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Liou YJ, Chen MH, Hsu JW, Huang KL, Huang PH, Bai YM. Dysfunction of circulating endothelial progenitor cells in major depressive disorder. Acta Neuropsychiatr 2024; 36:153-161. [PMID: 38178721 DOI: 10.1017/neu.2023.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVES Despite mounting evidence demonstrates circulating endothelial progenitor cells (cEPCs) quantitative changes in depression, no study has investigated cEPC functions in major depressive disorder (MDD). We investigated the role of cEPC adhesive and apoptotic functions in MDD. METHODS We recruited 68 patients with MDD and 56 healthy controls (HCs). The depression symptoms, anxiety, psychosomatic symptoms, subjective cognitive dysfunction, quality of life, and functional disability were evaluated using the Hamilton Depression Rating Scale and Montgomery-Åsberg Depression Rating Scale, Hamilton Anxiety Rating Scale, Depression and Somatic Symptoms Scale (DSSS), Perceived Deficits Questionnaire-Depression, 12-Item Short Form Health Survey (SF-12), and Sheehan Disability Scale (SDS), respectively. Working memory and executive function were assessed using a 2-back task and Wisconsin Card Sorting Test (WCST). Inflammatory marker (soluble interleukin-6 receptor, C-reactive protein, and tumor necrosis factor-α receptor-1), cEPC adhesive, and apoptotic levels were measured using in vitro assays. RESULTS The MDD patients showed significantly lower cEPC adhesive levels than the HCs, and this difference in adhesive function remained statistically significant even after adjusting for inflammatory marker levels. The cEPC adhesion levels were in inverse correlations with commission and omission errors in 2-back task, the percent perseverative response and percent perseverative errors in WCST, and the DSSS and SDS scores, but in positive correlations with SF-12 physical and mental component scores. cEPC apoptotic levels did not differ significantly between the groups. CONCLUSION The findings indicate that cEPC adhesive function is diminished in MDD and impacts various aspects of cognitive and psychosocial functions associated with the disorder.
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Affiliation(s)
- Ying-Jay Liou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Mc Carthy CE, Yusuf S, Judge C, Ferguson J, Hankey GJ, Gharan SO, Damasceno A, Iversen HK, Rosengren A, Ogah O, Avezum L, Lopez-Jaramillo P, Xavier D, Wang X, Rangarajan S, O'Donnell MJ. Pre-morbid sleep disturbance and its association with stroke severity: results from the international INTERSTROKE study. Eur J Neurol 2024; 31:e16193. [PMID: 38532299 DOI: 10.1111/ene.16193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 03/28/2024]
Abstract
BACKGROUND AND PURPOSE Whilst sleep disturbances are associated with stroke, their association with stroke severity is less certain. In the INTERSTROKE study, the association of pre-morbid sleep disturbance with stroke severity and functional outcome following stroke was evaluated. METHODS INTERSTROKE is an international case-control study of first acute stroke. This analysis included cases who completed a standardized questionnaire concerning nine symptoms of sleep disturbance (sleep onset latency, duration, quality, nocturnal awakening, napping duration, whether a nap was planned, snoring, snorting and breathing cessation) in the month prior to stroke (n = 2361). Two indices were derived representing sleep disturbance (range 0-9) and obstructive sleep apnoea (range 0-3) symptoms. Logistic regression was used to estimate the magnitude of association between symptoms and stroke severity defined by the modified Rankin Score. RESULTS The mean age of participants was 62.9 years, and 42% were female. On multivariable analysis, there was a graded association between increasing number of sleep disturbance symptoms and initially severe stroke (2-3, odds ratio [OR] 1.44, 95% confidence interval [CI] 1.07-1.94; 4-5, OR 1.66, 95% CI 1.23-2.25; >5, OR 2.58, 95% CI 1.83-3.66). Having >5 sleep disturbance symptoms was associated with significantly increased odds of functional deterioration at 1 month (OR 1.54, 95% CI 1.01-2.34). A higher obstructive sleep apnoea score was also associated with significantly increased odds of initially severe stroke (2-3, OR 1.48; 95% CI 1.20-1.83) but not functional deterioration at 1 month (OR 1.19, 95% CI 0.93-1.52). CONCLUSIONS Sleep disturbance symptoms were common and associated with an increased odds of severe stroke and functional deterioration. Interventions to modify sleep disturbance may help prevent disabling stroke/improve functional outcomes and should be the subject of future research.
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Affiliation(s)
| | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Conor Judge
- HRB Clinical Research Facility, University of Galway, Galway, Ireland
| | - John Ferguson
- HRB Clinical Research Facility, University of Galway, Galway, Ireland
| | - Graeme J Hankey
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Shahram Oveis Gharan
- Rush Alzheimer Disease Centre, Rush University Medical Centre, Chicago, Illinois, USA
| | | | | | - Annika Rosengren
- Molecular and Clinical Medicine, Gothenburg University, Gothenburg, Sweden
| | - Okechukwu Ogah
- Cardiology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Luísa Avezum
- Neurology Department, Hospital Santa Marcelina, Sao Paulo, Brazil
| | - Patricio Lopez-Jaramillo
- Director de Investigaciones Facultad de Medicina, Universidad de Santander, Bucaramanga-Santander, Colombia
| | - Denis Xavier
- Pharmacology and Clinical Research and Training, St John's Medical College and Research Institute, Bangalore, India
| | - Xingyu Wang
- Beijing Hypertension League Institute, Beijing, China
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
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Rangel MFDA, Silva LC, Gonçalves EH, Silva A, Teixeira-Salmela LF, Scianni AA. Presence of Self-Reported Sleep Alterations After Stroke and Their Relationship With Disability: A Longitudinal Study. Neurorehabil Neural Repair 2024:15459683241252826. [PMID: 38708936 DOI: 10.1177/15459683241252826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
BACKGROUND Sleep disorders have a prevalence of 30% to 70% in post-stroke individuals. The presence of sleep disorders and poor sleep quality after stroke can affect important functions and lead to worse outcomes. However, most studies are restricted to the acute post-stroke stage only. OBJECTIVE To investigate the frequency of self-reported sleep alterations in a sample of chronic stroke individuals and to identify which self-reported sleep alterations were associated with disability. METHODS Prospective exploratory study. Self-reported sleep alterations were measured by the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and STOP-Bang Questionnaire. The dependent variable was measured 3 years after the first contact by the Modified Rankin Scale (mRS). Step-wise multiple linear regression analysis was employed to identify which sleep alterations were associated with disability. RESULTS Sixty-five individuals with stroke participated. About 67.7% of participants had poor sleep quality, 52.4% reported insomnia symptoms, 33.9% reported excessive daytime sleepiness, and 80.0% were classified as intermediate or high risk for obstructive sleep apnea. Only risk for obstructive sleep apnea was significantly associated with disability and explained 5% of the variance in the mRS scores. CONCLUSION Self-reported sleep alterations had a considerable frequency in a sample of chronic stroke individuals. The risk of obstructive sleep apnea was associated with disability in the chronic stage of stroke. Sleep alterations must be considered and evaluated in the rehabilitation process even after a long period since the stroke onset.
