Design: A randomised, controlled, assessor-blinded trial.
Setting: Rehabilitation institute.
Participants: Thirty-six chronic poststroke (15.89?±?9.01 months) hemiparetic subjects (age: 46.44?±?7.89 years, 30 men and functional ambulation classification of median level 3).
Interventions: Activity-based MT comprised movements such as ball-rolling, rocker-board, and pedalling. The activities were provided on the less-affected side in front of the mirror while hiding the affected limb. The movement of the less-affected lower limb was projected as over the affected limb. Conventional motor therapy based on neurophysiological approaches was also provided to the experimental group. The control group received only conventional management.
Main outcome measures: Brunnstrom recovery stages (BRS), Fugl-Meyer assessment lower extremity (FMA-LE), Rivermead visual gait assessment (RVGA), and 10-metre walk test (10-MWT).
Results: Postintervention, the experimental group exhibited significant and favourable changes for FMA-LE (mean difference?=?3.29, 95% CI?=?1.23–5.35, p?=?.003) and RVGA (mean difference?=?5.41, 95% CI?=?1.12–9.71, p?=?.015) in comparison to the control group. No considerable changes were observed on 10-MWT.
Conclusions: Activity-based MT facilitates motor recovery of the lower limb as well as reduces gait deviations among chronic poststroke hemiparetic subjects. 相似文献
Method: Actigraphic data and questionnaires on sleep, sleepiness, and PA were compared between fifteen adults with ASD (ADOS range 7–19; ages 22.8 ± 4.5 years) and TDC.
Results: In comparison to the TDC group, the ASD group slept longer on average per night but took longer to fall asleep. In relationship to PA levels, the objective PA levels were lower in the ASD group than the TDC group. Fewer wake minutes during the sleep period in the ASD sample were associated with more PA the following day.
Conclusion: The findings support previous research that demonstrates differences in sleep parameters and PA between ASD and TDC. Interventions aimed at increasing PA in an ASD population may be beneficial for improved sleep. 相似文献
Methods: Data from 11,391 men and women (aged ≥50) were obtained from the English Longitudinal Study of Ageing cohort. Assessments were carried out at baseline (2002–2003) and at biannual follow-ups (2004–2013).
Results: Older adults who carried out moderate to vigorous activity at least once per week had a 34%–50% lower risk for cognitive decline and dementia over an 8–10 year follow-up period. From pre- to post-dementia diagnosis, those who decreased PA levels had a larger decrease in immediate recall scores, compared to those who maintained or increased PA levels (analyses were adjusted for changes in physical function).
Conclusion: PA was associated with cognitive outcomes in a dose-dependent manner. Reduction in PA after diagnosis was associated with accelerated cognitive decline and maintaining PA may reduce symptom progression in dementia. 相似文献
Objectives: To determine what speech errors can impart about cross-linguistic processing, as well as, associated language and impairment variables in Sepedi-English individuals with aphasia.
Method: The case series included six participants, purposively selected from three rehabilitation sites in South Africa. Detailed language and clinical profiles were obtained. Participants performed a confrontation naming task in their most dominant (MDL) and less dominant language (LDL). Responses were audio recorded, transcribed, and analyzed for overall accuracy and error type in MDL and LDL; verified by a Sepedi-speaking linguist and a qualified SLP.
Results: (1) No statistically significant differences in MDL-LDL naming accuracy were found, supporting recent literature of simultaneous inter-activation of both languages and shared word retrieval mechanisms. All types of speech errors occurred, and semantic errors were produced most frequently and consistently in each participant’s MDL and LDL. (2) Language proficiency, language recovery patterns, and aphasia type (Broca’s and Anomic) and severity (mild and/or moderate) appeared to be more strongly linked to cross-linguistic processing than Sepedi-English linguistic differences and age of acquisition of both languages.
Conclusions: Participants with bilingual aphasia may use typical cross-linguistic and word retrieval mechanisms, concurring with current theories of bilingualism. Findings are preliminary, warranting investigations of other language tasks, modalities, pairs, and related variables. 相似文献
Aims: In this study, we tested the hypothesis that language mixing behaviour in bilingual aphasia reflects lexical retrieval difficulty.
Methods & procedures: We recruited a Hebrew-English bilingual participant with mild-moderate non-fluent agrammatic aphasia and assessed his languages at three timepoints. We analysed the participant’s Hebrew and English production for retrieval during single-word naming, sentences, and discourse, and identified all instances of language mixing.
