scholarly journals A Systematically Conducted Scoping Review of the Evidence and Fidelity of Treatments for Verb and Sentence Deficits in Aphasia: Sentence Treatments

2021 ◽  
pp. 1-32
Author(s):  
Julie Hickin ◽  
Madeline Cruice ◽  
Lucy Dipper
Keyword(s):  
Outcome Measures ◽  
Argument Structure ◽  
Case Series ◽  
Sentence Production ◽  
Functional Communication ◽  
Case Control Studies ◽  
Level Of Evidence ◽  
Discourse Production ◽  
Treatment Research ◽  
The Impact

Purpose: This review article synthesizes and evaluates the evidence for sentence production treatments in aphasia, systematically charting impairment-based and functional communication outcomes. It reports (a) the level of evidence and fidelity of sentence treatments; (b) the impact of treatment on production of trained and untrained verbs and sentences, functional communication, and discourse; and (c) the potential active ingredients of treatment. Method: The search included studies from January 1980 to June 2019. The level of evidence of each study was documented, as was fidelity in terms of treatment delivery, enactment, and receipt. Studies were also categorized according to treatment methods used. Results: Thirty-three studies were accepted into the review and predominantly constituted Level 4 evidence (e.g., case control studies and case series). Thirty studies (90%) described treatment in sufficient detail to allow replication, but dosage was poorly reported, and fidelity of treatment was rarely assessed. The most commonly reported treatment techniques were mapping (10 studies: 30%), predicate argument structure treatment (six studies: 18%), and verb network strengthening treatment (five studies: 15%). Production of trained sentences improved for 83% of participants, and improvements generalized to untrained sentences for 59% of participants. Functional communication was rarely assessed, but discourse production improved for 70% of participants. Conclusions: The evidence for sentence treatments is predominantly generated from Level 4 studies. Treatments were effective for the majority of participants regarding trained sentence and discourse production. However, there is inconsistent use of statistical analysis to verify improvements, and diverse outcome measures are used, which makes interpretation of the evidence difficult. The quality of sentence treatment research would be improved by agreeing a core set of outcome measures and extended by ascertaining the views of participants on sentence treatments.

scholarly journals A Systematically Conducted Scoping Review of the Evidence and Fidelity of Treatments for Verb Deficits in Aphasia: Verb-in-Isolation Treatments

2020 ◽  
Vol 29 (1S) ◽  
pp. 530-559
Author(s):  
Julie Hickin ◽  
Madeline Cruice ◽  
Lucy Dipper
Keyword(s):  
Scoping Review ◽  
Clinical Decision Making ◽  
Current Evidence ◽  
Future Research ◽  
Functional Communication ◽  
Level Of Evidence ◽  
Low Level ◽  
Sufficient Detail ◽  
Treatment Research ◽  
The Impact

Purpose Aphasia research demonstrates increasing interest in the treatment of verb retrieval deficits. This systematically conducted scoping review reports on the level and fidelity of the current evidence for verb treatments; on its effectiveness regarding the production of trained and untrained verbs, functional communication, sentences, and discourse; and on the potential active ingredients. Recommendations to guide clinical decision making and future research are made. Method The computerized database search included studies from January 1980 to September 2018. The level of evidence of each study was documented, as was fidelity in terms of treatment delivery, enactment, and receipt. Studies were also categorized according to the treatment methods used. Results Thirty-seven studies were accepted into the review, and all but 1 constituted a low level of evidence. Thirty-three studies (89%) described treatment in sufficient detail to allow replication, dosage was poorly reported, and the fidelity of treatment was rarely assessed. The most commonly reported treatment techniques were phonological and semantic cueing in 25 (67.5%) and 20 (54%) studies, respectively. Retrieval of trained verbs improved for 80% of participants, and improvements generalized to untrained verbs for 15% of participants. There was not sufficient detail to evaluate the impact of treatment on sentence production, functional communication, and discourse. Conclusions The evidence for verb treatments is predominantly of a low level. There are encouraging findings in terms of treatments being replicable; however, this is tempered by poor monitoring of treatment fidelity. The quality of verb treatment research would be improved by researchers reaching consensus regarding outcome measures (including generalization to, e.g., sentences and discourse) by manualizing treatment to facilitate implementation and exploring the opinions of participants. Finally, while treatment is largely effective in improving production of trained verbs, lack of generalization to untrained items leads to the recommendation that personally relevant verbs are prioritized.

