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OTJR : Occupation, Participation and... 2014The objective was to assess effectiveness of apraxia treatments using a systematic review. In contrast to previous reviews, each study was rated as to its applicability... (Review)
Review
The objective was to assess effectiveness of apraxia treatments using a systematic review. In contrast to previous reviews, each study was rated as to its applicability to occupational therapy practice and its focus on occupational performance using the FAME rating system (defined by four categories: Feasibility, Appropriateness, Meaningfulness, Effectiveness). This systematic review included eight studies: four randomized controlled trials (level 1 evidence) and four pre-post designs (level 3 evidence). Three treatment approaches were reported: errorless learning with training of details; gesture training; and strategy training. FAME scores ranged from A to C. All studies reported significant treatment effects, but only one demonstrated an impact on observed occupational performance that transferred from clinic to home.
Topics: Apraxias; Humans; Occupational Therapy; Treatment Outcome
PubMed: 25347756
DOI: 10.3928/15394492-20141006-02 -
Journal of the American Medical... Jan 2015Fear of falling (FOF) and increased gait variability are both independent markers of gait instability. There is a complex interplay between both entities. The purposes... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Fear of falling (FOF) and increased gait variability are both independent markers of gait instability. There is a complex interplay between both entities. The purposes of this study were (1) to perform a qualitative analysis of all published studies on FOF-related changes in gait variability through a systematic review, and (2) to quantitatively synthesize FOF-related changes in gait variability.
METHODS
A systematic Medline literature search was conducted in May 2014 using the Medical Subject Heading (MeSH) terms "Fear" OR "fear of falling" combined with "Accidental Falls" AND "Gait" OR "Gait Apraxia" OR "Gait Ataxia" OR "Gait disorders, Neurologic" OR "Gait assessment" OR "Functional gait assessment" AND "Self efficacy" OR "Self confidence" AND "Aged" OR "Aged, 80 and over." Systematic review and fixed-effects meta-analysis using an inverse-variance method were performed.
RESULTS
Of the 2184 selected studies, 10 observational studies (including 5 cross-sectional studies, 4 prospective cohort studies, and 1 case-control study) met the selection criteria. All were of good quality. The number of participants ranged from 52 to 1307 older community-dwellers (26.2%-85.0% women). The meta-analysis was performed on 10 studies with a total of 999 cases and 4502 controls. In one study, the higher limits of the effect size's confidence interval (CI) were lower than zero. In the remaining studies, the higher limits of the CI were positive. The summary random effect size of 0.29 (95% CI 0.13-0.45) was significant albeit of small magnitude, and indicated that gait variability was overall 0.29 SD higher in FOF cases compared with controls.
CONCLUSIONS
Our findings show that FOF is associated with a statistically significant, albeit of small magnitude, increase in gait variability.
Topics: Accidental Falls; Aged; Fear; Gait Disorders, Neurologic; Humans
PubMed: 25230892
DOI: 10.1016/j.jamda.2014.06.020 -
Journal of Communication Disorders 2023Prosody serves central functions in language processing including linguistic functions (linguistic prosody), like structuring the speech signal. Impairments in... (Review)
Review
A systematic review on production and comprehension of linguistic prosody in people with acquired language and communication disorders resulting from unilateral brain lesions.
BACKGROUND
Prosody serves central functions in language processing including linguistic functions (linguistic prosody), like structuring the speech signal. Impairments in production and comprehension of linguistic prosody have been described for persons with unilateral right (RHDP) or left hemisphere damage (LHDP). However, reported results differ with respect to the characteristics and severities of these impairments AIMS: We conducted a systematic literature review focusing on production and comprehension of linguistic prosody at the prosody-syntax interface (i.e., phrase or sentence level) in LHDP and RHDP.
METHODS & PROCEDURES
In a systematic literature search we included: (i) empirical studies with (ii) adult RHDP and/or LHDP (iii) investigating production and/or comprehension of linguistic prosody at the (iv) phrase or sentence level (v) reporting quantitative data on prosodic measures. We excluded overview papers; studies involving participants with dysarthria, apraxia of speech, foreign accent syndrome, psychiatric diseases, and/or neurodegenerative diseases; studies focusing primarily on emotional prosody; and on lexical stress / word level; studies of which no full text was available and/or that were published in a language other than English. We searched the databases BIOSIS, MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Cochrane Library, PSYNDEX, PsycINFO and speechBITE, last searched on January 13 2022.We found 2,631 studies without duplicates. We identified 43 studies which were included into our systematic review. For data extraction and synthesis of results, we grouped studies by (i) modality (production vs. comprehension), (ii) function (syntactic structure vs. information structure), and (iii) by experiment task. For production studies, outcome measures were defined as the productive use of the different prosodic cues (lengthening, pause, f0, amplitude). For comprehension studies, performance measures (accuracy and reaction times) were defined as outcome measures. In accordance with the PRISMA 2020 statement (Page et al., 2021), we conducted a quality check to assess study risk of bias. Our review was pre-registered with PROSPERO (CRD42019120308).
