Implementation feasibility of animal-assisted therapy in a pediatric intensive care unit: effectiveness on reduction of pain, fear, and anxiety.

Animal-assisted therapies are an innovative strategy within health care humanization initiatives, and they could play a role in the reduction of pain or anxiety. The main objective of this work was to evaluate the feasibility of implementing animal-assisted therapy in a pediatric intensive care unit and its effectiveness for the reduction of pain, fear, and anxiety. A prospective, quasi-experimental study of animal-assisted therapy was designed in the pediatric intensive care unit of the Hospital Universitario 12 de Octubre of Madrid, from January 2019 to December 2019. The study sample included patients who had been admitted to the unit and were over 3 years old. Satisfaction surveys were collected from the patients, family, and health personnel involved. Physiological variables and the level of pain (visual analog scale or Wong-Baker scale), fear (Child Medical Fear Scale), and anxiety (modified Yale Preoperatory Anxiety Scale) were evaluated before and after each session. Any existence of adverse events was recorded. A total of 74 therapy sessions were performed on 61 patients. All sessions were completed without any adverse effects. A total of 164 surveys were collected, providing an overall project rating of 9.69 out of a possible 10. The survey comments were found to be positive in most cases. No differences were found in the physiological variables measured before and after each session. There was a statistically significant decrease in pain, fear, and anxiety levels (p < 0.01).   Conclusion: The implementation of an animal-assisted therapy project in a pediatric intensive care unit is feasible and safe and has a high degree of acceptance among both participants and healthcare staff. Animal-assisted therapy is effective for the reduction of pain, fear, and anxiety, and therefore, it could be considered an adjunct to non-pharmacological therapy. What is Known: • Animal assisted therapies (AAT) are an innovative strategy that could be beneficial to help pediatrics patients cope with admission difficulties and could even play a role in reducing pain, anxiety and/or delirium. • To date there are not studies to analyze the effectiveness of AAT in the field of Pediatric Intesive Care. What is New: • Our study confirms the feasibility and effectiveness of the implementation of an AAT in the field of Pediatric Intensive Care with a high degree of acceptance by participants, caregivers and healthcare personnel. • AAT demonstrated a reduction in pain, fear and anxiety in pediatrics patients admitted to Pediatric Intensive Care Unit.

Equilibrio ocupacional, discapacidad y funcionalidad en personas con enfermedades reumáticas / Occupational balance, disability and functionality in people with rheumatic disease

Fundamento. El objetivo del presente estudio es conocer el equilibrio ocupacional de las personas con enfermedad reumá-tica y analizar su relación con la participación, el rendimiento y satisfacción con las actividades de la vida diaria (AVD), así como evaluar si la edad o recibir tratamiento no farmacológico influ-yen en los resultados.Método. Estudio transversal realizado entre marzo y noviembre de 2021 en personas con diagnóstico de enfermedad reumática en fase no avanzada procedentes de la Asociación ConArtritis, seleccionadas mediante muestreo aleatorio simple. Se recogie-ron, on-line y/o por teléfono, datos sociodemográficos y pun-tuaciones de los cuestionarios OBQ, IMPACT-S, COPM, y de un cuestionario creado ad hoc para las AVD.Resultados. Los 47 participantes no presentaban un buen equi-librio ocupacional (OBQ: 34,2; DE: 13,7). A pesar de una buena participación en AVD (IMPACT-S: 76,8; DE: 13,1), el grado de desempeño y de satisfacción con las AVD distó de ser óptimo (COPM-R: 3,9; DE=2,0 y COPM-S: 4,3; DE=2,5). El 46,8% encon-traba limitaciones en al menos cuatro AVD, tanto básicas como instrumentales, y el 61,7% utilizaba al menos un producto de apoyo en su día a día. Estas limitaciones disminuían su tiem-po de descanso y afectaban a su actividad laboral, aficiones y relaciones personales. El grado de desempeño se relacionó ne-gativamente con la edad (p=0,04); recibir tratamiento no farma-cológico no modificó las puntuaciones.Conclusión. Los datos recabados sugieren que las personas con enfermedad reumática en fases no avanzadas de la enfermedad perciben que su equilibrio ocupacional mejoraría si encontra-sen menos limitaciones en las AVD (AU)

