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LaCroix K, Horelka L, Hung C, Brown DA. Estimating highest capacity propulsion performance using backward-directed force during walking evaluation for individuals with acquired brain injury. J Neuroeng Rehabil 2024; 21:134. [PMID: 39103946 DOI: 10.1186/s12984-024-01428-4] [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: 04/10/2023] [Accepted: 07/17/2024] [Indexed: 08/07/2024] Open
Abstract
There are over 5.3 million Americans who face acquired brain injury (ABI)-related disability as well as almost 800,000 who suffer from stroke each year. To improve mobility and quality of life, rehabilitation professionals often focus on walking recovery soon after hospital discharge for ABI. Reduced propulsion capacity (force output of the lower limbs to counteract ground reaction forces) negatively impacts walking ability and complicates recovery during rehabilitation for brain injured people. We describe a method, using backward-directed resistance (BDR) in a robotic-based treadmill device, to allow measurement of maximum walking propulsion force (MWPF) that is not otherwise possible during overground walking assessment. Our objective was to test the construct validity of a maximum walking propulsion force (MWPF) measure that reflects a person's propulsive strength against applied BDR, while walking on a robotic treadmill-based device for participants with acquired brain injury (ABI). Our study enrolled 14 participants with ABI at an in inpatient rehabilitation in Galveston, TX from 8/1/21 - 4/31/22. The range of weight-adjusted MWPF was 2.6-27.1% body weight (%BW), mean 16.5 ± 8.4%BW, reflecting a wide range of propulsive force capability. The strongest correlation with overground tests was between the 6-minute walk test (6-MWT) distance and the MWPF values (r = 0.83, p < 0.001) with moderate correlations between the 10-meter walk tests at comfortable (CWS) and fast speeds (FWS). The Five Times Sit-to-Stand (used as a standard clinical measure of functional lower extremity strength) and MWPF tests were poorly correlated (r = 0.26, p = 0.4). Forward model selection included 6-MWT distance, age, and overground CWS as significant partial predictors of MWPF. We conclude that this novel MWPF measure is a valid representation of maximum propulsive force effort during walking for people post-ABI. Additional research could help determine the impact of interventions designed to increase propulsive force generation during rehabilitation training to improve overground walking performance.
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Affiliation(s)
- Kelli LaCroix
- MD-PhD Combined Degree Program, Department of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, USA.
- , Galveston, USA.
| | - Lauren Horelka
- Moody Neurorehabilitation Institute at Galveston, 1528 Post Office St, Galveston, TX, USA
| | - Clif Hung
- Moody Neurorehabilitation Institute at Galveston, 1528 Post Office St, Galveston, TX, USA
| | - David A Brown
- School of Health Professions, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, USA
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Wright JR, D'Ausilio J, Holmberg JM, Timpson M, Preston T, Woodfield D, Snow GL. Using Quality Indicator Codes to Identify Patients' Fall Risk in Inpatient Rehabilitation Facilities. Arch Phys Med Rehabil 2023; 104:1394-1401. [PMID: 37024006 DOI: 10.1016/j.apmr.2023.03.011] [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: 09/30/2022] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To discover if quality indicator (QI) codes are associated with patient falls in inpatient rehabilitation facilities (IRFs). DESIGN This retrospective cohort study explored differences between patients who fell and those who did not fall. We analyzed potential associations between QI codes and falls using univariable and multivariable logistic regression models. SETTING We collected data from electronic medical records at 4 IRFs. PARTICIPANTS In 2020, our 4 data collection sites admitted and discharged a total of 1742 patients older than 14 years . We only excluded patients (N=43) from statistical analysis if they were discharged before admission data had been assigned. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Using a data extraction report, we collected age, sex, race and ethnicity, diagnosis, falls, and QI codes for communication, self-care, and mobility performance. Staff documented communication codes on a 1-4 scale and self-care and mobility codes on a 1-6 scale, with higher codes representing greater independence. RESULTS Ninety-seven patients (5.71%) fell in the 4 IRFs over a 12-month period. The group who fell had lower QI codes for communication, self-care, and mobility. When adjusting for bed mobility, transfer, and stair-climbing ability, low performance with understanding, walking 10 feet, and toileting were significantly associated with falls. Patients with admission QI codes below 4 for understanding had 78% higher odds of falling. If they were assigned admission QI codes below 3 for walking 10 feet or toileting, they had 2 times greater odds of falling. We did not find a significant association between falls and patients' diagnosis, age, sex, or race and ethnicity in our sample. CONCLUSIONS Communication, self-care, and mobility QI codes appear to be significantly associated with falls. Future research should explore how to use these required codes to better identify patients likely to fall in IRFs.
