Margaret Donovan-Hall

Predicting Adherence to Exercise-Based Therapy in Rehabilitation

Objective: to determine whether the theory of planned behavior (TPB) would predict adherence to exercise-based therapy and whether perceived symptom changes during therapy would add to the prediction of adherence. Design: prospective observational study. Participants: 106 women and 44 men undertaking rehabilitation for dizziness. Method: the TPB predictors were assessed with a structured interview at baseline and at 3 months after the beginning of therapy. Symptoms provoked by the exercises were measured at baseline, at the initial therapy session, and at 1 week and 3 weeks after the beginning of therapy. Results: both pretreatment and posttreatment intentions were related to adherence. Symptom perceptions independently predicted adherence. Conclusions: the findings suggest that interventions to improve adherence could be based on the TPB, but symptom experiences during treatment also need to be taken into account in such interventions

Exploring positive adjustment in people with spinal cord injury.

This study explored adjustment in people with spinal cord injury; data from four focus groups are presented. Thematic analysis revealed four themes, managing goals and expectations, comparison with others, feeling useful and acceptance, showing participants positively engaged in life, positively interpreted social comparison information and set realistic goals and expectations. These positive strategies show support for adjustment theories, such as the Cognitive Adaptation Theory, the Control Process Theory and Response Shift Theory. These results also provide insight into the adjustment process of a person with spinal cord injury and may be useful in tailoring support during rehabilitation.

A qualitative study exploring views and experiences of people with stroke undergoing transcranial direct current stimulation and upper limb robot therapy

Abstract Background: Neurorehabilitation technologies used mainly in research such as robot therapy (RT) and transcranial direct current stimulation (tDCS) can promote upper limb motor recovery after stroke. Understanding the feasibility and efficacy of stroke rehabilitation technologies for upper limb impairments is crucial for effective implementation in practice. Small studies have explored views of RT by people with stroke; however experiences of people receiving tDCS in combination with RT have never been explored. Objective: To explore views and experiences of people with sub-acute and chronic stroke that had previously taken part in a randomised controlled trial involving tDCS and RT for their impaired upper limb. Methods: An interview study includes open and closed questions. Face-to-face interviews were audio recorded. Open-ended question responses were transcribed and analyzed using thematic analysis; closed questions were analyzed using descriptive analysis. Results: Participants felt that RT was enjoyable (90%) and beneficial for their affected arm (100%). From the open question data, it was found that the intervention was effective for the impaired arm especially in the sub-acute stage. Main reported concerns were that tDCS caused painful, itching and burning sensations and RT was sometimes tiring and difficult. Participants recommended that future research should focus on designing a more comfortable method of tDCS and develop a robot that promotes hand movements. Conclusions: This study provides new knowledge about the benefits and barriers associated with these technologies which are crucial to the future effective implementation of these tools in practice.