جستجوی مقالات مرتبط با کلیدواژه « disability » در نشریات گروه « پزشکی »

Few low- or middle-income countries (LMICs) have prioritized the expansion of rehabilitation services. Existing scholarship has identified that problem definition, governance, and structural factors are influential in the prioritization of rehabilitation. The objective of this study was to identify the factors influencing the prioritization and implementation of rehabilitation services in Uganda.

A case study design was utilized. The Prioritization of Rehabilitation in National Health Systems framework guided the study. Data sources included 33 key informant interviews (KIIs) with governmental and non-governmental stakeholders and peer-reviewed and grey literature on rehabilitation in Uganda. A thematic content analysis and concept map were conducted to analyze the data.

Rehabilitation is an unfunded priority in Uganda, garnering political attention but failing to receive adequate financial or human resource allocation. The national legacy of rehabilitation as a social program, instead of a health program, has influenced its present-day prioritization trajectory. These include a fragmented governance system, a weak advocacy coalition without a unified objective or champion, and a lack of integration into existing health systems structures that makes it challenging to scale-up service provision. Our findings highlight the interactive influences of structural, governance, and framing factors on prioritization and the importance of historical context in understanding both prioritization and implementation.

Our findings demonstrate challenges in prioritizing emerging, multi-sectoral health areas like rehabilitation. Strategic considerations for elevating rehabilitation on Uganda’s policy agenda include generating credible indicators to quantify the nature and extent of the population’s need and uniting governmental and non-governmental actors around a common vision for rehabilitation’s expansion. We present opportunities for strengthening rehabilitation, both in Uganda and in similar contexts grappling with many health sector priorities and limited resources.

Children with disabilities need assistive technology (AT) to explore their surroundings, participate in social activities, and gain developmental skills. This study aimed to assess AT needs and barriers to access it for these children. 

The study participants comprised 217 children with disabilities aged 6-12 years, randomly selected from the registration list of Chaharmahal and Bakhtiari Welfare Organization, Chaharmahal and Bakhtiari Province, Iran, in 2022. After obtaining informed consent from their parents, study data were gathered by phone interview using the rapid assessment of AT (rATA) tool of the World Health Organization (WHO).

Among the 217 participants, 108(49.8%) used AT devices, and 102(47%) had unmet needs. Of the 55 AT devices named in the rATA, only 14 were used by the children. The most commonly used devices were hearing aids, glasses, and wheelchairs. Unmet needs of ‘chairs for bath/toilet,’ ‘wheelchairs,’ and ‘therapeutic footwear’ accounted for 50% of 132 unmet AT needs. The most common reasons for lacking AT were lack of financial resources (52%) and knowledge about AT devices (30.1%). Most clients were satisfied with AT-use training (92.3%), but only 20.2% were satisfied with AT device repair services.

This study highlights the need to improve AT device repair services, overcome financial challenges, and increase parental knowledge about AT devices as the most prevalent barriers to using AT devices. Developing a child-specific version of the rATA tool that includes questions about education and play engagement AT needs is suggested for better estimation of AT needs for children with disabilities in the future.

Low back pain is one of the most significant musculoskeletal problems, causing various functional limitations that adversely affect individuals' quality of life.

The effect of combined Pilates-Kinsey and Mulligan-Kinsey exercises in women with non-specific chronic back pain has not been investigated.

In the present quasi-experimental study, thirty women with non-specific chronic back pain with a range age of 35 - 65 years old were included in the study and were randomly divided into two Pilates-Kinesiotype (n = 15) and Mulligan-Kinesiotype (n = 15) groups. Exercise interventions were conducted for 6 weeks and 3 sessions per week. Pain, lumbar range of motion, hamstring stiffness and hip rotation were measured before and after the training intervention. Also, analysis of covariance (ANCOVA) test was used to analyze the data.

The results showed that there is a significant difference between the effect of Pilates-Kinesiotype training and Mulligan Kinesiotype training in the variables of pain, hamstring stiffness and hip rotation (P < 0.05) and the reduction of pain and hip rotation in the Pilates-Kinesiotype training group compared to The Mulligan-Kinesiotype group was better. But the hamstring range of motion was better in the Mulligan-Kinesiotype group than in the Pilates-Kinesiotype group. In addition, the results showed that there is no significant difference between the waist range of motion of the research groups (P < 0.05).

Due to the fact that mulligan and Pilate's exercises together with Kinesiotype have an effect on pain variables, hamstring stiffness and hip rotation, and each of mulligan and Pilate's exercises have different effectiveness. These exercises can be used in combination with Kinesiotype to help women with non-specific chronic back pain.

