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Pediatric Blood & Cancer Sep 2015Pediatric, adolescent, and young adult survivors of bone sarcomas are at risk for poor quality of life (QOL). We conducted a systematic review and meta-analysis to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pediatric, adolescent, and young adult survivors of bone sarcomas are at risk for poor quality of life (QOL). We conducted a systematic review and meta-analysis to summarize the literature describing QOL in this population and differences in QOL based on local control procedures.
PROCEDURE
Included studies described ≥5 patients <25 years old who had completed local control treatment for bone sarcoma, defined QOL as a main outcome, and measured it with a validated instrument. Data extraction and quality assessments were conducted with standardized tools. Meta-analyses compared QOL based on surgical procedure (limb-sparing vs. amputation) and were stratified by assessment type (objective physical function, clinician-assessed disability, patient-reported disability, and patient-reported QOL). Effect sizes were reported as the standard mean difference when multiple instruments were used within a comparison and weighted mean difference otherwise. All were weighted by inverse variance and modeled with random effects.
RESULTS
Twenty-two of 452 unique manuscripts were included in qualitative syntheses, eight of which were included in meta-analyses. Manuscripts were heterogeneous with respect to included patient populations (age, tumor type, time since treatment) and QOL instruments. Prospective studies suggested that QOL improves over time, and that female sex and older age at diagnosis are associated with poor QOL. Meta-analyses showed no differences in outcomes between patients who underwent limb-sparing versus amputation for local control.
CONCLUSION
QOL studies among children and AYAs with bone sarcoma are remarkably diverse, making it difficult to detect trends in patient outcomes. Future research should focus on standardized QOL instruments and interpretations.
Topics: Adolescent; Age Factors; Amputation, Surgical; Bone Neoplasms; Child; Child, Preschool; Cross-Sectional Studies; Disabled Persons; Female; Humans; Limb Salvage; Male; Prospective Studies; Quality of Life; Recovery of Function; Sarcoma; Self Report; Surveys and Questionnaires; Survivors; Young Adult
PubMed: 25820683
DOI: 10.1002/pbc.25514 -
Preventive Medicine Feb 2017The relationship between the built environment and physical activity has been well documented. However, little is known about how the built environment affects physical... (Review)
Review
The relationship between the built environment and physical activity has been well documented. However, little is known about how the built environment affects physical activity among people with disabilities, who have disproportionately higher rates of physical inactivity and obesity. This study is the first systematic review to examine the role of the built environment as a moderator of the relationship between having a disability (physical, sensory or cognitive) and lower levels of physical activity. After conducting an extensive search of the literature published between 1990 and 2015, 2039 articles were screened, 126 were evaluated by abstract and 66 by full text for eligibility in the review. Data were abstracted using a predefined coding guide and synthesized from both qualitative and quantitative studies to examine evidence of moderation. Nine quantitative and six qualitative articles met the inclusion criteria. Results showed that most research to date has been on older adults with physical disabilities. People with disabilities described how aspects of the built environment affect neighborhood walking, suggesting a positive moderating role of features related to safety and aesthetic qualities, such as benches, lighting and stop light timing. There were mixed results among studies that examined the relationship quantitatively. Most of the studies were not designed to appropriately examine moderation. Future research should utilize valid and reliable built environment measures that are more specific to disability and should include people with and without disabilities to allow for testing of moderation of the built environment.
Topics: Disabled Persons; Environment Design; Exercise; Humans; Mobility Limitation; Residence Characteristics; Safety; Walking
PubMed: 27471026
DOI: 10.1016/j.ypmed.2016.07.019 -
JAMA Dec 2002Several well-publicized recent studies have suggested that disability among older Americans has declined in the last decade. (Review)
Review
CONTEXT
Several well-publicized recent studies have suggested that disability among older Americans has declined in the last decade.
OBJECTIVES
To assess the quality, quantity, and consistency of recent evidence on US trends in the prevalence of self-rated old age disability and physical, cognitive, and sensory limitations during the late 1980s and 1990s and to evaluate the evidence on trends in disparities by major demographic groups.
DATA SOURCES
We searched MEDLINE and AGELINE for relevant articles published from January 1990 through May 2002 and reviewed reference lists in published articles.
STUDY SELECTION
From more than 800 titles reviewed, we selected 16 articles based on 8 unique repeat cross-sectional and cohort surveys of US prevalence trends in disability or functioning among persons generally aged 65 or 70 years or older.
DATA EXTRACTION
We evaluated survey quality according to 10 criteria, ranked the surveys as good, fair, or poor, and calculated for each outcome the average annual percent change.
