This study delves into the causes and trends of disability-related health burdens across Indian states. Through multiple Disability-Adjusted Life Years (DALY) types (covering communicable diseases, noncommunicable diseases, and injuries), gender disparities, and Human Development Index (HDI) values, these disability trends were evaluated. The data for this study was compiled from censuses, health research organisations, and data centres, among various other sources. We built regression models and used them to analyze trends across past decades and make projections for 2031. Our regression results show a strong inverse relationship between communicable disease DALYs and HDI. In other words, ongoing improvements in development and infrastructure significantly reduced communicable disease DALYs. In contrast, noncommunicable DALYs did not decrease despite rising HDI. And lastly, injury DALYs showed moderate declines with higher HDI, which reflects improvements in healthcare and safety systems. Gender analysis showed male overrepresentation among people with disabilities. These results from our study support that there is a need to shift public health focus toward chronic diseases and address gender disparities in disability outcomes.
Abstract:
Background: Cerebral palsy (CP) is a neurological disorder that impacts movement, posture, and muscle tone due to brain damage in fetal development, infancy, or early childhood.
Objective: To compare anxiety and depression among primary caregivers of male versus female children with cerebral palsy.
Methodology: This cross-sectional comparative study was carried out between February 2020 and March 2021 with the caregivers of CP-inflicted children admitted at a rehabilitation center in Karachi, Pakistan. Among 46 approached caregivers, only 30 (75%) voluntarily participated in the study. Group 1 encompassed caregivers of male CP-inflicted patients (n=19) and group 2 encompassed caregivers of female CP-inflicted patients (n=11). Data on physical characteristics and additional impairments accompanying CP was gathered whereas face-to-face meetings were arranged with primary caregivers to gather data for sociodemographic questionnaire and Hospital anxiety depression scale (HADS).
Results: No significant differences were observed in the two groups concerning the physical characteristics of CP cases and sociodemographic characteristics of caregivers. Compared to the caregivers of female CP children, caregivers of male CP children had significantly higher anxiety (7.09±1.64; 8.42±1.6, p=0.044), depression (5.90±1.8; 8.10±1.88, p=0.004) and total HADS scores (6.50±1.79; 8.26±1.75, p=0.006).
Conclusion: Caregivers of male CP children were more prone to anxiety and depression problems. There was no significant correlation found between the sociodemographic profile of the caregivers and the characteristics of CP with the gender of CP children.
Keywords: Anxiety; Caregivers; Cerebral Palsy; Children; Depression; Pakistan
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
Saad Tariq, Mamoona Tasleem Afzal, Anam Javed
et al.
Background: Neck pain is a disorder that has lifetime and point prevalence almost as high as low back pain. It also leads to substantial disability and economic burden on society. Physical therapists use several interventions with this population such as ischemic compression which is a standard treatment used for the treatment of trigger point release in routine physical therapy practice. Dry needling is comparatively a newer treatment intervention in practice now for the relieve of pain causing trigger points not specifically in case of neck pain but in other condition such as Fibromyalgia, Myofascial Pain Syndrome as well.
Objective: To determine the effectiveness of Trigger point Dry Needling compared with ischemic compression release in the patients having neck pain due to myofascial trigger points and to create awareness about better treatment intervention for trigger point release among medical community.
Methodology: A Randomized Clinical Trail of 16 weeks duration is conducted in Physical Therapy Department of Holy Family Hospital Rawalpindi comprised of patients with neck pain associated with trigger points. A sample of 30 patients was taken fulfilling the inclusion & exclusion criteria. Initially the patients were recruited using non-probability convenient sampling, later the allocation between the groups was done randomly using sealed envelope method. Participants were randomly divided in dry needling group (N = 15) and trigger point compression release group (N = 15). The data was collected at 1st week and final (4th) week. Improvement was assessed through Visual Analog Scale(VAS) and Northwick Park Neck Pain Questionnaire(NPQ).
Results: Findings from independent t- test used for comparison between the two groups showed significant p-value at the final week which is less than 0.05 for both VAS and NPQ (P=0.038; 0.018 respectively). Within the group comparison using repeated measure ANOVA showed significant improvement in the experimental group for both the variables after week 2, with the significant value of wilk’s lambda ^ (^=0.001) which is less than 0.05.
Conclusion: Dry needling is more effective than ischemic compression for the trigger point release.
Key Words: Dry needling, Ischemic compression, Neck pain
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
Seyed Saeed Ahmadi, Mohyeddin Teimourisangani, Mahshid Hozhabr
et al.
