Effects of Assistive Technology Application in Dementia Intervention for People with Mild Cognitive Impairment & Mild Alzheimer Type Dementia and Caregiver.

Background: Dementia, a degenerative disease, requires alternative treatment to maintain function, but previous studies suggest only the therapeutic effect of a temporary program. Primary Study Objective: The current study aimed to examine the effects of assistive technologies on cognitive function, daily living ability, and psychosocial symptoms in elderlies with mild cognitive impairment, elderlies with mild dementia and their caregivers. Design: The research team designed an experimental study that used application as the intervention. Setting: To recruit participants living in the local community, research participation was supported through local public health centers, welfare centers, and social welfare organizations. Evaluation and intervention were conducted by visiting the participant's home. Participant: The study participants were 29 Mild Cognitive Impairment (MCI) and 16 mild Alzheimer type dementia (AD) patients over the age of 75 with a total of 45 patients, 10 MCI caregivers and 11 AD caregivers with a total of 21 caregivers. Intervention: The assistive technologies used for intervention are 3 area (8 daily living assistive devices, 7 safety assistive technologies, and 7 cognitive assistive technologies). Up to 5 assistive technologies were provided to one subject, and they were instructed to use them every day for 8 weeks. Outcome measure: Participants were evaluated at baseline and postintervention using specific scales appropriate to an area: cognitive function, activities of daily living, depression, anxiety, quality of life, satisfaction. Results: Cognitive function showed statistically significant changes in the MCI group. Basic activities of daily living, depression, anxiety, quality of life, satisfaction showed statistically significant positive effects in both MCI and AD groups. Instrumental activities of daily living did not show any statistically significant differences. Conclusion: As an alternative to dementia care in the future, the application and management of assistive technologies for each area should be provided at the government level.

The effect of exercise combined with a cognitive-enhancement group training program on cognition and depression in the community-dwelling elderly.

[Purpose] In this study, we investigated the effects of combining exercise with a cognitive-enhancement group program on cognition and depression in a group of community-dwelling elderly people. [Subjects and Methods] The study's subjects consisted of 30 community-dwelling elderly people of both genders, whose average age was 78 years. They participated in a program of physical exercise combined with a cognitive-enhancement group training program. This consisted of sessions lasting 60 minutes that took place once a week over 3 months. To assess the participants' levels of cognition and depression, we conducted batteries of tests using, respectively, the Korean versions of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K) and the Geriatric Depression Scale-Short Form (GDS-SF). [Results] The Verbal Fluency test, Word List Memory test, Modified Boston Naming test, Mini Mental Status Examination (Korean Version) (MMSE-KC), Constructional Praxis task and Constructional Recall task showed significant improvement, but improvement in the Word List Recall and Word List Recognition tests did not achieve significant levels. Meanwhile, the symptoms of depression were shown to decrease significantly. [Conclusion] Physical exercise combined with a cognitive-enhancement group training program was effective in improving, some of the components of cognition, as well as alleviating depression. This program should be used for the prevention of dementia in community-dwelling elderly, through the intervention should be complemented in order to improve more of the components of cognition.

Effects of screen size on smartphone functionality and usability for stroke patients with hemiparalysis.

[Purpose] The effect of screen size on smartphone functionality and usability for patients with stroke, considering both the non-dominant and dominant hand smartphone usage, was investigated in this study. [Subjects and Methods] Thirteen patients with stroke participated in this study-five pre-non-dominant hand users and eight pre-dominant hand users. The smartphone screen sizes used were 4.2, 4.5, and 5.6 inches. Usability was assessed in terms of discomfort experienced during dragging operations, which was self-reported using a four-point Likert scale. Functionality was assessed in terms of completion time and the frequency of errors in the task requiring users to quickly touch numbers 0 through 9 in order on the keypad. [Results] For all three screen sizes, a significant difference between the dominant and non-dominant hands was found in usability, completion time, and frequency of errors. For dominant hand users, differences in usability and completion time were found among the three screen sizes. Among the three screen sizes, no difference in the frequency of errors was found in either of the groups. [Conclusion] This study will be useful as basic research on usability and functionality with stroke patients using only pre-non-dominant or pre-dominant hand.

The correlation between proprioception and handwriting legibility in children.

[Purpose] This study investigated the association between proprioception, including joint position sense and kinetic sense, and handwriting legibility in healthy children. [Subjects and Methods] Assessment of joint position sense, kinetic sense, and handwriting legibility was conducted for 19 healthy children. Joint position sense was assessed by asking the children to flex their right elbow between 30° to 110° while blindfolded. The range of elbow movement was analyzed with Compact Measuring System 10 for 3D motion Analysis. Kinetic sense was assessed using the Sensory Integration and Praxis Test. The children were directed to write 30 words from the Korean alphabet, and the legibility of their handwriting was scored for form, alignment, space, size, and shape. To analyze the data, descriptive statistics and Spearman correlation analysis were conducted using IBM SPSS Statistics 20.0. [Results] There was significant negative correlation between handwriting legibility and Kinetic sense. A significant correlation between handwriting legibility and Joint position sense was not found. [Conclusion] This study showed that a higher Kinetic sense was associated with better legibility of handwriting. Further work is needed to determine the association of handwriting legibility and speed with Joint position sense of the elbow, wrist, and fingers.

Discomfort and muscle activation during car egress in drivers with hemiplegia following stroke.

