Reducing Driving Risk Factors in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD): Insights from EEG and Eye-Tracking Analysis.

Adolescents with attention deficit hyperactivity disorder (ADHD) face significant driving challenges due to deficits in attention and executive functioning, elevating their road risks. Previous interventions targeting driving safety among this cohort have typically addressed isolated aspects (e.g., cognitive or behavioral factors) or relied on uniform solutions. However, these approaches often overlook this population's diverse needs. This study introduces the "Drive-Fun" innovative intervention (DFI), aimed at enhancing driving skills among this vulnerable population. The intervention was tested in a pilot study including 30 adolescents aged 15-18, comparing three groups: DFI, an educational intervention, and a control group with no treatment. Assessments included a driving simulator, EEG, and Tobii Pro Glasses 2. Evaluation was conducted pre- and post-intervention and at a 3-month follow-up. Results indicated that the DFI group significantly improved in the simulated driving performance, attentional effort, and focused gaze time. The findings underscore that holistic strategies with personalized, comprehensive approaches for adolescents with ADHD are particularly effective in improving driving performance. These outcomes not only affirm the feasibility of the DFI but also highlight the critical role of sensor technologies in accurately measuring and enhancing simulator driving performance in adolescents with ADHD. Outcomes suggest a promising direction for future research and application.

Optimal Duration of In-Vehicle Data Recorder Monitoring to Assess Bus Driver Behavior.

This study examined the optimal sampling durations for in-vehicle data recorder (IVDR) data analysis, focusing on professional bus drivers. Vision-based technology (VBT) from Mobileye Inc. is an emerging technology for monitoring driver behavior and enhancing safety in advanced driver assistance systems (ADASs) and autonomous driving. VBT detects hazardous driving events by assessing distances to vehicles. This naturalistic study of 77 male bus drivers aimed to determine the optimal duration for monitoring professional bus driving patterns and the stabilization point in risky driving events over time using VBT and G-sensor-equipped buses. Of the initial cohort, 61 drivers' VBT data and 66 drivers' G-sensor data were suitable for analysis. Findings indicated that achieving a stable driving pattern required approximately 130 h of VBT data and 170 h of G-sensor data with an expected 10% error rate. Deviating downward from these durations led to higher error rates or unreliable data. The study found that VBT and G-sensor data are both valuable tools for driving assessment. Moreover, it underscored the effective application of VBT technology in driving behavior analysis as a way of assessing interventions and refining autonomous vehicle algorithms. These results provide practical recommendations for IVDR researchers, stressing the importance of adequate monitoring durations for reliable and accurate outcomes.

Upper Limb Kinematics of Handwriting among Children with and without Developmental Coordination Disorder.

Background: Children with developmental coordination disorder (DCD) often experience difficulties with handwriting legibility and speed. This study investigates the relationship between handwriting and upper limb kinematics to characterize movement patterns of children with DCD and typically developing (TD) children. Methods: 30 children with and without DCD matched for age, gender, and parent education were compared across handwriting abilities using a standardized handwriting assessment of both copied and dictated tasks (A-A Handwriting). The 3D motion capture system (Qualysis) was used to analyze upper limb kinematics and characterize movement patterns during handwriting and contrasted with written output. Results: Children with DCD wrote fewer legible letters in both copying and dictation. Children with DCD also showed poor automatization of key writing concepts. Atypical wrist postures were associated with reduced legibility for children with DCD (F (1,27) 4.71, p = 0.04, p-η2 = 0.15); whereas for TD children, better legibility was associated with greater variations in movement speed, particularly of the wrist (rho = −0.578, p < 0.05). Conclusion: Results reflect different movement parameters influencing handwriting in children with DCD. An improved understanding of the movement characteristics during handwriting of these children may assist intervention design.

Effects of aquatic physical intervention on fall risk, working memory and hazard-perception as pedestrians in older people: a pilot trial.

