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IntroductionCognitive stimulation, an individual or group intervention approach aiming to improve cognitive and social functioning among individuals with mild-to-moderate dementia, is often considered a complex intervention. The patient's experience of a complex intervention is unique and often determines its effectiveness. This proposed qualitative systematic review aims to comprehensively synthesise the experiences of individuals with dementia and their informal caregivers who have participated in cognitive stimulation programs, identifying perceived benefits, challenges, barriers, and facilitators to this approach to intervention.MethodsThis review will consider qualitative studies that evaluate the experiences of individuals with a diagnosis of dementia and/or the informal caregivers of individuals with dementia who have participated in a cognitive stimulation program. Searches will be conducted across MEDLINE (Ovid), Embase (Elsevier), PsycINFO, Scopus, CINAHL (EBSCO) and Web of Science. Quality of eligible studies will be assessed using the JBI Critical Appraisal Checklist for Qualitative Research, and a standardised data extraction tool in JBI SUMARI will be used to extract data from relevant studies. The meta-aggregation approach will be used to pool qualitative research findings, which will then be synthesised to produce a single set of findings in narrative format.DiscussionThis qualitative systematic review will identify and synthesise the evidence regarding the experiences of individuals with dementia who have taken part in a cognitive stimulation program and the experience of their informal caregivers. As a variety of cognitive stimulation programs exist, our findings will summarise the experiences of these interventions to inform the future development and delivery of cognitive stimulation programs.Trial registrationPROSPERO registration number: CRD42022383658.

Introduction Emerging evidence suggests that robotic devices for upper limb rehabilitation after a stroke may improve upper limb function. For robotic upper limb rehabilitation in stroke to be successful, patients’ experiences and those of the rehabilitation professionals must be considered. Therefore, this review aims to synthesise the available evidence on experiences of patients after a stroke with rehabilitation robots for upper limb rehabilitation and the experiences of rehabilitation professionals with rehabilitation robots for upper limb stroke rehabilitation.Methods and analysis Database search will include MEDLINE (Ovid), EMBASE (Elsevier), Cochrane CENTRAL, PsycINFO, Scopus, Web of Science, IEEE and CINAHL (EBSCOhost). Grey literature from Open Grey, PsyArXiv, bioRxiv, medRxiv and Google Scholar will also be searched. Qualitative studies or results from mixed-method studies that include adult patients after a stroke who use upper limb rehabilitation robots, either supervised by rehabilitation professionals or by patients themselves, at any stage of their rehabilitation and/or stroke professionals who use upper limb rehabilitation robots will be included. Robotic upper limb rehabilitation provided by students, healthcare assistants, technicians, non-professional caregivers, family caregivers, volunteer caregivers or other informal caregivers will be excluded. Articles published in English will be considered regardless of date of publication. Studies will be screened and critically appraised for methodological quality by two independent reviewers. A standardised tool from JBI System for the Unified Management, Assessment and Review of Information for data extraction, the meta-aggregation approach for data synthesis and the ConQual approach for confidence evaluation will be followed.Ethics and dissemination As this systematic review is based on previously published research, no informed consent or ethical approval is required. It is anticipated that this systematic review will highlight the experiences of patients after a stroke and perceived facilitators and barriers for rehabilitation professionals on this topic, which will be disseminated through peer-reviewed publications and national and international conferences.PROSPERO registration number CRD42022321402.

The importance of neurorehabilitation services for people with disabilities is getting well-recognized in low- and middle-income countries (LMICs) recently. However, accessibility to the same has remained the most significant challenge, in these contexts. This is especially because of the non-availability of trained specialists and the availability of neurorehabilitation centers only in urban cities owned predominantly by private healthcare organizations. In the current COVID-19 pandemic, the members of the Task Force for research at the Indian Federation of Neurorehabilitation (IFNR) reviewed the context for tele-neurorehabilitation (TNR) and have provided the contemporary implications for practicing TNR during COVID-19 for people with neurological disabilities (PWNDs) in LMICs. Neurorehabilitation is a science that is driven by rigorous research-based evidence. The current pandemic implies the need for systematically developed TNR interventions that is evaluated for its feasibility and acceptability and that is informed by available evidence from LMICs. Given the lack of organized systems in place for the provision of neurorehabilitation services in general, there needs to be sufficient budgetary allocations and a sector-wide approach to developing policies and systems for the provision of TNR services for PWNDs. The pandemic situation provides an opportunity to optimize the technological innovations in health and scale up these innovations to meet the growing burden of neurological disability in LMICs. Thus, this immense opportunity must be tapped to build capacity for safe and effective TNR services provision for PWNDs in these settings.

