Motor Disability Research Articles

Changes in Fecal Gut Microbiome of Home Healthcare Patients with Disabilities through Consumption of Malted Rice Amazake.

The aim of this study was to investigate changes in gut microbiome both during and after the consumption of malted rice amazake (MR-Amazake), a fermented food from Japan, in home healthcare patients with disabilities including patients with severe motor and intellectual disabilities (SMID). We monitored 12 patients who consumed MR-Amazake for six weeks, investigating them before and after the intervention as well as six weeks after the end of intake to compare their physical condition, diet, the type of their medication, Constipation Assessment Scale (CAS), and an analysis of their comprehensive fecal microbiome using 16S rRNA sequencing. Their constipation symptom significantly alleviated and principal coordinates analysis revealed that 30% of patients showed significant changes in gut microbiome after MR-Amazake ingestion. Furthermore, Bifidobacterium was strongly associated with these changes. These changes were observed only during MR-Amazake intake; the original gut microbiome was restored when MR-Amazake intake was discontinued. These results suggest that six weeks is a reasonable period of time for MR-Amazake to change human gut microbiome and that continuous consumption of MR-Amazake is required to sustain such changes.

Imperfect Surrogate Users: Understanding Performance Implications of Augmentative and Alternative Communication Systems through Bounded Rationality, Human Error, and Interruption Modeling

Nonspeaking individuals with motor disabilities frequently rely on augmentative and alternative communication (AAC) systems that allow users to communicate through a text entry interface coupled with a speech synthesizer. Such systems are notoriously difficult to evaluate with end-users. However, recent research has proposed envelope analysis as a method to estimate text entry rates and keystroke savings by simulating the interaction of an expert surrogate user entering sentences on a conceptual word-predictive text entry system. While only a part of the evaluation process of an AAC system, this method enables AAC designers to benefit from quantitative insights early on in the design process. This paper extends prior work by (1) demonstrating how to incorporate natural language generation, such as sentence generation, in such analyses; (2) presenting a model of an imperfect surrogate user that incorporates bounded rationality, human error, and interruptions to provide a more realistic simulation of text entry behavior; and (3) demonstrating how to estimate model parameters by observing users' actual typing behavior. We validate the model with data collected from eight participants using an AAC system on a touchscreen.

A novel framework for classification of two-class motor imagery EEG signals using logistic regression classification algorithm.

Robotics and artificial intelligence have played a significant role in developing assistive technologies for people with motor disabilities. Brain-Computer Interface (BCI) is a communication system that allows humans to communicate with their environment by detecting and quantifying control signals produced from different modalities and translating them into voluntary commands for actuating an external device. For that purpose, classification the brain signals with a very high accuracy and minimization of the errors is of profound importance to the researchers. So in this study, a novel framework has been proposed to classify the binary-class electroencephalogram (EEG) data. The proposed framework is tested on BCI Competition IV dataset 1 and BCI Competition III dataset 4a. Artifact removal from EEG data is done through preprocessing, followed by feature extraction for recognizing discriminative information in the recorded brain signals. Signal preprocessing involves the application of independent component analysis (ICA) on raw EEG data, accompanied by the employment of common spatial pattern (CSP) and log-variance for extracting useful features. Six different classification algorithms, namely support vector machine, linear discriminant analysis, k-nearest neighbor, naïve Bayes, decision trees, and logistic regression, have been compared to classify the EEG data accurately. The proposed framework achieved the best classification accuracies with logistic regression classifier for both datasets. Average classification accuracy of 90.42% has been attained on BCI Competition IV dataset 1 for seven different subjects, while for BCI Competition III dataset 4a, an average accuracy of 95.42% has been attained on five subjects. This indicates that the model can be used in real time BCI systems and provide extra-ordinary results for 2-class Motor Imagery (MI) signals classification applications and with some modifications this framework can also be made compatible for multi-class classification in the future.

Empowering Independence: A Scoping Review on Innovations in Smart Home Technology for People with Motor Disabilities

Individuals with disabilities, particularly those with motor impairments, comprise a significant portion of the global population. smart home technologies have become a viable tool for improving their living conditions and promoting independence. This paper systematically synthesizes recent research on smart home technologies that enhance the living conditions of people with mobility impairments. Among the 27 studies reviewed, individuals with various mobility disabilities benefited from smart home technology, and independent living became more feasible. However, some limitations still exist, including the efficiency and convenience of wearable equipment, system sophistication, and generalization to a wider range of use. The findings of this study may inform the design of next-generation smart home technology for universal users.