Objectives: Aphasia, an acquired multimodal language disorder caused by brain damage, impacts various linguistic and cognitive skills. Naming is a key aspect of language processing. This skill relies heavily on cognitive functions, such as reaction time, working memory, and executive functions, which together support effective communication. Understanding the relationships between these components can provide critical insights for improving rehabilitation strategies.
Methods: This study included 20 individuals diagnosed with Broca’s aphasia and 20 neurologically healthy controls. The participants were assessed using tasks measuring rapid automatized naming (RAN), reaction time, working memory, and executive function.
Results: People with aphasia (PWA) demonstrated significantly lower performance in all assessed domains compared to controls (P<0.001). RAN scores were markedly lower, with performance improving in high-context environments (P<0.001). Reaction times were significantly delayed in linguistic and non-linguistic tasks (P<0.001). Correlation analysis revealed positive relationships between RAN, working memory, and executive functions (P<0.001). However, RAN showed no direct correlation with reaction time (P>0.05).
Discussion: The findings indicate a relationship between cognitive and linguistic processes in aphasia, with working memory and executive function significantly related to language performance. Contextual visual cues are also associated with improvements in naming accuracy and speed. These results highlight the potential value of integrated cognitive-linguistic rehabilitation approaches for enhancing communication skills and quality of life (QoL) in individuals with aphasia.
Medicine, Vocational rehabilitation. Employment of people with disabilities
Sanam Kainat , Shabana khan , Raifat Mehmood
et al.
Background: Cognitive skills are important in athletics, especially in football, because quick thinking, teamwork and fast reaction times are key. Concussions have different results for female athletes than for males which can result in changes in both cognitive and physical performance. Yet, there is not much information available on cognition and performance link in female football players who have had concussions.
Objective: To determine the association between cognitive function and physical performance in female football players with a history of concussion.
Methodology: This cross-sectional study included n=84 female football players aged 14–25 years. Verbal Cognition Test (VCT) for executive function, Delayed Word Recall (DWR) for working memory, Digit Backward (DB) for memory and Attention and Month in Reverse Order (MRO) for executive function were used to test cognitive function. Physical performance assessments included the Vertical Jump, Run Three, 505 Agility and 3-HOP Tests (both right and left legs). The study used a multiple regression analysis while controlling for age, BMI, amount and timing of play, number of headings during games, collisions and temporary loss of consciousness.
Result: The results show that having lesser VCT and MRO leads to poorer results in the 3-HOP Right Leg test (p<0.05). Practicing high-heading skills allowed athletes to complete Run Three faster (p=0.043). Nearly significant findings indicated that concussion history did play a moderating role in the results (p=0.079). For Vertical Jump, 505 Agility and 3-HOP Left Leg tests, no significant relationships were discovered.
Conclusion: The performance of female football players in lower-body power and agility is affected by cognitive functions, especially by verbal skills and reaction time.
Vocational rehabilitation. Employment of people with disabilities
Objectives: Gestural usage is one of the earliest signs of intentional communication abilities. In children with down syndrome (DS), one of the most severely compromised areas of functioning is language. In the linguistic profile of children with DS, gesture use and receptive vocabulary are relative strengths. The present study examines the relative use of types of gestures and words in children with DS. Also, this study compares that with a group of expressive language, ability-matched typically developing (TD) children. Additionally, the present research verifies the relationship between total gestures and word production by children with DS and expressive language ability-matched TD children.
Methods: In this prospective study, 30 Tamil-speaking children (15 children in the DS group and 15 children in the TD group) and their parents participated. The parents were asked to play with their children normally, as they do at home, using the set of toys given, and this session was recorded in video. Deictic gestures and words, as well as representational gestures and words, were analyzed with a specific coding scheme.
Results: The DS group used more deictic gestures (Mean±SD, 35±14.10) compared to deictic words (Mean±SD, 2.73±1.79), with a significant difference (P<0.05, Z=-3.40, P=0.00064). Also, children with DS used more representational words (Mean±SD, 46.13±22.63) than representational gestures (Mean±SD, 12.53±8.20), with a significant difference (Z=-3.29, P=0.001). Meanwhile, this was found to be a moderately positive correlation between overall gesture and word production in the DS group (rs=0.574, P=0.02) and TD group (rs=0.558, P=0.03). This study revealed no significant difference between children in the DS and TD groups regarding the use of deictic gestures and words. Additionally, there was a significant difference in the use of representative gestures (P=0.0018) and words (P=0.02) between DS and TD groups. Children in the DS group used more representational gestures compared to children in the TD group.
