Psychometric testing of the Chinese version of the International Classification of Functioning, Disability, and Health Measure of Participation and Activities Screener in people with stroke.

BACKGROUND: Clinicians need a validated measure to assess the activity and participation of Chinese people with stroke. OBJECTIVES: To culturally adapt and psychometrically test the Chinese (Cantonese) version of the International Classification of Functioning, Disability and Health Measure of Participation and Activities (C-IMPACT-S) in community-dwelling people with stroke. METHODS: We followed the standard translation procedures to culturally adapt the C-IMPACT-S. Then we administered the C-IMPACT-S to 100 people with stroke and 50 healthy counterparts for psychometric testing, including the ceiling and floor effects, internal consistency, test - retest, measurement error, minimal detectable change, correlations with other outcome measures, known-group validity and optimal cutoff scores. RESULTS: The C-IMPACT-S has no floor effects but ceiling effects in item 5. It has poor to excellent (Cronbach's α = 0.56-95) internal consistency and fair to excellent (Intraclass correlation coefficients = 0.58-1.00) test-retest reliability. The overall C-IMPACT-S mean score and activity and participation component mean scores had statistically significant no to weak correlations with the Fugl-Meyer Assessment, the Chinese versions of Geriatric Depression Scale, Fatigue Assessment Scale, Lawton Instrumental Activities of Daily Living Scale and Community Integration Measure. The stroke participants had lower C-IMPACT-S scores then their health counterparts. The optimal cutoff scores of the overall C-IMPACT-S and activity and participation domains were 88.02% (sensitivity 72%, specificity 80%), 80.56% (sensitivity 86%, specificity 68%) and 91.67% (sensitivity 68%, specificity 80%), respectively. CONCLUSIONS: C-IMPACT-S is a reliable and valid measure for assessing the levels of activity and participation of people with chronic stroke.

Effects of home-based and telerehabilitation exercise on mental and physical health, and disease cost in people with Alzheimer's disease: A meta-analysis.

BACKGROUND: Alzheimer's disease (AD) is a very disabling long-term disease that requires continuous regular care. A cost-effective and sustainable means of such care may be physical activity or exercise delivered at home or through telerehabilitation. The aim of this study is to determine the effects of home-based or telerehabilitation exercise in people with AD. METHOD: PubMED, Embase, Web of Science (WoS), PEDro, and CENTRAL were searched for randomized controlled trials until January 2024. The data extracted include the characteristics of the participants, the interventions used for both experimental and the control groups, the baseline, post-intervention and follow-up mean and standard deviation values on the outcomes assessed and the findings of the included studies. Cochrane risks of bias assessment tool and PEDro scale were used to assess the risks of bias and methodological quality of the studies. The results were analyzed using narrative and quantitative syntheses. RESULT: Eleven articles from nine studies (n=550) were included in the study. The results showed that, only global cognitive function (SMD = 0.72, 95% CI = 0.19-1.25, p=0.007), neuropsychiatric symptom (MD = -5.28, 95% CI =-6.22 to -4.34, p<0.0001) and ADL (SMD =3.12, 95% CI =0.11-6.13, p=0.04) improved significantly higher in the experimental group post-intervention. At follow-up, the significant difference was maintained only in neuropsychiatric symptoms (MD =-6.20, 95% CI =-7.17 to -5.23, p<0.0001). CONCLUSION: There is a low evidence on the effects of home-based physical activity or exercise on global cognitive function, neuropsychiatric symptoms and ADL.

Examining the role of attention focus walking training on conscious motor processing during rehabilitation by older adults at risk of falling: A randomized controlled trial.

