Crash protection systems for handicapped school bus occupants. Volume III: appendices. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

The development of an independent locking securement system for mobility aids on public transportation vehicles. Final report.

Federal Transit Administration, Washington, D.C.

Application of the quality functional deployment method in mobility aid securement system design. Final report.

Federal Transit Administration, Washington, D.C.

Sleep-related breathing disorder in Duchenne muscular dystrophy: Disease spectrum in the paediatric population

Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease with death usually occurring because of respiratory failure. Signs of early respiratory insufficiency are usually first detectable in sleep. Objective: To study the presentation of sleep-related breathing disorder (SRBD) in patients with DMD. Method:> A retrospective review of patients with DMD attending a tertiary paediatric sleep disorder clinic over a 5-year period. Symptoms, lung function and polysomnographic indices were reviewed. Results: A total of 34 patients with DMD were referred for respiratory assessment (1-15 years). Twenty-two (64%) reported sleep-related symptomatology. Forced vital capacity (FVC) was between 12 and 107% predicted (n = 29). Thirty-two progressed to have polysomnography of which 15 were normal studies (median age: 10 years) and 10 (31%) were diagnostic of obstructive sleep apnoea (OSA) (median age: 8 years). A total of 11 patients (32%) showed hypoventilation (median age: 13 years) during the 5-year period and non-invasive ventilation (NIV) was offered to them. The median FVC of this group was 27% predicted. There was a significant improvement in the apnoea/hypopnoea index (AHI) (mean difference = 11.31, 95% CI = 5.91-16.70, P = 0.001) following the institution of NIV. Conclusions: The prevalence of SRBD in DMD is significant. There is a bimodal presentation of SRBD, with OSA found in the first decade and hypoventilation more commonly seen at the beginning of the second decade. Polysomnography is recommended in children with symptoms of OSA, or at the stage of becoming wheelchair-bound. In patients with the early stages of respiratory failure, assessment with polysomnography-identified sleep hypoventilation and assisted in initiating NIV.

Is There Hospitality for Disabled Travelers?

There is a plethora of options about what constitutes “accessibility.” Countries like England and Canada are making significant progress in improving accommodations. The Americans with Disability Act is being revised, but critics say hotels are not complying with either the letter or the spirit of the law. The author, a retired FIU professors who writes about disabled travel from his wheelchair, explores these issues from a very personal point of view.

Morbidity and mortality following pelvic rami fractures in an elderly Newfoundland population

Introduction: Pelvic rami fractures in the elderly are associated with significant morbidity and mortality. Despite our rapidly aging population there is a paucity of literature dealing with fractures of the pelvic rami in this age group. The purpose of this study is report mortality rates following these injuries in the Eastern region of Newfoundland. Additionally, we aim to describe and quantify the important resultant morbidity in this vulnerable elderly population . Methods: A retrospective chart review was performed of all the pelvic fractures in individuals over the age of 60 between 2000 and 2005 in the Eastern Health region of Newfoundland and Labrador. From these patients, only those with the radiographic parameters consistent with low energy pattern pelvic ring injuries were included. Excluded from the study were those with concurrent fractures of the femur. Survival data, comorbidities, injury characteristics, hospital stay, ambulatory status, and place of residence were recorded from the chart. A surrogate control group was formulated from Statistics Canada survival data for use as a survival comparison group. Results: There were 80 fractures of the pelvis identified in patients over 60 years old from 2000-2005. Of these, 43 met our inclusion/exclusion criteria and were used in our analysis. The one and five year mortalities of these patients were 16.3% (95% CI; 7.80% to 30.3%) and 58.1% (95% CI; 43.3% to 71.6%), respectively. These were both significantly different from the point estimates from our constructed age and gender matched control group from the Statistics Canada data of 6.58% (one year mortality) and 31.3% (five year mortality). Morbidity was quantified by change in ambulatory status (independent, walker/cane assisted, wheelchair) and change in residential independence (independent, assisted living, nursing home). Post fracture, 36% of patients permanently required increased ambulatory aids and 21% of patients required a permanent increase in everyday level of care. Conclusion: This study suggests that there may be significantly increased mortality and morbidity following low energy pattern pelvic rami fractures in an elderly population compared to age and gender matched controls. In contrast to previous studies describing these injuries, there is greater homogeneity in this population with respect to age and mechanism of injury. This study generates several important hypotheses for future research and in particular highlights the need for larger prospective studies to identify factors predicting the highest risk for poor outcomes in this population.

