bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inclusive design of tools for daily living
Authors: Swann Julie 
Published: May 2014

All humans, irrespective of their age or environment, use tools to facilitate daily living tasks. Humans are not the only species to use tools, and the use of tools to assist those with disabilities is not a modern day concept. However, the development of new materials, mass production, transportation, technology and communication has helped to develop a wide range of assistive equipment for people with disabilities. This article examines the history of assistive equipment and how the concept of inclusive design has contributed to its development. It then explains why society should encourage the development of more inclusive design features and how therapists can be involved in this process.
The JCM Moonlite Sleep System: Assisting in the provision of 24-hour postural support
Authors: Collins Fiona 
Published: May 2014

Children and adults with mobility problems often suffer with contraction of unused muscles, which can consequently pose a risk to joint stability. Both contraction and joint instability can be extremely painful, leading to among other issues, poor quality of sleep. Although seating provision attempts to maintain appropriate posture during the day, suitable equipment provision must also be considered for the night. Sleep systems aim to provide appropriate support, promote postural symmetry and increase quality of sleep. This article discusses the Moonlite Sleep System, manufactured by JCM. It describes the features and benefits of the system and summarizes client feedback to date.
Help-seeking for medically unexplained hearing difficulties: A qualitative study
Authors: Pryce Helen , Wainwright David 
Published: May 2014

Aims Up to 10% of audiology patients report diffi culties hearing speech in noise even though clinical investigation reveals normal hearing thresholds, in other words, no evidence of physical pathology. The diagnostic category applied to these patients is known as King-Kopetzky Syndrome (KKS). This study aimed to gather descriptions of patients' experiences of the clinical encounter involving their KKS diagnosis and analyse the themes of help-seeking, as part of a larger study into the process of coping with medically unexplained hearing diffi culties. Method A qualitative approach was employed, comprising unstructured interviews in the homes of 25 patients who had attended audiology services (and received a diagnosis of KKS) in Bath and Cardiff. Thematic analysis of transcripts was undertaken, infl uenced by grounded theory techniques. Findings Informants characterized the clinical encounter as either negative or positive. Negative consultations were those in which patients' illness claims were dismissed and as such not validated. Positive encounters were typifi ed by the provision of meaningful information that reconciled clinical information with the patients' experiences of hearing loss. Conclusion Successful management of medically unexplained illnesses requires the adoption of a patient-centred approach, rather than focusing on the absence of observable pathology
Baby boomers' use and perception of recommended assistive technology
Authors: Steel Dianne M , Gray Marion A 
Published: May 2014

Aims The aim of this study was to enhance the understanding of the baby boom generation's use and perception of recommended assistive technology. Methods A mixed quantitative and qualitative research design was employed, primarily based on a phenomenological framework. Literature was reviewed to provide an overview of the factors found to influence the use of assistive technology. Twelve patients (born 1946-1965 inclusive) from a regional Australian public hospital, who were recommended assistive technology upon discharge, were administered questionnaires. Semi-structured interviews were undertaken with four participants. Findings Eight participants followed recommendations to hire/purchase assistive technology. All of the participants who obtained recommended assistive technology stated they ‘used’ it. Cost was identified as influencing non-use. Conclusions There was some variation from the literature in factors that influenced use, highlighting the importance of further examination of baby boomers and assistive technology use. The importance of choice and the diversity of opinion shown within this study group reinforces the need for a focus on patient-centred practice and acknowledgement of individual needs in the prescription of assistive technology.
The availability and use of allied health care in care homes in the Midlands, UK
Authors: Sackley C , Hoppitt T , Cardoso K , Levin S 
Published: May 2014

Aims A review by an international charity for older people, Help the Aged, suggested that older people living in care homes in the UK do not receive the appropriate levels of access to health professionals. The authors aimed to establish the access to and use of services provided by allied health professions to care homes in Oxfordshire and Warwickshire. Methods A postal survey with telephone follow up of the use of and access to allied health-care services in 121 Oxfordshire and Warwickshire care homes was conducted using an established questionnaire. Findings The majority of homes reported using a chiropodist (91%), an optician (86%), hearing services (63%) and a physiotherapist (65%). Less than half of the homes reported using an occupational therapist (41%), a dietician (44%) or a speech and language therapist (39%). A third used an alternative therapist (35%) and a similar number (35%) a social activities organizer. There was inconsistency in the sources of funding and the reasons for referral, particularly regarding occupational therapy and the provision of aids and adaptations. Conclusions The expertise of allied health-care professions available in UK hospital and domiciliary National Health Service (NHS) settings is not evident or accessible in the care home setting unless funded privately. When taking into account the high levels of impairments in these settings, access would appear to be contrary to the UK National Service Framework for Older People, which suggests that the NHS will provide a universal service for all based on clinical need, not ability to pay.
Bilateral movement therapy post-stroke: underlying mechanisms and review
Authors: Tabak Rachel , Plummer-D'Amato Prudence 
Published: May 2014

