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Background: Low back pain (LBP) is a common musculoskeletal disorder, and respiratory exercise is considered a nonsurgical management method. Therefore, this systematic review and meta-analysis aims to estimate the results of randomized controlled trials on the effect of respiratory training in reducing LBP and its dose relationship. Methods: The present study was conducted from January 2020 to January 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (2020). Relevant studies were searched in multiple databases including PubMed, Web of Science, the Cochrane Library, EBSCO, Scopus, ScienceDirect, Wan Fang and China Knowledge Network, ClinicalTrials.gov, and Google Scholar, using a combination of MeSH/Emtree terms and free-text words. The heterogeneity of the studies was assessed using the I2 statistic. Results: A total of 14 publications were included in the meta-analysis, with a total sample size of 698 individuals, aged 60–80 years. Respiratory exercise was effective in relieving LBP (standardized mean difference = −0.87, P <.00001) and improving physical disability (standardized mean difference = −0.79, P <.00001). The type of breathing and the total duration of breathing exercises were found to be the source of heterogeneity in this study by subgroup analysis. Subgroup analysis revealed that the most significant effect sizes of breathing resistance exercise to reduce LBP and the most significant effect sizes of breathing relaxation techniques to alleviate physical disability were performed 3 to 5 times per week and period >4 weeks. Respiratory exercise reducing LBP and improving functional disability was most effective when the total duration of the intervention was >500 minutes. Funnel plots showed that the results of the 2 overall studies were reliable without publication bias. Conclusions: Respiratory exercise can effectively reduce LBP and improve physical disability. Therefore, these exercises can be regarded as a part of a LBP management plan. We recommend an exercise program with 30 to 50 minutes, 3 to 5 times per week, and >4 weeks of breathing resistance exercise program as the most effective for treating LBP. [ABSTRACT FROM AUTHOR]

BACKGROUND: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives. OBJECTIVE: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. METHODS: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. RESULTS: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. DISCUSSION: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.

ObjectiveAssessing functional limitations for adults at high risk of frailty yields valuable information for identifying those in need of therapy. We evaluate a self-report measure used to assess physical function among Medicare recipients in the United States.DesignSecondary analysis of the 2020 Medicare Health Outcomes Survey.SettingA random sample of adult enrollees of 510 managed care plans.Participants287,476 adults (37% completion rate): 58% women; 16% were

Context: Hip muscle imbalance, especially between gluteal muscles and tensor fasciae latae (TFL), is one of the risk factors for developing low back pain which should be considered in rehabilitation programs. This study compared the effect of exercises with gluteal-to-TFL muscle activation index above and below 50 on pain intensity, disability, and lower limbs' range of motion (ROM) in patients with nonspecific chronic low back pain. Design: A semiexperimental intervention study with a pretest and posttest. Methods: A total of 45 patients with nonspecific chronic low back pain were randomly divided into 2 experimental groups of gluteal-to-TFL muscle activation index above 50 (n = 15), below 50 (n = 15), and a control group (n = 15). Pain intensity (visual analog scale), disability (Roland–Morris Disability Questionnaire), and lower limbs' ROM including hip extension, hip abduction, hip external rotation, and knee extension (goniometer) were assessed at pretest and after 8 weeks of intervention. Results: Within-group comparison showed significant improvement of pain, disability, and ROMs in both experimental groups. No significant changes were observed in the control group. In between-group analysis, significant differences were observed in group of gluteal-to-TFL muscle activation index above 50 for only pain (P =.03) and disability (P =.01). For ROMs, although clinical improvement of lower limbs' ROMs was higher in group of gluteal-to-TFL muscle activation index above 50, no statistically significant differences were found between 2 experimental groups. Both experimental groups were superior to the control group for all outcomes. Conclusions: Findings indicate the statistically and clinically superior effectiveness of exercises with a gluteal-to-TFL muscle activation index above 50 in the reduction of pain and disability. Based on the clinical significance of exercises with a gluteal-to-TFL muscle activation index above 50 for improving ROMs, utilizing specific exercises that more activated gluteal muscle compared to TFL is recommended for patient with restricted lower limbs' ROMs. [ABSTRACT FROM AUTHOR]

BackgroundTools, such as the STarTBack Screening Tool (SBT), have been developed to identify risks of progressing to chronic disability in low back pain (LBP) patients in the primary care population. However, less is known about predictors of change in function after treatment in the specialty care population.ObjectiveWe pursued a retrospective observational cohort study involving LBP patients seen in a multidisciplinary specialty clinic to assess which features can predict change in function at follow-up.MethodsThe SBT was administered at initial visit, and a variety of patient characteristics were available in the chart including the presence of chronic overlapping pain conditions (COPCs). Patient Reported Outcomes Measurement Information System-10 (PROMIS-10) global physical health (PH) and global mental health (MH) were measured at baseline and at pragmatic time points during follow-up. Linear regression was used to estimate adjusted associations between available features and changes in PROMIS scores.Results241 patients were followed for a mean of 17.0 ± 7.5 months. Mean baseline pain was 6.7 (SD 2.1), PROMIS-10 global MH score was 44.8 (SD 9.3), and PH score was 39.4 (SD 8.6). 29.7% were low-risk on the SBT, 41.8% were medium-risk, and 28.5% were high-risk. Mean change in MH and PH scores from baseline to the follow-up questionnaire were 0.86 (SD 8.11) and 2.39 (SD 7.52), respectively. Compared to low-risk patients, high-risk patients had a mean 4.35 points greater improvement in their MH score (p= 0.004) and a mean 3.54 points greater improvement in PH score (p= 0.006). Fewer COPCs also predicted greater improvement in MH and PH.ConclusionsSBT and the presence of COPC, which can be assessed at initial presentation to a specialty clinic, can predict change in PROMIS following treatment. Effort is needed to identify other factors that can help predict change in function after treatment in the specialty care setting.

Purpose: To develop a Korean version of simple, intuitive descriptions (SIDs) for clinical use of the generic functioning domains in the International Classification of Disease 11th revision (ICD-11) Chapter V. Methods: The initial Korean SID version proposal for the International Classification of Functioning, Disability, and Health (ICF) Rehabilitation set was translated following the Italian version. The remaining 17 codes were developed using original ICF descriptions; WHO Disability Assessment Schedule, Model Disability Survey, Korean Classification of Functioning, Disability, and Health; and previous studies. The final proposal for the Korean version of SIDs was selected through virtual conferences and three rounds of voting. Results: This study developed SIDs for the 47 generic functioning domains in the Chapter V of ICD-11. However, the SID for 20 of the 47 codes was confirmed in vote A, for 23 codes in vote B and for the remaining 4 in the final vote. All experts agreed with the final SID proposal. Conclusions: This is the first study in South Korea to attempt the development of SIDs for ICD-11 Chapter V. Therefore, the findings of this study could be used to evaluating of disability, functioning when ICD-11 is adopted for use in Korean clinical settings. IMPLICATIONS FOR REHABILITATION: Simple, intuitive descriptions (SIDs) highlight the core concepts of the ICF category definitions in a user-friendly manner and enhance the utility of the ICF for routine clinical practice. The 11th revision of the International Classification of Disease (ICD-11) was developed in 2019 with the addition of Chapter V which reflects functioning domains and better explains the association between functioning and disease. In addition, Chapter V is based on ICF, so the concept of ICF must be included, and concept definition is required for use in clinical practice. This study developed a Korean version of SIDs for clinical use of the generic functioning domains in the ICD-11 Chapter V. [ABSTRACT FROM AUTHOR]

Purpose: To examine the reliability of ADL interview (ADL-I) ability measures when administered by different health professionals (HPs). Materials and methods: Older adults with stable ADL ability were invited to participate in three ADL-I interviews, administered by occupational therapists (OTs), physical therapists (PTs), and nursing staff (NS), respectively. Methods based on classic and modern test theory were applied. Results: Overall, n = 36 older adults and n = 11 HPs participated. Intraclass Correlation Coefficients were acceptable for research purposes (> 0.7), but not for clinical use. Mean differences in ADL ability measures were significant when comparing measures based on interviews by OTs to measures based on interviews by PTs and NS. Further, in 25 to 47% of the individuals, ADL-I ability measures differed significantly across HPs. Limits of Agreement revealed that measures based on interviews by OTs were systematically lower compared to measures based on interviews by PTs and NS. Four ADL-I items displayed Differential Item Functioning based on HP. Conclusion: When using the ADL-I, it is recommended to only involve one profession, to increase the reliability of measures. Results highlight the importance of evaluating reliability of measures based on instruments administered across HPs before implementation in rehabilitation practice and research. IMPLICATIONS FOR REHABILITATION: Evaluations of activities of daily living (ADL) ability conducted in rehabilitation practice by different health professionals may not generate comparable results. When using the ADL-Interview, it is recommended to only involve one profession, to increase reliability of measures. The results of the present study highlight the importance of evaluating if ADL instruments can produce reliable measures in terms of both interrater reliability and measurement error. [ABSTRACT FROM AUTHOR]

