Management of first metatarsophalangeal joint osteoarthritis by physical therapists and podiatrists in Australia and the United Kingdom: a cross-sectional survey of current clinical practice.

BACKGROUND: First metatarsophalangeal (MTP) joint osteoarthritis (OA) is a common and painful problem that causes significant disability. There is limited research on assessment and treatment options, and the efficacy of current management strategies is unknown. The aim of this study was to determine how podiatrists and physical therapists in Australia and the United Kingdom (UK) manage people with first MTP joint OA. METHODS: A survey of podiatrists and physiotherapists was conducted. Potential respondents were recruited through professional representative organisations in Australia and the UK. Participants completed a bespoke online survey regarding the assessment and treatment approaches they most commonly use for patients with first MTP joint OA. Descriptive statistics were calculated and differences between professions compared using chi-square. RESULTS: Two hundred respondents (n = 113 (57%) podiatrists and n = 140 (70%) from Australia) completed the survey. Assessment tests were similar between professions and included x-ray (n = 151/164; 92%), range of motion (n = 127/141; 90%), and a pain scale (n = 78/99; 79%). Podiatrists were more likely than physical therapists to discuss over-the-counter medication (42% vs 17%; p < 0.001), prescribe orthoses (97% vs 66%; p < 0.001), particularly custom orthoses (78% vs 42%; p < 0.001), and provide advice on footwear (92% vs 78%; p < 0.01) when treating first MTP joint OA. In contrast, physical therapists used more exercise-based approaches to treatment, including exercise therapy (91% vs 34%; p < 0.001), increasing general activity (70% vs 49%; p < 0.01), and advice to pace activities (83% vs 48%; p < 0.001). CONCLUSION: Podiatrists and physical therapists use an array of assessment and treatment approaches for people with first MTP joint OA, albeit there is limited evidence to support their clinical utility. Treatment strategies differ between professions, particularly with respect to medication, orthoses and exercise. It is unclear whether these commonly-used strategies improve symptoms associated with first MTP joint OA

Eye movements during reading and topic scanning: effects of word frequency

The study examined the nature of eye movement control and word recognition during scanning for a specific topic, compared with reading for comprehension. Experimental trials included a manipulation of word frequency: the critical word was frequent (and orthographically familiar) or infrequent (2 conditions: orthographically familiar and orthographically unfamiliar). First-pass reading times showed effects of word frequency for both reading and scanning, with no interactions between word characteristics and task. Therefore, in contrast to the task of searching for a single specific word (Rayner and Fischer, 1996), there were immediate and localized influences of lexical processing when scanning for a specific topic, indicating that early word recognition processes are similar during reading and topic scanning. In contrast, there were interactions for later measures, with larger effects of word frequency during reading than scanning, indicating that reading goals can modulate later processes such as the integration of words into sentence context. Additional analyses of the distribution of first-pass single fixation durations indicated that first-pass fixations of all durations were shortened during scanning compared with reading, and reading for comprehension produced a larger subset of longer first-pass fixations compared with scanning. The implications for the nature of word recognition and eye movement control are discussed

Effects of adult aging on letter position coding in reading: evidence from eye movements

It is well-established that young adults encode letter position flexibly during natural reading. However, given the visual changes that occur with normal aging, it is important to establish whether letter position coding is equivalent across adulthood. In 2 experiments, young (18-25 years) and older (65 years) adults' were recorded while reading sentences with words containing transposed adjacent letters. Transpositions occurred at beginning (rpoblem), internal (porblem), or end (problme) locations in words. In Experiment 1, these transpositions were present throughout reading. By comparison, Experiment 2 used a gaze-contingent paradigm such that once the reader's gaze moved past a word containing a transposition, this word was shown correctly and did not subsequently change. Both age groups showed normal levels of comprehension for text including words with transposed letters. The pattern of letter transposition effects on eye movements was similar for the young and older adults, with greater increases in reading times when external relative to internal letters were transposed. In Experiment 1, however, effects of word beginning transpositions during rereading were larger for the older adults. In Experiment 2 there were no interactions, confirming that letter position coding is similar for both age groups at least during first-pass processing of words. These findings show that flexibility in letter position encoding during the initial processing of words is preserved across adulthood, although the interaction effect in rereading in Experiment 1 also suggests that older readers may use more stringent postlexical verification processes, for which the accuracy of word beginning letters is especially important

Insights into the processing of collocations during L2 English reading: evidence from eye movements

We report an eye movement experiment that investigates the effects of collocation strength and contextual predictability on the reading of collocative phrases by L2 English readers. Thirty-eight Chinese English as foreign language learners (EFL) read 40 sentences, each including a specific two-word phrase that was either a strong (e.g., black coffee) or weak (e.g., bitter coffee) adjective-noun collocation and was either highly predictable or unpredictable from the previous sentence context. Eye movement measures showed that L2 reading times for the collocative phrases were sensitive to both collocation strength and contextual predictability. However, an interaction effect between these factors, which appeared relatively late in the eye movement record, additionally revealed that contextual predictability more strongly influenced time spent reading weak compared with strong collocations. This was most likely because the greater familiarity of strong collocations facilitated their integration, even in the absence of strong contextual constraint. We discuss the findings in terms of the value of collocations in second language learning

Effects of aging, word frequency, and text stimulus quality on reading across the adult lifespan: evidence from eye movements