DATA SYNTHESIS
Among the 8 surveys, 2 were rated as good, 4 as fair, 1 as poor, and 1 as mixed (fair or poor, depending on the outcome) for assessing trends. Analyses of surveys rated fair or good showed consistency of declines in any disability (-1.55% to -0.92% per year), instrumental activities of daily living disability (-2.74% to -0.40% per year), and functional limitations. Surveys provided limited evidence on cognition and conflicting evidence on self-reported ADL (changes ranged from -1.38% to 1.53% per year) and vision trends. Evidence on trends in disparities by age, sex, race, and education was limited and mixed, with no consensus yet emerging.
CONCLUSIONS
Several measures of old age disability and limitations have shown improvements in the last decade. Research into the causes of these improvements is needed to understand the implications for the future demand for medical care.
Topics: Activities of Daily Living; Aged; Disabled Persons; Frail Elderly; Geriatrics; Health Surveys; Humans; Persons with Mental Disabilities; Prevalence; Socioeconomic Factors; United States; Visually Impaired Persons
PubMed: 12495394
DOI: 10.1001/jama.288.24.3137 -
International Journal of Environmental... Jan 2023Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with... (Review)
Review
Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with intellectual disability (ID), and even more so for women with ID. This paper systematically reviews the current qualitative and quantitative evidence on the rights of people with ID in regard to Articles 23 (right to home and family) and 25 (health, specifically sexual and reproductive health) of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the current literature, following PRISMA 2020, was carried out in ERIC, PsychInfo, Scopus, PubMed, ProQuest, and Web of Science. In all, 151 articles were included for review. The studies were categorized into six themes: attitudes, intimate relationships, sexual and reproductive health, sexuality and sex education, pregnancy, and parenthood. There are still many barriers that prevent people with ID from fully exercising their right to sexuality, reproductive health, and parenthood, most notably communicative and attitudinal barriers. These findings underline the need to continue advancing the rights of people with ID, relying on Schalock and Verdurgo's eight-dimensional quality of life model as the ideal conceptual framework for translating such abstract concepts into practice and policy.
Topics: Pregnancy; Humans; Female; Intellectual Disability; Quality of Life; Reproductive Health; Sexual Behavior; Sexuality; Disabled Persons; Health Knowledge, Attitudes, Practice
PubMed: 36674341
DOI: 10.3390/ijerph20021587 -
Pain Sep 2019Hypersensitivity due to central pain mechanisms can influence recovery and lead to worse clinical outcomes, but the ability of quantitative sensory testing (QST), an... (Meta-Analysis)
Meta-Analysis Review
Hypersensitivity due to central pain mechanisms can influence recovery and lead to worse clinical outcomes, but the ability of quantitative sensory testing (QST), an index of sensitisation, to predict outcomes in chronic musculoskeletal disorders remains unclear. We systematically reviewed the evidence for ability of QST to predict pain, disability, and negative affect using searches of CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, and PubMed databases up to April 2018. Title screening, data extraction, and methodological quality assessments were performed independently by 2 reviewers. Associations were reported between baseline QST and outcomes using adjusted (β) and unadjusted (r) correlations. Of the 37 eligible studies (n = 3860 participants), 32 were prospective cohort studies and 5 randomised controlled trials. Pain was an outcome in 30 studies, disability in 11, and negative affect in 3. Meta-analysis revealed that baseline QST predicted musculoskeletal pain (mean r = 0.31, 95% confidence interval [CI]: 0.23-0.38, n = 1057 participants) and disability (mean r = 0.30, 95% CI: 0.19-0.40, n = 290 participants). Baseline modalities quantifying central mechanisms such as temporal summation and conditioned pain modulation were associated with follow-up pain (temporal summation: mean r = 0.37, 95% CI: 0.17-0.54; conditioned pain modulation: mean r = 0.36, 95% CI: 0.20-0.50), whereas baseline mechanical threshold modalities were predictive of follow-up disability (mean r = 0.25, 95% CI: 0.03-0.45). Quantitative sensory testing indices of pain hypersensitivity might help develop targeted interventions aiming to improve outcomes across a range of musculoskeletal conditions.
Topics: Affect; Disabled Persons; Humans; Musculoskeletal Pain; Pain Measurement; Pain Threshold; Prognosis; Prospective Studies; Randomized Controlled Trials as Topic
PubMed: 31045746
DOI: 10.1097/j.pain.0000000000001590 -
Prosthetics and Orthotics International Dec 2015To date no review has been published that analyzes the efficacy of assistive devices on the walking ability of ambulant children and adolescents with spina bifida and,... (Comparative Study)
Comparative Study Review
The effects of orthoses, footwear, and walking aids on the walking ability of children and adolescents with spina bifida: A systematic review using International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a reference framework.
