Use Of Assist Devices Research Articles

Experiences of individuals with severe disabilities using assistive devices: A qualitative study.

Experiences of individuals with severe disabilities using assistive devices: A qualitative study.

Geriatric factors affecting the safety of direct oral anticoagulants in atrial fibrillation patients aged 80 years and older: An observational prospective cohort study

Background. Older age is associated with the presence of geriatric syndromes, whose effect on the safety of direct oral anticoagulants in atrial fibrillation patients is studied extensively. Scientific literature focuses on the prevention of major bleeding, while clinically relevant non-major bleeding occurs much more frequently and can have a significant impact on the patient’s condition. Objective. To assess the potential of geriatric factors for predicting the risk of clinically relevant non-major bleeding on direct oral anticoagulants in nonvalvular atrial fibrillation patients aged 80 years and older. Methods. The article presents the results of an observational prospective cohort study that included 367 atrial fibrillation patients aged 80 years and older on direct oral anticoagulants. The study was conducted at a multi-specialty inpatient clinic in Moscow from January 2019 to December 2022 and reflected real clinical practice. The medical records were prospectively analyzed for the presence of clinically relevant non-major bleeding; the observation period lasted 12 months. The patients were divided into groups: the main group comprising patients with clinically relevant non-major bleeding (n = 195), with a median age of 84 [82; 87] years, and the control group consisting of patients without clinically relevant non-major bleeding (n = 172), with a median age of 84 [82; 88] years. The groups were comparable in terms of key bleeding risk factors. In order to identify geriatric risk factors, a comprehensive geriatric assessment was performed in four main domains: physical status; mental and emotional status; functional capacity; identification of social problems. Statistical data processing and visualization were performed in the R software environment, version 4.4.0 (R Foundation for Statistical Computing, Vienna, Austria). Differences were considered statistically significant at p < 0.05. Results. The performed analysis identified risk factors for clinically relevant non-major bleeding in all four domains of the comprehensive geriatric assessment: social (living in a family, number of household members, legal marriage, and church attendance); mental and emotional (Geriatric Depression Scale); physical and functional (balance tests, Lawton IADL scale, use of assistive devices, senile asthenia as per the Age is No Barrier questionnaire, SPRINT (Systolic Blood Pressure Intervention Trial) frailty index, p < 0.05). In the course of a multiple-factor analysis, a multiple-factor logistic regression model was created to predict clinically relevant non-major bleeding, and a prognostic nomogram was derived to estimate the probability of clinically relevant non-major bleeding (prognostic accuracy of 59.9%, sensitivity of 48.9%, and specificity of 72.4%). The predictors were as follows: number of household members, Barthel ADL score, Lawton IADL score, Timed Up and Go Test, and use of any assistive device. Conclusion. In the study, socially active, emotionally stable, mobile, and robust patients were shown to have a higher risk of developing clinically relevant non-major bleeding events. The authors identified geriatric factors that may serve as predictors of clinically relevant non-major bleeding on direct oral anticoagulants in atrial fibrillation patients aged over 80 years. Given the active AI implementation in clinical practice, the obtained data can be integrated into clinical decision support systems.

Utilization and impact of assistive device use on mental health among children with disabilities in Nigeria: a cross-sectional study

Background Assistive devices (ADs) play a critical role in mitigating accessibility barriers and enhancing inclusion. Despite the global acknowledgment of the benefits of ADs, there is a notable lack of information on their utilization and impact in global south countries, including Nigeria. Purpose To explore the prevalence and factors associated with the use of ADs and examine the relationship of these ADs with anxiety and depression among disabled children in Nigeria. Method We conducted a retrospective analysis of the 2021 Nigeria Multiple Indicator Cluster Survey (MICS), including data of 22,443 children aged between 5 and 17 who participated in the survey and answered the functioning module. Disability was screened using the Washington Group and UNICEF child functioning module. Logistics regression was used to estimate the odds (with 95% CI) of using ADs and associations with anxiety and depression among the children. Results Shows that 43.2%, 37.2%, and 28.9% of those with seeing, hearing and walking difficulties are using ADs, respectively. Factors such as age, school attendance, and maternal education are associated with ADs use. Across the three difficulties, ADs users consistently had lower adjusted odds of depression and anxiety compared to non-users. For example, children with seeing difficulties who used ADs had lower odds of depression (aOR = 1.43 vs. 1.66) and anxiety (aOR = 1.48 vs. 1.74). Conclusion This study revealed notable socioeconomic disparities in the access and utilization of ADs among disabled children. The disparity underscores the need for an overarching, multifaceted, and multisectoral approach to promote accessibility to ADs.