BACKGROUND: Normal aging is associated with balance, mobility and working memory decline that increase fall risk and influence activity of daily living functions. Mounting evidence suggests that physical activity is beneficial for decreasing aging effects. Previous studies have focused on land-based physical activity. Research concerning the aquatic environment is scarce. The primary objectives of this three arm intervention pilot study were to examine the effects of an aquatic physical intervention program on balance, gait, fall risk and working memory among community-dwelling older individuals. The secondary objective was to examine the effects of an aquatic physical intervention program on safety of street-crossing among community-dwelling older individuals. METHODS: Forty-two healthy participants aged 65 or older were enrolled into one of three intervention groups: aquatic physical intervention (API) (N = 13), on-land physical intervention (OLPI) (N = 14) or non-physical intervention (NPI) (N = 15). The intervention took place from 2018 until 2019 at Tel-Aviv University, Sheba medical center and Reich Center. The protocol included 30-min sessions twice a week for 12 weeks. Balance, gait and fall risk were assessed by the Tinneti test, working memory abilities were assessed by digit span and Corsi blocks tests and simulated safe streets-crossing was assessed by the hazard perception test for pedestrians. Testing and data collection was conducted at baseline, after six weeks and 12 weeks of intervention. All members of the professional team involved in evaluating participants were blind to the intervention group to which participants were allocated. RESULTS: The differences in Tinetti balance (F (2, 39)=10.03, p < 0.01), fall risk (F (2, 39)=5.62, p0 > .05), digit span forward (F (2, 39)=8.85, p < 0.01) and Corsi blocks forward (F (2, 39)=3.54, p < 0.05) and backward (F (2, 39)=6.50, p < 0.05) scores after 12 weeks between the groups were significant. The API group showed improved scores. The differences in hazard perception test for pedestrians scores after 12 weeks of intervention between the groups were marginally significant (F (2, 39)=3.13, p = 0.055). The API group showed improved scores. CONCLUSIONS: These findings may affect experts working with the elderly population when making decisions concerning therapeutic prevention interventions for the deficiencies of elderly patients. Older adults practicing aquatic physical activity could contribute to their increased safety. TRIAL REGISTRATION: Trial registration number: ClinicalTrials.gov Registry NCT03510377. Date of registration: 10/31/2017.

Return-to-Work Barriers Among Manual Workers After Hand Injuries: 1-Year Follow-up Cohort Study.

OBJECTIVE: To determine time of return to work (TRTW) in relation to multivariable predictors among male manual workers after hand injury (HI) over a 12-month follow-up. DESIGN: A cohort study with baseline medical information, functional evaluation, and 3-, 6-, 9-, and 12-month follow-up telephone interviews. SETTING: Seven physical rehabilitation community occupational therapy clinics. PARTICIPANTS: Participants (N=178) with acute HI aged 22-65. Two participants were lost to follow-up. INTERVENTION: Not applicable. MAIN OUTCOME MEASURE: The dependent variable was TRTW. The independent variables originated from 4 domains: personal factors, environmental factors, body function and structure, and activity limitation and participation restriction. The proportion of return to work (RTW) at each time point was calculated. Multiple Cox regressions established a predictive model for TRTW. RESULTS: At the end of the study, 75.3% participants returned to work. The median TRTW was 94 days. In the final model, only compensation factors and education contributed significantly to overall RTW, but when separate analyses were performed, decreased level of self-efficacy, higher workplace demands, level of pain, level of emotional response to trauma, reduced physical capability of the hand, and higher level of disability were significantly associated with delayed TRTW. CONCLUSIONS: TRTW was determined by the physical capability of the hand, pain, and psychosocial factors, but it was also affected by legal factors. Participants who did not return to work during the first 9 months are at risk for long-term disability. Developing treatment programs for those who are at risk for not returning to work, taking into consideration these factors, is recommended.

Camera-tracking gaming control device for evaluation of active wrist flexion and extension.

STUDY DESIGN: Cross sectional. INTRODUCTION: Measuring wrist range of motion (ROM) is an essential procedure in hand therapy clinics. PURPOSE OF THE STUDY: To test the reliability and validity of a dynamic ROM assessment, the Camera Wrist Tracker (CWT). METHODS: Wrist flexion and extension ROM of 15 patients with distal radius fractures and 15 matched controls were assessed with the CWT and with a universal goniometer. RESULTS: One-way model intraclass correlation coefficient analysis indicated high test-retest reliability for extension (ICC = 0.92) and moderate reliability for flexion (ICC = 0.49). Standard error for extension was 2.45° and for flexion was 4.07°. Repeated-measures analysis revealed a significant main effect for group; ROM was greater in the control group (F[1, 28] = 47.35; P < .001). The concurrent validity of the CWT was partially supported. CONCLUSION: The results indicate that the CWT may provide highly reliable scores for dynamic wrist extension ROM, and moderately reliable scores for flexion, in people recovering from a distal radius fracture. LEVEL OF EVIDENCE: N/A.

