Assessment of upper body accelerations in young adults with intellectual disabilities while walking, running, and dual-task running.

There is an increasing interest about upper body accelerations during locomotion and how they are altered by physical impairments. Recent studies have demonstrated that cognitive impairments affect gait stability in the elderly (i.e., their capacity for smoothing upper body accelerations during walking) but little attention has been paid to young adults with intellectual disabilities. The purpose of this study was to examine upright stability in young adults with intellectual disabilities during walking, running, and dual-task running (playing soccer). To this aim a wearable trunk-mounted device that permits on-field assessment was used to quantify trunk acceleration of 18 male teenagers with intellectual disabilities (IDG) and 7 mental-age-matched healthy children (HCG) who participated in the same soccer program. We did not find any significant difference during walking in terms of speed, whereas speed differences were found during running (p=.001). Upper body accelerations were altered in a pathology-specific manner during the dual task: the performance of subjects with autistic disorders was compromised while running and controlling the ball with the feet. Differences in upright locomotor patterns between IDG and HCG emerged during more demanding motor tasks in terms of a loss in the capacity of smoothing accelerations at the trunk level.

An integrated psychological strategy for advanced colorectal cancer patients.

BACKGROUND: There is evidence regarding the usefulness of psychosocial intervention to improve health related quality of life (HRQOL) in adult cancer patients. The aim of this report is to describe an integrated approach and to evaluate its feasibility in routine clinical practice in 98 advanced colorectal cancer (ACC) patients during chronomodulated chemotherapy. METHODS: A prospective non-randomised design was developed and applied in a cancer out-patient setting. The intervention consisted of an integrated approach, whereby the psycho-oncologist had an active role in the health care team with the physician and routinely included psychological understanding in the medical treatment program. The psychological evaluation assessed: a) adaptation, awareness, psychopathological disorders through a psychodynamic interview; b) anxiety and depression using the HAD scale; c) subjective perception of care quality through a structured interview and d) HRQOL evaluation assessment with the EORTC QLQ C30. Outcomes data were collected before and after 18 weeks of chemotherapy. RESULTS: After 18 weeks of chemotherapy a significant improvement of adaptation and awareness was observed. The HADs results showed a significant decrease in anxiety when compared to pre-treatment. The structured interview showed a significant increase of patients who positively experienced the impact of medical treatment on HRQOL, anxiety, depression, interpersonal relationships, free-time and who positively experienced the care quality. Indeed, a majority of patients positively experienced the team relationship modality during the whole treatment. All scales on the EORTC questionnaire remained unchanged during the entire treatment. CONCLUSION: Our results suggest that it is feasible to carry out an integrated approach during chemotherapy. These results seem to support the integrated approach as a tool in aiding advanced colorectal cancer patients' ability to cope with their diagnosis and treatment although an appropriately designed study is required to confirm this.