1
|
de Sousa Junior RR, Sousa AB, de Lima AFB, de Barros Santos-Rehder R, Simão CR, Fischer G, Camargos ACR, Clutterbuck GL, Leite HR. Intervenções de esportes modificados para crianças e adolescentes com deficiência: Uma revisão de escopo. Dev Med Child Neurol 2024. [PMID: 38831546 DOI: 10.1111/dmcn.15963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 04/05/2024] [Indexed: 06/05/2024]
Abstract
Resumo gráfico: Intervenções de esportes modificados para crianças e adolescentes com deficiência: Uma revisão de escopo.
Collapse
Affiliation(s)
| | - Alice Bustamante Sousa
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Arthur Felipe Barroso de Lima
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | | | - Gabriela Fischer
- Departamento de Educação Física, Universidade Federal de Santa Catarina, Florianopolis, SC, Brasil
| | - Ana Cristina Resende Camargos
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Georgina L Clutterbuck
- Escola de Ciências da Saúde e Reabilitação, The University of Queensland, Brisbane, QLD, Australia
| | - Hércules Ribeiro Leite
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| |
Collapse
|
2
|
Bonnechère B. Unlocking the Black Box? A Comprehensive Exploration of Large Language Models in Rehabilitation. Am J Phys Med Rehabil 2024; 103:532-537. [PMID: 38261757 DOI: 10.1097/phm.0000000000002440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
ABSTRACT Rehabilitation is a vital component of health care, aiming to restore function and improve the well-being of individuals with disabilities or injuries. Nevertheless, the rehabilitation process is often likened to a " black box ," with complexities that pose challenges for comprehensive analysis and optimization. The emergence of large language models offers promising solutions to better understand this " black box ." Large language models excel at comprehending and generating human-like text, making them valuable in the healthcare sector. In rehabilitation, healthcare professionals must integrate a wide range of data to create effective treatment plans, akin to selecting the best ingredients for the " black box. " Large language models enhance data integration, communication, assessment, and prediction.This article delves into the ground-breaking use of large language models as a tool to further understand the rehabilitation process. Large language models address current rehabilitation issues, including data bias, contextual comprehension, and ethical concerns. Collaboration with healthcare experts and rigorous validation is crucial when deploying large language models. Integrating large language models into rehabilitation yields insights into this intricate process, enhancing data-driven decision making, refining clinical practices, and predicting rehabilitation outcomes. Although challenges persist, large language models represent a significant stride in rehabilitation, underscoring the importance of ethical use and collaboration.
Collapse
Affiliation(s)
- Bruno Bonnechère
- From the REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium; Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium; and Department of PXL-Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
| |
Collapse
|
3
|
de Sousa Junior RR, Souto DO, Ferreira FR, da Silva E Dutra FCM, Camargos ACR, Clutterbuck GL, Leite HR. Percepções dos pais sobre uma intervenção de esportes modificados para crianças com paralisia cerebral. Dev Med Child Neurol 2024; 66:e63-e74. [PMID: 37984440 DOI: 10.1111/dmcn.15796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 11/22/2023]
Abstract
O Sports Stars Brasil tem como objetivo promover a participação em atividades de lazer. O Sports Stars foi uma intervenção agradável, de curto prazo, com dosagem pequena, focada na participação. Os pais dos participantes do Sports Stars Brasil perceberam benefícios em todas as "minhas palavras favoritas". Esta intervenção de esportes modificados foi capaz de integrar todas as "minhas palavras favoritas".
Collapse
Affiliation(s)
- Ricardo Rodrigues de Sousa Junior
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Deisiane Oliveira Souto
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Fabiane Ribeiro Ferreira
- Graduate Program in Occupational Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Fabiana Caetano Martins da Silva E Dutra
- Graduate Program in Occupational Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Ana Cristina Resende Camargos
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Georgina L Clutterbuck
- School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia
| | - Hércules Ribeiro Leite
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| |
Collapse
|
4
|
Rodrigues De Sousa Junior R, Oliveira Souto D, Ribeiro Ferreira F, Caetano Martins Da Silva E Dutra F, Resende Camargos AC, Clutterbuck GL, Ribeiro Leite H. Parents' perceptions of a modified sports intervention for children with cerebral palsy. Dev Med Child Neurol 2024; 66:744-754. [PMID: 37929798 DOI: 10.1111/dmcn.15795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023]
Abstract
AIM To explore the perceptions of parents of children with cerebral palsy (CP) participating in a modified sports intervention, Sports Stars Brazil. METHOD Parents of children with CP (n = 15, 6-12 years old, nine males, six females), classified in Gross Motor Function Classification System levels I and II, who participated in the Sports Stars Brazil intervention, were recruited for this descriptive qualitative study. Children received the 8-week (1 hour per week) modified sports intervention. After the intervention, parents participated in a focus group. The F-word (fitness, family, fun, functioning, friends, and future) interpretation of the International Classification of Functioning, Disability and Health was used to guide the discussion. Participants were invited to report their experience of participating in the intervention using the F-words for a childhood disability model. Transcripts were coded using content analysis. RESULTS Parents reported positive experiences of the Sports Stars Brazil intervention, including a decrease in sedentarism (fitness), improvement of motor skills (functioning), greater connection between child and family (family), better socialization (friends), increased participation in pleasurable activities (fun), and awareness of the importance of physical activity (future). All positive experiences were interconnected. INTERPRETATION This study presents the ability of the Sports Stars Brazil intervention to integrate all aspects of functioning and supports its role as an engaging and promising intervention option for ambulant children with CP. WHAT THIS PAPER ADDS The parents of children participating in Sports Stars Brazil perceived benefits across all F-words. This modified sports intervention integrated all F-words into one concept.
Collapse
Affiliation(s)
- Ricardo Rodrigues De Sousa Junior
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Deisiane Oliveira Souto
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fabiane Ribeiro Ferreira
- Graduate Program in Occupational Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fabiana Caetano Martins Da Silva E Dutra
- Graduate Program in Occupational Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Resende Camargos
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Georgina L Clutterbuck
- School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia
| | - Hércules Ribeiro Leite
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
5
|
MacKean A, Godfrey E, Jones GD, Kedroff L, Sparks L, Jones GL. Effectiveness of remotely delivered motivational conversations on health outcomes in patients living with musculoskeletal conditions: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2024; 123:108204. [PMID: 38402714 DOI: 10.1016/j.pec.2024.108204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE To evaluate the efficacy of remotely delivered motivational conversations on health outcomes in musculoskeletal populations. METHODS Four electronic databases (inception-March 2022) were searched and combined with grey literature. Randomised control trials (RCTs) evaluating the effect of remotely delivered motivational conversation-based interventions within musculoskeletal populations, using valid measures of pain, disability, quality of life (QoL), or self-efficacy were included. Overall quality was assessed using GRADE criteria. Meta-analyses were performed using random effects models with pooled effect sizes expressed as standardised mean differences ( ± 95%CIs). RESULTS Twelve RCTs were included. Meta-analyses revealed very-low to moderate quality evidence that remote interventions have a positive effect on pain and disability both immediately post intervention and at long-term follow-up compared to control, and have a positive effect on self-efficacy immediately post intervention. There was no effect on QoL immediately post intervention or at long-term follow up. CONCLUSION Remotely delivered motivation-based conversational interventions have a positive effect on pain, disability, and self-efficacy but not on QoL. PRACTICE IMPLICATIONS Motivational conversations, delivered remotely, may be effective in improving some health-related outcomes in MSK populations. However, higher quality evidence is needed to determine optimal intervention durations, and dosing frequencies using sufficient sample sizes and follow-up time frames.
Collapse
Affiliation(s)
- Alice MacKean
- Guy's and St Thomas' NHS Foundation Trust Physiotherapy Department, London, UK
| | - Emma Godfrey
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gareth D Jones
- Guy's and St Thomas' NHS Foundation Trust Physiotherapy Department, London, UK; Centre for Human and Applied Physiological Sciences (CHAPS), Faculty of Life Sciences & Medicine, King's College London, UK
| | - Louise Kedroff
- Physiotherapy Dept, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Lucinda Sparks
- University College London Hospitals NHS Foundation Trust Physiotherapy Department, London, UK
| | - Gareth L Jones
- Guy's and St Thomas' NHS Foundation Trust Physiotherapy Department, London, UK.
| |
Collapse
|
6
|
Gomes E, Alder G, Bright FAS, Signal N. Understanding task "challenge" in stroke rehabilitation: an interdisciplinary concept analysis. Disabil Rehabil 2024:1-11. [PMID: 38821140 DOI: 10.1080/09638288.2024.2356010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/10/2024] [Indexed: 06/02/2024]
Abstract
PURPOSE Rehabilitation plays a critical role in minimising disability after stroke, with the concept of "challenge" proposed to be essential to rehabilitation efficacy and outcomes. This review unpacks how challenge is conceptualised in stroke rehabilitation literature from the perspectives of physiotherapy, occupational therapy, speech-language therapy and people with stroke. A secondary purpose was to provide a definition of challenge that is applicable to stroke rehabilitation. METHODS Principle-based concept analysis was utilised to examine challenge within the stroke rehabilitation literature. Forty-two papers were included. Data analysis involved immersion, analytical questioning, coding and synthesis to elicit the conceptual components of challenge. RESULTS Challenge was understood as a multidimensional and dynamic concept with three facets: nominal, functional and perceived challenge. Functional and perceived challenge were integral to optimal challenge. Optimal challenge was central to enhancing the outcomes and experiences of people with stroke, in rehabilitation and everyday life. CONCLUSIONS Challenge is a key concept which, when carefully optimised to the person's ability and experience, may positively influence their learning, recovery and engagement after stroke. This review lays a conceptual foundation for better understanding, operationalisation and advancement of challenge, offering important implications for addressing the growing burden of stroke disability, through rehabilitation.
Collapse
Affiliation(s)
- Emeline Gomes
- Rehabilitation Innovation Centre, Auckland University of Technology, Auckland, New Zealand
| | - Gemma Alder
- Rehabilitation Innovation Centre, Auckland University of Technology, Auckland, New Zealand
| | - Felicity A S Bright
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Nada Signal
- Rehabilitation Innovation Centre, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
7
|
Rich T, Phelan H, Gravely A, Falbo K, Krebs E, Finn J, Matsumoto M, Muschler K, Kiecker J, Hansen A. Examining patient reported outcome measures for phantom limb pain: measurement use in a sample of Veterans with amputation. Disabil Rehabil 2024:1-9. [PMID: 38813752 DOI: 10.1080/09638288.2024.2356017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/12/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Phantom limb pain (PLP) is treated with medications and non-drug treatments. Best clinical practices for measuring treatment outcomes have not been defined. The objective of this study was to evaluate the internal consistency of patient-reported outcomes measures (PROMs) in a sample of Veterans with lower limb amputation. MATERIALS AND METHODS The Veteran phone survey included administering PROMs [1) PLP numeric rating scale (NRS), 2) general pain NRS, 3) Pain, Enjoyment, and General Activity (PEG) scale, 4) Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference Short Form 6b Replacement, 5) PROMIS Short Form Depression 4a and 6) PROMIS Short Form Anxiety 4a]. RESULTS Fifty Veterans (48 male, 2 female; average age: 66 years) completed PROMs. In our sample, 40 Veterans (80%) experienced PLP with an average PLP NRS of 5 (±3.4). Internal consistency of each measure was good to excellent based on Cronbach's alpha co-efficient of >0.80. Correlations were moderate between PLP NRS and all other measures (≤0.32). Although many Veterans expressed bothersome PLP, the scores reflecting pain interference and impact on function were lower than pain intensity. Consistent use of outcome measures is needed to determine the effect of interventions for amputation-related pain.
Collapse
Affiliation(s)
- Tonya Rich
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Family Medicine and Community Health, University of MN, Minneapolis, MN, USA
| | - Hannah Phelan
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Medical College of WI, Milwaukee, WI, USA
| | - Amy Gravely
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
| | - Kierra Falbo
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Family Medicine and Community Health, University of MN, Minneapolis, MN, USA
| | - Erin Krebs
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Jacob Finn
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MNUSA
| | - Mary Matsumoto
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | | | - Jessica Kiecker
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
| | - Andrew Hansen
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Family Medicine and Community Health, University of MN, Minneapolis, MN, USA
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
8
|
White A, Carding P, Booth V, McGlashan J, Van Stan J, Logan P, Awad R. Pre- and post-operative voice therapy for benign vocal fold lesions: protocol for a non-randomised, multicentre feasibility trial with embedded process evaluation. Pilot Feasibility Stud 2024; 10:84. [PMID: 38783383 PMCID: PMC11112800 DOI: 10.1186/s40814-024-01508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Management of benign vocal fold lesions (BVFLs) is variable with individuals receiving surgery, voice therapy, or a combination of these approaches. Some evidence suggests that the best outcomes may be achieved when patients are offered pre- and post-operative voice therapy in addition to phonosurgery, but what constitutes pre- and post-operative voice therapy is poorly described. The pre- and post-operative voice therapy (PAPOV) intervention has been developed and described according to the TIDieR checklist and Rehabilitation Treatment Specification System (RTSS) for voice. The PAPOV intervention is delivered by specialist speech and language therapists trained in the intervention and comprises 7 essential and 4 additional components, delivered in voice therapy sessions with patients who are having surgery on their vocal folds for removal of BVFLs. STUDY DESIGN Non-randomised, multicentre feasibility trial with embedded process evaluation. METHOD Forty patients from two sites who are due to undergo phonosurgery will be recruited to receive the PAPOV intervention. Measures of feasibility, including recruitment, retention, and adherence, will be assessed. The feasibility of gathering clinical and cost effectiveness data will be measured pre-treatment, then at 3 and 6 months post-operatively. An embedded process evaluation will be undertaken to explain feasibility findings. DISCUSSION This study will assess the feasibility of delivering a described voice therapy intervention protocol to patients who are undergoing surgery for removal of BVFLs. Findings will be used to inform the development and implementation of a subsequent effectiveness trial, should this be feasible. TRIAL REGISTRATION This trial has been prospectively registered on ISRCTN (date 4th January 2023), registration number 17438192, and can be viewed here: https://www.isrctn.com/ISRCTN17438192 .
