BSc (Hons) Physiotherapy

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7262

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A 10 metre 6-minute walk test can not be used as an appropriate alternative to the standardised 30 metre 6-minute walk test: an inter- test reproducibility study
(Queen Margaret University, 2016)
Question: Does a 10-metre 6 minute walk test (6MWT) show acceptable agreement to the standardised 30-metre 6MWT, to be used as an appropriate alternative? Design: A within participant, inter-test reproducibility design Setting: Sports Hall, Queen Margaret University. Participants: 25 healthy participants, between 18 and 24 years, were recruited from the Queen Margaret University student population. Intervention: Participants attended for one session in which they were required to perform one 10m 6MWT and one 30m 6MWT. The 6MWTs were performed in accordance with the standardised American Thoracic Society guidelines. Total distance walked, number of laps, heart rate, Borg rate of perceived exertion and anthropometric data was recorded under strict experimental conditions. Outcome Measures: 6-minute walk distance in metres (6MWD). Results: Moderate inter-test reproducibility was found between the 10m 6MWT and the 30m, with an ICC score of 0.584 (95% CI of -0.53-0.879). Bland and Altman analysis produced a range of 94.12 m between 95% limits, showing moderate agreement. All of the participants walked further in the 30m 6MWT trial with a mean increase 13.18% (65.88 m) in 6MWD. Conclusion: The 10m 6MWT appears to have moderate agreement to the 30m 6MWT, however, when the results are considered with minimal detectable change values, this agreement can not be considered acceptable. The 10m 6MWT can not be interchanged with the standardised 30m 6MWT in clinical practice. It is recommended that further research, looking at the agreement between the 10m 6MWT and the 30m 6MWT, using more clinical populations and larger sample sizes.
A preliminary study evaluating the concurrent validity of a waist worn and a wrist worn ActiGraph - during free-living activities in people with Parkinson's disease over a seven day period.
(Queen Margaret University, 2016)
Background: Parkinson's disease (PD) is one of the most prevalent neurological conditions within the aging population. One of the symptoms of PD is the decline in physical activity and an increase in sedentary behaviour. It is essential to monitor activity within this population as exercise is recognised to slow the process of the disease. Therefore it is essential to have valid tools to measure sedentary behaviour within this population. Objective: Establish the concurrent validity between an ActiGraph worn on the waist and worn on the wrist. Participants: 9 participants were recruited (7 males and 2 females). All had a confirmed diagnosis of Parkinson's, a Hoehn and Yahr rating of 3 or less and an MMSE of 28 or above. Methods: Participants wore two ActiGraphs, one on their non-dominant wrist and one on their left hip for 7 days during free living. Data collected from the devices was analysed and comparisons were made between the sedentary time recorded on the waist and on the wrist. Results: There was a strong correlation between the devices (0.7 and 0.72), daily sedentary and weekly sedentary behaviour respectively. However the bias between the devices was considerably high at 24.43, 24.96 respectively. Conclusion: Further research is needed to conclude the concurrent validity between the devices. The wrist worn device needs more testing to test appropriateness for this population. Therefore, at present it could be suggested to wear the waist worn ActiGraph when evaluating sedentary behaviour within this population.
activPAL as a valid method of recording physical activity and sedentary behaviour in people with mild to moderate Parkinson's Disease.
(Queen Margaret University, 2016)
Objective: Establish whether the activPAL activity monitor accurately measures physical activity and sedentary behaviour in people with mild to moderate Parkinson's Disease. Design: Cross-sectional, observational, validation study. Participants: 12 participants with mild to moderate Parkinson's Disease. Method: Each participant wore an activPAL activity monitor. They individually performed a range of controlled, functional and walking activities. This was captured and coded on video to define a gold standard. The time spent sedentary and active was calculated and the results from activPAL and video observation (VO) were compared. Results: Data from 10 participants was included in the analysis. Correlation coefficients for sedentary time ranged from r = 0.988 to 1 p < 0.001 and for active time for controlled activities was r = 0.526 p > 0.001 and ranged from r = 0.976 to 1 p < 0.001 for functional and walking activities. The mean difference between activPAL and VO for time spent sedentary was -34.30s (controlled activities) and -16.20s (random activities) and for time spent active was 10.40s (controlled activities), 2.50s (random activities), 0.30s (walking activities). Conclusion: ActivPAL is a valid tool to measure physical activity and sedentary behaviour in people with mild to moderate Parkinson's Disease. It is more accurate in measuring physical activity than sedentary behaviour.
