People With Physical Disabilities Research Articles

Pilot evaluation of a behavioral weight loss program for adults with physical disabilities: State of Slim Everybody usability and feasibility.

People with physical disabilities (PWD) have a higher prevalence of obesity than populations without disability, but most evidence-based weight loss programs have not included this population. The State of Slim (SOS) program is an evidence-based weight loss program that has demonstrated success in producing weight loss in populations without disability, but it has not been adapted for or evaluated in PWD. The SOS program was systematically adapted using the evidence-informed Guidelines, Recommendations, and Adaptations Including Disability (GRAIDs) framework. A total of 35 participants enrolled in the State of Slim Everybody program. The program was offered entirely online. Body weight, attendance, and food log completion were also tracked weekly. The program length was 16.5h and included weekly group instruction, with optional one-on-one sessions provided upon request. Following completion, participants completed post-evaluation surveys on overall satisfaction with the program. The primary outcomes were program effectiveness (i.e., body weight), usability, and feasibility. Thirty-two out of 35 participants completed the program, representing a retention rate of 91.4%. Average weight loss was 10.9% (9.9±0.7kg (t (31)=-13.3, p =< 0.0001)). On a 1 (dissatisfied/completely useless) to 5 (very satisfied/completely helpful) Likert scale, the average score for overall program satisfaction was 4.8±0.1 and program helpfulness 4.6±0.1. The State of Slim Everybody program demonstrated significant weight loss and good usability and feasibility in PWD. Existing adaptation frameworks can be used to create inclusive health promotion programs for adults with physical disabilities.

Demographic covariates and vocational rehabilitation services as predictors of employment outcomes of people with physical disabilities: a hierarchical logistic regression analysis

Purpose Stable employment is essential for the health, psychosocial, and financial well-being of people with physical disabilities (PwPD). Unfortunately, the low employment rate for PwPD in the U.S. exposes them to adverse effects of unemployment, including depression, anxiety, low self-esteem, and physical pain. Helping PwPD find gainful employment will improve their general health and well-being. However, few empirical studies examine factors affecting the employment outcomes of PwPD. This study aims to examine the relationship between demographic covariates, vocational rehabilitation (VR) services, and employment outcomes of PwPD. Materials and Methods This secondary data analysis study includes 17,598 PwPD from the U.S. Department of Education’s Rehabilitation Services Administration’s Case Service Report (RSA-911) dataset. Our analysical approach was hierarchical logistic regression analysis. Results For VR services, workplace support, technology support, job placement assistance, and VR counseling significantly contribute to predicting employment outcomes for PwPD. Even after entering VR services, the demographic variables (age, race, education, referral sources, low-income, long-term unemployment, and disability significancy) were still significant predictors of employment. Conclusions Findings from this study can be used by state VR counselors and other disability service providers to plan and select effective employment-related interventions to improve the employment outcomes of PwPD.

Reliability and Validity of the International Physical Activity Questionnaire Adapted to Include Adults With Physical Disability.

People with physical disabilities (PWD) participate in less physical activity than people without physical disabilities (PWoD), which increases the risk for several negative health consequences. Comparing physical activity between PWD and PWoD remains a challenge since no reliable and valid survey exists to measure physical activity in both populations. The International Physical Activity Questionnaire (IPAQ) was adapted to be inclusive of PWD using a recently developed survey adaption framework; however, the adapted IPAQ has not been assessed for reliability and validity. The objective of this study was to assess the reliability and validity of the adapted IPAQ. To assess test-retest reliability, the adapted IPAQ was completed twice within a 72-hour period by 172 individuals (PWD: n = 102, PWoD: n = 70) and compared using intraclass correlation coefficients. Using Spearman rho, convergent validity and construct validity were assessed in 62 individuals by comparing the adapted IPAQ against the original instrument and activity monitor measured step count, respectively. The adapted IPAQ demonstrated moderate test-retest reliability, with intraclass correlation coefficients of total scores for the total sample of .690 (95% confidence interval [CI] .581-.770) and among subgroup analysis (PWD, .640, 95% CI, .457-.761; PWoD, .758, 95% CI, .610-.850). Correlation coefficients were also good for the assessment of convergent validity of total score (.727; 95% CI, .579-.829;P < .001). Construct validity assessment yielded moderate coefficient (.406; 95% CI, .166-.596; P = .001). The adapted IPAQ demonstrated acceptable reliability and validity and is appropriate for use in PWD and PWoD.