Collapse
Affiliation(s)
- Anna White
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
- Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - Paul Carding
- Oxford Institute of Applied Health Research, Oxford, UK
| | - Vicky Booth
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | - Pip Logan
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rehab Awad
- University Hospital Lewisham NHS Trust, London, UK
- Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt
| |
Collapse
|
9
|
de Sousa Junior RR, Sousa AB, de Lima AFB, de Barros Santos-Rehder R, Simão CR, Fischer G, Camargos ACR, Clutterbuck GL, Leite HR. Modified sports interventions for children and adolescents with disabilities: A scoping review. Dev Med Child Neurol 2024. [PMID: 38736257 DOI: 10.1111/dmcn.15952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 05/14/2024]
Abstract
AIM To establish the scope of the literature on modified sports interventions for children and adolescents with disabilities. METHOD For this scoping review, articles were screened and the characteristics of studies were extracted. The modified sports interventions were described in terms of their structure, using the items of the Template for Intervention Description and Replication. Components of intervention treatment were described by using the language of the Rehabilitation Treatment Specification System. Results were analysed and validated by a group of professionals, using the Public and Patient Involvement strategy. RESULTS Twelve studies were eligible for inclusion, investigating interventions for children with autism spectrum disorder, cerebral palsy, and other conditions. Most studies presented a moderate level of evidence. Active ingredients were repeated sports-related motor training and introduction to the sport through a 'learning by action' mechanism. The intervention target was gross motor skills performance, and intervention aims (indirect outcomes) were physical activity participation and different body functions. INTERPRETATION The inclusion of stakeholders in this review helped to validate our findings about the characteristics and structure of modified sports interventions, to identify research gaps, and to provide a step process for clinical implementation. Future investigations are warranted of the effectiveness of modified sports investigations with better quality studies, including participation outcomes and studies with non-ambulant children.
Collapse
Affiliation(s)
- Ricardo Rodrigues de Sousa Junior
- School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Alice Bustamante Sousa
- School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Arthur Felipe Barroso de Lima
- School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Gabriela Fischer
- Department of Physical Education, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Ana Cristina Resende Camargos
- School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Georgina L Clutterbuck
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Hércules Ribeiro Leite
- School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| |
Collapse
|
10
|
Lee S, Faroqi-Shah Y. A Meta-Analysis of Anomia Treatment in Bilingual Aphasia: Within- and Cross-Language Generalization and Predictors of the Treatment Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1558-1600. [PMID: 38629966 PMCID: PMC11087086 DOI: 10.1044/2024_jslhr-23-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/15/2023] [Accepted: 01/14/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE The present meta-analysis investigated the efficacy of anomia treatment in bilingual and multilingual persons with aphasia (BPWAs) by assessing the magnitudes of six anomia treatment outcomes. Three of the treatment outcomes pertained to the "trained language": improvement of trained words (treatment effect [TE]), within-language generalization of semantically related untrained words (WLG-Related), and within-language generalization of unrelated words (WLG-Unrelated). Three treatment outcomes were for the "untrained language": improvement of translations of the trained words (cross-language generalization of trained words [CLG-Tx]), cross-language generalization of semantically related untrained words (CLG-Related), and cross-language generalization of unrelated untrained words (CLG-Unrelated). This study also examined participant- and treatment-related predictors of these treatment outcomes. METHOD This study is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42023418147. Nine electronic databases were searched to identify word retrieval treatment studies of poststroke BPWAs of at least 6 months postonset. Pre- and posttreatment single-word naming scores were extracted for each eligible participant and used to calculate effect sizes (within-case Cohen's d) of the six treatment outcomes. Random-effects meta-analyses were conducted to assess weighted mean effect sizes of the treatment outcomes across studies. Multiple linear regression analyses were used to examine the effects of participant-related variables (pretreatment single-word naming and comprehension representing poststroke lexical processing abilities) and treatment-related variables (type, language, and duration). The methodological quality of eligible studies and the risk of bias in this meta-analysis were assessed. RESULTS A total of 17 published studies with 39 BPWAs were included in the meta-analysis. The methodological quality of the included studies ranged from fair (n = 4) to good (n = 13). Anomia treatment produced a medium effect size for TE (M = 8.36) and marginally small effect sizes for WLG-Related (M = 1.63), WLG-Unrelated (M = 0.68), and CLG-Tx (M = 1.56). Effect sizes were nonsignificant for CLG-Related and CLG-Unrelated. TE was significantly larger than the other five types of treatment outcomes. TE and WLG-Related effect sizes were larger for BPWAs with milder comprehension or naming impairments and for treatments of longer duration. WLG-Unrelated was larger when BPWAs received phonological treatment than semantic and mixed treatments. The overall risk of bias in the meta-analysis was low with a potential risk of bias present in the study identification process. CONCLUSIONS Current anomia treatment practices for bilingual speakers are efficacious in improving trained items but produce marginally small within-language generalization and cross-language generalization to translations of the trained items. These results highlight the need to provide treatment in each language of BPWAs and/or investigate other approaches to promote cross-language generalization. Furthermore, anomia treatment outcomes are influenced by BPWAs' poststroke single-word naming and comprehension abilities as well as treatment duration and the provision of phonological treatment. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25595712.
Collapse
Affiliation(s)
- Seongsil Lee
- Department of Hearing and Speech Sciences, University of Maryland, College Park
| | - Yasmeen Faroqi-Shah
- Department of Hearing and Speech Sciences, University of Maryland, College Park
| |
Collapse
|
11
|
O'Grady HK, Kho ME. The Promise and Opportunity Costs of New Rehabilitation Technology in the ICU. Crit Care Med 2024; 52:837-839. [PMID: 38619340 DOI: 10.1097/ccm.0000000000006217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Affiliation(s)
- Heather K O'Grady
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Michelle E Kho
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Physiotherapy Department, St. Joseph's Healthcare, Hamilton, ON, Canada
| |
Collapse
|
12
|
Van Stan JH, Roy N, Stemple J, Gartner-Schmidt J, Gillespie AI, Whyte J, Duffy J, Turkstra L. Rehabilitation Treatment Specification System: Content and Criterion Validity Across Evidence-Based Voice Therapies for Muscle Tension Dysphonia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-18. [PMID: 38597797 DOI: 10.1044/2024_ajslp-23-00362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
PURPOSE Systematically improving voice therapy outcomes is challenging as the clinician actions (i.e., active ingredients) responsible for improved patient functioning (i.e., targets) are relatively unknown. The theory-driven Rehabilitation Treatment Specification System (RTSS) and standard, voice-specific terminology based on the RTSS (RTSS-Voice) may help address this problem. This qualitative study evaluated if the RTSS and RTSS-Voice can describe four evidence-based voice therapies for muscle tension dysphonia without missing critical aspects (content validity) and identify commonalities and differences across them (criterion validity). METHOD Qualitative interviews were completed between the clinicians (protocol experts) who developed and/or popularized the vocal function exercises, laryngeal reposturing, circumlaryngeal massage, and conversation training therapies as well as RTSS experts to produce RTSS specifications that met two consensus criteria: (a) The protocol expert agreed that the specification represented their treatment theory, and (b) the RTSS experts agreed that the specifications correctly adhered to both the RTSS framework and the RTSS-Voice's standard terminology. RESULTS The RTSS and RTSS-Voice comprehensively described voice therapy variations across and within the four diverse treatment programs, needing only the addition of one new target: overall auditory-perceptual severity. CONCLUSIONS The RTSS and RTSS-Voice exhibited strong content validity. The standard RTSS-Voice terminology helped identify, for the first time, commonalities and differences in treatment ingredients, targets, and mechanisms of action across four treatments developed for the same patient population. In the long term, the RTSS and RTSS-Voice could provide the framework for an ever-growing collection of clinically meaningful and evidence-based therapy algorithms with potential to improve research, education, and clinical care. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25537624.
Collapse
Affiliation(s)
- Jarrad H Van Stan
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
- MGH Institute of Health Professions, Boston, MA
| | | | | | | | | | - John Whyte
- Moss Rehabilitation Research Institute, Elkins Park, PA
| | | | | |
Collapse
|
13
|
Albishi AM. Knowledge, attitudes, and perceptions of physical therapists towards conventional physical therapy-across-sectional study. Ann Med Surg (Lond) 2024; 86:1942-1949. [PMID: 38576907 PMCID: PMC10990403 DOI: 10.1097/ms9.0000000000001883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/21/2024] [Indexed: 04/06/2024] Open
Abstract
Background Conventional physical therapy (CPT) is widely used in clinical practice and known to contribute beneficially to patient's health conditions but remains loosely defined. Research has shown inconsistency in the definition and utilization of CPT among physical therapists in clinical and research settings, limiting its generalisability and reproducibility. Therefore, this study evaluates physical therapists' knowledge, attitudes, and perceptions toward CPT. Methods A cross-sectional study using a self-administered questionnaire containing 36 questions was distributed among 238 licensed physical therapists. Descriptive and inferential statistics were used to measure the physical therapists' knowledge, attitudes, and perceptions towards CPT. Results Physical therapists showed limited knowledge of CPT in rehabilitation (4.09±1.698, 51%). However, the knowledge scores were significantly associated with age (P=0.002), educational levels (P=0.006), and years of work experience (P=0.001). Nevertheless, physical therapists showed an overall positive attitude towards CPT and perceived it as essential to rehabilitation. Conclusion Most physical therapists have low knowledge about CPT but positive attitudes and perceptions. Therefore, customized medical education is necessary to incorporate CPT theories and applications into physical therapists' rehabilitation programs.
Collapse
Affiliation(s)
- Alaa M. Albishi
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
14
|
Wolfberg J, Whyte J, Doyle P, Gherson S, Muise J, Petty B, Tolejano CJ, Hillman RE, Stadelman-Cohen T, Van Stan JH. Rehabilitation Treatment Specification System for Voice Therapy: Application to Everyday Clinical Care. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:814-830. [PMID: 38101322 PMCID: PMC11001165 DOI: 10.1044/2023_ajslp-23-00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/15/2023] [Accepted: 11/04/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Rehabilitation intervention descriptions often do not explicitly identify active ingredients or how those ingredients lead to changes in patient functioning. The Rehabilitation Treatment Specification System (RTSS) provides guidance to identify the critical aspects of any rehabilitation therapy and supported the development of standardly named ingredients and targets in voice therapy (Rehabilitation Treatment Specification System for Voice Therapy [RTSS-Voice]). This study sought to test the content validity of the RTSS-Voice and determine if the RTSS-Voice can be used to identify commonalities and differences in treatment (criterion validity) across clinicians in everyday clinical practice. METHOD Five speech-language pathologists from different institutions videotaped one therapy session for 59 patients diagnosed with a voice or upper airway disorder. Specifications were created for each video, and iterative rounds of revisions were completed with the treating clinician and two RTSS experts until consensus was reached on each specification. RESULTS All 59 sessions were specified without the addition of any targets or ingredients. There were two frequent targets: (a) increased volition and (b) decreased strained voice quality. There were three frequent ingredients: (a) information regarding the patient's capability and motivation to perform a therapeutic behavior, (b) knowledge of results feedback, and (c) opportunities to practice voicing with improved resonance and mean airflow. Across sessions treating vocal hyperfunction, there was large variability across clinicians regarding the types and number of treatment components introduced, types of feedback provided, and vocal practice within spontaneous speech and negative practice. CONCLUSIONS The RTSS and the RTSS-Voice demonstrated strong content validity, as they comprehensively characterized 59 therapy sessions. They also demonstrated strong criterion validity, as commonalities and differences were identified in everyday voice therapy for vocal hyperfunction across multiple clinicians. Future work to translate RTSS principles and RTSS-Voice terms into clinical documentation can help to understand how clinician and patient variability impacts outcomes and bridge the research-practice gap. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24796875.
