Advertisement
Original research| Volume 99, ISSUE 7, P1289-1294, July 2018

Life Starts at Home: Bathing, Exertion and Participation for People With Mobility Impairment

Published:January 03, 2018DOI:https://doi.org/10.1016/j.apmr.2017.11.015

      Abstract

      Objective

      To investigate the relationship between perceived exertion while bathing/dressing/grooming and associations with social-recreational activities outside the home for individuals with mobility impairment (MI).

      Design

      A 2-study approach was used to examine data from the American Time Use Survey (ATUS) and primary data from the Health and Home Survey (HHS). The relationship between bathing/dressing/grooming and engagement in social-recreational activities was explored, as well as the role that exertion in the bathroom may play in participation in these activities.

      Setting

      General community setting.

      Participants

      For the ATUS survey, participants (n=6002) included individuals who reported an MI. For the HHS, 2 mail-based recruitment methods were used to recruit a sample of individuals with MI (n=170) across 3 geographically diverse U.S. communities.

      Interventions

      Not applicable.

      Main Outcome Measures

      Participation in social and recreational activities.

      Results

      People with MI (relative to those without MI) were less likely to report spending any time bathing/dressing/grooming on a given day, but spent more time when they did. People with MI reported higher exertion while bathing/dressing/grooming than people without. People with MI were less likely to leave the house or engage in social-recreational activities on days where they did not engage in bathing activities. People who reported greater exertion in the bathroom engaged in fewer social-recreational activities.

      Conclusions

      Exertion in the bathroom may present a barrier to participation, indicating a relationship between exertion in the bathroom and social-recreational participation. Research that examines the impact of home modifications on exertion and participation is needed.

      Keyword

      List of abbreviations:

      ACS (American Community Survey), ATUS (American Time Use Survey), BCEQ (Brief Community Engagement Questionnaire), CI (Confidence interval), CIL (Center for Independent Living), HHS (Health and Home Survey), MI (Mobility impairment), OR (Odds ratio)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Office for Civil Rights
        Section 504 of the Rehabilitation Act of 1973: handicapped persons' rights under federal law.
        U.S. Dept of Education, Washington (DC)1992
      1. U.S. Dept of Housing and Urban Development. Fair Housing Amendments Act of 1988. p 800-901.