Efficacy of a telerehabilitation intervention programme using biofeedback among computer operators.

Computer operators spend long periods of time sitting in a static posture at computer workstations and therefore have an increased exposure to work-related musculoskeletal disorders (WRMSD). The present study is aimed at investigating the feasibility and effectiveness of a tele-biofeedback ergonomic intervention programme among computer operators suffering from WRMSD. Twelve subjects with WRMSD were assigned an ergonomic intervention accompanied by remote tele-biofeedback training, which was practised at their workstations. Evaluations of pain symptoms and locations, body posture and psychosocial characteristics were carried out before and after the intervention in the workplace. The hypothesis was partially verified as it showed improved body position at the workstation and decreased pain in some body parts. Tele-biofeedback, as part of an intervention, appears to be feasible and efficient for computer operators who suffer from WRMSD. This study encourages further research on tele-health within the scope of occupational therapy practice. Practitioner summary: Research concerning tele-health using biofeedback is scarce. The present study analyses the feasibility and partial effectiveness of a tele-biofeedback ergonomic intervention programme for computer operators suffering from WRMSD. The uniqueness and singularity of this study is the usage of remote communication between participants and practitioners through the Internet.

Validity of the modified RULA for computer workers and reliability of one observation compared to six.

Awkward body posture while typing is associated with musculoskeletal disorders (MSDs). Valid rapid assessment of computer workers' body posture is essential for the prevention of MSD among this large population. This study aimed to examine the validity of the modified rapid upper limb assessment (mRULA) which adjusted the rapid upper limb assessment (RULA) for computer workers. Moreover, this study examines whether one observation during a working day is sufficient or more observations are needed. A total of 29 right-handed computer workers were recruited. RULA and mRULA were conducted. The observations were then repeated six times at one-hour intervals. A significant moderate correlation (r = 0.6 and r = 0.7 for mouse and keyboard, respectively) was found between the assessments. No significant differences were found between one observation and six observations per working day. The mRULA was found to be valid for the assessment of computer workers, and one observation was sufficient to assess the work-related risk factor.

Simulator Driving Abilities, Executive Functions, and Adaptive Behavior Among Adolescents With Complex Attention Deficit Hyperactivity Disorder.

OBJECTIVE: To examines the driving skills, executive functions, and adaptive behavior of adolescents diagnosed with Attention-deficit/hyperactivity disorder (ADHD) combined with emotional difficulties and/or learning disabilities (complex ADHD), compared to adolescents without ADHD. METHOD: A cross-sectional study including 30 adolescents with complex ADHD and 33 adolescents without ADHD aged 15 to 18 years. Driving skills on a simulator, executive functions, and adaptive behavior were evaluated. RESULTS: Adolescents without ADHD demonstrated significantly higher total scores on the driving simulator, indicating better driving performance compared to adolescents with complex ADHD. In the complex ADHD group, after controlling for different Conners Comprehensive Behavior Rating Scale-Self Report scales, driving simulator scores were partially correlated with executive functions. CONCLUSION: These findings emphasize the unique needs of adolescents with complex ADHD. Given the significance of driving in today's society, it is crucial to consider the development of intervention programs to support this population's driving skills.

Effects of aquatic exercise program versus on-land exercise program on cancer-related fatigue, neuropathy, activity and participation, quality of life, and return to work for cancer patients: study protocol for a randomized controlled trial.

