Obsessional Slowness: A Case Study

2008 ◽  
Vol 75 (4) ◽  
pp. 249-254 ◽  
Author(s):  
Wendy Lam ◽  
Karen W. Wong ◽  
Mary-Ann Fulks ◽  
Liisa Holsti
Keyword(s):  
Treatment Options ◽  
Treatment Phase ◽  
Post Treatment ◽  
Behavioural Intervention ◽  
Single Subject ◽  
Baseline Phase ◽  
Carry Over ◽  
Withdrawal Design

Background. Obsessional slowness is a rare psychiatric disorder with few treatment options and limited research to date. Some suggest that targeted behavioural interventions may reduce the time taken for functional daily activities. Purpose. To examine whether a behavioural intervention would reduce the amount of time taken for an adolescent with obsessional slowness to walk to class. Methods. A single-subject A-B-A withdrawal design was incorporated into this case study. The treatment involved one-to-one pacing and prompting during the subject's walk to gym class. Walking times to gym class were measured during a baseline phase, during a one-month treatment phase, and during a post-treatment follow-up phase. Findings. The subject's walking times decreased during the treatment phase. Post-treatment walking times suggested a carry-over effect. Implications. This study adds to the sparse evidence on treatments for obsessional slowness and suggests occupation-based treatment options.

scholarly journals Into the Wild, Out of the Woods: A Systematic Case Study on Facilitating Emotional Change

2019 ◽  
Vol 63 (15-16) ◽  
pp. 2586-2610
Author(s):  
E. Gunst ◽  
J. Willemsen ◽  
M. Desmet ◽  
J. C. Watson ◽  
T. Loeys ◽  
...  
Keyword(s):  
Behavioral Treatment ◽  
Psychological Symptoms ◽  
Treatment Phase ◽  
Self Report ◽  
Potential Contribution ◽  
Process Data ◽  
Baseline Phase ◽  
Treatment As Usual ◽  
Emotional Change

Cognitive and behavioral treatment programs for individuals who have committed sexual offenses (ISOs) have shown significant but small effect sizes. A growing body of research points toward the importance of difficulties in affect regulation (AR) as a risk factor for sexual recidivism. On this basis, it seems important to target difficulties in AR in treatment. The current systematic case study investigates the potential contribution of emotion-focused therapy (EFT) to changing problematic AR in ISOs. Kevin was a high-risk offender with a traumatic history who met the diagnostic criteria of pedophilic and borderline disorders, with serious AR difficulties. Self-report outcome measures, observation measures, and a biomarker were used to track changes in AR, psychological symptoms, and distress during baseline (Phase A); treatment as usual (Phase B); treatment with an EFT component added (Phase C); and follow-up (Phase A). Statistically significant change was found in AR, psychological symptoms, and distress during treatment (Phase B + C); however, it is not possible to attribute these changes causally to EFT. An examination of the qualitative process data provides deeper insights into how the client reacted to specific EFT interventions. Verbatim clinical vignettes are included to clarify key interventions, hindrances, and mechanisms of change. This study provides preliminary support for the role of therapy to facilitate emotional change in ISOs.

The Use of Visual Prompts to Increase Kegel Exercise Performance in Pregnant Women: A Case Study

1997 ◽  
Vol 14 (4) ◽  
pp. 231-235
Author(s):  
Carole Elliott ◽  
Stephen Houghton ◽  
Shane Langsford
Keyword(s):  
Pregnant Women ◽  
Exercise Performance ◽  
Repeated Measures ◽  
Treatment Phase ◽  
Multiple Baseline ◽  
Baseline Phase ◽  
Kegel Exercises ◽  
Repeated Measures Analysis ◽  
Visual Prompts

A multiple baseline research design utilising visual prompts was implemented with 7 women in varying stages of pregnancy (24 to 35 weeks) to increase their frequency of Kegel pelvic exercises. Following a baseline phase, in which participants self-recorded their rates of Kegel exercise, an intervention comprising visual prompts was introduced. A return to baseline phase was then implemented where the visual prompts were removed. Data were analysed in two ways. First, a Friedman one-way repeated measures analysis of variance revealed a significant increase in the frequency of Kegel exercises during intervention. When the intervention was removed, the frequency of Kegel exercises decreased, in some cases to a level below that established as the original baseline. Second, data were analysed for each participant using DMITSA 2.0, which revealed that, while all individuals experienced increases in Kegel exercising from baseline to treatment phase, only 3 of the 7 experienced significant increases. Similarly, while 6 of the 7 participants experienced reductions in frequency of exercises when the treatment phase concluded, in only one case was the reduction significant. These findings are also compared to recommended rates of Kegel exercise regimes.