What factors affect the quality of life of employed physically disabled people? A qualitative exploration of their experiences.

According to the literature, the majority of People With Physical Disabilities (PWPDs) have a low Quality of Life (QOL). The goal of this study was to look at the experiences of a group of employed PWPDs in Iran in terms of the factors influencing their QOL. A conventional qualitative content study was carried out in Qazvin City, Iran, from February to August 2020. Twenty-eight semi-structured, in-depth interviews with 20 employed PWPDs (6 men and 14 women), 5 five family members, and 3 of the participants' employers (n = 3) were conducted. Participants were asked about their experiences with factors that impacted the QOL of employed PWPDs. Continuous analysis of data began and continued up to data saturation. The participants' experiences on influencing variables QOL were merged into four major categories: psychological state, socioeconomic problems, structural obstructions, and physical constraints. Conducting psychological therapy to reduce stress and using adaptive coping strategies, changing perceptions of the community about PWPDs via the media, and also improving environmental infrastructure may help to increase QOL in PWPDs.

Weight history of individuals with and without physical disability in the International Weight Control Registry.

People with physical disabilities (PWD) have an increased risk of obesity and related comorbidities compared with people without physical disabilities (PWoD). Previously identified contributors to weight loss maintenance pose challenges to PWD. However, it is not known if PWD experience less success in weight management. Six hundred and nine participants in the International Weight Control Registry (IWCR) were eligible for this analysis (PWD, n=174; PWoD, n=435). Self-reported weight history metrics were compared using general linear models. Perceived weight history category was compared using Chi-squared tests. Importance of diet and physical activity strategies for weight management were compared using Wilcoxon rank-signed tests. PWD reported higher current body mass index (BMI) (36.1±0.7 vs. 31.0±0.5; p<0.0001) and more weight loss attempts (9.1±0.7 vs. 7.1±0.4; p=0.01) than PWoD. Current weight loss percentage (PWD 13.0±1.0; PWoD, 13.0±0.6; p=0.97) and weight loss category (χ 2 [3, N=609]=2.9057, p=0.41) did not differ between the groups. There were no differences in any weight strategy between PWD who were successful and those who regained. PWD and PWoD in the IWCR achieved similar levels of weight maintenance success. However, higher BMI and more weight loss attempts suggest that PWD may face challenges with weight management. More research is needed to identify strategies leading to success for PWD.

Conflict between Respect for Autonomy and Care: A Grounded Theory Study on Action Strategies to Care for People with Physical Disabilities

People with physical disabilities (PWD) are a large population group in Germany. Due to functional limitations of the body, they may be dependent on nursing assistance. PWDs’ wishes for assistance can be expressed verbally to nurses. However, these wishes do not always match what nurses want to happen. As a result, nursing care and the autonomy of PWDs can be critically opposed to each other. Thirteen problem-centered interviews were conducted with nurses on the care of PWDs. According to Strauss and Corbin (2010), analysis was conducted using grounded theory. When caring for PWDs, nurses may be confronted with wishes and needs they cannot or do not want to fulfill. As a result, they experience a conflict between care and respect for autonomy. Nurses critically assess these situations, including professional, ethical, and legal-organizational aspects. They interact with PWDs as well as colleagues to manage the conflict. Positive outcomes result in the conflict being resolved; negative outcomes result in nurses stopping care. Ambivalence also exists, which is characterized by tensions in further care. Nurses want to support PWDs, enable participation, and promote independence. They want to feel comfortable with their decisions. Therefore, they weigh carefully whether wishes for nursing assistance are realized or denied. Decision coaching can be a new task for academic nurses to enable PWDs to make health-promoting decisions for themselves.

