anne mandy | University of Brighton (original) (raw)

Papers by anne mandy

Research paper thumbnail of Sources of stress in undergraduate podiatry students in the UK and Australia

International Journal of Therapy and Rehabilitation, 2006

ABSTRACT High sources of stress have been reported in health-care students, including physiothera... more ABSTRACT High sources of stress have been reported in health-care students, including physiotherapy students. However, there are no studies investigating stress in podiatry students. This study was undertaken to examine the sources of stress in undergraduate podiatry students in universities in both the UK and Australia. The Undergraduate Sources of Stress (USOS) questionnaire, comprising 18 items in three subscales (academic demands, financial issues, personal issues), was administered to students in all years of the bachelor programmes in the UK (n=54/97, response rate=56%) and Australia (n=56/94, response rate=60%). Academic concerns were rated highest for all students, particularly the amount to learn, time demands and intellectual demands of the course. UK levels of academic stress are greatest when students are in their first year, when academic demands are combined with clinical education placements. The university fees were significantly higher for Australian students (P=0.001). In total, 64% of podiatry students in Australia worked in paid employment while studying, compared with 41% of the UK podiatry students. Mean hours of paid employment were 5.3hours for UK students and 7.0hours for Australian students. However, there was no correlation between any of the stress subscales on number of hours worked. High levels of academic stress reported by podiatry students are consistent with other student health-care professions.

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Research paper thumbnail of Measurement of hand/handrim grip forces in two different one arm drive wheelchairs

BioMed research international, 2014

The aim of this study was to explore the total and regional grip forces in the hand when propelli... more The aim of this study was to explore the total and regional grip forces in the hand when propelling two different manual one arm drive wheelchairs: the Neater Uni-wheelchair (NUW) and a foot steered Action3 wheelchair. 17 nondisabled users were randomly assigned to each wheelchair to drive around an indoor obstacle course. The Grip, a multiple sensor system taking continuous measurement of handgrip force, was attached to the propelling hand. Total grip force in each region of the hand and total grip force across the whole hand were calculated per user per wheelchair. The Action3 with foot steering only generated significantly greater total grip force in straight running compared to the NUW and also in the fingers and thumb in straight running. The results suggest that the Action3 with foot steering generated greater grip forces which may infer a greater potential for repetitive strain injury in the upper limb. Further work is required to explore whether the difference in grip force ...

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Research paper thumbnail of Comparison of activities of daily living in two different one arm drive wheelchairs: a controlled trial

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Research paper thumbnail of Comparison of activities of daily living (ADLs) in two different one arm drive wheelchairs: a study of individuals/participants with hemiplegia

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Research paper thumbnail of Clinical Educators' Reactions to Aging

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Research paper thumbnail of Professional stereotyping and interprofessional education

Learning in Health and Social Care, 2004

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Research paper thumbnail of Repeatability and Limits of Agreement in Measurement of Hip Migration Percentage in Children with Bilateral Cerebral Palsy

Physiotherapy, 2003

To determine the repeatability and limits of agreement for X-ray measurement of hip migration per... more To determine the repeatability and limits of agreement for X-ray measurement of hip migration percentage in children with cerebral palsy.An inter-rater and intra-rater study.Twenty hip and pelvic X-rays (40 hips) were measured by three health professionals on two separate occasions.Repeatability of the measure was expressed as 95% limits of agreement. Measurements of hip migration were within 7.6% of each other when measured by the same rater on two occasions. When two raters were compared, measurements were within 8.1% of each other.Measurement of hip and pelvic X-rays can be made using the described method within limits of agreement that are acceptable for clinical decision-making. The information thus obtained on the degree and rate of hip subluxation/dislocation can be used to inform therapy and surgical decision-making.