Background. We aimed to assess the occupational balance of people with rheumatic disease, analyze its relationship with par-ticipation, performance, and satisfaction with daily life activi-ties, and evaluate whether age or receiving non-pharmacological treatment affects the outcome.Methods. Cross-sectional study carried out between March and November 2021; patients with non-advanced stage of rheumatic disease from the ConArtritis Association –selected through sim-ple random sampling–, were included. Sociodemographic data and scores from the OBQ, IMPACT-S, COPM questionnaires, and a questionnaire created ad hoc for daily life activities were collected online and/or by telephone.Results. The occupational balance of the 47 participants was low (OBQ: 34.2; SD: 13.7). Despite a high participation in daily life activities (IMPACT-S: 76.8; SD: 13.1), the degree of perfor-mance and satisfaction with these activities was far from op-timal (COPM-R: 3.9; SD: 2.0 and COPM-S: 4.3; SD: 2.5); 46.8% of the participants found limitations in at least four daily life activities (basic and instrumental) and 61.7% used at least one support product in their daily lives. These limitations reduced their resting time and affected their jobs, hobbies, and personal relationships. The level of performance was negatively related to age (p=0.04); No changes in the scores were found in patients who received non-pharmacological treatment.Conclusion. Our results suggest that individuals with non- advanced stage of a rheumatic disease perceive that their oc-cupational balance may be improved should they have fewer limitations in daily life activities (AU)

[Occupational balance, disability and functionality in people with rheumatic disease]. / Equilibrio ocupacional, discapacidad y funcionalidad en personas con enfermedades reumáticaS

BACKGROUND: We aimed to assess the occupational balance of people with rheumatic disease, analyze its relationship with participation, performance, and satisfaction with daily life activities, and evaluate whether age or receiving non-pharmacological treatment affects the outcome. METHODS: Cross-sectional study carried out between March and November 2021; patients with non-advanced stage of rheumatic disease from the ConArtritis Association - selected through simple random sampling -, were included. Sociodemographic data and scores from the OBQ, IMPACT-S, COPM questionnaires, and a questionnaire created ad hoc for daily life activities were collected online and/or by telephone. RESULTS: The occupational balance of the 47 participants was low (OBQ: 34.2; SD: 13.7). Despite a high participation in daily life activities (IMPACT-S: 76.8; SD: 13.1), the degree of performance and satisfaction with these activities was far from optimal (COPM-R: 3.9; SD: 2.0 and COPM-S: 4.3; SD: 2.5); 46.8% of the participants found limitations in at least four daily life activities (basic and instrumental) and 61.7% used at least one support product in their daily lives. These limitations reduced their resting time and affected their jobs, hobbies, and personal relationships. The level of performance was negatively related to age (p=0.04); No changes in the scores were found in patients who received non-pharmacological treatment. CONCLUSIONS: Our results suggest that individuals with non- advanced stage of a rheumatic disease perceive that their occupational balance may be improved should they have fewer limitations in daily life activities.

The Potential of Digital Screening Tools for Childhood ADHD in School Environments: A Preliminary Study.

Attention deficit hyperactivity disorder (ADHD) is a highly prevalent developmental disorder in children. However, accurately identifying ADHD in early childhood remains a crucial challenge. Electronic health (e-health) systems offer promising possibilities to enhance the diagnostic process for ADHD, particularly concerning the executive functions (EFs) that play a direct role. This study aims to validate an evidence-based tool for screening ADHD through EFs in the school environment. The tool, named Sendero Gris, is designed for tablet devices and is based on a previously validated test with the same name. To ensure its validity, a comparison was made between the results obtained from the tool to be validated and the original format of the test. The analysis revealed no statistically significant differences between the two approaches at a 90% confidence level (p-value = 0.49). Moreover, a user experience study focusing on usability was conducted to assess the children's inclination to use the developed tool, yielding highly positive results. The implementation of Sendero Gris on a tablet device, with its objective and versatile nature, seems to maintain the potential of the original format as a screening tool for ADHD.

Prospective One-Year Follow-Up of Sensory Processing in Phelan-McDermid Syndrome.

