Displaying all 11 publications

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  1. Sharma, Shobha, Hardial Singh, Baljit Kaur
    MyJurnal
    Pelbagai bentuk pendekatan pengendalian pergerakan lipatan vokal paradoksikal (PLVP) telah dibincangkan dalam kajian-kajian sebelum ini, tetapi adalah penting untuk mengiktirafkan sifat kompleksiti kecelaruan ini dan perlunya diagnosis yang betul bagi membolehkan pengendalian yang sewajarnya dijalankan. Dapatan penyelidikan mendapati bahawa kecelaruan ini lazimnya berlaku di kalangan wanita muda yang mempunyai sejarah masalah perubatan yang berkaitan. Artikel ini membincangkan tentang kajian kes tunggal tentang seseorang kanak-kanak lelaki berumur 11 tahun yang mempunyai kecelaruan PLVP. Keadaan PLVP ini telah didiagnosis oleh pakar Otorinolaringologi di Pusat Perubatan Universiti Malaya, Kuala Lumpur. Ujian nasendoskopi menunjukkan pergerakan lipatan vokal adalah normal dalam pernafasan senyap dan sewaktu serangan episodik. Kanak-kanak ini kemudiannya dirujuk untuk terapi pertuturan; kecelaruan PLVPnya dikendalikan khususnya menggunakan rehabilitasi pertuturan. Pengurusan kecelaruan bagi kanak-kanak lelaki ini dibincangkan daripada mula rawatan sehingga beliau didiscaj daripada rawatan.
  2. Sharma, Shobha, Haryani Harun, Rahayu Mustaffa Kamal, Srinovianti Noerdin
    MyJurnal
    This study in the management of dysphagia or swallowing disorders involved 72 contactable Speech-Language Pathologists (SLP) in Malaysia. A survey was undertaken to identify the patterns of dysphagia management by SLPs in Malaysia by identifying the percentage of SLPs in Malaysia who have managed swallowing disorders, the approximate number of patients, assessment and therapy techniques used, other professional involvement and the factors that influenced the confidence levels of the SLPs in managing swallowing disorders. Fifty percent (50%) of the forty four SLPs (61.6%) who responded to the survey had previously managed swallowing disorders. It was estimated that 5% (430 of 8268) of patients referred to the SLPs in Malaysia presented with dysphagia and were subsequently managed for their swallowing problems. The oromotor examination was carried out most frequently (100%) for evaluation of dysphagia while the compensatory technique proved to be the most frequently used management technique (77.3%). Most referrals to the SLPs were received from the neurosurgeon (59.1%); the otorhinolaryngologist was most referred to by the SLPs (50%). By using the Chi-squared analysis, it was found that clinical training in dysphagia at the undergraduate or post-graduate levels influenced the confidence levels of the SLPs in managing dysphagia cases (χ2 = 10.063 with p value = 0.007).
  3. Mani S, Sharma S, Singh DK
    J Telemed Telecare, 2021 Feb;27(2):88-97.
    PMID: 31272309 DOI: 10.1177/1357633X19861802
    INTRODUCTION: The aim of this study was to determine the concurrent validity and reliability of telerehabilitation (TR)-based evaluation of the cervical spine among adults with non-specific neck pain (NS-NP).

    METHODS: A total of 11 participants with NS-NP were recruited. Pain intensity, active range of motion (AROM), posture, deep neck flexor (DNF) endurance, combined neck movements and disability were measured using face-to-face and TR methods, with a one-hour break in between. TelePTsys, an image-based TR system, was used for TR assessment.

    RESULTS: A high degree of concurrent validity for pain (bias = 0.90), posture (bias = 0.96°), endurance (bias = -2.3 seconds), disability (bias = 0.10), AROM (extension bias = -0.60 cm, flexion bias = 1.2 cm, side flexion bias = -1.00, rotation bias = -0.30 cm) was found. Standard error of measurement and coefficient of variation (CV) values were within the acceptable level for concurrent validity, except the CV for cervical flexion and endurance. There was a high degree of reliability demonstrated for pain, posture, AROM, endurance and disability measurements. The average-measure interclass correlation coefficient (ICC(3,1)) ranged from 0.96 to 0.99 for inter-rater, and 0.93 to 0.99 for intra-rater reliabilities. There was moderate agreement for combination movement for validity (78.5%, p 