This study examined the impact of walking training with different attention focus instructions on real-time conscious motor processing and fall-related rehabilitation outcomes in older adults at risk of falling. A total of 102 community-dwelling older adults (mean age = 75.2 years, SD = 6.8 years) were randomly assigned to three groups: no attention focus walking group (NAFWG), external attention focus walking group (EAFWG), or internal attention focus walking group (IAFWG). All groups underwent 12 training sessions. Assessments were conducted at baseline, post-training, and six months later, measuring real-time conscious motor processing, functional balance and gait, balance ability, functional mobility, walking ability, trait conscious motor processing propensity, fear of falling, and recurrent falls. The EAFWG showed significant reduction on real-time conscious motor processing immediately after training (p = 0.015). No changes were observed for the IAFWG and NAFWG. All groups showed significant improvements in functional balance and gait (p < 0.001) and balance ability (p < 0.001) post-training. Implementing external focus instructions during walking training could be a feasible and beneficial strategy for reducing real-time conscious motor processing, which may improve walking performance and prevent falls in older adults. Further research is needed to examine the sustained benefits of these interventions and determine optimal training dosage for older adults with different risks of falling in fall prevention.

The effects of errorless psychomotor training in the Y balance lower limb reaching task.

This study investigated the training effect of errorless psychomotor training, a motor training method with perceptual, attentional, and psychological manipulation, in a balance-related, lower limb reaching task (Y balance reaching task) on dynamic balance by young adults. Thirty-nine participants (Mean age = 27.03 years, SD = 2.64 years) were trained with different psychomotor training methods in the Y balance reaching task. Results illustrate that errorless psychomotor training significantly improved the participants' dynamic balance and proprioceptive abilities. Additionally, gaze fixation duration on target during reaching decreased after errorless psychomotor training, suggesting that errorless psychomotor training could decrease visual information demand and be concurrently compensated by up-weighting on proprioception. This multisensory reweighting and cross-modal attention could contribute to the improvement of dynamic balance ability in sports.

Attentional Focus Strategies for Promoting Children's Motor Learning: A Scoping Review With a Learner-Task-Environment Framework.

There is emerging evidence that attentional focus instructions and feedback may help children with motor learning. However, information relevant to learner characteristics, settings, and contexts in which attentional focus strategies can be used has not been synthesized. Therefore, in this review, we adopted a learner-task-environment framework to map the evidence to date related to attentional focus strategies in children's motor learning. We adapted the framework for scoping reviews put forth by Arksey and O'Malley (2005) and the enhanced protocol recommended by the Joanna Briggs Institute (Peters et al., 2021). Two researchers (a) identified the research question, (b) identified relevant studies, (c) selected studies, (d) charted the data, and (e) collated, summarized, and reported these results. We included 30 papers, all of which used an experimental or quasi-experimental design. Most studies have focused on typically developing children and those in middle childhood as learners. The movement tasks in these studies included isolated fundamental movement skills and sport-related tasks. All but one study were situated in non-clinical settings (i.e., school, laboratory). We found limited use of attentional focus strategies for learning movement tasks in early childhood, especially among children with neurodevelopmental disorders. Movement tasks were mostly isolated skills, and there was extremely limited application to clinical settings.

Prevalence, associated factors and predictors of post stroke pneumonia in a Nigerian population: A retrospective study.

OBJECTIVES: Stroke can trigger an immune response that can raise the risk of infection, alter tracheal epithelium, reduce pulmonary clearance and impair secretions drainage capacity. Infection, altered tracheal epithelium, reduced pulmonary clearance, impaired secretions drainage capacity and aspiration can cause pneumonia after stroke. The aim of this study is to find out the prevalence of post stroke pneumonia in a Nigerian population and factors that are associated with it. MATERIALS AND METHOD: Study data was extracted from the case files of patients with stroke who were managed between 1st January, 2011 and 1st February, 2021 in the study setting. RESULTS: The result showed that, there was a record of only 591 patients with stroke (mean age, 62.78 ± 14.86 years) who were managed in the two hospitals during the period of the study. Out of this number, only 102 (17.3 %) had pneumonia. Presence of the pneumonia was only significantly (p < 0.05) associated with sex, type of stroke, lower limb muscle power, and outcome (died or alive). However, only those with ischaemic stroke are less likely to have pneumonia (Odds ratio=  0.467; CI: 0.275 to 0.791, p=  0.005), and patients who survived the stroke and are alive are less likely to develop pneumonia (Odds ratio=  0.150; CI: 0.092 to 0.245, p < 0.001). CONCLUSIONS: Pneumonia occurs to a large extent after stroke. Therefore, it is important measures are taken to prevent it or complications arising from it especially in those with a hemorrhagic stroke.