As a health vulnerable group, people with disabilities require more health-promoting behavior than non-disabled people. We aimed to identify the types of health behavior of disabled people and to track the trajectories of stress by the type of health behaviors.

Data came from the Panel Survey of Employment for the Disabled Second Wave by the Employment Development Institute (EDI) in Korea. We used dataset from the first 6 years of the 2nd wave of PSEDSW (2016-2021). The current study analyzed 3,991 subjects. The types of health behavior were identified through latent class analysis (LCA) and the trajectories of stress were estimated through multi-group latent growth modeling using Mplus 8.0.

Two types of groups in health behaviors, smoking-drinking group (SD), nonsmoking-less drinking group (NLSD) were derived. Depending on the types of health behavior, the trajectories of stress appeared significantly different: the NLSD had significantly lower stress than the SD in the first year, and this low-level stress trajectory was maintained continuously for 6 years.

Health behaviors could be suitable as a stress coping method for people with disabilities. This study suggests that it is necessary to make efforts to create an environment that supports people with disabilities to learn healthier ways to cope with stress.

The outstanding performance of Paralympic athletes improves their quality of life and resilience. The present study explores the role of mental toughness in predicting resilience and distress tolerance in Paralympic athletes.

This descriptive and correlational study was conducted on Paralympic athletes who were members of the Iran Sports Federation for the Disabled (IRISFD) and were invited to attend the Paralympic games. The participants were 128 Paralympic athletes (n=60 women and n=68 men) who were selected via the simple random sampling method. The data were collected using the mental toughness questionnaire-48 (MTQ48), the Connor-Davidson resilience scale (CD-RISC) and the distress tolerance scale (DTS). The collected data were analyzed using the multiple regression analysis by the SPSS software, version 26.

The results showed that mental toughness can predict resilience and distress tolerance in Paralympic athletes. Moreover, mental toughness accounted for 47.8% of the variances in resilience and 28.6% of the variance in distress tolerance. In addition, the analysis of the standard beta coefficients showed that mental toughness can positively and significantly predict resilience and distress tolerance in Paralympic athletes, with β coefficients equal to 0.69 and 0.53, respectively.

Mental toughness is a psychological construct that affects the performance and success of Paralympic athletes and increases their resilience and distress tolerance. Thus, a part of the preparation process, namely training and skill development programs for Paralympic games should focus on the mental toughness of athletes.

This scoping review allows a better understanding of current evidence regarding mirror therapy (MT) among children to help the future development of MT intervention protocol on children.

PubMed, Science-Direct, Web of Science and ProQuest databases were searched from January 2005 to January 2023 for interventions within the scope of MT for children. Google Scholar was also scanned for additional resources. The process of the present study was according to guidelines of the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. The main inclusion criteria were articles in English and Persian language and peer-reviewed empirical studies of MT for children. This study charted methodological information from articles according to participant characteristics, design, intervention, and outcome measures. 

Of 18 studies that were included in this scoping review, 17 studies were conducted in children with hemiplegic cerebral palsy, and only two studies were in other conditions. A total of 16 articles were randomized controlled clinical trials, one case study and one single subject. Meanwhile, 33 outcomes were in the body structures (BS) and functions level, and 10 outcome measures were in the activities and participation levels of the International classification of functioning. 

The review indicates that in future studies, it is necessary to pay more attention to other disorders beyond hemiplegic cerebral palsy; furthermore, levels of activity and participation as the outcome need to be used more.

Cerebral palsy is one of the most prevalent physical disabilities in childhood. Children afflicted with this condition face a myriad of challenges and potential disabilities, which complicate treatment efforts. Integrating scales with other diagnostic instruments is increasingly crucial for accurately assessing these children and devising effective treatment strategies. This study primarily aims to review functional classification systems based on the International Classification of Functioning, Disability, and Health (ICF) for children with cerebral palsy and explore the relationships among these systems. This study was designed to review the ICF-based functional classification systems. A comprehensive search was conducted across multiple databases, including Google Scholar, PubMed, ERIC, OVID, ProQuest, Scopus, Web of Knowledge, and OTseeker. Search terms related to cerebral palsy and various aspects of body function, activity, and participation were utilized. The search was conducted until September 2022 to gather relevant literature for analysis. The analysis of the reviewed articles revealed the existence of five valid and reliable classification systems. In most studies, the correlation among these systems was moderate. Owing to their simplicity and comprehensiveness, these classification systems have significantly impacted the depiction of the functional status of children with cerebral palsy and the quality of their care. However, additional classification systems remain needed to address other overlooked functions and complete the overall description. The outcomes of this review indicated the development of classification systems for certain functions in children with cerebral palsy. In conjunction with the classifications above, creating additional new systems for overlooked functions could offer a comprehensive and integrated understanding of children with cerebral palsy's crucial functional capacities and performances.

