Participation Of Survivors Research Articles

A systematic investigation of detectors for low signal-to-noise ratio EMG signals

Background: Active participation of stroke survivors during robot-assisted movement therapy is essential for sensorimotor recovery. Robot-assisted therapy contingent on movement intention is an effective way to encourage patients' active engagement. For severely impaired stroke patients with no residual movements, a surface electromyogram (EMG) has been shown to be a viable option for detecting movement intention. Although numerous algorithms for EMG detection exist, the detector with the highest accuracy and lowest latency for low signal-to-noise ratio (SNR) remains unknown. Methods: This study, therefore, investigates the performance of 13 existing EMG detection algorithms on simulated low SNR (0dB and -3dB) EMG signals generated using three different EMG signal models: gaussian, Laplacian, and biophysical model. The detector performance was quantified using the false positive rate (FPR), false negative rate (FNR), and detection latency. Any detector that consistently showed FPR and FNR of no more than 20%, and latency of no more than 50ms, was considered an appropriate detector for use in robot-assisted therapy. Results: The results indicate that the Modified Hodges detector – a simplified version of the threshold-based Hodges detector introduced in the current study – was the most consistent detector across the different signal models and SNRs. It consistently performed for ~90% and ~40% of the tested trials for 0dB and -3dB SNR, respectively. The two statistical detectors (Gaussian and Laplacian Approximate Generalized Likelihood Ratio) and the Fuzzy Entropy detectors have a slightly lower performance than Modified Hodges. Conclusions: Overall, the Modified Hodges, Gaussian and Laplacian Approximate Generalized Likelihood ratio, and the Fuzzy Entropy detectors were identified as the potential candidates that warrant further investigation with real surface EMG data since they had consistent detection performance on low SNR EMG data.

Characterizing the impact of multiple chronic conditions on return to participation in chronic stroke survivors

ABSTRACT Background Each year, 795,000 Americans experience a stroke. As stroke mortality declines, more individuals are in the chronic phase of recovery (>6 months post-stroke). Over 80% of stroke survivors have multiple, chronic health conditions (MCC). While the relationship between MCC and mortality and function during acute recovery has been explored, less is known about how MCC burden affects participation in chronic stroke survivors. Objective This study investigated whether MCC burden is related to participation in those with chronic stroke. Methods Two hundred and sixty-six participants with chronic (≥6 months) stroke were included in this cross-sectional and retrospective analysis. Participants had a mean age of 62.2 ± 12.8 years, and time since stroke (TSS) of 36.0 ± 44.6 months (114F/152 M). Participants completed the 6-minute Walk Test (6MWT), Activities-Specific Balance Confidence Scale (ABC), Modified Cumulative Illness Rating Scale (MCIR) to quantify the presence and severity of chronic illness across 14 body systems, and the Stroke Impact Scale – Participation subscale (SIS-P). Participation (SIS-P) was the dependent variable. Independent variables were entered into a sequential regression model in three blocks: demographic variables, physical capacity (6MWT distance) and balance self-efficacy (ABC), and MCC burden (MCIR). Results After adjusting for age, sex, and time since stroke, physical capacity and balance self-efficacy explained 31.4% (p < 0.001), and the MCC burden explained 2.0% (p = 0.004). Higher participation was related to lower MCC burden. Conclusions MCC burden is a significant contributor to variance in participation in chronic stroke survivors, above and beyond demographics, physical capacity, and self-efficacy, and therefore should be considered when creating rehabilitation programs to improve participation.

Interventions for work participation of unemployed or work-disabled cancer survivors: a systematic review

