An awareness approach to the covert symptoms of stuttering

Speech-language clinicians working with the confirmed stuttering client are often faced with the clinical management of the covert symptoms of stuttering in addition to the more observable and measurable overt symptoms. The authors report the successful use of awareness techniques to exaggerate the subjective experience of these covert symptoms and encourage the use of these techniques as an adjunct to the counseling and desensitization procedures traditionally employed. A transcribed clinical management session in which several awareness techniques are used to aid the client in an introspective examination of “anticipation of stuttering,” is analyzed in order to reach some specific recommendations for using awareness techniques in the clinical management of the covert symptoms of stuttering.     

The impact of sport and physical activity on the well-being of combat veterans: A systematic review

ObjectivesThis review examined the potential impact of sport and physical activity upon the subjective and psychological well-being of combat veterans in the aftermath of physical or psychological combat trauma.DesignA systematic review was conducted. The question guiding this review was ‘what is the impact of sport and physical activity on the well-being of combat veterans?’MethodsKey databases were searched for articles relating to the use of sport and/or physical activity in supporting combat veterans. 11 studies were identified as relevant for inclusion. Data from these studies were extracted by means of a directed content analysis, the results of which were reported in a narrative synthesis.ResultsSport and physical activity enhances subjective well-being in veterans through active coping and doing things again, PTSD symptom reduction, positive affective experience, activity in nature/ecotherapy, and quality of life. Impact on psychological well-being includes determination and inner strength, focus on ability and broadening of horizons, identity and self-concept, activity in nature/ecotherapy, sense of achievement/accomplishment, and social well-being. Participating in sport and/or physical activity can also enhance motivation for living.ConclusionsThe review advances knowledge by producing a synthesis of evidence that highlights the value of sport and physical activity for supporting the well-being and rehabilitation of disabled combat veterans and combat veterans diagnosed with Post-Traumatic Stress Disorder. It also develops knowledge by identifying the type of sports and physical activities used to promote well-being, offering the first definition of combat veterans in the sport literature, taking a critical approach, and highlighting the under researched role of nature-based physical activity.     

Effects of whole body vibration on spasticity and lower extremity function in children with cerebral palsy

AimThe aim of this study was to evaluate the effect of whole body vibration (WBV) on lower extremity spasticity and ambulatory function in children with cerebral palsy (CP) with a complete crossover design.MethodSixteen participants aged 9.8(2.3) years received a 20-min WBV and a control condition in a counterbalanced order on two separate days. Change scores of each outcome variable were used to show the improvement.ResultsRepeated-measures analyses revealed significant differences in condition scores among variables including active range-of-motion (active ROM, increased), relaxation index (RI, increased), Modified Ashworth Scale (MAS, decreased), timed up-and-go (TUG, decreased), and Six Minute Walk Test (6MWT, increased). Significant differences were also found in time change scores for MAS and 6MWT. Correlation results revealed that TUG was significantly correlated with RI (r = −.512, p = .042), and 6MWT (r = −.700, p = .003).InterpretationThis study suggested that WBV intervention can control the spasticity, enhance ambulatory performance and increase active ROM. Along with previous results, data from this study revealed the potential use of WBV in clinical rehabilitation in children with CP. Future investigations should focus on finding the combination of treatment frequency and duration to achieve an ideal result.     

Chapter 8: “Always Green and Full of Sap”: Facilitating Wholeness in Aging

SUMMARY

Wholeness in aging is difficult to define, especially in the face of physical disability or catastrophic illness. How one meets the challenges of aging depends upon numerous physical, emotional, and spiritual factors. Rehabilitation may play an important role in restoring wholeness to those with physical disabilities. Likewise, a physical fitness program may lessen some of the effects of aging, helping the older person maintain a higher quality of life. The lived theologies of the older patients and their caregivers also interact, providing an important ground of connection in rediscovery of wholeness as well. Ultimately, our most important role as healthcare providers is to help our older patients regain and maintain this multidimensional wholeness even in times of physical challenge.     

Effects of a self-regulation intervention on exercise are moderated by depressive symptoms: A quasi-experimental study

This study investigated whether a computer-based self-regulation intervention increases physical exercise in individuals with or without depressive symptoms. A total of 361 individuals in orthopedic rehabilitation, 36 of them with depressive symptoms, were recruited in Germany. In a quasi-experimental study, individuals were allocated to either a computer-based self-regulation intervention or an online questionnaire. Exercise was measured at the beginning of rehabilitation and six weeks after rehabilitation. Depressive symptoms were assessed at the end of rehabilitation. An analysis of covariance was conducted, controlling for exercise baseline, sex, and phase of assessment. A main effect for depressive symptoms (p = .005) and intervention group (p = .011), as well as a marginal interaction of intervention x depressive symptoms were found (p = .076). Results indicate that the self-regulation exercise intervention in an orthopedic rehabilitation setting seem to be only effective in non-depressed individuals. Future research should examine how health behavior change programs can be designed more effectively for individuals with depressive symptoms.     

