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A high prevalence of manual wheelchair rear-wheel misalignment could be leading to increased risk of repetitive strain injuries

OTT, Joseph
HENDERSON, Travis
WILSON-JENE, Holly
KOONTZ, Alicia
PEARLMAN, Jonathan
2021

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Purpose: To determine the prevalence and severity of manual wheelchair rear wheel misalignment in community-dwelling manual wheelchair users and estimate the associated increases in rolling resistance (RR) and risk of repetitive strain injuries (RSIs).


Materials and Methods: Data were collected in an outpatient rehabilitation clinic, a university research laboratory, and at adaptive sporting events in the United States. Two hundred active, self-propelling man- ual wheelchair users were recruited. Angular misalignment (referred to as toe angle) while the wheelchair was loaded with the user, and the difference between the maximum and minimum toe angle (referred to as slop) with the wheelchair unloaded.

 

Results: Average results for toe angle and slop (movement in the rear wheels) were 0.92 and 0.61 degrees, respectively. Using a lab-based testing method, we quantified the impact of increased RR forces due to misalignment in increased RR forces. Our results indicate that the average toe angle while under load and slop, without loading, measured in the community increase required propulsion force by 3.0 N. Combined toe angle and slop (i.e., the worst-case scenario) added increased propulsion force by 3.9 N. Conclusions: We found that rear-wheel misalignment was prevalent and severe enough that it may increase the risk for RSIs and decrease participation. To mitigate this issue, future work should focus on reducing misalignment through improved maintenance interventions and increased manufacturing qual- ity through more stringent standards.

Kindergarten Redshirting: Implications for Children with Disabilities

SANDS, Michelle M
MONDA-AMAYA, Lisa
MEADAN, Hedda
2021

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The purpose of this paper is to explore issues and concerns related to academic redshirting in kindergarten and to discuss implications of this practice for children with disabilities. Although parents cite a variety of reasons for redshirting their child, only limited evidence of academic or social benefit can be found. A search was conducted to identify studies relevant to academic redshirting and inclusive of children with disabilities published within the past 20 years, and 17 articles were identified related to the topic. From these articles, three central topics emerged: (a) prevalence, predictors, or parent motivations for kindergarten redshirting, (b) the impact of redshirting on academic achievement and post-secondary outcomes, and (c) the impact of this practice on a child’s behavior. While assumptions can be made based on the research conducted using a general education population, the impact of kindergarten redshirting on the success of children with disabilities is unclear due to the limited amount of research that currently exists. Implications for children with disabilities are discussed.

Preliminary experiences in acute occupational therapy for in-patients with coronavirus-19 (COVID-19): leveraging assistive technology in three case studies of male veterans

RICH, Tonya
HICKS, Brandon
DAHL, Abigail
SULLIVAN, Elle
BARRETT, Benjamin
BEDORE, Beau
2020

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Purpose:

Coronavirus 2019 (COVID-19) was first identified in December 2019 with millions of cases reported globally in the succeeding months. Initial hospitalisation strives to minimise multisystem organ failure and of those that survive, individuals can present with profound rehabilitation needs. The purpose of this case series is to describe occupational therapy (OT) and special technology considerations for three male Veteran patients hospitalised with suspected or confirmed COVID-19. 

 

Methods: 

This is a descriptive case series using a retrospective electronic health record review at a Veterans Administration hospital. The case series includes three male Veterans with confirmed or suspected COVID-19 (ages 69–78) who were referred to OT. The cases were selected to demonstrate the novel use of technology and strategies to reduce the risk of transmission. In two of three of our cases, we describe acute rehabilitation with a focus on activity tolerance, participation in occupations, and discharge planning. In all cases, we measured vital signs and activity tolerance as primary outcomes. 

 

Results and conclusions: 

The findings suggest that outcome measures focussing on activity tolerance to maintain stable vital signs during the recovery phase is central to the progression of activities. We observed in our cases that the Person-Environment-Occupation-Performance (PEOP) model can guide practice and complement the medical model in management of these patients. We utilised technology to engage family members in the rehabilitation care and minimise exposure risks.