Background: Supporting unemployed or work-disabled cancer survivors in their work participation can have extensive individual and societal benefits. We aimed to identify and summarise interventions for work participation of unemployed or work-disabled cancer survivors. Methods: Five databases (Medline, Embase, PsycINFO, CINAHL and Cochrane Library) were systematically searched for quantitative studies on interventions aimed at enhancing work participation of unemployed or work-disabled cancer survivors. Work participation refers to participation in the workforce, fulfilling one’s work role. Manual and automatic screening (with ASReview software) were performed on titles and abstracts, followed by manual full-text screening. Data were extracted regarding study, patient and intervention characteristics, and work participation outcomes. Risk of bias (RoB) was assessed using the Cochrane RoB2 and QUIPS tools. Results: We identified 10,771 articles, of which we included two randomised controlled trials (RCTs), of which one feasibility RCT, and three cohort studies. In total, 1862 cancer survivors were included, with predominantly breast cancer. Work participation was mainly measured as time to return to work (RTW) and RTW rate. Interventions included components of coaching (e.g., psychological or rehabilitation), training (e.g., building confidence and managing fatigue) and self-management. Two RCTs with unclear RoB did not show an effect of multicomponent interventions compared to care as usual. One cohort study found a significant effect of a psycho-educational intervention on RTW rates, with moderate RoB. The other two cohort studies, with moderate RoB, reported significant associations between components including job search and placement assistance, and work participation. Discussion: Only few interventions aimed at enhancing work participation of unemployed or work-disabled cancer survivors, have been evaluated. In two cohort studies, promising components for future multicomponent interventions were identified. However, findings suggest that more evidence is necessary on such multicomponent interventions, in which elements explicitly directed at work and including the workplace should be included.

Association of physical activity, smoking, and socioeconomic factors on health checkup participation in community-dwelling stroke survivors aged 50 years or older

BackgroundWe investigated the sociodemographic and health-related factors associated with health checkup participation in community-dwelling stroke survivors.MethodsAmong participants of the Korea National Health and Nutrition Examination Survey, 642 stroke survivors were included. We investigated the sociodemographic, medical, and health-related quality of life factors—evaluated by the EuroQol 5-Dimension Questionnaire (EQ-5D)—associated with participation in any type of health checkup. To explore the associations between multiple variables and health checkup participation, a multivariable complex-sample logistic regression model was used.ResultsOne-third of the community-dwelling stroke survivors did not receive a health checkup in the past two years. Insufficient physical activity (OR: 0.5, 95% CI: 0.3–0.9), current smoking (OR: 0.4, 95% CI: 0.2–0.8), low education level (OR: 0.5, 95% CI: 0.3–0.9), living alone (OR: 0.5, 95% CI: 0.3–0.998), and no occupation (OR: 0.5, 95% CI: 0.3–0.9) showed independent negative associations with health checkup participation. Among the five EQ-5D dimensions, mobility, self-care, usual activities, and pain/discomfort dimensions were associated with health checkup participation rate.ConclusionPolicies and further research are needed to promote health checkups for stroke survivors who are physically inactive, currently smoking, living alone, unemployed, less educated, or having extreme problems in their daily lives.

MHealth Technology as a Help Tool during Breast Cancer Treatment: A Content Focus Group

To assess the usability and preferences of the contents of mHealth software developed for breast cancer patients as a tool to obtain patient-reported outcomes (PROMs), improve the patient's knowledge about the disease and its side effects, increase adherence to treatment, and facilitate communication with the doctor. an mHealth tool called the Xemio app provides side effect tracking, social calendars, and a personalized and trusted disease information platform to deliver evidence-based advice and education for breast cancer patients. A qualitative research study using semi-structured focus groups was conducted and evaluated. This involved a group interview and a cognitive walking test using Android devices, with the participation of breast cancer survivors. The ability to track side effects and the availability of reliable content were the main benefits of using the application. The ease of use and the method of interaction were the primary concerns; however, all participants agreed that the application would be beneficial to users. Finally, participants expressed their expectations of being informed by their healthcare providers about the launch of the Xemio app. Participants perceived the need for reliable health information and its benefits through an mHealth app. Therefore, applications for breast cancer patients must be designed with accessibility as a key consideration.

Translation and cross-cultural adaptation of the Brazilian version of the PM-Scale: A specific measure of participation after stroke

BackgroundThe PM-Scale was developed specifically to assess participation in individuals after stroke based on the concepts contained in the International Classification of Functioning, Disability and Health. However, this measure is only available in English and French. ObjectiveTo translate and cross-culturally adapt the PM-Scale to Brazilian Portuguese, followed by the validation and testing of reliability of the translated version. MethodsThe translation process followed standard guidelines. Preliminary test-retest reliability was determined using the intraclass correlation coefficient (ICC2,1). The Rasch model was employed to analyse the validity, unidimensionality, invariance, and internal consistency of the Brazilian version of the PM-Scale. ResultsThe final translated version of the PM-Scale presented appropriate semantic, idiomatic, cultural, and conceptual equivalence. The preliminary analysis revealed excellent intra-observer and inter-observer reliability (ICC2,1 = 0.91; 95%CI: 0.83, 0.95 and ICC2,1 = 0.81; 95%CI: 0.64, 0.89, respectively). The analysis of the Rasch model revealed only one erratic item. An excellent overall fit was found for items (mean ± SD = 0.01 ± 1.02) and adequate fit was found for persons (mean ± SD = 1.16 ± 0.88). Internal consistency was considered adequate (person separation index = 1.77, reliability = 0.76). No significant invariance was found with regards to the personal characteristics of the sample (p > 0.05). ConclusionThe Brazilian version of the PM-Scale is a valid, unidimensional, linear, reliable scale for measuring participation in stroke survivors and can be administered in less than five minutes.

