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.

The Influence of Self-Perception on Manipulative Dexterity in Adults with Multiple Sclerosis.

BACKGROUND: Multiple sclerosis is a disorder which causes a loss of functionality, affecting the person's ability to perform activities of daily living, such as interpersonal interactions and relationship, dressing, self-care, or bathing, as well as having a negative impact on work and leisure activities. AIMS: This study examined the relationship (correlational or associations/predictive) between self-perceived quality of life and performance of manipulative dexterity. Also, this study sought to measure predictors of dexterity. Study Design. A cross-sectional study from two associations of MS within the Community of Madrid, Spain. Methods and Procedures. A final sample of 30 people with multiple sclerosis. The outcome measures used were the ABILHAND questionnaire, the Purdue Pegboard Test, the Nine Hole Peg Test, and the Box and Block Test. RESULTS: No significant correlations were found between dexterity and self-perception tests; however, correlations were found between perceived dexterity and quality of life (p < 0.001). Scores for the ABILHAND questionnaire, which measures the perception of skills in daily living, predicted up to 60% of the variance in the dexterity tests. CONCLUSIONS: The results of this study suggest that interventions for improving the manipulative dexterity of people with multiple sclerosis should address the person's perception of improving their manipulative dexterity and the perceived of quality of life, as both factors may influence manipulative dexterity.

Drooling, Swallowing Difficulties and Health Related Quality of Life in Parkinson's Disease Patients.

BACKGROUND: Parkinson's disease (PD) is the most common neurodegenerative disorder associated with motor and nonmotor symptoms. Drooling, one of the nonmotor symptoms, can be present in 70-80% of patients with PD. The aim of this paper is to study the characteristics of PD patients with drooling compared to those without in terms of age, gender, disease duration, stage of the disease, swallowing difficulties, and health-related quality of life; methods: a cross-sectional study was conducted. The sample was divided into two groups: PD with drooling (n = 32) and PD without drooling (n = 30). Age, gender, disease duration and Hoehn & Yahr (H & Y) stage, Sialorrhea Clinical Scale for Parkinson's Disease (SCS-PD), the 10-item Eating Assessment Tool (EAT-10), and the 39-item Parkinson's Disease Questionnaire (PDQ-39) were compared between groups; Results: 62 individuals with PD, 40 men and 22 women (mean age 73 ± 8 years), were included. Overall, 32 patients reported drooling, and 30 did not exhibit it. The ANCOVA found significant differences between groups for the EAT-10 score (0.83, 95% CI = 5.62-9.03; p = 0.016) and SCS-PD score (1.48, 95% CI = 0.86-6.81; p < 0.001). Analysis of the PDQ-39 scores revealed no significant differences between groups for the PDQ-39 total score (p > 0.057) and in all subscales. The inclusion of gender, age, disease duration, and H & Y as covariates did not influence the results (all p > 0.05). CONCLUSIONS: drooling is related to swallowing difficulties assessed with EAT-10 but not with health-related quality of life assessed with PDQ-39 in PD patients with drooling compared to PD patients without it. Age, gender, duration of the disease, and the H & Y state of PD patients with and without drooling seem to be similar.

A Descriptive Cross-Sectional Study of Manipulative Dexterity on Different Subtypes of Multiple Sclerosis.

BACKGROUND: Manipulative dexterity impairments affect 76% of individuals with multiple sclerosis (MS). Patients with MS can experience reduced skill when performing both basic activities of daily living and instrumental activities of daily living. Many studies consider that physical rehabilitation leads to a decrease in the level of disability, especially at the mild and moderate stages of the disease. However, most studies fail to distinguish between the different MS subtypes. PURPOSE: Our aims were (1) to describe the manipulative skills of people according to the different subtypes of MS, (2) to analyze the correlation between dexterity and self-perception variables, and (3) to identify possible predictors of functionality. Study Design. A descriptive cross-sectional study. METHODS: 30 individuals with MS. The measurement tools used were the ABILHAND, the Purdue Pegboard Test (PPT), the Nine-Hole Peg Test, and the Box and Block Test. RESULTS: All subtypes of MS obtained lower scores for manipulative dexterity compared to normal skill levels, with individuals with primary progressive MS displaying the lowest values. However, the analysis of differences between the different subtypes did not reveal statistically significant intragroup differences. In addition, differences were found regarding the effect size of practically all the variables analyzed for both manipulative dexterity (PPT, NHPT, and BBT) and the self-perception of ADLs (ABILHAND), for which high values (d r = 0.72) and very high values (d r = 1.46) were obtained. CONCLUSIONS: Although no significant differences were found between the different types of MS, the assessment of manual dexterity and perceived efficacy of daily activities must be considered as prognostic factors in the progression of the disease. These findings may help support further research on targeted interventions to improve dexterity deficiencies, as well as promote an improved quality of therapeutic interventions.

