Public Mixed Funding for Residential Aged Care Facilities Residents' Needs in the Asia-Pacific Region: A Scoping Review.

Due to population aging and sociodemographic change, there is an increasing reliance on residential aged care facilities in the Asia-Pacific region. Most countries have adopted taxation as the primary means to levy capital for funding universal health services and means-testing of benefits may be further incorporated as a policy balance between horizontal equity and fiscal sustainability. It was hypothesized that residential care needs are evaluated by assessments relating to funding; this scoping review seeks to synthesize how such assessments relate to the care needs of residents. Searches were conducted in concordance with a priori protocol for English-language literature published since 2008 in Embase, CINAHL, PubMed, Scopus, JBI, TROVE, and four peak international organizations for studies and reports that describe the assessment of residents' needs in Asia-Pacific countries that used a mixture of taxation and means-testing to publicly fund residential aged care. One paper and 47 reports were included. Australia, New Zealand, and Singapore utilize a taxation and means-tested user charge approach to fund residential aged care needs. The common care needs assessed include health conditions, daily activities, cognition, psychiatric, and behavioral needs. While essential care needs are publicly funded, other holistic care needs, such as spirituality and autonomy-based needs, still need to be covered for meaningful occupation by the residents.

Development and feasibility of first- and third-person motor imagery for people with stroke living in the community.

BACKGROUND: Impairment of arm movement occurs in up to 85% of people post-stroke, affecting daily living activities, and quality of life. Mental imagery effectively enhances hand and daily function in people with stroke. Imagery can be performed when people imagine themselves completing the movement or imagine another person doing it. However, there is no report on the specific use of first-person and third-person imagery in stroke rehabilitation. AIMS: To develop and assess the feasibility of the First-Person Mental Imagery (FPMI) and the Third-Person Mental Imagery (TPMI) programs to address the hand function of people with stroke living in the community. METHODS: This study comprises phase 1-development of the FPMI and TPMI programs, and phase 2-pilot-testing of the intervention programs. The two programs were developed from existing literature and reviewed by an expert panel. Six participants with stroke, living in the community, participated in the pilot-testing of the FPMI and TPMI programs for 2 weeks. Feedback collected included the suitability of the eligibility criteria, therapist's and participant's adherence to intervention and instructions, appropriateness of the outcome measures, and completion of the intervention sessions within the specified time. RESULTS: The FPMI and TPMI programs were developed based on previously established programs and included 12 hand tasks. The participants completed four 45-min sessions in 2 weeks. The treating therapist adhered to the program protocol and completed all the steps within the specified time frame. All hand tasks were suitable for adults with stroke. Participants followed the instructions given and engaged in imagery. The outcome measures selected were appropriate for the participants. Both programs showed a positive trend towards improvement in participants' upper extremity and hand function and self-perceived performance in activities of daily living. CONCLUSIONS: The study provides preliminary evidence that these programs and outcome measures are feasible for implementation with adults with stroke living in the community. This study outlines a realistic plan for future trials in relation to participant recruitment, training of therapists on the intervention delivery, and the use of outcome measures. TRIAL REGISTRATION: Title: Effectiveness of first-person and third-person motor imagery in relearning daily hand tasks for people with chronic stroke: a randomised controlled trial. REGISTRATION NO: SLCTR/2017/031. Date registered: 22nd September 2017.

The efficacy of imagery in the rehabilitation of people with Parkinson's disease: protocol for a systematic review and meta-analysis.

BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disorder of the nervous system that affects movement. Individuals with PD commonly experience difficulty initiating movements, slowness of movements, decreased balance, and decreased standing ability. It has been shown that these motor symptoms adversely affect the independence of individuals with PD. Imagery is the cognitive process whereby a motor action is internally reproduced and repeated without overt physical movement. Recent studies support the use of imagery in improving rehabilitation outcomes in the PD population. However, these data have inconsistencies and have not yet been synthesised. The study will review the evidence on the use of imagery in individuals with PD and to determine its efficacy in improving rehabilitation outcomes. METHODS: Randomised controlled clinical trials comparing the effects of imagery and control on activities, body structure and function, and participation outcomes for people with PD will be included. A detailed computer-aided search of the literature will be performed from inception to June 2021 in the following databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, and Scopus. Two independent reviewers will screen articles for relevance and methodological validity. The Physiotherapy Evidence Database (PEDro) scale will be utilised to evaluate the risk of bias of selected studies. Data from included studies will be extracted by two independent reviewers through a customised, pre-set data extraction sheet. Studies using imagery with comparable outcome measures will be pooled for meta-analysis using the random effect model with 95% CI. If individual studies are heterogeneous, a descriptive review will analyse variance in interventions and outcomes. A narrative data analysis will be considered where there is insufficient data to perform a meta-analysis. DISCUSSION: Several studies investigating imagery in the PD population have drawn dissimilar conclusions regarding its effectiveness in rehabilitation outcomes and clinical applicability. Therefore, this systematic review will gather and critically appraise all relevant data, to generate a conclusion and recommendations to guide both clinical practice and future research on using imagery in the rehabilitation of people with PD. FUNDING: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42021230556.

Adapted Taekwondo Training for Prepubertal Children with Developmental Coordination Disorder: A Randomized, Controlled Trial.

This study evaluated the effectiveness of adapted Taekwondo (TKD) training on skeletal development and motor performance in children with developmental coordination disorder (DCD). One hundred forty-five prepubertal children with DCD were allocated to either the TKD or control groups. Children in the TKD group participated in a weekly 1-hour adapted TKD intervention and daily TKD home exercises for 12 weeks. The primary outcome (delay in skeletal development) and secondary outcomes (Movement Assessment Battery for Children (MABC) total impairment score, eye-hand coordination (EHC) scores, and a standing balance score) were measured at baseline, after the intervention and 3 months after the intervention. Skeletal development improved in both groups over time (p < 0.017). The TKD group had a significant delay in skeletal development at baseline compared to the control group (p = 0.003) but caught up with the controls at 3 months (p = 0.041). Improvements in the MABC scores were also seen in both groups across time (p < 0.017). Only the TKD group had a significant improvement in the EHC movement time at 3 (p = 0.009) and 6 months (p = 0.016). The adapted TKD intervention may be effective in improving the skeletal development and EHC movement time of children with DCD. For motor performance, the effect of maturation might be more profound.

Influence of pelvic padding and Kinesiology Taping on pain perception, kinematics, and kinetics of falls in female volleyball athletes.

BACKGROUND: Volleyball digging techniques may cause pelvic injuries among female volleyball athletes. Pelvic padding and Kinesiology Taping (KT) may reduce impact force and pain and improve posture during a fall. This study examined the effects of pelvic padding and KT on pain perception, fall kinematics, and kinetics among female volleyball athletes. METHODS: Twenty-four female volleyball athletes were exposed to two pelvic padding scenarios (with and without padding) and two KT conditions (with and without KT applied on the rectus abdominis muscle) during a fall in the forward direction. The maximum impact force during landing and maximum acceleration of the pelvis were registered using a force platform and an accelerometer, respectively. The maximum lumbar (hyper) extension angle, forward reach distance, and total fall time were measured by video analysis. Pain level was quantified using a visual analog scale. RESULTS: The application of pelvic padding (with and without KT) reduced pain when compared to the no padding condition (p < 0.008). Applying KT alone reduced forward reach distance when compared to the 'pelvic padding and KT' condition (p < 0.010). In fact, when both pelvic padding and KT were applied, participants reached further when compared to the 'no pelvic padding and no KT' condition (p < 0.001). No significant main and interaction effects were found in all other outcomes. CONCLUSIONS: Volleyball shorts with pelvic pads are recommended for female volleyball athletes to reduce pain in the digging maneuver and may help to increase their forward reach distance. However, KT is not recommended as it reduces the forward reach distance and cannot reduce pain or improve fall kinematics and kinetics.

Acute Effects of Tai Chi Training on Cognitive and Cardiovascular Responses in Late Middle-Aged Adults: A Pilot Study.

