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To evaluate the balance in patients with total knee arthroplasty (TKA) and knee osteoarthrosis (KOA), measured by postural stability computerized evaluation (PSCE), and to evaluate the effect of post-TKA patients' characteristics in their performance on PSCE. An observational cross-sectional study was conducted in two sets of patients: (A) patients with KOA and primary TKA surgery scheduled and (B) patients who underwent primary TKA >9 months. Sociodemographic, radiographic, clinical and PSCE parameters (using the Biodex Balance System) were assessed. Post-TKA patients placed more load on the replaced knee than the contralateral osteoarthritic knee (p = 0.027). They had less imbalance on the balance tests performed with the eyes open, on stable (p = 0.032), and unstable platforms (p = 0.022). These patients also showed better postural stability in monopodalic stance, both standing on the TKA (p = 0.010) and contralateral knee (p = 0.017). Age, weight, pain on the operated knee, extension deficit on the operated knee, and Berg Balance Scale scores on post-TKA patients were significantly associated with their performance on PSCE tests. PSCE can be useful to quantify the balance of post-TKA and KOA patients. Total knee arthroplasty is the definitive treatment for knee osteoarthrosis and it has several benefits, but its effect on balance is still unknown. Postural stability computerized evaluation is used to evaluate balance on vestibular diseases and it has been recently studied on musculoskeletal conditions. Postural stability computerized evaluation may be useful to evaluate patients' balance before and after total knee arthroplasty. [ABSTRACT FROM AUTHOR]

To describe physical functioning after severe COVID-19-infection. An explanatory sequential mixed method design was used. Thirty-nine participants performed tests and answered questionnaires measuring physical functioning six months after hospitalisation due to COVID-19. Thirty of these participants participated in semi-structured interviews with questions regarding how they perceived their physical functioning and recovery from COVID-19 at 12 months post-hospitalisation. At six months, physical functioning measured via chair stand test and hip-worn accelerometers was lower than normal reference values. There was a reduction in breathing muscle strength. Participants estimated their functional status during different activities as lower compared to those before COVID-19-infection, measured with a patient-specific functional scale. At one year after infection, there were descriptions of a rough recovery process and remaining symptoms. Patients recovering from severe COVID-19 seem to have reduced physical functioning and activity levels, and they perceive their recovery to be slow and difficult. They experienced a lack of clinical support and contradictory advice regarding rehabilitation. Coaching in returning to physical functioning after the infection needs to be better co-ordinated and there is a need for guidelines for health professionals to avoid patients receiving contradictory advice. Coronavirus infection disease-19 (COVID-19) can have a great impact on a person's physical functioning. In the early course of the COVID-19 pandemic there were not any clear guidelines regarding rehabilitation for this group of patients. As some people with COVID-19 may have impairments in their physical functioning up to one year after leaving hospital there is a need to provide rehabilitation. [ABSTRACT FROM AUTHOR]

To investigate the therapeutic potentials of the home-based exercise program (HEP) with an augmented reality (AR) system to improve balance in patients with stroke. Sixty-eight patients with stroke were recruited in this randomized controlled study with blind observer. Patients in the smart-rehab group underwent HEP with an AR system for four weeks, whereas patients in the control group underwent the written and pictorial HEP. Assessments of balance and fear of falling were performed three times: at baseline (T0), immediately (T1), and four weeks (T2) after cessation of HEP. The change in balance from T0 to T1 was significantly higher in the smart-rehab group than in the control group (p < 0.017). The change in fear of falling from T0 to T1 and T2 was significantly higher in the smart-rehab group than in the control group, respectively (p < 0.017). One participant with vertebral artery dissection in the smart-rehab group discontinued participation due to a transient ischemic attack which resolved during the study period. The results of this study suggest that the HEP with the AR system might be effective to improve balance in patients with stroke. However, more careful precautions for the HEP using the AR system are also required. Balance was modestly improved in both home-based exercise programs, slightly more in AR home exercise group. AR home-based program was significantly better in reducing fear of falling compared to the control group. No falls were recorded, however, safety for patients with arterial dissection needs to be carefully considered due to the possibility of adverse effects. [ABSTRACT FROM AUTHOR]