Outcomes & Results: We found that there was a greater frequency of language mixing during production of more difficult lexical items, namely the post-morbidly less proficient language (compared to the more proficient language), function words (compared to content words), and single-word naming (compared to retrieval in the context of connected speech tasks), but not for verbs (compared to nouns).
Conclusions: In this bilingual participant with non-fluent aphasia, language mixing behaviour closely resembles lexical retrieval difficulty. Thus, we suggest that bilingual speakers with aphasia may mix their languages as a strategy to maximise communication. 相似文献
Methods: Physical function was assessed using the Physiological Profile Assessment (PPA) in 593 participants (cognitively normal [CN]: n = 342, mild cognitive impairment [MCI]: n = 77, dementia: n = 174) at baseline and in 490 participants available for reassessment 1-year later. Neuropsychological performance and physical activity (PA) were assessed at baseline.
Results: Median baseline PPA scores for CN, MCI and dementia groups were 0.41 (IQR = ?0.09–1.02), 0.66 (IQR = ?0.06–1.15) and 2.37 (IQR = 0.93–3.78) respectively. All baseline neuropsychological domains and PA were significantly associated with baseline PPA. There were significant interaction terms (Time × Cognitive Group, Global Cognition, Processing Speed, Executive Function and PA) in the models investigating PPA decline. In multivariate analysis the Time × Executive Function and PA interaction terms were significant, indicating that participants with poorer baseline executive function and reduced PA demonstrated greater physical decline when compared to individuals with better executive function and PA respectively.
Discussion: Having MCI or dementia is associated with greater physical decline compared to CN older people. Physical inactivity and executive dysfunction were associated with physical decline in this sample, which included participants with MCI and dementia. Both factors influencing physical decline are potentially amenable to interventions e.g. exercise. 相似文献
Method: Participants’ (n = 50, 72 ± 5 yrs, 27 females) LLPA energy expenditure and volume was assessed via a validated questionnaire investigating five epochs (14–80 yrs). Using current WHO PA recommendations as reference, participants were stratified into energy expenditure and volume groups. CF outcomes were attention, executive functions, working memory and memory. BP was assessed using magnetic resonance spectroscopy (MRSI) and brain derived neurotropic factor (BDNF).
Results: Correlation analysis revealed associations of mean LLPA energy expenditure with attention (CF) and N-acetylaspartate to choline ratios (NAA/Cho) (MRSI). ANOVA revealed higher interference control performance (CF) and NAA/Cho in participants complying with current PA recommendations (2-3 h per week) compared to non-compliers. Further CF and BP outcomes including BDNF were not associated with LLPA.
Conclusion: Lifelong adherence to minimum recommended PA seems to be associated with markers of cognitive function and neuronal integrity in old age. 相似文献
Aim: Our study assessed whether this verbal perseveration might be related to episodic memory decline, values of teaching, inhibitory decline, and/or decline in cognitive theory of mind.
Methods & Procedures: Thirty mild AD patients and 33 control older adults were asked to perform four verbal fluency tasks, and repeated words were retained as an index of repetitive verbalization. Participants were also administered the Grober and Buschke episodic memory task, scales of values of teaching, the Hayling inhibition task, and the false-belief task for the cognitive theory of mind.
Outcomes & Results: Results showed more repetitive verbalization in AD patients than in control older adults. Repetitive verbalization was significantly correlated with inhibition and episodic memory in AD patients. As for control older adults, repetitive verbalization was significantly correlated with values of teaching and inhibition. Regression analyses showed that repetitive verbalization was significantly predicted by inhibition in AD patients and values of teaching in control older adults.
Conclusions: Repetitive verbalization may reflect the difficulty in inhibiting irrelevant stimuli in AD patients, but it may serve as a tool to ensure transmission of personal knowledge in normal aging. Our findings suggest distinct functions of repetitive verbalization in normal aging and AD. 相似文献
Method: Twenty-six patients with mild AD and 28 controls were tested in two conditions: with and without odor exposure. In each condition, participants were invited to retrieve two childhood memories, two adulthood memories, and two recent memories.
Results: Analysis showed that AD patients produced a higher number of and more specific childhood memories, adulthood memories, and recent memories after odor exposure than without odor.
Discussion: These findings demonstrate how odor exposure may alleviate anterograde and retrograde amnesia, at least when considering the ability of patients with mild AD to retrieve few recent or remote memories. 相似文献
Summary of review: A database of articles published in the last decade was compiled using the following search terms combinations: (“upper extremity” OR “upper limb” OR arm) AND (kinematic OR motion OR movement) AND (analysis OR assessment OR measurement). The articles included in this review: (1) had the purpose to analyze objectively three-dimension kinematics of ULs, (2) studied functional movements or activities of daily living involving ULs, and (3) studied healthy and/or poststroke adults. Fourteen articles were included (four studied a healthy sample, three analyzed poststroke patients, and seven examined both poststroke and healthy participants).