An exploration of orthopaedic physiotherapists' experiences with the use of outcome measures in practice: A qualitative study
(Queen Margaret University, 2016)
Objective: Explore orthopaedic physiotherapists' views and experiences with the use of outcome measures (OMs) in practice and investigate whether OMs influence orthopaedic physiotherapists' clinical decision-making. Design: Qualitative, phenomenological design Participants: Six HCPC registered orthopaedic physiotherapists working in NHS Scotland (in-patient and out-patient). All participants were female, with a median age of 43 years (Range 25-59) and a median duration of experience in orthopaedic physiotherapy of 8 years (Range 0.42-22) Methods: Individual, semi-structured interviews over the phone, lasting approximately 40 minutes. Results: Two a priori themes were confirmed and four themes emerged from the data; 1. Awareness and understanding of OMs. 2. Physiotherapists' views towards using OMs. 3. How physiotherapists select OMs to use in practice. 4. How OMs are used in practice (a priori). 5. Barriers towards using OMs (a priori). 6. Factors influencing the future use of OMs. Conclusion: Orthopaedic physiotherapists use OMs to support clinical decision-making and justify the effectiveness of physiotherapy interventions. OMs used in practice were selected based on validity and practicality of use. Lack of time, lack of knowledge and measures being inappropriate for patients were identified as main barriers towards using OMs in orthopaedic practice. Easy accessible OM databases with information and active educational strategies, combined with increased support from managers were suggested to increase use of OMs in orthopaedic practice.
An exploration of the activPAL™ activity monitor in measurement of sedentary and physical activity patterns in people with mild to moderate Parkinson’s disease: A validation study.
(Queen Margaret University, 2016)
Background Measurement of physical activity (PA) and sedentary behaviour (SB) may facilitate individually-tailored interventions aimed at modifying the progression of Parkinson’s disease (PD) symptoms. Accelerometry is suggested as a practical and objective measurement tool. Aim This study aims to investigate the validity of the activPAL in measuring PA and SB in people with mild to moderate PD with direct observation (DO) as the criterion measure. Design Cross-sectional, DO, validation study. Methods Eight men and two women (mean age 69 ± 7.3) with mild to moderate PD (median Hoehn and Yahr 1.5, IQR 1-2) were recruited. Wearing an activPAL, they completed a controlled module consisting of 3-minute periods in different postures and a “free-living” module consisting of four randomly selected ADLs. The trial was captured on a video-camera and the time spent in different postures was classified. This was aligned and compared with the activPAL output data. Results The activPAL has a low percentage error for SB in both modules (9.11% and 3.37%) and a higher percentage error for PA (-15.1% and -19.63%). There was no statistically significant correlation between the activPAL and DO in module 1 (r=0.68, p=0.03 and r=0.55, p=0.098), however, high correlation in module 2 (r=0.94, p<0.001 and r=0.99, p<0.001). Wide limits of agreement (LOA) (range -112.6s – 106s) were demonstrated between the activPAL and DO throughout the whole test. Conclusion The activPAL overestimated SB and underestimated PA. Wide LOA may be considered clinically unacceptable. Further research is warranted to validate the activPAL before its use in practice.
An investigation into the accuracy and test-retest reliability of the Microsoft Kinect compared to the perometer for measuring lower limb volume in a healthy adult population.
(Queen Margaret University, 2017)
Question: Is the Kinect an accurate and reliable method of measuring lower limb volume compared to the perometer when testing a healthy adult population? Design: A study of accuracy and test-retest reliability of the Kinect compared to the perometer. Two measurement methods were analysed and each participant was randomly allocated to each measurement method. Participants: The sample population consisted of 15 healthy adults (7 male and 8 female) between the ages of 18 and 34. Intervention: Each participant had the volume of their dominant lower limb measured using the perometer and the Kinect three times. Outcome measures: The accuracy and test-retest reliability of the lower limb volumes recorded by the Kinect in comparison with the perometer. Results: High intraclass correlation coefficient (ICC) values were found for the perometer (0.994) and for the Kinect (0.956). The perometer had the lowest standard error of measurement (SEM) (145.8) compared to the Kinect (911.9). The Kinect had the propensity to overestimate limb volume compared to the perometer. The mean difference observed between the Kinect and the perometer was 625.7 (±633.1). The limits of agreement (LOA) were calculated as 1867.7 for the upper LOA and -615.2 for the lower LOA. Conclusion: The Kinect is an unreliable and inaccurate method of measuring lower limb volume. Therefore, it cannot be used interchangeably with the perometer. Further investigation is required in a healthy population prior to using the Kinect in a population with lymphoedema. In order to do this, a standardised protocol is required for the Kinect.