This study explored the immediate effects of Tai Chi (TC) training on attention and meditation, perceived stress level, heart rate, oxygen saturation level in blood, and palmar skin temperature in late middle-aged adults. Twenty TC practitioners and 20 nonpractitioners volunteered to join the study. After baseline measurements were taken, the TC group performed TC for 10 minutes while their cognitive states and cardiovascular responses were concurrently monitored. The control group rested for the same duration in a standing position. Both groups were then reassessed. The participants' attention and meditation levels were measured using electroencephalography; stress levels were measured using Perceived Stress Scale; heart rate and blood oxygenation were measured using an oximeter; and palmar skin temperature was measured using an infrared thermometer. Attention level tended to increase during TC and dropped immediately thereafter (p < 0.001). Perceived stress level decreased from baseline to posttest in exclusively the TC group (p = 0.005). Heart rate increased during TC (p < 0.001) and decreased thereafter (p = 0.001). No significant group, time, or group-by-time interaction effects were found in the meditation level, palmar skin temperature, and blood oxygenation outcomes. While a 10-minute TC training could temporarily improve attention and decrease perceived stress levels, it could not improve meditation, palmar skin temperature, or blood oxygenation among late middle-aged adults.

Musculoskeletal strength, balance performance, and self-efficacy in elderly ving tsun chinese martial art practitioners: implications for fall prevention.

Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = -0.575, P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly.

Meta-analysis on the effect of mental imagery on motor recovery of the hemiplegic upper extremity function.

BACKGROUND/AIM: Studies have shown that mental imagery can enhance relearning and generalisation of function after stroke. The aim of this meta-analysis was to evaluate evidence on the effects of mental imagery on motor recovery of the hemiplegic upper extremities after stroke. METHODS: A comprehensive data base search of the literature up to December 2012 was performed using PubMed, EBSCO host (Academic Search Premier, CINAHL and Educational Resource Information Center), PsycINFO, Medline, and ISI Web of Knowledge (Science Citation Index and Social Sciences Citation Index). Randomised clinical trials or controlled clinical trials that included mental imagery for improving upper extremity motor function for stroke patients were located. Relevant articles were critically reviewed and methodological quality was evaluated using the PEDro Scale, and study results synthesised. RESULTS: Five randomised clinical trials and one controlled clinical trial met the inclusion criteria. Five of the six studies yielded positive findings in favour of mental imagery. Quantitative analysis showed a significant difference in the Action Research Arm Test (overall effect: Z=6.75; P<<0.001). CONCLUSION: Review of the literature revealed a trend in support of the use of motor imagery for upper extremity motor rehabilitation after stroke. Mental imagery could be a viable intervention for stroke patients given its benefits of being safe, cost-effective and rendering multiple and unlimited practice opportunities. It is recommended that researchers incorporate imaging techniques into clinical studies so that the mechanism whereby mental imagery mediates motor recovery or neural adaptation for people with stroke can be better understood.

A randomized controlled trial of mental imagery augment generalization of learning in acute poststroke patients.

BACKGROUND AND PURPOSE: Our previous studies demonstrated that mental imagery intervention enhanced poststroke patients relearning daily task performance. This study aimed to test the efficacy of mental imagery for promoting generalization of the task skills learned in a training environment to trained and untrained tasks carried out in a novel environment. METHODS: Thirty-five acute poststroke patients were randomly assigned to the mental imagery (MI; n=18) or conventional functional rehabilitation (FR; n=17) group. The MI intervention was 3-week standardized practices and daily tasks using the chunking-regulation-rehearsal strategies. Outcome measurements were the performances on trained and untrained tasks in the training and novel environments. RESULTS: The MI patients showed significantly better performances on 4 of 5 trained tasks (P=0.001 to 0.026) versus only 1 task in the FR patients (P=0.021). The MI patients also outperformed their FR counterpart on the 3 (of 5) (P=0.025 to 0.049) trained and 2 (of 3) untrained tasks (P=0.042 to 0.045) carried out in the novel environment. CONCLUSIONS: The mental imagery intervention was useful for improving patients' ability on performing the tasks which they did not previously trained on and in places different from the training environments. These involved generalization of the skills learned at the task performance level. Our findings are limited to poststoke patients who share similar characteristics with those in this study.