Abstract. BACKGROUND: There is limited research exploring shoulder activity in different one arm ... more Abstract. BACKGROUND: There is limited research exploring shoulder activity in different one arm drive wheelchairs. OBJECTIVE: To compare EMG activity in six muscles surrounding the shoulder joint during propulsion of three different modified Action3 manual one arm drive wheelchairs. Surface EMG was measured during dynamic propulsion of each wheelchair during propulsion around an indoor obstacle course. METHODS: Seventeen non-disabled users were randomly assigned to each wheelchair in turn. The EMG data was measured using the biometrics data link system v 7.5. Total activity levels for each muscle were calculated per user per wheelchair. RESULTS: The NuDrive produced the highest levels of activity in triceps muscle in straight running and also in biceps and pectoralis major over mats and around corners. The Neater produced the lowest levels of activity in biceps and pectoralis major over mats and around corners. There was no significant difference in activity in the other muscles in the different wheelchairs. CONCLUSIONS: The results indicate that fatigue could result from propelling certain one arm drive wheelchairs. They will also help to inform clinical decision making in the prescription of wheelchairs in this group. The contribution of findings would support the need to replicate the study in a user population.
Limited published data exploring patients&amp... more Limited published data exploring patients' emotional recovery after day case foot surgery are available. The aim of the present study was to explore the changes in patient mood from preoperatively to 8 weeks postoperatively after outpatient forefoot surgery. The patients completed the Profile of Mood States-Bipolar™ questionnaire, Speilberger State-Trait Anxiety Inventory, and a 10-cm visual analog scale to measure pain preoperatively and again at 1, 2, and 8 weeks postoperatively. Of the 6 mood subscales, 3 showed statistically significant improvements by 8 weeks postoperatively: composed-anxious (Student's t test, t = -5.319; df = 84; p = .05); confident-unsure (t = -2.074; df = 84; p = .02); and clearheaded-confused (t = -2.46; df = 84; p = .007). Furthermore, the decrease in anxiety and pain was statistically significant after foot surgery. These findings have contributed to the understanding of patients' psychological needs in relation to outpatient day case foot surgery, and foot and ankle surgeons' understanding of patients' mood and anxiety levels can contribute to improving patient care and enhancing patient-practitioner relationships, which, in turn, could improve patients' perceived outcomes of their surgery.
Diabetes is a condition of particular importance to the Maltese population. Currently, 10% of the... more Diabetes is a condition of particular importance to the Maltese population. Currently, 10% of the Maltese population has diabetes, compared with 2-5% of the population in the majority of Malta's neighbouring European nations (Rocchiccioli et al, 2005). The high prevalence of diabetes results in nearly one out of every four deaths of Maltese people occurring before the age of 65 years (Cachia, 2003). In this article we explore the possible contributions of the unique Maltese culture to the epidemiology, we hope that some lessons can be taken when attempting educational interventions in people of differing backgrounds.
International Journal of Therapy and Rehabilitation, 2006
ABSTRACT High sources of stress have been reported in health-care students, including physiothera... more ABSTRACT High sources of stress have been reported in health-care students, including physiotherapy students. However, there are no studies investigating stress in podiatry students. This study was undertaken to examine the sources of stress in undergraduate podiatry students in universities in both the UK and Australia. The Undergraduate Sources of Stress (USOS) questionnaire, comprising 18 items in three subscales (academic demands, financial issues, personal issues), was administered to students in all years of the bachelor programmes in the UK (n=54/97, response rate=56%) and Australia (n=56/94, response rate=60%). Academic concerns were rated highest for all students, particularly the amount to learn, time demands and intellectual demands of the course. UK levels of academic stress are greatest when students are in their first year, when academic demands are combined with clinical education placements. The university fees were significantly higher for Australian students (P=0.001). In total, 64% of podiatry students in Australia worked in paid employment while studying, compared with 41% of the UK podiatry students. Mean hours of paid employment were 5.3hours for UK students and 7.0hours for Australian students. However, there was no correlation between any of the stress subscales on number of hours worked. High levels of academic stress reported by podiatry students are consistent with other student health-care professions.
