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  • 1
    Online Resource
    Online Resource
    Dual task measures in older adults with and without cognitive impairment: response to simultaneous cognitive-exercise training and minimal clinically important difference estimates
    Springer Science and Business Media LLC ; 2023
    In:  BMC Geriatrics Vol. 23, No. 1 ( 2023-10-16)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-10-16)
    Abstract: Responsiveness and minimal clinically important difference (MCID) are critical indices to understand whether observed improvement represents a meaningful improvement after intervention. Although simultaneous cognitive-exercise training (SCET; e.g., performing memory tasks while cycling) has been suggested to enhance the cognitive function of older adults, responsiveness and MCID have not been established. Hence, we aimed to estimate responsiveness and MCIDs of two dual task performance involving cognition and hand function in older adults with and without cognitive impairment and to compare the differences in responsiveness and MCIDs of the two dual task performance between older adults with and without cognitive impairment. Methods A total of 106 older adults completed the Montreal Cognitive Assessment and two dual tasks before and after SCET. One dual task was a combination of Serial Sevens Test and Box and Block Test (BBT), and the other included frequency discrimination and BBT. We used effect size and standardized response mean to indicate responsiveness and used anchor- and distribution-based approaches to estimating MCID ranges. When conducting data analysis, all participants were classified into two cognitive groups, cognitively healthy (Montreal Cognitive Assessment ≥ 26) and cognitively impaired (Montreal Cognitive Assessment 〈 26) groups, based on the scores of the Montreal Cognitive Assessment before SCET. Results In the cognitively healthy group, Serial Seven Test performance when tasked with BBT and BBT performance when tasked with Serial Seven Test were responsive to SCET (effect size = 0.18–0.29; standardized response mean = 0.25–0.37). MCIDs of Serial Seven Test performance when tasked with BBT ranged 2.09–2.36, and MCIDs of BBT performance when tasked with Serial Seven Test ranged 3.77–5.85. In the cognitively impaired group, only frequency discrimination performance when tasked with BBT was responsive to SCET (effect size = 0.37; standardized response mean = 0.47). MCIDs of frequency discrimination performance when tasked with BBT ranged 1.47–2.18, and MCIDs of BBT performance when tasked with frequency discrimination ranged 1.13–7.62. Conclusions Current findings suggest that a change in Serial Seven Test performance when tasked with BBT between 2.09 and 2.36 corrected number (correct responses – incorrect responses) should be considered a meaningful change for older adults who are cognitively healthy, and a change in frequency discrimination performance when tasked with BBT between 1.47 and 2.18 corrected number (correct responses – incorrect responses) should be considered a meaningful change for older adults who are cognitively impaired. Clinical practitioners may use these established MCIDs of dual tasks involving cognition and hand function to interpret changes following SCET for older adults with and without cognitive impairment. Trial registration NCT04689776, 30/12/2020.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-023-04390-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2059865-8
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  • 2
    Online Resource
    Online Resource
    The effects of high versus low frequency of combined physical and cognitive training on cognitive function in older adults with cognitive decline: a quasi-experimental study
    Springer Science and Business Media LLC ; 2023
    In:  BMC Geriatrics Vol. 23, No. 1 ( 2023-02-14)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-02-14)
    Abstract: The effects of combined training can be affected by training characteristics such as frequency, session length, and duration. No empirical studies to date have directly compared how combined physical and cognitive training offered at different training frequencies affects cognitive function for older adults with cognitive decline. This study investigated the impact of training frequency on cognitive outcomes after combined physical and cognitive training for older adults with cognitive decline. Methods A quasi-experimental study was conducted in community facilities and day care centers. The study assigned 89 older adults with cognitive decline into high-frequency (HF) or low-frequency (LF) training groups. The participants received 90- to 105-min training sessions, one (LF) or three (HF) times a week, for 12 weeks. Outcome measures were the Montreal Cognitive Assessment, Word List subtest of the Wechsler Memory Scale, Digit Symbol Substitution Test (DSST), and Stroop Color Word Test. Results The HF group demonstrated greater improvement in immediate memory measured by the WL-IM ( F  = 8.7, P  = 0.004) and in executive function measured by the SCWT ( F  = 5.89, P  = 0.017) than the LF group. Compared with the HF group, the LF group showed a great improvement in delayed memory measured by the WL-DM ( F  = 9.62, P  = 0.003). The HF and LF groups both increased in processing speed and global cognitive function. Conclusions Our study indicated that the different training frequency of combined physical and cognitive training may result in benefits on different cognitive functions in older adults with cognitive decline. These findings may assist clinical practitioners in choosing appropriate training frequencies based on various intervention purposes for the elderly with cognitive decline. Trial registration ClinicalTrials.gov Identifier NCT03619577 (08/08/2018).
