bluuebunny/crossref_metadata_2025_split huggingface dataset:
Energy expenditure of dressing in patients with stroke
Authors: Singh Anupa , Stewart Aimee , Franzsen Denise 
Published: May 2014

Aims: The primary aim of this study was to compare the energy expended and time taken in dressing the upper and lower body of 23 subjects who had survived a stroke within the previous 18 months, with a control group of subjects at risk from stroke. Secondary aims were to establish a relationship between energy costs and motor impairment, and the relationship between the energy expenditure and the subjects’ perceived level of exertion. Methods: Measurement of the energy expenditure and time taken to dress was done by means of a triaxial accelerometer. The accelerometer was used to convert total caloric expenditure (in kilocalories) to metabolic equivalents (METs) allowing comparability of the energy costs in the physical activity undertaken. The degree of motor impairment present in the limbs was also documented. Parametric data were analyzed using t-tests to establish if a difference between the two groups existed for age, height, gender, and energy expenditure. A linear regression was performed to determine a relationship between variables such as energy expenditure, time, and weight. An ANOVA was used to establish variances between the groups. Findings: Results indicated that significantly more energy was expended in dressing the upper body in the experimental group (P<0.05). No significant differences were found in the energy expenditure in dressing the lower limbs. Subjects with stroke took four times longer to dress than controls. Despite having active movement, stroke survivors were not able to translate this into the functional task of dressing. There was a linear relationship between the energy expenditure and perception of difficulty indicating a significant relationship between these variables. Conclusions: Recommendations include an increased awareness of therapists to understand the elevated energy expenditure in routine activities of daily living (ADL) tasks such as dressing in patients with a neurological disorder in order to re-engage them into ADL.
Platelet-rich plasma therapy as a first-line treatment for severe Achilles tendon tear: a case report
Authors: Sampson Steven , Aufiero Danielle , Meng Michael , Bledin Anthony , Gillette Terry , Zall Mona 
Published: May 2014

Steven Sampson, Danielle Aufiero, Michael Meng, Anthony Bledin, Terry Gillette, Mona Zall Background: This case report evaluates non-surgical ultrasound-guided injection of platelet-rich plasma (PRP) in a sports medicine setting, as a first-line treatment to repair a severely torn Achilles tendon of a 71-year-old male. Diagnosis was made through clinical examination and imaging, and follow-up data was collected at 6 and 24 weeks post-injection. Content: At 6 weeks post-injection, autologous PRP resulted in a substantial reduction of the Achilles torn fibres, with only minor focal tear evident on musculoskeletal ultrasound. At 24 weeks post-injection, the tear was completely resolved on MRI and the patient returned to full functional activity. Conclusions: Currently there is limited data, with mixed results, regarding PRP treatment for Achilles tendinopathy, and limited reports of using PRP in humans within the first few weeks of injury. This case report demonstrates success of early PRP therapy to repair a severe Achilles tendon tear, from both radiological and functional perspectives. However, larger controlled trials using follow up MRI and sonographic imaging are needed to determine if early PRP treatment post tendon injury would be a safe and effective alternative to accelerate healing.
Indicators facilitating research-based practice in allied health profession departments
Authors: Thomas Lois , Roddam Hazel , Baker Paula , French Beverley , Burton Christopher 
Published: May 2014

Lois Thomas, Hazel Roddam, Paula Baker, Beverley French, Christopher Burton Background: The implementation of research in practice is influenced not only by individual clinicians, but the organisational context in which they operate. Strategies aimed at increasing research use therefore need to incorporate a wider range of factors, rather than solely focusing on achieving change in individual practitioners. Content: This article presents findings relating to the identification of organisational factors facilitating research-based practice in allied health profession (AHP) departments. Fifty eight AHP clinicians and operational managers from nine teams participated in the study, representing four National Health Service organisations. Participants completed the benchmarking survey tool in their teams and were asked to provide examples of elements within their organisation which facilitated research-based practice in relation to 17 benchmarks of departmental context. Conclusions: The AHPs in this study provided a rich variety of indicators facilitating research-based practice in their organisations. There was some evidence of strategies in place to facilitate this at an organisational level but little evidence of collaboration across professional boundaries.
Chedoke Arm and Hand Activity Inventory-9 (CAHAI-9): a multi-centre investigation of clinical utility
Authors: Rowland Tennille , Gustafsson Louise , Turpin Merrill , Henderson Robert , Read Stephen 
Published: May 2014

