Combined Effects of Virtual Reality and Computer Game-Based Cognitive Therapy on the Development of Visual-Motor Integration in Children with Intellectual Disabilities: A Pilot Study.

PURPOSE: Visual-motor integration is a good indicator of a child's overall developmental and functional level. This study investigated the combined effects of virtual reality (VR) and computer game-based cognitive therapy on the development of visual-motor integration in children with intellectual disabilities. METHODS: The study used a single-group pre-post study design and 13 children with intellectual disabilities who were recruited from a community rehabilitation center participated in the study. We used the Wii VR video game and the CoTras computer game to deliver cognitive therapy over 12 sessions. The Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) was used to evaluate motor function related to visual-motor integration to identify changes in function, and the Developmental Test of Visual Perception-2 (DTVP-2) was used to assess changes in visual perception function associated with visual-motor integration. RESULTS: The VR and computer game-based cognitive therapy has shown significant difference in total standard score of BOT-2 associated with visual-motor integration representing improved motor function (p < 0.01). Comparison of the DTVP-2 scores showed the significant difference in visual-motor integration of spatial relation and visual-motor speed (p < 0.05), motor-reduced visual perception (p < 0.01), and general visual perception (p < 0.01). CONCLUSIONS: Results of this study provide useful evidence supporting the possibility of combined VR and computer game-based cognitive therapy for children with intellectual disabilities.

Participation based intervention with acquired brain injury: Systematic review and meta-analysis.

BACKGROUND: Continued long-term rehabilitation programs with acquired brain injury are important for their participation in meaningful daily activities. OBJECTIVE: This paper investigated the participation-based interventions on outcomes in patients with acquired brain injury. METHODS: A systematic review and meta-analysis search for randomized control trials published between 1998 and 2019 using PubMed, CINAHL, and MEDLINE was performed. Nine studies were selected and analyzed for systematic review. Five studies analyzed the effectiveness of participation-based intervention using meta-analysis and assessed the level of evidence of qualitative studies. RESULTS: A total of 843 publications were searched. Nine studies met the inclusion criteria and were of high quality. The effective score for improving participation following participation-based interventions in persons with acquired brain injury was 0.32 and significant in this study (p < 0.05). CONCLUSIONS: The findings of this systematic review and meta-analysis suggest that, in persons with acquired brain injury, participation-based interventions are essential for community living.

Virtual rehabilitation of upper extremity function and independence for stoke: a meta-analysis.

We aimed to conduct a systematic literature review with a meta-analysis to investigate whether virtual reality (VR) approaches have beneficial effects on the upper extremity function and independent activities of stroke survivors. Experimental studies published between 2007 and 2017 were searched from two databases (EBSCOhost and PubMed). This study reviewed abstracts and assessed full articles to obtain evidence on qualitative studies. For the meta-analysis, the studies that estimated the standardized mean between the two groups analyzed the statistical values necessary for calculating the effect size. The present study also evaluated the statistical heterogeneity. In total, 34 studies with 1,604 participants were included, and the number of participants in each study ranged from 10 to 376. Nine studies were assessed to evaluate the quantitative statistical analysis for 698 patients with hemiparetic stroke. The results of the meta-analysis were as follows: The overall effect size was moderate (0.41, P<0.001). The 95% confidence interval ranged from 0.25 to 0.57. However, no significant heterogeneity and publication bias were observed. The results of this study showed that VR approaches are effective in improving upper extremity function and independent activities in stroke survivors.

Effectiveness of occupation-based interventions on performance's quality for hemiparetic stroke in community-dwelling: A randomized clinical trial study.

