<p> <b>Background:</b> The effect of trigger point dry needling (TDN) on myofascial trigger points (MTP) in Achilles tendinopathy are unknown. <b> Objectives:</b> To determine the feasibility of a large randomized controlled trial (RCT) to compare the effects of TDN to exercise in a patient population with Achilles tendinopathy. <b>Methods:</b> This single-factor, pretest-posttest control group design included 22 subjects between the ages of 24 and 65 years with Achilles tendinopathy. Subjects were randomly assigned to either a control group (MT+Ex) or experimental group (TDN+MT+Ex). Subjects in both groups completed 8 physical therapy treatment sessions over 4 weeks. The intervention for the TDN+MT+Ex group included TDN to MTPs in the gastrocnemius, soleus or tibialis posterior each session while the same soft tissue mobilization and exercise program was conducted in both groups. <b>Results:</b> Within group analysis was performed for each group at 4 week and 90 day follow up. Significant improvement (p &lt; .05) was achieved for FAAM, NPRS, pain pressure threshold and strength in both groups at 4 weeks and 90 days. The GROC was significant for MT + Ex at 90 days. The MCID for the FAAM, GROC were surpassed in both groups at 4 weeks and 90 days. NPRS surpassed the MCID for the MT + Ex group at 4 weeks. <b> Conclusion:</b> A large RCT to investigate the effects of TDN on MTP in Achilles tendinopathy is feasible with modifications. <b>Recommendations: </b> Special considerations for data collection sites should be given to the health care system, insurance payor, and financial burden to subjects.</p><p>

Literature in the area of play was surveyed, summarized, and organized. The historical approach was used for the collection of data for this study. Materials gathered were acquired through the sources provided by library services as well as current authorities in the field of play therapy. As the material was collected, the focus areas or sections began to naturally develop because of the commonality of the articles. The material found was divided into theory, approach, position, and research. The material found on theory and approach was organized into Chapter II. The material found on position and research was organized into Chapter III. Body movements of both child and therapist offer much research possibility. Since most of the child's language is nonverbal, it is critical that persons develop ways of evaluating and identifying his body signals. Research is needed on the potential use of every toy which is included in the playroom. Research is needed on the potential potency and effect of every type limit set within the play therapy process. Research is needed on the effect of the therapist on the process. Research is needed in reference to training models for the development of play therapy skills in professionals, paraprofessionals, and parents.

<p> Using a semi-structured qualitative methodology, this study examines the symbolic and interactional abilities of preschool children with moderate to severe language impairment and of typically developing preschoolers and how they compare within the context of joint-reminiscing with a parent. Patterns of interaction were identified across three frames of analysis including, children&rsquo;s contributions to reminiscing, breakdowns in orientation to shared past events, and breakdowns in conversation format. The analysis describes how participants in both group are negotiating event-related meanings, conversational expectations, and stances in time throughout reminiscing conversations. The results point to the same underlying mechanisms giving rise to these negotiations for both groups and provide demonstrations of how parents can facilitate and support such negotiations.</p><p>

A handful of studies have examined children's perception of clear speech in the presence of background noise. Although accurate vowel perception is important for listeners' comprehension, no study has focused on whether vowels uttered in clear speech aid intelligibility for children listeners. In the present study, American-English (AE) speaking children repeated the AE vowels /ε, æ, ɑ, ʌ/ in the nonsense word /gəbVpə/ in phrases produced in conversational and clear speech by two female AE-speaking adults. The recordings of the adults' speech were presented at a signal-to-noise ratio (SNR) of -6 dB to 15 AE-speaking children (ages 5.0-8.5) in an examination of whether the accuracy of AE school-age children's vowel identification in noise is more accurate when utterances are produced in clear speech than in conversational speech. Effects of the particular vowel uttered and talker effects were also examined. Clear speech vowels were repeated significantly more accurately (87%) than conversational speech vowels (59%), suggesting that clear speech aids children's vowel identification. Results varied as a function of the talker and particular vowel uttered. Child listeners repeated one talker's vowels more accurately than the other's and front vowels more accurately than central and back vowels. The findings support the use of clear speech for enhancing adult-to-child communication in AE, particularly in noisy environments.

Thesis (M.A.(Community-Based Counselling Psychology))--University of the Witwatersrand, Faculty of Humanities, 2013. / The amount of research that examines adherence to antiretroviral treatment is now immeasurable. However, research on understanding the subjective experiences of men who have sex with men (MSM) and living with HIV while taking antiretroviral therapy remains limited. This research uses a qualitative methodology, using semi-structured interviews, carried out on nine participants who frequently use a Johannesburg support group aimed at MSM living with HIV. The time period of these men living with HIV and taking antiretroviral therapy varied from a number of months to many years. The interviews were audio-recorded and transcribed. In terms of analysis, thematic content analysis was used identified the enablers and barriers to treatment adherence. These were broken into biopsychosocial factors with the main outcomes of this research suggesting that adherence is complex and influences are far beyond just biological. The majority of the elements raised by the participants indicate the significance of psychological and social factors. This makes the development of adherence interventions aimed at MSMs more detailed than simply following medical provider directions. There appeared to be consensus that although some participants of this research would prefer to not take antiretroviral therapy because of the side-effects, the alternative for them was something that they wanted to consider, such as illness and death. The belief that the medication is keeping them healthy, improving quality of life and allowing them to focus on day-to-day living seemed to dominate over the psychological effects of the condition or the medication in terms of adherence. Because of the way that HIV is perceived within society, the threat of discrimination is real and for many of the participants shape the way they see themselves, the world and this in turn guides their thinking when it comes to issues, especially with disclosure. Above all, this research explores the antiretroviral adherence factors specifically associated to MSM.

