Telerehabilitation for people with physical disabilities and movement impairment: development and evaluation of an online toolkit for practitioners and patients.

PURPOSE: Telerehabilitation has increasingly been used since the COVID-19 pandemic but with limited guidance available on undertaking physical assessments using remote methods. We aimed to provide such guidance by developing a Telerehab Toolkit, an online information and training resource for practitioners, patients, and carers on telerehabilitation for people with physical disabilities and movement impairment. MATERIALS AND METHODS: Development and evaluation of the toolkit were informed by the Knowledge to Action framework and took place iteratively in two phases-knowledge creation and action. Information was collated from various sources including literature review, online survey, service evaluation, and focus group discussions. The toolkit has been evaluated using think-aloud interviews, e-mail and social media feedback from users, and analytics data on user engagement with the website. RESULTS: The Telerehab Toolkit focuses on remote physical assessments, and contains information on technology, digital skills, remote assessment tools, information governance, and safety for telerehabilitation. Resources include top tips from practitioners and patients, how-to guides, checklists, videos, and links to evidence. CONCLUSIONS: The Telerehab Toolkit has been well-received by practitioners, healthcare students, patients, and carers, is being disseminated widely, and is freely available (www.plymouth.ac.uk/research/telerehab). IMPLICATIONS FOR REHABILITATIONTelerehabilitation has been increasingly used since the COVID-19 pandemic, but with limited guidance and training for practitioners on undertaking safe and effective remote physical assessments.The Telerehab Toolkit has been developed iteratively using the Knowledge to Action framework; it is a free online resource for practitioners and patients with specific guidance on telerehabilitation for physical disabilities and movement impairment.It is anticipated that the resource will help to improve the knowledge, skills, and confidence of the current and future rehabilitation workforce.

Using Technology to Enhance Special Education. Advances in Special Education. Volume 37

"Using Technology to Enhance Special Education," Volume 37 of Advances in Special Education, is a logically, thoughtfully organized, and well-sequenced text. It focuses on how general and special educators can use technology to work with children and youth with disabilities. This cutting-edge book involves researchers, scholars, educators, and leaders who are knowledge producers in the field. It is written to respond to today's changing world where technology has become a very powerful force. As it stands, the world is getting smaller and smaller;and what is happening in a location quickly becomes known everywhere. For example, during the tense periods of the global COVID pandemic, technology became the livewire of our world. This book begins with an introduction to technology and students with disabilities;and the remaining chapters focus on the role of technology in the education of students with learning disabilities, emotional and/or behavioral disorders, and intellectual disabilities, autism spectrum disorders, physical and health impairments, hearing impairments/deafness, visual impairments, and traumatic brain injuries. In addition, some chapters focus on the role of technology in achieving equitable and inclusive education, building culturally and linguistically responsive general and special education, and creatively using digital comics to improve written narratives. In the end, this book concludes with a chapter that forward looking ways to infuse technology in special education. We feel that this volume is an excellent resource for special education researchers, scholars, practitioners, and professionals who teach and serve students with disabilities.

Effects of self-efficacy, self-esteem, and disability acceptance on the social participation of people with physical disabilities: Focusing on COVID-19 pandemic.

PURPOSE: The objective of this study was to understand the effects of self-efficacy, self-esteem, and the degree of disability acceptance of people with physical disabilities living in COVID-19 pandemic on their social participation. METHODS: Among the 4577 registered disabled people who participated in the 2nd wave of the Panel Survey of Employment for the Disabled (PSED), 1682 people with physical disabilities who faithfully answered all the survey items were selected as the final study subjects. This study used the variables of social participation, self-efficacy, self-esteem, and disability acceptance, which were validated by experts' review and consulting and research at the Korea Employment Agency for Persons with Disability. Pearson's correlation analysis and multiple linear regression analysis were performed to identify variables that could predict the social participation of the study subjects. RESULTS: The self-efficacy, self-esteem, and the degree of disability acceptance of people with physical disabilities were positively correlated with social participation. The results of this study showed that self-efficacy, self-esteem, the degree of disability acceptance, economic activity, and education level explained 22.4% of social participation. CONCLUSIONS: It was found that self-efficacy, self-esteem, and the degree of disability acceptance of people with physical disabilities were important variables affecting social participation. These psychoemotional variables shall be considered for intervention approaches to improve the social participation of people with physical disabilities in the future.