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Research paper thumbnail of Management of hip dislocation with postural management

Child Care Health and Development, 2002

Background Hip dislocation in children with cerebral palsy has a well-documented history and morb... more Background Hip dislocation in children with cerebral palsy has a well-documented history and morbidity.Objective This paper presents a retrospective study of children with bilateral cerebral palsy who had various postural management and its effect on hip deformity. The most widely accepted theoretical model of hip subluxation/dislocation is that an imbalance in muscle length and strength around the hip leads to acetabular dysplasia and consequent hip subluxation. Maintenance of muscle length and strength and loadbearing is therefore a logical prevention. Research on normal infants’ postures has provided biomechanical data to form the theoretical basis of 24 h postural management equipment.Methods The notes and X-rays of 59 children with bilateral cerebral palsy from East and West Sussex and Oxfordshire were examined and measured to determine whether a relationship existed between postural management and the level of hip subluxation/dislocation. X-rays were measured using Reimers’ hip migration percentage. Postural management support was divided into three groups for analysis. Category 1: use of a 24-h postural management approach using Chailey Adjustable Postural Support (CAPS) systems in lying, sitting and standing; category 2: two items of CAPS (either lying/sitting or sitting/standing supports); category 3: use of the CAPS seat only and/or any other postural supports. Hip status was recorded for analysis as both hips safe (under 33% migrated), or one/both hips subluxed.Results Children using ‘All CAPS’ before hip subluxation maintained significantly more hip integrity than other groups (χ2P < 0.05).Conclusions Postural management interventions have an important role in the prevention of hip dysplasia.

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Research paper thumbnail of Hip subluxation and dislocation in cerebral palsy - a prospective study on the effectiveness of postural management programmes

Physiotherapy Research International, 2009

Background and Purpose. Hip subluxation and dislocation are common sequelae in children with bila... more Background and Purpose. Hip subluxation and dislocation are common sequelae in children with bilateral cerebral palsy and are currently managed by surgical interventions. This study aimed to investigate the effectiveness of early postural management programmes on hip subluxation and dislocation at five years, and the need for treatment in children with bilateral cerebral palsy, and to compare these findings with a historical control group. Methods. A prospective cohort study followed 39 children who commenced using postural management equipment under 18 months of age. Levels of ability, type and amount of equipment use and treatments were recorded every three months. At 30 and 60 months, the hips were X-rayed and the hip migration percentage was measured. The results were compared with the historical control group. Results. Children who used equipment at recommended and moderate levels had significantly less chance of both hips being subluxed than those using equipment at minimal levels (two-tailed Fisher's exact χ2 p = 0.024). The frequency of children with hip problems was significantly less in the intervention group in comparison to the historical control group at five years (χ2 = 11.53, df = 2, p = 0.006). The frequency of children receiving bilateral or unilateral treatments, i.e. surgery, use of a hip and spinal orthosis and/or botulinum toxin injections, in the intervention group was significantly less compared to the historical control group (two-tailed Fisher's exact p = 0.001). Conclusion. The early provision of postural management equipment has a role to play in reducing the number of hip problems and therefore the need for treatment of hip subluxation/dislocation in cerebral palsy at five years of age. Copyright © 2009 John Wiley & Sons, Ltd.

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Research paper thumbnail of Postdischarge support for elective hip arthroplasty patients

Physiotherapy Theory and Practice, 2000

... Anne Mandy, Andrew Pearman, School of Health Care Professions, Eastbourne, Sussex BN20 7UR, U... more ... Anne Mandy, Andrew Pearman, School of Health Care Professions, Eastbourne, Sussex BN20 7UR, UK K. Ross, Eastbourne District General ... intervention is aimed at functional independence, and is augmented by exercise programs to increase muscle strength and stamina. ...

