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BackgroundLoss of fine motor skills is observed in many neurological diseases, and remote monitoring assessments can aid in early diagnosis and intervention. Hand function can be regularly assessed to monitor loss of fine motor skills in people with central nervous system disorders; however, there are challenges to in-clinic assessments. Remotely assessing hand function could facilitate monitoring and supporting of early diagnosis and intervention when warranted.ObjectiveRemote assessments can facilitate the tracking of limitations, aiding in early diagnosis and intervention. This study aims to systematically review existing evidence regarding the remote assessment of hand function in populations with chronic neurological dysfunction.MethodsPubMed and MEDLINE, CINAHL, Web of Science, and Embase were searched for studies that reported remote assessment of hand function (ie, outside of traditional in-person clinical settings) in adults with chronic central nervous system disorders. We excluded studies that included participants with orthopedic upper limb dysfunction or used tools for intervention and treatment. We extracted data on the evaluated hand function domains, validity and reliability, feasibility, and stage of development.ResultsIn total, 74 studies met the inclusion criteria for Parkinson disease (n=57, 77% studies), stroke (n=9, 12%), multiple sclerosis (n=6, 8%), spinal cord injury (n=1, 1%), and amyotrophic lateral sclerosis (n=1, 1%). Three assessment modalities were identified: external device (eg, wrist-worn accelerometer), smartphone or tablet, and telerehabilitation. The feasibility and overall participant acceptability were high. The most common hand function domains assessed included finger tapping speed (fine motor control and rigidity), hand tremor (pharmacological and rehabilitation efficacy), and finger dexterity (manipulation of small objects required for daily tasks) and handwriting (coordination). Although validity and reliability data were heterogeneous across studies, statistically significant correlations with traditional in-clinic metrics were most commonly reported for telerehabilitation and smartphone or tablet apps. The most readily implementable assessments were smartphone or tablet-based.ConclusionsThe findings show that remote assessment of hand function is feasible in neurological disorders. Although varied, the assessments allow clinicians to objectively record performance in multiple hand function domains, improving the reliability of traditional in-clinic assessments. Remote assessments, particularly via telerehabilitation and smartphone- or tablet-based apps that align with in-clinic metrics, facilitate clinic to home transitions, have few barriers to implementation, and prompt remote identification and treatment of hand function impairments.

Identifying factors that impact physical function in older populations is important for the maintenance of good health with aging. Age-related hyperkyphosis, an excessive curvature in the thoracic spine, affects up to 40% of the older adults and is more common in older females than males. An association of age-related hyperkyphosis with impaired physical function has been reported in numerous studies, however, other studies have reported that a greater magnitude of kyphosis did not associate with impaired physical function. Given the inconsistencies regarding the impact of hyperkyphosis on physical function, the purpose of our study is to perform a systematic review of the existing studies in order to better describe the association between hyperkyphosis and physical function. Prospective and retrospective cohort, case-control, and cross-sectional studies which measure physical function by valid functional tests and questionnaires in older females will be included. We will search Scopus, ISI Web of Science, Cochrane Library, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PEDro databases. Studies will be searched and then selected by two independent reviewers based on quality assessment tools from the National Heart, Lung, and Blood Institute (NHLBI). A meta-analysis will be conducted if data reported for individual studies allow. Specifically, if two or more individual studies provide measures of central tendency and variability from any of the categories of physical function measures, data will be gathered for meta-analysis. If a meta-analysis is not possible, data will be synthesized and described in a narrative form by size and variability of effect, direction of effect, and association with hyperkyphosis.

BackgroundIndividuals with multiple sclerosis (MS) frequently report sexual dysfunction, a condition that may result in low sexual satisfaction and decreased quality of life. Although sexual dysfunction is usually treated pharmacologically, physical therapists, especially those trained in pelvic floor physical therapy (PT), are well-equipped to address a variety of impairments that contribute to poor sexual function. The current evidence for effectiveness of PT interventions in improving sexual dysfunction, sexual satisfaction, and the emotional well-being aspect of quality of life was analyzed.MethodsThe PubMed, CINAHL, and PEDro databases were searched through December 2019. Articles were included if participants had a clinical diagnosis of MS, reported sexual dysfunction or pain with intercourse, and had an intervention within the PT scope that addressed sexual dysfunction. Means and SDs were extracted from each study independently by two authors. Effect sizes (d) and 95% CIs were calculated within and across studies.ResultsEight studies met the inclusion criteria. Combined effects were significant and large across six studies for sexual function (d = 0.82, 95% CI, 0.57-1.06), moderate across seven studies for sexual satisfaction (d = 0.65, 95% CI, 0.43-0.87), and moderately large across two studies for emotional well-being (d = 0.78, 95% CI, 0.17-1.40). Between-group differences reached significance for sexual satisfaction (d = 0.29, 95% CI, 0.03-0.55).ConclusionsSexual function, sexual satisfaction, and emotional well-being can all be effectively addressed with various PT interventions. Highly effective interventions included pelvic floor muscle training and mindfulness. Future research should compare PT interventions with non-PT controls to determine best practice in this population.