BACKGROUND: Exercise has shown positive effects on fatigue, exhaustion, neuropathy, and quality of life in cancer patients. While on-land exercises have been studied, the aquatic environment offers unique advantages. Water's density and viscosity provide resistance, enhancing muscle strength, while hydrostatic pressure improves venous return. This trial aims to investigate the effect of aquatic exercises on time to return to work, work hours, work-related difficulties, daily life activity and participation, quality of life, exhaustion, fatigue, and neuropathy among cancer patients, compared to on-land exercise intervention group and a non-exercise group. METHODS: This randomized controlled trial will include 150 cancer patients aged 18-65 years with stage III colon cancer or breast cancer patients with lymph node involvement. Participants in the aquatic exercise intervention group will undergo an 8-week, twice-weekly group-based Ai-Chi program, while the on-land exercise group will perform identical exercise. The control group will not engage in any exercise. The primary outcome will be assessed using an employment barriers questionnaire, capturing return to work date and working hours and daily life participation and activity and quality of life. Secondary outcomes include exhaustion, fatigue, and neuropathy. Data will be collected at baseline, post-intervention (8 weeks), and at 3,12, and 24 months. Mixed variance analyses will explore relationships among groups and over time for independent variables, with separate analyses for each dependent variable. DISCUSSION: The potential benefits include an earlier return to work for patients, reducing their need for social and economic support. The study's implications on socio-economic policies are noteworthy, as a successful intervention could offer a cost-effective and non-invasive solution, improving patients' quality of life and increasing their participation in daily activities. This, in turn, could lead to a faster return to work, contributing to both personal well-being and broader societal interests by reducing reliance on social services. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov NCT05427344 (22 June 2022).

Employment barriers questionnaire: Development and determination of its reliability and validity.

BACKGROUND: The high unemployment rate among people with disabilities (PWDs) can be attributed to barriers found in the work environment and demands of the job itself. Given the lack of comprehensive tools to identify these barriers, we developed the Employment Barriers Questionnaire (EBQ). OBJECTIVE: The objective of this study was to develop and examine the EBQ's reliability and validity for detecting employment barriers and possible modifications to overcome them. METHODS: Two stages were conducted: stage I was a cross-sectional design. Stage II included a cross-sectional and prospective design. Thirty-nine people with physical disabilities (mean age 47.21±10.78 years) were recruited, 51% of which were employed during data collection. During stage I, we developed a first version of the EBQ (EBQ.I) and evaluated its internal reliability. The EBQ.I was filled twice, one week apart to assess test-re-test reliability. Predictive validity was tested using a regression model to predict the employment status of stage II based on EBQ.I's results from stage I. In stage II, we generated a second version (EBQ.II) and tested its internal-reliability and known-groups validity, by comparing the EBQ.II's results between employed and unemployed subjects. RESULTS: The results showed that the EBQ.II has a high internal-reliability (α= 0.79-0.97) and a medium-large known-groups validity (-3.95≤Z≤-2.26, p < 0.05). Additionally, the EBQ.I has a high test re-test reliability (ICC = 0.85-0.94, p < 0.001) and predictive validity (ß= 0.861, p = 0.033). CONCLUSION: This study has illustrated that the EBQ.II is a unique, reliable and valid tool for identifying employment barriers and modifications to address them, expected to improve vocational rehabilitation efforts.

Complementary contribution of parents and therapists in the assessment process of children.

BACKGROUND/AIM: Traditional developmental models assume that the underlying capacities of children contribute to their participation. In this framework, preschoolers who are referred for occupational therapy services usually undergo an assessment intended to identify capacities in certain domains. Contrary to this, newer ecological models assume that child participation is a consequence of a multidimensional interaction between personal and environmental factors. As a result clinicians are increasingly focusing their assessment on performance and participation. This study aimed to assess the correlation between children's performance skills, their capacities and participation; and to explore whether parents' observations, alongside therapist observations and standardised assessments, contribute to an enhanced understanding of child participation. METHOD: Participants included 188 parents and their children, aged 4-6 years, with and without mild developmental difficulties. Data were collected using standardised assessments for child capacities, and questionnaires completed by parents and occupational therapists regarding child participation and performance skills. RESULTS: Significant correlations were found between parent assessments of child performance skills and child participation, but not with child capacities. The opposite was found to be true for occupational therapist assessments of child performance skills which were found to correlate with child capacities, but not with participation. Additionally, an interaction effect was found for both groups. Occupational therapists reported higher performance skills as compared to parents, but the difference was only significant for children without mild difficulties. CONCLUSION: As suggested by ecological models of child participation, the findings highlight the importance of parent-therapist collaboration in the assessment process of children.

