Disability and rehabilitation
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The aim of this study was to involve older people and physiotherapists in the development of acceptable strategies to promote uptake and adherence with an exercise-based falls prevention programme. ⋯ A focus on self-management support may provide the key to promoting uptake and adherence with an exercise-based falls prevention programme. Physiotherapists should move from being "experts" to "enablers" who use their professional knowledge and expertise to support older people at risk of falling to maintain optimum levels of health and independence. Implications for Rehabilitation Despite the established efficacy of exercise-based falls prevention programmes, their impact remains limited by low levels of uptake and adherence. Clinical encounters between physiotherapists and older people at risk of falling offer the opportunity for the exchange of new information to promote patient empowerment and shared decision-making. Physiotherapists need to move away from being experts who care for and do to their patients to enable us to use their professional knowledge and expertise to maintain optimum levels of health and independence for older people at risk of falling.
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Although controversial, an amputation for longstanding and therapy-resistant Complex Regional Pain Syndrome Type I (CRPS-I) may improve quality of life and pain intensity. Resilience, the way people deal with adversity in a positive way may be related to these positive outcomes. This study focused on the relationship between resilience and post-amputation outcomes, i.e. quality of life, pain and recurrence of CRPS-I and psychological distress. ⋯ The results confirmed our hypothesis that patients with an amputation because of CRPS-I who have a higher resilience also have a higher quality of life and experience lower psychological distress. The prognostic value of resilience in this patient group requires further research. Implications for Rehabilitation Until characteristics of patients with positive quality of life outcome have been further unraveled, amputation for CRPS-I should only be performed in expertise centers. Resilience, the process of adapting well in the face of adversity, should be further explored in Rehabilitation Medicine research in general. Measurement of resilience should be a standard procedure when patients with CRPS-I request an amputation. Improving resilience of patients in in- and outpatient rehabilitation clinics might be an additional treatment in rehabilitation care.
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Pain is commonly experienced in those with cerebral palsy (CP), and previous research suggests an increase in behavioural and emotional problems in children experiencing pain and pain anxiety. Therefore, it was hypothesised that pain intensity and pain anxiety would predict behavioural and emotional problems in children with CP. ⋯ Whilst pain intensity appears to be associated with behavioural and emotional problems in children, pain anxiety may be more strongly associated still.
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Review Comparative Study
Content comparison of self-reported disability measures for the elderly according to the international classification of functioning, disability and health.
To identify self-reported disability measures developed for older adults by performing a systematic literature review and to compare the contents of all identified measures based on the International Classification of Functioning, Disability and Health (ICF). ⋯ The ICF can be used as a conceptual framework not only for assessing measures but also for developing new measures. According to this ICF-based content comparison, the contents of currently available measures for disability in older adults vary significantly from one another. Our study may provide useful information for the selection of suitable measures for a particular purpose, as well as the development of new measures.
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To systematically review and synthesise the research evidence linking pain to psychological concerns about falling in community dwelling older adults. ⋯ This review provides provisional evidence that pain is associated with fear of falling (FOF), avoidance of activities due to FOF and falls efficacy in community dwelling older adults. Implications for Rehabilitation Pain is a common and pervasive problem in community dwelling older adults and can affect an individual's mobility, levels of physical activity and increase their falls risk. Psychological concerns related to falls, such as fear of falling (FOF), falls efficacy and balance confidence are also common and troublesome issues in older adults, yet the association with pain has not been investigated with a systematic review. This review provides provisional evidence that pain may increase older adult's risk of developing FOF, avoiding activities due to a FOF and impact their falls efficacy. In recognition of the findings of this review, clinicians working with older adults with pain should consider assessing psychological concerns related to falls and if necessary intervene if they identify an individual at risk.