Introduction Comprehensive and interdisciplinary measurement of rehabilitation outcome is an essential part of the assessment and prognosis of a patient. Thus, this requires substantial contributions from the patient, their family and the rehabilitation professional working with them. Moreover, the measurement tool should be comprehensive and must consider the cultural compatibility, cost efficiency and contextual factors of the region. Methods The Comprehensive Rehabilitation Outcome Measurement Scale (CROMS) was developed through consensus and followed the Delphi process incorporating inputs from various rehabilitation professionals. The domains and items were finalized using Principal Component Analysis (PCA). The tool was validated in two native languages and back-translated considering the semantic equivalence of the scale. Intra-class correlation coefficient was performed to determine the agreement between the therapist and patient-reported scales. Results The final CROMS carries 32 comprehensive items that can be completed by the person with disability and the professional team. CROMS compares well to similar items on FIM (l ICC of 0.93) and has good internal consistency with a Cronbach's Alpha of 0.92 for both patient and therapist reported measures. Conclusions The 32 item CROMS is a tool that can potentially be used to evaluate the functional independence of various patient populations, predominantly patients with neurological disabilities.
BACKGROUND Individuals with Parkinson’s disease (PD) experience reduced balance ability and are prone to fall. As the disease advances with age, the traditional forms of physiotherapy are prone to fail in long-term exercise intervention as patients lose interest in performing the exercises. The use of virtual reality game technology consists of tasks in virtual environments that combine physical and cognitive demands in a fun and motivating manner which leads to adherence in a long-term exercise intervention. The objectives of the study were to know the adherence of Kinect adventure games in individuals with PD by attendance percentage of prescribed sessions and analyse the impact of balance after the games in them. METHODS An experimental study with pre-post design in which 11 individuals were selected, with a mean age of 67.8 years. Home-based balance exercises were given three days a week up to 6 weeks (18 sessions). Kinect adventure games were implemented for another six weeks. Adherence was measured by attendance percentage in terms of the frequency of sessions completed. The secondary outcome measure was to assess balance. Participants were evaluated before intervention and post-intervention using BESTest. Descriptive statistics were used to compare the BESTest scores of pre and post-intervention. RESULTS The adherence percentage of Kinect adventure game therapy was 38 %. The adherence percentage of home-based balance exercises was only 9 %. The best scores improved in home-based balance exercise compared to Kinect adventure game therapy. CONCLUSIONS The participants with Parkinson’s disease did not adhere to Kinect adventure game therapy. For the attended sessions the balance improved for home-based balance exercise compared to Kinect game therapy. KEY WORDS Exercise Barrier, Adherence, Balance Training, Virtual Reality, Video Games
Introduction: Comparison of sway parameters of visually impaired participants to that of the sighted population may give insight into the intrinsic risk of falls relative on various surfaces. Sway is a natural mechanism to adjust posture and maintain balance. But the sway characteristics on uneven surfaces are ill explored. There is a paucity of evidence on baseline values of sway amplitude in visually impaired women in comparison to sighted women, which underpins the importance of this study. Methods: Eighteen visually impaired young women and an equal number of age-matched sighted peers were recruited by convenience to this prospective observational study. Sway amplitude of the participants were measured using a sway meter on three different surfaces, with eyes opened and closed conditions, using videography and analyzed using Kinovea motion analyzing software. Demographics and participant characteristics were summarized using descriptive statistics. The comparison of sway amplitude in both directions were performed using independent samples t-test. Results: Visually impaired women demonstrated lower amplitude of sway than sighted young women, irrespective of surface. Discussion: There was a gradual increase in sway amplitude as the standing surfaces changed from even to sand and pebbles, respectively, for both groups. Information for Practitioners: Contrary to the existing evidence, the results of this study indicate that visually impaired young individuals may not be at higher intrinsic risk of falls on various terrains than their sighted peers. The authors hypothesize that the lower sway among visually impaired participants can be attributed to the learned strategy for safety from exposure to real-life pragmatic environments during everyday activities, which enabled them to adopt postural strategies as a safety measure. Hence, this strategy can potentially be used in dynamic situations to decrease the propensity for falls during ambulation in visually impaired individuals.
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