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Affiliation(s)
- Jonathan R Wright
- Rehabilitation Services, Intermountain Healthcare, Salt Lake City, Utah; Doctor of Physical Therapy Department, Rocky Mountain University, Provo, Utah.
| | - Jamie D'Ausilio
- Rehabilitation Services, Intermountain Healthcare, Salt Lake City, Utah
| | - Janene M Holmberg
- Rehabilitation Services, Intermountain Healthcare, Salt Lake City, Utah
| | - Misti Timpson
- Rehabilitation Services, Intermountain Healthcare, Salt Lake City, Utah; Doctor of Physical Therapy Department, Rocky Mountain University, Provo, Utah
| | - Trevor Preston
- Enterprise Analytics, Intermountain Medical Center, Murray, Utah
| | - Devyn Woodfield
- Enterprise Analytics, Intermountain Medical Center, Murray, Utah
| | - Gregory L Snow
- Statistical Data Center, Intermountain Medical Center, Murray, Utah
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Cheraghi-Sohi S, Davies K, Gordon L, Jones H, Sanders C, Ong BN. A study to explore the usefulness of a mobile health application to support people with mild cognitive and/or communication impairment due to dementia and their carers. Digit Health 2023; 9:20552076231173560. [PMID: 37256005 PMCID: PMC10225958 DOI: 10.1177/20552076231173560] [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] [Received: 12/23/2022] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
Background Mobile apps for health (mHealth) have the potential to support people living with dementia. However, dementia is a complex and progressive condition that imposes specific constraints on the introduction/use of mhealth. Few studies have explored mHealth adoption and use within the complexity of everyday domestic settings. This study used an existing App co-designed with people living with mild cognitive and communication impairment (PWMCCI) due to learning disabilities and examined the usefulness for PWMICCI due to dementia and their carers. Methods A qualitative study of people with dementia and their carers. Data were collected in a phased approach to identify the potential need for, as well as the usability and utility of the app. Analysis employed the Domestication of Technology Model (DTM) to explore, in a novel way mHealth, in this user group(s). Results Most participants did not adopt the mHealth during the study period but some (n = 2) did routinely as it fulfilled a unique, unmet need. The use of DTM highlighted the complexities of dementia, pressure on carers and duplication of effort created barriers to app adoption and use in the long term. Conclusions The ability of mHealth to support PWMCCI due to dementia and/or their carers may have potential. Users were motivated to try the technology but for any potential to be fully realised, the interplay between complexity of the condition including its progressive nature, demand on carers and nature of the technology needs to be more fully understood. Such issues place unique constraints around the size and window of opportunities for mHealth in this user group.