Work capacity assessments and efforts to achieve a job match for claimants in a social security setting: an international inventory

SENGERS, Johan H
AMBA, Femke I
BROUWER, Sandra
STAHL, Christian
2020

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Purpose: Many high-income countries are witnessing a shift of focus on eligibility for disability benefits towards promotion of work reintegration. However, little is known about how countries assess work cap- acity, and how a job match is then obtained. The current study aims to compare work capacity assess- ments and available efforts to achieve a job match in eight high-income OECD countries.

 

Methods: A survey was conducted among key stakeholders concerning organization of work capacity assessments in social security settings, and efforts made to obtain a job, across eight OECD countries: Australia, Denmark, Finland, Iceland, Sweden, the Netherlands, the United Kingdom and the United States. 

 

Results: In most countries, work capacity is assessed at several time points, with variations in moments and in information used for job matching. In countries obtaining information on personal and work levels, the search to find a job match usually begins with the persons who have disabilities.

 

Conclusion: Although a shift towards a holistic focus in work capacity assessment has been recognized, medical factors still prevail. Limited emphasis is placed on the implications of functional limitations for the possibilities of work. A holistic approach to assessment needs to be coupled with holistic support measures through provision of coordinated and high quality job matching services.

COVID-19 outcomes among people with intellectual and developmental disability living in residential group homes in New York State

LANDES, Scott D.
TURK, Margaret A.
FORMICA, Margaret K.
McDONALD, Katherine E.
STEVENS, J. Dalton
June 2020

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In order to investigate whether people with intellectual and developmental disabilities (IDD) are at higher risk of severe outcomes from COVID-19, the COVID-19 outcomes among people with IDD living in residential groups homes in the state of New York and the general population of New York State were compared. Data for people with IDD are from a coalition of organizations providing over half of the residential services for the state of New York, and from the New York State Department of Health. Analysis describes COVID-19 case rates, case-fatality, and mortality among people with IDD living inresidential group homes and New York State through May 28, 2020

 

Disability and Health Journal, https://doi.org/10.1016/j.dhjo.2020.100969

 

Interventions for anxiety in mainstream school-aged children with autism spectrum disorder (ASD)

HILLMAN, Kylie
DIX, Katherine
AHMAD, Kashfee
LIETZ, Petra
TREVITT, Jenny
ULJAREVIC, Mirko
VIVANTE, Giacomo
HEDLEY, Darren
May 2020

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Anxiety is a common problem in school-aged children with autism spectrum disorder (ASD). Cognitive behavioural therapy (CBT) and other psychosocial interventions have been developed as alternatives to pharmacological intervention to treat anxiety in students with ASD.

 

This Campbell systematic review examines the effects of interventions for reducing anxiety in school-aged children with autism spectrum disorder, compared to treatment-as-usual. The review summarises evidence from 24 studies using an experimental or quasi-experimental design.

 

Twenty-four studies, involving 931 school-aged children with ASD (without co-occurring intellectual disability) and clinical anxiety, are summarised in this review. The studies were experimental or quasi-experimental control-treatment trials, deemed to be of sufficient methodological quality and with reduced risk of bias. Studies spanned the period 2005 to 2018 and were mostly carried out in Australia, the UK and the USA.

Examined interventions ranged across clinical, school-based, or home-based settings, with group or individual treatment formats. Twenty-two of the studies used a CBT intervention. One study used peer-mediated theatre therapy and one study examined the benefits of Thai traditional massage for reducing anxiety. Most interventions involved parents/caregivers and were conducted face-to-face.

