Physical Mobility Impairments Research Articles

Prevalence of Impaired Physical Mobility in Dialysis Patients: A Single-Centre Cross-Sectional Study.

Impaired physical mobility in hemodialysis (HD) patients is considered an important modifiable risk factor of increased all-cause morbidity and mortality. To our knowledge, no study to date has determined the overall burden of limited physical mobility in prevalent HD patients. The aim of this research is to investigate impaired physical mobility and its clinical correlates. We conducted a cross-sectional observational study in all patients of the Centre for Acute and Complicated Dialysis at the University Medical Centre of Ljubljana, where the most complex patients receive HD on average three times per week. The data were collected through interviews based on a prepared questionnaire and medical history review. A total of 205 patients were included in this study (63.9 ± 15.4 years). Sixty percent (122/205) of the patients had little or no physical mobility impairment, and others were categorized with a minor or severe mobility limitation. A minor mobility impairment was found in 21% (43/205) of patients: 10 patients (5%) used a mobility aid in the form of a crutch, 9 patients (4%) were dependent on two crutches or a walker, and 24 patients (12%) were temporarily dependent on the assistance of a third person. Severe mobility limitations were observed in 22% (40/205) of patients, ranging from being confined to bed (19/205, 9%), confined to bed but able to perform some movements (19/205, 9%), and ambulatory but dependent on the assistance of a third person for locomotion (2/205, 1%). The most common causes of the limitation of mobility were neurological (19/40, 47.5%), cardiovascular (9/40, 22.5%), musculoskeletal (8/40, 20%), and other causes (4/40, 10%). A significant, moderate positive correlation was observed between mobility problems and the age of the participants (r = 0.36, p < 0.001), while a significant, small positive correlation was obtained between the mobility problems and C-reactive protein (r = 0.15, p = 0.044). Moreover, mobility problems had a small but significant negative correlation with albumin levels (r = -0.15, p = 0.042). When controlling for age, results yield no significant correlations, and, in regression analysis, only the age (p < 0.001) and male gender (p = 0.007) of the participants were independent predictors of mobility impairment. We conclude that impaired mobility has a high overall prevalence among chronic HD patients. Strategies to prevent and improve mobility limitations are strongly needed.

Adverse Childhood Experiences and Aging-Associated Functional Impairment in a National Sample of Older Community-Dwelling Adults.

Prior research on the health implications of adverse childhood experiences (ACEs) has focused on early or midlife adults, not older adults who bear the greatest burden of health-related functional impairment. To examine associations between ACEs, objectively measured physical mobility and cognitive impairment, and functional disability in older community-dwelling adults. Cross-sectional analysis. Community-dwelling older U.S. adults ages 50years and older. Participants completed structured questionnaires assessing history of ACEs (childhood experience of violence/abuse, witnessing of violence, financial insecurity, parental separation, or serious illness), underwent standardized physical performance testing (tandem balance, 3-m walk, chair stand test) and cognitive testing (survey adaptation of the Montreal Cognitive Assessment), and reported functional disability (difficulty with activities of daily living). Among the 3387 participants (aged 50 to 97years; 54% female), 44% reported a history of one or more types of ACEs. Thirty-five percent met criteria for physical mobility impairment, 24% for cognitive impairment, and 24% for functional disability. After adjusting for age, gender, race, and ethnicity, participants reporting any ACE history were more likely to demonstrate physical mobility impairment (OR 1.30, 95% CI 1.11-1.52) and cognitive impairment (OR 1.26, 95% CI 1.03-1.54) and report functional disability (OR 1.69, 95% CI 1.38-2.07), compared to those with no ACE history. Childhood experience of violence was associated with greater physical mobility impairment (OR 1.38, 95% CI 1.11-1.71) and functional disability (OR 1.86, 95% CI 1.49-2.33). Older adults with a history of ACEs are more likely to experience physical and cognitive functional impairment, suggesting that efforts to mitigate ACEs may have implications for aging-associated functional decline. Findings support the need for trauma-informed approaches to geriatric care that consider the potential role of early life traumatic experiences in shaping or complicating late-life functional challenges.

