Journal of Health and Rehabilitation Sciences

Experiences of People with Motor Disabilities and Visual Impairments in Croatia with Assistive Technology

2025-11-20T05:30:11+01:00

Introduction: Assistive technology (AT) is a term that encompasses assistive products, and the systems and services associated with them. Despite existing legislation and the fact that AT is an important part of this process, there are many barriers to access AT. The purpose of this study is to explore the differences in the evaluation of the assistive technology (AT) availability and the AT services quality in Croatia between people with visual impairments (IwVI) and people with motor disabilities (IwMD).

Methods: We created an online questionnaire about knowledge of AT, previous training and the need for further training, and the benefits and challenges regarding AT. In addition to the online questionnaire, we obtained qualitative data on AT use.

Results: The results show that most participants were not aware of AT before they started using it but also did not know about their rights to benefits and the purchase of AT. Participants reported financial problems in purchasing assistive devices and were forced to fund AT from their own resources or through donations. Many of the participants, regardless of the type of disability, had and still have problems with AT that are not adapted to their personal abilities and needs.

Conclusion: To improve access to AT and the quality of services, it is necessary to bring together professionals and experienced AT users who will disseminate accurate and trustworthy information to ensure the best cost-benefit ratio of AT for individuals with different disabilities.

Exploring an inclusive educational program within Higher Education for individual with Intellectual Disabilities.

2025-11-06T04:38:38+01:00

Introduction: Individuals with Intellectual Disability (ID) have traditionally been excluded from Higher Education (HE). As HE moves towards more inclusive practices for individuals with ID, there is a need to capture the experience of support staff implementing and facilitating such programs. This paper explores an inclusive educational program within higher level designed specifically for individuals with an ID from support staff’s perspective.

Methods: A qualitative design was employed, utilising a focus group interview and purposive sampling to gather in-depth insights.

Results: This study highlights the transformative potential of an inclusive program in HE for students, staff, the University and the wider community. Findings demonstrate that when educational environments can embrace co-creation, collaboration, and a values-driven approach, students have the opportunity to experience meaningful growth in their confidence, self-esteem, social integration and capacity. Staff and peers are further provided with opportunities to challenge assumptions, increase understanding and gain renewed perspectives on teaching, learning and inclusion. However, despite the evident benefits, without secure investment, sustained policy commitment and a systemic culture change, such opportunities are limited.

Conclusion: This study has implications for the further development and sustainability of inclusive education for individuals with ID in HE nationally and internationally. Further research to examine student perspectives is warranted, to inform the future development and delivery of inclusive programs for individuals with an ID.

Functional and Anatomical Outcomes Following Intravitreal Bevacizumab in Treatment-Naïve Centre-Involving Diabetic Macular Edema: A 3-Month Prospective Evaluation

2025-10-20T02:55:48+02:00

Introduction: Diabetic macular edema (DME) remains a major cause of vision impairment worldwide. Intravitreal bevacizumab, though used off-label, is an established therapy for centre-involved DME (CI-DME). This study evaluated how effectively microperimetry complements standard measures—best-corrected visual acuity (BCVA) and central macular thickness (CMT)—in assessing treatment outcomes.

Methods: In this prospective observational study, 52 eyes with treatment-naïve CI-DME received three monthly bevacizumab injections. BCVA, CMT (via OCT), and mean retinal sensitivity (by microperimetry) were recorded at baseline, one month, and three months. Statistical analyses included the Wilcoxon signed-rank test for repeated measures and Spearman’s rank correlation for structure–function relationships.

Results: After three months, mean BCVA improved from 0.50 ± 0.095 to 0.67 ± 0.088 (p < 0.001), while CMT decreased from 401.9 ± 87.6 µm to 329.5 ± 23.2 µm (p < 0.001). Mean retinal sensitivity rose from 14.96 ± 1.01 dB to 16.50 ± 1.39 dB (p < 0.001). Improvement in BCVA correlated positively with both CMT reduction (ρ = 0.340, p = 0.014) and sensitivity gain (ρ = 0.412, p = 0.004), while CMT reduction correlated inversely with sensitivity improvement (ρ = –0.367, p = 0.009).

Conclusion: Three consecutive bevacizumab injections resulted in significant anatomical and functional recovery in eyes with CI-DME. The consistent correlations between macular structure and function underscore the value of microperimetry as a sensitive, complementary tool for evaluating therapeutic response beyond standard acuity and OCT metrics.

Development and validation of Thought, Language, and Communication Assessment Scale for Persons with Aphasia

2025-10-08T01:37:45+02:00

Introduction: Aphasia impacts language and thought organization, disrupting effective communication. Thought, Language, and Communication (TLC) are interrelated, and breakdowns in one domain often affect the others. A comprehensive assessment tool is essential to understand and address these interlinks. This study aimed to develop and validate the Thought, Language, and Communication Assessment Scale for Persons with Aphasia (TLCAS-PWA) for Persons with Aphasia (PWA) and Neurotypical Individuals (NTI).

Method: The tool was developed through literature review and expert validation, comprising 14 parameters across communication, language, and thought domains, rated on a 5-point scale. It was administered to 20 PWA and 20 NTI.

Results: Among PWA, PCS showed the highest mean scores, while Self-reference was least frequent. At the domain level, both PWA and NTI had higher scores in Communication Disorder and lower in Language Disorder. Mann-Whitney U tests revealed significant differences between groups across all the domains. Psychometric analysis showed good internal consistency (α = 0.88), excellent inter-rater reliability (ICC = 0.98), and stable test–retest reliability.

Conclusion: TLCAS-PWA is a valid tool that aids clinicians in assessing TLC in aphasia, supporting diagnosis, intervention, and progress monitoring.

Evaluation of horizontal fusional vergence in young children with intermittent exotropia using the synoptophore and prism bar.

2025-10-14T02:09:21+02:00

Purpose: The aim of the study was to compare the synoptophore and prism bar for assessing horizontal fusional vergence (HFV) in young children with intermittent exotropia (IXT).

Methods: The research involved ninety-eight subjects with IXT, aged between six and sixteen years. The examination included vision assessment, a cover test, identification of the dominant eye, and measurement of the angle of deviation using a prism bar. The subjects' HFV (positive and negative fusional vergence) was assessed using a horizontal prism bar and synoptophore at both near and far distances. We assessed IXT's control utilizing the Newcastle score for both near and far distances.

Results: The positive fusional vergence (PFV) break points of the synoptophore above those of the prism bar at both near and distance ranges (P < 0.01). There was a statistically significant difference in PFV recovery points for both near (P < 0.01) and distance (P < 0.01). There were no statistically significant changes in the near-negative fusional vergence (NFV) blur and break points as determined by the prism bar and synoptophore. The distance, NFV blur, and break points were larger on the synoptophore compared to the prism bar (P < 0.01).The difference in NFV recovery points was statistically significant at both near (P = 0.05) and distance (P = 0.03).

Conclusion: It is essential to exercise caution when assessing the PFV and NFV in young children with IXT, as the synoptophore and prism bar are not comparable in these kinds of situations.