Physical Mobility Impairments Research Articles

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.

Physical Mobility Impairment and Risk for Cardiovascular Disease.

Background: People with disabilities (PWD) often self-report reduced access to preventive health services and poorer health than people without disability. Risk factors for chronic disease are more prevalent in PWD, increasing risk for secondary conditions including cardiovascular disease (CVD).Methods: Logistic regression was used to analyze data from the 2016 Behavioral Risk Factor Surveillance Survey to explore the relationship between disability with mobility impairment and CVD.Results: Difficulty walking and climbing stairs significantly predicted concomitant CVD and diabetes in logistic regression models.Conclusion: Information from this study may be useful in addressing CVD risk for adults with mobility impairments.

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.

Application of Artificial Neural Networks in Modeling Direction Wheelchairs Using Neurosky Mindset Mobile (EEG) Device

The implementation of Artificial Neural Network in prediction the direction of electric wheelchair from brain signal input for physical mobility impairment.. The control of the wheelchair as an effort in improving disabled person life quality. The interaction from disabled person is helping in relation to social life with others. Because of the mobility impairment, the wheelchair with brain signal input is made. This wheel chair is purposed to help the disabled person and elderly for their daily activity. ANN helps to develop the mapping from input to target. ANN is developed in 3 level: input level, one hidden level, and output level (6-2-1). There are 6 signal from Neurosky Mindset sensor output, Alpha1, Alpha2, Raw signal, Total time signal, Attention Signal, and Meditation signal. The purpose of this research is to find out the output value from ANN: value in turning right, turning left, and forward. From those outputs, we can prove the relevance to the target. One of the main problem that interfering with success is the problem of proper neural network training. Arduino uno is chosen to implement the learning program algorithm because it is a popular microcontroller that is economic and efficient. The training of artificial neural network in this research uses 21 data package from raw data, Alpha1, Aplha2, Meditation data, Attention data, total time data. At the time of the test there is a value of Mean square Error(MSE) at the end of training amounted to 0.92495 at epoch 9958, value a correlation coefficient of 0.92804 shows that accuracy the results of the training process good.  Keywords: Navigation, Neural network, Real-time training, ArduinoÂ

Nursing Diagnosis of Impaired Physical Mobility in Elderly People at Primary Health Care

Objective: to identify the frequency of the nursing diagnosis of Impaired Physical Mobility Impairment and its components in elderly population registered in a Primary Health Care Unit.&#x0D; Method: cross-sectional study conducted from November 2014 to February 2015, performed with 50 seniors at their homes. A questionnaire on patients's identification, their health conditions and their mobility was used.&#x0D; Results: the nursing diagnosis in question was identified in 71.4% of the population. The most present related factors were: lack of knowledge about the advantages of physical activity (66.7%), discomfort (76.9%), pain (82.1%), joint stiffness (76+9%) and sedentary lifestyle (82.1%). The defining characteristics were: limited capacity to perform gross motor skills (89.7%) and fine motor skills (56.4%), and engagement in substitution of movements (74.4%).&#x0D; Conclusion: participants showed difficulties related to physical mobility, evidencing a need for better care from health professionals.&#x0D; Keywords: Nursing Diagnosis; Elderly; Nursing.&#x0D;

What is the best way of assessing obesity in children with physical disabilities and mobility impairments?

What is the best way of assessing obesity in children with physical disabilities and mobility impairments?

Evaluating disability management in the Manitoban construction industry for injured workers returning to the workplace with a disability

The poor safety record of the construction industry raises concerns about the extent to which it is able to integrate workers disabled as a result of a workplace injury back to the workplace. A review of the literature indicates there is little empirical evidence about the status of disability management (DM) in the Canadian construction industry, specifically with respect to injured construction workers returning to the workplace with a disability. To address this limitation, a web-based survey was administered to a sample of Manitoban construction organizations to enquire about workers disabled as a result of a workplace injury in the industry, practices in place to accommodate them, and barriers to their employment. The analysis of the responses of 88 organizations showed that the majority of responding organizations employed few disabled workers. Disabilities due to musculoskeletal injuries were the most common, followed by physical mobility and hearing impairments. Respondents saw retaining valued and experienced employees and maintaining employee morale as the main reasons for implementing a DM program. They also found the lack of suitable modified or alternate work to be the most important barrier to DM; however, they identified the provision of such work as the most common practice implemented by them, raising questions about this work’s suitability to disabled workers.

