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  1. Engkasan JP, Stucki G, Ali S, Yusof YM, Hussain H, Latif LA
    J Rehabil Med, 2018 Apr 18;50(4):346-357.
    PMID: 29159419 DOI: 10.2340/16501977-2283
    In February 2017, the World Health Organization (WHO) launched its historic "Rehabilitation 2030: A Call for Action". Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO's Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation (SOCSO) Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation (CQM-R Malaysia). The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health (ICF) is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  2. Mat Rosly M, Mat Rosly H, Davis Oam GM, Husain R, Hasnan N
    Disabil Rehabil, 2017 04;39(8):727-735.
    PMID: 27108475 DOI: 10.3109/09638288.2016.1161086
    INTRODUCTION: Exergames have the potential to enable persons with disabilities to take part in physical activities that are of appropriate "dose-potency" and enjoyable within a relatively safe home environment. It overcomes some of the challenges regarding transportation difficulties in getting to commercial gymnasium facilities, reducing physical activities perceived as "boring" or getting access into the built environment that may be "wheelchair unfriendly".

    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.

    Matched MeSH terms: Disabled Persons/rehabilitation*
  3. Altalmas T, Aula A, Ahmad S, Tokhi MO, Akmeliawati R
    Assist Technol, 2016;28(3):159-74.
    PMID: 27187763 DOI: 10.1080/10400435.2016.1140688
    Two-wheeled wheelchairs are considered highly nonlinear and complex systems. The systems mimic a double-inverted pendulum scenario and will provide better maneuverability in confined spaces and also to reach higher level of height for pick and place tasks. The challenge resides in modeling and control of the two-wheeled wheelchair to perform comparably to a normal four-wheeled wheelchair. Most common modeling techniques have been accomplished by researchers utilizing the basic Newton's Laws of motion and some have used 3D tools to model the system where the models are much more theoretical and quite far from the practical implementation. This article is aimed at closing the gap between the conventional mathematical modeling approaches where the integrated 3D modeling approach with validation on the actual hardware implementation was conducted. To achieve this, both nonlinear and a linearized model in terms of state space model were obtained from the mathematical model of the system for analysis and, thereafter, a 3D virtual prototype of the wheelchair was developed, simulated, and analyzed. This has increased the confidence level for the proposed platform and facilitated the actual hardware implementation of the two-wheeled wheelchair. Results show that the prototype developed and tested has successfully worked within the specific requirements established.
    Matched MeSH terms: Disabled Persons/rehabilitation
  4. Naicker AS, Htwe O, Tannor AY, De Groote W, Yuliawiratman BS, Naicker MS
    Phys Med Rehabil Clin N Am, 2019 11;30(4):867-877.
    PMID: 31563176 DOI: 10.1016/j.pmr.2019.07.009
    An increase in population and chronic conditions leading to disability require increasing emphasis on rehabilitation and health intervention. Poorer countries do not usually have the rehabilitation workforce needed to promote societal inclusion and participation. The roles of the rehabilitation workforce were often not clearly defined, leading to task shifting among rehabilitation professionals. Barriers to capacity building were poor availability of human resources and insufficient training program/supports for their professional development. Facilitators were local government support and international non-governmental organizations collaboration. Recommendations for capacity building effort are for collaboration with the developed nations to encourage funding, training, education, and sharing of resources.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  5. Singh DKA, Rahman NNA, Seffiyah R, Chang SY, Zainura AK, Aida SR, et al.
    Med J Malaysia, 2017 04;72(2):119-121.
    PMID: 28473675 MyJurnal
    INTRODUCTION: There is limited information regarding the effects of interactive virtual reality (VR) games on psychological and physical well-being among adults with physical disabilities. We aimed to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities.

    METHODS: Fifteen participants completed the intervention using Wii VR games in this pilot study. Depressive, Anxiety and Stress Scales (DASS) and Capabilities of Upper Extremity (CUE) questionnaires were used to measure psychological well-being and upper limb motor function respectively. Upper limb reaction time was measured using reaction time test.

    RESULTS: Results showed that there was a significant difference (p<0.05) in DASS questionnaire and average reaction time score after intervention.