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Affiliation(s)
- Sudeh Cheraghi-Sohi
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Karen Davies
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | | | - Huw Jones
- Maldaba Ltd, 125 Charing Cross Road, London, UK
| | - Caroline Sanders
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- NIHR School for Primary Care Research, The University of Manchester, Williamson Building, Oxford Road, Manchester, UK
| | - Bie Nio Ong
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
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Rashid M, Harish SP, Mathew J, Kalidas A, Raja K. Comprehensive rehabilitation outcome measurement scale (CROMS): development and preliminary validation of an interdisciplinary measure for rehabilitation outcomes. Health Qual Life Outcomes 2022; 20:160. [PMID: 36456958 PMCID: PMC9714173 DOI: 10.1186/s12955-022-02048-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 09/15/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Comprehensive and interdisciplinary measurement of rehabilitation outcome is an essential part of the assessment and prognosis of a patient. Thus, this requires substantial contributions from the patient, their family and the rehabilitation professional working with them. Moreover, the measurement tool should be comprehensive and must consider the cultural compatibility, cost efficiency and contextual factors of the region. METHODS The Comprehensive Rehabilitation Outcome Measurement Scale (CROMS) was developed through consensus and followed the Delphi process incorporating inputs from various rehabilitation professionals. The domains and items were finalized using Principal Component Analysis (PCA). The tool was validated in two native languages and back-translated considering the semantic equivalence of the scale. Intra-class correlation coefficient was performed to determine the agreement between the therapist and patient-reported scales. RESULTS The final CROMS carries 32 comprehensive items that can be completed by the person with disability and the professional team. CROMS compares well to similar items on FIM (l ICC of 0.93) and has good internal consistency with a Cronbach's Alpha of 0.92 for both patient and therapist reported measures. CONCLUSIONS The 32 item CROMS is a tool that can potentially be used to evaluate the functional independence of various patient populations, predominantly patients with neurological disabilities.
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Affiliation(s)
| | | | | | | | - Kavitha Raja
- JSS College of Physiotherapy, Mysuru, 570004, India
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McKay C, Seel RT, Young J, Johnson C. Organizational characteristics of Brain Injury Clubhouse Model programs. Brain Inj 2022; 36:221-231. [PMID: 35148240 DOI: 10.1080/02699052.2022.2033835] [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: 11/02/2022]
Abstract
OBJECTIVE We provide an overview of the Clubhouse Model and the history and development of Brain Injury Clubhouses. We describe organizational-level characteristics associated with eight Brain Injury Clubhouses to address gaps in the literature and inform future studies or program development. METHODS A electronic survey, the Clubhouse Profile Questionnaire (CPQ) was tailored for Brain Injury Clubhouses. The CPQ gathers program-level data that can be used to identify active ingredients of Clubhouses, understand best practices, examine, and evaluate program characteristics. The brain injury version of the CPQ was administered to a sample of eight Clubhouses affiliated with the International Brain Injury Clubhouse Association as part of a project designed to gather data on Clubhouse program characteristics and describe sociodemographic characteristics of people served by Brain Injury Clubhouses. RESULTS CPQ data from eight Brain Injury Clubhouses was analyzed. Brain Injury Clubhouse programs in this sample served approximately 17 members per day. There was wide variability in the size, funding and funding mechanisms, and length of operation of Brain Injury Clubhouses in this study. CONCLUSIONS Findings suggest that Brain Injury Clubhouses offer a wide range of services and supports. Additional research on the impact of Brain Injury Clubhouses is needed.
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Affiliation(s)
- Colleen McKay
- Program for Clubhouse Research, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Ronald T Seel
- Center for Rehabilitation Science and Engineering (CERSE), Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jason Young
- Community Brain Injury Services, Richmond, Virginia, USA
| | - Cindi Johnson
- Side by Side Brain Injury Clubhouse, Stone Mountain, Georgia, USA
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O'Brien K, Dave R, Shekhar S, Hannah-Shmouni F, Comis LE, Solomon BI, Chen M, Gahl WA, FitzGibbon E, Gochuico BR, Estrada-Veras JI. Survivorship Issues in Adult Patients With Histiocytic Neoplasms. J Natl Compr Canc Netw 2021; 19:1312-1318. [PMID: 34781266 PMCID: PMC10481619 DOI: 10.6004/jnccn.2021.7096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022]
Abstract
Adult-onset histiocytoses (AOH), primarily Rosai-Dorfman disease (RDD), Erdheim-Chester Disease (ECD), and adult Langerhans cell histiocytosis (ALCH), are a group of related histiocytic neoplastic disorders featuring multisystemic manifestations. The disorders are largely incurable, and are essentially chronic neoplastic diseases with a variable prognosis. Prompt diagnosis and treatment is important to prevent debilitating and even life-threatening complications. Survivorship issues abound in AOH, due to their multisystemic manifestations and the sometimes recalcitrant chronic inflammation, which can lead to other debilitating complications such as fatigue, weakness, and pain. Because these disorders are rare, few healthcare professionals are proficient in their management; therefore the aim of these guidelines is to offer guidance on how to manage patients, and how to create survivorship care plans through the efforts of an interdisciplinary team.