Occupational performance in multiple sclerosis and its relationship with quality of life and fatigue.

BACKGROUND: Performance and perceived satisfaction of daily occupations in people with multiple sclerosis (MS) can affect the perception of their quality of life and be impacted by the level of fatigue. AIM: To describe the performance and occupational self-perception, as well as to analyze whether there is a relationship between the perception of occupational performance and the quality of life and perceived fatigue. DESIGN: A descriptive cross-sectional study. SETTING: Participants were referred by the services of Neurology of the various hospitals in Madrid. The assessment process was performed either at the MS' associations, in the participants' home, or at the Laboratory of Cognitive Intervention of the Health Sciences Faculty of the University. POPULATION: A total sample of 30 people with MS (pwMS) selected by non-probabilistic consecutive sampling during a three-months uptake patient recruitment period. METHODS: The outcome measures used were the Canadian Occupational Performance Measure (COPM), the Modified Fatigue Impact Scale (MFIS) and the Multiple Sclerosis Quality of Life 54 (MSQoL-54). Descriptive analysis, parametric and non-parametric tests and multiple linear regression models were used. RESULTS: A statistically significant positive correlation was found between occupational performance and physical and mental health. Also, high physical health scores were associated with high satisfaction scores. Multiple regression models indicated that high levels of satisfaction were associated with high levels of physical health (P= 0.013). CONCLUSIONS: The better the perception of the physical aspects that influence the quality of life, the better the perceived satisfaction of pwMS. Fatigue may not influence self-perceived satisfaction and performance. CLINICAL REHABILITATION IMPACT: The physical factors affecting perceived satisfaction should be considered when planning interventions to promote quality of life in pwMS. Although fatigue associated with MS may influence perceived performance and satisfaction, no relevant associations were found between variables.

Spanish Transcultural Adaptation of the Activity Card Sort.

The Activity Card Sort (ACS) measures the level of participation, as perceived by each person which, unlike other scales, makes it both personal and significant. However, there is a limitation to applying the ACS to Spanish older adults as it is restricted to culturally relevant activities solely in the United States. Therefore, the aim of this study was to select activity items that reflected Spanish older adults' lifestyles in order to develop the Activity Card Sort-Spain Version (ACS-SP). Frequently, activities performed in Spain (n = 103) were listed in an initial draft. The Likert scale was administrated to a large group of Spanish nationals over the age of 60 years (n = 98) to establish which type of activities will be eventually included in the Spanish version. The final version was drawn up comprising 79 activities distributed between four performance areas. In addition, other activities that were not previously included by other assessment tools were considered and have been listed in this review, such as taking a nap, going out for a drink or "tapas," or searching for a job. The gradual adaptation to ACS for Spaniards will make it possible to measure the level of an individual's participation within a community. However, further work on psychometric properties is needed.

'Being normal' and self-identity: the experience of volunteering in individuals with severe mental disorders-a qualitative study.

OBJECTIVE: This study sought to explore the views and experiences of a group of people with severe mental disorders (SMDs) who performed volunteer services. DESIGN: A qualitative phenomenological study. SETTING: Community public mental health services of the Community of Madrid and the province of Barcelona (Spain). PARTICIPANTS: Purposive sampling techniques were used between September 2016 and April 2017. The inclusion criteria were: individuals aged 18-65 years who participated in volunteer activities during the performance of this study, based on the regulations of volunteer services in Spain and the community of Madrid; a diagnosis of non-organic psychotic disorder (F20.x, F21, F22, F24, F25, F28, F29, F31.x, F32.3 and F33) according to the International Classification of Diseases, 10th Revision; an evolution of ≥2 years; and a moderate to severe dysfunction of global functioning with scores ≤70 in the Global Assessment of Functioning Scale. Ultimately, 23 people with SMD participated in the study with a mean age of 47 years (SD 8.23). METHODS: Data were collected through in-depth interviews and researcher field notes. A thematic analysis was performed following appropriate guidelines for qualitative research. RESULTS: Two main themes emerged to describe the experience of participating in volunteer activities: (1) rebuilding self-identity, based on the participant's experience of volunteering, of acquiring a new role and a new perceived identity that made them feel valued and respected; and (2) being a so-called normal person with a 'normal' life, based on recovering a sense of normality, unmarked by the illness, thanks to daily responsibilities and occupations. CONCLUSIONS: Qualitative research offers insight into the way people with SMD experience volunteering and may help to improve understanding of the underlying motivations that drive these individuals. These findings may be applied to improve guidance during their process of recovery and subsequent inclusion into society.

