Description:
Growing cultural and linguistic diversity globally is increasingly requiring speech pathologists to provide effective and equitable aphasia rehabilitation to clients with whom they do not share a language. Little is known about how rehabilitation is being adapted and provided when a language mismatch arises between the therapist and the client. This scoping review aims to systematically map the evidence related to aphasia rehabilitation when the speech pathologist and the client do not share a language. A comprehensive search was conducted in September 2020. Twenty studies comprising surveys and/or interviews and descriptive publications were reviewed. Speech pathologists frequently report a lack of confidence, skill, and preparation to work with culturally and linguistically diverse clients with aphasia. Furthermore, there is a shortage of published evidence, guidelines, resources, and access to interpreters to support their practice. Further research is needed into aphasia rehabilitation when there is no shared language between client and speech pathologist, with particular attention to the therapy approach selected and adaptations required for the target language and culture. Information is needed concerning how the speech pathologist and interpreter work together, as well as the experiences of interpreters and people with aphasia and their families.
Description:
•The occurrence of urinary incontinence was higher in women with breast cancer.•Women with breast cancer experienced higher distress and impact of urinary symptoms.•Routine screening and offer of treatment for urinary symptoms may be indicated. One of the sequalae of breast cancer treatments may be pelvic floor (PF) dysfunction such as urinary incontinence (UI), faecal incontinence (FI), and pelvic organ prolapse (POP). The aim of this study was to compare the occurrence and related distress and impact of PF dysfunction between women with and without breast cancer. Women with and without breast cancer participated in this cross-sectional study. The Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire were used to quantify the prevalence and related distress, and impact of PF dysfunction. Factors associated with PF outcomes were examined using logistic and linear regressions while controlling for known risk factors for PF dysfunction (age, body mass index, and parity). 120 women with breast cancer, and 170 women without breast cancer responded. The occurrence of any type of UI was higher in women with breast cancer than women without breast cancer (percentage difference=17% 95% CI: 7, 29). Women with breast cancer experienced higher impact of urinary symptoms (mean difference=18.2 95% CI: 8.9, 27.7) compared to those without. Multivariable analysis indicated that having breast cancer (β 0.33 95%CI: 0.08, 0.51) was the strongest predictor of greater impact of urinary symptoms. Women with breast cancer reported a higher occurrence and impact of urinary symptoms than women without breast cancer. While further studies are required to confirm our findings, routine screening and offering treatment for urinary symptoms may be indicated for women with breast cancer.
Description:
OBJECTIVE. The Health Promoting Activities Scale (HPAS) measures the self-rated frequency with which adults participate in activities that promote health. We evaluated the internal consistency, construct validity, and intrarater reliability of the HPAS with a cohort of mothers (N = 56) of school-age children. METHOD. We used an online survey that included the HPAS and measures of mental and physical health. Statistical analysis included intraclass correlation coeffcients (ICCs), measurement error, error range, limits of agreement, and minimum detectable change (MDC). RESULTS. The HPAS showed good internal consistency (Cronbach's
Description:
Background: Mechanical injury in patients with spinal cord injury (SCI) rarely transects the cord completely, even when the injury is classified as complete. These patients can show sub-clinical evidence of spared motor connections, which might be amenable to targeted rehabilitation. Neurophysiological evaluations can complement the clinical evaluation by providing objective data about conduction across the SCI site. Case Description: A twenty-four year old patient with SCI was admitted to a rehabilitation centre 49 days post traumatic SCI. His injury was categorized as motor and sensory complete (AIS A) with a neurological level of C4. The strength of his triceps bilaterally was recorded 0/5 repeatedly by his therapists during the five-month period post-injury. As a result, no training was provided for these muscles during the rehabilitation program. Neurophysiological Assessment: Motor evoked potentials (MEPs) were recorded from his left triceps with transcranial magnetic stimulation (TMS) which confirmed the existence of spared corticospinal connections to this muscle post-injury. Intervention: He completed a series of active-assisted exercises with an EMG-triggered neuromuscular stimulation (NMS) device for his left triceps comprising 20-minutes elbow extension (15 trials), three times per day for 4 weeks. Outcome: The strength of his left triceps gradually improved to 2/5. Discussion: Neurophysiological evaluation can be useful in identifying residual function below the level of injury, which can, in turn, be enhanced through appropriate rehabilitation strategies.