Falls in the oldest old: role of gender, living situation, and assistive devices.

Falls can have serious health consequences, especially in the oldest old (individuals 90+ years), for whom falls often result in injury or even death. Few studies have examined falls in the oldest old. We aim to assess fall prevalence, fall rate, and rate change over time according to gender, living situation, and assistive device use. Participants are from The 90+ Study, a longitudinal study of individuals 90 years and older with evaluations every 6 months. Participants, or their informants, were asked how many times they have fallen in the past year (first visit) or since their last visit (follow up visits). We calculated unadjusted baseline fall prevalence. Using generalized linear mixed regression models, we estimated adjusted baseline fall rate and adjusted change in rate over time by gender, living situation, and assistive device. In 1672 participants (mean age 93 years, range 90-110 years), unadjusted baseline prevalence of 1+ falls was 47.9% in women and 47.8% in men. Estimated adjusted baseline fall rate was 0.66 falls per person year in women and 0.71 falls per person year in men. In women, fall rate did not change significantly over time, whereas in men, fall rate increased by an average of 6% per year. Both men and women in nursing homes had a higher fall rate compared with those in the community. In nursing homes, fall rate remained stable over time in men and decreased over time in women. Fall rate was higher in both men and women using assistive devices. However, walkers were associated with a decrease in fall rate over time in women and in participants in nursing homes. Canes were unexpectedly associated with an increase in fall rate over time. Individuals 90 years and older had a high prevalence of falls overall. The higher and increasing rate of falls over time in men compared to women, suggests that efforts should be made to increase the uptake of fall prevention strategies specifically in men in the oldest age categories. The increasing fall rate in participants using canes suggests that referral to a health care provider trained in gait analysis prior to assistive device prescription could assist with fall prevention efforts in the oldest old.

The Experiences of Living with a Visual Impairment in Peru: Personal, Medical, and Educational Perspectives

Background: Nearly 5 million people in Peru live with visual impairments, many of which are irreversible. within addition to eye care services, these individuals could benefit from government services and rehabilitation to improve their quality of life and promote equitable, inclusive social participation. Although numerous government policies address this, little is known about their perception and implementation. Methods: Semi-structured individual online interviews were conducted with 29 people (7 low vision, 12 blind, 6 educators/rehabilitators, 4 medical doctors) in Peru between July and November 2024. Each participant was asked to respond to the same 16 open-ended questions. Their transcripts were coded into themes in 5 domains: assistive devices, vision rehabilitation services, government assistance programs, accessibility for people with visual impairments, and eye care services. The themes were compared among members of each group. Results: Themes from educators/rehabilitators aligned well with those with blindness but much less with ophthalmologists and those with low vision. Participants mentioned that assistive devices are not traditionally provided by the government. There was little mention of vision rehabilitation services, particularly from low vision participants. Additionally, participants with visual impairments mentioned a lack of sensitivity from teachers, employers, and transport drivers. Interestingly, none of the participants with visual impairments benefitted from financial assistance. Conclusions: Many of the barriers are societal, referring to the lack of understanding from the public in relation to employment, education, transportation, or the use of assistive devices. People with visual impairments and educators should be included in any policy decisions to promote equality for Peruvians with vision loss.

Agenesis of Corpus Callosum: A Clinical Study of Complete Versus Partial Agenesis in a 20-Year Retrospective Cohort.

