Engagement In Daily Activities Research Articles

Randomized Controlled Trial of Acceptance and Commitment Therapy for Fatigue Interference With Functioning in Metastatic Breast Cancer.

Fatigue is a highly prevalent and disabling symptom for patients with metastatic breast cancer (MBC). Evidence-based interventions for managing fatigue in advanced cancer populations are lacking. This phase II randomized controlled trial tested the effect of acceptance and commitment therapy (ACT) on fatigue interference with functioning in patients with MBC. Eligible patients were women with stage IV breast cancer who had moderate to severe fatigue interference. Patients completed a baseline assessment that included self-report measures of fatigue interference with activities, mood, and cognition (primary outcome) and sleep interference with functioning, engagement in daily activities, and quality of life (QOL; secondary outcomes). Then patients were randomly assigned to six weekly telephone-delivered sessions of either ACT (n = 116) or education/support (n = 120). Follow-up assessments occurred at 2 weeks, 3 months, and 6 months postintervention (means, 9.69, 20.51, and 33.59 weeks postbaseline, respectively). Linear mixed model analyses showed that compared with patients in the education/support condition, patients in the ACT condition reported significantly less fatigue interference (P = .018). These results were significant at 2 weeks and 6 months postintervention. ACT's effect on sleep interference was not statistically significant after the Sidak adjustment for multiple comparisons (P = .037). ACT patients showed a steady decline in sleep interference, a trend that was not found for education/support patients. Engagement in daily activities and QOL did not significantly differ between study groups, except for functional QOL (P = .006). Compared with education/support patients, ACT patients showed significantly better functional QOL at 2 weeks and 6 months postintervention. Results suggest that a brief, telephone-delivered ACT intervention can reduce fatigue interference with functioning in patients with MBC.

Age-related breakdown in networks of inter-muscular coordination.

Assessing inter-muscular coordination in older adults is crucial, as it directly impacts an individual's ability for independent functioning, injury prevention, and active engagement in daily activities. However, the precise mechanisms by which distinct muscle fiber types synchronize their activity across muscles to generate coordinated movements in older adults remain unknown. Our objective is to investigate how distinct muscle groups dynamically synchronize with each other in young and older adults during exercise. Thirty-five young adults and nine older adults performed one bodyweight squat set until exhaustion. Simultaneous surface electromyography (sEMG) recordings were taken from the left and right vastus lateralis, and left and right erector spinae. To quantify inter-muscular coordination, we first obtained ten time series of sEMG band power for each muscle, representing the dynamics of different muscle fiber types. Next, we calculated the bivariate equal-time Pearson's cross-correlation for each pair of sEMG band power time series across all leg and back muscles. The main results show (i) an overall reduction in the degree of inter-muscular coordination, and (ii) increased stratification of the inter-muscular network in older adults compared to young adults. These findings suggest that as individuals age, the global inter-muscular network becomes less flexible and adaptable, hindering its ability to reorganize effectively in response to fatigue or other stimuli. This network approach opens new avenues for developing novel network-based markers to characterize multilevel inter-muscular interactions, which can help target functional deficits and potentially reduce the risk of falls and neuro-muscular injuries in older adults.

Outcome of Endoprosthetic Hip Reconstruction Following Resection of Malignant Bone Tumors.