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Research paper thumbnail of Psychological sequelae in women following either parturition or non-gynaecological surgery

Journal of Reproductive and Infant Psychology, 1998

Childbirth, in 10% of cases, is followed by an affective disorder. However, whether this is speci... more Childbirth, in 10% of cases, is followed by an affective disorder. However, whether this is specifically due to parturition or reflects a generalized stress response is unclear. This prospective study uses the Profile of Mood States to assess mood in 96 women before and after parturition and, unlike previous studies, compares the results with those from women undergoing non-gynaecological surgery

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Research paper thumbnail of Evidence of a possible role of altered angiotensin function in the treatment, but not etiology, of depression

Biological Psychiatry, 1999

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Research paper thumbnail of Energy expenditure, and comfort in a modified wheelchair for people with hemiplegia: A controlled trial

Disability & Rehabilitation: Assistive Technology, 2007

The aim of this pilot study using non-disabled subjects was to measure energy expenditure, hand p... more The aim of this pilot study using non-disabled subjects was to measure energy expenditure, hand position and ride comfort, in a standard dual handrim Sunrise Breezy Wheelchair compared to one modified with a novel ergonomic self propelled steering (ESP) mechanism kit. The clinical reasoning underpinning the engineering design of the ESP kit was to develop a more ergonomically efficient mechanism for wheelchair steering and propulsion for individuals who had sustained cerebral vascular accidents. Ten non-disabled males participated in a repeated measures trial by driving two manual wheelchairs - a standard manual dual handrim wheelchair and one fitted with the steering conversion kit. Wheelchairs were randomly assigned, to participants who drove each wheelchair around a designated circuit. Oxygen consumption, carbon dioxide and heart rate were measured as indicators of ergonomic efficiency using a Cosmed analyser. Comfort for each wheelchair was measured using a validated questionnaire. Heart rate (bpm), oxygen consumption (O2 ml/min) and exhaled carbon dioxide (CO2 ml/min) were significantly lower in the modified wheelchair (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.006 and P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.014, respectively). All comfort ratings were reported to be significantly greater in the ESP (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The ESP conversion kit transforms a standard Sunrise Breezy Wheelchair into one that is ergonomically more efficient and comfortable for non-disabled subjects.

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Research paper thumbnail of Measures of energy expenditure and comfort in an ESP wheelchair: a controlled trial using hemiplegic users

Disability & Rehabilitation: Assistive Technology, 2009

The aim of this pilot study using hemiplegic subjects was to measure energy expenditure, hand pos... more The aim of this pilot study using hemiplegic subjects was to measure energy expenditure, hand position and ride comfort, in a standard dual handrim Sunrise Breezy wheelchair compared to one modified with a novel ergonomic self-propelled steering (ESP) mechanism kit. A previous study by Mandy et al. (Disabil Rehabil Assist Technol 2007;2:255-260) reported that the attachment of the ESP kit to a standard Sunrise Breezy wheelchair provided a more ergonomically efficient mechanism for wheelchair steering and propulsion for non-disabled individuals. Thirteen hemiplegic stroke users participated in a repeated measures trial by driving two manual wheelchairs--a standard manual dual handrim wheelchair and one fitted with the ESP steering conversion kit. Wheelchairs were randomly assigned, to participants who drove each wheelchair around a designated circuit. Oxygen consumption, carbon dioxide and heart rate were measured as indicators of ergonomic efficiency using a Cosmed analyser. Comfort for each wheelchair was measured using a validated questionnaire. Oxygen consumption (O(2)mls/min) and exhaled carbon dioxide (CO(2)mls/min) were significantly lower in the modified wheelchair (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.004 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.04, respectively). Time taken to complete the course was significantly faster in the ESP (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). There was no significant difference in heart rate readings between the wheelchairs. All comfort ratings were reported to be significantly greater in the ESP (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The ESP conversion kit transforms a standard Sunrise Breezy wheelchair into one that is ergonomically more efficient and comfortable for hemiplegic subjects.

