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1.
Artigo em Inglês | MEDLINE | ID: mdl-38083082

RESUMO

Schizophrenia spectrum disorder (SSD) is a neurobiological illness that causes considerable deficits in body functions and activity participation. This study examined the effects of a computerized cognitive training (CCT) on cognition, motor functions and activity participation with a quasi-experimental, pretest-posttest design. A total of 14 patients participated. All participants underwent two stages of CCT but one did not complete the posttest. The training was 3 times a week, 40 minutes each time and lasted for 12 weeks. Cognition, upper extremity motor, postural control performance, and activity participation (work behavior) were measured at three times: before and after 6 and 12 weeks of training. CCT improved participant's cognition and work behavior significantly and have the tendency to improve motor function. The training dosage might be insufficient for motor function improvement.Clinical Relevance- SSD patients benefit from the CCT in cognition and work behavior significantly but Motor function slightly.


Assuntos
Esquizofrenia , Humanos , Esquizofrenia/terapia , Treino Cognitivo , Cognição , Projetos de Pesquisa , Equilíbrio Postural
2.
Gait Posture ; 98: 248-254, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36201926

RESUMO

BACKGROUND: Nonarticulated and low-temperature thermoplastic ankle-foot orthoses (AFOs) have a semirigid design and are effective in improving the postural control mechanism (PCM) in individuals with poststroke hemiparesis. AFOs with an anterior leaf (AAFOs) are more often prescribed than are AFOs with a posterior leaf (PAFOs); however, the effects of AAFOs on the PCM during sit-to-stand transfer (STST) have not been explored. RESEARCH QUESTIONS: Do AAFOs and PAFOs change the PCM differently during STST? METHODS: A cross-sectional quasi-experimental design was adopted in this study. Fourteen individuals with poststroke hemiparesis (10 men and 4 women, aged between 38 and 71 years, stroke onset between 1 and 17 months) performed STST with shoes only, an AAFO with shoes, or a PAFO with shoes. Vertical ground reaction force (VGRF) and center-of-pressure (CoP) coordinates were collected using a pressure mat to calculate PCM parameters. A single-factor repeated measures analysis of variance was performed to answer the research question. RESULTS: (1) The weight-bearing percentage of the paretic leg was significantly lower when the participants wore a PAFO (p = 0.018) than when they wore an AAFO (p = 0.019) during the first 5 and 5-10 s after rising. (2) A small rate of change of the VGRF increment (dF/dT) was detected when participants wore AFOs, particularly AAFO. (3) The maximum mediolateral displacement of the CoP when standing up was significantly different among the three conditions (p = 0.012). SIGNIFICANCE: For patients with poststroke hemiparesis, AAFO and PAFOs change the PCM during STST performance. Only AAFO improved the PCM possibly because of the rigidity and clearance of the heel region, which provide somatic sensory feedback. Therefore, rehabilitation professionals should educate hemiplegic patients who use AAFOs or PAFOs to perform dynamic daily tasks slowly for their safety.


Assuntos
Órtoses do Pé , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Masculino , Humanos , Feminino , Pré-Escolar , Tornozelo , Estudos Transversais , Acidente Vascular Cerebral/complicações , Paresia/etiologia , Paresia/reabilitação
3.
PLoS One ; 17(6): e0264745, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35771832

RESUMO

Schizophrenia spectrum disorder (SSD) is a disabling mental illness that causes considerable deficits in motor and cognitive functions. The purpose of this study was to examine the effects of combining traditional multitask training (TMT) and video games--a new form of multitask training (video game multitask training VGMT)--on cognition and motor control performance in people with SSD. This was a quasi-experimental, pretest-posttest design study. A total of 25 patients participated in this study voluntarily (13 males and 12 females, average age = 59.61 years, SD- 11.46 years). All participants underwent two stages of training. The first stage involved TMT, and the second stage involved VGMT. Each training stage was 12 weeks long, with sessions twice a week that lasted for 40 minutes. Cognition, upper extremity motor and postural control performance, and functional mobility and subjective balance confidence were measured at three times: before and after the first-stage training and after the second-stage training. The results revealed that TMT and the combination of TMT and VGMT improved SSD patient's cognition, upper extremity motor control, functional mobility and postural control performance. The subjective confidence of balance during the performance of daily activities was also mildly improved. Training with multitasks in the form of video games tended to further improve the outcome measures. Patients with SSD could benefit from regular participation in various forms of multitasking activities. Whether video games training are better than TMT in improving the functional ability of people with SSD needs further investigation. Study protocol registration: Clinicaltrials.gov, ID: NCT04629898. Registered brief title: Level of Immersion of Virtual Reality and Cognition and Motor Performance in Patients of Schizophrenia Spectrum Disorder.


