Digital platforms to facilitate physical activities for people with physical or sensory disabilities: A scoping review.

BACKGROUND: People with disabilities (PWD) commonly experience difficulties in accessing their environments, which can lead to restricted participation in outdoor leisure-time physical activity. Participating in outdoor leisure-time physical activity (OLTPA) provides health and social benefits to PWD and benefits to the communities in which they live. OBJECTIVE: The aim of the study was to identify features existing in digital platforms that facilitate access to OLTPA for PWD. METHODS: A scoping review was conducted in four library databases and in Google advance search to identify relevant scientific and grey literature, and websites. Each step of the review was independently conducted by two co-authors who confirmed consensus of results. Descriptive data analyses were performed. RESULTS: Seven scientific studies and ten websites were included in the scoping review. Seven presented mobile apps, nine presented a website and one presented an online database. Sources reported five main obstacles to using digital platforms that support access to physical activities (e.g., lack of digital literacy, technical issues, unintuitive design), and 10 facilitators (e.g., possibility to personalize your online space, accessibility features of the navigation). Among these sources, a trend emerged in the most important factors and features to consider for the visuals and navigation of the platforms. CONCLUSION: The features of digital platforms that facilitate access to OLTPA include intuitive design compliant with accessibility guidelines and supported by navigation tools, personalization of the online space, and features for social interactions.

Effectiveness of wheelchair skills training for improving manual wheelchair mobility in children and adolescents: protocol for a multicenter randomized waitlist-controlled trial.

BACKGROUND: Self-directed mobility during childhood can influence development, social participation, and independent living later in life. For children who experience challenges with walking, manual wheelchairs (MWCs) provide a means for self-directed mobility. An effective MWC skills training program exists for adults, but controlled trials have not yet been documented in children and adolescents. This paper outlines the protocol for a multi-centre randomized wait-list controlled trial. The primary objective is to test the hypothesis that children and adolescents who receive MWC skills training will have higher MWC skills capacity compared to children and adolescents in the control group who receive usual care. The secondary objectives are to explore the influence of MWC skills training in children and adolescents (MWC use self-efficacy and satisfaction with participation in meaningful activities), and parents (perceived MWC skills); and to measure retention three months later. METHODS: A multi-centre, parallel-group, single-blind randomized wait-list controlled trial will be conducted. A sample of 60 children and adolescents who use MWCs will be recruited in rehabilitation centres, specialized schools, and the communities of three Canadian cities. Participants will be randomized (1:1) to the experimental (Wheelchair Skills Training Program [WSTP]) or wait-list control group (usual care). Performance-based and self-report measures will be completed at baseline (T1), three months (post-intervention, T2), and three months post-intervention (T3). The primary outcome will be MWC skills capacity post-intervention. Secondary outcomes will be MWC use self-efficacy and satisfaction with participation of the child/adolescent, and parent-perceived MWC skills. The WSTP will consist of 12 sessions, 45-60 min each, delivered 1-2 times per week by trained personnel with health professions education. Training will be customized according to the child's baseline skills and participation goals that require the use of the MWC. The wait-list control group will receive usual care for 3 months and then receive the WSTP after completing T2 evaluations. Data will be analysed using ANCOVA (controlling for baseline scores). DISCUSSION: MWC skills training may be one way to improve self-directed mobility and related outcomes for children and adolescents. The results of this multi-centre randomized wait-list controlled trial will allow for the effectiveness of the intervention to be evaluated in a variety of clinical contexts and geographical regions. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05564247, Version October 3, 2022.

Psychometric properties of the psychosocial impact of assistive devices scale (PIADS): A systematic review.

The Psychosocial Impact of Assistive Devices Scale (PIADS) is commonly used to assess the psychosocial effects of an assistive device. Given its growing use, an appraisal of the evidence regarding its psychometric properties is required. We conduct a systematic review using validated critical appraisal scales to analyze both the quality and content of the evidence on the psychometric properties of the PIADS. PubMed/Medline, Embase, and CINAHL were systematically searched for identification of studies. Two independent reviewers appraised the retrieved studies using MacDermid and COSMIN-RoB checklists, and extracted data regarding the psychometric measurements reported. MacDermid scores showed that 8 out of 11 studies were, at least, of good methodological quality. COSMIN-RoB scores ranged from inadequate to very good. Except criterion and construct validity, which have presented a moderate level of evidence, the other psychometric properties assessed have demonstrated a high level of evidence. Cross-cultural validity, measurement error, and responsiveness have not been studied. Few studies have yet evaluated the psychometric properties of the PIADS. However, the quality of the evidence that they provide is mostly adequate. Therefore, this review supports the use of the PIADS, which has overall good psychometric properties.