Agenesis of the corpus callosum (ACC) has a wide spectrum of anatomic manifestations associated with incompletely understood clinical variability. In this retrospective cohort study, 161 children with ACC were classified into complete ACC and partial ACC. Partial and complete ACC diagnoses were confirmed by postnatal magnetic resonance imaging (MRI) and further classified as isolated or complex (associated with other brain abnormalities or genetic diagnoses). Clinical characteristics, clinical outcomes, and co-occurring genetic variations were collected by chart review. Median age at last neurologic evaluation for the complete and partial ACC cohorts were 2.8 years and 2.3 years, respectively; thus, an average of 2-3 years of follow-up data were analyzed per patient. Results showed that children with complete and partial ACC had similar birth characteristics. Children with complete ACC were more frequently diagnosed prenatally; additionally, complete ACC patients had lower rates of cerebral palsy. When comparing complex complete ACC and complex partial ACC to isolated complete ACC and isolated partial ACC, respectively, the complex subcohorts had a higher level of motor delay, assistive device use, cerebral palsy, ventriculoperitoneal shunt placement, epilepsy, language delay, and cognitive delay than the isolated subcohorts. About 50% of children had genetic variants associated with neurodevelopmental disorders in this cohort. Additionally, >50% of our patients with motor and nonmotor developmental delays, as well as >60% of patients that required assistive devices and had cerebral palsy, were also found to have genetic anomalies. Although research describing ACC and its outcomes is expanding, there is still a need for large cohort studies with robust follow-up data to help further understand the disease.

Racial Differences in the Trends, Clinical Characteristics and Outcomes of Patients Undergoing Coronary Atherectomy.

Racial disparities persist in cardiovascular care, but little is known about differences in outcomes following coronary atherectomy by race or ethnicity. This study examines in-hospital outcomes and utilization trends of coronary atherectomy among Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) patients using data from the National Inpatient Sample database (2016-2021). NHB patients were younger and exhibited a higher prevalence of comorbidities such as diabetes, hypertension, and chronic kidney disease compared with NHW patients. Despite this, multivariate analyses revealed that NHB patients had lower odds of in-hospital mortality (adjusted odds ratio [aOR]: 0.80; 95% CI: 0.68-0.95), cardiogenic shock (aOR: 0.84; 95% CI: 0.75-0.95), and percutaneous left ventricular assist device use (aOR: 0.87; 95% CI: 0.76-0.99) compared with NHW patients. However, NHB patients are associated with higher odds of acute kidney injury (aOR: 1.13; 95% CI: 1.02-1.24). Notably, among patients with a high comorbidity burden (Elixhauser score ≥4), NHB patients maintained a mortality advantage (OR: 0.82; 95% CI: 0.70-0.96). Coronary atherectomy utilization increased for both groups from 2016 to 2021. Our findings highlight the complex interaction between racial disparities, sex and clinical outcomes, emphasizing the need for further research to understand these trends and improve targeted strategies for equitable cardiovascular care.

Standardized Measurement of Muscle Strength and Physical Performance for Sarcopenia: An Expert-Based Delphi Consensus.

Despite updated sarcopenia guidelines, inconsistent protocols still cause clinical confusion and may compromise diagnostic and outcome accuracy. This Delphi study aimed to establish expert consensus to support the standardization of muscle strength and physical performance assessments for sarcopenia. A two-round modified Delphi study was conducted with 26 experts in geriatrics and sarcopenia. Participants completed two rounds of anonymous questionnaires evaluating 39 items across seven domains using a nine-point Likert scale or choice-based questions. Consensus was defined as ≥75% agreement. In total, 27 of 38 statements (71.1%) reached consensus across two rounds Experts supported further standardization of assessments in alignment with the Asian and Korean Working Group on Sarcopenia (AWGS and KWGS) guidelines. For handgrip strength, consensus was achieved on using both mechanical and hydraulic dynamometers, hydraulic protocols, value selection, measurement time, and positioning, but not on mechanical protocols, repetitions, recovery intervals, repetitions, or unified cutoff values. For calf circumference, consensus was reached on measurement position, method, and value selection, but not on guideline application. In gait speed assessment, agreement was reached on speed, repetitions, assistive device use, and equipment type, but not on value selection, distance, acceleration/deceleration phases, or device interchangeability. For the 400-m walk test, the KWGS guideline and speed were endorsed. Chair stand test (CST) and Timed up-and-go (TUG) test reached consensus on armrest use, value selection, and repetitions, but not on seat height, (CST), or speed (TUG). This study highlights areas of agreement and ongoing uncertainty, supporting future standardization efforts sarcopenia assessment methods.