Collapse
Affiliation(s)
- Jeremy Wolfberg
- Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation, Boston
- MGH Institute of Health Professions, Boston, MA
| | - John Whyte
- Moss Rehabilitation Research Institute, Elkins Park, PA
| | - Patricia Doyle
- University of Connecticut School of Medicine, Farmington
| | | | - Jason Muise
- Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation, Boston
- MGH Institute of Health Professions, Boston, MA
| | | | | | - Robert E. Hillman
- Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation, Boston
- MGH Institute of Health Professions, Boston, MA
- Harvard Medical School, Boston, MA
| | - Tara Stadelman-Cohen
- Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation, Boston
- MGH Institute of Health Professions, Boston, MA
| | - Jarrad H. Van Stan
- Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation, Boston
- MGH Institute of Health Professions, Boston, MA
- Harvard Medical School, Boston, MA
| |
Collapse
|
15
|
Hawley JL, Hancock AB. Incorporating Mobile App Technology in Voice Modification Protocol for Transgender Women. J Voice 2024; 38:337-345. [PMID: 34706847 DOI: 10.1016/j.jvoice.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE Motivated by practice and feedback principles of motor learning, a hybrid clinic-home protocol for voice feminization was developed to minimize the role of SLPs to 1 of supervision and professional guidance and to maximize learning during independent practice apart from intervention sessions. The purpose was to explore the effectiveness and acceptability of the innovative service delivery. METHOD This single-subject changing criterion design included four transgender women who completed a 10-week hybrid clinic-home voice intervention program delivered via 30 -minute weekly in-clinic sessions and a technology-supported home program. The program was client-centered and capitalized on principles of motor learning in that it incorporated frequent practice with intermittent, knowledge-of-result feedback. Participants' desired outcomes were measured using acoustics, self and listener ratings of audio samples, and a program evaluation questionnaire. RESULTS Average speaking fundamental frequency of phrases and picture descriptions gradually increased into the 170-220 Hz range for all except one participant. All four transgender women were perceived to sound more feminine following treatment compared to baseline. Participants found the in-clinic sessions useful, the app easy to use, and noted limited fatigue or discomfort. CONCLUSION Four transwomen met their goals using this hybrid clinic-home service delivery format. Further investigations may elucidate key factors of the success achieved in the current study by designing comparison delivery models and including people from other populations.
Collapse
Affiliation(s)
- Janet L Hawley
- Speech, Language, and Hearing Sciences Department, University of Arizona, Tucson, Arizona.
| | - Adrienne B Hancock
- Dept of Speech, Language, and Hearing Sciences, George Washington University, Washington, District of Columbia
| |
Collapse
|
16
|
Hall Z, Elbourn E, Togher L, Carragher M. Co-constructed communication therapy for individuals with acquired brain injury: A systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:496-518. [PMID: 36640114 DOI: 10.1111/1460-6984.12841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Meaningful, varied, joyful conversation is an important therapy target for adults with language or cognitive-communication disorders following acquired brain injury (ABI). However, the complexity of daily communication is often reduced to component parts within intervention programmes, with mixed evidence of generalization to everyday conversation. Interventions targeting co-construction of communication within a dyad offer a structured way in which to retain and treat elements of everyday conversation for individuals and their communication partner (CP). Such interventions exist but they are variably labelled, target different ABI populations and have not been synthesized. AIMS To identify the nature, scope and effects of intervention studies targeting co-constructed communication in adults with ABI. METHOD This systematic review was completed using PRISMA Guidelines. Six databases (MEDLINE, Embase, CINAHL, Scopus, LLBA, PsychInfo) were searched and 1210 studies were screened. Data were extracted and studies were rated for methodological quality and completeness of reporting. Outcome measures and effects of treatment were collated through descriptive synthesis. MAIN CONTRIBUTION This review highlights an emerging evidence base in relation to an intervention approach that targets everyday communication. Co-constructed communication interventions have been reported by 13 studies, from a total of 206 participants with post-stroke aphasia, traumatic brain injury and progressive language impairments. These interventions take a range of formats, including referential communication tasks, retell/recount therapies and communication training programmes. Methodological quality evaluation indicated mostly low-level study designs. Heterogeneity was identified in primary outcome measures, with 28 unique primary outcome measures reported across studies. Most studies demonstrated change in task-specific or broad communication outcome measures. CONCLUSIONS Co-constructed communication interventions may offer clinicians a systematic, protocolized, replicable way to target everyday communication for adults with ABI. More high-quality, experimental designs with complete reporting and psychometrically sound outcome measures are needed to strengthen the evidence base. WHAT THIS PAPER ADDS What is already known on this subject Everyday conversation is an important therapy target for adults with ABI, but there is mixed evidence of therapy gains generalizing to everyday life. Many interventions reduce conversation to component parts such as naming or sentence construction. A different approach is needed to capture the social, dyadic, interactive and multifaceted nature of conversation. We propose the term 'co-constructed communication interventions' as a therapy genre targeting semi-structured dialogue. These interventions retain elements of everyday conversation (such as multimodal communication and situating tasks within dyads), combined with experimental elements (where stimuli prompt interactions and responses can be scored against normative data). What this paper adds to existing knowledge This review proposes and describes a distinct genre of discourse intervention within the current evidence base with a novel operational definition of 'co-constructed communication'. What are the potential or actual clinical implications of this work? Co-constructed communication interventions directly target elements of everyday communication by situating the therapy goals within a dyadic, interactive, multimodal task. A range of intervention tasks have been identified, including collaborative storytelling and problem-solving. This review will be of interest to clinicians working with adults with ABI; co-constructed communication interventions may offer a useful, replicable way to target aspects of everyday communication. This synthesis of the current evidence base encourages clinicians' informed, evidence-based decisions around these interventions.
Collapse
Affiliation(s)
- Zali Hall
- The Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Elise Elbourn
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Leanne Togher
- The Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Marcella Carragher
- The Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| |
Collapse
|
17
|
Linden MA, McKinlay A, Hawley C, Aaro-Jonsson C, Kristiansen I, Meyer-Heim A, Ewing-Cobbs L, Wicks B, Beauchamp MH, Prasad R. Further recommendations of the International Paediatric Brain Injury Society (IPBIS) for the post-acute rehabilitation of children with acquired brain injury. Brain Inj 2024; 38:151-159. [PMID: 38329039 DOI: 10.1080/02699052.2024.2309252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Paediatric acquired brain injury is a life-long condition which impacts on all facets of the individual's lived experience. The existing evidence base continues to expand and new fields of enquiry are established as clinicians and researchers uncover the extent of these impacts. PRIMARY OBJECTIVE To add to recommendations described in the International Paediatric Brain Injury Society's 2016 paper on post-acute care for children with acquired brain injury and highlight new areas of enquiry. REVIEW OF INFORMATION Recommendations were made based on the opinions of a group of experienced international clinicians and researchers who are current or past members of the board of directors of the International Paediatric Brain Injury Society. The importance of each recommendation was agreed upon by means of group consensus. OUTCOMES This update gives new consideration to areas of study including injuries which occur in pre-school children, young people in the military, medical referral, young offenders and the use of technology in rehabilitation.
Collapse
Affiliation(s)
- Mark A Linden
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Carol Hawley
- Warwick Medical School - Mental Health and Wellbeing, University of Warwick, UK
| | | | - Ingela Kristiansen
- Department of Pediatric Neurology, Uppsala University Hospital, Uppsala, Sweden
| | - Andreas Meyer-Heim
- Rehabilitation Centre, University Children's Hospital Zürich, Zurich, Switzerland
| | - Linda Ewing-Cobbs
- Department of Pediatrics, UTHealth Houston, McGovern Medical School, USA
| | | | - Miriam H Beauchamp
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
| | - Rajendra Prasad
- Department of Neurosurgery, Indraprastha Apollo Hospitals, New Delhi, India
| |
Collapse
|
18
|
Nip ISB. Articulatory and Vocal Fold Movement Patterns During Loud Speech in Children With Cerebral Palsy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:477-493. [PMID: 38227476 PMCID: PMC11000802 DOI: 10.1044/2023_jslhr-23-00411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/19/2023] [Accepted: 11/25/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE Speech motor control changes underlying louder speech are poorly understood in children with cerebral palsy (CP). The current study evaluates changes in the oral articulatory and laryngeal subsystems in children with CP and their typically developing (TD) peers during louder speech. METHOD Nine children with CP and nine age- and sex-matched TD peers produced sentence repetitions in two conditions: (a) with their habitual rate and loudness and (b) with louder speech. Lip and jaw movements were recorded with optical motion capture. Acoustic recordings were obtained to evaluate vocal fold articulation. RESULTS Children with CP had smaller jaw movements, larger lower lip movements, slower jaw speeds, faster lip speeds, reduced interarticulator coordination, reduced low-frequency spectral tilt, and lower cepstral peak prominences (CPP) in comparison to their TD peers. Both groups produced louder speech with larger lip and jaw movements, faster lip and jaw speeds, increased temporal coordination, reduced movement variability, reduced spectral tilt, and increased CPP. CONCLUSIONS Children with CP differ from their TD peers in the speech motor control of both the oral articulatory and laryngeal subsystems. Both groups alter oral articulatory and vocal fold movements when cued to speak loudly, which may contribute to the increased intelligibility associated with louder speech. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24970302.
Collapse
|
19
|
Hayward KS, Dalton EJ, Barth J, Brady M, Cherney LR, Churilov L, Clarkson AN, Dawson J, Dukelow SP, Feys P, Hackett M, Zeiler SR, Lang CE. Control intervention design for preclinical and clinical trials: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable. Int J Stroke 2024; 19:169-179. [PMID: 37824750 PMCID: PMC10811967 DOI: 10.1177/17474930231199336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/16/2023] [Indexed: 10/14/2023]
Abstract
Control comparator selection is a critical trial design issue. Preclinical and clinical investigators who are doing trials of stroke recovery and rehabilitation interventions must carefully consider the appropriateness and relevance of their chosen control comparator as the benefit of an experimental intervention is established relative to a comparator. Establishing a strong rationale for a selected comparator improves the integrity of the trial and validity of its findings. This Stroke Recovery and Rehabilitation Roundtable (SRRR) taskforce used a graph theory voting system to rank the importance and ease of addressing challenges during control comparator design. "Identifying appropriate type of control" was ranked easy to address and very important, "variability in usual care" was ranked hard to address and of low importance, and "understanding the content of the control and how it differs from the experimental intervention" was ranked very important but not easy to address. The CONtrol DeSIGN (CONSIGN) decision support tool was developed to address the identified challenges and enhance comparator selection, description, and reporting. CONSIGN is a web-based tool inclusive of seven steps that guide the user through control comparator design. The tool was refined through multiple rounds of pilot testing that included more than 130 people working in neurorehabilitation research. Four hypothetical exemplar trials, which span preclinical, mood, aphasia, and motor recovery, demonstrate how the tool can be applied in practice. Six consensus recommendations are defined that span research domains, professional disciplines, and international borders.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Peter Feys
- Reval University of Hasselt, Hasselt, Belgium
| | - Maree Hackett
- University of New South Wales, Sydney, NSW, Australia
| | | | | |
Collapse
|
20
|
Hayward KS, Dalton EJ, Barth J, Brady M, Cherney LR, Churilov L, Clarkson AN, Dawson J, Dukelow SP, Feys P, Hackett M, Zeiler SR, Lang CE. Control intervention design for preclinical and clinical trials: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair 2024; 38:30-40. [PMID: 37837348 PMCID: PMC10798031 DOI: 10.1177/15459683231209162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Control comparator selection is a critical trial design issue. Preclinical and clinical investigators who are doing trials of stroke recovery and rehabilitation interventions must carefully consider the appropriateness and relevance of their chosen control comparator as the benefit of an experimental intervention is established relative to a comparator. Establishing a strong rationale for a selected comparator improves the integrity of the trial and validity of its findings. This Stroke Recovery and Rehabilitation Roundtable (SRRR) taskforce used a graph theory voting system to rank the importance and ease of addressing challenges during control comparator design. "Identifying appropriate type of control" was ranked easy to address and very important, "variability in usual care" was ranked hard to address and of low importance, and "understanding the content of the control and how it differs from the experimental intervention" was ranked very important but not easy to address. The CONtrol DeSIGN (CONSIGN) decision support tool was developed to address the identified challenges and enhance comparator selection, description, and reporting. CONSIGN is a web-based tool inclusive of seven steps that guide the user through control comparator design. The tool was refined through multiple rounds of pilot testing that included more than 130 people working in neurorehabilitation research. Four hypothetical exemplar trials, which span preclinical, mood, aphasia, and motor recovery, demonstrate how the tool can be applied in practice. Six consensus recommendations are defined that span research domains, professional disciplines, and international borders.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Peter Feys
- Reval University of Hasselt, Hasselt, Belgium
| | - Maree Hackett
- University of New South Wales, Sydney, NSW, Australia
| | | | | |
Collapse
|
21
|
Reilly KT, Holé J, Nash S, Pugniet V, Servajean V, Varsovie D, Jacquin-Courtois S. Description of an interdisciplinary, holistic cognitive rehabilitation program for adults with mild to moderate cognitive impairment after acquired brain injury. Disabil Rehabil 2024; 46:129-138. [PMID: 36748833 DOI: 10.1080/09638288.2022.2157058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/06/2022] [Indexed: 02/08/2023]
Abstract
PURPOSE Cognitive rehabilitation research has progressed slowly, in part due to incomplete reporting of intervention content and delivery and the difficulties this produces for discerning program effectiveness. This knowledge gap can be reduced by providing detailed intervention descriptions. We document the content/ingredients and therapeutic targets of a cognitive rehabilitation program for adults with mild-to-moderate cognitive impairment. METHODS The documentation process used a method of participatory/collaborative research. Discussions with the clinical team identified session content/ingredients and therapeutic targets, which were then described using Body Functions, and Activities & Participation domains from the International Classification of Function, Disability and Health (ICF). Domains most frequently targeted by each clinician were identified as Primary Targets. RESULTS Each clinician produced a detailed description of session content, implementation, and ICF-coded therapeutic targets. This revealed that the whole program targets 29 ICF domains, seven of which were identified as Primary Targets: Higher-level Cognitive; Attention; Memory; Emotional; Global Psychosocial, Temperament and Personality, and Conversation. CONCLUSIONS Documentation of treatment targets enabled identification of appropriate outcome measures which are now being used to investigate program efficacy. This step-by-step explanation of the documentation process could serve as a guide for other teams wanting to document their rehabilitation interventions and/or establish similar programs.IMPLICATIONS FOR REHABILITATIONIncomplete reporting of intervention content and delivery contributes to difficulties in discerning the effectiveness of complex rehabilitation programs.Current recommendations for rehabilitation intervention reporting suggest that these difficulties can be partially overcome by providing detailed descriptions of intervention content/ingredients and treatment targets.Human and physical resources differ widely from one clinical setting to another and the existence of clear program descriptions can guide clinicians who wish to create similar programs.Detailed descriptions of rehabilitation interventions are necessary to accurately measure patient outcomes and generate testable hypotheses about proposed mechanisms of action.Program descriptions are needed for the development of treatment theories and the advancement of evidence-based practice in rehabilitation.
