Disability and rehabilitation
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Purpose: To understand preferences, barriers, and facilitators to participating in community-based exercise opportunities among adults living with chronic pain. Materials and Methods: An interpretive description methodology based on semi-structured interviews was conducted. Adults (age>18 years) living with chronic pain (pain >3 months in duration) were recruited from a multidisciplinary chronic pain clinic in Toronto, Canada. ⋯ Adults living with chronic pain reported specific preferences, barriers, and facilitators to participating in community-based exercise opportunities, including accessibility, instrinsic factors, social factors, and program factors. Most adults living with chronic pain reported a preference for community-based exercise opportunities that: (1) are delivered by an instructor who is knowledgeable about chronic pain; (2) involve gentle exercise; (3) are group-based; and (4) include other individuals with similar physical capabilities. Healthcare providers, community-based organizations, and researchers should develop, implement, and evaluate person-centered community-based exercise opportunities for adults living with chronic pain that consider their unique preferences, barriers, and facilitators to participation.
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Purpose: Invisible symptoms have a negative impact on people living with Multiple Sclerosis (MS), related to the very notion that they are "unseen." It is important to understand the notion of "invisibility" in MS, as invisible symptoms are particularly distressing, and there is a paucity of research focussing on their invisible nature and its specific impact. We aimed to systematically identify, appraise and synthesise qualitative research regarding the notion of "invisibility" in relation to people's lived experience of symptoms of MS. Methods and materials: Articles meeting inclusion criteria were critically appraised and synthesised using a meta-ethnographic approach. ⋯ It is important for healthcare professionals to validate MS patients' experiences around "invisibility" and provide appropriate support. Healthcare professionals should address with MS patients any issues around disclosure of their diagnosis to those around them and support them to navigate these decisions. Raising awareness about the impact of "invisibility" for people with MS may help to lessen patient burden and promote understanding amongst healthcare professionals and the general public.
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Purpose: To evaluate the effects and to compare transcutaneous electrical nerve stimulation protocols, alone or as additional therapy in chronic post-stroke spasticity through a systematic review and meta-analysis of randomized clinical trials. Methods: Search was conducted in MEDLINE, Cochrane Library, EMBASE and Physiotherapy Evidence Database through November 2017 (CRD42015020146). Two independent reviewers performed articles selection, data extraction and methodological quality assessment using the Cochrane Collaboration's risk of bias tool. ⋯ Implications for RehabilitationTranscutaneous electrical nerve stimulation as additional treatment to physical interventions can lead to additional reduction in chronic post-stroke spasticity. High and low frequency transcutaneous electrical nerve stimulation showed similar results, with a smaller numerical superiority of low frequency TENS. More studies are needed to substantiate the best protocol of transcutaneous electrical nerve stimulation to the treatment of spasticity.
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Purpose: Perilunate (fracture) dislocations are rare injuries and diminished functional outcomes are reported. However, Patient Reported Outcomes (PROs) following these injuries are rarely described. The aim of this study was to investigate the long-term impact of perilunate (fracture) dislocations using a range of measures, including pain, function, and quality of life. ⋯ Grip strength is not diminished in patients with perilunate (fracture) dislocations. Pain, restrictions in physical functioning, diminished satisfaction and lower general health status are likely to be present following perilunate (fracture) dislocations. If conservative treatment including pain medication and rehabilitation strategies do not relief pain following perilunate (fracture) dislocations, surgical treatment options such as wrist denervation or arthrodesis should be considered.