ObjectivesPeople with cerebellar ataxia have few options to improve the standing stability they need for function. Strategic placement of light weights on the torso using the balance-based torso-weighting (BBTW) method has improved stability and reduced falls in people with multiple sclerosis, but has not been tested in cerebellar ataxia. We examined whether torso-weighting increased standing stability and/or functional movement in people with cerebellar ataxia.MethodsTen people with cerebellar ataxia and 10 matched controls participated in this single-session quasi-experimental pilot study. People with ataxia performed the Scale for the Assessment and Rating of Ataxia (SARA) prior to clinical testing. All participants donned inertial sensors that recorded postural sway; stopwatches recorded duration for standing and mobility tasks. All participants stood for up to 30 s on firm and foam surfaces with eyes open then eyes closed, and performed the Timed Up and Go (TUG) test. Light weights (0.57-1.25 kg) were strategically applied to a vest-like garment. Paired t tests compared within-group differences with and without BBTW weights. Independent t tests assessed differences from controls. All t tests were one-tailed with alpha set at .05.ResultsDuration of standing for people with ataxia was significantly longer with weighting (p = .004); all controls stood for the maximum time of 120 s with and without weights. More severe ataxia according to SARA was moderately correlated with greater improvement in standing duration with BBTW (Pearson r = .54). Tasks with more sensory challenges (eyes closed, standing on firm surface) showed less body sway with weighting. Duration for the TUG was unchanged by torso-weighting in people with ataxia.ConclusionStrategic weighting improved standing stability but not movement speed in people with ataxia. BBTW has potential for improving stability and response to challenging sensory conditions in this population. Future studies should further examine gait stability measures along with movement speed.

The advancement of college reading abilities from novice to expert is not an automatic outcome of an undergraduate education. Faculty play a large role in the undergraduate academic reading experience through course curricula and in-class instruction. However, descriptions of faculty beliefs about collegiate academic reading and pedagogical practices are notably absent in the literature. This article explores college faculty's open-ended comments about academic reading in the undergraduate experience. Our research reveals a paradox: while faculty across disciplines believe that academic reading is essential for undergraduates' success, they typically do not engage in academic reading pedagogies. Constraints cited include perceived tradeoffs between academic reading and course content, and views of academic reading as a static, undifferentiated skill. The invisibility of reading within course pedagogy is further exacerbated by context: faculty's epistemology and the institutional culture of the university in which faculty teach.

BACKGROUND: Foot drop in people with multiple sclerosis (MS) commonly leads to decreased mobility and quality of life (QOL). Functional electrical stimulation (FES) of the peroneal nerve can improve the gait of people with foot drop, yet various barriers restrict widespread use. The purpose of this case series was to examine the feasibility of a telerehabilitationmonitored FES device and report changes in functional mobility and QOL in people with moderate MS-related disability. METHODS: FES use was progressed over 8 weeks via 3 telerehabilitation sessions. Feasibility of telerehabilitation was assessed by percentage of telerehabilitation visits completed and participant-reported satisfaction. At baseline and study completion, functional mobility with and without FES were assessed by the Timed 25-Foot Walk (T25FW), Timed Up and Go (TUG), and 2-Minute Walk Test (2MWT), Multiple Sclerosis Impact Scale (MSIS-29), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Fatigue was assessed via the Modified Fatigue Impact Scale (MFIS) before and after the intervention. RESULTS: Eleven participants (mean age = 50.4 years [SD 10.8]; 2 males) completed the study. All (33/33) telerehabilitation visits were completed and participants attained high levels of satisfaction with no adverse events. At 8 weeks, compared to baseline, there were clinically meaningful improvements on the T25FW, 2MWT, and TUG for 45%, 55%, and 82% of participants, respectively. Clinically meaningful improvements on the MSIS-29 and MSWS-12 were also recorded for 64% and 36% of participants, respectively. CONCLUSIONS: Telerehabilitation was safe and feasible for FES intervention, and improvements in functional mobility and QOL were observed. Telerehabilitation to monitor FES may improve access and reduce patient burden; therefore, studying its efficacy is warranted. [ABSTRACT FROM AUTHOR]

To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps.Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined.137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering.These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability.

