Health-related quality of life in working-age adults with visual impairments in Germany

Purpose The purpose of this study was to gather data about physical activity and quality of life (QoL) for people of working age with visual impairments to optimize upcoming physical activity-based interventions in vocational rehabilitation. Methods Two hundred and seventy-seven former participants of four vocational rehabilitation centres in Germany answered an online questionnaire. The health-related QOL has been assessed by means of the WHOQOL-BREF questionnaire. The data were analysed via multivariate analysis of covariances (MANCOVAs), univariate analysis of covariances (ANCOVAs) and discriminant function analysis. Results Compared to a normative group of adults aged 36–45, the study group showed lower values in all domains of QOL. The MANCOVA (visual acuity) produced no multivariate significant effect. Also, the ANCOVA showed no significant effect for the global dimension of the WHOQOL-BREF. The MANCOVA (leisure time activity) produced a multivariate significant effect. Post-hoc ANCOVAS revealed significant effects for all four domains of QoL. The ANCOVA analysing the global domain showed a similar significant effect as well. The active persons had higher values in all domains of QoL compared to the more passive participants. Conclusion Interventions in vocational rehabilitation should focus on leisure time activity to enhance QoL. At this stage, the role of physical activity is still unclear and further studies are needed.

• Implications for rehabilitation

• People with visual impairments often show a worse quality of life than normal-sighted people.

• The degree of severity of the visual impairment does not affect quality of life.

• Sport and physical activity are effective means of improving quality of life.

• An active leisure time activity supports the improvement of the quality of life of visual-impaired people that participated in a vocational rehabilitation.

     

Self-efficacy and health status improve after a wellness program in persons with multiple sclerosis

Purpose: To determine if an intensive wellness program for persons with MS results in improved self-efficacy, quality of life (QOL), or physical activity outcomes. Methods: 129 subjects participated in one of seven 4-day interdisciplinary educational wellness programs throughout the United States. This intervention was based on the philosophy that health management is important to disease management. The program consisted of psychological and physiological evaluations, lectures and workshops. Before the intervention and after at 1, 3 and 6 months, self-efficacy (MS Self-Efficacy Scale, MSSE, control), health related QOL (SF-36) and physical activity (Physical Activity Scale for Persons with Physical Disabilities, PASAID) was assessed. Results: Improvements were noted at 1, 3 and 6 months post-intervention. Those present at 6 months included, MSSE, role physical, vitality and mental health scales of the SF-36. PASAID did not change. Improvements were independent of disability (EDSS). Conclusion: A 4-day multidisciplinary educational wellness program can result in improvement in self-efficacy and health-related QOL in persons with MS and can be stable up to at least 6 months. Improvements do not depend on degree of disability.

Implications for Rehabilitation

• Multiple sclerosis is a neurologic disease that can have a significant negative impact on self-efficacy and quality of life.

• Some wellness based programs have been shown to be effective in improving self-efficacy and quality of life (QOL) in persons with MS.

• Distance or time could be barriers to access effective wellness programs.

• An intensive “traveling” 4-day interdisciplinary educational wellness program can result in improvements in self-efficacy and health-related quality of life in persons with MS.

• Improvements were not dependent on a person’s level of disability (i.e. EDSS).

     

Translation,cross-cultural adaptation and validation of the Persian version of COOP/WONCA charts in Persian-speaking Iranians with multiple sclerosis

Purpose: Translation, cross-culturally adaptation and validation of a Persian version of COOP/WONCA charts in Persian-speaking Iranians with multiple sclerosis (MS).

Method: The Persian version of COOP/WONCA charts was developed after a standard forward translation, synthesis and backward translation. A total of 197 subjects with MS participated in this study. They were asked to complete the COOP/WONCA charts and Short-Form 36 Health Survey (SF-36). The COOP/WONCA charts were re-administered to 50 patients, 4 weeks after the first session. Expanded Disability Status Scale (EDSS) was also scored for each subject by the referring physician. Construct validity was assessed by testing linear relationship between corresponding domains of the COOP/WONCA charts, the SF-36 and the EDSS. Test–retest reliability was examined using interclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) values.