  4. Mani S, Sharma S, Omar B, Paungmali A, Joseph L
    J Telemed Telecare, 2017 Apr;23(3):379-391.
    PMID: 27036879 DOI: 10.1177/1357633X16642369
    Purpose The purpose of this review is to systematically explore and summarise the validity and reliability of telerehabilitation (TR)-based physiotherapy assessment for musculoskeletal disorders. Method A comprehensive systematic literature review was conducted using a number of electronic databases: PubMed, EMBASE, PsycINFO, Cochrane Library and CINAHL, published between January 2000 and May 2015. The studies examined the validity, inter- and intra-rater reliabilities of TR-based physiotherapy assessment for musculoskeletal conditions were included. Two independent reviewers used the Quality Appraisal Tool for studies of diagnostic Reliability (QAREL) and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool to assess the methodological quality of reliability and validity studies respectively. Results A total of 898 hits were achieved, of which 11 articles based on inclusion criteria were reviewed. Nine studies explored the concurrent validity, inter- and intra-rater reliabilities, while two studies examined only the concurrent validity. Reviewed studies were moderate to good in methodological quality. The physiotherapy assessments such as pain, swelling, range of motion, muscle strength, balance, gait and functional assessment demonstrated good concurrent validity. However, the reported concurrent validity of lumbar spine posture, special orthopaedic tests, neurodynamic tests and scar assessments ranged from low to moderate. Conclusion TR-based physiotherapy assessment was technically feasible with overall good concurrent validity and excellent reliability, except for lumbar spine posture, orthopaedic special tests, neurodynamic testa and scar assessment.
  5. Mustaffa Kamal R, Ward EC, Cornwell P, Sharma S
    Int J Speech Lang Pathol, 2015 Dec;17(6):594-604.
    PMID: 25874970 DOI: 10.3109/17549507.2015.1026276
    PURPOSE: The purpose of the current study was to explore infrastructure issues that may be barriers to the establishment and improvement of dysphagia services in Malaysia compared to settings with established dysphagia management services (i.e. Queensland, Australia).

    METHOD: A mixed method design incorporating quantitative and qualitative data was used to increase credibility, validity and comprehensiveness of the results. Thirty-eight hospitals (Malaysia = 21, Queensland = 17) participated in Phase 1 (quantitative component) of the study involving completion of an infrastructure checklist by a speech-language pathologist from each hospital regarding availability of networking and communication, staffing and financial support, facilities and documentation of guidelines for dysphagia management. Subsequently, eight sub-samples from each cohort were then involved in Phase 2 (qualitative component) of the study involving a semi-structured interview on issues related to the impact of infrastructure availability or constraints on service provision.

    RESULT: The current study reveals that multiple challenges exist with regard to dysphagia services in Malaysian government hospitals compared to Queensland public hospitals.

    CONCLUSION: Overall, it was identified that service improvement in Malaysia requires change at a systems and structures level, but also, more importantly, at the individual/personal level, particularly focusing on the culture, behaviour and attitudes among the staff regarding dysphagia services.

  6. Subramaniam P, Thillainathan P, Mat Ghani NA, Sharma S
    PLoS One, 2023;18(10):e0291620.
    PMID: 37796820 DOI: 10.1371/journal.pone.0291620
    The Life Story Book has been commonly used in promoting person-centred care in older adults, especially for persons with dementia. This involves collecting the life stories and memories of the person living with dementia and compiling them into a book or folder, which is used by staff or family to assist the person recall these memories. Evidence on the use, benefits and influences of the Life Story Book in dementia care is limited. This systematic literature review aimed to collect past reviews and provide a thorough overview of the use, benefits, and impact of the Life Story Book for the person with dementia, the relatives, family, and caregivers. The electronic databases PubMed, Scopus, Science Direct and Web of Science as well as grey literature through Google Scholar were searched to select the relevant studies. Seven studies that meet the inclusion criteria were selected and data synthesised. Findings revealed that the use of the Life Story Book has no specific guidelines and has been described with numerous characteristics and varied implementation methods. The Life Story Book intervention is found to provide positive outcomes for the person with dementia and the carers involved. Six out of the seven studies reported that Life Story Book enhanced communication between persons with dementia, relatives, care staff, and residents. The review extends the current evidence on the usage of the Life Story Book in dementia care and confirms that the use of life stories leads to better care in various settings. However, more research is needed to reveal the potential of the Life Story Book in enhancing communication. Guidelines and training are also required to make the best use of the Life Story Book.
  7. Sia LL, Sharma S, Kumar S, Ajit Singh DK
    Digit Health, 2024;10:20552076241248916.
    PMID: 38665882 DOI: 10.1177/20552076241248916
    OBJECTIVE: This study explored the perceived benefits, barriers, and recommendations of telerehabilitation for musculoskeletal disorders among physiotherapists in Malaysia.

    METHODS: This study employed an exploratory qualitative methodology to gather the perceptions of government-employed physiotherapists in Malaysia regarding the benefits, barriers, and recommendations for telerehabilitation in treating musculoskeletal disorders. The researchers conducted semistructured focus group discussions (FGDs) via Google Meet, which were recorded, transcribed, and analyzed using thematic analysis.

    RESULTS: Five FGDs were conducted with 24 participants, 37.5% of whom had prior experience with telerehabilitation. The data analysis returned three main themes: (1) perceived benefits, (2) barriers, and (3) recommendations. Four subthemes were derived from perceived benefits: (1a) saving time and money, (1b) convenience, (1c) clients responsible for their treatment, and (1d) alternatives for infectious diseases. Perceived barriers revealed three subthemes: (2a) technology, (2b) organization, and (2c) personal barriers. Finally, participants provided recommendations for improving telerehabilitation services, including training programs to facilitate greater acceptance of this modality.