Aims:Assessment of upper limb ability is a common focus of the occupational therapist in acute stroke. Chedoke Arm and Hand Activity Inventory - 9 (CAHAI-9) is an activity based assessment developed to include relevant functional tasks and to be sensitive to clinically important changes in upper limb function. The aim of this study was to investigate the clinical utility of CAHAI-9 in an acute stroke setting.Methods:Thirty-two occupational therapist participants from eight hospitals completed 100 CAHAI-9 assessments, on 92 patients with stroke, over six months. Occupational therapists completed questionnaires regarding the clinical utility of CAHAI-9.Findings:The mean patient age was 69 years and mean CAHAI-9 score was 39/63. The mean administration time was 16 minutes. Eighty-three percent of therapists indicated they would use CAHAI-9 again. Eight-seven percent agreed CAHAI-9 was useful for patients with mild and moderate (91%) upper limb deficits however only 25% agreed for severe deficits.Conclusions:The findings indicate that CAHAI-9 shows promise as an upper limb ability assessment in acute stroke, with therapists indicating they would use CAHAI-9 again. However, further investigation of the scoring issues may be warranted before CAHAI-9 is ready for clinical use in Australian acute care settings.
Early Stroke Discharge Team: a participatory evaluation
Authors: Moule Pam , Young Pat , Glogowska Margaret , Weare Jayne 
Published: May 2014

Aims: International evaluation of Early Stroke Discharge (ESD) has concentrated on measuring the impact of service provision. This research aimed to address the question, ‘How did the ESD team members and external stakeholders experience the service implementation process?’ Methods: Between October 2009 and February 2010, six team members and four external stakeholders were interviewed as part of a participatory evaluation. Interviews were used to explore the experiences of the process of inception and implementation of the team. Transcripts were subjected to thematic analysis. Findings: Five themes related to the experiences of the introduction of the ESD team: Setting up the team; team working experience; team within the context of other services and professionals; effectiveness in achieving aims; learning for the future. Within the themes issues relating to funding, leadership, team management and working were highlighted. Conclusions: It is clear that at the inception of a new ESD service it is crucial to engage all stakeholders in the development of the service, and review the interface with existing care provision. Decisions regarding the management and leadership of the team and professionals within it are also required, and should be guided by an understanding of the patient care pathway. While specific to the UK, this article provides information that is relevant internationally.
Effects of glossopharyngeal breathing on voice in cervical spinal cord injuries
Authors: Johansson Kerstin M , Nygren-Bonnier Malin , Klefbeck Brita , Schalling Ellika 
Published: May 2014

Aims: Glossopharyngeal Pistoning for Lung Insufflation (GI, also called glossopharyngeal breathing) is a method to increase vital capacity (VC) when respiratory muscle function is limited. The authors’ aims were to evaluate the effects of GI on voice and speech in people with cervical spinal cord injury (CSCI), and to document specific instantaneous effects of GI on voice and speech. Methods: Seven individuals with CSCI performed ten GI-cycles four days weekly for eight weeks. Intervention outcomes included spirometry, registration of the subglottal air pressure (PS), audio recording of speech and self-ratings with the Swedish version of the Voice Handicap Index (Sw-VHI). VC, PS and sound pressure level (SPL) were also registered with GI. Findings: Main changes pre/post intervention: Median SPL for syllable repetition increased 7.1 dB (P=0.046) and for loud reading 4.1 dB (P=0.018). Median phonatory instability decreased to 1.2% (P=0.046), median phrase length (words per breath) increased from 9.5 to 12.8 (P=0.004). Four participants pre and three post intervention scored >20 on Sw-VHI. With GI median VC increased 0.6 litres, median SPL for habitual voice increased 4.6 dB (P=0.030), for loud voice 7.2 dB (P=0.030) and median PS for loud voice increased 4.5 cm H2O (P=0.024). Conclusions: The results indicate some positive effects of GI on voice/speech and thus may support the implementation of GI in clinical practice.
Use of theoretical conceptual practice models by occupational therapists in the US: a pilot survey
Authors: Ikiugu Moses N. 
Published: May 2014