Enhancing Communication and Access: The Role of Internet of Things Technologies in Developing Library Services for Persons with Disabilities

This paper explores the role of IoT technologies in developing library services for persons with disabilities. It highlights the challenges faced by individuals with disabilities in accessing and navigating library resources, such as physical barriers, limited mobility, visual or hearing impairments, and cognitive disabilities. However, by integrating IoT technologies, libraries can proactively address these challenges and create inclusive spaces where everyone feels welcome and supported. The paper includes a literature review that examines studies on using IoT in different settings to cater to the needs of people with disabilities. It emphasizes the importance of ongoing research, investment, and collaboration to address challenges and maximize the benefits of IoT technologies in improving the lives of individuals with disabilities. The research methodology section outlines a study conducted on individuals with physical and visual impairments to identify the challenges they face in utilizing university libraries and their requirements for programs and devices that would enable them to access information sources. The data analysis reveals the need for devices and software, such as tablets, voice recognition software, specialized keyboards, text enlargement software, screen readers, page-turners, and Braille printers, to facilitate access to library resources. Furthermore, the paper presents IoT services required by persons with disabilities to access library resources independently. It discusses twelve IoT services that can be implemented to enhance accessibility and improve the library experience for this group. In conclusion, the paper emphasizes the transformative potential of IoT technologies in improving the lives of individuals with disabilities. By embracing IoT and adopting inclusive practices, libraries can fulfill their mission of providing equitable access to information and knowledge for all community members.

Pneumonia Risk Increased by Dementia-Related Daily Living Difficulties: Poor Oral Hygiene and Dysphagia as Contributing Factors

Although pneumonia is the leading cause of death among patients with dementia, the specific underlying causes remain unclear. In particular, the potential connection between pneumonia risk and dementia-related daily living difficulties, such as oral hygiene practice and mobility impairment, and the use of physical restraint as a management practice, has not been extensively studied. In our retrospective study, we included 454 admissions corresponding to 336 individual patients with dementia who were admitted to a neuropsychiatric unit due to behavioral and psychological symptoms. The admissions were divided into two groups: those who developed pneumonia while hospitalized (n=62) and those who did not (n=392). We investigated differences between the two groups in terms of dementia etiology, dementia severity, physical conditions, medical complications, medication, dementia-related difficulties in daily living, and physical restraint. To control potential confounding variables, we used mixed effects logistic regression analysis to identify risk factors for pneumonia in this cohort. Our study found that the development of pneumonia in patients with dementia was associated with poor oral hygiene, dysphagia, and loss of consciousness. Physical restraint and mobility impairment showed a weaker, nonsignificant association with the development of pneumonia. Our findings suggest that pneumonia in this population may be caused by two primary factors: increased pathogenic microorganisms in the oral cavity due to poor hygiene, and an inability to clear aspirated contents due to dysphagia and loss of consciousness. Further investigation is needed to clarify the relationship between physical restraint, mobility impairment, and pneumonia in this population.

TReating Incontinence for Underlying Mental and Physical Health (TRIUMPH): a study protocol for a multicenter, double-blinded, randomized, 3-arm trial to evaluate the multisystem effects of pharmacologic treatment strategies for urgency-predominant urinary incontinence in ambulatory older women