Conclusion: Most articles used optoelectronic systems with markers; however, the presentation of laboratory and task-specific errors is missing. Markerless systems, used in some studies, seem to be promising alternatives for implementation of kinematic analysis in hospitals and clinics, but the literature proving their validity is scarce. Most articles analyzed “joint kinematics” and “end-point kinematics,” mainly related with reaching. The different stroke locations of the samples were not considered in their analysis and only three articles described their psychometric properties.
Implication of key findings: Future research should validate portable motion capture systems, document their specific error at the acquisition place and for the studied task, include grasping and manipulation analysis, and describe psychometric properties. 相似文献
Aims: To investigate whether when tools are used to measure language abilities beyond the single-word and sentence levels, such as analysing discourse production, improvement in the post-morbidly more proficient language may be observed.
Methods & Procedures: A Hebrew-English bilingual person with mild-moderate non-fluent agrammatic aphasia was recruited. He received 36 h of Verb Network Strengthening Treatment (VNeST) in English only, with pre- and post- treatment assessment of his language abilities in both English and Hebrew.
Outcome & Results: Significant improvement was observed in the treated language (English) for noun and verb retrieval in object and action picture naming and within sentence production, but not for the untreated language (Hebrew). In discourse, greater and more widespread improvement was observed in the untreated language (Hebrew) than in the treated language (English).
Conclusions: We advocate for more wide-ranging measurement tools in the field to reduce the risk of missing valuable information regarding generalisation. Only with a more representative understanding of the effects of language treatment in bilinguals with aphasia can we better understand the mechanisms behind cross-language generalisation. 相似文献
Methods: Semi-structured interviews with caregivers and interventionists post-treatment were coded for themes related to ways to address the needs of non-responder caregivers.
Results: The following suggestions recurred among non-responder caregivers and interventionists: (1) tailor skills and psychoeducation material to caregiver’s needs; (2) provide greater overall support within the realm of caregiving; (3) explore and process caregiver’s emotions around caregiving experience and grief; (4) address interpersonal difficulties and barriers to asking for help; (5) spend more time practicing skills to aid in implementing them at home.
Conclusions: For many non-responders, a longer-term treatment targeting caregivers’ emotional processing, interpersonal skills, social connection, acquisition and implementation of skills is indicated. 相似文献
Method: Forty-one MS patients and 25 healthy controls completed measures of executive control that have previously been used to characterize deficit in MS: antisaccade and endogenously cued saccade paradigms, and the Stroop color and word test. Relationships between task performance and volumetric measures of frontal white matter, frontal gray matter, striatum, and pallidum were investigated.
Results: MS participants performed significantly more poorly on the Stroop and antisaccade tasks than controls. For MS patients, higher erroneous responding on the antisaccade task was related to reduced frontal white matter volume.
Conclusion: These findings suggest that loss of frontal white matter may underlie executive control deficits in MS, and provides information that may inform the development of targeted cognitive training strategies in MS. 相似文献
Methods: Residential elderly (n = 329, M = 87 years) filled out questionnaires on forgivingness, depressive symptoms, life satisfaction, subjective health and the developmental task of integrity/despair. Structural equation modeling was used to test the mediational role of integrity-despair in the relation between forgivingness and the aspects of functioning. Direct and indirect effects are tested.
Results: The results confirmed earlier findings stating that forgivingness and depression are negatively associated in residential elderly and that the developmental task of finding integrity and avoiding despair is significant mediator in this relationship. A similar pattern of mediational associations was found for life satisfaction. However, for subjective health only a direct effect between forgiveness and subjective health was found, whereas the developmental task of integrity and despair did not function as an underlying mechanism.
Discussion: Framed within a life span perspective, we showed that the developmental task of finding a balance between integrity and despair is an important intrapersonal mechanism through which forgivingness is related with depressed feelings and life satisfaction for residential elderly. A different mechanism might explain the direct effect between forgiveness and subjective health. 相似文献
Objectives: To examine if ABF sound design influences the motor performance of patients with stroke.