Assistive devices for ALS patients: exploring wishes and values through focus groups

Purpose Amyotrophic Lateral Sclerosis (ALS) is a progressive disease leading to loss of muscle strength and control, and as such limiting patients’ independence. Assistive devices can help individuals with ALS; however, their use by ALS patients is limited. To increase use rates, we expect that devices need to be tailored to ALS patients. The aim of this study was to identify wishes, requirements and values of ALS patients regarding assistive devices for the upper extremity through focus groups involving ALS patients, their relatives and medical professionals. Methods and Materials Four focus groups were conducted, recorded and transcribed. Two focus groups with ALS patients and their relatives contained a “Day in a Life” and “Empathy map” method, while during two focus groups with medical professionals, “Day in the Life” method and “Provoking statements” were used. Activities mentioned were counted and categorized into “Daily activities” and “Elective activities”. Results Qualitative analysis of transcripts yielded three themes: (1) ALS patients’ considerations on use and wishes for assistive devices, (2) external factors influencing the use of assistive devices and (3) change in ALS patients’ needs over time. In addition to maintaining independence in activities of daily living, the results highlight that retaining the ability to perform elective activities such as hobbies, is important. Moreover, there is a clear need for assistive devices designed for ALS patients with limited upper extremity strength, but who are not confined to a wheelchair. Conclusion These findings can guide the development of assistive devices tailored to the needs of ALS patients.

Participation in activities among people with long-term spinal cord injury in Sweden and the USA - an explorative study using secondary data analysis.

Secondary data analysis. To explore differences in participation, secondary health complications, and the use of assistive devices and personal assistance among people with long-term SCI in Sweden and the USA. Community dwelling individuals with SCI in Sweden and USA. Secondary analysis of data collected via PARTS-Mv3 among individuals living with SCI in Sweden (n = 73) and in the USA (n = 45). Descriptive analyses provided information regarding the participants, their participation in activities, and secondary health complications, together with the use of assistive devices and personal assistance. Both samples included more males than females. The mean ages for the Sweden and USA samples were 63.7 and 58, respectively. The mean time since injury was 36.3 years for Sweden and 35.9 for the USA. Perceived health was significantly higher in Sweden (3.80) than in the USA (2.89). The USA sample reported higher occurrence of secondary health complications than Sweden. The amount and type of participation in activities varied between countries, so also the use of assistive devices and personal assistance. Participation differences were identified when comparing individuals with long-term SCI living in Sweden and in the USA. Further explanatory work is needed to determine whether the differences can be attributed to the varying social and health care systems of the two countries. Understanding how cultural differences influence participation can provide valuable information to determine which system is more likely to positively influence the participation of individuals with long-term SCI.

Effect on forearm muscle activity of manipulative assistive devices' use in activities of daily living.

Effect on forearm muscle activity of manipulative assistive devices' use in activities of daily living.

The remapping of peripersonal space after stroke, spinal cord injury and amputation: A PRISMA systematic review.

Peripersonal space (PPS) is the body-centered area where interactions occur and objects can be reached. Its boundaries are dynamic, modulated by ongoing sensorimotor experiences: limb immobilization shrinks PPS, whereas tool use expands it. However, consistent clinical information on PPS alterations remains limited due to methodological heterogeneity, varying types and severities of sensorimotor disorders, and diverse experimental paradigms. This review explores the causal mechanisms of PPS processing by integrating findings from brain-lesioned patients and individuals with body deafferentation, such as amputees and spinal cord injury (SCI) patients. By comparing the effects of brain lesions and sensorimotor deafferentation, it clarifies how PPS is encoded, maintained, and reorganized following central nervous system damage, bodily changes, and the use of assistive devices. A systematic search of Scopus, Web of Science, and PubMed identified 17 studies: 4 on stroke patients (N = 100), 6 on SCI patients (N = 104), and 7 on amputees (N = 65). Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Despite the limited number of studies and methodological variability, findings consistently show that sensorimotor changes significantly affect PPS. Notably, a contraction of PPS around the affected limb was observed in stroke, SCI patients, and amputees. Assistive devices were able to restore PPS after training, or even immediately in the case of prosthesis use. A shared neurophysiological mechanism across these conditions may underlie PPS as an online construct, continuously updated to reflect the body's current state and its interaction with the environment.

Time Course and Predictors of Persistent Postoperative Dysphagia in Patients with Congenital Heart Disease Following Cardiac Surgery.