The effects of exposure duration and practice on the immediate memory spans of children and adults

Immediate memory spans for alphabetic items were determined for second-grade, fifth-grade, and adult subjects. Subjects were tested on three days, ten trials per day at each of three exposure durations: 15, 50, and 200 msec. One half of the subjects were presented with exposure durations in an ascending order, the other half in a descending order. The results indicated that immediate memory span increases with age and practice. The exposure duration effect depended on the order and day in which durations were presented. There was a suggestion that the exposure duration effect was also dependent upon the age and sex of the subject. The ordering of array positions from most accurately reported to least accurately reported was identical for all three age levels, indicating that scanning strategies are well established at an early age.     

A scale to measure attitudes toward working

The purpose of this study was to develop a scale that could measure attitude toward work and be used to determine the relation between length of unemployment time and work attitudes. Standardization of the Employment Readiness Scale was completed through its administration to three independent groups (N = 430): (1) employed workers: employees who worked in unskilled, semiskilled, and occasionally skilled job classifications; (2) unemployed individuals who were actively looking for regular employment at the Tennessee State Employment Service; and (3) the chronically unemployed: individuals, who, for the most part, were not looking for regular employment and who were seeking night lodging and meals at the Salvation Army or the Knoxville Union Rescue Mission. Through item analysis, it was determined that 43 of the 45-scale items were significant at or beyond the .01 level. It was further established that a relationship existed between work attitudes and length of unemployment. The longer an individual was unemployed, the less positive was his attitude toward work.     

Walking impairs cognitive performance among people with multiple sclerosis but not controls

People with multiple sclerosis (MS) complain of problems completing two tasks simultaneously; sometimes called ‘dual-tasking’ (DT). Previous research in DT among people with MS has focused on how adding a cognitive task interferes with gait and few have measured how adding a motor task could interfere with cognition. We aimed to determine the extent to which walking affects a concurrent working memory task in people with MS compared to healthy controls. We recruited MS participants (n = 13) and controls (n = 10) matched by age (±3 years), education (±3 years) and gender. Participants first completed the cognitive task (subtracting 7’s from the previous number) and then again while walking on an instrumented walkway. Although there were no baseline differences in cognition or walking between MS participants and controls, MS participants demonstrated a 52% decrease in number of correct answers during DT (p < 0.001). Mental Tracking Rate (% correct answers/min) correlated strongly with MS-related disability measured using the Expanded Disability Status Scale (EDSS; r(11) = −0.68, p < 0.01). We propose that compromised mental tracking during walking could be related to limited neural resource capacity and could be a potentially useful outcome measure to detect ecologically valid dual tasking impairments.     

Dynamic testing of learning potential in adults with cognitive impairments: A systematic review of methodology and predictive value

Dynamic testing includes procedures that examine the effects of brief training on test performance where pre‐ to post‐training change reflects patients’ learning potential. The objective of this systematic review was to provide clinicians and researchers insight into the concept and methodology of dynamic testing and to explore its predictive validity in adult patients with cognitive impairments. The following electronic databases were searched: PubMed, PsychINFO, and Embase/Medline. Of 1141 potentially relevant articles, 24 studies met the inclusion criteria. The mean methodological quality score was 4.6 of 8. Eleven different dynamic tests were used. The majority of studies used dynamic versions of the Wisconsin Card Sorting Test. The training mostly consisted of a combination of performance feedback, reinforcement, expanded instruction, or strategy training. Learning potential was quantified using numerical (post‐test score, difference score, gain score, regression residuals) and categorical (groups) indices. In five of six longitudinal studies, learning potential significantly predicted rehabilitation outcome. Three of four studies supported the added value of dynamic testing over conventional testing in predicting rehabilitation outcome. This review provides preliminary support that dynamic tests can provide a valuable addition to conventional tests to assess patients’ abilities. Although promising, there was a large variability in methods used for dynamic testing and, therefore, it remains unclear which dynamic testing methods are most appropriate for patients with cognitive impairments. More research is warranted to further evaluate and refine dynamic testing methodology and to further elucidate its predictive validity concerning rehabilitation outcomes relative to other cognitive and functional status indices.