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The Daily Living Questionnaire (DLQ) constitutes one of a number of functional cognitive measures, commonly employed in a range of medical and rehabilitation settings. One of the drawbacks of the DLQ is its length which poses an o...
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The Daily Living Questionnaire (DLQ) constitutes one of a number of functional cognitive measures, commonly employed in a range of medical and rehabilitation settings. One of the drawbacks of the DLQ is its length which poses an obstacle to conducting efficient and widespread screening of the public and which incurs inaccuracies due to the length and fatigue of the subjects.Objective This study aims to use Machine Learning (ML) to modify and abridge the DLQ without compromising its fidelity and accuracy.
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Executive dysfunction after stroke is associated with limitations in daily activities and disability. Existing interventions for executive dysfunction show inconsistent transfer to everyday activities and require frequent clinic v...
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Executive dysfunction after stroke is associated with limitations in daily activities and disability. Existing interventions for executive dysfunction show inconsistent transfer to everyday activities and require frequent clinic visits that can be difficult for patients with chronic mobility challenges to access. To address this barrier, we developed a telehealth-based executive function intervention that combines computerized cognitive training and metacognitive strategy. The goal of this study was to describe intervention development and to provide preliminary evidence of feasibility and acceptability in three individuals who completed the treatment protocol. The three study participants were living in the community and had experienced a stroke >6 months prior. We assessed satisfaction (Client Satisfaction Questionnaire-8 [CSQ-8]), credibility (Credibility and Expectancy Questionnaire), and feasibility (percent of sessions completed). All three subjects rated the treatment in the highest satisfaction category on the CSQ-8, found the treatment to be credible, and expected improvement. Participants completed a median of 96% of computerized cognitive training sessions and 100% of telehealth-delivered metacognitive strategy training sessions. Individuals with chronic stroke may find a remotely delivered intervention that combines computerized cognitive training and metacognitive strategy training to be feasible and acceptable. Further evaluation with larger samples in controlled trials is warranted.
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The critical role that awareness deficits play in contributing to rehabilitation outcome and independent functioning of brain injured adults is readily acknowledged by rehabilitation professionals. However, there are inconsistenci...
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The critical role that awareness deficits play in contributing to rehabilitation outcome and independent functioning of brain injured adults is readily acknowledged by rehabilitation professionals. However, there are inconsistencies in the scope of what is included within the concept of awareness and the way in which it is measured within the literature. A comprehensive model of awareness is needed to guide the development of measurement tools and interventions. This paper expands upon concepts originally proposed by Crosson and colleagues [12] and proposes a comprehensive model of awareness that integrates parallel themes in cognitive psychology, social psychology and neuropsychology. It argues that a hierarchical view of awareness does not capture the complexities and subtleties of awareness symptoms and proposes a dynamic relationship between knowledge, beliefs, task demands and context of a situation. A distinction between knowledge and awareness, that one has prior to a task, and that, which is activated during task performance, is emphasized. Suggestions for expanding assessment and intervention methodology are derived from the perspective of research within the areas of metacognition and self-efficacy.
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Introduction: Individuals with Intellectual and Developmental Disabilities (IDD) experience broad impairments that affect their functional performance and consequently result in the need for supervision and assistance on a daily b...
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Introduction: Individuals with Intellectual and Developmental Disabilities (IDD) experience broad impairments that affect their functional performance and consequently result in the need for supervision and assistance on a daily basis. The literature contains effectiveness studies of functional interventions provided to adolescents and adults with IDD. However, existing differences in participant characteristics, study design, and type of functional intervention limit the ability to derive clinical evidence-based decisions. This scoping review sought to explore the breadth and depth of evidence related to interventions designed to promote everyday performance of adolescents and adults with IDD. Methods: We conducted an electronic and hand search that yielded 1568 papers, after an extensive selection process reduced to a sample of 24 studies. Results: A three-step extraction process of the 24 studies revealed 16 studies used functional training and technology-based approaches to teach individuals with IDD functional skills. Seven studies used functional training without a technology component, and two studies used functional training while comparing technology-based to non-technology based approaches. Overall, it appeared that functional training with the use of technology, especially Video Modelling (VM) and Prompting, were the most frequently and effectively used interventions to promote everyday performance. Gaps in research include limited studies on middle and older aged adults with moderate to severe IDD, minimal use of self-chosen goals or activities and use of technology as a continuous support. Conclusion: Our findings show a lack of studies for individuals age 30 and above with severe IDD. Additionally, this scoping review highlight that everyday functional performance of adolescents and adults with IDD can be enhanced with the usage of technology based functional interventions utilising VM and prompting methods.
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Stroke in younger populations is a public health crisis and the prevalence is rising. Little is known about the progress of younger individuals with stroke in rehabilitation. Characterization of the course and speed of recovery is...