      2. U.S. Dept of Justice. The Americans with Disabilities Act. 1990;101-336.

      3. U.S. Dept of Labor and Education. Workforce Innovation and Opportunity Act (WIOA). Pub L 2014; p 113-128.

        • Administration on Community Living (ACL)
        ACL strategic plan.
        (2013-2018. Available at:)
        • Seekins T.
        • Shunkamolah W.
        • Bertsche M.
        • et al.
        A systematic scoping review of measures of participation in disability and rehabilitation research: A preliminary report of findings.
        Disabil Health J. 2012; 5: 224-232
        • World Health Organization
        International Classification of Functioning, Disability, and Health.
        World Health Organization, Geneva2001
        • Williams R.M.
        • Ehde D.M.
        • Smith D.G.
        • Czerniecki J.M.
        • Hoffman A.J.
        • Robinson L.R.
        A two-year longitudinal study of social support following amputation.
        Disabil Rehabil. 2004; 26: 862-874
        • Bishop Y.M.
        • Fienberg S.E.
        • Holland P.W.
        • Light R.J.
        • Mosteller F.
        Estimating the size of a closed population.
        in: Discrete multivariate analysis: theory and practice. MIT Pr, Cambridge1999: 229-256
        • Connell B.R.
        • Sanford J.A.
        Difficulty, dependence, and housing accessibility for people aging with a disability.
        J Archit Plann Res. 2001; 18: 234-242
        • Stark S.
        Creating disability in the home: the role of environmental barriers in the United States.
        Disabil Soc. 2001; 16: 37-49
        • Stineman M.G.
        • Ross R.N.
        • Maislin G.
        • Gray D.
        Population-based study of home accessibility features and the activities of daily living: clinical and policy implications.
        Disabil Rehabil. 2007; 29: 1165-1175
        • Dunlop D.D.
        • Hughes S.L.
        Disability in activities of daily living: patterns of change and a hierarchy of disability.
        Am J Public Health. 1997; 87: 378-383
        • Greiman L.
        • Ravesloot C.
        Housing characteristics of households with wheeled mobility device users from the American Housing Survey: do people live in homes that facilitate community participation?.
        Community Dev (Columb). 2016; 47: 63-74
        • Petersson I.
        • Lilja M.
        • Hammel J.
        • Kottorp A.
        Impact of home modification services on ability in everyday life for people ageing with disabilities.
        J Rehabil Med. 2008; 40: 253-260
        • Haak M.
        • Fänge A.
        • Horstmann V.
        • Iwarsson S.
        Two dimensions of participation in very old age and their relations to home and neighborhood environments.
        Am J Occup Ther. 2008; 62: 77-86
        • Heinemann A.W.
        • Magasi S.
        • Hammel J.
        • et al.
        Environmental factors item development for persons with stroke, traumatic brain injury, and spinal cord injury.
        Arch Phys Med Rehabil. 2015; 96: 589-595
        • U.S. Census Bureau
        Current population survey design and methodology. Technical paper 66.
        U.S. Census Bureau, Washington (DC)2006
        • U.S Census Bureau
        ACS disability definitions.
        (Available at:)
      4. ILRU Director of Centers for Independent Living (CILs) and Associations–2017 (Vol 39). CIL center and association directory.
        (Available at:)
        • Livingston N.A.
        • Hargrove T.
        • Greiman L.
        • Myers A.
        • Ipsen C.
        • Ravesloot C.
        An investigation into the temporal scaling of community participation measurement.
        Rehabil Psychol. 2015; 60: 367-375
        • Borg G.
        Psychophysical scaling with applications in physical work and the perception of exertion.
        Scand J Work Environ Health. 1990; 16: 55-58
        • Lovell T.W.
        • Sirotic A.C.
        • Impellizzeri F.M.
        • Coutts A.J.
        Factors affecting perception of effort (session rating of perceived exertion) during rugby league training.
        Int J Sports Physiol Perform. 2013; 8: 62-69
        • Scherr J.
        • Wolfarth B.
        • Christle J.W.
        • Pressler A.
        • Wagenpfeil S.
        • Halle M.
        Associations between Borg’s rating of perceived exertion and physiological measures of exercise intensity.
        Eur J Appl Physiol. 2013; 113: 147-155
        • Kruger J.
        • Wirtz D.
        • Van Boven L.
        • Altermatt T.W.
        The effort heuristic.
        J Exp Soc Psychol. 2004; 40: 91-98
        • Demoulin C.
        • Verbunt J.A.
        • Winkens B.
        • Knottnerus J.A.
        • Smeets R.J.
        Usefulness of perceived level of exertion in patients with chronic low back pain attending a physical training programme.
        Disabil Rehabil. 2010; 32: 216-222
        • Sage M.
        • Middleton L.E.
        • Tang A.
        • Sibley K.M.
        • Brooks D.
        • McIlroy W.
        Validity of rating of perceived exertion ranges in individuals in the subacute stage of stroke recovery.
        Top Stroke Rehabil. 2013; 20: 519-527
        • Fry D.K.
        • Pfalzer L.A.
        Reliability of four functional tests and rating of perceived exertion in persons with multiple sclerosis.
        Physiother Can. 2006; 58: 212-220
        • Hofferth S.L.
        • Flood S.M.
        • Sobek M.
        American Time Use Survey data extract system. Minnesota Population Center: Minneapolis, MN.
        2013 (Available at:)
        https://www.atusdata.org/atus/
        Date accessed: February 6, 2018
        • Bureau of Labor Statistics, BLS
        American Time Use Survey user’s guide: understanding ATUS 2003 to 2015.
        Bureau of Labor Statistics, Washington (DC)2016
        • Murtagh K.N.
        • Hubert H.B.
        Gender differences in physical disability among an elderly cohort.
        Am J Public Health. 2004; 94: 1406-1411
        • Das J.
        • Stephen B.
        Mirror, mirror on the wall: the effect of time spent grooming on earnings.
        J Socio Econ. 2011; 40: 26-34
        • Hammel J.
        • Magasi S.
        • Heinemann A.
        • et al.
        Environmental barriers and supports to everyday participation: a qualitative insider perspective from people with disabilities.
        Arch Phys Med Rehabil. 2015; 96: 578-588
        • Cho H.Y.
        • MacLachlan M.
        • Clarke M.
        • Mannan H.
        Accessible home environments for people with functional limitations: a systematic review.
        Int J Environ Res Public Health. 2016; 13: 826
        • Stark S.
        Removing environmental barriers in the homes of older adults with disabilities improves occupational performance.
        OTJR (Thorofare, N J). 2004; 24: 32-40
        • Ward B.
        • Myers A.
        • Wong J.
        • Ravesloot C.
        Disability items from the current population survey (2008–2015) and permanent versus temporary disability status.
        Am J Public Health. 2017; 107: 706-708
        • Kielhofner G.
        Conceptual foundations of occupational therapy practice.
        FA Davis, Philadelphia2009
        • Katz S.J.
        • Kabeto M.
        • Langa K.M.
        Gender disparities in the receipt of home care for elderly people with disability in the United States.
        JAMA. 2000; 284: 3022-3027