Describe the long-term presence, predictors, and time course of postoperative dysphagia in selected congenital heart disease (CHD) patients following cardiac surgery. Retrospective study of selected CHD patients who underwent cardiac surgery that is at high risk for dysphagia and vocal fold mobility impairment (VFMI) and underwent speech pathology assessment from 2019 to 2024. Demographics, clinical history, VFMI, dysphagia severity and feeding modality were assessed. There were 322 mostly infant patients; median age was 0.64 (IQR0.19-6.9) months. Most patients were male (177,55%) and 119 (37%) had single ventricle (SV) disease. A full PO diet was maintained in 105 (32.6%) patients throughout follow-up. One hundred and ten (34.2%) patients improved from tube feeding (TF) at initial discharge to a full PO diet in a median 10.4months (IQR4.4-23.2), whereas 107 (33.2%) remained on TFs with severe dysphagia at the end of follow-up (median 7.2, IQR1.5-17.3 months). VFMI was present in 83 patients postoperatively. VFMI resolved in 35 (38.8%) patients in a median 4.8 months (IQR2.4-8.2). VFMI and dysphagia recovery were not associated. However, the time to VFMI recovery and time to dysphagia resolution were correlated (r = 0.77, p = 0.0001). Patients with a genetic syndrome, Blalock-Thomas-Taussig shunt and/or ventricular assist device use were more likely to require persistent TF. Patients who had coarctation/aortic arch repair or SV disease were less likely to require TF at the end of follow-up. Dysphagia necessitating tube feeding persists for several months after VFMI resolves. This study will help set prognostic expectations for caregivers.

Ventricular Assist Device Use in Pediatric Restrictive and Hypertrophic Cardiomyopathy: An ACTION Registry Analysis.

The use of ventricular assist devices (VADs) in children with restrictive (RCM) and hypertrophic cardiomyopathy (HCM) remains rare. We describe the outcomes of patients with RCM and HCM supported by VAD in the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry from March 2012 to December 2024. Thirty-four patients were identified: 20 left-sided VAD (LVAD), 13 biventricular VAD (BiVAD), and 1 total artificial heart (TAH). Median age at implant was 2.5 years (0.3-17.5), weight was 11.8 kg (4.5-81.8), and body surface area (BSA) was 0.54 m2 (0.26-2.01). Diagnoses included RCM in 25 (73.5%) patients and HCM in 9 (26.5%). Illness severity at implant was high with 38.2% Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1, 41.2% on extracorporeal membrane oxygenation (ECMO), 52.9% on ventilator support, 88.2% treated with greater than or equal to 1 inotrope, and 52.9% supported with TPN. Four patients (11.8%) died on device, 25 (73.5%) were transplanted, 4 (11.8%) were alive on device, and 1 (2.9%) was transferred to another center. Patients who died all had HCM diagnosis, required BiVAD support, and experienced adverse events. The cause of death was inadequate support (1), infection (2), and multi-organ failure (1). Ventricular assist device support is a reasonable strategy for select RCM and HCM patients, although outcomes in HCM are less favorable.

Socio-health factors, ability to perform instrumental and basic activities of daily living, and use of assistive mobility devices during the COVID-19 pandemic: Interrelationships and impact on long-term survival

Introduction Functional dependence for the performance of basic activities of daily living (ADLs) is one of the main causes of institutionalization. This study analyzed the interrelationships between basic and instrumental activities of daily living, use of assistive mobility devices, socioeconomic factors, changes during COVID-19 pandemic confinement, and 3-year survival in the ADL-dependent people of the Orcasitas neighborhood of Madrid (Spain). Methods A longitudinal descriptive study, carried out on the entire population of functional dependent patients (Barthel ≤ 60) in the Orcasitas neighborhood. We included 127 patients, 78.7% women and 21.3% men, with a mean age of 86 years. Pre-pandemic, post-confinement (June 2020) and June 2023 data were contrasted. Results Results: The use of crutches-cane was associated with a higher probability of being independent in performing ADLs, leaving home (OR 4.848; CI 1.428–16.458), improving functional capacity during confinement (OR 3.621; CI 1.409–9.308), and even ceasing to be functionally dependent (OR 0.394; CI 0.165–0.941). Using a wheelchair was associated with a higher level of dependency (OR 2.583; CI 1.167–5.714) and higher mortality (HR 1.913; CI 1.106–3.309). After COVID-19 pandemic confinement, having a financial income of less than 11,200 euros/year (OR 2.413; CI 1.159–5.023), or using a wheelchair (OR 2.464; CI 1.009–6.017), increased the risk of living homebound. Living homebound decreased the probability of survival, while maintaining the ability to leave home increased it (OR 3.880; CI 1.834–8.211). Economic capacity modulated the results. Lower economic capacity was associated with higher mortality (HR 2.47 (Exp(B) 0.405; CI 0.232–0.708). Living in confinement and having a low economic income were associated with higher mortality (OR 0.127; CI 0.029–0.562), mortality that was also higher with respect to those who could leave their home (OR 6.697; CI 2.084–21.525). Conclusions Functional ADL-dependence affects multiple facets of the person. Confinement triggered changes in the baseline conditions of this cohort, which were influenced by the level of dependency, mobility capacity and economic income level. Economic capacity modulated the results, showing that social inequalities influence survival. The ability to leave home and the use of a wheelchair should be included in the assessment of the risk level of this population group.