Results: Related domains of COOP/WONCA charts and SF-36 demonstrated strong linear relationships with Spearman’s coefficients ranging from ?0.51 to ?0.75 (pp0.70) except for feelings and quality-of-life domains that were 0.50 and 0.51, respectively.

Conclusions: The Persian version of the COOP/WONCA charts was shown to be psychometrically appropriate to evaluate the functional level and quality of life in Persian-speaking Iranians with MS.

• Implications for rehabilitation

• COOP/WONCA charts are now available in Persian and demonstrate good psychometric properties.

• COOP/WONCA charts demonstrate excellent reliability and construct validity in a Persian-speaking Iranian population with MS.

• Minimal detectable change in COOP/WONCA is now available in MS to guide within and between group analyses.

• Knowledge on a wide variety of physical, mental and emotional parameters as well as the status of patients’ symptoms, daily activities and quality of life helps rehabilitation clinicians and service providers plan preventive and remedial interventions more effectively.

     

The role of physical status versus mental status in predicting the quality of life of patients with lumbar disk herniation

Purpose: To explore the role of physical status versus mental status in predicting the quality of life (QOL) of patients with lumbar disk herniation (LDH).

Method: In this correlative study 51 patients with LDH were recruited in their conservative stage of treatment. After profiling their physical status, all participants reported about pain level (according to VAS), pain perception using the Pain Catastrophizing Scale (PCS), and disability level (according to Oswestry Low Back Pain Disability Questionnaire). Their mental status was evaluated using the Spielberger’s State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI-II). Their QOL was evaluated by the World Health Organization Quality of Life Questionnaire, brief version (WHOQOL-BREF).

Results: Physical status/disability level correlated with anxiety and depression. While Physical status predicted physical QOL, mental status, and mainly anxiety and depression were the significant predictors of psychological, social, and environmental QOL.

Conclusions: Mental status may play a significant role in reducing most QOL domains among patients with LDH. The evaluation and intervention process should consider both physical and mental status and their relation to the person's QOL. Since QOL is a major parameter in determining intervention type and success this elaborated perspective may contribute to the intervention planning and outcomes.

• Implications for rehabilitaion

• A significant mental distress may accompany the physical disability of patients with LDH.

• The role of this mental distress in reducing the QOL of patients with LDH may be greater than that of their physical disability.

• The evaluation and intervention for patients with LDH should refer to both physical and mental status and explore their impacts on quality of life in order to elevate intervention success.

     

Are the changes in observed functioning after multi-disciplinary rehabilitation of patients with fibromyalgia associated with changes in pain self-efficacy?

Objective: To examine the hypothesis that change in pain self-efficacy is associated with observed and self-reported activity, pain intensity, catastrophizing, and quality of life after multi-disciplinary rehabilitation of fibromyalgia patients.

Design: In-depth analyses of secondary outcomes of a randomized-controlled trial.

Subjects: Women (N?=?187) with fibromyalgia.

Methods: Outcomes were Pain Self-Efficacy, Assessment of Motor and Process Skills (AMPS), SF-36 Physical Function (SF-36-PF), pain intensity, and SF-36 Mental Composite Score (SF-36-MCS) to assess quality of life and pain catastrophizing. Individual and group associations between outcomes were examined.

Results: Individual changes in pain self-efficacy were not associated with changes in observed activity: AMPS motor (r_s?=?0.08, p?=?0.27) and process (r_s?=?0.12, p?=?0.11), not even in those patients with a clinically relevant improvement in observed functioning (38.5%), and only weakly or moderatly with changes in SF-36-PF; (r_s?=?0.31, p?r_s?=?0.41, p?r_s?=??0.31, p?p?=?0.24). However, a subgroup (34%) had a clinically relevant improvement in pain self-efficacy. This group was younger (mean age 41.4 vs. 45.8, p?=?0.01), more recently diagnosed (1.8 vs. 2.8 years, p?=?0.003), but had an unresolved welfare situation (59% vs. 40%, p?=?0.02).

