Quality of life in older Chinese-speaking adults with hearing impairment

Purpose: General and hearing-specific health-related quality of life (HRQoL) was examined in elderly Chinese with hearing impairment. Methods: Sixty-four Chinese speakers aged ≥65 years and did not use hearing aids were evaluated using Chinese versions of the Short-Form 36 health survey (SF-36) and the Hearing Handicap Inventory for the Elderly (Screening Version) (HHIE-S). Results on the SF-36 were compared to norms obtained in a general elderly Chinese population. The relationships between HRQoL and degree of hearing impairment, and between SF-36 and HHIE-S were also evaluated. Results: Elderly Chinese speakers with hearing impairment rated six of the eight scales of the SF-36 poorer, compared to a general elderly Chinese population. When average hearing impairment in the better ear exceeded 40 dB HL, SF-36 ratings were poorer than those with better hearing. Poorer better ear hearing was significantly related to poorer ratings on the Vitality scale of the SF-36 and the three scales of the HHIE-S, after controlling for age, gender and number of coexisting chronic health problems. Ratings on SF-36 and HHIE-S did not correlate. Conclusion: Elderly Chinese who are hearing impaired experienced poorer general and hearing-specific HRQoL, and HRQoL is reduced further among those with greater hearing impairment.

Implications for Rehabilitation

• Hearing impairment adversely affects communication and is associated with social isolation.

• Older Chinese with hearing impairment report poorer physical functioning, role limitations due to physical problems, vitality, social functioning, role limitations due to emotional problems and general mental health than the general population.

• Degree of hearing impairment seems to exhibit lesser differential effects on self-reported quality of life among older Chinese, compared to those reported in Western societies.

• Treatment to improve communication should be evaluated for its impact on disease-specific and health-related quality of life.

     

The influence of Pilates exercises on body balance in the standing position of hearing impaired people

Abstract

Purpose: Hearing impairment may affect the body posture maintenance. The aim of the study was to evaluate the effect of modified Pilates exercise program on the body posture maintenance in hearing impaired people.

Methods: Eighty students (aged 13–24) were enrolled and randomly allocated into two groups: test group (n?=?41) which attended an original program based on modified Pilates exercises and control group (n?=?39) which attended standard physical education classes. Stabilographic tests were conducted at baseline and after 6-week training program.

Results: Both groups showed improved control of body balance in a standing position manifested in reductions of the length of path, surface area, and speed of deflection. Modified Pilates program was significantly more effective in improving body balance control in relaxed posture and with feet together than standard physical education classes. The greater efficiency of the modified Pilates program was expressed in a significant improvement in balance control parameters, i.e., path length, surface area, and speed of deflection.

Conclusions: The modified Pilates program was more effective in improving body balance control in the hearing impaired people than standard physical education classes. Modification of physical activity recommendations for hearing impaired students may be considered; however, further research is required.

• Implications for Rehabilitation

• Hearing impairment impacts the mental, social and, physical spheres of life as well as deteriorates equivalent reactions and the way body posture is maintained.

• In hearing impaired people, control of body balance and muscle coordination is often disturbed, thus more attention should be paid to exercises associated with balance which may improve the ability to learn and develop motor skills.

• Modified Pilates program was significantly more effective in improving body balance control than standard physical education classes in hearing impaired people.

     

Severe to profound hearing impairment: quality of life,psychosocial consequences and audiological rehabilitation

Abstract

Purpose: To study the quality of life (QoL) and psychosocial consequences in terms of sick leave and audiological rehabilitation given to patients with severe to profound hearing impairment. Method: A retrospective study of data on 2319 patients with severe to profound hearing impairment in The Swedish Quality Register of Otorhinolaryngology, followed by a posted questionnaire including The Hospital Anxiety and Depression Scale (HADS). Results: The results indicate greater levels of anxiety and depression among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo had strong negative effects on QoL. The proportion of sick leave differed between the studied dimensions in the study. The proportion of patients who received extended audiological rehabilitation was 38% in the present study. Conclusions: Treatment focused on anxiety, depression, tinnitus and vertigo must be given early in the rehabilitation process in patients with severe or profound hearing impairment. Because sick leave differs greatly within this group of patients, collaboration with the regional Social Insurance Agency is crucial part of the rehabilitation. The study also shows that presently, only a small proportion of patients in Sweden with severe to profound hearing impairment receive extended audiological rehabilitation.

