24 research outputs found
Embracing additive manufacture: implications for foot and ankle orthosis design
<p>Abstract</p> <p>Background</p> <p>The design of foot and ankle orthoses is currently limited by the methods used to fabricate the devices, particularly in terms of geometric freedom and potential to include innovative new features. Additive manufacturing (AM) technologies, where objects are constructed via a series of sub-millimetre layers of a substrate material, may present the opportunity to overcome these limitations and allow novel devices to be produced that are highly personalised for the individual, both in terms of fit and functionality.</p> <p>Two novel devices, a foot orthosis (FO) designed to include adjustable elements to relieve pressure at the metatarsal heads, and an ankle foot orthosis (AFO) designed to have adjustable stiffness levels in the sagittal plane, were developed and fabricated using AM. The devices were then tested on a healthy participant to determine if the intended biomechanical modes of action were achieved.</p> <p>Results</p> <p>The adjustable, pressure relieving FO was found to be able to significantly reduce pressure under the targeted metatarsal heads. The AFO was shown to have distinct effects on ankle kinematics which could be varied by adjusting the stiffness level of the device.</p> <p>Conclusions</p> <p>The results presented here demonstrate the potential design freedom made available by AM, and suggest that it may allow novel personalised orthotic devices to be produced which are beyond the current state of the art.</p
WELLFOCUS PPT – modified positive psychotherapy to improve well-being in psychosis: study protocol for a pilot randomised controlled trial
BACKGROUND: The promotion of well-being is an important goal of recovery oriented mental health services. No structured, evidence-based intervention exists that aims to increase the well-being in people with severe mental illness such as psychosis. Positive psychotherapy (PPT) is a promising intervention for this goal. Standard PPT was adapted for use with people with psychosis in the UK following the Medical Research Council framework for developing and testing complex interventions, resulting in the WELLFOCUS Model describing the intended impact of WELLFOCUS PPT. This study aims to test the WELLFOCUS Model, by piloting the intervention, trial processes, and evaluation strategy. METHODS/DESIGN: This study is a non-blinded pragmatic pilot RCT comparing WELLFOCUS PPT provided as an 11-session group therapy in addition to treatment as usual to treatment as usual alone. Inclusion criteria are adults (aged 18–65 years) with a main diagnosis of psychosis who use mental health services. A target sample of 80 service users with psychosis are recruited from mental health services across the South London and Maudsley NHS Foundation Trust. Participants are randomised in blocks to the intervention and control group. WELLFOCUS PPT is provided to groups by specifically trained and supervised local therapists and members of the research team. Assessments are conducted before randomisation and after the group intervention. The primary outcome measure is well-being assessed by the Warwick-Edinburgh Mental Well-being Scale. Secondary outcomes include good feelings, symptom relief, connectedness, hope, self-worth, empowerment, and meaning. Process evaluation using data collected during the group intervention, post-intervention individual interviews and focus groups with participants, and interviews with trial therapists will complement quantitative outcome data. DISCUSSION: This study will provide data on the feasibility of the intervention and identify necessary adaptations. It will allow optimisation of trial processes and inform the evaluation strategy, including sample size calculation, for a future definitive RCT. TRIAL REGISTRATION: Current Controlled Trials ISRCTN04199273 – WELLFOCUS study: an intervention to improve well-being in people with psychosis, Date registered: 27 March 2013, first participant randomised on 26 April 2013
The impact of positive psychological interventions on well-being in healthy elderly people
This systematic review aims to evaluate the impact of Positive Psychological Interventions (PPIs) on well-being in healthy older adults. Systematic review of PPIs obtained from three electronic databases (PsycINFO, Scopus, and Web of Science) was undertaken. Inclusion criteria were: that they were positive psychology intervention, included measurement of well-being, participants were aged over 60 years, and the studies were in English. The Cochrane Collaboration Guidelines dimensions of quality control, randomization, comparability, follow-up rate, dropout, blinding assessors are used to rate the quality of studies by two reviewers independently. The RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) for evaluation of PPIs effectiveness was also applied. The final review included eight articles, each describing a positive psychological intervention study. The reminiscence interventions were the most prevalent type of PPIs to promote and maintain well-being in later life. Only two studies were rated as high quality, four were of moderate-quality and two were of low-quality. Overall results indicated that efficacy criteria (89%), reach criteria (85%), adoption criteria (73%), implementation criteria (67%), and maintenance criteria (4%) across a variety of RE-AIM dimensions. Directions for future positive psychological research related to RE-AIM, and implications for decision-making, are described
The differential relationship of an afterschool physical activity intervention on brain function and cognition in children with obesity and their normal weight peers
Efeitos do uso de órteses na Doença de Charcot-Marie-Tooth: atualização da literatura
A Doença de Charcot-Marie-Tooth (DCMT) é a
neuropatia periférica hereditária mais comum em seres humanos,
apresentando incidência de 1:2.500 pessoas. A fraqueza
distal crural na DCMT provoca inúmeras alterações na
marcha, como, por exemplo, na velocidade, no comprimento,
na largura e cadência dos passos. Vários recursos em reabilitação
têm sido propostos para gerenciar os problemas de
deambulação, dentre eles, destaca-se a utilização de órteses.
O objetivo deste estudo é apresentar e discutir os resultados
de estudos sobre os efeitos da utilização de órteses
nos padrões de marcha na DCMT. Neste estudo foi utilizada
atualização da literatura através das principais bases de
dados nacionais/internacionais (SciELO, LILACS e MEDLINE),
publicados entre os anos de 2006–2012. O tratamento da
DCMT consiste em fisioterapia e utilização de equipamentos
de assistência, visto que ainda não há fármacos ou terapia
gênica capaz de atenuar os danos clínicos e funcionais. Tal
associação busca maximizar a função e melhorar a qualidade
de vida desses pacientes, na tentativa de evitar agravos
adicionais relativos à incapacidade física. A partir de atualização
de literatura é possível concluir que existe consenso
sobre a utilização de órteses nos membros inferiores para
promover a estabilização das articulações do tornozelo e um
padrão de deambulação mais funcional, evitando sinergias
inadequadas de movimento e atenuando o risco de quedas. ________________________________________________________________________________________________ABSTRACT: Charcot-Marie-Tooth (CMT) disease is the
most common hereditary peripheral neuropathy in humans,
presenting incidence of 1:2.500 people. The distal
crural weakness of the CMT causes numerous gait impairment
changes, for example, velocity, length, width
and cadence of the steps. Several rehabilitation resources
have been proposed to manage the walking problems,
among them, the use of orthoses is highlighted.
The objective of this study was to present and discuss
the results of studies on the effects of orthotic uses in
CMT gait patterns. In this study it was used to literature
update through major national/international databases
(SciELO, LILACS and MEDLINE), published between
the years 2006–2012. The CMT treatment consisted
of physical therapy and using of assistive equipment,
since there are no drugs or gene therapy able to attenuate
the clinical and functional damages. This association
seeks to maximize the function and improve life quality
of these patients in an attempt to prevent additional
injuries related to physical disability. From literature update
it is possible to conclude that there is a consensus
on the use of lower limb orthoses to promote the
stabilization of the ankle articulation and a more functional
pattern of walking, avoiding inadequate synergy
of movement and reducing the risk of falls