The risk of fall and fracture with the initiation of a prostate-selective α antagonist: a population based cohort study

Study question Do men starting treatment with prostate-specific α antagonists have increased risk of fall and fracture?Methods Administrative datasets from the province of Ontario, Canada, that contain patient level data...

An individual rehabilitation program: Evaluation by Parkinsonian patients and their physiotherapists

ObjectivesThe purpose of this work was to study the feasibility of an individual Parkinson disease (PD) rehabilitation program based on each patient's prevalent symptoms and to determine the effects of this program on patient's quality of life as well as the level of patient's and physiotherapist's satisfaction with the program. Patients and methodsIn association with physiotherapists with expertise in PD, a physical medicine and rehabilitation physician, we elaborated a physical therapy program based on the core areas for physical therapy in PD: transfers; posture; balance and falls; physical capacity and inactivity. Within this program, we selected exercises tailored to each patient's main impairment and proposed this selection to their local physiotherapist for three months. Quality of life was evaluated with PDQ-39 at baseline and after three months of the individualized physical therapy program. We built an anonymous satisfaction questionnaire for patients and physiotherapists that was filled out at the end of the program. ResultsOne hundred and three individuals with moderately advanced but clinically stable idiopathic PD were included. Significant improvement was found for the emotional well-being, bodily discomfort and stigma domain (P ≤ 0.05). No significant improvement was found for the other PDQ-39 domains. The mean global satisfaction figures for this program were 6.0±2.4 and 7.2±2.1 for patients and physiotherapists respectively. Most of the patients felt improved by the physiotherapy program and especially for transfer, balance, gait, and mobility. ConclusionOur study found evidence of the potential benefits of a patient-tailored physiotherapy program. Such a program was feasible and had a favorable impact on patients’ quality of life and on physiotherapists’ practices for PD patients. Specific physiotherapy may be effective to limit physical mobility impairment. Our results also pointed out that physiotherapy may be efficient to confine the negative impact of social isolation, pain and emotional reactions. Such a program should be associated with a therapeutic education intervention such as encouraging patients to perform physical therapy exercises alone.

The significance of uprightness: parents’ reflections on children’s responses to a hands-free walker for children

The benefits and drawbacks of facilitating independent walking in children with physical mobility impairments, such as cerebral palsy, remain to be determined. This knowledge gap creates decision dilemmas about which mobility practices parents and children should adopt and rehabilitation professionals should foster. These dilemmas are reflected in continuing debates about allocation of time, effort and resources to optimize walking versus encouraging use of manual or powered wheelchairs. Recent studies have reported only modest measurable walking progress for severely disabled children using hands-free walkers. Despite these seemingly disappointing results, parents remained highly motivated to encourage their children to use these walking devices and appraised them very positively. In the present paper, we suggest that parents’ symbolic value of their children assuming upright comportment may explain why they perceive hands-free walkers positively and why they are so motivated to devote much time and effort to improving independent, walking-based mobility of their children.

Neighborhood Eating and Activity Advocacy Teams (NEAAT): engaging older adults in policy activities to improve food and physical environments

Local food and physical activity environments are known to impact health, and older adults are generally more vulnerable to health-related environmental impacts due to poorer physical function and mobility impairments. There is a need to develop cost-conscious, community-focused strategies that impact local food and physical activity environment policies. Engaging older adult community residents in assessment and advocacy activities is one avenue to address this need. We describe the Neighborhood Eating and Activity Advocacy Team project, a community-based participatory project in low-income communal housing settings in San Mateo County, CA, as one method for engaging older adults in food and physical activity environment and policy change. Methods and strategies used by the "community action teams" to generate relevant neighborhood environmental data, build coalitions, prioritize complex issues, and advocate for change are presented. Advocacy groups are feasible among older adults to improve food and physical activity environments.