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Research paper thumbnail of Changing self-efficacy in individuals following a first time stroke: preliminary study of a novel self-management intervention

Clinical Rehabilitation, 2009

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Research paper thumbnail of Reasons for recovery after stroke: A perspective based on personal experience

Disability and Rehabilitation, 2008

The purpose of this study was to learn more about individual beliefs and personal strategies used... more The purpose of this study was to learn more about individual beliefs and personal strategies used to support the period of recovery after stroke. It sought to identify the factors that were perceived to be enablers as well as challenges to recovery. Personal actions or experiences, which were perceived to be effective in influencing progress, would be identified. Qualitative in-depth interviews were carried out with 10 participants (mean age 61.8 years). Time following stroke onset ranged between 6 weeks and 13 months. All participants had some residual activity limitation and three participants had varying degrees of aphasia. The interviews were approximately 60 - 90 minutes and all data was subjected to content analysis. Analyses of interview data identified two main themes which were perceived to have influenced progress after stroke. The first related to internal factors such as personal control over progress, optimism and fears of dependency and the second included more external factors, such as the influence of therapeutic interactions and success with a specified marker of independence such as dressing, washing and walking. An important finding of this study was that individuals all identified a number of specific factors which had supported or hindered their own recovery. There were a diversity of both internal/personal and external factors which may not be surprising, given the complexity of stroke, but all participants stressed the importance of both factors. The findings from this study are preliminary and relate only to this particular group of participants, as such they cannot be generalizable to the stroke population as a whole. However, the interaction between the two themes identified requires further exploration, especially in relation to therapy which could have both a positive and negative influence on personal control. There is a clear need to understand how professionals can, in the first place, take time to identify each individual&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s preferences and personal goals and secondly, make sure that these are fully addressed in a planned treatment programme. This will ensure that progress in individuals after stroke is supported by professionals with a more eclectic, individualized approach.

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Research paper thumbnail of Who's in control after a stroke? Do we disempower our patients

Physiotherapy Research International, 2000

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Research paper thumbnail of Comparison of activities of daily living (ADLs) in two different one arm drive wheelchairs: a study of individuals/participants with hemiplegia

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Research paper thumbnail of PLEASE SCROLL DOWN FOR ARTICLE Measures of energy expenditure and comfort in an ESP wheelchair: a controlled trial using hemiplegic users'

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Research paper thumbnail of 2 0 1 3 A comparison of vertical reaction forces during propulsion of three different one-arm drive wheelchairs by hemiplegic users

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Research paper thumbnail of Sources of stress in undergraduate podiatry students in the UK and Australia

International Journal of Therapy and Rehabilitation, 2006

ABSTRACT High sources of stress have been reported in health-care students, including physiothera... more ABSTRACT High sources of stress have been reported in health-care students, including physiotherapy students. However, there are no studies investigating stress in podiatry students. This study was undertaken to examine the sources of stress in undergraduate podiatry students in universities in both the UK and Australia. The Undergraduate Sources of Stress (USOS) questionnaire, comprising 18 items in three subscales (academic demands, financial issues, personal issues), was administered to students in all years of the bachelor programmes in the UK (n=54/97, response rate=56%) and Australia (n=56/94, response rate=60%). Academic concerns were rated highest for all students, particularly the amount to learn, time demands and intellectual demands of the course. UK levels of academic stress are greatest when students are in their first year, when academic demands are combined with clinical education placements. The university fees were significantly higher for Australian students (P=0.001). In total, 64% of podiatry students in Australia worked in paid employment while studying, compared with 41% of the UK podiatry students. Mean hours of paid employment were 5.3hours for UK students and 7.0hours for Australian students. However, there was no correlation between any of the stress subscales on number of hours worked. High levels of academic stress reported by podiatry students are consistent with other student health-care professions.

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Research paper thumbnail of Measurement of hand/handrim grip forces in two different one arm drive wheelchairs

BioMed research international, 2014

The aim of this study was to explore the total and regional grip forces in the hand when propelli... more The aim of this study was to explore the total and regional grip forces in the hand when propelling two different manual one arm drive wheelchairs: the Neater Uni-wheelchair (NUW) and a foot steered Action3 wheelchair. 17 nondisabled users were randomly assigned to each wheelchair to drive around an indoor obstacle course. The Grip, a multiple sensor system taking continuous measurement of handgrip force, was attached to the propelling hand. Total grip force in each region of the hand and total grip force across the whole hand were calculated per user per wheelchair. The Action3 with foot steering only generated significantly greater total grip force in straight running compared to the NUW and also in the fingers and thumb in straight running. The results suggest that the Action3 with foot steering generated greater grip forces which may infer a greater potential for repetitive strain injury in the upper limb. Further work is required to explore whether the difference in grip force ...

