Showing papers in "Disability and Rehabilitation in 2001"
TL;DR: Multivariate analysis revealed that school life in elementary, middle and high school could be defined by six distinct factors describing individual and group roles, which yielded a second order latent variable that captured the complex and multi-dimensional aspect of participation.
Abstract: Introduction: The policies of integration and full inclusion in school activities have been enacted to promote the independence and social participation of students with disabilities. This study examined the nature and extent of participation in schools by students with disabilities in the context of the physical, social and psychological features of the school environment. Method: A national survey was completed by 1180 teachers of students with disabilities in the US describing student participation in school activities encompassing involvement in social activities, sports, academic and artistic/creative endeavours. Results/Conclusions: Multivariate analysis revealed that school life in elementary, middle and high school could be defined by six distinct factors describing individual and group roles. Structural equation modelling yielded a second order latent variable that captured the complex and multi-dimensional aspect of participation, accounting for availability, eligibility, student characteristics...
334 citations
TL;DR: Single subject designs are ideally suited for research in the rehabilitation practice environment and can help establish the efficacy of rehabilitation practice and contribute to rehabilitation science.
Abstract: Purpose : The objective of this article is to offer an overview of single subject designs and provide clinicians with information regarding the components of single subject designs and how they can be used in clinical and other rehabilitation environments. Method/Result : Three basic designs in single subject research are presented, with corresponding examples illustrating each design. A review of visual and statistical analysis techniques commonly used in single subject designs is provided, and the advantages and limitations of each are noted. Conclusion : Single subject designs are ideally suited for research in the rehabilitation practice environment. If properly applied, these designs can help establish the efficacy of rehabilitation practice and contribute to rehabilitation science.
219 citations
TL;DR: Measurement of basic activities of daily living and mobility as measured by the BI and RMI is reliable poststroke, and measurements used to assess extended activities ofdaily living were less reliable in this study.
Abstract: Purpose : To assess the test-retest reliability of a range of outcome measures in stroke patients. Method : Twenty-two patients >1 year post-stroke were tested twice at an interval of 1 week using the Barthel Index (BI); the Rivermead Mobility Index (RMI); the Nottingham Extended Activities of Daily Living Scale (NEADL); and the Frenchay Activities Index (FAI). The mean difference (bias) and reliability coefficient (random error) were calculated for the total scores. Percentage agreement and the kappa coefficient were used to analyse individual items. Results : The mean differences and reliability coefficients were BI 0.4 - 2.0, RMI 0.3 - 2.2, the NEADL 0.6 - 5.6, FAI -0.6 - 7.1. There was little bias between assessments. The performance of the BI and RMI were better with lower random error. The NEADL and FAI did not perform as well having larger random error components. Percentage agreements were generally high especially for the BI (>75% ) and RMI (>85% ), but there was considerable variatio...
201 citations
TL;DR: Findings from available studies of prognostic factors for OLBP disability in a clinically-relevant framework are synthesized to evaluate interventions guided by prognosis and develop clinical recommendations based on the evidence.
Abstract: Purpose : Disability following acute occupational low back pain (OLBP) represents a significant and preventable health outcome, yet confusion about prognostic factors have limited the development of effective, targeted interventions for those at greatest risk. The purpose of this study was to synthesize findings from available studies of prognostic factors for OLBP disability in a clinically-relevant framework. Method : A systematic search of the MEDLINE database was conducted to identify empirical studies assessing the value of various prognostic factors to predict extended disability after an acute episode of OLBP. Relevant studies were screened based on a number of inclusionary criteria. Prognostic factors were catalogued, summarized, and evaluated based on agreement across studies, and clinical recommendations were developed based on the evidence. Results : Of 361 studies of OLBP disability found, 22 met specific criteria for inclusion. Significant prognostic factors included low workplace support, pe...
198 citations
TL;DR: Prisposing factors persist after treatment of contractures thus for treatment to be effective long-term management programmes need to be developed.