To assess the change in individual outcomes for people with disability and complex needs after moving into newly built, individualised apartments in the community. People with disability (neurological disorder or cerebral palsy) and complex needs (n = 15, aged 18–65 years) completed quantitative self-report measures over two time-points (pre-move and 6–24 months post-move). Pre-move living arrangements included group homes, residential aged care, private rentals, and living with parents. Post-move living arrangements were individualised apartments built for people with disability. Health, wellbeing, community integration, and support needs were compared across pre- and post-move timepoints. Paired sample t-tests showed significant improvements consistent with large effects in wellbeing (p = 0.031, Eta2=0.29) and community integration (p = 0.008, Eta2=0.41), particularly home integration, and a trend towards improved health (p = 0.077, Eta2=0.21). A Wilcoxon signed rank test demonstrated a trend towards reduced support needs (z= −1.941, p = 0.052) consistent with a medium effect (r = 0.35) and an average decrease of 2.4 support hours per participant per day. Well-located housing with appropriate design, technology and support provision makes a positive contribution to wellbeing, community integration, and health for people with complex disability. People with disability who move into individualised apartments experience significant positive change in health, wellbeing, and participation. Findings highlight the benefits of housing that foster independence and enable personal choice and control. Evidence suggests that investment in appropriately designed and well-located housing has positive outcomes for people with disability. Evidence collected within this outcome framework has the potential to ensure models of housing and support that are responsive to the diverse and changing needs of people with disability. [ABSTRACT FROM AUTHOR]

This study aims to translate the Selective Control Assessment of the Lower Extremity (SCALE) into Turkish language, assess its reliability and validity in children with spastic cerebral palsy. Fifty-two children with CP (mean age 9 years 8 months, range 4–18 years) included in this cross-sectional study. Intra- and interrater reliability was assessed by intraclass correlation coefficient (ICC). The SCALE was correlated with the Gross Motor Function Classification System (GMFCS), the Physician's Rating Scale (PRS), and Gross Motor Function Measurement (GMFM) to assess validity. Intra- and interrater reliability of the SCALE were excellent (ICC > 0.75). SCALE and GMFCS (r = −0.786, p < 0.001), SCALE and PRS (r = 0.761, p < 0.001), SCALE and GMFM (r = 0.863, p < 0.001) were highly correlated. SCALE scores differed significantly between GMFCS levels and between types of spastic CP. The Turkish version of the SCALE appears to be a valid and reliable tool to assess selective voluntary motor control of the lower limbs in children with spastic CP. The Turkish version of the Selective Control Assessment of the Lower Extremity is a valid and reliable assessment for children with spastic CP. The SCALE scores differed significantly between Gross Motor Function Classification System levels I versus II and levels II versus III as well as between types of spastic CP. The current study suggests that the SCALE is a quick and easy outcome measure to assess selective motor control in patients with spastic CP. [ABSTRACT FROM AUTHOR]