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Affiliation(s)
| | - Leonardo Carvalho Silva
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Estefany Horrany Gonçalves
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Andressa Silva
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Aline Alvim Scianni
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Zão A, Altenmüller E, Azevedo L. Performance-related Pain and Disability among Music Students Versus Professional Musicians: a Multicenter Study using a Validated Tool. Pain Med 2024:pnae032. [PMID: 38676668 DOI: 10.1093/pm/pnae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 03/15/2024] [Accepted: 04/18/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To evaluate prevalence of performance-related pain among musicians and compare pain characteristics, associated disability and approach to pain management, between music students and professional musicians. METHODS A multicenter cross-sectional study was performed in a multi-stage stratified cluster random sample of 585 musicians, stratified by music students (294, among which 234 were at pre-university level and 60 at university level) and professional musicians (291). The main outcome was performance-related pain, measured by Performance-related Pain among Musicians Questionnaire (PPAM). Secondary outcomes were: pain management approach, physical activity levels, fatigue, distress, and health-related quality of life. RESULTS The lifetime prevalence of performance-related pain was 55.0% (n = 322), being significantly higher among professionals (57.5% versus 42.5%, p < 0.001). Pain intensity scores were significantly higher in professional musicians (p < 0,05), but pain interference in performance was higher among music students, who also reported significantly higher levels of fatigue (p = 0.008) and distress (p < 0.001), and lower quality of life (p < 0.001). Regardless of the high levels of pain intensity and interference, fatigue, anxiety and depression, and low levels of quality of life, 33% musicians who developed pain had never looked for healthcare (this proportion is significantly higher for music students, 57%, p < 0.001). CONCLUSIONS We present the first multicenter study on performance-related pain among musicians with different backgrounds, using a validated tool, and distinguishing music students from professional musicians. Performance-related pain is a highly prevalent and disabling condition among musicians, however, its proper evaluation and management are still often underappreciated, contributing to significant impairments and reduced quality of life.
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Affiliation(s)
- Ana Zão
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS) and Associate Laboratory-Health Research Network (CINTESIS@RISE), Porto, Portugal
- Chronic Pain Unit and Physical and Rehabilitation Medicine Department, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar-Universidade do Porto, Porto, Portugal
- International Center of Arts Medicine, Porto, Portugal
| | - Eckart Altenmüller
- Institute of Music Physiology and Musician's Medicine; University of Music, Drama, and Media, Hannover, Germany
| | - Luís Azevedo
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS) and Associate Laboratory-Health Research Network (CINTESIS@RISE), Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS) at FMUP, Porto, Portugal
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Hu J, Zhu J, Zhou Z, Yang X, Zhu M, Wu P. Clinical Outcomes of Arthroscopic Surgery in Patients with Gluteal Muscle Contracture: Single-Institution Results from a High-Volume Cohort. Med Sci Monit 2024; 30:e942945. [PMID: 38442083 PMCID: PMC10924427 DOI: 10.12659/msm.942945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/02/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The aim of this study was to assess clinical outcomes of arthroscopic surgery for gluteal muscle contracture (GMC) with at least 2 years of follow-up in a large sample. MATERIAL AND METHODS A total of 665 patients who underwent arthroscopic release procedure at our institution between March 2014 and December 2018 and met the inclusion criteria were included in this study. All the patients were operated on by the same surgeon and the surgeon released the contracture band from anterior to posterior starting from the anterior edge of the ITB, the contracture band of the gluteus maximus, and vastus medialis tensor. After exclusion, 544 patients (218 males and 326 females) were finally included. Clinical outcomes at 2 years of postoperative follow-up were evaluated by a combination of several methods, including a new criterion we proposed for postoperative assessment, which included the cross-leg test, difficulty in squatting with legs together, and abnormal gait, the visual analogue scale (VAS), the modified Harris hip score (mHHS), and the satisfaction of patients. RESULTS The average follow-up time was 48.2±14.9 months. Based on the new criteria, 513 (94.3%) patients were evaluated as good, 25 (4.6%) as fair, and 6 (1.1%) as poor. The mHHS increased from 72.1±6.0 (range, 56.0-81.3) to 97.3±2.2 (range, 92.3-100.0) (P<0.001). The VAS decreased from 3.3±1.1 (range, 0-5) to 0.062±0.13 (range, 0-1) (P<0.001). For subjective satisfaction, 526 (96.7%) patients were satisfied, 14 (2.6%) patients were neutral, and 4 (0.7%) patients were dissatisfied. CONCLUSIONS In a large sample, favorable and durable clinical outcomes were observed after the arthroscopic procedure. Clinical symptoms and mHHS showed significant improvement with a minimum 2-year follow-up.