Objectives This article investigates the role of pain in disability trends in the United States, within the context of recent unfavorable disability trends and the concurrent rise in pain. Methods We conducted a 2-part analysis using National Health Interview Survey data from 2002 to 2018 for U.S. adults aged 45–84. First, we assessed how changes in the prevalence of 5 site-specific types of pain (headaches/migraines, joint, low back, neck, and facial/jaw pain) associated with disability trends. Second, we used self-reported causes of disability and examined whether there has been a change in the proportion of individuals who attribute their disability to 1 of 5 chronic or acute painful conditions. Results The 5 site-specific types of pain, individually and collectively, were significantly associated with increases in disability. If site-specific chronic pain had not increased during the study period, the trend for functional limitations would have been 40% lower, and that for activity limitations would have shown a slight decline instead of an increase. Attributions of functional limitations to painful conditions increased by 23% during the 2002–2018 period, representing an additional 9.82 million Americans experiencing pain-attributable disability. Arthritis/rheumatism, back/neck problems, and other musculoskeletal/connective conditions were the primary sources of pain-related disability. Discussion Our research provides the first systematic, national examination of how pain is contributing to disability trends in the United States. The findings have implications for disability reduction policies and shed light on the far-reaching consequences of pain for overall population health. [ABSTRACT FROM AUTHOR]

The Oswestry disability index (ODI) is widely utilized as a patient reported outcome (PRO) tool to assess patients presenting with low back pain (LBP) and following thoracolumbar spine surgery. No primary study has calculated the baseline range of ODI values in the diverse American population. Establishing age-adjusted normative values for ODI in the American population is crucial for assessing the utility of treatment strategies. The purpose of this study is to describe the baseline range of functional low back disability as measured by the ODI in an American population. Cross-sectional observational study. A total of 1214 participants were recruited from the United States in January 2024 using a combination of the Connect and PrimePanel platforms by CloudResearch to complete a survey administered on a RedCap online database. The survey consisted of 10 demographic questions and the 10 ODI survey questions. The distribution of the survey was designed to obtain approximately 100 respondents in each of the following age groups: 18–29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, 70 to 79, and 80 to 89. The distribution of the sample was similarly designed to match the United States Census racial data with 78.1% White, 13.9% Black, and 7.9% other. Oswestry disability index (ODI). A crowd-sourcing platform called Cloudresearch was used to collect a representative sample of the US population by answering questions of the Oswestry disability questionnaire (ODQ), a 10-question survey. The final sample size was 797 participants including 386 (48.4%) males and 411 (51.6%) females; 169 participants were excluded that did not complete the survey and an additional 248 were excluded for failing attention check questions. The overall mean ODI score for the combined age groups was 14.35 (95% CI [13.33, 15.37]). The mean ODI scores increased with age, with the highest mean ODI in ages 70 to 79 at 18.0 (95% CI [14.76, 21.24]). Female participants reported higher mean ODI scores than their male counterparts in the 18 to 29 age group (p=.01), 50 to 59 age group (p=.01), and 60 to 69 age group (p=.02). Additionally, a weak positive correlation was found between Body Mass Index (BMI) and ODI scores (r = 0.22, p<.001). Our findings demonstrate a clear trend of increased disability with age. This study describes the baseline range of functional low back pain disability in the United States population. By defining these parameters, healthcare professionals can better tailor age and sex-specific interventions to manage disability in the aging US population, ultimately improving patient care and both operative and nonoperative treatment plans for LBP-related thoracolumbar pathology. [ABSTRACT FROM AUTHOR]

Objectives: We evaluate the presence of sensitization-associated symptoms and neuropathic pain features and identify if there is an association between these symptoms and pressure pain sensitivity, pain, and related-disability in lateral elbow tendinopathy. Methods: Thirty-seven (43% women, age: 45.5 ± 9.5 years) patients with lateral elbow tendinopathy completed: demographic (i.e. age, height, and weight); clinical (i.e. pain history, pain intensity, and Disabilities of the Arm, Shoulder and Hand); and psychophysical (i.e. pressure pain thresholds at the elbow, cervical spine, hand, and leg) outcomes, and the Central Sensitization Inventory and Self-administered Leeds Assessment of Neuropathic Symptoms and Signs questionnaires. Step-wise multiple linear regression models were performed to identify predictors of sensitization- or neuropathic-associated symptoms. Results: Six (16%) patients exhibited sensitization-associated symptoms (mean: 46.5, SD: 6.1), whereas 13 (35%) patients showed neuropathic-associated symptoms (mean: 13.5; SD: 1.4). Sensitization-associated symptoms were positively associated with neuropathic-associated symptoms (r = 0.538, P =.001) and negatively associated with pressure pain thresholds at the leg (r = -0.378, P =.021). Neuropathic-associated symptoms were positively associated with related-disability (r = 0.479, P =.003) and negatively associated with pressure pain threshold at the elbow (r = -0.394, P =.017). Stepwise regression analyses revealed that neuropathic-like symptoms explained 26.8% of the variance of sensitization symptoms (r2: 0.268), whereas pressure pain threshold at the elbow explained an additional 6.6% to neuropathic-like symptoms (r2: 0.334). Conclusion: This explorative study identified sensitization- and neuropathic-associated symptoms in 16% and 35% of the people with lateral elbow tendinopathy. Sensitization- and neuropathic-associated symptoms were associated. Pressure pain sensitivity at the elbow (peripheral sensitization) was associated with neuropathic -associated symptoms. [ABSTRACT FROM AUTHOR]

Background: The efficacy of various supervision methods for stabilization exercises in patients with chronic low back pain (CLBP) remains uncertain. Objective: To evaluate the impact of supervised and unsupervised stabilization exercises in patients with CLBP. Methods: Sixty-six participants were assigned to the in-person-supervised, tele-supervised, or unsupervised groups. All participants received a 20–30-minute exercise program three times a week for 4 weeks. We assessed functionality (Oswestry Disability Index), pain intensity (Numeric Rating Scale), and kinesiophobia (Tampa Scale of Kinesiophobia) before and after the 4 weeks. The outcomes were analyzed using effect size, minimum clinically important difference (MCID), minimal detectable change (MDC), Wilcoxon test, and post hoc analyses. Results: While the unsupervised group improved in all measures (p <.05) both the tele-supervised (p =.001) and in-person-supervised (p <.001) groups achieved superior functionality exceeding MDC. The in-person-supervised group demonstrated greater functionality (p <.001) than the tele-supervised group, exceeding MCID. Pain intensity decreased in the tele-supervised (p =.011) and in-person-supervised groups (p <.001) compared to the unsupervised group, exceeding MCID and MDC. No significant difference was found in post-treatment NRS score changes between the supervised groups (p =.071). The in-person-supervised group displayed a greater reduction in kinesiophobia than the tele-supervised (p <.001) and unsupervised groups (p <.001) but not exceeding MCID or MDC. Effect sizes were large within and between groups except for a small effect size between the tele-supervised and unsupervised groups in kinesiophobia. Conclusion: While tele-supervised stabilization exercises alleviate pain and enhance functionality, in-person-supervised exercises may be more effective in improving functionality and reducing kinesiophobia in patients with CLBP. [ABSTRACT FROM AUTHOR]

Objective: We investigated if theta burst stimulation could enhance recovery by reducing key symptoms when implemented acutely post fracture in participants with an isolated upper limb fracture. Methods/Design: This was a pilot study with a randomized matched pair, sham-controlled, participant-blind design of a 10-day prolonged continuous theta burst stimulation protocol. Two main groups were included: I) participants with isolated upper limb fracture receiving active theta burst stimulation and II) patients with isolated upper limb fracture receiving SHAM/placebo. Another group (III) of healthy individuals was the reference group. Disability and pain intensity were collected through questionnaires (disabilities of the Arm, Shoulder, and Hand as well as numerical rating scale (NRA)) at three time points (baseline; 72 hrs after intervention, 3 mos after injury). Group III completed the baseline assessment. Results: Seventy-nine participants were enrolled. Individuals in the ACTIVE and SHAM groups had similar baseline measures. For disability, the interaction between intervention and time approached significance (F = 2.33; P = 0.11), whereas it was significant for pain (F = 3.42; P = 0.04). At 3 mos after injury, the ACTIVE group reported reduced disability (F = 4.71; P = 0.04) and pain (F = 5.84; P = 0.02) at 3 mos after injury compared to the SHAM group, with clinical measures from ACTIVE group being like controls. Conclusions: In isolated upper limb fracture patients, a 10-day theta burst stimulation intervention implemented acutely posttraumatic had beneficial effects on symptoms of functional recovery and pain at 3 mos after trauma. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effects on pain and disability recovery after a whiplash of a guided neck-specific exercise therapy, compared to a different or an unguided neck-specific exercise therapy. Design: A literature search was conducted from inception to May 31, 2023, in three electronic databases: PubMed, ScienceDirect, and Web of Science. Eleven randomized controlled trials were included. Metaanalyses were performed with Review Manager software. The standardized mean difference with a 95% confidence interval was used to measure the effect sizes and only short-term time points were considered. Results: Not all studies reported a significant decrease of pain and disability in the neck-specific exercise group compared to controls. However, meta-analyses demonstrated a significantly greater decrease in neck pain (standardized mean difference: −0.25; 95% confidence interval: [−0.38, −0.12]; P=0.0002) and neck-disability index (standardized mean difference: −0.35; 95% confidence interval: [−0.54, −0.15]; P=0.0005) in the neck-specific exercise group. Conclusions: In addition to the benefits that a guided neck-specific exercise therapy has on motivation and program adherence, it provides greater benefits in pain and disability than a different or unguided neck-specific exercise therapy. Positive results are observed primarily with intervention periods of more than 6 wks and at least two sessions per week. [ABSTRACT FROM AUTHOR]