BackgroundUrgency-type urinary incontinence affects one in four older community-dwelling women and overlaps with other common aging-associated health syndromes such as cognitive impairment, physical mobility impairment, and depression. Observational studies have raised concern about potentially higher rates of delirium and dementia in older adults taking anticholinergic bladder medications, but few prospective data are available to evaluate the effects of these and other pharmacologic treatments for urgency incontinence on cognition and other multisystem functional domains important to older women.MethodsThe TRIUMPH study is a randomized, double-blinded, 3-arm, parallel-group trial comparing the multisystem effects of anticholinergic versus beta-3-adrenergic agonist bladder therapy and versus no active bladder anti-spasmodic pharmacotherapy in older women with urgency incontinence. Women aged 60 years and older (target N = 270) who have chronic urgency-predominant urinary incontinence and either normal or mildly impaired cognition at baseline are recruited from the community by investigators based in northern California, USA. Participants are randomized in equal ratios to take identically encapsulated oral anticholinergic bladder therapy (in the form of tolterodine 2 mg extended release [ER]), oral beta-3 adrenergic agonist bladder therapy (mirabegron 25 mg ER), or placebo daily for 24 weeks, with the option of participant-directed dose titration (to tolterodine 4 mg ER, mirabegron 50 mg ER, or matching placebo daily). Participants also receive patient-oriented information and instructions about practicing first-line behavioral management strategies for incontinence. The primary outcome is change in composite cognitive function over 24 weeks assessed by a comprehensive battery of cognitive tests, with a secondary exploration of the persistence of change at 36 weeks. Secondary outcomes include changes over 24 and 36 weeks in domain-specific cognitive function; frequency, severity, and impact of urgency-associated urinary symptoms; physical function and balance; sleep quality and daytime sleepiness; psychological function; and bowel function.DiscussionThe TRIUMPH trial addresses the need for rigorous evidence to guide counseling and decision-making for older women who are weighing the potential multisystem benefits and risks of pharmacologic treatments for urgency incontinence in order to preserve their day-to-day functioning, quality of life, and independence in older age.Trial registrationClinicalTrials.gov NCT05362292. Registered on May 5, 2022.

Quality of Opioid Use Disorder Treatment for Persons With and Without Disabling Conditions

Adverse outcomes associated with opioid use disorder (OUD) are disproportionately high among people with disabilities (PWD) compared with those without disability. A gap remains in understanding the quality of OUD treatment for people with physical, sensory, cognitive, and developmental disabilities, specifically regarding medications for OUD (MOUD), a foundation of treatment. To examine the use and quality of OUD treatment in adults with diagnosed disabling conditions, compared with adults without these diagnoses. This case-control study used Washington State Medicaid data from 2016 to 2019 (for use) and 2017 to 2018 (for continuity). Data were obtained for outpatient, residential, and inpatient settings with Medicaid claims. Participants included Washington State full-benefit Medicaid enrollees aged 18 to 64 years, continuously eligible for 12 months, with OUD during the study years and not enrolled in Medicare. Data analysis was performed from January to September 2022. Disability status, including physical (spinal cord injury or mobility impairment), sensory (visual or hearing impairments), developmental (intellectual or developmental disability or autism), and cognitive (traumatic brain injury) disabilities. The main outcomes were National Quality Forum-endorsed quality measures: (1) use of MOUD (buprenorphine, methadone, or naltrexone) during each study year and (2) 6-month continuity of treatment (for those taking MOUD). A total of 84 728 Washington Medicaid enrollees had claims evidence of OUD, representing 159 591 person-years (84 762 person-years [53.1%] for female participants, 116 145 person-years [72.8%] for non-Hispanic White participants, and 100 970 person-years [63.3%] for participants aged 18-39 years); 15.5% of the population (24 743 person-years) had evidence of a physical, sensory, developmental, or cognitive disability. PWD were 40% less likely than those without a disability to receive any MOUD (adjusted odds ratio [AOR], 0.60; 95% CI, 0.58-0.61; P < .001). This was true for each disability type, with variations. Individuals with a developmental disability were least likely to use MOUD (AOR, 0.50; 95% CI, 0.46-0.55; P < .001). Of those using MOUD, PWD were 13% less likely than people without disability to continue MOUD for 6 months (adjusted OR, 0.87; 95% CI, 0.82-0.93; P < .001). In this case-control study of a Medicaid population, treatment differences were found between PWD and people without these disabilities; these differences cannot be explained clinically and highlight inequities in treatment. Policies and interventions to increase MOUD access are critical to reducing morbidity and mortality among PWD. Potential solutions include improved enforcement of the Americans with Disabilities Act, workforce best practice training, and addressing stigma, accessibility, and the need for accommodations to improve OUD treatment for PWD.

