Use of the Halstead Category Test as a cognitive predictor of functional recovery in the hemiplegic upper limb: a cross-validation study.

Current motor learning theory suggests that recovery in the hemiplegic upper limb partially depends on the client's cognitive ability to maximize sensory feedback in order to activate appropriate efferent motor pathways. Study 1 investigated the use of the Category Test as a predictor of functional recovery. Initial scores on the Upper Extremity Function Test and the Category Test explained 81% of the variance of the discharge Upper Extremity Function score (N = 29). Psychological factors such as the client's attitude and motivation were less significant than more direct measures of the biological event. Study 2 (N = 16) confirmed these results and also found that stroke survivors who made fewer errors on the Category Test performed better on a functional disability test. Survivors making the fewest errors on the Category Test also showed the greatest amount of change in arm and hand function. The results are discussed in terms of the role of cognitive and biological factors that might influence recovery.

The use of the Lanthony New Color Test in determining the effects of aging on color vision.

The primary purpose of this study was to collect data on the loss of color vision as a function of age. The Lanthony New Color Test (NCT), which measures acquired losses of color vision in the dimensions of hue, saturation, and brightness, was used to compile data on 68 subjects. The minimum number of subjects were 10 per decade from age 30 to 90 years. An age gradient of selective loss of discrimination of saturation beginning at age 50 was demonstrated, with rapid change noted after age 60. Similar findings were seen for hue but were not evident for brightness. By age 70, a neutral zone emerged at blue/purple, Munsell chroma level 2. The instrument was shown to be reliable and valid in comparison to the Farnsworth Dichotomous Panel D.15. It is seen that this information will provide a basis for planning safer, more functional environments for elderly people.

Stroke treatment: comparison of integrated behavioral-physical therapy vs traditional physical therapy programs.

This was a controlled study of the efficacy of two forms of therapy on upper limb functions of hemiparetic patients--one heavily behavioral and the other based on Bobath therapeutic exercises. It arose from an earlier pilot study comparing EMG biofeedback with physical therapy from which it was concluded that both the elapsed time since the acute stroke and the severity of residual disability were particularly important factors. Of 29 patients included and randomly assigned to one or the other heavily systematized therapies, 18 were classified as having early-severe and 11 as late-mild conditions. Multiple function tests by a "blinded" special technician in another location revealed that overall both forms of therapy obtained worthwhile clinical and statistical improvement, which was maintained at nine-month recheck testing; but there was no statistically significant superiority of one therapy over the other under the very specific circumstances of the research design. Ease of delivering care and other socioeconomic considerations become important factors in choosing either or both of these methods.