Abstract: Purpose : To examine the techniques used for the treatment of contracture in the context of current scientific knowledge of muscle. Method : Synthesis of data available from MEDLINE, RECAL, EMBASE, the Cochrane Library and relevant texts. Results : The development of contractures through immobilisation, muscle weakness and spasticity is described. The effects of passive stretching, continuous passive movement, serial plastering, splinting, electrical stimulation, botulinum injections and surgical tenotomies in the treatment of contractures in persons with neurological and orthopaedic conditions are identified. The strengths and weaknesses of these modalities are discussed. Conclusion : Predisposing factors persist after treatment of contractures thus for treatment to be effective long-term management programmes need to be developed. New treatment techniques, used in series or combined, offer the prospect of improved management of contracture. Scientific and clinical research is needed to investigate the e...
173 citations
TL;DR: The findings indicate that the newly revised SCIM (Catz-Itzkovich) is a valid and highly reproducible measure of daily function in patients with spinal cord lesions, and is superior to the original SCIM.
Abstract: Purpose : To examine the suitability of the revised Spinal Cord Independence Measure, the Catz-Itzkovich SCIM, for evaluation of patients with spinal cord lesions, as compared to the original SCIM and to the Functional Independence Measure (FIM). Method : The revised SCIM was applied by paired independent teams of occupational therapists, physiotherapists and nurses and the FIM by a single nurse. The examiners assigned scores to the functional capabilities of 28 patients with spinal cord lesions. The scores by the revised SCIM were analysed for reproducibility as between the two teams of examiners (interrater reliability) and for their correlation with the FIM scores. Results : The frequency of identical scoring by two independent examiners (total agreement) was 80% or higher for 13/18 individual functions listed in the revised SCIM. In the self-care category it was 80-99%, as compared to 75-87% before revision. In neither bowel management nor bed mobility was there an increase over the original SCIM in t...
157 citations
TL;DR: Findings provide a greater understanding of the issues to be taken into consideration in the rehabilitation of people with a lower limb amputation.
Abstract: Purpose: This research aimed to develop a clearer picture of the experience of residual limb pain and phantom limb pain following a lower limb amputation and to gain a greater understanding of thei...
147 citations
TL;DR: In this article, the authors compared the quality of life (QoL) between diabetic patients with (former or present) and without foot ulcers and found that the former group had significantly worse QoL than the latter group.
Abstract: Purpose: To compare Quality of Life (QoL) between diabetic patients with (former or present) and without foot ulcers. Methods: Two patient groups of comparable age, sex distribution, type distribution and duration of diabetes were studied. Fourteen patients with former or present, but clinically stable diabetic foot ulcers (DFUs) were studied. The control group was 24 unknown patients with DFUs. None of the participants had other diabetic complications or conditions that would potentially affect QoL. A diabetic foot risk score and QoL were assessed. QoL was scored with the RAND-36, the Barthel Score (ADL) and the Walking and Walking Stairs Questionnaire (WSQ). Results: Marked and significant differences were found in physical functioning (p < 0.001), social functioning (p < 0.05), physical role (p < 0.001) and health experience (p < 0.05) between the two groups with the RAND-36 and the four sub scales of the WSQ (all p 0.001). On all these scales, QoL was significantly poorer in the study group. A correla...
144 citations
TL;DR: The proposed biopsychosocial model assumes that LBP-related chronic disability is possibly, in some cases, a stress-related disorder and could particularly improve the understanding of the interrelationships between certain variables.
Abstract: Purpose : Since the early 1990s, numerous prospective studies have been published on the determinants of chronic disability related to low back pain (LBP) of non-specific origin whose human and financial costs are enormous. The significant contribution of psychosocial factors is being increasingly recognized. However, additional efforts are needed to clarify their role and to improve the interventions. The purpose of this theoretical paper is to propose a coherent organization of the medical and psychosocial determinants identified in prospective studies into a conceptual framework. Method : Several models available in the field of pain and disability as well as in health psychology were reviewed. Results : A recent version of the stress coping model was chosen and adapted to the problem. The adapted model suggests that stress, particularly that caused by the pain associated with LBP, could have a negative impact on the outcome either: (1) indirectly through the negative emotional responses that it produc...