Background/Aims: The purpose of this study was to investigate if a sample of United States occupational therapists: 1) extensively used theoretical conceptual practice models to guide clinical decision-making; 2) combined theoretical conceptual practice models; 3) were interested in learning more about how to use the models and to combine them systematically in practice. Methods: The study was conducted using a survey questionnaire to gather data from 46 occupational therapists who were members of the American Occupational Therapy Association. Findings: The study participants perceived theory to be important as a guide to practice. They tended to combine models in clinical decision-making but the majority did not have a consciously thought-out systematic approach to doing so. Many were interested in learning more about how to use theoretical models and to combine them in clinical decision-making. Conclusions: The findings indicated that the study participants may benefit from and would be willing to participate in learning programmes designed to help them improve their theory application and specifically their theoretical model combination skills.
Effect of closed kinematic chain exercises in improving gait and function in cerebral palsy: a case report
Authors: Anwer Shahnawaz , Equebal Ameed , Kumar Ratnesh , Nezamuddin Md. 
Published: May 2014

Background and purpose: Recent research shows that functional therapy programmes lead improvement in motor abilities of children with cerebral palsy (CP). Many studies reported the effect of closed kinematic chain (CKC) exercises in improving gait parameters. This case report describes the effect of CKC exercises in improving gait parameters of children with CP, thereby increasing functional independency. Case description: A 12-year-old male child with right-sided hemiplegic CP with 1+ spasticity on the Modified Ashworth Scale (MAS). The child was able to ambulate independently without walking aids. Intervention: The patient received CKC exercises for 30 minutes, 3 times a week for a period of 4 weeks. The CKC exercise programme included a static bicycling exercise, mini-squatting exercise, and step up and down exercise. The patient also received stretching exercises for the hamstring, quadriceps, and gastrocnemius muscles after CKC exercises. Results: An increase in step length, stride length, cadence, and velocity was noted. The patient also improved their functional status as measured by functional independence measure for children (WeeFIM). Conclusion: This study concluded that CKC exercises can improve gait parameters and functional status in CP. Further research is warranted to confirm the generalisability of these findings and to identify which sub group of CP might benefit from these exercises.
Return to work and wellbeing after stroke—a success story?
Authors: Trygged Sven 
Published: May 2014

Background: Persons still in the labour force some years after a stroke generally have overcome a great range of difficulties. This study builds on the assumption that return to work and wellbeing are strongly related. Aim: To explore long-term wellbeing among individuals who have returned to work after a stroke. Method: Interviews with ten members of a stroke association aged 39-56 were recorded and transcribed. An overall picture of these responses is presented along with one illustrative case. Results: In spite of having recovered reasonably well from the stroke, several of the interviewees were struggling to stay in the labour market. An important finding was that even many years post-stroke, working life was fragile and the future uncertain for several respondents. Also, contingent on the risk of losing services—for example disability transport—there was the fear of losing independence. Conclusions: This mainly exploratory study has turned up some interesting research ideas that need to be elaborated on in future studies.
The Paralympic Games: from a rehabilitation exercise to elite sport (and back again?)
Authors: Brittain Ian 
Published: May 2014

