bluuebunny/crossref_metadata_2025_split huggingface dataset:
The process of transformation in rehabilitation: what does it look like?
Authors: Jehanne Dubouloz Claire , King Judy , Ashe Brenda , Paterson Barbara , Chevrier Jacques , Moldoveanu Mirela 
Published: May 2014

IntroductionEducators and proponents of adult learning theory understand that adults can experience significant events in their lives that can lead to a process of transformation that challenges or changes pre-existing values, beliefs and behaviours. This process of transformation can occur at any point in an adult's life, including when learning to live with a chronic illness and disability. The purpose of this article is to introduce health care providers to the possible process of transformation during rehabilitation.ContentThe authors present a suggested model of the process of transformation in rehabilitation, one developed as part of a larger metasynthesis qualitative research project related to rehabilitation, physical health, chronic illness, and disability. The article proposes how this model could be helpful for health care providers when interacting with adults learning to live with chronic health conditions.ConclusionsThe process of transformation provides insight regarding the complexity of patients' experiences learning to live with chronic health conditions. The article concludes by identifying future directions for practice and research.
The effect of fear of movement on the lives of people with chronic low back pain
Authors: Ashby Samantha , Richards Kailee , James Carole 
Published: May 2014

AimsThis article looks at the effect that fear of movement can have on the lives of people with chronic low back pain. It describes the experiences of people who were attending a six week work hardening programme as part of their vocational rehabilitation in Sydney, Australia.MethodA thematic content analysis of data collected during an ethnographic study of eleven unemployed participants with chronic low back pain who attended the work hardening programme took place. The analysis focused on the effects of fear of movement on the participants' lives.FindingsThe fear of movement impacted on all aspects of the participants' daily occupations and restricted their occupational roles. These changes involved loss of occupational roles, relationship changes, loss of participation in leisure and encountering barriers to returning to paid employment.ConclusionsThe fear of movement impacted on all aspects of the participants' daily occupations and restricted their occupational roles. These changes involved loss of occupational roles, relationship changes, loss of participation in leisure and encountering barriers to returning to paid employment.
Developing a competent and flexible workforce using the Calderdale Framework
Authors: Smith Rachael , Duffy Jayne 
Published: May 2014

Background Successive UK Governments have sought to reform the NHS by putting the patient at the centre of service design. There is also a drive to modernize the NHS workforce. Contents The Calderdale Framework provides a tool to facilitate the development of a competent and flexible workforce, and engages clinicians throughout the process. This review uses a case study to illustrate the implementation of the Calderdale Framework in practice, leading to the development of competency based training and new ways of working for support staff. Conclusions Use of the Calderdale Framework within the Clinical Therapy and Rehabilitation Directorate of the Calderdale NHS Trust, led to a competency trained support staff workforce. It is a useful tool for clinicians and managers wishing to review service design and workforce development.
Single case experimental design: an overview
Authors: Rassafiani Mehdi , Sahaf Robab 
Published: May 2014

Background In health related research, it is critical not only to demonstrate the efficacy of intervention, but to show that this is not due to chance or confounding variables. Content Single case experimental design is a useful quasi-experimental design and method used to achieve these goals when there are limited participants and funds for research. This type of design has various advantages compared to group experimental designs. One such advantage is the capacity to focus on individual performance outcomes compared to group performance outcomes. Conclusions This comprehensive review demonstrates the benefits and limitations of using single case experimental design, its various design methods, and data collection and analysis for research purposes.
Applied research: building the evidence base for health sector development
Authors: Thunhurst Colin , Randall Sue 
Published: May 2014

Background Over recent years there has been a growth of interest in applied research. With the continuing explosion in academically focused peer reviewed publishing, researchers have been forced to reconsider the relevance of their work and its relationship to key health sector developments. Contents In this article we consider the nature of applied research – how does it differ from pure research, translational research, action research and/or monitoring and evaluation? We present a case study example drawn from a currently active area of applied research. We consider the fundamental questions that have to be considered by applied researchers – How can they retain methodological rigour?; Does he who pays the piper unduly call the tune?; Is the ‘opportunism’ of applied research compatible with ethical considerations? Is an academic environment the most appropriate one in which to undertake applied research? Conclusions The need for applied research has never been more pressing; yet executing it has never been more problematic. Notwithstanding the methodological and practical problems encountered, we argue that it plays a vital role in the development of health systems and of health systems researchers.
Development of a clinical screening tool to differentiate levels of challenging patient behaviour
Authors: Royle Jane , Whitehill Yvonne 
Published: May 2014