Purpose/Objective: Small sample sizes are a common problem in disability research. Here, we show how Bayesian methods can be applied in small sample settings and the advantages that they provide. Method/Design: To illustrate, we provide a Bayesian analysis of employment status (employed vs. unemployed) for those with disability. Specifically, we apply empirically informed priors, based on large-sample (N = 95,593) July 2019 Current Population Survey (CPS) microdata to small subsamples (average n = 26) from July 2021 CPS microdata, defined by six specific difficulties (i.e., hearing, vision, cognitive, ambulatory, independent living, and self-care). We also conduct a sensitivity analysis, to illustrate how various priors (i.e., theory-driven, neutral, noninformative, and skeptical) impact Bayesian results (posterior distributions). Results: Bayesian findings indicate that people with at least one difficulty (especially ambulatory, independent living, and cognitive difficulties) are less likely to be employed than people with no difficulties. Conclusions/Implications: Overall, results suggest that Bayesian analyses allow us to incorporate known information (e.g., previous research and theory) as priors, allowing researchers to learn more from small sample data than when conducting a traditional frequentist analysis. Impact and Implications: We provide a Bayesian tutorial for selecting priors, computing, and interpreting results within the context of disability research. We hope to inspire future research using Bayesian analysis for small sample disability data. [ABSTRACT FROM AUTHOR]

Background: There is limited knowledge about the possible long‐term effects on jaw motor function after whiplash trauma. Objectives: The primary aim was to evaluate integrated jaw and head–neck movement amplitudes during jaw function in individuals 2 years after whiplash trauma, compared to controls. The secondary aim was to evaluate changes between the acute stage and a 2‐year follow‐up in terms of jaw and head–neck movement amplitudes during jaw function. Methods: This study included 28 cases exposed to a whiplash trauma 2 years earlier (13 women) and 28 controls (13 women) without previous neck trauma. Head and jaw movement amplitudes were recorded during maximal jaw opening–closing movements using an optoelectronic 3D recording system. For a subpopulation of 12 cases and 15 controls, recordings had also been performed in the acute stage after the whiplash trauma. Jaw and head movement amplitudes were analysed using linear regression with group and sex as independent variables. The subpopulation longitudinal analysis was adjusted for movement amplitudes at baseline. Results: Jaw movement amplitudes were significantly associated with group (coefficient: −0.359: 95% CI: −10.70 to −1.93, p =.006) with smaller amplitudes of jaw movements for whiplash cases. Head movement amplitudes were not associated with group (coefficient: −0.051, 95% CI: −4.81 to 3.20, p =.687). In the longitudinal analysis, both jaw and head movement amplitudes showed significant associations between baseline and the 2‐year follow‐up. Conclusion: The present findings indicate that the effects on jaw function in terms of jaw opening capacity in the acute stage after whiplash trauma do not spontaneously recover. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether acts of offensive behaviour (threats, violence, workplace bullying and sexual harassment) in the workplace and type of perpetrator (internal or external to the workplace) of the offensive behaviours predicted risk of disability pension in Danish eldercare workers. Methods: We merged survey responses from 8731 female eldercare workers with a national register on social transfer payments (Danish Register for Evaluation of Marginalisation (DREAM)), including all types of disability benefits. Using Cox proportional hazards models, we investigated the prospective association between self-reported exposures at baseline and the risk of receiving disability pension (any type of disability benefit payment) during 11 years of follow-up, while adjusting for potential confounders. Results: Self-reported exposure to threats (hazard ratio (HR) 1.14; 95% confidence interval (CI) 1.00–1.32), violence (HR 1.16; 95% CI 1.00–1.35) and bullying (HR 1.44; 95% CI 1.22–1.71) predicted increased risk of disability pension during follow-up, when adjusted for age and educational attainment. When further adjusted for psychosocial working conditions only bullying remained a statistically significant (HR 1.39; 95% CI 1.16–1.67) predictor of disability pension. The results indicated no elevated risk for participants reporting sexual harassment. Moreover, we observed stronger associations between self-reported exposure to threats, violence and workplace bullying and risk of disability pension when the perpetrator was internal to the workplace (i.e. colleagues, managers and/or subordinates), than when the perpetrator was reported to be external to the workplace (i.e. service users, and/or relatives of service users). Conclusions: Results indicate that prevention of work-related exposure to threats, violence and workplace bullying may contribute to reduce involuntary early retirement in female eldercare workers. [ABSTRACT FROM AUTHOR]

* OBJECTIVE: To investigate whether improvements in forward bending were related to improvements in pain and disability in people with chronic low back pain (CLBP) who were undergoing Cognitive Functional Therapy (CFT). * DESIGN: Longitudinal observational study. * METHODS: Two hundred and sixty-one participants with CLBP received CFT. Forward bending was assessed at each treatment session over 13 weeks (an average of 4.3 timepoints per participant [range, 1-8]). Spinal range of motion (ROM) and velocity were recorded using 2 inertial measurement units located at T12 and S2. Participants reported (1) average pain intensity (0-10 scale) (pain) and (2) pain-related activity limitation (Roland Morris Disability Questionnaire [disability]) via online questionnaires at 0, 3, 6, and 13 weeks. Multivariate multilevel models were used to evaluate associations between individual rates of change over time for 3 spinal movement measures (trunk velocity, trunk ROM, lumbar ROM) and pain/disability. tRESULTS: Strong correlations were observed for increased trunk velocity with reduced pain (r = -0.81; 95% CI: -0.98, -0.05) and with reduced disability (r = -0.77; 95% CI: -0.95, -0.22). Moderate correlations were observed between increased trunk ROM with reduced pain (r = -0.37; 95% CI: -0.67, 0.04) and with reduced disability (r = -0.32; 95% CI: -0.6, 0.03). There was no evidence of association between changes in lumbar ROM and pain (r = -0.46; 95% CI: -0.90, 0.44) or disability (r = -0.01; 95% CI: -0.56, 0.55). tCONCLUSION: Reductions in pain and disability were strongly correlated with increased trunk velocity in people with CLBP who were undergoing CFT. These findings are consistent with CFT that explicitly trains "nonprotective" spinal movement. [ABSTRACT FROM AUTHOR]

BACKGROUND: Value-based healthcare delivery focuses on optimizing care provided by measuring the healthcare outcomes which are most important to the clients relative to the total care costs. However, the understanding of what adds value for clients during work disability assessment is lacking. OBJECTIVE: To explore what medical examiners (MEs) perceive as valuable during the work disability assessment process, by exploring possible: 1) facilitators, 2) barriers and 3) opportunities to add value for the client during the work disability assessment. METHODS: For this explorative qualitative study, 7 semi-structured interviews were conducted with MEs in the Netherlands. Thematic coding was performed for all interviews. RESULTS: A large variety of facilitators (n = 22), barriers (n = 17) and opportunities (n = 11) were identified and inductively subdivided into four main themes: 1) coherent process, including all time related aspects, 2) interdisciplinary collaboration, including all aspects related to the collaboration between the ME and other professionals, 3) client-centred interaction, including all aspects related to the supportive interplay from the ME towards the client, and 4) information provision on all aspects during the work disability assessment process towards the client to ensure a valuable work disability assessment process. CONCLUSIONS: The overview of identified possible facilitators, barriers and opportunities to add value for clients from the perspective of the ME may stimulate improvement in the current work disability assessment practice and to better match the client needs. [ABSTRACT FROM AUTHOR]