Discussion: Children in the DS group exhibited an association between gesture and word production during parent-child interaction, which is similar to children in the TD group. This relationship persists despite specific issues with DS children’s expressive language traits. Children in the DS group used more representational gestures compared to children in the TD group to compensate for their deficits in speech and language skills.
Medicine, Vocational rehabilitation. Employment of people with disabilities
Florence Naab, Mary A. Asirifi, Charles Ampong Adjei
et al.
About 8% of Ghanaians, including adolescents, have various types of disabilities. Although many legal and constitutional protections for people with disabilities, including adolescents, exist in Ghana, it is widely known that these persons face a variety of psychosocial issues. Several factors have been identified as contributing to the unremitting marginalisation of people with disabilities in general, but the extent to which these can be generalised to adolescents with disabilities is unknown. This study, therefore, sought to document the determinants, manifestations, and consequences of disability-related stigma among differently abled adolescents in three special schools in northern, middle, and southern Ghana. An exploratory descriptive qualitative design was used. Overall, 54 participants were purposively selected for a semi-structured interview and focus group discussions. Braun and Clarke’s procedure for thematic analysis was followed. The findings showed a variety of stigmatising experiences by adolescents with disabilities in their sociocultural context. More broadly, the cause of disability was linked to the ramifications of parental sins against the gods, being a descendant of river gods, and the consequences of bewitchment/curses by family members. Others included the perceived transmissibility of the disability and disability as a visible condition. Stigma manifested in the form of pejorative labelling, ableism, and social exclusion. The consequences of this stigma included negative psychological and emotional effects (i.e., depression, low self-esteem, and a lack of confidence) and suicidal ideation. There is an urgent need for stigma reduction interventions for adolescents with disabilities in Ghana as part of an effort to improve their wellbeing.
Vocational rehabilitation. Employment of people with disabilities
The diffusion of artificial intelligence, particularly generative models, is expected to transform labor markets in uneven ways across sectors, territories, and social groups. This paper proposes a methodological framework to estimate the potential exposure of employment to AI using sector based data, addressing the limitations of occupation centered approaches in the Spanish context. By constructing an AI CNAE incidence matrix and applying it to provincial employment data for the period 2021 to 2023, we provide a territorial and gender disaggregated assessment of AI exposure across Spain. The results reveal stable structural patterns, with higher exposure in metropolitan and service oriented regions and a consistent gender gap, as female employment exhibits higher exposure in all territories. Rather than predicting job displacement, the framework offers a structural perspective on where AI is most likely to reshape work and skill demands, supporting evidence based policy and strategic planning.
Monika Blue Kwapisz, Yoav Ackerman, Jennifer Nguyen
et al.
Online proctoring systems (OPS) are technologies and services that are used to monitor students during an online exam to deter cheating. However, OPS often violates student privacy by implementing overly intrusive surveillance to which students cannot consent meaningfully. The technologies used in OPS have been shown to unfairly flag students with disabilities. Our reflexive thematic analysis of interviews with students who have first-hand experience with online invigilated exams and who have disability accommodations points to their anxiety about the interaction between surveillance and their disabilities, leading to fears about misrepresentation and increased cognitive load on the exam. Students describe the compromises they need to make with their privacy and accommodations to take remote tests and share their privacy values. We present the implications for the design of OPS to mitigate the issues faced by disabled students.
Accessible parking is critical for people with disabilities (PwDs), allowing equitable access to destinations, independent mobility, and community participation. Despite mandates, there has been no large-scale investigation of the quality or allocation of disability parking in the US nor significant research on PwD perspectives and uses of disability parking. In this paper, we first present a semi-structured interview study with 11 PwDs to advance understanding of disability parking uses, concerns, and relevant technology tools. We find that PwDs often adapt to disability parking challenges according to their personal mobility needs and value reliable, real-time accessibility information. Informed by these findings, we then introduce a new deep learning pipeline, called AccessParkCV, and parking dataset for automatically detecting disability parking and inferring quality characteristics (e.g., width) from orthorectified aerial imagery. We achieve a micro-F1=0.89 and demonstrate how our pipeline can support new urban analytics and end-user tools. Together, we contribute new qualitative understandings of disability parking, a novel detection pipeline and open dataset, and design guidelines for future tools.
