Background: Para-athletes are at heightened risk of sports-related injuries due to sport-specific demands, disability types and environmental exposures. Despite global research, limited data exist on injury profiles in low-resource settings such as South Africa.
Objectives: To profile injuries, determine their prevalence and identify associated risk factors among South African Para-athletes.
Method: A cross-sectional study was conducted among 86 South African Para-athletes (response rate: 74.14%) using a self-developed questionnaire. Data on demographics, disability type, sporting history, injury history and risk factors were analysed using descriptive statistics and logistic regression.
Results: Among 86 Para-athletes (median age 27 years), limb deficiency was the most common impairment (50%) and athletics (44%) the leading sport. Athletes trained 5.3 sessions per week and competed 3.4 days/quarter; adapted environments were significantly more common in men (67% vs. 33%, p = 0.015). Median injuries over 12 months were three, mainly in the lower quadrant (74%, p = 0.617), with strains (34%) and sprains (24%) most frequent. Multivariable analysis showed that swimming (odds ratio [OR] = 0.05, p = 0.010) and strength training (OR = 0.05, p = 0.002) were strong protective factors against injury. In contrast, skipping a warm-up during training significantly increased injury risk (OR = 3.2, 95% confidence interval [CI]: 1.3–7.9, p = 0.011), with athletes who did not warm up being more than three times as likely to sustain an injury compared with those who performed a warm-up.
Conclusion: South African Para-athletes experience a substantial injury burden, highlighting the need for tailored prevention strategies and improved access to rehabilitation and education.
Contribution: This study provides the first comprehensive injury profile of South African Para-athletes, informing inclusive, evidence-based interventions.
Vocational rehabilitation. Employment of people with disabilities, Communities. Classes. Races
Zainab Ali Hussein, Raghad Talib Taha Khazraji, Hind Kadhim Gazi
Objectives: To test the effectiveness of proprioceptive neuromuscular facilitation (PNF) on muscle strength, spasticity, functional mobility, and range of motion (ROM) in hemiplegic patients with foot drop.
Methods: This was a single-arm, pre-post study of 30 adults (21–60 years) with hemiplegic foot drop receiving a 14-week PNF. The interventions included contract-relax stretching, resistance training (D1/D2 diagonal patterns), and functional exercises. The assessed outcomes were muscle strength, spasticity, ankle dorsiflexion ROM, and functional mobility.
Results: Following the intervention, all outcomes significantly improved. Tibialis anterior (TA) strengthened grade 2 to 3 (P<0.001, r=0.62), and 42% achieved grades 4–5. There were large effect sizes for the quadriceps, hamstrings, and calf muscles (r=0.51–0.62). TA spasticity dropped from grade 3 to 2 (P<0.001, r=0.75), and 68% reached grade ≤2. Functional mobility improved by 5.21 cm (P<0.001, r=0.83), and ankle dorsiflexion ROM increased by 8.5° (P<0.001, r=0.52).
Discussion: Diagonal patterns and resistance training decrease the degree of spasticity and increase strength and mobility, making it possible to use this PNF type even in comparison to shorter-term protocols. These findings support the use of PNF to address foot drop in stroke rehabilitation.
Medicine, Vocational rehabilitation. Employment of people with disabilities
BACKGROUND:
Clubfoot relapse is a common occurrence following the Ponseti technique, potentially progressing from flexible to rigid deformity if untreated.
OBJECTIVE:
This study aimed to analyze the patterns of relapse observed in clubfeet treated with the Ponseti method.
METHODOLOGY:
A prospective study involving 250 patients were conducted at the clubfoot department in Peshawar. Patient data, including age, initial Pirani score, number of casts required, gender, and affected foot, were taken from hospital records. Statistical analysis was performed using SPSS version 22, with significance set at a p-value of less than 0.05.
RESULTS:
The study involved 151 cases of bilateral relapse clubfoot and 99 cases of unilateral relapse clubfoot. Patients with bilateral relapse clubfoot had a mean age of 11.20 days, whereas those with unilateral relapse clubfoot had a mean age of 9.60 days. The mean Pirani score for bilateral relapse clubfoot was 5.67, slightly higher than the score of 5.5 for unilateral cases. On average, patients with bilateral relapse clubfoot required 6.4 casts, while those with unilateral relapse clubfoot needed slightly fewer casts, with a mean of 6.3. Analysis of relapse patterns revealed similar trends in both groups, with decreased ankle dorsiflexion (DF) up to neutral, dynamic forefoot adduction/supination, and rigid equinus being the most common patterns observed.