This cross-sectional study at a four-year college explored the alignment between students' and faculty perceptions and behaviors regarding academic reading. Constructs from the academic reading literature were used to create a 10-item survey, modified slightly for faculty and students to respond to the same prompts. A convenience sample of 848 students and a snowball sample of 63 faculty examined the value of academic reading, academic reading practices, and attitudes toward academic reading pedagogy. Differences in agreement between students and faculty were statistically significant for all items. Students and faculty agree that undergraduate education should make students proficient academic readers, although the faculty mean is significantly higher than the students'. The expert-novice, Dunning-Kruger effect, and disengagement compact are three theories proposed to explain results.

Background and Purpose: Thoracic hyperkyphosis may adversely influence physical function in older adults, but the literature is mixed and confounded by possible sex differences. This systematic review and meta-analysis aimed to examine the association between hyperkyphosis and physical function in older females. Methods: Scopus, ISI Web of Science, Cochrane Library, PubMed, CINAHL, and PEDro databases were searched through 2021 for studies that included measures of thoracic hyperkyphosis and physical function with extractable data for females older than 60 years. Studies were excluded if they were qualitative, case reports, case series, ecological studies, reviews, or were not published in English. The study quality and risk of bias were assessed using checklists from the National Heart, Lung, and Blood Institute. Data were synthesized using Cohen's d effect size and 95% confidence interval (CI), and random-effects models were used for the meta-analyses. Results and Discussion: Three cohort and 22 cross-sectional studies of fair to good quality met the inclusion criteria. Eight studies reporting single-group data showed a moderate association between greater kyphosis angles and lower physical function (d = -0.57; 95% CI -0.73, -0.40). Fourteen studies reporting 2-group data showed a large negative effect on physical function for groups with greater kyphosis angles (d = -1.16; 95% CI -1.53, -0.78). Three studies that reported multivariate data also tended to show negative associations between physical function and hyperkyphosis. Limitations include a relative lack of causal evidence; confirming causation requires additional longitudinal studies. Studies have assessed various physical function categories, including strength, gait, and balance. Future studies could determine the categories of function most affected so that preventive interventions could target hyperkyphosis appropriately. Conclusions: Hyperkyphosis was associated with lower physical function in older females. Three cohort studies suggest that greater kyphosis angles may predict greater loss of physical function over time. These results imply that therapies that help to minimize hyperkyphosis may help preserve function in older females. [ABSTRACT FROM AUTHOR]

Background and Purpose: The symptom of fatigue impairs function in people with multiple sclerosis (MS). Choosing appropriate measures to assess fatigue is challenging. The purpose of this article is to report the findings of a systematic review of patient-reported fatigue measures for people with MS. Methods: PubMed, CINAHL, and Embase databases were searched through January 2020 using terms related to fatigue and MS. Studies were included if the sample size was 30 or more or smaller samples if adequately powered, and if information about measurement characteristics (ie, test-retest reliability, content validity, responsiveness, interpretability, or generalizability) of the measure(s) could be extracted. Study quality was appraised with the 2-point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Data about measurement characteristics, psychometrics, and clinical utility were extracted and results were synthesized. Results: Twenty-four articles met inclusion criteria with information about 17 patient-reported fatigue measures. No studies had critical methodologic flaws. Measurement characteristic data were not available for all measures. Clinical utility varied in time to complete and fatigue domains assessed. Discussion and Conclusions: Five measures had data pertaining to all properties of interest. Of these, only the Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) had excellent reliability, responsiveness data, no notable ceiling/floor effects, and high clinical utility. We recommend the MFIS for comprehensive measurement and the FSS for screening of subjective fatigue in people with MS. [ABSTRACT FROM AUTHOR]

Natural disasters have been shown to have a substantial impact on school-age children. Consequently, schools are positioned to be a source of support while helping students resume familiar roles and routines. However, few studies have examined how schools prepare for and respond to disasters. In this study, we investigated the impact of Hurricane Katrina on the educational system in southeast Louisiana 1 year later. A survey was distributed to students in graduate courses in the College of Education and Human Development at Southeastern Louisiana University, and results from 62 graduate students employed as teachers in three defined regions were examined. Changes in student enrollment and emotional well-being were identified as top school-related problems. Teachers also reported changes in their roles within the classroom and consistently identified the need for emotional and material support. Differences in responses among the three regions were also identified. The results provide valuable insights for university preparation programs and school districts. (Contains 2 tables.)