Background: People with neurological dysfunction have been significantly affected by the ongoing coronavirus disease 2019 (COVID-19) crisis in receiving adequate and quality rehabilitation services. There are no clear guidelines or recommendations for rehabilitation providers in dealing with patients with neurological dysfunction during a pandemic situation especially in low- and middle-income countries. The objective of this paper was to develop consensus-based expert recommendations for in-hospital based neurorehabilitation during the COVID-19 pandemic for low- and middle-income countries based on available evidence. Methods: A group of experts in neurorehabilitation consisting of neurologists, physiotherapists and occupational therapists were identified for the consensus groups. A scoping review was conducted to identify existing evidence and recommendations for neurorehabilitation during COVID-19. Specific statements with level 2b evidence from studies identified were developed. These statements were circulated to 13 experts for consensus. The statements that received ≥80% agreement were grouped in different themes and the recommendations were developed. Results: 75 statements for expert consensus were generated. 72 statements received consensus from 13 experts. These statements were thematically grouped as recommendations for neurorehabilitation service providers, patients, formal and informal caregivers of affected individuals, rehabilitation service organizations, and administrators. Conclusions: The development of this consensus statement is of fundamental significance to neurological rehabilitation service providers and people living with neurological disabilities. It is crucial that governments, health systems, clinicians and stakeholders involved in upholding the standard of neurorehabilitation practice in low- and middle-income countries consider conversion of the consensus statement to minimum standard requirements within the context of the pandemic as well as for the future.

The purpose of this study was to demonstrate the use of an outcome-driven model of decision-making in the implementation of computer access technology (CAT) for a pre-school child with athetoid cerebral palsy. The child did not have the fine motor skills required to hold a pencil but had the cognitive abilities to learn to write; therefore, we explored the use of a CAT device to enable written communication. Case study methodology was used to describe the selection process, child-level outcomes, and clinical challenges faced by the therapist in the use of a consortium model that was designed for an outcome-driven model of decision-making. The critical role of an occupational therapist in this process using a family-centered approach is discussed. [ABSTRACT FROM AUTHOR]

Stress and burnout is a problem becoming increasingly prevalent amongst occupational therapists, particularly those working in mental health. By the nature of the profession, occupational therapists are at risk for high levels of stress, which can lead to burnout from the profession. This may affect job retention and recruitment in the area of mental health. This study aimed to measure the levels of stress and burnout experienced by a range of occupational therapists working in mental health, using the Perceived Stress Scale (PSS) and the Maslach Burnout Inventory (MBI). These results were compared to demographic variables, in order to compare stress and burnout to personal and work variables. The 21 therapists surveyed had a mean stress level of 13, as measured on the PSS. This correlates with results from a study evaluating the mean stress level of a normal population. Levels of burnout showed that occupational therapists working in mental health experience moderate levels of emotional exhaustion, low depersonalisation, and high personal accomplishment. These results indicate that therapists can feel emotionally overextended, but it does not bleed into other areas that may lead to burnout. [ABSTRACT FROM AUTHOR]