Reliability and validity of the Hebrew version of the International Spinal Cord Injury Activities and Participation Basic Data Set.

BACKGROUND: The International Spinal Cord Injury (SCI) Activities and Participation Basic Data Set (APBDS) was created to facilitate comparisons of levels of function and disability in SCI individuals worldwide. AIM: Evaluating the reliability and validity of the APBDS's Hebrew translation was our goal. DESIGN: Observational, cross-sectional study. SETTING: University and Outpatient Rehabilitation Department of a Medical Center. POPULATION: Individuals with spinal cord injury (SCI). METHODS: The APBDS's Hebrew version was administered to fifty individuals with SCI. Reliability was evaluated through Cronbach Alpha Test and a test-retest method. Validity was determined by testing for convergence with the World Health Organization Disability Assessment Scale (WHODAS) 2.0 and the Medical Outcomes Short Form Health Survey (SF-12). RESULTS: The Hebrew APBDS had a high test-retest reliability (ICC=0.792) and an adequate Cronbach alpha test (α=0.792). Significant convergent validity was partial with both the WHODAS 2.0 (strong in the self-care objective (r=-0.648) and subjective (r=-0.666), moderate in the total objective (r=-0.640) and subjective (r=-0.570) domains of the APBDS) and the SF-12 (moderate between the total objective domain and the Physical composite score (r=0.378), poor with the Mental composite score (r=0.310)). CONCLUSIONS: Although the Hebrew APBDS's moderate reliability and validity warrants further research, it opens new vistas regarding assessment of SCI individuals' satisfaction, activity, and participation. CLINICAL REHABILITATION IMPACT: We feel that this data set may be used in the long-term follow-up of SCI individuals in the Sheba SCI rehabilitation registry.

Reducing musculoskeletal disorders among computer operators: comparison between ergonomics interventions at the workplace.

Typing is associated with musculoskeletal disorders (MSDs) caused by multiple risk factors. This control study aimed to evaluate the efficacy of a workplace intervention for reducing MSDs among computer workers. Sixty-six subjects with and without MSD were assigned consecutively to one of three groups: ergonomics intervention (work site and body posture adjustments, muscle activity training and exercises) accompanied with biofeedback training, the same ergonomics intervention without biofeedback and a control group. Evaluation of MSDs, body posture, psychosocial status, upper extremity (UE) kinematics and muscle surface electromyography were carried out before and after the intervention in the workplace and the motion lab. Our main hypothesis that significant differences in the reduction of MSDs will exist between subjects in the study groups and controls was confirmed (χ(2) = 13.3; p = 0.001). Significant changes were found in UE kinematics and posture as well. Both ergonomics interventions effectively reduced MSD and improved body posture. PRACTITIONER SUMMARY: This study aimed to test the efficacy of an individual workplace intervention programme among computer workers by evaluating musculoskeletal disorders (MSDs), body posture, upper extremity kinematics, muscle activity and psychosocial factors were tested. The proposed ergonomics interventions effectively reduced MSDs and improved body posture.

Convergent validity of vision based technology (VBT) among professional bus drivers.

INTRODUCTION: Due to the relative rarity of crashes, researchers use traffic offenses, police records, public complaints, and In-Vehicle Data Recorder (IVDR) data as proxies for assessing crash risk. In this study, a unique IVDR system, called Vision-Based Technology [(VBT), (Mobileye Inc.)] was used to monitor perilous naturalistic driving events, such as insufficient distance from other vehicles and pedestrian or bicycle rider near-misses. The study aimed to test the convergent validity of VBT as an indicator of crash involvement risk. METHODS: Data from 61 professional drivers working for a large bus company were analyzed (16 of 77 in the original data cohort were excluded for insufficient VBT data). Data included: recorded VBT data, objective data collected from official records (crash records provided by the bus company, and public complaints of reckless driving), self-report data regarding crash involvement, and police tickets. The correlation between VBT, objective and self-reported data was analyzed. Binary-logistic regression modeling (BLM) was used to calculate the odds ratio (OR) for participants involved in a car crash. RESULTS: Correlations were found between the total VBT risk score and official crash records, public complaints, and self-reports of crash involvement. The BLM correctly classified 90% of those who were involved in a crash (sensitivity) and 60% of those who were "crash-free" (specificity). The VBT total risk score was the only significant contributing factor to crash risk, and for each point of increase, the odds of being involved in a crash increased by a factor of 1.55. CONCLUSIONS: It is the first study to provide empirical evidence validating the VBT as an indicator of crash involvement and driver safety among professional bus drivers. PRACTICAL APPLICATIONS: VBT technology can provide researchers and clinicians a better understanding of bus drivers' risky driving behaviors- a valuable contribution to road safety interventions for this target group.

