Sensory processing and adaptive behavior in Phelan-McDermid syndrome: a cross-sectional study.

Phelan-McDermid syndrome (PMS) is a genetic disorder caused by a mutation or deletion of the SHANK3 gene (chromosome 22q13.3), characterized by different sensory processing anomalies. The objective of this study is to expand and provide a detailed definition of the sensory profile of patients with PMS. The secondary objective was to examine the relationship between sensory patterns and adaptive behavior. A cross-sectional study was carried out among 51 Spanish patients with a confirmed genetic diagnosis of PMS. All the participants' parents completed the Short Sensory Profile-Spanish (SSP-S) and the Adaptive Behavior Assessment System II (ABAS-II). Correlational, multiple regression and hierarchical cluster analyses were performed. An atypical sensory profile was identified in almost 75% of PMS patients. Definite differences were found among scores; nonetheless, sub-threshold values were observed in tactile sensitivity, underresponsive/seeks sensation, auditory filtering, and low energy/weak sensory categories. Conceptual, social, and practical domains, as well as the General Adaptive Composite (GAC) of the ABAS-II showed extremely low scores (i.e., <70). Significant correlations were found (p<0.005) between SSP-S scores and the conceptual, social, practical, and GAC index of the ABAS-II, whereby higher SSP-S scores were associated with better skills and higher adaptive performance. The cluster analysis indicated that the group with the largest mutation size (7.23 Mb) showed the greatest sensory processing difficulties and very low adaptive skills. CONCLUSIONS: Patients with PMS show an atypical sensory profile, which correlates with limitations in general adaptive behaviors. WHAT IS KNOWN: • PMS sensory processing difficulties were associated with a pattern of underresponsive/seeks sensation, low energy/weak, and tactile hyporeactivity. • Sensory processing difficulties have been associated with limitations in the development of appropriate adaptive communication and interaction behaviors. WHAT IS NEW: • Sensory definite differences associated with tactile hyperreactivity, as well as significant effects of underresponsiveness/seeks sensation and auditory filtering categories on the adaptive abilities were found in SHANK3deletion patients. • Cluster analysis suggests that smaller mutation sizes were related to better sensory processing and higher adaptive skills, while patients with larger deletion sizes have greater adaptive difficulties and worse sensory processing skills.

Mental Practice and Manipulative Skills Training Among People With Multiple Sclerosis: A Pilot Study.

IMPORTANCE: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that produces both motor and cognitive dysfunctions. Impairments in limb function as a result of MS cause a decline in the performance of activities of daily living (ADLs). OBJECTIVE: To determine whether the use of mental practice (MP) or MP combined with training in motor manipulation skills (skills training) would improve gross and fine motor skills and treatment satisfaction among people with MS. DESIGN: Pilot study with a duration of 3 mo plus 3-mo follow-up. SETTING: Two MS associations. PARTICIPANTS: Thirty-five patients diagnosed with MS of the relapsing-remitting and progressive secondary subtypes, ages 25 to 60 yr. INTERVENTION: The participants were allocated to one of three groups according to their order of inclusion in the study: (1) MP, (2) MP + skills training, or (3) control group. The treatment protocol had a 6-wk duration and a total of 12 sessions. Outcomes and Measures: Blinded evaluators performed three assessments for each patient (pretreatment, posttreatment, and 3-mo follow-up) using the Nine-Hole Peg Test, Box and Block Test, ABILHAND, and Canadian Occupational Performance Measure (COPM). RESULTS: We found no evidence of benefits in self-perceived performance of ADLs with respect to gross and fine motor skills; however, there was an improvement in perceived satisfaction and in the performance of activities, independent of the treatment received. CONCLUSIONS AND RELEVANCE: Perceived ADL performance and satisfaction with performance increases among people with MS when they receive MP, MP + skills training, and conventional rehabilitation treatment. What This Article Adds: Mental practice combined with conventional treatment could contribute to patients perceiving improved performance of ADLs. Self-reported outcome measures, such as the COPM, could provide highly valuable information about occupation performance that may not match the objective evidence.

Cultural adaptation and psychometric properties of the Jefferson empathy scale health professions students' version in SpanishOccupational therapy students.

