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Biomedical subjects

T L Packer

Publications and source records attributed to T L Packer.

8 recordsLinked to original sources

Evaluating a new mobility device: feedback from women with disabilities in India.

PURPOSE: To gather the opinions of potential wheeled mobility device users at an early stage in the design process to ensure the development of technology which would meet their functional needs. METHOD: Eight women with bilateral lower extremity disabilities living in Gujarat state, India, participated in this study. The women were introduced to a working model of a new wheeled ground mobility device (GADI2) for a brief trial and participated in a feedback interview which solicited information on different aspects of the design, specifically the interface between the device and the user, the physical environment and the sociocultural environment. Both qualitative and quantitative data were collected and analysed. RESULT: Although the overall response to the device was positive, there was a lack of consensus in some of the feedback gathered. There were varying opinions across the participants and recommendations were often in opposition to what would typically be recommended in a traditional rehabilitation setting. CONCLUSIONS: This study investigates and discusses the research findings from a rehabilitation perspective with a focus on the functional versus technical design aspects. The importance of involving potential consumers in the design of technology is highlighted. The small sample size and lack of consensus in some of the results indicates the need for further research and field testing of this new mobility device design.

Adolescent↗

Attitudes to disability of Russian occupational therapy and nursing students.

Positive student attitudes toward disability are essential to client-centred rehabilitation. Instilling such attitudes in students enrolled in the first occupational therapy (OT) and post-diploma nursing management (NM) courses in Russia was a key objective of the curriculum development team. The team's aim was to combat the traditional Russian attitude of pity, dependence and marginalization. To this end, the introductory classes were developed and taught by teachers from the All Russia Society of Disabled (ARSD). This paper examines the attitudes to disability in Russia and compares the attitudes of three groups of students. Students in the OT and NM programmes (n = 18) in Volgograd were compared to other nursing students in the same college (n = 21) and to nursing students in a Moscow medical school (n = 20). All completed the Scale of Attitudes Toward Disabled Persons (SADP). The Kruskal-Wallis and Mann-Whitney U statistics revealed that students in the OT and NM programmes had significantly more positive scores (P = 0.01) than either of the other groups. This suggests that the strategies adopted by the curriculum team were successful in developing positive attitudes in students.

Adult↗

Designing appropriate rehabilitation technology: a mobility device for women with ambulatory disabilities in India.

Mobility is an essential requirement for personal independence and social participation. For persons with an ambulatory disability, a lack of mobility creates barriers to the realization of these goals. In developed countries, significant research and development has resulted in the technological advancement of assistive devices. Unfortunately, transfer of these technologies to developing countries has proven difficult. Consequently, effort has been directed at designing appropriate technology in these countries--most often in the form of wheelchairs and hand-driven tricycles. For activities within and around the home, however, especially in cultures where many activities are traditionally performed on the floor, wheelchairs and tricycles are often inappropriate solutions. In response to this, a novel mobility device has been designed for use by women with ambulatory disabilities living in rural and low-income areas of India. The device is intended to assist the user in performing activities of daily living which occur within and near the home, and at ground level. To this end, the device conceptually differs from traditional wheelchair designs in that it physically keeps the rider near to the floor. This paper describes the new device as well as the cross-cultural and cross-professional collaborative methodology used in its design.

Activities of Daily Living↗

The mobility needs of women with physical disabilities in India: a functional perspective.

The purpose of this research was to explore the functional mobility needs of women with lower extremity disabilities in Gujarat state, India. Ten women participated in a Mobility Needs Assessment which used multiple data collection methods to gather quantitative and qualitative information in five main areas. The results indicated that the physical environment was diverse, at times unpredictable, and environmental barriers were commonly encountered. The women travelled relatively long distances to perform self-care activities such as bathing and toileting. Furthermore, the women had compensated for their disability by implementing different strategies, such as four methods of locomotion, ten sitting positions, and various methods for carrying objects. Activities of daily living were similar amongst the women, although some women required assistance to complete specific activities successfully. Although the women expressed different views on how they felt about their present level of mobility, all were able to identify activities they wished to perform if they could move more easily. The resulting information contributed towards an area where little has been documented previously.