Study design:Cross sectional survey.Objective:To examine the nature and prevalence of common mental disorders among informal carers of people with Spinal Cord Injury (SCI) and the association with their leisure satisfaction.Setting:Christian Medical College, Vellore, Tamilnadu, India.Methods:A cross-sectional survey of informal carers of people SCI at the Department of Physical Medicine and Rehabilitation. Fifty-three informal carers of people with SCI were interviewed using the Revised Clinical Interview Schedule to assess psychiatric morbidity, and using the Leisure Satisfaction Scale to measure leisure and contentment. Data on carers with psychiatric morbidity were compared to those without common mental disorders using univariate and multivariate statistics.Results:Study reported a high morbidity (53%), with most consistent diagnoses of depression and anxiety. Carers who were spouses, women, currently married and those with lower education had greater psychiatric morbidity and lesser leisure satisfaction, even after adjusting for age and education using logistic/linear regression. Age, occupation, residence, socioeconomic status, type and duration of SCI were not associated with either morbidity or leisure satisfaction.Conclusion:Many carers of people with SCI suffer from psychiatric morbidity and also have low scores on leisure satisfaction.Spinal Cord (2006) 44, 676–679. doi:10.1038/sj.sc.3101899; published online 17 January 2006 [ABSTRACT FROM AUTHOR]

The need for a sound social support system, and its positive impact on physical, mental and behavioural health in the ever-increasing spinal cord injury (SCI) clientele, is undeniable. It is evident from recent research that spousal support should be weighed as an important contributing factor to the ongoing health and well-being of their SCI partners. Stress (severe depressive symptoms) to the care-giving spouses, and implications on their health and thereby the SCI partner, is often underestimated. Thus the present study is an attempt to treat this highly susceptible population through the provision of support groups. This study was a two-group experimental design. The study results bring to light the definite impact of SCI on the spouse's well-being. Thus it is essential to direct research towards life domains designed to improve the quality of life of these individuals. This research demonstrates the unquestionable positive effect of group therapy on the impact of well-being of spouses of SCI survivors. This finding may only be the tip of the iceberg and further research with a larger sample size must be conducted for the adequate generalization of this study. [ABSTRACT FROM AUTHOR]

Leisure is an important component in the lives of persons with disabilities and it is often associated with life satisfaction, self-esteem and depression. However, leisure specialists have all but ignored the leisure patterns and needs of people with disabilities. Thus this study attempts leisure intervention through groups by altering the attitude of patients towards leisure and subsequently finding out the effect on leisure satisfaction and quality of life. This study was a clinical trial conducted for patients with spinal cord injury who were evaluated using both the World Health Organization quality of life scale and the leisure satisfaction scale prior to intervention and afterwards. The experimental group had five 1 h-long group sessions as intervention while the control group had none. Twenty-five clients with paraplegia were included in both the experimental and the control groups. The mean ages of clients in both the groups were 33.40 and 37.24 years respectively. Significant improvements were observed in all domains of quality of life and leisure satisfaction in the experimental group as compared with the control group. The data show the definite impact of leisure satisfaction on quality of life. It is evident from the study that leisure intervention groups facilitate both leisure satisfaction and improved quality of life. Such an assertion definitely requires further research, corroboration and substantiation. [ABSTRACT FROM AUTHOR]

Early ambulation after lower extremity amputation has profound benefits on the functional, psychological outcomes and enhanced prosthetic compliance among this clientele. The various potential risks of immobility--pain, oedema, muscle atrophy, phantom sensations, contractures, aerobic de-conditioning, and the like, are reduced due to early ambulation. Moreover, it assists in accelerated wound healing, preservation of postural reflexes and, above all, achievement of better psychological well-being. Though such benefits have been observed in the history of prosthetic rehabilitation, a cost-effective prosthesis for such an early management among Third World nations is still unavailable. Therefore, this article is an attempt to present an indigenously developed temporary prosthesis designed to make the above benefits possible at a lower cost. This prosthesis helps in myriad ways--immediate prosthetic fitting, early weight bearing, early ambulation--and also has the added advantage of being adjustable to anthropological variations. The ischial weight bearing, lateral opening socket reduces the pressure and shear over the stump, thus avoiding stump complications. This increases the prosthetic acceptance by the client due to early involvement in the rehabilitation. Above all, it is cost effective and comfortable, thus enhancing compliance and superior outcome in prosthetic rehabilitation, especially among the clients in Third World nations. [ABSTRACT FROM AUTHOR]