Barriers and strategies affecting the use of assistive devices for falls prevention among people with Parkinson’s disease: a qualitative pilot study

BackgroundAs Parkinson’s disease (PD) progresses, patients experience difficulties with gait and balance, requiring assistive devices to ensure fall prevention and safety. Despite the advantages provided by these aids, many people with PD do not adhere to their use.ObjectiveThis study aims to explore the barriers to using assistive devices among people with PD and identify strategies to improve their adherence.MethodsWe used a qualitative, exploratory, and descriptive research design. Individual semi-structured interviews were conducted from October 2021 to July 2022, with participants selected through convenience sampling. Thematic analysis was performed to analyze data.ResultsNineteen participants were interviewed, with the majority being male (63.2%) and a mean age of 72.3. This research identified several barriers to using assistive devices that were grouped under six broad themes and 14 subthemes. These themes included disease symptoms, physical limitations associated with holding the device, stigma, symbolism of the device, level of involvement of health professionals, and environmental factors. Concerning the strategies to improve adherence, they were grouped into themes that reflect different priority settings in the health sector. At the macro level, participants emphasized the significance of community education and intergenerational contact. At the meso level, participants highlighted the need for support groups, as well as prescription and training provided by health professionals. Finally, at the micro level, participants emphasized the importance of tailored care and shared decision-making.ConclusionThis study’s findings offer insights on barriers and strategies reported by people with PD, improving assistive device utilization.

Medical Needs of Very-Low-Birth-Weight Preterm Infants Post-Discharge: A Population-Based Study in Taiwan

Introduction: The aim of this study was to explore the outcomes, home use of medical assistive devices, and interdisciplinary medical needs of very-low-birth-weight (VLBW) infants at a corrected age of 2 years. Methods: Analyses were performed using perinatal, neonatal, and 2-year follow-up data from VLBW infants registered in the Taiwan Premature Infant Follow-up Network (TPFN) between 2011 and 2017. Basic information, survival, and disease conditions during hospitalization were recorded. Medical needs at discharge, outcomes at a corrected age of 2 years, active involvement in outpatient healthcare services, and referrals were investigated. Results: From 2011 to 2017, a total of 9,243 VLBW preterm neonates were enrolled in the TPFN. Of these neonates, 140 had severe congenital anomalies, 8,044 survived to discharge, and 6,150 returned for follow-up evaluation. At discharge, 10.2% of infants received home oxygen therapy (HOT), and 6.5% used home monitoring devices. Among the infants diagnosed with chronic lung disease, 26.6% received HOT. At a corrected age of 2 years, the most common interventions and recommended referrals were rehabilitative treatments (34.5%), followed by early intervention system services (16.5%), ophthalmology/otolaryngology management (4.4%), neurological follow-up (4.1%), and mental health assessment and treatment (2.5%). Conclusion: After hospital discharge, VLBW preterm infants exhibit substantial healthcare needs, with significant demands of HOT, rehabilitation, and early intervention services by a corrected age of 2 years. These findings highlight the importance of coordinated outpatient care and long-term follow-up to address the developmental and medical challenges faced by this vulnerable population.

Effects of Lower Limb Position and Peri-Hip Muscle Co-Contraction on the Efficiency of Voluntary Pelvic Floor Muscle (PFM) Contraction During PFM Exercises.