Fear of falling, meaningful activity participation and community reintegration among stroke survivors in southwest Nigeria: a cross-sectional study

Background/Aims Community reintegration remains one of the most important goals of rehabilitation. The aim of this study was to investigate the relationships between fear of falling, meaningful activity participation and community reintegration of community-dwelling stroke survivors. Methods The Fall Efficacy Scale-International, Engagement in Meaningful Activities Survey and Reintegration to Normal Living Index were used to assess fear of falling, meaningful activity participation and community reintegration respectively among self-ambulant stroke survivors receiving treatment in physiotherapy outpatient clinics. The study was a cross-sectional survey. Tests of relationships, regression and association were performed with a level of significance set at P&lt;0.05. Results A significant relationship was found between fear of falling and community reintegration (r=−0.27; P=0.01; 95% confidence interval=−0.53 to 0.04); meaningful activity participation and community reintegration (r=0.72; P=0.001; 95% CI=0.48 to 0.89) and fear of falling and meaningful activity participation (r=−0.71; P=0.53; 95% CI=−0.32 to 0.24). Older participants had lower levels of community reintegration and meaningful activity participation. A significant association was found between fear of falling and fall history (P=0.02); increased falls meant higher levels of fear of falling. Sex and duration of stroke had no significant impact on fear of falling, meaningful activity participation and community reintegration. Meaningful activity participation was the strongest predictor of community reintegration (β=1.7; 95% CI=1.30 to 2.11; P=0.001). Conclusions Fear of falling might limit participation in meaningful activity and community integration among stroke survivors. These parameters should be assessed by allied health professionals during stroke rehabilitation.

Multidimensional analysis of sedentary behaviour and participation in Spanish stroke survivors (Part&Sed-Stroke): a protocol for a longitudinal multicentre study

IntroductionStroke survivors usually experience long-lasting functional, emotional and social consequences that might contribute to sedentary behaviour and participation restrictions, which are important targets to address during rehabilitation. However, the trajectory...

Co-Design and Validation of a Family Nursing Educational Intervention in Long-Term Cancer Survivorship Using Expert Judgement.

The number of cancer survivors is increasing exponentially thanks to early screening, treatment, and cancer care. One of the main challenges for healthcare systems and professionals is the care of cancer survivors and their families, as they have specific needs that are often unmet. Nursing students, as future healthcare professionals, need education to face these new health demands. They will need to develop specific competencies to help them care for and empower this emerging population. The aim of the study was to co-design and validate an educational intervention on long-term cancer survivorship for nursing, through a multidisciplinary panel of experts. Group interviews were conducted with a panel of 11 experts, including eight professionals from different backgrounds (oncology, cancer nursing, pharmacology, and education), a long-term cancer survivor, a family member of a cancer survivor, and a nursing student. The experts validated a pioneer educational intervention to train nursing students in long-term cancer survival. The co-design and validation of the intervention from an interdisciplinary perspective and with the participation of long-term cancer survivors and their families was considered relevant as it included the vision of all the stakeholders involved in long-term cancer survivorship.

