Browsing by Person "Hooper, Julie"

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A project to qualitatively evaluate an exercise programme for wheelchair users with MS: an opportunity for clinically-based student research?
(2008-09-27) Galante, Claudia; Bulley, Catherine; Hooper, Julie
This presentation will describe a clinical/academic research collaboration via each team member's project 'journey'. A programme of monthly exercise classes, intended to facilitate maintenance of physical function of wheelchair-dependent people with MS, was developed and piloted by Julie Hooper at an out-patients physiotherapy gym. The MS Society Edinburgh branch part-funded the classes. Formal independent evaluation of the pilot programme was required. A focus group study to explore the six participants' experiences was proposed and registered with NHS Lothian R&D by Julie Hooper. Discussion between her and Cathy Bulley highlighted the possibility of the study being carried out as a supervised student project, both to provide necessary evaluation rigour and offer the opportunity for a student to gain qualititative research skills in a clinical environment. Claudia Galante conducted the focus group and wrote up the results for her dissertation. Key findings demonstrated the strong desire of the group to be more physically active, and multiple benefits to their quality-of-life. Dissemination of the findings is underway to help inform future service provision for this population. This project represented a very successful pilot of clinically-based dissertations that benefitted all parties; more such collaborations are now being planned.
Ankle Kinematics and Temporal Gait Characteristics over the Duration of a 6-Minute Walk Test in People with Multiple Sclerosis Who Experience Foot Drop
(Hindawi Publishing Corporation, 2018-07-02) van der Linden, Marietta; Andreopoulou, Georgia; Scopes, Judy; Hooper, Julie; Mercer, Tom
Foot drop is a common gait impairment in people with MS (pwMS) but in some foot drop may only occur after a period of prolonged walking and may be a sign of motor fatigability. The purpose of the study was to explore whether, for pwMS, an adapted six-minute walk test (6minWT) would result in an increase in foot drop as measured using electrogoniometry. Sagittal ankle kinematics were recorded for fifteen participants (10 females and 5 males, aged 37-64) with MS (EDSS 4-6) throughout the 6minWT. Ankle kinematics and temporal stride parameters were compared between the first and last 10 gait cycles of the 6minWT. Peak dorsiflexion in swing was significantly reduced at the end of the 6minWT compared to the start, with six of the fifteen participants having a decrease of two degrees or more. Statistically significant changes in temporal stride parameters suggested a decrease in walking speed. Our results suggest that with the protocol used in this study it is feasible to identify patients who experience increased foot drop as a result of a prolonged exercise task.
Do wheelchair-dependent people with multiple sclerosis want to exercise?
(2008) Galante, Claudia; Hooper, Julie; Bulley, Catherine
E-learning in physiotherapy education
(Elsevier Science B.V. Amsterdam, 2007-09) Peacock, Susi; Hooper, Julie
This paper reports the findings of a 1-year research project into the role of e-learning as a mechanism to support and enhance the learning environment for pre- and post-registration physiotherapists. The findings reveal tutor and student perceptions about what study entails, the anticipated respective roles of individuals in the learning process and how those individuals believe learning should occur when supported by e-learning in a tertiary education institution. Critical differences between the two groups of students, at different stages of their professional education, and their different uses of virtual learning environments are highlighted. This study raises some key issues that need to be addressed by educational institutions deploying e-learning in order to prepare students to engage with such a learning medium, which is likely to be unfamiliar to them at the outset of their undergraduate studies. In addition, physiotherapists need the skills, time and resources to regularly access and actively participate in the online environment. These points are essential if online communities such as interactiveCSP (www.interactivecsp.org.uk) are to be sustainable. Employers have a crucial role in promoting the professional development of staff by supporting such initiatives and ensuring that they are inculcated into an organisational culture which promotes the sharing of expertise and practice that is evidence based.
Experiences of functional electrical stimulation (FES) and ankle foot orthoses (AFOs) for foot-drop in people with multiple sclerosis
(Informa Healthcare, 2014-05-06) Bulley, Catherine; Mercer, Tom; Hooper, Julie; Cowan, P.; Scott, S.; van der Linden, Marietta
Purpose: A constructivist phenomenological study explored impacts of ankle foot orthoses (AFOs) or functional electrical stimulation (FES) on people with foot-drop from multiple sclerosis (MS). Method: Focus groups following topic guides were analysed using interpretative phenomenological analysis, with researcher reflexivity, participant verification and peer checking of analysis. Participants with sustained use of the devices (under 2 y) were invited from two quantitative studies that (a) investigated immediate FES effects (n_12) and (b) compared habitual use of AFO (n_7) or FES (n_6). Two focus groups addressed AFO (n_4) and FES (n_6) experiences. Results: Similar numbers of positive and negative aspects were described for AFO and FES. Both reduced fatigue, improved gait, reduced trips and falls, increased participation, and increased confidence; greater balance/stability was reported for AFOs, and increased walking distance, fitness and physical activity for FES. Barriers to both included avoiding reliance on devices and implications for shoes and clothing; a non-normal gait pattern was reported for AFO, and difficulties of application and limitations in the design of FES. However, participants felt the positives outweighed the negatives. Conclusions: Participants felt benefits outweighed the drawbacks for AFO and FES; greater understanding of user preferences and satisfaction may increase likelihood of usage and efficacy.