A survey of older adult patients in special secure psychiatric care in Scotland from 1998 to 2007

The population is ageing and the needs of older adults may not be being met in the field of forensic psychiatry. This survey gathered information about the number and the needs of older adult patients in a special secure forensic psychiatry care in Scotland. Inpatients of The State Hospital, Carstairs aged 55 or over throughout a 10-year period were included. This population has heterogeneous and complex needs. The most common diagnoses are of psychotic illnesses. Most patients are admitted from other secure psychiatric facilities or prison and the duration of admission is long. There are high rates of physical illness, mobility impairment, sensory impairment and polypharmacy. Offences tend to be at the severe end of the spectrum, including homicide, sexual offences and other violent offences. Most patients are single males and socioeconomic classes IV and V are over-represented. Further research will inform development of services for this population.

Mental Health Service Use and Outcomes After the Enschede Fireworks Disaster: A Naturalistic Follow-Up Study

This study documented the number of people seeking help for mental health problems after a fireworks disaster in Enschede, the Netherlands. It describes their diagnostic characteristics, interventions provided, and their results. Researchers coded data from intakes and medical charts of all patients who sought help (N=1,659) and entered treatment (N=663) at a disaster relief service between May 13, 2000 (day of the disaster), and June 1, 2004. Patients who received more than eight treatment sessions (N=394) and were in treatment one year after the disaster were interviewed with the Composite International Diagnostic Interview (CIDI) (N=228, response rate, 58%) and other questionnaires (N=271, response rate, 69%). In the population probably exposed, the cumulative referral-incidence for disaster-related mental health problems over four years was approximately 10%; in terms of referrals to the mental health facility over five years, the proportion of disaster-related referrals was 5.7%. Among adults, posttraumatic stress disorder (PTSD) was the most common clinical diagnosis (53%, chart sample). However, depression was the most common CIDI diagnosis (58%, CIDI interview sample). The recovery rate was about 50% on the basis of clinical judgment (chart sample), between 69% and 76% on the basis of "healthy" scores on symptoms, and between 39% and 60% in social and physical functioning (interview sample). Apart from persons seeking support during the first weeks postdisaster, the largest influx occurred after about one year and was limited in size. Clinicians in specialized services should be aware that conditions other than PTSD, such as depression, anxiety, substance abuse, and somatoform disorders, are also quite common after disasters.

Disability as a Diversity Factor: Implications for Human Resource Practices

Based on important findings from the four investigations in this special issue, this article discusses strategies that Human Resource Development (HRD) and Human Resource Management (HRM) personnel can use to minimize the unlawful termination of employees with disabilities and thereby preserve the diversity they bring to the workforce. HRD and HRM practitioners are constantly faced with the challenges of managing diversity given the rationale that a diverse workforce is more productive and more representative of the American population (Selden &amp; Selden, 2001). Lack of awareness of the various forms of disability and of diversity management skills—key skills a good HRD practitioner ought to have—often results in conflict and mistrust, all of which can lead to failure to achieve individual, process, and organizational performance goals (Kochan et al., 2002). Diversity management, therefore, must take into consideration the various forms of disability—physical (mobility impairment and chronic illness), sensory (visual and hearing impairment), cognitive (mental retardation and learning disability), and emotional (depression and other psychological conditions)—as they interact with different (a) workplace demands and tasks; (b) attitudes and expectations of employers and coworkers; and (c) perceptions of people with disabilities themselves. To manage disability as a diversity issue, it is imperative that HRD and HRM practitioners, employees, management, and organizational leaders understand the meaning of disability as a diversity factor in the workplace and the potential impact of disability on critical HRM and HRD practices related to job retention and termination.

Are we promoting the health of people with physical mobility impairments? A literature review