Return to work during first year after intensive care treatment and the impact of demographic, clinical and psychosocial factors

ObjectivesTo describe work participation in survivors during first year after intensive care unit discharge and examine the impact of selected demographic, clinical and psychosocial factors on return to work 12 months after discharge. Research methodology/DesignA predefined sub-study (prospective cohort study) of a randomised controlled trial. SettingA Norwegian single-centre university hospital. Medical and surgical adult intensive care survivors, working/on sick leave before admission, in the intensive care unit ≥24 h, were included. Main outcome measuresReturn to work three, six and 12 months after discharge, and impact of age, pre-existing comorbidities, previous serious life events, coping ability, hope and social support on return to work 12 months after discharge. ResultsIncluded were 284 patients, with mean age 47 years (SD 13.9) and 47 % women. One year after discharge, 69 % were back at work. In the regression analysis, with working at 12 months (yes/no) as the dependent variable, 178 patients, completing questionnaires at three as well as 12 months, were included. Lower age (OR 0.96, 95 % CI [0.93–0.99]), lower pre-existing comorbidities (OR 0.65, 95 % CI [0.43–0.97]), previous serious life events (OR 6.53, 95 % CI [2.14–19.94]), and greater hope at three months (OR 1.09, 95 % CI [1.01–1.17]) were all independently associated with higher odds of returning to work. ConclusionFollowing intensive care, age, pre-existing comorbidities, experience of previous serious life events and hope all have a significant impact on return to work, and are important variables to consider during intensive care treatment and rehabilitation. Implications for clinical practiceAttention must be paid to patients with prior working capability to ensure return to work after intensive care treatment. Older adults with pre-existing comorbidities might benefit from early, individualised rehabilitation to regain previous working capacity. In addition, there is also a need to support patients’ hope during and after critical illness.

The mediating effect of anxiety on the association between residual neurological impairment and post-stroke participation among persons with and without post-stroke depression

ABSTRACT Previous research has reported that residual neurological impairment and emotional factors play a role in regaining successful participation post-stroke. The objective of this study was to investigate the mediating impact of anxiety on the association between residual neurological impairment and participation in survivors with and without post-stroke depressive symptoms. Participants (N = 79) were classified into 2 categories, those with post-stroke depressive symptoms (N = 40) and those without post-stroke depressive symptoms (N = 39). Variables measured in this study: residual neurological impairment (NIH Stroke Scale Score), participation (Reintegration to Normal Living Index), depressive symptoms (Patient Health Questionnaire-9), and trait anxiety (State-Trait Anxiety Inventory). A regression-based mediation analysis was conducted for each group of participants. The majority of participants had some level of anxiety. Residual neurological impairment predicted participation in stroke survivors both with (β = -.45, p = .003) and without (β = -.45, p = .004) post-stroke depressive symptoms. Anxiety mediated this relationship in participants with depressive symptoms (β = -.19, 95% CI = -.361 ∼ -.049), but not in participants without depressive symptoms (β = -.18, 95% CI = -.014 ∼ .378). Depressive and anxious symptoms should both be addressed to best facilitate participation by stroke survivors.

Comparison of Chronic Health Conditions and Health Behaviors in Long-Term Young Adult Hodgkin Lymphoma (YAHL) Survivors to That of Their Unaffected Co-Twin Controls

Background: Long-term survivors of young adult Hodgkin lymphoma (YAHL) are at risk of experiencing late effects due to cancer diagnosis and treatment. Many studies have compared survivors to unrelated controls from various sources, which could introduce confounding. Unaffected co-twins of cases are an ideal comparison because they are matched on many exposures, extending to in utero, are the same age and cohort, and are partially or completely matched on genome. Here we compare medical conditions, life milestones, lifestyle and behaviors, and psychological well-being in 35 long-term YAHL survivors and their unaffected co-twin controls(70 individual twins, 35 twin pairs) to obtain a more valid risk estimate of the contribution of the cancer and its treatment. Methods: Participants were enrolled in either the International Twin Study (national volunteer twin registry) or California Twin Program (population-based twin registry based on California birth certificates linked to the Department of Motor Vehicles) and completed online questionnaires including chronic health conditions, health behaviors, the achievement of developmental milestones (e.g., college degree attainment, employment, and having children), and life satisfaction. Twin comparisons were made using conditional logistical regression with p-values estimated using McNemar's test. Adjustment was not necessary as twins were mostly matched on potential confounders. All analyses were performed in STATA, version 17.0. Results: The mean age at diagnosis among survivors was 27 years (median: 26, range 16-48 years). The mean age at participation of survivors and unaffected co-twins was 56 years of age (median: 55, range: 40-74 years), with an average interval of 29 years between diagnosis and participation. 57% of YAHL survivors and 6% co-twin controls were female. 89% of participants were non-Hispanic white. 54% were monozygotic (MZ); 32% were like-sex dizygotic (DZ) and 14% were unlike-sex DZ. We observed significant increases in chronic medical conditions among YAHL survivors who were 4.33 times as likely to report a secondary malignancy as their unaffected co-twin controls (p=022). Breast cancer was the most commonly reported cancer, occurring in 8 survivors and one co-twin control (odds ratio [OR]=8.0, p= 0.05); all survivors with breast cancer had radiation therapy. Thyroid disease occurred in 23 survivors (18 had hypothyroidism) and 5 co-twin controls (OR=¥, p <0.001). Cardiovascular disease (any) occurred in 16 survivors and 5 co-twin controls (OR=12.0, p=0.017). Six survivors and no co-twin controls were affected with lung disease, mainly pulmonary fibrosis (p=0.031). After 29 years post-diagnosis, there were no significant differences between YAHL survivors and their twins with respect to healthcare utilization, substance use, physical activity, or developmental milestones relative to their unaffected co-twin. In particular, both twins had similar numbers of children and educational attainment. Life satisfaction was significantly lower among YAHL survivors (OR=¥, p=.043) but was unrelated to the occurrence of chronic conditions (p = 0.10). Conclusions: Decades after diagnosis, excess chronic conditions and lower life satisfaction were observed among YAHL survivors compared to their unaffected co-twin. The risk of cancer and chronic disease attributable to YAHL and its treatment is a more valid estimate when compared to unaffected co-twin controls of the survivors, who may also develop chronic conditions due to other factors in common. There were no differences in engagement in health behaviors or achievement of developmental milestones, potentially due to the importance of shared early-life experiences on these characteristics.