144 citations
TL;DR: Quality of life does not differ across disease course groups, but rather varies by age and duration, and those with progressive disease courses experience greater levels of impairment and disability than other groups.
Abstract: Purpose: The aim of this study was to ascertain the health status and quality of life of a community based cohort of people with multiple sclerosis. Method: A postal questionnaire with self-completed measures of impairment, disability, physical dependency and quality of life was sent to a random sample of 203 people with multiple sclerosis from a population register. The sample was stratified according to five disease courses. The population register is of the prevalent population of 760 people with multiple sclerosis resident in the Leeds Health Authority. The register used multiple sources of ascertainment and is prospectively maintained with new incident cases. Results: The estimated mean age of people with multiple sclerosis is 46 years (SE: 0.85), and mean duration of disease is 14.4 years (SE: 0.69). Almost four in five (78%) are female, and one in six (17%) live alone. Impairments of balance, vision and memory are common and in all cases there is little difference in the frequency between disease c...
133 citations
TL;DR: The muscle weakness and bilateral activation failure in the stroke patients was not explained by either excessive antagonist activity or disuse atrophy and had potential for increased voluntary strength and if this were addressed during rehabilitation, then the rate and extent of functional recovery might be enhanced.
Abstract: Purpose: Muscle weakness may contribute to functional problems after stroke, but is rarely addressed during rehabilitation. Functional problems are commonly thought to be caused by abnormal movement patterns or possibly disuse atrophy. We investigated voluntary isometric strength, activation and the extent of co-contraction in the knee muscles during the first six months during stroke. Methods: Twelve stroke patients (58 3 years, mean SEM, 7 female) were studied bilaterally on admission for rehabilitation (21 1 days after stroke) and then at 1, 2, 3, and 6 months. Twenty healthy controls (61 5 years, 17 female) were tested once on their preferred leg. Subjects performed maximal voluntary contractions of the quadriceps and hamstring muscles. Simultaneous measurements were made of agonist force and surface EMG from agonist and antagonist muscles. Voluntary activation was estimated using the twitch superimposition technique. Results: Both paretic muscles showed lower (p 0.01-0.0005) voluntary strength than b...
TL;DR: Age and perceived barriers in the physical and social environment contribute to the handicap creation process following a stroke, taking into consideration age and the level of impairments and disabilities.
Abstract: Background and purpose : Little is known about the potential role of environmental factors in the handicap creation process following a stroke. The objective of this study was to explore the presence of a relationship between environmental factors and the occurrence of handicap following a stroke, taking into consideration age and the level of impairments and disabilities. Methods : This is a cross-sectional study where data were collected 6 months after discharge from an intensive functional rehabilitation unit. A convenience sample of 51 participants was recruited at the time of their admission to the rehabilitation unit for rehabilitation post-stroke. Perceived influence of environmental factors was measured using the Measure of the Quality of the Environment (MQE). Handicap situations were measured with the Assessment of Life Habits (LIFE-H). Impairments and disabilities comprised six domains (cognition, perception, depression, communication, sensorimotor function and comorbidity) assessed using a var...
TL;DR: The dominance of the Bobath concept needs to be justified by establishing that it is both effective and efficient at achieving its treatment aims of normalizing tone, improving intrinsic recovery of the affected side and function within everyday tasks.
Abstract: Purpose : The Bobath concept is one of the most widely used approaches in stroke rehabilitation within Europe. This survey aimed to provide an expert consensus view of the theoretical beliefs underlying current Bobath practise in the UK. Method : Questionnaires (with sections related to: therapist background, physiotherapy management, theoretical beliefs and gait re-education strategies used) were posted to all senior level physiotherapists working in stroke care ( n = 1022). Results : The majority of respondents had more than 10 year's experience overall and at least 5 years experience in stroke care. The Bobath concept was the preferred approach ( n = 67%) followed by an 'eclectic' approach ( n = 31%). Despite a high level of consensus between groups, there were 13 significant differences highlighted between Bobath and 'eclectic' groups related to recovery, control of tone, the analysis and facilitation of normal movement and function. In summary, Bobath therapists considered that patients needed to hav...
