Do social determinants influence post-stroke aphasia outcomes? A scoping review.

PURPOSE: To conduct a scoping review on five individual social determinants of health (SDOHs): gender, education, ethnicity, socioeconomic status, and social support, in relation to post-stroke aphasia outcomes. MATERIALS AND METHODS: A comprehensive search across five databases was conducted in 2020 and updated in 2022. Twenty-five studies (3363 participants) met the inclusion criteria. Data on SDOHs and aphasia outcomes were extracted and analysed descriptively. RESULTS: Twenty studies provide information on SDOH and aphasia recovery outcomes. Five studies provide insights on SDOH and response to aphasia intervention. Research on SDOH and aphasia recovery has predominantly focussed solely on language outcomes (14 studies), with less research on the role of SDOH on activity, participation, and quality of life outcomes (6 studies). There is no evidence to support a role for gender or education on language outcomes in the first 3 months post stroke. SDOHs may influence aphasia outcomes at or beyond 12 months post onset. CONCLUSIONS: Research on SDOHs and aphasia outcomes is in its infancy. Given SDOHs are modifiable and operate over a lifetime, and aphasia is a chronic condition, there is a pressing need to understand the role of SDOHs on aphasia outcomes in the long term.

Research on the role of Social Determinants of Health (SDoH) and aphasia outcomes is in its infancy.The role of SDoHs has been mainly investigated in relation to language outcomes.Little is known about the SDoHs on activity, participation, and quality of life outcomes.Rehabilitation professionals should consider the potential influence of individual SDoHs such as gender, education, socioeconomic status, ethnicity, and social support on a person's access to aphasia services and aphasia outcomes long term.

Allied Health Clinicians' Uptake of Evidence in Stroke Rehabilitation: A Systematic Review of Determinants Targeted in Implementation Studies.

OBJECTIVE: This study aimed to determine whether targeting specific implementation determinants is associated with allied health clinicians' uptake of evidence when implemented within stroke rehabilitation settings. DATA SOURCES: 7 key databases were searched to identify articles published between 1990 and 2022 for inclusion. Reference lists of relevant articles were hand searched. STUDY SELECTION: Studies were independently screened by 2 authors and included if the implementation intervention targeted allied health clinical practice in any stroke rehabilitation context and reported at least 1 quantitative measure of evidence uptake. Thirty studies met inclusion criteria. DATA EXTRACTION: Data were independently extracted by the first and second author. Implementation outcomes for each study were categorized as either mostly successful, partially successful, or not successful based on the degree of evidence uptake achieved. Determinants targeted were categorized using the Consolidated Framework for Implementation Research (CFIR). DATA SYNTHESIS: Patterns between the degree of evidence uptake and determinants targeted across studies were analyzed by the first and second authors in 1 of 3 groups: A (pre-post statistical analysis), B (pre-post descriptive analysis), or C (post-only descriptive analysis). Patterns between evidence uptake and determinants targeted were first identified within groups A and B, with group C consulted to support findings. All studies categorized as "mostly successful" targeted facilitation in combination with establishing face-to-face networks and communication strategies. Conversely, no studies rated "not successful" targeted either of these determinants. Studies rated "partially successful" targeted either 1, but seldom both, of these determinants. CONCLUSIONS: This review has provided descriptive evidence of determinants which may be important to target for allied health clinicians' uptake of evidence within stroke rehabilitation settings.

The Acute Effects of Different Exercise Intensities on Associative Novel Word Learning in Healthy Older Adults: A Randomized Controlled Trial.

Recent studies show positive effects of acute exercise on language learning in young adults with lower baseline learning abilities; however, this is yet to be investigated in older adults. This study investigated the acute effects of different exercise intensities on new word learning in healthy older adults with lower and higher baseline learning abilities. Sixty older adults (mean age = 66.4 (4.6); 43 females) performed either a single bout of stretching exercise, moderate-intensity continuous exercise, or high-intensity interval exercise followed by a word learning task. In lower baseline learners, between-group differences were observed on immediate new word recall success, with the moderate-intensity continuous exercise group performing better than the stretching group. These findings suggest immediate benefits of moderate-intensity continuous exercise that are limited to word learning performance of older adults with lower baseline learning abilities. Further investigation into underlying mechanisms could lead to a better understanding of individual differences in responding to acute exercise.

The Immediate Effects of Acute Aerobic Exercise on Cognition in Healthy Older Adults: A Systematic Review.

BACKGROUND: Age-related cognitive decline is a worldwide challenge, highlighting the need for safe, effective interventions that benefit cognition in older adults. Harnessing the immediate and long-term pleiotropic effects of aerobic exercise is one approach that has gained increasing interest. OBJECTIVE: The aim of this review is to provide knowledge on the immediate effects of acute aerobic exercise on cognitive function of healthy older adults and to assess the methodological quality of studies investigating these effects. METHODS: A database search in PubMed, CINAHL, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, Web of Science, ClinicalTrials.gov and Google Scholar was conducted using a systematic search strategy. RESULTS: Fifteen studies were identified and cognitive domains investigated included executive function and visual perception. Results from 14 of 15 studies showed that an acute bout of aerobic exercise can enhance at least one subsequent cognitive performance of healthy older adults when measured within 15 min post-exercise. CONCLUSION: The small number of studies available, the limited domains of cognition investigated, the great variability between research protocols, and the low overall quality rating limits the conclusions that can be drawn. More comprehensive randomised controlled trials are needed to address these limitations and verify the potential benefits of acute aerobic exercise.

Normative Study of the Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES) Test in the French-Canadian Population.

Purpose: The Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES; MacDonald, 2005) test was designed for use by speech-language pathologists to assess verbal reasoning, complex comprehension, discourse, and executive skills during performance on a set of challenging and ecologically valid functional tasks. A recent French version of this test was translated from English; however, it had not undergone standardization. The development of normative data that are linguistically and culturally sensitive to the target population is of importance. The present study aimed to establish normative data for the French version of the FAVRES, a commonly used test with native French-speaking patients with traumatic brain injury in Québec, Canada. Method: The normative sample consisted of 181 healthy French-speaking adults from various regions across the province of Québec. Age and years of education were factored into the normative model. Results: Results indicate that age was significantly associated with performance on time, accuracy, reasoning subskills, and rationale criteria, whereas the level of education was significantly associated with accuracy and rationale. Conclusion: Overall, mean scores on each criterion were relatively lower than in the original English version, which reinforces the importance of using the present normative data when interpreting performance of French speakers who have sustained a traumatic brain injury.