Legal Degree of Disability in Childhood-Craniopharyngioma Survivors During Long-Term Follow-Up

Cranioparyngiomas are rare low-grade embryonic malformational tumors of the sellar/parasellar region. The prognosis after diagnosis during childood and adolescence is influenced by (neuro)endocrine long-term sequelae. A legal status of the degree of disability (GdB), according to the German Social Code Book V that is worthy of support provides financial means for psychosocial integration and participation of craniopharyngioma survivors. HIT-Endo is a German registry study on craniopharyngioma patients aged≤18 years at diagnosis . In a sample of 108 patients, the degree of disability and the association with endocrine, ophthalmological, neuropsychological (QLQ-C30; MFI-20; FMH-scale) and psychosocial parameters was analyzed after a mean follow-up period of 16 years. 47 patients (43%) did not receive a GdB or received a GdB of 30-40, 43 patients (40%) a GdB of 50-90 and 18 patients (17%) the maximal GdB of 100. Higher GdB were associated with lower education, higher body mass index standard deviation and a higher degree of visual impairment and hypothalamic involvement of the craniopharyngioma. Patients with a GdB of 100 reported loss in physical and cognitive function, dyspnea, and pain (QLQ-C30), as well as fatigue (MFI-20), and limitations in social and occupational contexts. They further had a lower functional capacity (German daily life ability scale (FMH)) compared to those with a smaller GdB. The GdB is associated with psychosocial and physical impairments and reflects the long-term consequences of craniopharyngioma. A low functional capacity may indicate a high GdB in later life of craniopharyngioma survivors.

Impact of the SARS-CoV-2 Pandemic on the Utilization of Cancer Rehabilitation: a Difference-in-Differences Analysis

Restricted access to rehabilitative care due to the SARS-CoV-2 pandemic may affect the participation of cancer survivors and risks progression of the underlying disease. The aim of our analyses was to examined the extent to which cancer rehabilitations in Germany decreased due to the SARS-CoV-2 pandemic. Data were retrieved from the German Pension Insurance which is the main provider for medical rehabilitation in Germany. We used monthly cross-sectional data on the utilization of cancer rehabilitation (Ca-rehab-services according to section 15 for working-aged people or section 31 social security code VI for pensioners) in 2019 and 2020. We used a difference-in-differences model to determine the reduction in rehabilitation utilization attributable to the pandemic and reported incidence rate ratios (IRR). We included 146,924 cancer rehabilitations in 2019 and 113,117 cancer rehabilitations in 2020. Compared to the previous year, the nationwide decline in cancer rehabilitations was greatest in April 2020 (63.2%). Utilization of cancer rehabilitation was reduced by 11.5% for benefits according to section 15 social security code VI (IRR=0.885; 95% CI: 0.864 to 0.906) and by 26.5% for benefits according to section 31 (IRR=0.735; 95% CI: 0.717 to 0.754) due to the pandemic. For pensioners the decline in utilization was more pronounced in Western Germany than in Eastern Germany and greater for non-post-acute rehabilitations than for post-acute rehabilitations. The analyses show a pandemic-related decline in cancer rehabilitations, especially in cancer rehabilitation services for pensioners. Failure to seek medical rehabilitation, through which physical and psychological recovery and relief from disease and treatment side effects can be achieved, will have a lasting impact on the participation for many cancer survivors. Repeated monitoring of work ability and health of chronically ill people could generate necessary data to clarify why people in need of rehabilitation have avoided seeking medical rehabilitation and how they can be supported.