An investigation into the accuracy and test-retest reliability of the perometer compared to a water displacement method for measuring lower limb volume in healthy human participants.
(Queen Margaret University, 2017)
Aim: To investigate the accuracy and test-retest reliability of the perometer compared to a water displacement method for measuring lower limb volume in healthy human participants. Design: Between-methods agreement and test-retest reliability study. Participants: 15 healthy volunteers (8 females and 7 males) with no drop-outs. Intervention: All participants had their dominant lower limb volumes measured using both the vertically-oriented perometer and volumeter. Allocation to either tests was random and in no specific order, but both tests had to be completed. Outcome measures: ICC(3,1) model was used to determine the test-retest reliability for each method, while the measurement error was determined using within-subject standard deviation. A one sample t-test was used to determine the accuracy of the vertically-oriented perometer compared to the volumeter, while a Bland and Altman difference plot was constructed to determine the limits of agreement between both methods. Results: There was a lack of agreement between the perometer and water displacement method. The Bland-Altman difference plot showed that the perometer overestimated lower limb volume by 832ml compared to the water displacement method. The respective upper and lower limits of agreement were 220 and 1444ml. The test-retest reliability of the perometer method was ICC(3,1)=0.994. The measurement error of the perometer method was clinically acceptable (149ml). Conclusion: There was a lack of agreement between the two methods investigated. Therefore, the perometer and water displacement methods are not interchangeable. It is recommended that future validity and reliability studies for the vertically-oriented perometer are conducted on an older and clinical population.
An investigation of Physical Activity levels in Asthmatic Children: A Service Evaluation Study
(Queen Margaret University, 2016)
Objective: To investigate the physical activity levels in asthmatic children in relation to asthma control and body mass index (BMI). Design: A service evaluation study. Participants: 21 boys and 16 girls between the ages of 5 and 14 were recruited from The Royal Hospital for Sick Children (Edinburgh) asthma clinic following recent exacerbation of their condition. Participants were excluded if they suffered from any other health conditions or physical disabilities which may have affected their ability to exercise. Main Outcome Measures: The Physical Activity Questionnaire for Children (PAQ-C) was administered to participants along with the Asthma Control Test (ACT) to assess asthma severity and control. BMI in relation to age and sex was also calculated for each child. Results: Only weak correlations were evident between variables. The results suggest that children with poor asthma control and high BMI participate in less physical activity, whilst those with a higher BMI were shown to have better asthma control. In addition, physical activity levels appeared lower in older children. Conclusion: It can be concluded that physical activity participation is generally low in this population, indicating a need for intervention. Although significant results were not achieved, this study provides a basis for further research in the field.
An investigation of Physical Activity levels in Asthmatic Children.
(Queen Margaret University, 2016)
Objective: Establish the physical activity levels of asthmatic children and identify if relationships exist between physical activity levels, asthma control and BMI. Design: A service evaluation quantitative research design Participants: 37 Asthmatic Children aged 5-15 all attending the Edinburgh Royal Infirmary Asthma Clinic. Outcome measures: Physical Activity Questionnaire (PAQ-C), Asthma Control Test (ACT) were used and BMI was calculated. Results: Low PAQ-C scores were found (mean 2.49 +/-0.12 s.d) Pearson's correlation was used to determine if there was a relationship between the total scores of the ACT and PAQ-C. Spearmen's correlation was used Correlative to determine if a relationship existed between PAQ-C and BMI and between BMI-ACT. No correlative findings were statistically significant. A weak positive correlation was found between PAQ-C and ACT [r= 0.12, n=37, p=0.49], A weak negative monotonic correlation was found between PAQ-C and BMI [rs=-0.23, n=37, p=0.18], a weak positive monotonic correlation BMI-ACT [rs=0.15, n=37, p=0.39]. Conclusion: Asthmatic children had low levels of physical activity. The evaluation was unable to demonstrate statically significant findings however it was able to demonstrate weak relationships between PAQ-C and ACT, PAQ-C and BMI and between BMI and ACT. This suggests that BMI and Asthma control may be linked to physical activity levels amongst asthmatic children further research is required in this field is needed to establish the causality of low activity and interventions to improve physical activity levels.
