Restauration d’un contexte de libre choix et insertion professionnelle des allocataires du RMI

This study deals with the vocational rehabilitation of minimum wage integration beneficiaries (RMI) and their commitment with an assistance service of vocational rehabilitation. We postulate that these public is perceived like not very autonomous by the welfare workers and that their freedom of action is some reduced. So we studied the impact of a context of freedom on the course of these public. Two results appeared. Firstly, a high context of freedom increases the commitment of people towards the welfare workers. Secondly, we observed that context of freedom did not have impact on the vocational rehabilitation of the individuals recently registered in RMI device. Nevertheless, in a freedom context, people registered since longer had the same probability to success that people recently registered in RMI device.     

The Use of the Term Virtual Reality in Post-Stroke Rehabilitation: A Scoping Review and Commentary

Virtual reality (VR) offers many opportunities for post-stroke rehabilitation. However, “VR” can refer to several types of computer-based rehabilitation systems. Since these systems may impact the feasibility and the efficacy of VR interventions, consistent terminology is important. In this study, we aimed to optimize the terminology for VR-based post-stroke rehabilitation by assessing whether and how review papers on this topic defined VR and what types of mixed reality systems were discussed. In addition, this review can inspire the use of consistent terminology for other researchers working with VR. We assessed the use of the term VR in review papers on post-stroke rehabilitation extracted from Scopus, Web of Science and PubMed. We also developed a taxonomy distinguishing 16 mixed reality systems based on three factors: immersive versus semi-immersive displays, the way in which real and virtual information is mixed, and the main input device. 64% of the included review papers (N = 121) explicitly defined VR and 33% of them described different subtypes of VR, with immersive and non-immersive VR as the most common distinction. The most frequently discussed input devices were motion-capture cameras and handheld devices, while regular 2D monitors were the most frequently mentioned output devices. Our analysis revealed that reviews on post-stroke VR rehabilitation did not or only broadly defined “VR” and did not focus on a specific system. Since the efficacy and feasibility of rehabilitation may depend on the specific system, we propose a new data-driven taxonomy to distinguish different systems, which is expected to facilitate communication amongst researchers and clinicians working with virtual reality.     

Teaching medical staff psychological concepts via a hospital newsletter

Despite the increased recognition of the critical role of social and psychological factors in health and illness, the teaching of psychology is rarely integrated in medical education. Staff generally have minimal formal training in psychological concepts. Patients on the inpatient rehabilitation unit frequently present with unexpected reactions in response to acute trauma and resulting changes in identity and capabilities. Rehabilitation goals therefore, must be based on psychological, as well as physical, capacities. A one-page, user-friendly newsletter was designed to illustrate basic psychological principles via case vignettes. The topics of fear, countertransference, and resistance were selected as critical issues staff frequently encounter in their work with patients. The newsletters provided the staff with basic conceptual tools for effectively treating patients, and the work of psychologists was demystified. The newsletter format is proposed as a creative adjunct to didactic teaching.Copies of the newsletter Insight can be obtained by request from Dr. Gold.     

Targeted Memory Reactivation During Sleep,But Not Wake,Enhances Sensorimotor Skill Performance: A Pilot Study

The benefits of sleep on memory consolidation have been enhanced for declarative and motor sequence learning through replaying classically conditioned auditory stimuli during sleep, known as targeted memory reactivation (TMR). However, it is unknown if TMR can influence performance of a sensorimotor skill, in the absence of the cognitive requirements of sequence learning. Here, young adults performed a nondominant arm throwing task separated by a full night of sleep or a full day of wake, with half of all participants receiving TMR between sessions. Participants who received TMR during sleep demonstrated enhanced sensorimotor performance relative to all other groups. In conclusion, this pilot study indicates that it is feasible to influence sensorimotor skill performance through TMR during sleep and may serve as a future adjunct to physical rehabilitation. Future studies will aim to confirm the present results with a larger sample size as well as investigate the effects of TMR during sleep on older adults both with and without a history of stroke.     