Development and Evaluation of a Cognitive Behavioural Intervention for Chronic Post-Stroke Insomnia

2018 ◽  
Vol 46 (6) ◽  
pp. 641-660 ◽  
Author(s):  
Katie Herron ◽  
Lorna Farquharson ◽  
Abigail Wroe ◽  
Annette Sterr
Keyword(s):  
Sleep Onset ◽  
Community Dwelling ◽  
Post Treatment ◽  
Dysfunctional Attitudes ◽  
Future Research ◽  
Behavioural Intervention ◽  
Sleep Onset Latency ◽  
Post Stroke ◽  
Cognitive Behavioural

Background:Cognitive behavioural therapy for insomnia (CBTI) has been successfully applied to those with chronic illness. However, despite the high prevalence of post-stroke insomnia, the applicability of CBTI for this population has not been substantially researched or routinely used in clinical practice.Aims:The present study developed a ‘CBTI+’ protocol for those with post-stroke insomnia and tested its efficacy. The protocol also incorporated additional management strategies that considered the consequences of stroke.Method:A single-case experimental design was used with five community-dwelling individuals with post-stroke insomnia. Daily sleep diaries were collected over 11 weeks, including a 2-week baseline, 7-week intervention and 2-week follow-up. The Insomnia Severity Index, Dysfunctional Attitudes and Beliefs About Sleep Scale, Epworth Sleepiness Scale, Fatigue Severity Scale and Stroke Impact Scale were administered pre- and post-treatment, as well as at 2-week follow-up.Results:At post-treatment, three participants no longer met diagnostic criteria for insomnia and all participants showed improvements on two or more sleep parameters, including sleep duration and sleep onset latency. Three participants showed a reduction in daytime sleepiness, increased quality of life and reduction in unhelpful beliefs about sleep.Conclusions:This study provides initial evidence that CBTI+ is a feasible and acceptable intervention for post-stroke insomnia. Furthermore, it indicates that sleep difficulties in community-dwelling stroke populations are at least partly maintained by unhelpful beliefs and behaviours. The development and delivery of the CBTI+ protocol has important clinical implications for managing post-stroke insomnia and highlights directions for future research.

Reduction of Hemifacial Spasm and Dysarthria Following EMG Biofeedback

1984 ◽  
Vol 49 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Rick T. Rubow ◽  
John C. Rosenbek ◽  
Michael J. Collins ◽  
Gastone G. Celesia
Keyword(s):  
Hemifacial Spasm ◽  
Relaxation Training ◽  
Speech Therapy ◽  
Emg Biofeedback ◽  
Feedback Training ◽  
Facial Spasm ◽  
History Of ◽  
Carry Over

In this case study, a geriatric patient who had an 18-year history of hemifacial spasm was given EMG-biofeedback-assisted relaxation training. No formal speech therapy was provided. Our results confirmed two hypotheses: (a) The patient would learn to reduce frontalis EMG and facial spasm with and then without biofeedback, and (b) as a result, speech would be markedly improved. At both the 1-month and 15-month follow-up the patient retained the ability to relax his facial muscles with similar carry-over to speech. Possible neurophysiologic mechanisms of action mediating the feedback training are discussed.

scholarly journals Multidiscpinary Approach in Nasopharyngeal Cancer

Medicinus ◽  
2018 ◽  
Vol 5 (2) ◽  
Author(s):  
Henry Kodrat
Keyword(s):  
Risk Factors ◽  
Multidisciplinary Approach ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Nasopharyngeal Cancer ◽  
Diagnostic Procedures ◽  
Post Treatment ◽  
Treatment Toxicity

<p>Nasopharyngeal cancer (NPC) is endemic in Indonesia. The purpose of the review is to describe the risk factors, clinical symptoms, diagnostic procedures and staging, management and treatment options, and follow-up. Multi-disciplinary approach to the NPC not only for treatment, but also has been started from the diagnosis proccess. The multidisciplinary approach also plays role after treatment, especially for the follow-up and rehabilitation of post-treatment toxicity.</p><p><strong>Keywords: </strong>cancer, nasopharynx, radiotherapy.</p>

scholarly journals Accelerated hydrotherapy and land-based rehabilitation in soccer players after anterior cruciate ligament reconstruction: a series of three single subject case studies

