NeuroRehabilitation
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NeuroRehabilitation · Jan 2008
ReviewDecision-making capacity and competency in the elderly: a clinical and neuropsychological perspective.
With our ageing population, the number of older adults with cognitive impairment has also increased. There is both an acute and growing need for evidence-based assessments to identify their decision making capacity and competence. In the present article we (1) present definitions of decision-making capacity and competence, (2) review cognitive functions that are central to decision-making capacity as well as the methods and procedures commonly used to assess these domains, and (3) address the communication of assessment findings to patients and their loved ones. The importance of assessing decision-making capacity in the context of specific functions and of respecting the values and interests of older adults are emphasized.
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NeuroRehabilitation · Jan 2008
ReviewNon-pharmacological and pharmacological treatment of the cognitive and behavioral symptoms of Alzheimer disease.
This paper discusses the various pharmacological and behavioral treatments for the cognitive, emotional, and behavioral symptoms of Alzheimer disease (AD). The medications that are currently FDA-approved for the treatment of the cognitive/functional deficits of AD will first be discussed. ⋯ Principles of behavioral management, tips for communication, and recommendations for caregivers are discussed. Lastly, risk and protective factors and their relevance to delaying the expression of dementia are also examined.
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NeuroRehabilitation · Jan 2008
Case ReportsCasual leisure and the sensory diet: a concept for improving quality of life in neuropalliative conditions.
This case report describes the leisure lifestyle of two individuals with neuropalliative conditions who expressed themselves satisfied with their use of leisure time and whose leisure occupations were based around sensory stimulation to each of the five senses, proprioception and vestibular stimulation in turn. It evaluates the concept of leisure as a means of giving a meaning to life and therefore increasing quality of life, suggests greater use of the existing sensory diet framework in the domain of neuropalliative conditions and proposes a direction for future research in order to provide casual leisure opportunities for individuals with severe cognitive dysfunction in order to improve their quality of life.
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To explore agonist and antagonist muscle characteristics, depression and physical functioning of patients with Fibromyalgia Syndrome (FMS). ⋯ These findings suggest presence of unusual muscle activity occurring in the bicep muscle of FMS and non-FMS chronic pain patients, which establishes a possible link between muscle dysfunction, mood and pain.
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NeuroRehabilitation · Jan 2008
A pilot study into the effect of vocal exercises and singing on dysarthric speech.
This pilot study aimed to investigate the effects of vocal exercises and singing on intelligibility and speech naturalness for subjects with acquired dysarthria following traumatic brain injury or stroke. A multiple case study design was used, involving pre, mid, and post-treatment assessments of intelligibility, rate, naturalness, and pause time for four subjects with dysarthria. Each subject participated in 24 individual music therapy sessions over eight weeks involving oral motor respiratory exercises, rhythmic and melodic articulation exercises, rhythmic speech cuing, vocal intonation therapy, and therapeutic singing using familiar songs. ⋯ Statistically significant improvements in functional speech intelligibility were achieved but improvements in rate of speech were not significant. Speech naturalness improved post-treatment and a reduction in the number and length of pauses was verified via waveform analysis. Preliminary findings suggest that a program of vocal exercises and singing may facilitate more normative speech production for people with acquired dysarthria and support the need for further research in this area.