BACKGROUND
To date no review has been published that analyzes the efficacy of assistive devices on the walking ability of ambulant children and adolescents with spina bifida and, differentiates between the effects of treatment on gait parameters, walking capacity, and walking performance.
OBJECTIVES
To review the literature for evidence of the efficacy of orthotic management, footwear, and walking aids on gait and walking outcomes in ambulant children and adolescents with spina bifida.
STUDY DESIGN
Systematic literature review.
METHODS
A systematic literature search was performed to identify studies that evaluated the effect of any type of lower limb orthoses, orthopedic footwear, or walking aids in ambulant children (≤18 years old) with spina bifida. Outcome measures and treatment results for gait parameters, walking capacity, and walking performance were identified using International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as the reference framework.
RESULTS
Six case-crossover studies met the criteria and were included in this systematic review. Four studies provided indications of the efficacy of the ankle-foot orthosis in improving a number of kinematic and kinetic properties of gait, stride characteristics, and the oxygen cost of walking. Two studies indicated that walking with forearm crutches may have a favorable effect on gait. The evidence level of these studies was low, and none of the studies assessed the efficacy of the intervention on walking capacity and walking performance.
CONCLUSIONS
Some data support the efficacy of using ankle-foot orthosis and crutches for gait and walking outcomes at the body functions and structures level of the ICF-CY. Potential benefits at the activities and participation level have not been investigated.
CLINICAL RELEVANCE
This is the first evidence-based systematic review of the efficacy of assistive devices for gait and walking outcomes for children with spina bifida. The ICF-CY is used as a reference framework to differentiate the effects of treatment on gait parameters, walking capacity, and walking performance.
Topics: Activities of Daily Living; Adolescent; Child; Child, Preschool; Crutches; Disability Evaluation; Disabled Persons; Evidence-Based Medicine; Female; Foot Orthoses; Gait Disorders, Neurologic; Humans; Male; Netherlands; Quality of Life; Randomized Controlled Trials as Topic; Risk Assessment; Self-Help Devices; Shoes; Spinal Dysraphism; Treatment Outcome; Walking
PubMed: 25107922
DOI: 10.1177/0309364614543550 -
Disability and Rehabilitation 2015This systematic review examines the literature to identify the context and extent of implementation of the International Classification of Functioning, Disability and... (Review)
Review
The use of the International Classification of Functioning, Disability and Health to understand the health and functioning experiences of people with chronic conditions from the person perspective: a systematic review.
PURPOSE
This systematic review examines the literature to identify the context and extent of implementation of the International Classification of Functioning, Disability and Health (ICF) model to understand the experience of health and functioning in persons with chronic conditions from the person perspective.
METHOD
The literature search was conducted through five electronic databases between 2001 and December 2012. Reference lists of included papers were also searched. Articles in which the ICF was used to understand the health and functioning experience of adults with chronic conditions from the person-perspective were included. Data were extracted and analysed to identify the year of publication, geographical location, health condition, context of ICF use, authors' remarks and identified limitations of the ICF.
RESULTS
Thirty-seven qualitative and mixed-methods studies were included representing 18 countries and a range of chronic conditions. The ICF was found to be used to elicit and analyse people's narratives, with the majority of studies reporting that the ICF provides a comprehensive analysis of experiences and needs from the person perspective. Some limitations to its use and the need to classify the "personal factors" component were reported.
CONCLUSION
The ICF has been used to provide a comprehensive understanding of health and functioning in persons with chronic conditions from the person perspective, although there are currently relatively few studies which have used the ICF in this context. Limitations regarding its use were reported which should be considered by users of the model and during its revision process.
IMPLICATIONS FOR REHABILITATION
The ICF encourages a bio-psycho-social and person-centred approach to healthcare and may provide a useful tool for guiding clinical assessment and encouraging clinicians to consider the multitude of factors which impact health, which may result in more specific and individualised treatment targeted at individual needs. Using a common framework that can be understood across health disciplines may enhance interdisciplinary communication and collaboration, improving health care delivery. The ICF may be used to compare perspectives of individuals and their health professionals and to identify people's needs that are not adequately being addressed, which may have significant implications for improving healthcare provided and overall health outcomes.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Chronic Disease; Disability Evaluation; Disabled Persons; Female; Health Personnel; Health Status; Humans; International Classification of Functioning, Disability and Health; Male; Middle Aged; Young Adult
PubMed: 24986707
DOI: 10.3109/09638288.2014.935875 -
American Journal of Physical Medicine &... Feb 2012This literature review focuses on the literature on disability from the ethical and human rights perspective in the light of the International Classification of... (Comparative Study)
Comparative Study Review
This literature review focuses on the literature on disability from the ethical and human rights perspective in the light of the International Classification of Functioning, Disability, and Health in the period from January 1, 2008, to June 30, 2010. This article identifies and examines studies that deal with the subject of disability with reference to rights, ethical issues, and justice. A total of 42 articles and 33 books were selected. The subject most frequently dealt with in studies on disability is that of human rights (76% of the articles and 79% of the books examined), followed by topics relating to welfare (52% of articles and 64% of books), International Classification of Functioning, Disability, and Health (38% of articles and 45% of books), justice (24% of articles and 48% of books), education (21% of articles and 61% of books), and work (19% of articles and 39% of books). The subject of disability is dealt with in various fields of study and various disciplines. Most of the studies are based on the legal approach. It is to be hoped that there will be an increase in the philosophical and ethical study of disability, which has only recently entered the European debate.