Assuntos
Esquizofrenia , Jogos de Vídeo , Idoso , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Esquizofrenia/terapia , Extremidade Superior
4.
Schizophr Res ; 222: 375-381, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32402607

RESUMO

OBJECTIVES: Employment status is considered a crucial predictor of improved functioning for patients with psychotic disorders. Frailty affects not only physical well-being but also employment outcomes, but few studies have explored the association between frailty and employment outcomes in patients with schizophrenia. This study is a longitudinal follow-up study that aimed to determine whether frailty is associated with employment outcomes in schizophrenia. METHODS: All 561 stable patients with schizophrenia in a therapeutic community in Taiwan were recruited. Employment outcomes, defined as the cumulative annual work duration (months per year) and income (USD per year), were investigated repeatedly at the end of 1-, 2-, 3-, and 4-year follow-ups after enrollment. Generalized estimating equation models were constructed to determine the association between frailty and employment outcomes after controlling for variables, including age, sex, education, antipsychotic medication and daily dose, cognitive function, instrumental activities of daily living, medical comorbidity, and initial employment state at the beginning year. RESULTS: The average age was 53.78 years, and 64.7% were men. Among them, 57 patients (10.2%) met the frailty criteria at the baseline. After controlling for other factors, we found that patients with frailty were employed 1.01 month less (p = 0.004) and earned 17.2 USD less (p = 0.029) per year than those without frailty. CONCLUSIONS: Frailty may reduce duration of employment and income for patients with schizophrenia. The biopsychosocial care model for these patients should include development of strategies to prevent or reverse preexisting frailty to improve and preserve employment outcomes.


Assuntos
Fragilidade , Esquizofrenia , Atividades Cotidianas , Emprego , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico , Esquizofrenia/epidemiologia , Taiwan/epidemiologia
5.
PLoS One ; 14(4): e0212161, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31009471

RESUMO

The purpose of this study was to determine whether functional walking performance measured with Timed Up-and-Go (TUG) and center of pressure (CoP) progression pattern is different across adolescents with various curve severity of idiopathic scoliosis (IS). The CoP coordinates during a stance phase for self-paced level walking between adolescent with three different severities of IS (mild IS, moderate IS, and severe IS) and age-matched normal subjects were measured with foot pressure measurement. The average data of three trials were compared among groups with repeated measure analysis of variance. Results showed that the TUG was different between normal and AIS subjects, indicating use of TUG as a marker of functional walking performance in AIS is plausible but studies with larger sample size is needed before using TUG to identify AIS with different scoliosis severity. The results also showed that the CoP displacement, velocity and acceleration during a stance phase was different across groups, and with the most prominent deviations found in the moderate IS group. The medial-lateral shifting of the CoP trajectory at mid-foot regions in all IS groups deviated the most. A tendency of asymmetry in CoP progression pattern between feet in IS groups was also found. The deviation of the spine alignment in frontal plane could change the CoP progression patterns during level walking, suggesting the risk of the locomotors subjecting to abnormal loading during daily walking. Education and conservative interventions might be needed for preservation of medical outcome and prevention of back pain and/or musculoskeletal consequences later in the lives of AIS with and without surgical correction.