Description:
The Brain Motor Control Assessment (BMCA) is a surface electromyography (sEMG)-based measure of motor output from the central nervous system during a variety of reflex and voluntary motor tasks. The aim of this study was to assess the pattern of voluntary movements in patients with spinal cord injury (SCI) to investigate whether BMCA could add more resolution to clinical assessments and the recovery path of these patients. Ten participants were recruited from the Royal Talbot Rehabilitation Centre as part of a multicenter randomized controlled trial. Four participants received usual care while the other 3 participants received usual care plus an intensive task-specific hand training program in conjunction with functional electrical stimulation for 8 weeks. BMCA assessments were completed for 7 participants at this center 4 times over a period of 1 year. Generalized linear model analysis showed a significant main effect of task ( < .001) and assessment time ( = .003) on the Similarity Index. However, there were no significant interactions among the factors ( > .05). Based on ARAT or summed upper limb strength scores, some participants showed significant improvement after 8 weeks of rehabilitation, however this improvement was not reflected in the pattern of muscle activation that was captured by BMCA. The quantifiable features of BMCA through surface EMG may increase the resolution of SCI characterization by adding subclinical details to the clinical picture of lesion severity and progression during rehabilitation.
Description:
Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammation, demyelination of axons, and oligodendrocyte loss in the central nervous system. This leads to neurological dysfunction, including hand impairment, which is prevalent among patients with MS. However, hand impairment is the least targeted area for neurorehabilitation studies. Therefore, this study proposes a novel approach to improve hand functions compared to current strategies. Studies have shown that learning new skills in the motor cortex (M1) can trigger the production of oligodendrocytes and myelin, which is a critical mechanism for neuroplasticity. Transcranial direct current stimulation (tDCS) has been used to enhance motor learning and function in human subjects. However, tDCS induces non-specific effects, and concurrent behavioral training has been found to optimize its benefits. Recent research indicates that applying tDCS during motor learning can have priming effects on the long-term potentiation mechanism and prolong the effects of motor training in health and disease. Therefore, this study aims to assess whether applying repeated tDCS during the learning of a new motor skill in M1 can be more effective in improving hand functions in patients with MS than current neurorehabilitation strategies. If this approach proves successful in improving hand functions in patients with MS, it could be adopted as a new approach to restore hand functions. Additionally, if the application of tDCS demonstrates an accumulative effect in improving hand functions in patients with MS, it could provide an adjunct intervention during rehabilitation for these patients. This study will contribute to the growing body of literature on the use of tDCS in neurorehabilitation and could have a significant impact on the quality of life of patients with MS. 2023 Zoghi and Jaberzadeh.
Description:
Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammation, demyelination of axons, and oligodendrocyte loss in the central nervous system. This leads to neurological dysfunction, including hand impairment, which is prevalent among patients with MS. However, hand impairment is the least targeted area for neurorehabilitation studies. Therefore, this study proposes a novel approach to improve hand functions compared to current strategies. Studies have shown that learning new skills in the motor cortex (M1) can trigger the production of oligodendrocytes and myelin, which is a critical mechanism for neuroplasticity. Transcranial direct current stimulation (tDCS) has been used to enhance motor learning and function in human subjects. However, tDCS induces non-specific effects, and concurrent behavioral training has been found to optimize its benefits. Recent research indicates that applying tDCS during motor learning can have priming effects on the long-term potentiation mechanism and prolong the effects of motor training in health and disease. Therefore, this study aims to assess whether applying repeated tDCS during the learning of a new motor skill in M1 can be more effective in improving hand functions in patients with MS than current neurorehabilitation strategies. If this approach proves successful in improving hand functions in patients with MS, it could be adopted as a new approach to restore hand functions. Additionally, if the application of tDCS demonstrates an accumulative effect in improving hand functions in patients with MS, it could provide an adjunct intervention during rehabilitation for these patients. This study will contribute to the growing body of literature on the use of tDCS in neurorehabilitation and could have a significant impact on the quality of life of patients with MS. 2023 Zoghi and Jaberzadeh.