BACKGROUND: Phelan-McDermid syndrome (PMS) is caused by the loss (deletion) of a small portion of chromosome 22 in a region designated q13.3 (22q13.3 deletion). PMS is one of the most common genetic forms of autism spectrum disorder (ASD) in which sensory reactivity difficulties have been described on limited occasions. METHODS: The objective of this study is to identify whether changes in sensory reactivity skills occur after one year of follow-up in a group of 44 participants diagnosed with PMS. All participants completed the Short Sensory Profile (SSP). Two-factor ANOVA tests were performed with repeated measures for the study of the evolution of the scores. RESULTS: Participants with PMS showed significant changes after one year of follow-up in sensory reactivity skills associated with tactile hyperreactivity (p = 0.003). The rest of the study variables did not show significant differences compared to the baseline assessment, showing definite differences associated with patterns of hypo-responsiveness and sensory seeking, low/weak energy, and difficulties in auditory filtering. CONCLUSIONS: Understanding the evolution of sensory reactivity skills can facilitate the adjustment to behavioral changes in people with PMS and design-targeted interventions to address sensory reactivity challenges.

Serious Game for the Screening of Central Auditory Processing Disorder in School-Age Children: Development and Validation Study.

BACKGROUND: Currently, many central auditory processing disorder screening tests are available for children, and serious games (SGs) are frequently used as a tool for the diagnosis of different neural deficits and disorders in health care. However, it has not been possible to find a proposal that unifies both ideas. In addition, the validation and improvement of SGs, in general, does not take into account the player-game interaction, thus omitting valuable information about the playability and usability of the game. OBJECTIVE: This study presented Amalia's Planet, a game conceived for use in school environments, which allows a first assessment of a child through their performance of the proposed tasks related to different aspects of auditory performance. In addition, the game defines a series of events in relation to the execution of the tasks, which were evaluated for the subsequent optimization of its performance and the improvement of its usability. METHODS: Using screening tools based on the use of SG technologies, a total of 87 school-age children were evaluated to test the various hypotheses proposed in this study. By grouping users according to whether they had personal history of hearing pathologies, the discriminant power, playability, and usability of the final solution were examined using traditional statistical techniques and process mining (PM) algorithms. RESULTS: With a confidence level of 80% for test 2 (P=.19), there was no statistical evidence to reject the null hypothesis that a player's performance is affected by whether the player had a previous auditory pathology. Furthermore, the tool allowed the screening of 2 players initially categorized as healthy because of their low level of performance in the tests and the similarity of their behavior with that of the group of children with a previous pathology. With regard to the validation of the proposed solution, the use of PM techniques made it possible to detect the existence of events that lasted too long, which can lead to player frustration, and to discover small structural flaws in the game. CONCLUSIONS: SGs seem to be an appropriate tool for the screening of children at risk of central auditory processing disorder. Moreover, the set of PM techniques provides a reliable source of information regarding the playability and usability of the solution to the development team, allowing its continuous optimization.

Descriptive Analysis of Adaptive Behavior in Phelan-McDermid Syndrome and Autism Spectrum Disorder.

Introduction: The variety in symptomatology and clinical presentation of individuals diagnosed with Phelan-McDermid Syndrome (PMS) can delay medical diagnosis, so identifying specific neurobehavioral variables and facilitating differential diagnosis with patients with idiopathic Autism Spectrum Disorder (ASD) can guide early detection. Methods: A descriptive analysis of the level of adaptive behavior in 50 patients diagnosed with PMS was performed (SHANK3 deletion: N = 44; SHANK mutation : N = 6). Subsequently, a comparative analysis was performed with 28 children aged between 4 years and 6 years and 11 months (SHANK3 deletion = 14; ASD = 14). Differences between the two groups were evaluated and Bonferroni correction was applied for multiple comparisons. Results: Differences were identified in the variables of communication (z = -2.715, p = 0.007), Self-Direction (z = -2.199, p = 0.028) and social participation (z = -3.190, p = 0.001), with better adaptive behavior skills being observed in participants with a SHANK3 mutation . Better adaptive skills in the sample of participants with ASD , were found and statistically significant differences were identified in the variables of academic skills (z = -3.084, p = 0.002), use of community resources (z = -1.889, p = 0.050) and health and safety (z = -2.90, p = 0.004). Conclusion: Participants with SHANK3 mutation show better communication and social participation skills than those with a diagnosis of SHANK3 deletion. The observed differences between ASD and individuals with PMS reflect deficits in practical and conceptual adaptive skills that may limit and hinder daily adaptive functioning.