• Implications for Rehabilitation

• Greater levels of anxiety and depression have been found among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo have strong negative effects on QoL in this group of patients.

• Only a small proportion of patients with severe to profound hearing impairment receive extended audiological rehabilitation today, including medical, technical and psychosocial efforts.

• Extended audiological rehabilitation focused on anxiety, depression, tinnitus and vertigo must be given, together with technical rehabilitation, early in the rehabilitation process in patients with severe or profound hearing impairment.

     

Higher social distress and lower psycho-social wellbeing: examining the coping capacity and health of people with hearing impairment

Abstract

Purpose: The objectives of this paper are as follows: (1) propose an explanatory model as to how hearing disability may impact on health and (2) examine the model’s utility. Methods: Data were collected on the psycho-social wellbeing, disability and physical health of farmers (n?=?56) participating in an intervention to manage the social impacts of hearing disability. Two models were proposed and examined using multiple hierarchical linear regression. Model 1 used self-rated quality of life and model 2 used capacity to manage hearing and listening impairments, as dependent variables. Results: The analyses found that physical measures of hearing impairment (audiograms) were not correlated with physical or mental health outcomes. However, in model 1, self-confidence and self-rated ability to manage hearing impairment were most closely associated with reduced quality of life (anxiety and diastolic blood pressure were positively associated with quality of life). In model 2, higher anxiety and reduced self-confidence were associated with decreasing ability to successfully manage one’s hearing impairment. Conclusions: The findings support the explanatory model that stress is higher and wellbeing lower when the fit between the person’s coping capacity and environmental demands is poor.

• Implications for Rehabilitation

• This paper demonstrates that anxiety is associated with coping with the psycho-social aspects of hearing disability.

• This finding has important implications for the many hearing services, which only provide assessment and devices.

• To negate anxiety and its long-term impacts, rehabilitation providers need to ensure people with hearing disability have the capacity to manage the psycho-social aspects of communication breakdown.

     

Adolescents with disabilities participate in the shopping mall: facilitators and barriers framed according to the ICF

Purpose: Community participation is restricted for youth with disabilities. The mall is an important gathering place where adolescents often socialise and develop community living skills, yet participation may be restricted. The aim of this study was to evaluate the facilitators and barriers to participation in a shopping mall through the perspectives of adolescents with disabilities.

Method: Semi-structured individual interviews were conducted with adolescents aged 12–19 years with a physical and/or sensory disability. Audio recordings were transcribed verbatim and coded following a template analysis using the International Classification of Functioning Disability and Health (ICF).

Results: Eleven youth (six females, mean age?=?17.0 years) participated. Medical conditions included visual impairment, hearing impairment, cerebral palsy, hemiplegia, osteogenesis imperfecta and congenital amputations. Six themes were identified by the adolescents: what the shopping mall means to me, physical environment, transportation, social factors, attitudes and the person. The majority of themes mapped to the ICF’s ‘environmental factors’.

Conclusions: Facilitators and barriers identified were either generic or disability-specific, implying that some modifications to shopping malls may be beneficial across disability types. Changes made to the physical, social and attitudinal environment are required to enable full participation of youth with disabilities within a shopping mall and other built environments of high public access.

• Implications for Rehabilitation

• The meaning of the shopping mall according to youth with disabilities includes socialisation, shopping, getting out of the home and employment.

• The majority of themes mapped to ‘environmental factors’ indicating that most obstacles to participation are caused by environmental barriers.

• Facilitators and barriers identified were either generic or disability-specific implying that some modifications to shopping malls may be beneficial across disability types.

• Changes made to the physical, social and attitudinal environment are required to enable full participation of youth with disabilities within a shopping mall.