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Affiliation(s)
- Jianhai Hu
- School of Medicine, Anhui University of Science and Technology, Huainan, Anhui, PR China
- Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Jiazhuang Zhu
- Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Zheng Zhou
- Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Xiaoxiang Yang
- Department of Orthopedics, Bengbu Second People’s Hospital, Bengbu, Anhui, PR China
| | - Min Zhu
- School of Medicine, Anhui University of Science and Technology, Huainan, Anhui, PR China
| | - Peng Wu
- Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, PR China
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Unuvar BS, Gercek H, Tufekci O, Torlak MS, Erbas O. The relationship between lower extremity muscle tightness and pain and disability in individuals with non-specific chronic low back pain. Work 2024:WOR230547. [PMID: 38393876 DOI: 10.3233/wor-230547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Low back pain is a common health issue, and such pains are often associated with muscle tightness. Understanding the link between lower back pain and tight lower extremity muscles is essential for effective pain management and enhanced quality of life. OBJECTIVE The objective of this study was to investigate the relationship between lower extremity muscle tightness and pain and disability in individuals with non-specific low back pain (NSLBP). METHODS A total of 52 individuals with NSLBP were enrolled in this cross-sectional study. Lower extremity muscle tightness was assessed using various clinical tests, including the Active Knee Extension Test, Active Straight Leg Raise, Ober Test, and Modified Thomas Test. Pain intensity and disability were evaluated using the Visual Analog Scale and the Oswestry Disability Index, respectively. Statistical analyses were conducted to assess the correlation between muscle tightness, pain, and disability. RESULTS The study found weak to moderate negative correlations between lower extremity muscle tightness and both pain intensity and disability in individuals with NSLBP (r: -0.287 to -0.526, p < 0.05). Dominant and non-dominant extremities exhibited differences in muscle flexibility, with the dominant extremity showing greater flexibility (p < 0.05). CONCLUSIONS In individuals with NSLBP, lower extremity muscle tightness is closely related to pain severity and disability. These findings suggest that lower extremity muscle tightness plays a significant role in the severity of low back pain and disabilities. Additionally, the observed flexibility difference between dominant and non-dominant extremities warrants further investigation for more personalized treatment approaches.
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Affiliation(s)
- Bayram Sonmez Unuvar
- Department of Audiology, Faculty of Health Sciences, KTO Karatay University, Konya, Turkiye
| | - Hasan Gercek
- Department of Therapy and Rehabilitation, Vocational School of Health Services, KTO Karatay University, Konya, Turkiye
| | | | - Mustafa Savas Torlak
- Department of Therapy and Rehabilitation, Vocational School of Health Services, KTO Karatay University, Konya, Turkiye
| | - Onur Erbas
- Health Sciences Institute, Karamanoğlu Mehmetbey University, Karaman, Turkiye
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Castilho JDS, Barbosa RMF, Ayupe KMA, Defilipo ÉC, Chagas PSDC. Reliability and Acceptability to Caregivers of Telehealth Administration of the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) for Brazilian Youth with Down Syndrome. Physiother Can 2024; 76:104-108. [PMID: 38465305 PMCID: PMC10919367 DOI: 10.3138/ptc-2021-0110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 03/12/2024]
Abstract
Purpose To estimate test-retest reliability of the two versions of the PEDI-CAT administered via telehealth to caregivers of Brazilian young people with DS, to compare scores on the two versions, and to determine caregiver acceptance of telehealth administration of the assessment. Method A methodological study approved by the research ethics committee. Data collection was performed online, with a mean duration of 45.0 minutes for the content-balanced version of the PEDI-CAT and 17.5 minutes for the speedy version. Results In total, 28 caregivers of individuals with DS up to age 21 years participated (mean = 5.9 years; SD = 4.9 years). Intra-class correlation coefficients for the four domains of the PEDI-CAT content-balanced version and four domains of the PEDI-CAT speedy version ranged from 0.77 to 0.97. There was a statistical difference between the versions in the scores of the social-cognitive domain (p < 0.05). A mean of 105 items (SD = 21) was administered in the content-balanced version and a mean of 51 items (SD = 8) in the speedy version. All the caregivers found the method of administration of the PEDI-CAT acceptable. Conclusions This study demonstrated that either version of the Brazilian version of the PEDI-CAT can be used by telehealth in clinical practice to assess children, adolescents, and young adults with DS.
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Affiliation(s)
- Julia de Souza Castilho
- From the:Faculty of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | | | - Érica Cesário Defilipo
- Department of Physical Therapy, Universidade Federal de Juiz de Fora - campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Paula Silva de Carvalho Chagas
- Department of Physical Therapy of the Old, the Adult and Maternal-Infant, Faculty of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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Santos GMCD, Byrne RL, Cubas-Atienzar AI, Santos VS. Factors associated with delayed diagnosis of leprosy in an endemic area in Northeastern Brazil: a cross-sectional study. CAD SAUDE PUBLICA 2024; 40:e00113123. [PMID: 38198383 PMCID: PMC10775965 DOI: 10.1590/0102-311xen113123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/19/2023] [Accepted: 10/05/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to investigate the factors related to the individual and the health system that contribute to delayed diagnosis of leprosy in an endemic area in the Northeastern Brazil. This is a cross-sectional study of 120 individuals with leprosy. Demographic and clinical data and information on the factors related to the individual and the health system that contribute to delayed diagnosis of leprosy were obtained. Delayed diagnosis in months was estimated for each participant by interviews. A multivariate Poisson's regression analysis was performed between the outcome and the independent variables. The median delay in the diagnosis of leprosy was 10.5 (4.0-24.0) months. Approximately 12.6% of participants had grade 2 disability (G2D) at the time of diagnosis. In the multivariate Poisson regression analysis, males, older age, low schooling level, residing in urban areas, multibacellar or tuberculoid leprosy, not seeking healthcare immediately after symptom onset, suspected leprosy, excessive referrals, and the need for three or more consultations to confirm the diagnosis were associated with longer diagnostic delay. This study found a significant delay in the diagnosis of leprosy in Arapiraca, Northeastern Brazil, which may explain the continuously high rate of G2D among new cases. Factors related to the individual and the health system were associated with longer diagnostic delay. Interventions to raise awareness of the disease among the general population and strengthen primary health care are urgently needed.