Adapting an evidence-based physical activity questionnaire for people with physical disabilities: A methodological process

BackgroundPractitioners and researchers often adapt tools, practices, and programs to meet the needs of culturally diverse population groups, but do not consider populations with disability. While there is some research on guidelines for adapting evidence-based programs, there is no systematic process for adapting survey instruments. Rather than creating separate instruments for people with physical disabilities (PWD), it is critical that instruments are designed to capture data on people with and without disabilities for comparison purposes. Given the disproportionately high rates of physical inactivity and obesity in PWD, we developed a methodology to adapt an evidence-based physical activity instrument. ObjectiveTo create a methodology to adapt surveys to be inclusive of PWD and use the methodology to adapt an evidence-based physical activity survey. MethodsA framework was developed to adapt a physical activity survey instrument (International Physical Activity Questionnaire, IPAQ) to be inclusive of PWD. The framework, referred to as SAVe-IT, includes five steps: Step 1) Select survey instrument to adapt; Step 2) Adapt the survey instrument; Step 3) Verify adaptations with experts; Step 4) Implement pilot test; Step 5) Test the tool to confirm reliability. ResultsThe adapted IPAQ passed review by the expert panels and the pilot test (n = 20). Assessment of test-retest reliability (n = 30) yielded strong intraclass correlation coefficients of 0.950 for the total score for the whole sample, 0.950 for PWD (n = 15) and 0.952 for people without disability (n = 15). ConclusionsThe SAVe-IT framework resulted in the successful adaptation of the IPAQ and can be used in populations with and without physical disabilities.

Entrepreneurship education and the moderating role of inclusion in the entrepreneurial action of disabled students

Educators and policymakers have sought to open entrepreneurship to a broader range of students. The paper investigates the role of entrepreneurship education in the development of People with Physical Disabilities (PWPDs) and the moderating role of inclusion in their entrepreneurial action. This research employed a cross-sectional survey of 253 students with physical disabilities across tertiary institutions in Nigeria. The findings underscore the significant role of entrepreneurship education in enhancing the entrepreneurial action of physically disabled students. The finding of the study established the moderating role of inclusion in the relationship between entrepreneurship education and the entrepreneurial action of physically disabled students. This implies that the commitment of the educators to accept and support physically disabled students in the class will create an environment in which physically disabled students can learn to monitor and respond to entrepreneurial changes in the environment. This will in turn prepare them to engage in a business start-up. This research highlights that entrepreneurship education and inclusion make significant contributions to physically disabled students’ entrepreneurial action. Therefore, these factors are key to consider in preparing physically disabled students to become entrepreneurial graduates. The study contributes to the extant literature by underscoring the value of creating an environment of inclusion in entrepreneurship education.

A gender perspective on the use of mobile social network applications to enhance the social well-being of people with physical disabilities: the mediating role of sense of belonging

ABSTRACT The rapid development of information and communication technologies has demonstrated their potential to enable people with physical disabilities (PPD) to improve their livelihoods and reduce social exclusion in China. Only a few studies have been conducted to investigate how online social support boosts PPD’s sense of belonging and to determine which type of social support they need. We followed the sense of belonging theory and social support theory to review the related literature and understand the mechanisms by which PPD may use mobile applications to receive support in the online environment. Both personal interviews and questionnaire surveys were conducted. We collected data from 337 PPD from the China Disabled Person’s Federation. Results of the statistical analysis revealed that both emotional and informational support are significantly related to sense of belonging. Furthermore, sense of belonging affects social connection and social well-being. The results of the moderation analysis showed female and male PPD received different kinds of support. The findings offer insights for disability service institutions interested in better enablement of PPD.

Factor Structure of the Short-Form of Center for Epidemiological Studies Depression Scale for People With Physical Disabilities.

