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Keir Starmer isn't even in Downing Street yet already his government-in-waiting is in danger of being defined by its [pounds sterling]28 billion green spending pledge, just as Tony Blair's administration [...]

We all know that increasing the diversity of your boardroom increases the success of your company because politicians, business leaders and academics keep telling us so. No one has ever [...]

Like Prince Harry, I never knew I had unconscious bias until it was pointed out to me, but now it has been I know I will have to do something [...]

Imagine that, just as Britain was closing down for the first Covid lockdown in the spring of 2020, you were 18 years old and had received an offer from the [...]

Since Boris Johnson quit as an MP last month, Labour has been confident about winning the Uxbridge and South Ruislip by-election. Yet not so confident that Danny Beales, the party's [...]

Objective. The step test (ST) 0is a common clinical assessment of dynamic balance among survivors of stroke. The ST assesses a person's ability to place their paretic (paretic ST) or nonparetic (nonparetic ST) foot rapidly and repeatedly on and off a standardized block while standing. No study has formally explored if the 2 tests are interchangeable. Our study aimed to: (1) differentiate the correlates of paretic and nonparetic ST, and (2) compare their associations with physical function and falls. Methods. Eighty-one survivors of stroke were consecutively recruited from inpatient rehabilitation units (n = 4) and were assessed within 1 week prior to discharge. In addition to the ST, a handheld dynamometer and computerized posturography were used to measure lower limb muscle strength and standing balance, respectively. Self-selected gait speed and Timed Up and Go test were also assessed as measures of physical function. Falls data were monitored for 12 months post discharge using monthly calendars. Multivariable regression analyses were used to differentiate (1) the correlates of paretic and nonparetic STs, and (2) their associations with physical function and falls. Results. The median score for the paretic and nonparetic STs were 8 and 9 steps, respectively. Paretic ankle plantar-flexor and dorsiflexor strength were the strongest correlates of nonparetic ST whereas both paretic ankle and knee extensor strength were the strongest correlates of paretic ST. In multivariable analyses adjusting for each other, both STs were independently associated with gait speed and Timed Up and Go scores. Paretic ST (odds ratio = 0.37; 95% CI = 0.22 to 0.62) was a stronger predictor than nonparetic ST (odds ratio = 0.51; 95% CI = 0.34 to 0.78) in predicting future falls. Conclusion. This study confirmed that the paretic and nonparetic STs are noninterchangeable. ST scores should be assessed separately to achieve a more complete interpretation. Impact. To our knowledge, this study is the first to objectively evaluate the similarities and differences between paretic and nonparetic STs. This information may refine the use and interpretation of the 2 STs for survivors of stroke. Keywords: Balance, Outcome Measurement, Rehabilitation, Step Test, Stroke, Introduction Balance deficits can contribute to activity limitations and disability after stroke and are commonly assessed to guide treatment and predict outcomes. (1) There is a wide range of clinical [...]

Objective. Children born Methods. In this cohort study, 123 children born Results. Children born Conclusion. Preschool-aged children born Impact. In our study, children born Lay Summary. Preschool-aged children born Keywords: Grip Strength, Motor Function, Preterm Birth, Preschool Child, Physical Activity, Sedentary behavior, Introduction Preterm birth is a substantial cause of global morbidity in childhood. (1) Preschool-aged children born Physical activity (PA) is important in early childhood, as higher PA levels are associated [...]

Objective. Technology is being increasingly used for physical assessment and interventions in health care settings. However, clinical adoption is relatively slow, and the factors affecting use remain underexplored. This study aimed to investigate factors influencing technology use by clinicians working in neurorehabilitation. Methods. In this qualitative study, 9 physical therapists and 9 occupational therapists (N = 18) were recruited from urban and regional locations in Australia and in Singapore. Three 60-minute focus groups were conducted via video conferencing. Each group comprised 3 physical therapists and 3 occupational therapists working across different neurorehabilitation settings. Participants were asked to discuss which technologies they used in their workplace for physical assessment and treatment and barriers, motivators, and future desires for technology use. Transcripts were analyzed independently using an inductive approach to generate codes and themes. Results. Our results comprised 3 themes and 7 categories. These were encompassed by a single overarching theme, namely 'Technology use is influenced by the benefits and challenges of the technology itself, users, and organizational context.' Themes showed that technology should promote effective interventions, is preferred if easy to use, and should be dependable. Furthermore, clinical reasoning is important, and users have varying levels of receptivity and confidence in technology use. Also, organizational resources are required, along with supportive cultures and processes, to facilitate technology use. Conclusions. The themes identified multiple and interlinking factors influencing clinicians' use of technology in neurorehabilitation settings. Clinicians often consider context-specific benefits and challenges when deciding whether to use technology. Although our study found that clinicians generally perceived technology as having a beneficial role in improving health outcomes, there were several challenges raised. Therefore, the characteristics of the technology itself, individual users, and organizational context should be considered. Impact. These findings will guide successful technology implementation and future developments. Keywords: Physical Therapists, Occupational Therapy, Neurology, Rehabilitation, Stroke, Introduction An increasing number of electronic devices are being used for physical assessment and interventions within health care settings. (1-3) More efficient and effective rehabilitation services are necessary, and technology [...]

Objective. Parkinson disease (PD) is the second-most common neurodegenerative condition worldwide. Approximately 50% of people with PD experience freezing of gait, a motor symptom associated with falls, disability, and poorer quality of life. Accurate assessment of freezing of gait severity is important for guiding management. The aim of this systematic review was to determine the measurement properties of subjective and objective clinical assessments of freezing of gait severity using the COSMIN methodology to facilitate better outcome measure selection. Methods. Three databases (MEDLINE, EMBASE, and CINAHL) were searched. The COSMIN Risk of Bias checklist was used for evaluating quality of included studies. Data on measurement properties were extracted. Where possible, meta-analysis was performed. Results. Nineteen studies investigating measurement properties of 7 outcome measures (patient-reported outcome measures, n = 3; objective assessment tools, n = 4) were included. Ten studies evaluated the Freezing of Gait Questionnaire. Based on COSMIN criteria, the best performing outcome measures were the Freezing of Gait Questionnaire and the Dynamic Parkinson Gait Scale. Both outcome measures demonstrated sufficient structural validity, internal consistency, reliability, construct validity, and responsiveness. The Freezing of Gait Questionnaire was supported with mostly moderate to high quality of evidence, but the evidence for the Dynamic Parkinson Gait Scale was of low quality due to inadequate sample size. Conclusions. Content validity and measurement invariance remain unknown for all outcome measures. The Freezing of Gait Questionnaire is the best measure currently available. Further external validation and reliability studies would strengthen the evidence to support the use of the Dynamic Parkinson Gait Scale. Impact. Awareness of limitations of outcome measures facilitates better selection. Without evidence for content validity and measurement invariance, clinicians should consider if their chosen test accurately measures freezing of gait severity and whether it can be applied in populations different to the original study's population. Lay Summary. Accurately assessing freezing of gait severity is important for guiding management of this disabling symptom. The best clinical assessment currently available is one that relies on the self-report of patients. Keywords: Parkinson Disease, Gait Disorders: Neurologic, Decision Making: Clinical, Introduction Parkinson disease (PD) is a common, disabling neurodegenerative brain disorder. (1) Freezing of gait (FOG) affects approximately 50% of people with PD, increasing in prevalence as the disease progresses. [...]