Background: Spinal cord injury (SCI) rehabilitation remains a major clinical challenge, with limited treatment options for functional recovery. Temporal interference (TI) electrical stimulation has emerged as a promising non-invasive neuromodulation technique capable of delivering deep and targeted stimulation. However, the application of TI stimulation in SCI rehabilitation remains largely unexplored. Methods: This study aims to investigate the feasibility of applying non-invasive TI electrical stimulation for SCI rehabilitation. Through computational modeling, we analyzed the electric field distribution characteristics in the spinal cord under different TI stimulation configurations. Based on these findings, we propose a clinically applicable TI stimulation protocol for SCI rehabilitation. Results: The results demonstrate that TI stimulation can effectively deliver focused electric fields to targeted spinal cord segments while maintaining non-invasiveness. The electric field intensity varied depending on individual anatomical differences, highlighting the need for personalized stimulation parameters. The proposed protocol provides a practical framework for applying TI stimulation in SCI rehabilitation and offers a non-invasive alternative to traditional spinal cord stimulation techniques. Conclusions: This study establishes the feasibility of using non-invasive TI stimulation for SCI rehabilitation. The proposed stimulation protocol enables precise and targeted spinal cord modulation. However, further research is needed to refine personalized stimulation parameters and validate the clinical efficacy of this approach.
Rehabilitation is essential and critical for post-stroke patients, addressing both physical and cognitive aspects. Stroke predominantly affects older adults, with 75% of cases occurring in individuals aged 65 and older, underscoring the urgent need for tailored rehabilitation strategies in aging populations. Despite the critical role therapists play in evaluating rehabilitation progress and ensuring the effectiveness of treatment, current assessment methods can often be subjective, inconsistent, and time-consuming, leading to delays in adjusting therapy protocols. This study aims to address these challenges by providing a solution for consistent and timely analysis. Specifically, we perform temporal segmentation of video recordings to capture detailed activities during stroke patients' rehabilitation. The main application scenario motivating this study is the clinical assessment of daily tabletop object interactions, which are crucial for post-stroke physical rehabilitation. To achieve this, we present a framework that leverages the biomechanics of movement during therapy sessions. Our solution divides the process into two main tasks: 2D keypoint detection to track patients' physical movements, and 1D time-series temporal segmentation to analyze these movements over time. This dual approach enables automated labeling with only a limited set of real-world data, addressing the challenges of variability in patient movements and limited dataset availability. By tackling these issues, our method shows strong potential for practical deployment in physical therapy settings, enhancing the speed and accuracy of rehabilitation assessments.
This study investigates the application of novel model architectures and large-scale foundational models in temporal series analysis of lower limb rehabilitation motion data, aiming to leverage advancements in machine learning and artificial intelligence to empower active rehabilitation guidance strategies for post-stroke patients in limb motor function recovery. Utilizing the SIAT-LLMD dataset of lower limb movement data proposed by the Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, we systematically elucidate the implementation and analytical outcomes of the innovative xLSTM architecture and the foundational model Lag-Llama in short-term temporal prediction tasks involving joint kinematics and dynamics parameters. The research provides novel insights for AI-enabled medical rehabilitation applications, demonstrating the potential of cutting-edge model architectures and large-scale models in rehabilitation medicine temporal prediction. These findings establish theoretical foundations for future applications of personalized rehabilitation regimens, offering significant implications for the development of customized therapeutic interventions in clinical practice.
Employment contracts are used to agree upon the working conditions between employers and employees all over the world. Understanding and reviewing contracts for void or unfair clauses requires extensive knowledge of the legal system and terminology. Recent advances in Natural Language Processing (NLP) hold promise for assisting in these reviews. However, applying NLP techniques on legal text is particularly difficult due to the scarcity of expert-annotated datasets. To address this issue and as a starting point for our effort in assisting lawyers with contract reviews using NLP, we release an anonymized and annotated benchmark dataset for legality and fairness review of German employment contract clauses, alongside with baseline model evaluations.
Solomon Amenyo, Maura R. Grossman, Daniel G. Brown
et al.