    CONCLUSION: There is a potential for using interactive VR games as an exercise tool to improve psychological wellbeing and upper limb reaction time among adults with disabilities.

    Matched MeSH terms: Disabled Persons/rehabilitation*
  6. Engkasan JP, Ehsan FM, Chung TY
    J Rehabil Med, 2012 Jan;44(1):19-23.
    PMID: 22124514 DOI: 10.2340/16501977-0904
    The aims of this study were to examine the ability of patients to return to driving cars and riding motorcycles after lower limb amputation, and to explore the factors that significantly affect such ability.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  7. Goh HT, Ramachandram K, Ahmad-Fauzi A, Subamanian P
    J Geriatr Phys Ther, 2016 Jul-Sep;39(3):132-9.
    PMID: 26288234 DOI: 10.1519/JPT.0000000000000064
    BACKGROUND AND PURPOSE: Social participation restriction is a common barrier encountered by older adults and individuals with physical disabilities. To best direct the limited resource to support social services for individuals with disability, there is a need to objectively measure social participation restriction. A number of tools to measure levels of social participation are available, but none of them has been translated into the Malay language. This cross-sectional study examined the test-retest reliability and concurrent validity of the Life Habits Assessment (LIFE-H 3.1) that had been translated and culturally adapted to the Malay language.

    METHODS: Seventy-five individuals with physical disabilities (age, mean [standard deviation] = 58 [10] years; 49 males) participated in this study. Participants were interviewed twice with the Malay version LIFE-H 3.1, approximately 1 week apart. The Barthel Index (BI) and the World Health Organization Assessment of Quality of Life-Brief version (WHOQoL-BREF) were administered in the first interview as well. Intraclass correlation coefficients and the Bland-Altman Bias D were used to examine test-retest reliability. The Spearman correlation coefficients were computed to quantify the correlation between the Malay version LIFE-H 3.1 and the BI and the WHOQoL-BREF, respectively, to examine the concurrent validity of the Malay version LIFE-H 3.1. Furthermore, standard error of measurement and minimal detectable change were calculated.

    RESULTS: The Malay version LIFE-H 3.1 had excellent test-retest reliability as evidenced by good to excellent intraclass correlation coefficients (0.71-0.95) and minimal Bland-Altman biases (0.01-0.12). The correlations between the Malay version LIFE-H 3.1 and the BI were fair to good (r = 0.28-0.69). The correlations between the Malay version LIFE-H 3.1 and the WHOQoL-BREF were weak to fair, ranging from 0.02 to 0.57.

