Medicine

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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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Subject: search.filters.subject.Rehabilitation

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    Psychometric validation of the In-hand manipulation assessment (IHMA)
    (W.B. Saunders, 2024-11) Liu, K.P.Y.; Chapman, A.; Tsoi, T.L.Y.; Thach, P.; Welage, N.; Tulliani, N.
    OBJECTIVE To determine the inter-rater reliability, and criterion and discriminant validity of the In-Hand Manipulation Assessment (IHMA) with patients after stroke.DESIGN Participants were videotaped, completing the IHMA and scored by 2 blinded assessors to determine the inter-rater reliability. Stroke participants also completed the Jebsen-Taylor Hand Function Test, and healthy participants completed the Nine-Hole Peg Test to determine the validity of the IHMA.SETTING Community and hospital settings.PARTICIPANTS A total of 46 participants with 22 healthy young adults, 14 healthy older adults and 10 people with stroke.INTERVENTIONS Not applicable.MAIN OUTCOME MEASURES Not applicable.RESULTS The inter-rater reliability of the IHMA was good (for all participants: intraclass correlation coefficient = 0.78-0.98, P≤.001; for stroke participants: Kappa statistics = 0.70-1.00, P≤.001). The IHMA demonstrated good discriminant validity between the healthy young adults and healthy older adults for time and completion scores (Ps=.012 and ≤.001). The criterion validity of the IHMA was moderate to good when compared with the Nine-Hole Peg Test (r = -0.45 to 0.84), but no significant correlation was found with the Jebsen-Taylor Hand Function Test. Modifications to the IHMA tasks and instructions were made based on the performance of participants to improve its clinical utility with people after stroke.CONCLUSIONS The IHMA demonstrated good inter-rater reliability, good discriminant validity, and moderate-to-good criterion validity with the Nine-Hole Peg Test. The proposed modifications to the IHMA will enhance its administration.
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    Development and feasibility of first- and third-person motor imagery for people with stroke living in the community
    (BioMed Central, 2023) Welage, N.; Bissett, M.; Coxon, K.; Fong, K.N.K.; Liu, K.P.Y.
    BACKGROUND: Impairment of arm movement occurs in up to 85% of people post-stroke, affecting daily living activities, and quality of life. Mental imagery effectively enhances hand and daily function in people with stroke. Imagery can be performed when people imagine themselves completing the movement or imagine another person doing it. However, there is no report on the specific use of first-person and third-person imagery in stroke rehabilitation. AIMS: To develop and assess the feasibility of the First-Person Mental Imagery (FPMI) and the Third-Person Mental Imagery (TPMI) programs to address the hand function of people with stroke living in the community. METHODS: This study comprises phase 1-development of the FPMI and TPMI programs, and phase 2-pilot-testing of the intervention programs. The two programs were developed from existing literature and reviewed by an expert panel. Six participants with stroke, living in the community, participated in the pilot-testing of the FPMI and TPMI programs for 2 weeks. Feedback collected included the suitability of the eligibility criteria, therapist's and participant's adherence to intervention and instructions, appropriateness of the outcome measures, and completion of the intervention sessions within the specified time. RESULTS: The FPMI and TPMI programs were developed based on previously established programs and included 12 hand tasks. The participants completed four 45-min sessions in 2 weeks. The treating therapist adhered to the program protocol and completed all the steps within the specified time frame. All hand tasks were suitable for adults with stroke. Participants followed the instructions given and engaged in imagery. The outcome measures selected were appropriate for the participants. Both programs showed a positive trend towards improvement in participants' upper extremity and hand function and self-perceived performance in activities of daily living. CONCLUSIONS: The study provides preliminary evidence that these programs and outcome measures are feasible for implementation with adults with stroke living in the community. This study outlines a realistic plan for future trials in relation to participant recruitment, training of therapists on the intervention delivery, and the use of outcome measures.TRIAL REGISTRATION: Title: Effectiveness of first-person and third-person motor imagery in relearning daily hand tasks for people with chronic stroke: a randomised controlled trial.REGISTRATION NO: SLCTR/2017/031. Date registered: 22nd September 2017.