BACKGROUND: In occupational therapy, empathy is a fundamental concept and has a positive impact on health and quality of care outcomes for patients. It is a basic and essential concept that should prevail in the training of occupational therapy students. The aim of this study is to validate and cross-culturally adapt the Jefferson Medical Empathy Scale, version for health professionals (JSE-HPS) in a sample of Spanish university students of occupational therapy. METHODS: A cross-sectional descriptive study was conducted between 2019 and 2020. A convenience sample was selected, consisting of 221 students from the four courses of the Occupational Therapy degree at the Universidad Rey Juan Carlos during the 2019-20 academic year. Each of the participants voluntarily and anonymously completed a sociodemographic data sheet (including age and sex), in addition to the following assessment scales: JSE-HPS and the Interpersonal Reactivity Index (IRI). RESULTS: A culturally adapted version of the JSE-HPS that guarantees conceptual and grammatical equivalence specific to the study population was obtained. The psychometric analysis of the translated version showed a Cronbach coefficient α of 0.786. The test-retest reliability analysis showed an intraclass correlation coefficient of 0.90 (95% CI = 0.86-0.93, p < 0.0001). Confirmatory factor analysis (CFA) showed positive results (χ2 = 269.095, df = 167, p < 0.001, Confirmatory Fit Index [CFI] = 0.90, Root Mean Square Error of Approximation [RMSEA] = 0.04). CONCLUSION: The cultural adaptation and psychometric results suggest that the Spanish version of the JSE-HPS is a valid and reliable way to evaluate the empathic ability of occupational therapy students.

Effects of virtual reality associated with serious games for upper limb rehabilitation inpatients with multiple sclerosis: randomized controlled trial.

BACKGROUND: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance. METHODS: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of 1 month without receiving any treatment. RESULTS: In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side. CONCLUSIONS: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance. TRIAL REGISTRATION: This randomized controlled trial has been registered at ClinicalTrials.gov Identifier: NCT04171908 , Nov 2019.

Validity of a Fully-Immersive VR-Based Version of the Box and Blocks Test for Upper Limb Function Assessment in Parkinson's Disease.

In recent decades, gaming technology has been accepted as a feasible method for complementing traditional clinical practice, especially in neurorehabilitation; however, the viability of using 3D Virtual Reality (VR) for the assessment of upper limb motor function has not been fully explored. For that purpose, we developed a VR-based version of the Box and Blocks Test (BBT), a clinical test for the assessment of manual dexterity, as an automated alternative to the classical procedure. Our VR-based BBT (VR-BBT) integrates the traditional BBT mechanics into gameplay using the Leap Motion Controller (LMC) to capture the user's hand motion and the Oculus Rift headset to provide a fully immersive experience. This paper focuses on evaluating the validity of our VR-BBT to reliably measure the manual dexterity in a sample of patients with Parkinson's Disease (PD). For this study, a group of twenty individuals in a mild to moderate stage of PD were recruited. Participants were asked to perform the physical BBT (once) and our proposed VR-BBT (twice) system, separately. Correlation analysis of collected data was carried out. Statistical analysis proved that the performance data collected by the VR-BBT significantly correlated with the conventional assessment of the BBT. The VR-BBT scores have shown a significant association with PD severity measured by the Hoehn and Yahr scale. This fact suggests that the VR-BBT could be used as a reliable indicator for health improvements in patients with PD. Finally, the VR-BBT system presented high usability and acceptability rated by clinicians and patients.

The Impact of a Novel Immersive Virtual Reality Technology Associated with Serious Games in Parkinson's Disease Patients on Upper Limb Rehabilitation: A Mixed Methods Intervention Study.