Diabetes mellitus is a condition of particular importance to the Maltese population. Currently 16... more Diabetes mellitus is a condition of particular importance to the Maltese population. Currently 16.7% of the Maltese population is living with diabetes or impaired glucose tolerance. A cultural and historical evaluation of this area-restricted archipelago population has suggested that the associated high prevalence of diabetes may be the result of the Baker-Pederson hypothesis cycles following an original adaptation to a thrifty near starvation diet.
One of the core components of diabetes care is the promotion of diabetes education to improve sel... more One of the core components of diabetes care is the promotion of diabetes education to improve self-management, which would reduce the financial and personal burden that diabetes imposes. However, as education and knowledge alone do not always translate into improved metabolic outcomes, a fuller undestanding of the factors that contribute to suboptimal self-management is important if improved diabetes outcomes are to be achieved. In this article the authors question the current approaches to diabetes education, and highlight how education might be broadened to produce more effective outcomes. The authors suggest a move away from traditional, didactic, diabetes-related education, which has failed in a number of settings, towards innovative approaches that are person-centred to improve metabolic outcomes and quality of life for individuals with diabetes.
Journal of the American Podiatric Medical Association
Professional and occupational burnout is a recognized syndrome among healthcare professionals, al... more Professional and occupational burnout is a recognized syndrome among healthcare professionals, although the point at which burnout begins is unclear. There is a dearth of research investigating burnout and occupational stress in relation to podiatric medicine, although two recent studies have reported high levels of burnout expressed by podiatric medical practitioners. This study was undertaken to compare the levels of burnout in newly qualified practitioners in Australia and the United Kingdom. The results suggest that levels of burnout are higher in these groups than indicated by the published normative medical data. Occupational stress was associated with lack of professional status and with geographic and professional isolation. Within these two themes, there were clear differences between the two groups.
The aim of this study was to explore the total and regional grip forces in the hand when propelli... more The aim of this study was to explore the total and regional grip forces in the hand when propelling two different manual one arm drive wheelchairs: the Neater Uni-wheelchair (NUW) and a foot steered Action3 wheelchair. 17 nondisabled users were randomly assigned to each wheelchair to drive around an indoor obstacle course. The Grip, a multiple sensor system taking continuous measurement of handgrip force, was attached to the propelling hand. Total grip force in each region of the hand and total grip force across the whole hand were calculated per user per wheelchair. The Action3 with foot steering only generated significantly greater total grip force in straight running compared to the NUW and also in the fingers and thumb in straight running. The results suggest that the Action3 with foot steering generated greater grip forces which may infer a greater potential for repetitive strain injury in the upper limb. Further work is required to explore whether the difference in grip force ...
Disability and Rehabilitation: Assistive Technology, 2015
Abstract Aims: This pilot study measured activities of daily living performance in individuals/pa... more Abstract Aims: This pilot study measured activities of daily living performance in individuals/participants with hemiplegia propelling both a standard dual handrim Action 3 wheelchair and a standard Action 3 wheelchair with a Neater Uni-Wheelchair kit attachment. The kit consists of a steerable front. Does the use of the NUW affect the performance quality of activities of daily living in individuals/participants with hemiplegia. Is there a difference in the motor and process skills during activities of daily living performance, and in the time taken to complete the activities. Four individuals/participants with hemiplegia were used in a cross over, repeated measures trial. Assessment of Motor and Process Skills of users undertaking making a bed and laying a table "Swedish style", tasks were measured and time taken to complete each task were recorded. Bed making completion time was quicker in the Neater Uni-wheelchair (p < 0.03). Motor skills were significantly higher than the process ability skills (p < 0.05). Activities of daily living tasks in the Neater Uni-wheelchair were completed more efficiently with no loss in quality of motor and process skills performance. This suggests that the Neater Uni-wheelchair is a viable alternative to current one arm drive provision. Implications for Rehabilitation Inappropriate wheelchair provision can result in capacity limitation and poorer quality of ADL motor skill as well-lowered process performance skill. AMPS can help to explain motor and process skill differences in complex activities.
... Anne Mandy, Andrew Pearman, School of Health Care Professions, Eastbourne, Sussex BN20 7UR, U... more ... Anne Mandy, Andrew Pearman, School of Health Care Professions, Eastbourne, Sussex BN20 7UR, UK K. Ross, Eastbourne District General ... intervention is aimed at functional independence, and is augmented by exercise programs to increase muscle strength and stamina. ...