OUTCOMES & RESULTS
Of the 43 studies reviewed, 30 studies involved RHDP (n = 309), assessing production in 15 studies and focusing on comprehension of prosody in 16 studies (one study investigated production and comprehension). LHDP (n = 438) were included in 35 studies of which 15 studied production and 21 evaluated comprehension of prosody (one study investigated production and comprehension). Despite the heterogeneity of results in the studies reviewed, our synthesis of results suggests that both LHDP and RHDP show limitations, but no complete impairment, in their production and/or comprehension of linguistic prosody. Prosodic limitations are evident in different areas of processing linguistic prosody, like syntactic disambiguation or the distinction between sentence types. There is a tendency towards more severe limitations in LHDP as compared to RHDP.
CONCLUSIONS
We only included published studies into our review and did not perform an assessment of risk of reporting bias as well as systematic certainty assessments of the outcomes. Despite these limitations, we conclude that both groups show deficits in production and comprehension of linguistic prosody, but neither LHDP nor RHDP are completely impaired in their prosodic processing. This suggests that prosody is a relevant communicative resource for LHDP and RHDP worth being addressed in speech-language-therapy.
Topics: Adult; Humans; Comprehension; Language; Linguistics; Communication Disorders; Brain; Speech Perception
PubMed: 36623377
DOI: 10.1016/j.jcomdis.2022.106298 -
American Journal of Speech-language... May 2023This systematic review aims to summarize and evaluate the available literature on speech and language therapy interventions for acquired apraxia of speech since 2012.
PURPOSE
This systematic review aims to summarize and evaluate the available literature on speech and language therapy interventions for acquired apraxia of speech since 2012.
METHOD
A systematic search in six electronic databases was performed from 2013 to 2020. The following primary outcomes were summarized: (a) improvement in targeted behaviors, (b) generalization, and (c) maintenance of outcomes. Moreover, studies were evaluated for the level of evidence and the clinical phase.
RESULTS
Of the 3,070 records identified, 27 studies were included in this review. The majority of the studies ( = 22) used articulatory kinematic approaches followed by intersystemic facilitation/reorganization treatments ( = 4) and other approaches ( = 1). According to the classes defined in (Gronseth et al., 2017), one was Class II, 10 were Class III, 10 were Class III-b (fulfill Class III criteria except for independence of assessors' criterion), and five were Class IV. In terms of clinical phase, one study classified as Phase III, 10 as Phase II, and 15 as Phase I.
CONCLUSIONS
Among the interventions for apraxia of speech, articulatory kinematic treatments have become prominent over the last 8 years. Focusing on self-administrated therapies, use of technology for therapy administration and development of treatments that focus on apraxia of speech and aphasia simultaneously were identified as new advancements in the apraxia of speech literature. The methodological quality, clinical phase, and level of evidence of the studies have improved within the past 8 years. Large-scale randomized controlled trials for articulatory kinematic approaches and future studies on other treatment approaches are warranted.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.22223785.
Topics: Humans; Speech Therapy; Speech; Apraxias; Aphasia; Speech Production Measurement
PubMed: 36917788
DOI: 10.1044/2022_AJSLP-21-00236 -
Applied Neuropsychology. Adult 2022Apraxia is widely used to describe one of the more disabling deficits following left strokes. The role of rehabilitation in treating apraxic stroke patients remains...
Apraxia is widely used to describe one of the more disabling deficits following left strokes. The role of rehabilitation in treating apraxic stroke patients remains unclear. This systematic review was conducted to study the impacts of various rehabilitation interventions on the limb apraxia post-stroke. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched for the experimental studies that investigated the effects of the rehabilitation interventions on apraxia in patients with stroke. The methodological quality was rated using the Physiotherapy Evidence Database scale (PEDro). Six studies met our inclusion criteria in this systematic review. Four were randomized controlled trials, pilot ( = 1), and case study ( = 1). The scores on the PEDro scale ranged from two to eight, with a median of seven. The results showed some evidence for the effects of strategy training and gesture training interventions on the cognitive functions, motor activities, and activities of daily livings outcomes poststroke. The preliminary findings showed that the effects of the strategy training and the gesture training on apraxia in patients with stroke are promising. Further randomized controlled trials with long-term follow-ups are strongly needed.