Acessibilidade no ambiente escolar: reflexões com base no estudo de duas escolas municipais de Natal-RN

This work was originated through the results of the analysis of the services for the needs of people with disabilities that were permitted by the physical space of two schools of the municipality of Natal/RN. The general objective/goal was to subsidize the elaboration of alternatives for the planning of environments that could be used by any person. The study used the empirical research through the adoption of a multimethod approach including: (i) technical visits oriented by the NBR 9050, (ii) contact with users that have reduced mobility (visually impaired and wheelchair or crutch users) through escorted travels and interviews, and (iii) interview with school managers. The evidence from the research, even though with significant development of laws that guarantee people with disabilities their right to citizenship, the physical environment of our schools still present with many obstacles that prevent the mobility of people with disabilities which proves their lack of readiness to accommodate them. Therefore, the actions taken to address the accessibility has been the adoption of temporary solutions that makes the adaptation more difficult, adds obstacles and reinforces the undesirable segregation, however still very present in our society. Finally, there is the indication that in order to achieve the spatial configuration that promotes social contact and integration in between the persons with different physical status, it is necessary to completely comprehend the activities developed in each space, from the conception of the equipment to the individual learning needs, having in mind creating environments that stimulates the execution of the tasks in an independent manner without the assistance of others. The inclusion regarding attention to accessibility in the decision making process, directed to the arquitectural and urban project, would decrease the constant need to redevelop and adapt spaces, and should be definitely incorporated as an important component in the production of space

Physiotherapy in Malawi – a step in the right direction

Physiotherapists in Malawi are in short supply and the demand for this service is increasing. This profession is instrumental in the rehabilitation of patients following accident and disease. Early input from a physiotherapist can be life changing; for example, timely physiotherapy could prevent a patient from becoming wheelchair-bound for life. This article explores the role of physiotherapists, in the context of what they do, the medical conditions that benefit from physiotherapy and the services available in Malawi. The clinical focus will be on orthopaedic, musculoskeletal and neurological conditions, since those are the specialties of the authors. With the start of the physiotherapy degree programme at the College of Medicine, University of Malawi, huge steps have been taken to address this neglected profession.

Acessibilidade no ambiente escolar: reflexões com base no estudo de duas escolas municipais de Natal-RN

This work was originated through the results of the analysis of the services for the needs of people with disabilities that were permitted by the physical space of two schools of the municipality of Natal/RN. The general objective/goal was to subsidize the elaboration of alternatives for the planning of environments that could be used by any person. The study used the empirical research through the adoption of a multimethod approach including: (i) technical visits oriented by the NBR 9050, (ii) contact with users that have reduced mobility (visually impaired and wheelchair or crutch users) through escorted travels and interviews, and (iii) interview with school managers. The evidence from the research, even though with significant development of laws that guarantee people with disabilities their right to citizenship, the physical environment of our schools still present with many obstacles that prevent the mobility of people with disabilities which proves their lack of readiness to accommodate them. Therefore, the actions taken to address the accessibility has been the adoption of temporary solutions that makes the adaptation more difficult, adds obstacles and reinforces the undesirable segregation, however still very present in our society. Finally, there is the indication that in order to achieve the spatial configuration that promotes social contact and integration in between the persons with different physical status, it is necessary to completely comprehend the activities developed in each space, from the conception of the equipment to the individual learning needs, having in mind creating environments that stimulates the execution of the tasks in an independent manner without the assistance of others. The inclusion regarding attention to accessibility in the decision making process, directed to the arquitectural and urban project, would decrease the constant need to redevelop and adapt spaces, and should be definitely incorporated as an important component in the production of space

A funcionalidade e o controlo do tronco em atletas de basquetebol em cadeira de rodas e a sua relação com o desempenho motor

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia

Propiedades psicométricas de los instrumentos para la medición de la actividad física en adultos con discapacidad física relacionada con lesión de médula espinal: una revisión sistemática

Objetivo: Evaluar las propiedades psicométricas de los instrumentos para la medición de la actividad física en adultos de 18-65 años con discapacidad física por lesión de médula espinal. Materiales y métodos: Revisión sistemática. Las bases de datos de Medline, Scopus, Web of Science y 19 revistas especializadas fueron consultadas durante once días entre abril de 2015 y febrero de 2016 para identificar estudios originales de validación, sin límite de tiempo y que estuvieran publicados en español, francés y/o inglés. La calidad metodológica de los instrumentos de medición se evaluó usando las diferentes cajas de propiedades de la lista COSMIN. Resultados: Se identificaron 9229 referencias, de las cuales sólo 12 cumplieron los criterios de inclusión, dando como resultado 13 instrumentos de medición. Se evaluaron seis propiedades psicométricas. La propiedad más común fue la confiabilidad, además se observó que la calidad metodológica de los estudios incluidos no representa los resultados de las propiedades psicométricas de los instrumentos de medición. La calidad metodológica de los instrumentos para la evaluación de la actividad física en población con lesión medular espinal es “baja” para propiedades como consistencia interna, error de medición, sensibilidad, validez de criterio (con excepción del WISCI II que tiene buena validez) y excelente para validez de contenido y fiabilidad. Conclusión: Se ha encontrado que instrumentos empleados hasta el presente en la medición de la actividad física en población con discapacidad física relacionada con lesión de médula espinal han sido creados para otros tipos de discapacidad y otros instrumentos deben ser validados en futuros estudios.