Browsing by Person "Zanudin, Asfarina"

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A community-based exercise program for ambulant adolescents and young adults with cerebral palsy, a feasibility study
(European Federation of Adapted Physical Activity, 2021-11-22) Zanudin, Asfarina; Mercer, Tom; Samaan, Cynthia; Jagadamma, Kavi; McKelvie, Gillian; van der Linden, Marietta
The aim of this study was to investigate the feasibility of an 18-week exercise program for adolescents and young adults with cerebral palsy (CP). Fourteen individuals aged 16-25 (GMFCS I-III) performed aerobic and strength exercises at their community leisure center up to three times a week. A physiotherapist provided instruction at the first session and between 2-4 times thereafter. The fitness instructor on duty provided supervision when required. Feasibility of the exercise program was explored through an exercise logbook and participant feedback survey. Gross motor function, muscle strength, aerobic capacity and Timed Up and Go test were assessed at baseline, 6, 12 and 18 weeks and quality of life and self-esteem at baseline and 12 weeks. Participants completed on average 14.8 (range 5-23) weeks of the exercise program and an average of 31 (range 10-52) sessions. The feedback survey indicated that the exercise program was mostly well accepted, adverse effects were reported by three participants. Moderate effects (d=0.57-0.64) were found for leg muscle strength increase at week 12. Other measures showed small or negligible effects. This study indicated the feasibility of a community exercise program for young people with CP and provides recommendations for sustainable exercise programs for this group.
Psychometric properties of measures of gait quality and walking performance in young people with Cerebral Palsy: A systematic review
(Elsevier, 2017-07-04) Zanudin, Asfarina; Mercer, Tom; Jagadamma, Kavi; van der Linden, Marietta
Availability of outcome measures (OMs) with robust psychometric properties is an essential prerequisite for the evaluation of interventions designed to address gait deterioration in young people with Cerebral Palsy (CP). This review evaluates evidence for the reliability, validity and responsiveness of outcome measures of gait quality and walking performance in young people with CP. A systematic search was performed in MEDLINE, CINAHL, PubMed and Scopus. Articles that met the eligibility criteria were selected. Methodological quality of studies was independently rated by two raters using the modified COnsensus-based Standard for the selection of health status Measurement INstruments checklist. Strength of evidence was rated using standardised guidelines. Best evidence synthesis was scored according to Cochrane criteria. Fifty-one articles reporting on 18 distinct OMs were included for review. Best evidence synthesis indicated a moderate to strong evidence for the reliability for OMs of walking performance but conflicting evidence for the reliability of OMs of gait quality. The evidence for responsiveness for all OMs included in this review was rated as 'unknown'. The limitations of using the modified COSMIN scoring for small sample sizes are acknowledged. Future studies of high methodological quality are needed to explore the responsiveness of OMs assessing gait quality and walking performance in young people with CP. 2017 Elsevier B.V.
The effects of a pragmatic community exercise programme in adolescents and young adults with Cerebral Palsy
(Queen Margaret University, Edinburgh, 2017) Zanudin, Asfarina
Evidence suggests that the walking ability of people with cerebral palsy (CP) often deteriorates in early adulthood. This is especially problematic as the health care for young people with disabilities changes considerably over the course of the transition from paediatric to adult health care services. This suggests the importance of providing young people with the appropriate tools for managing their disability on a largely independent basis if they hope to reduce or delay this physical decline. One such strategy is the introduction of young people to an exercise programme which may be carried out independently of the health care system. Therefore, the main aim of this thesis was to investigate the feasibility and effectiveness of an 18-week pragmatic community exercise programme in adolescents and young adults with CP. Acknowledging the importance of assessing the effects of exercise studies using outcome measures (OMs) which are reliable, valid and responsive to change, a secondary aim of this thesis was to synthesise the psychometric evidence for the measures of gait quality and walking performance currently used for adolescents and young people with CP through a systematic review. Additional psychometric evidence for measures commonly used to assess the efficacy of exercise interventions was provided by a test-retest reliability study as part of this thesis. A standardised quality checklist (COSMIN) was used in the systematic review (Study 1) to measure methodological quality. The strength of the evidence was rated using standardised guidelines. The synthesis of best evidence was scored according to the Cochrane criteria, which indicated that the reliability (inter-rater) of the Functional Mobility Scale was characterised by a 'strong' level of evidence. The evidence for the responsiveness for all OMs included in this review was rated as 'unknown'. Only one study reported on measurement error when reporting on reliability. In Study 2, test-retest reliability (Intraclass Correlation Coefficient (ICC) and Minimal Detectable Change) was calculated for physical function, habitual physical activity (HPA), quality of life (QoL) and self-esteem measures in a group of adolescents and young adults with CP (n=8) and their age-matched peers (n=14). The ICCs for physical function and HPA OMs ranged from moderate to good but were poor for the measures of QoL and self-esteem. The RCT (Study 3) showed no statistically significant improvement following the exercise programme in any of the OMs at 6 weeks (experimental n=9, control n=7). A small effect size (d=0.54) in favour of the experimental group was found for the Canadian Occupational Performance Measure (COPM). Considering the experimental group only, a statistically significant improvement was found for the COPM at 12 weeks (n=7, p=0.02) compared to the baseline. Feasibility issues were also identified. This study was limited by its small sample size. This thesis contributes to the evidence base on pragmatic community exercise programmes for adolescents and young adults with CP and confirms the test-retest reliability (consistency) of physical function and HPA OMs commonly used to assess the efficacy of exercise interventions in CP.