Correlations between body postures and musculoskeletal pain in guitar players.

BACKGROUND: The guitar-playing community is the largest group at risk of developing playing related musculoskeletal disorders. A thorough investigation of the relationships between the various risk factors and players' report on musculoskeletal pain using objective and accurate means of assessment has yet to be reported. PURPOSE: (a) to explore the correlations between demographic characteristics, anthropometric measurements, playing habits, and personal habits of guitar player and their complaints of musculoskeletal pain, (b) explore the correlations between the upper body kinematics of guitar players during playing the guitar and their complaints of musculoskeletal pain, and (c) compare the upper body kinematics of guitar players during playing the guitar while sitting versus standing. METHODS: Twenty-five guitar players (27.5±4.6 years old) filled out questionnaires regarding their guitar-playing habits, and the Standardized Nordic Questionnaires for the analysis of musculoskeletal symptoms. Kinematics of their torso and upper limbs were tracked while they played a tune twice, once while sitting and once while standing. RESULTS: We found moderate correlations between the number of painful joints in the last year and factors, such as physical comfort while playing, years of playing, and position during playing. During standing, lower back pain severity correlated with the rotation range of the torso, while during sitting, it moderately correlated with the average radial-ulnar deviation of the right wrist. During sitting, we found higher anterior and right tilt of the torso, combined with greater abduction of the right shoulder, higher flexion in the left shoulder and higher radial deviation in the left wrist. CONCLUSION: Our results point to several risk factors, related both to playing habits but also to playing posture, which should be considered by the guitar players in order to prevent playing-related musculoskeletal disorders.

Transition to Labor Market among Young Adults with Serious Mental Illness.

Background: The research on job attainment and retention among young adults with serious mental illness (SMI) is limited. The objective of this study was to investigate the contributions of emotional, cognitive, motor, demographic, and work-related factors to the transition into supported employment (SE) and retention. Methods: This cross-sectional study included young adults with SMI involved in prevocational (N = 21) services or those who have transferred to SE (N = 21) following prevocational services. Work-related self-efficacy, executive functions, and motor skills were approached with standard and well-established tools. Results: There was a significant difference between groups in most dimensions of work-related self-efficacy, job history and experience, cognitive strategies, and general independence in daily life. The multivariate analysis demonstrates that holding a profession, experiencing self-efficacy in general work skills, cognitive strategies, and independence in living situations explained the between-group differences (χ2(4) = 34.62, p < 0.001; correct classification−90.2%). Conclusions: The study identifies the factors contributing to a sustainable transition to employment among young adults with SMI, suggesting the importance of a comprehensive approach to address a range of personal factors in an integrative way. The augmentation of prevocational training with continued employment support may be beneficial to meet the unique needs of young adults with SMI.

The Effects of an In-vehicle Collision Warning System on Older Drivers' On-road Head Movements at Intersections.

