvement persisted during 18 months follow up. The transposition of acupuncture points from canine charts is a viable alternative for chelonians.

How Young People with Disabilities Conceptualize The Body, Sex and Marriage in Urban India: Four Case Studies

Historically in India as elsewhere in the world, there has been a deep-rooted cultural antipathy to persons with disabilities. They have been portrayed as medical anomalies, helpless victims and a lifelong burden for family and society. While today there is a general recognition in India of the need to enhance educational and employment opportunities for persons with disabilities in order to promote economic self-reliance and independent living, their sexual needs, dreams and aspirations are more or less invisible. Sexual and reproductive rights are considered irrelevant for persons with disabilities. Using qualitative data, this paper discusses notions of sexual identity among urban Indian youth through four case studies of college students in Delhi. Gender emerges as a key analytical category in perceptions of sexuality among young men and women with visual and loco-motor disabilities. The paper does not claim to capture the complex reality of disabled sexuality in India, but highlights some key issues in a hitherto largely under-research domain. But the author’s analysis carries added value, since she herself has low vision; thus conferring a reflexive angle to the research.

Coordination in arm movements during crawl stroke in elite swimmers with a loco-motor disability

The purpose of this study was to investigate selected kinematics parameters of the arm stroke in crawl swimmers with disabilities and to examine the potential use of an index of arm coordination (IdC) to evaluate the stroking technique of swimmers with diverse functional abilities. The degree of overlap in the propulsive phases (superposition model) and lag time between the propulsive phases (catch-up model) was examined in 18 well-trained swimmers with loco-motor disabilities, 9 females and 9 males, from functional classes S3–S10 with S10 being most functional. Based on the results, correct coordination appears to be fundamental to swimming crawlstroke in both able-bodied swimmers as well as swimmers with a disability. Some swimmers with disabilities examined here exhibited extreme values at both ends of the index scale. This might be essential to maintaining balance while swimming when not all limb activity contributes to the forward movement.

Assessing advanced locomotor recovery after total hip arthroplasty with the timed stair test.

To assess advanced locomotor performance with the timed stair test (TST) and to determine if the level of performance of a group of women one year after hip replacement changed with the functional demands of the tasks. Comparison of the performance of two groups of women. General community. A convenient sample including 18 women who had had a total hip replacement 11 months earlier (patients) and 15 healthy age-matched women (comparison group). Three tests were administered: the 10-m walk test, the unloaded TST and the loaded TST (10 kg). The duration of each test was recorded and transformed into speed and the level of performance was assessed by calculating percentage deficit using corresponding values from the comparison group. The TST is made of four subtasks: (1) standing up and walking, (2) ascending stairs, (3) turning and descending stairs, (4) walking back, turning and sitting down. Significant differences in performance were found for all three tests with the patients showing a slower performance. The percentage deficits increased significantly from the less difficult (walking: 18%) to the more difficult conditions (unloaded TST: 23% and loaded TST: 28%), with the greatest deficits found during stair descent. Strong correlations were also found between walking deficits and TST deficits (loaded: r = 0.82; unloaded: r = 0.88). By combining mobility, walking and stair activities, the TST can be used to assess various components of advanced locomotor performance. The progressive level of difficulty of the TST subtasks as well as the addition of a load make it useful to detect subtle locomotor disabilities.

Muscle pain in athletes with locomotor disability.

Athletes with locomotor disabilities (LDA) participate in many competitive sport activities, yet little is known about sport-related muscle pain (SRMP). This study assessed the prevalence, determinants, and main characteristics of SRMP in LDA. A cross-disability epidemiological survey was used to investigate the occurrence of SRMP during the previous year by using a questionnaire administrated by medical doctors. SRMP was defined as any muscle pain experienced during the past 12 months that either occurred during sport activity (training or competition) and/or was reported as a consequence of physical exercise, causing discomfort for at least 1 d and not related to systemic disease. A total of 227 LDA were recruited randomly from the population (567 LDA) who participated in selected National sports events (including swimming, athletics, wheelchair basketball matches, and others) organized by the Italian Federation of Sports for Disabled. Collected data were statistically analyzed with univariate and multivariate logistic regression models to identify possible determinants of SRMP, through the estimate of the prevalence odds ratios. The SRMP period prevalence rate was equal to 50.7% (95% confidence interval (44.0-57.4%)), ranging from 47.0% (swimmers) to 58.8% (basketball athletes). In 71.1% of cases, SRMP lasted less than 1 wk and only 8.7% experienced pain for more than 1 month. SRMP had a higher prevalence in amputees (75.0%) and spinal cord injured LDA (58.1%) than the other groups. There was increased prevalence rate of SRMP with increased training volume. The multivariate logistic regression model showed disorder type, body mass index, and training volume as determinants of SRMP. Prospective studies could be devised to assess the role of anthropometric characteristics and training volume as risk factors of SRMP.

Rehabilitation of cerebral palsy in a developing country: the need for comprehensive assessment.

Records of 100 children with cerebral palsy from rural India attending a cerebral palsy clinic were analysed to determine the frequency of associated handicaps and to evaluate whether appropriate intervention had been instituted for these handicaps. All the children underwent speech, hearing, psychological, ophthalmologic, neurological, physical, functional and orthopaedic evaluations on their visit to the clinic. History was elicited from the parents of the patients to identify which of the disabilities were recognized either by them or their primary care physician, and whether any intervention had been instituted. The mean age of the patients was 6.9 years. Eighty-two per cent of the children had one or more disabilities apart from locomotor disabilities, visual defects being the commonest (54%). Fifty-four per cent of the children had more than one associated disability. Although 43% of the patients had been referred by a primary care physician, one or more associated disabilities had not been recognized and epilepsy was the only associated problem that had been treated prior to the evaluation. The study emphasizes the need for comprehensive evaluation of all children with cerebral palsy to enable proper rehabilitation.

Descriptive epidemiology of physical activity in university graduates with locomotor disabilities.

The descriptive epidemiology of physical activity in a sample of 577 University of Illinois graduates (1952-1991) with locomotor disabilities was assessed by mail survey. The survey requested basic demographic information, age, gender, marital status, household income. Respondents were asked to rate their current activity levels and activity levels during their college years compared to others their age on a 5 point scale: (1) much less active to (5) much more active. Completed surveys were received from 229 alumni (40%); 59 semi-ambulatory, 115 paraplegic, 55 quadriplegic. Results indicated current physical activity was associated with mobility limitation. With more severe mobility limitations the percentage reporting being less/much less active increased (42.4% semi-ambulatory, 56.5% paraplegic, 66.7% quadriplegic, P < 0.001) and the percentage reporting being more active decreased (20.3% semi-ambulatory, 16.5% paraplegic, 13.0% quadriplegic, P < 0.001). Current physical activity was significantly lower (P < 0.05) with increasing age, lower self-rated health, higher disability severity and among those who were sedentary during college. Physical activity did not differ by gender, marital status or household income. Multiple regression analysis indicated that health status was a significant predictor of current physical activity in all mobility categories (P < 0.001) after controlling for age, gender, income, disability severity and college activity. Among both paraplegics and quadriplegics physical activity during college was significantly associated (P < 0.001 paraplegic; P < 0.01 quadriplegic) with current physical activity. These results document a low level of physical activity in a well-educated sample of individuals with locomotor disabilities and suggest that exposure to physical activity in an educational setting may be an effective technique for increasing physical activity in individuals with locomotor disabilities.