Collapse
Affiliation(s)
- Karen T Reilly
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, Bron, France
| | - Julie Holé
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, Bron, France
- Physical Medicine and Rehabilitation Department, Henry-Gabrielle Hospital, Hospices Civils de Lyon, Saint Genis Laval, France
| | - Stuart Nash
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, Bron, France
- Physical Medicine and Rehabilitation Department, Henry-Gabrielle Hospital, Hospices Civils de Lyon, Saint Genis Laval, France
| | - Virginie Pugniet
- Physical Medicine and Rehabilitation Department, Henry-Gabrielle Hospital, Hospices Civils de Lyon, Saint Genis Laval, France
| | - Valérie Servajean
- Physical Medicine and Rehabilitation Department, Henry-Gabrielle Hospital, Hospices Civils de Lyon, Saint Genis Laval, France
| | - Didier Varsovie
- Physical Medicine and Rehabilitation Department, Henry-Gabrielle Hospital, Hospices Civils de Lyon, Saint Genis Laval, France
| | - Sophie Jacquin-Courtois
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, Bron, France
- Physical Medicine and Rehabilitation Department, Henry-Gabrielle Hospital, Hospices Civils de Lyon, Saint Genis Laval, France
| |
Collapse
|
22
|
Batista DDJ, Duarte JMDT, Siqueira LTD, Almeida AA, Lopes LW, Ribeiro VV. Volitional and Non-volitional Devices Used in Voice Therapy and Training: A Scoping Review-Part A. J Voice 2023:S0892-1997(23)00348-X. [PMID: 38155057 DOI: 10.1016/j.jvoice.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To map the volitional and non-volitional devices used by speech and language pathologists (SLPs) in voice training and therapy and characterize their use in research on voice interventions. METHODS This scoping review is the first part of a larger study. The electronic search was carried out by mapping the references in PubMed/Medline, LILACS/BVS, Scopus, Web of Science, EMBASE, and the Cochrane Library, and the manual search was carried out in the grey literature. Two blind independent reviewers selected and extracted data; divergences were solved by consensus. The data extracted in this part of the study were the authorship and year of publication, country, study design, sample characteristics, intervention modality, ingredient, target, mechanism of action, dosage, and outcome measures. They were addressed with descriptive analysis. RESULTS Publications that use devices as ingredients are mostly from the last two decades, mainly carried out in the United States of America and Brazil, in adults of both sexes with behavioral dysphonia. Forty-two types of devices were used, many of them with similar approaches but different nomenclatures. Most devices were used voluntarily, focusing on vocal function, and aiming to increase source and filter interaction. Most studies used silicone tubes. The most reported technical specification to apply the ingredient was surface electrodes on the neck. Device dosage was time-controlled, and the most used outcomes were self-assessment and acoustic analysis. CONCLUSION Devices are currently used as ingredients in vocal interventions, with a greater focus on increasing the source and filter interaction, associated with silicone tubes (the most used devices in these studies), which have been dosed with performance time. Outcomes were measured with self-assessment instruments.
Collapse
Affiliation(s)
- Denis de Jesus Batista
- Center for Exact and Natural Sciences, Postgraduate program in Decision Models and Health of Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil
| | - João M da Trindade Duarte
- Center for Human Sciences, Letters and Arts, Postgraduate program in Linguistics of Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Larissa T D Siqueira
- Department of Speech-Language Pathology and Audiology of the Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Anna A Almeida
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Department of Speech-Language Pathology and Audiology, Graduate Program in Linguistics, and Graduate Program in Decision Models and Health of the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Leonardo W Lopes
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Department of Speech-Language Pathology and Audiology, Graduate Program in Linguistics, and Graduate Program in Decision Models and Health of the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Vanessa V Ribeiro
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Faculty of Medicine, Speech-Language Pathology and Audiology course and the Postgraduate Program in Medical Sciences of the Universidade de Brasília, Brasília, Distrito Federal, Brazil.
| |
Collapse
|
23
|
Fletcher K, Wydera S, Thorpe N, Radford K, das Nair R, Booth V. A rapid realist review of clinical neuropsychology rehabilitation programmes to improve psychological wellbeing and quality of life for people with acquired brain injuries. Neuropsychol Rehabil 2023:1-36. [PMID: 37975854 DOI: 10.1080/09602011.2023.2273580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 10/03/2023] [Indexed: 11/19/2023]
Abstract
Approximately 20% of acquired brain injury (ABI) survivors experience reduced psychological wellbeing (PWB). Neuropsychological rehabilitation (NPR) is one approach supporting people with ABI to participate meaningfully in activities despite challenges. Although literature supports NPR effectiveness, little is known about change mechanisms. This systematic realist review identifies what NPR programmes have been designed, delivered, and evaluated for people with ABI to improve PWB and/or quality of life (QOL), as well as providing a context-relevant understanding of what NPR includes and how NPR might lead to positive outcomes. A rapid realist review was conducted in three phases: (1) structured retrieval and evidence extraction; (2) stakeholder consultation; (3) analysis and synthesis. Searches were completed, and findings from 35 publications and one stakeholder consultation were synthesized into a refined logic model. Six context-mechanism-outcome chains (CMOCs) were identified. Participants' relationships to internal experiences, and feelings of self-worth, mastery, and connection appeared to be mechanisms that led to improved PWB and QOL. Adaptation and individualized programmes were also key mechanisms to explain successful NPR. Embedding CMOCs into NPR could improve PWB and/or QOL for people with ABI. The logic model will inform ongoing development of a new online, group-based, NPR programme.
Collapse
Affiliation(s)
- K Fletcher
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
- Midlands Partnership NHS Foundation Trust, Stafford, UK
| | | | - N Thorpe
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - K Radford
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - R das Nair
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- SINTEF, Trondheim, Norway
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - V Booth
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| |
Collapse
|
24
|
de Jesus Batista D, Lopes LW, Almeida AA, Siqueira LTD, Ribeiro VV. What Factors Determine the Use of Volitional and Non-Volitional Devices in Vocal Interventions Performed by Brazilian Speech-Language Pathologists? J Voice 2023:S0892-1997(23)00346-6. [PMID: 37957072 DOI: 10.1016/j.jvoice.2023.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE To analyze the determining factors for using devices in vocal interventions and characterize their use by Brazilian speech-language pathologists (SLPs). METHODS This cross-sectional observational study had a sample of 148 SLPs with clinical practice in voice. They answered an online questionnaire via Google Forms about sociodemographic data, training, work in the area, and the use of devices in vocal interventions. Data were analyzed descriptively and inferentially. RESULTS Tubes, straws, and masks were the most commonly used devices. SLPs specializing in voice are more inclined to use thermotherapy and kinesio tapings while being less inclined to use therapeutic ultrasounds and nebulizers. Voice specialists are less likely to employ electrostimulation. The choice to use photobiomodulation and auditory monitoring devices is influenced by the years of clinical experience, whereas the speech-language therapy training duration affects the use of electrostimulation. The age of the professional also plays a role in the utilization of vibratory stimulation. Vibratory stimulation, auditory monitoring devices, thermotherapy, and nebulization are more frequently utilized among individuals who rely on their voices for occupational purposes, whereas electrostimulation is less common. The use of photobiomodulation is infrequent in children; vibratory stimulation is more common in adolescents, and thermotherapy is relatively common among older individuals. Most of these devices are typically prescribed in execution time during vocal intervention. CONCLUSION The specialization, the time since graduation and in the occupation, and the target population of the service are the determining factors for the use of devices. They are used in vocal therapy and training, targeting vocal function.
Collapse
Affiliation(s)
- Denis de Jesus Batista
- Postgraduate Program in Decision Models and Health, Statistics Departament, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Associate Postgraduate Program in Speech-language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas.
| | - Leonardo Wanderley Lopes
- Associate Postgraduate Program in Speech-language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas; Department of Speech-Language Therapy, and Postgraduate Program in Decision Models and Health at the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Anna Alice Almeida
- Associate Postgraduate Program in Speech-language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas; Department of Speech-Language Therapy, and Postgraduate Program in Decision Models and Health at the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | | | - Vanessa Veis Ribeiro
- Associate Postgraduate Program in Speech-language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas; Speech-language Therapy Course and Postgraduate Program in Medical Sciences, Universidade de Brasília
| |
Collapse
|
25
|
Tetnowski JT, Tetnowski JA, Damico JS. Looking at gesture: The reciprocal influence between gesture and conversation. JOURNAL OF COMMUNICATION DISORDERS 2023; 106:106379. [PMID: 37769381 DOI: 10.1016/j.jcomdis.2023.106379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION There is limited research in group communication treatment for people with aphasia but existing studies report benefits of gesture to support conversation. Gesture supports conversation through recipient design features and reducing linguistic demands of lexical retrieval and formulation. Additionally, gesture serves an affiliative function. However, the relationship between gesture use and gestural capacity has not been widely examined. As part of a larger study on group cohesiveness and conversation, this investigation examined the patterns of co-speech gesture within authentic conversations among persons with aphasia to discern the functions of gesture use for the participants, changes in the use of gesture over time, and the relationship between gesture use and gesture ability. METHODS Conversation Analysis (CA) was applied in an embedded case-study design. Three participants received an academic semester of group and individual conversation-based treatment according to Facilitating Authentic Conversation (Damico et al., 2015). Four conversations from the treatment were selected and transcribed for multi-modality communication with CA conventions applied, and then cyclically analysed for patterns of gesture. RESULTS Participants demonstrated gesture that served social and linguistic functions: ratifying clinicians' proxy turns, turn-allocation, turn repair, relaying novel visual information, emphasizing content, demonstrating affiliation with the prior speaker, demonstrating their assessment others' talk, and demonstrating humor. All three participants showed an increased rate of gesture per turn and increasingly used gesture to repair conversation breakdown. Increased gesture use over the course of the semester coincided with increased scores for pantomime on the Porch Index of Communicative Ability (Porch, 1981, PICA). CONCLUSION Individuals with aphasia demonstrated increased use of gesture for varied purposes and improved gestural processing following a semester of conversation-based treatment. This is significant because gesture is an effective support for the repair of conversation breakdown typical of persons with aphasia.
Collapse
Affiliation(s)
- Jennifer Thompson Tetnowski
- University of Oklahoma Health Sciences Center, Department of Communication Sciences and Disorders, Oklahoma City, OK, USA.
| | - John A Tetnowski
- Oklahoma State University, Department of Communication Sciences and Disorders, Stillwater, OK, USA
| | - Jack S Damico
- University of Colorado Boulder, Department of Speech, Language, and Hearing Sciences, Boulder, CO, USA
| |
Collapse
|
26
|
Blanchard E, Harvi J, Vasudevan J, Swanson RL. Platelet-Rich Plasma for Adhesive Capsulitis: A Systematic Review. Cureus 2023; 15:e46580. [PMID: 37808592 PMCID: PMC10557468 DOI: 10.7759/cureus.46580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/10/2023] Open
Abstract
Adhesive capsulitis (AC) is a common cause of shoulder pain seen in 3%-5% of the population. Platelet-rich plasma (PRP) is platelet-rich blood with pro-inflammatory and anti-inflammatory properties that has been proposed as a treatment option for patients with AC. The purpose of this study was to analyze outcomes of range of motion (ROM) and subjective outcomes, including the visual analog scale (VAS), disability of arm, shoulder, and hand (DASH), and shoulder pain and disability index (SPADI) scores. PubMed, Embase, and Cochrane databases were searched, and manuscripts were screened using defined preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria. Two reviewers independently screened articles for inclusion/exclusion using PICOS criteria and extracted data regarding ROM and subjective outcome scores. Nineteen total articles were included. Eleven of the 19 studies recorded ROM as a dependent variable. All articles reported improved ROM with PRP injection when compared to baseline. When recording degrees of shoulder ROM in different planes at the latest follow-up, there were a total of 67 comparative data points for PRP vs. control. Of the 67 comparisons, 62 (93%) had a larger final ROM in the PRP group. VAS scores were reported in 16 of the 19 studies, DASH scores were reported in eight of the 19 articles, and SPADI scores were reported in seven of the 19 articles. VAS, DASH, and SPADI scores were all superior in the PRP group compared to the control. Two studies reported the same final VAS score, but the PRP groups had a larger overall improvement. Of the studies that reported objective ROM outcomes, the PRP group had greater ROM at the longest follow-up compared to control in the vast majority of comparisons. For the studies that reported subjective outcomes, all patients that received PRP had a decrease in VAS pain scores and an improvement in DASH and SPADI questionnaires.
