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Background: Falls are frequent in older adults and can cause trauma, injury, and death. Fall prevention with virtual reality presents good results in improving postural control. Transcranial Direct Current Stimulation (tDCS) has been used with the same aim; however, the combination of the two techniques has still been little studied. Purpose: To assess whether tDCS can enhance the effect of video game training (VGT) on improving the postural balance of healthy older women. Method: A blinded, randomized, controlled clinical trial was conducted with 57 older women who were randomized to three balance training groups: Control Group (VGT), Anodal Group (VGT combined with anodic tDCS‐atDCS), and Sham Group (VGT combined with sham tDCS‐stDCS). Balance training was performed twice a week for four weeks, totalizing eight 20‐min sessions using VGT associated with tDCS. Postural balance was assessed pre‐and post‐training and 30 days after the end of the eight sessions using the Mini‐Balance Evaluation Systems Test. Results: Compared to pre‐intervention the Mini BEST test increased similarly in the three groups in post‐intervention (control: pre 23.7 ± 2.8 to post 27.0 ± 2.2; anodal: pre 24.4 ± 1 to post 27.7 ± 0.8 and sham: pre 24.2 ± 1.9 to post 26.5 ± 1.6; p < 0.001) and follow‐up (control: pre 23.7 ± 2.8 to follow‐up 26.8 ± 2.3; anodal: pre 24.4 ± 1 to follow‐up 27.3 ± 1.4 and sham: pre 24.2 ± 1.9 to follow‐up 26.8 ± 1.5; p < 0.001). Conclusion: There was an improvement in the postural balance of the three training groups that were independent of tDCS. Discussion: Some studies have shown the positive tDCS effects associated with other tasks to improve balance. However, these results convey the effects of only anodic‐tDCS compared to sham‐tDCS. Possibly, the effect of VGT surpassed the tDCS effects, promoting a ceiling effect from the combination of these two therapies. However, studies with other therapies combined with tDCS for older adults deserve to be investigated, as well as in frail older people. [ABSTRACT FROM AUTHOR]

Copyright of ConScientiae Saúde is the property of Nove de Julho University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ConScientiae Saúde is the property of Nove de Julho University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/aims: This study aimed to estimate the discriminatory power of 26 items on the Stroke Specific Quality of Life Scale questionnaire to evaluate the participation component of the International Classification of Functioning, Disability and Health. Methods: A prospective study was conducted using accuracy procedures based on the Standards for Reporting Diagnostic Accuracy Studies to evaluate individuals with hemiparesis stemming from a stroke. Discriminatory power was estimated based on the area under the receiver operating characteristic curve with a 95% confidence interval. Two groups were defined for the analysis: community-dwelling and institutionalised individuals. A 5% level of significance (α=0.05) was considered for all analyses. Results: The area under the receiver operating characteristic curve was 0.888 (95% confidence interval: 0.794–0.949; P=0.001). Analysis indicated a cut-off point of ≥80 with 73.9% sensitivity and 100% specificity. Conclusions: The 26 items of the Stroke Specific Quality of Life questionnaire that evaluate the participation component of the International Classification of Functioning, Disability and Health demonstrate adequate discriminatory power. A cut-off point of ≥80 seems to best discriminate the perception of participation between community-dwelling and institutionalised stroke survivors. [ABSTRACT FROM AUTHOR]

Introduction. SATIS-Stroke was developed to measure satisfaction regarding activities and participation among stroke survivors based on the concepts contained in the International Classification of Functioning, Disability, and Health. However, this measure is only available in English and French. Objective. Perform the translation and cross-cultural adaptation of SATIS-Stroke to Brazilian Portuguese and test the preliminary reliability of this measure. Methods. The translation process followed standardized guidelines and consisted of six phases: initial translation, back-translation, analysis of expert committee, test of final version, submission, and assessment of all written reports. To test the preliminary test-retest reliability, the measure was administered by a single observer on two occasions with an interval of 7 to 14 days for the determination of intraobserver agreement and administered again by a second observer for the determination of interobserver agreement. Reliability was analyzed using the intraclass correlation coefficient (ICC2,1) and respective 95% confidence intervals (CI). Results. All stages of the cross-cultural adaptation process were respected and the final translated version of SATIS-Stroke exhibited semantic, idiomatic, cultural, and conceptual equivalence to the original version. The preliminary analysis revealed excellent intraobserver and interobserver reliability (ICC = 0.93; 95% CI: 0.83-0.97, p = 0.001 and ICC = 0.90; 95% CI: 0.74-0.96; p = 0.001, respectively). The items demonstrated adequate internal consistency, although ceiling and floor effects were considered beyond acceptable standards for some items. In the exploratory factor analysis, three factors were extracted that aggregated more than one construct to each component, but all were related to the "Activities and Participation" component of the International Classification of Functioning, Disability, and Health. Conclusion. The final version of the SATIS-Stroke scale in Brazilian Portuguese proved to be adequate and reliable for use on the Brazilian population. Further studies are underway to give continuity to the validation process and analyze the others measurement properties of the scale in the Brazilian population. [ABSTRACT FROM AUTHOR]

