The author examined current literature supporting the use of innovative, music-based interventions to support young children with autism spectrum disorder and other developmental disabilities engage in the things that they want, need, and desire to do. The author introduced Song-based Interventions for Navigating Gains in Occupational Therapy (SING-OT), as an innovative, music-based educational intervention program designed to support the engagement, participation, and performance needs of young children with disabilities. SING-OT uses an evidenced-supported, client-centered, and interests and strengths-driven approach. This proposed multi-phase program focuses on improving knowledge on the literature connecting evidence to song-based interventions and providing access to uniquely composed, occupation-inspired songs, that support children’s performance and participation needs. Additionally, conducting an initial feasibility study that assesses the effectiveness of task completion in a common personal hygiene and grooming task within the preschool setting was recommended. Future developments extend to improving caregiver health and wellness outcomes through training opportunities. The author provided a comprehensive program evaluation plan that highlights key stakeholders, a proposal for a single-subject study design, and implications of the program. The SING-OT program can be utilized as (1) an additional intervention tool for practicing occupational therapy practitioners and other professionals, (2) an avenue for interprofessional collaboration, and (3) a vehicle for improving the occupational performance outcomes among young children with disabilities.

Objectives The purpose of this systematic review was to investigate the effectiveness of video prompting and modeling with handheld devices/mobile technology to increase the ability of individuals with ID to engage in daily living skills. Methods A comprehensive systematic search in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards to identify relevant experimental studies utilizing video prompting or modeling on handheld devices to teach daily living skills for individuals with ID was conducted. Results Twenty-four SCRD studies met criteria for inclusion involving 64 participants with varying levels of ID with 79% (N = 19) of studies involving domestic skills (e.g., cleaning, cooking, doing laundry), and 21% (N = 5) involving community skills; 75% (N = 18) used video prompting, 21% (N = 5) used video modeling, and 4% (N = 1) used both. Conclusions Effect sizes and visual analysis indicated that video prompting or modeling through handheld devices were effective in teaching daily living skills to individuals with ID. Future research for this population should include studies to teach personal skills (e.g., dressing, grooming, toileting) as there were no studies in this domain.

Research has demonstrated that everyday functional abilities are compromised in mild cognitive impairment (MCI), a transitional stage between normal cognitive aging and dementia, as well as in healthy aging. These functional changes have been shown to be strong predictors of future decline, highlighting their importance. However, early changes in everyday functioning remain poorly characterized, largely due to a scarcity of sensitive measures capable of detecting subtle disruption. Recent research suggests that eye-tracking methodology may be effective in addressing this gap. Fifty-two participants (27 younger adults and 25 non-demented older adults) completed a novel eye-tracking task involving passive viewing of a naturalistic scene and verbalization of a task goal (e.g., make coffee, pack a lunch). Participants also completed a performance-based measure of everyday action that required them to enact the same tasks (e.g., coffee, lunch) that were included in the eye-tracking paradigm, self-report measures of functional ability, and neuropsychological measures. Mixed ANOVAs were conducted to examine group (young, old) and condition (passive viewing, verbalization)/task (simple, complex) effects on eye-tracking and everyday action performance. Independent samples t-tests/Mann-Whitney U tests were conducted to examine group differences in eye-tracking and everyday action performance. Correlation analyses across all measures were conducted to evaluate the potential mechanisms of eye-tracking and everyday action results. Results showed no significant group differences in the primary eye-tracking variables, but both groups made a lower proportion of fixations to distractor (i.e., non-target) objects during task verbalization compared to passive scene viewing. Older adults made more inefficient actions during performance-based everyday task completion, particularly when task demands were high. Eye tracking and everyday action variables were related to different measures of self-reported functional ability. Finally, eye-tracking variables were primarily related to neuropsychological measures of executive functions/working memory, whereas everyday action performance was most strongly related to measures of verbal learning and memory. These findings suggest that age-related functional changes at the level of eye movements may occur after changes in behavioral performance of everyday tasks. Importantly, performance-based assessment of everyday action appears sensitive to age-related decline. Additionally, naturalistic eye movements and everyday task performance may reflect distinct components of self-reported functioning and may be driven by distinct cognitive processes. Future research with refined naturalistic eye-tracking tasks and samples with a wider range of impairment is necessary to further explore these findings and improve characterization and detection of risk for dementia. / Psychology