Collapse
Affiliation(s)
- Erica Blanchard
- Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Jackson Harvi
- Physical Medicine and Rehabilitation, Philadelphia College of Osteopathic Medicine, Philadelphia, USA
| | - John Vasudevan
- Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Randel L Swanson
- Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, USA
- Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| |
Collapse
|
27
|
Batista DDJ, da Silva RD, Martins AA, de Araújo CM, Santos RS, Filho OG, Taveira KVM, Ribeiro VV. Internal Consistency of the Voice Handicap Index in Individuals With Dysphonia: A Systematic Review and Meta-Analysis. J Voice 2023:S0892-1997(23)00253-9. [PMID: 37778959 DOI: 10.1016/j.jvoice.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To analyze the internal consistency of the Voice Handicap Index (VHI) for evaluating the vocal handicap of individuals with dysphonia. METHODS This is a systematic review. Studies with a cross-sectional design and including a population of individuals with dysphonia, which validated the VHI and analyzed its internal consistency, were included. The following electronic databases were searched: Cochrane Library, EMBASE, LILACS, and PubMed, including Medline, Scopus, and Web of Science. A manual search was performed in gray literature through the Biblioteca Digital Brasileira de Teses e Dissertações and ProQuest Dissertation & Theses. In addition, the list of references of studies selected in the electronic search was mapped, and an expert in the area was consulted. Two reviewers blindly and independently conducted the selection, data extraction, and analysis of the risk of bias, the certainty of the evidence, and good psychometric measures. A meta-analysis was performed with a random effects model using the JAMOVI 2.3.2 software. RESULTS Forty-nine studies were analyzed. In risk of bias assessment, the studies were classified as having inadequate structural validity and very good internal consistency. The analysis of good psychometric properties indicated indeterminate structural validity and insufficient internal consistency. The overall value of Cronbach's alpha was estimated at 0.94, thus suggesting a very good internal consistency. However, there was high heterogeneity. The level of certainty of the evidence was too low for internal consistency. CONCLUSION The VHI proved to be a consistent and reliable patient-reported outcome measure to evaluate voice handicap in individuals with dysphonia; however, studies are heterogeneous, and the certainty of evidence is very low.
Collapse
Affiliation(s)
- Denis de Jesus Batista
- Decision Models and Health, Statistics Department, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil.
| | - Rayane Délcia da Silva
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Communication Disorders, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil.
| | - Agnes Andrade Martins
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Dentistry, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - Cristiano Miranda de Araújo
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Communication Disorders, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil; Dentistry, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil.
| | - Rosane Sampaio Santos
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Graduate Program in Communication Disorders, Universidade Tuiuti do Paraná.
| | - Odilon Guariza Filho
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.
| | - Karinna Veríssimo Meira Taveira
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil; Universidade Federal do Rio Grande do Norte, Curitiba, Paraná, Brazil.
| | - Vanessa Veis Ribeiro
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil; Speech and Language Therapy Course and the Graduate Program in Medical Sciences, Universidade de Brasília, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Brasília, Distrito Federal, Brazil.
| |
Collapse
|
28
|
Pontes ES, Vaiano TG, Bastos RSDA, Lopes LW. Opinion of speech-language pathologist on the use of photobiomodulation in the vocal clinic. Codas 2023; 35:e20220060. [PMID: 37729333 PMCID: PMC10547142 DOI: 10.1590/2317-1782/20232022060pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 12/01/2022] [Indexed: 09/22/2023] Open
Abstract
PURPOSE to investigate the opinion of Brazilian speech-language pathologists on the training, performance, and parameters used for the application of photobiomodulation (PBM) in the vocal clinic. METHODS observational, cross-sectional, and quantitative study, carried out through a web survey hosted on the Google Forms digital platform, composed of questions related to training, professional performance, and knowledge about PBM in the voice area. Twenty-nine speech-language pathologists of both sexes participated. Data were analyzed using descriptive statistics. RESULTS all participants knew the theoretical foundations of PBM, and among them, 28 (96.6%) knew its use specifically in the voice area; twenty-five respondents (86.2%) had a device to perform the irradiation, and all of them used it routinely in their clinical practice in voice. The majority (96.6%, 28) participated in a PBM training course, including specific approaches to the voice area. Participants stated that PBM is a resource that can be used in the area of voice to improve performance in sung (86.2%, 25) and spoken (82.8%, 24), in addition to its application in cases of inflammatory processes in the vocal folds (79.3%, 23). As for dosimetry parameters, the most used wavelength was 808 - 830nm (37.9%, 11) and 660/808nm simultaneously (37.9%, 11), with a dose of 3-5 J per point for the patients with inflammatory processes in the vocal folds (51.7%, 15) and 6-9 J (44.8%, 13) per point for patients whose objective was improvement/conditioning. CONCLUSION the study participants demonstrated knowledge and training in PBM and its applicability to the voice area.
Collapse
|
29
|
Barth J, Geed S, Mitchell A, Brady KP, Giannetti ML, Dromerick AW, Edwards DF. The Critical Period After Stroke Study (CPASS) Upper Extremity Treatment Protocol. Arch Rehabil Res Clin Transl 2023; 5:100282. [PMID: 37744191 PMCID: PMC10517370 DOI: 10.1016/j.arrct.2023.100282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Objective To present the development of a novel upper extremity (UE) treatment and assess how it was delivered in the Critical Periods After Stroke Study (CPASS), a phase II randomized controlled trial (RCT). Design Secondary analysis of data from the RCT. Setting Inpatient and outpatient settings the first year after stroke. Participants Of the 72 participants enrolled in CPASS (N=72), 53 were in the study groups eligible to receive the treatment initiated at ≤30 days (acute), 2-3 months (subacute), or ≥6 months (chronic) poststroke. Individuals were 65.1±10.5 years of age, 55% were women, and had mild to moderate UE motor capacity (Action Research Arm Test=17.2±14.3) at baseline. Intervention The additional 20 hours of treatment began using the Activity Card Sort (ACS), a standardized assessment of activities and participation after stroke, to identify UE treatment goals selected by the participants that were meaningful to them. Treatment activities were broken down into smaller components from a standardized protocol and process that operationalized the treatments essential elements. Main Outcome Measures Feasibility of performing the treatment in a variety of clinical settings in an RCT and contextual factors that influenced adherence. Results A total of 49/53 participants fully adhered to the CPASS treatment. The duration and location of the treatment sessions and the UE activities practiced during therapy are presented for the total sample (n=49) and per study group as an assessment of feasibility and the contextual factors that influenced adherence. Conclusions The CPASS treatment and therapy goals were explicitly based on the meaningful activities identified by the participants using the ACS as a treatment planning tool. This approach provided flexibility to customize UE motor therapy without sacrificing standardization or quantification of the data regardless of the location and UE impairments of participants within the first year poststroke.
Collapse
Affiliation(s)
- Jessica Barth
- Veterans Affairs Medical Center, Center of Innovation for Long-Term Supports and Services, Providence, RI
- MedStar National Rehabilitation Hospital, Washington, DC
- Center for Brain Plasticity and Recovery, Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC
| | - Shashwati Geed
- MedStar National Rehabilitation Hospital, Washington, DC
- Center for Brain Plasticity and Recovery, Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC
| | - Abigail Mitchell
- MedStar National Rehabilitation Hospital, Washington, DC
- Center for Brain Plasticity and Recovery, Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC
| | - Kathaleen P. Brady
- MedStar National Rehabilitation Hospital, Washington, DC
- Center for Brain Plasticity and Recovery, Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC
| | - Margot L. Giannetti
- MedStar National Rehabilitation Hospital, Washington, DC
- Center for Brain Plasticity and Recovery, Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC
| | - Alexander W. Dromerick
- MedStar National Rehabilitation Hospital, Washington, DC
- Center for Brain Plasticity and Recovery, Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC
| | - Dorothy F. Edwards
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI
| |
Collapse
|
30
|
Chiaravalloti N, Alexander A. Strengthening the connection between clinical research and clinical practice of cognitive rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1084071. [PMID: 37476474 PMCID: PMC10354336 DOI: 10.3389/fresc.2023.1084071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 06/05/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Nancy Chiaravalloti
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ, United States
| | - Aubree Alexander
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ, United States
| |
Collapse
|
31
|
Lester-Smith RA, Miller CH, Cherney LR. Behavioral Therapy for Tremor or Dystonia Affecting Voice in Speakers with Hyperkinetic Dysarthria: A Systematic Review. J Voice 2023; 37:561-573. [PMID: 34112549 DOI: 10.1016/j.jvoice.2021.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Hyperkinetic dysarthria is characterized by atypical involuntary movements within the speech mechanism that may affect the respiratory, laryngeal, pharyngeal-oral, or velopharyngeal-nasal subsystems and may alter speech production. Although articulatory impairments are commonly considered in hyperkinetic dysarthria, speakers with hyperkinetic dysarthria may also present with changes in voice quality, pitch, and loudness. In approximately 70% of speakers with hyperkinetic dysarthria, these voice alterations are associated with tremor or dystonia. The purpose of this systematic review was to investigate the association between behavioral therapy for tremor or dystonia affecting voice in speakers with hyperkinetic dysarthria and improvement in the functional, perceptual, acoustical, aerodynamic, or endoscopic characteristics of voice. METHOD MEDLINE (PubMed), Embase, PsycINFO, and ClinicalTrials.gov online databases were searched in August 2017, December 2018, and April 2020 for relevant studies. The searches provided 4,921 unique records, and six additional unique records were added from other sources. Twelve studies met the criteria for inclusion in the systematic review. Participants who received concurrent medical treatment were included in this review to ensure that the search was inclusive of all relevant studies and informative for typical clinical scenarios. RESULTS The most commonly administered treatment ingredient was relaxation training, which was investigated in three of the four studies on tremor and three of the eight studies on dystonia. Of these six studies, only one used an experimental design and administered relaxation training as the only behavioral approach. This single-case experiment reported a significant reduction in participant ratings of tremor severity and interference with activities of daily living, although the speaking subscale reportedly did not improve and oral medications were administered concurrently. In two group studies that tested potential behavioral therapy targets, production of a low pitch improved acoustical measures for participants with essential tremor and improved auditory-perceptual judgments for participants with laryngeal dystonia. Behavioral therapy improved functional, acoustical, and aerodynamic outcomes in participants with laryngeal dystonia who were also receiving botulinum toxin injections in a randomized cross-over study and a non-randomized controlled study. Because one study employed easy onset and breathing exercises, while the other employed loud voice exercises, the mechanism of action for improvement in voice associated with behavioral therapy requires further investigation. CONCLUSION This systematic review describes the current evidence for treatment of tremor and dystonia affecting voice in speakers with hyperkinetic dysarthria and highlights the need for future research on behavioral therapy for these disorders.
Collapse
Affiliation(s)
- Rosemary A Lester-Smith
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Think + Speak Lab, Shirley Ryan AbilityLab, Chicago, Illinois.
| | - Corinne H Miller
- Galter Health Sciences Library & Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Leora R Cherney
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Think + Speak Lab, Shirley Ryan AbilityLab, Chicago, Illinois
| |
Collapse
|
32
|
Schneider KJ, Critchley ML, Anderson V, Davis GA, Debert CT, Feddermann-Demont N, Gagnon I, Guskiewicz KM, Hayden KA, Herring S, Johnstone C, Makdissi M, Master CL, Moser RS, Patricios JS, Register-Mihalik JK, Ronksley PE, Silverberg ND, Yeates KO. Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review. Br J Sports Med 2023; 57:771-779. [PMID: 37316188 DOI: 10.1136/bjsports-2022-106685] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVES We evaluated interventions to facilitate recovery in children, adolescents and adults with a sport-related concussion (SRC). DESIGN Systematic review including risk of bias (modified Scottish Intercollegiate Guidelines Network tool). DATA SOURCES MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Embase, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL Plus with Full Text, SPORTDiscus and Scopus searched until March 2022. STUDY ELIGIBILITY CRITERIA (1) Original research including randomised controlled trials (RCTs), quasi-experimental designs, cohort, comparative effectiveness studies; (2) focus on SRC; (3) English; (4) peer-reviewed and (5) evaluated treatment. RESULTS 6533 studies were screened, 154 full texts reviewed and 13 met inclusion (10 RCTs, 1 quasi-experimental and 2 cohort studies; 1 high-quality study, 7 acceptable and 5 at high risk of bias). Interventions, comparisons, timing and outcomes varied, precluding meta-analysis. For adolescents and adults with dizziness, neck pain and/or headaches >10 days following concussion, individualised cervicovestibular rehabilitation may decrease time to return to sport compared with rest followed by gradual exertion (HR 3.91 (95% CI 1.34 to 11.34)) and when compared with a subtherapeutic intervention (HR 2.91 (95% CI 1.01 to 8.43)). For adolescents with vestibular symptoms/impairments, vestibular rehabilitation may decrease time to medical clearance (vestibular rehab group 50.2 days (95% CI 39.9 to 60.4) compared with control 58.4 (95% CI 41.7 to 75.3) days). For adolescents with persisting symptoms >30 days, active rehabilitation and collaborative care may decrease symptoms. CONCLUSIONS Cervicovestibular rehabilitation is recommended for adolescents and adults with dizziness, neck pain and/or headaches for >10 days. Vestibular rehabilitation (for adolescents with dizziness/vestibular impairments >5 days) and active rehabilitation and/or collaborative care (for adolescents with persisting symptoms >30 days) may be of benefit.