Topics: Disability Evaluation; Disabled Persons; Ethics, Medical; Female; Health Status Indicators; Human Rights; Humans; Interdisciplinary Communication; International Classification of Diseases; Liability, Legal; Male; Psychology
PubMed: 22193322
DOI: 10.1097/PHM.0b013e31823d5437 -
Journal of Racial and Ethnic Health... Jun 2019Disability in older adults leads to poor quality of life, is costly for the health system, and is a risk for mortality. Little is known about disability in older...
BACKGROUND
Disability in older adults leads to poor quality of life, is costly for the health system, and is a risk for mortality. Little is known about disability in older immigrants to the USA.
OBJECTIVE
To synthesize the evidence on the prevalence and factors associated with disability in older adult immigrants.
METHODS
We conducted searches in PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus. Disability was defined as difficulty in performing basic or instrumental activities of daily living. Older adult was defined as 65 years and older. Immigrant status was defined as someone born outside of the USA.
RESULTS
Eighteen articles met the inclusion criteria. Seven studied Hispanic/Latino immigrants, six studied Asian immigrants, four studied diverse older immigrant samples, and one studied European immigrants. Prevalence of disability ranged from 2 to 49% in Asians and 3 to 58.1% in Hispanic/Latinos. In a diverse sample of immigrants, the prevalence of disability was 19.3%. Correlates of disability included female gender, low income, limited education, single status, migration in late adulthood, obesity, arthritis, and diabetes. Factors protective against disability in older adult immigrants were acculturation, migrating at a younger age, exercise, alcohol intake, and church attendance.
CONCLUSION
Disability prevalence was generally lower in Asian immigrants compared to Hispanic/Latino immigrants. Identification of the precise rates and factors associated with disability in older immigrants can inform health interventions for this population.
Topics: Activities of Daily Living; Aged; Disabled Persons; Emigrants and Immigrants; Female; Health Status Disparities; Humans; Male; Middle Aged; Prevalence; Risk Factors; Sex Factors; United States
PubMed: 30618007
DOI: 10.1007/s40615-018-00554-9 -
Journal of Rehabilitation Medicine Jun 2018To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low-... (Review)
Review
OBJECTIVE
To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low- to middle-income countries.
DATA SOURCES
CINAHL, EMBASE, MEDLINE, CENTRAL, PsycINFO, Business Source Premier, HINARI, CEBHA and PubMed.
STUDY SELECTION
Systematic reviews, randomized control trials and observational studies comparing >2 models of rehabilitation care in any language. Date extraction: Standardized forms were used. Methodological quality was assessed using AMSTAR and quality of evidence was assessed using GRADE.
DATA SYNTHESIS
Twenty-four systematic reviews which included 578 studies and 202,307 participants were selected. In addition, four primary studies were included to complement the gaps in the systematic reviews. The studies were all done at various countries. Moderate- to high-quality evidence supports the following models of rehabilitation services: psychological intervention in primary care settings for people with major depression, admission into an inpatient, multidisciplinary, specialized rehabilitation unit for those with recent onset of a severe disabling condition; outpatient rehabilitation with multidisciplinary care in the community, hospital or home is recommended for less severe conditions; However, a model of rehabilitation service that includes early discharge is not recommended for elderly patients with severe stroke, chronic obstructive pulmonary disease, hip fracture and total joints.
CONCLUSION
Models of rehabilitation care in inpatient, multidisciplinary and specialized rehabilitation units are recommended for the treatment of severe conditions with recent onset, as they reduce mortality and the need for institutionalized care, especially among elderly patients, stroke patients, or those with chronic back pain. Results are expected to be generalizable for brain/spinal cord injury and complex fractures.
Topics: Activities of Daily Living; Aged; Disabled Persons; Female; Humans; Male; Mental Disorders; Poverty; Quality of Life
PubMed: 29616278
DOI: 10.2340/16501977-2325