BACKGROUND: Parkinson's disease is a neurodegenerative disorder that causes impaired motor functions. Virtual reality technology may be recommended to optimize motor learning in a safe environment. The objective of this paper was to evaluate the effects of a novel immersive virtual reality technology used for serious games (Oculus Rift 2 plus leap motion controller-OR2-LMC) for upper limb outcomes (muscle strength, coordination, speed of movements, fine and gross dexterity). Another objective was to obtain qualitative data for participants' experiences related to the intervention. METHODS: A mixed methods intervention (embedded) study was used, with a qualitative design after a technology intervention (quantitative design). The intervention and qualitative design followed international guidelines and were integrated into the method and reporting subheadings. RESULTS: Significant improvements were observed in strength (p = 0.028), fine (p = 0.026 to 0.028) and gross coordination dexterity, and speed movements (p = 0.039) in the affected side, with excellent compliance (100%) and a high level of satisfaction (3.66 ± 0.18 points out of the maximum of 4). No adverse side effects were observed. Qualitative findings described patients' perspectives regarding OR2-LMC treatment, facilitators and barriers for adherence, OR2-LMC applications, and treatment improvements. CONCLUSIONS: The intervention showed positive results for the upper limbs, with elements of discordance, expansion, and confirmation between qualitative and quantitative results.

Leap motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson's disease: a feasibility study.

BACKGROUND: Non-immersive video games are currently being used as technological rehabilitation tools for individuals with Parkinson's disease (PD). The aim of this feasibility study was to evaluate the effectiveness of the Leap Motion Controller® (LMC) system used with serious games designed for the upper limb (UL), as well as the levels of satisfaction and compliance among patients in mild-to-moderate stages of the disease. METHODS: A non-probabilistic sampling of non-consecutive cases was performed. 23 PD patients, in stages II-IV of the Hoehn & Yahr scale, were randomized into two groups: an experimental group (n = 12) who received treatment based on serious games designed by the research team using the LMC system for the UL, and a control group (n = 11) who received a specific intervention for the UL. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, as well as satisfaction and compliance, were assessed in both groups pre-treatment and post-treatment. RESULTS: Within the experimental group, significant improvements were observed in all post-treatment assessments, except for Box and Blocks test for the less affected side. Clinical improvements were observed for all assessments in the control group. Statistical intergroup analysis showed significant improvements in coordination, speed of movements and fine motor dexterity scores on the more affected side of patients in the experimental group. CONCLUSIONS: The LMC system and the serious games designed may be a feasible rehabilitation tool for the improvement of coordination, speed of movements and fine UL dexterity in PD patients. Further studies are needed to confirm these preliminary findings.

Post-COVID-19 Condition: How Sociodemographic Factors, Physical Well-Being and Functionality Influence Quality of Life and Mental Health Symptoms.

BACKGROUND: Long COVID-19 syndrome remains a global public health problem, with more than 145 million people affected with multisystemic symptoms. Addressing the requirements of individuals impacted by a syndrome characterised by a complex and variable clinical presentation is of utmost importance. Identifying the variables that can exert influence and understanding their progression is essential for directing treatment strategies aimed at enhancing both independence and quality of life. Therefore, the aim of this study was to analyse the influence of sociodemographic and clinical variables on existence and their relationship with asthenia, anxiety symptoms and low mood. METHODS: An analytical study secondary to an observational cross-sectional descriptive study. RESULTS: Logistic regression showed significant univariate effects on asthenia [sex (p = 0.034); age (p = 0.042); Activities of Daily Living Questionnaire [ADQL (p = 0.002)] [physical functioning (p < 0.001) and general health (p = 0.014)] and multivariate [sex (p = 0.019), adult age (p = 0.01) and physical functioning (p = 0.04)]]; low mood [time of evolution (p = 0.028) and multivariate [time course (p = 0.007), ADLQ (p = 0.011), role physical (p = 0.013) and general health (p = 0.001)]] and anxiety [physical functioning (p = 0.046) and multivariate [physical functioning (p = 0.034), age (p = 0.011), time of evolution (p = 0.001) and ADQL (p = 0.011)]]. CONCLUSIONS: Increased age, gender and longer evolution time seem to favour the prevalence and occurrence of mental health symptoms; greater independence and good physical functioning are protective factors with respect to the occurrence of mental health-related symptoms in patients affected by post-COVID-19 condition.

Economic Cost of Rehabilitation with Robotic and Virtual Reality Systems in People with Neurological Disorders: A Systematic Review.