Collapse
Affiliation(s)
- Kathryn J Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | | | - Vicki Anderson
- Child Neuropsychology, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Psychology, University of Melbourne, Parkville, Victoria, Australia
| | - Gavin A Davis
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Cabrini Health, Malvern, Victoria, Australia
| | - Chantel T Debert
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Nina Feddermann-Demont
- Department of Neurology, University Hospital Zurich, Zurich Switzerland Sports Neuroscience, University of Zurich, Zurich, Switzerland
| | - Isabelle Gagnon
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Kevin M Guskiewicz
- Sports Medicine Research Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Stanley Herring
- Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine and Neurological Surgery, University of Washington, Seattle, Washington, USA
| | | | - Michael Makdissi
- Florey Institute of Neuroscience and Mental Health - Austin Campus, Heidelberg, Victoria, Australia
- Australian Football League, Melbourne, Victoria, Australia
| | - Christina L Master
- Pediatrics and Sports Medicine, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Jon S Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Johna K Register-Mihalik
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul E Ronksley
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Noah D Silverberg
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Keith Owen Yeates
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Psychology, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
33
|
Diedrichs VA, Lundine JP, Blackett DS, Durfee AZ, Pan XJ, Harnish SM. A randomized crossover single-case series comparing blocked versus random treatment for anomia. Neuropsychol Rehabil 2023; 33:821-848. [PMID: 35287561 PMCID: PMC9470780 DOI: 10.1080/09602011.2022.2050411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
The motor learning literature has demonstrated that blocked practice facilitates better acquisition of motor skills, whereas random practice facilitates retention and transfer. The verbal learning and memory literature offers similar evidence. The purpose of this study was to investigate effects of blocked versus random practice in treatment for anomia. The study used a single site, randomized crossover design, with two replicated experimental phases (two blocked and two random) for each of 10 individuals with anomia. Each phase consisted of a cued picture-naming treatment. Individual treatment and maintenance effects, as well as weighted averages and group effects, were calculated using Tau-U based on the proportion of correctly named probes. Nine of 10 participants demonstrated treatment effects during each of the four phases. Acquisition was comparable for blocked and random practice. Maintenance effects were observed following seven blocked phases of treatment and 12 random phases of treatment across participants. For four of 10 participants the random schedule resulted in better maintenance of trained items. Although further research is needed, the present data suggest that for word retrieval treatment with multiple repetitions of the same items, a random presentation may benefit maintenance of treatment gains.
Collapse
Affiliation(s)
| | - Jennifer P. Lundine
- Department of Speech and Hearing Science, The Ohio State University, Columbus, USA
| | | | | | | | - Stacy M. Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus, USA
| |
Collapse
|
34
|
Van Stan JH, Holmes J, Wengerd L, Juckett LA, Whyte J, Pinto SM, Katz LW, Wolfberg J. Rehabilitation Treatment Specification System: Identifying Barriers, Facilitators, and Strategies for Implementation in Research, Education, and Clinical Care. Arch Phys Med Rehabil 2023; 104:562-568. [PMID: 36306923 PMCID: PMC10073238 DOI: 10.1016/j.apmr.2022.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To explore rehabilitation professionals' experiences and perspectives of barriers and facilitators to implementing the Rehabilitation Treatment Specification System (RTSS) in research, education, and clinical care. DESIGN A cross-sectional survey with free text and binary responses was completed by rehabilitation professionals. Survey data were analyzed with a deductive approach of directed content analysis using 2 implementation science frameworks: Consolidated Framework for Implementation Research (CFIR) and the Expert Recommendations for Implementing Change (ERIC). SETTING Rehabilitation professionals across research, educational, and clinical settings. PARTICIPANTS One hundred and eleven rehabilitation professionals-including speech-language pathologists, occupational therapists, physical therapists, physicians, psychologists, researchers, and clinic directors-who explored possible uses or applications of the RTSS for clinical care, education, or research (N=111). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Frequency of reported CFIR barriers and facilitators, as well as keywords related to CFIR and ERIC constructs. RESULTS The barriers and facilitating strategies differed according to the end-users' intended use, that is, research, education, or clinical. Overall, the 4 most frequently encountered CFIR barriers were the RTSS's complexity, a lack of available RTSS resources, reduced access to knowledge and information about the RTSS, and limited knowledge and beliefs about the RTSS. The ERIC-CFIR matching tool identified 7 ERIC strategies to address these barriers, which include conducting educational meetings, developing and distributing educational materials, accessing new funding, capturing and sharing local knowledge, identifying and preparing champions, and promoting adaptability. CONCLUSIONS When attempting to use the RTSS, rehabilitation professionals commonly encountered barriers to understanding and skillfully using the framework. Theory-driven implementation strategies have been identified that have potential for addressing the RTSS's complexity and lack of educational and skill-building resources. Future work can develop the identified implementation strategies and evaluate their effects on RTSS implementation.
Collapse
Affiliation(s)
- Jarrad H Van Stan
- Harvard Medical School, Boston, MA; Massachusetts General Hospital, Boston, MA; MGH Institute of Health Professions, Charlestown, MA.
| | - Jain Holmes
- University of Nottingham, Nottingham, England
| | | | | | - John Whyte
- Moss Rehabilitation Research Institute, Elkins Park, PA
| | | | - Leanna W Katz
- Spaulding Rehabilitation Hospital, Charlestown, MA; Boston University, Boston, MA
| | - Jeremy Wolfberg
- Massachusetts General Hospital, Boston, MA; MGH Institute of Health Professions, Charlestown, MA
| |
Collapse
|
35
|
Passaretti B, Turkstra LS, Gallagher T, Jiang A, Cahill P, Campbell W. Reporting of Classroom-Based Morphological Awareness Instruction and Intervention for Kindergarten to Grade 3 Students in the Literature: A Scoping Review. Lang Speech Hear Serv Sch 2023; 54:648-669. [PMID: 36802889 DOI: 10.1044/2022_lshss-22-00090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
PURPOSE The purpose of this scoping review was to document how the literature reports morphological awareness instruction and interventions delivered by speech-language pathologists (SLPs) and/or educators in classroom settings for kindergarten to Grade 3 students. METHOD We followed the Joanna Briggs Institute's methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines. Six relevant databases were searched systematically with article screening and selection completed by two reviewers calibrated for reliability. For data charting, one reviewer extracted content and a second reviewer verified it was pertinent to the review question. Charting for the reported elements of morphological awareness instruction and interventions was guided by the Rehabilitation Treatment Specification System. RESULTS The database search yielded 4,492 records. After removal of duplicates and screening, 47 articles were selected for inclusion. Interrater reliability for source selection exceeded the pre-established criterion of k = .61. Our analysis generated a comprehensive description of the elements of morphological awareness instruction as reported in the included articles. CONCLUSIONS Our findings provide school-based SLPs and educators a systematic means of reviewing the literature to identify key elements of morphological awareness instruction in published articles for application of evidence-based practices with fidelity, thus helping to close the research-to-practice gap. Our manifest content analysis revealed reporting of the elements for classroom-based morphological awareness instruction was varied, and in some cases, underspecified in the articles included in our study. Implications for clinical practice and future research to advance knowledge and promote implementation of evidence-based practices by SLPs and educators in today's classrooms are discussed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22105142.
Collapse
Affiliation(s)
- Basiliki Passaretti
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Lyn S Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Tiffany Gallagher
- Department of Educational Studies & Brock Learning Lab, Brock University, St. Catharines, Ontario, Canada
| | - Annie Jiang
- CanChild, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Division of Respirology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Peter Cahill
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Wenonah Campbell
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,CanChild, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
36
|
Gibson J, Sampford J, Myers-Ingram R, Jones GD. Embedding the rehabilitation treatment specification system (RTSS) into clinical practice: an evaluation of a pilot teaching programme. BMC MEDICAL EDUCATION 2023; 23:85. [PMID: 36732729 PMCID: PMC9896736 DOI: 10.1186/s12909-022-03861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/03/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Deficiency in the provision and quality of treatment specification by rehabilitation clinicians impairs the ability to differentiate effective from ineffective elements of treatment. The standardised language of the rehabilitation treatment specification system (RTSS) has been proposed as a countermeasure. To date, there is no evidence of its use in clinical practice and what effect it may have. This study aimed to assess the ability of a pilot teaching programme to embed the RTSS into the clinical practice of an inpatient oncology physiotherapy team. The objectives were to evaluate the teaching programme's effect on; participants' familiarity and perceived benefit of the RTSS, its uptake, participants' clinical reasoning, and their feelings and attitudes towards adopting the RTSS. This study provides an evaluation of the pilot teaching programme which will subsequently inform a larger iteration in an ongoing Health Education England (HEE) project aiming to disseminate and embed the RTSS into physiotherapy practice to improve physiotherapists' treatment specification. METHODS A 6-week, multi-modal RTSS pilot teaching programme based upon socio-constructivist theory was delivered to 10 inpatient oncology physiotherapists at a large urban UK trust in 2021. Self-reported measures and clinical case note audits were assessed before and after the RTSS teaching programme to evaluate its effect on RTSS familiarity and perceived benefit, uptake, and clinical reasoning. A post-teaching focus group was undertaken. It was qualitatively analysed using an inductive, independent thematic approach to evaluate clinicians' reflection and adoption. RESULTS Ten participants (8F, 29.4(±3.5) years) with variable clinical experience completed the RTSS teaching programme (six 1-hour lecture/case-based-learning sessions weekly) with 85% mean attendance. Nine yielded complete data for analyses, and 7 participated in the focus group. There was significant improvements in self-reported familiarity and confidence using the RTSS. Furthermore, there was a significant effect of the teaching on self-reported clinical reasoning overall and specifically in knowledge and theory application. But this was not reflected in clinicians' uptake of RTSS language, nor in the quality of clinical reasoning emergent in their case notes. Qualitative analyses revealed that while clinicians' conceptual understanding and the relative advantage of using the RTSS in practice was pervasive, they articulated that translating its perceived academic disposition into their clinical practice a challenge. CONCLUSIONS The RTSS teaching programme was shown to be effective in improving self-reported measures of clinical reasoning, despite clinical uptake of the RTSS remaining low. Future iterations should be tested across physiotherapy specialisms and in a larger sample with consideration of pedagogical and cultural measures to support the clinical diffusion of the RTSS.
Collapse
Affiliation(s)
- Jamie Gibson
- Department of Physiotherapy, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK.
- Health Education England (HEE), Leeds, UK.
| | - Jade Sampford
- Department of Physiotherapy, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Richard Myers-Ingram
- Department of Physiotherapy, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Gareth D Jones
- Department of Physiotherapy, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK
- Centre for Human & Applied Physiological Sciences (CHAPS), Faculty of Life Sciences & Medicine, King's College London, London, UK
| |
Collapse
|
37
|
Kho ME, Connolly B. From Strict Bedrest to Early Mobilization. Crit Care Clin 2023; 39:479-502. [DOI: 10.1016/j.ccc.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
|
38
|
Bonnechère B, Timmermans A, Michiels S. Current Technology Developments Can Improve the Quality of Research and Level of Evidence for Rehabilitation Interventions: A Narrative Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23020875. [PMID: 36679672 PMCID: PMC9866361 DOI: 10.3390/s23020875] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/19/2022] [Accepted: 01/05/2023] [Indexed: 06/01/2023]
Abstract
The current important limitations to the implementation of Evidence-Based Practice (EBP) in the rehabilitation field are related to the validation process of interventions. Indeed, most of the strict guidelines that have been developed for the validation of new drugs (i.e., double or triple blinded, strict control of the doses and intensity) cannot-or can only partially-be applied in rehabilitation. Well-powered, high-quality randomized controlled trials are more difficult to organize in rehabilitation (e.g., longer duration of the intervention in rehabilitation, more difficult to standardize the intervention compared to drug validation studies, limited funding since not sponsored by big pharma companies), which reduces the possibility of conducting systematic reviews and meta-analyses, as currently high levels of evidence are sparse. The current limitations of EBP in rehabilitation are presented in this narrative review, and innovative solutions are suggested, such as technology-supported rehabilitation systems, continuous assessment, pragmatic trials, rehabilitation treatment specification systems, and advanced statistical methods, to tackle the current limitations. The development and implementation of new technologies can increase the quality of research and the level of evidence supporting rehabilitation, provided some adaptations are made to our research methodology.
