Balance assessment with decreased base of support for children with disabilities.

Background: Children's ability to achieve an appropriate motor development is largely associated with their capacity to control balance. Furthermore, accomplishing balance tasks with a narrowed base of support is a necessary precursor to engaging in everyday functional activities and developing more complex balance abilities.

Purpose: To investigate the relationship between the tandem stance (TS) and the single-limb stance (SLS) items of the Pediatric Balance Scale (PBS) assessment tool with the PBS total score in children with impaired balance.

Caring for Coma after Severe Brain Injury: Clinical Practices and Challenges to Improve Outcomes: An Initiative by the Curing Coma Campaign.

Severe brain injury can result in disorders of consciousness (DoC), including coma, vegetative state/unresponsive wakefulness syndrome, and minimally conscious state. Improved emergency and trauma medicine response, in addition to expanding efforts to prevent premature withdrawal of life-sustaining treatment, has led to an increased number of patients with prolonged DoC. High-quality bedside care of patients with DoC is key to improving long-term functional outcomes.

Lower extremity muscle activity during reactive balance differs between adults with chronic traumatic brain injury and controls.

Background: Control of reactive balance is key to achieving safe independent walking and engagement in life activities. After traumatic brain injury (TBI), motor impairments and mobility challenges are persistent sequelae. To date, no studies have explored muscle activity of individuals with chronic TBI during a task that requires reactive control of balance.

Effect of Data and Gap Characteristics on the Nonlinear Calculation of Motion During Locomotor Activities.

This study investigated how data series length and gaps in human kinematic data impact the accuracy of Lyapunov exponents (LyE) calculations with and without cubic spline interpolation. Kinematic time series were manipulated to create various data series lengths (28% and 100% of original) and gap durations (0.05-0.

Design and Evaluation of a Bilateral Semi-Rigid Exoskeleton to Assist Hip Motion.

This study focused on designing and evaluating a bilateral semi-rigid hip exoskeleton. The exoskeleton assisted the hip joint, capitalizing on its proximity to the body's center of mass. Unlike its rigid counterparts, the semi-rigid design permitted greater freedom of movement.

One-Year Recovery Among Survivors of Prolonged Severe COVID-19: A National Multicenter Cohort.

Objectives: Understanding the long-term effects of severe COVID-19 illness on survivors is essential for effective pandemic recovery planning. Therefore, we investigated impairments among hospitalized adults discharged to long-term acute care hospitals (LTACHs) for prolonged severe COVID-19 illness who survived 1 year.

Design: The Recovery After Transfer to an LTACH for COVID-19 (RAFT COVID) study was a national, multicenter, prospective longitudinal cohort study.

The Effectiveness of Upper Extremity Orthotic Interventions on Performance Skills and Performance of Occupations for Adults after Stroke: A Scoping Review.

The objective of this study was to determine the effectiveness of upper extremity orthoses on improving performance skills and performance of occupations after stroke. Databases searched included CINAHL, PubMed, and OT Seeker. Articles were included if published between 2012 to 2022, English, peer-reviewed, level of evidence IB, IIB, or IIIB, and included upper extremity orthoses, adults after a stroke, and performance skill and performance of occupation outcome measures; six studies meet inclusion criteria.

Prognosis and enhancement of recovery in disorders of consciousness.

Disorders of consciousness after severe brain injury encompass conditions of coma, vegetative state/unresponsive wakefulness syndrome, and minimally conscious state. DoC clinical presentation pose perplexing challenges to medical professionals, researchers, and families alike. The outcome is uncertain in the first weeks to months after a brain injury, with families and medical providers often making important decisions that require certainty.

Virtual Rehabilitation and COVID-19: Varied Adoption and Satisfaction Among Patients and Providers Participating in a Multi-Site Survey Study.

The COVID-19 pandemic compelled rapid healthcare adaptations including increased use of telehealth (TH) and virtual care (VC) to provide rehabilitation services. This multi-site cross-sectional survey study examined rehabilitation patients' and providers' experiences with service delivery during the COVID-19 pandemic, including the use of TH/VC. Patients and providers who received or provided rehabilitation services were recruited from 1 of 3 large, post-acute rehabilitation systems located in the Southeastern and Midwestern United States during the COVID-19 pandemic.

Emergence from Disorders of Consciousness: Optimizing Self-Agency Through Communication.

Language and communication deficits are intrinsic to disorders of consciousness. This article will provide an overview of language and communication deficits that can significantly confound the accuracy of diagnostic assessment in these patients. Authors will also discuss interventions to promote early communication using assistive technology and augmentative communication rehabilitation strategies.

Structural Equation Modeling: Effects of Master Adaptive Learner and Clinical Learning Environment Attributes on Career Satisfaction and Intention to Stay.

Objective: The objective of this observational study was to test a proposed conceptual model depicting the influence of personal and environmental attributes of clinical learning environments on rehabilitation professionals' career satisfaction and intention to stay with their current organization. The mediating effects of 2 loci of engagement were also assessed.

Methods: Rehabilitation professionals (physical therapists, occupational therapists, speech-language pathologists, and registered nurses; n = 436) from 4 health care organizations in the Northeast, Southeast, and Midwest regions in the USA completed a battery of questionnaires related to personal attributes (resilience and orientation toward lifelong learning), environmental attributes (innovation support and basic psychological need satisfaction at work), loci of engagement (professional and organizational), career satisfaction, and intention to stay.

Differences in Role and Support Between Volunteer and Paid Community Health Workers in the State of Nebraska.