Physical Activity Participation and Barriers for Children and Adolescents with Disabilities

Children and adolescents with disabilities benefit from physical activity. However, this population has lower fitness levels and higher rates of obesity than their peers, suggesting that they are not meeting physical activity guidelines and are experiencing barriers to participation. The purpose of this study was to quantify physical activity participation and barriers experienced by children and adolescents with disabilities in our area. Forty-five parents or caregivers of children aged 2-18 with physical and/or intellectual disabilities completed a questionnaire regarding physical activity participation in an average week and barriers to participation, prior to the SARS-CoV-2 pandemic. Data were analysed using quantitative and qualitative methodologies. Ninety-one percent (41/45) of the children and adolescents with disabilities did not participate in sufficient physical activity to meet physical activity guidelines irrespective of type and severity of the disability (p > 0.05). Physical activity participation decreased with increasing age (r = -0.478, p = 0.001). The most commonly identified barrier was 'environments and programmes not able to handle nature of disability.' In our sample, the majority of children and adolescents with disabilities did not meet physical activity guidelines, with access reported as a primary barrier. This may have negative consequences on the physical and mental health of children and adolescents with disabilities. The SARS-CoV-2 pandemic may have worsened the rates of physical activity participation noted in our study.

MOOD STATES AND QUALITY OF LIFE IN PARALYMPIC BOCCIA ATHLETES IN THE COVID-19 PANDEMIC

Introduction: Although studies have been conducted in the athlete population during the pandemic, its impacts on Paralympic athletes are still unknown. Objective:To evaluate the mood and quality of life of Paralympic boccia players during the COVID-19 pandemic period. Method: Questionnaires assessing mood, quality of life, and demographic data were sent electronically via social media.The study included 43 athletes from all functional classes (BC1= 8, BC2 = 12, BC3 =11, and BC4 = 11) and four regions of Brazil (Northeast= 12, Southeast = 12, Central-West = 3, and South = 17). ANOVA, t test, and similar non-parametric tests were used, with the respective effect sizes (ES). Resu Its: Regarding mood states, BC4 athletes differed from BC1 athletes in the depression subscale score (25.5 vs.14.5, p = 0.026, ES=1.47).The fatigue subscale score differed between BC4 and BC1 athletes (17.8 vs. 10.4, p= 0.023, ES=138) and between BC4 and BC2 athletes (17.8 vs 10.3, p = 0.008, ES=1.32). BC4 athletes had higher total mood disturbance (TMD) values than BC1 (175 vs. 141, p = 0.025, ES=1.35) and BC2 (175 vs.141, p = 0.025, ES=0.97) athletes. Lower stress (18.5 vs.21.8, p = 0.027, ES=0.64) and TMD (148.0 vs 162.0;p = 0.044;ES= 0.53) values were observed among the national level athletes. In terms of quality of life, differences were found between BC4 and BC2 athletes in the psychological health domain (3.73 vs. 4.49, p = 0.024, ES=0.89) and between athletes from the Northeast and South in the environment domain (3.39 vs. 4.18, p=0.030, ES=0.44). Conclusion: BC4 athletes are more susceptible to negative mood and quality-of-life perceptions. Additionally, athletes from the Northeast region may have poorer perceptions of quality of life related to the environment in which they live.

Telerehabilitation for physical disabilities and movement impairment: A service evaluation in South West England.

RATIONALE, AIMS AND OBJECTIVES: Telerehabilitation was used to ensure continued provision of care during the COVID-19 pandemic, but there was a lack of guidance on how to use it safely and effectively for people with physical disabilities and movement impairment. In this service evaluation, we aimed to collate information on practitioner and patient experiences, challenges and facilitators, and examples of best practice to inform the development of an online toolkit and training package. METHODS: Guided discussions were carried out with 44 practitioners, 7 patients and 2 carers from five health and social care organisations in South West England, and analysed thematically. RESULTS: Practitioners and patients had positive experiences of telerehabilitation and were optimistic about its future use. Recognized benefits for people with physical disabilities included greater flexibility, reduced travel and fatigue, having appointments in a familiar environment and ease of involving family members. Challenges encountered were: technological (usability issues, access to technology and digital skills); difficulties seeing or hearing patients; the lack of 'hands-on' care; and safety concerns. Facilitators were supported by colleagues or digital champions, and family members or carers who could assist patients during their appointments. Key themes in best practice were: person-centred and tailored care; clear and open communication and observation and preparation and planning. Practitioners shared tips for remote physical assessments; for example, making use of patient-reported outcomes, and asking patients to wear bright and contrasting coloured clothing to make it easier to see movement. CONCLUSION: Telerehabilitation holds promise in health and social care, but it is necessary to share good practice to ensure it is safe, effective and accessible. We collated information and recommendations that informed the content of the Telerehab Toolkit (https://www.plymouth.ac.uk/research/telerehab), a practical resource for practitioners, patients and carers, with a focus on remote assessment and management of physical disabilities and movement impairment.