    CONCLUSION: The findings of this study offer crucial insights into the evolving landscape of telerehabilitation in Malaysia. These findings revealed a greater prevalence of barriers to enablers among Malaysian physiotherapists, potentially influenced by varying experience levels. Despite the prevailing lack of experience among participants, this research underscores the significance of identifying barriers and enablers in implementing telerehabilitation with participants offering recommendations for integrating telerehabilitation into their practices. This study provides clear insights and a roadmap for stakeholders aiming to shape the future of telerehabilitation among physiotherapists in Malaysia.

  8. Ranganathan H, Singh DKA, Kumar S, Sharma S, Chua SK, Ahmad NB, et al.
    BMC Med Educ, 2021 Jul 10;21(1):376.
    PMID: 34246264 DOI: 10.1186/s12909-021-02803-8
    BACKGROUND: Online learning is an attractive option for educators, especially as means of overcoming the challenges posed by the global pandemic. Although it is best to evaluate student readiness prior to commencement of an online course, to ensure successful development and delivery of student-centric teaching and learning strategies, readiness towards online learning among physiotherapy undergraduates is unknown. The main aim of this study was to examine physiotherapy undergraduates' readiness towards online learning.

    METHODS: In this cross-sectional study, participants were selected through a combination of total population and convenience sampling. The Student Online Learning Readiness questionnaire was distributed among physiotherapy undergraduates from two public and two private universities in Malaysia to investigate their technical, social and communication competencies. Information about device characteristics were obtained to evaluate their equipment readiness. Descriptive and group comparisons were conducted using independent t-test, and analysis of variance with p  80% possessed smartphones and laptop) level of equipment readiness. Institution and gender had no significant effect on the level of readiness (p > 0.05). Year 1 and 2 had significantly higher levels of social competencies with instructor compared to final year physiotherapy undergraduates (p 

  9. Kamal S, Kamaralzaman S, Sharma S, Jaafar NH, Chern PM, Hassan NI, et al.
    Nutrients, 2022 Dec 09;14(24).
    PMID: 36558401 DOI: 10.3390/nu14245241
    Individuals with cerebral palsy (CP) frequently present with multiple feeding problems, which may require food texture modification to ensure safe feeding. This review aims to explore the challenges individuals with CP and their caregiver's face and recommend modified food textures to ensure safety and improve the quality of life and nutritional status. A systematic search was carried out through four databases (i.e., EBSCO (Medline), PubMed, Science Direct, and Web of Science) between January 2011 and May 2022. Out of 86 articles retrieved, seven were selected based on keywords and seven other studies through manual search-five cross-sectional studies, two qualitative studies, one correlational study, one mixed method study, one case-control study, two sections of books, and two educational materials. The findings suggest that preparation and intake of food with modified texture play a necessary role in the safety of swallowing in addition to physical, social, and environmental aspects. Safety was found to be the crucial part of the food texture modification provision besides considering the stress of the caregivers and the nutritional status of individuals with CP. Currently, there are no standard guidelines available pertaining to food texture modification. This led to uncertainties in the dietary provision among caregivers, which may lead to undernourishment. Hence, standard guidelines relating to food texture modification that focuses on food preparation and menus with calorie and nutrient information are timely to be developed.
  10. Kamal S, Hamzaid NH, Kamaralzaman S, Sharma S, Jaafar NH, Chern PM, et al.
    Transl Pediatr, 2023 Sep 18;12(9):1601-1618.
    PMID: 37814717 DOI: 10.21037/tp-23-195
    BACKGROUND: Individuals with severe cerebral palsy (CP) often experience various health issues, including feeding difficulties, which can adversely affect their nutritional status and caregivers' quality of life, e.g., more time spent for feeding rather than own selfcare. This study aimed to determine the prevalence of poor nutritional status among individuals with severe CP and explore its role as predictors for caregivers' quality of life.

    METHODS: This cross-sectional study was conducted in a government hospital (Cheras Rehabilitation Hospital), Community-Based Rehabilitation (CBR) Program, and Spastic Centre [non-profit organization (NGO)] in Klang Valley, Malaysia. Seventy-one participants with Gross Motor Function Classification System (GMFCS) level IV and V were recruited. Sociodemographic data, health-associated data, and anthropometric data were collected. Caregivers' quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) CP module version 3.0 which included domains such as Movement and Balance, Eating Activities, and School Activities.

    RESULTS: Most participants were males (60.6%), with 61 classified as level IV in the GMFCS classification. According to the Eating and Drinking Ability Classification System (EDACS), 59 children were at level IV. In total, 40.8% were underweight according to CP growth chart and 49.3% had mid-upper arm circumference (MUAC) readings below the 5th percentile. The lowest scores in the PedsQL CP module version 3.0 were observed in the Daily Activities (5.34±10.87), and School Activities domains (8.15±18.65). Sociodemographic and anthropometric data, including body mass index (BMI)-for-age, MUAC, body fat, triceps, and subscapular skinfold measurement, were predictors for the School Activities domain [F (11, 44)=3.981, P<0.005, R2=0.499].

    CONCLUSIONS: Poor nutritional status in individuals with severe CP has been shown to negatively impact caregivers' quality of life. Therefore, a multidisciplinary approach involving nutritional intervention is essential to improve dietary provision and the nutritional status of children with CP.

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