Assuntos
Escoliose/fisiopatologia , Caminhada , Adolescente , Pé/patologia , Pé/fisiopatologia , Humanos , Escoliose/patologia , Coluna Vertebral/patologia , Coluna Vertebral/fisiopatologia
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2018: 2329-2332, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30440873

RESUMO

This study examines the interaction effects among incidences of falls, visual conditions, and stance postures on the magnitude of center of pressure sway (MCOPS) in patients with schizophrenia. The coordinates of COP in ten postural control demands were measured in subjects with at least one or without any falls in the previous year. MCOPS was calculated by the default program in Balance 3.78 software. Cognitive functions were also measured. The findings include: (1) the MCOPS increased as the postural control demands increase in subjects who have fallen; (2) MCOPS in subjects without falls was the largest for the lowest postural control demands; (3) MCOPS increased when the eyes were closed in subjects without a history of falls but decreased in subjects with a history of falls; (4) cognition function in subjects who have fallen was inferior to that in those without falls. The interference visual condition and stance postures on MCOPS tended to be different in schizophrenia with or without incidences of falls indicating the possible association between psychomotor dysfunction and falls in the subjects.


Assuntos
Acidentes por Quedas , Equilíbrio Postural , Postura , Esquizofrenia/fisiopatologia , Cognição , Humanos
7.
Front Hum Neurosci ; 11: 326, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28713252

RESUMO

Subjective visual vertical (SVV) judgment and standing stability were separately investigated among patients with adolescent idiopathic scoliosis (AIS). Although, one study has investigated the central mechanism of stability control in the AIS population, the relationships between SVV, decreased standing stability, and AIS have never been investigated. Through event-related potentials (ERPs), the present study examined the effect of postural control demands (PDs) on AIS central mechanisms related to SVV judgment and standing stability to elucidate the time-serial stability control process. Thirteen AIS subjects (AIS group) and 13 age-matched adolescents (control group) aged 12-18 years were recruited. Each subject had to complete an SVV task (i.e., the modified rod-and-frame [mRAF] test) as a stimulus, with online electroencephalogram recording being performed in the following three standing postures: feet shoulder-width apart standing, feet together standing, and tandem standing. The behavioral performance in terms of postural stability (center of pressure excursion), SVV (accuracy and reaction time), and mRAF-locked ERPs (mean amplitude and peak latency of the P1, N1, and P2 components) was then compared between the AIS and control groups. In the behavioral domain, the results revealed that only the AIS group demonstrated a significantly accelerated SVV reaction time as the PDs increased. In the cerebral domain, significantly larger P2 mean amplitudes were observed during both feet shoulder-width-apart standing and feet together standing postures compared with during tandem standing. No group differences were noted in the cerebral domain. The results indicated that (1) during the dual-task paradigm, a differential behavioral strategy of accelerated SVV reaction time was observed in the AIS group only when the PDs increased and (2) the decrease in P2 mean amplitudes with the increase in the PD levels might be direct evidence of the competition for central processing attentional resources under the dual-task postural control paradigm.

8.
Front Aging Neurosci ; 8: 80, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27199732

RESUMO

The cerebral cortex provides sensorimotor integration and coordination during motor control of daily functional activities. Power spectrum density based on electroencephalography (EEG) has been employed as an approach that allows an investigation of the spatial-temporal characteristics of neuromuscular modulation; however, the biofeedback mechanism associated with cortical activation during motor control remains unclear among elderly individuals. Thirty one community-dwelling elderly participants were divided into low fall-risk potential (LF) and high fall-risk potential (HF) groups based upon the results obtained from a receiver operating characteristic analysis of the ellipse area of the center of pressure. Electroencephalography (EEG) was performed while the participants stood on a 6-degree-of-freedom Stewart platform, which generated continuous perturbations and done either with or without the virtual reality scene. The present study showed that when there was visual stimulation and poor somatosensory coordination, a higher level of cortical response was activated in order to keep postural balance. The elderly participants in the LF group demonstrated a significant and strong correlation between postural-related cortical regions; however, the elderly individuals in the HF group did not show such a relationship. Moreover, we were able to clarify the roles of various brainwave bands functioning in motor control. Specifically, the gamma and beta bands in the parietal-occipital region facilitate the high-level cortical modulation and sensorimotor integration, whereas the theta band in the frontal-central region is responsible for mediating error detection during perceptual motor tasks. Finally, the alpha band is associated with processing visual challenges in the occipital lobe.With a variety of motor control demands, increment in brainwave band coordination is required to maintain postural stability. These investigations shed light on the cortical modulation of motor control among elderly participants with varying fall-risk potentials. The results suggest that, although elderly adults may be without neurological deficits, inefficient central modulation during challenging postural conditions could be an internal factor that contributes to the risk of fall. Furthermore, training that helps to improve coordinated sensorimotor integration may be a useful approach to reduce the risk of fall among elderly populations or when patients suffer from neurological deficits.