Educators' perceptions on students with disabilities, inclusion and instructional technology after COVID-19

Inclusion for students with disabilities in general education settings has become more popular with the use of technology. How educators perceive inclusion, students with disabilities, and technology has dramatically influenced technology incorporating in inclusive environments. The purpose of this qualitative study was to examine how perceptions of educators on inclusion, students with disabilities, and the incorporation of technology in instruction before and after COVID-19 affected inclusive practices for students with disabilities. This study focused on finding out how teachers' experience and knowledge affected how inclusion was planned and implemented for students with disabilities. This study utilized the use of email interviews (N-10) among participants in an urban district in southern California. The result of this study indicated that teachers' experience, knowledge, and support received about inclusion and students with disabilities greatly affected their willingness to use technology and implement inclusion in general education settings. In addition, the data indicated that educators needed continuous professional training and ongoing support about inclusive practices, accommodations for students with disabilities, and technology for successfully implementing inclusive education for students with disabilities. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Perceived impact of lockdown on daily life in children with physical disabilities and their families during the COVID-19 pandemic.

BACKGROUND: The first lockdown during COVID-19 pandemic in France led to an abrupt change in children's daily lives. For children with physical disabilities and their families, activities were limited, access to healthcare and therapy was disrupted, and family organization was altered. The objective was to report the impact of the lockdown on daily life activities and well-being of children with physical disabilities as perceived by caregivers. METHODS: Two online national surveys were addressed to the parents of children with physical disabilities (ECHO survey: 6 April to 11 May 2020) and without disabilities (E-COPAIN survey: 24 April to 11 May 2020), confined at home during the lockdown. A lockdown impact score was calculated from difficulties related to children's well-being (morale, behaviour and social interaction) and daily life activities (schooling and physical activity) and compared between groups. Data on family environment, parental stress and concerns were collected. RESULTS: One thousand three hundred seventy-six children (9.45 ± 4.78 years, 54% girls) in ECHO survey and 367 children (7.3 ± 4.4 years, 48% girls) in E-COPAIN survey were included. A negative impact of lockdown was found on 81% of children with physical disabilities. Behavioural problems were significantly more frequent (59.5% vs. 47.4%, P < .005) and parental stress was higher (6.1 ± 3.33 vs. 5.3 ± 3.01, P = .005) in the ECHO group. Associated impairments (odds ratio [OR] = 1.45 [1.30-1.62], P < .001), parental stress (OR = 1.09 [1.06-1.12], P < .001) and continuation of rehabilitation (OR = 0.80 [0.72-0.89], P < .001) were determinants of the level of difficulty experienced. CONCLUSIONS: The lockdown had a considerable, negative impact on the daily life of children with disabilities and their families. Guiding policymakers with the essential daily life activities and the services to provide for children with physical disabilities would offer valuable insights to manage such a sanitary crisis and allow to identify the most vulnerable population.

Teleassessments for Enrollment of Adults With Physical or Mobility Disability in a Home-Based Exercise Trial in Response to COVID-19: Usability Study.

BACKGROUND: The Scale-Up Project Evaluating Responsiveness to Home Exercise And Lifestyle Tele-Health (SUPER-HEALTH) initiative is a large randomized controlled study that aims to overcome logistical barriers to exercise via telehealth for people with physical disabilities. However, at the start of the COVID-19 pandemic, enrollment was halted due to limited operations at the testing site, which included no onsite visits that involved participant data collection. In response to the limited operations, a modified data collection protocol was developed for virtual enrollment of study participants. OBJECTIVE: This paper presents feasibility data on using teleassessments to enroll people with mobility impairment into a home-based exercise trial. METHODS: The modified protocol replaced onsite enrollment and data collection visits with teleassessments using a computer tablet and testing equipment that was shipped to the participants' home address prior to the synchronous teleassessments conducted by an exercise physiologist through Zoom. The participants were mailed a teleassessment toolkit that included a digital blood pressure cuff, spirometer, hand dynamometer, mini disc cone, and measuring tape (to complete standardized testing). The teleassessment measures included resting blood pressure and heart rate, forced vital capacity, grip strength, Five Times Sit to Stand, and Timed Up and Go. Feasibility metrics included technological effectiveness, efficiency, and safety. The technological effectiveness of the telehealth assessment was determined by the percentage of sessions completed without technical issues with ≥90% criteria set a priori. Efficiency was measured by a session duration of ≤2 hours. Safety was measured by the number of adverse events related to the teleassessments reported. RESULTS: Data from 36 participants were included in this feasibility study, and 34 (94%) participants completed all teleassessments without technical issues. For efficiency, the teleassessment sessions were completed in a mean time of 65 minutes and a maximum session length of 110 minutes. There were no adverse events reported to indicate concerns with the safety of teleassessments. CONCLUSIONS: The modified teleassessment protocol, in response to COVID-19 restrictions, may be a feasible process for enrolling adults with mobility impairment into a home exercise trial who otherwise would have not been able to participate. TRIAL REGISTRATION: ClinicalTrials.gov NCT03024320; https://clinicaltrials.gov/ct2/show/NCT03024320.

