Monash Disability Education and Research Network (MoDERN)
It is estimated that 1 in 5 Australians are currently living with a disability (ABS, 2009). A group of researchers and educators across Monash University have formed a network to enable inter-faculty collaboration. This network utilises the expertise in disability within and external to Monash University to support inter-professional education in the area of disability, provide innovation in the disability sector, encourage students to undertake research in the disability field and provide a multidisciplinary framework for the supervision of HDR students. Above all, the synergy between innovation, research and education will improve the lives of those living with disability and their carers.
Research
This network utilises the expertise in disability to support inter-professional education in the area of disability, provide innovation in the disability sector and encourage students to undertake research in the disability field.
Education
The network provides a number of education initiatives, catering to a range of needs. Short courses currently run in the area of disability are available for professionals and students.
Estimating the Incidence and Prevalence of Traumatic Spinal Cord Injury in Australia
The objective was to determine estimates of the incidence and prevalence of traumatic spinal cord injury (TSCI) in Australia as of June 30, 2011.
Interventions models followed 2 population-based databases of hospital separations of patients with TSCI, giving upper and lower estimates of incidence; national population profiles and life tables; levels of TSCI based on Australian Spinal Cord Injury Registry; and life expectancy for persons with spinal cord injury under 3 scenarios—1 constant and 2 with a trend standardized mortality ratio (SMR).
Results found the lower estimate of incidence was 21.0 per million population per year, and the upper estimate was 32.3 per million population per year. The derived prevalence rates ranged from 490 per million population (10,944 persons–lower incidence, trend SMR with survival from 1948) up to 886 per million population (19,784 persons–higher incidence, constant SMR). The prevalence was highest in males, persons aged 46 to 60 years, and those with tetraplegia.
In conlcusion we have reported a method for calculating an estimate of the prevalence of TSCI which provides information that will be vital to optimize health care planning for this group of highly disabled members of society.
A comparison of flat and ramped, contoured cushions as adaptive seating interventions for children with neurological disorders.
This study is a part of an ongoing effort to address the lack of rigorous, scientific evidence to inform the prescription of adaptive seating interventions for children with neurological disorders. The aim is to investigate one aspect of the seat – the cushion, at the same time as developing a battery of tests which are objective, easy to implement and reliable with which adaptive seating interventions can be measured. Method: A total of 35 school-aged children with neurological disorders were assessed in a bespoke adaptive seating system to compare the use of a flat and a ramped, contoured cushion. The measures used were an accelerometer to measure stability, two actigraphs to measure activity, a pressure mapping system to measure weight distribution, goniometry to measure posture and activities to measure functional ability. Results: The results generally support the use of ramped, contoured cushions over flat cushions. The accelerometer and pressure mapping system show particular promise in future research. The actigraphs were unreliable, although other models may prove more suitable. The goniometry produced the best results, although it was the least reliable to implement and the seated functional activities need further work. Interpretation: The methodology showed in a number of ways that ramped contoured cushions were more effective than flat seat cushions for a heterogeneous population of children. Accelerometry and pressure mapping showed particular promise for advancing research and practice in the area of adaptive seating, with further work required in other areas. In particular, it is recommended that future efforts pursue the use of more reliable electronic measurement.
Exploring the experience of clients with tetraplegia utilizing assistive technology for computer access
Purpose: Assistive technology for computer access can be used to facilitate people with a spinal cord injury to utilize mainstream computer applications, thereby enabling participation in a variety of meaningful occupations. The aim of this study was to gain an understanding of the experiences of clients with tetraplegia trialing assistive technologies for computer access during different stages in a public rehabilitation service. Method: In order to explore the experiences of clients with tetraplegia trialing assistive technologies for computer use, qualitative methodology was selected. Data were collected from seven participants using semi-structured interviews, which were audio-taped, transcribed and analyzed thematically. Results: Three main themes were identified. These were: getting back into life, assisting in adjusting to injury and learning new skills. Conclusions: The findings from this study demonstrated that people with tetraplegia can be assisted to return to previous life roles or engage in new roles, through developing skills in the use of assistive technology for computer access. Being able to use computers for meaningful activities contributed to the participants gaining an enhanced sense of self-efficacy, and thereby quality of life.
Implications for Rehabilitation
- Findings from this pilot study indicate that people with tetraplegia can be assisted to return to previous life roles, and develop new roles that have meaning to them through the use of assistive technologies for computer use.
- Being able to use the internet to socialize, and complete daily tasks, contributed to the participants gaining a sense of control over their lives.
- Early introduction to assistive technology is important to ensure sufficient time for newly injured people to feel comfortable enough with the assistive technology to use the computers productively by the time of discharge.
- Further research into this important and expanding area is indicated.
Health-related quality of life of ambulant adults with cerebral palsy and falls and mobility decline: a preliminary cross sectional study, Health and Quality of Life Outcomes
Despite an increasing number of studies examining the profile of falls and mobility decline in adults with cerebral palsy (CP), little is known about its impact on an individual’s life quality. The aim of this preliminary study was to assess the wellbeing and health status aspects of health-related quality of life (HRQOL) in ambulant adults with CP and explore the relationship of falls and mobility decline with HRQOL.
The method involved ambulant adults with CP completing postal surveys which sought demographic data, mobility (Gross Motor Function Classification System; GMFCS-E&R), presence of mobility decline, falls history, and HRQOL (Personal Wellbeing Index (PWI), Short Form-36 Health Survey (SF-36)).
Thirty-four community-dwelling ambulant adults with CP with a mean age of 44.2 years (SD; 8.6; range 26–65) participated. Twenty-eight (82%) participants reported mobility decline since reaching adulthood, and a similar proportion of individuals (82%) reported having had more than two falls in the previous year. The health status and wellbeing of this sample of ambulant adults with CP were generally lower compared with the Australian normative population. Mobility decline was found by univariate regression analysis to be associated with mental health status (β = 0.52; p = 0.002), but not when other predictor variables were included in the multivariate model (β = 0.27; p = 0.072). In contrast, self-reported history of falls was found to be a significant contributing factor for both physical health status (β = −0.55; p = 0.002) and personal wellbeing (β = −0.43; p = 0.006).
This sample of ambulant adults with CP perceived their HRQOL to be poor, with some health status and wellbeing domains below that of population wide comparisons. A majority of these individuals also experienced a fall in the last year and a decline in their mobility since reaching adulthood. While further research is required, this preliminary study has highlighted the potential implications of falls and mobility decline on HRQOL in adults with CP.