Conclusion: The main hypothesis was falsified, as there was no association between pain self-efficacy and actual performance of activity. The relation to functioning may be limited to perceived, cognitive-emotional aspects, as indicated by the weak to moderate correlations to the self-reported measures.

• Implications for Rehabilitation

• Improvement in observed activity post multi-disciplinary rehabilitation was not associated with change in pain self-efficacy.

• Patients performed better after rehabilitation, but did not perceive to have improved their capacity.

• The relationship between pain self-efficacy and functioning may be limited to cognitive-emotional aspects rather than actual activity.

• Both observational and self-reported measures should be included in evaluating outcomes of rehabilitation for patients with fibromyalgia.

     

Community-based study of health-related quality of life in spinal cord injury,muscular dystrophy,multiple sclerosis,and cerebral palsy

Purpose: To assess health-related quality of life (HRQOL) in adults with spinal cord injury (SCI), muscular dystrophy (MD), multiple sclerosis (MS), and cerebral palsy (CP). Methods: This is a multicenter, community-based, cross-sectional study of adults diagnosed with CP (94), MD (99), MS (98), SCI (99), and healthy adults (105). The WHOQOL-BREF and WHOQOL-DIS questionnaire were used. Results: Significant differences in physical functioning between adults with CP and SCI and adults with MS (p?=?0.003 and p < 0.001, respectively), as well as between adults with SCI and MD (p?=?0.001) were found. Univariate tests revealed significant psychological functioning differences between adults with SCI and MD (p?=?0.02) and SCI and MS (p?=?0.001). There was a significant difference in physical functioning between controls and adults with SCI (p?=?0.049) and a significant difference in psychological functioning between controls and adults with MS (p?=?0.039). No statistically significant differences were found between the groups in social and environmental domains. Conclusions: Physical and physiological functioning were affected to various degrees in the studied neurodisabilities, while all groups reported similar levels of functioning and well-being in social and environmental domains.

Implications for Rehabilitation

• Health-related quality of life (HRQOL) in adults with neurodisabilities living in a community differs from HRQOL in these individuals sampled in clinical and/or rehabilitation settings.

• Psychosocial aspects of HRQOL relevant to physical disability were similarly affected across those groups.

• Physical and physiological domains in HRQOL were affected to various degrees among adults with neurodisabilities living in a community.

• Levels of functioning and well-being in social and environment domains of HRQOL are similar among adults with neurodisabilities living in a community.

• Community-based study of health-related quality of life in spinal cord injury, muscular dystrophy, multiple sclerosis, and cerebral palsy.

     

Quality of life in older Chinese-speaking adults with hearing impairment

Purpose: General and hearing-specific health-related quality of life (HRQoL) was examined in elderly Chinese with hearing impairment. Methods: Sixty-four Chinese speakers aged ≥65 years and did not use hearing aids were evaluated using Chinese versions of the Short-Form 36 health survey (SF-36) and the Hearing Handicap Inventory for the Elderly (Screening Version) (HHIE-S). Results on the SF-36 were compared to norms obtained in a general elderly Chinese population. The relationships between HRQoL and degree of hearing impairment, and between SF-36 and HHIE-S were also evaluated. Results: Elderly Chinese speakers with hearing impairment rated six of the eight scales of the SF-36 poorer, compared to a general elderly Chinese population. When average hearing impairment in the better ear exceeded 40 dB HL, SF-36 ratings were poorer than those with better hearing. Poorer better ear hearing was significantly related to poorer ratings on the Vitality scale of the SF-36 and the three scales of the HHIE-S, after controlling for age, gender and number of coexisting chronic health problems. Ratings on SF-36 and HHIE-S did not correlate. Conclusion: Elderly Chinese who are hearing impaired experienced poorer general and hearing-specific HRQoL, and HRQoL is reduced further among those with greater hearing impairment.

