TOP-DOWN AND BOTTOM-UP STRATEGY USE AMONG GOOD AND POOR READERS IN EFL READING COMPREHENSION

This study revealed the readers’ use of top-down and bottom-up strategies in EFL learning context in Taiwan. The participants, 111 undergraduates EFL learners, were classified into good and poor readers. Quantitative and qualitative data were collected through a questionnaire and interviews. The results showed that almost no difference was confirmed between good and poor readers in bottom-up and total strategy use, whereas it was found that good readers tended to use more top-down strategies than poor readers. It is suggested that both groups of readers use bottom-up strategies to a similar degree; however, the use of top-down strategies has helped good readers advance their level of reading comprehension.  Article visualizations

Projection of Supply and Demand of the Physical Therapy Manpower in Taiwan for the Next Twenty Years: Part I. Current Status and Productivity of Physical Therapists and Physical Therapist Assistants

Background and purposes: The purposes of this study were 1) to describe the general productivity and productivities in 4 special fields (neurological, orthopedic, pediatric, and cardiopulmonary) of physical therapists (PT) and physical therapist assistants (PTA) in Taiwan, and 2) to explore the association between characteristics of PT/PTA and productivity. Method: Questionnaire was mailed to the members of all PT and PTA associations in Taiwan. The total mailing number of questionnaire for PT and PTA were 2466 and 1117, respectively. The content of this questionnaire included basic demographic data and information in clinical work. Survey period was between September, 2002 and December, 2002. Results: Total returned questionnaires were 764 from PT and 269 from PTA. General productivity for aPT was 21.39 patients per day, assuming working 8 hours per day. For each specialization field, the productivity of neurological, orthopedic, pediatric, cardiop­ ulmonary patients of each PT per day was 19.72 (sd=9.50), 24.98 (sd=11.07), 15.55 (sd=8.75), and 21.42 (sd=10.63), respectively. For the association between PT characteristics and productivity, working place and PT\u27 s gender were significantly associated with general productivity. PT\u27s age, educational level, and working place were significantly associated with neurological and pediatric productivities. Working experience was also significantly associated with neurological productivity. PT\u27 s characteristics were not significantly associated with orthopedic and cardiopulmonary productivity. General productivity for a PTA was 29.75 patients per day. The productivity of neurological, orthopedic, pediatric, cardiopulmonary patients of each PTA per day was 22.29 (sd=9.50), 35.07 (sd=11.07), 19.48 (sd=8.75), and 19.55 (sd=10.63), respectively. Only PTA\u27s education level was signifi­cantly associated with orthopedic productivity. There were no other significant associations between any of the PTA\u27s characteristics and productivity. Conclusion: This study repported the current status of clincial practice in PT and PTA. There will be a series of articles investigating the projection of supply and demand of physical therapy manpower for the next twenty years

Gait performance and prefrontal cortex activation during single and dual task walking in older adults with different cognitive levels

BackgroundGrowing evidence shows the cognitive function influences the motor performance. The prefrontal cortex (PFC) as a part of the executive locomotor pathway is also important for cognitive function. This study investigated the differences in motor function and brain activity among older adults with different cognitive levels, and examined the significance of cognition on motor functions.MethodsNormal control (NC), individuals with mild cognitive impairment (MCI) or mild dementia (MD) were enrolled in this study. All participants received a comprehensive assessment including cognitive function, motor function, PFC activity during walking, and fear of fall. The assessment of cognitive function included general cognition, attention, executive function, memory, and visuo-spatial. The assessment of motor function included timed up and go (TUG) test, single walking (SW), and cognitive dual task walking (CDW).ResultsIndividuals with MD had worse SW, CDW and TUG performance as compared to individuals with MCI and NC. These gait and balance performance did not differ significantly between MCI and NC. Motor functions all correlated with general cognition, attention, executive function, memory, and visuo-spatial ability. Attention ability measured by trail making test A (TMT-A) was the best predictor for TUG and gait velocity. There were no significant differences in PFC activity among three groups. Nevertheless, the PFC activated more during CDW as compared with SW in individuals with MCI (p = 0.000), which was not demonstrated in the other two groups.ConclusionMD demonstrated worse motor function as compared to NC and MCI. The greater PFC activity during CDW in MCI may be considered as a compensatory strategy for maintaining the gait performance. Motor function was related to the cognitive function, and the TMT A was the best predictor for the gait related performance in present study among older adults

Factors influencing obstacle crossing performance in patients with Parkinson's disease.