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Berduszek RJ, Reneman MF, Dekker R, van der Sluis CK. Measurement properties of the Dutch versions of QuickDASH and PRWHE in patients with complaints of hand, wrist, forearm and elbow. J Back Musculoskelet Rehabil 2024:BMR230225. [PMID: 38250756 DOI: 10.3233/bmr-230225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND The shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient Rated Wrist/Hand Evaluation (PRWHE) are commonly used questionnaires to assess patient-reported hand function. Information about the measurement properties of the Dutch versions is scarce. OBJECTIVE To gain insight into the measurement properties of the Dutch language versions of the QuickDASH and the PRWHE in patients with (non)specific complaints of the hand, wrist, forearm and elbow. METHODS Internal consistency, construct validity, test-retest reliability, responsiveness, and floor and ceiling effects were assessed according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations. RESULTS Questionnaires were filled out by 132 patients. Internal consistency of QuickDASH (Cronbach's α= 0.92) and PRWHE (Cronbach's α= 0.97) was high. Predefined hypotheses for construct validity were not confirmed for 75% for both QuickDASH and PRWHE (accordance with 62% of predefined hypotheses for both questionnaires). Test-retest reliability of QuickDASH (ICC = 0.90) and PRWHE (ICC = 0.87) was good. Both QuickDASH (AUC = 0.84) and PRWHE (AUC = 0.80) showed good responsiveness. No floor or ceiling effects were present. CONCLUSIONS Measurement properties of the Dutch language versions of the QuickDASH and the PRWHE, applied to patients with (non)specific complaints of the hand, wrist, forearm and elbow, were very similar. Test-retest reliability and responsiveness were good for both QuickDASH and PRWHE. Construct validity could not be demonstrated sufficiently.
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Tapia-Haro RM, García-Ríos MC, Castro-Sánchez AM, Toledano-Moreno S, Casas-Barragán A, Aguilar-Ferrándiz ME. Analysis of Hand Function, Upper Limb Disability, and Its Relationship with Peripheral Vascular Alterations in Raynaud's Phenomenon. Diagnostics (Basel) 2023; 14:93. [PMID: 38201402 PMCID: PMC10795737 DOI: 10.3390/diagnostics14010093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to compare vascular involvement, hand functionality, and upper limb disability between Raynaud's phenomenon participants and controls. Also, we analyzed the relationships between vascular impairment, mobility, and strength with disability in this Raynaud population. We conducted a case-control study with fifty-seven participants. We registered sociodemographic and clinical data; vascular variables (temperature, cold test, blood flow, and oxygen saturation); functional variables (pinch strength, range of motion), and disability (Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire) (Q-DASH). Raynaud participants present more disability in all Q-DASH subscales, lower hands' temperature pre and post cold test, decreased blood flow on radial artery, decreased ranges of motions at passive extension of index finger, and active flexion and extension of thumb than the healthy controls. The multivariate regression analysis showed that extension of the index finger, lateral pinch strength, and oxygen saturation were significantly associated with disability in RP, almost the 55% of the total variance on the upper limb, 27% at sports/arts, and 42% at work. Our findings suggest that RP has a disabling effect on the upper extremities and a practice of activities in people who suffer it. Also, disability in Raynaud seems to be more related with hand mobility and strength impairment than vascular injury.
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Affiliation(s)
- Rosa Mª Tapia-Haro
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18071 Granada, Spain; (R.M.T.-H.); (M.C.G.-R.); (A.C.-B.)
- ibs.GRANADA Instituto de Investigación Biosanitaria, 18012 Granada, Spain;
| | - Mª Carmen García-Ríos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18071 Granada, Spain; (R.M.T.-H.); (M.C.G.-R.); (A.C.-B.)
- ibs.GRANADA Instituto de Investigación Biosanitaria, 18012 Granada, Spain;
| | | | - Sonia Toledano-Moreno
- ibs.GRANADA Instituto de Investigación Biosanitaria, 18012 Granada, Spain;
- Biomedicine Program, Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), 18071 Granada, Spain
| | - Antonio Casas-Barragán
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18071 Granada, Spain; (R.M.T.-H.); (M.C.G.-R.); (A.C.-B.)
- ibs.GRANADA Instituto de Investigación Biosanitaria, 18012 Granada, Spain;
| | - Mª Encarnación Aguilar-Ferrándiz
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18071 Granada, Spain; (R.M.T.-H.); (M.C.G.-R.); (A.C.-B.)
- ibs.GRANADA Instituto de Investigación Biosanitaria, 18012 Granada, Spain;
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Aytekin E, Ozgonenel L, Coskun H, Dede BT, Demir SE. Use of the Oswestry Disability Index in ankylosing spondylitis. Rev Assoc Med Bras (1992) 2023; 69:e20230927. [PMID: 37971134 PMCID: PMC10645179 DOI: 10.1590/1806-9282.20230927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/26/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE The Oswestry Disability Index is considered the gold standard in the evaluation of disability in patients with chronic mechanical back pain. The aim of this study was to assess the applicability of Oswestry Disability Index in patients with ankylosing spondylitis and its relationship with disease assessment parameters for ankylosing spondylitis. METHODS A total of 100 patients diagnosed with ankylosing spondylitis were included in the study group. The control group consisted of 50 individuals with nonspecific low back pain. The Oswestry Disability Index and Bath Ankylosing Spondylitis Disease Activity Index were applied to both groups. In addition, the Visual Analog Scale, the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein, the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate, the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Ankylosing Spondylitis Quality of Life scales were applied in the study group. the Erythrocyte Sedimentation Rate, C-Reactive Protein levels, and HLA-B27 analysis were noted as laboratory markers in ankylosing spondylitis patients. RESULTS The scores of Oswestry Disability Index had a significant correlation with scores of Bath Ankylosing Spondylitis Disease Activity Index in ankylosing spondylitis patients (r=0.543) and in the control group (r=0.401). There was a significant correlation between the scores of Oswestry Disability Index and the Bath Ankylosing Spondylitis Functional Index (r=0.544), Bath Ankylosing Spondylitis Metrology Index (r=0.317), the Ankylosing Spondylitis Quality of Life (r=0.723), the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate (r=0.501), the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (r=0.530), Visual Analog Scale-Rest (r=0.476), and Visual Analog Scale-Activity (r=0.441) values in patients with ankylosing spondylitis. CONCLUSION Evaluation of Oswestry Disability Index in conjunction with Bath Ankylosing Spondylitis Disease Activity Index may warn the physician to interpret high Bath Ankylosing Spondylitis Disease Activity Index scores in the context of mechanical pain. Therefore, the use of Oswestry Disability Index in patients with ankylosing spondylitis will be beneficial.