Implications for Rehabilitation

• Hearing impairment adversely affects communication and is associated with social isolation.

• Older Chinese with hearing impairment report poorer physical functioning, role limitations due to physical problems, vitality, social functioning, role limitations due to emotional problems and general mental health than the general population.

• Degree of hearing impairment seems to exhibit lesser differential effects on self-reported quality of life among older Chinese, compared to those reported in Western societies.

• Treatment to improve communication should be evaluated for its impact on disease-specific and health-related quality of life.

     

Does treadmill training with Hybrid Assistive Limb (HAL) impact the quality of life? A first case series in the United States

Abstract

Introduction: Recently published studies show remarkable improvements in functional mobility after treadmill training with HAL^® in patients with spinal cord injuries. The aim of this study was to evaluate the impact of HAL^®-assisted treadmill training on quality of life.

Patient/Method: A case series of six patients participating in a single-centre prospective, interventional pilot study, who were suffering neurologic motor deficits. The quality of life was assessed using the EQ-5D questionnaire and mobility was assessed using the PROMIS v1.2 Physical Function – Mobility Score before treadmill training, at 12-weeks, and at 6-months.

Results: Five out of six patients showed improvement in the PROMIS v1.2 Physical Function – Mobility score. Four patients did not show changes in the EQ-5D at 6 months follow-up, relative to baseline. The EQ-5D score of one patient worsened while improved in another patient at 6 months follow-up compared to the baseline.

Conclusion: Our study details the first experience in a larger series regarding the effects of HAL^®-assisted treadmill training on quality of life. Whereas five out of six patients showed improvements in mobility scores, only one patient showed improvement of life quality at 6 months follow-up. Life quality is influenced by a multitude of factors and lager randomized trials are needed to assess the effect of HAL^®-assisted training on quality of life.

• Implications for Rehabilitation

• Treadmill training with HAL is safe and feasible for patients with neurologic disorders

• Treadmill training with HAL improved the functional mobility

• Improvements in the quality of life were unverifiable

     

Investigation of quality of life in mothers of children withcerebral palsy in Iran: association with socio-economic status,marital satisfaction and fatigue

Purpose: This study aimed to compare the quality of life (QOL) of Mothers of Children with Cerebral Palsy (MCCPs) with mothers of Typically Developing (TD) children as a Control Group (CG). The association of the mediating variables including socio-economic status (SES), marital satisfaction and fatigue with maternal QOL was also evaluated. Method: The MCCPs group consisted of 120 mothers (mean age: 30.3?±?5.5 years) of children with CP. The CG included 100 mothers (mean age: 29.9?±?4.5 years) of TD children. Demographic characteristics of the participants were recorded and the data was collected by World Health Organization Quality of Life-BREF (WHOQOL-BREF), SES Questionnaire, Index of Marital Satisfaction (IMS) and Fatigue Severity Scale–Persian (FSS-P). Data analysis was done by SPSS version 16.0. Results: The QOL and SES were lower, while FSS-P and IMS were higher in MCCPs group than CG (p < 0.001). The SES, IMS and FSS-P associated with all domains of QOL in MCCPs group, while they did just with some domains of QOL in CG (p < 0.05). Conclusions: The lower QOL in MCCPs group is supposed to be mediated by the SES, marital satisfaction and fatigue so, maternal empowerment in terms of these mediators and family-centered approach are recommended.

Implications for Rehabilitation

• The mothers of children with CP compared to mothers of typically developing children face particular challenges relating to rearing the child with disability.

• These tedious and chronic challenges influence on QOL, socio-economic status, marital satisfaction and perceived fatigue in mothers of children with CP.

• The QOL of mothers of children with CP seems to be exacerbated by factors such as lower SES, marital dissatisfaction and higher perceived fatigue.

