The negative discrepancy between residual functional capacity and reduced use of the contralesional hand, frequently observed after a brain lesion, has been termed Learned Non-Use (LNU) and is thought to depend on the interaction of neuronal mechanisms during recovery and learning-dependent mechanisms. Albeit the LNU phenomenon is generally accepted to exist, currently, no transdisciplinary definition exists. Furthermore, although therapeutic approaches are implemented in clinical practice targeting LNU, no standardized diagnostic routine is described in the available literature. Our objective was to reach consensus regarding a definition as well as synthesize knowledge about the current diagnostic procedures. We used a structured group communication following the Delphi method among clinical and scientific experts in the field, knowledge from both, the work with patient populations and with animal models. Consensus was reached regarding a transdisciplinary definition of the LNU phenomenon. Furthermore, the mode and strategy of the diagnostic process, as well as the sources of information and outcome parameters relevant for the clinical decision making, were described with a wide range showing the current lack of a consistent universal diagnostic approach. The need for the development of a structured diagnostic procedure and its implementation into clinical practice is emphasized. Moreover, it exists a striking gap between the prevailing hypotheses regarding the mechanisms underlying the LNU phenomenon and the actual evidence. Therefore, basic research is needed to bridge between bedside and bench and eventually improve clinical decision making and further development of interventional strategies beyond the field of stroke rehabilitation.

Use of the paretic arm and hand is a key indicator of recovery and reintegration after stroke. A sound methodology is essential to comprehensively identify the possible factors impacting daily arm/hand use behavior. We combined ecological momentary assessment (EMA), a prompt methodology capturing real-time psycho-contextual factors, with accelerometry to investigate arm/hand behavior in the natural environment. Our aims were to determine (1) feasibility and (2) measurement validity of the combined methodology. We monitored 30 right-dominant, mild-moderately motor impaired chronic stroke survivors over 5 days (6 EMA prompts/day with accelerometers on each wrist). We observed high adherence for accelerometer wearing time (80.3%), EMA prompt response (84.6%), and generally positive user feedback upon exit interview. The customized prompt schedule and the self-triggered prompt option may have improved adherence. There was no evidence of EMA response bias nor immediate measurement reactivity. An unexpected small but significant increase in paretic arm/hand use was observed over days (12–14 min), which may be the accumulated effect of prompting that provided a reminder to choose the paretic limb. Further research that uses this combined methodology is needed to develop targeted interventions that effectively change behavior and enable reintegration post-stroke.

Sensory-based subtypes among autistic children have been well documented, but little is known about longitudinal sensory subtypes beyond autistic populations. This prospective study aimed to identify subtypes based on trajectories of parent-reported sensory features measured at 6–19 months, 3–4, and 6–7 years of age among a community-based birth cohort (N = 1,517), and to examine their associations with school-age clinical and adaptive/maladaptive outcomes on a subset sample (N = 389). Latent class growth analysis revealed five trajectory subtypes varying in intensity and change rates across three sensory domains. In contrast to an Adaptive-All Improving subtype (35%) with very low sensory features and overall better school-age outcomes, an Elevated-All Worsening subtype (3%), comprised of more boys and children of parents with less education, was associated with most elevated autistic traits and poorest adaptive/maladaptive outcomes. Three other subtypes (62% in total) were generally characterized by stable or improving patterns of sensory features at mild to moderate levels, and challenges in certain outcome domains. Our findings indicate that characterizing children based on early sensory trajectories may contribute to earlier detection of subgroups of children with sensory challenges who are more likely to experience developmental challenges by school age, followed by early targeted interventions for improved long-term outcomes.

Aim: Investigate the experiences, challenges, and difficulties faced by people with Parkinson's disease (PD) when using standard cutlery during meals and explore their preferences for features in assistive cutlery. Methods: This study employed a mixed-methods, narrative, and descriptive approach using phenomenological methodology. Data were collected in two phases: Phase 1 focused on understanding participants' experiences and difficulties through phone or video interviews, while Phase 2 involved home visits to evaluate their preferences for cutlery features. Structured interviews with open- and closed-ended questions were transcribed and analyzed thematically. Analyst triangulation was employed to ensure reliability. Results: Phase one included 41 participants, while phase two included 15. Most participants reported difficulties using standard cutlery, citing challenges such as spills and reduced grip stability. Despite these difficulties, few had prior experience with assistive devices. Barriers to using adaptive cutlery included lack of awareness, limited access, cost, and concerns about its appearance. Some participants reported feeling embarrassed, which led them to avoid dining with others. Suggestions for improving regular cutlery focused on increasing the depth of forks and spoons to minimize spills. Most participants expressed a preference for cutlery with textured handles, deeper bowls, and medium size and weight. Conclusion: People with PD experience difficulties using regular cutlery, and few are aware of or use assistive devices. Participants expressed a desire for improvements in cutlery design that could improve their dining experience. Textured handles, medium size and weight, and deeper bowls were the most popular preferences among participants.These design improvements have the potential to enhance the dining experience and promote greater social participation among individuals with PD.

Physical environment has long been recognized within occupational therapy as a key factor contributing to residents’ functional abilities. However, the specific aspects of the physical environment that matter and the extent to which they do so remain less understood. This paper reports a quantitative study of the relationship between a characteristic of the physical home environment—the degree of interconnectedness of its rooms—and the cognitive ability of adults. Working with demographic, health, and home layout data collected from a sample of community-dwelling older adults in Atlanta, Georgia (N=72, Mage=69.5), we found that the cognitive functioning determined by the Montreal Cognitive Assessment (MoCA) score was significantly associated with the average connectivity and mean depth of the homes while controlling participants’ age and education. Regression analysis suggested home connectivity independently explained a little more than 4% of the variance in the MoCA scores. The results further revealed that the relationship may be better modeled using non-linear models, and that the increase in the numbers of circulation rings as average room connectivity rises may be partly, but not entirely, responsible for its association with cognitive ability. The study points to directions for further work, including causal modeling, based on recommendations that could be developed for homes to support older adults’ abilities to continue to reside in their own homes as they grow older.