Chronic non-specific neck pain is one of the most common musculoskeletal disorders in modern society and is considered a cause of disability in many jobs, especially in office workers.

In this study, 36 female office worker with mean±SD age of 39.20±4.29 years, mean ± SD weight of 70.60±12.37 kg and mean±SD height of 163.15±6.23 cm were randomly divided into three groups: 1. Dynamic neuromuscular stability exercises 2. Stabilization Exercises and 3. Control group. Stabilization exercises with emphasis on the effect on deep neck muscles dynamic neuromuscular stability exercises with emphasis on the effect on cervical thoracic and lumbar pelvic chain coordination were performed for six weeks (3 sessions per week). Visual Analog Scale and disability questionnaire were used to measure the pain and disability of the subjects, respectively, and to measure muscle tolerance, two methods of assessing activation score and deep neck flexor muscle performance index were used by compression biofeedback device. Finally, data analysis was performed using SPSS software (version 22)at the significance level of P=0.05.

The one-way ANOVA test results showed a significant difference between the three groups in all variables (P<0.05). The Turkey post hoc test results showed no significant difference between the pain score and disability of the dynamic neuromuscular stability exercises and stabilization exercise groups (P>0.05). On the other hand, the results showed that after six weeks of training, there was no significant difference between muscle activation score and muscle performance index in the control and stabilization exercise groups (P>0.05).

Both training protocols had a significant effect on reducing pain and disability. However, dynamic neuromuscular stability and stabilization exercises substantially increased the tolerance of deep neck flexor muscles compared with the stabilization exercises group. It can also be a better approach to treat non-specific chronic neck pain.

There is little evidence regarding the relationship between gait performance and psychological factors in people with chronic neck pain. This study evaluates gait performance in patients with neck pain and explores the relationship between gait performance and kinesiophobia, pain catastrophizing, pain intensity, and disability.

A cross-sectional study was conducted on 34 patients with chronic neck pain and 29 age- and sex-matched controls were recruited for this study. The participants performed timed up-and-go (TUG), and 10-m walk tests (TMW) with and without head-turning tests. The associations between clinical gait tests, kinesiophobia (Tampa scale of kinesiophobia (TSK), pain catastrophizing scale, pain intensity (visual analog scale), and disability (neck disability index) were assessed.

People with neck pain had significant differences in the TUG, and TMW with and without head-turning tests compared to controls (P<0.01). Kinesiophobia and pain catastrophism were significantly correlated with TMW tests (r range=0.45 to 0.71, and 0.40 to 0.47, respectively). Pain intensity and disability were not correlated with gait tests.

The gait performance, as represented by TUG and TMWs test scores, altered in patients with chronic neck pain in comparison controls. Fear of motion and pain catastrophizing thoughts correlated with clinical gait test scores.

There is conflicting evidence regarding the effects of exercise on shoulder impingement syndrome. Exercise therapy is one of the methods used to reduce pain and increase muscle strength in patients with shoulder impingement syndrome. There are several exercise therapy programs available in this area. The purpose of this study is to evaluate the effect of exercise therapy on pain and disability in patients with shoulder impingement syndrome.

This randomized clinical trial was conducted in 25 patients with impingement syndrome from the Dastgheib Yasaei Pain Clinic in Fasa. Patients were randomized to receive medication (n=13) or medication plus exercise therapy (n=12). The Oswestry Disability Index (ODI) and the Verbal Numeric Rating Scale were used to measure disability and pain intensity before and after the intervention. Patient satisfaction was measured using the Likert scale. Independent and paired t-test, Mann-Whitney U test, and chi-squared were performed at a significant level of P≤0.05. Analyses were performed with SPSS software (version 25.0).

There were no differences between groups in pre-intervention demographics (P>0.05), pain intensity (P=0.16), and ODI scores (0.93). Post-intervention pain and ODI scores were significantly higher in the medication group than in the medication-exercise group (P=0.06, P=0.03, respectively). There was a significant difference in pain and ODI scores at post-intervention compared to pre-intervention in both groups (P<0.001). The difference in pain intensity between pre- and post-intervention in both groups was also statistically significant (P=0.006). There was a significant difference in patient satisfaction between groups (P=0.03).

