Simultaneous bilaternal training for improving arm function after stroke

Background Simultaneous bilateral training, the completion of identical activities with both arms simultaneously, is one intervention to improve arm function and reduce impairment. Objectives To determine the effects of simultaneous bilateral training for improving arm function after stroke. Search strategy We searched the Cochrane Stroke Trials Register (last searched August 2009) and 10 electronic bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2009), MEDLINE, EMBASE, CINAHL and AMED (August 2009). We also searched reference lists and trials registers. Selection criteria Randomised trials in adults after stroke, where the intervention was simultaneous bilateral training compared to placebo or no intervention, usual care or other upper limb (arm) interventions. Primary outcomes were performance in activities of daily living (ADL) and functional movement of the upper limb. Secondary outcomes were performance in extended activities of daily living and motor impairment of the arm. Data collection and analysis Two authors independently screened abstracts, extracted data and appraised trials. Assessment of methodological quality was undertaken for allocation concealment, blinding of outcome assessor, intention-to-treat, baseline similarity and loss to follow up. Main results We included 18 studies involving 549 relevant participants, of which 14 (421 participants) were included in the analysis (one within both comparisons). Four of the 14 studies compared the effects of bilateral training with usual care. Primary outcomes: results were not statistically significant for performance in ADL (standardised mean difference (SMD) 0.25, 95% confidence interval (CI) -0.14 to 0.63); functional movement of the arm (SMD -0.07, 95% CI -0.42 to 0.28) or hand (SMD -0.04, 95% CI -0.50 to 0.42). Secondary outcomes: no statistically significant results. Eleven of the 14 studies compared the effects of bilateral training with other specific upper limb (arm) interventions. Primary outcomes: no statistically significant results for performance of ADL (SMD -0.25, 95% CI -0.57 to 0.08); functional movement of the arm (SMD -0.20, 95% CI -0.49 to 0.09) or hand (SMD -0.21, 95% CI -0.51 to 0.09). Secondary outcomes: one study reported a statistically significant result in favour of another upper limb intervention for performance in extended ADL. No statistically significant differences were found for motor impairment outcomes. Authors' conclusions There is insufficient good quality evidence to make recommendations about the relative effect of simultaneous bilateral training compared to placebo, no intervention or usual care. We identified evidence that suggests that bilateral training may be no more (or less) effective than usual care or other upper limb interventions for performance in ADL, functional movement of the upper limb or motor impairment outcome

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

The Impact of Education on Fear of Falling in Elderly Women

Context: More than one third of individuals 65 and older fall each year. Approximately 85% of these falls occur in the homes of independent older adults. Falls can lead to an increased fear of falling, defined as a pervasive concern that a fall may occur. Fear of falling can decrease quality of life due to a lower sense of well-being, limiting mobility, and reduction of social interaction. Reduction in activity can result in a sedentary lifestyle and poor balance which increases the risk of falling. Fifty percent of women 75 years and older participate in no physical activity beyond activities of daily living. Older women, on average, participate in half the amount of moderate and vigorous activity as young women. Activity and education based programs have been shown to increase balance confidence in all participants independent of the program they participated in.The aim of the intervention utilized in this study was to decrease fear of falling in elderly women and improve their overall quality of life. Objective: The purpose of the study was to determine how an educational intervention that utilized balance training and home safety assessment would impact fear of falling in elderly women at different activity levels based on the results from activPAL technology. Setting: All subject were tested at Butterfield Trail Village in Fayetteville, AR for all assessments. Participants: Eight older women; 3 in the high activity group, 2 in the moderate activity group, and 3 in the low activity group. The mean age was 79.1 years, the mean height was 161.7 cm, and the mean weight was 61.1 kg. Methods: The participants were recruited from Butterfield Trail senior living community. The participants were given a health history questionnaire and informed consent. The pre-assessment given was the Falls Efficacy Scale- International (FES-I) to determine the participants’ fear of falling. activPAL monitors were given to each participant to wear for 7 days to determine activity level. A one-on-one education session was conducted with each participant after activity assessment. A post FES-I assessment was given after completion of the education session. Main Outcome Measures: A dependent t-test was conducted to compare pre and post FES-I scores. Differences between groups (group x time) were assessed using a repeated measures ANOVA. Statistical significance was set at α = .05. Correlational analysis was conducted to examine the relationship between fear of falling and activity level Results: Statistical significance was not found in any of the outcome measures. Mean FES-I scores dependent t-test: pre 25.5 + 5.9, post 30.5 + 7.2, mean difference -1.9, p-value .58. Repeated measures ANOVA: low activity pre 27.7 + 3.5 post 32.3 + 8.1, moderate activity pre 31.0 + 1.4 post 33.5 + 6.4, high activity pre 19.0 + 3.0 post 26.7 + 7.6. Correlational analysis: a moderate correlation (-.63) was found between activity level and fear of falling. Conclusion: The education intervention utilized in this study that used a variety of materials and techniques was not effective in reducing fear of falling in elderly women across all activity levels

Assistive technology design and development for acceptable robotics companions for ageing years

© 2013 Farshid Amirabdollahian et al., licensee Versita Sp. z o. o. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs license, which means that the text may be used for non-commercial purposes, provided credit is given to the author.A new stream of research and development responds to changes in life expectancy across the world. It includes technologies which enhance well-being of individuals, specifically for older people. The ACCOMPANY project focuses on home companion technologies and issues surrounding technology development for assistive purposes. The project responds to some overlooked aspects of technology design, divided into multiple areas such as empathic and social human-robot interaction, robot learning and memory visualisation, and monitoring persons’ activities at home. To bring these aspects together, a dedicated task is identified to ensure technological integration of these multiple approaches on an existing robotic platform, Care-O-Bot®3 in the context of a smart-home environment utilising a multitude of sensor arrays. Formative and summative evaluation cycles are then used to assess the emerging prototype towards identifying acceptable behaviours and roles for the robot, for example role as a butler or a trainer, while also comparing user requirements to achieved progress. In a novel approach, the project considers ethical concerns and by highlighting principles such as autonomy, independence, enablement, safety and privacy, it embarks on providing a discussion medium where user views on these principles and the existing tension between some of these principles, for example tension between privacy and autonomy over safety, can be captured and considered in design cycles and throughout project developmentsPeer reviewe

Queen Elizabeth's Foundation Brain Injury Centre Inspection of FEFC-funded provision in non-sector establishments for students with learning difficulties and/or disabilities (Report from the Inspectorate; 2000-01)

Independent Establishment 04/00 Inspection of FEFC-Funded Provision in non-sector establishments for students with learning difficulties and/or disabilities. Queen Elizabeth’s Foundation Brain Injury Centre, Surrey Inspected September 200