Aims
The aim of this review is to synthesize and evaluate effectiveness of exergaming on balance, lower limb functional mobility and functional independence in individuals with chronic stroke.
Design
...The present review is a systematic review and meta‐analysis. The review is written in accordance with the guidelines from the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA)
Data Source
Searches were conducted across seven databases (PubMed, EMBASE, Web of Science, CINAHL, CENTRAL, Scopus and PEDro) and in grey literature from inception until January 2021.
Review Methods
Only randomized controlled trials (RCTs) written in English were included. All eligible studies were assessed for risk of bias by two reviewers independently. Meta‐analyses were performed using RevMan 5.4.1 software. Narrative syntheses were adopted whenever meta‐analysis was inappropriate. The overall quality of evidence from included studies was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.
Results
4511 records were retrieved, with 32 RCTs eligible for inclusion and 27 RCTs included in meta‐analysis. Meta‐analyses reported statistically significant small effect sizes favouring exergaming on balance (pooled standardized mean difference SMD = 0.25, 95% confidence interval CI, 0.08–0.41, p = .004), lower limb functional mobility (pooled SMD = 0.29, 95% CI 0.08–0.50, p = .007) and functional independence (pooled SMD = 0.41, 95% CI 0.09–0.73, p = .01). Most of the included studies failed to provide adequate description of the measures taken to prevent bias.
Conclusion
Exergaming has favourable effects on improving balance, lower limb functional mobility and functional independence among individuals with chronic stroke, making it a suitable adjunct to conventional physiotherapy.
Impact
People with chronic stroke have difficulty achieving the required rehab intensity. Exergaming can help individuals with chronic stroke to undertake further rehabilitation exercises at home. It can be a suitable adjunct to conventional physiotherapy.
Victime d’un accident du travail, Monsieur M. s’est vu attribuer un taux d’incapacité permanente partielle de 8 % par la sécurité sociale. Estimant que ce taux ne correspondait pas à la réalité de ...ses séquelles, il a saisi le Tribunal, lequel a missionné un kinésithérapeute expert judiciaire. Pour fonder sa réponse, l’expert a pris en considération non seulement les déficits d’amplitude analytiques, mais également leur répercussion sur la fonction et les conséquences des douleurs séquellaires.
Cognitive impairments figure prominently in COVID-19 survivors. Cognitive remediation therapy (CRT) improves functional outcomes reducing long-term cognitive deficits in several neurological and ...psychiatric conditions. Our case-control study investigates the efficacy of a CRT programme administered to COVID-19 survivors in the post-acute phase of the illness. Seventy-three COVID-19 survivors presenting cognitive impairments at one-month follow-up were enrolled. Among them, 15 patients were treated with a two-month CRT programme, and 30 non-treated patients were matched conditional to their baseline cognitive functioning. Cognitive functions were assessed before and after treatment. Depression and quality of life were also evaluated. Mixed model ANOVA revealed a significant effect over time of the CRT programme on global cognitive functioning (F = 4.56, p = 0.039), while no significant effect was observed in the untreated group. We observed a significant effect of the improvement in verbal fluency (χ
2
= 7.20, p = 0.007) and executive functions (χ
2
= 13.63, p < 0.001) on quality of life. A positive significant correlation was found between depressive symptomatology and verbal fluency (r = −0.35), working memory (r = −0.44), psychomotor coordination (r = −0.42), and executive functions (r = −0.33). Our results could pave the way to a plausible innovative treatment targeting cognitive impairments and ameliorating the quality of life of COVID-19 survivors.
Research on Criterion A of the alternative model for personality disorders is recently expanding and provides mixed results concerning the unidimensional operational definition of severity by the ...model, characterized by impaired self (identity and self-direction) and interpersonal (empathy and intimacy) functioning. Studies resulted in one, as well as two or more factor structures. The present study demonstrated the importance of the structural and relational differentiation of self and interpersonal dimensions of personality functioning. One thousand seventy-four participants (community and clinical mixed sample) completed the Level of Personality Functioning Scale - Brief Form 2.0 (LPFS-BF 2.0), the Personality Inventory for DSM-5 Short Form and the Questionnaire for the World Health Organization Disability Assessment. An LPFS-BF 2.0 two-factor structure with self and interpersonal functioning factors was corroborated by confirmatory factor analyses and bifactor modeling. Joint Exploratory Factor Analysis of the LPFS-BF 2.0 domains with maladaptive personality domains clearly differentiated the personality functioning factors. While the self-functioning factor was more closely linked to negative affect (and to disinhibition and psychoticism), the interpersonal functioning factor connected to detachment. Self-functioning predicted functional impairment along and beyond personality domains. The LPFS-BF 2.0 appears a useful tool for clinical routine monitoring of both self and interpersonal functioning.
Cross-sectional, longitudinal, and genetic associations exist between irritability and depression. Prior studies have examined developmental trajectories of irritability, clinical outcomes, and ...associations with child and familial depression. However, studies have not integrated neurobiological measures. The present study examined developmental trajectories of irritability, clinical outcomes, and cortical structure among preschoolers oversampled for depressive symptoms.
Beginning at 3 to 5 years old, a sample of 271 children enriched for early depressive symptoms were assessed longitudinally by clinical interview. Latent class mixture models identified trajectories of irritability severity. Risk factors, clinical outcomes, and cortical thickness were compared across trajectory classes. Cortical thickness measures were extracted from 3 waves of magnetic resonance imaging at 7 to 12 years of age.