Aims This article describes the design of a systematic interdisciplinary clinical tool developed to differentiate levels of challenging behaviour (CB) in patients following a traumatic or acquired brain injury in order to facilitate decisions regarding rehabilitation and management needs. Methods A ‘top-down and bottom-up’ approach was used, based on clinical case examples and adaptations from the Overt Aggression Scale – Modified for Neurorehabilitation (OAS-MNR) (Alderman et al, 1997). Inter-rater reliability, face and content validity were tested through opportunistic sampling and blind re-screening of 20 patients on a post-acute neurorehabilitation ward. Findings Inter-rater reliability for overall decision on suitability for inpatient neurorehabilitation referral was significant (V = 0.84; P = 0.03); with significant inter-rater reliability within CB ratings. Ninety-three percent of staff were able to make an agreed decision regarding overall level of CB; there was a 95% concordance between staff using the tool; 90% of expert neurorehabilitation staff agreed with the decision from the tool, indicating a high degree of feasibility and clinical utility. Conclusions Changes were made to improve the tool's overall clinical usefulness. Findings indicate it is accessible for ward staff, and appropriate for use as a decision and management aid for patients presenting with a range of CBs. Further exploration of psychometric properties across settings and aetiology of CB is recommended.
Evaluation of trunk acceleration in healthy individuals and those with low back pain
Authors: Aluko Augustine , DeSouza Lorraine , Peacock Janet 
Published: May 2014

Augustine Aluko, Lorraine DeSouza, Janet Peacock Aims: The aim of this study was to investigate trunk acceleration as a measure of performance in both healthy individuals and those with low back pain (LBP). The study explored the difference in behaviour of trunk acceleration during flexion-extension movements between these two groups. This study investigated the test-retest reliability of the Lumbar Motion Monitor (LMM) using a single task protocol. Methods: Trunk acceleration of a group of healthy participants (M = 5, F = 5) and a group of participants with LBP (M = 4, F = 6) was evaluated using the LMM. Two sets of measurements were obtained from participants performing trunk flexion-extension movements for 8 seconds. Each participant had a 10 minute rest period between measures. Data were analysed using a two-way mixed model for an intra-class correlation (ICC) analysis to investigate the reliability of the measure, and a Bland-Altman graph was used to demonstrate the levels of agreement between those repeated measures. Results: The LBP group of participants demonstrated a slower three dimensional performance than the healthy group. The ICC for average sagittal acceleration (0.96, 95% confidence interval (CI) 0.90-0.98) and peak sagittal acceleration (0.89, 95% CI 0.75-0.96) with a 95% limit of agreement for the repeated measures of between -100.64 and +59.84 degrees/s2 demonstrates the reliability of the measure. The higher ICC and its narrow confidence interval suggest that average rather than peak acceleration is more reliable. Within group measures for both the healthy and LBP groups demonstrated similar reliability for average acceleration (ICC 0.98, 95% CI 0.92-0.99) and for peak acceleration (healthy group ICC 0.94, CI 0.76-0.99; LBP group ICC 0.92, 95% CI 0.67-0.98). Conclusions: Low back pain may reduce trunk acceleration. The LMM may be used to measure trunk acceleration as a descriptor of trunk performance in response to an onset of LBP. However, the Bland-Altman limits suggest that its reliability is dependent upon the harness upon which the LMM is secured remaining in a fixed position.
An evaluation of patients’ and staff members’ satisfaction with, and knowledge of, a volunteer service
Authors: Stiller Kathy , Benger Kathy , Oatey Anthea 
Published: May 2014

Kathy Stiller, Kathy Benger, Anthea Oatey Aims: Volunteers provide valuable services across the community, including healthcare organisations. The purpose of this prospective study was to determine patients’ and staff members’ level of satisfaction with, and knowledge of, a volunteer service at a rehabilitation centre. The volunteer services provided to patients included coordinating television hire, doing laundry, ward visiting, escorting patients to appointments outside the rehabilitation centre, and running a kiosk for patients, staff and visitors. Methods: Purpose-designed surveys were used to investigate the level of satisfaction and knowledge. Patients who had received services from the volunteers, nursing and social work staff who referred patients to the service, and senior management, medical and therapy staff were eligible for participation. Ninety-seven patients and 54 nursing, 6 social work, 23 senior managerial, 5 medical and 20 therapy staff participated in the study. Findings: Overall, patients were highly satisfied with the volunteers’ services they received in terms of the helpfulness of the services, and the personal qualities of the volunteers. Staff members were also highly satisfied with the volunteers’ services in terms of the types of services they provided to patients, the referral process, response times and personal qualities of the volunteers. The level of knowledge of patients and staff members regarding the range of services available was variable. Conclusions: A volunteer service provided at a rehabilitation centre was highly rated by both patients and staff members. However, the level of knowledge about the range of services was not always high, providing an opportunity for the volunteers to raise their profile across the rehabilitation centre in the future.
Geographic differences in traumatic brain injury and spinal cord injury rehabilitation
Authors: Mazurek Micah , Johnstone Brick , Hagglund Kristofer , Yamato Yuko 
Published: May 2014

