Carer experiences of life after stroke - a qualitative analysis

Aims and objectives. Carers' experiences of caring for a stroke survivor were explored, including reactions and changes in their lives. Method. A phenomenological approach was taken to the collection and analysis of data. Semi-structured interviews lasting an average of 43 min were carried out with nine informal carers in their own homes. All were married to someone who had survived a stroke. Results. An overarching theme emerged, entitled: 'lives turned upside-down'. It took time for participants to understand the long-term impacts of stroke. Carers experienced increased caring and domestic workloads alongside reduced participation and altered expectations of life. They found emotional and cognitive changes in their partners particularly distressing, and would have valued more information and help with adjusting to the increased emotional, physical and cognitive workload of caring. Conclusions. It is important to support carers of people who have survived a stroke in adjusting to their changed lifestyles. This may affect their quality of life as well as sustainability of caring, and requires further research

A mixed methods service evaluation of a pilot functional electrical stimulation clinic for the correction of dropped foot in patients with chronic stroke.

Aim To undertake a service evaluation of the pilot Lothian functional electrical stimulation (FES) clinic using both quantitative and qualitative methods and clinical practice reflection.\ud Background Clinical guidelines recommend that FES, for the management of dropped foot after stroke, is delivered by a specialist team. However, little detail is provided about the structure and composition of the specialist team or model of service delivery. A pilot Lothian FES clinic was developed to explore the clinical value of providing such a service to stroke patients with dropped foot and identify any service modifications.\ud Methods Mixed methods were used to evaluate the service and included quantitative, qualitative and reflective components. Phase 1: Before and after service evaluation of patients attending the FES clinic between 2003 and 2007. Outcomes of gait velocity and cadence were recorded at initial clinic appointment and 6 months after application of FES. Phase 2: Qualitative research exploring patients with stroke and carers’ experiences of the FES clinic. Data were collected via semi-structured interviews. Phase 3: A reflection on the service delivery model. Participants: Phase 1: 40 consecutive out-patients with stroke; Phase 2: 13 out-patients with stroke and 9 carers; Phase 3: Three specialist physiotherapists engaged in running the FES clinic.\ud Findings Statistically significant improvements (p < 0.001) were demonstrated in gait velocity and cadence. Qualitatively, one super-ordinate theme ‘The FES clinic met my needs’ emerged. Within this were four sub-themes, namely 1. ‘Getting to grips with FES wasn’t difficult’; 2. ‘It’s great to know they’re there’; 3. ‘Meeting up with others really helps’ and 4. ‘The service is great but could be better’. On reflection, minor modifications were made to the service delivery model but overall the service met user needs. This dedicated FES clinic produced positive physical outcomes and met the needs of this chronic stroke population

Engaging and empowering first-year students through curriculum design: perspectives from the literature

There is an increasing value being placed on engaging and empowering first-year students and first-year curriculum design is a key driver and opportunity to ensure early enculturation into successful learning at university. This paper summarises the literature on first-year curriculum design linked to student engagement and empowerment. We present conceptualisations of ‘curriculum’ and examples from first-year curriculum design. We also note the limited literature where students have been involved in designing first-year curricula. The results of the literature review suggest that key characteristics of engaging first-year curricula include active learning, timely feedback, relevance and challenge. The literature also points to the importance of identifying students' abilities on entry to university as well as being clear about desired graduate attributes and developmental goals. Acknowledging realities and constraints, we present a framework for the first-year curriculum design process based on the literature

Exploring decolonising the curriculum in physiotherapy: our learning stories as dedicated novices.

Kavi C Jagadamma - ORCID: 0000-0003-2011-0744 https://orcid.org/0000-0003-2011-0744Background: There is increasing awareness that we must engage with decolonising physiotherapy curricula to respect plurality of knowledge and become more consistent with global priorities towards humanising healthcare. Aim: By reflecting on our discomfort and vulnerabilities, we strove to understand and engage in decolonising the physiotherapy curriculum. Through this we hope to motivate others and contribute to this important transformation. Conclusions: Using Mezirow’s transformative learning theory, we reflected on our struggle with our disorienting dilemmas regarding the need to engage in decolonising the physiotherapy curriculum. We have become alert to insecurities about our knowledge and ability to engage sensitively in the necessary conversations. As we progress towards ‘full’ transformation, we have concluded that we must take action to generate change while continuing to learn and reflect.https://doi.org/10.19043/ipdj.122.01012pubpub

Comparison of Epoch and Uniaxial versus Triaxial Accelerometers in the Measurement of Physical Activity in Preschool Children: A Validation Study

This study compared accelerometry cut points for sedentary behavior, light and moderate to vigorous intensity activity (MVPA) against a criterion measure, the Children's Activity Rating Scale (CARS), in preschool children. Actigraph accelerometry data were collected from 31 children (4.4 0.8 yrs) during one hour of free-play. Video data were coded using the CARS. Cut points by Pate et al., van Cauwenberghe et al., Sirard et al. and Puyau et al. were applied to calculate time spent in sedentary, light and MVPA. Repeated-measures ANOVA and paired t tests tested differences between the cut points and the CARS. Bland and Altman plots tested agreement between the cut points and the CARS. No significant difference was found between the CARS and the Puyau et al. cut points for sedentary, light and MVPA or between the CARS and the Sirard et al. cut point for MVPA. The present study suggests that the Sirard et al. and Puyau et al. cut points provide accurate group-level estimates of MVPA in preschool children