Effects and safety of vagus nerve stimulation on upper limb function in patients with stroke: a systematic review and meta-analysis.

Vagus nerve stimulation (VNS) is used to deliver electric current to stimulate the vagus nerve. The aim of this study is to carry out a systematic review and meta-analysis to determine its effects on motor function in patients with stroke. PubMED, Embase, Web of Science (WoS), and Scopus were searched. Data on time since stroke, and mean scores and standard deviation on outcomes such as level of impairment and motor function were extracted. The results showed that invasive (MD 2.66, 95% CI 1.19-4.13, P = 0.0004) and non-invasive (MD 24.16, 95% CI 23.56-24.75, P = 0.00001) VNS are superior at improving level of motor impairment than the control post intervention and at follow-up respectively. Similarly, VNS improved motor function post intervention (MD 0.28, 95% CI 0.15-0.41, P < 0.0001); and there was no significant difference in adverse events between invasive VNS and control (OR 2.15, 95% CI 0.97-4.74, P = 0.06), and between non-invasive VNS and control (OR 4.54, 95% CI 0.48-42.97, P = 0.19). VNS can be used to improve motor function in patients with stroke.

Effectiveness of a theory-driven mHealth intervention in promoting post-surgery rehabilitation adherence in patients who had anterior cruciate ligament reconstruction: A randomized clinical trial.

RATIONALE: Patients with anterior cruciate ligament (ACL) reconstruction often have poor adherence to post-surgery rehabilitation. OBJECTIVE: This study applied the integrated model of self-determination theory and the theory of planned behavior to examine the effects of a smartphone-delivered intervention on the recovery outcomes of patients with an ACL rupture during post-surgery rehabilitation period. Additionally, we explored the effects of the intervention on participants with different beliefs toward rehabilitation at baseline. METHODS: The randomized control trial recruited 96 eligible participants (M age = 27.82 years, SD = 8.73; female = 39%) who underwent ACL reconstruction surgery. Participants were randomly assigned to an intervention group (n = 41), which received standard post-surgical treatment (usual-care) and smartphone application ("ACL-Well"), or a usual-care control group (n = 55). The primary outcomes were recovery outcomes from ACL surgery measured by knee muscle strength and laxity, and subjective knee evaluation completed 4-month post-intervention. Secondary outcomes were the psychological and behavioral outcomes measured at baseline, at 2- and 4-month post-intervention. RESULTS: ANCOVA indicated no significant between-group differences in primary outcomes: knee muscle strength, knee laxity and subjective knee evaluation, Fs(1, 27 to 55) = 0.01 to 1.36, p = .25 to .99, η2 = 0.01 to 0.03. For the secondary outcomes, growth mixture modelling revealed self-determined treatment motivation declined significantly over the intervention period in the control group (M slope = -0.39 to -0.12, p = .01 to .04), but not in the intervention group (M slope = -0.19 to -0.08, p = .06 to .38). CONCLUSIONS: The smartphone application fell short in promoting orthopedic outpatients' recovery outcomes. Yet, it shows some promises as a mean to maintain patients' motivation and adherence to treatment.

Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice.

