Experience of Multisensory Environments in Public Space among People with Visual Impairment

This qualitative study explored the role of sensory characteristics embedded in the built environment and whether they support or hinder people with visual impairment in their use of public spaces. An online survey link was e-mailed to the presidents and committee members of each state’s chapters and associations of the National Federation of the Blind in the United States, resulting in 451 direct invitations to participate. Written responses of the survey questions from 48 respondents with visual impairment were analyzed. Three main themes: Barriers, Supporters, and Context-Dependence emerged from the respondents’ experience of multisensory characteristics within the built environment. The four subthemes subsumed in Barriers were: (1) Population specific design, (2) Extreme sensory backgrounds, (3) Uneven ground surfaces and objects, and (4) Inconsistent lighting. For Supporters, respondents provided specific examples of various sensory characteristics in built environments, including audible cues and echoes, smells, tactile quality of the ground surface, and temperature. Context-Dependence referred to the effects of sensory characteristics embedded in public spaces depending on one’s vision condition, the proximity to the sensory cues and the purpose of the activities one was performing at that moment. Findings provide occupational therapy practitioners an in-depth understanding of the transactional relationship between embedded sensory characteristics in the built environment, occupations, and people with visual impairment in order to make appropriate modifications or removal of barriers that affect occupational performance and engagement. Suggestions for occupational therapists as well as architects, designers, planners, policy makers/legislators related to functional sensory cues in the design of built environments were provided to increase accessibility in the use of public spaces by people with visual impairment

Factors Associated with the Use of Standardized Power Mobility Skills Assessments among Assistive Technology Practitioners

<div><p></p><p>This study investigated self-reported prevalence of and factors affecting clinicians’ use of standardized assessments when evaluating clients for power mobility devices (PMDs), and explored assessments clinicians typically use when carrying out PMD evaluation. An email survey was sent to Assistive Technology Professionals listed in the Rehabilitation Engineering and Assistive Technology Society of North America directory. Three hundred and fifty-four respondents, qualified to conduct formal power mobility skills assessments, completed the online survey. Of those, 122 (34.5%) respondents reported that they were aware of the presence of standardized performance-based power mobility skills assessments, but only 28 (7.9%) used these assessments in their practice. Multivariate analysis revealed that the odds of the respondents who use the standardized assessments were 18 times higher for those who were aware of the presence of these assessments than those who were not [adjusted OR = 17.85, P < 0.0001]. The odds of using the standardized assessment for respondents who did not identify themselves as occupational or physical therapists were 5 times higher than those who were therapists [adjusted OR = 0.20, P < 0.0001]. This survey revealed that the assistive technology practitioners who recommend PMDs mainly use non-standardized mobility skills assessments. Reasons for not using standardized assessments were discussed.</p></div

Pain in adults with cerebral palsy: A systematic review and meta-analysis of individual participant data

Background There is little focus on adults with cerebral palsy (CP) in research and health care and insufficient knowledge on how to identify and manage pain in this population. Objectives This systematic review and meta-analysis aimed to determine whether pain prevalence in adults with CP is high and to explore variations in pain prevalence of subgroups, pain locations, pain severity and pain interference. Methods Potential datasets were identified by experts in the field and literature searches in Embase, MEDLINE, and Cochrane, from January 2000 to October 2016. Included studies had a representative sample of ≥ 25 adults with CP and ≥ 1 pain outcomes. Methodological quality assessment, pain prevalence estimates and logistic regression models for subgroup effects on pain prevalence were conducted. Results In total, 17 eligible studies were identified from 4584 publications. A meta-analysis was performed with individual participant data from 15 studies totalling 1243 participants (mean [SD] age 34.3 [12.6] years). Overall mean pain prevalence was 70% (95% CI 62–78). Women were more likely to have pain than men (P < 0.001). The odds of pain was increased in adults with gross motor function level II (odds ratio [OR] 1.92, 95% CI 1.22–3.12) and IV (OR 1.77, 95% CI 1.03–4.29). Participants with pain reported pain predominantly in the legs (76%, 95% CI 66–84), and mean pain severity was 3.7/10 (95% CI 2.7–4.7) and pain interference 3.5/10 (95% CI 2.5–4.5). Conclusions This meta-analysis provides the first reliable pain prevalence estimate in a large international sample of adults with CP. The high prevalence of pain, 70%, suggests that adults with CP should be routinely screened for pain and treated accordingly. The range of measurement instruments used by the included studies emphasizes using common outcome measures specific to pain internationally