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Affiliation(s)
- Ebru Aytekin
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic – Istanbul, Turkey
| | - Levent Ozgonenel
- Istanbul Bilim University School of Medicine, Florence Nightingale Hospital, Department of Physical Medicine and Rehabilitation – Istanbul, Turkey
| | - Hudanur Coskun
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic – Istanbul, Turkey
| | - Burak Tayyip Dede
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic – Istanbul, Turkey
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Resnik L, Borgia M, Heinemann AW, Stevens P, Clark MA, Ni P. The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P): subscales for one and two-handed tasks. Disabil Rehabil 2023; 45:3768-3778. [PMID: 36357971 DOI: 10.1080/09638288.2022.2138572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 10/06/2022] [Accepted: 10/15/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE To develop a self-report measure of activity performance for upper limb prosthesis users that quantifies outcomes by level of amputation and prosthesis type. MATERIALS AND METHODS Telephone survey of 423 adults with major upper limb amputation (ULA) who used a prosthesis. Item generation, cognitive, and pilot testing were followed by field testing. Items were categorized as one- or two-handed. Factor and Rasch analyses evaluated unidimensionality, monotonicity, item fit, differential item functioning (DIF), and reliability. Test-retest reliability was evaluated with intraclass correlation coefficients (ICCs). Known group validity was assessed with ANOVAs. RESULTS Respondents with unilateral ULA utilized prosthesis for 24% of unilateral and 38% of bilateral tasks. Those with bilateral ULA utilized prostheses for 64% of unilateral and 46% of bilateral tasks. Factor analyses identified a One-handed Task factor (CFI = 0.963, TLI = 0.950, and RMSEA = 0.064) and a Two-Handed Task factor (CFI = 0.958, TLI = 0.953, and RMSEA = 0.053). Response categories were collapsed to address monotonicity. After DIF adjustment, person reliability was 0.49 and 0.82 for One-handed and Two-handed Task scales, respectively, and ICCs were 0.88 and 0.91. Both scales differed by amputation level (p < 0.001). CONCLUSIONS The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) measure of upper limb function of prosthesis users has promising psychometric properties.Implications for rehabilitationMeasurement of upper limb function in persons with amputation is challenging, given currently available measures which do not explicitly grade activity performance with a prosthesis.The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) builds upon the original Orthotics and Prosthetics User Survey (OPUS) UEFS Scale with modified instructions, a revised item set, response categories and scoring algorithm.The UEFS-P consists of two unidimensional scales, the One-handed Tasks scale and the Two-handed Tasks scale.The UEFS-P scales have clear advantages over existing self-report measures of upper limb function that ask about difficulty with performing functional activities without accounting for prosthesis use, and do not differentiate persons who use and do not use a prosthesis.
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Affiliation(s)
- Linda Resnik
- Providence VA Medical Center, Providence, RI, USA
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | | | - Allen W Heinemann
- Shirley Ryan AbilityLab and Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Phillip Stevens
- Hanger Institute for Education and Clinical Research, Austin, TX, USA
- Division of PM&R, University of Utah Health, Salt Lake City, UT, USA
| | - Melissa A Clark
- School of Public Health, Brown University, Providence, RI, USA
| | - Pengsheng Ni
- Boston University School of Public Health, Boston, MA, USA
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13
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Marin CE, Pinto PDO, Dos Passos GR, Cuervo DL, Wagner MB, Becker J, Sato DK. Reliability of telemedicine evaluation for EDSS functional systems in multiple sclerosis. J Telemed Telecare 2023:1357633X231207903. [PMID: 37904499 DOI: 10.1177/1357633x231207903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Introduction: There was an increase in telemedicine during the COVID-19 pandemic to follow patients with multiple sclerosis (MS). However, there is scarce data if online evaluations can cover important information assessed during in-clinic appointments, especially the Expanded Disability Status Score (EDSS). This study aims to develop a remote evaluation tool for EDSS functional systems and compare the performance with face-to-face evaluations. Methods: This was a single-center study that included all MS patients followed up at outpatient clinics of Hospital São Lucas Pontifícia Universidade Católica do Rio Grande do Sul, between April and August 2022. Initially, patients were routinely in-clinic evaluated by one trained neurologist for EDSS. After, patients were evaluated remotely without any information about the in-clinic EDSS results. We used a standardized interview with an interactive video platform to evaluate EDSS functional systems by telemedicine. Results: Forty-nine participants completed the two steps. Intra-class coefficient was 0.97 (95% CI: 0.95-0.98), concordance for EDSS below 4.0 was 0.87 (95% CI: 0.77-0.93) and ≥4.0 was 0.97 (95% CI: 0.89-0.99). There was perfect agreement in the final EDSS in 71.4% of the online and in-clinic evaluations. In the multivariate analysis, the visual (beta = 0.453; p = 0.003) and pyramidal (beta = 0.403; p = 0.009) systems contributed significantly to the difference in the final EDSS. Conclusion: The telemedicine tool created in this study can detect changes in functional systems with reliable results compared to in-clinic EDSS assessment. Telemedicine evaluations may reduce the number of in-clinic visits and the disease burden for patients with MS.