This study examined the role of health care access and health care resources in the association between subjective aging and activities of daily living among older adults. We examined subjective aging in the context of subjective cognitive decline (SCD) relationships in three studies: (1) a scoping review of healthcare access (HCA) and resources (HCR) on dementia and COVID-19 among African American older adults; (2) subjective cognitive decline in basic activities of daily living (bADL) across age cohorts, older adults and (3) subjective cognitive decline in instrumental activities of daily living (IADL) across older adults' moderation by HCA and mediation by HCR. For the scoping review, we utilized the population, concept, and context inclusion and exclusion criteria for study admissibility for articles published on dementia and COVID-19 studies in English language journals that published from January 2019 to December 2022. The two empirical studies utilized the 2021 round 11 of the National Health and Aging Trends dataset of older adults aged 70 to above 90 funded by the National Institute for Aging. We employed multiple regression and the bias-corrected percentile Bootstrap with 5000 samples using standard path-analytic approaches for the moderated-mediation approach for the two empirical studies. Findings from the scoping review indicated racial and age disparities affected older African American adults with dementia and COVID-19, associated with lower HCA and marginal HCR. Results of mediation–moderation analysis showed SCD, lower HCR, and HCA predict a decline in bADL to be higher among the older-old age (80-89) compared to the middle-old age (70-79) or oldest-old (90 years +) cohorts. We observed similar effects for IADL. The findings from the two empirical studies suggest a "doughnut" effect by which the older-old age cohort of 80-89 may be coping less well with their bADL, as well as IADL, while the oldest-old may have adapted to functional loss in their everyday living and/or comprises adults who may have passed a mortality selection despite a more significant burden of comorbidity.

Wearable sensors and systems have become increasingly popular for diverse applications. An emerging technology for physical activity assessment is Smart Textile Systems (STSs), comprised of sensitive/actuating fiber, yarn, or fabric that can sense an external stimulus. All required components of an STS (sensors, electronics, energy supply, etc.) can be conveniently embedded into a garment, providing a fully textile-based system. Thus, STSs have clear potential utility for measuring health-relevant aspects of human activity, and to do so passively and continuously in diverse environments. For these reasons, STSs have received increasing interest in recent studies. Despite this, however, limited evidence exists to support the implementation of STSs during diverse applications. Our long-term goal was to assess the feasibility and accuracy of using an STS to monitor human activities. Our immediate objective was to investigate the accuracy of an STS in three representative applications with respect to occupational scenarios, healthcare, and activities of daily living. A particular STS was examined, consisting of a smart socks (SSs), using textile pressure sensors, and smart undershirt (SUS), using textile strain sensors. We also explored the relative merits of these two approaches, separately and in combination. Thus, five studies were completed to design and evaluate the usability of the smart undershirt, and investigate the accuracy of implementing an STS in the noted applications. Input from the SUS led to planar angle estimations with errors on the order of 1.3 and 9.4 degrees for the low-back and shoulder, respectively. Overall, individuals preferred wearing a smart textile system over an IMU system and indicated the former as superior in several aspects of usability. In particular, the short-sleeved T-shirt was the most preferred garments for an STS. Results also indicated that the smart shirt and smart socks, both individually and in combination, could detect occupational tasks, abnormal and normal gaits, and activities of daily living with greater than 97% accuracy. Based on our findings, we hope to facilitate future work that more effectively quantifies sedentary periods that may be deleterious to human health, as well as detect activity types that may be help or hinder health and fitness. Such information may be of use to individuals and workers, healthcare providers, and ergonomists. More specifically, further analyses from this investigation could provide strategies for: (a) modifying a sedentary lifestyle or work scenario to a more active one, and (b) helping to more accurately identify occupational injury risk factors associated with human movement. / PHD / The use of interactive or “smart” textiles that have sensing material(s) incorporated into them supports an emerging technology for physical activity assessment called Smart Textile Systems (STSs). STSs are an increasingly useful technology for researchers, athletes, patients, and others. Our aims in the current study were the development and assessment of a new smart undershirt (SUS) that was designed to monitor low-back and shoulder motions, and to evaluate the preferred placement and usability of two STSs. We also assessed the accuracy of two smart garments, smart socks (SSs) and the SUS, both individually and in combination. Accuracy was evaluated in terms of the ability of these systems to distinguish between diverse simulated occupational tasks, normal and abnormal walking patterns, and several typical daily activities. Our investigation indicated that STSs could discriminate between different human activities common in three domains: occupational scenarios, healthcare, and activities of daily life. We also found that both smart garments (i.e., SSs and SUS) provided similar accuracy for activity classification, typically exceeding 97%, and thus there was no clear superiority between these two smart garments. We conclude that, overall, smart garments represent a promising area of research and a potential alternative for discriminating and monitoring a range of human activities. Use of this technology in the future may have positive implications for health promotion.