Over the past few decades, tumor arthroplasty has evolved into an established therapeutic approach for addressing bone defects following tumor resection in the extremities. As the diagnosis has a significant impact on patients' lives, it is important to give clear expectations for functional recovery. Therefore, we investigated both the functional outcomes and the quality of life (QoL) after tumor arthroplasty for malignant hip tumors. This retrospective study included patients who had undergone resections of malignant hip tumors with consecutive modular hip arthroplasty between 2010 and 2018. Demographics, tumor entity, and complications stemming from both tumors and treatments were evaluated through the analysis of medical records and perioperative records. The assessment of functional outcomes was conducted with the following patient-reported outcome measures (PROMs): the Harris Hip Score (HHS), Musculoskeletal Tumor Society Score (MSTS), and the Short Form Survey 36 (SF-36). Furthermore, we performed subgroup analysis in two groups: one divided into survivors and non-survivors, as well as younger individuals (<57 years) and older individuals (>57 years). A total of 30 patients were included in the study. At the time of follow-up, 19 patients were deceased. The average duration of follow-up was 3.2 (±2.51) years. The average age at the time of surgery was 60.3 (±15.20) years. Notably, there were no cases of amputation reported (0%). Five cases of implant failure were identified (16.67%). Among these, one was attributed to infection (3.3%), while four resulted from aseptic loosening (13.3%). In terms of functional outcomes, MSTS indicated good results (18 ± 7; range: 7-28; 60%), and the HHS demonstrated moderate outcomes (75.3%). Younger survivors (<57 years) exhibited notably superior results in terms of both the MSTS and physical functioning in the SF-36 (p = 0.03). In summary, this study shows declining tumor arthroplasty-related complications and satisfying functional outcomes as well as QoL. Noteworthy aspects include the relatively low rates of amputation and local tumor recurrences, which significantly favor the selection of appropriate therapeutic options. Moreover, the findings underscore the substantial impact of patients' age on overall functionality and engagement in daily activities.

Vocational functioning in young people accessing services for first-episode psychosis and ultra-high risk of psychosis: A longitudinal naturalistic cohort study.

Young people with first-episode psychosis (FEP) or at ultra-high risk (UHR) of psychosis often have lower vocational engagement than their peers. This study examines the effect of treatment in early intervention for psychosis services in Australia on engagement in education and employment. This is a naturalistic sample of young people aged 12-25 with FEP (n = 1574) and UHR (n = 1515), accessing treatment in the headspace Early Psychosis (hEP) programme. Engagement in education and employment was assessed at baseline and every 90 days in treatment. Mixed effects logistic regression were used to analyse changes over time. On entering the hEP programme, approximately 49% of the young people with FEP and 28% of the young people at UHR status identified as Not in Education, Employment or Training (NEET). The odds of being NEET were reduced by 27% (95% confidence interval = [14, 39]) for every 6 months treatment for the FEP group, but no change in NEET status was observed in the UHR group. In both groups, absence from daily activities was significantly reduced during time in treatment. While there are methodological challenges analysing real-world non-control group cohort data, the findings indicate positive effects of the hEP programme on vocational and daily activity engagement for young people with FEP and at UHR status. A large proportion of the young people still identified as NEET after receiving treatment services, suggesting further refinement to ensure targeted and consistent vocational support throughout care.

Effect of Cognitive Orientation to Daily Occupational Performance (CO-OP) on Motivation of Children with Cerebral Palsy: A Pilot Clinical Randomized Controlled Trial

ABSTRACT Children with cerebral palsy (CP) may experience challenges with motivation to engage in motor activities during rehabilitation sessions, which can impact therapy outcomes. This study investigated the effect of the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention on the motivation and achievement of motor-based goals in rehabilitation sessions for children with CP. In this pilot randomized trial, eighteen children aged 8–13 years with CP participated and were randomly assigned to either the CO-OP or bottom-up usual care group. The CO-OP group received 12 performance-based cognitive intervention sessions. The CO-OP intervention significantly enhanced the motivation of children with CP to engage and participate in therapeutic activities, as evidenced by the Pediatric Motivation Scale (PMOT) and its four sub-scales (p < 0.05, based on repeated measures ANOVA). Moreover, the Goal Attainment Scale (GAS) T-scores were higher for both posttest and follow-up assessments in the CO-OP group compared to the bottom-up usual care group. Additionally, independent sample t-test results demonstrated a significant difference in the mean scores of the Canadian Occupational Performance Measure (COPM) between the two groups. The Cognitive Orientation to daily Occupational Performance (CO-OP) intervention successfully enhanced the motivation and facilitated the achievement of motor-based goals from the patient perspective in children with CP. The client-centered approach, focusing on meeting the basic psychological needs of the participants, contributed to improved therapy outcomes in terms of functional abilities, goal attainment, and engagement in daily activities. These findings highlight the potential of the CO-OP intervention as an effective approach for enhancing motivation and improving therapy outcomes in children with CP.