Is functional electrical stimulation effective in improving walking in adults with lower limb impairment due to an upper motor neuron lesion? An umbrella review

From Wiley via Jisc Publications RouterHistory: received 2022-12-12, rev-recd 2023-04-20, accepted 2023-05-09, epub 2023-06-01Article version: VoRPublication status: PublishedBulley, Cathy; orcid: 0000-0001-8338-5388 https://orcid.org/0000-0001-8338-5388Marietta van der Linden - ORCID: 0000-0003-2256-6673 https://orcid.org/0000-0003-2256-6673Purpose: To conduct an umbrella review of systematic reviews on functional electrical stimulation (FES) to improve walking in adults with an upper motor neuron lesion. Methods: Five electronic databases were searched, focusing on the effect of FES on walking. The methodological quality of reviews was evaluated using AMSTAR2 and certainty of evidence was established through the GRADE approach. Results: The methodological quality of the 24 eligible reviews (stroke, n = 16; spinal cord injury (SCI), n = 5; multiple sclerosis (MS); n = 2; mixed population, n = 1) ranged from critically low to high. Stroke reviews concluded that FES improved walking speed through an orthotic (immediate) effect and had a therapeutic benefit (i.e., over time) compared to usual care (low certainty evidence). There was low‐to‐moderate certainty evidence that FES was no better or worse than an Ankle Foot Orthosis regarding walking speed post 6 months. MS reviews concluded that FES had an orthotic but no therapeutic effect on walking. SCI reviews concluded that FES with or without treadmill training improved speed but combined with an orthosis was no better than orthosis alone. FES may improve quality of life and reduce falls in MS and stroke populations. Conclusion: FES has orthotic and therapeutic benefits. Certainty of evidence was low‐to‐moderate, mostly due to high risk of bias, low sample sizes, and wide variation in outcome measures. Future trials must be of higher quality, use agreed outcome measures, including measures other than walking speed, and examine the effects of FES for adults with cerebral palsy, traumatic and acquired brain injury, and Parkinson's disease.pubpu

Support after COVID-19 study: a mixed-methods cross-sectional study to develop recommendations for practice

From BMJ via Jisc Publications RouterHistory: received 2021-10-28, accepted 2022-05-12, ppub 2022-08, epub 2022-08-26Publication status: PublishedFunder: Chief Scientist Office; FundRef: http://dx.doi.org/10.13039/501100000589; Grant(s): COV/QMU/20/04Objectives of study stage 1 were to: explore people’s experiences of illness due to COVID-19 while feeling socially isolated or socially isolating; identify perceptions of what would support recovery; and synthesise insights into recommendations for supporting people after COVID-19. Study stage 2 objectives were to engage stakeholders in evaluating these recommendations and analyse likely influences on access to the support identified. Design: A two-stage, multimethod cross-sectional study was conducted from a postpositivist perspective. Stage 1 included an international online survey of people’s experiences of illness, particularly COVID-19, in isolation (n=675 full responses). Stage 2 involved a further online survey (n=43), two tweetchats treated as large online focus groups (n=60 and n=27 people tweeting), two smaller focus groups (both n=4) and one interview (both using MS teams). Setting: Stage 1 had an international emphasis, although 87% of respondents were living in the UK. Stage 2 focused on the UK. Participants: Anyone aged 18+ and able to complete a survey in English could participate. Stage 2 included health professionals, advocates and people with lived experience. Main outcome measures: Descriptive data and response categories derived from open responses to the survey and the qualitative data. Results: Of those responding fully to stage 1 (mean age 44 years); 130 (19%) had experienced COVID-19 in isolation; 45 had recovered, taking a mean of 5.3 (range 1–54) weeks. 85 did not feel they had recovered; fatigue and varied ‘other’ symptoms were most prevalent and also had most substantial negative impacts. Our draft recommendations were highly supported by respondents to stage 2 and refined to produce final recommendations. Conclusions: Recommendations support access to progressive intensity and specialism of support, addressing access barriers that might inadvertently increase health inequalities. Multidisciplinary collaboration and learning are crucial, including the person with COVID-19 and/or Long Covid in the planning and decision making throughout

Specialised footwear for foot drop - Bibliography to support NIHR i4i Connect EOI v2

TITLE: Specialised footwear for foot drop: Laying the foundations for product launch and NHS adoption strategyExpression of Interest for the NIHR i4i Connect Grant AwardFebruary 2024Bibliography to support Expression of Interest application from Health Design CollectiveVersion 2</p

Specialised footwear for foot drop - Bibliography to support NIHR i4i Connect EOI

TITLE: Specialised footwear for foot drop: Laying the foundations for product launch and NHS adoption strategyExpression of Interest for the NIHR i4i Connect Grant AwardFebruary 2024Bibliography to support Expression of Interest application from Health Design Collective</p

Physiotalk: Connectedness and Constructive Change - An explanatory theory SUPPL 1

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