Carolyn Hanson

Effect of participation in physical activity on body image of amputees

Wetterhahn KA, Hanson C, Levy CE: Effect of participation in physical activity on body image of amputees. Am J Phys Med Rehabil 2002;81:194–201. ObjectiveThe purpose of this study was to examine body image in individuals with amputations and to determine if a relationship exists between body image and level of participation in physical activity and sports. A secondary objective was to examine correlations between two body-image assessments. DesignA nonrandomized survey was given to a convenience-volunteer sample of individuals of at least 18 yr of age with a lower limb amputation. ResultsTwenty-four participants were active and 32 were minimally active. Statistical significance was preset at P < 0.05, with a 95% confidence interval. An overall significant difference was found between groups on the MBSRQ and on three of the 10 MBSRQ subscales. Significant correlations were found between six MBSRQ subscales and the ABIS. ConclusionA positive relationship was found between regular participation in physical activity and body image among lower limb amputees.

Detecting submaximal efforts in grip strength testing with the coefficient of variation

The use of the coefficient of variation (CV) to determine level of effort in grip strength testing was examined empirically. Twenty-nine asymptomatic subjects participated in two conditions of testing: 100% effort and 50% effort. Order of conditions was counterbalanced and each subject was run in both conditions twice in the same order in order to assess the stability of the method. The number of trials (grasps) per condition was three for a total of 12 grasps for the study. The submaximal (50%) effort condition showed significantly more variability than the maximal effort condition in both sets of conditions (p<.01). Intra-class correlation coefficients were very low for both maximal effort and submaximal efforts (.036 and .025) indicating very low stability for the coefficient of variation. Classification rates were also found to have unacceptably large errors with 69% of the submaximal efforts being classified as maximal with the traditional 15% CV cutoff and 55% misclassification of submaximal efforts with an optimized 11% CV cutoff. It was concluded that the currently practiced method of using a low number of repetitions to calculate the CV may result in very unstable measures. Furthermore the “false negative” rate in using this method is unacceptably high for practical application. The implications of using the method and suggestions for improvement are discussed.

Body image and exercise in people with and without acquired mobility disability

Purpose : This study was conducted to determine whether differences existed in self-perceived body image between adults with and without Acquired Mobility Disability (AMD), and whether a relationship existed between exercise and self-perceived body image in adults with AMD. Method : Thirty adults with AMD were paired with 30 able-bodied controls and matched on gender, age, ethnicity and exercise level. Both groups completed the Multidimensional Body-Self Relations Questionnaire (MBSRQ) which measures body image on 10 subscales related to appearance, fitness, health/illness, body-areas satisfaction and weight-related attitude. Results : A 2 2 2 two-way ANOVA, with disability (AMD vs able-bodied) and exercise (active vs non-active) serving as the main factors, was used to examine group differences of each on the 10 subscales of the MBSRQ separately. Results indicated that there was a significant interaction between disability and exercise on Health Orientation [F(1, 56)=22.46, p=0.000]. Post-hoc analysis indicated that active able-bodied individuals scored higher on the health orientation subscale than the other three subgroups. No other comparisons on health orientation were significant. There was a significant main effect of disability on appearance orientation [F(1, 56)=10.44, p=0.002] and health evaluation [F(1, 56)=10.48, p=0.002], and a significant main effect of exercise on appearance evaluation [F(1, 56)=10.75, p=0.002] and fitness orientation [F(1, 56)=40.96, p=0.000]. The AMD group scored higher on appearance orientation than the able-bodied group, whereas the able-bodied group scored higher on health evaluation. The physically active group scored higher than the non-active group on appearance evaluation and fitness orientation. Conclusions : The present study indicated that individuals with AMD rated their body image comparable to the able-bodied controls except in the attention paid to appearance and perceptions about physical health. When taking the effect size of the main effect of exercise into consideration, the members of the active mobility disability group appear to evaluate their physical appearance (appearance evaluation) and health (health evaluation) better, are more concerned with fitness (fitness orientation) and more satisfied with different body parts (body areas satisfaction) when compared to their nonactive mobility disability counterparts. The potential role of exercise on improving body image in individuals with mobility disabilities should be systematically investigated.

Comparing Wheelchair Cushions for Effectiveness of Pressure Relief: A Pilot Study

The purpose of this study was to determine if there were differences in pressure relieving abilities among six commonly prescribed wheelchair cushions and whether differences were related to the participants body mass. In addition, the participants perception of cushion comfort was investigated. A convenience sample of 40 adult wheelchair users were recruited from a rehabilitation hospital. Participants sat on the following six cushions for 5 minute periods: Flexseat, Jay 2, Pindot, ROHO High, ROHO Low, and Stimulite. Pressure measurements were recorded with the Xsensor Pressure Mapping System, a new instrument available to therapists. It was discovered that ROHO High and ROHO Low cushions were more effective in relieving pressure than the other cushions. Cushion pressure relieving abilities were largely dependent on the individuals body mass. ROHO cushions were also perceived to be more comfortable than all other cushions tested regardless of body mass and pressure relief.