Background/aims: To examine potential geographic differences among individuals with traumatic brain injury (TBI) and spinal cord injury (SCI) in demographics, rehabilitation services/costs, and outcomes at one year follow-up. Methods: 152 participants with TBI from the Missouri Model Brain Injury System and 149 participants with SCI from the Missouri Model Spinal Cord Injury System were enrolled at initial acute or rehabilitation hospitalization and followed for one year. Measures included demographics, rehabilitative services/costs, functional independence measure, residency at discharge, and substance use. Findings: Few differences in demographics or rehabilitation services were found when comparing rural and urban groups, and there were no differences in one year outcomes measured. Conclusions: The results suggest that, contrary to expectations, individuals with severe disabilities in rural areas do not necessarily experience worse outcomes than those in urban areas, indicating potential improvements in access to services in rural areas.
Is higher education ready for the information revolution?
Authors: Bartholomew Nicola 
Published: May 2014

Background: The management of chronic conditions has evolved to include tele-rehabilitation systems but are these changes being realised in practice and is the increasing adoption of networked environments refected in pre-registration health education? This paper outlines a scoping exercise which explores current health informatics education in regional higher education institutions for medical, nursing, and allied health professions pre-registration curricula in England. Aims: to establish whether health informatics (HI) competencies are integral to regional higher education (HE) health care programmes and whether graduates would be equipped to work safely and effectively within networked primary care, secondary care and rehabilitation centres. Methods: a mixed research model was adopted; generating data from a regional sample of education providers offering pre-registration medical, nursing, and/or allied health professional programmes. Data collection was by way of online survey and interviews. From 27 identified regional programmes, academics (n=14) representing nine different medical and health professions responded via interview and online questionnaire; a response rate of 51%. Students representing eight health professions (n=186) responded to online questionnaires. Findings: Basic information communications technology (ICT) skills, information literacy, and knowledge management are well supported within the identified programmes of study. However, several endorsed informatics standards are not fully integrated. Time constraints and a shortage of expertise were identified as barriers to integration. Sixty-one percent of students would value more access to, and training on clinical information systems. Conclusions: The report revealed limitations in the provision of informatics education; within HE health care curricula and offers recommendations to improve practice.
Effects of ‘The Listening Program’ on Children with Profound and Multiple Learning Difficulties
Authors: Francis Helen 
Published: May 2014

Background: ‘The Listening Program’ (TLP), a commercially available music-based auditory stimulation technique, claims to positively affect behaviour and learning in people with autism and dyslexia through targeting auditory processing difficulties. The author investigated changes in mood (calm vs anxious), attention to task, and person engagement in young people with profound and multiple learning difficulties (including auditory processing deficit) who participated in TLP. These behaviours were also examined following exposure to regular classical music. Methods: In a multiple single case study twelve participants aged 9-19 years completed TLP plus a shorter placebo regular classical music cycle. Assessment procedures included video recording, observational checklists, the school's ‘Profound Education’ Curriculum, and a post-study questionnaire for carers. Results: Greater indications of positive change were seen in attention to task and person engagement after TLP than with regular music. These positive changes were more apparent in participants with sensory processing difficulties, particularly those with Rett Syndrome. Participants with predominantly motor impairment (cerebral palsy) did not show measurable change. Some improvement in mood was observed following both regular classical music and TLP for those with sensory processing difficulty. Conclusions: The challenge posed by carrying out studies with this client group is addressed and decision making for subsequent clinical practice is examined.
Reliability and validity of an electronic dynamometer for measuring grip strength
Authors: Allen Deborah , Barnett Fiona 
Published: May 2014