Topics: Activities of Daily Living; Apraxias; Humans; Physical Therapy Modalities; Stroke; Stroke Rehabilitation
PubMed: 33851895
DOI: 10.1080/23279095.2021.1900188 -
Cortex; a Journal Devoted To the Study... May 2021Non-invasive brain stimulation (NIBS) techniques are widely used in research settings to investigate brain mechanisms and increasingly being used for treatment purposes.... (Review)
Review
Non-invasive brain stimulation (NIBS) techniques are widely used in research settings to investigate brain mechanisms and increasingly being used for treatment purposes. The aim of this study was to systematically identify and review the current literature on NIBS studies of limb praxis and apraxia in healthy subjects and stroke patients with a scoping review using PRISMA-ScR guidelines. MEDLINE-PubMed, EMBASE and PsycINFO were searched. Inclusion criteria were English peer-reviewed studies focusing on the investigation of limb praxis/apraxia using repetitive transcranial magnetic stimulation (rTMS), or transcranial direct current stimulation (tDCS). Fourteen out of 139 records met the inclusion criteria, including thirteen studies with healthy subjects and one with stroke patients. The results of our systematic review suggest that in healthy subjects NIBS over left inferior parietal lobe (IPL) mainly interfered with gesture processing, by either affecting reaction times in judgment tasks or real gesturing. First promising results suggest that inhibitory continuous theta burst stimulation (cTBS) over right IPL may enhance gesturing in healthy subjects, explained by transcallosal facilitation of left IPL. In stroke patients, excitatory anodal tDCS over left IPL may improve limb apraxia. However, larger well powered and sham-controlled clinical trials are needed to expand on these proof-of-concept results, before NIBS could be a treatment option to improve limb apraxia in stroke patients.
Topics: Apraxias; Brain; Healthy Volunteers; Humans; Stroke; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation
PubMed: 33691224
DOI: 10.1016/j.cortex.2021.02.006 -
Cureus Mar 2022Apraxia is a cognitive-motor planning disorder that expresses itself as an inability to perform purposeful and skilled movements in the absence of sensory or motor... (Review)
Review
Apraxia is a cognitive-motor planning disorder that expresses itself as an inability to perform purposeful and skilled movements in the absence of sensory or motor loss and hampers patients' ability to perform activities of daily living (ADL). ADL is a set of everyday tasks required for personal care and independent living, executed through a complex interaction between sensorimotor integration and motor learning. We have designed a 'Strategy training' program for apraxia patients by reviewing the existing clinical trial literature on the above-said topic per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Strategy training is an evidence-based standardized occupational therapy program to improve ADL in apractic patients by teaching them a variety of compensatory strategies to combat impairment and improve activity performance. Three basic steps of strategy training include: 1) initiation-development of an action plan, 2) execution-performance of the plan, and 3) control-assessment and result of action performed. The patient group suggested for strategy training comprises post-stroke (past 20 weeks) apraxia patients aged 40-90 years of both genders, highly motivated and fit to perform ADL. After preliminary assessment, 'strategy training' will be specifically executed through an exclusively visual feedback approach in which apraxia patients learn eight ADLs in 8 weeks (three sessions of 30 minutes/week for 8 weeks). They practice two ADLs for 15 minutes each in every session, thus a total of six sessions will be allocated to learn two ADLs simultaneously followed by the next set of ADLs. Strategy training for brushing teeth is described in detail to show how each step of this training program is implemented for a specific ADL. As this strategy training program is based on individual care, attention, and augmenting motivational aspects, it is expected to teach patients compensatory strategies to learn and perform ADL more smoothly, swiftly, and most importantly independently. The program is not aimed at treating clinical motor symptoms of apraxia per se but to help patients function more independently post apractic motor impairment.
PubMed: 35494920
DOI: 10.7759/cureus.23547 -
PloS One 2021To date services for children with Developmental Coordination Disorder (DCD) have not been informed by the perspective of children with DCD. This study aimed to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To date services for children with Developmental Coordination Disorder (DCD) have not been informed by the perspective of children with DCD. This study aimed to synthesise the findings of discrete qualitative studies reporting the lived experiences views and preferences of children and young with DCD using a meta-ethnographic approach to develop new conceptual understandings.
