Disability and rehabilitation
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The six-minute walk test (6MWT) is a sub-maximal exercise test measuring the distance that a patient can walk quickly in a period of 6 minutes (6MWD). The objectives of this systematic review are to evaluate the 6MWT's suitability for measuring the impact of an intervention, to compare the 6MWD walked by patients with schizophrenia with data for the general population or matched controls, to identify the determinants of 6MWD and to examine the measurement properties and quality procedures of the 6MWT. ⋯ The Six-Minute Walk Test reliably assesses the functional exercise capacity in patients with schizophrenia. The impact of therapeutic interventions on patients, as measured by the 6MWT, cannot be confirmed. Clinicians should take into account overweight, antipsychotic medication use and the physical self-perception when considering the functional exercise capacity in schizophrenia. Clinicians should follow International standards such as these of the American Thoracic Society when using the Six-Minute Walk Test in patients with severe mental illnesses.
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The aims of this review were (1) to provide insight into the natural course of upper-extremity (UE) impairments and UE activity limitations associated with facioscapulohumeral dystrophy (FSHD) and limb-girdle muscular dystrophies (LGMD), and (2) to provide an overview of outcome measures used to evaluate UE function and activity in patients with FSHD and LGMD. ⋯ There is a need for specific outcome measures on the level of UE activity. Both the level of capacity and performance should be assessed. Possible outcome measures include 3D motion analysis to assess UE function, questionnaires like the Abilhand to assess UE capacity and accelerometry to assess performance of UE activities in daily life.
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The aim of this study was to determine the reliability and concurrent validity of commonly used physical performance tests using the OmniVR Virtual Rehabilitation System for healthy community-dwelling elders. ⋯ Virtual reality equipment is not only used to treat balance impairments but it is also used to measure and determine physical impairments through the use of physical performance tests. Virtual reality equipment is a reliable and valid tool for collecting physical performance data for the 5 × STS, FFR, TUG and 30-s stand test for healthy community-dwelling elders.
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Self-management has become an important concept in stroke rehabilitation. This study explored allied healthcare professionals' (AHPs) perceptions and beliefs regarding the self-management of stroke survivors and their knowledge and skills regarding stroke self-management interventions. ⋯ Post-stroke self-management is a learning process with different levels dependent on pre-stroke lifestyle and self-management skills, the post-stroke phase of recovery, the cognitive abilities of stroke survivors and the support of caregivers (co-management). Persons with cognitive impairments are not persons who cannot learn to self-manage; rather, they need more specific self-management support. Case studies describing the abilities of stroke survivors, who are successful in self-management post-stroke, can help to develop "ability oriented" stroke-illness scripts. Addressing "ability oriented" stroke-illness scripts in bachelor and post-graduate education will enhance positive professional beliefs concerning the self-management post-stroke, and will help professionals in coaching in stroke survivors' goal setting in self-management programmes. Professionals' account suggests that stroke self-management programmes should also be delivered post-discharge at stroke survivors' own homes.
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Although clinical practice guidelines can facilitate evidence-based practice and improve the health outcomes of stroke patients, they continue to be underutilised. There is limited research into the reasons for this, especially in speech pathology. This study provides the first in-depth, qualitative examination of the barriers and facilitators that speech pathologists perceive and experience when implementing guidelines. ⋯ In most Western nations, stroke remains the single greatest cause of disability, including communication and swallowing disabilities. Although adherence to stroke clinical practice guidelines improves stroke patient outcomes, guidelines continue to be underutilised, and the reasons for this are not well understood. This is the first in-depth qualitative study identifying the complex barriers and facilitators to guideline implementation as experienced by speech pathologists in stroke care. Suggested implementation strategies include local monitoring of guideline implementation (e.g. team meetings, audits), increasing collaboration on implementation projects (e.g. managerial involvement, networking), and seeking speech pathologist input into guideline development.