With age might come a decline in crucial driving skills. The effect of a collision warning system (CWS) on older drivers' head movements behavior at intersections was examined. Methods: Twenty-six old-adults, between 55 and 64 years of age, and 16 Older drivers between 65 and 83 years of age, participated in the study. A CWS (Mobileye Inc.) and a front-back in-vehicle camera (IVC) were installed in each of the participants' own vehicles for 6 months. The CWS was utilized to identify unsafe events during naturalistic driving situations, and the IVC was used to capture head direction at intersections. The experimental design was conducted in three phases (baseline, intervention, and carryover), 2 months each. Unsafe events were recorded by the CWS during all phases of the study. In the second phase, the CWS feedback was activated to examine its effect on drivers' head movement' behavior at intersections. Results: Older drivers (65+) drove significantly more hours in total during the intervention phase (M = 79.1 h, SE = 10) than the baseline phase (M = 39.1 h, SE = 5.3) and the carryover phase (M = 37.7 h, SE = 5.4). The study revealed no significant differences between the head movements of older and old-adult drivers at intersections. For intersection on the left direction, a significant improvement in drivers' head movements' behavior was found at T-junctions, turns and four-way intersections from phase 1 to phase 3 (p < 0.01), however, two intersection types presented a decrease along the study phases. The head movements' behavior at roundabouts and merges was better at phase 1 compared to phase 3 (p < 0.01). There was no significant reduction of the mean number of CWS unsafe events across the study phases. Conclusions: The immediate feedback provided by the CWS was effective in terms of participants' head movements at certain intersections but was harmful in others. However, older drivers drove many more hours during the active feedback phase, implying that they trusted the system. Therefore, in the light of this complex picture, using the technological feedback with older drivers should be followed with an additional mediation or follow-up to ensure safety.

Effects of Ai-Chi Practice on Balance and Left Cerebellar Activation during High Working Memory Load Task in Older People: A Controlled Pilot Trial.

BACKGROUND: Normal aging is associated with balance and working memory decline. From a neurobiological standpoint, changes in cerebellar functional plasticity may mediate the decline in balance and working memory for older adults. Mounting evidence suggests that physical activity is beneficial for decreasing aging effects. Previous studies have focused on land-based physical activity and research concerning the aquatic environment is scarce. This study investigated the effectiveness of Ai-Chi on balance abilities and cerebral activation during a high working memory load task among community-dwelling older people. METHODS: A total of 19 people aged 65-86 years were allocated to receive Ai-Chi practice (n = 6), structured on-land Ai-Chi practice (n = 7) or guided-imagery of Ai-Chi practice (n = 6) for a bi-weekly, 30-min exercise session for 12 weeks. Balance was measured by the Tinetti balance sub-test and working memory was measured by the N-back test during functional-MRI scan. RESULTS: The Ai-Chi practice group presented a significant change in balance between pre and post intervention (balance t = -4.8, p < 0.01). In the whole-brain analysis, during high working memory load task, the Ai-Chi practice group presented a decrease in left cerebellar activation. Region of interest analyses yielded similar results by which pre-cerebellar activation was higher than post-intervention (t = 2.77, p < 0.05). CONCLUSIONS: Ai-Chi is an available, non-invasive intervention method that may serve as a tool to improve cerebellar activation that in turn might improve balance. In addition, our findings may provide new insights into the neuronal mechanisms that underlie both motor and cognitive abilities.

Performance of Everyday Occupations and Perceived Health of Spouses of Men With Spinal Cord Injury at Discharge and 6 Months Later.

STUDY DESIGN: An exploratory longitudinal study. OBJECTIVES: (a) Compare the occupational performance, and life satisfaction of spouses of men with SCI with those of spouses of healthy men, (b) compare the occupational performance, perceived health, and life satisfaction of spouses of men with SCI at discharge from inpatient rehabilitation and 6 months postdischarge; and (c) assess whether the functioning levels of men with SCI and the perceived mental health of the spouse, correlate with her occupational performance. SUMMARY OF BACKGROUND DATA: Spouses of men with spinal cord injury (SCI) report having symptoms of depression and anxiety. However, their ability to choose everyday occupations and perform them satisfactorily (occupational performance) was less studied. METHODS: Fifteen women spouses of men with SCI and 15 women spouses of healthy men participated. Study measures included four self-report questionnaires and the Occupational Performance History Interview that was analyzed quantitatively and measured occupational performance by three components: occupational identity, competence, and settings. RESULTS: Occupational performance and life satisfaction of caregivers were lower than those of spouses of healthy men and did not significantly change over 6 months. However, they had higher scores on physical, mental, and general health 6 months postdischarge than at discharge. Mental health of the spouse correlated with her occupational identity. CONCLUSION: It is recommended that rehabilitation intervention focus not only on patients with SCI, but also on their healthy spouses to promote their occupational performance, health, and well-being. LEVEL OF EVIDENCE: 3.