BACKGROUND: Occupations define activities that people perform to occupy themselves and that people have meaning and value to them. The use of occupation-based intervention addresses activity daily of living performance. OBJECTIVES: This study was to investigate the effects of occupation-based interventions on performance's quality for hemiparetic stroke in community-dwelling. METHODS: Forty-three participants were enrolled in this study with a full understanding of the purpose and method of the research and had a diagnosis with hemiparetic stroke. Participants were randomized to one of two treatment groups: Experimental group (n = 23) or control groups (n = 20). The experimental group applied occupation-based intervention and control group applied action focusing intervention. All participants underwent ten treatment sessions during the study period and conducted pre- and post-assessment. Several instruments were used to measure quality of performance. RESULTS: After the intervention training, the qualities of occupational performance were significantly higher in the experimental group applied occupation-based intervention than the control group applied action focusing intervention (p < 0.001). CONCLUSIONS: Based on the results of this study, occupation-based intervention has positive effects on quality of performing daily activities and occupational activities independently in persons with hemiparetic stroke.

Effects of sensory awareness, imagery and observation on electroencephalography in adult with psychological stress.

[Purpose] The aim of the present study was to examine the effects of brain activation using sensory awareness, imagery, and observation in adults with psychological stress. [Participants and Methods] The participants of the study were 30 adults with psychological stress. They responded to questionnaires, including a stress response inventory. Data for brain activation were collected for sensory awareness, imagery, and observation using electroencephalography. To determine the neurological changes in the brain, this study analysed the relative power of sensory motor rhythm of the participants using electroencephalography. [Results] Results showed that the relative power of the sensory motor rhythm was significantly greater during awareness and imagery of sensory than during observation. [Conclusion] The results of this study suggest that awareness, imagery, and observation of sensation should be considered as useful modalities in people with psychological stress.

Differences in body awareness and its effects on balance function and independence in activities of daily living for stroke.

[Purpose] The present study aimed to investigate the association between body awareness with postural control and independence in performing activities of daily living in patients with hemispheric stroke. Eighty-one patients who were diagnosed with stroke participated in this study. [Participants and Methods] The participants were divided into three groups according to their risk for falls. Furthermore, these participants were classified into four groups according to their degree of independence in performing activities of daily living. This study used three measuring tools, namely the body awareness questionnaire, Berg balance scale, and modified Barthel index. [Results] Body awareness was significantly correlated with balance function in the group with low risk for falls compared with that in the group with high risk for falls. Body awareness was significantly correlated with the degree of independence in performing activities of daily living in the group that needed minimal assistance compared with the groups that needed moderate and severe assistance. Results showed that body awareness was associated with postural control and the degree of independence in performing activities of daily living in individuals with hemiparetic stroke. [Conclusion] Body awareness is among the primary factors that affect the motor function of patients with stroke in rehabilitation settings.

Cognitive Rehabilitation of Adaptive Behavior in Children with Neurodevelopmental Disorders: A Meta-Analysis.

OBJECTIVES: Negative behavioral problems often occur following the onset of neurodevelopmental disorders and have an overall impact on the affected children, specifically in terms of their social developmental level. In children, social development behavior has been shown to spontaneously mature over time with the cognitive therapy intervention effects. This study performed a meta-analysis to provide a statistical synopsis of the available evidence of social development behavioral changes following cognitive therapy in children with neurodevelopmental disorders. METHODS: Data was collected from two online search engines, including EBSCOhost and PubMed, from January 1, 2006, to August 31, 2016, using the terms "cognition," "cognitive function," and "disease including neurodevelopmental disorder with DSM-5." Two assessors searched the literature using independent inclusion criteria and evaluated the quality of results using the Jadad score. Six articles were chosen using the Comprehensive Meta-Analysis program (version 2.0). RESULTS: Six articles reporting randomized controlled trial studies were included. The effective scores for improving adaptive behavior following cognitive therapy in children with neurodevelopmental disorder were 0.64. The effective score of adaptive behavior was significant in this study (p < 0.05). The results showed no significant statistical heterogeneity and publication bias. CONCLUSIONS: The findings of the meta-analysis suggest that cognitive interventions are effective at improving adaptive behavior associated with neurodevelopmental disorders.

Cognitive rehabilitation with neurodevelopmental disorder: A systematic review.