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Affiliation(s)
- Kevin O'Brien
- Office of the Clinical Director, National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Rahul Dave
- Inova Fairfax-Virginia Commonwealth University College of Medicine, Falls Church, Virginia
| | - Skand Shekhar
- Clinical Research Branch, National Institute of Environmental Health Sciences, NIH, Bethesda, Maryland
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland
| | - Fady Hannah-Shmouni
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland
| | - Leora E Comis
- Rehabilitation Medicine Department, Clinical Center, NIH, Bethesda, Maryland
| | - Beth I Solomon
- Speech Language Pathology Section, Rehabilitation Medicine Department, Mark O. Hatfield Clinical Research Center, NIH, Bethesda, Maryland
| | - Marcus Chen
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland; and
| | - William A Gahl
- Office of the Clinical Director, National Human Genome Research Institute, NIH, Bethesda, Maryland
| | | | - Bernadette R Gochuico
- Office of the Clinical Director, National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Juvianee I Estrada-Veras
- Office of the Clinical Director, National Human Genome Research Institute, NIH, Bethesda, Maryland
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Oyesanya TO, Arulselvam K, Thompson N, Norelli J, Seel RT. Health, wellness, and safety concerns of persons with moderate-to-severe traumatic brain injury and their family caregivers: a qualitative content analysis. Disabil Rehabil 2019; 43:685-695. [PMID: 31298958 DOI: 10.1080/09638288.2019.1638456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Persons with moderate-to-severe traumatic brain injury (TBI) face issues with health, wellness, and safety that affect their ability to independently manage their care, even for individuals who are ≥75% independent in activities of daily living. These issues often lead to increased family involvement in managing the person's condition after discharge home. PURPOSE We explored health, wellness, and safety concerns after discharge home from inpatient rehabilitation from the perspectives of persons with TBI who are ≥75% independent in activities of daily living and their family caregivers. MATERIALS AND METHODS We interviewed 27 persons with TBI and family caregivers and used conventional content analysis to analyse the data. RESULTS Seven themes related to health, wellness, and safety encompassed participants' experience. Health themes included: (1) attempting to manage medications and (2) navigating mental health difficulties. Wellness themes included: (1) working to stay physically active, (2) dealing with sleep and sleeplessness, and (3) adjusting to changing social relationships. Safety themes were: (1) addressing mobility challenges and (2) compensating for complications with cognitive functioning. CONCLUSIONS Findings can guide the development of tools, supports, and resources to promote health, wellness, and safety of persons with TBI as they recover after discharge home.Implications for rehabilitationFindings on numerous concerns related to health, wellness, and safety suggest the need for implementation or development and testing of tools, supports, and resources to promote health, wellness, and safety of persons with traumatic brain injury as they recover after discharge home.Our findings can be used to educate healthcare providers and increase awareness of the nuanced challenges patients and families face after discharge home.Findings can also be used by providers to educate patients and families on realistic expectations for life after discharge.