This study aimed to examine the factor structure of the short-form of Center for Epidemiological Studies Depression Scale (CES-D-11) using confirmatory factor analysis (CFA). We extracted data from 670 people with physical disabilities (PWPD) from the Korea Welfare Panel. To investigate the model fit regarding factor structure, a one-factor model, four-factor model, and four-factor within bifactor model, as reported in previous studies, were examined using CFA, and goodness-of-fit indices were compared. As a result of the analysis, the four-factor model and the four-factor within bifactor model satisfied the criteria of correspondence with goodness-of-fit indices. Reliability of the four individual factors ranged from 0.722 to 0.834, indicating acceptable reliability. Validity and reliability of the four-factor within bifactor structure was confirmed through CFA and reliability analysis. In future studies using the CES-D-11 to measure depression in PWPD, comparison between four sub-factors and total scores might be possible.

Attitudes toward people with physical disabilities: An examination of social context, discipline, disability type, and demographics

BACKGROUND: Despite the existence of studies examining attitudes toward people with disabilities (PWDs) in a workplace context, little is known about attitudes in other social contexts such as dating and marriage. OBJECTIVE: The purpose of this study is threefold. First, the study seeks to examine how social context (i.e., work, dating, marriage) influences attitudes toward people with physical disabilities (PWPDs). Second, it examines potential influence of participant characteristics (i.e., gender, major, disability education, and frequency of contact). Third, it explores whether attitudes vary across different disability types. METHODS: To measure the influence of social context on attitudes toward PWPDs, the study used the Disability Social Relationship Scale (DSR), which was completed by 395 undergraduate students in Austria. RESULTS: Participants demonstrate more positive attitudes toward PWPDs in the workplace than in the social contexts of dating and marriage. Participants who had more frequent contact with PWDs (i.e., in a workplace/service setting or in a personal relationship) demonstrate more positive attitudes toward PWPDs. Participants have more positive attitudes toward some disability types (i.e., deafness/hardness of hearing) than others (blindness/visual impairment). CONCLUSION: We offer recommendations for future research and practice aimed at creating awareness of biases toward PWDs while promoting social justice.

Hiring People with Disabilities As a Csr Strategy in the Tourism Industry

According to corporate social responsibility (CSR), firms should conduct activities focusing not only on the self-interest of the firm but also on benefiting society. Drawing on the CSR approach, this study investigates the barriers to employment for people with physical disabilities (PWPDs) in the Hong Kong (HK) tourism industry. Forty-seven human resources (HR) managers, directors, and members of the HK Hotel Association were interviewed. The main barriers to employing PWPDs include firms' lack of intent to employ people with disabilities (PWDs), the physical layout of organizations, the lack of an HR management model related to PWDs, and the lack of communication between industry and related nongovernmental organizations (NGOs) related to PWPDs.

Home-based care for people with disabilities: Role of registered nurses within the District health system in Thailand

BackgroundIn Thailand, the number of people with physical disabilities (PwD) has been increasing. Following sweeping health care reforms in 2002, efforts were made to improve accessibility to health care by greatly increasing the number of Registered Nurses (RNs) working in local community health centres. Little is known, however, about the role of RNs in improving accessibility to home-based care and the outcomes of care for PwD in Thailand. AimTo explore the role of RNs in providing high quality home-based services for PwD who have severe limitations in movement. MethodsA case study design was used to explore and describe the role of RNs in home-based care for PwD in one rural and one urban area in lower north Thailand. There were 73 participants, including PwD and their family members, community health volunteers, primary care providers, local government officers and members of the District Health management team. Data were collected from in-depth interviews and focus groups, which were analysed using thematic analysis. ResultsThe roles of RNs in home-based care for PwD were found in four domains, as case manager, rehabilitation care provider, manager of the community health volunteers and broader care coordinator. ConclusionThe full scope of the RN role in the provision of home-based care for PwD, in the district health system of Thailand, not only involves direct nursing care. The role also encompasses planning and co-ordination of the broad range of professional and non-professional services to meet the needs of PwDs in rural and urban settings.

A Mobile App to Promote Adapted Exercise and Social Networking for People With Physical Disabilities: Usability Study.