Responsiveness and Minimal Clinically Important Difference of the Canadian Occupational Performance Measure Among Patients With Frozen Shoulder.

Patient-reported outcome measures provide insights into intervention effects on patients. The Canadian Occupational Performance Measure (COPM) emphasizes identifying priorities in daily activity engagement and evaluating an individual's perception of changes over time. To assess the responsiveness of the COPM and the minimal clinically important difference (MCID) among patients with frozen shoulders. Prospective, single-blind, randomized controlled trial. Two physical medicine and rehabilitation clinics. Ninety-four patients with frozen shoulders enrolled in a previous study. Baseline and 3-mo evaluations of the COPM and other measures. Responsiveness was assessed using effect size (ES) and standardized response mean (SRM). The MCID values were determined through a distribution-based approach, which used the 0.5 standard deviation and ES methods, and an anchor-based approach, which used the receiver operating characteristic curve method. The ES and SRM results indicated that the COPM had high responsiveness. The distribution-based MCID values for COPM Performance and COPM Satisfaction were 1.17 and 1.44, respectively. The anchor-based MCID values were 2.5 (area under the curve [AUC] = 0.78, 95% confidence interval [CI] [0.64-0.91]) and 2.1 (AUC = 0.76, 95% CI [0.60-0.91]), respectively. The findings suggest that the COPM is a responsive outcome measure for patients with frozen shoulder. The established MCID values for the COPM can be valuable for interpreting changes in patient performance and satisfaction, thus aiding clinical interventions and research planning. Plain-Language Summary: This is the first study to review the effectiveness of the Canadian Occupational Performance Measure (COPM) to determine the success of occupational therapy interventions for people with a frozen shoulder. The findings suggest that the COPM is an effective and valuable tool for clients with a frozen shoulder to understand their experiences and treatment priorities and to detect meaningful changes in their performance and satisfaction after an occupational therapy intervention.

Observational evidence of the association between physical and psychological determinants of aging with cognition in older adults

Aging involves physical and cognitive deterioration in older adults. Detecting predictors of dementia early is crucial to identify its onset. This study aimed to associate physical and psychological determinants with cognitive performance in older adults. Observational study with 221 older adults, classified according to cognitive impairment. We evaluated cognitive function by Mini-Mental State Examination. Physical determinants encompassed muscle strength, functional mobility, and cardiorespiratory fitness, while psychological consisted of quality of life and activities of daily living. Multiple linear regression was performed to investigate this relationship. Physical and psychological determinants were significantly linked to cognitive impairment, including lower muscle strength, reduced functional mobility and of cardiorespiratory fitness. The influence of environment, autonomy, and engagement in daily activities on cognitive impairment was also observed. The analysis of physical and psychological determinants could help to aid in distinguishing individuals with cognitive impairment.

Three Perspectives on Older Adults' Daily Performance, Health, and Technology Use During COVID-19: Focus Group Study.