METHODS
A systematic search of ten databases; Academic Search Complete, AMED, CINAHL, ERIC, MEDLINE, PsychArticles, PsychInfo, EMBASE, SPORTDiscus, and Web of Science, was conducted between March and April 2019, and updated in early June 2020. Meta-ethnography, following the method described by Noblit and Hare was used to synthesise included studies. The Joanna Briggs Institute Checklist was used to appraise all included papers. PROSPERO registration number CRD42019129178.
RESULTS
Fifteen studies met the inclusion criteria. Meta-ethnographic synthesis produced three themes; a) 'It's harder than it should be': Navigating daily activities b) Fitting in, and c) 'So what? I drop things': Strategies and supports to mitigate challenges. Children with DCD describe a mismatch between their abilities and performance norms for daily activities that led to a cascade of negative consequences including negative self-appraisal, bullying and exclusion. In the face of these difficulties children described creative and successful strategies they enacted and supports they accessed including; assistance from others (parents, friends and teachers), focusing on their strengths and talents, accepting and embracing their difference, adopting a "just do it" attitude, setting personal goals, self-exclusion from some social activities, using humour or sarcasm, viewing performance expectations as a social construct, and enjoying friendships as a forum for fun, acceptance and protection against exclusion.
CONCLUSION
Service provision for children and young people with DCD should address the social and attitudinal environments, focus on friendship and social inclusion and address stigma-based bullying particularly within the school environment. Furthermore, practitioners should identify and foster children's own strategies for navigating daily life activities with DCD. The identified themes resonate with contemporary disability theory and the International Classification of Functioning. The social and attitudinal environmental context of children and young people with DCD profoundly influences their experiences. Future intervention development and service provision for children and young people with DCD should consider opportunities to address social and attitudinal environmental factors.
Topics: Adolescent; Apraxias; Child; Humans; Motor Skills Disorders
PubMed: 33661934
DOI: 10.1371/journal.pone.0245738 -
International Journal of... Dec 2016Treatment intensity (sometimes referred to as "practice amount") has been well-investigated in learning non-speech tasks, but its role in treating speech disorders has... (Review)
Review
PURPOSE
Treatment intensity (sometimes referred to as "practice amount") has been well-investigated in learning non-speech tasks, but its role in treating speech disorders has not been largely analysed. This study reviewed the literature regarding treatment intensity in speech disorders.
METHOD
A systematic search was conducted in four databases using appropriate search terms. Seven articles from a total of 580 met the inclusion criteria. The speech disorders investigated included speech sound disorders, dysarthria, acquired apraxia of speech and childhood apraxia of speech. All seven studies were evaluated for their methodological quality, research phase and evidence level.
RESULT
Evidence level of reviewed studies ranged from moderate to strong. With regard to the research phase, only one study was considered to be phase III research, which corresponds to the controlled trial phase. The remaining studies were considered to be phase II research, which corresponds to the phase where magnitude of therapeutic effect is assessed. Results suggested that higher treatment intensity was favourable over lower treatment intensity of specific treatment technique(s) for treating childhood apraxia of speech and speech sound (phonological) disorders.
CONCLUSION
Future research should incorporate randomised-controlled designs to establish optimal treatment intensity that is specific to each of the speech disorders.
Topics: Humans; Speech Disorders; Speech Therapy
PubMed: 27063688
DOI: 10.3109/17549507.2015.1126640 -
International Journal of... Aug 2023Music-based interventions are used in the treatment of childhood speech sound disorders (SSDs). Hypotheses on working mechanisms are being developed, focussing on shared... (Review)
Review
PURPOSE
Music-based interventions are used in the treatment of childhood speech sound disorders (SSDs). Hypotheses on working mechanisms are being developed, focussing on shared neural processes. However, evidence of the effect of treatment with musical elements in SSDs in children is lacking. This study reviews the literature regarding the use of music-based interventions in the treatment of childhood SSDs.
METHOD
A systematic search in six databases was conducted, yielding 199 articles, eight of which met the inclusion criteria. Included articles were reviewed on study characteristics, patient characteristics, interventions, outcomes and methodological quality.
RESULT
This review included four case studies, three single-subject design studies and one cohort study. Seven studies reported positive outcomes on speech production, but outcome measures in the four studies with experimental design were not all aimed at the level of speech (motor) processes. Methodological quality was sufficient in one study.
CONCLUSION
Seven out of eight studies in this review report positive outcomes of music-based interventions in the treatment of SSDs. However, these outcomes are not sufficiently supported by evidence due to insufficient methodological quality. Suggestions for improving methodological quality in future research are presented.
Topics: Child; Humans; Music; Speech Sound Disorder; Cohort Studies; Speech Therapy
PubMed: 35900281
DOI: 10.1080/17549507.2022.2097310