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Affiliation(s)
- Cássia E Marin
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Paula de O Pinto
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Giordani R Dos Passos
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Neurology Department, Instituto do Cérebro do Rio Grande do Sul (INSCER), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Daissy Lm Cuervo
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Mario B Wagner
- Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Jefferson Becker
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Neurology Department, Instituto do Cérebro do Rio Grande do Sul (INSCER), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Douglas K Sato
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Neurology Department, Instituto do Cérebro do Rio Grande do Sul (INSCER), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
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Sahbaz T, Medin-Ceylan C. Stroke severity to determine musculoskeletal symptoms in family caregivers. Rev Lat Am Enfermagem 2023; 31:e4004. [PMID: 37820216 PMCID: PMC10561800 DOI: 10.1590/1518-8345.6725.4004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/12/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE the objective of this study is to examine the relationship between the musculoskeletal problems experienced by the family members who care for stroke patients, physical health and disability levels. METHOD the subjects included in the study were patients and family caregivers admitted to the Kanuni Sultan Suleyman Training and Research Hospital Physical Medicine and Rehabilitation outpatient clinic with a stroke diagnosis between May 30 th, 2019, and May 30 th, 2021. The caregivers were assessed using the Extended Nordic Musculoskeletal Questionnaire. Validated scales were employed to evaluate stroke patients' physical health and disability level. RESULTS a total of 104 stroke patients and 104 caregivers who met our inclusion criteria took part in this study. Low back complaints in the last month were associated with the patients' Functional Ambulation Score (FAS), Functional Independence Measure (FIM), Stroke Impact Scale (SIS) and Brunnstrom scores. Neck pain was the second musculoskeletal complaint, but was not statistically associated with patient-related factors. Upper limb problems were associated with FAS, FIM, SIS, Brunnstrom and the Modified Ashworth Scale scores. CONCLUSION according to our findings, the low back is the body area most affected by musculoskeletal complaints in family caregivers of stroke patients, closely related to the patients' functional capacity and disability levels. CLINICAL TRIALS NUMBER NCT04901637 (1) Stroke survivors highly depend on informal caregivers for daily living. (2) Family caregivers are at an increased risk of experiencing musculoskeletal problems. (3) The caregivers' musculoskeletal symptoms are related to the level of the patient disability. (4) Preventive medicine should become a part of nursing education for family caregivers.
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Affiliation(s)
- Tugba Sahbaz
- Beykent University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Cansın Medin-Ceylan
- University of Health Sciences, Istanbul Physical Therapy Rehabilitation Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
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15
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Paramasivam A, Jaiswal A, Budhiraja S, Holzhey P, Santhakumaran P, Ogedengbe T, Martin J, DAS S, Côté S, Hassid R, James TG, Kennedy B, Tang D, Tran Y, Colson-Osborne H, Li Chen Che M, Minhas R, Granberg S, Wittich W. The International Classification of Functioning, Disability and Health Core Set for deafblindness. Part I: a systematic review of outcome measures. Eur J Phys Rehabil Med 2023; 59:615-627. [PMID: 37458491 PMCID: PMC10664768 DOI: 10.23736/s1973-9087.23.07890-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 05/16/2023] [Accepted: 06/23/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION The International Classification of Functioning, Disability, and Health (ICF), developed by the World Health Organization, is a classification framework that focuses on the health and functioning of people with disabilities. As part of an ICF Core Set development, four studies need to be conducted, one of which is a systematic review. This study presents part 1 of the systematic review that aims to describe the outcome measures identified in the literature related to functioning in individuals with deafblindness. EVIDENCE ACQUISITION The research team screened articles from eight scientific databases, three journals, and Google Scholar (March 2011 to September 2022). Articles were included if they studied individuals with deafblindness aged 18 and older. Studies that examined genetics or laboratory experiments involving animals were excluded. Data were extracted into a logbook with key descriptors such as study location and design, age of study population, and instruments/outcome measures used, which were further categorized into one of the following types: 1) standardized; 2) patient-reported measures, standardized (PT-S); 3) patient-reported measures, not standardized (PT-not S); 4) health professional, reported measures, standardized (HP-S); 5) Technical measures; 6) other measures (parent-reported standardized and laboratory measures). EVIDENCE SYNTHESIS The review included 147 studies, of which most were conducted in Europe (47.6%) and North America (27.9%). Of the 314 identified outcome measures, 57 were Standardized, 59 were Patient Reported-Standardized (PT-S), 178 were patient reported non-standardized (PT-Not S) variables, 11 were health professional reported, standardized, five were technical, and four were classified as other measures. CONCLUSIONS Most instruments measured functioning in daily activities and the mental health of individuals with deafblindness. Three deafblind-specific instruments were identified in this study, highlighting the need for more deafblind-specific instruments to be developed and utilized in research.