2008 ◽  
Vol 20 (4) ◽  
pp. 109 ◽  
Author(s):  
B-L Momberg ◽  
C Louw ◽  
L Crous
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Objective Measure ◽  
Treatment Phase ◽  
Single Subject ◽  
Walking Ability ◽  
Baseline Phase ◽  
Baseline Design ◽  
Anterior Cruciate

Objective. To investigate the effectiveness of accelerated rehabilitation and accelerated hydrotherapy after anterior cruciate ligament (ACL) reconstruction in male athletes participating in soccer. Design. A non-concurrent single subject, multiple baseline design (ABA design) was conducted over 10 weeks. A series of three N=1 studies was conducted to assess the effect of an accelerated hydrotherapy programme on pain, function, and range of motion. Setting. The study was conducted at a private physiotherapy practice in Port Elizabeth, South Africa. Interventions. The land rehabilitation programme was a homebased programme supervised every week by the physiotherapist. The accelerated hydrotherapy consisted of a 6-week programme, and participants attended two treatment sessions of accelerated hydrotherapy per week each of 30 minutes\' duration. Main outcome measures. The knee injury and osteoarthritis outcome scale (KOOS) as a subjective measure of pain, function and quality of life; the goniometer to measure active knee ROM and the 6-minute walking test (6MWT) as an objective measure of function. Results. All three patients demonstrated good improvement during the treatment phase for the KOOS scale and progressed well in terms of their walking ability during the study. Significant improvement was gained during the baseline phase for all three participants with high initial levels of knee flexion while active knee extension improved gradually in all three participants. Conclusion. The study findings indicate that an accelerated landbased and hydrotherapy programme may be useful in improving patient outcomes and that there are no risks for harm. Clinical relevance. The study findings indicate that accelerated hydrotherapy may be a useful and safe adjunct to an accelerated land-based programme after ACL reconstruction South African Journal of Sports Medicine Vol. 20 (4) 2008: pp. 109-114

scholarly journals Low-dose Mifepristone (25 mg) in Treatment of Uterine Myoma in Perimenopausal Women

2013 ◽  
Vol 1 (1) ◽  
pp. 34-37
Author(s):  
Arun Nagrath ◽  
Garima Gupta ◽  
Shikha Seth ◽  
Ekta Singh ◽  
AS Mathur
Keyword(s):  
Low Dose ◽  
Treatment Phase ◽  
Blood Parameters ◽  
Post Treatment ◽  
Uterine Myoma ◽  
Pain Scores ◽  
Perimenopausal Women ◽  
Complete Treatment ◽  
Uterine Volume

ABSTRACT Objectives To evaluate the effect of low-dose mifepristone (25 mg) on symptomatic myoma in perimenoapausal women. Study design Prospective observational clinical trial. Materials and methods Ninety-three perimenopausal women of age 35 to 50 years having symptomatic myoma were selected from gynecology outpatient department and given 25 mg mifepristone once daily continuously for 3 months. Baseline uterine size, uterine volume, myoma size, volume, their number, position, characteristics, hemoglobin and blood parameters, were taken and followed monthly for 6 months. Bleeding and pain scores were checked on monthly visits. Change in above parameters were tabulated during the first 3 months treatment phase and then next 3 months post-treatment phase for analysis. Statistical analysis Done by calculating mean, standard deviation, standard error and percentage distribution of variables. Results Menorrhagia was the commonest symptom which led patients to report to hospital. Mean uterine volume reduced to 63.69% of baseline, mean dominant myoma volume reduced to 53.62% and hemoglobin level raised to 137% after complete treatment of 3 months. Changes persisted in next 3 months post-treatment follow-up, while hysterectomy was required in 10 (12.2%) cases. Conclusion Three months treatment of 25 mg mifepristone effectively controls bleeding, reduces the uterine and myoma volume and thus can avoid blood transfusion and hysterectomy in a lot of symptomatic myoma cases. How to cite this article Seth S, Singh E, Mathur AS, Gupta G, Nagrath A. Low-dose Mifepristone (25 mg) in Treatment of Uterine Myoma in Perimenopausal Women. J South Asian Feder Menopause Soc 2013;1(1):34-37.