Collapse
Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, 3590 Diepenbeek, Belgium
| | - Annick Timmermans
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Sarah Michiels
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Department of Otorhinolaryngology, Antwerp University Hospital, 2650 Edegem, Belgium
| |
Collapse
|
39
|
White A, Carding P, Booth V, Logan P. Pre- and post-operative voice therapy (PaPOV): Development of an intervention for patients with benign vocal fold lesions. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:94-110. [PMID: 36047250 PMCID: PMC10086784 DOI: 10.1111/1460-6984.12771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Pre- and post-operative voice therapy may improve voice and quality-of-life outcomes for patients undergoing phonosurgery to remove benign vocal fold lesions (BVFLs). However, what constitutes voice therapy in this population is poorly described, resulting in a poor evidence base, lack of clinical guidelines and unwarranted variation in management. In order to develop the evidence base, a robust, iterative process of intervention development work should precede feasibility testing and effectiveness studies. METHODS & PROCEDURES Guidance for developing complex interventions, drawing on evidence, theory and modelling, was used to inform the development of a pre- and post-operative voice therapy intervention entitled 'PaPOV'. Data from four sources of evidence were synthesized using a published triangulation protocol. Data from a systematic review, national survey of current practice, expert interview study, and patient and public involvement conversations were used to populate a triangulation matrix, outlining components of a PaPOV. Data were coded to reflect areas of agreement, dissonance and silence with each component of the intervention. Based on this evidence, an assessment of convergence for each intervention component could be made. OUTCOMES & RESULTS In total, 61 components of the PaPOV intervention were explored. Of these, 27 were categorized as having stability of consensus according to a priori criteria. A total of 34 failed to meet the criteria. This was more frequently due to silence (27) rather than dissonance (seven) in the data. By evidencing areas of agreement and stability of consensus across data sources, the validity of individual findings has been enhanced. Furthermore, the study has exposed specific areas of the intervention that lack consensus and require exploration through further intervention development studies. CONCLUSIONS & IMPLICATIONS This systematic triangulation process has contributed to the development of a PaPOV intervention for patients with BVFLs. Exploration of specific components relating to the intervention will allow outstanding questions to be answered in preparation for feasibility testing. WHAT THIS PAPER ADDS What is already known on the subject BVFLs cause dysphonia by preventing vocal fold closure, impacting on vibratory characteristics and increasing compensatory muscle tension. Management for these patients is variable with them being offered phonosurgery, voice therapy, pharmacological management or a combined approach. Pre- and post-operative voice therapy may improve both voice and quality-of-life outcomes. This patient group has unique complexities when considering voice therapy, including surgical preparation, wound healing and epithelial mobilization. What this paper adds to existing knowledge This study uses a robust triangulation process to synthesize current evidence and patient experiences in order to inform the development of a PaPOV. It outlines some of the key components and considerations when delivering pre- and post-operative voice therapy to adults with BVFLs. Furthermore, it serves as a methodological example for intervention development in complex interventions, highlighting key guidance and recommended processes for developing and evaluating complex interventions. What are the potential or actual clinical implications of this work? The 61 components discussed as potential 'ingredients' for a PaPOV enable clinicians to reflect on key considerations when planning and delivering voice therapy to adults with BVFLs. This study highlights the pitfalls both clinically and in research of failing to describe interventions adequately and the benefits of using accurate, specific and agreed terminology in clinical practice, such as that outlined in the Rehabilitation Treatment Specification System (TRSS).
Collapse
Affiliation(s)
- Anna White
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of MedicineUniversity of NottinghamNottinghamUK
| | - Paul Carding
- Faculty of Health and Life SciencesOxford Institute of Nursing, Midwifery and Allied Health ResearchOxfordUK
| | - Vicky Booth
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of MedicineUniversity of NottinghamNottinghamUK
| | - Pip Logan
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of MedicineUniversity of NottinghamNottinghamUK
| |
Collapse
|
40
|
Development of a Safe Mobilisation Program to Improve Functional Mobility and Reduce Fall Risk in Older Adults With Cognitive Impairment and Gait Disorders. TOPICS IN GERIATRIC REHABILITATION 2023. [DOI: 10.1097/tgr.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
41
|
Crispiatico V, Baldanzi C, Bertuletti M, Grassi S, Tedeschi F, Groppo E, Rovaris M, Cattaneo D, Vitali C. Factors Associated With Treatment-Related Changes in Voice Volume in People With Multiple Sclerosis. Int J MS Care 2023; 25:1-7. [PMID: 36711218 PMCID: PMC9881420 DOI: 10.7224/1537-2073.2021-056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Vocal disorders are frequent in people with multiple sclerosis (MS). Cognitive impairment, fatigue, depression, and other clinical characteristics can be associated with treatment effectiveness in rehabilitation. Finding baseline characteristics that identify those who are responding to treatment can help the clinical decision-making process, which can then help improve the effectiveness of voice treatment. We developed a model to identify factors associated with treatment-related improvement on voice intensity in people with MS. METHODS Data are from a randomized controlled trial of the effects of voice therapy. Forty-four people with MS were enrolled and randomized to receive Lee Silverman Voice Treatment LOUD, specifically addressing voice intensity, or conventional speech-therapy group. Voice intensity (dB) was measured during monologue before and after treatment and was used to differentiate those who responded (posttreatment voice intensity > 60 dB) from those who did not. Possible associated factors were cognitive impairment, fatigue, depression, disability, and disease duration. Associations were assessed by univariate logistic regression and univariate and multivariate linear regressions. RESULTS Mean ± SD monologue voice intensity is improved in the whole sample (before rehabilitation: 51.8 ± 4.2 dB; and after rehabilitation 57.0 ± 6.5 dB; P < .001), and 11 people with MS (27.5%) responded to treatment. Specificity of treatment was associated with the return to normal voice intensity (OR, 14.28; 95% CI, 12.17-309.56) and we found a linear association between voice improvement and the specificity of treatment (6.65 [SE = 1.54] dB; P < .05). Moreover, the analysis revealed a nonlinear association between improvement and fatigue, suggesting increased benefits for people with MS with moderate fatigue. Other factors were not significantly associated with treatment effectiveness. CONCLUSIONS Moderate fatigue and the specificity of the intervention seem to be key factors associated with clinically relevant improvement in voice intensity even in people with MS with a high level of disability and long disease duration.
Collapse
Affiliation(s)
- Valeria Crispiatico
- From the ASTeR Lab Adult Speech-therapy Team Research and Department of Neurorehabilitation (VC, CB, MB, SG, FT, MR, DC, CV), IRCSS Fondazione Don Carlo Gnocchi, Milano, Italia
| | - Cinzia Baldanzi
- From the ASTeR Lab Adult Speech-therapy Team Research and Department of Neurorehabilitation (VC, CB, MB, SG, FT, MR, DC, CV), IRCSS Fondazione Don Carlo Gnocchi, Milano, Italia
| | - Martina Bertuletti
- From the ASTeR Lab Adult Speech-therapy Team Research and Department of Neurorehabilitation (VC, CB, MB, SG, FT, MR, DC, CV), IRCSS Fondazione Don Carlo Gnocchi, Milano, Italia
| | - Silvia Grassi
- From the ASTeR Lab Adult Speech-therapy Team Research and Department of Neurorehabilitation (VC, CB, MB, SG, FT, MR, DC, CV), IRCSS Fondazione Don Carlo Gnocchi, Milano, Italia
| | - Francesca Tedeschi
- From the ASTeR Lab Adult Speech-therapy Team Research and Department of Neurorehabilitation (VC, CB, MB, SG, FT, MR, DC, CV), IRCSS Fondazione Don Carlo Gnocchi, Milano, Italia
| | - Elisabetta Groppo
- From Ospedale San Paolo - ASST Santi Paolo e Carlo, Milano, Italia (EG)
| | - Marco Rovaris
- From the ASTeR Lab Adult Speech-therapy Team Research and Department of Neurorehabilitation (VC, CB, MB, SG, FT, MR, DC, CV), IRCSS Fondazione Don Carlo Gnocchi, Milano, Italia
| | - Davide Cattaneo
- From the ASTeR Lab Adult Speech-therapy Team Research and Department of Neurorehabilitation (VC, CB, MB, SG, FT, MR, DC, CV), IRCSS Fondazione Don Carlo Gnocchi, Milano, Italia
- From the Department of Physiopathology and Transplants, University of Milano, Italia (DC)
| | - Chiara Vitali
- From the ASTeR Lab Adult Speech-therapy Team Research and Department of Neurorehabilitation (VC, CB, MB, SG, FT, MR, DC, CV), IRCSS Fondazione Don Carlo Gnocchi, Milano, Italia
| |
Collapse
|
42
|
Harvey S, Rose ML, Brogan E, Pierce JE, Godecke E, Brownsett SLE, Churilov L, Copland D, Dickey MW, Dignam J, Lannin NA, Nickels L, Bernhardt J, Hayward KS. Examining Dose Frameworks to Improve Aphasia Rehabilitation Research. Arch Phys Med Rehabil 2022; 104:830-838. [PMID: 36572201 DOI: 10.1016/j.apmr.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 11/22/2022] [Accepted: 12/08/2022] [Indexed: 12/25/2022]
Abstract
The effect of treatment dose on recovery of post-stroke aphasia is not well understood. Inconsistent conceptualization, measurement, and reporting of the multiple dimensions of dose hinders efforts to evaluate dose-response relations in aphasia rehabilitation research. We review the state of dose conceptualization in aphasia rehabilitation and compare the applicability of 3 existing dose frameworks to aphasia rehabilitation research-the Frequency, Intensity, Time, and Type (FITT) principle, the Cumulative Intervention Intensity (CII) framework, and the Multidimensional Dose Articulation Framework (MDAF). The MDAF specifies dose in greater detail than the CII framework and the FITT principle. On this basis, we selected the MDAF to be applied to 3 diverse examples of aphasia rehabilitation research. We next critically examined applicability of the MDAF to aphasia rehabilitation research and identified the next steps needed to systematically conceptualize, measure, and report the multiple dimensions of dose, which together can progress understanding of the effect of treatment dose on outcomes for people with aphasia after stroke. Further consideration is required to enable application of this framework to aphasia interventions that focus on participation, personal, and environmental interventions and to understand how the construct of episode difficulty applies across therapeutic activities used in aphasia interventions.
Collapse
Affiliation(s)
- Sam Harvey
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Miranda L Rose
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.
| | - Emily Brogan
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - John E Pierce
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Erin Godecke
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Sonia L E Brownsett
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Queensland Aphasia Research Centre, University of Queensland, Brisbane, Australia; Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Leonid Churilov
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Melbourne Medical School, University of Melbourne, Parkville, Australia; Stroke Division, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Australia
| | - David Copland
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Queensland Aphasia Research Centre, University of Queensland, Brisbane, Australia; Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Michael Walsh Dickey
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh PA; Geriatric Research, Education, and Clinical Center and Audiology and Speech Pathology Service, VA Pittsburgh Healthcare System, Pittsburgh PA
| | - Jade Dignam
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Queensland Aphasia Research Centre, University of Queensland, Brisbane, Australia; Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Natasha A Lannin
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Brain Recovery and Rehabilitation Group, Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Lyndsey Nickels
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Julie Bernhardt
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Melbourne Medical School, University of Melbourne, Parkville, Australia; Stroke Division, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Australia
| | - Kathryn S Hayward
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia; Melbourne Medical School, University of Melbourne, Parkville, Australia; Stroke Division, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Australia
| |
Collapse
|
43
|
The Importance of Rehabilitation for Functional Recovery and Long-Term Outcomes for Recovery From Critical COVID-19 Illness. Crit Care Med 2022; 50:1843-1845. [PMID: 36394405 PMCID: PMC9668354 DOI: 10.1097/ccm.0000000000005690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
44
|
Bane M, Morton M, Angadi V, Andreatta R, Stemple J. Vocal Function Exercises With and Without Maximally Sustained Phonation: A Randomized Controlled Trial of Individuals With Normal Voice. J Voice 2022:S0892-1997(22)00317-4. [PMID: 36379827 PMCID: PMC10175512 DOI: 10.1016/j.jvoice.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To determine the effect of maximally sustained phonation on efficacy of Vocal Function Exercises as measured by percent of maximum phonation time goal attained. The hypothesis was that maximally sustained phonation would result in greater improvements in percent of maximum phonation time goal attained. STUDY DESIGN Randomized controlled trial. METHODS A convenience sample of individuals with normal voice were recruited in a university academic clinic setting. Of 34 participants who volunteered for the study, 31 completed baseline assessment and 23 completed all study procedures. Participants were randomized to complete Vocal Function Exercises (traditional group TG), modified Vocal Function Exercises with reduced requirement for maximally sustained phonation (midpoint group MG), or modified Vocal Function Exercises with removed requirement for maximally sustained phonation (baseline group BG). The primary outcome measure was percent of maximum phonation time goal obtained during Vocal Function Exercises. RESULTS The MG (p = 0.008) and TG (p = 0.001) groups significantly improved percent of maximum phonation time goal attained after six weeks of exercise, while the BG group (p = 0.0202) did not (ɑ = 0.0125). Difference among groups was not statistically significant (p = 0.67, ɑ = 0.0125). Hedges' g effect sizes of 0.29 (-0.66, 1.25) and 0.51 (-0.57, 1.58) were obtained comparing MG and TG groups, and BG and TG groups, respectively. CONCLUSIONS Greater requirements for maximally sustained phonation improved efficacy of Vocal Function Exercises in enhancing normal voice as measured by percent of maximum phonation time goal attained. Maximally sustained phonation may be modified to some extent while preserving efficacy of Vocal Function Exercises, however complete elimination of maximally sustained phonation may attenuate improvement. Additional research in a clinical population is warranted.