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Affiliation(s)
- Abinethaa Paramasivam
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Atul Jaiswal
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada -
| | - Shreya Budhiraja
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Peter Holzhey
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Praveena Santhakumaran
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Tosin Ogedengbe
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Jana Martin
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Supriya DAS
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Samuel Côté
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Romina Hassid
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Tyler G James
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Beth Kennedy
- Central Michigan University, Mt Pleasant, MI, USA
| | - Diana Tang
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Yvvone Tran
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | | | - Muriel Li Chen Che
- CRESAM National Center of Rare Disabilities and Deafblindness, Saint Benoit, France
| | - Renu Minhas
- DeafBlind Ontario Services, Newmarket, ON, Canada
| | - Sarah Granberg
- Örebro University, School of Health Sciences, Örebro, Sweden
| | - Walter Wittich
- Wittich Vision Impairment Research Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
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Arenas-Vargas LE, López-Reyes L, Cárdenas-Robledo S. Multiple sclerosis functional tests and their comparability with self-administered values: A pilot study. Biomedica 2023; 43:406-417. [PMID: 37871567 PMCID: PMC10644983 DOI: 10.7705/biomedica.6873] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/29/2023] [Indexed: 10/25/2023]
Abstract
Introduction Neurological impairment in multiple sclerosis is highly variable among patients and over time it is difficult to quantify. The Multiple Sclerosis Outcome Assessment Consortium established sensitive, cost-effective, clinically significant, and reproducible measures of different functional systems to measure outcomes in clinical trials. However, their use in clinical care routines is not widespread due to time and training constraints. Objective To evaluate the self-administration feasibility of the timed 25-foot walking, symbol-digit-modality, and 9-peg hole tests in healthy individuals. Materials and methods We performed a descriptive pilot study. Healthy individuals between 18 and 80 years of age were included. The Timed 25-Foot Walking Test (T25- FWT), the Symbol Digit Modality Test (SDMT), and the Nine-Hole Peg Test (9-HPT) (using the dominant and non-dominant hand) were administered by a trained physician, who also instructed the subjects about test self-administration. The correlation and agreement, between the guided and self-administered tests were assessed with Pearson and Spearman coefficients and the Bland-Altman method. Results Thirty-eight healthy volunteers were included. The median age was 36 (range: 23-55) years old, and 55.26% were female. The correlation coefficient between guided and selfadministered tests was 0.37 for the T25-FWT (p=0.01), 0.54 for the SDMT (p<0.001), and 0.64 and 0.65 for the 9-HPT, in the dominant and non-dominant hands, respectively (p<0,001). Both forms of administration were concordant for the T25-FWT (95%CI: -1,49 to 1,43), the 9-HPT with dominant hand (95%CI: -5,23 to 4,09), the 9-HPT with non-dominant hand (95%CI: -7,75 to 7,14) and the SDMT (95% CI: -20,94 to 24,10). Conclusions We provide a proof of concept related to the feasibility of the selfadministration of the T25-FWT, the 9-HPT, and the SDMT, as a tool to improve monitoring in routine clinical practice.
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Affiliation(s)
- Laura Estefanía Arenas-Vargas
- Centro de Esclerosis Múltiple, Hospital Universitario Nacional de Colombia, Bogotá, D.C., Colombia; Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Lorena López-Reyes
- Centro de Esclerosis Múltiple, Hospital Universitario Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Simón Cárdenas-Robledo
- Centro de Esclerosis Múltiple, Hospital Universitario Nacional de Colombia, Bogotá, D.C., Colombia; Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
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Snoeck-Krygsman SP, Donker-Cools BHPM, Jansen LP, Hoving JL, Schaafsma FG. Designing an evidence-based working method for medical work disability prognosis evaluation-an intervention mapping approach. Front Public Health 2023; 11:1112683. [PMID: 37744493 PMCID: PMC10516134 DOI: 10.3389/fpubh.2023.1112683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Purpose Performing evidence-based work disability prognosis evaluation (WDPE) of clients on sick leave is a difficult task for physicians. The aim was to develop a working method to support physicians in performing evidence-based WDPE and to improve WDPE quality. Materials and methods Intervention Mapping (IM) supplemented with elements of the Behavior Change Wheel (BCW) guided project planning for developing the working method. This approach allowed combination with other frameworks and, e.g., behavior change theories. WDPE quality challenges were analyzed on various ecological levels, e.g., the individual (i.e., the physician), interpersonal (i.e., the client) and organizational level, culminating into a multilevel logic model of the problem. Determinants that contributed to this problem, e.g., lack of physicians' knowledge on performing evidence-based WDPE, were identified. Performance objectives were formulated that could contribute to a desired change in WDPE quality. From the performance objectives and determinants (e.g., knowledge), change objectives were derived. In order to achieve these change objectives, suitable intervention functions (e.g., education) and policy categories (e.g., service provision) were identified, allowing the formulation of intervention components. Behavior change techniques (e.g., feedback on outcomes of a behavior) were selected to serve the intervention functions to deliver the desired change. This led to the conceptualization of an intervention plan. Results The intervention "Prognosable" is presented. It consists of a stepwise working method (SWM) for evidence-based WDPE. The SWM offers an overview of important aspects (e.g., medical condition, clients' confidence in return-to-work) to consider in individual clients' WDPE. The SWM helps physicians to identify crucial functional limitations, find and appraise evidence-based information, weigh all relevant prognostic aspects and it supports physicians to conclude with an evidence-based WDPE, tailored to the individual client. The intervention "Prognosable" was designed, which also includes an educational program and a supportive software tool to enable implementation of the SWM. Conclusion IM combined with BCW elements guided the development of a SWM for evidence-based WDPE. The SWM will be delivered through an educational program for physicians supported by a digital tool. The SWM, educational program and digital tool are ready to be implemented and evaluated in practice as the intervention "Prognosable."
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Affiliation(s)
- Sylvia P. Snoeck-Krygsman
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
- Department of Social Medical Affairs (SMZ), The Dutch Social Security Institute, The Institute for Employee Benefits Schemes (UWV), Amsterdam, Netherlands
| | - Birgit H. P. M. Donker-Cools
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
- Department of Social Medical Affairs (SMZ), The Dutch Social Security Institute, The Institute for Employee Benefits Schemes (UWV), Amsterdam, Netherlands
| | - Lyanne P. Jansen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
| | - Jan L. Hoving
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
| | - Frederieke G. Schaafsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
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Saltychev M, Hellgren H, Juhola J. Factors affecting association between pain severity and physical activity among people with low back pain. Int J Rehabil Res 2023; 46:293-296. [PMID: 37421303 PMCID: PMC10653291 DOI: 10.1097/mrr.0000000000000591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/03/2023] [Indexed: 07/10/2023]
Abstract
The aim was to identify factors, which may affect the relationship between physical activity and pain severity among patients with low back pain (LBP). It was a cross-sectional survey-based study among 1332 consecutive patients with LBP. Linear regression models were employed. Patients were 47.6 years old and 64% were women. For the entire sample, pain severity and the intensity of physical activity were negatively associated. Higher physical activity was associated with younger age, higher educational level, normal weight and optimal perceived general health. Sex, smoking, marital status and occupation did not demonstrate significant interactions on the association. The severity of disability showed paradoxical effect on the relationship between pain and physical activity - severe disability was associated with increase in physical activity.