9.
Biomed Res Int ; 2015: 463792, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26583110

RESUMO

To understand the progression of recovery in postural stability and physical functioning after patients received the minimally invasive total hip arthroplasty (MTHA), we monitor the pain level, functional capacity, and postural stability before and after operation within one year. In total of 23 subjects in our study, we found out that MTHA was effective in relieving pain in first 2 weeks and restoring the hip joint integrity, but the postural stability was influenced especially in tandem stand in both anterior-posterior and medial-lateral directions. The recovery of postural stability and functional capacity in one year duration fluctuated and no consistent improvement tendency was found. We suggested clinicians designing postsurgery rehabilitation program for consistent and progressive long-term recovery of postural stability and fall prevention to optimize surgical results and prevent undesired postoperative consequences.


Assuntos
Artroplastia de Quadril/reabilitação , Articulação do Quadril/fisiopatologia , Equilíbrio Postural/fisiologia , Postura/fisiologia , Acidentes por Quedas , Idoso , Feminino , Seguimentos , Pé/fisiopatologia , Articulação do Quadril/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Período Pós-Operatório
10.
J Occup Rehabil ; 24(3): 439-45, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24077894

RESUMO

PURPOSE: The Frenchay Activities Index (FAI) is a frequently used measure that assesses instrumental activities of daily living (IADL). However, the measurement properties of the FAI are largely unknown for patients with traumatic limb injuries. The purpose of this study was to examine the measurement properties of a Chinese version of the FAI, including score distribution, internal consistency, construct validity, predictive validity, and responsiveness in patients with traumatic limb injuries. METHODS: We performed a secondary data analysis, primarily using non-parametric item response theory, on a data set. The FAI and the World Health Organization Quality of Life Assessment (WHOQOL-BREF) were administered via telephone interview to a cohort of patients at 3, 6, and 12 months after injury. Totals of 342 patients' data (at 3 months after injury), 1,010 patients' data (6 months), and 987 patients' data (12 months) were available for analysis. RESULTS: After the deletion of 5 items (i.e., travel outings, gardening, household/car maintenance, reading books, and gainful work), the 10-item revised FAI (R-FAI) formed a unidimensional construct. The R-FAI exhibited a unidimensional construct at each of the 3 time points. The R-FAI had sufficient score distribution, internal consistency, predictive validity, and responsiveness in patients with limb injuries. CONCLUSIONS: Our results support the conclusion that the R-FAI has satisfactory measurement properties. The R-FAI is useful for assessing IADL in patients with limb injuries.


Assuntos
Atividades Cotidianas , Avaliação da Deficiência , Extremidades/lesões , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Taiwan
11.
Artigo em Inglês | MEDLINE | ID: mdl-25571336

RESUMO

Center of pressure (CoP) progression during level walking in subjects with Adolescents Idiopathic Scoliosis (AIS) was measured. Participants were divided into three groups according to scoliosis severity. CoP progression among groups was compared quantitatively and qualitatively. The results showed that scoliosis severity affects CoP progression significantly in the hind-foot and forefoot areas. This result indicated that spine alignment might affect the control of heel, ankle and toe rockers in the ankle-foot complex. The effects of scoliosis severity is mainly on the CoP of right foot plantar surface, indicating asymmetrical influence of IS on bilateral lower limb coordination during walking. These results might contribute to musculoskeletal complains over the apparatus within trunk-foot in the later lives of this population.