Functional Capacity and Health-Related Quality of Life in Individuals Post Stroke
(2008-01) Almkvist Muren, Marie; H_tler, Matthias; Hooper, Julie
Background: In individuals post stroke, cardiovascular and functional capacity is frequently reduced independent of severity. The psychological consequences of this reduction have only been briefly investigated. This study investigated the relationship between functional capacity and health-related quality of life (HRQoL) in individuals post stroke. Method: Thirty subjects with a mild stroke were tested 60 27 months (mean SD) post stroke. Functional capacity was quantified with the 6-minute walk test (6MwT) and perceived HRQoL was evaluated by using the Stroke Impact Scale (SIS) version 3.0 questionnaire. Results: The 6MWT distance walked was 353 137 m, that is, 63% of the distance predicted for healthy adults. HRQoL was reduced with the lowest SIS scores in the domains of strength, hand function, and participation domains and the highest scores in the domains of mobility, communication, activities of daily living/instrumental activities of daily living (ADL/IADL), and memory. The SIS domains of hand function, strength, mobility, ADL/IADL, and participation were all positively correlated with 6MWT distance, with the strongest correlation for the latter four domains. Conclusion: Reductions in both functional capacity and HRQoL were documented. Functional capacity was positively correlated with six of the HRQoL domains and was strongest with the SIS domains most related to demands made on the individual throughout the day. 2008 Thomas Land Publishers, Inc.
Gait kinematics of people with Multiple Sclerosis and the acute application of Functional Electrical Stimulation
(Elsevier, 2014-04) van der Linden, Marietta; Scott, S. M.; Hooper, Julie; Cowan, P.; Mercer, Tom
This study aimed to (i) compare the gait characteristics of people with Multiple Sclerosis (pwMS) to those of healthy controls walking at the same average speed, and (ii) assess the effects of the acute application of Functional Electrical Stimulation (FES) to the dorsiflexors. Twenty-two people with pwMS (mean age 49 years), prescribed FES, and 11 age matched healthy controls participated. Three dimensional gait kinematics were assessed whilst (i) pwMS and healthy controls walked at self-selected speeds (ssws), (ii) Healthy controls also walked at the average walking speed of the pwMS group, and (iii) people with MS walked using FES. Compared to healthy controls walking at their ssws, pwMS walked slower and showed differences in nearly all gait characteristics (p<0.001). Compared to healthy controls walking at the same average speed, pwMS still exhibited significantly shorter stride length (p=0.007), reduced dorsiflexion at initial contact (p=0.002), reduced plantar flexion at terminal stance (p=0.008) and reduced knee flexion in swing (p=0.002). However, no significant differences were seen between groups in double support duration (p=0.617), or hip range of motion (p=0.291). Acute application of FES resulted in a shift towards more normal gait characteristics, except for plantar flexion at terminal stance which decreased. In conclusion, compared to healthy controls, pwMS exhibit impairment of several gait characteristics that appear to be independent of the slower walking speed of pwMS. The acute application of FES improved most impaired gait kinematics. A speed matched control group is warranted in future studies of gait kinematics of pwMS.
Habitual Functional Electrical Stimulation Therapy Improves Gait Kinematics and Walking Performance, but Not Patient-Reported Functional Outcomes, of People with Multiple Sclerosis who Present with Foot-Drop
(2014-08-18) van der Linden, Marietta; Hooper, Julie; Cowan, P.; Weller, B.; Mercer, Tom
Background: People with Multiple Sclerosis (pwMS) often experience a disturbed gait function such as foot-drop. The objective of this pilot study was to investigate the medium term effects of using Functional Electrical Stimulation (FES) to treat foot-drop over a period 12 weeks on gait and patient reported outcomes of pwMS. Methods and Findings: Nine pwMS aged 35 to 64 (2 males, 7 females) were assessed on four occasions; four weeks before baseline, at baseline and after six weeks and twelve weeks of FES use. Joint kinematics and performance on the 10 meter and 2 minute walk tests (10WT, 2 minWT) were assessed with and without FES. Participants also completed the MS walking Scale (MSWS), MS impact scale (MSIS29), Fatigue Severity Score (FSS) and wore an activity monitor for seven days after each assessment. Compared to unassisted walking, FES resulted in statistically significant improvements in peak dorsiflexion in swing (p = 0.006), 10MWT (p = 0.006) and 2 minWT (p = 0.002). Effect sizes for the training effect, defined as the change from unassisted walking at baseline to that at 12 weeks, indicated improved ankle angle at initial contact (2.6u, 95% CI 21u to 4u, d = 0.78), and a decrease in perceived exertion over the 2 min walking tests (21.2 points, 95% CI 25.7 to 3.4, d =20.86). Five participants exceeded the Minimally Detectable Change (MDC) for a training effect on the 10mWT, but only two did so for the 2 minWT. No effects of the use of FES for 12 weeks were found for MSWS, MSIS29, FSS or step count. Conclusion: Although FES to treat foot-drop appears to offer the potential for a medium term training effect on ankle kinematics and walking speed, this was not reflected in the patient reported outcomes. This observed lack of relationship between objective walking performance and patient reported outcomes warrants further investigation.