During COVID-19 lockdowns, older adults' engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the important role of older adults' social environments-including their families and health professionals-in influencing their technology use, research into their unique perspectives is lacking. This study aimed to explore the daily activity performance, health, and technology use experiences of healthy independent Israeli adults (aged ≥65 years) during COVID-19 from a 3-dimensional perspective: older adults, older adults' family members, and health professionals. Nine online focus groups, averaging 6-7 participants per group, were conducted with older adults, family members, and health professionals (N=59). Data were analyzed using thematic analysis and constant comparative methods. The intertwining of daily activity performance and health emerged as a central theme, with differences between the groups. Older adults prioritized their self-fulfilling routines based on motivation and choice, especially in social-familial activities. In contrast, family members and health professionals focused on serious physical and mental health COVID-19-related consequences. A consensus among all three groups revealed the meaningful role of technology use during this period in bridging functional limitations. Participants delved into technology's transformative power, focusing on the need for technology to get engaged in daily activities. This study illustrates the profound interplay between daily activity performances, physical and mental health, and technology use, using a 3-dimensional approach. Its focus on technology's uses and benefits sheds light on what older adults need to increase their technology use. Interventions for improving digital activity performance can be tailored to meet older adults' needs and preferences by focusing on motivational and preference-related activities.

Exploring the Effects of Major Depressive Disorder on Daily Occupations and the Impact of Psychotherapy: A Literature Review.

Major depressive disorder (MDD) is a prevalent psychological mood disorder that can disrupt one's functioning and result in decreased engagement in daily activities. Psychotherapy, in different approaches, is a common approach for individuals experiencing MDD. Nevertheless, a literaturereview of the research supporting the effectiveness of psychotherapeutic interventions in patients with MDD-impacted areas of their daily occupations, such as back to work, cognitive deficits, and well-being, has not been conducted. A literature review was carried out to evaluate the effectiveness of psychotherapy on daily occupations for individuals diagnosed with MDD. Due to variations in study design and outcome measures, a best evidence synthesis was carried out instead of a meta-analysis. Forty-one identified articles were fully assessed in total. These studies were conducted in various countries so that a global approach could be considered comprehensive. The findings showed strong evidence supporting the effectiveness of psychotherapy on return-to-work interventions in improving depressive symptoms. There was limited evidence for the effectiveness of psychotherapy on lifestyle interventions in reducing anxiety and suicidal ideation, as well as limited evidence for enhancing work participation. Notably, there were no studies evaluating individualized client-centered psychotherapy interactions with occupations, revealing a research gap. Challenges such as incomplete reporting within studies and study heterogeneity prevented a meta-analysis. While the overall evidence base for the effectiveness of psychotherapy for MDD in treating functionality is limited, the findings provide strong support for the efficacy of occupational therapy return-to-work interventions. This is particularly important given the economic costs associated with mental health issues and work-related absences. Further research is required to strengthen the existing evidence base.

The hidden burden of dysmenorrhea among adolescent girls in Palestine refugee camps: a focus on well-being and academic performance

BackgroundDysmenorrhea (painful menstruation) is a condition that may have a profound effect on adolescent girls’ health status and well-being. It can impede their engagement in daily activities and hamper their regular school attendance. This study aims to explore the relationship between dysmenorrhea, well-being, and academic performance among adolescent girls living in Palestine refugee camps in the West Bank and Jordan.MethodsWe conducted a household survey between June and September 2019, with a total sample of 2737 adolescent girls 15 to 18 years old. Dysmenorrhea severity was assessed using the Working Ability, Location, Intensity, Duration of pain Dysmenorrhea scale (WaLIDD). The WHO-5 scale was used to evaluate the girls’ overall well-being. Menstrual academic disruption (MAD) was measured using a self-reported scale. Multiple linear regression models were employed to evaluate the association between dysmenorrhea, well-being, and academic performance. Directed Acyclic Graphs (DAGs) were employed to identify variables for control in regression models.ResultsThe mean dysmenorrhea score was 6.6 ± 2.6, with 37.9% and 41.2% expressing moderate and severe symptoms, respectively. The mean WHO-5 score was 58.7 ± 25.1, and 34.9% reported a low well-being status. The mean MAD score was 3.1 ± 3.3. 26% reported missing school due to dysmenorrhea, 36% said dysmenorrhea impacted their ability to concentrate, and 39% were unable to study for tests, and complete homework. The first regression analysis showed a reduction of 1.45 units in WHO-5 score for each unit increase in dysmenorrhea. The second regression analysis showed a non-linear increase in MAD score for increasing dysmenorrhea. For each dysmenorrhea score less than 4 (mild) there was a modest increase in MAD scores (coefficient 0.08, p-value = 0.006), and for each dysmenorrhea score above 4 there was a stronger increase in MAD scores (coefficient 0.95, p < 0.001).ConclusionDysmenorrhea poses significant challenges to the well-being and academic performance of adolescent girls living in Palestine refugee camps. Collaborative efforts and multifaceted approaches are crucial to address dysmenorrhea effectively. This involves research, targeted interventions, culturally sensitive strategies, and fostering a supportive environment that empowers girls to thrive academically and beyond.