Collapse
Affiliation(s)
- Maria Bane
- University of Kentucky Department of Communication Sciences and Disorders, Lexington, Kentucky.
| | - Mariah Morton
- University of Kentucky Department of Communication Sciences and Disorders, Lexington, Kentucky
| | - Vrushali Angadi
- University of Kentucky Department of Communication Sciences and Disorders, Lexington, Kentucky
| | - Richard Andreatta
- University of Kentucky Department of Communication Sciences and Disorders, Lexington, Kentucky
| | - Joseph Stemple
- University of Kentucky Department of Communication Sciences and Disorders, Lexington, Kentucky
| |
Collapse
|
45
|
Santana ÉR, Lopes L, de Moraes RM. Recognition of the Effect of Vocal Exercises by Fuzzy Triangular Naive Bayes, a Machine Learning Classifier: A Preliminary Analysis. J Voice 2022:S0892-1997(22)00307-1. [PMID: 36376192 DOI: 10.1016/j.jvoice.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Machine learning (ML) methods allow the development of expert systems for pattern recognition and predictive analysis of intervention outcomes. It has been used in Voice Sciences, mainly to discriminate between healthy and dysphonic voices. Parameter patterns of vocal acoustic analysis and vocal perceptual assessment can be evaluated by ML classifiers, such as the Fuzzy Triangular Naive Bayes (FTriangNB), after using techniques that improve the vocal quality of individuals with healthy or dysphonic voices. Thus, the goal of this study was to analyze the performance of the FTriangNB to detect patterns in the acoustic parameters and the auditory-perceptual assessment of 12 women with dysphonia and 12 vocally healthy women, after performing three vocal exercises (tongue trills, semi-occluded vocal tract exercise with a high-resistance straw - SOVTE, and over-articulation). METHODS The FTriangNB classifier contained in the Fuzzy Class package was implemented in the data analysis software R Studio version 1.4.1106 for Macintosh. The confusion matrix was extracted, as well as the accuracy, the Kappa coefficient, and the class statistics. The final result was compared with those generated by FTriangNB with the same variables from the preapplication database of the exercises. RESULTS The FTriangNB presented good accuracy (87.5%) and Kappa coefficient (81.3%), and showed almost perfect agreement after application of the exercises, while the results before the application of the exercises demonstrated accuracy without acceptable discrimination capacity (33.3%) and Kappa coefficient with a poor agreement (-6.67%). The Semioccluded Vocal Tract Exercises (SOVTE) with high strength straw presented with a sensitivity and Negative Predictive Value (NPV) of value 1 (one), and the over-articulation's specificity and Positive Predictive Value (PPV) also showed a value of 1 (one). CONCLUSIONS The FTriangNB showed great accuracy in recognizing the effect of vocal exercises. Exploratory studies with larger samples using FTriangNB, as well as other Machine Learning classifiers should be further carried out for this purpose in the Voice Science to enable inferences.
Collapse
Affiliation(s)
- Émile Rocha Santana
- Department of Life Sciences, Collegiate of Speech Language and Hearing Sciences, State University of Bahia, UNEB, Departamento de Ciências da Vida I, Colegiado de Fonoaudiologia. Salvador 41150-000, Bahia, Brazil; Department of Statistics, Graduate Program in Decision Models and Health of the Federal University of Paraíba (UFPB), Campus I, Centro de Ciências Exatas e da Natureza, Departamento de Ciências Exatas. João Pessoa 58051-900, Paraíba, Brazil.
| | - Leonardo Lopes
- Department of Speech Therapy, Federal University of Paraíba, UFPB, Campus I, Centro de Ciências da Saúde, Departamento de Fonoaudiologia, Cidade Universitária, João Pessoa 58051-900, Paraíba, Brazil.
| | - Ronei Marcos de Moraes
- Department of Statistics, Graduate Program in Decision Models and Health of the Federal University of Paraíba (UFPB), Campus I, Centro de Ciências Exatas e da Natureza, Departamento de Ciências Exatas. João Pessoa 58051-900, Paraíba, Brazil.
| |
Collapse
|
46
|
Cavanaugh R, Quique YM, Dickey MW, Hula WD, Boss E, Evans WS. Practice-Related Predictors of Semantic Feature Verification Treatment for Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2366-2377. [PMID: 35290089 DOI: 10.1044/2021_ajslp-21-00296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Specifying the active ingredients in aphasia interventions can inform treatment theory and improve clinical implementation. This secondary analysis examined three practice-related predictors of treatment response in semantic feature verification (SFV) treatment. We hypothesized that (a) successful feature verification practice would be associated with naming outcomes if SFV operates similarly to standard feature generation semantic feature analysis and (b) successful retrieval practice would be associated with naming outcomes for treated, but not semantically related, untreated words if SFV operates via a retrieval practice-oriented lexical activation mechanism. METHOD Item-level data from nine participants with poststroke aphasia who received SFV treatment reported in the work of Evans, Cavanaugh, Quique, et al. (2021) were analyzed using Bayesian generalized linear mixed-effects models. Models evaluated whether performance on three treatment components (facilitated retrieval, feature verification, and effortful retrieval) moderated treatment response for treated and semantically related, untreated words. RESULTS There was no evidence for or against a relationship between successful feature verification practice and treatment response. In contrast, there was a robust relationship between the two retrieval practice components and treatment response for treated words only. DISCUSSION Findings were consistent with the second hypothesis: Retrieval practice, but not feature verification practice, appears to be a practice-related predictor of treatment response in SFV. However, treatment components are likely interdependent, and feature verification may still be an active ingredient in SFV. Further research is needed to evaluate the causal role of treatment components on treatment outcomes in aphasia.
Collapse
Affiliation(s)
| | - Yina M Quique
- Center for Education in Health Sciences, Northwestern University, Chicago, IL
| | | | - William D Hula
- University of Pittsburgh, PA
- VA Pittsburgh Healthcare System, PA
| | - Emily Boss
- Integrative Reconnective Aphasia Therapy, Pittsburgh, PA
| | | |
Collapse
|
47
|
Savage WM, Harel NY. Reaching a Tipping Point for Neurorehabilitation Research: Obstacles and Opportunities in Trial Design, Description, and Pooled Analysis. Neurorehabil Neural Repair 2022; 36:659-665. [DOI: 10.1177/15459683221124112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The record-breaking pace of COVID-19 vaccine development and implementation depended heavily on collaboration among academic, government, and commercial stakeholders, especially through data-sharing and robust multicenter trials. Collaborative efforts have not been as fruitful in fields such as neurorehabilitation, where non-pharmacological interventions play a much larger role. Barriers to translating scientific advancements into clinical practice in neurorehabilitation include pervasively small study sizes, exacerbated by limited funding for non-pharmacological multicenter clinical trials; difficulty standardizing—and adequately describing—non-pharmacological interventions; and a lack of incentives for individual patient-level data-sharing. These barriers prevent reliable meta-analysis of non-pharmacological clinical studies in neurorehabilitation. This point-of-view will highlight these challenges as well as suggest practical steps that may be taken to improve the neurorehabilitation pipeline between evidence and implementation.
Collapse
Affiliation(s)
- William M. Savage
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Noam Y. Harel
- Department of Neurology and Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| |
Collapse
|
48
|
Namasivayam-MacDonald A, Rapley M, Stewart J, Webster E, Quon C, Rogus-Pulia N. Impact of Dysphagia Rehabilitation in Adults on Swallowing Physiology Measured With Videofluoroscopy: A Mapping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2195-2228. [PMID: 35868298 PMCID: PMC9907451 DOI: 10.1044/2022_ajslp-21-00342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE The research aims of this review were to (a) map swallowing rehabilitation approaches to specific swallowing impairments using the Modified Barium Swallow Impairment Profile (MBSImP) to develop evidence maps, (b) match desired rehabilitation treatment targets to treatment approaches, and (c) identify gaps in the literature and highlight which rehabilitation approaches require further investigation to support accurate mapping of interventions to physiologic change. METHOD A mapping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review extension framework. The databases searched were CINAHL, Ovid Medline, and Ovid Embase. Data extracted included swallowing rehabilitation approach details via the Rehabilitation Treatment Specification System framework, study characteristics, and resulting change in swallowing physiology. The resulting change in swallowing physiology was mapped onto MBSImP components, where applicable, and effect sizes were reported where data were available. Extracted data were summarized in the form of evidence maps. RESULTS Forty-three unique articles met the inclusion criteria for this review and were divided into single-approach and multi-approach exercise studies. Within single-approach studies, 13 different exercise approaches were investigated, and 117 outcome measures could be mapped to MBSImP components. Within multi-approach studies, 13 different combinations of exercise approaches were investigated and 60 outcome measures could be mapped to MBSImP components. CONCLUSIONS This review supports speech-language pathologists in incorporating current best evidence into their practice, as it found there is potential for improvement in many MBSImP components by using rehabilitative exercises. In the future, more intervention studies are needed to ensure that recommended rehabilitation approaches are beneficial for improving the targeted swallowing physiology.
Collapse
Affiliation(s)
| | - Megan Rapley
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Josephine Stewart
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Eryn Webster
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Christina Quon
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Rogus-Pulia
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin–Madison
- Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI
| |
Collapse
|
49
|
Diedrichs VA, Jewell C, Harnish SM. A SCOPING REVIEW OF THE RELATIONSHIP BETWEEN NONLINGUISTIC COGNITIVE FACTORS AND APHASIA TREATMENT RESPONSE. TOPICS IN LANGUAGE DISORDERS 2022; 42:212-235. [PMID: 36338795 PMCID: PMC9629776 DOI: 10.1097/tld.0000000000000290] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
| | - Courtney Jewell
- Department of Speech and Hearing Science, The Ohio State University
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University
| |
Collapse
|
50
|
He Y, Nie X, He T, Qi X, Chen Z, Duan W, Wei Y, Liu X, Liu Y. Impact of Early Rehabilitation on Outcomes in Patients With Acute Ischemic Stroke After Endovascular Treatment. Front Neurol 2022; 13:877773. [PMID: 35677333 PMCID: PMC9168462 DOI: 10.3389/fneur.2022.877773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background This study aims to examine the effects of early rehabilitation on functional outcomes in patients with acute ischemic stroke treated with endovascular treatment (EVT). Methods Eligible patients with large vessel occlusion stroke treated with EVT, who received early rehabilitation or standard care treatment during hospitalization, were enrolled in a multicenter registration, prospective observational study, a registration study for Critical Care of Acute Ischemic Stroke After Recanalization. Early rehabilitation was defined as rehabilitation interventions initiated within 1 week after acute stroke. The primary outcome was the favorable functional outcome (defined as modified Rankin Scale scores of 0 to 2) at 90 days. Independent association between early rehabilitation and the primary outcome was investigated using multivariable logistic regression in the entire sample and in subgroups. Results A total of 1,126 patients (enrolled from July 2018 to May 2019) were included in the analyses, 273 (24.2%) in the early rehabilitation group and 853 (75.8%) in the standard care group. There was no significant difference in favorable functional outcomes at 90 days between the two groups (45.4 vs. 42.6%, p = 0.41). Patients in the early rehabilitation group had a lower death rate within 90 days compared with the standard care group (6.2 vs. 20.5%, p < 0.01). The multivariable logistic regression analyses showed that the early rehabilitation was not significantly associated with the favorable functional outcome at 90 days (adjusted odds ratio, 1.01 [95% CI, 0.70–1.47]; p = 0.95). There was no significant difference between subgroups in the favorable functional outcome at 90 days. No significant interaction was found between subgroups. Conclusions Patients with stroke receiving early rehabilitation had a lower death rate. However, these clinically meaningful effects of early rehabilitation did not show on functional outcome at 90 days in patients with large vessel occlusion stroke treated with EVT. Registration URL: http://www.chictr.org.cn; Unique identifier: ChiCTR1900022154.
Collapse
Affiliation(s)
- Yi He
- Department of Pain and Rehabilitation, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Ximing Nie
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao He
- Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Xiao Qi
- Department of Pain and Rehabilitation, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Zhenzhen Chen
- Department of Pain and Rehabilitation, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Wei Duan
- Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Yufei Wei
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiran Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Liu
- Department of Pain and Rehabilitation, Xinqiao Hospital, Army Medical University, Chongqing, China
- *Correspondence: Yong Liu
| |
Collapse
|