A systematic review of using telenursing health education among families who have patients with physical impairments

Many families care for patients with impaired physical mobility independently at home; stable patients or with special considerations are usually allowed to go home by the hospital and continue treatment at home. The telenursing application is one of the interventions that can be implemented to help increase the knowledge and skills of families caring for patients at home. This study aimed to determine the implementation model of telenursing educational applications for families caring for patients with impaired physical mobility at home. This research is a literature study using the PRISMA approach. A systematic review using PICO. The database searches used were Google Scholar, PubMed, Crossref, ScienceDirect, and Wiley Online Library with the keywords telenursing OR telehealth OR mobile application AND physical immobility OR physical mobility impairment OR physical mobility disruption AND therapy AND the family caregiver. From the six research articles reviewed, it was found that the telenursing application is an implementation that can be applied to increase the knowledge and skills of families caring for sick family members at home. Interventions include education and training in audio, video, text, film, and consultation. The media used is WhatsApp, websites, telephones, and other cellular telecommunication-based applications. Telenursing applications are the best solution to help families caring for patients with impaired physical mobility at home.&#x0D; Keywords: Telenursing; physical impairments; health education; family caregiver; telenursing

Investigation of elevator-aided evacuation strategies for older people in high-rise elderly housing

Staircase evacuation is the major means of fire evacuation for current high-rise residential buildings. However, its feasibility may be questioned as the increasing aging population and many recent constructions of elderly community estates comprising high-rise apartment buildings. The weakness in physical strength and mobility impairment of older people may impede the successful implementation of staircase evacuation. Therefore, it is reasonable to consider facilitating older people's evacuation with elevators, shorted as elevator-aided evacuation (EAE). In order to find the most appropriate EAE strategy for high-rise elderly housing evacuation, three possbile strategy modes for EAE are proposed: horizontally rationed EAE (S1), vertically rationed EAE (S2), and refuge floor gathered EAE (S3). Using evacuation simulation to examine evacuation efficiencies of these proposed strategy modes varying in different evacuation scenarios, we find that S2 is appropriate for middle high-rise building (12 & 24 stories) evacuation; S3 is suitable for ultra high-rise building (36 & 48 stories) evacuation with a low occupants' density per floor; S1 is the most preferable for evacuation of ultra high-rise buildings (36 & 48 stories) with a high occupants' density per floor. More importantly, the ratio of occupants assigned to use elevators and stairs for evacuation needs to be regulated according to the occupancy information. Thus, a smart elevator-aided building fire evacuation scheme is suggested, which aims to determine the optimal EAE strategy according to the real-time on-site situation.

Cerebral small vessel disease is associated with concurrent physical and cognitive impairments at preclinical stage.