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-023-03802-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2059865-8
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  • 3
    Online Resource
    Online Resource
    Clinical efficacy of aerobic exercise combined with computer-based cognitive training in stroke: a multicenter randomized controlled trial
    Informa UK Limited ; 2022
    In:  Topics in Stroke Rehabilitation Vol. 29, No. 4 ( 2022-05-19), p. 255-264
    Details
    In: Topics in Stroke Rehabilitation, Informa UK Limited, Vol. 29, No. 4 ( 2022-05-19), p. 255-264
    Type of Medium: Online Resource
    ISSN: 1074-9357 , 1945-5119
    URL: Article
    DOI: 10.1080/10749357.2021.1922045
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2022
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  • 4
    Online Resource
    Online Resource
    Validity and Responsiveness of the Revised Nottingham Sensation Assessment for Outcome Evaluation in Stroke Rehabilitation
    AOTA Press ; 2016
    In:  The American Journal of Occupational Therapy Vol. 70, No. 2 ( 2016-03-01), p. 7002290040p1-7002290040p8
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    In: The American Journal of Occupational Therapy, AOTA Press, Vol. 70, No. 2 ( 2016-03-01), p. 7002290040p1-7002290040p8
    Abstract: OBJECTIVE. This study establishes the concurrent validity, predictive validity, and responsiveness of the Revised Nottingham Sensation Assessment (rNSA) during rehabilitation for people with stroke. METHOD. The study recruited 147 patients with stroke. The main assessment used was the rNSA, and outcome measures were the Fugl-Meyer Assessment sensory subscale (FMA–S) and motor subscale (FMA–M) and the Nottingham Extended Activities of Daily Living (NEADL) scale. RESULTS. Correlation coefficients were good to excellent between the rNSA and the FMA–S. The rNSA proprioception measure was a predictor for the FMA–S. The rNSA stereognosis and tactile-pinprick measures for the proximal upper limb were predictors for the FMA–M and the NEADL scale, respectively. Responsiveness was moderate to large for three subscales of the rNSA (standardized response mean = .51–.83). CONCLUSION. This study may support the concurrent validity, predictive validity, and responsiveness of the rNSA for people with stroke.
    Type of Medium: Online Resource
    ISSN: 0272-9490 , 1943-7676
    URL: Article
    DOI: 10.5014/ajot.2016.018390
    Language: English
    Publisher: AOTA Press
    Publication Date: 2016
    detail.hit.zdb_id: 2159893-9
    SSG: 5,2
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  • 5
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    Online Resource
    The Effects of High and Low Training Dosage in Elderly With Mild Cognitive Impairment (MCI)
    AOTA Press ; 2020
    In:  The American Journal of Occupational Therapy Vol. 74, No. 4_Supplement_1 ( 2020-08-01), p. 7411515441p1-7411515441p1
    Details
    In: The American Journal of Occupational Therapy, AOTA Press, Vol. 74, No. 4_Supplement_1 ( 2020-08-01), p. 7411515441p1-7411515441p1
    Abstract: Date Presented 03/28/20 This study aims to compare the effects of dosage of sequential combination of cognitive and physical exercise training for the elderly with MCI. The high dosage (HD) group received a total of 36 training sessions and the low dosage (LD) group received a total of 12 training sessions. Both groups improved significantly in physical, cognition, and daily function. The LD group saw more benefits in general cognitive function. It is suggested that LD training was enough to improve functions in elderly with MCI. Primary Author and Speaker: I-Ching Chuang Additional Authors and Speakers: Ching-yi Wu
    Type of Medium: Online Resource
    ISSN: 0272-9490 , 1943-7676
    URL: Article
    DOI: 10.5014/ajot.2020.74S1-PO7609
    Language: English
    Publisher: AOTA Press
    Publication Date: 2020
    detail.hit.zdb_id: 2159893-9
    SSG: 5,2
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  • 6
    Online Resource
    Online Resource
    A Pilot Randomized Controlled Trial of Botulinum Toxin Treatment Combined with Robot-Assisted Therapy, Mirror Therapy, or Active Control Treatment in Patients with Spasticity Following Stroke
