-
European Stroke Journal Dec 2023To propose a consensus-based definition and framework for motor rehabilitation after stroke. (Review)
Review
PURPOSE
To propose a consensus-based definition and framework for motor rehabilitation after stroke.
METHODS
An expert European working group reviewed the literature, attaining internal consensus after external feedback.
FINDINGS
Motor rehabilitation is defined as a process that engages people with stroke to benefit their motor function, activity capacity and performance in daily life. It is necessary for people with residual motor disability whose goal is to enhance their functioning, independence and participation. Motor rehabilitation operates through learning- and use-dependent mechanisms. The trajectory of motor recovery varies across patients and stages of recovery. Early behavioral restitution of motor function depends on spontaneous biological mechanisms. Further improvements in activities of daily living are achieved by compensations. Motor rehabilitation is guided by regular assessment of motor function and activity using consensus-based measures, including patient-reported outcomes. Results are discussed with the patient and their carers to set personal goals. During motor rehabilitation patients learn to optimize and adapt their motor, sensory and cognitive functioning through appropriately dosed repetitive, goal-oriented, progressive, task- and context-specific training. Motor rehabilitation supports people with stroke to maximize health, well-being and quality of life. The framework describes the International Classification of Functioning, Disability and Health in the context of stroke, describes neurobiological mechanisms of behavioral restitution and compensation, and summarizes recommendations for clinical assessment, prediction tools, and motor interventions with strong recommendations from clinical practice guidelines (2016-2022).
CONCLUSIONS
This definition and framework may guide clinical educators, inform clinicians on current recommendations and guidelines, and identify gaps in the evidence base.
Topics: Humans; Activities of Daily Living; Stroke Rehabilitation; Recovery of Function; Disabled Persons; Quality of Life; Consensus; Motor Disorders; Stroke
PubMed: 37548025
DOI: 10.1177/23969873231191304 -
The Lancet. Public Health May 2024Health systems often fail people with disabilities, which might contribute to their shorter life expectancy and poorer health outcomes than people without disabilities.... (Review)
Review
Health systems often fail people with disabilities, which might contribute to their shorter life expectancy and poorer health outcomes than people without disabilities. This Review provides an overview of the existing evidence on health inequities faced by people with disabilities and describes existing approaches to making health systems disability inclusive. Our Review documents a broad range of health-care inequities for people with disabilities (eg, lower levels of cancer screening), which probably contribute towards health differentials. We identified 90 good practice examples that illustrate current strategies to reduce inequalities. Implementing such strategies could help to ensure that health systems can expect, accept, and connect people with disabilities worldwide, deliver on their right to health, and achieve health for all.
Topics: Humans; Disabled Persons; Healthcare Disparities; Delivery of Health Care
PubMed: 38702096
DOI: 10.1016/S2468-2667(24)00042-2 -
International Journal of Environmental... Oct 2023This paper explores the concepts of inclusion, participation, and belonging in the context of development for children with disabilities. The importance of creating an... (Review)
Review
This paper explores the concepts of inclusion, participation, and belonging in the context of development for children with disabilities. The importance of creating an environment that embraces diversity, encourages active engagement, and nurtures a sense of belonging for children is discussed. The authors provide insights into the benefits of inclusive practices, strategies to enhance participation, and methods to foster a sense of belonging in children with disabilities. The authors argue that service providers and service systems must move beyond fostering social inclusion and inclusive education, although emphasized globally, and focus on promoting participation and ultimately belonging to ensure that children with disabilities are full members of their communities.
