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Participation Restriction (participation + restriction)
Selected AbstractsEnergy efficiency in gait, activity, participation, and health status in children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2008Claire Kerr BSc (Hons) Physio PhD The aim of the study was to establish if a relationship exists between the energy efficiency of gait, and measures of activity limitation, participation restriction, and health status in a representative sample of children with cerebral palsy (CP). Secondary aims were to investigate potential differences between clinical subtypes and gross motor classification, and to explore other relationships between the measures under investigation. A longitudinal study of a representative sample of 184 children with ambulant CP was conducted (112 males, 72 females; 94 had unilateral spastic C P, 84 had bilateral spastic C P, and six had non-spastic forms; age range 4-17y; Gross Motor Function Classification System Level I, n=57; Level II, n=91; Level III, n=22; and Level IV, n=14); energy efficiency (oxygen cost) during gait, activity limitation, participation restriction, and health status were recorded. Energy efficiency during gait was shown to correlate significantly with activity limitations; no relationship between energy efficiency during gait was found with either participation restriction or health status. With the exception of psychosocial health, all other measures showed significant differences by clinical subtype and gross motor classification. The energy efficiency of walking is not reflective of participation restriction or health status. Thus, therapies leading to improved energy efficiency may not necessarily lead to improved participation or general health. [source] A survey of foot problems in juvenile idiopathic arthritisMUSCULOSKELETAL CARE, Issue 4 2008G. Hendry BSc(Hons) Abstract Background:,Evidence suggests that foot problems are common in juvenile idiopathic arthritis (JIA), with prevalence estimates over 90%. The aim of this survey was to describe foot-related impairment and disability associated with JIA and foot-care provision in patients managed under modern treatment paradigms, including disease-modifying anti-rheumatic drugs (DMARDs) and biologic therapies. Methods:,The Juvenile Arthritis Foot Disability Index (JAFI), Child Health Assessment Questionnaire (CHAQ), and pain visual analogue scale (VAS) were recorded in 30 consecutive established JIA patients attending routine outpatient clinics. Foot deformity score, active/limited joint counts, walking speed, double-support time (s) (DS) and step length symmetry index % (SI) were also measured. Foot-care provision in the preceding 12 months was determined from medical records. Results:,Sixty-three per cent of children reported some foot impairment, with a median (range) JAFI subscale score of 1 (0,3); 53% reported foot-related activity limitation, with a JAFI subscale score of 1 (0,4); and 60% reported participation restriction, with a JAFI subscale score of 1 (0,3). Other reported variables were CHAQ 0.38 (0,2), VAS pain 22 (0,79), foot deformity 6 (0,20), active joints 0 (0,7), limited joints 0 (0,31), walking speed 1.09,m/s (0.84,1.38,m/s), DS 0.22,s (0.08,0.26,s) and SI ±4.0% (±0.2,±31.0%). A total of 23/30 medical records were reviewed and 15/23 children had received DMARDS, 8/23 biologic agents and 20/23 multiple intra-articular corticosteroid injections. Ten children received specialist podiatry care comprising footwear advice, orthotic therapy and silicone digital splints together with intrinsic muscle strengthening exercises. Conclusion:,Despite frequent use of DMARD/biologic therapy and specialist podiatry-led foot care, foot-related impairment and disability persists in some children with JIA. Copyright © 2008 John Wiley & Sons, Ltd. [source] Rehabilitation of olfaction post-laryngectomy: a randomised control trial comparing clinician assisted versus a home practice approachCLINICAL OTOLARYNGOLOGY, Issue 1 2010E. Ward Clin. Otolaryngol. 2010, 35, 39,45. Objectives:, To determine (i) the prevalence of impaired olfaction in a group of individuals post-laryngectomy, and (ii) whether intensive, clinician-supported training of the Nasal Airflow Inducing Manoeuvre (NAIM) was more effective at improving olfactory acuity than intensive, home practice over a 6-week period. Designs:, Cohort study followed by a randomised control trial of two treatments over a 6-week period with a 3-month review. Participants:, Olfactory acuity was evaluated in 43 laryngectomy patients. Results revealed 95% had impaired olfactory acuity (anosmic or hyposmic). From this group 40 eligible participants with reduced olfactory acuity were then randomly assigned into either the clinician-supported or home practice treatment group. Main outcome measures:, Olfactory acuity and functional impact measures relating to olfactory acuity (participation restriction, wellbeing/distress). Results:, Although olfactory acuity significantly improved in both treatment groups following 6 weeks of therapy, results indicated significantly greater improvement in the clinician-assisted group immediately post-treatment. By 3 months, post-treatment effects were maintained. Both modes of treatment improved levels of patient wellbeing, however, only the clinician-assisted mode made a significant positive effect on levels of perceived participation restriction. Conclusion:, Reduced olfactory acuity is prevalent post-laryngectomy. Olfactory acuity can be