An investigation of the relationships between physical activity, asthma control and BMI in children with asthma using self-reported measures.
(Queen Margaret University, 2016)
Objective: This evaluation aims to assess the physical activity (PA) levels of children with asthma whilst assessing the relationships between PA, asthma control and body mass index (BMI). Design: A quantitative research method was adopted and branded as a service evaluation. Participants: 37 asthmatic participants (mean age of 10.7 including 21 males) were recruited through convenience sampling at an asthma outpatient clinic based in Edinburgh, Scotland. Outcome measures: Participants completed two self-reported questionnaires; the physical activity questionnaire for children (PAQ-C) and the asthma control test (ACT). Both questionnaires were completed within the clinic with parents and/or carers providing assistance if required. Results: Overall the group of participants were achieving low to moderate PA levels with a mean PAQ-C of 2.49. Most common sports found were running, walking, dance and football respectively. The mean ACT was 17.08 suggesting uncontrolled asthma. A small positive relationship was found between PAQ-C and ACT (r=0.12 p=0.49). A small positive relationship was established between the ACT and BMI (r=0.15 p=0.39) and a small weak negative relationship between the PAQ-C and BMI (r=-0.23 p=0.18). Conclusions: Despite the participants achieving low PA, the results are similar to that of healthy children. The small relationships found would suggest that other factors must be contributing to low PA and asthma control levels. PA could be promoted by health professionals to children with asthma in order to achieve higher levels.
An Investigation on the Physical Activity Levels in Asthmatic Children
(Queen Margaret University, 2016)
Objective: The purpose of this study was to investigate the physical activity levels in asthmatic children and establish whether there are any associations between physical activity levels and asthma control. Design: A service evaluation using a quantitative design. Participants: Twenty-one male and sixteen female asthmatic children aged 5 - 14 years were recruited through convenience sampling from the Royal Hospital for Sick Children. Outcome measures: Physical activity was measured by the Physical Activity Questionnaire for Children (PAQ-C) and asthma control was measured using the Asthma Control Test (ACT). Results: From the total PAQ-C summary scores, ranging from 1 (low activity) to 5 (high activity), of the thirty-seven children, the mean physical activity score was calculated to be 2.49. Pearson correlation coefficients were calculated to determine any associations between physical activity and asthma control and Spearman correlation coefficients were calculated to determine any associations between body weight, physical activity and asthma control. Statistical analysis showed a very weak positive association between PAQ-C and ACT (r = .118, p=.486), a weak negative association between BMI and PAQ-C (r=-.227, p=.176) and a very weak positive association between BMI and ACT (r=.146, p=.388), none of which were found to have any statistical significance. Conclusion: The results of this study show that physical activity levels in asthmatic children are low and there is no significant association between physical activity and asthma control. Further research is required to establish associations to low physical activity levels in asthmatic children.
Are pedestrian crossings in Edinburgh set to the correct walking speed and is this suitable for an elderly population? An observational study.
(2018)
Title: Are pedestrian crossings in Edinburgh set to the correct walking speed and is this suitable for an elderly population? An observational study. Design: Non-experimental, quantitative and observational. Participants: 101 Pedestrian crossings in Edinburgh Outcome Measures: The duration of the ‘solid green man light on to solid green man light off’, ‘green man on to end of the crossing phase’ and ‘audio signals’ at pedestrian crossings were timed. The width of pedestrian crossings was measured. Environmental factors such as the location of crossings and the presence of central islands was noted. Results: Only 2% of crossings were set to the recommended walking speed of 1.2 m/s. 50% were faster than 1.2 m/s. The mean walking speed for crossing during the green man was 1.16 m/s (SD± 0.62 m/s). The mean walking speed to cross the crossing before the end of the pedestrian crossing phase was 0.57 m/s (SD± 0.26 m/s). Audio signals were present at 37% of crossings. 39% of the crossings were between 10m – 15m with only 2 crossings having central islands recommended by the Department for Transport. 18% of crossings exceeded the Department for Transports maximum width of 15m. Conclusion: The walking speeds of pedestrian crossings in Edinburgh are not consistent and not in line with the 1.2 m/s set out by the Department for Transport (2005). Furthermore, the required walking speed of 1.2 m/s is not suitable for elderly pedestrians Therefore, a slower walking speed should be considered to increase the safety of elderly pedestrians.