PurposeThis paper aims to examine whether the health education and health promotion literature is inclusive of people with physical mobility impairments. The English government Department of Health statistics indicate that the number of people living with physical mobility impairments is increasing and this is largely a result of chronic illness survival. The current UK Government has set targets to reduce inequalities that disproportionally affect those with disabilities. In light of the above points, it was expected that this interest would be reflected by a growing health promotion literature.Design/methodology/approachIn order to achieve an overview of health promotion offered for those with physical mobility impairments, a literature review was conducted. The literature was systematically reviewed using keywords and inclusion criteria. The range of published literature searched included research journals, health promotion texts, health and disability policy documents, as well as web sites offered on the internet.FindingsThere is a dearth in the information and development of health promotion for those with physical mobility impairments. Health policy documents offer little that is specifically focused for this group of people in particular. The majority of the relevant literature comes from the USA. Two theoretical positions are offered in the literature: one argues that those with physical impairments require a medical model approach to support individual's adjustment to society; and the other argues that emphasis should be placed on social change to accommodate those with physical impairments. While there are a range of initiatives in legislation and policy that utilise the social model position, the lack of UK health promotion interventions and the small number of US studies for improving the health of those with physical mobility impairments tends to encourage the medical model approach.Research limitations/implicationsThis review focuses particularly on health promotion for those with physical mobility impairments. Although not exhaustive, it highlights the need for further research into effective development of health promotion for those with physical mobility impairments in the UK.Practical implicationsFar more needs to be done to promote the health of those with physical mobility impairments. Both the medical model and social change approaches are required to deliver health promotion for this segment of the population.Originality/valueThere are no other reviews of the literature with a focus on physical mobility impairment and health promotion. This paper considers an often‐neglected group of people and identifies a need for effective health promotion information and resources.

Les activités de groupe des centres de jour pour personnes âgées correspondent-elles aux besoins des différents profils de participants ?

This study was carried out to explore the fit between health and functional characteristics of Day Program participants and the types of program activities they were offered in Day Programs. The subjects were 132 participants from 5 Day Programs in Montreal. Four different participant profile groups were identified using cluster analysis. A classification of program activities was created by a panel of experts. Participation in these activities was studied for each profile group, and compared to recommended activities for such client groups outlined through examination of the literature and consultation with our panel of experts. Results showed only partial correspondence between program activities and participants' needs. This correspondence seemed higher for individuals with physical health problems or mobility impairments and weaker for those presenting depressive symptoms or cognitive impairments. These results suggest a need to review activity program components and determine ways to match better these with client needs to optimise the benefits of Day Program participation.

Dynamics of Frailty and ADL Dependence in a Five-Year Longitudinal Study of Octogenarians

Using a sample of octogenarians from the Swiss Interdisciplinary Longitudinal Study on the Oldest Old, the authors investigated the predictive validity of an expanded working definition of frailty based on deficiencies in mobility, memory, energy, and physical or sensory capacities and analyzed the resulting health transitions. The five domains were considered as predictors of the onset of dependence in activities of daily living (ADLs) and death using logistic multilevel and Cox survival regression models. Health transitions were studied with Markov chains. Deficiencies in memory, energy, and sensory capacities contributed to the prediction of the onset of ADL dependence and death in participants free of physical pains and mobility impairments. With two domains affected, frailty in very old persons indicated an increased risk of adverse outcomes. The study of transitions showed that ADL-independent frailty was a highly probable and relatively long transitional stage between robustness and ADL dependence.

Quality of life in the Canadian Implantable Defibrillator Study (CIDS)

Background The primary aim of this study was to compare quality-of-life outcome between patients randomized to implantable cardioverter defibrillator (ICD) therapy and patients randomized to amiodarone treatment in the Canadian Implantable Defibrillator Study (CIDS). A secondary aim was to evaluate the effects on quality-of-life outcomes of receiving shocks from the device. Methods Quality of life was assessed in 317 English-speaking participants by use of the Rand Corporation's 38-item Mental Health Inventory (MHI) and the Nottingham Health Profile (NHP). Assessments were done in the hospital at baseline and with mailed questionnaires after 2, 6, and 12 months of follow-up. Sixty-two percent of patients completed the follow-up assessments at 6 and 12 months. Results Repeated measures analysis of variance revealed significant time by treatment group interaction effect on total MHI and the psychological distress and psychological well-being sub-scales, and on 5 of the 7 NHP scales (energy, physical mobility, emotional reactions, sleep disturbance, and lifestyle impairment) (P <.05). Emotional and physical health scores were shown to improve significantly in the ICD group and were either unchanged (emotional health) or deteriorated (energy and physical mobility) in the amiodarone-treated group by means of post-hoc comparisons. Quality of life did not improve in the subgroup of patients in the ICD-treated group who received ≥5 shocks from their device. Conclusion Quality of life is better with ICD therapy than with amiodarone therapy. The beneficial quality-of-life effects from an ICD are not evident in patients who receive numerous shocks from their device. (Am Heart J 2002;144:282-9.)