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Apostolidis A.,Aristotle University of Thessaloniki | Cocci A.,University of FlorenceItaly | Emmanuel A.,University College LondonUnited Kingdom | Gajewski J.B.,Dalhousie UniversityHalifaxCanada | And 7 more authors.
Neurourology and Urodynamics | Year: 2016

Background: Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. Aims: To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009. Materials and methods: A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and consequently amended to deliver evidence-based conclusions and recommendations in 2013. Results: The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic lower urinary tract dysfunction. The pathophysiology is categorized according to the nature of onset of neurological disease and the part(s) of the nervous system affected. Assessment requires clinical evaluation, general investigations, and specialized testing. Treatment primarily focuses on ensuring safety of the patient and optimizing quality of life. Symptom management covers conservative and interventional measures to aid urine storage and bladder emptying, along with containment of incontinence. A multidisciplinary approach to management is essential. Discussion: The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. © 2016 Wiley Periodicals, Inc.


Singh A.,University College LondonUnited Kingdom | Piana S.,University of GenoaItaly | Pollarolo D.,University College LondonUnited Kingdom | Volpe G.,University of GenoaItaly | And 5 more authors.
Human-Computer Interaction | Year: 2016

Chronic (persistent) pain (CP) affects 1 in 10 adults; clinical resources are insufficient, and anxiety about activity restricts lives. Technological aids monitor activity but lack necessary psychological support. This article proposes a new sonification framework, Go-with-the-Flow, informed by physiotherapists and people with CP. The framework proposes articulation of user-defined sonified exercise spaces (SESs) tailored to psychological needs and physical capabilities that enhance body and movement awareness to rebuild confidence in physical activity. A smartphone-based wearable device and a Kinect-based device were designed based on the framework to track movement and breathing and sonify them during physical activity. In control studies conducted to evaluate the sonification strategies, people with CP reported increased performance, motivation, awareness of movement, and relaxation with sound feedback. Home studies, a focus group, and a survey of CP patients conducted at the end of a hospital pain management session provided an in-depth understanding of how different aspects of the SESs and their calibration can facilitate self-directed rehabilitation and how the wearable version of the device can facilitate transfer of gains from exercise to feared or demanding activities in real life. We conclude by discussing the implications of our findings on the design of technology for physical rehabilitation. © 2016 Published with license by Taylor & Francis Group, LLC

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