The Relationship Between Participation in a Sports Camp and Students' Attitudes Towards Persons with Disabilities

This study measured the attitudes of students before and after volunteering in a two-day camp for persons with disabilities. The Attitudes Toward Disabled Persons scale (ATDP) Form A was used to measure the attitudes of 54 university students in various health care majors. Twenty-five experimental group participants were volunteers at the camp. The students completed the scale three times: before, immediately following, and six weeks after the camp. The control group consisted of twenty-nine students and were administered the ATDP scale initially, then at one week and six weeks later during a scheduled health professions class. Results showed no significant difference in ATDP scores between groups and suggest that the camp alone was not a strong enough factor to produce a difference in attitudes. Further analysis did suggest that the camp may promote positive attitude changes for students with less positive attitudes initially, while not further changing the attitudes of students which were already positive. This study adds to the body of knowledge exploring different methods to change attitudes towards persons with disabilities and suggests that a camp could serve as a observation experience for students in occupational therapy curricula as a way to provide contact with persons with disabilities.

A Pilot Study: Attitudes Toward Leisure and Leisure Motivation in Adults with Spinal Cord Injury

This pilot study explored the effect that an introduction to wheelchair sports would exert on attitudes and motivation toward leisure in a sample of adults with spinal cord injury. Individuals were tested using the Leisure Attitude Measurement (LAM) and the Leisure Motivation Scale (LMS) both before and after participating in a wheelchair sports program. Camp participants were demographically matched with a control group of persons who did not participate in a sports camp during the testing sessions. No significance was detected in within-group comparisons but high effect size and power on subscales of the LMS suggest a need for further studies. The experimental group, however, had significantly lower scores in stimulus avoidance as a leisure motivator which emphasizes the importance of social interaction in sports participation.

The Effects of Exercise on Occupational Functioning in the Well Elderly

Exercise benefits elders and may improve functional independence. The Model of Human Occupation proposes that functioning effectively is related to volition. This study aimed at clarifying the relationship between the occupation of exercise, functional abilities, and volition. Subjects included 48 community dwelling persons over 60 years of age divided into three groups based on physical and sedentary activities. Instruments used were the Functional Status Index (FSI) to measure occupational function and the Occupational Self Assessment (OSA) to measure volition. Results indicated that elders who reported regular exercise involvement functioned more independently (F= 5.187, p= .009).

The Relationship Between Strength, Pain, and Community Integration in Wheelchair Users: A Pilot Study

The purpose of this pilot study was to determine the differences between wheelchair users and their matched able-bodied controls in grip strength, pain (as expressed by scores on the McGill Pain Questionnaire [MPQ]), and community integration (as expressed by scores on the Craig Handicap Assessment and Reporting Technique [CHART]). We also explored the relationships among community integration, pain, strength, and demographic variables. Thirteen wheelchair users and 13 able-bodied participants were matched for gender, age, and activity level. The wheelchair-user group had significantly greater scores on the MPQ and significantly lower scores on the CHART. Step-wise multiple regression analyses revealed that the best predictor for pain was age for the wheelchair-user group and activity for the able-bodied group. The best predictor of the CHART for the wheelchair-user group was grip strength. In conclusion, pain was associated with age for the wheelchair-user group and with activity for the able-bodied group. In addition, grip strength was associated with community integration for the wheelchair-user group.

Occupational therapy: current practice and training issues in the treatment of cognitive dysfunction

A significant relationship exists between cognitive abilities and functional performance in activities of daily living. Occupational therapists are involved in providing cognitive rehabilitation to individuals with brain damage by assisting them in fulfilling self-care, work and leisure roles. Since occupational therapists specialize in functioning in the real world, they should have a primary role on the interdisciplinary team in assessing and treating cognition as it relates to function. Particular areas of expertise include assessment and intervention in daily living tasks, safety issues and cognitive/perceptual dysfunction. Treatment strategies in occupational therapy are classified into two approaches: remedial and compensatory. A combination of the two approaches has been found to be the most beneficial method of intervention. Though current training guidelines for occupational therapists in cognitive rehabilitation are vague, the major focus has been on evaluating functional status and intervening when cognitive/perceptual deficits are present. Future training for practitioners in this area will require more specialized experiences and education. Additional research will need to be conducted by therapists to document treatment efficacy. Despite current health care constraints, occupational therapists must not lose sight of delivering quality care in an individualized and holistic manner.