Background: The prevalence of neurological disorders is increasing worldwide. In recent decades, the conventional rehabilitation for people with neurological disorders has been often reinforced with the use of technological devices (robots and virtual reality). The aim of this systematic review was to identify the evidence on the economic cost of rehabilitation with robotic and virtual reality devices for people with neurological disorders through a review of the scientific publications over the last 15 years. Methods: A systematic review was conducted on partial economic evaluations (cost description, cost analysis, description of costs and results) and complete (cost minimization, cost-effectiveness, cost utility and cost benefit) studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The main data sources used were PubMed, Scopus and Web of Science (WOS). Studies published in English over the last 15 years were considered for inclusion in this review, regardless of the type of neurological disorder. The critical appraisal instrument from the Joanna Briggs Institute for economic evaluation and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) were used to analyse the methodological quality of all the included papers. Results: A total of 15 studies were included in this review. Ten papers were focused on robotics and five on virtual reality. Most of the studies were focused on people who experienced a stroke. The robotic device most frequently used in the papers included was InMotion® (Bionik Co., Watertown, MA, USA), and for those focused on virtual reality, all papers included used semi-immersive virtual reality systems, with commercial video game consoles (Nintendo Wii® (Nintendo Co., Ltd., Kyoto, Japan) and Kinect® (Microsoft Inc., Redmond, WA, USA)) being used the most. The included studies mainly presented cost minimization outcomes and a general description of costs per intervention, and there were disparities in terms of population, setting, device, protocol and the economic cost outcomes evaluated. Overall, the methodological quality of the included studies was of a moderate level. Conclusions: There is controversy about using robotics in people with neurological disorders in a rehabilitation context in terms of cost minimization, cost-effectiveness, cost utility and cost benefits. Semi-immersive virtual reality devices could involve savings (mainly derived from the low prices of the systems analysed and transportation services if they are applied through telerehabilitation programmes) compared to in-clinic interventions.

Influence of Clinical and Sociodemographic Variables on Health-Related Quality of Life in the Adult Population with Long COVID.

Worldwide, about 10 percent of patients affected by long COVID require appropriate follow-up and intervention. The main objective of this study was to analyze the long-term impact of mild long COVID in the adult population, and to determine the effect of clinical and sociodemographic variables on health-related quality of life in those affected. Methods: A cross-sectional descriptive study of a sample of Spanish adult patients with persistent COVID-19 symptoms at least three months after diagnosis. Data collection took place between April and July 2021. The health-related quality of life of the sample was low, with worse results in the physical component summary (PCS) 24.66 (SD = 4.45) compared to the mental component summary (MCS) 45.95 (SD = 8.65). The multi-regression analysis showed significant differences by sex in the dimensions of physical functioning (p = 0.040); bodily pain (p = 0.036); and health transition (p = 0.018). Additionally, a longer time since infection had a significant effect on physical functioning (p = 0.039); general health (p = 0.037); vitality (p = 0.034); and general health transition (p = 0.002). The effect of occupational imbalance was significant for all dimensions. Conclusions: people with long COVID have a reduced quality of life. Sex, time since infection, and occupational imbalance are predictors of a worse quality of life.

How Do Motor and Sensory Function Correlate with Daily Performance Recovery after Post-Stroke Robotic Intervention? A Secondary Analysis of a Non-Randomized Controlled Trial.

New technologies have been developed to complement conventional interventions to better target the specific needs of people with stroke, and they have been shown to improve both function and performance. However, it is unknown whether the baseline levels of sensorimotor function and performance interrelate with the improvement in upper limb and daily performance. Thus, the aim of this study was to examine the relationship between baseline levels of sensorimotor function and daily performance and its impact on post-intervention improvement in people with stroke following a robotic intervention. A single-blind, non-randomized, controlled clinical trial was conducted. Participants in the experimental group (n = 9) received a robotic intervention in addition to conventional treatment. Sensorimotor function was measured with Semmes-Weinstein Monofilaments® and the Fugl-Meyer Assessment Upper Extremity Scale. Upper limb and daily performance were measured with the MAL and SIS-16 scales. The multivariate regression models showed that baseline levels of upper limb performance and motor function predicted >95% of the variance in upper limb performance (p < 0.001), while pre-intervention levels of daily performance explained >75% of the post-intervention variance (p < 0.05). These findings indicate that basal upper limb motor function is associated with improved performance following a combined intervention of conventional treatment and robotic intervention.