OBJECTIVES:: To examine the impact of SCI from a non-Western cultural perspective. SETTING:: India. METHODS:: A philosophical approach. CONCLUSION:: Management of the individual with spinal cord injury needs to take in to account the individual's beliefs and cultural context.Spinal Cord (2001) 39, 323–326. [ABSTRACT FROM AUTHOR]

STUDY DESIGN: :A cross-sectional study that assessed people with spinal cord injury (SCI) and their carers who attended the 3-day health care program. OBJECTIVES: :The study examined the nature and prevalence of the factors associated with psychological morbidity among carers of people with SCI. SETTING: :A community reintegrated population of persons with SCI and their carers attended the 3-day program in the Department of Physical Medicine and Rehabilitation, Christian Medical College Hospitals, Vellore, South India. METHODS:: Thirty-eight people with SCI and their carers participated in this cross-sectional study. RESULTS:: Thirty (78.9%) carers of people with SCI were psychologically distressed. While carers were distressed, they were not significantly depressed. Educational level of carers and suicidal behavior of people with SCI were significantly associated with psychological distress. CONCLUSION: :The findings of this study suggest that health care workers should have a high index of suspicion of psychological morbidity, in carers of people with SCI. Identification of risk factors may lead to useful target interventions. SPONSORSHIP:: Nil.Spinal Cord (2000) 38, 559–562. [ABSTRACT FROM AUTHOR]

Design We recruited babies with moderate or severe hypoxic ischaemic encephalopathy (aged

The importance of exercise for health and the long-term management of various diseases is now well documented and established. However, the challenge is the lack of patient compliance to exercises, which is true for almost all diseases, from acute back pain to chronic arthritis. One of the factors for compliance is the perception that exercises are effective in ameliorating unpleasant symptoms. Precisely, people's perception and their attitude towards exercises matter the most in determining the treatment outcome in such conditions. Unfortunately, the psychology of exercise initiation and adherence in the patient population is seriously under-researched. Recent literature has identified the need to consider various similar factors like motivation, barriers to exercise, exercise-related beliefs, attitudes, and the formulation of self-perceptions and self-identity towards exercises. However, no good instrument exists that is sensitive and standardized to evaluate people's attitude towards exercises, which is fundamental and crucial in determining the final outcome of exercise-treatable diseases. Hence we have attempted to design a questionnaire to 'evaluate the level of people's attitude towards exercises'. [ABSTRACT FROM AUTHOR]

Introduction: Hand splinting after stroke is a common practice despite inadequate evidence. This warrants a better understanding of the therapists' splinting practice, to develop clinically meaningful treatment options., Aims: The study examined the nature and prevalence of the factors associated with therapists' hand splinting practice and their perceived splinting efficacy., Settings and Design: A cross-sectional national survey of hand-splinting practice among inpatient occupational therapists (OTs) in Ireland., Materials and Methods: Sixty-two therapists participated in this national survey., Statistical Analysis Used: A number of factors were analyzed to explore their relationship with therapists' perception of splint efficacy using Spearman's rank order correlation., Results: 53(85.5%) out of 62 survey respondents prescribed splints to their clients at the time of taking the survey. To reduce spasticity, to correct contractures and thus increase range of motion (ROM) were the commonly used splinting goals. These were the goals that were significantly associated with the therapists' splinting efficacy too., Conclusions: Hand-splint prescription following stroke was found to be a common practice among OTs who perceive splints to be quite effective. A custom-made, volar forearm-based wrist-hand splint is the preferred splint among therapists to achieve a number of clinical aims such as improving ROM, stretching soft tissue contractures and reducing spasticity in the upper extremity. A wide variety of splinting regimens is currently practiced, reflecting the lack of a universally accepted and comprehensive practice guideline to regulate therapy. Methodologically valid clinical trials evaluating the efficacy of therapist-preferred splints in achieving their favored outcomes are needed. Development of common, universally accepted therapeutic guidelines based on comprehensive scientific review of such studies is thus needed.