There has been some concern that participation in an intervention and exposure to a measurement instrument can change participants' interpretation of the items on a self-report questionnaire thereby distorting subsequent responses and biasing results. Differential item functioning (DIF) analysis using item response modeling can ascertain possible differences in item interpretation by testing for differences in item location between groups. The DIF for treatment versus control group differences at post-intervention assessment and the Time 1 and Time 2 differences in a control group were analyzed using data from a dietary change intervention trial for Boy Scouts. The measures included fruit and vegetable (FV) frequency of consumption, preferences and self-efficacy. Treatment-control group DIF at post-intervention assessment was detected in a higher percentage of items for FV frequency than for preference or self-efficacy. Time 1 to Time 2 differences in items for the control group were detected in one item for each of the three scales. Further research will need to clarify whether the obtained DIFs reflected true changes in frequency, preference or self-efficacy or some reinterpretation of items by participants following an intervention or merely after previous exposure to the measure. (Contains 6 tables.)

This paper is the first of several papers designed to demonstrate how the application of item response models in the behavioral sciences can be used to enhance the conceptual and technical toolkit of researchers and developers and to understand better the psychometric properties of psychosocial measures. The papers all use baseline data from the Behavior Change Consortium data archive. This paper begins with an introduction to item response models, including both dichotomous and polytomous versions. The concepts of respondent and item location, model interpretation, standard errors and testing model fit are introduced and described. A sample analysis based on data from the self-efficacy scale is used to illustrate the concepts and techniques. (Contains 9 figures and 3 tables.)

When measuring participant-reported attitudes and outcomes in the behavioral sciences, there are many instances when the common measurement assumption of unidimensionality does not hold. In these cases, the application of a multidimensional measurement model is both technically appropriate and potentially advantageous in substance. In this paper, we illustrate the usefulness of a multidimensional approach to measurement using an empirical example taken from the Behavior Change Consortium. Data from the Treatment Self-Regulation Questionnaire have been analyzed to investigate whether self-regulation can be regarded as a single construct, or if it has multiple dimensions based on the type of regulation or motivation that participants say helps them consider an improvement in healthy behavior. Comparison with consecutive analyses shows the advantages of multidimensional measurement for interpreting participant-reported data. (Contains 5 figures and 5 tables.)

This paper compares the approach and resultant outcomes of item response models (IRMs) and classical test theory (CTT). First, it reviews basic ideas of CTT, and compares them to the ideas about using IRMs introduced in an earlier paper. It then applies a comparison scheme based on the AERA/APA/NCME "Standards for Educational and Psychological Tests" to compare the two approaches under three general headings: (i) choosing a model; (ii) evidence for reliability--incorporating reliability coefficients and measurement error--and (iii) evidence for validity--including evidence based on instrument content, response processes, internal structure, other variables and consequences. An example analysis of a self-efficacy (SE) scale for exercise is used to illustrate these comparisons. The investigation found that there were (i) aspects of the techniques and outcomes that were similar between the two approaches, (ii) aspects where the item response modeling approach contributes to instrument construction and evaluation beyond the classical approach and (iii) aspects of the analysis where the measurement models had little to do with the analysis or outcomes. There were no aspects where the classical approach contributed to instrument construction or evaluation beyond what could be done with the IRM approach. Finally, properties of the SE scale are summarized and recommendations made. (Contains 2 figures and 5 tables.)

This article describes the development and field-testing of an observational tool, the Volunteer Tutor Instructional Practices Checklist. It is an example of action research in a clinical setting and will be of interest to all educators, including special education and reading center directors, in the training and ongoing supervision of community literacy volunteer tutors and preservice teachers. The tutees may be elementary or middle school age. The development of the instrument, reliability data, variety of uses, and administration and scoring are discussed.

Describes the Developing Scholars Mentor Program in the College of Education at the University of North Texas, designed to build relationships between undergraduate student researchers and faculty mentors. (EV)

Examines attitudes and concerns related to the use of alternative assessments in literacy education courses. Notes that the results were significant for Self-Evaluation and Peer Evaluation and the results for Instructor Modeling did not reach significance but were generally positive in support of modeling alternative assessment in education classes. (SG)

Describes the experiences and the effective instructional practices of one college student who over a three-year period was a literacy tutor in a university America Reads program. Describes his two distinctive tutoring roles. Examines social interactions, activities he used to scaffold instruction for at-risk emergent readers, and the impact of mentoring relationships with public school teachers and university faculty. (SR)

The authors, five junior scholars at the University of North Texas' College of Education, describe their collaborative efforts to develop their skills in one method of qualitative research: in-depth, oral history interviewing. Outcomes included understanding the importance of rapport between interviewer and interviewee, of ensuring that the interviewee's voice is heard, and of conceptual and technical preparation. (DB)