CONCLUSION:
This study identified five distinct subsets for classifying relapsed clubfoot deformities such as decreased ankle dorsi-flexion (DF) (28.1%), Rigid Equinus (16.8%), Dynamic forefoot supination/adduction (34.4%), fixed adduction of midfoot and forefoot (9.98%), and complete relapse pattern (10.9%). Early identification and intervention of relapses are crucial to mitigate the need for major soft tissue surgeries.
KEYWORDS:
Clubfoot, Ponseti Method, Relapse Pattern
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
Depression remains one of the biggest global challenges, requiring an active approach to tackle it across the different healthcare sectors. Given depression’s widespread prevalence and its association with chronic autoimmune conditions, such as diabetes mellitus, it has been predicted to be one of the significant causes of added disability worldwide and in Saudi Arabia (SA). To address this issue efficiently, organized efforts should be taken, which are proposed in this report as a corporate health needs assessment (HNA). In this study, a framework for a five-step HNA to detect depression among disabled adult patients in Madinah, SA, is proposed that can be used by health policymakers. These steps include getting started, identifying health priorities, assessing a health priority for action, planning for change, and moving on/project review. This proposal should provide a practical stepwise guideline to healthcare policymakers when planning healthcare services in Madinah.
Vocational rehabilitation. Employment of people with disabilities
Nazia Jabbar , Muhammad Ali Malik Awan , Samra Khokhar
et al.
Background: Teenage is an important stage for brain development, with significant impacts on education and health. Exploring how high-intensity interval training (HIIT) affects cognitive function in this population is crucial to comprehending how HIIT can improve general well-being and academic performance.
Objective: To determine the effects of high-intensity interval training on cognitive flexibility among female teenagers.
Methodology: A randomized clinical trial was conducted on n=40 female participants between 13-19 years without any serious medical, physical, or psychological illness for 6 months. All participants (n=40) were randomly divided into experimental (HIIT) and control groups equally. The protocols were performed in 4 mins in the first three weeks, 8 mins in the 4th to 6th week, and 12 mins in the 7th and 8th week, with sessions thrice a week. Data on cognitive flexibility was collected at baseline, after 4th week and 8th week from both groups through Digit Span (DST).
Results: With-in-group analysis the experimental group showed significant improvement (p<0.001) at each level of assessment of DST (forward and backward) till the 8th-week session with a large effect size whereas the non-significant improvement (p≥0.05) was observed in the control group. For Group Analysis, significant results (p<0.001) were obtained in the experimental group for DST (forward and backward) after the 4th week and at the end of intervention after the 8th week as compared to the control group.
Conclusion: It is concluded that the high-intensity exercise training program is beneficial for female teenagers to enhance their physical strengthening along with their cognitive abilities.
Clinicaltrials.gov Identifier: NCT05873478
Vocational rehabilitation. Employment of people with disabilities
BACKGROUND: There is clear federal priority to develop effective strategies to mitigate the continued disparity in employment opportunities and outcomes for people with significant disabilities. At the same time, there are calls for rehabilitation practitioners to understand, utilize, and implement evidence-based practices (EBP) with fidelity to improve rehabilitation outcomes, such as competitive integrated employment. Customized employment (CE) emerged as a promising practice that promotes improved employment outcomes. OBJECTIVE: The purpose of this manuscript is to describe published literature on CE and to make recommendations on the best methods for establishing CE as an evidence-based practice. METHOD: We included 10 articles classified as “data-based” articles from a review of the literature on CE conducted by Riesen et al. We also conducted an electronic search of articles on CE published between 2015 and 2021. RESULTS: This review indicates that CE research is predominantly descriptive. Based on the results of the review, we categorized CE research into three types: model description and project evaluation, perceptions of CE, and essential structure and competency. The descriptive studies suggest that CE produces quality employment outcomes for people with disabilities. CONCLUSION: While research on CE has expanded, future research on CE should use more robust indicators including (a) quality descriptions of the participants, (b) quality descriptions of settings and conditions, (c) descriptions of the independent variables, (d) descriptions of fidelity to procedures, and (e) quality descriptions of social validity measures. Researchers should also focus on using correlational research to establish customized employment as an evidence-based practice.