Sensory processing and adaptive behavior in Phelan-McDermid syndrome: a cross-sectional study.

Phelan-McDermid syndrome (PMS) is a genetic disorder caused by a mutation or deletion of the SHANK3 gene (chromosome 22q13.3), characterized by different sensory processing anomalies. The objective of this study is to expand and provide a detailed definition of the sensory profile of patients with PMS. The secondary objective was to examine the relationship between sensory patterns and adaptive behavior. A cross-sectional study was carried out among 51 Spanish patients with a confirmed genetic diagnosis of PMS. All the participants' parents completed the Short Sensory Profile-Spanish (SSP-S) and the Adaptive Behavior Assessment System II (ABAS-II). Correlational, multiple regression and hierarchical cluster analyses were performed. An atypical sensory profile was identified in almost 75% of PMS patients. Definite differences were found among scores; nonetheless, sub-threshold values were observed in tactile sensitivity, underresponsive/seeks sensation, auditory filtering, and low energy/weak sensory categories. Conceptual, social, and practical domains, as well as the General Adaptive Composite (GAC) of the ABAS-II showed extremely low scores (i.e., <70). Significant correlations were found (p<0.005) between SSP-S scores and the conceptual, social, practical, and GAC index of the ABAS-II, whereby higher SSP-S scores were associated with better skills and higher adaptive performance. The cluster analysis indicated that the group with the largest mutation size (7.23 Mb) showed the greatest sensory processing difficulties and very low adaptive skills. CONCLUSIONS: Patients with PMS show an atypical sensory profile, which correlates with limitations in general adaptive behaviors. WHAT IS KNOWN: • PMS sensory processing difficulties were associated with a pattern of underresponsive/seeks sensation, low energy/weak, and tactile hyporeactivity. • Sensory processing difficulties have been associated with limitations in the development of appropriate adaptive communication and interaction behaviors. WHAT IS NEW: • Sensory definite differences associated with tactile hyperreactivity, as well as significant effects of underresponsiveness/seeks sensation and auditory filtering categories on the adaptive abilities were found in SHANK3deletion patients. • Cluster analysis suggests that smaller mutation sizes were related to better sensory processing and higher adaptive skills, while patients with larger deletion sizes have greater adaptive difficulties and worse sensory processing skills.

Empathy in occupational therapy students: a cross-sectional study at a Spanish university.

INTRODUCTION: Empathy is an important interpersonal skill and a fundamental component in the professional-patient relationship, being the basis for implementing person-centred practice. In several studies, a decrease in empathy levels throughout training in medicine, nursing or dentistry, among others, has been shown. There are few studies on the occupational therapy branch of healthcare. The aim was to determine the degree of empathy perceived by students of occupational therapy at a Spanish university, as well as to analyse the differences between empathy levels according to the different degree courses and gender. METHODS: A descriptive cross-sectional study was designed with a sample of 221 occupational therapy students from a Spanish university. The Davis Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Empathy-Health Profession Student's Spanish version (JSPE-HPS-S) were used as outcome measures. RESULTS: According to the results found, high level of empathy was found on all dimension of the IRI (69.84 (9.80)) and the JSPE-HPS-S (122 (94-140)). Although high levels of empathy among occupational therapy students are observed in all degree courses, no significant differences were found between them. Statistically significant differences and a moderate effect size (r) were found between the variables according to the gender of the participants, with females showing greater empathy in the overall scores of the IRI as well as in the JSPE-HPS-S (p=0.002, r=0.212; p=0.001, r=0.327, respectively). CONCLUSIONS: Empathy is an essential competence for the development of quality occupational therapy practice. According to the results and although occupational therapy students showed high levels of empathy, it is important to pay attention to the evolution of empathy and to provide students with learning experiences that prevent its possible decline.

Cultural adaptation and psychometric properties of the Jefferson empathy scale health professions students' version in SpanishOccupational therapy students.