Background: Stroke results in impairment of motor function of both the upper and lower limbs. However, although it is debatable, motor function of the lower limb is believed to recover faster than that of the upper limb. The aim of this paper is to propose some hypotheses to explain the reasons for that, and discuss their implications for research and practice. Method: We searched PubMED, Web of Science, Scopus, Embase and CENTRAL using the key words, stroke, cerebrovascular accident, upper extremity, lower extremity, and motor recovery for relevant literature. Result: The search generated a total of 2,551 hits. However, out of this number, 51 duplicates were removed. Following review of the relevant literature, we proposed four hypotheses: natural instinct for walking hypothesis, bipedal locomotion hypothesis, central pattern generators (CPGs) hypothesis and role of spasticity hypothesis on the subject matter. Conclusion: We opine that, what may eventually account for the difference, is the frequency of use of the affected limb or intensity of the rehabilitation intervention. This is because, from the above hypotheses, the lower limb seems to be used more frequently. When limbs are used frequently, this will result in use-dependent plasticity and eventual recovery. Thus, rehabilitation techniques that involve high repetitive tasks practice such as robotic rehabilitation, Wii gaming and constraint induced movement therapy should be used during upper limb rehabilitation.

Putative role of non-invasive vagus nerve stimulation in cancer pathology and immunotherapy: Can this be a hidden treasure, especially for the elderly?

Cancer is globally a disease of significant public health concern owing to its prevalence, and association with morbidity and mortality. Thus, cost-effective treatments for cancer are important to help reduce its significant morbidity and mortality. However, the current therapeutic options for cancer such as chemotherapy, radiotherapy, and surgery may produce serious adverse events such as nausea, vomiting, fatigue, and peripheral neuropathy, especially in the long term. In addition, these therapeutic options may not be well tolerated by the elderly especially those who are frail. The current article is aimed at discussing an alternative therapeutic option, non-invasive vagus nerve stimulation (VNS), and the roles it plays in cancer pathology and immunotherapy. The VNS does this by reducing oxidative stress via silent information regulator 1 (SIRT1); inhibiting inflammation via both hypothalamic-pituitary-axis (HPA) and the release of corticosteroid from the adrenal gland, and cholinergic anti-inflammatory pathway (CAP), and increasing vagal activity which helps in the regulation of cell proliferation, differentiation, apoptosis, and metabolism, and increase chance of survival. Furthermore, it helps with reducing complications due to cancer or its treatments such as postoperative ileus and severity of peripheral neuropathy induced by chemotherapy, and improves cancer-related fatigue, lymphopenia, and quality of life. These suggest that the importance of non-invasive VNS in cancer pathology and immunotherapy cannot be overemphasized. Therefore, considering the safety of non-invasive VNS and its cost-effectiveness, it is a therapeutic option worth trying for these patients, especially in combination with other therapies.

Assistive robotic hand with bi-directional soft actuator for hand impaired patients.

Soft wearable robotic hand can assist with hand function for the performance of activities of daily living (ADL). However, existing robotic hands lack a mathematical way to quantify the grip force generated for better controlling the grasp of objects during the performance of ADL. To address this issue, this article presents a soft wearable robotic hand with active control of finger flexion and extension through an elastomeric-based bi-directional soft actuator. This actuator bends and extends by pneumatic actuation at lower air pressure, and a flex sensor embedded inside the actuator measures the angles of the fingers in real-time. Analytical models are established to quantify the kinematic and tip force for gripping of the actuator in terms of the relationship between the input pressure and the bending angle, as well as the output force, and are validated experimentally and by the finite element method. Furthermore, the ability of the soft robotic hand to grasp objects is validated with and without being worn on a human hand. The robotic hand facilitates hand opening and closing by the wearer and successfully assists with grasping objects with sufficient force for ADL-related tasks, and the grip force provided by the actuator is further estimated by the analytical models on two healthy subjects. Results suggest the possibility of the soft robotic hand in providing controllable grip strength in rehabilitation and ADL assistance.

The use of mindfulness-based interventions in stroke rehabilitation: A scoping review.