The Impact of Social Distancing Due to COVID-19 on Activities of Daily Living in Parkinson's Disease.

INTRODUCTION: To explore the impact of the lockdown and social distancing measures, applied for one year, due to the COVID-19 pandemic on Activities of Daily Living in patients with Parkinson's disease, as well as to determine the association between daily performance and tasks requiring more manipulative dexterity. METHODS: Data collection was carried out between 18 January and 22 March 2021 through telephone interviews. Patients were recruited from associations of patients with Parkinson's disease in Spain. A questionnaire was designed including items from standardized tools of the Activities of Daily Living Questionnaire to measure the level of independence and from the Dexterity Questionnaire for manipulative dexterity. RESULTS: There were 126 participants aged 36-89 years, 58% of whom were male. The results of our study reveal a significant decline in almost all the ADLs assessed. There is a moderate correlation between the degree of dependence in ADLs and the difficulty in performing activities requiring manipulative dexterity. CONCLUSIONS: Social isolation related to the COVID-19 pandemic and its consequences may have contributed to an increase in the deterioration of manipulative ability, leading to a loss of ability to perform ADLs. These results show specific needs to be considered in the rehabilitation treatment of these patients.

Designing an Informative App for Neurorehabilitation: A Feasibility and Satisfaction Study by Physiotherapists.

BACKGROUND: New technologies have gained popularity, especially the use of mobile phone applications, in neurorehabilitation. The aim of this paper was (1) to develop a free mobile application (NeurorehAPP) that provides information about and helps to select the appropriate mobile application related to a list of neurological disorders (cognitive impairment, Alzheimer's disease, Parkinson's disease, multiple sclerosis, traumatic brain injury, stroke, cerebral palsy, muscular dystrophy, spina bifida, and facial paralysis), based on different objectives such as healthy habits, information, assessment, and treatment; and (2) to assess the feasibility, acceptability, and degree of satisfaction by physiotherapists after using NeurorehAPP for a minimum of three months. METHODS: A free application was created to work with the Android® operating system. The degree of satisfaction and acceptance with the application was assessed with an adaptation of the Customer Satisfaction Questionnaire through a survey via email applied to physiotherapists from hospitals and neurological rehabilitation centers in Spain after using the application. RESULTS: NeurorehAPP includes a total of 131 apps. A total of 121 physiotherapists completed a satisfaction survey. The total sample showed 85.41% satisfaction with the service provided by the app and 86.41% overall satisfaction with NeurorehAPP. CONCLUSIONS: NeurorehAPP is a free, intuitive, and friendly app used with the Android® operating system that allows the selection of the most appropriate app according to the type of user, neurological disorder, objective, and FDA criteria. Physiotherapists showed a high degree of satisfaction and acceptance with NeurorehAPP.

Spanish Cultural Adaptation and Inter-Rater Reliability of the Revised Knox Preschool Play Scale.

BACKGROUND: The Revised Knox Preschool Play Scale (RKPPS) is a comprehensive assessment test that observes the level of play development; however, there is no culturally adapted version available with stable psychometric values that would allow its widespread use and provide objective information during clinical evaluations. METHODS: Cross-cultural adaptation included direct and retrospective translations, along with cognitive interviews with pediatric occupational therapists to analyze the comprehensibility of the translation. In addition, a final phase of linguistic revision was carried out to determine the grammatical and semantic fit of the adapted version. Finally, inter-rater reliability was analyzed in a sample of typically developing children aged four to six years old. RESULTS: The processes of translation and back-translation, cognitive interview, and linguistic review determined an adequate grammatical and semantic equivalence to the Spanish cultural context. Almost perfect agreement, with values between 0.82 and 0.94, was obtained for items and play dimensions, indicating that the precision of the measurements between both evaluators was excellent. CONCLUSIONS: The cross-culturally adapted version of the RKPPS meets the necessary adjustments for the sociocultural context and can be used in the clinical practice of occupational therapy.