Aims Up to 66% of individuals with stroke never regain functional use of their upper extremities. Bilateral movement training (BMT) is a task-specific rehabilitation technique that has recently been investigated for its influence on upper extremity recovery in individuals post-stroke. BMT is thought to affect the hemiparetic upper extremity by a phenomenon referred to as cross education, or the cross transfer effect. Methods This article reviews the theoretical accounts underlying the cross transfer effect and explain the means by which BMT may facilitate recovery of function in the hemiparetic arm. The current research evidence supporting the use of BMT as a therapeutic approach to stroke rehabilitation is discussed, and implications for clinical practice and recommendations for further research are presented. Findings Evidence is emerging that BMT improves impairments and function in people with hemiparesis after stroke. The main limitations of existing research on BMT include small sample sizes, varying initial impairment levels, and lack of control groups. Conclusions Future research needs to establish which individuals are most likely to benefi tfrom BMT, as well as the optimal dose of BMT, and whether BMT can be used as an adjunct to existing rehabilitation approaches for upper extremity rehabilitation.
Length of stay in an Australian stroke rehabilitation unit: a pilot study
Authors: Roberts Kate , Stiller Kathy , Harling Rachel 
Published: May 2014

AimsLength of stay (LOS) is an important consideration in rehabilitation, and it can be adversely affected by delayed discharge. The purpose of this prospective study was to document LOS, frequency of discharge delay, reasons for discharge delay and its impact on LOS.MethodsNinety-eight inpatients in a stroke rehabilitation unit were included in the study.FindingsSixty (61%) patients had a LOS that exceeded the Australasian Rehabilitation Outcomes Centre (AROC) benchmark LOS according to the Australian National Sub-acute and Non-acute Patient classification system. Twenty-five (26%) patients had delayed discharge resulting in a total delay of 886 days, with most of these related to delays in the provision of community services. When patients with discharge delay were factored out of analyses, LOS was still longer than AROC benchmark figures for 39 (57%) of the 69 patients without discharge delay.ConclusionsThe LOSs of the majority of patients included in this study were longer than the AROC benchmark figures, even when patients with discharge delay were factored out. Initiatives to address this problem include the implementation of a proactive computerized tool that will provide target LOSs and enable reasons for excessive LOS to be more closely examined.
Heterotopic ossification following cardiac arrest and hypoxic brain damage
Authors: Mackiewicz-Milewska Magdalena , Jung Stanislaw , Lach-Inszczak Sabina , Borland Steve , Szymku Iwona , Cieski Jakub , Cisowaka Adamiak Magorzata , Hagner Wojciech , Lasek Wladislaw 
Published: May 2014

Aims Heterotopic bone can cause restriction of movement when deposited in the soft tissues around joints. Neurogenic heterotopic ossification may follow brain injury. This article describes research into the incidence of heterotopic ossification after brain injury, and its impact on rehabilitation. Methods Thirty-nine patients who were admitted to the rehabilitation unit of University Hospital Bydgoszcz, Poland, after hypoxic brain injury due to cardiac arrest, were examined. Findings Six patients were identified as having developed heterotopic bone around one or more joints causing limitation of movement and delay in the rehabilitation process. Conclusions Heterotopic ossification occurs in up to 15% of patients following hypoxic brain injury. The development of the condition may often be missed clinically, and can hinder rehabilitation.
Social support and subjective health complaints in occupational rehabilitation
Authors: Øyeflaten Irene , M Gabriele Jeanne , B Fisher Edwin , R Eriksen Hege 
Published: May 2014

Aims The objective of this study was to examine differences in the social support rehabilitation patients received from rehabilitation staff and from support providers outside rehabilitation, and to examine the relationships between social support and the patients' reports of subjective health complaints (SHC). Methods A total of 131 patients (68% female, mean age 45 years) participating in a 4-week, inpatient, occupational rehabilitation programme were included. All patients completed questionnaires on demographic variables, SHC, and social support (Social Support Inventory, SSI) received from rehabilitation staff and from support providers outside rehabilitation. The factor structure of the Norwegian version of SSI was analysed identifying two factors; directive and nondirective social support. Findings Patients reported significantly more support from rehabilitation staff than from support providers outside rehabilitation, and they reported significantly more nondirective support compared to directive support. High directive support from providers outside rehabilitation was associated with more subjective health complaints. Conclusions Fully understanding the role of social support in health and well being will require attention not only to the source of support but also to its characteristics and nature, such as whether it is nondirective or directive.
An HIV mentorship programme for rehabilitation professionals: lessons learned from a pilot initiative
Authors: Solomon Patricia , O'Brien Kelly , Hard Julie , Worthington Catherine , Zack Elisse 
Published: May 2014