Barriers and facilitators of public transport use among people with disabilities: a scoping review.

Barriers to public transport use may be experienced differently by people with various types of disabilities (e.g., physical, intellectual, cognitive, sensory). Thus, it is important to identify the variable needs within each element of the travel chain. For example, the unavailability or low volume of auditory announcements in a stop or station or on the public transport vehicle may be a barrier to people with visual disability who rely on hearing the information. Consequently, this could provoke negative emotions and unpleasant experiences, which may not be the case for people with physical disabilities. The primary objective was to describe the barriers and facilitators to using public transport experienced by people with disabilities (PWD). The secondary aim was to explore experiences in terms of self-efficacy and satisfaction, when using public transport among people with disabilities. A scoping review was conducted. The search was performed in MEDLINE, TRANSPORT DATABASE, PsycINFO, EMBASE, and WEB OF SCIENCE from 1995 to 2023. Of 6,820 citations identified, 34 articles were included in the review for extraction. The main physical and social barriers included lack of ramp, long walking distance, long waiting time, unavailability of information at bus stop or station, and drivers' negative attitudes towards PWD. Personal factors that prevented the use of public transport included lack of confidence, and decreased satisfaction with public transport use. Strategies such as providing ramps on public transport vehicles, availability of kneeling buses and courtesy of bus drivers, and travel training were considered as enablers to the use of public transport that can lead the improved self-efficacy and satisfaction. In conclusion, this review identified the physical and social barriers and facilitators in travel chain, and highlighted issues related to lack of confidence or self-efficacy and decreased satisfaction when PWD and older adults are using public transport. Identifying and understanding the barriers and facilitators to the use of public transport by PWD is a milestone that may help policy makers and transport operators around the world to develop and implement interventions enabling access, use and inclusion of this mode of transport, as the experiences of PWD when using this mode of transport have an impact on their well-being.

Facilitators and barriers to the use of service dogs: an exploratory study using the Theoretical Domains Framework.

Purpose: Given the scarcity of service dogs to help individuals with mobility impairments in the community, it is crucial to identify facilitators and obstacles to the acquisition and use of service dogs in order to optimize their use and have a positive impact on the lives of individuals with disabilities. The goal of this study was to describe perceived facilitators and barriers influencing the acquisition and use of service dog by owners and rehabilitation providers, including those who had and had not recommended service dogs.Method: We conducted a phenomenological qualitative study involving in-depth interviews with nine service dog owners and 13 rehabilitation professionals in Canada. Our questionnaires were based on the Theoretical Domains Framework and the data were analyzed using a thematic content approach.Results: Knowledge, beliefs about consequences, and environmental context and resources were the domains most frequently mentioned by both dog owners and rehabilitation professionals. While service dog owners placed greater importance on their belief in their capacity to get and use service dogs, rehabilitation professionals focussed more on their role and identity within the process.Conclusion: Improving the knowledge of the availability and process of acquiring service dogs would be important for rehabilitation professions to improve the quality of life and functional capabilities of persons with disabilities.Implications for rehabilitationIdentifying determinants of service dog acquisition and use can support proposed strategies to optimize the use of this assistive technology;Determinants of service dog acquisition and use are are different for dog owners and rehabilitation professionals, which suggest the need of tailored knowledge translation strategies;Knowledge, beliefs about consequences, and environmental context and resources were the categories of determinants perceived as being more influential on the process.

Are adults with spinal cord injury meeting the spinal cord injury-specific physical activity guidelines? A look at a sample from a Canadian province.

STUDY DESIGN: One cross-sectional study. OBJECTIVES: To examine the extent to which a sample of adults with spinal cord injury (SCI) meet the SCI-specific physical activity guidelines and to identify potential demographic, injury and motivational characteristics related to participation. SETTING: Quebec, Canada. METHODS: A sample of 73 adults from the province of Quebec, Canada living with SCI completed the Leisure Time Physical Activity Questionnaire for People with Spinal Cord Injury to report their current frequency (sessions per week) and duration (minutes per session) in aerobic and resistance physical activity. RESULTS: Results showed that 12% of participants in this sample met the guidelines and as many as 44% reported 0 min of physical activity. Only the participants' mode of mobility and autonomous motivation for physical activity emerged as a marginal correlate of the likelihood of meeting the physical activity guidelines. CONCLUSION: Overall, physical activity participation rates among adults in this sample living with SCI remain quite low. Given the benefits of physical activity for adults with SCI, physical activity promotion efforts are needed.