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Research paper thumbnail of Comparison of activities of daily living in two different one arm drive wheelchairs: a controlled trial

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Research paper thumbnail of Comparison of activities of daily living (ADLs) in two different one arm drive wheelchairs: a study of individuals/participants with hemiplegia

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Research paper thumbnail of Clinical Educators' Reactions to Aging

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Research paper thumbnail of Professional stereotyping and interprofessional education

Learning in Health and Social Care, 2004

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Research paper thumbnail of Repeatability and Limits of Agreement in Measurement of Hip Migration Percentage in Children with Bilateral Cerebral Palsy

Physiotherapy, 2003

To determine the repeatability and limits of agreement for X-ray measurement of hip migration per... more To determine the repeatability and limits of agreement for X-ray measurement of hip migration percentage in children with cerebral palsy.An inter-rater and intra-rater study.Twenty hip and pelvic X-rays (40 hips) were measured by three health professionals on two separate occasions.Repeatability of the measure was expressed as 95% limits of agreement. Measurements of hip migration were within 7.6% of each other when measured by the same rater on two occasions. When two raters were compared, measurements were within 8.1% of each other.Measurement of hip and pelvic X-rays can be made using the described method within limits of agreement that are acceptable for clinical decision-making. The information thus obtained on the degree and rate of hip subluxation/dislocation can be used to inform therapy and surgical decision-making.

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Research paper thumbnail of Management of hip dislocation with postural management

Child Care Health and Development, 2002

Background Hip dislocation in children with cerebral palsy has a well-documented history and morb... more Background Hip dislocation in children with cerebral palsy has a well-documented history and morbidity.Objective This paper presents a retrospective study of children with bilateral cerebral palsy who had various postural management and its effect on hip deformity. The most widely accepted theoretical model of hip subluxation/dislocation is that an imbalance in muscle length and strength around the hip leads to acetabular dysplasia and consequent hip subluxation. Maintenance of muscle length and strength and loadbearing is therefore a logical prevention. Research on normal infants’ postures has provided biomechanical data to form the theoretical basis of 24 h postural management equipment.Methods The notes and X-rays of 59 children with bilateral cerebral palsy from East and West Sussex and Oxfordshire were examined and measured to determine whether a relationship existed between postural management and the level of hip subluxation/dislocation. X-rays were measured using Reimers’ hip migration percentage. Postural management support was divided into three groups for analysis. Category 1: use of a 24-h postural management approach using Chailey Adjustable Postural Support (CAPS) systems in lying, sitting and standing; category 2: two items of CAPS (either lying/sitting or sitting/standing supports); category 3: use of the CAPS seat only and/or any other postural supports. Hip status was recorded for analysis as both hips safe (under 33% migrated), or one/both hips subluxed.Results Children using ‘All CAPS’ before hip subluxation maintained significantly more hip integrity than other groups (χ2P < 0.05).Conclusions Postural management interventions have an important role in the prevention of hip dysplasia.

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Research paper thumbnail of Hip subluxation and dislocation in cerebral palsy - a prospective study on the effectiveness of postural management programmes