Association between participation self-efficacy and participation in stroke survivors

BackgroundMost stroke survivors face restrictions in functional disability and social participation, which can impede their recovery and community reintegration. Participation self-efficacy refers to survivors’ confidence in using strategies to manage participation in areas including community living and work engagement. This study aimed to assess the association between participation self-efficacy and participation among stroke survivors.MethodsThis study adopted a cross-sectional correlational design with a convenience sample of 336 stroke survivors recruited from five hospitals in China. Participation self-efficacy was measured using the Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES-C) and participation measured using the Chinese version of the Reintegration to Normal Living Index (RNLI-C). The association between participation self-efficacy and participation was examined using multiple regression analysis with adjustment for potential confounders.ResultsParticipants had a mean age of 69.9 ± 11.5 years, with most (81.6%) having an ischaemic stroke, and more than half (61.6%) a first-ever stroke. After adjustment for potential confounders, every 10-point increase in the PS-SES-C total score was significantly associated with an average 1.3-point increase in the RNLI-C total score (B = 1.313, SE = 0.196, p < 0.001).ConclusionsThis study demonstrates that participation self-efficacy is significantly associated with participation among Chinese community-dwelling survivors of a mild or moderate stroke. This suggests that rehabilitation programmes for stroke survivors may be more effective if they incorporate participation-focused strategies designed to enhance self-efficacy.(229 words).

Coaching-Based Teleoccupational Guidance for Home-Based Stroke Survivors and Their Family Caregivers: Study Protocol for a Superior Randomized Controlled Trial

Background Home-based rehabilitation has been shown to be useful for stroke survivors to participate in daily life activities and return to their families. However, many home-based stroke survivors face challenges in the lack of professional guidance, rational training plans, and insufficient motivation, which will affect their rehabilitation outcomes to varying degrees. Though occupational therapy and coaching are widely recommended for stroke rehabilitation, studies that combine these two interventions via telerehabilitation in home-based rehabilitation are limited. Hence, this study will explore whether coaching-based teleoccupational guidance (CTG) will help stroke survivors and caregivers obtain satisfactory outcomes. Methods This single-blind (assessor), two-arm parallel superior randomised controlled trial will be conducted in the Hebei General Hospital, Shijiazhuang, China. Ninety-two participant dyads in home-based rehabilitation will be recruited and randomised to either CTG (intervention group) or a standard telerehabilitation group (control group). Participant dyads in the intervention group will follow a 6-step circle procedure and receive 12 teleoccupational coaching sessions over 3 months via WeChat. Data will be collected at baseline, after the intervention (3 months), and follow-up (6 months). The Reintegration to Normal Living Index will be the primary outcome to assess the participation of stroke survivors. Secondary outcomes will not only involve an observation of changes in activities of daily living, intrinsic motivation, motor function, and quality of life of stroke survivors but also will focus on the caregivers' perceived benefit and care burden. Discussion. This trial will assess the effects of CTG compared with standard telerehabilitation. We believe that the results of this study will add to the understanding of occupational therapy for stroke survivors in home-based rehabilitation and provide a reference for developing health policy and facilitating other chronic management. Trial Registration Number. The Chinese Clinical Trial Registry ChiCTR2200061107.

Effects of computerized cognitive training on cognitive function, activity, and participation in individuals with stroke: A randomized controlled trial.