Comparing technology readiness of final year student and newly qualified AHP's, with AHP's who have been qualified for 10 years or more using the Technology Readiness Index (TRI): a prospective cohort study.
(Queen Margaret University, 2016)
Question: Comparing technology readiness of final year student and newly qualified AHP's, with AHP's who have been qualified for 10 years or more: a prospective cohort study. Design: A prospective cohort study was conducted which used online and paper copies of a questionnaire. The survey included patient demographic questions at the beginning and recorded participant's age, gender, profession, time since qualified (if qualified), or year of study (if a student). The quantitative Technology Readiness Questionnaire was then used to gain information about each participant's technology readiness. Participants: To be included in the study, respondents to the online survey had to be Physiotherapy students from QMU, year four AHP students from QMU or NHS Lothian AHP's. Outcome measures: The Technology Readiness Index (TRI) is a 16 item scale with questions focusing on technology readiness. Each question relates to one of the four dimensions of; optimism, innovativeness, insecurity and discomfort Results: Findings showed that there was minimal differences in overall TRI between the two groups, however final year and newly qualified AHP's scored significantly higher on optimism, innovativeness and insecurity. Conclusion: With the NHS driving technologies forward in order to improve the efficiency and effectiveness of care delivered, it is becoming a required trait for students and staff to be able to embrace these changes. The findings suggest a need for an increase in support and training to both student and qualified AHP's in order to help shape their attitudes towards the use of technology.
Comparison of the intra-rater and inter-rater reliability of two methods to measure tibial torsion: the gravity goniometer and the footprint method.
(Queen Margaret University, 2017)
Aim: To investigate the intra-rater and inter-rater reliability of the gravity goniometer and footprint method in measurement of tibial torsion and to investigate the agreement between the use of the gravity goniometer and the footprint method. Method: Twenty-two healthy participants (ten male and twelve female) had both footprint method and gravity goniometer measurements taken by three raters. Data collected occurred over three days, where participants attended two sessions. Raters and participant numbers were randomised. One researcher recorder data, to allow for blinding or raters from their measurements. Data analysis was performed using intraclass correlation coefficient (ICC) and Bland and Altman limits of agreement, to determine both inter and intra-rater reliability and agreement between methods. Results: The intra-rater reliability was excellent for both the gravity goniometer and the footprint method (0.64 and 0.67 respectively). Bland and Altman showed poor agreement with 18.82 between gravity goniometer measurements and 24.66 between footprint method. The inter-rater reliability showed moderate and poor ICC for gravity goniometer and footprint method (0.46 and 0.28). For agreement of the two methods Bland and Altman's limits of agreement showed 19.96 between limits of agreement. Conclusion: The results suggest that both gravity goniometer and footprint method have excellent intra-rater reliability, and both show poor inter-rater reliability. There is a large disagreement between methods, showing its lack of clinical suitability to use interchangeably. Additional research should be carried out to determine further suitability, and both methods should be compared to a gold standard.
Comparison of two methods of lower limb volume measurement Key Words: lymphedema, lower limb volume, perometry, volumeter and optoelectric perometry.