     

Systematic review of the influence of spasticity on quality of life in adults with chronic neurological conditions

Objective: To conduct a systematic review of the published evidence on the relationship between spasticity and quality of life (QOL) in chronic neurological conditions in adults. Data sources: MEDLINE, Embase, CINAHL and PsycINFO databases. Methods: The databases were searched from inception to October 2014 using keywords ‘spasticity’ and ‘quality of life’ for publications in English language. Cross-sectional and longitudinal studies reporting quantitative analyses on the association between spasticity and QOL were included. Appraisal of the studies and data extraction were conducted in accordance with Strengthening the Reporting of Observational Studies in Epidemiology guidance. Results: 17/652 studies (total of 27 827 patients) met inclusion criteria for review. These examined the relationship between spasticity and QOL in multiple sclerosis (MS), spinal cord injury (SCI) and stroke. Spasticity was found to be associated with significantly lower scores on health status measures, namely SF-12, SF-36 and EQ-5D, in MS and SCI, but less so in stroke. Spasticity was associated with considerably lower scores on physical components of the health status questionnaires, but with only marginally lower scores on mental components. The studies that employed global QOL measures, such as the World Health Organisation Quality of Life – BREF, found no significant relationship between spasticity and QOL. Spasticity was often associated with pain, sleep problems, fatigue and urinary dysfunction. Conclusions: Spasticity is associated with worse health status, however its relationship with overall QOL is not established. The relationship between spasticity and QOL is confounded by other impairments and requires multivariate analysis.

• Implications for Rehabilitation

• Effective management of spasticity may result in significant improvements in HRQOL.

• It is important to address multiple factors in the management of spasticity including pain, bladder problems, fatigue and sleep, as the interplay of these may have significant negative effects on HRQOL.

• Clinician-administered methods for measuring spasticity, such as the Ashworth scale, may not provide comprehensive assessment of spasticity.

• Incorporation of patient-reported measures for spasticity is pivotal in the assessment of therapeutic interventions.

     

Efficacy of leisure intervention groups in rehabilitation of people with an acquired brain injury

Abstract

Purpose: To determine whether participation in a week-long residential leisure intervention program targeting individuals with an acquired brain injury (ABI) improved the leisure satisfaction, self-esteem and quality of life (QOL) of participants. The program included leisure awareness, leisure resources, social interaction skills and leisure activity skills. Method: Using a pre- and post-intervention design leisure satisfaction, self-esteem and QOL were assessed prior to, immediately following and at three months post program. Data were analyzed using Wilcoxon signed-rank tests. Results: Participants were eight men and four women aged between 19 and 49 years who were recent clients of a rural Brain Injury Rehabilitation Service. The majority (7/12) had acquired their ABI more than two years previously, and for most (10/12) the cause was trauma. Program participants showed clinically important and statistically significant improvements in leisure satisfaction (p?=?0.002), self-esteem (p?=?0.03) and QOL (p?=?0.02 to 0.008 for four domains of the World Health Organisation Quality of Life – Bref scale) three months post program. Conclusion: Adults with an ABI participating in leisure education programs can experience improvements in leisure satisfaction, self-esteem and QOL following the program. The findings suggest that active leisure intervention programs should be included in the ongoing rehabilitative care of adults with an ABI.

• Implications for Rehabilitation

• Leisure participation, leisure satisfaction and social integration can be seriously compromised following an acquired brain injury (ABI).

• Engagement in leisure activities has positive effects on physical and mental health and is increasingly recognised as an important determinant of quality of life (QOL) for people with ABI.

• Participation in a short-term intensive leisure intervention program can improve leisure satisfaction, self-esteem and QOL.

• Active leisure intervention programs should be included in the ongoing rehabilitation and reintegration of adults with ABI.

     

Determinants of pain,disability, health-related quality of life and physical performance in patients with knee osteoarthritis awaiting total joint arthroplasty

Abstract

Purpose: In patients suffering from knee osteoarthritis awaiting knee arthroplasty, to measure associations between several selected determinants and pain, disability, health-related quality of life and physical performance.