Purpose: As people living with thalidomide embryopathy (TE) are now entering their seventh decade, we examine the impact of ageing and the prevalence of comorbid health conditions reported in holistic needs assessments (HNAs) by individuals with TE, compare it with an age-matched sample of the general population, and explore the relationship between comorbidities and TE pattern of impairment. Materials and methods: The HNA categories were mapped and compared to those of the Health Survey for England (HSE) and analysed across four impairment groups (A–D). Results: 94% (392/415) of individuals with TE residing in the UK participated in the HNA and consented to a secondary analysis of the data. Less than 2% (5/392) reported no comorbidities; 94% reported nervous system problems; including pain, pins and needles and numbness. Individuals with TE reported a significantly greater number of health comorbidities, including musculoskeletal problems, than the age-matched HSE population. Conclusions: Individuals with TE report significantly more health and well-being concerns than the general population of a similar age. Long-term monitoring is needed to ensure that support and rehabilitation services can meet their evolving needs. IMPLICATIONS FOR REHABILITATION: People living with thalidomide's teratogenic effects are now entering their seventh decade. As they age, these individuals experience the long-term consequences linked to over-use of certain joints, including musculoskeletal and neuropathic pain. An understanding of the lived experience of TE with increasing age has the potential to inform the planning and provision of adequate and appropriate rehabilitation services moving forward. Adoption of a holistic approach to rehabilitation could help people living with TE to maintain functional independence as they enter their seventh decade. [ABSTRACT FROM AUTHOR]

Purpose: There are several ways to include "disability" in research studies, which can be confusing or overwhelming for researchers, community members, and students. The aim of this paper is to share conceptualizations of disability and how to ask about "disability" in research studies. The paper provides a general introduction and brief analysis of the methodological approaches which can be used. Methods: We used reviews of the literature and extensive discussions to identify key articles, books, websites, and reports that provide guidance and examples of asking about disability in research. Results: Four primary approaches to asking study participants about disability were identified. For each of these, we provide background information, key points about the ways to use the approach including tools that have been developed, and example studies. A comparison table provides a high-level overview of similarities and differences in approaches. Other approaches and tools were also identified and are briefly described. Conclusion: Researchers involved in disability and rehabilitation research should be aware that there is not one best or singular way to ask about disability when conducting research. The approach or approaches chosen for a particular study need to match the purpose of the study. It is important that researchers take time to carefully consider their options and choose the best fit for their study. IMPLICATIONS FOR REHABILITATION: There are several different ways to ask about disability and functioning when conducting research that aims to include a disability component or focus. Researchers need to carefully select the best option(s) for their study. Whenever possible, researchers should use more than one approach and should allow for more than one type of disability or impairment to be selected. Researchers often require training to understand how to include disability in research. Allow adequate time and resources for training research team members so that the tools are implemented correctly. [ABSTRACT FROM AUTHOR]

Background: This study investigates the clinical efficacy and safety of percutaneous endoscopic nucleotomy combined with platelet-rich plasma (PRP) injection in treating lumbar disc herniation (LDH) in young and middle-aged adults. Methods: From April 2022 to September 2023, 60 patients diagnosed with LDH were randomly divided into two groups (n = 30/group). The observation group underwent percutaneous endoscopic nucleotomy combined with autologous PRP gel injection into the disc, while the control group underwent percutaneous endoscopic nucleotomy alone. Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) scores were recorded preoperatively and at three time points postoperatively: three days, three months, and six months. The modified Macnab criteria were employed to evaluate efficacy at the final follow-up. Additionally, MRI Pfirrmann grading of the operated disc segment and potential complications were assessed both preoperatively and at the final follow-up. Results: All patients were followed for a minimum of six months. VAS and ODI scores at all postoperative time points (three days, three months, and six months) exhibited significant differences compared to preoperative scores in both groups (P < 0.05). Notably, a significant difference was observed in VAS and ODI scores between the two groups at three days postoperatively (P < 0.05). Preoperative MRI Pfirrmann grading indicated no significant difference between groups (P = 0.669). However, at the final follow-up, the observation group demonstrated superior recovery compared to the control group (P = 0.013). The modified Macnab criteria revealed no significant difference in the rates of excellent and good outcomes between the observation group (96.67%) and the control group (93.33%) (P > 0.05). Furthermore, no patients experienced complications such as dural tears, nerve root injury, infection, or hematoma. Conclusion: The combination of percutaneous endoscopic nucleotomy and PRP injection could be a safe and effective treatment for LDH in young and middle-aged adults to promote disc repair following endoscopic procedures. [ABSTRACT FROM AUTHOR]

Background: Older adults with chronic diseases often experience higher rates of Activities of Daily Living (ADL) disability, with research primarily examining the transition between states of ADL disability and non-disability. The current study aims to analyze the patterns and factors of mutual transitions between multiple different ADL disability states in older adults with chronic diseases. Methods: This longitudinal study utilized data from the Shanghai Elderly Care Unified Needs Assessment (SECUNA) spanning 2014 to 2017, with 2014 being the baseline. The study included older adults aged 60 years and older with chronic diseases. Using the Markov model, individuals were classified into three states: no ADL disability, mild ADL disability, and severe ADL disability. Transition patterns were analyzed by calculating the frequency, intensity, and probability of transition, and the influencing factors of six transition scenarios were evaluated. Results: Older adults with mild ADL disability were more likely to experience improvement (transition intensity: 0.4731) rather than deterioration (transition intensity: 0.2226) in their ADL disability states. However, those with severe ADL disability faced challenges in improving their states (transition intensities: 0.0068 and 0.1204). Among the six ADL disability transition scenarios, place of residence was associated with four scenarios, age and economic sources were associated with three scenarios, sex was associated with two scenarios, and other factors were associated with one scenario. Conclusions: The transition patterns and factors differ among individuals with varying ADL disability states. It is essential for relevant agencies to implement tailored preventive healthcare strategies to effectively manage the health status of older adults with chronic diseases. [ABSTRACT FROM AUTHOR]

Background: Chronic neck pain is a common musculoskeletal condition that has an impact on the function and quality of life of an individual. Psychosocial factors along with the physical factors may have an impact on the perception of pain. Hence, the study aimed to find the correlation of psychosocial factors with pain, posture, function, and disability in chronic mechanical neck pain patients. Method: A cross-sectional study using a convenient sampling method was conducted in 55 chronic mechanical neck pain patients. The pain was assessed using numerical pain rating scale (NPRS), pain pressure threshold (PPT) using a pressure algometer, kinesiophobia using Tampa Scale for Kinesiophobia (TSK), pain catastrophizing using Pain Catastrophizing Scale, Posture analysis was done by various postural angle and flexicurve, cervical muscle endurance was tested using the craniocervical flexion test, cervical proprioception was measured using head repositioning accuracy test and Neck disability index was used to score disability. Result: A significant positive correlation was found between TSK and NDI (r = 0.34, p = 0.01). There is a negative correlation of PTT (right sternocleidomastoid) with Kinesiophobia (r = − 0.35, p = 0.008). There is a moderate positive correlation between posture (shoulder angle on the left side) and TSK (r = 0.3, p = 0.02). Conclusion: The study concludes that psychosocial factors not only have a significant role but are correlated to pain, posture, function, and disability in patients with chronic mechanical neck pain. [ABSTRACT FROM AUTHOR]

Background: The aims of this study were to establish national disability weights based on the health state preferences of a Dutch general population sample, examine the relation between results and respondent's characteristics, and compare disability weights with those estimated in the European disability weights study. Methods: In this cross-sectional study, a web-based survey was administered to a general population 18–75 years from the Netherlands. The survey included paired comparison questions. Paired comparison data were analysed using probit regression and located results onto the 0-to-1 disability weight scale using non-parametric regression. Bootstrapping was used to estimate 95% uncertainty intervals (95%UI). Spearman's correlation was used to investigate the relation of probit regression coefficients between respondent's characteristics. Results: 3994 respondents completed the questionnaire. The disability weights ranged from 0.007 (95%UI: 0.003–0.012) for mild distance vision impairment to 0.741 (95% UI: 0.498–0.924) for intensive care unit admission. Spearman's correlation of probit coefficients between sub-groups based on respondent's characteristics were all above 0.95 (p < 0.001). Comparison of disability weights of 140 health states that were included in the Dutch and European disability weights study showed a high correlation (Spearman's correlation: 0.942; p < 0.001); however, for 76 (54.3%) health states the point estimate of the Dutch disability weight fell outside of the 95%UI of the European disability weights. Conclusions: Respondent's characteristics had no influence on health state valuations with the paired comparison. However, comparison of the Dutch disability weights to the European disability weights indicates that health state preferences of the general population of the Netherlands differ from those of other European countries. [ABSTRACT FROM AUTHOR]