Despite the growing importance of community health workers (CHWs) in public health, it has been difficult to characterize the roles and scope of services for this workforce in part because of the variability in the employment status of CHWs, ranging from full-time, part-time, to volunteer. Based on analysis of survey data from a statewide assessment of the CHW workforce in Nebraska (n = 142) conducted between 2019 and 2020, the proportions of CHWs who worked full-time, part-time, or volunteer were respectively 64%, 12%, and 21%. Over three quarters (76.

Rehabilitation Management of the Burned Hand.

Burns to the hands constitute a small total surface area burn, but can result in significant functional challenges and disability. The complexity of multiple anatomical structures and intricate interplay of bones, muscles, and connective tissues requires specialized knowledge of how burns of the hand can affect function and independence. This article will provide an evidence-based overview of rehabilitation of the burned hand across the burn care continuum including a focus on evaluation, pain management, treatment interventions, and outcome assessment.

Evaluating as a computer access system for augmentative and alternative communication in cerebral palsy: A case study.

is a freely available software program that visually tracks the movement of facial features to allow individuals with motor impairments to control a computer mouse. The goal of this case study was to provide an evaluation of as a computer access method as part of a multiple modality communication system for an individual with cerebral palsy. The participant was asked to reproduce sentences and respond to ethical dilemmas for language sampling.

Clinical application of recommendations for neurobehavioral assessment in disorders of consciousness: an interdisciplinary approach.

Accurate diagnosis, prognosis, and subsequent rehabilitation care planning for persons with Disorders of Consciousness (DoC) has historically posed a challenge for neurological care professionals. Evidence suggests rates of misdiagnosis may be as high as 40% when informal beside evaluations are used to determine level of consciousness. The presence of myriad medical, neurological, functional (motor, sensory, cognitive) and environmental confounds germane to these conditions complicates behavioral assessment.

Trunk Velocity Changes in Response to Physical Perturbations Are Potential Indicators of Gait Stability.

Response to challenging situations is important to avoid falls, especially after medial perturbations, which require active control. There is a lack of evidence on the relationship between the trunk's motion in response to perturbations and gait stability. Eighteen healthy adults walked on a treadmill at three speeds while receiving perturbations of three magnitudes.

Multi-modal access method (eye-tracking + switch-scanning) for individuals with severe motor impairment: A preliminary investigation.

Individuals with severe motor impairments often require alternative means to access computers and communication technology. A range of alternative access devices exist; however, most rely on use of a single access modality. While this approach works for some individuals, it can be limiting for others.

Effect of gap-filling technique and gap location on linear and nonlinear calculations of motion during locomotor activities.

Background: Marker occlusion during camera-based movement analysis is common. Different interpolation techniques are available for estimating location of missing marker trajectories.

Research Question: What is the effect of gap location and interpolation technique on linear and nonlinear measures for a given kinematic time series?

Methods: Kinematic data were recorded during motor-assisted elliptical training and treadmill walking.

Muscle demand and kinematic similarities between pediatric-modified motor-assisted elliptical training at fast speed and fast overground walking: Real-world implications for pediatric gait rehabilitation.

The purpose of this research was to compare children's lower extremity muscle activity and kinematics while walking at fast pace and training at fast speeds with and without motor-assistance on a pediatric-modified motor-assisted elliptical. Twenty-one children without disabilities were recruited and fifteen completed all three training conditions at self-selected fast pace. Repeated-measures ANOVAs identified muscle demand (peak, mean, duration) differences across device conditions and fast walking.

Differentiating fallers from nonfallers using nonlinear variability analyses of data from a low-cost portable footswitch device: a feasibility study.

Purpose: Falls are one of the main causes of injuries in older adults. This study evaluated a low-cost footswitch device that was designed to measure gait variability and investigates whether there are any relationships between variability metrics and clinical balance tests for individuals with a history of previous falls.

Methods: Sixteen older adults completed a history of falls questionnaire, three functional tests related to fall risk, and walked on a treadmill with the footswitch device.

Personalization of Patient-Provider Communication Across the Lifespan.

People with disabilities are more likely to be hospitalized and use healthcare services relative to people without disabilities. They also report experiencing negative experiences interacting with health care providers during these encounters placing them at risk for preventable adverse medical events, poor quality of life, and dependence on others. Fortunately, providers and people with communication disabilities can take steps to improve these interactions by personalizing and implementing communication supports to empower people with communication disabilities to actively participate in these interactions and improve outcomes.

Margin of Stability May Be Larger and Less Variable during Treadmill Walking Versus Overground.

Margin of stability (MOS) is considered a measure of mechanical gait stability. Due to broad application of treadmills in gait assessment experiments, we aimed to determine if walking on a treadmill vs. overground would affect MOS during three speed-matched conditions.

Occupational injuries and patient lift usage among physical rehabilitation therapists.

Background: Physical therapists (PTs) and physical therapist assistants (PTAs) are at high risk for work-related musculoskeletal pain and discomfort.

Objective: Determine the prevalence and exposure risk factors for work-related injuries (WRIs) among rehabilitation PTs and PTAs.

Methods: A cross-sectional research survey was conducted among 170 PTs and 67 PTAs at 51 free-standing rehabilitation hospitals and rehabilitation units embedded in general hospitals in the Midwestern states of Iowa, Kansas, Missouri and Nebraska.

Feasibility of motor-assisted elliptical to improve walking, fitness and balance following pediatric acquired brain injury: A case series.

Purpose: Walking, fitness, and balance deficits are common following acquired brain injury (ABI). This study assessed feasibility, acceptability, and usefulness of a modified motor-assisted elliptical (ICARE) in addressing walking, fitness, and balance deficits in children with chronic ABIs.

Methods: Three children (> 5 years post-ABI) completed 24 ICARE exercise sessions (exercise time, speed, and time overriding motor-assistance gradually increased) to promote mass repetition of gait-like movements and challenge cardiorespiratory fitness.