A Kinematic and Kinetic Case Study of a Netball Shoulder Pass

The majority of studies analysing netball skills using force platforms have focused on reducing the risk of injury from compression and torsion forces on the knee and ankle joints during landing and pivoting. In this preliminary case study our aim was to investigate the efficacy of a combination of tools to describe the kinematic and kinetic mechanisms underlying the netball shoulder pass. The segmental movements of the netball shoulder pass were analysed from video and force platform data in order to develop a suitable methodology for use in a larger study. Peak vertical ground reaction force of 850 N was found to coincide with the point of maximum velocity of the centre of pressure, occurring 40 ms before ball release. The participant’s centre of pressure continued anteriorly for 40 ms after ball release. The wrist traveled in a linear path during the propulsion phases, maximising impulse to the ball. A large shear force also occurred in the anterior posterior direction coinciding with ball release due to friction between the left shoe and the force platform, resisting the forward momentum of the body. Negative acceleration of the upper limb following the propulsion phase reached a peak of 68.6 rad/s-2 for the arm and 82.4 rad/s-2 for the forearm. Peak shoulder deceleration torque was calculated at 4.1 Nm which was greater than during acceleration (1.6 Nm). The combination of kinematic and kinetic tools yielded a comprehensive analysis of the investigated skill. Future biomechanical studies may determine differences in skill execution between novice and professional players or variability in movement within a population of skilled netball players

Predicting interest to use mobile-device telerehabilitation (mRehab) by baby-boomers with stroke

Context and purpose: Demand for stroke rehabilitation services are reaching unprecedented levels due to an overall population aging, driven by the aging of the baby-boomer generation. Delivery of rehabilitation via mobile-device technologies may provide advantages towards meeting the increasing demands on the rehabilitation system by providing individuals with rehabilitation services in their homes and communities. The aim of this paper is to gain an understanding of the interest of current baby-boomers with stroke to use mobile-device technology to receive rehabilitation services such as education, assessments and exercise programs (mRehab). Methods: People living in the community with stroke born between 1946 and 1964 (i.e., baby-boomer generation) who participated in a larger telerehabilitation survey were included in this study. Regression modeling was used to evaluate personal, health/disability and technological predictors of interest to use mobile-devices for telerehabilitation. Results and significance: Fifty people with stroke, mean age 62.7 (4.4) years, 58% male, 54.2% with moderate or moderately severe disability were included; 86% had access to a mobile phone or tablet. Regression analysis resulted in statistically significant personal (education, β = 0.29 [95% CI = 0.05 to 1.11], population of residence, β = 0.30 [95% CI = 0.07 to 0.69]), health (comorbid conditions, β = 0.30 [95% CI = 0.02 to 0.20]) technology (ownership, β = 0.26 [95% CI = 0.01 to 0.86] and attitude towards telerehabilitation, β = 0.25 [95% CI = 0.01 to 0.79]) predictors of interest to use mobile-devices for telerehabilitation (R2 = 33.1%).This study identifies personal, health and technological factors which predict interest of baby-boomers with stroke with ongoing and complex health needs to use mRehab. Health professionals can use this information as they integrate mRehab into their practice and inform future development of mRehab solutions

Feel My Pain: Design and Evaluation of Painpad, a Tangible Device for Supporting Inpatient Self-Logging of Pain

Monitoring patients' pain is a critical issue for clinical caregivers, particularly among staff responsible for providing analgesic relief. However, collecting regularly scheduled pain readings from patients can be difficult and time-consuming for clinicians. In this paper we present Painpad, a tangible device that was developed to allow patients to engage in self-logging of their pain. We report findings from two hospital-based field studies in which Painpad was deployed to a total of 78 inpatients recovering from ambulatory surgery. We find that Painpad results in improved frequency and compliance with pain logging, and that self-logged scores may be more faithful to patients' experienced pain than corresponding scores reported to nurses. We also show that older adults may prefer tangible interfaces over tablet-based alternatives for reporting their pain, and we contribute design lessons for pain logging devices intended for use in hospital settings