Background: Many stroke survivors in low- and middle-income countries such as Ghana live with various degrees of disabilities. Insight into the level of disability and its determinants in stroke survivors has become very important. This study aimed to assess disability and determinants in stroke survivors in the Greater Accra Region of Ghana. Methods: One hundred and eight community-dwelling stroke survivors undergoing outpatient physiotherapy rehabilitation were sampled for the study. The World Health Organization disability assessment schedule (WHODAS) questionnaire was used to assess the level of disability in the participants. Sociodemographic and clinical data were gathered to help assess the determinants of disability. Association between sociodemographics and disability, and clinical characteristics and disability were determined using chi-square/Fisher's exact test. p values less than 0.005 were considered statistically significant. Results: Most of the study participants were reported to have moderate to severe disabilities in their bodily function. Age, gender, marital status, and employment status were found to be associated with the level of disability in stroke survivors. Conclusion: Disability and its determinants in stroke need to be given much attention as disability affects the ability of stroke survivors to function independently. [ABSTRACT FROM AUTHOR]

Background Exercise referral schemes (ERS) are an effective strategy for increasing physical activity (PA) in older adults. Behavioural self-management strategies (SMS) may augment the maintenance of PA and associated benefits in this population, resulting in preservation of the functional capacity and prevention of disability over the long-term. Aim The primary aim was to investigate the long-term (22-months) effects of ERS enhanced with SMS on functional capacity assessed by the Short Physical Performance Battery (SPPB) compared to ERS (primary comparison) and a control condition (CTRL). Secondarily, between-group effects after 4 and 16 months on the SPPB and self-reported disability outcomes were investigated. Methods 1360 physically inactive community-dwelling older adults ≥65 years from four European countries were randomized into (i) 16 weeks ERS enhanced with SMS (ERS-SMS), (ii) ERS alone and (iii) CTRL. In addition to SPPB, self-reported function and disability were assessed by the short-form late life function and disability index and with a six-item activity of daily living questionnaire. Results No long-term effects were found for the SPPB-score in ERS-SMS vs ERS (0.21 point, 95% CI [−0.04, 0.46]). Significant group × time effects were observed for the SPPB-score after 4 months in favour of ERS-SMS over CTRL (0.51 point, 95% CI [0.29, 0.73]) and ERS (0.46 point, 95% CI [0.24, 0.68]). Conclusion The study did demonstrate differences, in favour of ERS + SMS, but on SPPB these were small, and not sustained over time. The additional effect of SMS was inconsistent and uncertain. [ABSTRACT FROM AUTHOR]

Background: Loss of the ability to perform activities of daily living (ADLs) leads to negative health outcomes such as reduced quality of life, institutionalization, and mortality. In Korea, the proportion of older adults with disabilities is increasing along with rapid population aging. Therefore, providing a comprehensive approach to the prevention and management of ADL limitations in people with disabilities is necessary. This can be accomplished by understanding the trends and factors affecting these limitations over time. Purpose: This study was developed to examine the longitudinal trend and factors affecting ADL limitations over time among people with disabilities in Korea. Methods: Data from 346 people with disabilities in the 2008–2020 Korean Welfare Panel Study were used. Bivariate analysis and a Kendall trend test were performed to determine the longitudinal trends for ADL limitations, and multiple logistic regression was used to evaluate whether relevant variables could predict these limitations. Results: The prevalence of ADL limitations among people with disabilities increased by 16.5% over the 12 years of the study. The highest rate of increase in these limitations over time was found in people with mental disorders (27.8%), those over 65 years of age (27.3%), and those with depression (25.6%). In multiple logistic regression, the odds ratios of the variables were slightly different at each survey wave. However, severe disability and low educational level were consistently found to be associated with ADL limitations over time. Conclusions: The findings provide evidence of a significant relationship between level of disability and/or educational status and ADL limitations in people with disabilities in Korea. To prevent the development of ADL limitations in people with disabilities, comprehensive identification of longitudinal trends and factors affecting ADL limitations is necessary. Early intervention, including integrated services such as home rehabilitation services to prevent ADL limitations, especially for disabled people with severe disabilities and low educational levels, has the potential to delay ADL limitations. [ABSTRACT FROM AUTHOR]

Objectives: The aims of the study are to evaluate how upper limb impairment ratings are affected by updates to the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides) Sixth Edition 2024 compared with the AMA Guides Sixth Edition 2008 and to investigate potential correlations with judicial, legislative, and economic factors. Methods: Two expert evaluators reviewed 31 upper limb clinical vignettes from the 2008 and 2024 versions. The impairment ratings for each version were compared. Results: After following the impairment ratings steps in each version, the results for 2024 showed no significant differences when compared with the impairment ratings generated using 2008 methods (Cohen's kappa = 1.00). Conclusions: The updated AMA Guides Sixth Edition 2024 with improved, transparent processes and enhanced diagnosis-based impairment tables provides efficiency while retaining the accuracy, validity, and reliability of past versions of the AMA Guides. [ABSTRACT FROM AUTHOR]

The degree to which disability benefit programs provide an adequate standard of living to those with work-limiting disabilities has long been overlooked in social policy research. This paper presents a framework for assessing disability-related decommodification and then applies that framework to an analysis of the Social Security Disability (SSD) programs in the United States. The paper draws on survey data from the Health and Retirement Study linked to administrative records from the Social Security Administration, and further compares the U.S. estimates to those from 27 other countries. The results indicate that more than 50 percent of older adults of working-age with work-disabilities in the U.S. do not receive SSD benefits, though rates of benefit receipt are higher than the average across other high-income countries. Those that receive SSD benefits, moreover, experience greater difficulty achieving an adequate standard of living, as measured by an index of financial security, than those with similar characteristics in the U.S. who do not receive disability benefits. The paper thus provides a framework for future policy research on benefit adequacy, while evaluating the availability and generosity of disability benefits in the U.S. [ABSTRACT FROM AUTHOR]

Objective Research indicates that perceived injustice significantly influences pain-related outcomes and is associated with delayed recovery in adults. This systematic review examines the relationship between perceived injustice and pain-related outcomes in children with pain conditions. Methods A search of published studies in English in PubMed, PsychInfo, and Cochrane Database of Systematic Reviews from database inception through December 2022 were performed. The search criteria focused on studies that measured perceived injustice and pain-related outcomes in children with pain conditions. Out of 56 articles screened, 8 met the inclusion criteria, providing data on 1240 children with pain conditions. Results The average age of participants across all studies was 14.12 years (SD = 2.25), with 68.2% being female. There was strong evidence that higher perceived injustice is associated with worse pain intensity, functional disability, mental health outcomes, and emotional, social, and school functioning. Conclusion The results of this study underscore how perceptions of injustice are associated various pain-related outcomes across different domains of children's lives. The findings highlight the need for screening and treatments targeting injustice appraisals in pediatric populations with pain conditions. The discussion addresses possible determinants and mechanisms of perceived injustice, along with implications for research and clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: To explore the feasibility of an intervention using modified ride-on cars in terms of acceptability and potential changes in goal attainment, mobility, social function, and participation of children with Congenital Zika Syndrome (CZS). Materials and Methods: A pre- and post-intervention feasibility study was conducted with children with CZS, levels IV and V of the Gross Motor Function Classification System (GMFCS). The intervention consisted of 12 weeks of training (3 times a week for 40 min per session) and 4 weeks of follow-up. The primary outcomes included adherence, satisfaction, and learning in mobility. Secondary outcomes encompassed goal attainment, mobility, social/cognitive function, and participation. Descriptive statistics were performed. To explore potential individual changes with the intervention, Wilcoxon test was used to analyze Pediatric Evaluation of Disability Inventory – Computer Adaptive Test (PEDI-CAT) data and Young Children's Participation and Environment Measure (YC-PEM)/Participation and Environment Measure for Children and Youth (PEM-CY), along with standard error measurements of the PEDI-CAT domains Results: Four children participated (median age 4.75 years; two females: three at level V on the GMFCS). Adherence was 75% of the total intervention time, and family members reported being satisfied or very satisfied. Children showed gains in learning the use of the modified ride-on cars and an increase in goal attainment after the intervention. Individual changes were observed in the PEDI-CAT domains (mobility and social/cognitive), but there were no significant changes in participation outcomes. Conclusions: Children with CZS at GMFCS levels IV and V can learn to use motorized ride-on cars, attainment goals, and experience satisfaction. IMPLICATIONS FOR REHABILITATION: Motorized mobility for children with Congenital Zika Syndrome and severe physical and cognitive disabilities is feasible and can encourage future interventions focused on activities and participation. This research contributes to the understanding of the potential changes that motorized mobility can have on goal attainment, satisfaction, and learning. Motorized mobility can be a means to enable children with Congenital Zika Syndrome to have opportunities for participation and guarantee their rights. [ABSTRACT FROM AUTHOR]