Lower limb rehabilitation using modified constraint-induced movement therapy and motor relearning program on balance and gait in sub-acute hemiplegic stroke: a comparative study

Background: A stroke is described by the World Health Organization as “a clinical syndrome with rapidly developing symptoms that consist of a focal (or global, in a situation of coma) disruption of cerebral function that lasts more than 24 hours or leads to mortality without a known cause other than a vascular origin”. Stroke is the most prevalent cause of impairment and mortality on a global scale. Modified constraint-induced movement therapy (mCIMT) is an approach to therapy for motor disabilities that involves constraining the movements of the nonparetic limb, diligent practice and behaviour modification to extend the time the paretic limb is utilized for daily tasks. The motor relearning program (MRP) method involves many aspects of motor learning theory and is helpful in providing instructions for retraining practical skills (including walking, standing and sitting in balance and transferring abilities). So, the objective of this study is to assess the impact of the MRP and mCIMT on balance and gait in sub-acute hemiplegic stroke patients. Methods: In this study, each group will consist of 17 people in total. The randomization procedure will be conducted using a computer-generated random number system. For sample distribution, we will use the sequentially numbered opaque sealed envelope technique. Outcome measures will be as follows: Berg balance scale, Dynamic gait index, Trunk impairment scale, Functional reach test, 10 Meter walk test and Fall efficacy test. Each patient will be evaluated prior to and during treatment at baseline and six weeks later. Conclusions: There is sufficient evidence to derive the conclusion that the functional mobility and balance of stroke victims can be improved with physiotherapy. Therefore, this study will try to seek the comparison of mCIMT and MRP in sub-acute stroke subjects and compare the two regimes to determine which one will be superior. Registration: CTRI (CTRI/2023/05/052674; 16/05/2023).

ACQUIRED MOTOR DISABILITY AND RESILIENCE IN ADULTS SURVIVORS OF SEVERE TRAFFIC ACCIDENTS: A RETROSPECTIVE CLINICAL AND PROJECTIVE STUDY

The researcher addressed the study of evaluating the context of resilience in adults who, for over three (03) years, have experienced a severe traffic accident resulting in complete lower paralysis. Drawing on psychoanalytic exploration of resilience on one hand, and clinical and psychodynamic analysis of acquired motor disability in adults on the other hand, the concept of resilience was considered within the adopted definition as a dynamic context culminating in the integration of compounded shock (facing real threat of death and the shock linked to self-loss). This is followed by a rebound and identity reconstruction, ultimately leading to the resumption of life in a new direction, intertwined with a new body. Emphasis was placed on the idea that the context is influenced by the continuous interaction between each participant's internal psychological resources and external resources represented by their family and social environment, which they might have access to. To achieve this, the researcher resorted to qualitative analysis, employing semi-structured clinical interviews and projective techniques, including the Rorschach test and the Thematic Apperception Test (T.A.T). Furthermore, certain dimensions of psychological functioning were considered, such as the breadth of imaginative space, mentalization’s quality, the adaptive use of defense mechanisms and finally, the process of identity reconstruction. On the other hand, the external reality was approached through the potential encounter of the participants with a supporting person that assists them in regaining their re-narcissization. The results unveiled variations in the paths each participant took towards achieving resilience. This was linked to the diverse and effective interplay between their inner psychological reality and individual resources. The presence of a good resilience caregiver was noted to assist in surpassing the traumatic experience. A few participants displayed superficial resilience, while the results also demonstrated a diversity in the meaning assigned to the compounded traumatic event,including divine punishment, predestination, self-validation, and the discovery of new meaning in life

Action Research on Education for Children with Severe Motor and Intellectual Disabilities

Action Research on Education for Children with Severe Motor and Intellectual Disabilities

Vulnerability Scale for People with Motor Disabilities After an Acquired Neurological Lesion