TL;DR: A management programme for hemiplegic shoulder pain could comprise the following components: provision of an external support for the affected upper limb when the patient is seated, careful positioning in bed, daily static positional stretches, motor retraining and strapping of the scapula to maintain postural tone and symmetry.
Abstract: Purpose: Hemiplegic shoulder pain can affect up to 70% of stroke patients and can have an adverse impact on rehabilitation outcomes. This article aims to review the literature on the suggested causes of hemiplegic shoulder pain and the therapeutic techniques that can be used to prevent or treat it. On the basis of this review, the components of an optimal management programme for hemiplegic shoulder pain are explored. Method: English language articles in the CINAHL and MEDLINE databases between 1990 and 2000 were reviewed. These were supplemented by citation tracking and manual searches. Results: A management programme for hemiplegic shoulder pain could comprise the following components: provision of an external support for the affected upper limb when the patient is seated, careful positioning in bed, daily static positional stretches, motor retraining and strapping of the scapula to maintain postural tone and symmetry. Conclusions: Research is required to evaluate the effectiveness of the components of ...
TL;DR: The ATD PA's QOL subset appears to be a valid measure and, thus, it can be useful both in identifying subjective quality of life and predispositions to AT use early in rehabilitation.
Abstract: Purpose: Assesses the validity of a subset of items of the Assistive Technology Device Predisposition Assessment (ATD PA) as a measure of quality of life (QOL) for persons with new spinal cord injury Method: Subjects completed the ATD PA QOL subset, Satisfaction with Life Scale (SWLS), and Brief Symptom Inventory (BSI) while in acute rehabilitation The internal reliability of the QOL subset of the ATD PA was assessed Concurrent validity of the ATD PA's QOL subset with the SWLS and construct validity with the BSI depression subscale was assessed using Spearman correlations Subjects were recruited while acute rehabilitation inpatients in a general hospital and consisted of twenty persons with newly acquired SCI (10 males and 10 females) Results: Significant positive correlations between the ATD PA's QOL subset and SWLS (and significant negative correlations with the BSI depression subscale) suggest the QOL subset has concurrent and construct validity Conclusions: The ATD PA's QOL subset appears to be
TL;DR: The study investigated the discriminant validity of the Hospital Anxiety and Depression Scale (HADS) and the General Health Questionnaire (GHQ-12) to identify patients with comorbid mental disorders, specifically anxiety, depressive and somatoform disorders.
Abstract: Purpose: The detection of patients with comorbid mental illness is of high clinical importance in orthopaedic rehabilitation. To simplify detection of cases, screening instruments are recommended. The study investigated the discriminant validity of the Hospital Anxiety and Depression Scale (HADS) and the General Health Questionnaire (GHQ-12) to identify patients with comorbid mental disorders, specifically anxiety, depressive and somatoform disorders. Method: Two hundred and six patients with musculoskeletal disease from four orthopaedic rehabilitation clinics participated in a two-stage survey: (1) patients were assessed with the GHQ-12 and HADS; and (2) they were examined for DSM-IV mental disorders by clinical standardized interview (CIDI). Validity of the two instruments regarding the detection of mental disorders was compared using ROC-analysis and CIDI-diagnoses as criteria. Results: The HADS sumscale performed better in all analyses compared to the GHQ-12, specifically in detecting depressive and a...
TL;DR: Thorough pain assessment and management should be incorporated into the health programmes aimed at maximizing physical and psychological function in the older population.
