Effectiveness of a structured physical rehabilitation program on the physical fitness, mental health and pain for Chinese patients with major depressive disorders in Hong Kong - a randomized controlled trial with 9-month follow-up outcomes.

PURPOSE: The long-term and specific impacts on the physical and mental health for Chinese people with major depressive disorders (MDD) are not well-studied. The aim of the study is to investigate both short-and long-term effects of a structured physical rehabilitation program on the physical and mental health and pain for Chinese patients with MDD. METHODS: 84 Chinese patients with MDD were randomized to intervention (n = 42) or control group (n = 42). Intervention group received a 12-week physical rehabilitation program and the control group with 12-week waiting period followed the same pathway as the intervention group afterwards for longitudinal analysis. Data were collected at baseline (T1), end of 12-week program (T2) and 9-month follow-up period (T3). RESULTS: Significant pre- and post-intervention improvements were noted in cardiopulmonary function, depressive symptoms, pain, body composition, muscle strength and flexibility for the intervention group. Although mild attenuation is noted from T2 to T3, subjects without exercise habit experienced significant decline in cardiopulmonary function, depressive symptoms and pain (p < 0.05) but not in those who developed exercise habit (p > 0.05). CONCLUSION: Structured physical rehabilitation program could improve physical and mental fitness and pain for Chinese MDD patients. Its effects could be sustained up to 9 months after cessation of the program provided that people establish their own exercise habit.IMPLICATIONS FOR REHABILITATIONExercise is an effective means of improving physical and mental health and pain for people with major depressive disorders (MDD).People with MDD have multiple reasons, both physically and psychosocially, for physical deconditioning and hurdles for exercise.Structured supervised exercise program can enhance physical and mental health and may likely enhance exercise compliance in this population.

Early physiotherapy intervention in an Accident and Emergency Department reduces pain and improves satisfaction for patients with acute low back pain: a randomised trial.

QUESTION: What is the effect of early physiotherapy intervention on pain and patient satisfaction in acute low back pain? DESIGN: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS: 110 patients attending the Accident and Emergency Department of a local acute hospital. INTERVENTION: The experimental group received early physiotherapy intervention which consisted of education, reassurance, pain management, mobility training, interferential therapy, walking training, and walking aids as indicated. The control group received only walking training and walking aids as indicated. All participants received conventional medical intervention and outpatient physiotherapy intervention. OUTCOME MEASURES: Pain was measured using the Numeric Pain Rating Scale and satisfaction was measured using the Numeric Global Rating of Change Scale at baseline, discharge from the Accident and Emergency Department, admission to the Physiotherapy Outpatient Department, 1 month, 3 months, and 6 months. RESULTS: Participants in the experimental group had 1.6 out of 10 points (97.5% CI 0.8 to 2.3) less pain than the control group on discharge from the Accident and Emergency Department and still had 0.9 points (97.5% CI 0.1 to 1.6) less pain on admission to the Physiotherapy Outpatient Department. Participants in the experimental group were 2.1 out of 20 points (97.5% CI 1.2 to 2.9) more satisfied than the control group on discharge from the Accident and Emergency Department. CONCLUSION: Early physiotherapy intervention was effective in reducing pain and increasing satisfaction for patients with acute low back pain in an Accident and Emergency Department but the effect tailed off.

Cultural and language differences in voice quality perception: a preliminary investigation using synthesized signals.

BACKGROUND: Perceptual voice evaluation is a common clinical tool. However, to date, there is no consensus yet as to which common quality should be measured. Some available evidence shows that voice quality is a language-specific property which may be different across different languages. The familiarity of a language may affect the perception and reliability in rating voice quality. AIMS: The present study set out to investigate the effects of listeners' cultural and language backgrounds on the perception of voice qualities. METHODS AND PROCEDURES: Forty speech pathology students from Australia and Hong Kong were asked to rate the breathy and rough qualities of synthesized voice signals in Cantonese and English. OUTCOME AND RESULTS: Results showed that the English stimulus sets as a whole were rated less severely than the Cantonese stimuli by both groups of listeners. In addition, the male Cantonese and English breathy stimuli were rated differently by the Australian and Hong Kong listeners. CONCLUSIONS AND IMPLICATIONS: These results provided some evidence to support the claim that cultural and language backgrounds of the listeners would affect the perception for some voice quality types. Thus, the cultural and language backgrounds of judges should be taken into consideration in clinical voice evaluation.

Comparative performance of an adaptive directional microphone system and a multichannel noise reduction system.

The amplification outcomes of two hearing aid prescriptions, NAL-NL1 and Digital Perception Processing (DPP), of nine moderate to moderately severe hearing-impaired adults were compared in the same digital hearing instrument. NAL-NL1 aims at optimizing speech intelligibility while amplifying the speech signal to a normal overall loudness level (Dillon, 1999). DPP focuses on restoring loudness based on normal and impaired cochlear excitation models (Launer and Moore, 2003). In this comparison, DPP resulted in better sentence recognition performance than the NAL-NL1 algorithm in the signal-front/noise-side condition, and the two prescriptions gave similar performance in the signal-front/noise-front condition. Subjective evaluations by the participants using the Abbreviated Profile for Hearing Aid Benefit and sound quality comparisons did not give conclusive results between the two prescriptions. With each hearing aid prescription, the ability of the hearing aid circuitry to reduce the effects of noise was evaluated by a sentence-in-noise test in three conditions: (1) adaptive directional microphone (DAZ), (2) multichannel noise reduction system (FNC), and (3) a combination of FNC and DAZ (FNC + DAZ). In the signal-front/noise-side condition, DAZ and FNC + DAZ gave better performance than FNC in nearly all participants, whereas in the signal-front and noise-front evaluation, the conditions revealed no significant differences.

Perception of synthesized voice quality in connected speech by Cantonese speakers.

Perceptual voice analysis is a subjective process. However, despite reports of varying degrees of intrajudge and interjudge reliability, it is widely used in clinical voice evaluation. One of the ways to improve the reliability of this procedure is to provide judges with signals as external standards so that comparison can be made in relation to these "anchor" signals. The present study used a Klatt speech synthesizer to create a set of speech signals with varying degree of three different voice qualities based on a Cantonese sentence. The primary objective of the study was to determine whether different abnormal voice qualities could be synthesized using the "built-in" synthesis parameters using a perceptual study. The second objective was to determine the relationship between acoustic characteristics of the synthesized signals and perceptual judgment. Twenty Cantonese-speaking speech pathologists with at least three years of clinical experience in perceptual voice evaluation were asked to undertake two tasks. The first was to decide whether the voice quality of the synthesized signals was normal or not. The second was to decide whether the abnormal signals should be described as rough, breathy, or vocal fry. The results showed that signals generated with a small degree of aspiration noise were perceived as breathiness while signals with a small degree of flutter or double pulsing were perceived as roughness. When the flutter or double pulsing increased further, tremor and vocal fry, rather than roughness, were perceived. Furthermore, the amount of aspiration noise, flutter, or double pulsing required for male voice stimuli was different from that required for the female voice stimuli with a similar level of perceptual breathiness and roughness. These findings showed that changes in perceived vocal quality could be achieved by systematic modifications of synthesis parameters. This opens up the possibility of using synthesized voice signals as external standards or "anchors" to improve the reliability of clinical perceptual voice evaluation.