What are the perspectives of speech pathologists, occupational therapists and physiotherapists on using telehealth videoconferencing for service delivery to children with developmental delays? A systematic review of the literature.

OBJECTIVE: To identify the attitudes and perspectives of speech pathologists, occupational therapists and physiotherapists on using telehealth videoconferencing for service delivery to children with developmental delays. DESIGN: Systematic Literature Review. METHOD: An electronic search of databases Scopus, CINAHL, MEDLINE, PEDro, Speechbite, OTseeker and ScienceDirect was undertaken in October 2020. Articles were compared with eligibility criteria by 2 authors. All articles were appraised for quality and level of evidence. FINDINGS: Fourteen studies were deemed to be eligible. Results were synthesised using a narrative analysis. The themes identified were technology, self-efficacy, replacement of face-to-face services, time management, relationships, access and family-centred care. Each of these themes was seen as both a potential barrier and a facilitator when trying to provide services via telehealth. CONCLUSIONS: The results in this review cannot be generalised due to small sampling size, low response rates, lack of maximum variation sampling and under-representation of occupational therapists and physiotherapists. Study design was either mixed-methods survey or interview or only survey or interview. Risk of bias in studies was high. Further research is required including comparison studies and cost-benefit analysis.

A Meta-Synthesis of Qualitative Findings About Dance/Movement Therapy for Individuals With Trauma.

The therapeutic potential of using dance/movement therapy is being increasingly recognized. Preliminary interdisciplinary research findings suggest engaging the body in trauma treatment might reduce the length of treatment by addressing the connections among thoughts, feelings, neurobiology, and somatic responses in the survivor. Unfortunately, empirical research investigating its effectiveness as a psychotherapeutic intervention has been limited due to the lack of a clear manual for mental health care practitioners. The present study aims to synthesize findings from the existing qualitative literature in a qualitative meta-synthesis. Our findings will contribute to the development of a body-oriented intervention for mental health care practitioners to use for trauma.

An exploratory factor analysis of the Burden Assessment Scale with a sample of African-American families.

It remains unclear if the factor structures of commonly used caregiver burden scales normed on white samples are similar with samples from different ethnic communities. Our study tests the factor structure of the Burden Assessment Scale (BAS) using Exploratory Factor Analysis (EFA) with data from low-income, African American families caring for a family member with schizophrenia. The EFA solution included a 2 factor structure of subjective burden and objective burden with strong loadings demonstrating a clear differentiation between the factors. Our results suggest that low income, African American families appear to experience caregiving burden as one major or broad component in their lives similar to other areas that demand ongoing coping and adaptation. Likewise, the factor structure found with this sample as compared to the factor structure found with white samples suggests differences in the perception of and/or the reporting of burden. Study limitations as well as implications for practice are provided.

Effect of manual physiotherapy in homogeneous individuals with subacromial shoulder impingement: A randomized controlled trial.

OBJECTIVE: To compare the effect of specific interventions aimed at (1) the upper thoracic spine (passive mobilization) and (2) the posterior shoulder (massage, passive mobilization, and stretching) to (3) an active control intervention in a homogeneous group with extrinsic subacromial shoulder impingement (SSI). STUDY DESIGN: Single-centre, prospective, double-blinded, randomized controlled trial. METHOD: Eligible individuals with clearly defined extrinsic SSI were randomized to each group. Treatment duration was 12 consecutive weeks consisting of nine treatments over 6 weeks, followed by 6 weeks when one home exercise was performed daily. Outcomes included (1) active thoracic flexion/extension range of motion, (2) passive glenohumeral internal rotation and posterior shoulder range, (3) pain rating, and (4) shoulder pain and function disability index. Data were analysed at baseline, 6 and 12 weeks. Shoulder pain and function disability index scores were investigated via email 6 months after commencement of treatment. RESULTS: Twenty participants completed treatment in each group. No differences were identified between groups at baseline. Upper thoracic and posterior shoulder interventions, with a targeted home exercise, both significantly decreased pain and increased function scores and increased posterior shoulder range compared with active control at 12 weeks, and 6 months following cessation of the trial. CONCLUSION: Manual therapy treatment that addresses these extrinsic factors, of thoracic spine or posterior shoulder tightness, decreases the signs and symptoms of SSI. The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR; 12615001303538).

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement.

BACKGROUND: Current conservative management of subacromial shoulder impingement (SSI) includes generic strengthening exercises, especially for internal (IR) and external (ER) shoulder rotators. However, there is no evidence that the strength or the ratio of strength between these muscle groups is different between those with SSI (cases) and an asymptomatic population (controls). OBJECTIVE: To identify if isokinetic rotator cuff strength or the ratio of strength is significantly different between cases and controls. STUDY DESIGN: Case Control Study. METHOD: Fifty one cases with SSI and 51 asymptomatic controls matched for age, gender, hand dominance and physical activity level completed isokinetic peak torque glenohumeral IR and ER testing. Within the SSI group, 31 dominant limbs were symptomatic and 20 non-dominant limbs were symptomatic. IR and ER were measured separately using continuous reciprocal concentric (con) and eccentric (ecc) contraction cycles at a speed of 60 degrees per second and again at 120 degrees per second. Values of peak torque (PT), relative peak torque (RPT) and ratios were compared using independent t-tests between the SSI and asymptomatic groups. RESULTS: Significant strength differences between the two groups were present only when the symptomatic SSI shoulder was the dominant shoulder (con ER PT at 60°/second, ecc ER PT at 120°/second, ecc ER RPT at 120°/second and ecc IR PT at 60°/second and 120°/second). CONCLUSIONS: Changes in rotator cuff strength in SSI may be related to limb dominance, which may have implications for strengthening regimes. LEVEL OF EVIDENCE: Level 3a.