Impacts of the COVID-19 pandemic on health, financial worries, and perceived organizational support among people living with disabilities in Canada.

BACKGROUND: Individuals with physical or mental health disabilities may be particularly vulnerable to the impact of COVID-19 on their health and employment. OBJECTIVES: We examined COVID-19-related concerns for health, finances, and organizational support among workers with no disability, a physical, mental health, or both physical and mental health disability, and factors associated with COVID-19 perceptions. METHODS: An online, cross-sectional survey was administered to a sample of Canadians in the first wave of the COVID-19 pandemic. Questions asked about COVID-19 perceptions, demographics (gender, age, education), work context (e.g., sector, contract work) and employment conditions (e.g., job stress, control, accommodation needs). Descriptive, multivariable, and nested regression analyses examined factors associated with COVID-19 perceptions. RESULTS: A total of 3066 participants completed the survey. Workers with both a physical and mental health disability reported significantly greater health and financial concerns and less organizational support than those with no disability. Workers with a physical disability reported more health concerns and those with a mental health disability reported more financial concerns and less organizational support. Respondents with disabilities also reported significant differences in employment conditions (e.g., more contract work, stress, unmet accommodation needs) than those with no disability. Employment conditions were consistently significant predictors of COVID-19 perceptions and attenuated the significance of disability type in analyses. CONCLUSIONS: Concerns about the impact of COVID-19 on one's health, finances, and organizational support reflected existing disability inequities in employment conditions and highlight the importance of creating more inclusive employment opportunities for people living with physical and mental health disabilities.

Needs assessment: knowledge of self-management of asthma for children with co-morbid physical and intellectual disabilities: brief report.

OBJECTIVES: The main goal of this study was to conduct a needs assessment to ascertain professionals' and parents' knowledge of and perceptions about education for self-management of asthma for children with physical and intellectual disabilities (IDs). Another goal was to understand needs for education of children with IDs about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus) and other infectious diseases. METHODS: Surveys, presented in the RedCap system, were administered online. Respondents (n = 498) were recruited through sites and listservs for children with disabilities and individuals with asthma. Respondents answered eight questions about knowledge and education for self-management of asthma for children with physical disabilities and IDs. Respondents answered four questions pertaining to management of coronavirus for children with IDs. RESULTS: Respondents' indicated that it would be easier to educate youth with mild or moderate versus severe levels of disabilities. Children with IDs may not receive the education they need to manage their asthma. When comparing those in different occupations, teachers reported lower knowledge for educating children with IDs about asthma management and coronavirus. CONCLUSIONS: Doctors and nurses can develop programs for children with physical disabilities and IDs. Programming for youth with severe impairments is needed and perhaps developmentally appropriate programming for youth with IDs will improve education of youth and, concomitantly improve their self-management of asthma and potentially quality of life. Educating teachers is critical specifically about asthma triggers, how to involve youth in self-care, and how to educate children with IDs about coronavirus.Abbreviations:U.S.: United States;IDs: intellectual disabilities.

Emerging health challenges for children with physical disabilities and their parents during the COVID-19 pandemic: The ECHO French survey.

BACKGROUND: The daily lives of children with physical disabilities and their families have been significantly affected by the COVID-19 pandemic. The children face health risks, especially mental, behavioral, social and physical risks. OBJECTIVE: This study aimed to identify potential healthcare issues relating to the wellbeing of disabled children, continuity of rehabilitation and medical care, and parental concerns during the COVID-19 lockdown. METHODS: The Enfant Confinement Handicap besOins (ECHO [child lockdown disability needs]) national survey was developed by a multidisciplinary group and disseminated in France from April 6, 2020 via email and social networks. This online survey was addressed to the parents of children with physical disabilities aged 0 to 18 years. It explored the experiences of children and their families during the lockdown. Information regarding children's wellbeing, rehabilitation and family organization was collected. The first 1000 eligible surveys were analyzed. RESULTS: The children (mean [SD] age 9.5 [4.8] years) mostly had cerebral palsy (42%) or neuromuscular diseases (11%). The lockdown had negative effects on morale (44% of children), behaviour (55% of children) and social interactions (55% no contact with other children). Overall, 44% of children stopped physical activities; 76% were educated at home; 22% maintained medical follow-up, and 48% and 27% continued physiotherapy and occupational therapy respectively. For more than 60% of children, parents performed the therapy. The main parental concern was rehabilitation (72%) and their main difficulty was the mental load (50%); parents complained of lack of help and support (60%). CONCLUSIONS: This study highlighted substantial effects on the health of children with physical disabilities and loss of opportunity, with a massive interruption of medical follow-up and rehabilitation, during the lockdown. Regular assessment of the health benefit/risk is essential to support families and ensure continuity of care during a pandemic.