Interprofessional Education Through a Monthly Stroke Support Group.

AIMS: Interprofessional education (IPE) is an accreditation requirement in many health professional programs. A semester-long community-based stroke support group was designed with participation from faculty and health professional students in the occupational therapy, physical therapy, speech and language pathology, and therapeutic recreation programs. Objectives centered on measuring student perception of stroke and interprofessional collaboration. METHODS: A mixed-methodology using a concurrent triangulation design included a faculty developed pretest-posttest survey and focus group. The Student Perceptions of Interprofessional Clinical Education Revised (SPICE-R2) was given in the final two semesters. RESULTS: 45 students were involved in the program from 2016 to 2019. Findings were significant for all items on the pretest- posttest survey indicating students improved on their perception of stroke, the roles of other professions, and the value of interprofessional teamwork and team-based practice. Thematic analysis revealed that students identified the differences in stroke impact among participants and the importance of using a team approach in meeting participants' goals. CONCLUSION: Faculty and student participation in IPE delivery models coupled with perceived community benefit may positively impact program sustainability and improve student perceptions of interprofessional collaboration.

Walking speed questionnaire used to estimate gait speed in older adults: Comparisons with testing protocols and diagnostic accuracy.

BACKGROUND: Walking speed is an important clinical tool in the physical therapy examination of older adults, but not always feasible to measure. Clinicians may be limited by space, a client's functional limitations, or use of telehealth. The Walking Speed Questionnaire (WSQ) can be used to estimate walking speed, but the effects of testing protocols on the accuracy and diagnostic capability of the WSQ have not yet been investigated. OBJECTIVES: The purposes of this study were to compare estimated with recorded walking speed and examine effects of start condition and instructions in healthy older adults. METHODS: One hundred community dwelling adults 60 years or older were tested. After completing the WSQ, participants performed two trials of six walking conditions that included standing and walking starts under instructions to "walk at a usual pace," "as if crossing a street," and "fast." RESULTS: Participants averaged 72.4 (9.6) years of age. The WSQ average walking speed was 1.22 (0.16) m/s and was slower than each condition, p-value = 0.001, except for those performed with instructions to walk at usual pace with both standing, 1.23 (0.29) m/s and walking starts, 1.26 (0.30) m/s. Compared to the usual pace walking start condition, the WSQ sensitivity and specificity were 31% and 94% respectively with an 82% accuracy. A modified cutoff of the WSQ to 1.17 m/s improves sensitivity. CONCLUSIONS: If walking testing cannot be performed, the WSQ is a reasonable alternative providing an accurate estimate of a client's walking speed when walking at a usual pace.

Miller Fisher syndrome and Guillain-Barré syndrome: dual intervention rehabilitation of a complex patient case.

Purpose: Guillain-Barré syndrome (GBS) presents with acute peripheral neuropathy leading to ascending motor and sensory deficits. Miller Fisher syndrome (MFS), a GBS variant, is characterized by ophthalmoplegia, ataxia, and areflexia. In unusual cases, MFS and GBS overlap. The purpose of this case report is to illustrate the effects of an aquatic and land-based physiotherapy (PT) intervention on a patient with MFS-GBS.Case Description: A 57-year-old male physician was diagnosed with complex regional pain syndrome following a quadriceps muscle tear. Within 1 month, the patient experienced evolving motor, sensory, autonomic, and cranial nerve dysfunction and was diagnosed with MFS-GBS.Interventions: Five months post-onset, a 7-week intensive PT program was initiated including aquatic and land-based interventions.Outcomes: Following completion, functional improvements were demonstrated on the 6 Minute Walk Test, Timed-Up-and-Go, 10 Meter Walk Test and Short Form-36. However, 6 weeks after program completion, the patient had a recurrence.Conclusion: PT intervention demonstrated improvement in functional outcomes for a patient with a diagnosis of MFS-GBS. Complex patients lacking recovery within 6 months may benefit from continued rehabilitation. Other intervention approaches may need to be considered, including aquatic therapy.

Mice expressing a neutrophil elastase mutation derived from patients with severe congenital neutropenia have normal granulopoiesis.

Severe congenital neutropenia (SCN) is a syndrome characterized by an isolated block in granulocytic differentiation and an increased risk of developing acute myeloid leukemia (AML). Recent studies have demonstrated that the majority of patients with SCN and cyclic neutropenia, a related disorder characterized by periodic oscillations in the number of circulating neutrophils, have heterozygous germline mutations in the ELA2 gene encoding neutrophil elastase (NE). To test the hypothesis that these mutations are causative for SCN, we generated transgenic mice carrying a targeted mutation of their Ela2 gene ("V72M") reproducing a mutation found in 2 unrelated patients with SCN, one of whom developed AML. Expression of mutant NE mRNA and enzymatically active protein was confirmed. Mice heterozygous and homozygous for the V72M allele have normal numbers of circulating neutrophils, and no accumulation of myeloid precursors in the bone marrow was observed. Serial blood analysis found no evidence of cycling in any of the major hematopoietic lineages. Rates of apoptosis following cytokine deprivation were similar in wild-type and mutant neutrophils, as were the frequency and cytokine responsiveness of myeloid progenitors. The stress granulopoiesis response, as measured by neutrophil recovery after cyclophosphamide-induced myelosuppression, was normal. To define the leukemogenic potential of V72M NE, a tumor watch was established. To date, no cases of leukemia have been detected. Collectively, these data suggest that expression of V72M NE is not sufficient to induce an SCN phenotype or leukemia in mice.