These results suggest that a regular exercise program, along with medication, may be effective in reducing pain and disability in patients with shoulder impingement syndrome.

Chronic non-specific low back pain (CNSLBP) is a common health issue caused by a mix of biological, psychological, and social factors. Cognitive functional therapy (CFT) is a comprehensive way to treat CNSLBP that focuses on changing negative thoughts and unhelpful habits through relaxation techniques. Since the evidence on the efficacy of CFT is still limited, it is essential to conduct clinical trials aimed at the effectiveness of CFT in the treatment of CNSLBP. This study aims to examine the effect of cognitive functional therapy on psychological variables in women with CNSLBP.

Thirty women with CNSLBP were recruited for the clinical trial. They were randomly divided into two experimental and control groups (15 patients in each group). Our experimental group will have 18 individualized CFT sessions, each lasting an hour, over two months. The control group received no intervention. Pain intensity, disability, and kinesiophobia were assessed via the visual analog scale, Oswestry, and Tampa scale, respectively. Two-way repeated measures analysis of variance (ANOVA) was used to compare results between groups.

Two-way repeated measures ANOVA results showed that the experimental group compared to the control group in reducing pain (P=0.000, ηp2=0.787), disability (P=0.005, ηp2=0.457) and Kinesiophobia (P=0.000, ηp2=0.561) had a significant difference.

CFT reduced pain, disability, and kinesiophobia in patients with CNSLBP. Further evaluation of the efficacy of CFT in high-quality randomized clinical trials among patients with CNSLBP is recommended.

Fingolimod and interferons are used in the relapse form of multiple sclerosis (MS). The goal of this systematic review and meta‑analysis was to evaluate the efficacy of fingolimod versus interferon in patients with MS. The systematic search was done in PubMed, Scopus, Embase, Web of Science, and Google Scholar.

The references of included studies as well as conference abstracts were searched up to July 2021. The literature search revealed 8211 articles, and after deleting duplicates 5594 remained. For the meta‑analysis, four studies were included. The standardized mean difference (SMD) of the Expanded Disability Status Scale (EDSS) after treatment (interferon vs fingolimod) was −0.06 (95% CI: −0.28, 0.17) (I2 = 80.2%, P = 0.002).

The SMD of the annual relapse rate (ARR) after treatment (interferon – fingolimod) was −0.08 (95% CI: −0.53, 0.36) (I2 = 95.5%, P < 0.001). The SMD of the ARR after treatment and before treatment in the interferon group was − 1.45, (95% CI: −1.55, −1.36) (I2 = 0, P = 0.3). The SMD of ARR after treatment and before treatment in the fingolimod group was − 1.3, (95% CI: −1.94, −0.65) (I2 = 97.4%, P < 0.001).

The results of this systematic review show that efficacy of interferon and fingolimod in controlling relapse rate and disability is similar.

The death and fear of the COVID-19 pandemic has been a major concern in all countries. Estimating the burden of the disease is one of the indicators that estimates the severity of the damage caused by the disease. This study was performed to estimate the burden of years of life lost due to COVID-19 infection and premature death in North Khorasan.

In this study, all cases of definitive infection (PCR test positive) with COVID-19 from the beginning of the epidemic to April 2021 were included in the study. Disability-Adjusted Life -Years index (DALYs) was used to estimate the burden of the disease.

Since the beginning of the epidemic, 63697 definite cases of the disease have been identified (prevalence equal to 7%) and the total number of years of life lost due to disability and premature death was estimated at 24769 years. This number represents 28.7 years per 100,000 populations, which in women and men, this number was equal to 26.6 and 30.8, respectively.

According to the results of the study, COVID-19 has caused significant loss of years of life, which due to age and concomitant diseases, deaths are more common in the elderly.

According to the World Health Organization (WHO), more than 1 billion people (approximately 15% of world population) live with disability. Also, about half of these people lack access to healthcare facilities. Therefore, providing timely healthcare services, especially rehabilitation, is of great significance for these people. The goal of the study was to determine the objectives and policies in the field of rehabilitation in middle- and high-income countries and compare them with Iran.

Based on available databases, a comprehensive review of documents, papers, and books was performed in the field of rehabilitation related to high- and middle-income countries. 

Due to a lack of coordinated services, inappropriate access, unplanned distribution, unclear service delivery levels, neglect of health promotion and prevention levels, lack of a transparent referral system, unclear insurance system, and weak financial resources, the need for a national program with a service integration approach is strongly felt. The review of the rehabilitation programs and documents in other countries help us to design a conceptual framework of the rehabilitation service model, which is based on three principles: Removing barriers and developing access to healthcare services and programs; strengthening and developing rehabilitation using technology, community-based support, and rehabilitation services; and promoting comparable international data collection on disability and supporting research on disability and related rehabilitation services.