Aims: This article describes a study aiming to establish the concurrent validity and test-retest reliability of the Biometrics E-LINK EP9 electronic dynamometer. Methods: Grip strength testing was performed on 49 healthy participants. Three trials were completed for the right and left hands on the Biometrics and Jamar dynamometers, using a repeated measures design. Data was compared and used to establish concurrent validity of the Biometrics dynamometer. Fifteen participants repeated the testing a week later, for test-retest reliability of the Biometrics dynamometer. Findings: The Biometrics E-LINK EP9 evaluation system was found to have excellent validity (ICC 0.983-0.986). However, a small but statistically significant difference between the right hand grip strength scores of the Biometrics (31.65 ± 8.89) and Jamar (30.44 ± 9.49) dynamometer was revealed (p ≤ 0.05). Test-retest reliability of the Biometrics system proved excellent, with ICC scores of 0.986 for the left hand and 0.996 for the right hand. Conclusions: The results indicate that the Biometrics E-LINK EP9 evaluation system is valid, reliable and comparable to the Jamar hydraulic dynamometer, when used for measuring grip strength with the second handle position. However, due to the statistically significant differences found for the right hand grip strength scores, therapists should exercise caution when interchanging instruments.
Impact of Visual Impairment Assessment on Functional Recovery in Stroke Patients: a Pilot Randomized Controlled Trial
Authors: Jarvis Kathryn , Grant Emily , Rowe Fiona , Evans Janet , Cristino-Amenos Meritxell 
Published: May 2014

Aim: To determine whether providing therapy staff with objective information regarding the nature of visual impairment enhances functional recovery of stroke survivors. Methods: A mixed methodology incorporated a pilot randomized controlled trial (RCT) and qualitative study. Patients presenting acutely with functional disability and suspected visual deficit, underwent visual assessment. Patients with visual impairment were recruited; all subjects received rehabilitation. The sample was randomized to group A (control) where details of visual assessment were withheld from therapy staff and group B (experimental) where details of visual assessment were disclosed. Functional measures (Functional Independent Measure, timed walk) were recorded at baseline and 6-week follow-up. Health professionals participated in a focus group to discuss the perceived influence of the additional visual assessment service on functional outcome. Findings: 64 patients were recruited over 18 months (group A=31; group B=33). Drop out resulted in 19 subjects in group A and 20 in group B for full analysis. Significant functional improvement was noted in both groups, no significant difference was found between groups. Health professionals reported a perceived positive impact from the vision assessment service. Conclusions: Provision of visual assessment information did not influence functional recovery. Qualitative findings indicated perceived benefits from the provision of the vision assessment service.
A case of dressing apraxia? A case study
Authors: Haughey Fiona , Morgan Jacinta M , Stapleton Tadhg 
Published: May 2014

Dressing apraxia is defined as the condition in which automatic, spontaneous capacity for dressing is lost ( Brain, 1941 ). This case report details the rehabilitation of a 58-year-old man who required protracted ITU care for endocarditis complicated by bilateral hemispheric embolic infarcts. At presentation to the rehabilitation unit he exhibited significant visuo-perceptual changes and difficulties with dressing, domestic and community-based tasks. He developed insight into his spatial impairments and, following a period of intervention, compensated for these difficulties. However the dressing difficulties remained despite intervention. This is an unusual presentation and one that might typically be considered dressing apraxia. This case report aims to highlight the importance of considering apraxia related to dressing within a differential diagnosis of visuo-perceptual impairments. Our report suggests that there may be justification in the classification of dressing apraxia as an impairment outside the broader terms of ideomotor and ideational apraxia. It also highlights the difficulty in treating apraxia related to dressing particularly when the affected person has minimal insight into their difficulties.
Using head posture assessment to inform the management of neck pain: a pilot focus group study
Authors: Silva Anabela , Punt David , Johnson Mark 
Published: May 2014

Background/Aim: There is limited evidence about the procedures and rationale for head posture assessment in clinical practice for patients with neck pain. The aim of this study was to gather information from physiotherapists about the rationale and protocols they use when assessing head posture for these patients. Methods: This is a qualitative research study employing focus group interviews. Twenty-one physiotherapists with at least 3 years experience of working with patients with neck pain were asked to comment on their use of head posture assessment, including the procedures of assessment and the rationale for these. Interviews were audiotaped, transcribed and analysed using thematic analysis. Findings: Physiotherapists reported that they routinely assess head posture for patients with neck pain. Head posture was assessed by observing ‘deviations from the norm’ against an imaginary line of reference. Outcome was recorded using simple 2- and 4-point severity category scales. Participants claimed that the information provided was used in conjunction with the outcomes of other clinical tests to inform neck pain pathophysiology and treatment strategies, although discussions suggested that clinical experience and intuition was playing a major role in decision making. Conclusions: The procedures reported and rationale provided for assessing head posture are in line with recommendations found in physiotherapy textbooks, but are challenged by the available research.