ORCID Profile
0000-0002-2923-7277
Current Organisation
University of Otago Wellington
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Publisher: Informa UK Limited
Date: 24-03-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
DOI: 10.1097/JPO.0000000000000137
Abstract: Despite the high prevalence of chronic low back pain (LBP) in people with lower-limb utation, it is not clear whether there are differences in spinal and pelvic motion in in iduals with and without LBP. This exploratory study aimed to describe the spinal and pelvic kinematics during gait in people with transfemoral utation (TFA) and transtibial utation (TTA), with and without LBP. Eighteen participants with traumatic utation (6 TFA, 12 TTA) were grouped according to their utation level and presence (or absence) of LBP. Three-dimensional thoracic, lumbar, and pelvic kinematics during walking were reported to identify movement patterns that may be indicative of LBP. The TFA-LBP group elevated the pelvis on the intact side and minimized lumbar lateral flexion to achieve the same trunk lateral flexion angle (Trendelenburg gait) as those with TFA-No LBP. Those with TFA-LBP kept the lumbar spine rotated toward the prosthetic limb throughout the gait cycle. There were no differences in the spinal and pelvic kinematics of people with TTA-LBP and TTA-No LBP. This study provides preliminary evidence of differences in spinal and pelvic kinematics that may be associated with LBP in people with TFA.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-06-2021
DOI: 10.1097/J.PAIN.0000000000002364
Abstract: Telehealth is a promising approach to support self-management with the potential to overcome geographical barriers. Understanding patient perspectives will identify practical challenges to delivering self-management strategies by telehealth. The aim of this study was to synthesize the perceptions of people with chronic musculoskeletal pain for engaging in interventions delivered using telehealth. We searched MEDLINE, Embase, CINAHL, LILACS, and PsycINFO databases. We included qualitative studies that explored perceptions or experiences or attitudes of people with chronic musculoskeletal pain engaging with telehealth. We assessed the methodological quality using the Critical Appraisal Skills Programme checklist. Meta-synthesis was guided by a thematic synthesis approach. The level of confidence of review findings was assessed using the Confidence in the Evidence from Reviews of Qualitative Studies (GRADE-CERQual). Twenty-one studies were included (n = 429). Telehealth comprised web-based, videoconference-based, telephone-based, video-based, and smartphone app–based programs delivered solely or combined. Chronic musculoskeletal conditions included people with knee or hip osteoarthritis, chronic low back pain, persistent pain (chronic joint pain or nonspecific chronic musculoskeletal pain), rheumatoid arthritis, and functional fatigue syndrome. The enablers for engaging in telehealth interventions were as follows: (1) “at my own pace, space, and place” and (2) empowered patient. Barriers to engaging in telehealth interventions were as follows: (1) impersonal, (2) technological challenges, (3) irrelevant content, and (4) limited digital (health) literacy. Telehealth interventions with well-designed interactive platforms, flexibility to fit patients' routine, and the broad availability of material may favor better engagement. Encouragement of self-efficacy is linked to successful telehealth-delivered self-management programs.
Publisher: JMIR Publications Inc.
Date: 19-07-2019
Abstract: n emerging literature describes systematic reviews of the app stores to identify mobile applications (apps) to support diagnosis, assessment or management of health conditions. There are currently no guidelines for the conduct and reporting of methods of these studies. The first step in developing guidelines is to evaluate current reporting of methods of systematic reviews of health apps. he aims of this scoping review were: 1. To identify what parts of the ‘usual’ methods of systematic review are used and adapted in app-focused systematic reviews 2. To describe how methods of critical appraisal are adapted and done and 3. To assess what clinical recommendations are made and the ‘strength’ of those recommendations. systematic search of seven databases was undertaken to identify app-focused systematic reviews meeting the inclusion criteria: (1) the article was “systematic” defined by “systematic review” in the title OR an a priori systematic search procedure described in the article methods OR the app search process described based on PRISMA standard flow diagram (2) the article described a systematic search for apps in at least one app store (3) the article focused on a named health condition and (4) the focus of the article was apps for people with any diagnosed acute or chronic health condition or for clinicians in direct clinical care. Articles were excluded if not in English, focused on general or psychological health or nutrition. A data extraction template was created based on standard data elements in PRISMA guidelines. The extracted data from the included articles were summarised by frequencies. rom 2798 records, 26 of the 177 potentially eligible full text articles were included. In the 26 included app-focused systematic reviews, many of the typical procedures of a systematic review as operationalized for app-focused reviews were not reported at all, or not clearly reported. Absences, lack of clarity or completeness of reporting occured in: a priori review protocol registration or following a reporting guideline the processes of screening apps in the app stores the data extracted from app store description or the device the app was downloaded to for data extraction and appraisal tools for assessing the app quality, usability or clinical content. Further, there was no explicit reporting of clinical efficacy of apps or recommendations for use in the majority of reviews. he reporting of methods used in app-focused systematic reviews is variable and could be substantially improved. Development and publication of consensus reporting guidelines would increase transparency and quality of published studies. A repository for registration of reviews would ensure reviews are easy to find and not duplicated. These steps would also enable clinicians and people with health conditions to more easily find high quality apps.