Conclusion:

 The national rehabilitation program, with a service integration approach, provides a good platform for fair access to rehabilitation services for all people with disability. In this program, the health system is the most important reference to meet these needs. Therefore, it is suggested that this program pursue three main objectives Fair promotion of the healthcare services of rehabilitation for recipients, improving the response to the needs of rehabilitation service recipients, and reducing the financial and social risks of service recipients.

Smartphone is now an inevitable device for the populace, with its use growing progressively worldwide. There is lack of published literature focusing on the consequences of smartphone addiction on middle-aged and older adults in Nigeria. This study investigated the association between smartphone addiction, psychological status, insomnia and pain-related disability of the neck among staff of the College of Medicine, University of Lagos (CMUL).

This study involved the use of cross-sectional survey to investigate 271 (106 females, 165 males) staff of CMUL, Lagos, mean age (45.797±9.28 years) via purposive sampling technique in 2022. Four standard questionnaires were used for data collection; smart phone addiction scale (SAS), depression, anxiety and stress scale (DASS), neck pain disability index (NDI), and insomnia severity index (ISI).

The results revealed that 80 (29.5%) staff of college of medicine were addicted to smartphone use. Eleven (4.1%) staff of this college had severe depression, 16 (5.9%) had extremely severe anxiety while nine (3.3%) were severely stressed. Nine (3.3%) participants had clinical insomnia and five (1.8%) had moderate to severe problem with their neck. It was revealed that there was a significant association between smartphone addiction, pain-related disability of the neck (p=0.023), and insomnia (p=0.001). However, no significant association existed between depression (p=0.578), anxiety (p=0.060), stress (0.685), and smartphone addiction level of the participants

Smartphone addiction is predominant among staff of CMUL, and it is associated with neck pain-related disability and insomnia.

Neck pain is one of the most common musculoskeletal disorders among office workers. This study aimed to investigate the impact of strengthening the neck muscles on pain prevalence and neck disability among office workers.

This interventional study was performed among 85 University office workers (female=50 and male=35). Participants were randomly divided into the two groups (exercise group=42 subjects and control group=43 subjects). The exercise intervention was performed for 12 weeks, five sessions per week, and each session lasted approximately 15 minutes in the experimental group. Evaluations were performed at baseline and after 12 weeks: demographic questionnaire, Nordic questionnaire for measuring neck pain prevalence, and Neck Disability Index (NDI) for measuring functional disability were applied. The neck pain prevalence and NDI were compared before and after the intervention using McNemar and paired t-tests.

47.05% and 40% of all participants reported neck pain during the last 12 months and the last seven days, respectively. The neck pain prevalence during the last seven days (P<0.05) and NDI (P<0.01) after exercise were significantly decreased comparing to the other group.

About half of the office workers suffer from neck pain, and exercise intervention can improve and reduce the prevalence of neck pain and NDI by strengthening neck muscles.

 There is evidence supporting the effectiveness of mirror therapy (MT) in improving pain and function in the upper limbs. However, there are limited studies that validate its effectiveness in enhancing function and reducing pain among individuals with chronic back pain.

 This study aimed to assess the effect of motor correction exercises with and without MT on pain intensity and disability in patients with chronic low back.

 This randomized clinical trial study was conducted on 72 participants with chronic back pain referring to physiotherapy centers affiliated with Jundishapur University of Medical Sciences, Ahvaz. Specific exercises using MT were performed in the intervention group (36 participants) and without it in the control group (36 participants) for 10 weeks. The condition of the patients before and after the intervention and 3 months after the intervention was evaluated using a chronic pain questionnaire, pain intensity, and Oswestry index. The data were analyzed using SPSS version 22, employing descriptive and inferential statistical methods. A significance level of P ≤ 0.05 was used.

 A significant difference was observed between the groups for the variables that showed pain intensity after treatment (P = 0.001) and the difference remained in the follow-up (P = 0.003) Chronic pain after treatment and the difference at follow-up [-0.41 (-3.45 to 2.47), P = 0.001] and disability remained after treatment [-2.6 (-5.6 to 0.5); P = 0.02] which indicates the effectiveness of MT.

 Based on the results, MT was effective in reducing the pain intensity and disability experienced by patients with chronic back pain. As a result, considering its affordability and ease of access, patients can perform the exercises independently after receiving proper instruction and guidance.