The objectives were to examine: (1) the changes in independence in basic activities of daily living (ADL) following an outpatient occupational therapy (OT) intervention in people with neurological conditions; (2) the factors associated with good relative functional gain (RFG) and with good OT efficiency; (3) and the effects on instrumental activities of daily living (IADL) and caregiver assistance. A prospective observational study examining changes in a multicentre cohort (three urban hospitals). Ninety-eight adults were assessed on admission and after intervention. Barthel Index was the primary outcome (ADL). Acquired brain damage (ABI) was the most frequent diagnosis (84.7%). There was an improvement in ADL (p < 0.001); the effect size (r) was large (r = 0.59). RFG was good for 88.8% of participants. A good RFG was significantly associated with ABI, a lower number of hours of caregiver assistance, and a greater intensity of OT. The OT efficiency was good for 43.9% of participants. Factors significantly associated with good efficiency were being young and male patients, and receiving fewer hours of caregiver assistance. Secondary measures were improved: IADL (p < 0.001) and hours of caregiver assistance (p < 0.001). This study suggests that the intervention is an effective approach to improve functional independence. Little is known about the outcomes of outpatient occupational therapy intervention in neurorehabilitation services for the adult population with neurological diseases. In a multicentre cohort of neurorehabilitation outpatients, the occupational therapy intervention can lead to improvements in the level of independence in basic and instrumental daily activities, as well as reducing the hours of caregiver assistance. A good relative functional gain is associated with acquired brain injury, a lower number of hours of assistance, and a greater intensity of occupational therapy. The factors associated with good efficiency are being younger, male patients, and receiving fewer hours of assistance. [ABSTRACT FROM AUTHOR]

This prospective, observational cohort study investigated the effects of multidisciplinary rehabilitation of post Covid-19 sequelae and persistent symptoms and their impact on patients' functioning and quality of life. From 58 patients referred for neurorehabilitation, 43 were eligible for and participated in the present study. Before and after 8 weeks of rehabilitation, patients underwent physical, neuropsychological and respiratory evaluations and assessment of functional independence, impact of fatigue and quality of life. Forty of 43 individuals (52 ± 11.4 years, 24 male) completed the rehabilitation program. Fatigue (87.5%), dyspnea and/or shortness of breath (62.5%), and cognitive impairment (37.5%) were reported by both previously hospitalized and home-confined patients. Neurological sequelae (35.5%) were present only in hospitalized patients. After 8 weeks of rehabilitation, patients reported significant improvements in motor functional independence, upper and lower limb functionality, impact of fatigue on daily activities, respiratory muscle strength, cognitive performance, and quality of life. Post Covid-19 patients present with heterogeneous neurological, physical, and respiratory impairments requiring a multidisciplinary rehabilitation approach to reduce disability and improve functionality and quality of life. A comprehensive assessment of clinical profiles and responses to rehabilitation may facilitate the identification of rehabilitation candidates and help to design effective rehabilitation interventions. Post Covid-19 patients present multiple, heterogeneous neurological, physical and respiratory impairments that are observed in both previously hospitalized and home-confined patients. Eight weeks of multidisciplinary rehabilitation may significantly reduce disability and improve functionality and quality of life. A comprehensive assessment of their clinical profile and response to rehabilitation may facilitate the identification of rehabilitation candidates and help to design more effective rehabilitation interventions. [ABSTRACT FROM AUTHOR]

The aim of this prospective cohort study was to evaluate the level of physical activity, self-efficacy and health-related quality of life in patients with chronic pain, at baseline and one year after physiotherapy rehabilitation at a specialist pain clinic. All patients who underwent rehabilitation at the physiotherapy unit at the Pain Centre at Sahlgrenska University Hospital/Östra in Gothenburg during a nine-month period were asked to participate in the study. The participants were evaluated regarding self-efficacy, health-related quality of life (HRQoL) and physical activity during physiotherapy treatment and one year later. Physical activity was measured both subjectively (self-reported physical activity) and objectively (accelerometer). Out of 42 patients who participated in the baseline evaluation, 28 (19 women and nine men) were included in the one-year follow-up. The patients had increased levels of vigorous physical activity at one-year follow-up, without deterioration of pain. There were no significant changes regarding self-efficacy and HRQoL. Levels of physical activity and perceived physical function may be associated to levels of physical activity 1 year after rehabilitation. Patients with chronic pain can increase their level of vigorous physical activity after a period of rehabilitation without deterioration of pain. Physical activity is an important part of rehabilitation for chronic pain patients, but many patients expect more pain after exercise, which they fear may affect performance and maintenance of physical activity. Patients with chronic pain at a specialist clinic increased their level of vigorous physical activity one year after physiotherapist led rehabilitation without deterioration of pain. Levels of physical activity and perceived physical function during rehabilitation may predict levels of physical activity 1 year after rehabilitation. Physiotherapist led rehabilitation seems to be beneficial for long-term improved physical activity in patients with chronic pain [ABSTRACT FROM AUTHOR]