PURPOSE/OBJECTIVE: There is emerging evidence for the use of mindfulness-based interventions (MBIs) to improve health outcomes in the context of stroke rehabilitation. This scoping review identified recently available evidence and possible research gaps regarding how MBIs affect psychological and physical rehabilitation outcomes in individuals poststroke. RESEARCH METHOD/DESIGN: Electronic searches were performed using the four major databases, CINAHL, MEDLINE, PsycINFO, and Web of Science. Sixteen studies out of a total of 404 relevant studies met the selection criteria for inclusion in this review. RESULTS: Our findings indicate diverse results on the benefits of MBIs in individuals poststroke across a range of rehabilitative outcomes. For instance, significant improvements in mental fatigue, cognition, and quality of life were observed for most of the studies while the outcomes for mood and physical functioning were mixed. CONCLUSIONS/IMPLICATIONS: The available evidence lends qualified support to the view that mindfulness has the potential to be a therapeutic intervention that offers health benefits to individuals poststroke. Yet, the diversity of results highlights the need for a more rigorous examination in further research. We also identified several knowledge gaps in mindfulness research in the stroke population, such as the limited amount of evidence for mindfulness-based cognitive therapy (MBCT), inadequate evaluations of physical outcomes, and the lack of methodologically robust trials. Further investigations are warranted to strengthen the evidence for the feasibility and effectiveness of MBIs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index in people with chronic stroke.

Objective: To culturally adapt and examine the psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index (C-UEFI) in people with chronic stroke. Design: Cross-sectional study. Settings: University-affiliated neurorehabilitation research laboratory. Participants: The participants (N = 151) were people with chronic stroke (N = 101) and healthy controls (n = 50). Main outcome measures: We assessed the C-UEFI, Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Six-Minute Walk Test (6MWT), Motor Activity Log (MAL), Activity-Specific Balance Confidence (ABC) scale, Lawton Instrumental Activities of Daily Living (IADL) scale, Survey of Activities and Fear of Falling in the Elderly (SAFFE), Stroke Impact Scale (SIS) and Community Integration Measure (CIM) as outcome measures. Results: The C-UEFI items demonstrated good test-retest reliability (intraclass correlation coefficient [ICC]3, 1 = 0.872) and excellent internal consistency (Cronbach's α = 0.922). People with chronic stroke had poorer C-UEFI scores than the healthy controls. The overall C-UEFI mean score of 101 people with stroke was significantly correlated with the mean scores of the FMA-UE, WMFT, MAL, ABC scale, IADL scale, SAFFE, SIS and CIM and the distance covered in the 6MWT. The C-UEFI cut-off score to distinguish between people with chronic stroke and healthy older adults according to upper extremity function was 57.5 out of 59 (sensitivity: 88.1%; specificity: 84%). The C-UEFI had good content validity, with an acceptable fit to the two-factor structure model. Conclusions: The C-UEFI is reliable and valid for assessing functional recovery of upper extremity activity in Chinese people with chronic stroke.

Reliability, Concurrent Validity, and Minimal Detectable Change of Timed Up and Go Obstacle Test in People With Stroke.

OBJECTIVE: The aims of this study were to investigate the psychometric property of the timed Up and Go Obstacle (TUGO) test in people with stroke. DESIGN: Cross-sectional design. SETTING: University based neurorehabilitation laboratory. PARTICIPANTS: Twenty-eight people with stroke and 30 healthy older adults. INTERVENTION: Not Applicable. OUTCOME MEASURES: The TUGO (obstacle heights: 0, 5, 17 cm) test completion times, Fugl-Meyer Assessment (FMA) score, ankle dorsiflexor and plantarflexor muscle strength, Berg Balance Scale (BBS) score, Narrow Corridor Walking Test (NCWT) completion time, timed Up and Go (TUG) test completion time, and Community Integrated Measure. RESULTS: Excellent inter-rater (intraclass correlation coefficient [ICC]=0.999-1.000) and test-retest reliabilities (ICC=0.917-0.975) were found for TUGO test completion times for all obstacle heights. The TUGO test completion times for all obstacle heights were significantly correlated with NCWT and TUG test completion times (r=0.817-0.912). Only TUGO test completion times for 0 and 5 cm obstacle heights showed significant correlations with BBS scores (r=-0.518 to -0.534), while the TUGO test completion time for the 17 cm obstacle height correlated significantly with FMA scores. The minimal detectable change and optimal cut-off values for TUGO test completion times for the 0, 5, and 17 cm obstacle heights were 2.54, 3.60, and 3.07 s, and 14.69, 14.76, and 16.10 s, respectively. CONCLUSION: The TUGO test is a reliable, valid, and easy-to-administer clinical measure to discriminate between people with stroke and healthy older adults.