Introduction: After an acquired neurological lesion, some people are in situations of greater vulnerability to complications and comorbidities, which can exert impacts on their life and health, compromise their quality of life, and lead to hospitalizations and premature death. Identifying the vulnerability situation can guide nurses in the development of actions to prevent complications, comorbidities, and other conditions after the neurological lesion. Objective: To validate a scale to identify the vulnerability situation of people with motor disabilities after an acquired neurological lesion (Escala de Vulnerabilidade de Pessoas com Deficiência, EVU-PcD). Materials and method: The article presents a methodological development and psychometric study with a quantitative approach. The construct validity stages were as follows: application of the Vulnerability Scale for people with motor disabilities after an acquired neurological lesion (EVU-PcD) and reliability and confirmatory factor analysis. EVU-PcD, initially with 38 items, was applied to 102 individuals with acquired motor disabilities. Reliability was assessed using Cronbach’s alpha from 0.7 to 0.9. In the confirmatory factor analysis, the structural equations model for latent variables a path diagram was used. Results: The overall Cronbach’s alpha coefficient was 0.86, which was considered excellent. The fit indices, chi-square ratio (1.63), root mean square of approximation errors (0.08) and parsimonious fit quality index (0.61) presented acceptable indicators of adequacy to the final model with three domains and 28 items. Conclusions: The final factor structure of the EVU-PcD scale with 28 items showed satisfactory reliability and validity results to identify the vulnerability of people with motor disabilities after an acquired neurological lesion.

Long-term potentiation-like plasticity is retained during relapse in patients with Multiple Sclerosis

ObjectiveTo investigate the degree of synaptic plasticity in Multiple Sclerosis (MS) patients during acute relapses compared to stable MS patients and healthy controls (HCs) and to analyze its functional relevance. MethodsFacilitatory quadripulse stimulation (QPS) was applied to the primary motor cortex in 18 acute relapsing and 18 stable MS patients, as well as 18 HCs. The degree of synaptic plasticity was measured by the change in motor evoked potential amplitude following QPS. Symptom recovery was assessed three months after relapse. ResultsSynaptic plasticity was induced in all groups. The degree of induced plasticity did not differ between acute relapsing patients, HCs, and stable MS patients. Plasticity was significantly higher in relapsing patients with motor disability compared to relapsing patients without motor disability. In most patients (n = 9, 50%) symptoms had at least partially recovered three months after the relapse, impeding meaningful analysis of the functional relevance of baseline synaptic plasticity. ConclusionsQPS-induced synaptic plasticity is retained during acute MS relapses. Subgroup analyses suggest that stabilizing metaplastic mechanisms may be more important to prevent motor disability but its functional relevance needs to be verified in larger, longitudinal studies. SignificanceNew insights into synaptic plasticity during MS relapses are provided.

Clinical Profiles in Multiple Sclerosis: Cognitive Reserve and Motor Impairment along Disease Duration.

(i) Background: Cognitive impairment in people with multiple sclerosis (MS) has been studied in relation to certain clinical variables (e.g., motor disability and disease duration) and lifestyle factors such as cognitive reserve (CR). However, only very few studies have considered the interaction of clinical variables and cognitive reserve in preserving the integrity of the neuropsychological profile. In this paper, we hypothesised that a higher level of CR might predict good cognitive efficiency by modulating the clinical outcome of the disease. (ii) Methods: A sample of 100 participants with MS (age range 30-74), was recruited and assessed remotely with a questionnaire to measure CR and a cognitive screening test. Data were analysed through generalized additive models. (iii) Results: We found that the model analysing the interaction between CR and disease duration, and between CR and motor disability, was able to explain a significant percentage of cognitive performance. In particular, higher levels of CR predicted a better cognitive performance despite a long disease duration, unless the motor disability was severe. (iv) Conclusion: This study highlights the crucial role of CR in modulating cognitive efficiency in people with MS.

Therapeutic Role of Animals: A Comprehensive Literature Review on the Prevalent Forms and Species in Animal-Assisted Interventions

Animals have been valued and used to improve human physical and mental health since ancient times. Animal-assisted therapy (AAT) is a complementary approach to traditional medicine, involving trained animals. AAT can enhance cognition, commitment, character growth, and the learning process. Commonly used species in animal-assisted therapy include cats, dogs, horses, dolphins, and others. Feline-assisted therapy alleviates loneliness and stress, whereas canine-assisted therapy positively impacts emotions and overall well-being. Equine-assisted interventions benefit individuals with cognitive and motor disabilities. Dolphin-assisted therapy shows promise for conditions like autism and cerebral palsy. However, ethical concerns have arisen, particularly in children with behavioral disorders. Safety measures, adult supervision, and proper screening and hygiene practices are crucial in AAT programs. In conclusion, AAIs have a significant potential to enhance well-being and mental health across various contexts, but more research is needed to fully understand their effectiveness and safety in different settings and age groups. The existing literature consists of subjective accounts and inadequate methodologies.