BackgroundPeople with physical disabilities (PWD) experience several unique challenges that prevent them from participating in onsite exercise programs. Although mobile apps can provide a ubiquitous channel for delivering convenient exercise services within the community, no exercise apps have been designed for people with disabilities who experience certain functional limitations.ObjectiveThe aim of this study was to examine the usability of a mobile exercise app in PWD.MethodsA sequential explanatory mixed-method design was used to holistically test usability in 4 core areas: effectiveness (ie, ease of use), efficiency (ie, operation speed), perceived satisfaction, and usefulness. Participants completed 7 face-to-face usability tasks and 1 structured interview. Equipment included a computer tablet that came preinstalled with the exercise app. The app included exercise videos that focused on several components of fitness: aerobic capacity, muscular strength, functional strength or balance, and range of motion. The app contained 3 different versions of the exercise program: (1) a program for people with the ability to use the upper and lower limbs, (2) a seated program for people with the ability to use only upper limbs, and (3) a program designed for people with hemiparesis. The app also included educational resources in the form of infographics aimed at addressing key social cognitive theory constructs included social support, outcome expectancies, self-efficacy, and barriers or facilitators to exercising. Participant characteristics and quantitative usability data were descriptively reported. Qualitative data were analyzed using thematic analysis.ResultsA total of 12 PWD tested the usability of the exercise app and completed 96% (69/72) of the usability tasks on the first attempt. Operation speed varied among users, which prompted the development team to make minor revisions to the app. Qualitative results demonstrated 3 overarching themes: facilitates exercise adoption, positive experiences of videos, and easy to learn. Participants noted that the app circumvented several barriers to exercise associated with leaving the home (eg, inclement weather conditions, exacerbations of health conditions or disability symptoms, difficulties with transportation, and social support).ConclusionsThe mobile exercise app provided a simple platform that was effective, useful, and appreciated by PWD. Participants also perceived the app as easy to use and felt it was a valuable tool for assisting PWD to obtain regular exercise. Study findings also offered insight into the participants’ preferences for mobile exercise apps that can aid future research and development projects. Future exercise trials are needed to determine the true impact of mobile app technology on lifestyle physical activity in people with disabilities.Trial RegistrationClinicaltrials.gov NCT03024320; https://clinicaltrials.gov/ct2/show/NCT03024320 (Archived by WebCite at http://www.webcitation.org/75hNLgRFH).

Primary health care seeking behaviour of people with physical disabilities in Bangladesh: a cross-sectional study

BackgroundPeople with disabilities constitute about 10% of the total population of Bangladesh. They are more likely to experience poor health than those without disabilities. However, there is a lack of evidence on their primary health care (PHC) seeking behaviour for their general illness. The aim of this study was to understand the PHC seeking behaviour of people with physical disabilities (PWPDs), and to investigate the determinants of such behaviours.MethodsWe surveyed 282 PWPDs, aged ≥18 years, using a structured questionnaire. Participants were recruited from the out-patient department of a rehabilitation centre in Dhaka between November and December 2014. We explored PHC seeking behaviour using frequency distribution. We performed logistic regression to investigate the factors that determined their PHC seeking behaviours for general illness. In our logistic regression model, the outcome variable was whether PWPDs received treatment from a formal health care provider. The predictors were socio-demographic characteristics and clinical characteristics such as type of impairment and type of illness experienced.ResultsAmong 282 participants, 85% suffered from general illness in the past 6 months. The participants in the higher age group, for example, age group 31–45 years (OR = 3.9, [95% CI 1.2 to 13.4]), 46–59 years (OR = 13.6, [95% CI 2.9 to 63.7) and 60+ years (OR = 12.5, [95% CI 1.7 to 93.0]) were more likely to seek treatment from formal health care providers than the age group 18–30 years. The educational attainment of the primary income earning family member (OR = 3.2, [CI 1.1 to 9.6]), religion (OR = 0.3, [95% CI 0.1 to 0.98]) and mobility aid used (OR = 4.0, [95% CI 1.2 to 13]) were determinants for seeking health care from a formal health care provider. Moreover, the type of illness suffered by participant was a strong predictor of their decision to seek treatment from a formal health care provider. The participants who suffered from urinary tract infections (OR = 10.3, [95% CI 2.3 to 46.6]), ulcers (OR = 13.1, [95% CI 2.11 to 79.3]) and pain (OR = 3.6, [95% CI 1.4 to 9.4]) were more likely to seek treatment from formal health care provider than who suffered from fever.ConclusionsAge, religion, earning member’s education, type of mobility aids used and type of illness suffered were explicative determinants of PHC seeking behaviour of PWPDs. The results suggest that these factors should be considered when devising interventions for this population. Moreover, accessibility, quality of care and expertise of the providers in treating disabled people were among the other factors reported by PWPDs which influence their decision to seek health care. In order to provide inclusive health services, primary health centres need to consider these determinants.