Abstract. BACKGROUND: There is limited research exploring shoulder activity in different one arm ... more Abstract. BACKGROUND: There is limited research exploring shoulder activity in different one arm drive wheelchairs. OBJECTIVE: To compare EMG activity in six muscles surrounding the shoulder joint during propulsion of three different modified Action3 manual one arm drive wheelchairs. Surface EMG was measured during dynamic propulsion of each wheelchair during propulsion around an indoor obstacle course. METHODS: Seventeen non-disabled users were randomly assigned to each wheelchair in turn. The EMG data was measured using the biometrics data link system v 7.5. Total activity levels for each muscle were calculated per user per wheelchair. RESULTS: The NuDrive produced the highest levels of activity in triceps muscle in straight running and also in biceps and pectoralis major over mats and around corners. The Neater produced the lowest levels of activity in biceps and pectoralis major over mats and around corners. There was no significant difference in activity in the other muscles in the different wheelchairs. CONCLUSIONS: The results indicate that fatigue could result from propelling certain one arm drive wheelchairs. They will also help to inform clinical decision making in the prescription of wheelchairs in this group. The contribution of findings would support the need to replicate the study in a user population.
Limited published data exploring patients&amp... more Limited published data exploring patients' emotional recovery after day case foot surgery are available. The aim of the present study was to explore the changes in patient mood from preoperatively to 8 weeks postoperatively after outpatient forefoot surgery. The patients completed the Profile of Mood States-Bipolar™ questionnaire, Speilberger State-Trait Anxiety Inventory, and a 10-cm visual analog scale to measure pain preoperatively and again at 1, 2, and 8 weeks postoperatively. Of the 6 mood subscales, 3 showed statistically significant improvements by 8 weeks postoperatively: composed-anxious (Student's t test, t = -5.319; df = 84; p = .05); confident-unsure (t = -2.074; df = 84; p = .02); and clearheaded-confused (t = -2.46; df = 84; p = .007). Furthermore, the decrease in anxiety and pain was statistically significant after foot surgery. These findings have contributed to the understanding of patients' psychological needs in relation to outpatient day case foot surgery, and foot and ankle surgeons' understanding of patients' mood and anxiety levels can contribute to improving patient care and enhancing patient-practitioner relationships, which, in turn, could improve patients' perceived outcomes of their surgery.
Diabetes is a condition of particular importance to the Maltese population. Currently, 10% of the... more Diabetes is a condition of particular importance to the Maltese population. Currently, 10% of the Maltese population has diabetes, compared with 2-5% of the population in the majority of Malta's neighbouring European nations (Rocchiccioli et al, 2005). The high prevalence of diabetes results in nearly one out of every four deaths of Maltese people occurring before the age of 65 years (Cachia, 2003). In this article we explore the possible contributions of the unique Maltese culture to the epidemiology, we hope that some lessons can be taken when attempting educational interventions in people of differing backgrounds.
International Journal of Therapy and Rehabilitation, 2006
ABSTRACT High sources of stress have been reported in health-care students, including physiothera... more ABSTRACT High sources of stress have been reported in health-care students, including physiotherapy students. However, there are no studies investigating stress in podiatry students. This study was undertaken to examine the sources of stress in undergraduate podiatry students in universities in both the UK and Australia. The Undergraduate Sources of Stress (USOS) questionnaire, comprising 18 items in three subscales (academic demands, financial issues, personal issues), was administered to students in all years of the bachelor programmes in the UK (n=54/97, response rate=56%) and Australia (n=56/94, response rate=60%). Academic concerns were rated highest for all students, particularly the amount to learn, time demands and intellectual demands of the course. UK levels of academic stress are greatest when students are in their first year, when academic demands are combined with clinical education placements. The university fees were significantly higher for Australian students (P=0.001). In total, 64% of podiatry students in Australia worked in paid employment while studying, compared with 41% of the UK podiatry students. Mean hours of paid employment were 5.3hours for UK students and 7.0hours for Australian students. However, there was no correlation between any of the stress subscales on number of hours worked. High levels of academic stress reported by podiatry students are consistent with other student health-care professions.