Flow experience fosters university students' well-being through psychological resilience: Alongitudinal design with cross-lagged analysis.

Existing research has linked individuals' flow experience - a positive affective and cognitive state of deep immersion and engagement in daily activities - and their well-being, particularly among university students. A growing number of longitudinal studies have further contributed to this understanding. However, limited attention has been given to exploring the dynamic interplay between these two variables and their underlying mechanisms (i.e., the mediator) of psychological resilience, specifically among university students in the context of the COVID-19 pandemic. To address this research gap, the present study draws on self-determination, flow and broaden-and-build theories. It examines the temporal dynamics and relationships between flow experience and well-being, and the mediating role of psychological resilience among Chinese university students. The study adopts a three-wave longitudinal design with a sample of 474 university students in Southwest China. Participants' flow experience, well-being and psychological resilience were measured across three time waves. The findings of this study reveal that flow experience predicts well-being across the three waves and that psychological resilience mediates this prediction. This empirical evidence emphasizes the significance of both flow experience and psychological resilience in contributing to the well-being of university students over time amid COVID-19. These findings enrich our understanding of the factors contributing to well-being in educational settings and provide highly relevant and timely insights for developing strategies to foster well-being among university students, especially in the transition into the post-pandemic era; findings also offer valuable insights not only for researchers but also for educators and policymakers.

Sensory Considerations for Emerging Textile Applications

Textiles are increasingly playing a role as a therapeutic medium in the disability field as well as in everyday life. This paper aims to review the literature on the relationship between textiles and sensory integration or sensory preferences in the general population. A brief literature review was conducted using PubMed (MEDLINE), SCOPUS, and Google Scholar. The review of the current literature highlights some key themes in the literature, including the indication that adaptive and sensory clothing design requires consideration of the textiles and fabrics being used, the functionality and appearance of garments, and affordability and access. The evidence suggests that clothing design should utilize soft fabrics which are seamless, have limited external tags, support social participation and functional engagement in daily activities, and are accessible.

Improving Health for Older Adults With Pain Through Engagement: Protocol for Tailoring and Open Pilot Testing of a Mind-Body Activity Program Delivered Within Shared Medical Visits in an Underserved Community Clinic.