 

Campbell Systematic Reviews, Volume16, Issue2, June 2020, e1086

 
https://doi.org/10.1002/cl2.1086

 

Contingent Electric Shock as a Treatment for Challenging Behavior for People With Intellectual and Developmental Disabilities: Support for the IASSIDD Policy Statement Opposing Its Use

ZARCONE, Jennifer R
MULLANE, Michael P
LANGDON, Peter E
BROWN, Ivan
2020

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Issues: The International Association for the Scientific Study of Intellectual and Developmental Disabilities (IASSIDD) is an international group of researchers, clinicians, students, parents, and self-advocates that promotes worldwide research and exchange of information on intellectual and developmental disabilities. IASSIDD recently developed a policy statement regarding their opposition to the use of contingent electric skin shock (CESS) with individuals with challenging behavior and intellectual and developmental disabilities. To support the policy, the available literature was reviewed to evaluate the efficacy, side effects, generalization, and long-term effectiveness of the procedure as an intervention for challenging behavior.


Findings: The review provides a history that demonstrates that, although CESS can decrease the frequency of challenging behavior, it comes at a cost in terms of physical and emotional side effects, and questions remain regarding the long-term effectiveness of the procedure. In addition, we raise several ethical and methodological issues that make the research on the use of CESS even more concerning.


Conclusions: Although research continues in some countries, these studies are now rare. In fact, in the United States, the Food and Drug Administration has just banned the use of such devices with individuals with self-injury and aggression. It is hoped that, because there are many other forms of treatment that have shown to be effective for severe challenging behavior, we can completely avoid the use of CESS.

Mobility Analysis of AmpuTees (MAAT 4): classification tree analysis for probability of lower limb prosthesis user functional potential

WURDEMAN, Shane R
STEVENS, Phillip M
CAMPBELL, James H
2019

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Purpose: 

To develop a predictive model to inform the probability of lower limb prosthesis users’ functional potential for ambulation.

 

Materials and Methods: 

A retrospective analysis of a database of outcomes for 2770 lower limb prosthesis users was used to inform a classification and regression tree analysis. Gender, age, height, weight, body mass index adjusted for amputation, amputation level, cause of amputation, comorbid health status and functional mobility score [Prosthetic Limb Users Survey of Mobility (PLUS-M™)] were entered as potential predictive variables. Patient K-Level was used to assign dependent variable status as unlimited community ambulator (i.e., K3 or K4) or limited community/household ambulator (i.e., K1 or K2). The classification tree was initially trained from 20% of the sample and subsequently tested with the remaining sample.

 

Results: 

A classification tree was successfully developed, able to accurately classify 87.4% of individuals within the model’s training group (standard error 1.4%), and 81.6% within the model’s testing group (standard error 0.82%). Age, PLUS-M™ T-score, cause of amputation and body weight were retained within the tree logic.

 

Conclusions: 

The resultant classification tree has the ability to provide members of the clinical care team with predictive probabilities of a patient’s functional potential to help assist care decisions.

Adding meaning to physical fitness test results in individuals with intellectual disabilities

OPPEWAL, Alyt
HILGENKAMP, Thessa I M
February 2019

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Purpose: Evaluating physical fitness in individuals with intellectual disabilities (ID) is challenging, and a multitude of different versions of tests exist. However, psychometric properties of these tests are mostly unknown, and both researchers as clinical practitioners struggle with selecting appropriate tests for individuals with ID. We aim to present a selection of field tests with satisfactory feasibility, reliability, and validity, and of which reference data are available.

 

Methods: Tests were selected based on (1) literature review on psychometric properties, (2) expert meetings with physiotherapists and movement experts, (3) studies on population specific psychometric properties, and (3) availability of reference data. Tests were selected if they had demonstrated sufficient feasibility, reliability, validity, and possibilities for interpretation of results.

 

Results: We present a basic set of physical fitness tests, the ID-fitscan, to be used in (older) adults with mild to moderate ID and some walking ability. The ID-fitscan includes tests for body composition (BMI, waist circumference), muscular strength (grip strength), muscular endurance (30 second and five times chair stand), and balance (static balance stances, comfortable gait speed).

 

Conclusions: The ID-fitscan can be used by researchers, physiotherapists, and other clinical practitioners to evaluate physical fitness in adults with ID. Recommendations for future research include expansion of research into psychometric properties of more fitness tests and combining physical fitness data on this population in larger datasets.