    MDPI AG ; 2022
    In:  Toxins Vol. 14, No. 6 ( 2022-06-17), p. 415-
    Details
    In: Toxins, MDPI AG, Vol. 14, No. 6 ( 2022-06-17), p. 415-
    Abstract: Effects of the combined task-oriented trainings with botulinum toxin A (BoNT-A) injection on improving motor functions and reducing spasticity remains unclear. This study aims to investigate effects of 3 task-oriented trainings (robot-assisted therapy (RT), mirror therapy (MT), and active control treatment (AC)) in patients with stroke after BoNT-A injection. Thirty-seven patients with chronic spastic hemiplegic stroke were randomly assigned to receive RT, MT, or AC following BoNT-A injection over spastic upper extremity muscles. Each session of RT, MT, and AC was 75 min, 3 times weekly, for 8 weeks. Outcome measures were assessed at pretreatment, post-treatment, and 3-month follow-up, involving the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS), Motor Activity Log (MAL), including amount of use (AOU) and quality of movement (QOM), and arm activity level. All 3 combined treatments improved FMA, MAS, and MAL. The AC induced a greater effect on QOM in MAL at the 3-month follow-up than RT or MT. All 3 combined trainings induced minimal effect on arm activity level. Our findings suggest that for patients with stroke who received BoNT-A injection over spastic UE muscles, the RT, MT, or AC UE training that followed was effective in improving motor functions, reducing spasticity, and enhancing daily function.
    Type of Medium: Online Resource
    ISSN: 2072-6651
    URL: Article
    DOI: 10.3390/toxins14060415
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518395-3
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  • 7
    Online Resource
    Online Resource
    Psychometric Evaluation of an ICF -Based Instrumental Activities of Daily Living Assessment With Older Adults With Cognitive Decline
    AOTA Press ; 2020
    In:  The American Journal of Occupational Therapy Vol. 74, No. 6 ( 2020-11-01), p. 7406205050p1-7406205050p8
    Details
    In: The American Journal of Occupational Therapy, AOTA Press, Vol. 74, No. 6 ( 2020-11-01), p. 7406205050p1-7406205050p8
    Abstract: Importance: Identifying cognitive or physical limitations that contribute to difficulties in instrumental activities of daily living (IADLs) is critical for adequate intervention with community-dwelling older adults with cognitive decline. Objective: To establish the validity and responsiveness of an IADL scale based on the International Classification of Functioning, Disability and Health (the ICF–IADL) with respect to both cognitive and physical limitations. Design: Cross-sectional study. Setting: Multiple community care and senior centers. Participants: Eighty-two older adults. Intervention: Combination of physical exercise and cognitive training. Measures: Five criterion measures—Lawton IADL Scale, Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSS), Word Lists Test (WLT), and Timed Up and Go Test (TUG). Results: The ICF–IADL’s three summary scales—Disability Index (DI), Cognitive Disability Index (CDI), and Physical Disability Index (PDI)—had good concurrent validity with the Lawton IADL Scale. The DI and CDI had moderate to good associations with the MoCA. The DI’s and CDI’s predictive validity for scores on the Lawton IADL Scale, MoCA, and TUG was moderate to good and that of the PDI was fair. Responsiveness was large for the DI, moderate for the CDI, and small for the PDI. Conclusions and Relevance: The ICF–IADL can be used to measure disability in IADLs related to cognitive and physical limitations. The DI and CDI were better than the PDI in predicting outcomes in general cognitive function and dynamic balance and were more responsive to change after intervention than the PDI. What This Article Adds: The ICF–IADL addresses both cognitive and physical limitations and can be a valid assessment of IADLs. Occupational therapists can use it to determine difficulties in IADLs and causes of those difficulties, guide treatment planning, and monitor intervention effectiveness with community-dwelling older adults with cognitive decline.