BACKGROUND: In occupational therapy, empathy is a fundamental concept and has a positive impact on health and quality of care outcomes for patients. It is a basic and essential concept that should prevail in the training of occupational therapy students. The aim of this study is to validate and cross-culturally adapt the Jefferson Medical Empathy Scale, version for health professionals (JSE-HPS) in a sample of Spanish university students of occupational therapy. METHODS: A cross-sectional descriptive study was conducted between 2019 and 2020. A convenience sample was selected, consisting of 221 students from the four courses of the Occupational Therapy degree at the Universidad Rey Juan Carlos during the 2019-20 academic year. Each of the participants voluntarily and anonymously completed a sociodemographic data sheet (including age and sex), in addition to the following assessment scales: JSE-HPS and the Interpersonal Reactivity Index (IRI). RESULTS: A culturally adapted version of the JSE-HPS that guarantees conceptual and grammatical equivalence specific to the study population was obtained. The psychometric analysis of the translated version showed a Cronbach coefficient α of 0.786. The test-retest reliability analysis showed an intraclass correlation coefficient of 0.90 (95% CI = 0.86-0.93, p < 0.0001). Confirmatory factor analysis (CFA) showed positive results (χ2 = 269.095, df = 167, p < 0.001, Confirmatory Fit Index [CFI] = 0.90, Root Mean Square Error of Approximation [RMSEA] = 0.04). CONCLUSION: The cultural adaptation and psychometric results suggest that the Spanish version of the JSE-HPS is a valid and reliable way to evaluate the empathic ability of occupational therapy students.

The Impact of Anxiety and Upper Limb Disability on Participation Levels in People With Dystonia: An Observational Cross-Sectional Case-Control Study.

OBJECTIVE: This study sought to evaluate the level of anxiety in people with dystonia and to examine a possible relationship between the level of participation, anxiety, and functional limitations. DESIGN: This is an observational, cross-sectional, case-control study with 12 cases of focal dystonia and 12 healthy controls aged between 18 and 75 yrs. The Hamilton Anxiety Rating Scale, the QuickDASH scale, and the Measure of Participation and Activities were used. Differences in scores and effect size were analyzed through the Student t test and Cohen d test. A multiple regression model was performed to determine the relationship between variables. RESULTS: People with dystonia obtained higher scores in the three subsections of the Hamilton Anxiety Rating Scale (total anxiety, psychiatric anxiety, and somatic anxiety; P < 0.05) and on the QuickDASH scale, together with lower scores in participation in activities of daily living of the Measure of Participation and Activities (P = 0.01). Greater upper limb disability was associated with a greater negative impact on participation in activities of daily living (P < 0.01); however, no significant relationship was found with anxiety (P > 0.05). CONCLUSIONS: This study suggests that the ability of people with dystonia to participate in society is negatively affected by the level of disability of the upper limb, but even when anxiety-age-related differences were controlled for, no relationship was found between variables.

Terapia ocupacional en unidades de cuidados intensivos pediátricos y neonatales. Revisión sistemática / Occupational therapy in pediatric intensive care unit and neonatal intensive care unit. Systematic review

OBJETIVOS: enumerar y describir las intervenciones llevadas a cabo por terapeutas ocupacionales, realizadas en población infantil que se encuentren ingresados en unidades de cuidados intensivos pediátricos o neonatales, recogidas en la literatura científica. METODOLOGÍA: se realizó una búsqueda bibliográfica en las bases de datos Scopus, Cochrane, Web of Science, OT Seeker, Pubmed, en la que se incluyeron: ensayos clínicos aleatorizados, casos y controles, estudios pretest-postest, diseños transversales, estudios de cohortes y estudios cualitativos, entre otros, durante los últimos 10 años. RESULTADOS: de 448 registros, 65 fueron sometidos a una revisión completa, de ellos, 19 cumplieron los criterios de inclusión y fueron analizados. CONCLUSIONES: la figura del terapeuta ocupacional está presente en las unidades de cuidados intensivos. Las principales intervenciones son: posicionamiento, alimentación, ferulaje, educación a los padres y modificación del entorno. Se necesitarían investigaciones futuras para perfilar debidamente el ámbito de actuación y contribuir a un aumento de la presencia de esta figura profesional