Treatment for Progressive Impairments of Language

2010 ◽  
Vol 20 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Maya Henry
Keyword(s):  
Behavioral Treatment ◽  
Primary Progressive Aphasia ◽  
Sentence Production ◽  
Lexical Retrieval ◽  
Functional Communication ◽  
Language Performance ◽  
Communication Techniques ◽  
Primary Object ◽  
Behavioral Treatments ◽  
Treatment Research

Abstract Primary progressive aphasia (PPA) is a relatively new diagnostic entity, for which few behavioral treatments have been investigated. Recent work has helped to clarify the nature of distinct PPA variants, including a nonfluent variant (NFV-PPA), a logopenic variant (LV-PPA), and a semantic variant (SV-PPA). This paper reviews treatment research to date in each subtype of PPA, including restitutive, augmentative, and functional approaches. The evidence suggests that restitutive behavioral treatment can result in improved or stabilized language performance within treated domains. Specifically, sentence production and lexical retrieval have been addressed in NFV-PPA, whereas lexical retrieval has been the primary object of treatment in LV and SV-PPA. Use of augmentative communication techniques, as well as implementation of functional communication approaches, also may result in improved communication skills in individuals with PPA. The ideal treatment approach may be one that combines restitutive, augmentative, and functional approaches to treatment, in order to maximize residual cognitive-linguistic skills in patients. Additional research is warranted to determine which modes of treatment are most beneficial in each type of PPA at various stages of severity.

Application of Computerized Adaptive Testing to the Foot and Ankle Ability Measure

2020 ◽  
pp. 107110072097266
Author(s):  
Joseph T. O’Neil ◽  
Otho R. Plummer ◽  
Steven M. Raikin
Keyword(s):  
Computerized Adaptive Testing ◽  
Case Series ◽  
Adaptive Testing ◽  
Mean Difference ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Patient Reported ◽  
The Mean ◽  
Ability Measure ◽  
The Impact

Background: Patient-reported outcome measures are an increasingly important tool for assessing the impact of treatments orthopedic surgeons render. Despite their importance, they can present a burden. We examined the validity and utility of a computerized adaptive testing (CAT) method to reduce the number of questions on the Foot and Ankle Ability Measure (FAAM), a validated anatomy-specific outcome measure. Methods: A previously developed FAAM CAT system was applied to the responses of patients undergoing foot and ankle evaluation and treatment over a 3-year period (2017-2019). A total of 15 902 responses for the Activities of Daily Living (ADL) subscale and a total of 14 344 responses for the Sports subscale were analyzed. The accuracy of the CAT to replicate the full-form score was assessed. Results: The CAT system required 11 questions to be answered for the ADL subscale in 85.1% of cases (range, 11-12). The number of questions answered on the Sports subscale was 6 (range, 5-6) in 66.4% of cases. The mean difference between the full FAAM ADL subscale and CAT was 0.63 of a point. The mean difference between the FAAM Sports subscale and CAT was 0.65 of a point. Conclusion: The FAAM CAT was able to reduce the number of responses a patient would need to answer by nearly 50%, while still providing a valid outcome score. This measure can therefore be directly correlated with previously obtained full FAAM scores in addition to providing a foot/ankle-specific measure, which previously reported CAT systems are not able to do. Level of Evidence: Level IV, case series.

scholarly journals Current Treatment Options for Patulous Eustachian Tube: A Review of the Literature

2020 ◽  
pp. 014556132093280
Author(s):  
Petros Koltsidopoulos ◽  
Charalampos Skoulakis
Keyword(s):  
Eustachian Tube ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Case Series ◽  
Current Treatment ◽  
Case Control Studies ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Surgical Interventions ◽  
Patulous Eustachian Tube