Development and Standardization of Low-Verbal Material for Assessment of Central Auditory Processing in Arabic Language

Development and Standardization of Low-Verbal Material for Assessment of Central Auditory Processing in Arabic Language

Robotics at the Service of Wheelchair Mobility for People with Disabilities: Story of a Clinical-Scientific Partnership.

The mobility of people with motor disabilities combined with sensory or cognitive disabilities, sometimes leads to safety issues that make independent travel impossible. In this context, teams based in Rennes in the west of France have been working together for several years to design two devices: - an power wheelchair simulator to promote learning to drive in an immersive virtual environment - a driving assistance module that can be added to an power wheelchair to pass and avoid obstacles. This transdisciplinary work was made possible by the geographical and human proximity of the scientific, technical and clinical teams in order to best meet the needs of the end users who were integrated into this co-design approach. This article describes the evolution of this work and future prospects.

Telerehabilitation with ARC Intellicare to Cope with Motor and Respiratory Disabilities: Results about the Process, Usability, and Clinical Effect of the "Ricominciare" Pilot Study.

"Ricominciare" is a single-center, prospective, pre-/post-intervention pilot study aimed at verifying the feasibility and safety of the ARC Intellicare (ARC) system (an artificial intelligence-powered and inertial motion unit-based mobile platform) in the home rehabilitation of people with disabilities due to respiratory or neurological diseases. People with Parkinson's disease (pwPD) or post-COVID-19 condition (COV19) and an indication for exercise or home rehabilitation to optimize motor and respiratory function were enrolled. They underwent training for ARC usage and received an ARC unit to be used independently at home for 4 weeks, for 45 min 5 days/week sessions of respiratory and motor patient-tailored rehabilitation. ARC allows for exercise monitoring thanks to data from five IMU sensors, processed by an AI proprietary library to provide (i) patients with real-time feedback and (ii) therapists with information on patient adherence to the prescribed therapy. Usability (System Usability Scale, SUS), adherence, and adverse events were primary study outcomes. Modified Barthel Index (mBI), Barthel Dyspnea Index (BaDI), 2-Minute Walking Test (2MWT), Brief Fatigue Inventory (BFI), Beck Depression or Anxiety Inventory (BDI, BAI), and quality of life (EQ-5D) were also monitored pre- and post-treatment. A total of 21 out of 23 eligible patients were enrolled and completed the study: 11 COV19 and 10 pwPD. The mean total SUS score was 77/100. The median patients' adherence to exercise prescriptions was 80%. Clinical outcome measures (BaDI, 2MWT distance, BFI; BAI, BDI, and EQ-5D) improved significantly; no side effects were reported. ARC is usable and safe for home rehabilitation. Preliminary data suggest promising results on the effectiveness in subjects with post-COVID condition or Parkinson's disease.

Association between gestational levels of toxic metals and essential elements and cerebral palsy in children.

Cerebral palsy (CP) is the most common motor disability in childhood, but its causes are only partly known. Early-life exposure to toxic metals and inadequate or excess amounts of essential elements can adversely affect brain and nervous system development. However, little is still known about these as perinatal risk factors for CP. This study aims to investigate the associations between second trimester maternal blood levels of toxic metals, essential elements, and mixtures thereof, with CP diagnoses in children. In a large, population-based prospective birth cohort (The Norwegian Mother, Father, and Child Cohort Study), children with CP diagnoses were identified through The Norwegian Patient Registry and Cerebral Palsy Registry of Norway. One hundred forty-four children with CP and 1,082 controls were included. The relationship between maternal blood concentrations of five toxic metals and six essential elements and CP diagnoses were investigated using mixture approaches: elastic net with stability selection to identify important metals/elements in the mixture in relation to CP; then logistic regressions of the selected metals/elements to estimate odds ratio (OR) of CP and two-way interactions among metals/elements and with child sex and maternal education. Finally, the joint effects of the mixtures on CP diagnoses were estimated using quantile-based g-computation analyses. The essential elements manganese and copper, as well as the toxic metal Hg, were the most important in relation to CP. Elevated maternal levels of copper (OR = 1.40) and manganese (OR = 1.20) were associated with increased risk of CP, while Hg levels were, counterintuitively, inversely related to CP. Metal/element interactions that were associated with CP were observed, and that sex and maternal education influenced the relationships between metals/elements and CP. In the joint mixture approach no significant association between the mixture of metals/elements and CP (OR = 1.00, 95% CI = [0.67, 1.50]) was identified. Using mixture approaches, elevated levels of copper and manganese measured in maternal blood during the second trimester could be related to increased risk of CP in children. The inverse associations between maternal Hg and CP could reflect Hg as a marker of maternal fish intake and thus nutrients beneficial for foetal brain development.