BACKGROUND: A variety of cognitive rehabilitation has gained popularity in early childhood with neurodevelopmental disorder at clinical rehabilitation settings. OBJECTIVES: The purpose of this review was to analyze the cognitive therapies used and to analyze the methods applied in children with neurodevelopmental disorders. METHODS: This study searched for experimental studies published between 2006 and 2016 using two databases including EBSCOhost and PubMed. The keywords used included "diagnosis included in the neurodevelopment disorder of DSM-5" AND "cognition" or "cognitive function". After the searching, this study reviewed the abstracts initially and assessed full articles subsequently, and then we selected total of 26 studies. Two reviewers independently assessed the level of evidence of qualitative studies using the PICO method, and this study analyzed the frequency of participants, intervention information, and methods used were analyzed. RESULTS: This study was generated a total of 3,115 publications of literature review. Twenty-six studies were included in this review as for the levels of evidence of the qualitative studies selected. 12 studies was received the cognitive therapy for autism spectrum disorder, and 17 studies was participated grade-schooler (5-12 yrs) to investigate the effects of cognitive therapy. Cognitive therapy showed the level I evidence in participants with Autism spectrum disorder, attention-deficit/hyperactivity disorder, and global developmental disorder. CONCLUSIONS: The results of this study provide an indication about the types of cognitive therapies used in children with neurodevelopmental disorders, and provide available and beneficial information of cognitive therapies at research and clinical setting.

Comparison of Cognitive Orientation to daily Occupational Performance and conventional occupational therapy on occupational performance in individuals with stroke: A randomized controlled trial.

BACKGROUND: Cognitive Orientation to daily Occupational Performance (CO-OP) approach based on cognitive strategy in occupational therapy. OBJECTIVES: To investigate the effects of CO-OP approach on occupational performance in individuals with hemiparetic stroke. METHODS: This study was designed as a 5-week, randomized, single-blind. Forty-three participants who had a diagnosis of first stroke were enrolled in this study. The participants were randomly assigned to the experimental group (n = 20) or the control group (n = 23). The experimental group conducted CO-OP approach while the control group conducted conventional occupational therapy based on occupational performance components. This study measured Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS). Outcome measurements were performed at baseline and post-intervention. RESULTS: After training, the scores of COPM and PQRS in trained task were significantly higher for the score in the experimental group than the control group. In addition, the non-trained task was significantly higher for the score in the experimental group than the control group in COPM and the PQRS. CONCLUSIONS: This study suggests that the CO-OP approach is beneficial effects on the occupational performance to improvement in individuals with hemiparetic stroke, and have positive effects on generalization and transfer of acquired skills.

Analysis approaches and interventions with occupational performance.

[Purpose] The purpose of this study was to analyze approaches and interventions with occupational performance in patients with stroke. [Subjects and Methods] In this study, articles published in the past 10 years were searched. The key terms used were "occupational performance AND stroke" and "occupational performance AND CVA". A total 252 articles were identified, and 79 articles were selected. All interventions were classified according to their approaches according to 6 theories. All interventions were analyzed for frequency. [Results] Regarding the approaches, there were 25 articles for studies that provided high frequency interventions aimed at improving biomechanical approaches (31.6%). This included electrical stimulation therapy, robot therapy, and sensory stimulation training, as well as others. Analysis of the frequency of interventions revealed that the most commonly used interventions, which were used in 18 articles (22.8%), made use of the concept of constraint-induced therapy. [Conclusion] The results of this study suggest an approach for use in clinics for selecting an appropriate intervention for occupational performance.

Measurement of balance function and community participation in stroke survivors.

[Purpose] This study aimed to investigate the relationship between balance function and community participation in stroke survivors. [Subjects and Methods] Sixty-three patients diagnosed with hemiparetic stroke participated in this study (36 males, 27 females, aged 58.6 ± 15.2 years). The participants were assessed for balance function and their level of participation in the community, using activity card sorting and the Berg Balance Scale. A regression analysis was used to identify the influence of balance function on instrumental activities of daily living and leisure and social activities. [Results] The results of the regression analysis indicated that balance function measured by using the Berg Balance Scale affected community participation of patients with hemiparetic stroke. Participation in instrumental activities of daily living and leisure and social activities was affected by balance function. [Conclusion] This study provides useful information for designing efficient programs and identifying their effectiveness for enhancement of community participation in stroke survivors.