Diabetes mellitus is a condition of particular importance to the Maltese population. Currently 16... more Diabetes mellitus is a condition of particular importance to the Maltese population. Currently 16.7% of the Maltese population is living with diabetes or impaired glucose tolerance. A cultural and historical evaluation of this area-restricted archipelago population has suggested that the associated high prevalence of diabetes may be the result of the Baker-Pederson hypothesis cycles following an original adaptation to a thrifty near starvation diet.
One of the core components of diabetes care is the promotion of diabetes education to improve sel... more One of the core components of diabetes care is the promotion of diabetes education to improve self-management, which would reduce the financial and personal burden that diabetes imposes. However, as education and knowledge alone do not always translate into improved metabolic outcomes, a fuller undestanding of the factors that contribute to suboptimal self-management is important if improved diabetes outcomes are to be achieved. In this article the authors question the current approaches to diabetes education, and highlight how education might be broadened to produce more effective outcomes. The authors suggest a move away from traditional, didactic, diabetes-related education, which has failed in a number of settings, towards innovative approaches that are person-centred to improve metabolic outcomes and quality of life for individuals with diabetes.
Journal of the American Podiatric Medical Association
Professional and occupational burnout is a recognized syndrome among healthcare professionals, al... more Professional and occupational burnout is a recognized syndrome among healthcare professionals, although the point at which burnout begins is unclear. There is a dearth of research investigating burnout and occupational stress in relation to podiatric medicine, although two recent studies have reported high levels of burnout expressed by podiatric medical practitioners. This study was undertaken to compare the levels of burnout in newly qualified practitioners in Australia and the United Kingdom. The results suggest that levels of burnout are higher in these groups than indicated by the published normative medical data. Occupational stress was associated with lack of professional status and with geographic and professional isolation. Within these two themes, there were clear differences between the two groups.
The aim of this study was to explore the total and regional grip forces in the hand when propelli... more The aim of this study was to explore the total and regional grip forces in the hand when propelling two different manual one arm drive wheelchairs: the Neater Uni-wheelchair (NUW) and a foot steered Action3 wheelchair. 17 nondisabled users were randomly assigned to each wheelchair to drive around an indoor obstacle course. The Grip, a multiple sensor system taking continuous measurement of handgrip force, was attached to the propelling hand. Total grip force in each region of the hand and total grip force across the whole hand were calculated per user per wheelchair. The Action3 with foot steering only generated significantly greater total grip force in straight running compared to the NUW and also in the fingers and thumb in straight running. The results suggest that the Action3 with foot steering generated greater grip forces which may infer a greater potential for repetitive strain injury in the upper limb. Further work is required to explore whether the difference in grip force ...
Disability and Rehabilitation: Assistive Technology, 2015
Abstract Aims: This pilot study measured activities of daily living performance in individuals/pa... more Abstract Aims: This pilot study measured activities of daily living performance in individuals/participants with hemiplegia propelling both a standard dual handrim Action 3 wheelchair and a standard Action 3 wheelchair with a Neater Uni-Wheelchair kit attachment. The kit consists of a steerable front. Does the use of the NUW affect the performance quality of activities of daily living in individuals/participants with hemiplegia. Is there a difference in the motor and process skills during activities of daily living performance, and in the time taken to complete the activities. Four individuals/participants with hemiplegia were used in a cross over, repeated measures trial. Assessment of Motor and Process Skills of users undertaking making a bed and laying a table "Swedish style", tasks were measured and time taken to complete each task were recorded. Bed making completion time was quicker in the Neater Uni-wheelchair (p < 0.03). Motor skills were significantly higher than the process ability skills (p < 0.05). Activities of daily living tasks in the Neater Uni-wheelchair were completed more efficiently with no loss in quality of motor and process skills performance. This suggests that the Neater Uni-wheelchair is a viable alternative to current one arm drive provision. Implications for Rehabilitation Inappropriate wheelchair provision can result in capacity limitation and poorer quality of ADL motor skill as well-lowered process performance skill. AMPS can help to explain motor and process skill differences in complex activities.
... Anne Mandy, Andrew Pearman, School of Health Care Professions, Eastbourne, Sussex BN20 7UR, U... more ... Anne Mandy, Andrew Pearman, School of Health Care Professions, Eastbourne, Sussex BN20 7UR, UK K. Ross, Eastbourne District General ... intervention is aimed at functional independence, and is augmented by exercise programs to increase muscle strength and stamina. ...
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