Assuntos
Pé/fisiopatologia , Escoliose/patologia , Coluna Vertebral/patologia , Adolescente , Criança , Feminino , Humanos , Masculino , Escoliose/fisiopatologia , Índice de Gravidade de Doença , Caminhada , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-24110860

RESUMO

The purpose was to examine the effects of static anterior and posterior ankle-foot orthoses (AAFOs & PAFOs) using with regular shoes on improving static and gait function in patients recovering from stroke. Static and dynamic balance control were measured under four conditions: barefeet, wearing regular shoes only, and wearing regular shoes with AAFOs or PAFOs. The results indicated that wearing regular shoes markedly increased the center of pressure (CoP) sway (p < 0.05) in static standing conditions. Both AAFOs and PAFOs decreased CoP sway and increased bilateral limb loading symmetry compared to barefoot and wearing shoes alone (p < 0.05). PAFOs decreased CoP sway more than AAFOs (p > 0.05) and also boosted medial-lateral weight shifting more effectively (p < 0.05). Both types of AFOs increased walking efficiency but influenced the roll-over shape of the CoP adversely during level walking. The conclusions are that both AAFOs and PAFOs improved static and dynamic balance control when they were used with regular shoes and PAFOs appeared to be more efficient than AAFOs. Shoes worn daily with AFOs is a key consideration influencing balance control in stroke patients. However, AFOs with static design impeded the function of the three rocker systems of the foot during ambulation.


Assuntos
Articulação do Tornozelo/fisiopatologia , Órtoses do Pé , Pé/fisiopatologia , Marcha/fisiologia , Paresia/fisiopatologia , Equilíbrio Postural/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Caminhada/fisiologia , Adulto , Idoso , Tornozelo , Peso Corporal , Braquetes , Simulação por Computador , Processamento Eletrônico de Dados , Desenho de Equipamento , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Pressão , Sapatos
13.
Chang Gung Med J ; 35(1): 54-61, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22483428

RESUMO

BACKGROUND: The two-incision technique and the modified Watson-Jones technique use muscular intervals and avoid muscle cutting in total hip arthroplasty (THA). However these two techniques have not been compared. METHODS: A prospective randomized study of clinical outcomes and patient preferences was performed in 20 patients who had a two-incision THA in one hip and a modified Watson-Jones THA in the other between January 2004 and August 2007. The 20 patients were randomized equally to the two-incision first or the modified Watson-Jones first group. After the second surgery, patients were asked about their preferences for one of the two techniques and clinical results were analyzed. RESULTS: After a minimal follow-up of 2 years, there were no differences in the hospital course, clinical results, functional outcomes, and radiographic results between techniques. However more patients (70%) preferred the two-incision side to the modified Watson-Jones side in the first 6 months regardless which procedure was performed first. CONCLUSION: Given the similarity of these two techniques in cup implantation and with only a difference in femoral stem implantation, we think that the difference in patient preferences in the early postoperative period might be related to the surgical dissection and manipulation of the hip with the modified Watson-Jones technique.


Assuntos
Artroplastia de Quadril/métodos , Quadril/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Preferência do Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
14.
Am J Phys Med Rehabil ; 90(12): 969-78, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22019971

RESUMO

OBJECTIVE: The aim of this study was to evaluate the effects of virtual reality (VR) treadmill training on the balance skills of patients who have had a stroke. DESIGN: A total of 14 patients with strokes were recruited and randomly assigned to receive VR treadmill or traditional treadmill training. The outcome measures that were included for the study were center of pressure (COP) sway excursion, COP maximum sway in anterior-posterior direction, COP maximum sway in medial-lateral direction, COP sway area, bilateral limb-loading symmetric index, the sway excursion values for the paretic foot (sway excursion/P), paretic limb stance time (stance time/P), number of steps of the paretic limb (number of steps/P), and contact area of the paretic foot (contact A/P) during quiet stance, sit-to-stand transfer, and level walking. RESULTS: There were no significant improvements in COP-related measures and symmetric index during the quiet stance, either in the VR treadmill or traditional treadmill training group (P > 0.05). However, the difference between groups after training in COP maximum sway in medial-lateral direction during the quiet stance was significant (P = 0.038). Traditional treadmill training failed to improve sit-to-stand performance, whereas VR treadmill training improved symmetric index (P = 0.028) and sway excursion (P = 0.046) significantly during sit-to-stand transfer. The changes of symmetric index between groups were markedly different (P = 0.045). Finally, both groups improved significantly in stance time/P, but only VR treadmill training increased contact A/P (P = 0.034) after training during level walking. The difference between groups during level walking was not significant. CONCLUSIONS: Neither traditional treadmill nor VR treadmill training had any effect on balance skill during quiet stance, but VR treadmill training improved balance skill in the medial-lateral direction better than traditional training did. VR treadmill training also improved balance skill during sit-to-stand transfers and the involvement of paretic limb in level walking more than the traditional one did.