Objective: Patulous Eustachian tube (PET) is a clinical condition that is associated with troublesome aural symptoms and is difficult to be treated successfully. The purpose of this review is to examine the published literature regarding the therapeutic value of the current treatment options for PET. Methods: We searched Web of Science, PubMed and Medline from 1999 to 2019. The search focused on papers concerning the clinical evaluation of treatment methods in PET patients. Statistical techniques were not used. Results: Prospective and retrospective case series were the types of trials available for review. We included 28 articles that evaluated the efficacy of various conservative and surgical therapeutic options. The recovery rates ranged from 50% to 100%. In most studies the assessment of efficacy was based on the subjective improvement of patient symptoms as there is no validated outcome tool available. No severe adverse events were observed in any study. Conclusion: On the basis of the available literature, it seems that conservative treatments can be considered as a primary therapeutic option for PET. Concerning the surgical interventions they seem to be a safe and valuable solution in patients with refractory disease. Finally, given the low level of evidence, prospective case–control studies with long follow-up and robust setting looking into the therapeutic approach of PET are required. The need for establishment of standard criteria of PET recovery should be underlined.

scholarly journals Catastrophic High School and Collegiate Cheerleading Injuries in the United States: An Examination of the 2006-2007 Basket Toss Rule Change

2018 ◽  
Vol 11 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Rebecca K. Yau ◽  
Savannah G. Dennis ◽  
Barry P. Boden ◽  
Robert C. Cantu ◽  
James A. Lord ◽  
...  
Keyword(s):  
United States ◽  
High School ◽  
Case Series ◽  
Injury Rate ◽  
The United States ◽  
Level Of Evidence ◽  
Injury Rates ◽  
Rule Change ◽  
Before And After ◽  
The Impact

Background: Cheerleading is a specialized athletic activity that can lead to catastrophic injuries. Cheerleading rules are in place to maximize safety of participants. The purpose of this study was to describe catastrophic cheerleading injuries among high school and collegiate-level participants in the United States and to explore whether the 2006-2007 basket toss rule change was effective at reducing the number of catastrophic injuries. Hypothesis: The 2006-2007 basket toss rule change contributed to a reduction in the number of catastrophic injuries among high school and collegiate cheerleaders. Study Design: Case series. Level of Evidence: Level 4. Methods: Data on catastrophic cheerleading injuries were collected by the National Center for Catastrophic Sport Injury Research from July 2002 to June 2017. Information collected included cheerleader, event, and injury characteristics. The impact of the 2006-2007 rule change banning the basket toss on any hard surfaces was assessed by comparing injury rates and 95% CIs before and after the rule change. Results: There were 54 catastrophic cheerleading injuries, or 3.6 injuries per year. From July 2002 through June 2017, the injury rate was 2.12 per 1,000,000 cheerleaders (95% CI, 1.56-2.69). Most cheerleaders sustained serious injuries (n = 27; 50%) during practice (n = 37; 69%) to the head (n = 28; 52%) and cervical spine (n = 17; 32%). From July 2002 through June 2017, basket tosses were the stunt that accounted for the highest proportion of injuries (n = 19; 35%). The basket toss injury rate decreased from 1.55 to 0.40 per 1,000,000 cheerleaders among both high school and collegiate cheerleaders after the rule change. Conclusion: Catastrophic injury rates in cheerleading decreased dramatically after the 2006-2007 rule change banning basket tosses from being performed on any hard surfaces. In particular, there was a nearly 4-fold reduction in the rate of catastrophic basket toss injuries.

scholarly journals The Influence of Health Perception on Shoulder Outcome Measure Scores

2019 ◽  
Vol 22 (4) ◽  
pp. 173-182
Author(s):  
Richard E. Hardy ◽  
Engin Sungur ◽  
Christopher Butler ◽  
Jefferson C. Brand
Keyword(s):  
Outcome Measures ◽  
Prediction Models ◽  
Constant Score ◽  
Case Series ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Level Of Evidence ◽  
Individualized Care ◽  
Sf 36 ◽  
Patient Reported