Demographic, psychosocial, and health- and disability-related factors associated with psychological distress among people with physical disabilities.

Psychological distress among people with physical disabilities (PWPD) might affect their physical morbidity, reduce their quality and duration of life, and increase their need for health care services. Therefore, it is essential to explore the factors that might affect psychological distress among PWPD. The current study assesses the association between demographic factors (gender, education, and employment status), health- and disability-related factors (type of disability, visibility of the disability, disability duration, and self-rated health), and psychosocial factors (perceived discrimination and perceived social support), and psychological distress among PWPD in Israel. The data were collected through structured questionnaires administered to a sample of 433 PWPD. The findings suggest negative associations between education, employment status, duration of disability, self-rated health, and perceived social support, and psychological distress among PWPD. In addition, the findings indicate a positive association between perceived discrimination and psychological distress. No association was found between gender, type of disability, and visibility of the disability, and psychological distress. PWPD who are unemployed, less educated, with a shorter duration of disability and lower self-rated health, as well as those who feel more discriminated against and less social support, are more likely to experience higher levels of psychological distress. Therefore, it is important to raise PWPD's awareness of their rights and of the social possibilities and services available to them, to provide them with mental help, to engage in extensive social activities aimed at providing resources to PWPD, and to act to eliminate discrimination. (PsycINFO Database Record

Investigating the accessibility factors affecting hotel satisfaction of people with physical disabilities

People with physical disabilities (PwPD) have various incompacities, use different assistive devices and can encounter many barriers in hotels. The purpose of this study is to examine the effects of accessibility, disability types and forms of assistive devices on the hotel satisfaction of PwPD. A survey was conducted among PwPD who use mobility devices. Factor analysis revealed five accessibility dimensions: accessibility of public areas, rooms, recreation and other areas, baths in rooms, and food and beverage areas. Accessibility dimensions, disability types and forms of assistive devices had significant impact on the hotel satisfaction while accessibility of public, recreation and other areas, and baths in rooms were the strongest predictors of the satisfaction. People with acquired physical disabilities, powerchair and wheelchair users were the most disadvantaged group in hotels. Hotel satisfaction of PwPD is directly related to the accessibility of hotels. Insufficient and inaccessible areas have negative effect on this satisfaction.

Self-Esteem in People with Physical Disabilities: Differences between Active and Inactive Individuals

Summary The aim of the study was to determine the status of SE in people with physical disabilities (PwPD) and compare SE scores between active and inactive individuals. The sample of PwPD (n = 186) was divided into two groups of those who are regularly participating in sport (active; n = 88) and those who are not participating in any sport in their leisure (inactive; n = 98). The Rosenberg Self-Esteem Scale (RSES) was used as a primary research method. 10-item scale measures global self-worth by measuring positive and negative feelings about the self. Higher scores (from 10 to 40 points) indicate higher SE. The Pearson chi-square test was used to determine the differences of 10 RSES items and total scores between active and inactive PwPD. We found that the mean score of RSES in PwPD was 28.83 points; active PwPD observed total score of RSES 30.01 points and group of inactive PwPD showed the lowest SE by achieving 27.76 points. Mean scores comparison of each RSES item between active and inactive PwPD revealed higher SE in the group of active PwPD. Significantly higher SE was presented by 4 from 10 RSES items and by total score in the group of active PwPD. The results of our study confirmed that actively living PwPD have significantly higher SE comparing those PwPD who are living sedentary life style.

