Objective: This exploratory study investigated to what extent gait characteristics and clinical physical therapy assessments predict falls in chronic stroke survivors. Design: Prospective study. Subjects: Chronic fall-prone and non-fall-prone stroke survivors. Methods: Steady-state gait characteristics were collected from 40 participants while walking on a treadmill with motion capture of spatio-temporal, variability, and stability measures. An accelerometer was used to collect daily-life gait characteristics during 7 days. Six physical and psychological assessments were administered. Fall events were determined using a “fall calendar” and monthly phone calls over a 6-month period. After data reduction through principal component analysis, the predictive capacity of each method was determined by logistic regression. Results: Thirty-eight percent of the participants were classified as fallers. Laboratory-based and daily-life gait characteristics predicted falls acceptably well, with an area under the curve of, 0.73 and 0.72, respectively, while fall predictions from clinical assessments were limited (0.64). Conclusion: Independent of the type of gait assessment, qualitative gait characteristics are better fall predictors than clinical assessments. Clinicians should therefore consider gait analyses as an alternative for identifying fall-prone stroke survivors.
Logopedisten en klinisch linguïsten onderzoeken de taalontwikkeling van jonge kinderen met een vermoedelijke of al vastgestelde taalontwikkelingsstoornis. Ze onderzoeken ook de taalvaardigheid van personen met afasie. Naast gestandaardiseerde tests worden samples spontane taal geanalyseerd. Hiervoor worden uitingen ontlokt aan de patiënten via vaste protocollen. De sessies worden opgenomen, getranscribeerd en vervolgens grammaticaal geanalyseerd. Bij de grammaticale analyse wordt bepaald welke soorten constructies en fouten voorkomen en in welke mate, en dit wordt vergeleken met een norm. Taal- en spraaktechnologie (TST) kan er in prin-cipe aan bijdragen om het proces van transcriptie en grammaticale analyse efficiënter te maken en mogelijk zelfs om de kwaliteit van de assessments te verhogen. In dit artikel richten we ons op de mogelijkheden van TST voor de analyse van kindertaal.
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This case study presents the structured and evidence-informed approach toward developing a psychological assessment instrument within a national basketball federation. To this end, a two-phase approach was adopted. During the first phase, a focus group with the coaches was conducted to determine the key psychological characteristics pertinent to the case environment. This resulted in 10 identified key psychological characteristics. During the second phase, the results from the focus group were used to develop and conduct preliminary testing of a context-specific assessment instrument. Preliminary testing resulted in a refined instrument including nine characteristics. Based on the findings of this case study, the authors conclude this paper by outlining a number of reflections that can provide important considerations for sport psychologists, coaches, and talent identification and development organizations looking to develop and implement psychological assessment within their programs.
Everyone has the right to participate in society to the best of their ability. This right also applies to people with a visual impairment, in combination with a severe or profound intellectual and possibly motor disability (VISPIMD). However, due to their limitations, for their participation these people are often highly dependent on those around them, such as family members andhealthcare professionals. They determine how people with VISPIMD participate and to what extent. To optimize this support, they must have a good understanding of what people with disabilities can still do with their remaining vision.It is currently difficult to gain insight into the visual abilities of people with disabilities, especially those with VISPIMD. As a professional said, "Everything we can think of or develop to assess the functional vision of this vulnerable group will help improve our understanding and thus our ability to support them. Now, we are more or less guessing about what they can see.Moreover, what little we know about their vision is hard to communicate to other professionals”. Therefore, there is a need for methods that can provide insight into the functional vision of people with VISPIMD, in order to predict their options in daily life situations. This is crucial knowledge to ensure that these people can participate in society to their fullest extent.What makes it so difficult to get this insight at the moment? Visual impairments can be caused by a range of eye or brain disorders and can manifest in various ways. While we understand fairly well how low vision affects a person's abilities on relatively simple visual tasks, it is much more difficult to predict this in more complex dynamic everyday situations such asfinding your way or moving around during daily activities. This is because, among other things, conventional ophthalmic tests provide little information about what people can do with their remaining vision in everyday life (i.e., their functional vision).An additional problem in assessing vision in people with intellectual disabilities is that many conventional tests are difficult to perform or are too fatiguing, resulting in either no or the wrong information. In addition to their visual impairment, there is also a very serious intellectual disability (possibly combined with a motor impairment), which makes it even more complex to assesstheir functional vision. Due to the interplay between their visual, intellectual, and motor disabilities, it is almost impossible to determine whether persons are unable to perform an activity because they do not see it, do not notice it, do not understand it, cannot communicate about it, or are not able to move their head towards the stimulus due to motor disabilities.Although an expert professional can make a reasonable estimate of the functional possibilities through long-term and careful observation, the time and correct measurement data are usually lacking to find out the required information. So far, it is insufficiently clear what people with VZEVMB provoke to see and what they see exactly.Our goal with this project is to improve the understanding of the visual capabilities of people with VISPIMD. This then makes it possible to also improve the support for participation of the target group. We want to achieve this goal by developing and, in pilot form, testing a new combination of measurement and analysis methods - primarily based on eye movement registration -to determine the functional vision of people with VISPIMD. Our goal is to systematically determine what someone is responding to (“what”), where it may be (“where”), and how much time that response will take (“when”). When developing methods, we take the possibilities and preferences of the person in question as a starting point in relation to the technological possibilities.Because existing technological methods were originally developed for a different purpose, this partly requires adaptation to the possibilities of the target group.The concrete end product of our pilot will be a manual with an overview of available technological methods (as well as the methods themselves) for assessing functional vision, linked to the specific characteristics of the target group in the cognitive, motor area: 'Given that a client has this (estimated) combination of limitations (cognitive, motor and attention, time in whichsomeone can concentrate), the order of assessments is as follows:' followed by a description of the methods. We will also report on our findings in a workshop for professionals, a Dutch-language article and at least two scientific articles. This project is executed in the line: “I am seen; with all my strengths and limitations”. During the project, we closely collaborate with relevant stakeholders, i.e. the professionals with specific expertise working with the target group, family members of the persons with VISPIMD, and persons experiencing a visual impairment (‘experience experts’).