Introduction: The Canadian Occupational Performance Measure (COPM) was implemented at a state‐wide burns service to ensure compliance with current best evidence as outlined by the Australian and New Zealand Burns Association 'burn trauma rehabilitation: allied health practice guidelines'‐ Chapter 7 Measuring Post‐Burn Recovery, as a standard outcome measure for individuals with an admission time greater than 24 h. The primary aim of this study is to determine if individuals have a minimal important change in performance and satisfaction with activities that were identified as problematic on the COPM prior to their acute discharge. Previous research confirmed the feasibility of using the COPM in the acute burn ward and recommended the most appropriate timepoint for re‐measurement be confirmed, which is the secondary objective of this study. The benefits of confirming this timepoint include ensuring efficient use of clinicians' time without compromising the accuracy of the assessment and ensuring effective translation of the guidelines' recommendation. Methods: A prospective longitudinal study was undertaken, where all individuals who previously completed a COPM prior to acute discharge were sought to complete a re‐assessment while accessing outpatient services. Time frames for re‐assessment were open. Only individuals who were actively receiving occupational therapy outpatient services were included. COPM assessments were completed in person where possible, particularly for participants who required an interpreter, with phone and video calls also used when needed. Results: A total of 37 participants were included, with the timeframe between initial and post‐COPM assessment ranging from 2 to 643 days. Outcomes plateaued at approximately 12 months (365 days) post‐initial measurement (prior to discharge from acute ward). The most common occupational performance goals that participants identified were returning to work, sport, and driving. 86.5% of participants increased their satisfaction with these activities. The results of this study demonstrate improvements across the domains of performance and satisfaction occur for individuals with burns at approximately 3 months and 12 months post‐injury. Conclusion: Based on this study, it is suggested that when using the COPM assessment in a tertiary burn setting, re‐measurement be completed no earlier than 3 months and later than 12 months from burn injury, or upon discharge from the service. The findings from this study will be translated into clinical practice at this facility. PLAIN LANGUAGE SUMMARY: This study used the Canadian Occupational Performance Measure (COPM) to measure change in individuals' reports of performance and satisfaction of activities, which were identified as problematic post‐burn injury. Rehabilitation post‐burn injury is lengthy and can take months or years depending on the individual. A change in two or more scores on the COPM is determined as an important change. Thirty‐seven individuals participated in this study at different time points post‐discharge from the acute ward. The results demonstrate that the COPM should be used 3 months and 12 months post‐discharge from the acute ward for individuals who sustained a burn injury. [ABSTRACT FROM AUTHOR]

Objectives: Tinnitus is a phantom sound sensation without an external sound source. Due to its subjective and multifaceted nature it is measured using multi-item self-reported instruments. Many well-validated tinnitus-related questionnaires are available for clinical practice and scientific research, but so far no attention has been paid to their measurement invariance. The study aimed to examine measurement invariance of the Tinnitus Handicap Inventory with regard to gender and hearing impairment, and to identify the items that show differential item functioning (DIF) across the groups. Design: This is a retrospective study using medical data from patients with tinnitus. They completed the Tinnitus Handicap Inventory (THI) and underwent pure-tone audiometry. Study sample: 1106 adult patients with tinnitus (554 women and 552 men; 320 with normal hearing and 786 with hearing loss), aged 19–84 years. Results: In the analysis, multi-group confirmatory factor analysis, hybrid ordinal logistic regression, Kernel smoothing in Item Response Theory, and lasso regression were applied. Measurement invariance was demonstrated across gender, but across hearing status the measurement was non-invariant. Five items were found to have DIF. Conclusions: Researchers and clinicians should be aware of the potential risk of response bias when tinnitus severity is evaluated. [ABSTRACT FROM AUTHOR]

Purpose: Disability in activities of daily living (ADL) is a common unmet need among people with advanced respiratory disease. Rehabilitation could help prolong independence, but indicators for timely intervention in this population are lacking. This study aimed to identify trajectories of disability in ADLs over time, and predicting factors, in advanced respiratory disease. Method: Multi-site prospective cohort study in people with advanced non-small cell lung cancer (NSCLC), chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD), recruited from hospital or community services, throughout England. Disability in basic (Barthel Index) and instrumental (Lawton–Brody IADL Scale) ADLs were assessed monthly over six months. Visual graphical analysis determined individual trajectories. Multivariate logistic regression examined predictors of increasing disability in basic and instrumental ADLs. Findings: Between March 2020 and January 2021, we recruited participants with a diagnosis of NSCLC (n = 110), COPD (n = 72), and ILD (n = 19). 151 participants completed ≥3 timepoints and were included in the longitudinal analysis. Mobility limitation was an independent predictor of increasing disability in instrumental ADLs (odds ratio, 1⋅41 [CI: 1⋅14–1⋅74], p = 0⋅002). Conclusion: Mobility limitation could be used as a simple referral criterion across people with advanced respiratory disease to ensure timely rehabilitation that targets independence in ADLs. IMPLICATION FOR REHABILITATION: To our knowledge this is the first prospective cohort study of trajectories of disability in activities of daily living (ADL) in advanced respiratory disease, including recruitment during the Covid-19 pandemic. It adds to existing evidence by identifying individual variability in trajectories of ADL disability which are undetected at group level. The identification of mobility limitation as a predictor of increasing ADL disability, while controlling for malignant or non-malignant respiratory disease, is novel and has practical utility. Our findings have implications for clinical care, as early identification of functional decline through use of mobility limitation tools could flag early referral to rehabilitation services, potentially preventing or delaying forthcoming functional decline and avoiding reactive crisis management. Mobility limitation is a predictor of increasing disability in activities of daily living in advanced disease, which could be used to flag early referral to rehabilitation services, to help prevent or delay forthcoming functional decline and avoid reactive crisis management [ABSTRACT FROM AUTHOR]

Purpose: To identify and examine subgroups of people with spinal cord injury (SCI) with different patterns of lived experience, and examine hidden impairments and disability among functionally independent and ambulant people. Materials and methods: Latent profile analysis of population-based data from the Australian arm of the International Spinal Cord Injury (InSCI) Community survey (n = 1579). Results: Latent subgroups reflected levels of functional independence and extent of problems with health, activity/participation, environmental barriers, and self-efficacy. Quality of life (QoL), psychological profiles, and activity/participation were often as good or better in participants who reported lower (vs. higher) functional independence alongside comparable burden of health problems and environmental barriers. QoL, mental health, and vitality reflected self-efficacy and problem burdens more closely than functional independence. Ambulant participants reported a substantial burden of underlying, potentially hidden impairments, with QoL and mental health similar to wheelchair users. Conclusion: Hidden disability among more independent and/or ambulant people with SCI can affect well-being substantially. Early and ongoing access to support, rehabilitation, and SCI specialist services is important irrespective of cause, type, severity of injury, and level of functional independence. Improved access to SCI expertise and equity of care would help to improve early recognition and management of hidden disability. Trial registration: Not applicable. IMPLICATIONS FOR REHABILITATION: Hidden disability can substantially affect the well-being and quality of life of people with spinal cord injury (SCI) who appear to be functioning well and independently. Early and ongoing access to rehabilitation and SCI specialist services is important for people with SCI of any cause, type, severity, and level of functional independence. The potential for and implications of hidden disability are key considerations for the broader community of health practitioners who manage people with SCI, to ensure that appropriate referrals to specialist SCI services occur. Hidden disability is a key consideration in the design and implementation of disability support systems. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of mirror therapy (MT) and therapeutic exercise (TE) with the unaffected hand, on pain, sensitivity and functionality in individuals with unilateral carpal tunnel syndrome (CTS). Material and methods: A randomized controlled trial was carried out. Thirty-nine adults with unilateral CTS were included and randomly allocated to a six-week training programme based on MT (n = 20) or TE (n = 19). Visual Analogue Scale, Semmes-Weinstein monofilament test, Two-point discrimination (2PD), Disabilities of the Arm, Shoulder and Hand (DASH) and Boston Carpal Tunnel Questionnaire (BCTQ) were assessed before (T0) and after the intervention (T1), and at one-month follow-up (T2). Results: At T1, MT and TE showed significant improvements in pain (p = 0.001 and p = 0.03, respectively), however, only MT maintained the achieved effects at T2 (p = 0.01). In addition, 2PD significantly improved in MT in the first (p = 0.04) and fourth fingers (p = 0.02) at T1. The DASH score decreased at T1 in MT (p < 0.001) and TE (p = 0.01). Additionally, the BCTQ score improved in MT (p < 0.001), and TE (p < 0.001) at T1. The effects were maintained at T2 for DASH and BCTQ scores. Conclusions: Training of the unaffected hand resulted in a significant improvement of the affected hand in both groups; nevertheless, MT achieved a longer duration of the effects. IMPLICATIONS FOR REHABILITATION: Training of the unaffected hand may improve pain, sensitivity and functionality in people with unilateral tunnel carpal syndrome. Mirror therapy achieved longer duration of the effects on pain and hand functionality. Our research may inform clinical decision-making and guide the development of therapeutic interventions for patients with carpal tunnel syndrome. [ABSTRACT FROM AUTHOR]

