Purpose of Review The term primary progressive aphasia (PPA) refers to a diverse group of dementias that present with prominent and early problems with speech and language. They present considerable challenges to clinicians and researchers. Recent Findings Here, we review critical issues around diagnosis of the three major PPA variants (semantic variant PPA, nonfluent/agrammatic variant PPA, logopenic variant PPA), as well as considering ‘fragmentary’ syndromes. We next consider issues around assessing disease stage, before discussing physiological phenotyping of proteinopathies across the PPA spectrum. We also review evidence for core central auditory impairments in PPA, outline critical challenges associated with treatment, discuss pathophysiological features of each major PPA variant, and conclude with thoughts on key challenges that remain to be addressed. Summary New findings elucidating the pathophysiology of PPA represent a major step forward in our understanding of these diseases, with implications for diagnosis, care, management, and therapies.

Background: Pulmonary rehabilitation (PR) is a highly effective intervention for individuals with chronic obstructive pulmonary disease (COPD). Physical activity (PA) has been shown to increase after a centre-based programme, yet it is not clear if a home-based programme can offer the same benefit. This study aimed to evaluate the effect of home-based PR compared with the centre-based PR on the PA levels post 7 weeks of PR and 6 months follow-up.Method: In this study, 51 participants with COPD, of them, 36 (71%) men completed physical activity monitoring with a SenseWear Armband, at three time points (baseline, 7 weeks, and 6 months). The participants were randomly assigned to either centre-based supervised PR (n = 25; 69 ± 6 years; FEV1 55 ± 20% predicted) or home-based PR (n = 26; 68 ± 7 years; FEV1 42 ± 19% predicted) programmes lasting 7 weeks. The home-based programme includes one hospital visit, a self-management manual, and two telephone calls. The PA was measured as step count, time in moderate PA (3–6 metabolic equivalent of tasks [METs]) in bouts of more than 10 min and sedentary time (<2 METs).Results: Home-based PR increased step count significantly more than the centre-based PR after 7 weeks (mean difference 1,463 steps: 95% CI 280–2,645, p = 0.02). There was no difference in time spent in moderate PA was observed (mean difference 62 min: 95% CI −56 to 248, p = 0.24). Sedentary behaviour was also significantly different between the centre and home-based groups. The home group spent 52 min less time sedentary compared with the centre-based (CI −106 to 2, p = 0.039). However, after 6 months, the step count and time spent in moderate PA returned to baseline in both the groups.Conclusion: This study provides an important insight into the role of home-based PR which has the potential to be offered as an alternative to the centre-based PR. Understanding who may best respond from the centre or home-based PR warrants further exploration and how to maintain these initial benefits for the long-term.Trial Registry: ISRCTN: No.: ISRCTN81189044; URL: isrctn.com.

IntroductionExercise tests are a keystone in assessing patients for Pulmonary Rehabilitation (PR). Behavioural research has suggested that performing an outcome measure may influence the outcome.1 This has not been explored in respiratory disease in relation to performing an exercise test. Performing an exercise tests could improve confidence and alter subsequent exercise behaviour.AimTo assess if completing a single incremental shuttle walk test (ISWT) increases patients’ confidence in walking at home; managing breathlessness, or completing a shuttle walk test.MethodsPatients attending a PR assessment were asked to score their confidence levels according to the above criteria prior to their first ISWT, and then again following their 1 st ISWT. Patients answered the following questions before and after completing an ISWT with regards to their confidence in the following conditions: 1)Walking at home(Q1), 2)Managing breathlessness(Q2), and 3)Completing the ISWT(Q3). All questions were graded on a VAS scale of 0–10.Results90 patients (Mean age- 68.51 years; 48 Males; FEV1- 1.46 L; MRC median- 3) with respiratory disease answered the questions. There were statistically significant differences in confidence pre and post ISWT in all 3 questions (p=0.00). Pre-ISWT the values were (Q1) 5.74, (Q2) 6.25, (Q3) 7.07, the mean changes were: (Q1) +1.51; (Q2) +0.92; (Q3) +1.13 points. No significant changes in distance covered in the second ISWT were noted (21.2 m). There was no correlation between the change in confidence and change in distance covered between the two tests (r2= (Q1) 0.001, (Q2) 0.003, (Q3) 2.50, p≥0.05)ConclusionPerforming the ISWT increased patients’ perceived confidence levels to manage their breathlessness and walking at home. This may have implications when designing clinical trials particularly in the control group where the performance of an ISWT may alter exercise behaviours. Further research is required to investigate the effects of completing outcome measures in clinical trials.ReferenceGodin et al. The Effect of mere-measurement of cognitions on physical activity behaviour: A randomised controlled trial among overweight and obese individuals. International Journal of Behavioural Nutrition and Physical Activity 2011;8:2.