Assuntos
Teste de Esforço , Equilíbrio Postural/fisiologia , Reabilitação do Acidente Vascular Cerebral , Interface Usuário-Computador , Idoso , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Valores de Referência , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Acidente Vascular Cerebral/diagnóstico , Caminhada/fisiologia
15.
Am J Phys Med Rehabil ; 89(3): 186-97, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19966561

RESUMO

OBJECTIVES: Postural stability is often task-demand-dependent and often impaired in stroke patients. The purposes of this study were (1) to compare the difference in the center of pressure measures during forward bending of the trunk and reaching on postural actions between normal subjects and stroke patients and (2) to examine the effects of task demands on the center of pressure measures in both groups. DESIGN: Thirteen normal subjects and 23 stroke patients performed two trials of forward bending of the trunk and reaching for each of the targets at six locations at floor level while standing on a 0.5-m-long pressure mat. Center of pressure excursion, center of pressure average velocity, and bilateral limb weight-bearing ratios characterized the postural actions. Mixed-design analysis of variance was used. RESULTS: A significant target location by group interaction effects was found for all variables except the center of pressure average velocity. All variables except center of pressure average velocity showed significant group differences. The center of pressure excursion and bilateral limb weight-bearing ratio were smaller, and the center of pressure average velocity was larger in stroke patients than in normal subjects. The effects of target location on variables measured were prominent in stroke patients. The posturography of stroke patients was less regular than that of normal subjects. Stroke patients tended to avoid shifting their center of pressure toward the affected side, even when highly necessary. CONCLUSIONS: The difference of postural actions between groups depended on task demands. Small center of pressure displacement and fast center of pressure velocity characterized decreased adaptive postural actions. The amount of center of pressure shift and center of pressure velocity were also dependent on the task demands for both groups.


Assuntos
Movimento/fisiologia , Equilíbrio Postural/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Abdome , Idoso , Estudos de Casos e Controles , Feminino , Pé/fisiologia , Humanos , Masculino , Pressão , Tórax , Extremidade Superior/fisiologia , Suporte de Carga/fisiologia
16.
Am J Occup Ther ; 63(4): 414-22, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19708470

RESUMO

We examined the psychometric properties (internal consistency, concurrent criterion validity, and known-group validity) of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) in people with intellectual disabilities. A total of 111 people with intellectual disabilities and 19 people with no disabilities were included. We used Cronbach's alpha, Spearman's rho, the Kruskal-Wallis test, and one-way analysis of variance for analysis, where appropriate. Results showed good internal consistency on Orientation, Visual Perception, Spatial Perception, Visuomotor Organization, and Thinking Operations subscales (Cronbach's alphas = .82, .74, .76, .86, and .80, respectively), but not on the Motor Praxis subscale (alpha = .48). We found significant correlations between participants' performance on the Pictorial IQ test and disability level and scores on the LOTCA. The known-group validity of the LOTCA in people with intellectual disabilities was satisfactory. We concluded that the LOTCA is a suitable instrument for measuring cognitive abilities and visual perception in people with intellectual disabilities.


Assuntos
Transtornos Cognitivos/diagnóstico , Testes de Inteligência , Pessoas com Deficiência Mental , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Terapia Ocupacional , Reabilitação Vocacional , Adulto Jovem
17.
Am J Phys Med Rehabil ; 86(10): 791-9, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17885311

