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ItemPathways to participation in gymnastics: Understanding the experiences of families of children with disability.Toovey, R ; Shuttleworth, H ; Hickey, L ; Groleger Sršen, K ; Newman, C (University Rehabilitation Institute Republic of Slovenia, 2022-03-04)Introduction: The aim of this study was to understand the experiences of families of children with disability with participating in gymnastics, to inform how more supportive gymnastics environments can be created. Patients and Methods: Sequential explanatory mixed-methods study design. Eligible participants were parents or carers of children/young people with disability (any type, up to 25 years) who currently participate in, had participated in, or had attempted to participate in gymnastics in Victoria, Australia, in the last 3 years. Participants completed an online survey, with selected participants purposively invited to undertake a semi-structured interview. Sixty-eight parents provided survey responses, with eight interviews conducted. Quantitative survey data were analysed using descriptive statistics. Qualitative survey and interview data were analysed using inductive thematic analysis. All data were mixed to create a conceptual framework. Themes and the framework underwent member checking with parent advisors and interview participants. Results: Five key themes emerged: (1) Tailored, accessible and supportive facilities and programs make a difference, (2) An explicitly inclusive club culture helps young people get involved and stay involved, (3) Coach knowledge about engaging children with disability is valued, (4) Enjoyment and recognition of achievement are key facilitators of ongoing participation, and (5) Gymnastics has physical and social benefits. The conceptual framework integrated themes into stages along the participation pathway. Conclusion: Many participation-related interventions target children with disability and their families. Conversely, these findings provide guidance to gymnastics clubs on how to become more inclusive and supportive environments at each stage of participation.
ItemP132 Research in the time of COVID-19: Recruitment to a clinical trial comparing models of NIV implementation in people with MNDSheers, N ; Howard, M ; Hannan, L ; Retica, S ; Berlowitz, D (Oxford University Press (OUP), 2021-10-07)Abstract Introduction A pilot randomised controlled trial (RCT) examining the feasibility of a new model of non-invasive ventilation (NIV) implementation was due to commence in early 2020. Based on previous research, it was anticipated that 100% of people with motor neurone disease (MND) would be eligible, 60% would consent to participate and 20 people would be randomised in five months. The aim of this report is to describe the impact of COVID-19 pandemic contingencies on trial recruitment. Methods Report of project progress, participant screening and recruitment. Results First reports of COVID-19 coincided with study commencement and changed usual healthcare delivery. Lockdowns meant telehealth substituted for face-to-face assessment, respiratory function testing was limited and/or patients were reluctant to seek medical treatment. This modified pathway impacted evaluation of diagnosis, timing of need for NIV and procedural safety, with patients then referred specifically for a single-day hospital NIV implementation to enable face-to-face multidisciplinary assessment to aid decisions. Of 81 potential participants screened in an 8-month period, 64% were ineligible for the RCT. Despite this shift in eligibility rate, 16 people with MND have been recruited as of May 2021. Conclusion The current climate has amplified the significance of this research trial; people with MND have had reduced access to face-to-face services globally and clinicians have had to quickly adapt to a changing landscape of telemedicine and remote monitoring of patients. This trial’s screening data suggest that COVID-19 hasn’t stopped people with MND being implemented on NIV, but it has altered assessment pathways.
ItemMeasures of Bipedal Toe-Ground Clearance Asymmetry to Characterize Gait in Stroke Survivors.Datta, S ; Begg, R ; Rao, AS ; Karmakar, C ; Bajelan, S ; Said, C ; Palaniswami, M (IEEE, 2021-11)Post-stroke hemiparesis often impairs gait and increases the risks of falls. Low and variable Minimum Toe Clearance (MTC) from the ground during the swing phase of the gait cycle has been identified as a major cause of such falls. In this paper, we study MTC characteristics in 30 chronic stroke patients, extracted from gait patterns during treadmill walking, using infrared sensors and motion analysis camera units. We propose objective measures to quantify MTC asymmetry between the paretic and non-paretic limbs using Poincaré analysis. We show that these subject independent Gait Asymmetry Indices (GAIs) represent temporal variations of relative MTC differences between the two limbs and can distinguish between healthy and stroke participants. Compared to traditional measures of cross-correlation between the MTC of the two limbs, these measures are better suited to automate gait monitoring during stroke rehabilitation. Further, we explore possible clusters within the stroke data by analysing temporal dispersion of MTC features, which reveals that the proposed GAIs can also be potentially used to quantify the severity of lower limb hemiparesis in chronic stroke.