abstract: Dementia is a syndrome resulting from an acquired brain disease that affects many domains of cognitive impairment. The progressive disorder generally affects memory, attention, executive functions, communication, and other cognitive domains that significantly alter everyday function (Quinn, 2014). The purpose of this research was to gather a systematic review of cognitive-communication assessments and screeners used in assessing dementia to assist in early prognosis. From this review, there is potential in developing a new test to address the areas that people with dementia often have deficits in 1) Memory, 2) Attention, 3) Executive Functions, 4) Language, and 5) Visuospatial Skills. In the field of speech-language pathology, or medicine in general, there is no one assessment that can diagnose dementia. Additionally, this review will explore identifying speech and language characteristics of dementia through speech analytics to theoretically help clinicians identify early signs of dementia. / Dissertation/Thesis / Masters Thesis Communication Disorders 2019

The purpose of this study was to investigate relationships between performance by children on computerized rehabilitation tasks, age and standardized assessment instruments. It was hypothesized that children's performance would differ by age on standardized assessment instruments and computer tasks developed for rehabilitation of attention, visual/perceptual and visual memory skills.;Two hundred five children from three schools in Chesapeake, Virginia, completed the Benton Visual Retention Test - Administration C, the Trail Making Test (B), and six computer tasks. Significant correlation was found between age, and both assessment instruments as well as five of the computer tasks. Standardized instruments correlated with one of each type of computer task for attention, visual/perceptual and visual memory skills. Additionally, correlation was found between one computer program and the Trail Making Test for visual/perceptual skills.;Further study is needed to develop standardization of these computer tasks for use rehabilitation of attention, visual/perceptual and memory skills dysfunction.

Low back pain is a common but severe health problem. Chronic low back pain accounts for the bulk of the burden of low back pain. Exercise interventions are effective in the management of chronic low back pain. Current clinical thinking in physical therapy treats low back pain as a heterogeneous entity seeking to match specific interventions to subpopulations. None of these subgroups assess the role of gluteus medius dysfunction in chronic low back pain. These projects seek to describe the prevalence of gluteus medius weakness in people with chronic low back pain and test the effectiveness of a gluteus medius strengthening exercise intervention in people with chronic low back pain. Gluteus medius strength was assessed in 150 people seeking care for chronic low back pain and 75 healthy people without low back pain. Gluteus medius was found to be weaker on affected sides compared to unaffected sides within people with chronic low back pain and weaker than people without low back pain. Gluteus medius weakness was a strong predictor of the presence of low back pain. A gluteus medius strengthening program was compared with lumbar stabilization exercises in 56 people with chronic low back pain. Although there was a clinically significant improvement in pain in people who performed the gluteus medius strengthening exercise program, this was not significantly different from the stabilization exercise intervention. Adherence to exercise was significantly correlated with reduction in pain and perceived improvement of low back pain. Although gluteus medius weakness is common in people with low back pain and treating this weakness with a targeted exercise intervention is effective, it is not better than a standard stabilization exercise intervention. Doing exercise is likely more important than what exercise is done.

Injury occurs when people are exposed to an unexpected event. There is a knowledge gap regarding whether people can learn to respond to unexpected events and whether this learning is moderated by age, physical activity level, cognitive function, and motor cortical excitability. The purpose of this research was to examine the influence of: 1) age, 2) physical activity, 3) cognitive function, and 4) motor cortical excitability on motor performance and learning during a novel visual motor task of the wrist. The major outcomes of this research revealed that the ability to respond to unexpected events is reduced with age; however, with practice, older people retain the capacity to learn to respond to unexpected events. This work also demonstrates that elderly people use both feed-forward and feedback strategies to improve their response to unexpected events. Conversely, young people predominantly use a feed-forward strategy to improve their ability to respond to an unexpected event. Importantly, active older people show greater capacity to respond to unexpected events and to learn to improve responses than less active older people. Older people with higher cognitive function demonstrate a greater capacity to respond to unexpected events than those with lower cognitive function. Furthermore, merely increasing motor cortex excitability does not translate into improved performance after young people have learned a motor task. Taken together, age, physical activity, and cognitive function impact human performance and the capacity to learn to respond to unexpected events. These findings have important implications as to how to rehabilitate and/or prevent injury to unexpected events in older people.

Approximately 20% of the general population is affected by a vestibular disorder. Vestibular dysfunction is recognized as an important intrinsic factor leading to falls. Despite research on balance strategies with platform perturbations, limited information exists on neuromuscular performance of the knee with perturbations during functional tasks. Improved understanding of the effects of BVL on neuromuscular control of the knee will aid researchers and clinicians in developing rehabilitation programs that address the adaptations and balance deficits that occur with vestibular loss. Hence, the main purpose was to examine accuracy of performance, knee muscle activation patterns and long latency responses in response to unexpected perturbations during a controlled single leg squat in healthy individuals and those with bilateral vestibular loss (BVL). The first study provided information about the ability to improve performance accuracy with perturbations based on the feedback available. It also showed concomitant changes in the LLR of quadriceps muscles with learning. In the second study, it was found that competent subjects with BVL show similar performance accuracy as healthy individuals during the SLS, with the exception of endpoint error. Muscle strategies are slightly different and vary on firm and foam surfaces. A significant finding was that the LLR is reduced in this group in response to unexpected perturbations, especially when visual feedback is absent. Rehabilitation and/or time living with bilateral vestibular deficiency can lead to a reorganization of the central nervous system, which may partly explain the alterations in neuromuscular control. More research is needed to determine the relationship between the long latency response and fall risk and if different training dosages with perturbations affect these in both healthy and vestibular-deficient populations.