Introduction Having a personality disorder negatively impacts work functioning [1]. It is associated with a low education level, work conflicts, dismissals, demotions, unemployment [2], disability [3] and early retirement [4]. The Organisation for Economic Co-operation and Development [5] reported 80% of unemployment in personality disorder inpatients in Switzerland; this rate is similar for people with severe mental illnesses (e.g., schizophrenia, severe mood disorders). Moreover, when interviewed about challenging staff members, employers frequently describe issues with interpersonal relationships, responsibility for one’s actions, emotional stability and acceptance of instructions. These impairments that are typical to personality disorder often result in dismissals [6, 7]. Cluster B (i.e., dramatic, erratic), including antisocial, borderline, histrionic, and narcissistic personality disorders, is the one most associated with disability – earlier age of work disability and failure to return to work. Cluster A (i.e., odd, eccentric), such as paranoid and schizoid personality disorders, is second, with an expanded risk of disability. Cluster C (i.e., fearful, anxious), including avoidant, dependent, and obsessive–compulsive personality disorders, is often considered the least problematic [2, 8], with a similar functional impairment level as other common disorders [9]. Vocational rehabilitation programmes have been developed to help psychiatric patients regain employment. The Individual Placement and Support (IPS) model of supported employment gained worldwide interest and demonstrated the best efficacy, notably higher employment rates and fewer days before finding a job compared with control conditions [10]. IPS targets quick reintegration of the patient into the competitive job market (i.e. regular paid jobs available to everyone, with equal conditions for all workers), stating that employment contributes greatly to their well-being by reducing symptoms and providing meaning to their lives. Anyone with mental illnesses can join IPS and benefit from the individual support the job coaches offer [11]. IPS appeared in the early 1990s and was created specifically for people with severe mental illnesses, whose work rehabilitation is affected by stigma [12], cognitive deficits [13], increased absenteeism [14] and decreased work performance due to their symptoms [1]. Finding satisfaction in their social role is their primary motivation to work [15] (Black et al., 2019). Supported employment shows effectiveness in professionally reintegrating this population [16]. People with personality disorders display different rehabilitation-related challenges. These disorders are characterised Individual placement and support effectiveness for personality disorders compared with other mental disorders: a retrospective study
Surajo Kamilu Sulaiman, Ashiru Hamza Mohammad, Aminu Alhassan Ibrahim
et al.
Objectives: To overcome the inherent limitations of the medical and social models of disability, the World Health Organization developed the first international conceptualization of disability: the International Classification of Functioning, Disability, and Health (ICF). Despite the ICF’s robustness, it is still underutilized in research and practice in Low- and Middle-Income Countries (LMICs). This article discusses the applications, strengths, limitations, and unique considerations when using the ICF to explore disabilities in LMICs like Nigeria.
Methods: A literature search was conducted in Medline, CINAHL, Web of Science, AMED, and Google Scholar. Articles were selected if they reported on any of the development, structure, applications, strengths, and limitations of the ICF. The review draws from the selected articles using a narrative discussion.
Results: The literature search yielded 22 articles that met the eligibility criteria. The ICF is a classification of components of health and functioning, which views disability as an outcome of a dynamic interaction between a person’s health condition and contextual factors. The ICF was developed cross-culturally; thus, it is applicable in various socio-environmental contexts. However, despite its comprehensiveness, the ICF is criticized for lack of clear theoretical underpinnings, overlapping and redundant components, and absence of systematized personal factors.
Discussion: The ICF has brought a significant paradigm shift in the measurement of disability by explicitly recognizing the role of contextual factors in the incapacitation process and placing all health conditions on an equal footing. Hence, stakeholders in disability research and practice in LMICs need to prioritize the ICF over other disablement models.
Medicine, Vocational rehabilitation. Employment of people with disabilities
Background: Work-related musculoskeletal pain arises in many occupations. Chefs working in restaurants perform the repetitive motion, forceful exertions in non-neutral body postures, which make them susceptible to musculoskeletal pain. This occupation needs to be evaluated for the chefs on the musculoskeletal pain scale for better understanding of their demanding job description in a restaurant which causes health problems.
Objective: To determine the frequency of musculoskeletal pain in chefs working in restaurants of Lahore.
Methodology: Cross-sectional survey design with convenient sampling technique was used. Numeric pain rating scale (NPRS) and the Nordic questionnaire was undertaken to determine the frequency among chefs working in different restaurants of Lahore. Inclusions of chefs were based on satisfying the criteria of age from 25-50, experience of 2 years or more and minimum working hours 8. While incomplete questionnaire, previous trauma or surgery to the site of pain or kitchen aid workers were excluded from the study. The data was gathered from the period of June 2018 till September 2018.