Physio-cognitive decline syndrome (PCDS) is a clinical construct of concurrent physical mobility and cognitive impairments in non-demented functional preserved elderly who are at risk of dementia and disable. The present study aimed to evaluate whether cerebral small vessel disease (SVD) is associated with this phenotype of accelerated aging. We stratified a non-demented non-stroke community-based population aged 50 or older into four groups: robust, isolated cognitive impairment no dementia (CIND), isolated physical mobility impairment no disable (MIND) and PCDS groups. SVD burden (SVD score) was defined by the presence of severe white matter hyperintensities (WMH), lacune(s) and cerebral microbleed (CMB). Univariate and multivariate analyses were performed to evaluate the cross-sectional relationships between SVD and PCDS. Seven hundred and nine eligible participants were included. There were 317 (44.7%) classified as robust group, 212 (29.9%) as CIND group, 117 (16.5%) as MIND group and 63 (8.9%) as PCDS group. SVD (SVD score ≥ 2) was significantly associated with PCDS, concurrent mobility physical and cognitive impairments (odds-ratio, OR=2.3; 95% confidence interval, 95% CI=1.3-4.0; p=0.003) but not with MIND or CIND, which was independent of age, sex and vascular risk factors. Among three SVD markers, the presence of severe WMH (OR=1.9; 95% CI=1.1-3.2; p=0.023) and lacune (OR=2.5; 95% CI=1.3-4.8; p=0.005) were significantly and mixed CMB (OR=2.0; 95% CI=1.0-4.1; p=0.058) was borderline-significantly associated with PCDS independent of age, sex and vascular risk factors. SVD was associated with PCDS, a phenotype with concurrent physical mobility and cognitive impairments in the non-demented non-disable elderly population. The present study revealed the clinical features of SVD at early, preclinical stage and has provided insights into the pathophysiology and future management strategy of accelerated functional declines in the elderly.

Towards a Smart Elevator-Aided Fire Evacuation Scheme in High-Rise Apartment Buildings for Elderly

Staircase evacuation is the major means of fire evacuation for current high-rise residential buildings. However, its feasibility may be questioned as more and more senior citizens live there in the future. The weakness in physical strength and mobility impairment of elderly people may impede the successful implementation of staircase evacuation. It is therefore reasonable to consider using elevators for overall evacuation in high-rise residential buildings. However, enhancing the fire protection of elevators and efficiently controlling the elevator-aided evacuation operations are two major difficulties for applying elevators in building fire evacuation. Recently, the use of smart control for building facility management has become a hot issue in built environment studies. An enabling solution for smart elevator-aided building fire evacuation (SEABFE) is proposed in this article. The solution supports the SEABFE by determining the safer and more efficient elevator-aided evacuation strategy based on real-time fire ground and evacuation progress on the scene. A simulated case study of fire evacuation in a typical high-rise residential building shows that the proposed SEABFE can be successfully performed. Apart from keeping the elevator operation safe, the planned elevator-aided evacuation strategy may save 38.0% of the time compared with the strategy using only staircases in the scene.

CASE STUDY: IMPLEMENTATION OF EVIDENCE BASED NURSING: RANGE OF MOTION EXERCISE TO THE PATIENT WITH FRACTURE FEMOR

Introduction: Femur fracture is a break in the continuity or fracture in the thigh caused by external pressure or physical exertion which is characterized by deformities such as shortening of the leg in the fractured part and limitation of motion. Objective: This case study aims to overcome the physical mobility constraints and activity limitations of the patient Method: Physical examination of the fracture of the femur was performed using the head-to-toe method in postoperative patients with Open Reduction Internal Fixation. The North American Nursing Diagnosis Association is used to determine nursing diagnoses. Meanwhile, nursing intervention refers to the Nursing Intervention Classification and the Nursing Outcomes Classification. Result: A nursing diagnosis of physical mobility impairment with the diagnosis number 00085 was given a nursing intervention in the form of a ROM excercise. After 7 days of nursing intervention, physical mobility impairments were resolved with the criteria that the patient's joint movement increased from stiffness to being able to move, the patient's muscle movement increased with muscle strength from 3 to 5, the patient's balance from very disturbed to slightly disturbed, the patient's way of walking from very annoyed to be quite annoyed. Conclusion: ROM Excercise can increase physical mobility aided by using a mobilization aid (crutch), so it is important to do in patients with a diagnosis of impaired physical mobility

"Our perspective matters."