    CONCLUSIONS: The Malay version LIFE-H 3.1 demonstrates excellent test-retest reliability and satisfactory validity. This questionnaire is an appropriate tool to assess social participation in rehabilitation for native Malay language speakers.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  8. Low WY, Zubir TN
    Asia Pac J Public Health, 2000;12 Suppl:S78-83.
    PMID: 11338746
    Sexuality of persons with spinal cord injury has received increased attention especially in the Western countries. However, in the local context, studies pertaining to the sexuality of the disabled are almost nil. This paper utilized a qualitative approach in assessing sexual knowledge, attitudes and practices of persons with spinal cord injury. Eight focus group discussions consisting of 28 adult spinal cord injured persons were carried out. The results showed that the frequency of sexual activity decreased following injury. The disabled themselves have a negative self-concept and a low self-esteem and this affects their attitudes towards sexuality and their sexual behaviour. Health care professionals tend to neglect this issue perhaps due to their insensitivity to the sexual needs for the disabled or a lack of understanding and expertise in this area. A need for sexual information related to their disability is warranted in the areas of reproduction, contraception and their ability/disability in achieving an erection or ejaculation. This study indicated a need for more comprehensive research in this neglected area of sexual issues of persons with disabilities. Public health education and counseling is deemed necessary for the disabled themselves so as to accommodate their sexual lives to their physical capabilities and desires. Attitudes and misconceptions of the public need to be corrected. Above all, there is a need for education and training for health care professionals in the area of sexual rehabilitation, which is currently non-existent in the country. Perhaps, it is timely to incorporate sexual rehabilitation as part of a holistic medical rehabilitation of the disabled.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  9. Naicker AS, Mohamad Yatim S, Engkasan JP, Mazlan M, Yusof YM, Yuliawiratman BS, et al.
    Phys Med Rehabil Clin N Am, 2019 11;30(4):807-816.
    PMID: 31563172 DOI: 10.1016/j.pmr.2019.07.006
    This article reviews the epidemiology, rehabilitation intervention strategies, and rehabilitation resources for persons with disabilities (PWD) in Malaysia. Currently, the registered number of PWD is 409,269 individuals, 1.3% of the total population, which is far less than the World Health Organization estimation of 10%. The rehabilitation implementation strategies include health policies, health promotion, and prevention programs. Health-related services for PWD are provided by many government agencies, including health, welfare, education, manpower, housing, and the private sector and nongovernment organizations. It is hoped national health programs can ensure special care and rehabilitation for PWD, optimizing self-reliance and social integration.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  10. Mat Rosly M, Halaki M, Mat Rosly H, Davis GM, Hasnan N, Husain R
    Disabil Rehabil, 2020 07;42(14):2067-2075.
    PMID: 30686132 DOI: 10.1080/09638288.2018.1544294
    Purpose: The Physical Activity Scale for Individuals with Physical Disabilities questionnaire provides an assessment of physical activity after spinal cord injury. This study sought to adapt, with cultural competence, the English questionnaire and translate it into Bahasa Malaysia, including evaluation of content and face validity, internal consistency and test-retest reliability, and completion of a factor analysis in order to validate the Malaysian version.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 rehabilitationThe 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.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  11. Stucki G, Pollock A, Engkasan JP, Selb M
    Eur J Phys Rehabil Med, 2019 Jun;55(3):384-394.
    PMID: 30990004 DOI: 10.23736/S1973-9087.19.05808-8
    Rehabilitation aims to optimize functioning of persons experiencing functioning limitations. As such the comparative evaluation of rehabilitation interventions relies on the analysis of the differences between the change in patient functioning after a specific rehabilitation intervention versus the change following another intervention. A robust health information reference system that can facilitate the comparative evaluation of changes in functioning in rehabilitation studies and the standardized reporting of rehabilitation interventions is the International Classification of Functioning, Disability and Health (ICF). The objective of this paper is to present recommendations that Cochrane Rehabilitation could adopt for using the ICF in rehabilitation studies by: 1) defining the functioning categories to be included in a rehabilitation study; 2) specifying selected functioning categories and selecting suitable data collection instruments; 3) examining aspects of functioning that have been documented in a study; 4) reporting functioning data collected with various data collection instruments; and 5) communicating results in an accessible, meaningful and easily understandable way. The authors provide examples of concrete studies that underscore these recommendations, whereby also emphasizing the need for future research on the implementation of specific recommendations, e.g. in meta-analysis in systematic literature reviews. Furthermore, the paper outlines how the ICF can complement or be integrated in established Cochrane and rehabilitation research structures and methods, e.g. use of standard mean difference to compare cross-study data collected using different measures, in developing core outcome sets for rehabilitation, and the use of the PICO model.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  12. Chen ST, Soo KL, Azriani AR, Van Rostenberghe H, Sakinah H
    Malays J Nutr, 2012 Aug;18(2):185-205.
    PMID: 24575666 MyJurnal
    Persons with disabilities (PWD) are susceptible to malnutrition. Caregivers or teachers in rehabilitation centres may not be adequately trained in nutrition management of PWD. The aims of this study were (i) to assess the nutrition knowledge, attitude and practice among teachers in community-based rehabilitation centres for PWD; and (ii) to evaluate changes in the nutrition knowledge and attitude of the teachers before and after exposure to a training workshop on nutrition management for PWD.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  13. Razaob NA, Tham SY, Mohd Rasdi HF, Wan Yunus F, Kadar M
    Occup Ther Health Care, 2020 Jan;34(1):32-47.
    PMID: 31920126 DOI: 10.1080/07380577.2020.1712632
    The Community Integration Questionnaire-Revised (CIQ-R) is a self-report standardized instrument designed to assess an individual's degree of community integration. The aim of this study was to translate, validate and conduct a reliability test of the CIQ-R Malay version. The development involved the three phases of translation, content validation and cognitive interviewing, test-retest reliability and internal consistency of the CIQ-R Malay version. The Content Validity Index (CVI) showed perfect agreement between the panel experts. The Intra-class Correlation Coefficient (ICC) demonstrated a moderate to excellent level of test-retest agreement (ICC 0.72 to 0.93). The Total CIQ-R Malay version and Home Integration subscale showed good internal consistency, with values of Cronbach's alpha ranging from 0.81 to 0.90. The findings from the present study provided preliminary support for the psychometric properties of the CIQ-R Malay version as a valid and reliable instrument to be used in Malaysia.
    Matched MeSH terms: Disabled Persons/rehabilitation*
  14. Mairami FF, Allotey P, Warren N, Mak JS, Reidpath DD
    Disabil Rehabil Assist Technol, 2018 10;13(7):658-664.
    PMID: 28836873 DOI: 10.1080/17483107.2017.1369586
    BACKGROUND: Stroke is a leading cause of disability that limits everyday activities and reduces social participation. Provision of assistive devices helps to achieve independence and social inclusion. However, due to limited resources or a lack of suited objects for their needs, individuals with disabilities in low and middle income countries (LMIC) often do not have access to assistive devices. This has resulted in the creation of purpose built innovative solutions. Methodology and case content: This paper uses a single case derived from a larger ethnographic study of stroke survivors in rural Malaysia to demonstrate the role of assistive devices in shaping stroke recovery and how existing structures can be modified. Second, the concept of affordances in relation to structures within the environment, issues of affordability and accessibility of assistive devices for individuals in LMIC are discussed.