How do diverse groups of learners in the health sciences respond to a new virtual learning environment?
(Queen Margaret University College, 2005-06) Peacock, Susi; Hooper, Julie; Learning Teaching Support Network for Health Sciences
Aims of the project In the original proposal, the stated aims of this research were to: 'Investigate learners' responses to their first exposure to a new learning experience in a VLE Examine learners' attitudes to the VLE as an effective learning environment through the project Compare and contrast attitudes to a VLE in two different physiotherapy programmes.' Objectives of the project The main objective of the research (as stated in the original proposal) was to provide a detailed analysis into the experience of two specific and differing physiotherapy student cohorts who were new to using VLEs in the learning experience. We aimed to: 'Provide an overview of the literature on the use and value of VLEs in the health sciences. This will focus specifically on initial learner attitudes to Information Technology in learning Conduct a study exploring students' reactions to, and participation in a VLE during the lifetime of the project Identify issues in preparing students in the use of a VLE drawn from diverse groups Evaluate the findings of the study which will: Review students attitudes to the use of a VLE in physiotherapy programmes Highlight individual, social and technical barriers for the meaningful implementation of the VLE from the student perspective Consider the potential for VLEs for the health science community as a whole as well as to the individual lecturer Raise awareness, throughout the duration of the project, of the potential roles of VLE in improving students learning.'
Pilates for people with multiple sclerosis who use a wheelchair: feasibility, efficacy and participant experiences
(Taylor & Francis Ltd, 2013-08) van der Linden, Marietta; Bulley, Catherine; Geneen, Louise; Hooper, Julie; Cowan, P.; Mercer, Tom
Purpose: This mixed methods study aimed to explore the feasibility, efficacy and the participants' experiences of a Pilates programme for people with Multiple Sclerosis (pwMS) who use a wheelchair. Method: Fifteen pwMS took part in the 12-week Pilates programme. At baseline and after 6 and 12 weeks of the programme, sitting stability, measured as maximum progression of the Centre of Pressure when leaning sideways (COPmax), posture, pain on a Visual Analogue Scale, function, fatigue and the impact of MS (MSIS29) were assessed. Ten participants took part in two focus groups within six weeks of the completion of the programme. Results: Significant improvements at the 12-week assessment were found in COPmax (p-=-0.046), sitting posture (p-=-0.004), pain in the shoulders (p-=-0.005) and back (p-=-0.005) and MSIS29 (p-=-0.006). The majority of participants described various physical, functional, psychological and social benefits from participation that reflected increased confidence in activities of daily living. Enjoyment of the classes was expressed by all, and most wished to continue participation. Conclusions: Pilates appears to be efficacious in improving sitting stability and posture and decreasing pain and was also well tolerated by wheelchair users with MS. Further mixed methods studies are warranted.Implications for Rehabilitation
Quantification of gait kinematics and walking ability of people with multiple sclerosis who are new users of functional electrical stimulation
(Taylor & Francis, 2013-03) Scott, S. M.; van der Linden, Marietta; Hooper, Julie; Cowan, P.; Mercer, Tom
Objective: To assess whether the application of Functional Electrical Stimulation improves gait kinematics and walking ability in people with multiple sclerosis who experience foot drop. Design: Acute open labelled comparative observation trial. Participants: Twelve people (3 females, 9 males, EDSS 2-4) with relapsing remitting multiple sclerosis (47.8 years (standard deviation 6.6)) who were new users of functional electrical stimulation. Methods: Gait kinematics were recorded using 3D gait analysis. Walking ability was assessed through the 10-m walk test and the 6-min walk test. All assessments were performed with and without the assistance of functional electrical stimulation. The effect of functional electrical stimulation was analysed using paired t-tests. Results: Ankle dorsiflexion at initial contact (p-=-0.026), knee flexion at initial contact (p-=-0.044) and peak knee flexion during swing (p-=-0.011) were significantly greater whilst walking with Functional Electrical Stimulation. The increased peak dorsiflexion in swing of nearly 4 degrees during functional electrical stimulation assisted walking approached significance (p-=-0.069). The 10-m walk time was significantly improved by functional electrical stimulation (p-=-0.004) but the 6 min walk test was not. Conclusion: The acute application of functional electrical stimulation resulted in an orthotic effect through a change in ankle and knee kinematics and increased walking speed over a short distance in people with multiple sclerosis who experience foot drop