Foreign domestic helpers constitute a significant proportion of migrant workers worldwide. This population subgroup provides an opportunity for understanding social determinants of oral health in immigrant community. A random sample of 122 Indonesian domestic helpers in Hong Kong completed a questionnaire on their demographic background, social characteristics (competency in local languages, immigration history, living condition, social connections, and leisure activities) and oral health behaviours (knowledge, attitudes, practice and self-efficacy). Their tooth status and periodontal health were assessed. Participants tended to start flossing after settling in Hong Kong. Favourable oral health knowledge was found in more acculturated participants, as indicated by proficiency in local languages and immigration history. Engagement in social and/or religious activities and decent living condition provided by employers were associated with favourable oral health behaviours and/or better oral health. Social determinants explained 13.2 % of variance in caries severity. Our findings support the significant impact of social circumstances on oral health of domestic workers.

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Background and objectives Bilateral upper limb training (BULT) and unilateral upper limb training (UULT) are two effective strategies for the recovery of upper limb motor function after stroke. This meta-analysis aimed to compare the improvements in motor impairment and functional performances of people with stroke after BULT and UULT. Research design and methods This systematic review and meta-analysis identified 21 randomized controlled trials (RCTs) met the eligibility criteria from CINAHL, Medline, Embase, Cochrane Library and PubMed. The outcome measures were the Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Action Research Arm Test (ARAT) and Box and Block Test (BBT), which are validated measures of upper limb function. Results Twenty-one studies involving 842 subjects with stroke were included. Compared with UULT, BULT yielded a significantly greater mean difference (MD) in the FMA-UE (MD = 2.21, 95% Confidence Interval (CI), 0.12 to 4.30, p = 0.04; I 2 = 86%, p<0.001). However, a comparison of BULT and UULT yielded insignificant mean difference (MD) in terms of the time required to complete the WMFT (MD = 0.44; 95%CI, -2.22 to 3.10, p = 0.75; I 2 = 55%, p = 0.06) and standard mean difference (SMD) in terms of the functional ability scores on the WMFT, ARAT and BBT (SMD = 0.25; 95%CI, -0.02 to 0.52, p = 0.07; I 2 = 54%, p = 0.02). Discussion and implications Compared to UULT, BULT yielded superior improvements in the improving motor impairment of people with stroke, as measured by the FMA-UE. However, these strategies did not yield significant differences in terms of the functional performance of people with stroke, as measured by the WMFT, ARAT and BBT. More comparative studies of the effects of BULT and UULT are needed to increase the reliability of these conclusions.

The results support the use of repeated applications of TENS as an adjunct therapy for improving walking capacity and reducing spasticity in stroke survivors.

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Objectives. To investigate the effect of two foot placements (normal or posterior placement) and three arm positions (hands on the thighs, arms crossed over chest, and augmented arm position with elbow extended) on the five times sit-to-stand (FTSTS) test times of individuals with chronic stroke. Design. Cross-sectional study. Setting. University-based rehabilitation clinic. Participants. A convenience sample of community-dwelling individuals with chronic stroke (N = 45). Methods. The times in completing the FTSTS with two foot placements and the three arm positions were recorded by stopwatch. Results. Posterior foot placement led to significantly shorter FTSTS times when compared with normal foot placement in all the 3 arm positions (P ≤ 0.001). In addition, hands on thigh position led to significantly longer FTSTS times than the augmented arm position (P = 0.014). Conclusion. Our results showed that foot placement and arm position could influence the FTSTS times of individuals with chronic stroke. Standardizing the foot placement and arm position in the test procedure is essential, if FTSTS test is intended to be used repeatedly on the same subject.

PurposeTo use structural equation modelling (SEM) to determine (1) the direct and indirect associations of strength of paretic lower limb muscles with the level of community integration, and (2) the direct association of walking endurance and balance performance with the level of community integration in community-dwelling stroke survivors.Materials and methodsIn this cross-sectional study of 105 stroke survivors, the Subjective Index of Physical and Social Outcome (SIPSO) was used to measure the level of community integration. Lower-limb strength measures included isometric paretic ankle strength and isokinetic paretic knee peak torque. The Berg Balance Scale (BBS) and the 6-minute walk test (6MWT) were used to evaluate balance performance and walking endurance, respectively.ResultsSEM revealed that the distance walked on the 6MWT had the strongest direct association with the SIPSO score (β = 0.41, p <0.001). An increase of one standard deviation in the 6MWT distance resulted in an increase of 0.41 standard deviations in the SIPSO score. Moreover, dorsiflexion strength (β = 0.18, p = 0.044) and the BBS score (β = 0.21, p = 0.021) had direct associations with the SIPSO score.ConclusionsThe results of the proposed model suggest that rehabilitation training of community-dwelling stroke survivors could focus on walking endurance, balance performance and dorsiflexor muscle strengthening if the aim is to augment the level of community integration.

The five times-sit-to stand test (FTSTS) is a clinical test which is commonly used to assessed the functional muscle strength of the lower limbs of older adults. The aim of this study was to examine the effect of different arm positions and foot placements on the FTSTS completion times of older female adults. [Subjects and Methods] Twenty-nine healthy female subjects, aged 63.1±5.3 years participated in this cross-sectional study. The times required to complete the FTSTS with 3 different arm positions (hands on thighs, arms crossed over chest, and an augmented arm position with the arms extended forward) and 2 foot placements (neutral and posterior) were recorded. The interaction effect and main effect of arm positions and foot placements were examined using a 3 (arm position) × 2 (foot placement) two-way repeated measures analysis of variance (ANOVA). [Results] There was no interaction effect among the 3 arm positions in the 2 foot placements. A significant main effect was identified for foot placement, but not arm position. Posterior foot placement led to a shorter FTSTS time compared to that of normal foot placement. [Conclusion] With the same arm position, FTSTS completion times with posterior foot placement tended to be shorter. Therefore, the standard foot placement should be used for FTSTS administration.