Results: This study includes n=200 male chefs. Mean and standard deviation of NPRS was 0.52 ± 1.35. 37(18.5%) chefs responded that they experienced pain within the past 12 months. Low back being the most affected region 12(8%), followed by region of neck 9(4.5%), shoulder 7(3.5%), wrist/hand 4(2.0%), knees 4(2.0%), hips/thighs 3(1.5%) ankle/feet 2(1.0%). The odds ratio of developing musculoskeletal pain if working >10 hours is OR=0.72 (0.08-6.2 95%CI). Significant association between the age groups and NPRS was found (χ2=16.30, p=0.012).
Conclusion: This study demonstrated that musculoskeletal pain is frequent in chefs, though it was found to be low on NPRS. Low back pain was found to be the frequent region of the complaint.
Keywords: Frequency, Low Back Pain, Musculoskeletal Pain, Numeric Pain Rating Scale.
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
Diana Alexandra CAMARGO ROJAS, Edwin Arcesio GÓMEZ SERNA, Pablo Sergio MOLINA MURCIA
In the education sector is a challenge for teachers to generate pedagogical strategies within their classroom considering the characteristics of the population. Additionally, teachers do not know the physical and social conditions of their students, which they can’t generate plans according to their needs. Objective: To characterize the physical condition and socioeconomic status of students with intellectual disabilities in the district schools of the city of Bogotá for people with disabilities. Method: Cross-sectional study, which used Brockport physical fitness test and the WHO STEPS survey. Population: 132 children and young people with intellectual disabilities. Results: In terms of body composition, 62.12% are in the healthy area and 6.82% have low weight, which requires follow-up by nutrition professionals; and 17.42% present high risk, a population that requires follow-up. In relation to the physical fitness the majority of the population, a 72.06%, need to improve in the grip strength and strength of abdominals, variables related to cardiovascular risk. Finally, it is important to mention that 73% of the population is in stratum 1 and 2, which can influence the practice of physical activity. <br />Conclusion: The population has a low physical fitness that is associated as in other studies with the socioeconomic status of families. The cardiovascular risk expressed in percentage of fat continues to be an element to work in the population.
Psychology, Vocational rehabilitation. Employment of people with disabilities
N. M. Bieliaieva, O. B. Yavorovenko, I. Kurylenko
et al.
The urgency of the problem is due to the significant increase in recent years in the number of young and middle-aged people who have passed the war, the need to develop adequate measures of social assistance and protection. An important task in the organization of the rehabilitation process is to determine the structure of the needs of servicemen with disabilities in various types of medical and social care and the development of individual rehabilitation programs (IRP) based on them. The purpose of the study: to determine the structure of the needs of servicemen with disabilities in medical and social rehabilitation depending on the severity of disability. Statistical data from 25 administrative territories of Ukraine for 2018 are analyzed, the needs of participants of military service with disabilities in medical and social rehabilitation measures, their structure are calculated. The data of the information base of the centers and the bureau of medical and social examination of the regions were used. Processing of the primary material was performed using the universal statistical package "Excel". In 2018, medical and social expert commissions (MSEC) of Ukraine for the first time and re-certified and recognized persons with disabilities 7843 combatants. Of these, disability of group I (IA and IB) was established in 2.6 %, II in 29.2 %, III in 68.2 % of cases. All victims for MSEC were formed IRP. The dependence of the needs of combatants in medical and social rehabilitation measures on the severity of disability has been established. For persons with disabilities of groups II and III, priority is given to medical and professional rehabilitation, group I social rehabilitation and technical means of rehabilitation with medical support. Of the medical rehabilitation services for persons with II and III groups of disability, sanatorium treatment is significant, and group I rehabilitation therapy. Among vocational rehabilitation services, employment in production conditions is important for persons with group III disabilities, in specially created conditions for persons with group II disabilities, at home for persons with group I disabilities. Vocational training was offered to a small number of people with disabilities of all groups. Among social rehabilitation services and technical means of rehabilitation, the services of social workers of territorial social service centers were significant for representatives of all disability groups, simpler means of transportation for persons of group III disability and more complex means for persons of group I. Determining the characteristics of the needs of servicemen with disabilities depending on its severity allows MSEC specialists to better form the IRP, develop targeted rehabilitation programs at the regional level, assess shortcomings in the organization of the rehabilitation process and build a rehabilitation system for combatants.