Material and methods: Validated self-reported measures were collected: (1) Western Ontario and McMaster Universities Osteoarthritis Index, (2) Lower Extremity Functional Scale (LEFS) and (3) Short-Form 36 (SF-36). Physical performance was also assessed with four validated performance tests. Demographic, socioeconomic, psychosocial and clinical characteristics of the participants were also measured. Multivariate regression analyses were used to evaluate potential associations.

Results: Higher fear-avoidance beliefs, greater comorbidities, psychological distress and use of a walking aid were significantly associated with worse pain, function or HRQOL (p?<?0.05) and explained 12%–35% of the variances of the self-reported measure scores. Pretest pain and change in pain during posttest, greater comorbidities, psychological distress and use of a walking aid were significantly associated with worse performance on the physical tests (p?<?0.05) and explained 41%–59% of the variances of the different physical tests results.

Conclusions: Several determinants were significantly associated with worse pain, disability, health-related quality of life or physical performance. Several of these associations may be considered clinically important, including psychosocial determinants in relation to self-reported measures, but to physical performance as well.

• Implications for rehabilitation

• Knee osteoarthritis is a highly prevalent and disabling condition incurring important socioeconomic costs.

• Several modifiable determinants have been shown to contribute to pain and disability in individuals suffering from knee OA awaiting TKA.

• Recent studies demonstrated the efficacy of education and rehabilitation (prehabilitation) in individuals awaiting TKA.

     

Meaning and components of quality of life among individuals with spinal cord injury in Yogyakarta Province,Indonesia

Purpose: Knowledge on the meaning of quality of life in individuals with spinal cord injury in developing countries is limited. This study aims to explore the meaning and components of quality of life for individuals with spinal cord injury in a rural area in Indonesia.

Method: Data were obtained through semi-structured interviews with 12 individuals with paraplegia (8 males, 4 females) aged 24–67?years. Thematic analysis was used to identify themes that constitute meaning and components of quality of life.

Results: Quality of life was not an easily understood concept, while “life satisfaction” and “happiness” were. Life satisfaction was associated with a person’s feeling when achieving goals or dreams and related to fulfillment of needs. Thirteen components of life satisfaction were identified and categorized into five domains as follows: (1) participation: earning income and work, being useful to others, community participation, and having skills and knowledge, (2) social support: social support, social relationship, (3) relationship with God: injury is God’s will, praying, (4) independence: being independent, mobility and accessibility, and health, and (5) psychological resources: accepting the condition, maintaining goals and motivation.

Conclusions: Social, cultural and religious influences were prominent in the perception of life satisfaction. The measurement of quality of life for individuals with spinal cord injury in Indonesia needs to consider locally perceived meaning and components of quality of life.

• Implications for Rehabilitation

• Financial, social and health needs of individuals with spinal cord injury in Indonesia must be immediately addressed.

• To increase financial independence, rehabilitation professionals should equip individuals with spinal cord injury with adequate self-employment skills.

• Sociocultural and religious aspects should be considered in the measurement of quality of life.

     

Translation,cross-cultural adaptation and validity of the Brazilian version of the Foot and Ankle Ability Measure questionnaire

Purpose: To translate and cross-culturally adapt the Foot and Ankle Ability Measure (FAAM) questionnaire and verify the psychometric properties of the Brazilian–Portuguese version of this instrument.

Methods: Analysis of validity was carried out by applying the Rasch model and evaluating correlations with the Short Form-36 (SF-36) Physical Function (PF) subscale. Test–retest reliability and internal consistency were analyzed with the intraclass correlation coefficient (ICC_2,1) and Cronbach’s alpha tests, respectively.

Results: Ninety subjects with various foot and ankle musculoskeletal disorders (age 37.05 SD 10.49 years) were included. The ICC_2,1 was 0.88 and 0.82 with Cronbach’s alphas of 0.93 and 0.90 for the “Activities of Daily Living” (ADL) and “Sports” subscales, respectively. Correlations with the SF-36 PF were 0.78 (p?95: 0.62–0.87) and 0.65 (p?95: 0.45–0.79) for the ADL and Sports subscales, respectively. Item reliability indices in Rasch analysis were 0.91 (ADL) and 0.84 (Sports). Three items from the ADL subscale (14.2%) did not match the expectations of the model. All items from the Sports subscale fit the model.