Background: Patient reported outcome measures assess clinical progress from the patient’s perspective. This study explored the relationship between shoulder outcome measures (The Disability of the Arm, Shoulder and Hand [DASH], American Shoulder and Elbow Surgeons Standard Shoulder Assessment score [ASES], and Constant score) by comparing the best possible scores obtained in an asymptomatic population compared to overall perception of health, as measured by the SF-36 outcome measure.Methods: Volunteers (age range, 20?69 years) with asymptomatic shoulders and no history of shoulder pain, injury, surgery, imaging, or pathology (bilaterally) were included. The DASH and ASES measures were completed by 111 volunteers (72 female, 39 male), of which 92 completed the Constant score (56 female, 36 male). The SF-36 was completed by all volunteers (level of evidence: IV case series).Results: The mean (x) score for ASES measure on the right shoulder was higher for the left-hand dominant side (x=100.00 vs. 95.02, <i>p</i>-value<0.001); no other significant differences. Better SF-36 scores were associated with better DASH scores. Our prediction models suggest that perception of overall health affects the DASH scores. Sex affected all three shoulder measures scores.Conclusions: Comparing scores of shoulder outcome measures to the highest possible score is not the most informative way to interpret patient progress. Variables such as health status, sex, and hand dominance need to be considered. Furthermore, it is possible to use these variables to predict scores of outcome measures, which facilitates the healthcare provider to deliver individualized care to their patients.

scholarly journals Insertional Achilles tendinopathy

2020 ◽  
Vol 14 (1) ◽  
pp. 68-73
Author(s):  
Lucas Candido Honório ◽  
Mariana Alcantara Roldi de Azeredo ◽  
Joaquim Maluf Neto
Keyword(s):  
Functional Performance ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Calcaneal Tendon ◽  
Functional Quality ◽  
Case Series Study ◽  
Therapeutic Study ◽  
The Impact

Objective: Retrospectively analyze surgical procedures performed on patients with insertional Achilles (calcaneal tendon) tendinopathy, focusing on outcomes and the impact on the patients’ functional quality. Methods: A descriptive, retrospective, case series study drawn up by collecting data directly from the patients’ medical records. For the functional analysis of patients, we used the questionnaire of the adapted American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS). An assessment was carried out on each of the patients who underwent surgery at our hospital from 2010 to 2019, using the surgical technique described in this article, i.e., resection of the affected portion of the tendon with its subsequent reinsertion. Results: All surgical patients achieved an improvement in their AOFAS score and in pain levels, with good functional performance only three months into the postoperative period, from 50.1 to 83.75 (p<0.001). Conclusion: The use of the technique proved very effective, particularly in terms of the maintenance of foot function and important improvement in pain levels, thus producing a relevant increase in function among patients. Level of Evidence IV; Therapeutic Study; Case Series.

scholarly journals Endoscopic posterior nasal neurectomy for intractable rhinitis: a systematic review of the literature Running Title: Endoscopic PNN: a systematic review

2021 ◽  
Author(s):  
Mun Leng Lee ◽  
Patrick Chakravarty ◽  
David Ellul
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Human Subjects ◽  
Case Series ◽  
Symptom Burden ◽  
Case Control Studies ◽  
Patient Reported ◽  
Maximal Medical Therapy ◽  
Non Allergic Rhinitis ◽  
Randomised Controlled

Objectives: Rhinitis affects up to 40% of the population worldwide and can significantly reduce quality of life. Some patients remain symptomatic despite maximal medical therapy. In refractory cases, posterior nasal neurectomy (PNN - the division of the intranasal nerve branches containing postganglionic parasympathetic fibres) is postulated to reduce symptom burden. The objectives of this paper were to review the literature to establish whether the procedure is effective and safe in the management of allergic and non-allergic rhinitis. Design: A systematic review of Pubmed, EMBASE and MEDLINE was undertaken. Studies were excluded if not available in English or undertaken in non-human subjects. Participants: Seventeen articles satisfied the inclusion criteria studying in total 2029 patients. Sample size ranged from 8-1056. Main Outcome Measures: Patient-reported objective and subjective outcomes and post-operative complications were reviewed Results: There were two randomised controlled trials, two case control studies, and the remaining thirteen were case series using both objective and subjective outcome measures. All but one study found improved patient reported outcomes following PNN. Complications were reported in 10 studies - haemorrhage was the most common complication and was observed in 28 patients (1.6% of subjects). Conclusions: Endoscopic posterior nasal neurectomy is safe and appears to be effective in the treatment of intractable rhinitis but the level of the available evidence was generally poor. Larger, well designed studies are needed to clarify its role in the management of difficult-to-treat rhinitis.

scholarly journals COVID-19 in pregnancy: What do we really know?