Purpose:Analyze the construct validity and internal consistency of the Stroke Specific Quality of Life (SS-QOL) items that address the participation component of the ICF as well as analyze the ceiling and floor effects. Methods:One hundred subjects were analyzed: 85 community-dwelling and 15 institutionalized individuals. The analysis of construct validity was performed using classic psychometrics: (1) the comparison of known groups (individuals without restriction to participation vs. those with restriction to participation) using the Mann–Whitney test and (2) convergent validity – correlation between the scores on the SS-QOL items that address participation and the subscale scores of measures used to evaluate the similar constructs and concepts [the Short-Form Health Survey (SF-36), Functional Independence Measure (FIM) and grip strength test]. Spearman’s correlation coefficients were calculated for this analysis. Cronbach’sαwas used for the analysis of internal consistency and both the ceiling and floor effects were analyzed. The level of significance for all analyses wasα = 0.05. Results:Thea priorihypotheses regarding construct validity were partially demonstrated, as only five of the eight domains exhibited positive moderate to strong correlations (r > 0.40) with measures that address constructs similar to those addressed on the SS-QOL questionnaire. The items demonstrated adequate internal consistency and are capable of differentiating individuals with and without restriction to participation. The ceiling and floor effects were considered adequate for the total SS-QOL score, but beyond acceptable standards for some domains. Conclusions:The 26 items of the SS-QOL questionnaire measure a multidimensional construct and therefore do not only address participation. However, the items demonstrated adequate internal consistency and are capable of differentiating individuals with and without restriction to participation. Implications for rehabilitationThe 26 items of the SS-QOL questionnaire demonstrated adequate internal consistency and are capable of differentiating individuals with and without restriction to participation.The present findings can guide healthcare professionals regarding the selection of an assessment tool for the evaluation of post-stroke participation.The findings can lead to consistent and standardization evaluations, which facilitates comparisons and discussion on functional health and social participation after stroke. [ABSTRACT FROM PUBLISHER]

Purpose:To evaluate the reproducibility of the Stroke Specific Quality of Life (SS-QOL) items that address the participation component of the International Classification of Functioning, Disability and Health (ICF) and analyse the correlation between the subscore of these 26 items and the total SS-QOL score. Methods:Seventy-five stroke survivors participated in this study. Reproducibility was evaluated using the intraclass correlation coefficient (ICC2,1), standard error of measurement (SEM), minimum detectable change (MDC) and the Bland–Altman plot. The correlation between the subscore of the 26 items and the total SS-QOL score was analysed using Spearman’s correlation coefficients (rho) and simple linear regression. An alpha risk ≤ 0.05 was considered for all analyses. Results:The SS-QOL items that address the participation component of the ICF demonstrated excellent reliability (intra-rater ICC2,1 = 0.96; inter-rater ICC2,1 = 0.95). The SEM and MDC were adequate. The Bland–Altman plot demonstrated satisfactory agreement. A significant and strong correlation (rho = 0.83) was found between the 26 SS-QOL items that address participation and the total SS-QOL score. Moreover, the evaluation of participation was found to explain 73% of the evaluation of health-related quality of life. Conclusion:The 26 SS-QOL items that address the participation component of the ICF demonstrated adequate reproducibility. Thus, participation, which represents the social aspects of functionality, can be adequately evaluated with these items.Implications for RehabilitationThe 26 Stroke Specific Quality of Life items that address participation proved to be reproducible for the analysis of social participation following a stroke.The findings can lead to a better understanding of the social participation of individuals with chronic hemiparesis and assist in the establishment of adequate treatment for such individuals.The rehabilitation process can be directed towards more specific goals focused on the patient expectations, thereby contributing to greater humanization and effectiveness of treatment to improve social participation following a stroke. [ABSTRACT FROM PUBLISHER]