Predictors of Mortality and Functional recovery after severe traumatic brain injury: protocol for a prospective cohort study

Introduction: traumatic brain injury is a global public health problem due to its severity and high rates of morbimortality worldwide. Identifying predictors associated with increased mortality and unfavorable functional outcomes after the traumatic brain injury event is crucial for minimizing morbidity and mortality rates. Therefore, this study aims to establish a protocol to investigate the predictors of mortality and functional recovery after severe traumatic brain injury in Brazil. Methods: The study will include all patients admitted for severe traumatic brain injury (Glasgow Coma Scale ≤ 8) at the State Hospital of Urgency and Emergency, which is the referral trauma hospital of Espirito Santo. The outcomes of interest are hospital mortality and functional recovery 24 months after hospital discharge. Subjects will be followed up at seventy-two hours, three months, six months, twelve months, and twenty-four months after the trauma. Morbidity will be determined by assessing: 1) the level of motor and cognitive disability, 2) functional impairment and quality of life, and 3) aspects of rehabilitation treatment. Additionally, the traumatic brain injury load, estimated by the years of life lost, will be calculated. Discussion: the results of this study will help identify variables that can predict morbidity and mortality, as well as diagnostic and therapeutic targets for patients with severe traumatic brain injury. Furthermore, the findings will have practical implications for: 1) the development of public policies, 2) investments in hospital infrastructure 3) understanding the socioeconomic impact of functional loss in the individuals. Study registration: the study received approval from the Ethics Committee of the Federal University of Espirito Santo under protocol number 4.222.002 on August 18, 2020.

Increased expression of Nav1.6 of reactive astrocytes in the globus pallidus is closely associated with motor deficits in a model of Parkinson's disease.

Parkinson's disease (PD) is a common neurodegenerative disease in elderly people, which is characterized by motor disabilities in PD patients. Nav1.6 is the most abundant subtype of voltage-gated sodium channels (VGSCs) in the brain of adult mammals and rodents. Here we investigated the role of Nav1.6 in the external globus pallidus (GP) involved in the pathogenesis of motor deficits in unilateral 6-OHDA(6-hydroxydopamine)lesioned rats. The results show that Nav1.6 is dramatically increased in reactive astrocytes of the ipsilateral GP in the middle stage, but not different from the control rats in the later stage of the pathological process in 6-OHDA lesioned rats. Furthermore, the down-regulation of Nav1.6 expression in the ipsilateral GP can significantly improve motor deficits in 6-OHDA lesioned rats in the middle stage of the pathological process. The electrophysiological experiments show that the down-regulation of Nav1.6 expression in the ipsilateral GP significantly decreases the abnormal high synchronization between the ipsilateral M1 (the primary motor cortex) and GP in 6-OHDA lesioned rats. Ca2+ imaging reveals that the down-regulation of Nav1.6 expression reduces the intracellular concentration of Ca2+ ([Ca2+ ]i) in primary cultured astrocytes. These findings suggest that the increased Nav1.6 expression of reactive astrocytes in the GP play an important role in the pathogenesis of motor dysfunction in the middle stage in 6-OHDA lesioned rats, which may participate in astrocyte-neuron communication by regulating [Ca2+ ]i of astrocytes, thereby contributing to the formation of abnormal electrical signals of the basal ganglia (BG) in 6-OHDA lesioned rats.

Motor rehabilitation after stroke: European Stroke Organisation (ESO) consensus-based definition and guiding framework.