To investigate internal consistency and construct validity of the of the Activities Scale for Kids performance (ASKp) in Italian children with cerebral palsy (CP). This cross-sectional study was conducted from 2014 up to 2019 and consisted in the single self-administration of the Italian ASKp to 206 children aged 5–15, with unilateral or bilateral CP, classified on the basis of the Gross Motor Function Classification System (GMFCS). The ASKp showed good internal consistency (Chronbach's α 0.91, 95% CI 0.89–0.93). It distinguished between children and adolescents (70.3 ± 16.6 versus 83.0 ± 18.0, respectively; p < 0.001), unilateral and bilateral CP clinical manifestations (82.5 ± 13.6 versus 72.4 ± 19.0, respectively; p = 0.002), children with and without intellectual disability (60.3 ± 18.3 versus 77.2 ± 17.3, respectively; p < 0.001). It also distinguished children using assistive devices for indoor mobility from children who did not use devices or those who use devices only for outdoor mobility (66.1 ± 18.3 versus 83.6 ± 12.8 and versus 80.4 ± 17.4, respectively; both p < 0.001). The ASKp could help integrate the perspective of children with CP in their rehabilitation process. Trial registration: ClinicalTrials.gov Identifier: NCT03325842 The ASKp is a valid and widely used measure for several ICF domains of activities and participation in pediatrics. It has never been formally validated in children with CP, although this disorder causes restrictions in everyday activities. Recently, the culturally adapted Italian version of the ASKp has been tested in typically developing Italian children, confirming its high acceptability and providing evidence of construct validity. This study confirms the internal consistency reliability and the construct validity of the Italian ASKp when applied to the population with CP. The ASKp can support rehabilitation professionals in planning therapeutic intervention targeted to relevant goals. [ABSTRACT FROM AUTHOR]

Traditional face-to-face learning is often replaced by virtual learning because it can be more feasible and cost-effective, and more recently due to the need for social distancing. The objective was to evaluate the effectiveness of two innovative knowledge translation (KT) interventions; in-person stakeholder-hosted, interactive, problem-based seminars (SHIPS) versus online problem-based tutorials (e-PBL) in changing knowledge, readiness to change, and self-efficacy with respect to the use of rehabilitation outcome measures. Physical and occupational therapists (n = 124) were recruited from four sites across Canada to participate in either an e-PBL or SHIPS. Evaluations of KT impact measured knowledge, self-efficacy to implement outcome measures in practice, and readiness to change. There were 112 participants who completed the study. Following the intervention, the mean knowledge scores for both groups improved, but there was greater improvement in participants who completed SHIPS. For self-efficacy and readiness to change, there was no significant difference between groups six months following the interventions. E-PBL was as good as a SHIPS for improving and retaining self-efficacy and readiness to change. Knowledge improved more with workshops than online delivery, while improvements in self-efficacy and readiness to change improved similarly regardless of delivery. This study compared the relative efficacy of internet and workshop-based education, focusing specifically on the use of outcome measures in physical and occupational therapy practice. Improvements in the self-efficacy of rehabilitation professionals with respect to outcome measure use had lasting effects regardless of KT intervention type, as it was retained six months following the intervention. Results from this study show that online interventions may be as effective as face-to-face workshops for improving readiness to change and self-efficacy for using outcome measures in practice by rehabilitation professionals. This is valuable information given the recent global pandemic, the need for social distancing, and the potential for learning interventions to focus within the online environment in the future. [ABSTRACT FROM AUTHOR]

