Methods of Goal-Setting in Rehabilitation of Adults with Physical Dysfunctions-A Scoping Review.

This scoping review utilized the JBI methodology to investigate methods of goal-setting used in the rehabilitation of adults with physical dysfunctions. Electronic databases were searched for articles published in the last 5 years. The inclusion of articles and data extraction were performed by two independent reviewers. Results were presented and synthesized numerically and thematically analyzed. Results suggest that goals should be client-centered and specific and long-term goals, should be complemented with medium and short-term goals. While various goal-setting methods are used in current practice, their full potential is often not realized due to improper implementation. Therefore, there is a need for educating clinicians to improve the goal-setting process and ensure its effectiveness.

Sensory Sub- and Suprathreshold TENS Exhibit No Immediate Effect on Postural Steadiness in Older Adults with No Balance Impairments.

Transcutaneous electrical nerve stimulation (TENS) has been reported to attenuate postural sway; however, the results are inconclusive, with some indicating the effect and others not. The study aimed to evaluate the effect of sensory sub- and suprathreshold low-frequency TENS applied through the plantar surface and posterior aspect of shanks on postural sway. In a group of healthy community-dwelling older adults, TENS was delivered with two different current intensities: (1) subsensory which is below conscious perception and (2) suprasensory threshold which is within the range of conscious perception. Frequencies of the TENS stimulation were sweeping from 5 to 180 Hz and were delivered through the plantar surface and posterior shanks of both legs. Postural sway was measured with a force platform in eyes-open and eyes-closed conditions. To evaluate potential fast adaptability to TENS stimuli, the results were evaluated in two time intervals: 30 seconds and 60 seconds. The results indicated that TENS with the chosen frequencies and electrode placement did not affect postural sway in both the sub- and suprathreshold intensities of TENS, in eyes-open and eyes-closed conditions, and in 30-second and 60-second time intervals. In conclusion, given that in this study sub- and suprathreshold TENS applied via the plantar surface of the feet did not attenuate postural sway, it would be easy to conclude that this type of electrical stimuli is ineffective and no further research is required. We must caution against this, given the specificity of the electrode placements. We recommend that future research be performed consisting of individuals with balance impairments and with different positions of electrodes.