Prospective One-Year Follow-Up of Sensory Processing in Phelan-McDermid Syndrome.

BACKGROUND: Phelan-McDermid syndrome (PMS) is caused by the loss (deletion) of a small portion of chromosome 22 in a region designated q13.3 (22q13.3 deletion). PMS is one of the most common genetic forms of autism spectrum disorder (ASD) in which sensory reactivity difficulties have been described on limited occasions. METHODS: The objective of this study is to identify whether changes in sensory reactivity skills occur after one year of follow-up in a group of 44 participants diagnosed with PMS. All participants completed the Short Sensory Profile (SSP). Two-factor ANOVA tests were performed with repeated measures for the study of the evolution of the scores. RESULTS: Participants with PMS showed significant changes after one year of follow-up in sensory reactivity skills associated with tactile hyperreactivity (p = 0.003). The rest of the study variables did not show significant differences compared to the baseline assessment, showing definite differences associated with patterns of hypo-responsiveness and sensory seeking, low/weak energy, and difficulties in auditory filtering. CONCLUSIONS: Understanding the evolution of sensory reactivity skills can facilitate the adjustment to behavioral changes in people with PMS and design-targeted interventions to address sensory reactivity challenges.

Influence of Age, Gender and Education Level on Executive Functions and Functioning in People with Stroke.

BACKGROUND: Alterations in mental functions are among the most frequent manifestations of stroke that have a direct impact on the patient's functionality. The objective of this study was to analyze the relationship of sociodemographic variables with the executive functions (EFs) of participants with right middle cerebral artery (MCA) stroke. METHODS: A cross-sectional observational case-control study was conducted at the State Center for Brain Damage in Madrid, Spain. Fifty-eight subjects were recruited and divided into two groups. Each participant was administered the following: the FIM+FAM Functional Assessment Measure, the Lawton and Brody scale, The Trail-Making Test, the Zoo Map Test and the Hanoi Tower. RESULTS: Statistically significant differences (p < 0.05) were identified between participants with ischemic stroke and control in functional and EF functions, as well as between participants with hemorrhagic stroke and control. No statistically significant differences were found in the experimental group between subjects who had sustained ischemic and hemorrhagic stroke. No significant associations were identified between the variables age, gender and education level in relation to functionality and executive functions (p > 0.05) in people with stroke. CONCLUSION: People who have suffered a right cerebral artery stroke have deficiencies in the EFS, resulting in poorer performance of the activity of daily living, compared to healthy subjects of the same age, gender and education level. In the correlational analysis of the stroke participants, no significant associations were identified between the variables gender, age and education level in relation to functionality and EF.

Descriptive Analysis of Adaptive Behavior in Phelan-McDermid Syndrome and Autism Spectrum Disorder.

Introduction: The variety in symptomatology and clinical presentation of individuals diagnosed with Phelan-McDermid Syndrome (PMS) can delay medical diagnosis, so identifying specific neurobehavioral variables and facilitating differential diagnosis with patients with idiopathic Autism Spectrum Disorder (ASD) can guide early detection. Methods: A descriptive analysis of the level of adaptive behavior in 50 patients diagnosed with PMS was performed (SHANK3 deletion: N = 44; SHANK mutation : N = 6). Subsequently, a comparative analysis was performed with 28 children aged between 4 years and 6 years and 11 months (SHANK3 deletion = 14; ASD = 14). Differences between the two groups were evaluated and Bonferroni correction was applied for multiple comparisons. Results: Differences were identified in the variables of communication (z = -2.715, p = 0.007), Self-Direction (z = -2.199, p = 0.028) and social participation (z = -3.190, p = 0.001), with better adaptive behavior skills being observed in participants with a SHANK3 mutation . Better adaptive skills in the sample of participants with ASD , were found and statistically significant differences were identified in the variables of academic skills (z = -3.084, p = 0.002), use of community resources (z = -1.889, p = 0.050) and health and safety (z = -2.90, p = 0.004). Conclusion: Participants with SHANK3 mutation show better communication and social participation skills than those with a diagnosis of SHANK3 deletion. The observed differences between ASD and individuals with PMS reflect deficits in practical and conceptual adaptive skills that may limit and hinder daily adaptive functioning.