Chronic musculoskeletal pain is prevalent and disabling among older adults in underserved communities. Psychosocial pain management is more effective than pharmacological treatment in older adults. However, underserved community clinics often lack psychosocial treatments, in part because of a lack of trained providers. Shared medical appointments, in which patients undergo brief medical evaluation, monitoring, counseling, and group support, are an efficacious and cost-effective method for chronic disease management in underserved clinics, reducing the need for specialized providers. However, shared medical visits are often ineffective for chronic pain, possibly owing to lack of inclusion of skills most relevant for older adults (eg, pacing to increase engagement in daily activities). We have described the protocol for the development and initial pilot effectiveness testing of the GetActive+ mind-body activity intervention for older adults with chronic pain. GetActive+ was adapted from GetActive, an evidence-based intervention that improved pain outcomes among mostly affluent White adults. We aim to establish the initial feasibility, acceptability, fidelity, and effectiveness of GetActive+ when delivered as part of shared medical appointments in a community clinic. We conducted qualitative focus groups and individual interviews with providers (n=25) and English-speaking older adults (aged ≥55 y; n=18) with chronic pain to understand the pain experience in this population, perceptions about intervention content, and barriers to and facilitators of intervention participation and implementation in this setting. Qualitative interviews with Spanish-speaking older adults are in progress and will inform a future open pilot of the intervention in Spanish. We are currently conducting an open pilot study with exit interviews in English (n=30 individuals in total). Primary outcomes are feasibility (≥75% of patients who are approached agree to participate), acceptability (≥75% of patients who enrolled complete 8 out of 10 sessions; qualitative), and fidelity (≥75% of session components are delivered as intended). Secondary outcomes include physical function-self-reported, performance based (6-minute walk test), and objective (step count)-and emotional function (depression and anxiety). Other assessments include putative mechanisms (eg, mindfulness and pain catastrophizing). We began enrolling participants for the qualitative phase in November 2022 and the open pilot phase in May 2023. We completed the qualitative phase with providers and English-speaking patients, and the results are being analyzed using a hybrid, inductive-deductive approach. We conducted rapid analysis of these data to develop GetActive+ before the open pilot in English, including increasing readability and clarity of language, reducing the number of skills taught to increase time for individual check-ins and group participation, and increasing experiential exercises for skill uptake. We provide a blueprint for the refinement of a mind-body activity intervention for older adults with chronic pain in underserved community clinics and for incorporation within shared medical visits. It will inform a future, fully powered, effectiveness-implementation trial of GetActive+ to help address the chronic pain epidemic among older adults. ClinicalTrials.gov NCT05782231; https://clinicaltrials.gov/study/NCT05782231. DERR1-10.2196/52117.

CONECTAR: A MINDSET TO INCREASE HISPANIC ENGAGEMENT IN DIGITAL TECHNOLOGY RESEARCH

Abstract In-home digital technology affords the opportunity for more precise and ecologically valid assessments of daily activity engagement. However, concerns about loss of privacy can hinder recruitment, especially within communities already underrepresented in research. Literature on effective, culturally tailored recruitment strategies is limited. Herein, we describe strategies employed for an in-home digital technology study with 100% Mexican American representation. Hispanic participants were recruited from the greater San Antonio area. Direct recruitment strategies conducted in both English and Spanish included community outreach events, a participant repository, cross-enrollment with other research studies, and by word of mouth. Mass recruitment strategies included flyer dissemination, newsletters, and digital announcements through community organizations (i.e., Salud America!) and national (i.e., Research Match) and institutional websites. Between September 2022 and February 2023, 31 participants were enrolled out of 154 individuals who were contacted. Of these, 29% were recruited from community events, 22.6% from word of mouth, 19.4% from cross-enrollment, 12.9% from the research repositories, and 16.1% from mass recruitment strategies. The most common reasons for non-enrollment included lack of interest (n=49), screen failure (n=29), and privacy concerns (n=12).Direct recruitment efforts achieved higher rates of enrollment, while mass media campaigns yielded lower responses and resulted in more unsuccessful contact attempts. Understanding the relationship between social networks and research beliefs may be particularly relevant given the Hispanic culture’s collectivist and family-oriented nature. Hence, social network theories, combined with a diffusion of innovation framework, may be advantageous for increasing trust and may consequently improve representation of diverse groups in research.

Perceived Control Over Time Among College Students with and without Attention Deficits and/or Specific Learning Disorders.