To study the prevalence, intensity, and bothersomeness of amputation-related pain and further to identify the potential risk factors in the victims with lower-limb amputation 10 years after the 2008 Sichuan earthquake. In the cross-sectional study, 66 victims with lower-limb amputation were recruited. The Prostheses Evaluation Questionnaire was used to document the prevalence, intensity, and bothersomeness of amputation-related pain. The bivariate relationships between amputation-related pain and each of demographic characteristics were analyzed. Majority of the enrolled lower-limb amputees (90.9%) reported to have one or more types of amputation-related pain. The intensity and bothersomeness of amputation-related pain were considered as severe in nearly 40% of these post-earthquake victims. The potential demographic risk factors associated with the prevalence, intensity, and bothersomeness of amputation-related pain were identified, including the age, lower level of education, marital status, employment, and comorbidity. The pain coming from phantom limb, residual limb, non-amputated limb, and back was found persistent in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The findings of this study could provide useful reference for optimization of post-disaster rehabilitation strategies to alleviate chronic pain in the victims following lower-limb amputation. The pain coming from phantom limb, residual limb, non-amputated limb, and back was found persistent in the victims with lower-limb amputation 10 years after the 2008 Sichuan earthquake. Continuous post-earthquake assessment and management of amputation-related pain should be taken into consideration for the victims with lower-limb amputation. The comorbidity should be effectively and efficiently controlled for the victims with lower-limb amputation due to its association with the intensity and bothersomeness of amputation-related pain. [ABSTRACT FROM AUTHOR]

The 6-Minute Walking Test (6MWT) is a safe, standardized and well utilized method to assess the functional capacity. Recently, it was reported that the published prediction equations cannot accurately predict a valid maximal oxygen consumption (V̇O2 peak) value in cancer survivors. Thus, the aim of this study was to establish and to validate a new equation based on the 6MWT to predict V̇O2 peak in childhood acute lymphoblastic leukemia (ALL) survivors. A total of 200 childhood ALL survivors were enrolled in this study, among which 168 participants underwent a cardiopulmonary exercise test and a 6MWT to assess their functional capacity and their cardiorespiratory fitness. In addition, participants completed a physical activity questionnaire. Participants were randomly divided in two groups to establish the equations (n = 118 (70%)) and to validate it (n = 50 (30%)). Multiple linear regression analyses were used to determine a new prediction equation for V̇O2 peak from 6MWT using clinical and specific variables related to the disease. The accuracy in between V̇O2 peak measured and V̇O2 peak predicted were assessed using the Bland and Altman method. The new establish clinical V̇O2 peak equation is: V̇O2 peak (mL.kg−1.min−1) = (−0.283*age(years)) − (0.099*weight(kg)) + (0.071*6MWD(meters)) −(0.135*HR end(bpm)) + 22.789 with a mean bias of 2.67 mL.kg−1.min−1 (95% CI (−9.64 to 14.98)). The new establish disease-specific V̇O2 peak equation is: V̇O2 peak (mL.kg−1.min−1) = (−0.236*age(years)) − (0.094*weight(kg)) −(0.120*HR end(bpm)) + (0.067*6MWD(meters)) + (0.065*MVLPA(min/day)) − (0.204*DT(years)) + 25.145 with a mean bias of 2.51 mL.kg−1.min−1 (95% CI (−9.98 to 15.01)). This is the first study that predicted V̇O2 peak from a 6MWT using clinical and specific variables related to the disease of childhood ALL survivors. The availability of these newly established V̇O2 peak equations makes them an accurate tool to provide a better follow-up and better adapted physical training for survivors. We invite researchers to use our assessment procedures for their further studies. It is critical to understand the cardiorespiratory fitness of the childhood ALL survivors The maximal oxygen consumption (i.e., V̇O2 peak) is recognized as the gold standard to measure the patient's cardiorespiratory fitness in the field of exercise physiology This study is novel and reports the validation of two new VO2 peak equations, from 6MWT, by using clinical and disease-specific variables of childhood ALL survivors The availability of such validated equations can better facilitate the follow-up of survivors' cardiorespiratory fitness, by relevant health care professionals and exercise physiologists. [ABSTRACT FROM AUTHOR]

