Barbara Mazer

Purpose: Long COVID is associated with a range of physical, cognitive, and/or psychological symptoms that significantly affect daily functioning. These individuals require rehabilitation services to address their limitations. This study explored the experiences of people with long COVID regarding access to and receipt of rehabilitation services. Methods: This qualitative study recruited 12 individuals with long COVID from a population‐based survey among the population of Laval (Quebec). Semistructured telephone interviews were conducted, recorded, transcribed verbatim, and analyzed using inductive thematic content analysis. Relevant elements were extracted, coded, and organized into themes/subthemes. Results: Twelve participants (seven females; five males) participated in the study. We identified three main themes, each with subthemes: (1) impact of long COVID on personal and professional life (e.g., professional life, leisure activities, and social life); (2) rehabilitation services (access barriers, perceptions of services received); and (3) psychosocial support (lack or presence of support). Access to rehabilitation services was hampered by several barriers: difficulties obtaining referrals, financial constraints, lack of awareness among health professionals, and service shortages. Participants who accessed rehabilitation services reported satisfaction with care they received and appreciated the multidisciplinary approach. Conclusions: Improving access to rehabilitation services for people with long COVID is essential to support their recovery, as timely and coordinated rehabilitation can facilitate reintegration into daily activities and reduce functional limitations. Strategies to enhance access include increasing health professional awareness, reducing financial and logistical barriers, and expanding service availability.

Many people experience symptoms months or years after COVID-19 infection. The impact of these symptoms on daily functioning and factors associated with functional decline are not well understood. This study aimed to describe functional changes among persons with long-Covid and explore associated sociodemographic and clinical factors. A total of 2764 adults who tested positive for COVID-19 were recruited at ≥12 wks after diagnosis. Participants responded to an electronic survey (Newcastle Post-COVID Syndrome Questionnaire (symptoms); COVID-19 Yorkshire Rehabilitation Screen (activities; perceived global health, mobility, personal care, daily activities). A total of 37.8% were classified as having long-Covid based on the positive response to “Are you still troubled by symptoms?” The majority reported a decline in global health, mobility, and participation in daily activities. Common changes in function included fatigue, breathlessness upon climbing stairs and when dressing, decline in participation in usual activities, anxiety, pain/discomfort, and reduced concentration. Having COVID-19 ≥ 1 yr prior was associated with change in perceived global health (odds ratio = 1.5). Being infected ≥12 mos prior (odds ratio = 1.5), hospitalized for COVID-19 (odds ratio = 2.2–2.4), ≥1 chronic comorbid conditions (odds ratio = 1.6), and obesity (odds ratio = 1.6) were associated with functional decline. Many of those infected with COVID-19 experience long-lasting symptoms impacting daily functioning. Multidisciplinary medical and rehabilitation services are needed to help improve recovery and maximize functioning.

Purpose: Knowledge translation (KT) refers to the process of applying the most promising research outcomes into practice to ensure that new discoveries and innovations improve healthcare accessibility, effectiveness, and accountability. The objective of this perspective paper is to discuss and illustrate via examples how the KT process can be implemented in an era of rapid advancement in rehabilitation technologies that have the potential to significantly impact pediatric healthcare. Methods: Using Graham et al.'s (2006) Knowledge-to-Action cycle, which includes the knowledge creation funnel and the action cycle, we illustrate its application in implementing novel technologies into clinical practice and informing healthcare policy changes. We explore three successful applications of technology research: powered mobility, head support systems, and telerehabilitation. Additionally, we examine less clinically mature technologies such as brain-computer interfaces and robotic assistive devices, which are hindered by cost, robustness, and ease-of-use issues. Conclusions: The paper concludes by discussing how technology acceptance and usage in clinical settings are influenced by various barriers and facilitators at different stakeholder levels, including clients, families, clinicians, management, researchers, developers, and society. Recommendations include focusing on early and ongoing design partnerships, transitioning from research to real-life implementation, and identifying optimal timing for clinical adoption of new technologies.

