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Title of Research Project |
Completed or Ongoing |
Summary |
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The effect of starting an exercise program for individuals with a disability |
Completed |
We recruited 31 clients with disabilities who were just starting exercise, and examined the effects of the first six months of exercise. These clients had significant increases in endurance, going from an average of 8.5 minutes of exercise to 11.6 minutes of exercise, a 39% increase in endurance. There were significant increases in strength for some clients, with increases of strength that ranged from 10% to 36% over the 6 month period. These clients also reported significant increases in activity level, outside of the regular exercise. While there were no statistically significant changes in the number of secondary conditions, these clients did have a decrease of .4 secondary conditions over the 6 month period. The first project was completed with grant support from the Medica Foundation and the Milbank Foundation
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Effects of the Loss of Funding for Exercise on Individuals with Disabilities
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Completed |
Thirty clients of the Courage Center Health, Wellness and Fitness Program ended up stopping exercise because their state waiver funding was cut during 2007. These clients were contacted regarding their health after they had stopped exercising. Some of the clients had tried to continue exercising, but most had been unable to exercise without assistance or specialized equipment. Over an average of 6 months without exercise, these clients increased the number of secondary conditions from 3.0 to 5.6, and the severity of the conditions had gone from not being a problem to being a mild problem. The problems which increased the most were fatigue, joint and muscle pain, and arthritis.
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The Effects of Revised Exercise Programs for People with Disabilities Who Currently Exercise
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Completed |
We recruited 52 participants with a wide range of diagnosis, including MS, spinal cord injury, and traumatic brain injury, as well as others. These participants had been exercises previously, but were re-evaluated and provided with a new exercise program. These participants made significant gains in strength, endurance, and decreases in secondary conditions. Since they first started exercising, they had decreased an average of 0.73 secondary conditions.
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Barriers to Voting for Persons with Disabilities |
Completed |
In May of 2009, a survey was developed to assess the accessibility of voting sites in Minnesota in the November 2008. The survey addressed common public accessibility issues, as well as issues surrounding the voting process itself, including the voting machines, absentee ballots, and the poll judges. The surveys were distributed through the Minnesota Consortium of Citizens with Disabilities. An unknown number of the surveys were distributed electronically. One hundred and twenty seven surveys were returned.
- 34% of respondents reported that transportation or parking were barriers to the polls
- While the individual responses for physical barriers at polling places were not high, 35% of respondents reported at least one physical barrier to the polls.
- 14% of the respondents reported that election judges had presented barriers to voting.
- 10% of respondents reported that providing identification would be a barrier to voting
In summary, about half of voters knew that accessible voting machines were available and three-quarters knew that they could use absentee ballots. There was a preference in this group to vote at the polls, rather than by absentee, even though there were many barriers reported in voting at the polls. The biggest problems for voters are transportation to and parking at the polling site more than one-third of the respondents and physical barriers at the polling site for more than one-third of the respondents. For a smaller number of respondents, election judges presented a barrier to voting for the respondents to this survey.
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Mind Body Integration Training: Effects on Staff of a Rehabilitation Facility |
Completed |
We have now completed two years of the Mind Body Integration Project and have found significant changes in staff job satisfaction, reported quality of life, decreased job stress and increased commitment to Courage Center and their professions. In addition, the staff report integrating changes, both in themselves and in their treatment.
The Strong Workplace Survey is a measure that is given yearly at Courage Center to evaluate staff satisfaction. Initially, we used this measure to be sure that the staff participating in this project were not a unique group, but were about as satisfied with their jobs as everybody else at Courage. In fact, we found that our group reflected the same scores as the general staff at Courage Center. 44 staff members participated in year long monthly sessions of the Mind Body Integration Project. We found that staff had increased their job satisfaction significantly at the close of the project.
Prior to participating in the Mind Body Project, 60% of the participants had considered leaving the agency. These numbers were very concerning because turnover of staff is a significant cost, and having staff leave the profession only exacerbates the shortages of health professions that currently exist nationwide. At one year post, these numbers had improved impressively. Following a year of participation in the project only 27% had considered leaving. At the beginning of the project 25% had considered changing their profession. Upon completion of the project only 8% considered changing their profession.
In particular, staff made gains in the areas of:
- knowing what was expected of them on their jobs
- opportunities to grow and learn,
- being recognized or praised for doing good work
- feeling that their job was important to the mission of Courage Center.
Closely related to these findings were significant decreases in job stress and pressure over the year participants were in the project. From the results of the Job Stress Survey, staff reported that the frequency of stressful events had not changed but the severity of these events did. This suggests that staff have developed techniques to handle stress more effectively in a highly pressured and demanding health care environment.
The impact on the staff also transferred to their relationships with clients.
“My treatments have changed because I am able to treat with better compassionate boundaries, without giving too much of myself. Prior to this experience I feel that I gave too much of myself while trying to “fix” my clients. Now that I am able to establish the rapport and work as hard as my clients do, I can let them know that I am there for them and willing to put in 100% if they are too. I don’t feel as tired and burnt out when I finish a treatment session.”
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Effects of a single session of Watsu |
Completed |
We surveyed 107 clients during International Watsu Week, and 67 clients sent in the post-test survey, with a response rate of 63%. 53 of the clients in this project were women, 12 were men, 2 did not report gender. The average age was 56.2 years (SD 13.0 years). The range in age was 23 to 78.
We examined the effect of a 20 minute Watsu session on a number of secondary conditions. We had asked the participants to send us the post-survey 2 to 3 days after their session. We tested 10 conditions, and using a Bonferroni correction, used a p=.005 as a level of significance and a Wilcoxon Signed Ranks test. We found significant improvement in the following conditions:
Fatigue, p=.000
Joint and Muscle Pain, p=.000
Sleep problems/disturbances in sleep, p=.000
Anxiety, p=.000
Balance and coordination problems, p=.000
Eating or weight problems, p=.000
Lack of flexibility or range of motion, p=.000
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Lower Extremity Dressing for Individuals with SCI at the C5 through C7 Level |
Completed |
We pulled a list of 77 former clients who had been at Courage Center in the last 3 years with a spinal cord injury level C5 through C7. Twenty-nine former clients agreed to participate. We asked them about their experience of lower extremity dressing. Specifically, were they able to dress when they left Courage Center, and whether they continued to do lower extremity dressing after discharge. Finally, if they were not as independent as they had been when they were discharged, we asked them why they had not continued to do lower extremity dressing. The 29 former clients we contacted had had an average length of stay of 8 months (SD 5.6 months).
Participants gave a variety of reasons that they were not doing their own dressing tasks, including that they had someone help them with self-care and lower extremity dressing tasks because it made it easier, they had never really been able to do lower extremity dressing, they experienced too much pain and stiffness, or they preferred to save their energy by not doing lower extremity dressing tasks for other activities they enjoyed.
These reasons were not indicative of the client’s motivation or desire but due to how they chose to use their energy, the severity of physical injury making LE dressing unattainable, and needing physical assistance to make it possible for them to be dressed.
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