(Queen Margaret University, 2017)
Objective: To investigate the agreement between lower limb volume measurements for the vertically orientated perometer and the water displacement method (volumeter). Design: Between methods agreement and test-retest reliability study. Setting: University setting. Participants: Fifteen university students were recruited using convenience sampling with no participant drop outs. Intervention: All participants' dominant lower limb volumes were measured using the vertically oriented perometer and the volumeter. Outcome measures: The Bland-Altman difference plot was used to determine the agreement between the two methods and its 95% confidence interval. Test-retest reliability and the measurement error for both methods was determined using the ICC (3,1) model and within subject standard deviation (sw) respectively. A one sample T-test was used to test the agreement between methods. Results: The Bland-Altman difference plot showed that the perometer method overestimated limb volume by 832ml compared to the water displacement method. A 95% confidence interval of 219ml and 1445ml was observed. The test-retest reliability of the perometer method was ICC (3,1) = 0.99 and the test-retest reliability for the volumeter was ICC(3,1) = 0.99 The measurement error of the perometer was 146ml and 204ml for the volumeter, both clinically acceptable. The one sample t-test score was T (14) = 10.309, P=0.001 with a confidence interval of 95%. Conclusion: There was a lack of agreement between the two methods investigated. Therefore the perometer and volumeter methods are not interchangeable. It is recommended that future validity studies for the perometer are conducted on a clinical population and on the foot
Compliance with guidelines for discharge and follow up care at a paediatric hospital: a service evaluation.
(Queen Margaret University, 2016)
Question: Does the discharge care and follow-up plan in a paediatric asthma hospital adhere to national guidelines? Design: A service evaluation. Participants: There were 33 children aged 5-14 years admitted to the Royal Hospital for Sick Children due to an exacerbation of asthma during the month of November 2014. The data required for this service evaluation was taken from the case notes of these children during November 2014. Only children aged between 5-14 years were included in the project. Outcome measures: A template of indicators for discharge and follow-up care was designed to measure adherence to the recommendations in the British Thoracic Society (BTS) audit (2013) and national SIGN guideline 141 (2014), with the current discharge and follow-up care delivered at the Royal Hospital for Sick Children. Patients admitted were classed as either new patients or readmission patients. The relationship between these two groups was evaluated using a two sample t-test for comparing proportions. Results: There were 76 patients admitted and 43 excluded due to inclusion criteria. Of the 33 patients who met the inclusion criteria 33% (n=11) were readmissions. Only 61% (n=20) of patients' received an asthma weaning plan. Follow-up was frequently utilised with 91% (n=30) of patients given some form of follow-up. There was no documentation of education or symptom score. Evidence of inhaler technique was anecdotal. Conclusion: This service evaluation highlighted a significant gap between the actual discharge care delivered and that recommended in the guidelines. The follow-up plan was adequate but the care could be improved to make it more structured and optimal for the patient.
Conceptualising a framework for Person-centred care through exploring perceptions of person-centred care in international nursing and physiotherapy online communities: An Interpretative Phenomenological Analysis
(2018)
Question: What are the perceptions of person centred care (PCC) within nursing and physiotherapy online social media communities? Design: A secondary qualitative analysis of pre-existing data, using an Interpretative Phenomenological Approach. Participants: An international population of 38 nurses and 23 physios who came together over twitter. Results: 4 themes were produced for this study covering; The Relationship between NMAHPs (Nurses, Midwifes and Allied Health Professionals) and Patient, The Perceptions of who Holds the Power Between Patient vs Practioner, Treating the Condition Not the Person and The impact of Organisational Demands on Healthcare Delivery. The study found that physiotherapists and nurses share a lot of the same perceptions around person centred practice. The study highlighted some differences of physiotherapists perceptions to those of nurses, namely informed decision making and education to empower. It was also found that physiotherapists are still working from a biomechanical approach at times. Nurses said patient privacy was important which was not expressed by physiotherapists. A Framework incorporating the views of physiotherapists alongside the established perceptions of PCC from nursing communities and literature has been developed. Conclusion: The results found that there are differences in perceptions of person centred care between physiotherapists and nurses. This needs to become accounted for in future when developing a PCC framework for Physiotherapists. The study has also proposed the basis for a framework which future research can build upon, paving the way for a person centred care framework that can benefit multiple professions.
Do ActiGraph™ activity monitors measure sedentary behaviour in people with Parkinson's disease; a concurrent validity study.