Computerized cognitive training (CCT) is an emerging alternative intervention for stroke survivors. This study investigated the effects of CCT on the cognition, activity, and participation of stroke survivors and compared the findings with those of match-dosed conventional cognitive training. This randomized controlled trial included 39 patients with stroke who were divided into the intervention group (n = 19; receiving CCT with Lumosity software) and the control group (n = 20; receiving conventional cognitive training). Both the groups were trained for 20 min, twice a week, for 12 weeks. Participants were evaluated at pretest, posttest, and 4-week follow-up. Outcome measures included various cognitive function tests and the Stroke Impact Scale scores. The CCT group exhibited significant improvement in global cognitive function (evaluated using the Mini-Mental State Examination and Montreal Cognitive Assessment) and specific cognitive domains: verbal working memory (backward digit span test), processing speed (Symbol Digit Modalities Test), and three MoCA subtests (attention, naming, and delayed recall). CCT exerted no significant effect on activities and participation. No significant between-group differences in changes in cognitive function were noted. However, CCT significantly improved cognitive function domains immediately after training, and these effects were sustained at the 4-week follow-up. Cognitive function of individuals with chronic stroke could improve after administration of CCT. However, future studies with a more rigorous design and higher training dose are warranted to validate our findings.

An innovative research approach for inclusion studies for those with Traumatic Brain Injury

Students with traumatic brain injury (TBI) are often marginalized in terms of participation in higher education because of an implicit association of TBI with less academic functioning. The first named author is a Ph.D. scholar who aimed to add her voice to the voices of others and examine the lived experience of students with the same condition to identify possible supports that would enhance inclusion in higher education. This research was driven by the desire to illuminate both the hidden nuances of personal experience (hence the use of autoethnography) and to highlight the lack of research about educational participation of TBI survivors. The analysis was from both professional and personal perspectives. Through an examination via an iterative and interconnected research process, the authors explored the question, what are the supports for participation and access for students with TBI in higher education considering the first author’s experiences. Traditional research might provide generalizable data but may not facilitate deep illumination of experience and voice. This examination transcended traditional research and comprised autoethnographic and interview-based inquiry. It challenged the research team to consider different perspectives and to interrogate their own interconnections in the same engagement while working towards the same goal. The concept of transmethodology will be discussed regarding the development of multiple perspectives that can assist in transgressing the common divisions in the theory and practice divide and explores knowledge of marginalization regarding participation for students with TBI. This paper argues for the importance of innovations such as transmethodology when researching deeply personal phenomena.

Occupational Participation, Performance, and Satisfaction in Survivors of Human Trafficking

Abstract Date Presented 04/02/2022 The purpose of the study is to identify occupational performance problems self-identified by survivors of human trafficking to further understand the occupational needs of this population. Social and emotional health promotion and maintenance, leisure exploration and participation, sleep preparation and participation, financial management, and symptom and condition management were the most commonly identified occupational performance problems. Primary Author and Speaker: Rebecca Marie Wangberg Additional Authors and Speakers: Shana Cerny

The effect of self-management programs on post-stroke social participation: A systematic review and meta-analysis

Objective The aim of this study was to identify the effectiveness of self-management programs on the improvement of social participation among stroke survivors. Data Sources: Cochrane Library, PubMed, Web of Science database, EMBASE, Medline, CINAHL plus, and APA PsycArticles were searched from their inception to December 20, 2021. Methods We considered randomized controlled trials and non-randomized controlled trials without language limits. Two reviewers independently screened the literature, evaluated risk of bias using the Cochrane’s risk of bias tool, scored the methodological quality using criteria of the Australian Evidence-based Health Care Center, and extracted the data. The outcome was social participation. RevMan 5.3 was used, and intergroup differences were determined by calculating standardized mean difference (SMD) and 95% confidence intervals (CIs). Results Of 1894 initial studies, totally 15 studies met the eligible criteria, consisting of six randomized controlled trials and nine non-randomized controlled trials. Four randomized controlled trials showed high methodological quality and two demonstrated medium quality. The randomized controlled trials involved a total of 430 stroke survivors and were published between 2007 and 2020. The meta-analysis from five randomized controlled trials demonstrates that the overall effect of self-management programs on social participation was not statistically significant (95% CI, -0.23 to 0.40; p = 0.61). Most of the non-randomized controlled trials were pre-/post-test design with an average sample size of 15.4. The effect of self-management program on social participation in most non-randomized controlled trials was insignificant as well. Conclusion The self-management programs seem not to be superior to usual care for the improvement on social participation in stroke survivors based on current evidence. Further well-designed investigation considering social participation as the primary outcome is still warranted.