Topics: Child; Humans; Disabled Persons; Social Inclusion
PubMed: 37887645
DOI: 10.3390/ijerph20206907 -
The Journal of Nutrition, Health & Aging Mar 2024This Mini-Review showcases the latest evidence on rehabilitation opportunities for older people with multimorbidity and frailty. There is growing evidence, that a... (Review)
Review
This Mini-Review showcases the latest evidence on rehabilitation opportunities for older people with multimorbidity and frailty. There is growing evidence, that a person-centered and contextualized rehabilitation approach may offer benefits, not only in the context of preserving mobility, but especially targeting social participation. Modern rehabilitation aligns with the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF), emphasizing the individual and collaboratively determined definition of personalized rehabilitation goals at the activity and participation level. Further studies are warranted to evaluate objective outcome-measurement tools within the domains of activity and participation.
Topics: Humans; Aged; Frailty; Disabled Persons; Social Participation; Disability Evaluation; Activities of Daily Living
PubMed: 38492946
DOI: 10.1016/j.jnha.2023.100012 -
Medicina (Kaunas, Lithuania) Jan 2024Neuroscience applied to motor activity is a growing area that aims to understand the effects of motor activity on the structures and functions of the Central Nervous... (Review)
Review
Neuroscience applied to motor activity is a growing area that aims to understand the effects of motor activity on the structures and functions of the Central Nervous System. Attention has been paid to this multidisciplinary field of investigation by the scientific community both because it is of great importance in the treatment of many chronic diseases and because of its potential applications in the Movement Sciences. Motor activity during a developmental age is, in fact, an indispensable tool for the physical and mental growth of children, both able-bodied and disabled. Through movement, individuals can improve their physical efficiency and promote their own better health, establish relationships with the environment and others, express themselves and their emotions, form their identity and develop cognitive processes. This literature review aims, therefore, to highlight how an adequate practice of motor activity offers extraordinary possibilities for everyone in relation to learning, from the perspective of an integral development of the person, and, consequently, can raise the awareness of those involved in the training and growth, especially the youngest, towards the educational value of motor and sports activities. According to this review, and in line with the modern neuroscientific approach toward the relationships between motor activities and cognitive functions, it is possible to claim that hypokinesia tends to inhibit learning. Therefore, it now seems more topical than ever to draw attention to the need to introduce working proposals that integrate brain-based motor activity programs into the school curriculum.
Topics: Child; Humans; Cognition; Learning; Schools; Disabled Persons; Exercise
PubMed: 38399504
DOI: 10.3390/medicina60020216 -
Psychiatria Danubina Dec 2023Foodservice has an important role in health care: it is an indispensable tool for the prevention and treatment of diseases related to an impaired state of nutrition. The...
BACKGROUND
Foodservice has an important role in health care: it is an indispensable tool for the prevention and treatment of diseases related to an impaired state of nutrition. The foodservice must reach an optimal level for nutritional and sensory quality, fundamental aspects for preparations aimed at users with physical and intellectual disabilities. The Serafico Institute in Assisi (SA) is a health care facility that houses disabled users and is concerned with their rehabilitation and with guaranteeing them an optimal quality of life. Our food model of reference is the Mediterranean Diet: widely studied and validated for the prevention of chronic degenerative diseases. Dietary proposals change throughout the year following the alternation of seasons, holidays and religious festivities.
SUBJECTS
The SA currently houses 82 resident and 27 semi-resident users. Residents range in age from 11 to 52 and are housed in 5 different dwellings, eating all meals internally: breakfast, lunch, dinner and one or two snacks according to personal needs. Semi-residents attend SA only during daytime hours are divided into two groups according to their age: infancy and adult. They do not all attend for the whole week. They only consume lunch internally.
RESULTS
The goal of our foodservice experience is to protect the sensory and nutritional quality of our users to ensure their adequate living and health conditions.Meals provided must first and foremost guarantee the requirements of food safety and food security, adapting the definitions themselves to the context, considering them an irreplaceable complement to the pathways of prevention and treatment. They represent an indispensable tool in the prevention and treatment of many diseases. Malnutrition by default or excess has a high impact on health management of individual users, representing often the "disease within a disease." The repercussion on their quality of life and care costs is known and therefore it is to be managed carefully and by promoting as much as possible the culture of prevention.