This investigation examined the ability of the self-reported Veterans Specific Activity Questionnaire (VSAQ) and the Yale Physical Activity Survey (YPAS) to predict an individual’s performance on a timed walking assessment. Twenty subjects 65 years of age and older (73.5 ± 4.8) volunteered for the study. There were 13 women and nine men. Subjects participated in an individual interview in which the VSAQ and the YPAS were administered. The subjects then participated in a timed 25 meter walking test (16.5 ± 2.5). The 25 meter walking test was given twice and the times for each individual was averaged. Descriptive analysis of the YPAS demonstrated that the predominant reported level of energy expenditure was used for work activities (50% ± 18.4). The least amount of calories for the entire group was expended in caretaking with a mean percentage of 3.3% (± 6.1). Exercise was the second highest calorie expending category with 21.9% (± 14.0) of total calories. However, recreational activities were a close third with a mean of 17% (± 19.0). Yard work represented 7.8% (± 7.8) of total calories. The mean score for the VSAQ was 7.4 (± 3.4). The regression analysis demonstrated that age, gender, and VSAQ score were significant predictors of physical performance on the walking test (p<0.05) (Time= -1.78 +0.274 Age +2.22 Gender - 0.366 VSAQ). The r-squared value for this was 62.5%. Performance time was significantly predicted by adding the selected values from the YPAS (exercise and work) and the value from the VSAQ (Time= 18.5 - 0.566 VSAQ +0.0568 %Exer + 0.0350 %Work). The r-squared value for this was 52.6%. There was also a significant correlation (p<0.05) between age, time, and performance (r²=0.5). Therefore, the VSAQ appears to be an alternative assessment tool for physical activity in this selected elderly population. / Master of Science

Yes / Objectives: To determine whether individual goal-oriented cognitive rehabilitation (CR) improves everyday functioning for people with mild-to-moderate dementia. Design and methods: Parallel group multi-centre single-blind randomised controlled trial (RCT) comparing CR added to usual treatment (CR) with usual treatment alone (TAU) for people with an ICD-10 diagnosis of Alzheimer’s, vascular or mixed dementia and mild-to-moderate cognitive impairment (MMSE score ≥ 18), and with a family member willing to contribute. Participants allocated to CR received ten weekly sessions over three months and four maintenance sessions over six months. Participants were followed up three and nine months post-randomisation by blinded researchers. The primary outcome was self-reported goal attainment at three months. Secondary outcomes at three and nine months included informant-reported goal attainment, quality of life, mood, self-efficacy, and cognition, and study partner stress and quality of life. Results: We randomised (1:1) 475 people with dementia; 445 (CR=281) were included in the intention to treat analysis at three months, and 426 (CR=208) at nine months. At three months there were statistically-significant large positive effects for participant-rated goal attainment (d=0.97, 95% CI 0.75 to 1.19), corroborated by informant ratings (d=1.11, 0.89 to 1.34). These effects were maintained at nine months for both participant (d=0.94, 0.71 to 1.17) and informant ratings (d=0.96, 0.73 to 1.2). The observed gains related to goals directly targeted in the therapy. There were no significant differences in secondary outcomes. Conclusions: Cognitive rehabilitation enables people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy. / National Institute for Health, Health Technology Assessment Programme, Grant/Award Number: 11/15/04