Association between daily activities, process skills, and motor skills in community-dwelling patients after left hemiparetic stroke.

[Purpose] The purpose of this study was to evaluate the relationships between daily activities, information processing, and motor skills in individuals with hemineglect after having a left hemiparetic stroke. [Subjects and Methods] The instrumental activities of daily living of 35 patients (22 male and 13 female; age: 57.1 ± 16.9 years) with hemineglect after having a left hemiparetic stroke were assessed by using three clinical measurement tools, including activity card sorting, assessment of motor and process skills, and the modified Barthel Index. [Results] The results of the regression analysis indicated that the patients' processing skills in instrumental activities of daily living after having a left hemiparetic stroke were reduced. Participation in leisure and social activities was also affected as assessed by using the modified Barthel Index. [Conclusion] This study supports the clinical need for rehabilitation intervention after a left hemiparetic stroke to improve patients' processing skills and independence in performing activities of daily living.

Tactile Perception for Stroke Induce Changes in Electroencephalography.

OBJECTIVE/BACKGROUND: Tactile perception is a basic way to obtain and evaluate information about an object. The purpose of this study was to examine the effects of tactile perception on brain activation using two different tactile explorations, passive and active touches, in individuals with chronic hemiparetic stroke. METHODS: Twenty patients who were diagnosed with stroke (8 right brain damaged, 12 left brain damaged) participated in this study. The tactile perception was conducted using passive and active explorations in a sitting position. To determine the neurological changes in the brain, this study measured the brain waves of the participants using electroencephalography (EEG). RESULTS: The relative power of the sensory motor rhythm on the right prefrontal lobe and right parietal lobe was significantly greater during the active tactile exploration compared to the relative power during the passive exploration in the left damaged hemisphere. Most of the measured brain areas showed nonsignificantly higher relative power of the sensory motor rhythm during the active tactile exploration, regardless of which hemisphere was damaged. CONCLUSION: The results of this study provided a neurophysiological evidence on tactile perception in individuals with chronic stroke. Occupational therapists should consider an active tactile exploration as a useful modality on occupational performance in rehabilitation training.

Suppressors of cytokine signaling promote Fas-induced apoptosis through downregulation of NF-κB and mitochondrial Bfl-1 in leukemic T cells.

Suppressors of cytokine signaling (SOCS) are known as negative regulators of cytokine- and growth factor-induced signal transduction. Recently they have emerged as multifunctional proteins with regulatory roles in inflammation, autoimmunity, and cancer. We have recently reported that SOCS1 has antiapoptotic functions against the TNF-α- and the hydrogen peroxide-induced T cell apoptosis through the induction of thioredoxin, which protects protein tyrosine phosphatases and attenuates Jaks. In this study, we report that SOCS, on the contrary, promote death receptor Fas-mediated T cell apoptosis. The proapoptotic effect of SOCS1 was manifested with increases in Fas-induced caspase-8 activation, truncated Bid production, and mitochondrial dysfunctions. Both caspase-8 inhibitor c-Flip and mitochondrial antiapoptotic factor Bfl-1 were significantly reduced by SOCS1. These proapoptotic responses were not associated with changes in Jak or p38/Jnk activities but were accompanied with downregulation of NF-κB and NF-κB-dependent reporter gene expression. Indeed, p65 degradation via ubiquitination was accelerated in SOCS1 overexpressing cells, whereas it was attenuated in SOCS1 knockdown cells. With high NF-κB levels, the SOCS1-ablated cells displayed resistance against Fas-induced apoptosis, which was abrogated upon siBfl-1 transfection. The results indicate that the suppression of NF-κB-dependent induction of prosurvival factors, such as Bfl-1 and c-Flip, may serve as a mechanism for SOCS action to promote Fas-mediated T cell apoptosis. SOCS3 exhibited a similar proapoptotic function. Because both SOCS1 and SOCS3 are induced upon TCR stimulation, SOCS would play a role in activation-induced cell death by sensitizing activated T cells toward Fas-mediated apoptosis to maintain T cell homeostasis.