     

The role of occupational therapy in vision rehabilitation of individuals with glaucoma

Abstract

Purpose: Specific to individuals with glaucoma: (1) provide an overview of the role of occupational therapists (OTs) as part of the vision rehabilitation team, (2) outline evaluation and intervention approaches provided by OTs, and (3) summarize the evidence to support those intervention approaches. Methods: Literature on vision rehabilitation and the typical practice patterns of OTs working with individuals with glaucoma are reviewed and the occupational therapy process is applied to evaluation and intervention approaches. The evidence which supports intervention approaches for individuals with glaucoma is presented. Results: The strength of the evidence to support common intervention approaches employed by OTs is weak or inconclusive; many studies lack quality methodological rigor. Moderate evidence supports patient education programs and strong evidence supports problem-solving and self-management strategies; this evidence is based on a limited number of studies. Conclusion: The prevalence of eye diseases is increasing; knowledge of how visual impairment affects disability will inform resource allocation and development of rehabilitation programs that address the unique needs of individuals with glaucoma. Rehabilitation specialists are key members of the healthcare team aligned to proactively recognize and develop comprehensive rehabilitation programs to maximize individuals’ function, quality of life and independence in everyday living.

• Implications for Rehabilitation:

• Glaucoma is one of the four major eye diseases that may result in visual impairment leading to disability.

• Research supports intervention approaches and vision rehabilitation techniques used by occupational therapists to optimize the health and well-being of individuals with glaucoma.

• Rehabilitation specialists are key members of the healthcare team who need to be alert to subtle behaviors that may be indicative of visual impairment versus attributed to other client factors.

     

Assistive technology as reading interventions for children with reading impairments with a one-year follow-up

Purpose: This pilot study investigated the possible transfer effect on reading ability in children with reading difficulties after a systematic intervention to train and compensate for reading deficiencies by using applications in smartphones and tablets. The effects of using assistive technology (AT) one year after the interventions were completely studied. School related motivation, independent learning and family relations were also considered.

Method: 35 pupils aged 10–12 years participated. They were assessed five times with reading tests. The participants, their parents and teachers were surveyed with questionnaires regarding their experience of using AT. The data from the assessments were analyzed with paired t-tests and Wilcoxon signed-rank tests. The data from the questionnaires were analyzed using content analysis.

Results: The paper shows that using AT can create transfer effects on reading ability one year after the interventions were finished. This means that reading impaired children may develop at the same rate as non-impaired readers. Also, increased school motivation and an increase in independent learning and family effects have been shown.

Conclusions: This paper provides implications in how to facilitate reading impaired pupils’ learning process and realizes the need to challenge the concept of reading to change to fit modern means of gaining information.

• Implications for rehabilitation

• Children with reading impairment could benefit from assistive technology in regards of their reading development process and increase their chances of not falling behind peers.

• Assistive technology as applications in smartphones and tablets may aid children with reading impairment to have an equal platform for learning in school as their peers without reading difficulties.

• Assistive technology could facilitate the information gaining process and subsequently increase motivation to learn and increase interest in reading activities.

• Assistive technology had wider effects on its users: stigmatizing situations when leaving the classroom for special education were avoided and positive effects on family life were noted.

     

Hearing assistive technologies in developing countries: background,achievements and challenges

Abstract

Purpose: The burden of hearing impairment and disability is substantial in the developing world. This review outlines the associated need for amplification devices in low and medium income countries and some of the initiatives that have been taken to improve access to such devices, particularly hearing aids. The main observed barriers to access are listed and possible ways to improve access are considered. Methods: Prevalence estimates for disabling hearing impairment are reviewed and a number of national and international examples of initiatives to facilitate use of hearing assistive devices in low and medium income countries are provided. Technologies that are potentially appropriate for hearing instruments in developing countries are suggested, as well as fitting programs that are more likely to be maintained over the long term. Results: Challenges to successful hearing instrument fitting in low and medium income countries are many. However, some programs point the way to improved access to such devices. Successful hearing aid fitting programs in developing countries have typically combined appropriate technology with a sustainable local support base. Conclusions: With a rising middle class in many developing countries, advances in technology, and ongoing training programs for those involved in amplification fitting, hearing device usage rates may eventually reach parity with those in developed economies.

