Introduction: To determine if athletes with coordination impairment (CI) can continue playing wheelchair rugby (WR), while an evidence-based classification system, including impairment tests for CI is not yet available. This is a defensible practise if they show similar activity limitations as athletes with other eligible impairment types (OI) within the same sports class. Methods: Standardised activities were measured in 58 elite WR athletes; 14 with CI and 44 with OI. Wheelchair activities consisted of 20-meter sprint, 12-meter sprint with full stop, intermittent sprint (3-meter sprint, stop, 3-meter sprint, stop, 6-meter sprint with full stop), sprint-curve-slalom-curve, turn on the spot 180°, turn on the spot 90°, stop, turn 90°in the same direction, X-test (short circuit with sharp turns) without the ball. Ball activities consisted of maximal throwing distance, precision throwing short (25% of maximum throw) and long (75% of maximal throw) distance and X-test with the ball (pick-up the ball and dribble whilst pushing). Descriptive statistics were used and Spearman’s Rank correlation was assessed for athletes with CI and OI for each outcome measure. Differences between athletes with CI and OI were assessed using a Mann-Whitney U test. Results: Most activities showed a high correlation with the athlete class in both athletes with CI and athletes with OI. Furthermore, outcome measures of athletes with CI overlapped with athletes with OI in the same sports class for all activities. There was a trend for worse performance in athletes with CI in turn on the spot 90°, stop, turn 90°in the same direction, the short distance one handed precision throw (P 0.11)and in the X-test with the ball (P 0.10). Discussion: Despite the current lack of evidence based impairment tests for CI, it is a defensible practise to not exclude athletes with CI from WR with the current classification system. The trends for differences in performance that were found can support athletes and coaches in optimising performance of athletes with CI.
DOCUMENT
Increasing attention has been paid to the ‘voice’ of people living with mild cognitive impairment (or dementia, but there is a lack of clarity about how everyday life is perceived from this insiderinsider’s perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MC I and dementia living at home.
DOCUMENT
PURPOSE: To investigate whether the adapted version of the Gross Motor Function Measure-88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) results in higher scores. This is most likely to be a reflection of their gross motor function, however it may be the result of a better comprehension of the instruction of the adapted version.METHOD: The scores of the original and adapted GMFM-88 were compared in the same group of children (n=21 boys and n=16 girls), mean (SD) age 113 (30) months with CP and CVI, within a time span of two weeks. A paediatric physical therapist familiar with the child assessed both tests in random order. The GMFCS level, mental development and age at testing were also collected. The Wilcoxon signed-rank test was used to compare two different measurements (the original and adapted GMFM-88) on a single sample, (the same child with CP and CVI; p<0.05).RESULTS: The comparison between scores on the original and adapted GMFM-88 in all children with CP and CVI showed a positive difference in percentage score on at least one of the five dimensions and positive percentage scores for the two versions differed on all five dimensions for fourteen children. For six children a difference was seen in four dimensions and in 10 children difference was present in three dimensions (GMFM dimension A, B& C or C, D & E) (p<0.001).CONCLUSION: The adapted GMFM-88 provides a better estimate of gross motor function per se in children with CP and CVI that is not adversely impacted bytheir visual problems. On the basis of these findings, we recommend using the adapted GMFM-88 to measure gross motor functioning in children with CP and CVI.
DOCUMENT
Background The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to the quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and physical capacities. However, until recently, the impact of the significantly prevalent visual impairments on the performance of activities of daily living has not yet been revealed within this group. Aim The purpose of this study was to investigate the impact of visual impairment on the performance of Activities of Daily Living for persons with a severe/profound intellectual disability. Method The Barthel Index (BI) and Comfortable Walking Speed (CWS) were employed in order to measure in 240 persons with severe/profound ID and having Gross Motor Functioning Classification System (GMFCS) levels I, II or III the ability of performing activities of daily living (ADL); this included 120 persons with visual impairment. Effects were analysed with linear regression analyses. Results The results of the study demonstrated that visual impairment has a minimal, but significant, effect on the ability of performing Activities of Daily Living (BI) for persons with a severe/profound intellectual disability. Forty four percent of the total BI score can be predicted by the GMFCS level and the level of ID; 45% with the additional presence of visual impairment. GMFCS levels II or III, a profound ID level, and visual impairment yielded lower BI scores compared to GMFCS Level I, severe ID, and no visual impairment. CWS scores did not significantly vary if visual impairment was present. Conclusions Visual impairment does slightly affect the ability to perform ADL in persons experiencing severe/profound ID.
DOCUMENT
This posterpresentation demonstrates the preliminary results of a validation study concering the Dutch version of the Quick Mild Cognitive Impairment screen (Qmci).
DOCUMENT
Increasing attention has been paid to the ‘voice’ of people living with mild cognitive impairment (MCI) or dementia, but there is a lack of clarity about how everyday life is perceived from this insider’s perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MCI and dementia living at home. A scoping review of qualitative studies, guided by the Joanna Briggs Institute Reviewers Manual, was conducted. Eight databases were searched, resulting in 6345 records, of which 58 papers published between 2011 and 2021 were included. Analysis was carried out by descriptive content analysis. Findings were categorized into seven spheres of everyday life: experiences related to the condition, self, relationships, activities, environment, health and social care and public opinions. The results show many disruptions and losses in everyday life and how people try to accommodate these changes. In all areas of everyday life, people show a deep desire to have reciprocal relationships, stay engaged through participation in activities and have a sense of belonging in the community. However, more research is needed on the factors that promote and impede the sense of reciprocity and belonging.