    FINDINGS AND CONCLUSIONS: Stroke recovery involves adapting to new limitations and discovering the support necessary to live life. These changes are influenced by a range of environmental factors. Healthcare professionals need to support stroke patients in identifying challenges and work to find innovative ways to address them. Stroke survivors may benefit from the use of an assistive device beyond its clinical function to participate purposefully in activities of daily living. Implications for Rehabilitation Stroke is a cause of disability that limits everyday activities and reduces social participation. Assistive devices help achieve independence, social inclusion and shape stroke recovery. Individuals with disabilities in low and middle income countries often do not have access to assistive devices and resort to innovative solutions that are purpose built. Stroke recovery involves adapting to new limitations and discovering the support necessary to live life as best as possible.

    Matched MeSH terms: Disabled Persons/rehabilitation*
  15. Khan F, Amatya B, de Groote W, Owolabi M, Syed IM, Hajjoui A, et al.
    J Rehabil Med, 2018 May 08;50(5):472-479.
    PMID: 29487941 DOI: 10.2340/16501977-2313
    OBJECTIVE: Despite the prevalence of disability in low-and middle-income countries, the clinical skills of the rehabilitation workforce are not well described. We report health professionals' perspectives on clinical skills in austere settings and identify context-specific gaps in workforce capacity.

    METHODS: A cross-sectional pilot survey (Pakistan, Morocco, Nigeria, Malaysia) of health professionals' working in rehabilitation in hospital and community settings. A situational-analysis survey captured assessment of clinical skills required in various rehabilitation settings. Responses were coded in a line-by-line process, and linked to categories in domains of the International Classification of Functioning, Disability and Health (ICF).

    RESULTS: Respondents (n = 532) from Pakistan 248, Nigeria 159, Morocco 93 and Malaysia 32 included the following: physiotherapists (52.8%), nurses (8.8%), speech (5.3%) and occupational therapists (8.5%), rehabilitation physicians (3.8%), other doctors (5.5%) and prosthetist/orthotists (1.5%). The 10 commonly used clinical skills reported were prescription of: physical activity, medications, transfer-techniques, daily-living activities, patient/carer education, diagnosis/screening, behaviour/cognitive interventions, comprehensive patient-care, referrals, assessments and collaboration. There was significant overlap in skills listed irrespective of profession. Most responses linked with ICF categories in activities/participation and personal factors.

    CONCLUSION: The core skills identified reflect general rehabilitation practice and a task-shifting approach, to address shortages of health workers in low-and middle-income countries.

    Matched MeSH terms: Disabled Persons/rehabilitation*
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