Methods: A total of four people with chronic stroke participated . They were asked to track target signals by their paretic ankle dorsiflexion. Half of the participants were assigned to one of the two groups. Those in the Error ABF group heard ABF that alerted them to the error between the target and the joint angle. Those in the Full ABF group heard ABF that presented both the target and the angle separately by modulating the frequencies of two sounds. Therefore, when there was no error, no sound or two sounds with the identical frequency were heard in the Error and Full ABF sessions, respectively. The same visual BF (VBF) was always present regardless of the group. The accuracy of the task was quantified via an accuracy index (AI, ranging from ?100 to 100). All participants were trained by repeating tracking, and the pre- and post-training AIs were obtained.
Results: The AIs of all participants increased after training, but the increase was greater for the Error ABF group (mean increase = 8.9 and 14.9 for the Full and Error groups, respectively).
Conclusions: The Full ABF was less effective than the Error ABF, probably because the VBF was present, and the information provided by the Full ABF was therefore redundant. 相似文献
Method: Seventy-two healthy older adults (age range 60–79) participated in the study. We measured ToM ability with a classic measure, the Faux Pas task, and selected the Describe-a-friend task to measure MST frequency; social relationships were investigated with the Lubben Social Network Scale. Correlation and regression analyses were performed.
Results: No significant association between MST and scores on the Faux Pas task emerged. In addition, MST (but not Faux Pas scores) significantly predicted friendships (but not family relationships) over and above general cognitive functioning.
Conclusion: These findings show the crucial distinction between possessing an ability and using it in daily life and suggest the need to move toward more ecological measures of older adults’ abilities. In addition, the present results indicate that the spontaneous use of ToM ability, not the ability per se, impacts on older adults’ social relationships. 相似文献
Aims: In the current study, we investigated the validity of making inferences about discourse performance based on scores from confrontation naming tests. Specifically, we investigated the strength of the relationship between word retrieval abilities, and the ability to convey information during discourse production.
Method & Procedures: Data from 118 monolingual PWA were retrieved from AphasiaBank and analyzed using structural equation modeling. Performance in confrontation naming tests was modeled as a latent variable based on the Boston Naming Test, the Western Aphasia Battery – R Naming Subtest, and the Verb Naming Test. Performance at the discourse level was modeled based on indices of informativeness in three discourse tasks (free speech, eventcasts, and story re-tell). Informativeness was quantified using the percentage of Correct Information Units.
Outcomes and Results: Based on the fit statistics, the model exhibited adequate fit, indicating that the relationship between confrontation picture naming and informativeness was adequately reflected in the model. We found a strong relationship between confrontation naming test performance and discourse informativeness (standardized regression coefficient between the two latent factors = .79).
Conclusions: Performance on confrontation naming tests was a strong predictor of the amount of information PWA communicated during discourse production. However, our results also highlight that performance on the latter cannot be predicted solely from the former, as evidenced by the large proportion of unexplained variance in the informativeness latent variable. 相似文献
Method: Sixty-five cognitively healthy older adults (HOA), 19 individuals with single domain mild cognitive impairment (sdMCI), 33 individuals with multi-domain MCI (mdMCI), and 13 individuals with dementia completed measures of memory, processing speed, working memory, and executive functioning, as well as eight different activities of daily living in a naturalistic environment. Task steps were divided into preparatory, action-oriented, and concluding steps.
Results: For action-oriented steps, the number of omission errors increased with level of cognitive impairment beyond sdMCI (i.e., HOA?=?sdMCI?<?mdMCI?<?dementia). In contrast, for preparatory and concluding steps, the dementia group committed more omission errors than the HOA, sdMCI, and mdMCI groups, which did not differ.
Conclusions: The results suggest that the more complex and integrative action-oriented steps may be the first type of everyday task step to be affected in the process of cognitive decline, with preparatory and concluding steps being preserved longer and only showing decline in later stages of impairment (i.e., dementia). Individuals with sdMCI may use other intact abilities to compensate for task omission errors. 相似文献
Aims: This retrospective study investigated the effects of one effective anomia therapy, Phonomotor Treatment (PMT), on discourse production.
Methods & Procedures: Twenty-six PWA participated in 60 h of PMT, which focuses on building a person’s ability to recognize, produce, and manipulate phonemes in progressively longer nonword and real-word contexts. Language samples were collected prior to, immediately after, and 3 months after the treatment program. Percent Correct Information Units (CIUs) and CIUs per minute were calculated.
Outcomes & Results: Overall, PWA showed significantly improved CIUs per minute, relative to baseline, immediately after treatment and 3 months later, as well as significantly improved percent CIUs, relative to baseline, 3 months following treatment.
Conclusions: PMT, which focuses on phonological processing, can lead to widespread improvement throughout the language system, including to the functionally critical level of discourse production. 相似文献