• Implications for Rehabilitation

• The historical development of affordable hearing device fitting provision in low and middle income countries is outlined.

• Three key barriers to widespread access to hearing device provision in many low and middle income countries (LMICs) are identified: lack of trained personnel, the high cost of many existing devices marketed in LMICs and limited public awareness of the benefits of hearing assistive technologies.

• Examples of programs that have sought to overcome these barriers in LMICs are given and may influence the ways in which future hearing health care is provided.

     

Maternal experiences of caring for an infant with neurological impairment after neonatal encephalopathy in Uganda: a qualitative study

Abstract

Purpose: The study investigated maternal experiences of caring for a child affected by neurological impairment after neonatal encephalopathy (NE) (“birth asphyxia”) in Uganda. Methods: Between September 2011 and October 2012 small group and one-on-one in-depths interviews were conducted with mothers recruited to the ABAaNA study examining outcomes from NE in Mulago hospital, Kampala. Data were analysed thematically with the aid of Nvivo 8 software. Findings: Mothers reported caring for an infant with impairment was often complicated by substantial social, emotional and financial difficulties and stigma. High levels of emotional distress, feelings of social isolation and fearfulness about the future were described. Maternal health-seeking ability was exacerbated by high transport costs, lack of paternal support and poor availability of rehabilitation and counselling services. Meeting and sharing experiences with similarly affected mothers was associated with more positive maternal caring experiences. Conclusion: Mothering a child with neurological impairment after NE is emotionally, physically and financially challenging but this may be partly mitigated by good social support and opportunities to share caring experiences with similarly affected mothers. A facilitated, participatory, community-based approach to rehabilitation training may have important impacts on maximising participation and improving the quality of life of affected mothers and infants.

• Implications for Rehabilitation

• Caring for an infant with neurological impairment after NE in Uganda has substantial emotional, social and financial impacts on families and is associated with high levels of emotional stress, feelings of isolation and stigma amongst mothers.

• Improved social support and the opportunity to share experiences with other similarly affected mothers are associated with a more positive maternal caring experience. High transport costs, lack of paternal support and poor availability of counselling and support services were barriers to maternal healthcare seeking.

• Studies examining the feasibility, acceptability and impact of early intervention programmes are warranted to maximise participation and improve the quality of life for affected mothers and their infants.

     

Pressure mapping to assess seated pressure distributions and the potential risk for skin ulceration in a population of sledge hockey players and control subjects

Abstract

Purpose: Ice sledge (or sled) hockey is a fast-paced sport that enables individuals with physical disabilities to play ice hockey. As the attraction to the sport continues to rise, the need for developing better equipment and installing preventative measures for injury will become increasingly important. One such injury includes skin pressure ulceration. Method: A total of 26 subjects including active controls and those with spinal cord injury, multiple sclerosis, limb amputation and traumatic brain injury were studied using a pressure mapping device at the 2012 National Disabled Veterans Winter Sports Clinic to determine the risk for skin pressure ulceration and the impact of cushioning and knee angle positioning on seated pressure distributions. Results: Sledge hockey athletes may be at increased risk for skin pressure ulceration based on seated pressure distribution data. This experiment failed to demonstrate a benefit for specialty cushioning in either group. Interestingly, knee angle positioning, particularly, knee extension significantly lowered the average seated pressures. Conclusions: When considering the risk for skin pressure ulceration, knee angle positioning is of particular clinical importance. More research is warranted, specifically targeting novel cushion and sledge designs and larger groups of individuals with sensory loss and severe spinal deformities.

• Implications for Rehabilitation

• Ice sledge (or sled) hockey is a fast-paced and growing adaptive sport played at the Paralympic level.

• Rehabilitation professionals should consider the potential for skin ulceration in this population of athletes.

• The effects of cushioning used in the sledge design warrants further investigation.

• Knee angle positioning; particularly, knee extension significantly lowers seated pressures and may reduce the potential for skin ulceration.