In most western countries, older adults depend on private cars for transportation and do not proactively plan for driving cessation. The objective of this review was to examine current research studies outlining effective interventions and strategies to assist older adults during their transition from driver to driving retirement or cessation. A search was completed across 9 databases using key words and MeSH terms for drivers, cessation of driving, and older adult drivers. Eligibility screening of 9,807 titles and abstracts, followed by a detailed screening of 206 papers, was completed using the Covidence platform. Twelve papers were selected for full-text screen and data extraction, comprising 3 papers with evidence-based intervention programs and 9 papers with evidence-informed strategies. Three papers met the research criteria of a controlled study for programs that support and facilitate driving cessation for older adults. Nine additional studies were exploratory or descriptive, which outlined strategies that could support older drivers, their families, and/or healthcare professionals during this transition. Driving retirement programs/toolkits are also presented. The driver retirement programs had promising results, but there were methodological weaknesses within the studies. Strategies extracted contributed to 6 themes: Reluctance and avoidance of the topic, multiple stakeholder involvement is important, taking proactive approach is critical, refocus the process away from assessment to proactive planning, collaborative approach to enable “ownership” of the decision is needed, and engage in planning alternative transportation should be the end result. Meeting the transportation needs of older adults will be essential to support aging in place, out-of-home mobility, and participation, particularly in developed countries where there is such a high dependency on private motor vehicles.

Background: Social participation is beneficial for individuals’ health. However, people with disabilities that may lead to mobility limitations tend to experience lower levels of social participation. Information and communication technologies such as the OnRoule mobile application (app) can help promote social participation. Objectives: To obtain potential users’ perceptions on the usability and content of the OnRoule app for providing information on accessibility, as well as its potential to optimize social participation. Materials and Methods: Cross-sectional user-centered design study. Individuals with physical disabilities (n = 18) were recruited through community organizations and interviewed using a semi-structured guide. Interviews were recorded, transcribed, and analyzed using thematic analysis. Results: Three main themes were identified: (1) “user-friendliness”; (2) “balance between the amount and relevance of information”; and (3) “potential use of the app”. Discussion and Conclusion: Findings from this study indicated that the app was easy to use, had pertinent information, and enabled a positive experience of finding information. However, several areas of improvement were identified, such as the clarity of specific elements, organization and amount of information, optimization of features, and inclusiveness. Apps such as OnRoule could optimize social participation by facilitating the process of finding resources in the community and building a sense of connectedness between users.

Background: Autonomy is a central concept in both bioethics and rehabilitation. Bioethics has emphasized autonomy as self-governance and its application in treatment decision-making. In addition to discussing decisional autonomy, rehabilitation also focuses on autonomy as functional independence. In practice, responding to patients with diminished autonomy is an important component of rehabilitation care, but also gives rise to tensions and challenges. Our objective was to better understand the complex and distinctive ways that autonomy is understood and upheld in the context of rehabilitation care by reviewing how autonomy is discussed in the rehabilitation literature. Methods: We conducted a scoping review addressing issues of autonomy in the context of mental and physical rehabilitation. Our process followed three sequential steps. We extracted and analyzed bibliometric information. We then examined how autonomy was defined and conceptualized. Finally, we examined how the articles discussed the roles of rehabilitation health professionals in responding to patient autonomy. Findings: The articles include 16 empirical reports, 17 case studies and 30 theoretical papers. The most common conceptual accounts of autonomy drew upon principlism, rights-based and legal analyses, and relational/social approaches. We identified four broad approaches for responding to patient autonomy: supporting, promoting, respecting and advocating. Conclusion: This review helps clarify some of the ambiguities and conceptual distinctions underlying discussions and practices related to autonomy in rehabilitation. It also draws attention to a wide range of activities that health professionals can undertake with the goal of supporting, promoting, respecting and advocating for patient autonomy in rehabilitation care.

Purpose: Little is known about the physical activity of adolescents born prematurely. This study aimed to: 1) describe relationships between moderate to vigorous physical activity (MVPA) in adolescents born prematurely and various factors and, 2) compare their MVPA level to guidelines.Method: A secondary analysis was performed using data from 64 adolescents (16.1 ± 2.5 years old, born £29 weeks gestation; 57.8% girls). Time spent in MVPA was based on accelerometry data. Sociodemographic, prematurity and comorbidity variables were based on questionnaire data or, for movement difficulty, from the results of the Movement Assessment Battery for Children—Second Edition.Results: Multiple regression analysis showed that participants who were older (b = -4.52, p < .001), female (b = 14.18, p = .014), with movement difficulty (b = 18.64, p = .014), with health problems (b = 11.78, p = .036) and without hyperactive behavior (trend, b = 2.04, p = .099) spent less time in MVPA. Together these variables explained 44.4% of the variance in MVPA. Most participants (79.7%) did not meet Canadian MVPA guidelines.Conclusion: Study results suggest that physical activity interventions should especially target adolescents born prematurely who are older, female, with health problems, and with marked movement difficulties.