Impact of somatosensory interventions on upper limb function in children with hemiplegic cerebral palsy: a single-subject design study

2021 ◽  
Vol 28 (1) ◽  
pp. 1-13
Author(s):  
Moloud Khoshbakht ◽  
Parvin Raji ◽  
Noureddin Nakhostin Ansari ◽  
Mahmoud Mahmodian
Keyword(s):  
Cerebral Palsy ◽  
Upper Extremity ◽  
Upper Limb ◽  
Visual Analysis ◽  
Treatment Phase ◽  
Single Subject ◽  
Upper Limb Function ◽  
Hemiplegic Cerebral Palsy ◽  
Spastic Hemiplegia

Background/aims Hemiplegia is one of the most common types of cerebral palsy. Upper limb dysfunction in these children can affect their quality of life. The aim of this study was to investigate the effects of somatosensory interventions on upper extremity sensory and motor functions in spastic hemiplegic children. Methods This single-subject study was performed in the occupational therapy clinic of Tehran University of Medical Sciences. Three participants (two boys and one girl) aged 8–12 years with spastic hemiplegia were assessed during baseline, treatment and follow-up phases. During the treatment phase, the children received 12 tactile and proprioceptive stimulation (active, passive and playful) sessions over 4 weeks. Four sensory measures (tactile localisation, stereognosis, two-point discrimination, proprioception) and one motor measure (Box and Block Test) were assessed during each phase. Results Improvement in function was seen in all three children based on visual analysis, with significant differences between the baseline and treatment scores in the majority of measures for all participants. Changes were sustained at follow up for most tests. The effect size was large for all three children. Conclusions Despite the small number of participants, sensory intervention with a focus on sensory deficits could help to improve upper extremity sensory and motor function in children with spastic hemiplegia.

scholarly journals The Effectiveness of Transcranial Magnetic Stimulation (TMS) Paradigms as Treatment Options for Recovery of Language Deficits in Chronic Poststroke Aphasia

2022 ◽  
Vol 2022 ◽  
pp. 1-25
Author(s):  
Anastasios M. Georgiou ◽  
Maria Kambanaros
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Treatment Options ◽  
Receptive Language ◽  
Single Subject ◽  
Language Therapy ◽  
Noninvasive Methods ◽  
The Right

Background. In an effort to boost aphasia recovery, modern rehabilitation, in addition to speech and language therapy (SALT), is increasingly incorporating noninvasive methods of brain stimulation. The present study is aimed at investigating the effectiveness of two paradigms of neuronavigated repetitive transcranial magnetic stimulation (rTMS): (i) 1 Hz rTMS and (ii) continuous theta burst stimulation (cTBS) each as a standalone treatment for chronic aphasia poststroke. Methods. A single subject experimental design (SSED) trial was carried out in which six people with aphasia (PWA) were recruited, following a single left hemispheric stroke more than six months prior to the study. Three individuals were treated with 1 Hz rTMS, and the remaining three were treated with cTBS. In all cases, TMS was applied over the right pars triangularis (pTr). Language assessment, with standardized and functional measures, and cognitive evaluations were carried out at four time points: twice prior to treatment (baseline), one day immediately posttreatment, and at follow-up two months after treatment was terminated. Quality of life (QoL) was also assessed at baseline and two months posttreatment. In addition, one of the participants with severe global aphasia was followed up again one and two years posttherapy. Results. For all participants, both rTMS paradigms (1 Hz rTMS and cTBS) generated trends towards improvement in several language skills (i.e., verbal receptive language, expressive language, and naming and reading) one day after treatment and/or two months after therapy. Rated QoL remained stable in three individuals, but for the other three, the communication scores of the QoL were reduced, while two of them also showed a decline in the psychological scores. The participant that was treated with cTBS and followed for up to two years showed that the significant improvement she had initially exhibited in comprehension and reading skills two months after TMS (1st follow-up) was sustained for at least up to two years. Conclusion. From the current findings, it is suggested that inhibitory TMS over the right pTr has the potential to drive neuroplastic changes as a standalone treatment that facilitates language recovery in poststroke aphasia.

Treatment of Chronic Vomiting and Extreme Emaciation by an Aversive Stimulus: Case Study

1972 ◽  
Vol 31 (3) ◽  
pp. 803-805 ◽  
Author(s):  
John T. Watkins
Keyword(s):  
Weight Gain ◽  
Electric Shock ◽  
Aversive Stimulus ◽  
Treatment Phase ◽  
Chronic Vomiting

Electric shock was administered to a severely retarded adolescent who weighed only 45 lb. and whose survival was in question. He was shocked over a period of 7 wk. whenever he attempted to vomit. The vomiting response was practically eliminated and remarkable weight gain occurred during the treatment phase and during the 3-mo. follow-up period.

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