Widely accepted models of disability suggest that actual use of an impaired upper extremity in everyday life frequently deviates from its motor capacity, as measured by laboratory tests. Yet, direct measures of real-world use of an impaired upper extremity are rare in pediatric neurorehabilitation. This paper examines how well the Pediatric Motor Activity Log-Revised (PMAL-R) measures this parameter, when the PMAL-R is administered as a structured interview as originally designed. Parents of 60 children between 2 and 8 years of age with upper-extremity hemiparesis due to cerebral palsy completed the PMAL-R twice. Additionally, the children were videotaped during play structured to elicit spontaneous arm use. More-affected arm use was scored by masked raters; it was thought to reflect everyday activity since no cues were given about which arm to employ. Testing sessions were separated by 3 weeks, during which 29 children received upper-extremity rehabilitation and 31 did not. The PMAL-R had high internal consistency (Cronbach's alpha = .93) and test-retest reliability (r = .89). Convergent validity was supported by a strong correlation between changes in PMAL-R scores and more-affected arm use during play, r(53) = .5, p < .001. The PMAL-R interview is a reliable and valid measure of upper-extremity pediatric neurorehabilitation outcome.

This qualitative study explored the role of sensory characteristics embedded in the built environment and whether they support or hinder people with visual impairment in their use of public spaces. An online survey link was e-mailed to the presidents and committee members of each state’s chapters and associations of the National Federation of the Blind in the United States, resulting in 451 direct invitations to participate. Written responses of the survey questions from 48 respondents with visual impairment were analyzed. Three main themes: Barriers, Supporters, and Context-Dependence emerged from the respondents’ experience of multisensory characteristics within the built environment. The four subthemes subsumed in Barriers were: (1) Population specific design, (2) Extreme sensory backgrounds, (3) Uneven ground surfaces and objects, and (4) Inconsistent lighting. For Supporters, respondents provided specific examples of various sensory characteristics in built environments, including audible cues and echoes, smells, tactile quality of the ground surface, and temperature. Context-Dependence referred to the effects of sensory characteristics embedded in public spaces depending on one’s vision condition, the proximity to the sensory cues and the purpose of the activities one was performing at that moment. Findings provide occupational therapy practitioners an in-depth understanding of the transactional relationship between embedded sensory characteristics in the built environment, occupations, and people with visual impairment in order to make appropriate modifications or removal of barriers that affect occupational performance and engagement. Suggestions for occupational therapists as well as architects, designers, planners, policy makers/legislators related to functional sensory cues in the design of built environments were provided to increase accessibility in the use of public spaces by people with visual impairment.

Purpose: The purpose of this exploratory pilot study was to examine the effect of exercise on pain and fatigue in adults with CP. Method: Twenty-six participants (12 ambulatory, 14 non-ambulatory; 10 males, 16 females; mean age 42.3 ± 11.2 years) enrolled in a study using a repeated measures design including baseline, intervention and follow-up phases of 12 weeks each; 20 participants completed all phases. Primary outcome measures used were the FACES pain scale, the count of body parts with pain and the PedsQL™ Multidimensional Fatigue Scale. Results: Significant beneficial changes were found in the pain and fatigue scales among the ambulatory participants during the intervention phase. However the beneficial changes diminished during the follow-up phase. Secondary outcomes examined included, pain interference, daily physical activity and health-related quality of life. Conclusion: Study outcomes suggest that exercise may provide some benefit for ambulatory adults with CP.