BACKGROUND: While considerable research has been conducted on employment of people with serious mental illness (SMI), there is a dearth of research in this area focused on the work experiences of women with SMI. OBJECTIVE: This article fills a gap in the research by presenting the results from a study exploring the work experiences of women with SMI. METHODS: Grounded theory methodology was used to analyze the qualitative data. Several qualitative validity strategies were employed to enhance data quality. RESULTS: Six themes relating to work emerged from analysis of the qualitative data: (1) work drain; (2) symptom visibility; (3) work disclosure; (4) inconsistent work; (5) nontraditional work; and (6) work assets. CONCLUSIONS: Vocational rehabilitation practitioners can tailor rehabilitation plans to support the unique needs of women with SMI and leverage their strengths to help them gain greater satisfaction and meaning from work.
Data from the National Longitudinal Transition Study 2012 (NLTS 2012) indicate that 38% of youths with visual impairments worked during high school (Lipscomb et al., 2017). Many youths with visual impairments participate in sponsored work experiences, often as a component of a transition program offered through their school, vocational rehabilitation agency, or a private agency. Sponsored work experiences fall under the Workforce Innovation and Opportunity Act’s (2016) work-based learning experiences, which are one of the five required activities under pre-employment transition services. Sponsored work experiences may take place during the summer or the school year, at the sponsoring organization or a business in the community. Their duration varies from a single day to several weeks to a semester. Some sponsored work experiences are unpaid, but others provide participating youths with a stipend or their pay is subsidized by the sponsoring organization. Sponsored work experiences can have benefits for youths who participate. For example, youths obtain hands-on experience performing a job in a work setting, gain exposure to the behind-the-scenes aspects of a job, develop soft skills and transferable skills, network with people in their community, and potentially earn money. On occasion, a youth is hired by the company as an employee after the conclusion of the work experience. Sponsored work experiences can also have downsides. Because these experiences are typically short-term, youths may not have the opportunity to continue working in sponsored positions, regardless of whether the position is a good fit for them. School or agency staff usually find and arrange work experiences on behalf of a youth, meaning that he or she does not need to (a) find the position; (b) apply for it; (c) consider if, when, and how to disclose his or her disability; (d) interview for the position; or (e) compete with others. In other words, youths do not get real-world practice with job-seeking skills.
Background: The kingdom of Swaziland is a signatory to policies on universal education that ensure high quality basic education for all. Education for All is a commitment to provide equal opportunities for all children and the youth as provided for in the country’s constitution of 2005. The tone for the introduction of inclusive education in Swaziland was inevitably set by the new constitution of 2005. Since then several policies have been produced by the government, all aimed at providing equal education opportunities to all children in the country. These policies include the Swaziland National Children’s Policy (2009), Poverty Reduction Strategy and Action Plan (2006) and Draft Inclusive Education Policy (2008). The Education for All Policy (2010) is the policy that upon implementation became a stimulus for the introduction of inclusive education into mainstream schools; as a result, all teachers in the country’s schools were expected to be competent enough to teach learners with a wide range of educational needs. However, in-service teachers received inadequate staff development and training ahead of the implementation of inclusive education and a majority of teachers were not professionally developed for inclusive education, as pre-service students at tertiary training level.
Objectives: This study investigated barriers in the implementation of inclusive education at high schools in the Gege branch, Swaziland, with a view to finding lasting solutions to inform research and government policy.
Method: This research is a qualitative interpretive case study based on selected schools in the Gege branch of schools. Data was obtained through semi-structured research interviews and document analysis. It was processed and analysed through data coding, unitising, categorising and emergence of themes, which became the findings of the study.
Results: Lack of facilities in the governments’ schools and teachers’ incompetence in identifying learners facing learning challenges in their classrooms are some barriers to inclusivity.
Conclusion: The study concludes that there is a need for the Ministry of Education and Training to craft an inclusive curriculum in line with the inclusive policy in order to cater for the diverse educational needs of all learners in mainstream schools. It is thought that instituting a vibrant in-service and pre-service teacher training programme by the Ministry of Education and Training will increase teachers’ capacity to a level where teaching in inclusive classrooms does not negatively affect their competence.
Vocational rehabilitation. Employment of people with disabilities, Communities. Classes. Races