Aims: This article describes a pilot programme aiming to identify the strengths and challenges associated with a human immunodeficiency virus (HIV) mentorship programme for rehabilitation professionals. Methods: This unique pilot programme incorporated elements of problem-based learning, interprofessionalism and multiple mentoring models. A group of five physiotherapy mentees met initially with three clinician mentors, and three mentors who were persons living with HIV, for a one day workshop to develop relationships, identify learning needs and engage in learning through discussion of case scenarios. Subsequently they met formally every month via teleconference, over a five-month period, followed by a final one-day workshop. Qualitative evaluation included interviews and focus group methodology. Transcripts from these were analyzed through qualitative content analyses. Findings: Participants viewed the mentorship programme positively, in particular the networks they were able to establish, and learning from the mentors living with HIV. However, barriers to participation were related to scheduling and lack of support to devote time to the programme from the mentees' clinical managers. Other challenges related to the mentees' limited opportunities to implement new knowledge, and to difficulties in engaging in informal mentorship activities. Conclusions: Lessons learned from this pilot programme are of value to those interested in developing HIV-related mentorship experiences for rehabilitation health professionals or for those in other emerging areas of practice.
A study of perceived factors affecting patients' participation in outpatient stroke physiotherapy exercise in Nigeria
Authors: Olaleye Omowunmi , Suddick Kitty 
Published: May 2014

Background/Aims: Stroke results in a range of disabilities, activities and restrictions which have been shown to benefit from physiotherapy rehabilitation and exercise. However there are numerous factors that prevent stroke patients from participating in their exercise programmes. The aim of this study was to explore the factors that were perceived to affect people with stroke in Nigeria in participating in their outpatient physiotherapy exercise. Methods: Semi-structured interviews were used to explore the topic. The interviews were transcribed and analyzed using thematic analysis. Eight male participants with stroke who were attending outpatient stroke physiotherapy in Nigeria were recruited in December 2009. Findings: The factors that were perceived to affect the participants' participation in their outpatient physiotherapy programme encompassed three dimensions: the internal and personal, the relational and experiential, and external factors. These dimensions were interconnected with the internal and personal factors being central to the participants' participation. Conclusions: This study has provided an insight into the factors that were important for a small group of Nigerian men post-stroke who were receiving out-patient stroke physiotherapy. This can lead to further research that could assist in informing the development of clinical practice and services.
Comparing the effects of rhythmic auditory cueing and visual cueing in acute hemiparetic stroke
Authors: Chouhan Swati , Kumar Sanjiv 
Published: May 2014

Introduction: Every individual requires proper upper limb functions as well as proper walking balance to meet day-to-day demands. Some of the most common problems faced after stroke are balance problems, which, in turn affect the recovery of activities of daily living (ADL), mobility, and lead to an increased risk of falls. In addition, about 80% of all stroke survivors have an upper limb paresis immediately after stroke affecting gross motor and fine motor problems. Objective: To evaluate the effectiveness of rhythmic auditory stimulation and conventional treatment on gross motor, fine motor activities, and walking imbalance; to evaluate the effectiveness of visual cues and conventional treatment on gross motor, fine motor activities, and walking imbalance; and to compare the effectiveness of rhythmic auditory stimulation and visual cueing with conventional treatment on gross motor, fine motor activities, and walking imbalance. Methodology: Design-a randomised controlled trial of 45 participants in acute stage were recruited. The subjects selected for the study were randomly allocated using sealed envelopes into three groups Group A-rhythmic auditory stimulation and conventional treatment, Group B-visual cueing and conventional treatment, Group C-conventional treatment. Outcome measures: Dynamic gait index and upper extremity Fugl Meyer motor score. Result: After one month of therapy a comparison of the groups showed a statistically significant improvement in all three groups independently (P=<0.05 in Group A, B, and C). On comparing post scores between the groups, a statistically significant difference was found between group A and C, and group B and C data (P=<0.05). Conclusion: Both the therapies were effective for gross motor, fine motor, and gait imbalance in acute hemiparetic stroke.
Falls risk factors and healthcare use in patients with a low-trauma wrist fracture attending a physiotherapy clinic
Authors: O'Reilly Ciara , Keogan Fiona , Breen Roisin , Moore Alan , Horgan N Frances 
Published: May 2014