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    Efficacy of Adopting KAATSU Training in Rehabilitating Exercises: A systematic review
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Perera, S.A.; Samaranada, V.A.; Kanchana, K.T.G.; Gayan, D.V.C.
    Introduction: KAATSU training is a short-term, low-intensity, novel, and patented method that results in muscle hypertrophy and strength gains. Exercise rehabilitation is conducted to maximize function restoration in the shortest amount of time possible, assisting individuals in resuming normal function with the lowest potential risk of re¬injury. Objectives: To review the feasibility of adopting KAATSU training as a method of exercise rehabilitation and evaluate the efficacy. Methodology: Based on the comprehensive studies concerning the guideline of PRISMA, the electronic databases of PubMed Central (n=178), Science Direct (n=14), Springer Link (n=2), Cochrane Library (n=19), and Google Scholar (n= 291) manually screened using the keywords "KAATSU," " rehabilitation", "muscle strength," "hypertrophy" and " sports medicine". After removing duplicates, 291 articles were screened twice for the keywords, and 21 were considered for the review. Results: Out of the nineteen controlled clinical trials, fourteen were conducted on healthy young populations, four on athletes and one on patients with ischaemic heart disease. The two case studies were conducted on old adults. The results of all the studies suggested that short-term low-intensity resistance exercise with KAATSU training would be an effective method for improving skeletal muscle mass, endurance capacity and strength. Conclusion: KAATSU training is a safe exercise method for the improvement of skeletal muscle mass, endurance capacity and strength in healthy young, elderly and populations with ischaemic heart disease. This may provide a complementary training method to exercise rehabilitation. However, conflicting evidence suggest the necessity of research on a broader level in adopting KAATSU training to re-building skeletal muscles after an injury.
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    Efficacy of a low-cost multidisciplinary team-led experiential workshop for public health midwives on dysphagia management for children with cerebral palsy
    (VU e-Publishing, Netherlands, 2018) Hettiarachchi, S.; Kitnasamy, G.; Mahendran, R.; Nizar, F. S.; Bandara, C.; Gowritharan, P.
    PURPOSE: Over the past decade there has been a growing focus on offering appropriate training to healthcare professionals and caregivers to support safe feeding practices for children with cerebral palsy. Early and consistent multidisciplinary intervention is required to minimise the risks of aspiration pneumonia. The high incidence of complications from aspiration pneumonia among children with cerebral palsy in Sri Lanka has made it necessary to conduct low-cost multidisciplinary team-led dysphagia awareness workshops for healthcare professionals and caregivers.METHOD: A group of 38 Public Health Midwives (PHMs) was offered an experiential workshop by a small multidisciplinary team (MDT). To determine changes in knowledge, a self-administered questionnaire that included a video-based client scenario was administered pre- and post-workshop. The data were analysed statistically using non-parametric within-participant t-tests.RESULTS: The post-workshop responses to the questionnaire indicated a significant increase in the level of knowledge. This included positive changes in the understanding and knowledge of cerebral palsy (t (37) =-7.44, p=.000), effects of cerebral palsy on eating and drinking skills (t (37) =-3.91, p=.000), positioning (t (37) = -9.85, p=.000), aspiration (t (37) =-3.46, p=.001), food categorisation (t (37), -3.85, p=.000) and client video observation (t (37)-3.91, p=.000) at a p=.05 level of significance. While there was also an increase in the knowledge on general guidelines during mealtimes, this did not reach statistical significance.CONCLUSION: The low-cost MDT-led experiential workshop was effective in increasing knowledge of feeding and dysphagia-related issues in cerebral palsy among a group of PHMs. This workshop could serve as a model for training PHMs and Community-Health Workers across the country in order to reach the Sustainable Development Goal of ‘good health and well-being’ for children with cerebral palsy and all children experiencing feeding difficulties. Follow-up workshops and continued professional development courses for midwives on dysphagia care are strongly recommended, in addition to collaborative clinical practice
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