Abstract: Purpose : The effect that pain has on everyday physical and psychological functioning in the older population is not well understood The main objective of this study was to describe the extent of pain and pain-related disability in the Canadian population and examine the relationships between demographic and health-related variables and pain-related interference in physical and psychological functioning Method : The data was obtained from the follow up study to The Canadian Study of Health and Ageing Information from 5703 Canadians 70 years of age and older was analysed in this study Results : Fifty-nine point three per cent of the women and 484% of the men reported having pain in the 4 weeks prior to the interview Of those who reported pain, a greater proportion of women compared with men reported that pain at least moderately interfered with physical functioning (moving about, normal tasks, recreational activities, sleep) and psychological functioning (mood, enjoyment of life) The intensity of pa
TL;DR: Generally a low emotional state with anxiety, depression and sleep-disturbances not only connected to pain is found in patients with chronic radicular neck pain, and a multidisciplinary rehabilitation with cognitive behavioural therapy and psychological interventions is recommended.
Abstract: Purpose: To describe and explore the relationships between pain, emotional state and coping strategies in patients with chronic radicular neck pain before and after surgery or conservative treatmen...
TL;DR: This paper examined the related literature on this topic and detailed the outcomes and nature of those selfefficacy enhancing strategies that have been incorporated into arthritis treatment regimens and indicated self-efficacy is potentially a potent predictor of the overall health status of the person with arthritis.
Abstract: Purpose: Self-efficacy, a cognitive construct implicating one's self-perception about one's performance ability, has been found to be a significant predictor of psychological well-being, adherence to prescribed treatments, and pain coping mechanisms of persons with arthritis. Heightened self-efficacy may also ameliorate arthritis-related symptoms of fatigue and depression, and preserve function and prolong physical wellbeing. Methods: To elaborate upon the utility of self-efficacy enhancing strategies as this pertains to ameliorating arthritisrelated disability, this paper examined the related literature on this topic and detailed the outcomes and nature of those selfefficacy enhancing strategies that have been incorporated into arthritis treatment regimens. Results: Despite limitations in the prevailing database, results indicated: (1) self-efficacy is potentially a potent predictor of the overall health status of the person with arthritis; and (2) carefully designed self-efficacy enhancing strategies ar...
TL;DR: A significant number of patients with minor head injury still complaining of post concussive symptoms, which may contribute to a delay in return to work, are shown.
Abstract: Purpose : It is known that post-concussive symptoms may persist after mild head injury. However, the majority of those patients are denied follow-up or support. A minor head injury clinic was thus established in North Staffordshire Hospital in 1993 to address these problems. Methods : Patients 16 - 65 years old attending hospital with minor head injury were invited to attend the clinic two weeks after presentation. A specialized brain injury nurse and/or assistant clinical psychologist assessed them. Patients with persistent symptoms were invited to a second assessment four weeks later. Results : One thousand two hundred and fifty-five patients were invited for first assessment, the most common cause of head injury was assault (454) followed by road traffic accident (334). Six hundred and sixteen patients did not attend the first assessment; most of non-attendees were those who had been assaulted (281). Six hundred and thirty-nine patients attended, (472) were male, their mean age was 33. Forty-three per ...
TL;DR: The identification of effective coping strategies to aid both long-term psychological and clinical well-being should improve the management of non-adherence.
Abstract: Purpose: How individuals cope with aspects of cystic fibrosis (CF) has the potential to influence their self management and the course of their disease. To evaluate how individuals cope with CF, a disease specific coping scale was developed and validated. A second objective of the work was to examine the relationship between coping styles and treatment adherence. Methods: The development of the coping scale constituted a longitudinal design. A cross-sectional questionnaire design was used to examine the coping-adherence relationship. The development and validation of the coping scale comprised three phases: (1) Initially, 60 patients were interviewed to identify CF concerns. From this information a list of 23 concerns were recorded; (2) Eighty-three patients were interviewed to identify CF coping responses. For each concern, they were asked what they did or thought to ease the worry. A list of 24 coping strategies were recorded that formed a comprehensive set of items as to how people with CF act, feel an...
TL;DR: Problems with everyday memory and activities of daily living were found to be associated with carer strain, which was associated with memory problems experienced by people with MS.