Background: Falls continue to be the most common cause of injury for those aged over 65 years of age. The aim of this study was to characterise multifactorial falls risk factors in participants who had sustained a low-trauma wrist fracture and identify their healthcare use. Methods: This was a case-control, observational study, incorporating a comprehensive multifactorial falls assessment on 41 consecutive adults between 55 and 80 years who sustained a low-trauma wrist fracture and were compared to 41 age-matched healthy controls. The assessments included falls history, balance, footwear, vision, lower-limb strength, cognition, self-efficacy and environmental hazards. Results: The mean age of the wrist fracture group was 67.3 (SD ± 7.0) and that of the age-matched controls was 68.5 (SD ± 5.7). There were statistically significant differences between the wrist fracture participants and the control participants in: the Timed Up and Go test (TUG) (P<0.002); the Modified Clinical Test of Sensory Integration and balance (M-CTSIB) (P<0.001); knee flexor strength (right: p<0.006, left: P<0.019); and cognition (P<0.009). There were higher levels of healthcare demands and medical interventions (referral to GP P<0.001; geriatrician P<0.04) and for further physiotherapy (P<0.001) for the participants following a low-trauma wrist fracture. Conclusions: The findings of this study highlight the need for a targeted falls prevention screening tool and intervention programmes for patients over 55 years of age who sustain a low-trauma wrist fracture.
Cervical disc herniation: Is the regression flawed by age? A case report
Authors: Di Ciaccio Emanuele , Polastri Massimiliano , Gasbarrini Alessandro 
Published: May 2014

Introduction/aim: Spontaneous regression of the herniated disc in the cervical tract is rare, and conservative treatment should be considered as a therapeutic option. This case study aims to describe the course of the recovery from cervical disc herniation (CDH) within a conservative care pathway using global postural reeducation (GPR). Methods: A 74-year-old Caucasian woman with a body mass index of 20.3 was diagnosed with CDH. She had a 4-month history of neck-arm burning pain and short-term dizziness. The treatment goals for the patient were: relief of her neck-arm pain; reduction of the dizziness; improvement in neck flexion and extension range of motion. The first treatment using GPR started 4 months after symptom onset and treatment was provided in an outpatient setting by the same physiotherapist each time. Eight, 1 hour therapeutic sessions were carried out weekly. The chosen exercises were: frog on the ground with upper limbs in abduction, and frog on the ground with upper limbs in adduction. Results: Two months after treatment initiation, neither flexion nor extension were painful, and the patient was able to perform movements that the symptoms previously compromised. Conclusions: This study is the first to describe the treatment of CDH in an older patient and the study raised two additional questions for further studies necessary to determine the effectiveness of GPR in this context. First, was the resolution described in this case report linked to a natural course? Second, is GPR effective for the treatment of CDH?
Barrett's oesophagus
Authors: Kochhar Suneeta 
Published: May 2014

“Barrett's oesophagus or columnar-lined oesophagus refers to oesophagus where the normal squamous lining has been replaced by a metaplastic columnar epithelium. Barrett's oesophagus is a pre-malignant condition of oesophageal adenocarcinoma. About 10-15 per cent of patients with reflux disease develop Barrett's oesophagus. If surveillance endoscopy is considered appropriate, it should be carried out every two years.”
Providing medical aid to Brazzaville, the Republic of Congo
Authors: King Richard 
Published: May 2014

Following five explosions in Brazzaville, the Republic of Congo on 4 March 2012, a field hospital was flown in from South Africa to help deal with the aftermath. Donated by the Ichikowitz Family Foundation, it aimed to treat the injured patients who were in excess of 2 300. On arrival, a singular old-style army tent, sponsored by the French petroleum company Total, was the only medical service on the site. The tent was manned by staff from the French charity Médecins d'Afrique. Building the hospital from the ground up took eight days and several late nights, during which time the population of the neighbouring refugee camp was growing. A four metre high wooden fence was built around the camp and hospital to keep some sort of control. The Red Cross and several other non-governmental organisations (NGOs) became actively involved, supplying clean water and food aid to the people. Since the events of 4 March 2012, the field hospital has gone on to provide medical aid to the communities of Brazzaville, dealing predominantly with human immunodeficiency virus (HIV), tuberculosis (TB), cholera, hepatitis A, typhoid and malaria. This article is a personal perspective that explains the origins of the field hospital and the work that it has done since 2012.