Attentional Focus Strategies to Improve Motor Performance in Older Adults: A Systematic Review.

Previous literature shows the beneficial effects of an external focus of attention on various sports skills in young adults. The objective of this systematic review is to evaluate the effects of external and internal focus of attention on motor performance in healthy older adults. The literature search was conducted in five electronic databases (PsycINFO, PubMed, SPORTDiscus, Scopus, and Web of Science). Eighteen studies that met the inclusion criteria were evaluated. Most of the motor tasks targeting older adults were related to postural control and gait. Over 60% of the included studies reported that the effect of an external focus was superior to that of an internal focus on motor performance in older adults. An external focus generally results in better motor performance than an internal focus among healthy older adults. However, the advantage of an external focus on locomotion may not be as significant as those illustrated in previous attentional focus studies. A challenging cognitive task may allow more automatic motor control than an external focus. Practitioners might provide clear instruction cues guiding performers to divert their attention away from their body and towards the movement effect for better performance, particularly in balancing tasks.

Associations of Device-Measured Physical Activity, Sedentary Behavior, and Executive Function in Preadolescents: A Latent Profile Approach.

PURPOSE: This study investigated the associations between physical activity (PA), sedentary behavior, and executive function in preadolescents. METHODS: One hundred and twenty preadolescents were recruited from 2 Hong Kong primary schools. PA and sedentary behavior were recorded for 7 consecutive days by accelerometer. Executive function performance, including inhibition (Stroop task and Flanker task) and working memory (Sternberg paradigm task), were measured. Body mass index and cardiorespiratory fitness (multistage fitness test) were tested. Latent profile analysis explored the profiles of PA and sedentary behavior in preadolescents. RESULTS: Three distinct profiles were identified: low activity, average activity, and high activity. Participants in low activity performed worse in the accuracy of Stroop task (vs average activity, P = .03; vs high activity, P < .01), Flanker task (vs average activity, P = .02; vs high activity, P < .001), and Sternberg paradigm task (vs average activity, P < .01; vs high activity, P < .01). No significant difference was observed between participants with average and high activities. No significant association was observed for profiles on body mass index and cardiorespiratory fitness. CONCLUSION: Supplementing the consensus of the literature that moderate to vigorous PA benefits cognition, the authors conclude that light PA may also enhance preadolescents' executive functioning.

Testing the psychometric properties of the Chinese (Cantonese) version of SATIS-Stroke in people with chronic stroke.

PURPOSE: To culturally adapt and examine the psychometric properties of the Chinese (Cantonese) version of SATIS-Stroke (C-SATIS-Stroke) in people with chronic stroke. MATERIALS AND METHODS: Forward and backward translations were performed in accordance with available guidelines. We administered the C-SATIS-Stroke to 101 people with stroke and 50 healthy older adults. We assessed the test-retest and internal reliability, measurement error, known-group validity, correlations with other outcome measures, optimal cut-off score and ceiling and floor effects. RESULTS: C-SATIS-Stroke demonstrated excellent internal consistency (Cronbach's α = 0.959) and good test-retest reliability (intraclass correlation coefficient3,1 = 0.913). Compared with healthy controls, people with chronic stroke had lower C-SATIS-Stroke scores. The mean C-SATIS-Stroke score was significantly correlated with the mean scores of the Activities-specific Balance Confidence Scale, Stroke Impact Scale, Community Integration Measure and Survey of Activities and Fear of Falling in the Elderly. The cut-off score to distinguish the levels of satisfaction with activity and participation between people with chronic stroke and healthy older adults was 80 out of 108 (sensitivity: 77%; specificity: 72%). C-SATIS-Stroke exhibited ceiling effects but not floor effects. CONCLUSIONS: C-SATIS-Stroke is a reliable and valid measure for assessing satisfaction with social participation among Chinese people with chronic stroke.IMPLICATIONS FOR REHABILITATIONSatisfactory semantic, idiomatic, cultural, and conceptual equivalence of the C-SATIS-Stroke are in line with those of the original English version of the SATIS-StrokeExcellent reliability and validity of the C-SATIS-Stroke are also in line with those of the original English version of the SATIS-StrokeThe C-SATIS-Stroke can be used to assess the subjective satisfaction feeling in terms of social participation among Chinese people with chronic stroke.