Comprehensive quantitative investigation of arm swing during walking at various speed and surface slope conditions

Previous studies have shown that inclusion of arm swing in gait rehabilitation leads to more effective walking recovery in patients with walking impairments. However, little is known about the correct arm-swing trajectories to be used in gait rehabilitation given the fact that changes in walking conditions affect arm-swing patterns. In this paper we present a comprehensive look at the effects of a variety of conditions on arm-swing patterns during walking. The results describe the effects of surface slope, walking speed, and physical characteristics on arm-swing patterns in healthy individuals. We propose data-driven mathematical models to describe arm-swing trajectories. Thirty individuals (fifteen females and fifteen males) with a wide range of height (1.58–1.91 m) and body mass (49–98 kg), participated in our study. Based on their self-selected walking speed, each participant performed walking trials with four speeds on five surface slopes while their whole-body kinematics were recorded. Statistical analysis showed that walking speed, surface slope, and height were the major factors influencing arm swing during locomotion. The results demonstrate that data-driven models can successfully describe arm-swing trajectories for normal gait under varying walking conditions. The findings also provide insight into the behavior of the elbow during walking.     

How visually impaired cyclists ride regular and pedal electric bicycles

The present study investigates whether visually impaired cyclists compensate for their vision limitations by maintaining a lower speed or a larger distance to the kerb than normally sighted cyclists when riding a regular bicycle or pedal electric bicycle (pedelec). A normally sighted control group (n = 10), a peripheral visual field loss group (n = 9), and a low visual acuity group (n = 12) rode a fixed route (7.5 km) in the Netherlands on a regular bicycle and on a pedelec. Speed and lateral position were measured when participants cycled a (I) one-way cycle path, (II) two-way cycle path, (III) residential area, and (IV) shared space zone. With regard to both the regular bicycle and the pedelec, no significant speed or lateral position differences were found between the three groups. In conclusion, for some people with severe and permanent visual impairments, and under certain circumstances, regular bicycle and pedelec riding may be possible without noticeable speed reduction or adapted lane position to compensate for their functional impairment. The present findings may further optimise the cycling advice provided by mobility trainers of vision rehabilitation centres and the independent mobility of visually impaired people.     

Persuasion Strategies Applied in Psychosocial Rehabilitation

Theoretically one of the most important questions in applied psychology is how people influence and control each other. What theoretical concepts can be used to explain these influences? Learning theory explanations have been popular in psychology, but other alternatives are also possible. In this article, rehabilitation is analysed through interactional persuasion strategies. Six strategies are proposed: coercion, threat, offer, guidance, appeal and appreciation. Each strategy corresponds to a specific atmosphere, and arouses either compatible or incompatible reactions from the target of a specific strategy. In the present model the major component of the persuasion strategy is the choice it provides. Choice depends on the amount of information and sense of personal control it provides. In order to attain specific rehabilitation objectives certain persuasion strategies are applied. Coercion, threat and offer are used for behavioural objectives and guidance; appeal and appreciation for cognitive-experiential objectives. In the last part of the article, various rehabilitation programmes are described by persuasion strategies.     

Using fMRI to study recovery from acquired dysphasia

We have used functional magnetic resonance imaging (fMRI) to characterize brain activations associated with two distinct language tasks performed by a 28-year-old woman after partial recovery from dysphasia due to a left frontal hemispheric ischemic stroke. MRI showed that her ischemic lesion extended posteriorly from the left inferior frontal to the perisylvian cortex. fMRI scans of both language tasks revealed substantial differences in activation pattern relative to controls. The nature of this difference was task-specific. During performance of a verbal semantic decision task, the patient, in contrast to controls, activated a network of brain areas that excluded the inferior frontal gyrus (in either hemisphere). A second task involving rhyme judgment was designed to place a heavier cognitive load on language production processes and activated the left inferior frontal gyrus (Broca's area) strongly in normal controls. During this task, the most prominent frontal activation in the patient occurred in the right homologue of Broca's area. Subsequent analysis of this data by methods able to deal with responses of changing amplitude revealed additional, less sustained recruitment by the patient of cortex adjacent to the infarct in the region inferior to Broca's area during rhyming. These results suggest that in addition to changes in cognitive strategy, recovery from dysphasia could be mediated by both the preservation of neuronal networks in and around the infarct and the use of homologous regions in the contralateral hemisphere.     

Training self-advocacy skills to adults with mild handicaps.

We developed and empirically evaluated an instructional program to teach self-advocacy skills to eight young adults with mild handicaps. Participants were taught to discriminate whether or not possible violations of legal rights occurred in socially validated scenarios and, if so, to role-play how to redress rights violations. Experimental control was demonstrated with a multiple probe design across four general legal rights categories for the discrimination component of training, and a multiple probe across groups of subjects for the redressing legal rights component of training. Participants'' behavior was probed in simulations and deceptions of legal rights violations in natural settings. There were marked increases in dependent measures after instruction. Difficulties in assessing generalization and maintenance of low-rate behaviors and suggestions for future research are presented.