Disability and rehabilitation
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Ehlers-Danlos syndrome (EDS) hypermobility-type is the most common hereditary disorder of the connective tissue. The tissue fragility characteristic of this condition leads to multi-systemic symptoms in which pain, often severe, chronic, and disabling, is the most experienced. Clinical observations suggest that the complex patient with EDS hypermobility-type is refractory toward several biomedical and physical approaches. In this context and in accordance with the contemporary conceptualization of pain (biopsychosocial perspective), the identification of psychological aspects involved in the pain experience can be useful to improve interventions for this under-recognized pathology. ⋯ As in other chronic pain conditions, these aspects should be more explored in EDS hypermobility-type, and integrated into chronic pain prevention and management programs. Implications for Rehabilitation Clinicians should be aware that joint hypermobility may be associated with other health problems, and in its presence suspect a heritable disorder of connective tissue such as the Ehlers-Danlos syndrome (EDS) hypermobility-type, in which chronic pain is one of the most frequent and invalidating symptoms. It is necessary to explore the psychosocial functioning of patients as part of the overall chronic pain management in the EDS hypermobility-type, especially when they do not respond to biomedical approaches as psychological factors may be operating against rehabilitation. Further research on the psychological factors linked to pain chronicity and disability in the EDS hypermobility-type is needed.
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Walking is commonly recommended to relieve pain and improve function in chronic low back pain. The purpose of this study was to conduct a systematic review and meta-analysis of randomized controlled trials concerning the effectiveness of walking interventions compared to other physical exercise on pain, disability, quality of life and fear-avoidance, in chronic low back pain. ⋯ Pain, disability, quality of life and fear-avoidance similarly improve by walking or exercise in chronic low back pain. Walking may be considered as an alternative to other physical activity. Further studies with larger samples, different walking dosages, and different walking types should be conducted. Implications for Rehabilitation Walking is commonly recommended as an activity in chronic low back pain. Pain, disability, and fear-avoidance similarly improve by walking or exercise. Adding walking to exercise does not induce greater improvement in the short-term. Walking may be a less-expensive alternative to physical exercise in chronic low back pain.
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Considering the perspectives of individuals with cognitive disability is important for their participation in their self-directed health care. The nominal group technique (NGT) has been identified as a method to gather opinions of people with cognitive disability; however, a synthesis of methodological considerations to undertake when employing the approach among people with cognitive disability is non-existent. ⋯ The use of the NGT to gain the health care perspectives of adults with cognitive disability is promising. Conducting nominal group techniques informed by the methodological considerations identified within this review can work towards ensuring that the health care perspectives of people with cognitive disability are considered. Implications for rehabilitation The emergent policy move towards self-directed health care for people with disability requires that the health care perspectives of people with disability are considered. Effective consultation and discussion techniques are essential to gain the health care perspectives of people with cognitive disability. After undertaking methodological considerations, the NGT can be an effective approach towards gaining the health care perspectives of people with cognitive disability.
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Considering the perspectives of individuals with cognitive disability is important for their participation in their self-directed health care. The nominal group technique (NGT) has been identified as a method to gather opinions of people with cognitive disability; however, a synthesis of methodological considerations to undertake when employing the approach among people with cognitive disability is non-existent. ⋯ The use of the NGT to gain the health care perspectives of adults with cognitive disability is promising. Conducting nominal group techniques informed by the methodological considerations identified within this review can work towards ensuring that the health care perspectives of people with cognitive disability are considered. Implications for rehabilitation The emergent policy move towards self-directed health care for people with disability requires that the health care perspectives of people with disability are considered. Effective consultation and discussion techniques are essential to gain the health care perspectives of people with cognitive disability. After undertaking methodological considerations, the NGT can be an effective approach towards gaining the health care perspectives of people with cognitive disability.
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The purpose of this article is to synthesise the scholarly literature related to perceptions of mild traumatic brain injury (mTBI) and health outcomes in an adult population. ⋯ Perceptions of mild traumatic brain injury, or how persons think about and understand mTBI and recovery, have important implications for rehabilitation intervention. Intervention research integrating perceptions of mild traumatic brain injury, while emerging, is needed. Engagement with the health psychology literature is recommended. Implications for rehabilitation Perceptions of mild traumatic brain injury (mTBI) and recovery have been associated with health outcomes and are worth considering in clinical rehabilitation practice. Studies reviewed demonstrate associations between negative perceptions of mTBI and increased symptom report, poor cognitive test performance, and impaired function. Potential implications for the rehabilitation process are discussed, including how to assess perceptions of mTBI in clinical interaction, and how to communicate information regarding symptoms, effects on daily life, and expectations for recovery following injury.