This study explores the integration of artificial intelligence (AI) or large language models (LLMs) into pediatric rehabilitation clinical documentation, focusing on the generation of SOAP (Subjective, Objective, Assessment, Plan) notes, which are essential for patient care. Creating complex documentation is time-consuming in pediatric settings. We evaluate the effectiveness of two AI tools; Copilot, a commercial LLM, and KAUWbot, a fine-tuned LLM developed for KidsAbility Centre for Child Development (an Ontario pediatric rehabilitation facility), in simplifying and automating this process. We focus on two key questions: (i) How does the quality of AI-generated SOAP notes based on short clinician summaries compare to human-authored notes, and (ii) To what extent is human editing necessary for improving AI-generated SOAP notes? We found no evidence of prior work assessing the quality of AI-generated clinical notes in pediatric rehabilitation. We used a sample of 432 SOAP notes, evenly divided among human-authored, Copilot-generated, and KAUWbot-generated notes. We employ a blind evaluation by experienced clinicians based on a custom rubric. Statistical analysis is conducted to assess the quality of the notes and the impact of human editing. The results suggest that AI tools such as KAUWbot and Copilot can generate SOAP notes with quality comparable to those authored by humans. We highlight the potential for combining AI with human expertise to enhance clinical documentation and offer insights for the future integration of AI into pediatric rehabilitation practice and other settings for the management of clinical conditions.
Sonia Peterson, Christopher Skerritt, Matthew Sprong
et al.
State Vocational rehabilitation (VR) Rehabilitation Services Administration (RSA) 911 data from fiscal year 2019 were used to evaluate the use of assessment services for eligibility determination and Individualized Plan for Employment (IPE) development for participants with psychiatric disabilities served in State VR agencies. Participants who received the State VR assessment service from a provider outside of the State VR agency were significantly more likely to obtain employment than those who did not receive an assessment service or only received assessment services within the State VR agency, x2 (1, N = 49,527) = 29.98, p < .001. The effect size was small, d = .03. A binary logistic regression analysis was conducted with a smaller sample of cases in which participants were served by State VR agencies who used the Aware case management system for reporting data to RSA. Participants who received the State VR assessment service from an outside provider were significantly more likely to obtain employment compared to those who did not receive this service (OR= 1.55, 95% CI: 1.12, 2.14, p=.01). Rehabilitation professionals who are certified by the Commission on Rehabilitation Counseling Certification (CRCC) and have completed additional training in the Individual Placement and Support (IPS) model are most qualified to provide the State VR assessment service to develop a State VR IPE with this population. State VR administrators should partner with these qualified professionals to help State VR participants with psychiatric disabilities develop an IPE that leads to competitive, integrated employment.
Background People with disabilities are one the most discriminated groups in the United States, and this discrimination negatively impacts the ability to find and maintain employment. While more companies are making it a priority to include people with disabilities in their workforces in order to diversify talent pools, many organizations still lack knowledge regarding the benefits of disability-employment and effective strategies for disability inclusion in the workplace. Objective There is a need to provide an integrative review of the disability inclusion literature for vocational rehabilitation professionals to expand employer engagement efforts by helping companies adopt strategies to hire and support people with disabilities in the workplace. Method A review of disability employment and disability inclusion publications was conducted. Findings from the research were compiled into a discussion of lessons learned for vocational rehabilitation professionals. Results The article shares the lessons learned from conducting disability-employment research with attention to the following domains: (1) stigmatizing attitudes of employers, (2) disability employment legislation, (3) characteristics of companies that promote disability-employment, (4) disability inclusion policies and practices, and (5) implicit bias and disability inclusion training for human resource (HR) professionals. Conclusion Providing employers and HR professionals with trainings on these domains will increase awareness of bias toward people with disabilities in the workplace and develop increasingly effective disability inclusion policies and practices for their organization.
Robert S. Ware, Catherine Franklin, Lyn McPherson
et al.
Health checks have beneficial effects on health outcomes in adults with intellectual disability; however, little is known about their effect on people with Down syndrome. The aim of this study was to assess the effect of receiving a health check on the unmet health needs of people with Down syndrome. A pooled analysis of three randomized trials conducted by the same Australian research team was undertaken. The trials used the same tools but differed by participant source (adults in 24 h supported accommodation, adults in private dwellings, adolescents living with parents). The intervention was a one-off health check, and the comparator was usual care. Among 216 participants, health actions were more likely to occur for those allocated to receive health checks, including increased hearing (odds ratio = 4.4; 95% confidence interval: 1.2, 16.4), vision (2.7; 1.1, 6.7), and thyroid (2.3; 1.3, 4.2) testing, and weight recording (4.7; 2.5, 8.8). Health checks conducted at the primary-care level produced substantially increased attention to the health needs of people with Down syndrome.
Vocational rehabilitation. Employment of people with disabilities