BACKGROUND: Tripping over obstacles is the major cause of falls in community-dwelling patients with Parkinson's disease (PD). Understanding the factors associated with the obstacle crossing behavior may help to develop possible training programs for crossing performance. This study aimed to identify the relationships and important factors determining obstacle crossing performance in patients with PD. METHODS: Forty-two idiopathic patients with PD (Hoehn and Yahr stages I to III) participated in this study. Obstacle crossing performance was recorded by the Liberty system, a three-dimensional motion capture device. Maximal isometric strength of the lower extremity was measured by a handheld dynamometer. Dynamic balance and sensory integration ability were assessed using the Balance Master system. Movement velocity (MV), maximal excursion (ME), and directional control (DC) were obtained during the limits of stability test to quantify dynamic balance. The sum of sensory organization test (SOT) scores was used to quantify sensory organization ability. RESULTS: Both crossing stride length and stride velocity correlated significantly with lower extremity muscle strength, dynamic balance control (forward and sideward), and sum of SOT scores. From the regression model, forward DC and ankle dorsiflexor strength were identified as two major determinants for crossing performance (R(2) = .37 to.41 for the crossing stride length, R(2) = .43 to.44 for the crossing stride velocity). CONCLUSIONS: Lower extremity muscle strength, dynamic balance control and sensory integration ability significantly influence obstacle crossing performance. We suggest an emphasis on muscle strengthening exercises (especially ankle dorsiflexors), balance training (especially forward DC), and sensory integration training to improve obstacle crossing performance in patients with PD

Virtual Reality-Based Wii Fit Training in Improving Muscle Strength, Sensory Integration Ability, and Walking Abilities in Patients with Parkinson's Disease: A Randomized Control Trial

Background: Virtual reality (VR) systems have been proven to increase motor performance in stroke and elderly patients. However, the effects have not been established in patients with Parkinson's disease (PD). The aim of this study was to examine the effects of VR-based training in improving muscle strength, sensory integration ability, and walking abilities in patients with PD through a randomized controlled trial. Methods: Thirty-six individuals who have been diagnosed with PD were randomly assigned to one of three groups (n = 12 for each group). Participants performed VR-based Wii Fit exercise (VRWii group) or traditional exercise (TE group) for 45 minutes, followed by treadmill training for another 15 minutes for 12 sessions in 6 weeks. Participants in the control group did not undergo the structured exercise program, but received fall-prevention education instead. The study outcomes included lower extremity muscle strength, sensory integration ability, walking velocity, stride length, and functional gait assessment. All outcomes were assessed at baseline, after training, and at 1 month follow-up. Results: Both the VRWii and TE groups showed more improvement in level walking velocity, stride length, functional gait assessment, muscle strength, and vestibular system integration compared with the control group after training and at 1 month follow-up. The VRWii training, but not the TE training, resulted in greater improvement in visual system integration than the control. Conclusion: VRWii training is as beneficial as TE in improving walking abilities, sensory integration ability, and muscle strength in patients with PD, and such improvements persisted for at least for 1 month. VRWii training is thus suggested to be implemented in patients with PD

Effects of exercise intensity on spatial memory performance and hippocampal synaptic plasticity in transient brain ischemic rats.