Altered fine motor control and manual dexterity in people with cocaine dependence: An observational study.

BACKGROUND/AIM: Cocaine consumption may result in irreversible structural changes in the brain. The long-term effects of cocaine are related to a wide range of deteriorated cognitive functions. This study aimed to examine the fine motor control and hand-function in cocaine users compared to healthy controls. METHODS: An observational study was conducted. Sociodemographic variables, substance consumption, the Purdue Pegboard and the Jebsen-Taylor Hand-function Test were evaluated bilaterally in 35 participants who were cocaine users and in 35 healthy participants. Differences between sides (dominant and non-dominant hands) and groups were analysed with analysis of variance (ANOVA). RESULTS: The ANOVA revealed significant differences between groups (P < 0.001) and between sides (dominant and non-dominant hands) (P = 0.005) for the one-hand pin placement subtest of the Purdue Pegboard Test. Also, ANOVA tests showed significant differences between sides, but not groups, for the simulated feeding (P < 0.001) and stacking checkers (P < 0.001) Jebsen-Taylor subtests. Cocaine user participants exhibited significantly lower scores in bilateral pin placement and required more time for the Jebsen-Taylor subtests compared to healthy participants. CONCLUSIONS: Cocaine user participants display deficits of fine motor control and some aspects of manual dexterity when compared to healthy controls. These findings show the convenience of incorporating functional rehabilitation by occupational therapists as a key component within the treatment of cocaine users. This study therefore opens a new field of practice for occupational therapy based on the assessment and treatment of motor deficits in the hand and the upper limb of people who consume cocaine.

The Occupational Profile of Women with Fibromyalgia Syndrome.

The aims of this study were to assess the functional level of women with fibromyalgia; to investigate the differences in the occupational activities between women with fibromyalgia and healthy women; and to analyse the perceived importance of occupational performance during self-care, productivity and leisure activities. A cross-sectional case control study was performed. Twenty women with fibromyalgia and 20 healthy women completed the Functional Independence Measure (FIM), the Canadian Occupational Performance Measure (COPM), a Numerical Pain Rating Scale, the Fibromyalgia Impact Questionnaire and the SF-36 health survey. The Chi-square test (χ2), the Student's t test and the Spearman's test were used on the data. The FIM revealed significant differences regarding several activities: personal hygiene, bathing and memory (p < 0.01). The COPM scores did not reveal significant differences between groups (p > 0.10). Women with fibromyalgia had higher disability and reduced quality of life and required greater assistance to perform specific activities of daily living, i.e. hygiene, than healthy women. This highlights the specific occupational therapy needs these women have for performing many basic activities and for improving their quality of life. Limitations of the study include the small sample size, the exclusion of male participants and the possible influence of the women's psychological status on the assessments performed. Findings should be generalized with caution. Copyright © 2015 John Wiley & Sons, Ltd.

Kinect Xbox 360 as a therapeutic modality for children with cerebral palsy in a school environment: a preliminary study.

BACKGROUND: Limited evidence is available about the effectiveness of virtual reality using low cost commercial consoles for children with developmental delay. OBJECTIVE: The aim of this preliminary study is to evaluate the usefulness of a videogame system based on non-immersive virtual reality technology (Xbox 360 KinectTM) to support conventional rehabilitation treatment of children with cerebral palsy. Secondarily, to objectify changes in psychomotor status of children with cerebral palsy after receiving rehabilitation treatment in addition with this last generation game console. METHODS: 11 children with cerebral palsy were included the study. A baseline, a post-treatment and a follow-up assessment were performed related to motor and the process skills, balance, gait speed, running and jumping and fine and manual finger dexterity. All the participants completed 8 weeks of videogame treatment, added to their conventional physiotherapy treatment, with Xbox 360 Kinect™ (Microsoft) game console. RESULTS: The Friedman test showed significant differences among the three assessments for each variable: GMFM (p = 0.001), AMPS motor (p = 0.001), AMPS process (p = 0.010), PRT (p = 0.005) and 10 MW (p = 0.029). Wilcoxon test showed significant statistically differences pre and post-treatment, in all the values. Similarly, results revealed significant differences between basal and follow-up assessment. There were not statistical differences between post-treatment and follow-up evaluation, indicating a long-term maintenance of the improvements achieved after treatment. CONCLUSIONS: Low cost video games based on motion capture are potential tools in the rehabilitation context in children with CP. Our Kinect Xbox 360 protocol has showed improvements in balance and ADL in CP participants in a school environment, but further studies are need to validate the potential benefits of these video game systems as a supplement for rehabilitation of children with CP.