     

Explicit motor sequence learning with the paretic arm after stroke

Purpose: Motor sequence learning is important for stroke recovery, but experimental tasks require dexterous movements, which are impossible for people with upper limb impairment. This makes it difficult to draw conclusions about the impact of stroke on learning motor sequences. We aimed to test a paradigm requiring gross arm movements to determine whether stroke survivors with upper limb impairment were capable of learning a movement sequence as effectively as age-matched controls.

Materials and methods: In this case-control study, 12 stroke survivors (10–138 months post-stroke, mean age 64 years) attempted the task once using their affected arm. Ten healthy controls (mean 66 years) used their non-dominant arm. A sequence of 10 movements was repeated 25 times. The variables were: time from target illumination until the cursor left the central square (onset time; OT), accuracy (path length), and movement speed.

Results: OT reduced with training (p?p?>?0.1). We quantified learning as the OT difference between the end of training and a random sequence; this was smaller for stroke survivors than controls (p?=?0.015).

Conclusions: Stroke survivors can learn a movement sequence with their paretic arm, but demonstrate impairments in sequence specific learning.

• Implications for Rehabilitation

• Motor sequence learning is important for recovery of movement after stroke.

• Stroke survivors were found to be capable of learning a movement sequence with their paretic arm, supporting the concept of repetitive task training for recovery of movement.

• Stroke survivors showed impaired sequence specific learning in comparison with age-matched controls, indicating that they may need more repetitions of a sequence in order to re-learn movements.

• Further research is required into the effect of lesion location, time since stroke, hand dominance and gender on learning of motor sequences after stroke.

     

Implementation and evaluation of a rehabilitation concept in a patient suffering from Scleredema Adultorum Buschke: a case report

Abstract

Purpose: Scleredema Adultorum Buschke is a disorder manifesting indurations of the skin mostly followed by musculoskeletal impairment. Data regarding this fact are seldom found and documentation of functional outcome of physical therapies and modalities related to Scleredema Adultorum Buschke is fragmentary. The aim of this case report is to demonstrate and to document an effective concept of rehabilitation in a patient suffering from Scleredema Adultorum Buschke.

Methods: A treatment plan was developed containing therapeutic ultrasound, manual lymphatic drainage, and physiotherapy. Assessments were performed at baseline and after therapy.

Results: Treatment by physical therapies of presented patient resulted in an improved functionality. Five out of eight Short Form-36 questionaire sections increased in terms of enhanced general health and level of activity.

Conclusions: Musculoskeletal impairment in a patient suffering from Scleredema Adultorum Buschke can be reduced by a multimodal concept of rehabilitation.

• Implications for Rehabilitation

• Rehabilitation professional should suspect scleredema in patients with diffuse skin thickening where hands and feet are spared

• Essential reactivating physical activity should be supported by skin softening physical modalities irrespective of etiology or primary therapy.

• There is a need for functional outcome measures and documentation in the rehabilitation of Scleredema Adultorum Buschke.

     

Emotional well-being and adjustment to vision loss in later life: a meta-synthesis of qualitative studies

Purpose: To review perceived emotional well-being in older people with visual impairment and perceived factors that inhibit/facilitate psychosocial adjustment to vision loss. Method: The databases of MEDLINE, EMBASE, PsycINFO and CINAHL were searched for studies published from January 1980 to December 2010, which recruited older people with irreversible vision loss, and used qualitative methods for both data collection and analysis. Results sections of the papers were synthesised using a thematic-style analysis to identify the emergent and dominant themes. Results: Seventeen qualitative papers were included in the review, and five main themes emerged from the synthesis: 1) the trauma of an ophthalmic diagnosis, 2) impact of vision loss on daily life, 3) negative impact of visual impairment on psychosocial well-being, 4) factors that inhibit social well-being, and 5) factors that facilitate psychological well-being. We found the response shift model useful for explaining our synthesis. Conclusions: Acquired visual impairment can have a significant impact on older people’s well-being and make psychosocial adjustment to the condition a major challenge. Acceptance of the condition and a positive attitude facilitate successful psychosocial adjustment to vision loss as well as social support from family, friends and peers who have successfully adjusted to the condition.

Implications for Rehabilitation

• Visual impairment can have a profound negative impact on individuals’ psychosocial well-being.