Traditional approaches to accessible human-computer interaction focus on the needs and requirements of users in the Global North. While there has been some work on interaction accessibility for people in the Global South, these efforts usually focus on assistive technology rather than universal design. The work described here uses the goals of universal design, like cultural appropriateness, to understand the needs of diverse users in Kampala, Uganda, and Kigali, Rwanda. Preliminary results have revealed prominent absences of features related to physical mobility and hearing impairments. The subsequent phase of this work is to partner with local organizations to implement the resulting recommendations. Our goal is for these recommendations to inform new information technology and interactions designs that can support local stakeholders in their efforts to provide transportation services to people of all abilities.

Participation in sport and physical activity in adults with intellectual disabilities

People with intellectual disability face a number of barriers to participation in physical activity. This paper aimed to determine rates of sport and physical activity participation in an Australian sample of adults with intellectual disability, compared with rates of participation in the general Australian population. A secondary aim was to investigate factors that may contribute to participation of adults with intellectual disability. Participants were part of the Australian Child to Adult Development (ACAD) study, consisting of a community sample with intellectual disability (n=305), groups of adults with autism (n=94), Down syndrome (n=64), fragile X syndrome (n=52), Williams syndrome (n=45), and Prader-Willi syndrome (n=30). Participation in sport/physical activity was reported over the past 3months. Rates of participation were reported for adults with intellectual disability and compared with rates in a general Australian population sample. The relationship between participation in physical activity and age, degree of intellectual disability, physical mobility, living situation, socio-economic disadvantage, and behaviour and emotional problems were also conducted. Participants in the ACAD community sample with intellectual disability participated in sport/physical activity at lower rates than the general Australian population (42% compared with 71%). Having no physical mobility impairment was significantly associated with higher rates of participation. Those with Down syndrome participated in sport/physical activity at higher rates than the community sample with intellectual disability, while no difference in sport/physical activity participation was observed in the groups with autism or other syndromes. Australian adults with intellectual disability participate in sport and physical activity at lower rates than the general population. Having a physical mobility impairment was associated with lower rates of participation. However, people living in supported accommodation were more likely to participate than those in other living situations. Having Down syndrome was associated with a higher participation rate than the community sample.

Application of Passive Range of Motion (ROM) Exercises to Increase the Strength of the Limb Muscles in Patients with Stroke Cases

Stroke is a condition that occurs when the blood supply to the brain is interrupted due to blockage or rupture of brain blood vessels with symptoms such as hemipareseis, slurred speech, difficulty walking, loss of balance and decreased muscle strength. The aim of knowing the application of passive Range of motion (ROM) exercises in non-hemorrhagic stroke patients with limb paralysis. This research method used a descriptive method with a case study approach in which one stroke patient was given passive ROM exercises. The results showed that data on decreased consciousness, BP 170/120 mm / Hg and decreased limb muscle strength. Nursing diagnosis of physical mobility impairment, the nursing intervention given was passive ROM exercises twice a day aimed at increasing muscle strength. Evaluation after six days of intervention, the patient could move his hands and feet. In the upper/ lower right limb from scale 2 to scale 3 and the upper / lower left limb from 0 to 1. The conclusion after being given passive ROM exercises, stroke patients experienced increased muscle strength in both extremities.

Drug Burden Index and Cognitive and Physical Function in Aged Care Residents: A Longitudinal Study