This novel study aims to explore the relationship between occupational participation, meaningful activity, and the health-related quality of life of people living with a diagnosis of colorectal cancer A cross-sectional study design with 113 colorectal cancer survivors (from two large public hospitals in Malaysia) was conducted. Data collection tools included the Occupational Participation Questionnaire, Engagement in Meaningful-activities, and the European Organization for Research and Treatment in Cancer Quality of Life (QOL) Questionnaire. Data analyses were conducted using SmartPLS to examine path analyses between the three measures. There were independent significant relationships between (1) occupational participation, and (2) meaningful activity engagements on the dependent variable of QOL in this cohort of cancer survivors. More importantly, the result showed that "meaningful-activity" positively and significantly mediates the path between occupational participation and quality of life [β = 0.250 (0.46*0.59), ρ < 0.001(t = 3.91)]. Engagement in meaningful activity mediates the occupational participation of a cohort of colorectal survivors, and produces an impact on their quality of life. This study demonstrates that "occupational participation" (an important construct in occupational therapy), has the potential to improve colorectal cancer survivors' quality of lives. Therefore, the role of occupational therapists must be optimized within the oncology team, to improve occupational participation and patients' abilities to engage in meaningful activities for better quality of life. Occupational therapy intervention addresses the needs of people of all ages, who encountered limitations in their daily occupational participations. Cancer can have significant impact on occupational performance, and occupational therapy can improve these limitations to improve their Quality of Life. Occupational therapy should be a vital part in the cancer survivorship treatment plan for it can significantly improve occupational performance and quality of life of cancer survivors. [ABSTRACT FROM AUTHOR]

This study investigated the association of resilience on caregiver burden and quality of life in informal caregivers of patients with severe traumatic musculoskeletal injuries. A prospective cohort study of eligible caregivers and acutely injured trauma patients was conducted during 2018 in South East Queensland, with follow-up 3 months after patient discharge. Resilience was examined using the 10-item Connor Davidson Resilience Scale. The primary outcomes, caregiver burden and quality of life were measured respectively, using the Caregiver Strain Index and the Short Form Version 12 Health Survey. Baseline measures were completed with fifty-three (77%) patient/carer dyads. Thirty-eight (28%) were available for follow up at 3 months. Significant reductions from baseline were found at follow up, for levels of resilience, mental health, physical exercise and community support. In multiple regression models, caregiver resilience at follow-up independently predicted lower caregiver burden (β = −0.74, p = 0.008) and higher levels of patient physical health and function (β = −0.69, p = 0.003). Upon commencing informal care, caregivers' resilience, mental health and support systems are adversely affected. Higher levels of caregiver resilience appear to be protective against caregiver burden and declines in patient physical function. Early evaluation of caregivers' resilience, their physical and mental health and socio-ecological networks could improve carer and patient health outcomes. After 3 months of providing informal care to severely injured musculoskeletal trauma patients, there are apparent declines in their mental health, resilience, community support and physical activity levels. However, those with higher levels of resilience compared to lower levels could be protected against caregiver burden. Higher caregiver resilience could also prevent declines in patients' physical function. The rehabilitation of severe trauma patients should additionally include routine assessment and management of informal caregivers with the aim to prevent caregiver burden. Early clinical assessment of caregiver resilience using a valid resilience measurement tool could identify caregivers at risk of caregiver burden and flag vulnerable caregivers for ongoing support in the community. Early assessment of caregivers' physical and mental health and health related behaviours could flag the need for health promotion interventions aimed at supporting caregivers' physical and mental health. [ABSTRACT FROM AUTHOR]