Clinical assessment of subacromial shoulder impingement - Which factors differ from the asymptomatic population?

BACKGROUND: To date, the significance of factors purported to be associated with subacromial shoulder impingement (SSI) and what differences, if any, are present in those with SSI compared to a matched asymptomatic population has not been identified. Gaining information about differences between people with SSI and asymptomatic people may direct clinicians towards treatments that impact upon these differences. OBJECTIVE: Compare the assessment findings of factors suggested to be associated with SSI; passive posterior shoulder range, passive internal rotation range, resting cervical and thoracic postures, active thoracic range in standing and scapula positioning between cases experiencing SSI and a matched asymptomatic group (controls). STUDY DESIGN: Case Control Study. METHOD: Fifty one SSI cases and 51 asymptomatic controls were matched for age, gender, hand dominance and physical activity level. The suggested associated factors were measured bilaterally. Independent t-tests were used to compare each of these measurements between the groups. Any variables for which a significant difference was identified, were then included in a conditional logistic regression analysis to identify independent predictors of SSI. RESULTS: The SSI group had significantly increased resting thoracic flexion and forward head posture, as well as significantly reduced upper thoracic active motion, passive internal rotation range and posterior shoulder range than the matched asymptomatic group. No independent predictors of SSI were identified in conditional logistic regression analysis. CONCLUSION: Thoracic posture, passive internal rotation range and posterior shoulder range were significantly different between cases experiencing SSI and a matched asymptomatic group. LEVEL OF EVIDENCE: Level 3a.

Stressful Life Events and Predictors of Post-traumatic Growth among High-Risk Early Emerging Adults.

Stressful life events (SLEs) may elicit positive psychosocial change among youth, referred to as Post-traumatic Growth (PTG). We assessed types of SLEs experienced, degree to which participants reported PTG, and variables predicting PTG across 24 months among a sample of high risk, ethnically diverse early emerging adults. Participants were recruited from alternative high schools (n = 564; mean age=16.8; 65% Hispanic). Multi-level regression models were constructed to examine the impact of environmental (SLE quantity, severity) and personal factors (hedonic ability, perceived stress, developmental stage, future time orientation) on a composite score of PTG. The majority of participants reported positive changes resulted from their most life-altering SLE of the past two years. Predictors of PTG included fewer SLEs, less general stress, having a future time perspective, and greater identification with the developmental stage of Emerging Adulthood. Findings suggest intervention targets to foster positive adaptation among early emerging adults who experience frequent SLEs.

Post-traumatic growth, stressful life events, and relationships with substance use behaviors among alternative high school students: a prospective study.

A highly stressful life event (SLE) can elicit positive psychosocial growth, referred to as post-traumatic growth (PTG) among youth. We examined PTG and the number of SLEs for their influence on substance use behaviours among a sample of older, diverse alternative high school students participating in a drug prevention programme (n=564; mean age=16.8; 49% female; 65% Hispanic). Surveys assessed PTG, SLEs and substance use behaviours at the two-year follow-up. Multilevel regression models were run to examine the effect of PTG and the number of SLEs on frequency of substance use at the two-year follow-up, controlling for baseline substance use, sociodemographic variables, peer substance use, attrition propensity and treatment group. Greater PTG scores were associated with lower frequencies of alcohol use, getting drunk on alcohol, binge drinking, marijuana use and less substance abuse at the two-year follow-up, but not associated with cigarette or hard drug use. Also, PTG did not moderate the relationship between cumulative number of SLEs and substance use behaviours, rather PTG appears to be protective against negative effects of a single, life-altering SLE. Fostering PTG from a particularly poignant SLE may be useful for prevention programmes targeting alcohol, marijuana and substance abuse behaviours among high-risk youth.

HIV serostatus and factors related to physical and mental well-being in Latina family AIDS caregivers.

In a survey of 154 Latina AIDS caregivers living in Los Angeles, we examined differences in the stress process for those who were HIV seropositive, seronegative, and those with an unknown serostatus. Most caregivers were monolingual, poor, suffered from chronic physical illness unrelated to HIV, and received few services. All three subsamples reached clinical cut-off levels for depression on the brief symptom inventory. In the sample as a whole and in all three groups we examined differences in primary and secondary stressors as predictors of mental and physical well-being; differences in background factors as they relate to mental and physical well-being; and differences in predictive value of various factors that may attenuate the relationship between stress and mental and physical well-being. Models predicting both mental and physical well-being differ across subsamples divided on the basis of serostatus. Based on these findings, we discuss implications for service provision designed to target these underserved Latina AIDS caregivers.

Stress and depression among HIV-positive and HIV-negative gay and bisexual AIDS caregivers.

From a survey of 416 gay and bisexual male AIDS caregivers, we examined differences in the stress process and predictors of depressive symptomatology by caregivers' HIV serostatus (n=164 HIV-positive and n=252 HIV-negative). Results indicate that HIV-positive caregivers reported higher levels of depressive symptomatology than those who were HIV-negative. Parallel regression analyses revealed that a younger age, role-related stress, and low self-esteem were common predictors of depressive symptomatology for both groups. Group-specific predictors of depression for the HIV-positive caregivers were poorer health and financial concerns. In contrast, the group-specific predictor for the HIV-negative caregivers was higher stress associated with direct acts of caregiving. These results suggest that in order to stem depressive symptomatology, gay and bisexual male caregivers need support directed at reducing stress stemming from their role as caregivers as well as services designed to address low self-esteem. In addition, serostatus should be taken into account when designing service plans because seropositive and seronegative caregivers may require different supportive services.