(Queen Margaret University, 2016)
Background: Parkinson's disease is a degenerative neurological disease that affects approximately 127,000 people within the UK. The common side effects of slowness of movement, rigidity and tremor along with tiredness and depression can lead to people with Parkinson's disease (pwPD) leading a less active lifestyle. Inactivity in pwPD has been shown to have a negative effect on the motor decline and it is therefore important to have a valid means of monitoring sedentary activity in pwPD. Objective: to investigate the concurrent validity of ActiGraph™ GT3X hip and wrist monitors in pwPD. Participants: 9 participants (7 male, 2 female) with early stage PD (Hoehn & Yahr ≤3) `(MMSE ≥24) recruited from the Parkinson's UK Group. Methods: 9 pwPD wore the ActiGraph™ GT3X hip and wrist monitors for 7 days noting the time worn and removed on a simple diary log. The monitor's data were then downloaded into ActiLife V6.12.0 with their diary logs to remove non-wear time to give total sedentary activity per day (minutes). Results: Daily: spearman correlation (rs=0.872, n=9, p= 0.002). Bland-altman upper limits of agreement are 353.33 and the lower is 73.44. Bias is 213.39 minutes (±71.4). Mean daily: pearson correlation (rs=0.872, n=9, p= 0.002). Bland-altman upper limits of agreement are 353.33, lower 73.44. Bias is 213.39 minutes (±71.4). Conclusion: the ActiGraph™ GT3X hip and wrist monitors are not concurrently valid when measuring sedentary behaviour of pwPD with the hip location registering higher sedentary activity in comparison to the wrist.
Evaluation of the relationship of the severity of lymphoedema with the number of co-existing medical conditions and frequency of cellulitis in cancer and non-cancer related lymphoedema: a service evaluation.
(Queen Margaret University, 2016)
Question: What is the relationship between the severity of lymphoedema with the number of medical conditions present and the frequency of cellulitis in patients with cancer and non-cancer related lymphoedema? Design: This research was undertaken as a service evaluation for the Lothian lymphoedema service. Participants: 258 patients with a recorded level of severity were included from the Lothian lymphoedema service. 26 patients without a recorded frequency of cellulitis were then excluded from the severity of lymphoedema and frequency of cellulitis analysis only. Patients with a recorded active cancer or history of cancer were included in the cancer group while those without were grouped into the non-cancer group. Results: A weak link between an increased severity of lymphoedema with an increased number of medical conditions was observed in both the cancer (p=0.003; τ=0.330) and non-cancer (p=0.03; τ=0.129) groups. No relationship between the severity of lymphoedema and frequency of cellulitis was found in the cancer (p=0.202; τ =0.221) and non-cancer (p=0.108; τ=0.064) groups. A number of factors influenced the validity of these results. Conclusion: Patients with a higher number of co-existing medical conditions are at a higher risk of developing a more severe lymphoedema in both patient with cancer and non-cancer related lymphoedema. The severity of lymphoedema has not been shown to influence the frequency of cellulitis therefore all patient with lymphoedema should be adequately educated about cellulitis.
Evaluation of walking speeds required at signal-controlled pedestrian crossings in Edinburgh: an observational study
(2018)
Objective: To evaluate the walking speeds required at signal-controlled pedestrian crossings in Edinburgh. Design: Non-experimental, quantitative and observational. Setting: 101 signal-controlled crossings (Pelican, Puffin or Toucan) in Edinburgh. Outcome Measures: Duration of solid green man phase and duration of the entire crossing period (solid green man phase and clearance phase) at each pedestrian crossing were measured with stopwatches. Distance of crossings were measured with a trundle wheel. Environmental factors like uneven surfaces, sloped roads, obstacles and auditory signals at pedestrian crossings were recorded. Results: Minimum speed required across the 101 crossings assuming pedestrians start crossing at initial appearance of green man had a mean of 0.57 ± 0.26ms−1(range of 0.07 – 1.33ms−1). Minimum required speed across the 101 crossing assuming pedestrians enter the crossing just at the end of the green man phase had a median of 1.22𝑚𝑠−1 (IQR = 0.98 – 1.65𝑚𝑠−1), with range of 0.36𝑚𝑠−1 to 5.02𝑚𝑠−1. 21% (21/101) of crossings had uneven surfaces, 1% (1/101) of crossings had presence of obstacles, 1% (1/101) of crossings had sloped pedestrian crossing and 63% (64/101) of crossings lacked auditory signals. Conclusion: Pedestrian crossings in Edinburgh does not allow sufficient time for elderly to cross the road in time. Insufficient time was given to clear the crossings in time assuming pedestrians start crossing right at the end of the green man phase for all pedestrians. Approximately one-quarter of the crossings had unsuitable road conditions for the elderly that reduces gait speed and increase risk of falls.