Background Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living. Therefore, the aim of our study is to compare the effects of an additional physiotherapy programme with systematically augmented levels of mobilisation with additional in-bed cycling (as the parallel group) on walking and other activities of daily living.

OF DIPLOMA THESIS Name and surname: Bc. Lia Medková Thesis supervisor: MUDr. Yvona Angerová, Ph. D., MBA Referee: Title thesis: The effect of sensation disorders on upper limb function in patients after brain injury Abstract The aim of this thesis was to determine The effect of sensation disorders on upper limb function in patients after brain injury. Method: The research for this thesis involved non-experimental pre-research and quasiexperiments. The thesis' theoretical hypothesis was developed on the basis of previous studies that had looked at the effect of brain damage on patients' upper limb function. A total of twenty patients between the ages of 20 - 59 were selected to participate in the empirical study reported in this thesis. All participating patients had suffered damage to their cerebral cortex. The causes of their brain damage included strokes, trauma and tumor. The participants were divided into two groups of ten using the Nottingham Sensory Assessment. Participants with sensory disorders were allocated to the experimental group. Participants without sensory disorders were placed in the control group. The Jebsen-Taylor test was performed on all participants to assess their upper limb function after they had suffered brain damage. Results: Hypothesis thesis: Disorders of superficial,...

Thesis (Ph.D. (Physiotherapy))--University of the Witwatersrand, Faculty of Health Sciences, 2013. / Stroke impacts on a survivor’s ability to participate in community activities such as return to work (RTW) and affects people who are still within the working age. Return to work contributes to life satisfaction and social identity at least partly through independence gained from income-generation. The impact of RTW programmes for stroke survivors is limited and not generalisable to South Africa. This study aimed to bridge this gap in South Africa, and was conducted within the Gauteng province as it comprises the largest share of the South African population. Objectives and Methodology: The aim of the study was to determine the current practice in RTW intervention programmes for stroke survivors in the Gauteng Province of South Africa and to establish the effect of a workplace intervention programme on the rate of RTW of previously employed stroke survivors. This study had two stages: Stage one: A cross sectional survey was performed using a self administered questionnaire to establish current practice in RTW intervention programmes and the therapists’ perceived barriers and enablers of RTW after stroke. Stage two study included: a) a randomised controlled trial (RCT) to evaluate a six week RTW intervention, with follow-up at three and six months. The workplace intervention programme was tailored according to the functional ability and workplace challenges of each stroke survivor and was as follows: Week one: Assessment for work skill. The assessment included work modules which identified potential problems such as: visual discrimination; eye hand coordination; form and spatial perception; manual dexterity; colour discrimination; cognitive problems, and job specific physical demand factors. Week two: The therapist interviewed the stroke survivor and employer separately to establish perceived barriers and enablers of RTW. This was followed by a meeting between the therapist, stroke survivor and employer/supervisor to discuss and develop a plan to overcome identified barriers and to strengthen identified enablers based on consensus between stroke survivor and employer. Week three: A work visit for the stroke survivor to demonstrate what they did at work and identify what they could still do safely and what they could not do. This included vocational counselling and coaching; emotional support; adaptation of the working environment; advice on coping strategies to compensate for mobility and upper limb functional limitations; and fatigue management. Weeks four, five and six: continuation of the work visits, while monitoring progress, and making necessary adjustments as per stroke survivor and employer’s needs. This was done at the workplace while the participants continued with their usual therapy at the hospital. The control group received usual care. The primary outcome was