A comparison of disability rights in employment: Exploring the potential of the UNCRPD in Uganda and the United States

OJOK, Patrick
GOULD, Robert
2019

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The disability employment policy systems in the US and Uganda are compared, and areas identified to improve implementation by examining the broader socio-cultural contexts that have shaped disability policy and practices of the two countries over time. Using the United Nations Conventions on the Rights of Persons with Disabilities (UNCRPD) as the overarching analytical framework, the analysis is framed within the discussion of the right to employment, as both countries are recognized for policy advances in this domain, but continue to experience low labor market participation for persons with disabilities. It identifies three critical areas that impact the realisation of disability rights in each context: ideological frameworks; hiring and retention initiatives; and state level supports. Ultimately, it considers the limitations of the rights based framework for actualising employment rights in the context of limited state and individual resources. 

 

Disability and the Global South, 2019, Vol.6, No. 2

 

Adapting an education program for parents of children with autism from the United States to Colombia

MAGANA, Sandy
TEHERO HUGHES, Marie
SALKAS, Kristen
MORENO ANGARITA, Marisol
2019

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One of the lingering aspects of coloniality in the Americas is paternalism. In Latin America, this power structure plays out among people with autism spectrum disorder (ASD) through beliefs that people with disabilities need to be protected and guarded at home, and that they are unable to learn and function in society. We developed a program to empower parents of children with ASD through peer education to help their children realize their potential. This program was implemented in the United States (US) for Latino immigrant families and then adapted for use in Bogotá, Colombia. In this paper, we discuss some of the ways the manifestations of colonialism have influenced the adaptation of this program from North to South. For example, in Colombian society it is not common to use non-professionals or peers to deliver scientific information because within a paternalistic society there is ‘respeto’ (respect) for persons who are older, male and have credentials. Therefore, promoting the use of peer-mothers in this context was a challenge in the adaptation that warranted compromise. We explore and discuss similarities and differences in the adaptation and delivery between North and South and problematize the idea of Latinos in the US versus Colombia.

 

Disability and the Global South, 2019 Vol.6, No. 1

Funding and inclusion in higher education institutions for students with disabilities

CHIWANDIRE, Desiree
VINCENT, Louise
2019

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Background: Historically, challenges faced by students with disabilities (SWDs) in accessing higher education institutions (HEIs) were attributed to limited public funding. The introduction of progressive funding models such as disability scholarships served to widen access to, and participation in, higher education for SWDs. However, recent years have seen these advances threatened by funding cuts and privatisation in higher education.

 

Objectives: In this article, the funding mechanisms of selected developed and developing democratic countries including the United Kingdom, the United States, Canada, Australia, South Africa and India are described in order to gain an insight into how such mechanisms enhance access, equal participation, retention, success and equality of outcome for SWDs. The countries selected are often spoken about as exemplars of best practices in relation to widening access and opportunities for SWDs through government mandated funding mechanisms. Method: A critical literature review of the sample countries’ funding mechanisms governing SWDs in higher education and other relevant government documents; secondary academic literature on disability funding; online sources including University World News, University Affairs, newspaper articles, newsletters, literature from bodies such as the Organisation for Economic Co-operation and Development, Disabled World and Parliamentary Monitoring Group. Data were analysed using a theoretically derived directed qualitative content analysis.

 

Results: Barriers which place SWDs at a substantial educational disadvantage compared to their non-disabled peers include bureaucratisation of application processes, cuts in disability funding, means-test requirements, minimal scholarships for supporting part-time and distance learning for SWDs and inadequate financial support to meet the day-to-day costs that arise as a result of disability.

 

Conclusion: Although the steady increase of SWDs accessing HEIs of the sampled countries have been attributed to supportive disability funding policies, notable is the fact that these students are still confronted by insurmountable disability funding-oriented barriers. Thus, we recommend the need for these HEIs to address these challenges as a matter of urgency if they are to respect the rights of SWDs as well as provide them with an enabling environment to succeed academically.