Implementation in rehabilitation: a roadmap for practitioners and researchers

PURPOSE: Despite growth in rehabilitation research, implementing research findings into rehabilitation practice has been slow. This creates inequities for patients and is an ethical issue. However, methods to investigate and facilitate evidence implementation are being developed. This paper aims to make these methods relevant and accessible for rehabilitation researchers and practitioners.\ud METHODS: Rehabilitation practice is varied and complex and occurs within multilevel healthcare systems. Using a "road map" analogy, we describe how implementation concepts and theories can inform implementation strategies in rehabilitation. The roadmap involves a staged journey that considers: the nature of evidence; context for implementation; navigation tools for implementation; strategies to facilitate implementation; evaluation of implementation outcomes; and sustainability of implementation. We have developed a model to illustrate the journey, and four case studies exemplify implementation stages in rehabilitation settings. RESULTS AND CONCLUSIONS: Effective implementation strategies for the complex world of rehabilitation are urgently required. The journey we describe unpacks that complexity to provide a template for effective implementation, to facilitate translation of the growing evidence base in rehabilitation into improved patient outcomes. It emphasizes the importance of understanding context and application of relevant theory, and highlights areas which should be targeted in new implementation research in rehabilitation. Implications for rehabilitation Effective implementation of research evidence into rehabilitation practice has many interconnected steps and a roadmap analogy is helpful in defining them. Understanding context for implementation is critically important and using theory can facilitate development of understanding. Research methods for implementation in rehabilitation should be carefully selected and outcomes should evaluate implementation success as well as clinical change. Sustainability requires regular revisiting of the interconnected steps

Is self-reporting workplace activity worthwhile? Validity and reliability of Occupational Sitting and Physical Activity Questionnaire in desk-based workers BMC Public Health

Background: Accelerometers can obtain precise measurements of movements during the day. However, the individual activity pattern varies from day-to-day and there is limited evidence on measurement days needed to obtain sufficient reliability. The aim of this study was to examine variability in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees. Methods: We included control participants (n = 135) from the Take a Stand! Intervention; a cluster randomized controlled trial conducted in 19 offices. Sitting time and physical activity were measured using an ActiGraph GT3X+ fixed on the thigh and data were processed using Acti4 software. Variability was examined for sitting time, standing time, steps and time spent in moderate-to-vigorous physical activity (MVPA) per day by multilevel mixed linear regression modelling. Results: Results of this study showed that the number of days needed to obtain a reliability of 80% when measuring sitting time was 4.7 days for work and 5.5 days for leisure time. For physical activity at work, 4.0 days and 4.2 days were required to measure steps and MVPA, respectively. During leisure time, more monitoring time was needed to reliably estimate physical activity (6.8 days for steps and 5.8 days for MVPA). Conclusions: The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time. The domain specific variability is of great importance to researchers and health promotion workers planning to use objective measures of sedentary behaviour and physical activity

Cornerstone Youth Services Nutrition and Physical Activity Capacity Building Project: Final Report

Healthy eating and physical activity habits during adolescence help support normal growth and development and underpin the establishment of lifelong health and wellbeing. The eating habits of many young people are inconsistent with dietary recommendations and, along with sedentary physical activity levels, escalate risks of current and future obesity, type 2 diabetes and mental health issues. Mental health conditions predominantly emerge during adolescence and early adulthood. People with a mental health condition are more likely to be overweight and have metabolic complications. Emerging research has demonstrated that healthy eating patterns (e.g., Mediterranean-style diets), based on whole grains, fruit and vegetables, lean protein and nuts, contribute to reducing obesity and metabolic chronic diseases, and to improving mental health. Early nutrition and physical activity interventions for young people at risk of developing a mental health condition are needed. Cornerstone Youth Services (CYS) provides social and emotional support for young people with mild to moderate mental health conditions in the greater Launceston area. CYS professionals reported a need for: 1) developing their capacity to provide brief, nutrition-related interventions; 2) greater access to referral pathways and arrangements with community and government organisations that provide specialist nutrition support; and 3) greater understanding of how they can use evidence-based resources to evaluate a client’s dietary habits and provide up-to-date advice about eating for health and wellbeing. CYS is uniquely placed to support healthy eating in this at-risk target group. CYS secured a $47,000 grant from the Healthy Tasmania Fund to increase its capacity to deliver best practice interventions aimed at improving both nutrition and mental health, and reducing obesity risk. CYS approached the University of Tasmania’s School of Heath Sciences (SHS) and Centre for Rural Health (CRH) to manage the full project. Drawing on their multidisciplinary expertise (including nutrition and dietetics, clinical and health psychology, exercise science, exercise physiology, and physiotherapy), the project team proposed to enhance the existing project brief by incorporating physical activity across all elements of the proposed project. Physical activity is well recognised as an essential component of physical and mental health and wellbeing

Is self-reporting workplace activity worthwhile? Validity and reliability of occupational sitting and physical activity questionnaire in desk-based workers