Purpose:To assess the impact of post-stroke depression on the participation component of the International Classification of Functioning, Disability and Health (ICF). Method:Thirty-five stroke survivors with chronic hemiparesis were divided into two groups: those with and without depression. The Geriatric Depression Scale (GDS) was used for the analysis of depressive symptoms. Participation was analysed using the Stroke Specific Quality of Life scale. The Mann–Whitney test was used to compare the participation scores between the two groups. Spearman’s correlation coefficients were calculated to determine the strength of the association between the assessment tools. Simple linear regression was used to determine the impact of depression on participation. An alpha risk of 0.05 was considered indicative of statistical significance. Results:The group with depression had low participation scores (p = 0.04). A statistically significant negative correlation of moderate magnitude was found between depression and participation (r =  −0.6;p  = 0.04). The linear regression model demonstrated that depression is a moderate predictor of participation (r2 = 0.51;p = 0.001). Conclusions:Depression is a moderate predictor of participation among stroke survivors, explaining 51% of the decline of this aspect. Thus, depression should be diagnosed, monitored and treated to ensure a better prognosis regarding social participation following a stroke.Implications for RehabilitationIndividuals with post-stroke depression experience a lower degree of social participation.Depression explains 51% of the decline in participation following a stroke.The present findings can serve as a basis to assist healthcare professionals involved in the rehabilitation of stroke survivors and can assist in the establishment of adequate treatment plans in stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Copyright of ConScientiae Saúde is the property of Nove de Julho University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The aim of the study is to identify the predictors of social participation in Down syndrome adults from the biopsychosocial model of the International Classification of Functioning, Disability, and Health. Methods: An exploratory, analytical, cross-sectional study was conducted with Down syndrome adults. The social participation was assessed using the Life Habits Assessment. The independent variables were determined using the International Classification of Functioning, Disability, and Health biopsychosocial model: body functions were assessed by body mass index, cognition function (Mini-Mental State Examination), and lower limbs muscle strength (Sit-to-Stand Test). Activities were assessed by the 8-Foot Up and Go Test. Environmental factors were assessed by the measure of the quality of the environment, and personal factors were assessed by age, sex, and education level. Results: The total Life Habits Assessment score indicates that individuals show moderate restriction in social participation, with major restriction in the education, employment, and responsibilities domains. The 8-Foot Up and Go Test was the best social participation predictor variable, followed by Mini-Mental State Examination, and the Sit-to-Stand Test. Contextual factors were not predictors of participation. Conclusions: It was concluded that individuals with Down syndrome present the most restrictions to social participation in activities that involve social roles. The predictors influencing social participation are functional mobility, cognition, and lower limb muscle strength. [ABSTRACT FROM AUTHOR]

SATIS-Stroke questionnaire has been translated and adapted for use in the Brazilian population, however, it is necessary to test the measurement properties in Brazilian population. To test the reliability, agreement, concurrent validity, and diagnostic accuracy of the SATIS-Stroke. Chronic stroke survivors were included. The calculations were made using scores in logits (Rasch Model). Reliability was tested using the intraclass correlation coefficient (ICC 2,1), standard error of measurement (SEM), minimal detectable change (MDC), and Bland-Altman plots. Concurrent validity was analyzed using Spearman's correlation coefficient. For such, the correlation between SATIS-Stroke and Stroke Specific Quality of Life (SS-QOL) questionnaires was determined. Diagnostic accuracy was estimated based on the area under the receiver operating characteristic (ROC) curve with a 95% confidence interval and considering the sensitivity and specificity of SATIS-Stroke in differentiating different types of activity and participation. Eighty stroke survivors were analyzed. Mean age was 57.98±13.85 years and 45.2% had severe impairment. Excellent reliability was found (intra-observer ICC 2,1 = 0.90; 95% CI: 0.84, 0.93; inter-observer ICC 2,1 = 0.89; 95% CI: 0.83, 0.93). The Bland-Altman plot demonstrated satisfactory agreement. In the analysis of concurrent validity, a strong, positive, significant correlation was found between SATIS-Stroke and SS-QOL (r s = 0.74; p <0.001 with an r2=0.44; p=0.001). Diagnostic accuracy was satisfactory, with 80.8% sensitivity and 85.2% specificity. The Brazilian version of the SATIS-Stroke questionnaire exhibited adequate reliability, concurrent validity, and diagnostic accuracy. Therefore, this is a valid, reproducible measure for the assessment of satisfaction with regard to activities and participation following a stroke. • The Brazilian version of the SATIS-Stroke questionnaire exhibited adequate measure properties. • SATIS-Stroke considers the perspective of the patient on their performance in activities and situations of daily living. • The SATIS-Stroke offers important data for decision-making with regard to treatment and follow up of stroke survivors. • These findings can contribute to the development of effective evaluation strategies. [ABSTRACT FROM AUTHOR]

Background: According to the International Classification of Functioning, Disability and Health (ICF), the participation component is considered to be the most complex component characterized in existing instruments that assess quality of life related to health (HRQoL). Questionnaires such as the Nottingham Health Profile (NHP) and the Stroke-Specific Quality of Life (SS-QOL) are currently used to evaluate the participation of individuals in life activities after stroke. However, because participation and HRQoL are different constructs, it is unclear whether these instruments are best suited to this evaluation. Objective: To investigate whether the NHP and SS-QOL are suitable instruments for assessing the participation component of ICF. Method: A cross-sectional study was conducted in which a sample of 35 individuals completed the SS-QOL and NHP. The study correlated the total score on the questionnaires with the scores on items that evaluate the participation component of the ICF. Both analyses used the Spearman correlation coefficient (r). Results: There was a statistically significant, positive and strong correlation between total score on the SS-QOL and NHP and the score on specific components related to participation (r=0.8, p=0.001 and r=0.9, p=0.001, respectively). Conclusions: Both the NHP and the SS-QOL show strong correlations between the total score and the score on items that assess the participation categories of the ICF. However, the SS-QOL questionnaire appeared to be the most complete for this assessment because it evaluates more distinct domains and contains the largest number of items related to participation. [ABSTRACT FROM AUTHOR]