Abstract: Purpose : To examine the factors associated with strain in carers of people with multiple sclerosis (MS). Method : People with MS were recruited from an MS management clinic. Demographic information, memory, executive function, attention/concentration, mood, disability and health of the person with MS, the carer's opinion of the care-recipient's memory and disability, and the carer's mood were recorded. A postal questionnaire to identify factors associated with carer strain was sent to carers. A further questionnaire was sent to carers to examine the association between memory problems in people with MS and carer strain. Results : Problems with everyday memory and activities of daily living were found to be associated with carer strain. Strained carers perceived strain to be a consequence of the memory problems (p<0.01). Aspects of the memory problems related to carer strain were the amount of time a carer could spend alone (p = 0.01), the carer's mood and less sympathetic feelings towards the person with...
TL;DR: The existing literature is reviewed with an aim to identify behavioural and emotional features that are candidates for Rett syndrome (RS) specific behaviours.
Abstract: Purpose / Method : There is increasing agreement that many genetic disorders have characteristic behavioural phenotypes; that is genetic anomalies have specific effects on behaviour. In this paper the existing literature is reviewed with an aim to identify behavioural and emotional features that are candidates for Rett syndrome (RS) specific behaviours. Results / Conclusion : A number of behavioural and emotional features have been reported to be common in individuals with RS. These behaviours may constitute an RS-specific profile of behaviour or behavioural phenotype. Alternatively, these behaviours may simply reflect the multiple disabilities found in individuals with severe or profound cognitive impairment. The diagnostic criteria for Rett syndrome include a number of the behavioural features, such as hand stereotypies and breathing difficulties, although other behavioural features are not included.
TL;DR: The findings show that a combination of conditions that include demographic and functional conditions place older people at risk for problems with the home environment that impede performance of daily living activities.
Abstract: Purpose : This paper describes the types of difficulties older people have with their home environments and the factors associated with having such difficulties. Method : Data were used from 296 study participants of the University at Buffalo's Consumer Assessments Study that examines the home modification needs and environmental difficulties of older people. A combination of socio-demographic variables, health and functional status indicators and measures of psychosocial well-being were used to predict environmental problems. Results : An average of 13 problems with the environment that posed as a barrier to safe and independent performance was observed in homes. It was found that most difficulties occurred in bathrooms, kitchens, bedrooms and access to entryways and rooms. Hierarchical multiple regression analysis showed that having home environmental problems was most strongly associated with younger age, being female, being of minority status, having pain, and greater physical disability. Conclusion :...
TL;DR: The results showed that the positive impact, present on adoption, did not diminish significantly for those who retained the use of the device, and the PIADS provides clinicians with a reliable and economical method for assessing the role of psychosocial factors in the retention or abandonment of an AD.
Abstract: Purpose: Abandonment of an assistive device (AD) is a frustrating issue yet is very common. An important reason for abandonment is that the device fails to improve the quality of life of the adopter. Method: By means of a new questionnaire, the Psychosocial Impact of Assistive Devices Scale (PIADS) the impact on quality of life of any AD can be measured. This study tested the hypothesis that the impact of the adoption of an AD would wane with time, as the user becomes more adapted to the AD. The study attempted to do a one year follow up on all patients at a leading Canadian clinic who had received first-time prescriptions for eyeglasses. Results: The results showed that the positive impact, present on adoption, did not diminish significantly for those who retained the use of the device. Conclusion: The PIADS provides clinicians with a reliable and economical method for assessing the role of psychosocial factors in the retention or abandonment of an AD.
TL;DR: The EuroQol did not measure the same aspects of quality of life as the FAMS and SF-54 and was not found to be a sensitive measure within this sample.
Abstract: Purpose : The quality of life of multiple sclerosis (MS) patients was assessed using two MS specific quality of life measures (FAMS and SF-54) and a short generic measure (EuroQol) in order to make recommendations for routine assessment. Factors contributing to quality of life within this population were also considered. Method : Questionnaires were either sent by post or completed at interview. Ninety-six MS patients known to a consultant in rehabilitation medicine completed the questionnaires. Results : Patients scored very low on subscales related to physical health. Correlations were high between the FAMS and SF-54 but low with the EuroQoL. Stepwise multiple linear regressions showed mood measures to account for the most variance on all quality of life composite scores. The MS patients within the study had much lower SF-36 quality of life scores than the general population and other illness groups. Conclusions : The EuroQol did not measure the same aspects of quality of life as the FAMS and SF-54 and ...