    Type of Medium: Online Resource
    ISSN: 0272-9490 , 1943-7676
    URL: Article
    DOI: 10.5014/ajot.2020.039354
    Language: English
    Publisher: AOTA Press
    Publication Date: 2020
    detail.hit.zdb_id: 2159893-9
    SSG: 5,2
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  • 8
    Online Resource
    Online Resource
    Role of Self-efficacy in the Predictive Relationship of Motor Ability to Functional Performance After Task-Related Training in Stroke: A Secondary Analysis of Longitudinal Data
    Elsevier BV ; 2021
    In:  Archives of Physical Medicine and Rehabilitation Vol. 102, No. 8 ( 2021-08), p. 1588-1594
    Details
    In: Archives of Physical Medicine and Rehabilitation, Elsevier BV, Vol. 102, No. 8 ( 2021-08), p. 1588-1594
    Type of Medium: Online Resource
    ISSN: 0003-9993
    URL: Article
    DOI: 10.1016/j.apmr.2021.03.017
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2040858-4
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  • 9
    Online Resource
    Online Resource
    Using Rasch Analysis to Validate the Motor Activity Log and the Lower Functioning Motor Activity Log in Patients With Stroke
    Oxford University Press (OUP) ; 2017
    In:  Physical Therapy Vol. 97, No. 10 ( 2017-10-01), p. 1030-1040
    Details
    In: Physical Therapy, Oxford University Press (OUP), Vol. 97, No. 10 ( 2017-10-01), p. 1030-1040
    Abstract: The Motor Activity Log (MAL) and Lower-Functioning MAL (LF-MAL) are used to assess the amount of use of the more impaired arm and the quality of movement during activities in real-life situations for patients with stroke. Objective This study used Rasch analysis to examine the psychometric properties of the MAL and LF-MAL in patients with stroke. Design This is a methodological study. Methods The MAL and LF-MAL include 2 scales: the amount of use (AOU) and the quality of movement (QOM). Rasch analysis was used to examine the unidimensionality, item difficulty hierarchy, targeting, reliability, and differential item functioning (DIF) of the MAL and LF-MAL. Results A total of 403 patients with mild or moderate stroke completed the MAL, and 134 patients with moderate/severe stroke finished the LF-MAL. Evidence of disordered thresholds and poor model fit were found both in the MAL and LF-MAL. After the rating categories were collapsed and misfit items were deleted, all items of the revised MAL and LF-MAL exhibited ordering and constituted unidimensional constructs. The person-item map showed that these assessments were difficult for our participants. The person reliability coefficients of these assessments ranged from .79 to .87. No items in the revised MAL and LF-MAL exhibited bias related to patients’ characteristics. Limitations One limitation is the recruited patients, who have relatively high–functioning ability in the LF-MAL. Conclusions The revised MAL and LF-MAL are unidimensional scales and have good reliability. The categories function well, and responses to all items in these assessments are not biased by patients’ characteristics. However, the revised MAL and LF-MAL both showed floor effect. Further study might add easy items for assessing the performance of activity in real-life situations for patients with stroke.
    Type of Medium: Online Resource
    ISSN: 0031-9023 , 1538-6724
    URL: Article
    DOI: 10.1093/ptj/pzx071
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2008745-7
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  • 10
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    Online Resource
    Upper extremity motor abilities and cognitive capability mediate the causal dependency between somatosensory capability and daily function in stroke individuals
    Springer Science and Business Media LLC ; 2022
    In:  Scientific Reports Vol. 12, No. 1 ( 2022-01-13)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-01-13)
    Abstract: Stroke individuals’ daily function has been demonstrated to be influenced by their somatosensory capability, cognitive capability, and upper extremity (UE) motor abilities. However, the structural relationships among these abilities on stroke individuals’ independence in daily function remain unclear. We analyzed the pretest measures of 153 stroke individuals in outpatient rehabilitation settings by structural equation modeling to determine the structural relationship among somatosensory capability, UE muscle strength, UE motor function, and cognitive capability that influences independence in daily function. The standardized results indicated somatosensory capability negatively influenced UE muscle strength, but positively influenced UE muscle strength mediated by UE motor function. UE muscle strength, then, positively influenced individuals’ independence in daily function. On the other hand, somatosensory capability positively influenced cognitive capability, which marginally and positively affected the performance of independence in daily function. To the best of our knowledge, this is the first study to demonstrate the influence of somatosensory capability on the daily function is mediated mainly by motor functions and marginally by cognitive capability. This structural model may allow future clinical therapists to design more effective task-related training protocols to promote the independence in daily function for stroke individuals.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-021-04491-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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