Background: With the advent of workplace health and wellbeing programs designed to address prolonged occupational sitting, tools to measure behaviour change within this environment should derive from empirical evidence. In this study we measured aspects of validity and reliability for the Occupational Sitting and Physical Activity Questionnaire that asks employees to recount the percentage of work time they spend in the seated, standing, and walking postures during a typical workday.Methods: Three separate cohort samples (N = 236) were drawn from a population of government desk-based employees across several departmental agencies. These volunteers were part of a larger state-wide intervention study. Workplace sitting and physical activity behaviour was measured both subjectively against the International Physical Activity Questionnaire, and objectively against ActivPal accelerometers before the intervention began. Criterion validity and concurrent validity for each of the three posture categories were assessed using Spearman's rank correlation coefficients, and a bias comparison with 95 % limits of agreement. Test-retest reliability of the survey was reported with intraclass correlation coefficients.Results: Criterion validity for this survey was strong for sitting and standing estimates, but weak for walking. Participants significantly overestimated the amount of walking they did at work. Concurrent validity was moderate for sitting and standing, but low for walking. Test-retest reliability of this survey proved to be questionable for our sample.Conclusions: Based on our findings we must caution occupational health and safety professionals about the use of employee self-report data to estimate workplace physical activity. While the survey produced accurate measurements for time spent sitting at work it was more difficult for employees to estimate their workplace physical activity

Barriers and facilitators to the implementation of individual placement and support (IPS) for patients with offending histories in the community: The United Kingdom experience

IntroductionWe aimed to identify the barriers and facilitators to the implementation of a high fidelity individual placement and support service in a community forensic mental health setting.MethodIn-depth interviews were conducted with clinical staff (n = 11), patients (n = 3), and employers (n = 5) to examine barriers and facilitators to implementation of a high fidelity individual placement and support service. Data was analysed using thematic analysis, and themes were mapped onto individual placement and support fidelity criteria.ResultsBarriers cited included competing interests between employment support and psychological therapies, perceptions of patients’ readiness for work, and concerns about the impact of returning to work on welfare benefits. Facilitators of implementation included clear communication of the benefits of individual placement and support, inter-disciplinary collaboration, and positive attitudes towards the support offered by the individual placement and support programme among stakeholders. Offences, rather than mental health history, were seen as a key issue from employers’ perspectives. Employers regarded disclosure of offending or mental health history as important to developing trust and to gauging their own capacity to offer support.ConclusionsImplementation of individual placement and support in a community mental health forensic setting is complex and requires robust planning. Future studies should address the barriers identified, and adaptations to the individual placement and support model are needed to address difficulties encountered in forensic settings

Moving stroke rehabilitation evidence into practice: a systematic review of randomized controlled trials

Objective To investigate the effectiveness of interventions aimed at moving research evidence into stroke rehabilitation practice through changing the practice of clinicians. Data sources EMBASE, CINAHL, Cochrane and MEDLINE databases were searched from 1980 to April 2019. International trial registries and reference lists of included studies completed our search. Review methods Randomized controlled trials that involved interventions aiming to change the practice of clinicians working in stroke rehabilitation were included. Bias was evaluated using Revman to generate a risk of bias table. Evidence quality was evaluated using GRADE criteria. Results Sixteen trials were included (250 sites, 14,689 patients), evaluating a range of interventions including facilitation, audit and feedback, education, and reminders. Eleven studies included multicomponent interventions (using a combination of interventions). Four used educational interventions alone and one used electronic reminders. Risk of bias was generally low. Overall, the GRADE criteria indicated that this body of literature was low quality. This review found higher efficacy of trials which targeted fewer outcomes. Subgroup analysis indicated moderate level GRADE evidence (103 sites, 10,877 patients) that trials which included both site facilitation and tailoring for local factors were effective in changing clinical practice. The effect size of these varied (OR 1.63-4.9). Education interventions alone were not effective. Conclusions A large range of interventions are used to facilitate clinical practice change. Education is commonly used, but in isolation is not effective. Multicomponent interventions including facilitation and tailoring to local settings can change clinical practice and are more effective when targeting fewer changes

Moving stroke rehabilitation research evidence into clinical practice: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable

Moving research evidence to practice can take years, if not decades, which denies stroke patients and families from receiving the best care. We present the results of an international consensus process prioritizing what research evidence to implement into stroke rehabilitation practice to have maximal impact. An international 10-member Knowledge Translation Working Group collaborated over a six-month period via videoconferences and a two-day face-to-face meeting. The process was informed from surveys received from 112 consumers/family members and 502 health care providers in over 28 countries, as well as from an international advisory of 20 representatives from 13 countries. From this consensus process, five of the nine identified priorities relate to service delivery (interdisciplinary care, screening and assessment, clinical practice guidelines, intensity, family support) and are generally feasible to implement or improve upon today. Readily available website resources are identified to help health care providers harness the necessary means to implement existing knowledge and solutions to improve service delivery. The remaining four priorities relate to system issues (access to services, transitions in care) and resources (equipment/technology, staffing) and are acknowledged to be more difficult to implement. We recommend that health care providers, managers, and organizations determine whether the priorities we identified are gaps in their local practice, and if so, consider implementation solutions to address them to improve the quality of lives of people living with stroke