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Affiliation(s)
- Tolu O Oyesanya
- Shepherd Center, Crawford Research Institute, Atlanta, GA, USA.,School of Nursing, Duke University, Durham, NC, USA
| | | | - Nicole Thompson
- Shepherd Center, Crawford Research Institute, Atlanta, GA, USA
| | - Jenna Norelli
- Shepherd Center, Crawford Research Institute, Atlanta, GA, USA
| | - Ronald T Seel
- Shepherd Center, Crawford Research Institute, Atlanta, GA, USA.,Department of Physical Medicine and Rehabilitation, Center for Rehabilitation Science and Engineering, VCU School of Medicine, Richmond, VA, USA
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Seel RT, Macciocchi S, Velozo CA, Shari K, Thompson N, Heinemann AW, Sander AM, Sleet D. The Safety Assessment Measure for persons with traumatic brain injury: Item pool development and content validity. NeuroRehabilitation 2017; 39:371-87. [PMID: 27497470 DOI: 10.3233/nre-161369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Persons with moderate to severe TBI are at increased risk for unintentional injury or harm in the home and community; however, there is currently no standard measure of safety risk they face now and in the future. OBJECTIVE To develop comprehensive and content valid scales and item pools for assessing safety and risk for persons with moderate to severe traumatic brain injuries. METHOD Qualitative psychometric methods for developing scales and items were used including literature review, item development and revision, focus groups with interdisciplinary rehabilitation staff (n = 26) for rating content validity, and cognitive interviewing of TBI family members (n = 9) for assuring item clarity. RESULTS The Safety Assessment Measure is comprised of 6 primary scales - Cognitive Capacity, Visuomotor Capacity, Wheelchair Use, Risk Perception, Self-Regulation, and Compliance Failures with Safety Recommendations - in which family caregivers or clinicians rate the risk for unintentional injury or harm in adults who have sustained moderate or severe TBI. The scale item pools encompass a broad spectrum of everyday activities that pose risk in the home and community and were rated as having excellent levels of content validity. CONCLUSIONS The Safety Assessment Measure scales and items cover a broad range of instrumental activities of daily living that can increase the risk of unintentional injuries or harm. Empirical evidence suggests that the Safety Assessment Measure items have excellent content validity. Future research should use modern psychometric methods to examine each scale unidimensionality, model fit, and precision.
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Affiliation(s)
| | - Stephen Macciocchi
- Shepherd Center, Atlanta, GA, USA.,University of Georgia, Athens, GA, USA
| | - Craig A Velozo
- University of Florida, Gainesville, FL, USA.,Medical University of South Carolina, Charleston, South Carolina, USA
| | | | | | - Allen W Heinemann
- Northwestern University and Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - Angelle M Sander
- Baylor College of Medicine, Houston, TX, USA.,Harris Health System, Houston, TX, USA.,TIRR Memorial Hermann, Houston, TX, USA
| | - David Sleet
- Centers for Disease Control and Injury Prevention, Atlanta, GA, USA
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McIntyre RS, Harrison J, Loft H, Jacobson W, Olsen CK. The Effects of Vortioxetine on Cognitive Function in Patients with Major Depressive Disorder: A Meta-Analysis of Three Randomized Controlled Trials. Int J Neuropsychopharmacol 2016; 19:pyw055. [PMID: 27312740 PMCID: PMC5091829 DOI: 10.1093/ijnp/pyw055] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/19/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Management of cognitive deficits in Major Depressive Disorder (MDD) remains an important unmet need. This meta-analysis evaluated the effects of vortioxetine on cognition in patients with MDD. METHODS Random effects meta-analysis was applied to three randomized, double-blind, placebo-controlled 8-week trials of vortioxetine (5-20mg/day) in MDD, and separately to two duloxetine-referenced trials. The primary outcome measure was change in Digit Symbol Substitution Test (DSST) score. Standardized effect sizes (SES) versus placebo (Cohen's d ) were used as input. Path analysis was employed to determine the extent to which changes in DSST were mediated independently of a change in Montgomery-Åsberg Depression Rating Scale (MADRS) score. Meta-analysis was applied to MADRS-adjusted and -unadjusted SES values. Changes on additional cognitive tests were evaluated (source studies only). RESULTS Before adjustment for MADRS, vortioxetine separated from placebo on DSST score (SES 0.25-0.48; nominal p < 0.05) in all individual trials, and statistically improved DSST performance versus placebo in meta-analyses of the three trials (SES = 0.35; p < 0.0001) and two duloxetine-referenced trials (SES = 0.26; p = 0.001). After adjustment for MADRS, vortioxetine maintained DSST improvement in one individual trial ( p = 0.001) and separation from placebo was maintained in meta-analyses of all three trials (SES = 0.24; p < 0.0001) and both duloxetine-referenced trials (SES 0.19; p = 0.01). Change in DSST with duloxetine failed to separate from placebo in individual trials and both meta-analyses. Change in DSST statistically favored vortioxetine versus duloxetine after MADRS adjustment (SES = 0.16; p = 0.04). CONCLUSIONS Vortioxetine, but not duloxetine, significantly improved cognition, independent of depressive symptoms. Vortioxetine represents an important treatment for MDD-related cognitive dysfunction.