MULTIFILE
It is estimated that visual and severe or profound intellectual disabilities affect 10,000 to 15,000 adults in the Netherlands, which is approximately 0.05-0.08% of the Dutch population. These adults have an intelligence quotient of less than 35 points, and their visual acuity is less than 6/18. Comorbidity is very common in these adults, i.e., they often experience other physical impairments, sensory impairments, or medical problems.People with severe or profound intellectual disabilities and visual impairment (MDVI) encounter numerous physical health problems simultaneously. In addition, they have lower physical activity and physical fitness levels compared to the general population. As a consequence, their ability to perform activities of daily living is decreased. Last but not least, persons with MDVI appear to be at risk of decreased participation. Royal Dutch Visio and the Hanze University closely collaborate with the Research Centre on Profound Intellectual and Multiple Disability of the Rijksuniversiteit Groningen to perform research in persons with MDVI. In this symposium, their research and that of international research groups will be presented concerning the following topics: participation, physical health problems, optometric issues, motor activation, and measuring muscle strength of persons
DOCUMENT
AIM: The objectives of this study were (i) to develop two cerebral visual impairment motor questionnaires (CVI-MQ's) for children with cerebral palsy (CP): one for children with Gross Motor Function Classification System (GMFCS) levels I, II and III and one for children with GMFCS levels IV and V; (ii) to describe their face validity and usability; and (iii) to determine their sensitivity and specificity.BACKGROUNDS: The initial versions of the two CVI-MQ's were developed based on literature. Subsequently, the Delphi method was used in two groups of experts, one familiar with CVI and one not familiar with CVI, in order to gain consensus about face validity and usability. The sensitivity and specificity of the CVI-MQ's were subsequently assessed in 82 children with CP with (n = 39) and without CVI (n = 43). With the receiver operating curve the cut-off scores were determined to detect possible presence or absence of CVI in children with CP.RESULTS: Both questionnaires showed very good face validity (percentage agreement above 96%) and good usability (percentage agreement 95%) for practical use. The CVI-MQ version for GMFCS levels I, II and III had a sensitivity of 1.00 and specificity of 0.96, with a cut-off score of 12 points or higher, and the version for GMFCS levels IV and V had a sensitivity of 0.97 and a specificity of 0.98, with a cut-off score of eight points or higher.CONCLUSION: The CVI-MQ is able to identify at-risk children with CP for the probability of having CVI.
DOCUMENT
BACKGROUND: Differentiating mild cognitive impairment (MCI) from dementia is important, as treatment options differ. There are few short (<5 min) but accurate screening tools that discriminate between MCI, normal cognition (NC) and dementia, in the Dutch language. The Quick Mild Cognitive Impairment (Qmci) screen is sensitive and specific in differentiating MCI from NC and mild dementia. Given this, we adapted the Qmci for use in Dutch-language countries and validated the Dutch version, the Qmci-D, against the Dutch translation of the Standardised Mini-Mental State Examination (SMMSE-D).METHOD: The Qmci was translated into Dutch with a combined qualitative and quantitative approach. In all, 90 participants were recruited from a hospital geriatric clinic (25 with dementia, 30 with MCI, 35 with NC). The Qmci-D and SMMSE-D were administered sequentially but randomly by the same trained rater, blind to the diagnosis.RESULTS: The Qmci-D was more sensitive than the SMMSE-D in discriminating MCI from dementia, with a significant difference in the area under the curve (AUC), 0.73 compared to 0.60 (p = 0.024), respectively, and in discriminating dementia from NC, with an AUC of 0.95 compared to 0.89 (p = 0.006). Both screening instruments discriminated MCI from NC with an AUC of 0.86 (Qmci-D) and 0.84 (SMMSE-D).CONCLUSION: The Qmci-D shows similar,(good) accuracy as the SMMSE-D in separating NC from MCI; greater,(albeit fair), accuracy differentiating MCI from dementia, and significantly greater accuracy in separating dementia from NC. Given its brevity and ease of administration, the Qmci-D seems a useful cognitive screen in a Dutch population. Further study with a suitably powered sample against more sensitive screens is now required.
DOCUMENT
ObjectiveIn the Netherlands, persons of Turkish, Moroccan and Surinamese descent form the largest groups of non-western immigrants. A high prevalence of mild cognitive impairment (MCI) and dementia has been described in immigrant populations in the United States of America and the United Kingdom. We determined the prevalence of MCI and dementia in older community-dwelling adults from the largest non-western immigrant groups in the Netherlands.MethodsParticipants, aged 55 years and older, of Turkish, Moroccan (Arabic or Berber), Surinamese (Creole or Hindustani) or Dutch descent were recruited via their general practitioners. Cognitive deficits were assessed using the Cross-Cultural Dementia screening instrument, which was validated in poorly educated people from different cultures. Differences in prevalence rates of MCI and dementia between the immigrant groups and a native Dutch group were analysed using chi-square tests.ResultsWe included 2254 participants. Their mean age was 65.0 years (standard deviation, 7.5), and 44.4% were male. The prevalence of MCI was 13.0% in Turkish, 10.1% in Moroccan–Arabic, 9.4% in Moroccan–Berber and 11.9% in Surinamese–Hindustani participants, compared to 5.9% in Surinamese–Creoles and 3.3% in native Dutch. The prevalence of dementia was 14.8% in Turkish, 12.2% in Moroccan Arabic, 11.3% in Moroccan Berber and 12.6% in Surinamese–Hindustani participants, compared to 4.0% in Surinamese–Creoles and 3.5% in native Dutch.ConclusionsMCI and dementia were three to four times more prevalent in the majority of non-western immigrant groups when compared to the native Dutch population. These differences are important for planning and improving healthcare facilities. Copyright © 2016 John Wiley & Sons, Ltd.
DOCUMENT
