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Displaying publications 41 - 44 of 44 in total

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Characteristics of persons with spinal cord injury who drive in Malaysia and its barriers: a cross sectional study

Lee RCH, Hasnan N, Engkasan JP

Spinal Cord, 2018 04;56(4):341-346.
PMID: 29288252 DOI: 10.1038/s41393-017-0034-2

STUDY DESIGN: Cross sectional study.

OBJECTIVES: To determine the prevalence, characteristics of and barriers to driving among persons with a spinal cord injury (SCI).

SETTING: SCI Rehabilitation Clinic, University Malaya Medical Centre (UMMC).

METHODS: This is a questionnaire-based study on persons with SCI who attended the UMMC SCI Rehabilitation Clinic between June 2015 and November 2016. The questionnaire comprised demographic data, clinical characteristics, driving variables, Spinal Cord Independence Measure III, WHOQOL-BREF, and Craig Handicap Assessment and Reporting Technique Short Form. Malaysians aged greater than 18 years old with any etiology and levels of SCI, had no other physical disabilities and not suffering from progressive illness were recruited. A single investigator administered the questionnaire via face-to-face interviews.

RESULTS: A total of 160 participants were included in this study. Overall, 37% of persons with SCI drove and owned a modified vehicle. Almost half of persons with paraplegia (47%) drove, but only 12% of tetraplegia did. A majority (93%) of those who drove aged below 60 years, and had higher level of independence in activity of daily living. More drivers (81%) compared to non-drivers (24%) were employed; drivers also reported better community reintegration and quality of life. Three commonest barriers to driving included medical reasons (38%), fear and lack of confidence (17%), and inability to afford vehicle modifications (13%).

CONCLUSIONS: The percentage of persons with SCI driving post injury is low. Based on the findings of this study, more efforts are needed to motivate and facilitate persons with SCI to drive.

Study site: SCI Rehabilitation Clinic, University Malaya Medical Centre (UMMC)
Fulltext The impact of a pressure ulcer prevention educational program based on the health belief model for persons with spinal cord injury

Hashim NM, Engkasan JP, Hasnan N

J Spinal Cord Med, 2022 Nov;45(6):898-906.
PMID: 33465010 DOI: 10.1080/10790268.2020.1860868

STUDY DESIGN: Pre- and post- trial.
OBJECTIVES: To determine the changes of health belief levels after a pressure ulcer (PrU) prevention educational program based on the Health Belief Model (HBM).
SETTING: Department of Rehabilitation Medicine, University Medical Centre, Malaysia.
METHODS: This study was conducted between May 2016 and May 2018. We created a multidisciplinary structured PrU prevention education program based on the HBM, consisting of didactic lectures, open discussions and a practical session. The content of the program was based on several PrU prevention guidelines. The education program focused on a group of 6-10 participants, and was conducted by a multidisciplinary team; i.e. doctor, physiotherapist, occupational therapist and a nurse. The skin care belief scales (SCBS) questionnaire was administered pre, post and 8-week post intervention, which measured the 9 domains of HBM. The data from the study was analyzed using repeated measures ANOVA to assess the effectiveness of the program.
RESULTS: Thirty spinal cord injured participants who fulfilled the inclusion and exclusion criteria completed this study. The results of the education program show statistically significant effects on Susceptibility; F (2,58) = 12.53, P < 0.05, Barriers to Skin Check Belief; F(2,58) = 5.74, P > 0.05, Benefits to Wheelchair Pressure Relief Belief; F(1.65,47.8) = 3.97, P < 0.05, Barriers to Turning and Positioning Belief; F(2,58) = 3.92, P
Quantifying Arms and Legs Contributions during Repetitive Electrically-Assisted Sit-To-Stand Exercise in Paraplegics: A Pilot Study

Abd Aziz M, Hamzaid NA, Hasnan N

J Vis Exp, 2022 Nov 11.
PMID: 36440840 DOI: 10.3791/63149

Execution of Sit-to-Stand (SitTS) in incomplete spinal cord injury (SCI) patients involves motor function in both upper and lower extremities. The use of arm support, in particular, is a significant assistive factor while executing SitTS movement in SCI population. In addition, the application of functional electrical stimulation (FES) onto quadriceps and gluteus maximus muscles is one of the prescribed management for incomplete SCI to improve muscle action for simple lower limb movements. However, the relative contribution of upper and lower extremities during SitTS has not been thoroughly investigated. Two motor incomplete SCI paraplegics performed repetitive SitTS to fatigue exercise challenge. Their performance was investigated as a mixed-method case-control study comparing SitTS with and without the assistance of FES. Three sets of SitTS tests were completed with 5-min resting period allocated in between sets, with mechanomyography (MMG) sensors attached over the rectus femoris muscles bilaterally. The exercise was separated into 2 sessions; Day 1 for voluntary SitTS and Day 2 for FES-assisted SitTS. Questionnaires were conducted after every session to gather the participants' input about their repetitive SitTS experience. The analysis confirmed that a SitTS cycle could be divided into three phases; Phase 1 (Preparation to stand), Phase 2 (Seat-off), and Phase 3 (Initiation of hip extension), which contributed to 23% ± 7%, 16% ± 4% and 61% ± 6% of the SitTS cycle, respectively. The contribution of arms and legs during SitTS movement varied in different participants based on their legs' Medical Research Council (MRC) muscle grade. In particular, the applied arm forces start to increase clearly when the leg forces start to decline during standing. This finding is supported by the significantly reduced MMG signal indicating leg muscle fatigue and their reported feeling of tiredness.
Fulltext Pulmonary rehabilitation using mechanical insufflation-exsufflation therapy for spinal cord injury – two case studies in the University Malaya Medical Centre

Tan, J.H., Aishah A. Fauzi, Hasnan, N.

JUMMEC, 2017;20(2):31-33.
MyJurnal

There is a high incidence of 36% to 83% of respiratory dysfunction in patients with acute cervical spinal cord
injury. Complications arising from respiratory dysfunction remain one of the most common causes of morbidity
and mortality in the spinal cord injured population. Specialized pulmonary care and therapy can help individuals
with tetraplegia to maintain a stable respiratory status allowing active participation in active rehabilitation.
This would allow them to achieve rehabilitation goals of independent function and community reintegration.
Mechanical insufflation-exsufflation (MIE) therapy is an option for secretion management in individuals with
acute spinal cord injury. In this paper, we present our experience using MIE as an adjunct to management of
secretions in the spinal cord injured population at the University of Malaya Medical Centre.