• The emotional needs of those with visual impairment should not to be neglected, particularly those recently diagnosed.

• Referrals to services may be appropriate for individuals with vision loss (e.g. counselling and peer support groups).

• It may also be appropriate to discuss with individuals the factors that inhibit/facilitate psychosocial adjustment to vision loss.

     

Applying the World Report on Disability to children’s communication

Abstract

Purpose: The World Report on Disability is an important milestone in the recognition of people with disabilities; however, the Report acknowledges that people with communication difficulties may be underrepresented in estimates of disability. Consequently, this article applies the nine recommendations from the World Report on Disability to supporting children’s communication skills. Method: Australia is similar to most Minority World countries since it places high regard on articulate and literate communication. Recent large-scale Australian studies of children with speech, language and communication needs were reviewed to determine prevalence, impact and associated environmental and personal factors. Studies of met and unmet need were reviewed and discussed in relation to legislation and policies. Results: Recent years have seen improvements in the collection of and access to disability data about children’s communication, including the involvement of children in research about the impact of communication difficulties on their lives. The prevalence of speech and language impairment in children is high and is associated with poorer educational and social outcomes at school-age. Significant unmet need for services was noted, and there were differences in health, education and disability policies regarding access to services. Conclusions: Updated legislation, policies and practices are needed to more effectively support access to services to support children’s communication across health, education and disability sectors.

• Implications for Rehabilitation

• There is a high prevalence of speech and language impairment in Australian children.

• Childhood speech and language impairment (and associated communication disability) can impact educational, social, behavioural and occupational outcomes throughout life.

• Many Australian children do not have sufficient access to targeted services (including speech-language pathology) to ameliorate the impact of their communication disability.

• Formulation of a national strategy to support children children’s communication is required.

     

Developing self-sustainable hearing centers in the developing world – case study of EARs Inc project in Dominican Republic

Abstract

Purpose: This paper presents the case study of the project EARS Ind developed in the Dominican Republic (DR) with the purpose of increasing access and affordability of hearing aid technology for the hearing impaired. This case study demonstrates how a program can fit hearing aids to patients with hearing impairments can be developed in low and middle income countries. Methods: The project planning documents and project statistics and reports were reviewed. A questionnaire and follow-up interviews were used to gain a clear understanding of the situation in the EARS Inc. DR hearing aid project. Results: The case study is presented of the development and services in the DR with a particular focus on the choices made in regard to hearing aid services including manufacturer choices, procurement, distribution, pricing and service delivery. The development of these services included the simultaneous development of a training program, ear mould laboratory, hearing aid repair services, also sales of batteries and accessories as well as the development of calibration services. Conclusions: The development of comprehensive diagnostic and rehabilitation services requires equipping and training local staff.

• Implications for Rehabilitation

• A good hearing aid fitting is more than technology – patient education and the clinician fitting the hearing aid are important.

• Access to follow-up services including battery supplies, hearing aid adjustments and hearing aid repairs is essential to any hearing aid fitting program in low and middle income countries.

• Check the WHO guidelines for hearing aid provision in developing countries when planning a program.

• When working in a country co-ordinate with local professional involved in hearing health where available.

     

Service,training and outreach – the EARS Inc. Model for a self sustainable hearing program in action

Abstract

Purpose: EARS Inc. is a faith based not-for-profit organization established in 1998. As an organization, it has consistently maintained a goal to provide both short-term and long-term projects in low and middle income countries. One specific project undertaken by EARS Inc involved developing a hearing health program in the Dominican Republic. Methods: This article is a review of the challenges and successes encountered on the road to establishing improved access and affordability of hearing aid technology for the hearing impaired in Domincan Republic. Results: Despite the challenges, after 12 years of local programming, the hearing health services in the Dominican Republic were successfully implemented. The development of these services included the simultaneous development of a training program, earmould laboratory, hearing aid repair services as well as calibration services and sales of batteries and accessories. Conclusions: As demonstrated in this review, it is possible to develop sustainable and comprehensive diagnostic and rehabilitation hearing services in a developing country. It is clear that training, equipping and empowering local staffs are instrumental to the success of the program.