ObjectivesAnticholinergic/antimuscarinic and sedative medications (eg, benzodiazepines) have been found to be associated with poorer cognitive and physical function and mobility impairment in older age. However, previous studies were mostly conducted among community-dwelling older individuals and had often a cross-sectional design. Accordingly, our aim was to examine longitudinal associations between cumulative exposure to anticholinergic and sedative medications and cognitive and physical function among residents from aged care homes. DesignLongitudinal study. Setting and ParticipantsA total of 4624 residents of Dutch aged care homes of whom data were collected between June 2005 and April 2014. MethodsOutcome measures were collected with the Long-Term Care Facilities assessment from the international Residential Assessment Instrument (interRAI-LTCF) and included the Cognitive Performance Scale, the Activities of Daily Living (ADL) Hierarchy scale, a timed 4-meter walk test, distance walked, hours of physical activity, and days being outside. Cumulative exposure to anticholinergic and sedative medications was calculated with the Drug Burden Index (DBI), a linear additive pharmacological dose-response model. Associations were examined with linear mixed models to take the potential dependence of observations into account (ie, data were collected at repeated assessment occasions of residents who were clustered in aged care homes). Analyses were adjusted for sex, age, dementia, comorbidity (neurological, psychiatric, cardiovascular, oncological, and pulmonary), fractures, depressive symptoms, and medications excluded from the DBI. ResultsWe observed significant longitudinal associations between a higher DBI and poorer ADLs, fewer hours of physical activity, and fewer days being outside. We found no significant longitudinal association between a higher DBI and poorer cognitive function. Conclusions and ImplicationsOver time, cumulative exposure to anticholinergic and sedative medications is associated with poorer physical but not cognitive function in aged care residents. Careful monitoring of aged care residents with high cumulative anticholinergic and sedative medication exposure is needed.

NURSING CARE IN MEETING PHYSICAL MOBILITY NEEDS INPATIENTS NON HEMORRHAGIC STROKE IN RSKD DADI MAKASSAR

Stroke is damage to brain tissue caused by a sudden reduction in or supply of oxygen in the blood. Brain tissue that has decreased oxygen supply will experience decreased function and cell death. The purpose of this study is to provide an overview of nursing care to meet the needs of physical mobility in stroke patients at RSKD Dadi Makassar. The study design was a case study in the form of a nursing care approach in two non-hemorrhagic stroke patients. The results showed both patients experienced weakness of the right limb which caused impaired physical mobility and total self-care deficit. Nursing interventions in patients include ambulation support, mobilization support, range of motion exercises and self-care assistance. Nurses should provide care and education to families about the care of stroke patients who experience physical mobility impairments and self-care deficits. Families also need to provide support to stroke patients undergoing treatment to increase motivation, speed up the recovery process and prevent complications.

The implementation and initial evaluation of a physical therapy program for captive chimpanzees (Pan troglodytes).

Due to advances in captive nonhuman primate (NHP) medical care, the number of geriatric chimpanzees (≥35-years old) is growing. With old age comes a variety of physical conditions, including arthritis, stroke, and mobility impairments. Programs aimed at enhancing the welfare of geriatric chimpanzees are now quite common, but there are few published empirical evaluations of the efficacy of such programs. The current study aimed to create, implement, and evaluate the effects of participation in a physical therapy (PT) program on physical health, mobility, welfare, and behavior. Nine chimpanzees with mobility impairments participated in personalized PT routines (using positive reinforcement training) twice per week for 5 months. Additionally, nine control chimpanzees (non-mobility-impaired, matched with PT chimpanzees on age and gender) participated in body exam behavior sessions (also using positive reinforcement training) twice per week. All chimpanzees were rated on 14 health, well-being, and behavior items, as well as level of mobility throughout the PT program. Chimpanzees that participated in the PT program showed significant increases in ratings of physical health, well-being, and activity levels across phases of the program. Furthermore, compared to control chimpanzees, PT chimpanzees showed significant increases in ratings of ease of movement. Because raters were not blind to physical therapy treatment, our results represent an initial evaluation of the program that may suggest that participation in the PT program has physical, behavioral, and welfare benefits. Assessments of novel geriatric-focused care strategies and programs are essential to further enhance the welfare of the captive chimpanzee population, which is currently comprised of many geriatric animals, whose proportion of the captive population will only increase.