OBJECTIVE: List and describe the interventions performed by occupational therapists, make in children who are admitted to paediatric or neonatal intensive care units, included in the scientific literature. METHODOLOGY: A bibliographic search was performed on the Scopus, Cochrane, Web of Science, OT Seeker, Pubmed databases, which included works with the following designs: randomized clinical trial, cases and controls, pretest-postest studies, cross-sectional designs, cohort studies and qualitative studies, among others, in the last 10 years. RESULTS: 448 records, 66 were subjected to a full review, of which 19 studies met the inclusion criteria and were analysed. CONCLUSION: the occupational therapist figure is present in intensive care units. The main interventions performed by occupational therapists are: Positioning, eating and feeding, parent education and adapting and modifying environment. Finally, future research would be needed to properly outline the scope of action and contribute to an increase in the presence of this professional figure

A Descriptive Cross-Sectional Study of Manipulative Dexterity on Different Subtypes of Multiple Sclerosis.

BACKGROUND: Manipulative dexterity impairments affect 76% of individuals with multiple sclerosis (MS). Patients with MS can experience reduced skill when performing both basic activities of daily living and instrumental activities of daily living. Many studies consider that physical rehabilitation leads to a decrease in the level of disability, especially at the mild and moderate stages of the disease. However, most studies fail to distinguish between the different MS subtypes. PURPOSE: Our aims were (1) to describe the manipulative skills of people according to the different subtypes of MS, (2) to analyze the correlation between dexterity and self-perception variables, and (3) to identify possible predictors of functionality. Study Design. A descriptive cross-sectional study. METHODS: 30 individuals with MS. The measurement tools used were the ABILHAND, the Purdue Pegboard Test (PPT), the Nine-Hole Peg Test, and the Box and Block Test. RESULTS: All subtypes of MS obtained lower scores for manipulative dexterity compared to normal skill levels, with individuals with primary progressive MS displaying the lowest values. However, the analysis of differences between the different subtypes did not reveal statistically significant intragroup differences. In addition, differences were found regarding the effect size of practically all the variables analyzed for both manipulative dexterity (PPT, NHPT, and BBT) and the self-perception of ADLs (ABILHAND), for which high values (d r = 0.72) and very high values (d r = 1.46) were obtained. CONCLUSIONS: Although no significant differences were found between the different types of MS, the assessment of manual dexterity and perceived efficacy of daily activities must be considered as prognostic factors in the progression of the disease. These findings may help support further research on targeted interventions to improve dexterity deficiencies, as well as promote an improved quality of therapeutic interventions.

Occupational performance in multiple sclerosis and its relationship with quality of life and fatigue.

BACKGROUND: Performance and perceived satisfaction of daily occupations in people with multiple sclerosis (MS) can affect the perception of their quality of life and be impacted by the level of fatigue. AIM: To describe the performance and occupational self-perception, as well as to analyze whether there is a relationship between the perception of occupational performance and the quality of life and perceived fatigue. DESIGN: A descriptive cross-sectional study. SETTING: Participants were referred by the services of Neurology of the various hospitals in Madrid. The assessment process was performed either at the MS' associations, in the participants' home, or at the Laboratory of Cognitive Intervention of the Health Sciences Faculty of the University. POPULATION: A total sample of 30 people with MS (pwMS) selected by non-probabilistic consecutive sampling during a three-months uptake patient recruitment period. METHODS: The outcome measures used were the Canadian Occupational Performance Measure (COPM), the Modified Fatigue Impact Scale (MFIS) and the Multiple Sclerosis Quality of Life 54 (MSQoL-54). Descriptive analysis, parametric and non-parametric tests and multiple linear regression models were used. RESULTS: A statistically significant positive correlation was found between occupational performance and physical and mental health. Also, high physical health scores were associated with high satisfaction scores. Multiple regression models indicated that high levels of satisfaction were associated with high levels of physical health (P= 0.013). CONCLUSIONS: The better the perception of the physical aspects that influence the quality of life, the better the perceived satisfaction of pwMS. Fatigue may not influence self-perceived satisfaction and performance. CLINICAL REHABILITATION IMPACT: The physical factors affecting perceived satisfaction should be considered when planning interventions to promote quality of life in pwMS. Although fatigue associated with MS may influence perceived performance and satisfaction, no relevant associations were found between variables.