• Implications for Rehabilitation

• A good hearing aid fitting is more than supplying technology. Patient education and the clinician fitting the hearing aid are important.

• Access to follow-up services including battery supplies, hearing aid adjustments and hearing aid repairs is essential for a hearing aid fitting program in low and middle income countries to be sustainable.

• Check the WHO guidelines for hearing aid provision in developing countries when planning a program.

• When working in a country, co-ordinate with local professionals involved in hearing health where available.

     

Fundamental movement skills proficiency in children with developmental coordination disorder: does physical self-concept matter?

Purpose: The purpose of this study was to (1) examine differences in fundamental movement skills (FMS) proficiency, physical self-concept, and physical activity in children with and without developmental coordination disorder (DCD), and (2) determine the association of FMS proficiency with physical self-concept while considering key confounding factors. Method: Participants included 43 children with DCD and 87 age-matched typically developing (TD) children. FMS proficiency was assessed using the Test of Gross Motor Development – second edition. Physical self-concept and physical activity were assessed using self-report questionnaires. A two-way (group by gender) ANCOVA was used to determine whether between-group differences existed in FMS proficiency, physical self-concept, and physical activity after controlling for age and BMI. Partial correlations and hierarchical multiple regression models were used to examine the relationship between FMS proficiency and physical self-concept. Results: Compared with their TD peers, children with DCD displayed less proficiency in various components of FMS and viewed themselves as being less competent in physical coordination, sporting ability, and physical health. Physical coordination was a significant predictor of ability in object control skills. DCD status and gender were significant predictors of FMS proficiency. Conclusions: Future FMS interventions should target children with DCD and girls, and should emphasize improving object control skills proficiency and physical coordination.

• Implications for Rehabilitation

• Children with DCD tend to have not only lower FMS proficiency than age-matched typically developing children but also lower physical self-concept.

• Self-perceptions of physical coordination by children with DCD are likely to be valuable contributors to development of object control skills. This may then help to develop their confidence in performing motor skills.

• Children with DCD need supportive programs that facilitate the development of object control skills. Efficacy of training programs may be improved if children experience a greater sense of control and success when performing object control skills.

     

Six-minute walking test in children

• Implications for Rehabilitation

• Six-minute walking test.

• The six-minute walking test is safe and widely performed in the world because of its easy implementation and low cost.

• Many countries have established normal values to the six-minute walking test in healthy children.

• However, the applicability of this test also gains popularity among children with other disease conditions.

     

Objectively measured physical activity in Brazilians with visual impairment: description and associated factors

Background: Low level of physical activity is a serious health issue in individuals with visual impairment. Few studies have objectively measured physical activity in this population group, particularly outside high-income countries. The aim of this study was to describe physical activity measured by accelerometry and its associated factors in Brazilian adults with visual impairment.

Methods: In a cross-sectional design, 90 adults (18–95 years old) answered a questionnaire and wore an accelerometer for at least 3 days (including one weekend day) to measure physical activity (min/day).

Results: Sixty percent of the individuals practiced at least 30?min/day of moderate-to-vigorous physical activity. Individuals who were blind were less active, spent more time in sedentary activities and spent less time in moderate and vigorous activities than those with low vision. Individuals who walked mainly without any assistance were more active, spent less time in sedentary activities and spent more time in light and moderate activities than those who walked with a long cane or sighted guide.

Conclusion: Our data highlight factors associated with lower levels of physical activity in people with visual impairment. These factors, such as being blind and walking without assistance should be tackled in interventions to increase physical activity levels among visual impairment individuals.

• Implications for Rehabilitation

• Physical inactivity worldwide is a serious health issue in people with visual impairments and specialized institutions and public policies must work to increase physical activity level of this population.

• Those with lower visual acuity and walking with any aid are at a higher risk of having low levels of physical activity.

• The association between visual response profile, living for less than 11 years with visual impairment and PA levels deserves further investigations

• Findings of the present study provide reliable data to support rehabilitation programs, observing the need of taking special attention to the subgroups that are even more likely to be inactive.