Background: The Paralympic Games, and their forebears the Stoke Mandeville Games, grew out of the rehabilitation of spinally injured military personnel at Stoke Mandeville Hospital, UK. Even though the Paralympic Games are rooted in a rehabilitation background they are now the second largest elite multi-sport event in the world after the Olympic Games. Content: Despite this move away from a rehabilitation model to an elite sporting model programmes have recently been introduced in Australia, Canada, the United Kingdom and the USA that use sport as an integral part of the rehabilitation of soldiers injured in current conflicts. These programmes are directly linked to the National Paralympic Committee (NPC) of each country and in some cases these soldiers are fast-tracked into that nation's Paralympic training programmes. This paper will look at some of the reasons why disability sport and the Paralympic Games have become so important and outline the role that they play in both rebuilding lives and as a form of social (re)education. Conclusion: The growing acknowledgement of the impact of sports participation upon the psychological and physical wellbeing of people with disabilities combined with the impact of disability sport in general and the Paralympic Games in particular upon non-disabled attitudes towards disability and the increasing number of soldiers severely injured in battle have conspired to re-new the link between injured military personnel and the Paralympic Games.
Street Soccer programme participation: Experiences of young people with psychosis
Authors: Lee Williams Philip , Lloyd Chris , King Robert , Paterson Michael 
Published: May 2014

Aims: This exploratory, qualitative, study aimed to identify why young people who had experienced psychosis consistently decided to attend the Street Soccer programme. Method: Patients using the early psychosis tertiary mental health service who were regularly attending the Street Soccer programme at the time of data collection were invited to participate in this exploratory qualitative study. Out of eight people invited, six young people agreed to be participants. All participants engaged in a one-to-one, semi-structured interview, which was recorded, transcribed and analysed using thematic analysis to reveal key themes related to the research question. Results: The key themes revealed from the thematic analysis included: needing to be encouraged to join the group; feeling welcomed and encouraged; gaining personal benefit (getting outside the house, getting fit, feeling less anxious) and increased desire to participate in new activities. Conclusions: Participation in the group programme was not dependent on participants having established treatment goals to initially attend but rather on persistent encouragement to attend by a health worker. The participants continued to attend the Street Soccer programme due to the group culture, and the tangible benefits they perceived were a result of their attendance.
Physical inactivity, depression and anxiety in acute stroke
Authors: Kroeders Rosalie , Bernhardt Julie , Cumming Toby 
Published: May 2014

Background: Physical inactivity and low mood are both common early after stroke, but it is unclear whether they are related. If they are found to be associated, this will have important implications for acute stroke care. Methods: We measured physical activity, using the Position Activity Logger (PAL2) electronic device, and psychological wellbeing, using the Irritability, Depression and Anxiety (IDA) scale, within 14 days of stroke. Findings: Patients were very inactive, spending a median of 96% of the day either sitting or lying down. Depressive symptoms were exhibited by 74% of patients, and anxiety symptoms were exhibited by 53% of patients. While depressive symptoms were not related to physical activity, there was some indication that patients with anxiety symptoms spent more of the day lying down and less of the day sitting, standing or walking than those without anxiety symptoms (P=0.06). Having a previous history of depression was strongly associated with mood problems in acute stroke. Conclusions: Understanding the relationship between physical activity and mood after stroke is important. It is possible that stroke patients with anxiety symptoms are reluctant to engage in out-of-bed activities in the acute stage.
Skilled nursing facility functional rehabilitation outcome: Analyses of stroke admissions
Authors: Shah Surya , Tartaro Christine , Chew Felicia , Morris Mike , Wood Christine , Wuzzardo Ashley 
Published: May 2014