Pelvic floor muscle (PFM) exercises are essential for managing stress urinary incontinence (SUI), and various approaches, including differing lower limb positions and the use of assistive devices, have been proposed to enhance their effectiveness. This study aimed to evaluate how different lower limb positions and co-contraction of peri-hip muscles affect the efficiency of voluntary PFM contractions. Nineteen healthy female participants performed four types of PFM exercises: supine (Exercise A, Ex-A), supine kneeling (Exercise B,Ex-B), supine kneeling with hip abduction (Exercise C,Ex-C), and supine kneeling with hip adduction (Exercise D,Ex-D). Bladder base elevation, as an indicator of PFM contraction efficiency, was assessed using ultrasound. The results showed that the supine kneeling position (Ex-B) produced significantly greater bladder base elevation compared to the standard supine position (Ex-A) (p < 0.01). However, adding hip abduction or adduction (Ex-C and Ex-D) led to significantly lower elevations than Ex-B (p < 0.01), suggesting that co-contraction of the peri-hip muscles may reduce the efficiency of voluntary PFM contractions. This study indicates that the supine kneeling position is the most effective posture for PFM exercises, emphasizing the importance of avoiding unnecessary peri-hip muscle engagement to maximize contraction efficiency. These findings may help improve exercise protocols for preventing and managing SUI. However, a limitation of the study is the exclusive inclusion of young, healthy women; further research is needed in SUI patients or at-risk populations to confirm these results and develop more targeted exercise strategies.

Prevalence of Patellofemoral Pain Syndrome Among Security Guards

Background: Patellofemoral Pain Syndrome (PFPS) is a prevalent musculoskeletal condition associated with anterior knee pain, often affecting individuals in physically demanding occupations. Despite its clinical importance, there is a lack of evidence on PFPS prevalence in security guards, a population frequently exposed to prolonged standing and repetitive knee stress. This study addresses the gap by assessing PFPS prevalence and age-related trends in this occupational group. Objective: To determine the prevalence and severity of Patellofemoral Pain Syndrome among male security guards aged 30–50 years, and to analyze its association with age-related occupational exposure. Methods: A cross-sectional study was conducted among 323 male security guards recruited through convenience sampling from hospitals and shopping malls in Gujranwala. Participants aged 30–50 years with at least one year of work experience were included, while individuals with orthopedic conditions, congenital abnormalities, or assistive device use were excluded. PFPS was assessed using the Kujala Anterior Knee Pain Scale. Ethical approval was obtained from the CMH Gujranwala Research Committee, and the study complied with the Declaration of Helsinki. Statistical analysis was conducted using SPSS v27, employing descriptive statistics and Chi-square tests to assess associations. Results: Moderate PFPS was observed in 39.0% of participants, with the highest prevalence in the 45–50-year age group. A statistically significant association between age and PFPS severity was found (χ² = 216.837, p &lt; 0.001), indicating increased risk with advancing age. Clinically, the findings reflect a considerable burden of PFPS related to occupational stress. Conclusion: PFPS is highly prevalent among security guards, particularly in older age groups, highlighting the occupational risk posed by prolonged standing and repetitive knee activity. These findings support the need for preventive strategies and ergonomic interventions to reduce PFPS-related disability in labor-intensive professions.

A study on the perception, learning experiences, and preferences in music among hard-of hearing adults.

The purpose of this study was to investigate the music perception, learning experiences, and preferences of adults with hard-of-hearing and to examine how these factors vary depending on the type of rehabilitative assistive devices they use. A total of 107 adults with hard-of-hearing participated in a questionnaire consisting of 25 items related to music perception, learning experiences, and preferences with desires for learning music. The participants demonstrated a relatively high ability to perceive and identify music sounds, although they experienced difficulties in fully appreciating music while using rehabilitative assistive devices. Despite these challenges, participants expressed a strong desire to engage in music learning, with a particular interest in elements that foster enjoyment, rhythm, and tactile-based learning. Significant differences were observed between groups wearing different types of rehabilitative assistive devices and those not wearing devices, particularly in terms of the recognition of emotional content in songs (P = .003), music preference (P = .019), and perception level of music sounds (P = .000). In addition, significant differences were found in the consideration of self-learning function (P < .05) and listening to songs function (P < .05) when developing music-learning devices based on the use of rehabilitative assistive devices. Based on these research findings, priorities for the development of music-learning devices for adults with hard-of-hearing and relevant technological considerations have been proposed.