Background: College students cope with a variety of activities that demand organizational skills which may increase stress. Perceived control over time is the perception of having enough time to finish one’s work meet one’s deadlines. This influences time management behaviors, satisfaction, independent engagement in daily activities, academic success and stress. Aim: To evaluate the self-perception of daily functions and control over time among college students with and without Attention Deficits and/or Specific Learning Disorders, who were seeking support, correlated with their demographic characteristics. Method: Participants: Thirty-six students (3 males, 33 females), mean age 23.42 + 4.80, who approached the college's student support center. Instruments: Behavioral Rating Inventory of Executive Functions (BRIEF- A) and Time Organization and Participation Scale (TOPS). Results: Significant correlations were found between the BRIEF - A and the TOPS subscales. Comorbidity of SLD and ADHD was associated with a lower perceived performance as measured in those scales while the demographic variables did not. Conclusions: Occupational therapists may have an important role in students' support centers and are encouraged to evaluate perceived control over time, of students, facilitate time management skills, and guide a discovery of strategies for balancing between demanding academic and extra curriculums tasks.

Pediatric strabismus is associated with increased severe functional impairment

Previous studies found children with strabismus have increased risk of physical injuries and reduced overall quality of life. However, the impact of strabismus on interpersonal relationships and engagement in daily activities is not well understood. The purpose of this study was to determine the association of strabismus with severe functional impairment and identify domains disrupted by strabismus.

Experts' Perceived Patient Burden and Outcomes of Knee-ankle-foot-orthoses (Kafos) Vs. Microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot Orthoses (Mp-sscos).

Patients with neuromuscular knee-instability assisted with orthotic devices experience problems including pain, falls, mobility issues and limited engagement in daily activities. The aim of this study was to analyse current real-life burden, needs and orthotic device outcomes in patients in need for advanced orthotic knee-ankle-foot-orthoses (KAFOs). An observer-based semi-structured telephone interview with orthotic care experts in Germany was applied. Interviews were transcribed and content-analysed. Quantitative questions were analysed descriptively. Clinical experts from eight centres which delivered an average of 49.9 KAFOs per year and 13.3 microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs) since product availability participated. Reported underlying conditions comprised incomplete paraplegia (18%), peripheral nerve lesions (20%), poliomyelitis (41%), post-traumatic lesions (8%) and other disorders (13%). The leading observed patient burdens were "restriction of mobility" (n=6), followed by "emotional strain" (n=5) and "impaired gait pattern" (n=4). Corresponding results for potential patient benefits were seen in "improved quality-of-life" (n=8) as well as "improved gait pattern" (n=8) followed by "high reliability of the orthosis" (n=7). In total, experts reported falls occurring in 71.5% of patients at a combined annual frequency of 7.0 fall events per year when using KAFOs or stance control orthoses (SCOs). In contrast, falls were observed in only 7.2 % of MPSSCO users. Advanced orthotic technology might contribute to better quality of life of patients, improved gait pattern and perceived reliability of orthosis. In terms of safety a substantial decrease in frequency of falls was observed when comparing KAFO and MP-SSCO users.

Perceived accessibility: How access to dockless bike-sharing impacts activity participation

The emergence and popularity of dockless bike-sharing systems have attracted extensive attention due to the associated environmental and health benefits. However, little consideration has been given to the potential individual social implications of dockless bike-sharing. Our knowledge about whether dockless bike-sharing systems have the ability to facilitate individuals’ engagement in daily activities is limited. The goal of this study is to gain more insight into how individuals’ personal characteristics and neighborhood environment features influence perceived access to different types of activities by dockless bike-sharing. Using survey data collected from residents in Beijing, we employed four ordinary least squares (OLS) regressions to assess the effect of individual and spatial attributes on the role dockless bike-sharing plays in users’ perceived accessibility to activities overall as well as to three different categories of activities—subsistence, maintenance and leisure. The results indicated that male users reported enjoying more benefits in accessing activities. Dockless bike-sharing users’ perceived benefits in accessing activities largely relied on their social support from their family and friends and their attitudes towards environmental and health concerns of travel. Additionally, users who agreed that dockless bike-sharing has helped them access bus stops and metro stations perceived higher benefits of dockless bike-sharing on activity participation. Our analysis also highlighted that dockless bike-sharing users in Beijing benefited most in their commuting trips, and to a lesser degree, when attending maintenance and leisure activities. The percentage of cycling paths within the home neighborhood tended to be positively associated with individuals’ perceived accessibility to subsistence activities.