Social competence is crucial to functioning in youth with chronic medical conditions. Developmentally sensitive measures of social functioning in this population can aid clinicians in identifying skill deficits and informing treatment interventions that improve social competence. The study explored the psychometric properties of a proposed social functioning measure utilizing data obtained from a clinical sample of chronically ill adolescents enrolled in an evidence-based manualized psychosocial treatment program. Initial exploratory findings support the potential for the SDI to be a valid, reliable, and clinically sensitive measure of adolescent social functioning in teens experiencing functional disability associated with their chronic health conditions. [ABSTRACT FROM AUTHOR]

Problematic use of opioids by older adults is associated with adverse effects and has become a public health crisis worldwide. Ageing-related disabilities in activities of daily living (ADL) could promote unnecessary use of opioids in this population. This study evaluates the association between ADL disability and opioid consumption in Brazilian older adults. Study design- cross-sectional secondary data analysis of the second wave of the Brazil Longitudinal Study of Ageing (ELSI-Brazil). Data from the second wave of the Brazil Longitudinal Study of Ageing (ELSI-Brazil) were used. Older adults with chronic pain were included. ADL disability was measured using the Katz Index. The primary outcome was opioid consumption for chronic pain. The primary association was explored using logistic regression models adjusting for predetermined confounders. Sensitivity analyses evaluating model performance were done by calibrating and validating the model using randomly split equal sets. In those who reported presence of chronic pain (n = 2865), the prevalence of opioid use was 29% (95% CI:23.1%–35.6%). In adjusted models, participants with moderate and severe ADL disability had 1.6 (95% CI:1.13–2.32; P = 0.009) and 3.8 (95% CI: 1.80–7.90; P < 0.001) times higher odds of opioid consumption compared to no disability, respectively. Being female, alcohol consumption, higher pain intensity, history of dementia, fractures, and presence of ≥2 comorbidities were significantly associated with increased opioid use (P < 0.05). Nearly one-third of the Brazilian elderly population experiencing chronic pain reported using opioids. The functional decline during the process of ageing appears to be a risk factor for pain intolerance and opioid use. Multidisciplinary approaches to detect early ADL disabilities and improve mobility and access to assistive technologies need to be established to prevent opioid overuse and addiction in elderly populations. [ABSTRACT FROM AUTHOR]

Background and Purpose: Walking speed (WS) is an easily assessable and interpretable functional outcome measure with great utility for the physical therapist providing care to older adults. Since WS was proposed as the sixth vital sign, research into its interpretation and use has flourished. The purpose of this scoping review is to identify the current prognostic value of WS for the older adult. Methods: A scoping review was conducted using PubMed, CINAHL, and SPORTDiscus to find relevant articles highlighting the predictive capabilities of WS for older adults. Titles and abstracts were reviewed to identify relevant articles. Articles were excluded based on the following criteria: sample included both younger and older adults without separate analyses, sample was focused on a particular disease, if the study was published before 2017, or if the study did not report relevant cut points for interpretation of WS. The search returned 1064 results. Following removal of articles not meeting inclusion criteria and critical appraisal, relevant cut points were extracted from 47 original research publications. Results and Discussion: A preliminary review of the included articles showed that WS is a valuable prognostic tool across many health domains, including mental health, mortality, disability, pain, bone and joint health, falls, cognition, physical activity, metabolic health, risk for cardiovascular disease, socialization, and metabolic health. The fastest WS of 1.32 meters per second (m/s) served as a cutoff for decreased risk for incident development of type 2 diabetes, while the slowest WS of less than 0.2 m/s was associated with increased duration of hospitalization. Multiple studies reported on the prognostic value of WS slower than 1.0 m/s. Conclusion: Although the reported range of predictive WS values was broad, multiple studies found WS of approximately 1.0 m/s to be a useful marker for delineating risk or decline across a variety of health domains. Clinicians may find it useful to use a WS slower than 1.0 m/s as a "yellow flag" to guide evaluation and intervention for their older adult clients. [ABSTRACT FROM AUTHOR]

Objective The global demand for assistive technology (AT) is extensive, with over 2.5 billion people requiring one or more assistive devices. This number is expected to increase to 3.5 billion by 2050. AT empowers individuals to enjoy a healthy, productive, and independent life. It has become a global priority, recognizing the importance of improving access to AT for those in need. Accurate measurement of the demand and accessibility of these technologies is crucial for effective action in this area. The World Health Organization (WHO) has developed the rapid assistive technology assessment tool (rATA) to address this need. This tool serves to measure the utilization and requirement of AT among populations. This study aims to introduce and explain the steps taken to translate the rATA tool and examine its face validity in Iran. Materials & Methods After receiving authorization from WHO, the English version of rATA was translated into Persian by two proficient experts in rehabilitation. Subsequently, a backward translation was conducted by two experts who were fluent in both Persian and English. Following a consensus on the resulting version, an expert panel comprising seven professionals in rehabilitation and health was established to validate the face validity of the Persian version. Necessary modifications were implemented based on their feedback and approval. Results The Persian version of the rATA consists of seven sections and 42 questions. These sections include preliminary information/administrative survey data, demographics, AT need assessment, supply and demand, satisfaction, recommendations, surveyor's comments, and post-survey administration. As per the expert committee's decision, an additional question was incorporated into the preliminary information section, and the answer choices now include an option for further AT providers. Conclusion The Persian version of the rATA serves as a valuable tool for gathering data on the demand and accessibility of AT within the Iranian context. These data can aid decision-makers and policymakers in devising strategies to enhance access to AT, ultimately contributing to the goal of achieving universal health coverage. Furthermore, due to its potential for global applicability, the rATA questionnaire can be utilized for inter-country comparisons, providing insights into Iran's status regarding access to AT. Additionally, it can serve as a reliable platform for policy learning, facilitating the exchange of reliable and evidence-based policies among different countries. [ABSTRACT FROM AUTHOR]

Background: Assessment of QoL has become an essential component in the holistic care of patients with acne. The Cardiff Acne Disability Index (CADI) is used globally to assess quality of life (QoL) in patients with acne. This study was done to validate CADI in Tamil, as 90 million of the global population are native speakers and Tamil is an official language of several countries. Methods: CADI was translated and validated into Tamil according to published guidelines. The Tamil versions of both CADI and Dermatology Life Quality Index (DLQI), was administered to 150 Sri Lankan young adults with acne. The clinical severity was assessed using the Global Acne Grading System (GAGS). Discriminant validity was tested by comparing the results of CADI with those of GAGS and DLQI, using reliability, validity, Cronbach's alpha, and Spearman's correlation coefficient measurements. Construct validity was assessed by factor analysis. Results: 70% were female, and the mean age was 25.1 (SD, 5.2). The majority (91.3%) had acne of mild to moderate severity when measured by GAGS. CADI-Tamil showed high internal consistency and reliability (Cronbach's alpha coefficient = 0.83). The CADI total score showed a strong correlation (0.86) with that of DLQI. The correlation between CADI and GAGS was low, whereas CADI had a high and significant correlations with the DLQI. The construct validity explained 61% of the variability. Conclusions: The CADI-Tamil is a reliable and valid tool for assessing the QoL of Tamil speaking patients with acne. This tool will help clinicians understand the patient's perspective on acne. [ABSTRACT FROM AUTHOR]

Intoduction: Common outcome measures for chronic neck pain are the Patient‐Specific Functional Scale (PSFS) and the neck disability index (NDI). The primary aim was to categorize the top‐rated, patient‐selected functional activity limitations of the PSFS to determine if there were consistent limited functional activities for individuals with chronic neck pain and how these compared to the constructs of activities on the NDI. The secondary aim was to determine the relationship between scores for individuals who completed both the NDI and PSFS. Design: A retrospective review of data extracted from the electronic medical record, EPIC, within two hospital‐based outpatient physical therapy clinics within a health care system. Methods: Retrospective analysis was performed on individual's characteristics, self‐selected functional activity limitations, and total scores of the PSFS and NDI. Most common categories of self‐selected functional activity limitations were developed by practicing physical therapists. These functional activity limitation categories of the PSFS were compared to the activities of the NDI. Mean PSFS total scores were correlated with the NDI total scores with Spearman's test. Results: Participants were individuals with chronic neck pain from January 2013–September 2018 (n = 2283). Movement‐based activities accounted for 60.8% of the functional activity limitations of the PSFS with the top functional activity limitations being cervical motion and exercise (32%). The PSFS total score moderately correlated with NDI (r = −0.50, p = <0.01) which may relate to the differences in constructs of the NDI and the top patient‐selected PSFS functional activity limitations found in this analysis. Conclusion: The results suggest that individuals with chronic neck pain present with similar categories of self‐selected functional activity limitations that differ from activities of the NDI. Additional research is needed to improve outcome measures to capture patient‐selected functional activity limitations and an individual's pain experience. [ABSTRACT FROM AUTHOR]

