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Topics in Stroke Rehabilitation Apr 2019Returning to driving after stroke is one of the key goals in stroke rehabilitation, and fitness to drive guidelines must be informed by evidence pertaining to risk of...
BACKGROUND
Returning to driving after stroke is one of the key goals in stroke rehabilitation, and fitness to drive guidelines must be informed by evidence pertaining to risk of motor vehicle collision (MVC) in this population.
OBJECTIVES
The purpose of the present study was to determine whether stroke and/or transient ischemic attack (TIA) are associated with an increased MVC risk.
METHODS
We searched MEDLINE, CINAHL, EMBASE, PsycINFO, and TRID through December 2016. Pairs of reviewers came to consensus on inclusion, based on an iterative review of abstracts and full-text manuscripts, on data extraction, and on the quality of evidence.
RESULTS
Reviewers identified 5,605 citations, and 12 articles met inclusion criteria. Only one of three case-control studies showed an association between stroke and MVC (OR 1.9, 95% CI 1.0-3.9). Of five cohort reports, only one study, limited to self-report, found an increased risk of MVC associated with stroke or TIA (RR 2.71, 95% CI 1.11-6.61). Two of four cross-sectional studies using computerized driving simulators identified a more than two-fold risk of MVCs among participants with stroke compared with controls. The difference in one of the studies was restricted to those with middle cerebral artery stroke.
CONCLUSIONS
The evidence does not support a robust increase in risk of MVCs. While stroke clearly prevents some patients from driving at all and impairs driving performance in others, individualized assessment and clinical judgment must continue to be used in assessing and advising those stroke patients who return to driving about their MVC risk.
Topics: Accidents, Traffic; Automobile Driving; Humans; Ischemic Attack, Transient; Stroke
PubMed: 30614401
DOI: 10.1080/10749357.2018.1558634 -
The Journal of Pain Feb 2019The left/right judgment task (LRJT) is the most commonly used method of assessing motor imagery performance. Abnormally long response times are thought to reflect... (Meta-Analysis)
Meta-Analysis
The left/right judgment task (LRJT) is the most commonly used method of assessing motor imagery performance. Abnormally long response times are thought to reflect delayed processing of body/spatial representations, and poor accuracy is thought to reflect disrupted cortical proprioceptive representations or body schema. Slower and less accurate responses on the LRJT have been reported in a variety of chronic musculoskeletal pain conditions. To date, no systematic review of the literature has been conducted to assess if altered motor imagery performance as measured by the LRJT is characteristic of all chronic musculoskeletal pain conditions. Therefore, the aim of this study was to conduct a comprehensive systematic review and meta-analysis of the literature to answer the following question: Do people with chronic musculoskeletal pain have impaired left/right body part judgment? Twenty-five studies (2,266 participants) including a range of chronic pain populations who undertook an LRJT were identified from searches of 8 electronic databases from inception to March 2017. Results indicate that chronic musculoskeletal pain conditions affecting the limbs and face (P ≤ .01) are associated with altered motor imagery performance as measured by the LRJT. PERSPECTIVES: This review synthesizes evidence of altered motor imagery performance using the LRJT across chronic musculoskeletal pain conditions. Consistent evidence was found for altered motor imagery performance in peripheral pain conditions, but evidence was less consistent for axial conditions. Treatment to restore a normal body schema may be beneficial in chronic limb and facial pain.
Topics: Chronic Pain; Humans; Imagination; Motor Activity; Musculoskeletal Pain; Proprioception; Space Perception
PubMed: 30098404
DOI: 10.1016/j.jpain.2018.07.004 -
Journal of Deaf Studies and Deaf... Jan 2019To be successful in school and life individuals need to learn to understand and manage their emotions, get along with others and exercise good judgment. Children and...
To be successful in school and life individuals need to learn to understand and manage their emotions, get along with others and exercise good judgment. Children and youth who are deaf or hard of hearing have long been considered a population at risk for not developing age-appropriate social-emotional skills. The purpose of this study was to identify, review, and summarize the intervention research addressing social and emotional learning with children and youth who are deaf or hard of hearing. We examined the research published in professional peer-reviewed journals between the years 1996 and 2017. Eight hundred and nineteen articles on the topic were reviewed. A total of 11 intervention studies were identified. A summary of each study as well as recommendations for future research are provided.
Topics: Child; Child, Preschool; Deafness; Early Intervention, Educational; Emotions; Female; Humans; Male; Persons With Hearing Impairments; School Health Services; Social Skills
PubMed: 30418589
DOI: 10.1093/deafed/eny030