To propose a consensus-based definition and framework for motor rehabilitation after stroke. An expert European working group reviewed the literature, attaining internal consensus after external feedback. Motor rehabilitation is defined as a process that engages people with stroke to benefit their motor function, activity capacity and performance in daily life. It is necessary for people with residual motor disability whose goal is to enhance their functioning, independence and participation. Motor rehabilitation operates through learning- and use-dependent mechanisms. The trajectory of motor recovery varies across patients and stages of recovery. Early behavioral restitution of motor function depends on spontaneous biological mechanisms. Further improvements in activities of daily living are achieved by compensations. Motor rehabilitation is guided by regular assessment of motor function and activity using consensus-based measures, including patient-reported outcomes. Results are discussed with the patient and their carers to set personal goals. During motor rehabilitation patients learn to optimize and adapt their motor, sensory and cognitive functioning through appropriately dosed repetitive, goal-oriented, progressive, task- and context-specific training. Motor rehabilitation supports people with stroke to maximize health, well-being and quality of life. The framework describes the International Classification of Functioning, Disability and Health in the context of stroke, describes neurobiological mechanisms of behavioral restitution and compensation, and summarizes recommendations for clinical assessment, prediction tools, and motor interventions with strong recommendations from clinical practice guidelines (2016-2022). This definition and framework may guide clinical educators, inform clinicians on current recommendations and guidelines, and identify gaps in the evidence base.

Combining brain-computer interfaces and multiplayer video games: an application based on c-VEPs.

Video games are crucial to the entertainment industry, nonetheless they can be challenging to access for those with severe motor disabilities. Brain-computer interfaces (BCI) systems have the potential to help these individuals by allowing them to control video games using their brain signals. Furthermore, multiplayer BCI-based video games may provide valuable insights into how competitiveness or motivation affects the control of these interfaces. Despite the recent advancement in the development of code-modulated visual evoked potentials (c-VEPs) as control signals for high-performance BCIs, to the best of our knowledge, no studies have been conducted to develop a BCI-driven video game utilizing c-VEPs. However, c-VEPs could enhance user experience as an alternative method. Thus, the main goal of this work was to design, develop, and evaluate a version of the well-known 'Connect 4' video game using a c-VEP-based BCI, allowing 2 users to compete by aligning 4 same-colored coins vertically, horizontally or diagonally. The proposed application consists of a multiplayer video game controlled by a real-time BCI system processing 2 electroencephalograms (EEGs) sequentially. To detect user intention, columns in which the coin can be placed was encoded with shifted versions of a pseudorandom binary code, following a traditional circular shifting c-VEP paradigm. To analyze the usability of our application, the experimental protocol comprised an evaluation session by 22 healthy users. Firstly, each user had to perform individual tasks. Afterward, users were matched and the application was used in competitive mode. This was done to assess the accuracy and speed of selection. On the other hand, qualitative data on satisfaction and usability were collected through questionnaires. The average accuracy achieved was 93.74% ± 1.71%, using 5.25 seconds per selection. The questionnaires showed that users felt a minimal workload. Likewise, high satisfaction values were obtained, highlighting that the application was intuitive and responds quickly and smoothly. This c-VEP based multiplayer video game has reached suitable performance on 22 users, supported by high motivation and minimal workload. Consequently, compared to other versions of "Connect 4" that utilized different control signals, this version has exhibited superior performance.

Assessing eating and swallowing in adults born with intellectual and motor disabilities: Face and content validity of a Swedish translation of the Dysphagia Assessment Package.

Adults born with intellectual disabilities (ID) and motor disabilities (MD) have higher risk of dysphagia and should be assessed to decrease risk of severe complications. However, standardised assessment tools in Swedish are lacking. The Dysphagia Assessment Package (DAP) was cross-culturally translated from English to Swedish (DAP-SE) and tested for content validity by an expert group. Face validity was assessed by five speech and language therapist (SLT) during meal observations (n=10), and the clinical relevance was reported in a study-specific questionnaire. The DAP-SE was culturally adapted within the process of translation and was found to contain clinically relevant aspects to assess and suggest further interventions for adults with ID and MD. Face and content validity was confirmed by the expert group. This study, in which the DAP-SE was tested in a small sample size, provides the first indications of the instrument's validity with respect to evaluating mealtimes, swallowing function and swallowing safety in adults born with ID and MD. The study adds to the knowledge on how to translate and culturally adapt an assessment tool to clinically assess dysphagia on a complex and vulnerable patient group.