significantly improved using either 6 weeks of clinician-assisted or home practice using the NAIM manoeuvre, although the current data suggest that intensive clinician-assisted treatment can assist patients to improve more rapidly and have a positive impact on functional state. [source] Disability and employment among U.S. working-age immigrantsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2010Huiyun Xiang MD Abstract Background There is little research which examines disability status and the employment decisions of the US immigrant working-age population. Methods The 2007 American Community Survey data were analyzed to compare disabilities and employment characteristics between immigrant and US-born adults 18,64 years of age. Separate logistic regression models of employment were constructed among persons with disabilities and among persons without disabilities. Each multivariate model included nativity/citizenship, sex, race/ethnicity, age, and education. Results In 2007, 40.8% (95% CI: 39.9,41.7) of immigrants with disabilities were employed, while only 34.9% (95% CI: 34.6,35.2) of US-born persons with disabilities were employed. For each type of disability, including difficulty working, immigrants with disabilities were more likely than their US-born counterparts to be employed. The median wage/salary incomes for persons with disabilities, foreign-born and US-born, respectively, were $20,000 and $22,000. In contrast, the median wage/salary incomes of foreign-born persons with mental impairments, self-care limitations, or participation restrictions exceeded those of US-born persons with these same disabilities. Nativity and citizenship had different effects in separate logistic models of employment for persons with disabilities and persons without disabilities. Among persons with disabilities, foreign-born citizens were more likely to be employed than the US-born, OR,=,1.40 (95% CI: 1.33,1.48), and non-citizens were also more likely to be employed, OR,=,1.74 (95% CI: 1.62,1.87), than US-born persons. Among persons without disabilities, foreign-born non-citizens were less likely to be employed than the US-born, OR,=,0.82 (95% CI: 0.82,0.85). Conclusion Immigrants with disabilities were more frequently employed than US-born persons with disabilities for all types of disabilities. Am. J. Ind. Med. 53:425,434, 2010. © 2010 Wiley-Liss, Inc. [source] Children's participation in home, school and community life after acquired brain injuryAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2010Jane Galvin Aims:,This study aimed to describe participation at home, school and in the community of Australian children who had sustained an acquired brain injury (ABI). Parent ratings regarding the impact of cognitive, motor and behavioural impairments on participation were obtained. In addition, the influence of environmental factors on participation was investigated. Methodology:,This study used a cross-sectional design with convenience sampling to recruit 20 children who attended a rehabilitation review clinic between September 2006 and September 2007. Participants completed the Child and Family Follow-up Survey (Bedell, 2004) to describe the participation of their children in home, school and community settings. The CFFS was developed based on the International Classification of Function, and uses parent report to measure the impact of impairments and environmental factors on children's participation in home, school and community life. Results:,The children were reported to have the greatest participation restrictions for structured events in the community, and social, play or leisure activities with peers either at school or in the community. Children were least restricted moving about in and around their own homes. Conclusions:,This research describes difficulties encountered by Australian children with ABI in participating in community-based activities with their same aged peers. This study adds to the current literature describing patterns of participation of United States children who have sustained brain injuries, and provides useful information for Australian therapists to consider when addressing children's return to school and engagement with their peers following brain injury. [source] Interrater reliability of the Personal Care Participation Assessment and Resource Tool (PC-PART) in a rehabilitation settingAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2009Christopher Turner Background:,The Personal Care Participation Assessment and Resource Tool (PC-PART), formerly the Handicap Assessment and Resource Tool (HART), assesses the domains of clothing, hygiene, nutrition, mobility, safety, residence and supports. Aim:,To examine the interrater reliability of the PC-PART in a rehabilitation setting. Methods:,Assessments made by the researcher were compared to the interdisciplinary rehabilitation team. The research and standard assessments occurred within three working days. Raters were blind to each other's scores. Sample participants were a consecutive case-series of rehabilitation clients with varied diagnoses, activity limitations and participation restrictions. Of 66 consecutive patients seen during the a priori determined enrolment period, 25 were included in the study (nine males and 16 females, aged 44,85 years). The remaining 41 patients did not meet the inclusion criteria. Conclusion:,The PC-PART has good interrater reliability. Clinicians, administrators and researchers can be reassured about this aspect of the validity of the tool. [source] | ||||||||||