Conclusions: There is evidence of validity and reliability of the FAAM-Brazil. Rasch analysis indicated that three items of the ADL subscale did not fit the model in the sample studied.

• Implications for Rehabilitation

• Self-report questionnaires are commonly used in both clinical practice and research because of their ability to efficiently collect information. If the instrument is created properly, the information collected can be used to interpret the effect of clinical conditions on physical function.

• The Foot and Ankle Ability Measure (FAAM) is an evaluative instrument that assesses functional limitations for those with foot- and ankle-related disorders. It was translated into four languages and has evidence of validity, reliability, and responsiveness.

• Evidence of validity and reliability is provided for the FAAM-Brazil when applied to subjects with a wide range of foot and ankle musculoskeletal disorders.

     

Effectiveness of commercial video gaming on fine motor control in chronic stroke within community-level rehabilitation

Abstract

Purpose: The purpose of this study was to investigate the effectiveness of commercial gaming as an intervention for fine motor recovery in chronic stroke. Methods: Ten chronic phase post-stroke participants (mean time since CVA?=?39 mos; mean age?=?72 yrs) completed a 16-session program using the Nintendo Wii for 15?min two times per week with their more affected hand (10 right handed). Functional recovery (Jebsen Hand Function Test (JHFT), Box and Block Test (BBT), Nine Hole Peg Test (NHPT)), and quality of life (QOL; Stroke Impact Scale (SIS)) were measured at baseline (pre-testing), after 8 sessions (mid-testing) and after 16 sessions (post-testing). Results: Significant improvements were found with the JHFT, BBT and NHPT from pre-testing to post-testing (p?=?0.03, p?=?0.03, p?=?0.01, respectively). As well, there was an increase in perceived QOL from pre-testing to post-testing, as determined by the SIS (p?=?0.009). Conclusion: Commercial gaming may be a viable resource for those with chronic stroke. Future research should examine the feasibility of this as a rehabilitation tool for this population.

• Implications for Rehabilitation

• Stroke survivors often live with lasting effects from their injury, however, those with chronic stroke generally receive little to no rehabilitation due to a perceived motor recovery plateau.

• Virtual reality in the form of commercial gaming is a novel and motivating way for clients to complete rehabilitation.

• The Nintendo Wii may be a feasible device to improve both functional ability and perceived quality of life in chronic stroke survivors.

     

Effects of singing on voice,respiratory control and quality of life in persons with Parkinson’s disease

Purpose Interventions focused on singing may provide additional benefits to established voice and respiratory therapies, due to their greater emphasis on the respiratory muscle control system in those with Parkinson’s disease (PD) progresses. The purpose of this study was to examine if singing can improve voice, respiratory pressure and quality of life (QOL) in persons with PD. Methods This pilot study measured the effects of a singing intervention in 27 participants with PD. Participants were assigned to a high (met twice weekly) or low (met once weekly) dosage group. Voice, respiratory and QOL measures were recorded before and after an 8-week singing intervention. Sessions were led by board-certified music therapists and included a series of vocal and articulation exercises and group singing. Results Both groups demonstrated significant improvements in maximum inspiratory and expiratory pressure, as well as phonation time. While other voice measures improved, they did not reach statistical significance. Voice QOL and whole health QOL also significantly improved. Conclusion These results suggest singing may be a beneficial and engaging treatment choice for improving and maintaining vocal function and respiratory pressure in persons with PD.

• Implications for Rehabilitation

• In a small sample, group singing proved beneficial for improving voice and respiratory impairment in persons with Parkinson’s disease.

• Completing group singing one time per week for 8 weeks was as effective as completing group singing two times per week for 8 weeks in persons with Parkinson’s disease.

• Group singing is an effective means of improving overall quality of life in persons with Parkinson’s disease.