Lower limb muscle impairment in myotonic dystrophy type 1: The need for better guidelines

In myotonic dystrophy type 1 (DM1), leg muscle weakness is a major impairment. There are challenges to obtaining a clear portrait of muscle strength impairment. A systematic literature review was conducted on lower limb strength impairment in late‐onset and adult phenotypes to document variables which affect strength measurement. Thirty‐two articles were reviewed using the COSMIN guidelines. Only a third of the studies described a reproducible protocol. Only 2 muscle groups have documented reliability for quantitative muscle testing and only 1 total score for manual muscle testing. Variables affecting muscle strength impairment are not described in most studies. This review illustrates the variability in muscle strength assessment in relation to DM1 characteristics and the questionable validity of the results with regard to undocumented methodological properties. There is therefore a clear need to adopt a consensus on the use of a standardized muscle strength assessment protocol. Muscle Nerve 51: 473–478, 2015     

Technology in the Lives of Women Who Live With Memory Impairment as a Result of a Traumatic Brain Injury

A large number of individuals who have experienced a traumatic brain injury are women; unfortunately, there is a lack of literature focusing on their treatment preferences. Electronic memory aids have the potential to offer tremendous assistance to increase the independence of individuals with memory impairment; however, the use of electronic memory aids with this female population has not been explored. The objective of this study was to investigate the perceptions and use of electronic memory aids in women with memory impairment as a result of a traumatic brain injury to further their use of this technology to enable their independence. Two focus groups were conducted, each with five women who self-reported a moderate to severe head injury. The primary theme that emerged was the willingness and interest of this sample to use this technology when provided with an appropriate introduction and learning environment. The results reaffirm current literature supporting the use of electronic memory aids with a population with a head injury. Individuals not currently using this technology were motivated to employ electronic memory aids in their daily lives. Further research must be conducted to develop strategies to enable this population's use of electronic memory aids.     

Parent perspectives of therapy services for their children with physical disabilities

Scand J Caring Sci; 2011; 25; 277–284
Parent perspectives of therapy services for their children with physical disabilities Background: Children who have physical disabilities typically attend occupational and physical therapy services on a regular basis. The importance of being family centred when providing services to children with a disability has been highlighted in recent years. Thus, it was considered important to gather the opinions of parents towards the services their child receives. Aim: To explore the perspectives of parents of children with physical disabilities to occupational and physical therapy services provided to their child. Method: Open interviews were conducted with 17 parents (14 mothers and three fathers) of children aged 7–13, selected through a purposeful sample. Data analysis was based on an inductive approach. Results: Nine categories emerged and were organized under three main headings: The role of the therapist, service location and arrangements, and characteristics of good service. Although several positive remarks were made, many parents in this study were poorly informed of intervention goals and what took place during therapy sessions. Most parents wished for mutual respect, joint decision‐making in planning intervention, and collaboration with the therapy services. The aspiration for active but manageable roles that did not demand a burdensome amount of the parents’ time and energy was evinced. The parents became increasingly critical of the services, as their children grew older. They placed emphasis on services being offered in their local community, and that more specialized service should be centralized, especially for the children with the most complex needs. Conclusions: The results reflect the importance of the needs and wants of the parents and children being respected. Thus, parents should play an active role in defining priorities and strategies for implementation. The results also indicate that therapists need to put more thought into the conditions and environment of the child instead of focusing solely on underlying issues connected to their impairments.     

Upper Extremity Function in Stroke Subjects: Relationships between the International Classification of Functioning, Disability, and Health Domains

Upper limb (UL) impairments are the most common disabling deficits after stroke and have complex relationships with activity and participation domains. However, relatively few studies have applied the ICF model to identify the contributions of specific UL impairments, such as muscular weakness, pain, and sensory loss, as predictors of activity and participation. The purposes of this predictive study were to evaluate the relationships between UL variables related to body functions/structures, activity, and participation domains and to determine which would best explain activity and participation with 55 subjects with chronic stroke. Body functions/structures were assessed by measures of grip, pinch, and UL strength, finger tactile sensations, shoulder pain, and cognition (MMSE); activity domain by measures of observed performance (BBT, NHPT, and TEMPA); and participation by measures of quality of life (SSQOL). Upper-limb and grip strength were related to all activity measures (0.52 < r < 0.82, p < .0001). Shoulder pain (r = −.39,p < .001) was the variable which was mostly related to participation. Grip strength alone accounted for 62%, 54%, and 36% of the variance in the activity measures (respectively TEMPA, BBT and NHPT). Shoulder pain accounted for 30% of the participation measure. Strength deficits and shoulder pain of the paretic UL demonstrated to be important targets for clinical interventions to improve activity and participation with chronic stroke subjects.

Level of Evidence

2c.