Reductions in stimulus quality may disrupt the reading performance of older adults more when compared with young adults because of sensory declines that begin early in middle age. However, few studies have investigated adult age differences in the effects of stimulus quality on reading, and none have examined how this affects lexical processing and eye movement control. Accordingly, we report two experiments that examine the effects of reduced stimulus quality on the eye movements of young (18-24 years), middle-aged (41-51 years), and older (65 years) adult readers. In Experiment 1, participants read sentences that contained a high-or low-frequency critical word and that were presented normally or with contrast reduced so that words appeared faint. Experiment 2 further investigated effects of reduced stimulus quality using a gaze-contingent technique to present upcoming text normally or with contrast reduced. Typical patterns of age-related reading difficulty (e.g., slower reading, more regressions) were observed in both experiments. In addition, eye movements were disrupted more for older than younger adults when all text (Experiment 1) or just upcoming text (Experiment 2) appeared faint. Moreover, there was an interaction between stimulus quality and word frequency (Experiment 1), such that readers fixated faint low-frequency words for disproportionately longer. Crucially, this effect was similar across all age groups. Thus, although older readers suffer more from reduced stimulus quality, this additional difficulty primarily affects their visual processing of text. These findings have important implications for understanding the role of stimulus quality on reading behavior across the lifespan

Aging effects on the visual span for alphabetic stimuli

Background: The visual span (i.e., an estimate of the number of letters that can be recognized reliably on a single glance) is widely considered to impose an important sensory limitation on reading speed. With the present research, we investigated adult age differences in the visual span for alphabetic stimuli (i.e., Latin alphabetic letters), as aging effects on span size may make an important contribution to slower reading speeds in older adulthood. Method: A trigram task, in which sets of three letters were displayed randomly at specified locations to the right and left of a central fixation point, was used to estimate the size of the visual span for young (18-30 years) and older (65+ years) adults while an eye tracker was used to ensure accurate central fixation during stimulus presentation. Participants also completed tests of visual acuity and visual crowding. Results: There were clear age differences in the size of the visual span. The older adults produced visual spans which were on average 1.2 letters smaller than the spans of young adults. However, both young and older adults produced spans smaller than those previously reported. In addition, span size correlated with measures of both visual acuity and measures of visual crowding. Conclusion: The findings show that the size of the visual span is smaller for older compared to young adults. The age-related reduction in span size is relatively small but may make a significant contribution to reduced parafoveal processing during natural reading so may play a role in the greater difficulty experienced by older adult readers. Moreover, these results highlight the importance of carefully controlling fixation location in visual span experiments

Are older adults more risky readers? Evidence from meta-analysis

According to an influential account of aging effects on reading, older adults (65+ years) employ a more “risky” reading strategy compared to young adults (18–30 years), in which they attempt to compensate for slower processing by using lexical and contextual knowledge to guess upcoming (i.e., parafoveal) words more often. Consequently, while older adults may read more slowly, they might also skip words more often (by moving their gaze past words without fixating them), especially when these are of higher lexical frequency or more predictable from context. However, this characterization of aging effects on reading has been challenged recently following several failures to replicate key aspects of the risky reading hypothesis, as well as evidence that key effects predicted by the hypothesis are not observed in Chinese reading. To resolve this controversy, we conducted a meta-analysis of 102 eye movement experiments comparing the reading performance of young and older adults. We focused on the reading of sentences displayed normally (i.e., without unusual formatting or structures, or use of gaze-contingent display change techniques), conducted using an alphabetic script or Chinese, and including experiments manipulating the frequency or predictability of a specific target word. Meta-analysis confirmed that slower reading by older compared to younger adults is accompanied by increased word-skipping, although only for alphabetic scripts. Meta-analysis additionally showed that word-skipping probabilities are unaffected by age differences in word frequency or predictability effects, casting doubt on a central component of the risky reading hypothesis. We consider implications for future research on aging effects on reading. (PsycInfo Database Record (c) 2022 APA, all rights reserved

Aging and pattern complexity effects on the visual span: evidence from Chinese character recognition

Research suggests that pattern complexity (number of strokes) limits the visual span for Chinese characters, and that this may have important consequences for reading. With the present research, we investigated age differences in the visual span for Chinese characters by presenting trigrams of low, medium or high complexity at various locations relative to a central point to young (18-30 years) and older (60+ years) adults. A sentence reading task was used to assess their reading speed. The results showed that span size was smaller for high complexity stimuli compared to low and medium complexity stimuli for both age groups, replicating previous findings with young adult participants. Our results additionally showed that this influence of pattern complexity was greater for the older than younger adults, such that while there was little age difference in span size for low and medium complexity stimuli, span size for high complexity stimuli was almost halved in size for the older compared to the young adults. Finally, our results showed that span size correlated with sentence reading speed, confirming previous findings taken as evidence that the visual span imposes perceptual limits on reading speed. We discuss these findings in relation to age-related difficulty reading Chinese

Flexibility in the perceptual span during reading: evidence from Mongolian

Readers can acquire useful information from only a narrow region of text around each fixation (the perceptual span), which extends asymmetrically in the direction of reading. Studies with bilingual readers have additionally shown that this asymmetry reverses with changes in horizontal reading direction. However, little is known about the perceptual span's flexibility following orthogonal (vertical vs. horizontal) changes in reading direction, because of the scarcity of vertical writing systems and because changes in reading direction often are confounded with text orientation. Accordingly, we assessed effects in a language (Mongolian) that avoids this confound, in which text is conventionally read vertically but can also be read horizontally. Sentences were presented normally or in a gaze-contingent paradigm in which a restricted region of text was displayed normally around each fixation and other text was degraded. The perceptual span effects on reading rates were similar in both reading directions. These findings therefore provide a unique (nonconfounded) demonstration of perceptual span flexibility