OBJECTIVE: This systematic review assessed available evidence whether "exergaming" could be a feasible modality for contributing to a recommended exercise prescription according to current ACSM™ or WHO guidelines for physical activity.
METHODS: Strategies used to search for published articles were conducted using separate search engines (Google Scholar™, PubMed™ and Web of Science™) on cardiometabolic responses and perceived exertion during exergaming among neurologically-disabled populations possessing similar physical disabilities. Each study was categorized using the SCIRE-Pedro evidence scale.
RESULTS: Ten of the 144 articles assessed were identified and met specific inclusion criteria. Key outcome measures included responses, such as energy expenditure, heart rate and perceived exertion. Twelve out of the 17 types of exergaming interventions met the ACSM™ or WHO recommendations of "moderate intensity" physical activity. Exergames such as Wii Jogging, Bicycling, Boxing, DDR and GameCycle reported moderate physical activity intensities. While Wii Snowboarding, Skiing and Bowling only produced light intensities.
CONCLUSION: Preliminary cross-sectional evidence in this review suggested that exergames have the potential to provide moderate intensity physical activity as recommended by ACSM™ or WHO in populations with neurological disabilities. However, more research is needed to document exergaming's efficacy from longitudinal observations before definitive conclusions can be drawn. Implications for Rehabilitation Exergaming can be deployed as physical activity or exercise using commercially available game consoles for neurologically disabled individuals in the convenience of their home environment and at a relatively inexpensive cost Moderate-to-vigorous intensity exercises can be achieved during exergaming in this population of persons with neurological disabilities. Exergaming can also be engaging and enjoyable, yet achieve the recommended physical activity guidelines proposed by ACSM™ or WHO for health and fitness benefits. Exergaming as physical activity in this population is feasible for individuals with profound disabilities, since it can be used even in sitting position for wheelchair-dependent users, thus providing variability in terms of exercise options. In the context of comprehensive rehabilitation, exergaming should be viewed by the clinician as "at least as good as" (and likely more enjoyable) than traditional arm-exercise modalities, with equivalent aerobic dose-potency as "traditional" exercise in clinic or home environments.
MATERIALS AND METHODS: A large scale survey of 13 centers in Malaysia was conducted involving 806 nurses in relation to oral hygiene care intentions and practices. In addition, information on personal and environmental factors was collected.
RESULTS: The response rate was 95.6% (778/806). The domains of the Theory of Planned Behavior were significantly associated with general intention to perform oral hygiene care: attitudes (β = 0.21, p
METHODS: Focus groups and interviews were conducted in peninsular Malaysia and Borneo.
RESULTS: Parents' perceptions of developmental delay stemmed from three sources: the cultural, resource, and the social environments.
CONCLUSION: There is a need to develop a medical support system in Malaysia that considers a life-course perspective, including prenatal care, screening/diagnosis, and services. This system should embrace a family-centered approach to diagnosis, referral, intervention, and support with sensitivity to cultural beliefs, family preferences, and barriers to care. Implications for Rehabilitation Parental perceptions of disability affect the strategies they use to cope. This research found that cultural conceptions of disability, available resources, and social support affect parental perceptions of disability. The resource environment in Malaysia significantly restricts parents' ability to cope with their child's disability. This research recommended that the medical system of Malaysia develops a life-course perspective to disability to provide a range of care for children with disabilities including prenatal care, screening and rehabilitation or coping services.
METHOD: An ethnographic approach with data obtained primarily through in-depth interviews was used. Twenty-seven participants identified as having suffered a stroke were drawn from a health and demographic surveillance system in Malaysia.
RESULTS: The physical and social disruption of the lives of stroke survivors was intensified by the resultant financial constraints placed upon individuals, families and households, compounded by inadequate support from the health, and welfare systems. Despite the disruption to their lives, most participants were, at least in part, able to reestablish their lives through various factors that include a strong family support and active coping strategies.
CONCLUSION: In LMIC, recovery can be shaped by the family unit and through active coping strategies especially those in relation to spirituality. Implications for rehabilitation The impact of stroke on survivors and lack of specialized stroke care compromise the recovery process and quality of life for stroke survivors in low and middle-income countries. Support from the family and reinforcement of religious coping were judged to successfully aid recovery. Physical and emotional impairments as well as psychosocial wellbeing of survivors in the context of environmental factors need to be addressed.
MATERIALS AND METHODS: A total of 250 participants completed the questionnaire that was distributed via email, postal mail, the internet, physically and by word of mouth. Sixty-eight respondents were re-contacted to complete the questionnaire again.
RESULTS: The adapted PASIPD demonstrated adequate internal consistency Cronbach's α = 0.68 and acceptable test-retest reliability, intraclass correlation = 0.87. Factor analysis extracted four main dimensions for physical activity; factor 1 (heavy housework, home repair, lawn work and gardening), factor 2 (sports and recreation), factor 3 (light housework and caring for another person) and factor 4 (leisure and occupational activities) that accounted for 64% of the physical activities' total variance.
CONCLUSION: The Malaysian-adapted English and translated Bahasa Malaysia versions of the questionnaires intended to measure physical activity levels in individuals with spinal cord injury, demonstrated good to acceptable validity and reliability. However, some individual items revealed weak reliability measures. Further work is needed to validate the questionnaire's criterion validity against other physical activity measures. Implications for rehabilitation The Malaysian adaptation of the Physical Activity Scale for Individuals with Physical Disabilities questionnaire provided preliminary support for its use since it has demonstrated adequate construct validity and reliability. The Malaysian adaptation of the Physical Activity Scale for Individuals with Physical Disabilities questionnaire can quantify the physical activity level of community-dwelling individuals with spinal cord injury, whilst deriving descriptive information on their physical activities. Deploying the Physical Activity Scale for Individuals with Physical Disabilities questionnaire to a spinal cord injury population in Malaysia may provide the first data on activities of daily living in an Asian developing country.
METHODS: A qualitative approach with data from in-depth interviews and observations were used to identify contextual factors that shaped recovery following stroke in a community. Twenty-seven individuals with stroke were drawn from a health and demographic surveillance system in Malaysia.
RESULTS: Hope and optimism, coping strategies, motivation and support from family and friends, and the use of alternative and complementary medicine shaped the process of recovery within a context where infrastructure is extremely limited.
CONCLUSION: The identification of factors that facilitate the recovery process provides a background in which health care providers can utilise to improve their understanding of the stroke experience. Such understanding could be instrumental in aiding health professionals to offer the most effective help to their clients. Implications for rehabilitation Identification of contextual factors provides a background for the understanding of the stroke experience. Incorporation of religion into rehabilitation could support and maintain hope in recovery for the survivors and aid acceptance. A collaboration of healthcare professionals with traditional medicine therapists may prove beneficial for the rehabilitation of stroke survivors in Malaysia.