Three trajectory classes were identified among these youth: 53.50% of children exhibited elevated irritability during preschool that decreased longitudinally, 30.26% exhibited consistently low irritability, and 16.24% exhibited consistently elevated irritability. Compared with other classes, the elevated irritability class exhibited higher rates of maternal depression, early life adversity, later psychiatric diagnoses, and functional impairment. Further, elevated baseline irritability predicted later depression beyond adversity and personal and maternal depression history. The elevated irritability class exhibited a thicker cortex in the left superior frontal and temporal gyri and the right inferior parietal lobule.
Irritability manifested with specific developmental trajectories in this sample enriched for early depression. Persistently elevated irritability predicted poor psychiatric outcomes, higher risk for later depression, and decreased overall function later in development. Greater frontal, temporal, and parietal cortical thickness also was found, providing neural correlates of this risk trajectory.
Highlights • The value of geriatric assessments in head and neck cancer is not evaluated yet. • Geriatric domains were prevalent in the head and neck cancer population. • Most studies had an ...association of a geriatric assessment with adverse outcomes. • None of the studies reported frailty or physical capacity with adverse outcomes.
Background
Refugee children might have experienced violent and traumatic events before settling into a new country. In the United Kingdom, the number of refugee children is increasing; however, ...little is known about their psycho‐social and physical well‐being.
Aim
This study aims to investigate the psychological well‐being and behaviour of refugee children compared to British‐born children on a number of psychological, social, behavioural, and health‐related issues and to investigate the role of friendship as a protective factor.
Samples
This study utilized a sample of 149 refugee children recruited from two charities, 79 of which are children aged 6–10 years and 70 older refugee children aged 11–16 years. The study also included 120 non‐refugee children recruited from primary schools aged 6–10 years.
Methods
This is a cross‐sectional study that investigates the psycho‐social well‐being of refugee children compared to non‐refugee British‐born children. The study explored symptoms of posttraumatic stress disorder, emotional and behavioural problems (Strengths and Difficulties Questionnaire), self‐esteem, friendships and popularity, bullying and victimization, physical health, and psychosomatic problems.
Results
Young refugee children reported more peer problems, functional impairment, physical health, and psychosomatic problems compared to the control children and older refugee children groups. On the other hand, older refugee children had lower self‐esteem (academic and social self‐peers) compared to the younger refugee children group. The differences between the groups were explained by friendship quality, number of friends, peer bullying/victimization, or sibling bullying/victimization except for physical health and psychosomatic problems.
Conclusions
While refugee children were found to be at risk on various levels, the findings also point to the fact that social relationships including friendship quality and number of friends played an essential protective role. Conversely, bullying was a risk factor that explained many of the refugees’ problems. These findings pave the way for future research to further probe into the well‐being of refugee children in the United Kingdom while also targeting relevant intervention schemes specifically tailored to address their needs.
Objectives
Among older women, the clinical presentation of urinary incontinence (UI) is heterogeneous; presenting as a pelvic floor condition or geriatric syndrome. We aimed to characterize the ...geriatric incontinence syndrome (GIS) to establish its foundation in clinical practice.
Design
Prospective study.
Setting
Geriatric Clinical Research Unit.
Participants
Sixty‐one community‐dwelling women aged 70 and older with bothersome UI symptoms.
Measurements
UI symptom type and severity were determined by 3‐day bladder diary. UI severity was defined; moderate UI defined as <2 UI episodes/day and severe UI defined as ≥2 UI episodes/day. Subjective assessment of physical performance was determined using the Short Physical Performance Battery (SPPB) score. Total SPPB scores >9 define normal physical performance and scores ≤9 defined impaired physical performance.
Results
The average age was 77.1 ± 5.8 (mean ± SD) years; 69% of women had severe UI and 31% had moderate UI. Demographic characteristics were similar between groups. Daytime voiding frequency was 7.1 ± 2.9 and nocturia was present equally between groups. The majority of women (59%) with severe UI had SPPB ≤9 compared with 26% among women with moderate UI (p = 0.02); featuring significantly slower chair stand scores (2.3 ± 1.4 vs 3.3 ± 0.9, p = 0.007) and gait speed (0.08 ± 0.2 m/s compared with 1.0 ± 0.2 in women with moderate UI).
Conclusions
A multifactorial GIS may be present in older women evidenced by the co‐existence of severe UI, physical disability, slower chair stand pace, and gait speed. Prospective studies are needed to understand how these clinical features may impact the clinical care of older incontinent women.
To determine the efficacy of repetitive transcranial magnetic stimulation vs sham stimulation on improving lower-limb functional outcomes in individuals with neurological disorders.
PubMed, CINAHL, ...Embase and Scopus databases were searched from inception to 31 March 2020 to identify papers (n = 1,198). Two researchers independently reviewed studies for eligibility. Randomized clinical trials with parallel-group design, involving individuals with neurological disorders, including lower-limb functional outcome measures and published in scientific peer-reviewed journals were included.
Two researchers independently screened eligible papers (n = 27) for study design, clinical population characteristics, stimulation protocol and relevant outcome measures, and assessed study quality.
Studies presented a moderate risk of selection, attrition and reporting bias. An overall effect of repetitive transcranial magnetic stimulation was found for outcomes: gait (effect size 95% confidence interval; 95% CI: 0.51 0.29; 0.74, p = 0.003) and muscle strength (0.99 0.40; 1.58, p = 0.001) and disorders: stroke (0.20 0.00; 0.39, p = 0.05), Parkinson's disease (1.01 0.65; 1.37, p = 0.02) and spinal cord injury (0.50 0.14; 0.85, p = 0.006), compared with sham. No effect was found for outcomes: mobility and balance.
Supplementary repetitive transcranial magnetic stimulation may promote rehabilitation focused on ambulation and muscle strength and overall lower-limb functional recovery in individuals with stroke, Parkinson's disease and spinal cord injury. Further evidence is needed to extrapolate these findings.
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