Physiotherapy Research International, 2009

Background and Purpose. Hip subluxation and dislocation are common sequelae in children with bila... more Background and Purpose. Hip subluxation and dislocation are common sequelae in children with bilateral cerebral palsy and are currently managed by surgical interventions. This study aimed to investigate the effectiveness of early postural management programmes on hip subluxation and dislocation at five years, and the need for treatment in children with bilateral cerebral palsy, and to compare these findings with a historical control group. Methods. A prospective cohort study followed 39 children who commenced using postural management equipment under 18 months of age. Levels of ability, type and amount of equipment use and treatments were recorded every three months. At 30 and 60 months, the hips were X-rayed and the hip migration percentage was measured. The results were compared with the historical control group. Results. Children who used equipment at recommended and moderate levels had significantly less chance of both hips being subluxed than those using equipment at minimal levels (two-tailed Fisher's exact χ2 p = 0.024). The frequency of children with hip problems was significantly less in the intervention group in comparison to the historical control group at five years (χ2 = 11.53, df = 2, p = 0.006). The frequency of children receiving bilateral or unilateral treatments, i.e. surgery, use of a hip and spinal orthosis and/or botulinum toxin injections, in the intervention group was significantly less compared to the historical control group (two-tailed Fisher's exact p = 0.001). Conclusion. The early provision of postural management equipment has a role to play in reducing the number of hip problems and therefore the need for treatment of hip subluxation/dislocation in cerebral palsy at five years of age. Copyright © 2009 John Wiley & Sons, Ltd.

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Research paper thumbnail of Postdischarge support for elective hip arthroplasty patients

Physiotherapy Theory and Practice, 2000

... Anne Mandy, Andrew Pearman, School of Health Care Professions, Eastbourne, Sussex BN20 7UR, U... more ... Anne Mandy, Andrew Pearman, School of Health Care Professions, Eastbourne, Sussex BN20 7UR, UK K. Ross, Eastbourne District General ... intervention is aimed at functional independence, and is augmented by exercise programs to increase muscle strength and stamina. ...

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Research paper thumbnail of Psychological sequelae in women following either parturition or non-gynaecological surgery

Journal of Reproductive and Infant Psychology, 1998

Childbirth, in 10% of cases, is followed by an affective disorder. However, whether this is speci... more Childbirth, in 10% of cases, is followed by an affective disorder. However, whether this is specifically due to parturition or reflects a generalized stress response is unclear. This prospective study uses the Profile of Mood States to assess mood in 96 women before and after parturition and, unlike previous studies, compares the results with those from women undergoing non-gynaecological surgery

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Research paper thumbnail of Evidence of a possible role of altered angiotensin function in the treatment, but not etiology, of depression

Biological Psychiatry, 1999

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Research paper thumbnail of Energy expenditure, and comfort in a modified wheelchair for people with hemiplegia: A controlled trial

Disability & Rehabilitation: Assistive Technology, 2007

The aim of this pilot study using non-disabled subjects was to measure energy expenditure, hand p... more The aim of this pilot study using non-disabled subjects was to measure energy expenditure, hand position and ride comfort, in a standard dual handrim Sunrise Breezy Wheelchair compared to one modified with a novel ergonomic self propelled steering (ESP) mechanism kit. The clinical reasoning underpinning the engineering design of the ESP kit was to develop a more ergonomically efficient mechanism for wheelchair steering and propulsion for individuals who had sustained cerebral vascular accidents. Ten non-disabled males participated in a repeated measures trial by driving two manual wheelchairs - a standard manual dual handrim wheelchair and one fitted with the steering conversion kit. Wheelchairs were randomly assigned, to participants who drove each wheelchair around a designated circuit. Oxygen consumption, carbon dioxide and heart rate were measured as indicators of ergonomic efficiency using a Cosmed analyser. Comfort for each wheelchair was measured using a validated questionnaire. Heart rate (bpm), oxygen consumption (O2 ml/min) and exhaled carbon dioxide (CO2 ml/min) were significantly lower in the modified wheelchair (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.006 and P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.014, respectively). All comfort ratings were reported to be significantly greater in the ESP (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The ESP conversion kit transforms a standard Sunrise Breezy Wheelchair into one that is ergonomically more efficient and comfortable for non-disabled subjects.