CONCLUSIONS
Food is nourishment for the soul and the body. Celebrating anniversaries, birthdays, celebrating every single day becomes an opportunity to give dignity to each of our youngsters, recognizing their physiological and emotional needs, the need to share the experience with others. Mealtime is an important time for every real or acquired family; it is a privileged relationship occasion in which we have the opportunity to develop numerous aspects central to the growth of each of us. We strongly believe that the dignity of each and every one of our yongsters also comes from the care we take in their nutrition and the way it is administered.
Topics: Adult; Humans; Quality of Life; Diet; Nutritional Status; Meals; Disabled Persons
PubMed: 37994065
DOI: No ID Found -
Revista Da Associacao Medica Brasileira... 2023Women and men can have the same illnesses, but with different prevalence and reactions to symptoms.
UNLABELLED
Women and men can have the same illnesses, but with different prevalence and reactions to symptoms.
OBJECTIVE
This study aimed to emphasize that distinct traits between men and women require a different approach for each of them.
METHODS
PubMed and Google Scholar were searched using the following terms: Disability Evaluations, Women's health, Osteoporosis, Osteoarthritis, and Lymphedema, Pregnancy.
RESULTS/CONCLUSION
Disease management can go beyond the symptoms, assessing the long-term consequences and possibly the disabilities they can generate, compromising the quality of life of the person, his/her family members, and eventually caregivers.
Topics: Humans; Pregnancy; Female; Male; Quality of Life; Women's Health; Disabled Persons; Caregivers
PubMed: 37556634
DOI: 10.1590/1806-9282.2023S115 -
JAMA Health Forum Sep 2023Most studies use impaired functioning alone to specify populations with disabilities. However, some people with functional impairments do not identify as disabled. With...
IMPORTANCE
Most studies use impaired functioning alone to specify populations with disabilities. However, some people with functional impairments do not identify as disabled. With functional status-based definitions, studies have shown disparate care quality for people with disabilities.
OBJECTIVE
To examine whether impairment and disability identity have different associations with perceived health care experiences and explore factors associated with disability identification.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study used a nationally representative survey of US adults conducted from April 20 through May 31, 2021, and analyzed between June 1 and August 31, 2022. Survey participants were 1822 English- or Spanish-speaking adults responding either online or via telephone.
EXPOSURES
Using 8 survey questions, participants were grouped according to presence of impairment and disability identity.
MAIN OUTCOMES AND MEASURES
Likert scale measures of trust, respect, and fairness (henceforth, procedural justice measures) were dichotomized. Sociodemographic characteristics and rates of procedural justice responses were compared across groups. Multivariable logistic regressions adjusting for baseline characteristics were performed to (1) estimate associations of impairment and disability identity with perceptions of procedural justice and (2) explore factors associated with disability identification. Analyses applied survey weights.
RESULTS
Of 6126 individuals invited to participate, 1854 (30.3%) completed the survey. Thirty-two were excluded due to unreportable gender, for a final analytic sample of 1822 participants. Participants with impairments (n = 816; mean [SD] age, 48.1 [17.0] years; 51.2% women, 48.8% men) had worse perceptions on 7 of 10 procedural justice measures (crude) compared with those without impairments (n = 1006; mean [SD] age, 49.6 [18.1] years, 55.1% female, 44.9% male). Among respondents with impairments, those who did (n = 340) vs did not (n = 476) identify as disabled gave better ratings for clinician communication efforts (a lot of effort, 38.8% vs 31.0%) and having health goals understood (understood very or fairly well, 77.2% vs 70.1%) but gave worse ratings for respect (almost never felt inferior or talked down to, 66.1% vs 59.1%). Disability identification was associated with more reports of unfair treatment (31.0% vs 22.4%; adjusted odds ratio, 1.65; 95% CI, 1.12-2.42) and of being unafraid to ask questions or disagree (50.5% vs 40.1%; adjusted odds ratio, 1.51; 95% CI, 1.04-20.19). Income and employment were associated with disability identification.
