IntroductionThere is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting.MethodsThis was a prospective, cohort study conducted in a single centre in the UK. 114 participants consecutively admitted to a Neuro-Rehabilitation Unit were prospectively assessed for fall accidents. Baseline assessment included a measure of balance (Berg Balance Scale) and a battery of standard cognitive tests measuring executive function, speed of information processing, verbal and visual memory, visual perception and intellectual function. The outcomes of interest were the risk of becoming a faller, balance and fall rate.ResultsTwo tests of executive function were significantly associated with fall risk, the Stroop Colour Word Test (IRR 1.01, 95% CI 1.00–1.03) and the number of errors on part B of the Trail Making Test (IRR 1.23, 95% CI 1.03–1.49). Composite scores of executive function, speed of information processing and visual memory domains resulted in 2 to 3 times increased likelihood of having better balance (OR 2.74 95% CI 1.08 to 6.94, OR 2.72 95% CI 1.16 to 6.36 and OR 2.44 95% CI 1.11 to 5.35 respectively).ConclusionsOur results show that specific subcomponents of executive functions are able to predict fall risk, while a more global cognitive dysfunction is associated with poorer balance.
Although associations between social cognition involving theory of mind and non-social executive skills have frequently been reported, dissociations in performance have also been found. The present study was designed to examine social and non-social cognition in uncomplicated Tourette Syndrome (TS). Adult TS participants without comorbid diagnoses were compared to matched healthy control participants on social cognition measures involving theory of mind and empathy, and on non-social executive tasks. Participants with TS were found to make more errors than a matched control group on an inhibitory task, but did not differ on other executive measures or on the social cognition measures. The implications of the findings for our understanding of TS and of the relationship between social cognition and executive skills are discussed.
This study identifies a simple yet powerful machine learning (Random Forest) based predictive model for an in-patient neurological population, utilizing a single neuropsychological test of cognitive function, the Trail Making test.
The first 2 weeks of admission is a high risk time for fallers, in particular those who become walkers or are cognitively impaired. Prevention policies should be put in place based on fall characteristics. Implications for Rehabilitation The ICF is a valuable instrument for describing subject and environmental factors during a fall-event. Falls are frequent events but do not usually cause serious injuries during inpatient rehabilitation. There is an increased fall risk for subjects with cognitive impairments or those relearning how to walk.
A case is reported of a patient who sustained a significant haemothorax while playing with a Nintendo™ Wii console.
Keywords: Haemothorax -Video game consoleCorrespondence to: AC Peek, Department of Orthopaedics, Northampton General Hospital, Cliftonville, Northampton NN1 5BD, UK E: annapeek@doctors.org.uk doi 10.1308/147870808X303100On-line Case Report Figure 1 Chest radiograph on presentation.
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