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Stroke in younger populations is a public health crisis and the prevalence is rising. Little is known about the progress of younger individuals with stroke in rehabilitation. Characterization of the course and speed of recovery is needed so that rehabilitation professionals can set goals and make decisions. This was a cohort study with data extracted from electronic medical records. Participants were 408 individuals diagnosed with stroke who participated in inpatient rehabilitation in an urban, academic medical center in the USA. The main predictor was age which was categorized as (18-44, 45-64, 65-74 and 75+). Outcomes included baseline-adjusted discharge functional independence measure (FIM) scores and FIM efficiency. In linear regression models for FIM scores, the reference category was the youngest age group. The oldest group was discharged with significantly lower FIM total (B = -8.84), mobility (B = -4.13), self-care (B = -4.07) and cognitive (B = -1.57) scores than the youngest group after controlling for covariates. The 45-64 group also finished with significantly lower FIM total (B = -6.17), mobility (B = -2.61) and self-care (B = -3.01) scores than youngest group. FIM efficiencies were similar for all ages in each of the FIM scales. Younger individuals with stroke make slightly greater functional gains compared to older individuals with stroke, but other factors, such as admission scores, are more important and the rates of recovery may be similar.
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Purpose: To investigate the feasibility of a novel client-centered cognitive strategy training intervention for people with Parkinson's disease (PD). Materials and methods: This was a case series of seven people with PD without de...
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Purpose: To investigate the feasibility of a novel client-centered cognitive strategy training intervention for people with Parkinson's disease (PD). Materials and methods: This was a case series of seven people with PD without dementia but with subjective cognitive decline. The intervention involved >5 treatment sessions at the participant's home. Participant acceptance and engagement were assessed by the Credibility/Expectancy Questionnaire (CEQ), Client Satisfaction Questionnaire (CSQ), enjoyment and effort ratings, and homework completion. Logistical information was tracked, and the Canadian Occupational Performance Measure (COPM) was an exploratory outcome measure. Data analysis was descriptive. Results: CEQ scores were positive and increased over time. CSQ scores were high (M-30.8, SD = 0.75), with all participants rating all items positively. Almost all (95%) effort and enjoyment ratings were >3 (Much), and homework completion rates averaged 84% (SD —18). Intervention duration was 6-15 weeks (M-9.2, SD-2.8), with treatment sessions averaging 1.7 h (SD-0.5). Group and most individual COPM ratings improved >2 points. Conclusions: These findings support the feasibility of the intervention for people with PD. It was acceptable, engaging, and promising in terms of its effect on self-identified functional cognitive problems
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The 3s Spreadsheet Test (3S Test) is a cancellation test with high stimulus density and low target-to-distractor ratio, to assess stimulus-centered and viewer-centered spatial neglect. Twenty-five stroke survivors with left-sided ...
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The 3s Spreadsheet Test (3S Test) is a cancellation test with high stimulus density and low target-to-distractor ratio, to assess stimulus-centered and viewer-centered spatial neglect. Twenty-five stroke survivors with left-sided neglect and 68 age-matched healthy controls took the 3S Test. Patients also took the Apples Test, a validated cancellation test. No patient's accuracy on the 3S Test was in the normal range. A total of 91.7% of the patients had an abnormal start; 52.6% of the patients took abnormally long time to complete the 3S Test. The 3S and Apples Tests agreed poorly on both the viewer-centered and stimulus-centered neglect classifications (k = .25 and .05, respectively), but consistently identified 8 of the 25 patients (32%) as having both forms of neglect while each isolated form of neglect was present in one patient (4%). Lesion data were consistent with previous studies. These findings suggest that the 3S Test is a sensitive cancellation test for assessing viewer-centered and stimulus-centered spatial neglect. We are currently developing the 3S Test version 2 to refine the test stimuli and the scoring procedure.
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Abstract Objectives To explore the relation between a computer adaptive functional cognitive questionnaire and a performance-based measure of cognitive instrumental activities of daily living (C-IADL) and to determine whether the ...
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Abstract Objectives To explore the relation between a computer adaptive functional cognitive questionnaire and a performance-based measure of cognitive instrumental activities of daily living (C-IADL) and to determine whether the Montreal Cognitive Assessment (MoCA) at admission can identify those with C-IADL difficulties at discharge. Design Prospective cohort study. Setting Acute inpatient rehabilitation unit of an academic medical center. Participants Inpatients (N=148) with a diagnosis of stroke (mean age, 68y; median, 13d poststroke) who had mild cognitive and neurological deficits. Interventions Not applicable. Main Outcome Measures Admission cognitive status was assessed by the MoCA. C-IADL at discharge was assessed by the Executive Function Performance Test (EFPT) bill paying task and Activity Measure of Post-Acute Care (AM-PAC) Applied Cognition scale. Results Greater cognitive impairment on the MoCA was associated with more assistance on the EFPT bill paying task (ρ=?.63; P P Conclusions Questionnaire and performance-based methods of assessment appear to yield different estimates of C-IADL. Low MoCA scores ( Highlights ? Persons with stroke and Montreal Cognitive Assessment scores ? C-IADL should be screened in patients with stroke who have mild or no cognitive impairments on the Montreal Cognitive Assessment. ? The Executive Function Performance Test bill paying task appears to be a good candidate for screening C-IADL in an inpatient rehabilitation setting. ? Performance-based and questionnaire methods of assessing C-IADL provide different estimates of C-IADL. ]]>
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