Spanish Transcultural Adaptation of the Activity Card Sort.

The Activity Card Sort (ACS) measures the level of participation, as perceived by each person which, unlike other scales, makes it both personal and significant. However, there is a limitation to applying the ACS to Spanish older adults as it is restricted to culturally relevant activities solely in the United States. Therefore, the aim of this study was to select activity items that reflected Spanish older adults' lifestyles in order to develop the Activity Card Sort-Spain Version (ACS-SP). Frequently, activities performed in Spain (n = 103) were listed in an initial draft. The Likert scale was administrated to a large group of Spanish nationals over the age of 60 years (n = 98) to establish which type of activities will be eventually included in the Spanish version. The final version was drawn up comprising 79 activities distributed between four performance areas. In addition, other activities that were not previously included by other assessment tools were considered and have been listed in this review, such as taking a nap, going out for a drink or "tapas," or searching for a job. The gradual adaptation to ACS for Spaniards will make it possible to measure the level of an individual's participation within a community. However, further work on psychometric properties is needed.

Efecto de la hipoterapia en esclerosis múltiple: estudio piloto en calidad de vida, espasticidad, marcha, suelo pélvico, depresión y fatiga / Effects of hippotherapy in multiple sclerosis: pilot study on quality of life, spasticity, gait, pelvic floor, depression and fatigue

Introducción y objetivo: La hipoterapia se está utilizando como un método muy prometedor en el tratamiento físico de los pacientes con esclerosis múltiple (EM). Material y método: Se realizó un ensayo clínico abierto comparativo pre-post con intervención de hipoterapia en pacientes de EM (n=6), no aleatorizado y con presencia de grupo control (n=4), de 6 meses de duración. El estudio fue realizado por la Fundación MHG. Resultados: Se obtuvo una mejoría estadísticamente significativa en el grupo terapia en la espasticidad pre y postestudio medida mediante la escala de Ashworth modificada (p=0,01); una mejoría estadísticamente significativa en el impacto de la fatiga (p<0,0001) medida con la FIS, en la percepción general de la salud en la escala de calidad de vida urinaria (p=0,033) medida mediante el KHQ, y en las subescalas 2, 3 y 4 del MSQOL-54 (p=0,011). En el grupo control no se produjo ninguna mejoría en ninguna de las escalas. Conclusiones: Este estudio refuerza la literatura existente que soporta la hipoterapia como una intervención adecuada para pacientes de EM. Se precisan futuros trabajos con muestras más grandes, presencia de grupo control y el cegado a nivel del investigador

Introduction and objective: Hippotherapy is being used as a promising method in the physical treatment of multiple sclerosis (MS). Material and method: Comparative open clinical pre-post study into hippotherapy intervention during a 6-month period in patients with MS (n=6). Not randomised and with control group (n=4). The study was performed by MHG Foundation. Results: A statistically significant improvement was observed in the therapy group in: spasticity pre-post measured by the modified Ashworth scale (P=.01). Statistically significant improvement in fatigue impact (P<.0001) measured with FIS; in general, perception of heath outcome in urinary quality of life scale KHQ (P=.033), and in subscales 2, 3 and 4 of MSQOL-54 (P=.011). Control group showed no improvement in any scale. Conclusions: This study reinforces current literature that supports hippotherapy as an adequate intervention for MS patients. Further studies with more participants, control groups and blinded research would be logical steps for future research in this field

Effects of hippotherapy in multiple sclerosis: pilot study on quality of life, spasticity, gait, pelvic floor, depression and fatigue. / Efecto de la hipoterapia en esclerosis múltiple: estudio piloto en calidad de vida, espasticidad, marcha, suelo pélvico, depresión y fatiga.

INTRODUCTION AND OBJECTIVE: Hippotherapy is being used as a promising method in the physical treatment of multiple sclerosis (MS). MATERIAL AND METHOD: Comparative open clinical pre-post study into hippotherapy intervention during a 6-month period in patients with MS (n=6). Not randomised and with control group (n=4). The study was performed by MHG Foundation. RESULTS: A statistically significant improvement was observed in the therapy group in: spasticity pre-post measured by the modified Ashworth scale (P=.01). Statistically significant improvement in fatigue impact (P<.0001) measured with FIS; in general, perception of heath outcome in urinary quality of life scale KHQ (P=.033), and in subscales 2, 3 and 4 of MSQOL-54 (P=.011). Control group showed no improvement in any scale. CONCLUSIONS: This study reinforces current literature that supports hippotherapy as an adequate intervention for MS patients. Further studies with more participants, control groups and blinded research would be logical steps for future research in this field.