Activities of Daily Living↗

Needs of people with disabilities used to determine clinical education.

Western rehabilitation techniques were first introduced into China in the early 1980s. The predominantly 'medical model' of health care in China has resulted in a shortage of rehabilitation personnel and limited experience determining the needs of clients. Occupational therapy practitioners in China are learning their new roles and clients, having never had any contact with occupational therapy, are unaware what services can be offered. The purpose of this research was to determine the most frequently self-identified functional problems (in the ares of self-care productivity and leisure) identified by 113 in-patients in four different hospitals in China, in order to assist therapists to develop programmmes that are responsive to clients' needs. Using the Canadian Occupational Performance Measure, both males and females identified significantly more self-care than leisure or productivity problems (P = 0.01). Females identified more productivity problems than males (P = 0.01) while males appeared to consider leisure difficulties as a priority more frequently than women. The study was jointly undertaken by a Canadian and a Chinese researcher. To our knowledge, this is the first time that occupational therapy personnel in China have formally surveyed clients about their rehabilitation needs, in order to develop priorities for programming.

Activities of Daily Living↗

Fatigue secondary to chronic illness: postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis.

Estimates of the percentage of patients with postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis who experience fatigue range from approximately 75% to 100%. In this study we describe the severity of fatigue and its impact on subjects with these three diagnoses. The Fatigue Severity Scale, the Human Activity Profile, and the Nottingham Health Profile were used to measure fatigue, activity, and health status respectively of each diagnostic group as well as a control group. Using a Kruskal-Wallis one-way analysis of variance followed by a Bonferroni-adjusted Mann Whitney U test all diagnostic groups reported significantly higher levels (p = .0000 to p = .002) of fatigue and lower perceived health status than the control group. Subjects with chronic fatigue and multiple sclerosis also had significantly reduced activity levels (p = .002 to p = .01) compared with the control group. Further attention should be directed toward understanding the relationship between fatigue and ability to engage in activities as well as strategies for remediation and/or compensation of the fatigue.

Adult↗

Elbow kinematics during sit-to-stand-to-sit of subjects with rheumatoid arthritis.

Independence in mobility is dependent on the ability to rise from a chair. Elbow kinematics of subjects with rheumatoid arthritis were compared to those of subjects with no known elbow pathology. Through a case study approach, four subjects with varying elbow pathology and symptoms, were compared with a control group of 10 subjects on four kinematic variables. Results indicated that whereas the overall movement pattern was similar between the two groups, a trend toward increased deviation occurred with increased elbow involvement (as measured using the Morrey Elbow Evaluation). The total time taken to complete the task increased and the maximum velocity decreased as scores on the Morrey Evaluation decreased. When the minimum flexion angle (maximum extension) used during the activity was compared with the minimum flexion angle available, the angle used was consistently 15 degrees to 20 degrees less than that available. This possible need for a residual range raises questions about the generally accepted belief that activities require between 30 degrees to 130 degrees of flexion and 100 degrees of rotation.

Adult↗

Activity and post-polio fatigue.

Fatigue was studied in 12 subjects with post-polio sequelae (PPS). Results of the Fatigue Severity Scale (FSS) demonstrated a mean score of 4.8 +/- 1.6 (non-disabled scores = 2.3 +/- 0.7). The Human Activity Profile (HAP) was not sensitive enough to measure fatigue. Fifty percent of subjects scored below the first percentile based on age and sex matched norms. The Activity Record (ACTRE) results revealed that subjects spent 5% of their time resting and 1% in planning or preparation activities. Fatigue peaked in the late morning or early afternoon and was relieved by rest periods. Use of energy conservation and work simplification skills along with frequent rest periods was suggested as a possible method for managing PPS fatigue.

Activities of Daily Living↗