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Bosnak M, Skrjanc I. Embedded Control System for Smart Walking Assistance Device. IEEE Trans Neural Syst Rehabil Eng 2016; 25:205-214. [PMID: 27093701 DOI: 10.1109/tnsre.2016.2553369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper presents the design and implementation of a unique control system for a smart hoist, a therapeutic device that is used in rehabilitation of walking. The control system features a unique human-machine interface that allows the human to intuitively control the system just by moving or rotating its body. The paper contains an overview of the complete system, including the design and implementation of custom sensors, dc servo motor controllers, communication interfaces and embedded-system based central control system. The prototype of the complete system was tested by conducting a 6-runs experiment on 11 subjects and results are showing that the proposed control system interface is indeed intuitive and simple to adopt by the user.
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Hayward B, Ransley F, Memery R. GPS Devices for Elopement of People With Autism and Other Developmental Disabilities: A Review of the Published Literature. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Brent Hayward
- Department of Health & Human Services; Melbourne Victoria Australia
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McKechnie D, Pryor J, Fisher MJ. Falls and fallers in traumatic brain injury (TBI) rehabilitation settings: an integrative review. Disabil Rehabil 2015; 37:2291-9. [PMID: 25613355 DOI: 10.3109/09638288.2014.1002578] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To critically appraise the research literature on the nature of falls and fallers in traumatic brain injury (TBI) rehabilitation settings. METHOD An integrative review of the literature using thematic analysis was undertaken. Papers identified via a systematic search strategy were independently appraised by two reviewers. A data extraction instrument was developed to record results and to aid identification of themes in the literature. Critical Appraisal Skills Programme instruments were utilised to conduct a methodological critique of the papers included. RESULTS Thirteen studies were identified as having between 4% and 100% TBI patients in their study cohorts. From these papers, up to 71% of falls took place in a patient's bedroom occurring in peaks and troughs over a 24-h period. With some divergent results, nine themes were identified describing faller characteristics including: (1) functional mobility impairments; (2) dizziness; (3) bladder and bowel dysfunction; (4) certain medications and number of medications prescribed; (5) executive functioning; (6) patient age; (7) fear of falling; (8) coma length following TBI; and (9) Functional Independence Measure (FIM™) total score, subscale scores and particular individual items. CONCLUSIONS Being a multifactorial phenomenon, falls are a complex clinical issue. Despite the heterogeneity of diagnosis related groups (DRGs) in the included studies, TBI patients were identified as a high falls risk patient population in several studies. Implications for Rehabilitation Due to multisystem impairments, falls in the traumatic brain injury (TBI) rehabilitation context are a multifactorial and significant clinical issue. When interpreting and generalising results from research into falls, clinicians need to be mindful that falls and faller characteristics may be dependent on study setting and patient population. There is need for context specific research into faller characteristics following a TBI; particularly in relation to post-traumatic amnesia.
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Affiliation(s)
- Duncan McKechnie
- a Sydney Nursing School, The University of Sydney , Sydney , New South Wales , Australia .,b Brain Injury Unit , Royal Rehab , Sydney , New South Wales , Australia , and
| | - Julie Pryor
- a Sydney Nursing School, The University of Sydney , Sydney , New South Wales , Australia .,c Nursing Research and Development , Royal Rehab , Sydney , New South Wales , Australia
| | - Murray J Fisher
- a Sydney Nursing School, The University of Sydney , Sydney , New South Wales , Australia .,c Nursing Research and Development , Royal Rehab , Sydney , New South Wales , Australia
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