 

African Journal of Disability, Vol 8, 2019

Development of an evidence-based practice framework to guide decision making support for people with cognitive impairment due to acquired brain injury or intellectual disability

DOUGLAS, Jacinta
BIGBY, Christine
November 2018

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Purpose: At least 5% of people in Australia and the USA have cognitive impairment and require support for decision-making. This paper details a research program whereby an evidence-based Support for Decision Making Practice Framework has been developed for those who support people with cognitive disabilities to make their own decisions across life domains.

 

Methods: The La Trobe framework was derived from a research program modeled on the Medical Research Council four-phase approach to development and evaluation of complex interventions. We completed phase one (development) by: (1) systematically reviewing peer-reviewed literature; and (2) undertaking qualitative exploration of the experience of support for decision-making from the perspectives of people with cognitive disabilities and their supporters through seven grounded theory studies. Results of phase two (feasibility and piloting) involving direct support workers and health professionals supported phase three (evaluation) and four (implementation), currently underway.

 

Results: The framework outlines the steps, principles, and strategies involved in support for decision-making. It focuses on understanding the will and preferences of people with cognitive disabilities and guides those who provide support including families, support workers, guardians, and health professionals.

 

Conclusions: This framework applies across diverse contemporary contexts and is the first evidence-based guide to support for decision-making.

2030 Agenda for sustainable development: Selected SDG indicators disaggregated by disability status

WASHINGTON GROUP ON DISABILITY STATISTICS
October 2018

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In light of the importance of disability data collection and the disaggregation of Sustainable Development Goal (SDG) outcome indicators by disability status, the Washington Group on Disability Statistics (WG) undertook an exercise to review, among WG member countries, the extent to which data on SDG indicators currently available can be disaggregated by disability status. Requests for disaggregated SDG data for 13 selected indicators were sent to 146 member countries. 48 countries responded and 39 provided data. Response data is tabulated and discussed.

Association between social factors and performance during Functional Capacity Evaluations: a systematic review

ANSUATEGUI ECHEITA, Jone
VAN HOLLAND, Berry J
GROSS, Douglas P
KOOL, Jan
OESCH, Peter
TRIPPOLINI, Maurizio
RENEMAN, Michiel F
March 2018

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Purpose: Determine the association of different social factors with Functional Capacity Evaluation (FCE) performance in adults.

 

Materials and methods: A systematic literature search was performed in MEDLINE, CINAHL, and PsycINFO electronic databases. Studies were eligible if they studied social factor’s association with the performance of adults undergoing FCE. Studies were assessed on methodological quality and quality of evidence. The review was performed using best-evidence synthesis methods.

 

Results: Thirteen studies were eligible and 11 social factors were studied. Considerable heterogeneity regarding measurements, populations, and methods existed among the studies. High quality of evidence was found for the association of FCE performance with the country of FCE and examiner’s fear behavior; moderate quality of evidence with previous job salary; and low or very low quality of evidence with compensation status, litigation status, type of instruction, time of day (workday), primary or mother language, and ethnicity. Other social factors were not studied.

 

Conclusions: Evidence for associations of various social factors with FCE performance was found, but robust conclusions about the strength of the associations cannot be made. Quality of evidence ranged from high to very low. Further research on social factors, also within a biopsychosocial context, is necessary to provide a better understanding of FCE performance.

Disability & the Global South (DGS), 2018, Vol. 5 No. 2 - Special issue: Intersecting Indigeneity, Colonisation and Disability

2018

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Articles include:

  • Editorial: Intersecting Indigeneity, colonialisation and disability
  • Yuin, Kamilaroi, Sámi, and Maori people’s reflections on experiences as ‘Indigenous scholars’ in ‘Disability Studies’ and ‘Decolonisation’
  • Audiology and Speech-Language Pathology: Practitioners’ Reflections on Indigeneity, Disability and Neo-Colonial Marketing
  • ‘My granddaughter doesn’t know she has disabilities and we are not going to tell her’: Navigating Intersections of Indigenousness, Disability and Gender in Labrador
  • Disabling Bodies of/and Land: Reframing Disability Justice in Conversation with Indigenous Theory and Activism
  • The Convention on the Rights of Persons with Disabilities and its implications for the health and wellbeing of indigenous peoples with disabilities: A comparison across Australia, Mexico and New Zealand
  • Challenges in global Indigenous–Disability comparative research, or, why nation-state political histories matter
  • ‘Black on the inside’: albino subjectivity in the African novel
  • The role of indigenous and external knowledge in development interventions with disabled people in Burkina Faso: the implications of engaging with lived experiences
  • An intersection in population control: welfare reform and indigenous people with a partial capacity to work in the Australian northern territory
  • Inclusion of marginalised Aboriginal and Torres Strait Islander Peoples with neurocognitive disability in the National Disability Insurance Scheme (NDIS)

 

Disabling bodies of/and land: Reframing disability justice in conversation with indigenous theory and activism

JAFFEE, Laura
JOHN, Kelsey
2018

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A central claim of this paper is that the destruction of Earth through practices of settler colonialism is inextricable from the disablement of Indigenous ontology, peoples, and communities. The disablement of land/body as a tactic of settler colonialism has persisted for centuries and takes multifarious forms. By highlighting Indigenous struggles to protect Mother Earth and her sacred resources, we suggest that Indigenous ontology, specifically relationships to land (Deloria, 1972), challenges Eurocentric/settler disability theory at the epistemological level by rejecting the taken-for-granted dualism between the environment and (disabled) humans within (settler) disability studies. Indigenous ontology, and Indigenous peoples’ experiences of settler colonialism, belie a clear bifurcation of humans and the environment, or bodies and space. Land appropriation, resource extraction, linguistic genocide, forced removal, erasure, and devastation by settlers invariably wreaks havoc on the land, spirit, livestock, and bodies of Indigenous peoples. Rejecting logics of elimination and imagining alternative futures- in opposition to the capitalist state’s projection of futures devoid of disability and Indigeneity- is essential for realizing national and bodily self-determination for non-Indigenous disabled and Indigenous peoples in the present and into the future.

 

Disability and the Global South, 2018, Vol.5, No. 2

The Americans with disabilities act at 25 years : lessons to learn from the convention on the rights of people with disabilities

KANTER, Arlene S
2015

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“In this Article, the Author argues that the Americans with Disabilities Act (ADA) and the subsequent ADA Amendments Act (ADAAA), have not realized the goal of ensuring equality for people with disabilities. The Author suggests that the Convention on the Rights of People with Disabilities

(CRPD), adopted in 2006 by the United Nations, offers a new approach to realizing the right to equality for people with disabilities”

Drake Law Review, Vol. 63

Human Rights

www.macao-tz.org
December 2014

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Malezi AIDS Care Awareness Organization (MACAO) is a non-profit organization reaching out to neglected Indigenous people in Ngorongoro District, Arusha Region of Northern Tanzania.  Macao founded in 2003, Macao is a humanitarian organization that provides assistance to approximately 200,000 Indigenous Maasai community in Ngorongoro district for addressing needs of water and sanitation, food security, health Care Research, Education, Research environment, Maasai Traditional Research, Human Rights and sustainable economic development by strengthening their livelihoods.  In addition to responding to major relief situations, MACAO focuses on long-term community development through over 4 Area Development Project. We welcome the donors and volunteers to join us in this programs, we are wolking in ruro villages.

Evacuation of people with visual impairments

Sørensen, Janne Gress
2014

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This Study aimed to increase knowledge and data on evacuation characteristics of vulnerable people and with a special focus on blind and visually impaired people.

 

An experimental program designed to obtain data on walking speeds horizontally and descending stairs, interaction between participants and their interaction with the building environment. Experiments were conducted in different buildings including office buildings, an institutional building and a tunnel. In total 148 people have participated in the experiments. Parallel to the evacuation experiments participants were interviewed not only about their experience with the experiments but also their use of different building types and the difficulties they meet.

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