Barriers to marriage and motherhood: the experiences of disabled women in Malaysia

ABSTRACT The conceptualisation of disability is contested globally and issues in gender studies further complicate the movement towards the development of an inclusive and equal society. However, most disability and gender research studies are based on the data collected in the Global North, and little is known about disabled women in the Global South. The data presented here is from a bigger study focusing on the lived experiences of women with disabilities. This paper sets to explore how disabled women in Malaysia experience their lives in terms of marriage and motherhood prospects. The data of this qualitative study was collected from a set of in-depth interviews involving 32 women in Malaysia with physical (mobility) impairment. Over a period of 6 months, 16 Malays, 8 Chinese and 8 Indian women were interviewed twice. The analysis proposes both retrospective and introspective accounts on marriage and motherhood. The data gathered from the in-depth interviews was transcribed and analysed thematically with the help of NVivo software. The findings indicated that most participants have experienced significant barriers concerning individual constraints, familial control, and societal barriers. These were discussed with the intrinsic aspects and contextual factors of living in a patriarchal and traditional society that significantly undermined the wellbeing of disabled women in this study. Nevertheless, many of those interviewed refused to give up their hope of having a family life despite the constant struggles they encountered in their pursuit of happiness. However, their aspirations to experience family life were restricted and this caused them to experience significant psycho-emotional problems. They were constantly reminded that they were ‘disabled’ and not worthy of experiencing life like other women. The paper will discuss these challenges and negative societal attitudes towards the issue.

Epionics SPINE-use of an objective method to examine spinal mobility in patients with axial spondyloarthritis

Axial spondylarthritis (axSpA) is achronic inflammatory disease of the spine that can be associated with loss of physical function, mobility and upright postural impairment. Established tools for the assessment of function that are largely based on subjective perception are semiquantitatively recorded by standardized questionnaires (Bath ankylosing spondylitis functional index, BASFI), while measurement of spinal mobility of patients with axSpA is based on physical examination of various movement regions particularly the axial skeleton (Bath ankylosing spondylitis metrology index, BASMI). Recently, aperformance test has been added to assess the range of motion and speed of certain tasks (AS performance-based improved test, ASPI); however, since these tests have limited reliability and reproducibility, more objective tests would be desirable. In this study the spinal mobility of patients with axSpA was quantified using the Epionics SPINE device (ES) and data were evaluated using the outcome measures in rheumatology (OMERACT) criteria. The ES automatically measures various patterns of spinal movements using electronic sensors, which also assess the range and speed of carrying out movements. Patients with back pain from other causes and persons without back pain served as controls. The measurement results obtained with ES differed between the groups and correlated with BASMI values (r = 0.53-0.82, all p =<0.03). Patients with radiographically detectable axSpA had more limited and slower mobility than those with non-radiographically detectable axSpA. Overall, the results presented here suggest that ES measurements represent avalid and objective measurement procedure of spinal mobility for axSpA patients.

The Impact of an Instructional Model with Assistive Technology on Achievement Satisfaction of People with Physical-Motor Impairments

Background: The use of new technologies in education is a topic that has attracted the attention of educational experts over the past two decades. The purpose of this study was to investigate the effect of an instructional model enriched with assistive technology on the achievement satisfaction of people with physical-motor impairments in learning English. Methods: The research method is semi-experimental, with a pre-test/post-test design using a control group. The statistical population consisted of male individuals with physical mobility impairments studying at Imam Ali Educational Center in Tehran. To determine the sample size,Cohen’s (1986) table was used. Based on the sample size table, 16 people were selected. In this method, after drawing up a student list with a random number table, the sample was selected after checking criteria for entry and exit. The experimental group was trained in six sessions using an instructional model enriched with online and offline assistive technologies, and the control group was trained in the usual way. Results: The mean ± standard deviation (SD) for pre- and post-test in the experimental group were 75.50 ± 5.90 and 82.25 ± 6.29, respectively, and was 75.38 ± 11 and 77.37 ± 11.91 in the control group. The results of the analysis of covariance between adjusted means of both groups for variable of academic satisfaction show a significant difference between the two groups (F =20.06, P &lt; 0.01). The effect size was 0.60. Conclusion: Using an instructional model enriched with assistive technology can be useful in teaching English to individuals with physical-motor impairments.