CONCLUSIONS AND RELEVANCE
In this cross-sectional survey study of US adults, health care perceptions differed between groups defined by impairment status and disability identity. These findings suggest that, alongside functional measures, health systems should capture disability identity to better address disparities for people with impairments.
Topics: Adult; Humans; Female; Male; Middle Aged; Trust; Respect; Cross-Sectional Studies; Communication; Disabled Persons
PubMed: 37738065
DOI: 10.1001/jamahealthforum.2023.3180 -
BMC Public Health Nov 2023Loneliness is a significant public health concern due to its detrimental impact on health and wellbeing. Despite people with disability reporting higher levels of... (Review)
Review
BACKGROUND
Loneliness is a significant public health concern due to its detrimental impact on health and wellbeing. Despite people with disability reporting higher levels of loneliness than the general population, there has been little research into how this is affecting their health and wellbeing. In light of this, the aim of our study was to scope both the existing evidence about the health and wellbeing outcomes associated with loneliness for people with disability, as well as the conceptual frameworks and measures utilised in this field of research.
METHODS
To conduct this scoping review, we followed the methodology outlined by JBI and searched MEDLINE, Scopus, Informit, Embase, and Web of Science for peer-reviewed, English-language articles published between 1 January 2000 and 8 February 2023. Two independent reviewers completed screening, full-text review and data extraction, with consensus sought at each stage. Data were analysed using content analysis and presented both numerically and narratively.
RESULTS
Out of the initial 1602 publications identified in the scoping review, only nine were included after duplicate removal, title and abstract screening, and full-text review. This limited number of studies, with the earliest study one published in 2015, represents a key finding. Eight of the nine studies were quantitative, and all were conducted in high income countries. Most of these studies utilised a version of the University of Los Angles Loneliness Scale to measure loneliness and addressed specific impairment groups. Notably, most of the studies identified associations between loneliness and health and wellbeing outcomes for people with disability.
CONCLUSIONS
This scoping review highlights the current scarcity of studies examining the effect that loneliness has on the health and wellbeing outcomes of people with disability. As most of the reviewed studies relied on loneliness measures designed for individuals without disability, they potentially overlook the unique life experiences of people with disability. Given that loneliness is an international public health concern, it is imperative that people with disability are not left behind or overlooked in efforts to address the impact of loneliness on health and wellbeing.
Topics: Humans; Loneliness; Population Groups; Disabled Persons
PubMed: 38031029
DOI: 10.1186/s12889-023-17101-9 -
International Journal of Environmental... Dec 2023The recent World Health Organization report on disability noted that people with disabilities (PWD) have many unmet health and rehabilitation needs, face numerous...
The recent World Health Organization report on disability noted that people with disabilities (PWD) have many unmet health and rehabilitation needs, face numerous barriers to accessing healthcare and specialized services, and have overall worse health than people without disability. In view of this urgency to better identify and address health inequities systematically, we convened an expert panel of 14 stakeholders to develop a strategic plan that addresses this issue. The panel identified two major obstacles to quality healthcare services for PWD: (1) lack of coordination between the various healthcare sectors and community well-being programs and (2) substantial challenges finding and accessing healthcare services that meet their specific needs. The expert stakeholder panel noted that well-being self-management programs (both online and in person) that are easily accessible to PWD are critically needed. PWD must transition from being cared for as patients to individuals who are able to self-manage and self-advocate for their own health and well-being plans and activities. The proposed strategic plan offers providers and local communities a framework to begin addressing accessible and appropriate healthcare-to-well-being services and programs for PWD in managing their health in partnership with their healthcare providers.
Topics: Humans; Translational Science, Biomedical; Disabled Persons; Health Care Sector; Health Facilities; Health Inequities
PubMed: 38248483
DOI: 10.3390/ijerph21010018