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 362
Author(s):  
Jerome Bouaziz ◽  
Marc Even ◽  
Frederique Isnard-Bogillot ◽  
Eli Vesale ◽  
Mariam Nikpayam ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pregnant Women ◽  
Current Knowledge ◽  
Case Reports ◽  
Case Series ◽  
Adverse Outcomes ◽  
Health Concern ◽  
Case Control Studies ◽  
Increased Risk ◽  
The Impact

Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to escalate worldwide and has become a pressing global health concern. This article comprehensively reviews the current knowledge on the impact of COVID-19 over pregnant women and neonates, as well as current recommendations for their management. We also analyse previous evidences from viral respiratory diseases such as SARS, Middle East respiratory syndrome, and influenza that may help to guide clinical practice during the current pandemic. We collected 23 case reports, case series, and case-control studies (18 from China) comprising 174 pregnant women with COVID-19. The majority of mothers showed a clinical presentation of the disease similar to that of non-infected adults. Preliminary evidences point towards a potentially increased risk of pregnancy adverse outcomes in women with COVID-19, with preterm delivery the most frequently observed (16.7%) followed by fetal distress (9.77%). The most commonly reported adverse neonatal outcomes included respiratory symptoms (7.95%) and low birth weight (6.81%). A few studies reported other maternal comorbidities that can influence these outcomes. Mothers with other comorbidities may be at higher risk of infection. Mother-to-child transmission of SARS-CoV-2 appears unlikely, with no study observing intrauterine transmission, and a few cases of neonatal infection reported a few hours after birth. Although the WHO and other health authorities have published interim recommendations for care and management of pregnant women and infants during COVID-19 pandemic, many questions remain open. Pregnant women should be considered in prevention and control efforts, including the development of drugs and vaccines against SARS-CoV-2. Further research is needed to confirm the exact impact of COVID-19 infection during pregnancy. To fully quantify this impact, we urgently need to integrate the current knowledge about viral characteristics, epidemiology, disease immunopathology, and potential therapeutic strategies with data from the clinical practice.

scholarly journals Vestibular Rehabilitation After Traumatic Brain Injury: Case Series

2016 ◽  
Vol 96 (6) ◽  
pp. 839-849 ◽  
Author(s):  
Ingerid Kleffelgaard ◽  
Helene Lundgaard Soberg ◽  
Kari A. Bruusgaard ◽  
Anne L. Tamber ◽  
Birgitta Langhammer
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Outcome Measures ◽  
Case Series ◽  
Vestibular Rehabilitation ◽  
Minimal Detectable Change ◽  
Perceived Disability ◽  
And Performance ◽  
The Impact ◽  
Balance Problems

Background and Purpose There has been an increasing focus on vestibular rehabilitation (VR) after traumatic brain injury (TBI) in recent years. However, detailed descriptions of the content of and patient responses to VR after TBI are limited. The purposes of this case series are (1) to describe a modified, group-based VR intervention and (2) to examine changes in self-reported and performance-based outcome measures. Case Description Two women and 2 men (aged 24–45 years) with mild TBI, dizziness, and balance problems participated in an 8-week intervention consisting of group sessions with guidance, individually modified VR exercises, a home exercise program, and an exercise diary. Self-reported and performance-based outcome measures were applied to assess the impact of dizziness and balance problems on functions related to activity and participation. Outcomes The intervention caused no adverse effects. Three of the 4 patients reported reduced self-perceived disability because of dizziness, diminished frequency and severity of dizziness, improved health-related quality of life, reduced psychological distress, and improved performance-based balance. The change scores exceeded the minimal detectable change, indicating a clinically significant change or improvement in the direction of age-related norms. The fourth patient did not change or improve in most outcome measures. Discussion A modified, group-based VR intervention was safe and appeared to be viable and beneficial when addressing dizziness and balance problems after TBI. However, concurrent physical and psychological symptoms, other neurological deficits, and musculoskeletal problems might influence the course of central nervous system compensation and recovery. The present case series may be useful for tailoring VR interventions to patients with TBI. Future randomized controlled trials are warranted to evaluate the short- and long-term effects of VR after TBI.

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