Shining new light on dementia treatment: ADAS‐Cog and quantitative EEG evidence of cognitive improvement in early and mid‐stage dementia using self‐administered 1070 nm transcranial near‐infrared photobiomodulation

AbstractBackgroundThe current evidence supporting nonpharmacologic treatment of dementia has focused mainly on environmental or interactive interventions, e.g., music, sensory stimulation, simulated presence, and validation therapies. Exercise and light therapy improved/maintained activities of daily living, while cognitive stimulation, exercise and reminiscence improved cognition. The strongest evidence for reducing emotional disorders so far has employed music, psychological interventions and reminiscence. PubMed lists 918 citations related to non‐pharmacological treatments for dementia with music therapy and behavioral management techniques being the most efficacious showing modest improvements at best. Non‐pharmacologic treatment interventions directed at reversing both cognitive and behavioral symptom of dementia are small, few in number and with wide variation in defining outcome measures, and little comparative data across approaches to guide further research efforts or systematic clinical applicability. Photobiomodulation using brief, daily, pulsed LED‐driven transcranial infrared light stimulation, has been shown to markedly alter both cognitive and behavioral symptoms in people with mild to moderate dementia. Improved functioning has been documented by both standard neuropsychological testing and noninvasive Quantitative electroencephalographic (QEEG) measures of functional connectivity. This presentation describes a multi‐site, randomized, placebo controlled, at‐home, self‐administered treatment protocol employing pulsed transcranial and intraocular 1068nm near‐infrared light to achieve reversal of cognitive decline, and improve dementia patient’s physical and interpersonal behavior. Study subjects (n=100) were evaluated at two locations at baseline, midpoint (30 days) and termination (60 days) using both Quantitative EEG and ADAS‐Cog and caregiver evaluation of subject’s change in ADLs. This trial was a replication of an earlier pilot trial and a recent safety/feasibility trial with no adverse events reported in any study. MMSE improved 21.0%, 4.8 points in the active treatment group and 1.6 points in the placebo group. Sleep duration increased in the active treatment group by an hour after 8 days of treatment and caregivers noted improved mood, energy, and positive engagement in daily activities. None of these functional changes were noted in the placebo arm subjects. Active group’s clock drawing improved 20% and no change in the control group. Logical memory recall improved 3.3 points (p&lt; .03) and time to completion of Trails A&amp;B decreased 23.7% (p&lt;.03).

A smart tech lever to augment caregivers' touch and foster vulnerable patient engagement and well-being

PurposeSome population groups face precarious health, reflecting their vulnerability, in terms of lack of agency or control. Smart technologies promise to transform people's lives from the enhanced connectedness, greater computational processing and more complex decision-making they can achieve. This study aims to investigate how smart technology can mitigate vulnerability and improve well-being.Design/methodology/approachThe research group, of three scholars and three managers, pursued an action research methodology with an iterative process of planning, action and learning. The authors conducted three related action studies: (1) adopting smart technologies, (2) fostering patient engagement and (3) assessing well-being.FindingsThe adoption of sensors and wearable devices had positive impacts for both patients and caregivers. Technologies highlighted their meaning as resources to support actors' (caregivers' and vulnerable patients') activities. Smart devices as resources get integrated, stimulate change and enable new practices. For caregivers, such innovative solutions help improve their knowledge of patients and their ability to act efficiently; for vulnerable patients, they fostered engagement in daily activities to improve well-being.Originality/valueThe paper delineates an overall model (SEVP) that describes how the integration of high-tech and high touch enables patient engagement to mitigate vulnerability and improve well-being.