Publisher: SAGE Publications
Date: 11-09-2020
Abstract: No guidelines exist for the conduct and reporting of manuscripts with systematic searches of app stores for, and then appraisal of, mobile health apps (‘health app-focused reviews’). We undertook a scoping review including a systematic literature search for health app-focused reviews describing systematic app store searches and app appraisal, for apps designed for patients or clinicians. We created a data extraction template which adapted data elements from the PRISMA guidelines for systematic literature reviews to data elements operationalised for health app-focused reviews. We extracted the data from included health app-focused reviews to describe: (1) which elements of the adapted ‘usual’ methods of systematic review are used (2) methods of app appraisal and (3) reporting of clinical efficacy and recommendations for app use. From 2798 records, the 26 included health app-focused reviews showed incomplete or unclear reporting of review protocol registration use of reporting guidelines processes of screening apps data extraction and appraisal tools. Reporting of clinical efficacy of apps or recommendations for app use were infrequent. The reporting of methods in health app-focused reviews is variable and could be improved by developing a consensus reporting standard for health app-focused reviews.
Publisher: Wiley
Date: 02-03-2017
DOI: 10.1016/J.PMRJ.2017.02.004
Abstract: Chronic low back pain (LBP) is a common musculoskeletal impairment in people with lower limb utation. Given the multifactorial nature of LBP, exploring the factors influencing the presence and intensity of LBP is warranted. To investigate which physical, personal, and utee-specific factors predicted the presence and intensity of LBP in persons with nondysvascular transfemoral utation (TFA) and transtibial utation (TTA). A retrospective cross-sectional survey. A national random s le of people with nondysvascular TFA and TTA. Participants (N = 526) with unilateral TFA and TTA due to nondysvascular etiology (ie, trauma, tumors, and congenital causes) and a minimum prosthesis use of 1 year since utation were invited to participate in the survey. The data from 208 participants (43.4% response rate) were used for multivariate regression analysis. Personal (ie, age, body mass, gender, work status, and presence of comorbid conditions), utee-specific (ie, level of utation, years of prosthesis use, presence of phantom-limb pain, residual-limb problems, and non utated limb pain), and physical factors (ie, pain-provoking postures including standing, bending, lifting, walking, sitting, sit-to-stand, and climbing stairs). LBP presence and intensity. A multivariate logistic regression model showed that the presence of 2 or more comorbid conditions (prevalence odds ratio [POR] = 4.34, P = .01), residual-limb problems (POR = 3.76, P < .01), and phantom-limb pain (POR = 2.46, P = .01) influenced the presence of LBP. Given the high LBP prevalence (63%) in the study, there is a tendency for overestimation of POR, and the results must be interpreted with caution. In those with LBP, the presence of residual-limb problems (β = 0.21, P = .01) and experiencing LBP symptoms during sit-to-stand task (β = 0.22, P = .03) were positively associated with LBP intensity, whereas being employed demonstrated a negative association (β = -0.18, P = .03) in the multivariate linear regression model. Rehabilitation professionals should be cognizant of the influence that comorbid conditions, residual-limb problems, and phantom pain have on the presence of LBP in people with nondysvascular lower limb utation. Further prospective studies could investigate the underlying causal mechanisms of LBP. II.
Publisher: Springer Science and Business Media LLC
Date: 31-05-2020
DOI: 10.1186/S13643-020-01390-X
Abstract: Chronic musculoskeletal pain represents an enormous burden in society. Best-practice care for chronic musculoskeletal pain suggests adoption of self-management strategies. Telehealth interventions (e.g., videoconferencing) are a promising approach to promote self-management and have the potential to overcome geographical barriers between patient and care providers. Understanding patient perspectives will inform and identify practical challenges towards applying the self-management strategies delivered via telehealth to everyday lives. The aim of this study is to synthesize the perceptions of in iduals with musculoskeletal pain with regards to enablers and barriers to engaging in telehealth interventions for chronic musculoskeletal pain self-management. A systematic review of qualitative studies will be performed based on searches of MEDLINE, EMBASE, CINAHL, LILACS, and PsycINFO databases. Screening of identified titles will be conducted by two independent investigators. Data extraction will retrieve detailed qualitative information from selected articles. The critical appraisal skills program (CASP) checklist will be used for critical appraisal of included studies, and the level of confidence in the findings will be assessed using the confidence in the evidence from reviews of qualitative research (GRADE-CERQual). A thematic synthesis approach will be used to derive analytical themes. This review will systematically identify, synthesize, and present enablers and barriers reported by people with musculoskeletal pain to engage in telehealth interventions. The review will provide information required to support the design and improvement of telehealth services. PROSPERO CRD42019136148
No related grants have been discovered for Hemakumar Devan.