The benefits of physical activity (PA) for health have been extensively studied; however, people with disabilities (PWDs) are more likely to be inactive compared to the general population. The topic of barriers and facilitators to PA for PWDs has been studied, but most reviews have focused on specific impairments, institution-based exercise programs, and/or persons who reside in high-income countries. A comprehensive review describing the barriers and facilitators to PA for community-dwelling PWDs (including developmental, intellectual, sensory, physical, and mental disabilities) from a global perspective has not been published. The aim of this paper is to describe the protocol used to conduct a systematic review concerning the socioenvironmental factors that encourage and discourage PA in PWDs around the world, by investigating the current knowledge, identifying gaps in the literature, and providing guidance for future research and guidelines. MEDLINE All, PsycINFO, and Web of Science Core Collection were searched. Gray literature sources included were extracted from the three main databases used for the literature search. A total of 6434 records were identified for the initial title/abstract screen. The following data were extracted from the final full-text articles: author, title, publication information (journal, year), study design, methodology, data collection instruments employed, language, country or countries where the study was conducted, subject characteristics, disabilities reported, disability characteristics, subjects' mobility level, a relation of stakeholder(s) to PWDs (self, family), PA mode, barriers, and facilitators.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Introduction: Health systems worldwide are challenged to address the health-care needs of persons with COVID-19. After the immediate need to mitigate the spread of COVID-19 and scale up relevant health-care capacities, one major challenge has emerged – scaling up rehabilitation to address the functioning limitations experienced by COVID-19 patients/survivors. To meet this challenge, the International Society of Physical and Rehabilitation Medicine (ISPRM) endeavors to develop a tool for the assessment and reporting of functioning of COVID-19 patients/survivors – “ClinFIT COVID- 19” to assist health professionals to optimally address patients' health-care needs. The first step in the development process is identifying the International Classification of Functioning, Disability, and Health (ICF) categories that ClinFIT COVID-19 should cover for acute, postacute, and long-term settings. Methods: The multistep process to develop the ClinFIT COVID-19 category list involved the development of a proposed list of ICF categories, a survey of ISPRM members worldwide about the proposed category list, and a postsurvey consultation with the ISPRM ClinFIT Task Force. Results: The final category list for the acute care context contains the seven categories provided to the survey participants (energy/drive functions, sleep, emotional functions, pain, exercise tolerance functions, carrying out daily routine, and walking) plus six categories related to respiration, mobility, and cognition. The postacute and long-term care versions also contain the seven categories plus additional categories relevant for the specific context. The postacute version contains 15 categories and the long-term 16 categories. Conclusions: To advance the next steps, the leaders of ISPRM and the Task Force call national and international societies of rehabilitation professionals to join this coordinated effort.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: The recovery of independent walking is one of the major goals of stroke rehabilitation; however, due to the current acute inpatient rehabilitation care paradigm, the intensity of walking practice provided has been far below that recommended for motor recovery to occur. A quality improvement initiative was implemented to encourage the physical therapist (PT) to incorporate various robotic gait training devices as part of the standard allotted PT sessions to improve the intensity of gait training. Materials and Methods: After 6 months, a retrospective review was performed to assess the feasibility of the robotic-assisted gait training (RAGT) intervention in limited-ambulatory stroke patients and determine preliminary efficacy of the RAGT program by analyzing Functional Index Measure (FIM) motor gain and accelerometer-based daily step counts in patients who received the RAGT versus a group treated with conventional therapy. Results: About 30% of limited-ambulatory patients admitted to the stroke rehabilitation unit received consistent integrated RAGT without safety concerns. Compared to those who received conventional treatment, these patients showed greater mean FIM motor gain (32.30 versus 17.88) at discharge (P < 0.005) and higher number of step counts in PT sessions (P < 0.005). Age, gender, or admission FIM motor were not associated with FIM motor gain. Conclusions: Across a 6-month initial implementation period, RAGT was feasible and was associated with higher repetition of walking practice and also with improved FIM motor scores in limited-ambulatory individuals in an acute inpatient stroke rehabilitation program. However, the frequency of RAGT and the percentage of patients participating need to further improve. Some strategies to address these concerns were identified.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Lateral epicondylitis is common and may negatively impact activities of daily living. Currently, various conservative treatments are available including physiotherapy, pharmacotherapy, and interventional physiatry. Among the interventional procedures, periarticular hyaluronic acid (HA) injection is an emerging treatment option, but it lacks firm evidence to support its use. Objective: The objective of the study was to determine the effectiveness and safety of HA in reducing pain and improving function of patients with lateral epicondylitis. Methods: We conducted a systematic review in January 2020. Randomized controlled trials identified from various electronic databases were included if they involved the following: Adults with lateral epicondylitis, periarticular injection of HA with or without other medications, and reported outcomes on pain, function, and adverse effects. Assessment of risk of bias was performed using the Cochrane Collaboration Tool. Pertinent data were extracted from the eligible studies for data analysis. Results: Among the 42 studies identified, we included two trials with a total of 388 participants followed up within 6–12 months. The trials employed similar techniques in administering HA, although they used different doses and preparations. The control groups used either normal saline or corticosteroid. In both trials, there were statistically significant improvements in pain and function in favor of HA. No serious adverse event was reported. Conclusion: Albeit with promising intermediate and long-term effects for lateral epicondylitis, HA remains to have limited evidence regarding its effectiveness and safety. We recommend further research to determine the most optimal HA preparation, dosage, and technique for lateral epicondylitis that will help standardize our procedures.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Objectives: This study aimed to evaluate the relationship between activities of daily livings (ADLs) and psychological distress along with the quality of life (QOL) in Japanese adults with Duchenne muscular dystrophy. Patients and Methods: This study surveyed 36 adults using the Functional Independence Measure (FIM), the 36-Item Short-Form Health Survey (SF-36 v2) version 2.0, World Health Organization QOL-26, and Hospital Anxiety and Depression Scale. Results: No significant correlation was observed between the FIM scores and scores for all three scales (R <,0.2,for every item). Conclusions: ADLs did not correlate significantly with psychological distress or QOL without considering independent demographic characteristic factors

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Currently, the challenge of replantation of the upper limb after amputation has become an achievable and meticulously perfected reality in recent decades and is in constant evolution. The surgical option for replantation should take into account not only a comprehensive analysis of the viability of the replantation but fundamentally its potential for long-term functional recovery. We present the clinical case of a 40-year-old man, victim of a work accident, with cut trauma, which resulted in distal amputation of his right forearm. The warm ischemia time was 5 h, having been submitted to joint replantation surgery. Following the surgery, physical medicine and rehabilitation (PMR) was referred early, carrying out a sequential functional rehabilitation program. This work aims to emphasize the importance of the role of PMR in an early, careful, and extensive rehabilitation program, a fundamental factor in the functional recovery and long-term prognosis of these injuries and prevention of complications.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]