Introduction:The purpose of this study was to facilitate programme evaluation in skilled nursing facilities (SNF) using activities of daily living to quantify productivity, to provide consistency in data management and to establish a stroke inpatient rehabilitation outcome benchmark.Method:A documentation system of ADL was designed and integrated into the electronic medical records; a prerecorded webinar was developed for training in the administration of the Modified Barthel Index (MBI); and a pilot study on 234 patients from 13 centres was completed to ensure the system was in place. SNF rehabilitation outcomes were determined from the changeover time in admission to discharge MBI scores in 2 041 stroke patients.Results:The mean age was 75.89 ± 13.69 years. The mean length of inpatient stay was 31.15 ± 21.82 days. Rehabilitation efficiency was 1.09 ± 1.1 points improvement in the MBI score per day. The degree of rehabilitation intervention effectiveness was 48.03 ± 31.90%. The rate of change indicates superior outcome.Future directions:The MBI is now being introduced across 37 States in the US and outcomes will be evaluated in approximately 26 000 persons to establish performance standards that SNF rehabilitation teams would expect for routine diagnostic related groups.
The Casey Allied Health Model of Interdisciplinary Care (CAHMIC): Development and implementation
Authors: Jacob Angela , Merrigan Rosemary , Roe Debbie , Brown Ted 
Published: May 2014

Background: Within the Allied Health Department at Casey Hospital, in Melbourne, Australia, a need for the development of an interdisciplinary care model was identified. The belief was that such a model would improve patient outcomes and staff ability to provide high-quality care. Objective: To outline the steps that were taken in developing, mapping, and formulating the Casey Allied Health Model of Interdisciplinary Care (CAHMIC). Methods: A mixed-methods approach consisted of a review of the relevant peer-reviewed literature, staff surveys, focus groups and quantitative data collection to investigate the scope of interdisciplinary practice that allied health staff provided. Findings: An initial survey involving 52 allied health staff revealed a high level of agreement between current practice and the existing literature identifying excellence in interdisciplinary care. A quantitative data collection over a 1-month period indicated that staff provided interdisciplinary care 49% of the time. From four focus groups they conducted, the authors identified five emergent themes about interdisciplinary care: interdisciplinary practice; effective interdisciplinary team structure and processes; collaboration; organisational culture; and outcomes. From these findings, the Casey Allied Health Model of Interdisciplinary Care (CAHMIC) was formulated. Conclusions: This research adds to the literature by investigating and describing the key components of an interdisciplinary team in terms of its structure and function, and how these attributes are perceived to contribute to the team members’ strong identification with, and valuing of, the model of care. The CAHMIC showed a high level of agreement with existing literature that identifies excellence in interdisciplinary care. The model has generated positive outcomes for staff and positive benefits for patient care. Other health services may find the CAHMIC to be a useful point of reference when investigating the interdisciplinary care they provide.
Chronic widespread pain and neurophysiological symptoms in joint hypermobility syndrome (JHS)
Authors: Clark Carol J , Khattab Ahmed D , Carr Eloise CJ 
Published: May 2014

BackgroundJoint Hypermobility Syndrome (JHS) is a multisystemic connective tissue disorder characterised by pain, tissue fragility and laxity. This study aims to investigate the prevalence of chronic widespread pain (CWP) and the extended neurophysiological features reported by a group of patients with JHS.MethodsNinety patients with JHS (mean age 34.7 ± 9.9 years), which was diagnosed in accordance with the Brighton criteria, and 113 healthy volunteers (mean age 35.7 ± 12.9) with no musculoskeletal pain participated in the study. A self-report questionnaire and pain chart were employed to collect data.ResultsCWP was reported by 86% of patients with JHS. The mean number of pain sites in this group was 9.8/17 ± 4.2. Fibromyalgia was reported by 19% of this group. Patients with JHS were significantly more likely to report the following than healthy volunteers: autonomic symptoms (70%, 12%); gastrointestinal symptoms (71%, 9%); and chronic fatigue syndrome (31%, 1%). Patients with JHS reported significantly higher mean functional difficulties scores (22.28 ± 4.90) than healthy volunteers (17.96 ± 3.73) (P<0.001), indicative of functional difficulties associated with developmental coordination disorder/dyspraxia.ConclusionPatients with JHS reported a wide range of neurophysiological symptoms of which CWP was a salient feature. There is a need to acknowledge and understand the extended symptoms associated with CWP in order to address the holistic needs of patients with JHS. Further studies and discussion are required to identify the complex inter-related multifactorial neurophysiological mechanisms in those with JHS.