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Research paper thumbnail of Measures of energy expenditure and comfort in an ESP wheelchair: a controlled trial using hemiplegic users

Disability & Rehabilitation: Assistive Technology, 2009

The aim of this pilot study using hemiplegic subjects was to measure energy expenditure, hand pos... more The aim of this pilot study using hemiplegic subjects was to measure energy expenditure, hand position and ride comfort, in a standard dual handrim Sunrise Breezy wheelchair compared to one modified with a novel ergonomic self-propelled steering (ESP) mechanism kit. A previous study by Mandy et al. (Disabil Rehabil Assist Technol 2007;2:255-260) reported that the attachment of the ESP kit to a standard Sunrise Breezy wheelchair provided a more ergonomically efficient mechanism for wheelchair steering and propulsion for non-disabled individuals. Thirteen hemiplegic stroke users participated in a repeated measures trial by driving two manual wheelchairs--a standard manual dual handrim wheelchair and one fitted with the ESP steering conversion kit. Wheelchairs were randomly assigned, to participants who drove each wheelchair around a designated circuit. Oxygen consumption, carbon dioxide and heart rate were measured as indicators of ergonomic efficiency using a Cosmed analyser. Comfort for each wheelchair was measured using a validated questionnaire. Oxygen consumption (O(2)mls/min) and exhaled carbon dioxide (CO(2)mls/min) were significantly lower in the modified wheelchair (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.004 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.04, respectively). Time taken to complete the course was significantly faster in the ESP (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). There was no significant difference in heart rate readings between the wheelchairs. All comfort ratings were reported to be significantly greater in the ESP (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The ESP conversion kit transforms a standard Sunrise Breezy wheelchair into one that is ergonomically more efficient and comfortable for hemiplegic subjects.

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Research paper thumbnail of Changing self-efficacy in individuals following a first time stroke: preliminary study of a novel self-management intervention

Clinical Rehabilitation, 2009

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Research paper thumbnail of Reasons for recovery after stroke: A perspective based on personal experience

Disability and Rehabilitation, 2008

The purpose of this study was to learn more about individual beliefs and personal strategies used... more The purpose of this study was to learn more about individual beliefs and personal strategies used to support the period of recovery after stroke. It sought to identify the factors that were perceived to be enablers as well as challenges to recovery. Personal actions or experiences, which were perceived to be effective in influencing progress, would be identified. Qualitative in-depth interviews were carried out with 10 participants (mean age 61.8 years). Time following stroke onset ranged between 6 weeks and 13 months. All participants had some residual activity limitation and three participants had varying degrees of aphasia. The interviews were approximately 60 - 90 minutes and all data was subjected to content analysis. Analyses of interview data identified two main themes which were perceived to have influenced progress after stroke. The first related to internal factors such as personal control over progress, optimism and fears of dependency and the second included more external factors, such as the influence of therapeutic interactions and success with a specified marker of independence such as dressing, washing and walking. An important finding of this study was that individuals all identified a number of specific factors which had supported or hindered their own recovery. There were a diversity of both internal/personal and external factors which may not be surprising, given the complexity of stroke, but all participants stressed the importance of both factors. The findings from this study are preliminary and relate only to this particular group of participants, as such they cannot be generalizable to the stroke population as a whole. However, the interaction between the two themes identified requires further exploration, especially in relation to therapy which could have both a positive and negative influence on personal control. There is a clear need to understand how professionals can, in the first place, take time to identify each individual&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s preferences and personal goals and secondly, make sure that these are fully addressed in a planned treatment programme. This will ensure that progress in individuals after stroke is supported by professionals with a more eclectic, individualized approach.

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Research paper thumbnail of Who's in control after a stroke? Do we disempower our patients

Physiotherapy Research International, 2000

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Research paper thumbnail of Comparison of activities of daily living (ADLs) in two different one arm drive wheelchairs: a study of individuals/participants with hemiplegia

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Research paper thumbnail of PLEASE SCROLL DOWN FOR ARTICLE Measures of energy expenditure and comfort in an ESP wheelchair: a controlled trial using hemiplegic users'

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Research paper thumbnail of 2 0 1 3 A comparison of vertical reaction forces during propulsion of three different one-arm drive wheelchairs by hemiplegic users

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