Quality of Life of People with Disabilities from Sport Participation Point of View

Summary The aim of the study was to compare the satisfaction with quality of life indicators (QoLI) and quality of life domains (QoLD) scores between people with physical disabilities (PPD) and people who are deaf or hard of hearing (PD/HH) from sport participation point of view. The study included 315 individuals with PPD (n = 150; male = 76) and PD/HH (n = 165; male = 85) divided into two groups of those who are regularly participating in sport and those who are not participating in any sport activity in their leisure. The second part of the Subjective Quality of Life Analysis (S.QUA.L.A.) was used. The Pearson chi-square test was used to determine the differences in 23 QoLI and 5 QoLD between PPD and PD/HH from sport participation point of view and student’s two-sample t-test was used to compare overall quality of life (QoL). We found that PD/HH who are participating regularly in sport presented significantly higher satisfaction with 7 evaluated QoLI and with all 5 QoLD. Overall QoL score was significantly higher (p &lt; .01) in PD/HH. In the group of people who are not participating in sport we found significantly higher satisfaction with 13 QoLI in PD/HH and with 8 QoLI in PPD. Satisfaction with 4 QoLD was significantly higher in PD/HH and only with domain (physical health) were significantly higher satisfied PPD (p &lt; .01). Overall QoL score did not show significant differences between groups of people with disabilities who are not participating in any sport. The results of our study confirmed that PD/HH have significantly higher QoL comparing PPD no matter if they participating in sport or not. This evaluation measured by S.QUA.L.A shows that it is a suitable tool to asses QoL in people with different kinds of disabilities.

Physiotherapy without borders: case of the international committee of the red cross (ICRC) supported project in Tindouf, Western Sahara

Background: Tindouf is situated in the South West of Algeria where around 160,000 Sahrawi refugees live in five camps, all victims of a conflict dating from 1973. No clear population census available, but the 0.5% given by theWorld Disability report (WHO, 2011) we conclude that 3000 people with physical disabilities (PwD) are living in this remote place suffering both from acquired and congenital disabilities. The ICRC is supporting the only rehabilitation facility depending on the Sahrawi Ministry of Health. Purpose: The aim of this review is to present a rehabilitation structure in a very challenging context but able to provide physiotherapy and comprehensive rehabilitation services. It will also discuss its achievements and constraints. Indeed, the limited care of PwD (e.g. victims of war or children with cerebral palsy) in this very special geo political and security context is unique but representative of other places in low resourced countries. Methods:Themain objectives of the ICRC physical rehabilitation are fourfold: assuring access, quality and long-term quality of services and social integration. In this context, the third objective will not be achieved, but the ICRC project is supporting the three others both at the physical rehabilitation centre and through its outreach programme. This presentation is a review of the project 7 years after its start. Results: Since 2007, a total of 759 persons received services through this programme, with 30 PwD receive physiotherapy services monthly. Uniquely in the region, physiotherapist helpers work in a multidisciplinary approach with the ortho-prosthetists assistants under supervision of Algerian staff. The treatments provided are basic but centred on the optimal use of the assistive devices and aiming at assuring independence in daily living activities. Within the camps, the identification of PwD is a priority and parents’ education on the care for their child with cerebral palsy is an essential part of the activities. The provision of rehabilitation is a unique way of improving the mobility and quality of life of this destitute population. Nevertheless, the daily challenges are immense, ranging from human resources, logistics to just environmental (climate). Conclusion(s): Such a project shows the importance to invest adequate resources on a medium-long term instead of just bringing sporadic support. It also of importance to try to get a clear picture of a context before initiating services, to include preventive measure in limiting further disabilities and to find, in collaboration with the partner, ways for the PwD to be re-integrated into society. Implications: Physiotherapy in Tindouf might not follow latest international guidelines, thus assures minimal care to gain mobility independence and hope for social integration through basic equipment and services adapted to the context. Training of national staff and support to the government in developing health services is important to assure quality of care for PwD.