Disability and rehabilitation
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To examine the perspectives of persons living with traumatic spinal cord injuries (tSCI) on their access to health and support services. The specific aims were to identify the perceived gaps in access, classify the nature of the perceived gaps and compare differences in perceptions of access between urban and rural participants. ⋯ Maintaining health and well-being in people with tSCI demands access to both conventional health care and support services. Implications for Rehabilitation Access to both health and support services are important to maintaining the health and wellness of people with spinal cord injury. People with spinal cord injuries take an active role in coordinating their health, at times assuming various roles to compensate for perceived shortcomings of health care providers. Negotiating balances of power with gatekeepers in the health and insurance sectors was a key function of the coordinating role assumed by people with spinal cord injury. In order to effectively address the needs of this population, a coordinated interdisciplinary out-reach service, which includes peer support, must cross boundaries to engage sectors beyond traditional health care services, such as insurers and wellness providers.
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HIV and disability are interrelated providing a double burden to HIV endemic countries in East and Southern Africa and their already fragile health systems. Although literature reveals that people with disabilities are particularly vulnerable to HIV and that HIV, its opportunistic infections and treatments can cause disability, only few interventions target this issue and none have been evaluated in this region. ⋯ Formative evaluation indicates that the workshops can be effective not only in sensitising healthcare workers and people with disabilities to opportunities to improve services for people with disabilities but also to provide knowledge and skills to initiate improvements. Skills that need more practical training (e.g. screening for disability) need to be trained in more detail, and this will inform the adaptation of the workshops. However, the workshop evaluation also revealed that without policy implementation and budget allocations this change would only be limited. Implications for Rehabilitation HIV, its co-morbidities and treatments cause health conditions and impairments that have the potential to develop into disability. People with disabilities are at increased risk of exposure to HIV. Rehabilitation professionals, healthcare workers and people with disabilities can be sensitised in a three-day workshop on the relationship of disability and HIV. However, the trained participants can only implement no or low-cost elements of interventions, while high-cost interventions need budget allocations at provincial and national level.
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Aim of this study is to assess the psychometric properties of the developed Greek version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in total knee replacement (TKR) patients. ⋯ The Greek KOOS was found to be a practical and comprehensible self-reported measure for TKR patients with acceptable psychometric properties. It is therefore, recommendable for usage in future clinical trials and clinical practice. Implications for Rehabilitation The Greek version of KOOS is an essential assessment scale to evaluate not only acute injuries but also chronic knee associated conditions in a holistic perspective. The Greek KOOS has been found to be a practical and comprehensible self-reported measure for TKR patients with acceptable psychometric properties, recommendable for usage in future clinical trials and clinical practice. KOOS Greek version (downloadable at the official site http://www.koos.nu/koosgreek.pdf ) was used in the validity study.
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Everyday activities are important factors for avoiding the development of chronic low back pain (LBP). The purpose this study was to explore LBP patients' perspective on long-term effects of participating in a counseling intervention designed to motivate them to change work routines and to exercise. ⋯ Maintaining everyday activities, including retaining one's occupation, is an important factor in low back pain rehabilitation. Counselling on low back pain rehabilitation must be aligned with people's beliefs about their illness. A counselling intervention made patients adopt exercising into their long-term management of low back pain.
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Physical functioning is a multidimensional construct covering perceived functioning, functional capacity and actual physical activity. Currently, the assessment of physical functioning in low back pain (LBP) patients has been limited to only one or two of these aspects. This study evaluates physical functioning of LBP patients by assessing the three individual aspects using questionnaires and ambulant sensor-based measurements. ⋯ Perceived functioning, actual physical activity and functional capacity are three independent outcome dimensions, being complementary but not redundant. Especially, perceived functioning and physical capacity need attention when evaluating LBP patients during rehabilitation. Implications for Rehabilitation Perceived physical functioning and physical capacity are negatively affected by low back pain and improve after treatment. Low back pain patients perform their daily activity independent of pain and complaints. Inertia sensor-based motion analysis can objectify treatment effects showing low back pain patients their progress in rehabilitation. New interventions can be justified with inertia sensor technology in low back pain patients.