Practical and clinical approaches using pacing to improve self-regulation in special populations such as children and people with mental health or learning disabilities
Description:
For special populations such as people with a mental health issue or learning disability, a disconnect between the ability to accurately monitor and regulate exercise behaviour can lead to reduced levels of physical activity, which, in turn, is associated with additional physical or mental health problems. Activity pacing is a strategy used in clinical settings to address issues of pain amelioration, while self-pacing research is now well addressed in sport and exercise science literature. It has been proposed recently that these overlapping areas of investigation collectively support the development of self-regulatory, lifestyle exercise skills across broad population groups. Activity pacing appears to have substantial application in numerous development and rehabilitation settings and, therefore, the purpose of this short communication is to articulate how an activity pacing approach could be utilized among population groups in whom self-regulatory skills may require development. This paper provides specific examples of exercise practice across 2 discrete populations: children, and people with mental health and learning difficulties. In these cases, homeostatic regulatory processes may either be altered, or the individual may require extrinsic support to appropriately self-regulate exercise performance. A support-based exercise environment or approach such as programmatic activity (lifestyle) pacing would be beneficial to facilitate supervised and education-based self-regulation until such time as fully self-regulated exercise is feasible.
Description:
For special populations such as people with a mental health issue or learning disability, a disconnect between the ability to accurately monitor and regulate exercise behaviour can lead to reduced levels of physical activity, which, in turn, is associated with additional physical or mental health problems. Activity pacing is a strategy used in clinical settings to address issues of pain amelioration, while self-pacing research is now well addressed in sport and exercise science literature. It has been proposed recently that these overlapping areas of investigation collectively support the development of self-regulatory, lifestyle exercise skills across broad population groups. Activity pacing appears to have substantial application in numerous development and rehabilitation settings and, therefore, the purpose of this short communication is to articulate how an activity pacing approach could be utilized among population groups in whom self-regulatory skills may require development. This paper provides specific examples of exercise practice across 2 discrete populations: children, and people with mental health and learning difficulties. In these cases, homeostatic regulatory processes may either be altered, or the individual may require extrinsic support to appropriately self-regulate exercise performance. A support-based exercise environment or approach such as programmatic activity (lifestyle) pacing would be beneficial to facilitate supervised and education-based self-regulation until such time as fully self-regulated exercise is feasible.
Description:
Against the backdrop of a global physical inactivity crisis, attempts to both understand and positively influence physical activity behaviours are characterized by a focus on individual-level factors (e.g. cognitions, attitudes, motivation). We outline a new perspective, drawn from an emerging body of work exploring the applicability of social identity and self-categorization theories to domains of sport and health, from which to understand and address this pervasive problem. This social identity approach suggests that the groups to which people belong can be, and often are, incorporated into their sense of self and, through this, are powerful determinants of physical activity-related behaviour. We start by reviewing the current state of physical activity research and highlighting the potential for the social identity approach to help understand how social factors influence these behaviours. Next, we outline the theoretical underpinnings of the social identity approach and provide three key examples that speak to the analytical and practical value of the social identity approach in physical activity settings. Specifically, we argue that social identity (1) can be harnessed to promote engagement in physical activity, (2) underpins exercise group behaviour, and (3) underpins effective leadership in exercise settings. We conclude by identifying prospects for a range of theory-informed research developments.
Peer educators in the facilitation of sexuality and respectful relationship education for people with an intellectual disability : a scoping review and narrative synthesis
Examining the intra-rater reliability of Transcranial Magnetic Stimulation (TMS)-Induced Motor Evoked Potentials (MEPs) within and between sessions: a step towards ensuring accuracy of observed mep changes in repeated measures studies conducted by newly trained TMS operators