Effects of rolling resistances on handrim kinetics during the performance of wheelies among manual wheelchair users with a spinal cord injury.

STUDY DESIGN: Repeated cross-sectional study. OBJECTIVES: To compare the effects of rolling resistances (RRs) on handrim kinetic intensity at the non-dominant upper limb and on handrim kinetic symmetry during wheelies performed by manual wheelchair users (MWUs) with spinal cord injury (SCI). SETTING: Pathokinesiology Laboratory. METHODS: Sixteen individuals with SCI who were able to perform wheelies participated in this study. During a laboratory assessment, participants randomly performed wheelies on four RRs: natural high-grade composite board, 5-cm thick soft foam, 5-cm thick memory foam, and with the rear wheels blocked by wooden blocks. Four trials were conducted for each of the RRs. Participant's wheelchair was equipped with instrumented wheels to record handrim kinetics, whereas the movements of the wheelchair were recorded with a motion analysis system. RESULTS: The net mean and peak total forces, including its tangential and mediolateral components, were greater during take-off compared with the other phases of the wheelie, independently of RR. During take-off, the greatest net mean and peak total and tangential forces were reached with the wheels blocked. Symmetrical tangential and mediolateral force intensities were applied at the dominant and non-dominant handrims. CONCLUSION: Wheelies performed on low or moderate density foam generate similar forces at the handrim than on a natural surface and significantly less forces than with the wheels blocked. Hence, when teaching individuals with an SCI to perform a stationary wheelie, the use of low or moderate density foam represents a valuable alternative for minimizing upper limb effort and may also optimize quasi-static postural steadiness.

Relationships between wheelchair skills, wheelchair mobility and level of injury in individuals with spinal cord injury.

STUDY DESIGN: Cross-sectional. OBJECTIVES: To describe the manual wheelchair (MWC) skill profiles of experienced MWC users with spinal cord injury and their wheeled mobility (distance and speed) while considering their level of injury and age. SETTING: Rehabilitation centers, participant's home and the community. METHODS: MWC skills were evaluated using the wheelchair skills test (WST) and wheeled mobility data were collected in the participants' own environment over a 7-day period, using a Cateye cycle computer (VELO 8). A total of 54 participants took part in the study. RESULTS: The mean total performance score of the sample on the WST was 80.7±11.8%, with a significant difference between participants with tetraplegia (C4-C8) and those with low-level paraplegia (T7-L2) (P<0.01). The average daily distance covered was 2.5±2.1 km at 1.7±0.9 km h(-1), with no significant difference between participants with paraplegia and those with tetraplegia (wheeled distance: P=0.70; speed: P=0.65). Significant relationships were found between MWC skills and daily wheeled distance (r=-0.32, P<0.05), but the correlation between these variables did not remain significant when controlling for age (partial r=0.26, P=0.07). CONCLUSION: These results suggest that the level of injury is related to MWC skills but not wheeled mobility. MWC skills are related to greater wheeled distance, but to a lesser extent when controlling for age.

Clinical results of an investigation of paediatric upper limb myoelectric prosthesis fitting at the Quebec Rehabilitation Institute.

This study was designed to investigate the satisfaction level of young users of myoelectric prostheses who received an upper limb myoelectric prosthesis, to assess their dropout rate and to identify which factors influence the use or non-use of the upper limb myoelectric prosthesis in the eastern part of Quebec (Canada). The users were fitted between 1990 and 1999 at the Quebec Rehabilitation Institute, a major rehabilitation centre located in the province of Quebec. This rehabilitation centre provides cutting-edge expertise not only for the eastern part of Quebec, but also across the entire province, because it is one of only two highly specialised centres serving all of Quebec. A literature review was completed to compile the results obtained in other rehabilitation centres and to identify factors influencing the use or non-use of paediatric upper limb myoelectric prostheses. The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) was used in order to assess the degree to which the children were satisfied with their prostheses. Eighteen (18) children were fitted and trained to use an upper limb myoelectric prosthesis. A total of 10 children and parents agreed to participate. Some 80% of participants said that they were satisfied with their prostheses. A dropout rate of 53% for the overall group (participants and non-participants) seems high compared with that of other studies. Recommendations linked to factors identified in the literature are made. The authors conclude that a multidisciplinary team and structured training and follow-up can improve the clinical results pertaining to all the factors proposed in the literature.