[Purpose] This study investigated and compared the discomfort experienced during car egress with the car door opened at different angles and muscle activation in drivers with hemiplegia following stroke and non-disabled drivers. [Subjects and Methods] The participants were five drivers with hemiplegia and five non-disabled drivers. The discomfort experienced during car egress was measured using the nine-point Likert scale when the door was opened wide and when it was opened 45°. Muscle activation was measured using the TeleMyo 2400T G2 electromyography system. Electromyograph electrodes were placed on the erector spinae, rectus abdominis, and rectus femoris muscles. [Results] In the non-disabled drivers, there was no significant difference in the discomforts they experienced during car egress when the door was opened wide and when it was opened 45°. However, the discomfort experienced by drivers with hemiplegia when the door was opened 45° was significantly higher than that experienced when it was opened wide. There was a significant difference in the activation of the erector spinae, but no difference in the activation of the rectus abdominis or rectus femoris muscles. [Conclusion] This study will help to understand the difficulties experienced by drivers with hemiplegia following stroke during car ingress and egress.

Muscle activation of drivers with hemiplegia caused by stroke while driving using a steering wheel or knob.

[Purpose] The aim of this study was to investigate three muscle activities of drivers with post-stoke hemiplegia while they were driving using a steering wheel or a spinner knob, and to compare them with those of non-disabled drivers. [Subjects and Methods] The subjects were four non-disabled drivers and five drivers with left hemiplegia. The subjects drove forward in a straight line for 5 m and then turned right or left using the steering wheel or spinner knob with only their right hand. EMG electrodes were placed over the anterior deltoid, biceps and triceps brachii on the right-side. [Results] While differences in muscle activation between the spinner knob and the steering wheel in the control group were not significant, those of the experimental group were significant. Activation of the biceps brachii while the control group turned the vehicle to the right using the spinner knob was significantly lower than when using the steering wheel. Activation of the biceps brachii while the experimental group turned the vehicle to the right using the spinner knob was significantly lower than that of the control group. [Conclusion] The results of this study indicate that a spinner knob requires less activation of the main muscle than a steering wheel, especially in drivers who have had a stroke. The results could be used as basic data when driver rehabilitation specialists prescribe the spinner knob for patients.

Effects of combining mental practice with electromyogram-triggered electrical stimulation for stroke patients with unilateral neglect.

[Purpose] The aim of this study was to investigate the effect of mental practice combined with electromyogram-triggered electrical stimulation on neglect and activities of daily living in stroke patients with unilateral neglect. [Subjects and Methods] Thirty-three stroke patients with unilateral neglect were recruited from a local university hospital, and were divided into two groups. The experimental group received an intervention consisting of mental practice combined with electromyogram-triggered electrical stimulation on the neglected side, while the control group received cyclic electrical stimulation at the same site. In addition, both groups received an identical intervention of conventional occupational and physical therapy. [Results] After the intervention, the experimental group showed a statistically significant improvement in the line bisection test result, star cancellation test result, and Catherine Bergego Scale scores. The control group showed a significant improvement only in the line bisection test result. [Conclusion] These data suggest that mental practice combined with electromyogram-triggered electrical stimulation is an effective, novel treatment for reducing unilateral neglect in stroke patients.

Comparison of Task Performance, Hand Power, and Dexterity with and without a Cock-up Splint.

[Purpose] The purpose of this study was to investigate the difference in task performance, grip and pinch strength, and dexterity with and without cock-up splints, which are widely used in occupational therapy practice. [Methods] Twenty-three participants performed Jebsen-Taylor hand function test and grooved pegboard for task performance and dexterity. The power grip and pinch strength was measured using Jamar hydraulic hand dynamometer and pinch gauge. [Results] In the result of the Jebsen-Taylor hand function test, task performance with the cock-up splint was slower compared to without the splint for all items. Men's grip power with the cock-up splint was found to be significantly decreased compared to without the splint. Women's grip and palmar pinch strength with the splint decreased significantly compared to without the splint. In the grooved pegboard test, the dexterity of both men and women with the cock-up splint decreased significantly compared to without the splint. [Conclusion] To assist patients to make wise decisions regarding the use of splints, occupational therapists must have empirical knowledge of the topic as well as an understanding of the theoretical, technical, and related research evidence. The results of this study will be useful in the analysis and understanding of changes in hand function in splint applications for people with hand dysfunction.

Comparison of Muscle Activation while Performing Tasks Similar to Activities of Daily Livings with and without a Cock-up Splint.

[Purpose] This study investigated changes in the activation of the main elbow muscle while performing tasks similar to activities of daily living (ADL) with and without a cock-up splint. [Methods] Sixteen participants performed a simulated feeding task and picked up light and heavy cans in the Jebsen-Taylor hand function test. The activation of the biceps brachii, the triceps brachii, and the brachioradialis with and without the cock-up splint was measured using a BTS FreeEMG 300 wireless electromyography system (BTS, Inc., Milan, Italy). [Results] The activation of the biceps brachii and the brachioradialis was significantly higher while performing the simulated feeding task with the cock-up splint than without the splint. While picking up the light and heavy cans, the activation of the brachioradialis was significantly decreased by wearing the cock-up splint. In the heavy cans task, the activation of the triceps brachii was significantly higher with the cock-up splint than without the splint. [Conclusion] This study showed that diverse muscles' activation was increased or decreased when wearing the cock-up splint while performing tasks similar to ADL. The results of this study can be used as an educational resource for therapists teaching patients about splint application and splint compliance in ADL.