Association between home layout connectivity and cognitive ability in community dwelling older adults: Implication for occupational therapy

Physical environment has long been recognized within occupational therapy as a key factor contributing to residents’ functional abilities. However, the specific aspects of the physical environment that matter and the extent to which they do so remain less understood. This paper reports a quantitative study of the relationship between a characteristic of the physical home environment—the degree of interconnectedness of its rooms—and the cognitive ability of adults. Working with demographic, health, and home layout data collected from a sample of community-dwelling older adults in Atlanta, Georgia (N=72, Mage=69.5), we found that the cognitive functioning determined by the Montreal Cognitive Assessment (MoCA) score was significantly associated with the average connectivity and mean depth of the homes while controlling participants’ age and education. Regression analysis suggested home connectivity independently explained a little more than 4% of the variance in the MoCA scores. The results further revealed that the relationship may be better modeled using non-linear models, and that the increase in the numbers of circulation rings as average room connectivity rises may be partly, but not entirely, responsible for its association with cognitive ability. The study points to directions for further work, including causal modeling, based on recommendations that could be developed for homes to support older adults’ abilities to continue to reside in their own homes as they grow older

International response of Occupational Therapy to the COVID-19 pandemic: A report from the Global Occupational Therapy Think Tank (GOTTT)

https://scholarworks.gsu.edu/gottt/1000/thumbnail.jp

Semantic Modulation in a Daily Occupational Performance

Occupational therapy practice places extra emphasis in finding a way to influence the meaning of an object to a person, because many of our daily occupations are object related. Meaning is an interpretive cognitive process that a person undergoes when deciding on an occupational interaction with an object or form. Within the past few years, a series of studies by Gentilucci have found a priming effect of object related words on the motor performance. The purpose of the present study was to extend Gentilucci’s (2003) study by adding a speech component to investigate whether the language induced effect of motor performance is further enhanced by speech production of the action congruent words. Twenty-eight adult participants either read aloud or read silently four object related words (‘far’, ‘near’, ‘large’, and ‘small’) written on a water bottle while reaching, grasping, and placing the bottle on a second spot. A movement recording and analysis system measured movements of the fingers and arm. A counterbalanced repeated measures analysis of variance, results showed a) no significant differences between reading aloud and reading silently conditions b) grasping aperture was significantly larger when participants read ‘large’ and reaching was significantly faster when participants read ‘far’ on the bottle. No other significance was found. The results indicated that it is possible to cognitively prime an occupational performance by using object or action congruent words in a specific manner. Occupational therapists might incorporate action congruent words as a priming cue to enhance performance of their client

Intermanual transfer of a new writing occupation in young adults without disability

It has been shown that acquisition of a skill by one hand is facilitated by previous learning of the same skill with the other hand. This is called intermanual transfer of learning, or cross-education. The investigators examined intermanual transfer of occupation of writing in a group of 10 right-handed subjects with no known motor disabilities. Subjects learned to perform a novel occupation of writing a foreign alphabet letter with either their right or left hand. Later, subjects reproduced the skill with the practised and unpractised contralateral hand. Pen movements and surface electromyography of the first dorsal interosseus muscle were recorded to assess the transfer of learning. Analysis revealed an almost full transfer of the learned motor task between hands in either left-to-right or right-to-left direction when movement time and movement size were compared. This indicates that transfer did not depend on hand dominance. These findings suggest that a task already learned by one hand can positively influence the learning of the same task by the other hand. The results have important implications for occupational therapy - namely, that activities comprising tasks previously learned by one hand would be more effective in facilitating improved performance by the other hand than activities comprising previously unlearned tasks in the case of retraining skills in patients with amputation or hemiplegia. Because the participants in this study were a small number of college students, research should be carried out with larger participants pools and participants with disabilities to consolidate the findings

Self-speech-induced facilitation of simple reaching movements in persons with stroke

OBJECTIVE. Occupational therapists are routinely involved in upper-extremity rehabilitation in persons with stroke. Recently we have reported that self-speech can be used to facilitate simple reach in young and older adults. The purpose of this study is to examine whether self-speech-induced facilitation of simple reach can be translated in persons with stroke. METHOD. Following a counterbalanced repeated-measure design, seven persons with right brain stroke performed reaching and placing a glass on a cabinet shelf under four concurrent speech conditions of vocalizing the word yeah with both hemiplegic and nonhemiplegic sides. These four conditions are self-vocalization, external vocalization, imaginary vocalization, and no vocalization. Consistent with our previous study, in this study we also recorded the movement kinematics of angular movement of the upper arm. RESULTS. Reaching velocity was significantly higher under self-vocalization conditions compared to the reaching velocity under no vocalization or other vocalization conditions (p\u3c .05). Motor performance in terms of velocity, nonhemiparetic side was significantly better than hemiparetic side (p\u3c .05). CONCLUSION. The results suggest that self-speech can be used in facilitating movements in patients with stroke. When working with patients with right hemispheric stroke, therapists might explore possibilities of using patient\u27s self-speech to enhance the quality of movement performance

Patient Characteristics and Functional Outcomes in a 5-Year Retrospective Stroke Cohort

Abstract Objective: This retrospective study examined the relationship between patient characteristics and intervention outcomes in stroke rehabilitation in a large, diverse inpatient database. Method: A query of the electronic medical record for 2008-2012 identified 939 patients treated for stroke. An analysis was conducted for dichotomized total, motor, and cognitive Functional Independence Measure scores using univariable and multivariable analyses and patients' characteristics. Results: There was a significant population of non-white patients in the cohort (53%). Race was not found to be a factor that influenced outcomes. Patients who responded to treatment were more likely to be younger than 80, with a length of stay greater than 11 days, and currently employed. Length of stay had the strongest association with a positive treatment response (P ≤ 0.001). Patients who were older than 80 years and not working/retired at the time of stroke had less response to treatment. Conclusion: The results of the present study show that patients with a minimum of 3 key characteristics, in a diverse stroke population, are most likely to benefit maximally from intensive inpatient stroke rehabilitation irrespective of their race, sex, or number of comorbidities

Association between home layout connectivity and cognitive ability in community dwelling older adults: Implication for occupational therapy

Physical environment has long been recognized within occupational therapy as a key factor contributing to residents’ functional abilities. However, the specific aspects of the physical environment that matter and the extent to which they do so remain less understood. This paper reports a quantitative study of the relationship between a characteristic of the physical home environment—the degree of interconnectedness of its rooms—and the cognitive ability of adults. Working with demographic, health, and home layout data collected from a sample of community-dwelling older adults in Atlanta, Georgia (N=72, Mage=69.5), we found that the cognitive functioning determined by the Montreal Cognitive Assessment (MoCA) score was significantly associated with the average connectivity and mean depth of the homes while controlling participants’ age and education. Regression analysis suggested home connectivity independently explained a little more than 4% of the variance in the MoCA scores. The results further revealed that the relationship may be better modeled using non-linear models, and that the increase in the numbers of circulation rings as average room connectivity rises may be partly, but not entirely, responsible for its association with cognitive ability. The study points to directions for further work, including causal modeling, based on recommendations that could be developed for homes to support older adults’ abilities to continue to reside in their own homes as they grow older