RESUMO

OBJECTIVE: To evaluate whether the functional use of certain task objects while standing influences reaching performance and postural balance in persons with left or right cerebral vascular accidents, and also in healthy individuals. DESIGN: Thirty-five stroke patients (20 patients with left and 15 patients with right cerebral vascular accidents) and 31 healthy controls (15 using the left and 16 the right arm) performed two experimental reaching tasks (task object present vs. absent) using the less affected arm while standing. For the object-present task, subjects held a glass and moved it forward as far as possible. For the object-absent task, subjects simply reached forward as far as possible. We measured reaching performance using kinematic analysis and assessed postural control using derivatives of the center of pressure, including forward displacement, mediolateral shift, and average velocity. RESULTS: Object presence did not significantly improve overall reaching performance in any group. However, for patients with left cerebral vascular accidents and controls (using either the left or the right arm), there were significant effects of object presence on the average velocity of the center of pressure. For patients with right cerebral vascular accidents, there were significant effects of task object on the forward distance and average velocity of the center of pressure. CONCLUSIONS: The positive findings regarding center-of-pressure derivatives suggest that a functional use of objects during a standing reaching task can decrease postural sway, as represented by the average velocity of the center of pressure, in individuals with and without stroke. Patients with right cerebral vascular accidents may benefit considerably more from functional object use during a standing reaching task, apparently because such tasks can facilitate greater forward displacement of the center of pressure.


Assuntos
Destreza Motora , Equilíbrio Postural , Reabilitação do Acidente Vascular Cerebral , Adulto , Idoso , Análise de Variância , Fenômenos Biomecânicos , Estudos de Casos e Controles , Feminino , Lateralidade Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/fisiopatologia
18.
Am J Phys Med Rehabil ; 85(3): 201-8, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16505635

RESUMO

OBJECTIVES: To investigate whether whole-body reaching (WBR) could be a task with adequate and gradable dynamic balance challenges for stroke patients. DESIGN: A total of 23 subjects with hemiplegia, after their first stroke, participated in this study. The degree of dynamic balance challenges of WBR was graded by varying the distance to the targets that the subjects had to reach. A foot-pressure measurement system was used to measure the amount of center-of-pressure shift during performance of WBR and sit-to-stand transfer. The Berg Balance Scale (BBS) was administered, and the BBS total score was calculated. Static and dynamic BBS subscores were separately calculated to further understanding of the subject performance regarding balance. Paired t tests were used to examine the effects of target distance on center-of-pressure shift. Correlations between measures of center-of-pressure shift during performance of WBR and of sit-to-stand transfer, BBS total score, BBS static subscores, and BBS dynamic subscores and measures of center-of-pressure shift during performance of sit-to-stand transfer were analyzed. RESULTS: Significant effects of distance on three of the variables representing amount of center-of-pressure shift were found (P < 0.05). The correlations between WBR and sit-to-stand transfer were positive and moderate. The correlations between WBR and sit-to-stand transfer were stronger when the subjects were reaching for a closer target than when reaching for a farther target. The correlations between WBR and BBS total score were weak to moderate; the correlations between WBR and three scores of the BBS across target distance were inconsistent; and the correlations were higher when the subjects were reaching for a farther target than when reaching for a closer target. CONCLUSIONS: WBR for targets at different distances imposed graded dynamic balance challenges on stroke patients and might be an appropriate dynamic balance measure. However, WBR, as applied in this study, showed limitations in measuring the lateral dynamic stability of stroke patients.


Assuntos
Equilíbrio Postural/fisiologia , Propriocepção/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Avaliação da Deficiência , Feminino , Hemiplegia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
19.
Occup Ther Int ; 8(3): 168-183, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11823881

RESUMO

The need of a standardized evaluation tool for clinical practice is acknowledged by occupational therapists worldwide. The purpose of this study was to examine the inter-rater and test-retest reliabilities of the Taiwanese Rehabilitation Functional Scale (TaRFS) developed in Taiwan. Seventy-five subjects with varying diagnoses were recruited to participate in the study. They came from an inpatient re-habilitation unit within a university-affiliated hospital. All participants were tested on a functional measure of their independence on activities of daily living and cognitive-social tasks, and of their sense of well-being. The Activity of Daily Living (ADL) and CognitiveSocial Skills (CSS) subscales of the TaRFS were found to be reliable across raters and times. But individual items on the Subjective Well Being subscale were not stable across time. The results indicated that the ADL subscale as well as most items in the CSS subscale of the TaRFS can be utilized reliably in clinical practice. The SWB subscale of the TaRFS may need further revision in order to be used stably across time. The development of the TaRFS and future revision of the scale can be beneficial for occupational therapists in Taiwan to provide evidence of their intervention efficacy.

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