AIM This study examined the causal relation between spasticity, weakness, gross motor function, and functional outcome (expressed as activity limitation) in children with cerebral palsy (CP) and tested models of functional outcome mediated by gross motor function.METHOD Eighty-one children (50 males, 31 females) with CP were recruited for this cross-sectional study. Their mean age was 10 years 4 months (SD 1y 9mo). Strength was assessed using the Manual Muscle Test. Spasticity was assessed by the Modified Ashworth Scale. The Gross Motor Function Measure assessed gross motor function. The Functional Skills domain of the Pediatric Evaluation of Disability Inventory assessed functional outcome. Twenty-eight children (34.6%) had quadriplegia, 44 children (54.3%) had diplegia, and nine children (11.1%) had hemiplegia. Children were classified using the Gross Motor Function Classification System with 14 (17.3%) in level I, 9 (11.1%) in level II, 13 (16.0%) in level III, 5 (6.2%) in level IV, and 40 (49.4%) in level V.RESULTS The proposed path model showed good fit indices. The direct effects were significant between spasticity and gross motor function (b=)0.339), between strength and gross motor function (b=0.447), and between gross motor function and functional outcome (b=0.708). Spasticity had a significant negative indirect effect (b=)0.240) and strength had a significant positive indirect effect (b=0.317) on functional outcome through effects on gross motor function.INTERPRETATION Activity-based rather than impairment-based intervention is more important for reducing activity limitation in children with CP. The study established a base from which researchers can further develop a causal model between motor impairments and functional outcome.

This meta-analysis verifies associations between three dimensions of special education teachers’ (SET) burnout (emotional exhaustion, depersonalization, and personal accomplishment) and student-, teacher-, and school-related variables. Altogether, 28 peer-reviewed English articles and 13 dissertations (total sample of teachers = 6,623) published between 1983 and December 2018 were analyzed. The degree of correlation effect sizes between special education teachers’ burnout and its related variables was extensive. Results revealed distinct relations by each burnout dimension: emotional exhaustion, depersonalization, and personal accomplishment and student-, teacher-, and school-related variables. Student age (Fisher’s Z = .316) was significantly associated with SET depersonalization. Self-efficacy (Fisher’s Z = −0.390, emotional exhaustion; −0.321, depersonalization; 0.633, personal accomplishment), stress (0.366, emotional exhaustion; 0.340, depersonalization; −0.110 personal accomplishment), and support from school personnel (−0.119, emotional exhaustion; −0.140, depersonalization; 0.172, personal accomplishment) were also significantly related to each burnout dimension. Support programs to relieve SET burnout must consider these variables.

Purpose: The purpose of this study was to use meta-analysis to evaluate the variables related to depression in patients who have had a stroke. Methods: The materials of this study were based on 16 variables obtained from 26 recent studies over a span of 10 years which were selected from doctoral dissertations, master's thesis and published articles. Results: Related variables were categorized into sixteen variables and six variable groups which included general characteristics of the patients, disease characteristics, psychological state, physical function, basic needs, and social variables. Also, the classification of six defensive and three risk variables group was based on the negative or positive effect of depression. The quality of life (ES = -.79) and acceptance of disability (ES=-.64) were highly correlated with depression in terms of defensive variables. For risk variables, anxiety (ES= .66), stress (ES= .53) showed high correlation effect size among the risk variables. Conclusion: These findings showed that defensive and risk variables were related to depression among stroke patients. Psychological interventions and improvement in physical functions should be effective in decreasing depression among stroke patients.

[Purpose] The purpose of this study was to investigate the psychometric properties of the lower extremity subscale of the Fugl-Meyer Assessment lower extremity (FMA-LE) for community-dwelling hemiplegic stroke patients. [Subjects] The participants were 140 community-dwelling hemiplegic stroke patients. [Methods] To determine the psychometric properties of the FMA-LE, we examined construct validity, response characteristics, item discrimination, and internal consistency. [Results] Factor analysis of the FMA-LE revealed that the first factor explained 61.73% of the variance and provided evidence of unidimensionality. The FMA-LE did not show ceiling or floor effects; Cronbach’s α was 0.935 (95% CI: 0.919–0.950). [Conclusion] Because the FMA-LE seems to be both valid and reliable, we conclude that it is appropriate for the measurement of the lower extremity motor impairment of community-dwelling hemiplegic stroke patients.

[Purpose] The purpose of this study was to investigate the psychometric properties of the Falls Efficacy Scale using Rasch analysis in patients with hemiplegic stroke. [Subjects] Fifty-five community-dwelling hemiplegic stroke patients were selected as participants. [Methods] Data were analyzed using the Winsteps program (version 3.62) with the Rasch model to confirm the unidimensionality through item fit, reliability, and appropriateness of the rating scale. [Results] There were no misfit persons or items. Furthermore, infit and outfit statistics appeared adjacent. The person separation value was 3.07, and the reliability coefficient was 0.90. The reliability of all items was at an acceptable level for patients with hemiplegic stroke. [Conclusion] This was the first study to investigate the psychometric properties of the Falls Efficacy Scale using Rasch analysis. The results of this study suggest that the 6-point Falls Efficacy Scale is an appropriate tool for measuring the self-perceived fear of falling in patients with hemiplegic stroke.