RTW rate. The secondary outcomes included activities of daily living (measured with the Barthel Index); mobility (measured with the Modified Rivermead Mobility Index); basic cognitive function (measured with the Montreal Cognitive Assessment) and perceived quality of life (measured with the Stroke Specific Quality of life Scale). Another aim of stage two study was to: b) establish the stroke survivors’ and employers’ perceived barriers and enablers of RTW (this was done with the experimental group only); and to: c) identify predictors of RTW. Stage one study results: Thirty six (68%) of the 53 questionnaires sent to stroke rehabilitation facilities were returned. Seventeen (47%) of the 36 clinical settings referred stroke survivors to facilities offering RTW services; 12 (33%) facilities did not refer stroke survivors for RTW and did not offer RTW services; and seven (20%) facilities offered RTW services. Of the seven facilities that rendered RTW services for stroke survivors, five (71%) communicated with the employer to discuss reasonable accommodation and four (57%) did assessments for potential to RTW. The most common reason given by the 29 facilities for not offering RTW services was that they referred stroke survivors to other therapists who offered these services. The second most common reason was the unemployment status of the stroke survivor at the time of having stroke. The therapists’ most commonly perceived barriers of RTW were the severity of the stroke survivors’ physical impairments (n = 3) (36%) and their employment status (n = 11) (31%) at the time of having stroke. The most commonly perceived enablers were willingness of the employer to reasonably accommodate the stroke survivor at work (n = 12) (33%), family support (n = 8) (22%) and increased length of hospital stay to allow for intensive rehabilitation (n = 7) (19%). Stigma in the workplace was the only variable which had a statistically significant relationship with the type of clinical facility therapists worked at (p = 0.02). Stage two study results: The average age for the study group was 45 (SD: 8.7) years and the average stroke duration was 4.6 (SD: 1.8) weeks. There were 41 (51%) male stroke survivors and 39 (49%) female stroke survivors. Majority (55%) of the stroke survivors were breadwinners (63%), had a grade 11 to 12 educational level (64%), an income above R5000 (46%) and had a helper (74%) whom they did not have to pay (81%). Stroke survivors who returned to work had better quality of life at six months after stroke than those who did not RTW (p = 0.05). Results from the qualitative study indicated that the perceived enablers of RTW included: ability of the employer to provide reasonable accommodation and good interpersonal working relationships between stroke survivor, employer and co-workers. The perceived barriers of RTW included: unaffordable reasonable accommodation costs; inaccessible transport; having cognitive (memory and attention) and speech impairments and high unemployment rates. The overall RTW rate was 20% at three months follow-up and 40% at six months follow-up. Twenty seven percent of the stroke survivors in the intervention group returned to work at three months compared to 12% in the control group (p = 0.13). At six months, the majority of stroke survivors (60%) in the intervention group returned to work compared to 20% in the control group (p <0.001). The following factors were predictive of RTW: male gender (p = 0.03); fewer speech problems (p = 0.02); increased time off work post stroke (p = 0.001); ability to perform activities of daily living (p = 0.02); good mobility (p = 0.01) and good cognitive ability (p = 0.02). The stroke survivors in the intervention group were 5.2 times more likely to RTW than those in the control group at six months following stroke, and for every unit increase in the activities of the Barthel Index and Montreal Cognitive assessment score, the likelihood of RTW increased by 1.7 and 1.3 respectively. Conclusion: A RTW intervention consisting of workability assessments and workplace visits was effective in facilitating RTW for stroke survivors in Gauteng province, South Africa. Key predictors of RTW included male gender; increased time off work post stroke; ability to perform activities of daily living; good mobility and good cognitive ability and were identified as facilitating RTW; speech problems were identified as barriers to RTW. Overall, these results suggest the need to direct resources towards increasing work place intervention strategies after stroke.