Purpose: An increasing number of children and young adults with complex medical conditions and respiratory failure are treated with home mechanical ventilation (HMV). The current study aimed to describe how young adults using HMV experience their everyday life with the ventilator, their physical impairments and their opportunities for an educational and professional career. Materials and methods: Data were collected via narrative interviews with nine young HMV users (3 females and 6 males, aged 18–31 years) in their homes. Two were ventilated invasively, six were ventilated non-invasively and one was treated with continuous positive airway pressure (CPAP) via facemask. Data were analysed using a phenomenological hermeneutical method. Result: A multi-professional team contributed to participants' safety and ability to participate in society through higher education and professional work. A good and valuable life, mostly feeling healthy were experienced but also prejudice and stiffened social society structures. Conclusion: The findings of this study prove the importance of having long-standing access to a competent and supportive available multi-professional healthcare team when living with a long-term complex condition. These teams provided well-functioning human and technological support in everyday lives. Implications for Rehabilitation: An increasing number of children and young adults are treated with home mechanical ventilation due to respiratory failure. The home mechanical ventilation treatment provided rest from breathing and improved sleep quality in such a way that work and higher studies could be managed. Longstanding access to a supportive multi-professional healthcare team provided feelings of being safe, which in turn boosted self-confidence in life and preparedness to meet new challenges. [ABSTRACT FROM AUTHOR]

Purpose: To determine prevalence of musculoskeletal complaints (MSCs) in adults with major congenital upper limb differences (CoULD) compared to able-bodied controls, and to examine associations of MSCs and disability with various biopsychosocial factors. Materials and methods: Questionnaire-based cross-sectional study assessing MSCs, disability (using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)), general and mental health status, physical work demands, and upper extremity range of motion. Results: Seventy-one individuals with CoULD (participation rate: 41%) and 71 controls matched on age, gender, and education were included (49% female, mean age 28.9 years). Year prevalence of MSCs was significantly higher in the CoULD group (35%) than in the control group (18%). The CoULD group was less often employed and had lower scores on all measures of upper limb range of motion and hand grip. MSCs were associated with higher DASH scores and higher reported work demands. Disability was associated with female gender, more joints with limited range of motion, unemployment, and lower general and mental health. Factors associated with disability did not differ between groups. Conclusions: MSCs are a frequent problem in young adults with major CoULD. To prevent or reduce MSC and disability, clinicians and researchers should be aware of the associated factors. Implications for rehabilitation: The year prevalence of musculoskeletal complaints (MSCs) in those with major congenital upper limb differences (CoULD) was approximately double to that of the control group, implying a potential relationship between CoULD and MSCs. Rehabilitation professionals should develop personalized strategies to manage work demands in those with CoULD, considering the association between MSCs and higher reported work demands. Recognizing the impact of a negatively perceived body image on mental health, clinicians should integrate psychological counseling into rehabilitation treatments to support mental well-being and improve overall quality of life in those with CoULD. Rehabilitation professionals should educate individuals with CoULD about the potential associations between upper limb work demands, MSCs, and disability. [ABSTRACT FROM AUTHOR]

Objectives: Estimating the risk of diabetes mellitus (DM) is important for the proper management of patients with spinal cord injury (SCI). We investigated the short-term and long-term risks of DM among patients with SCI, according to the presence or severity of post-SCI disability and the level of injury. Methods: We conducted a retrospective cohort study using the Korean National Health Insurance Service (2010–2018) database. After matching by age and sex, 6129 SCI patients and 22,979 controls were included. The primary outcome was incident DM, and risk was evaluated for both the short term (within 1 year after SCI) and the long term (after 1 year of SCI diagnosis). Results: The risk of DM was higher among patients with cervical- and thoracic-level SCI accompanied by disability compared to the controls during follow-up (4.6 ± 2.6 years). The short-term risk of DM was higher among patients with SCI (odds ratio [OR] 2.51, 95% confidence interval [CI] 1.91–3.27) than among the controls and it was even higher among patients with severe disability (OR 5.38, 95% CI 2.91–9.27). According to the level of injury, patients with cervical SCI had the highest short-term risk of DM (with disability, OR 4.93, 95% CI 3.07–7.63). There was no significant increase of DM risk in the long term, after 1 year of SCI diagnosis. Conclusions: Patients with SCI accompanied by severe disability and cervical-level injury had higher risks of pronounced DM in the short term. The findings of this study emphasize the need for active surveillance of DM among patients with high-level SCI and disability, especially in the short term, in addition to continuous monitoring and proper management of DM in the long term. [ABSTRACT FROM AUTHOR]

Although laws and standardization bodies promote user participation in digital accessibility evaluations, people with disabilities still consider themselves excluded from this process. One reason could be the lack of systematized knowledge about evaluation methods involving users. This article seeks to understand how and for what purpose digital accessibility evaluations with user participation were conducted in the scientific literature from 2018 to 2021. Three types of user participation emerged: 1) user-based usability testing to evaluate task accomplishment, user reactions and interface qualities; 2) interviewing users to assess the local and social factors impacting digital service accessibility; 3) using questionnaires or crowdsourcing to check the compliance of certain interfaces with accessibility standards. Participants are primarily chosen based on their functional impairments and, to a lesser degree, their project-related skills, biographical information, technology habits, among other criteria. The comprehensive user insights gained with these methods are judged to be positive whereas the lack of representativeness of the selected user samples is found to be regrettable. The article finally discusses the definitions of accessibility and disability that underpin these methodologies. [ABSTRACT FROM AUTHOR]

This viewpoint advocates for significant reforms in the disability certification guidelines for mental illnesses in India. Currently, two years duration of illness is required before certification, which delays essential support. The proposed model emphasizes assessing the functional impact of conditions, aligns with global standards, and suggests regular reassessments to improve accessibility and inclusivity in mental health services. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lumbopelvic movement patterns during prone hip extension has been proposed as a clinical screening method for trunk muscle dysfunction in patients with chronic low back pain (CLBP). However, correlations between trunk muscle onset and pelvic kinematics have not been investigated. OBJECTIVE: To examine the correlation between trunk muscle onset and pelvic kinematics during prone hip extension in participants with CLBP. METHODS: Fifteen patients with CLBP and 15 healthy individuals participated. We evaluated the muscle activities of the lumbar multifidus, the longissimus, and the semitendinosus via electromyogram and the displacement angles of the pelvic tilt, oblique and rotation. RESULTS: The onset of the multifidus at the ipsilateral side of hip extension was significantly delayed in the patients with CLBP compared to the control group (P < 0.001). The onset of the ipsilateral multifidus in the control group was significantly correlated with increased anterior pelvic tilt angle (P = 0.019, r = 0.597), whereas no significant correlation was observed in the CLBP group (P = 0.810, r = - 0.068). CONCLUSION: The results suggest that pelvic kinematics during prone hip extension does not predict the delayed trunk muscle onset in patients with CLBP. [ABSTRACT FROM AUTHOR]

BACKGROUND: Student circus artists put constant stress on their back. However, the presence of low back pain (LBP) and related disability in this population remains unclear. OBJECTIVES: To 1) examine LBP history in circus artists and compare related disability scores using the Oswestry Disability Index (ODI) and the Athlete Disability Index (ADI), and 2) examine the correlation between LBP-related disability scores, pain intensity and pain catastrophizing. METHODS: Thirty-three circus students completed an online survey on demographics, training history, and LBP. Participants reporting LBP filled the ODI, ADI, numerical pain rating scale (NPRS), and Pain Catastrophizing Scale (PCS). Descriptive statistics and Pearson's correlation coefficients were used to assess the correlations between the ODI, ADI, NPRS, and PCS. RESULTS: There was a significant positive correlation between the ODI and ADI (r = 0.77, p < 0.001) and between the NPRS and ADI (r = 0.52, p = 0.03), but no correlation between NPRS and ODI. While the PCS scores were significantly correlated with the NPRS ((r = 0.71; p < 0.001) and the ADI (r = 0.51; p = 0.032), no correlation was observed between the PCS and ODI scores (p = 0.088). Based on the ODI scores, 94.44% of the artists reporting LBP were classified with mild disability, 5.56% moderate, and 0% severe disability as compared to 66.67%, 27.78% and 5.55% with the ADI, respectively. CONCLUSION: Our study highlights the potential of the ADI as an effective tool for assessing LBP-related disability in circus artists, supported by a strong correlation with the NPRS. [ABSTRACT FROM AUTHOR]