Spanish Transcultural Adaptation and Validity of the Behavioral Inattention Test.

OBJECTIVE: To adapt, validate, and translate the Behavioral Inattention Test as an assessment tool for Spanish individuals with unilateral spatial neglect. DESIGN: A cross-sectional descriptive study. SETTING: University laboratories. PARTICIPANTS: A sample of 75 Spanish stroke patients and 18 healthy control subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Behavioral Inattention Test. RESULTS: The Spanish version of the Behavioral Inattention Test shows a high degree of reliability both in the complete test (α = .90) and in the conventional (α = .93) and behavioral subtests (α = .75). The concurrent validity between the total conventional and behavioral scores was high (r = -.80; p < 0.001). Significant differences were found between patients with and without unilateral spatial neglect (p < 0.001). In the comparison between right and left damaged sides, differences were found in all items, except for article reading (p = 0.156) and card sorting (p = 0.117). CONCLUSIONS: This measure is a useful tool for evaluating unilateral spatial neglect as it provides information on everyday problems. The BIT discriminates between stroke patients with and without unilateral spatial neglect. This measure constitutes a reliable tool for the diagnosis, planning, performance, and design of specific treatment programs intended to improve the functionality and quality of life of people with unilateral spatial neglect.

Cognitive performance in women with fibromyalgia: A case-control study.

BACKGROUND/AIM: This study aimed to evaluate the differences in cognitive skills between women with fibromyalgia and healthy women, and the correlations between functional independence and cognitive limitations. METHODS: A cross-sectional study was performed. Twenty women with fibromyalgia and 20 matched controls participated. Outcomes included the Numerical Pain Rating Scale, the Functional Independence Measure, the Fibromyalgia Impact Questionnaire and Gradior© software. The Student's t-test and the Spearman's rho test were applied to the data. RESULTS: Women affected required a greater mean time (P < 0.020) and maximum time (P < 0.015) during the attention test than the healthy controls. In the memory test they displayed greater execution errors (P < 0.001), minimal time (P < 0.001) and mean time (P < 0.001) whereas, in the perception tests, they displayed a greater mean time (P < 0.009) and maximum time (P < 0.048). Correlations were found between the domains of the functional independence measure and the cognitive abilities assessed. CONCLUSIONS: Women with fibromyalgia exhibited a decreased cognitive ability compared to healthy controls, which negatively affected the performance of daily activities, such as upper limb dressing, feeding and personal hygiene. Patients required more time to perform activities requiring both attention and perception, decreasing their functional independence. Also, they displayed greater errors when performing activities requiring the use of memory. SIGNIFICANCE OF THE STUDY: Occupational therapists treating women with fibromyalgia should consider the negative impact of possible cognitive deficits on the performance of daily activities and offer targeted support strategies.

A Virtual Environment to Improve the Detection of Oral-Facial Malfunction in Children with Cerebral Palsy.

The importance of an early rehabilitation process in children with cerebral palsy (CP) is widely recognized. On the one hand, new and useful treatment tools such as rehabilitation systems based on interactive technologies have appeared for rehabilitation of gross motor movements. On the other hand, from the therapeutic point of view, performing rehabilitation exercises with the facial muscles can improve the swallowing process, the facial expression through the management of muscles in the face, and even the speech of children with cerebral palsy. However, it is difficult to find interactive games to improve the detection and evaluation of oral-facial musculature dysfunctions in children with CP. This paper describes a framework based on strategies developed for interactive serious games that is created both for typically developed children and children with disabilities. Four interactive games are the core of a Virtual Environment called SONRIE. This paper demonstrates the benefits of SONRIE to monitor children's oral-facial difficulties. The next steps will focus on the validation of SONRIE to carry out the rehabilitation process of oral-facial musculature in children with cerebral palsy.