Assessing the level of perceived social support among community-dwelling stroke survivors using the Multidimensional Scale of Perceived Social Support.

Social support has an important role in stroke rehabilitation. The Multidimensional Scale of Perceived Social Support (MSPSS) is an instrument examining the adequacy of perceived social support. However, the psychometric properties of the Chinese version of MSPSS (MSPSS-C) have not been examined in Chinese people with stroke. This study aimed at investigating the psychometric properties of the MSPSS-C, identifying the correlations between MSPSS-C scores and health-related measures of these people; and examining the differences in the levels of perceived social support between people with and without stroke in Hong Kong using a cohort of 57 community-dwelling people with stroke and 50 age-matched healthy controls. We found that the MSPSS-C subscales demonstrated excellent internal consistency, and a ceiling effect was observed for the family subscale of the MSPSS-C. The total MSPSS-C score had significant weak to moderate correlations with the scores of the concerned variables of interests. Exploratory factor analysis revealed a two-factor structure for the MSPSS-C. People with stroke had lower levels of perceived social support from friends and their significant other than those without stroke. The MSPSS-C is a valid tool for assessing perceived social support among chronic stroke survivors with moderate to very severe motor impairment.

Establishing childhood disability clinics may help reduce the prevalence of disability among children in Africa: A viewpoint.

Globally, there are about a billion people comprising of about 95 million children who experience disability. The number of people in Africa living with disability is about 80 million people; out of which 10%-15% are children of school age. The causes of disability among these children include epilepsy, vision loss, or hearing loss, cerebral palsy, poliomyelitis, tetanus, cerebrospinal meningitis and malaria. However, these causes of disability are preventable and can be managed with proper care. The aim of this article is to propose the establishment of childhood disability clinics in Africa in order to help prevent or reduce the incidence/ prevalence of disability among children. Some of the mandates of the clinics will be to carry out routine assessment of children for disability, to provide education on disability and strategies for disability prevention to parents and caregivers, to promptly prevent and manage disability or its causes. However, establishing these clinics requires shared commitment of all the stakeholders.

Rehabilitation of Severe Impairment in Motor Function after Stroke: Suggestions for Harnessing the Potentials of Mirror Neurons and the Mentalizing Systems to Stimulate Recovery.

Rehabilitation of severe impairment in motor function following stroke is very challenging. This is because one of the driving forces for recovery of motor function is tasks practice, something this category of patients cannot voluntarily perform. However, it has now been shown that tasks practice can equally be carried out cognitively and through observation of another person's practice, using techniques known as mental practice and tasks observation, respectively. Mental practice and tasks observation are believed to activate networks of neurons in the brain known as mirror neurons and mentalizing systems to induce recovery. The effectiveness of these techniques has, however, limited evidence at the moment. One possible explanation for this could be the nature of the protocols of these techniques, especially as regards to the intensity of practice. This article proposes ways the potentials of the mirror neurons and mentalizing systems can be harnessed to optimize recovery of severe impairment in motor function using mental practice and tasks observation. The article suggests, among other ways, protocols where tasks observation or mirror therapy are carried out first, and are then followed by mental practice, increasing the number of times the tasks are observed or mentalized, observation of significant others performing the tasks and mental practice of very familiar tasks.