The Use of Portable Devices for the Instrumental Assessment of Balance in Patients with Chronic Stroke: A Systematic Review.

BACKGROUND: Improving balance remains a challenge in stroke rehabilitation. The technological development has allowed the design of more accessible and user-friendly systems for assessing postural control. OBJECTIVES: The aim of this review was to analyze portable devices for the instrumental assessment of balance in patients with chronic stroke. METHODS: PRISMA guidelines were used to carry out the systematic review. The literature search was restricted to articles written in English or Spanish published from 2013 to December 2022 in Pubmed, Web of Science, Scopus, PEDro, and CINAHL. Of the 309 search results, 229 unique references were reviewed after duplicates were removed. The PEDro scale was applied to evaluate the methodological quality of the included papers, and the degree of evidence and level of recommendation were determined through the Oxford Centre for Evidence-Based Medicine. RESULTS: A total of seven articles reporting on five different balance testing devices were included in this systematic review; they regarded BIORescue, a smartphone application, and the Biodex-BioSway Balance System for the evaluation of standing balance, and SwayStar Balance and Xsens ForceShoes™ for the evaluation of dynamic balance during walking. CONCLUSIONS: The use of portable devices that assess balance in adult patients with chronic stroke is scarce.

Headaches and Dizziness as Disabling, Persistent Symptoms in Patients with Long COVID-A National Multicentre Study.

Background: Currently, about 15% of coronavirus disease-19 (COVID-19) patients are affected by Long COVID worldwide; however, this condition has not yet been sufficiently studied. The aim of this study was to identify the impact of symptom persistence as well as clinical and socio-demographic variables in a cohort of people with Long COVID. Methods: We conducted a descriptive cross-sectional study of a sample of adult patients from different Spanish regions presenting with Long COVID. Data collection was conducted between April and July 2021. Functional status and dependency were assessed. Results: A multivariate linear regression was performed, and the model was statistically significant (F (7; 114) = 8.79; p < 0.001), according to the overall ALDQ score. The variables with a statistically significant effect on the degree of dependence were age (p = 0.014), time since diagnosis (p = 0.02), headaches (p = 0.031), and dizziness (p = 0.039). Functional status post-COVID showed a positive and significant relationship with the percentage of dependence (p < 0.001). Conclusions: People affected by Long COVID showed moderate dependency status and limitations in functionality. Those with neurological symptoms, such as dizziness and headaches, as well as older age, showed a higher degree of dependency. Improvements in dependency status occurred with increasing time since diagnosis.

Effects of Intensive Vibratory Treatment with a Robotic System on the Recovery of Sensation and Function in Patients with Subacute and Chronic Stroke: A Non-Randomized Clinical Trial.

BACKGROUND: Sensory-motor deficits are frequent and affect the functionality after stroke. The use of robotic systems to improve functionality and motor performance is advisable; therefore, the aim of the present study was to evaluate the effects of intensive, high-frequency vibration treatment administered with a robotic system in subacute and chronic stroke patients in terms of upper limb sensitivity, motor function, quantity and quality of movement, and quality of life. METHODS: A simple-blind, non-randomized controlled trial was conducted. The control group received conventional rehabilitation treatment and the experimental group received robotic treatment with an Amadeo® robot in addition to their conventional rehabilitation sessions. RESULTS: Intragroup analysis identified significant improvements in the experimental group in hand (p = 0.012), arm (p = 0.018), and shoulder (p = 0.027) sensitivity, as well as in motor function (FMA-UEmotor function, p = 0.028), integration of the affected limb (MAL-14amount scale, p = 0.011; MAL-14How well scale, p = 0.008), and perceived quality of life (SIS-16, p = 0.008). The measures between the control and experimental groups showed statistically significant differences in motor performance and spontaneous use of the affected limb (MAL-14amount scale, p = 0.021; MAL-14How well scale, p = 0.037). CONCLUSIONS: Intensive, high-frequency vibration with a robotic system, in combination with conventional intervention, improves the recovery of upper limb function in terms of quantity and quality of movement in patients with subacute and chronic stroke.