TL;DR: It was concluded that SPM training in children with cerebral palsy will be applied to combined programmes and the relationship with individual and group treatments developed.
Abstract: Purpose: This study was planned to investigate the effects of individual and group approaches to sensory-perceptual-motor (SPM) training on children with cerebral palsy. Method: This study was carried out at the School of Physical Therapy and Rehabilitation of Hacettepe University, Occupational Therapy Unit. Forty-one children who were diagnosed as having spastic diplegic cerebral palsy by the Department of Paediatric Neurology of Hacettepe University were assessed. Forty-one children with cerebral palsy were randomly divided into three groups. Individual and group SPM training were given to first group (IND) (n 16) and second group (GRP) (n 16) respectively. The third group was determined as a control group (n 9) and only the home programme was given. All children were evaluated with Ayres Southern California Sensory Integration Test and Physical Ability Test before and after training. The SPM training programmes were applied for 1.5 hours, 3 days per week for 3 months. Results: Estimates of effect sizes...
TL;DR: It now appears that females with RS present with a much broader phenotype than originally described, and mutations in the MECP2 gene encoding X-linked methyl-CpG-binding-protein 2 have been identified in some females with Rett syndrome.
Abstract: Purpose : Rett syndrome is a neurodevelopmental disorder that occurs almost exclusively in females. In recent years there has been increased knowledge concerning the multidisciplinary management of individuals with Rett syndrome. The aim of this paper is to provide an update of the clinical phenotype, natural history and current genetic understanding of the disorder. Results / Conclusion : Rett syndrome is thought to be the second most common cause of severe mental retardation in females after Down syndrome. it now appears that females with RS present with a much broader phenotype than originally described. Recently, mutations in the MECP2 gene encoding X-linked methyl-CpG-binding-protein 2 have been identified in some females with Rett syndrome.
TL;DR: It is suggested that motivated parents may not require expensive technologies or lengthy training in order to enhance their children's early communication and participation in storybook reading.
Abstract: Purpose : Storybook reading provides a natural language learning context in which to support early symbolic communication. In this study, we explored the impact of (1) resting hand splints, (2) light tech augmentative communication systems such as voice-output devices and symbols, and (3) very basic parent training on the symbolic communication and labelling behaviours of six girls with Rett syndrome. Method : Mothers and daughters were videotaped as they read familiar and unfamiliar storybooks in their homes. Results : Group and individual data collected from the six girls indicated that they became more active and successful participants in the interactions during storybook reading. The girls employed a wider range of communication modes and increased the frequency of their labelling. Familiar storybook reading encouraged greater symbolic communication than unfamiliar storybooks in half the girls. Conclusion : This study suggests that motivated parents may not require expensive technologies or lengthy t...
TL;DR: Fibromyalgia has had a negative impact on the quality of life in female patients who attended the Rheumatology Outpatient Unit of Sorocaba Hospital Complex.
Abstract: Purpose: The purpose of this study is to assess the impact of Fibromyalgia (FM) on the female patient's quality of life who attended the Rheumatology Outpatient Unit of Sorocaba Hospital Complex and compare it to the quality of life of healthy control group, through the Medical Outcome Study Short-form 36 item Survey (SF36). Subjects: 32 women who fitted the American College of Rheumatology Classification Criteria for Fibromyalgia and 28 healthy women. Materials and Methods: The groups were submitted to 'Medical Outcome Study 36 Item Short-form Survey' (SF36). This questionnaire is composed of 8 scales about several aspects of the quality of life. Results: The SF36 scales in the Fibromyalgia group presented the following results: general health - 43.3; functional ability - 39.4; bodily pain - 26.5; physical functioning - 14.8 (0- 75); vitality - 38.5 (5-85); emotional functioning - 32.2; mental health - 44.2; social functioning - 45.1. The SF36 scales in the control group presented the following results: ...