Memory impairment is commonly noted in stroke survivors, and can lead to delay of functional recovery. Exercise has been proved to improve memory in adult healthy subjects. Such beneficial effects are often suggested to relate to hippocampal synaptic plasticity, which is important for memory processing. Previous evidence showed that in normal rats, low intensity exercise can improve synaptic plasticity better than high intensity exercise. However, the effects of exercise intensities on hippocampal synaptic plasticity and spatial memory after brain ischemia remain unclear. In this study, we investigated such effects in brain ischemic rats. The middle cerebral artery occlusion (MCAO) procedure was used to induce brain ischemia. After the MCAO procedure, rats were randomly assigned to sedentary (Sed), low-intensity exercise (Low-Ex), or high-intensity exercise (High-Ex) group. Treadmill training began from the second day post MCAO procedure, 30 min/day for 14 consecutive days for the exercise groups. The Low-Ex group was trained at the speed of 8 m/min, while the High-Ex group at the speed of 20 m/min. The spatial memory, hippocampal brain-derived neurotrophic factor (BDNF), synapsin-I, postsynaptic density protein 95 (PSD-95), and dendritic structures were examined to document the effects. Serum corticosterone level was also quantified as stress marker. Our results showed the Low-Ex group, but not the High-Ex group, demonstrated better spatial memory performance than the Sed group. Dendritic complexity and the levels of BDNF and PSD-95 increased significantly only in the Low-Ex group as compared with the Sed group in bilateral hippocampus. Notably, increased level of corticosterone was found in the High-Ex group, implicating higher stress response. In conclusion, after brain ischemia, low intensity exercise may result in better synaptic plasticity and spatial memory performance than high intensity exercise; therefore, the intensity is suggested to be considered during exercise training

Reliability of the Chinese Version of the Trail Making Test and Stroop Color and Word Test among Older Adults

Summary: Background: Both Trail Making Test (TMT) and Stroop Color and Word Test (SCWT) are the most popular neuropsychological tests for assessing executive function. This study aimed to examine alternate form reliability of the Chinese version of the TMT Part B (C-TMT-B) and test-retest reliability of the Chinese version of the TMT and SCWT among older adults. Methods: Twenty participants were recruited in the alternate form reliability study and another 20 participants were recruited in the test-retest reliability study. Original version of the TMT-A and TMT-B and the Chinese version of the TMT-B and SCWT were used as the measurement tools. A retest was conducted 3–7 days later to assess its reliability. The reliability of tests was estimated with intraclass correlation coefficient (ICC) estimates and their 95% confident intervals. Results: The alternate form reliability of C-TMT-B was moderate to excellent with ICC of 0.89 and 95% confident interval of 0.63–0.96. Test-retest reliability coefficients for TMT-A, C-TMT-B, C-SCWT with congruous condition, and C-SCWT with incongruous condition were estimated as 0.82, 0.93, 0.91, and 0.91, respectively. Conclusion: Our findings suggest that the Chinese version of the TMT and SCWT are reliable instruments for measuring executive function among older adults. Keywords: alternate form reliability, executive function, measurement tools, older adults, test-retest reliabilit

Differences in Kinematic and Electromyographic Characteristics Between Young and Older Adults During Circular Turning

Background: Direction change while walking is a complex task of locomotor activity and is necessary during daily activities, but little is known about whether aging alters turn-related characteristics compared with straight walking. The objective of this study was to investigate the effects of aging on the biomechanical characteristics and walking velocity during circular turning. Methods: The participants included 17 healthy older adults (65–80 years old) and 16 young adults. Walking velocity, the first and second peak knee flexion, ankle plantarflexion, ankle dorsiflexion, and electromyographic amplitudes of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius medialis were measured during walking along a 5 m straight path and a 5 m circumference curved path with a radius of 0.8 m. Results: The two groups made comparable decreases in turning velocity as compared with straight walking, but older adults decreased the second peak knee flexion instead of the second peak ankle plantarflexion, and the knee remained flexed during the loading response. Older people also needed higher amplitudes of the tibialis anterior in the outer leg, and biceps femoris in the inner leg, to facilitate turning, which were not seen in young adults. Moreover, older adults did not decrease amplitudes of the rectus femoris and biceps femoris in the outer leg, and tibialis anterior in the inner leg, as noted in young adults. Conclusion: Aging does not exert further effects on turning velocity, but older adults use different biomechanical strategies to turn