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Affiliation(s)
- Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku
| | - Henri Hellgren
- Clinical Division, Faculty of Medicine, University of Turku, Turku, Finland
| | - Juhani Juhola
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku
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Ramirez-Parada K, Gonzalez-Santos A, Riady-Aleuy L, Pinto MP, Ibañez C, Merino T, Acevedo F, Walbaum B, Fernández-Verdejo R, Sanchez C. Upper-Limb Disability and the Severity of Lymphedema Reduce the Quality of Life of Patients with Breast Cancer-Related Lymphedema. Curr Oncol 2023; 30:8068-8077. [PMID: 37754500 PMCID: PMC10527643 DOI: 10.3390/curroncol30090585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
Breast cancer-related lymphedema (BCRL) is characterized by arm swelling, pain, and discomfort, reducing the quality of life (QoL) of affected individuals. BRCL is caused via the blockage or disruption of the lymphatic vessels following cancer treatments, leading to an accumulation of fluid in the affected arm. While current BCRL rehabilitation treatments seek to reduce arm swelling, our study aimed to examine the impact of both the magnitude of lymphedema (ΔVolume) and arm disability on three dimensions of QoL: social, physical, and psychological. Using the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) and the Upper Limb Lymphedema 27 questionnaire (ULL) in a group of 30 patients, we found that the magnitude of lymphedema (ΔVolume) was associated with the social dimension of QoL (r = 0.37, p = 0.041), but not with other dimensions. On the other hand, arm disability was associated with all evaluated dimensions of QoL (social, physical, and psychological: p < 0.001, p = 0.019, and p = 0.050 (borderline), respectively). These findings suggest that BCRL rehabilitation strategies should not only aim to reduce the magnitude of lymphedema but should also seek to improve or preserve arm functionality to enhance the QoL of BCRL patients.
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Affiliation(s)
- Karol Ramirez-Parada
- Department of Health Sciences, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile;
| | - Angela Gonzalez-Santos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
- Biosanitary Research Institute of Granada—Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- ’Cuídate’ from Biomedical Group (BIO277), Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, 18071 Granada, Spain
| | - Layla Riady-Aleuy
- Department of Lymphatic Rehabilitation and Esthetics, Lymphology Clinic, Santiago 7510032, Chile
| | - Mauricio P. Pinto
- Support Team for Oncological Research and Medicine (STORM), Santiago 8330077, Chile;
| | - Carolina Ibañez
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile; (C.I.); (T.M.); (F.A.); (B.W.)
| | - Tomas Merino
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile; (C.I.); (T.M.); (F.A.); (B.W.)
| | - Francisco Acevedo
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile; (C.I.); (T.M.); (F.A.); (B.W.)
| | - Benjamin Walbaum
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile; (C.I.); (T.M.); (F.A.); (B.W.)
| | - Rodrigo Fernández-Verdejo
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago 7500000, Chile
| | - Cesar Sanchez
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile; (C.I.); (T.M.); (F.A.); (B.W.)
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Colomer C, Llorens R, Sánchez C, Ugart P, Moliner B, Navarro MD, Noé E, Ferri J. Reliability and validity of the Spanish adaptation of the Functional Independence Measure + Functional Assessment Measure. Eur J Phys Rehabil Med 2023; 59:452-457. [PMID: 37226445 PMCID: PMC10548398 DOI: 10.23736/s1973-9087.23.07841-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND The Functional Independence Measure + Functional Assessment Measure (FIM+FAM) Scale is one of the most widely used instruments to measure functional independence post-stroke, and features many cultural adaptations to various languages. AIM The aim of this study was to determine the psychometric properties of a Spanish cross-cultural adaptation of the FIM+FAM for use in the stroke population. DESIGN Observational study. SETTING Outpatient long-term service of a neurorehabilitation unit. POPULATION One hundred and twenty-two individuals with stroke. METHODS The functional independence of the participants was assessed with the adapted version of the FIM+FAM. Additionally, the functional, motor and cognitive condition of the participants was assessed with a battery of standardized clinical instruments. Finally, a group of 31 participants out of the total were evaluated a second time with the FIM+FAM by a different evaluator than the one who performed the first evaluation. Internal consistency, inter-rater reliability and convergent validity with other clinical instruments of the adapted version of the FIM+FAM were determined. RESULTS The internal consistency of the adapted version of the FIM+FAM was excellent, as evidenced by Cronbach's α values that exceeded 0.973. The inter-rater reliability was likewise excellent, with correlations above 0.990 in all domains and subscales. Additionally, the convergent validity of the scale adaptation with clinical instruments was variable, with values ranging from 0.264 to 0.983, but consistent with the construct assessed in the different instruments examined. CONCLUSIONS The internal consistency, inter-rater reliability and convergent validity of the Spanish-adapted version of the FIM+FAM Scale showed excellent reliability and validity of the adaptation, which supports its use to assess functional independence after stroke. CLINICAL REHABILITATION IMPACT Availability of a valid adaptation for the evaluation of functional independence after stroke in Spanish population.
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Affiliation(s)
- Carolina Colomer
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain -
| | - Roberto Llorens
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
- Neurorehabilitation and Brain Research Group, Instituto Universitario de Investigación en Tecnología Centrada en el Ser Humano, Universitat Politècnica de València, Valencia, Spain
| | - Clara Sánchez
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - Patricia Ugart
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - Belén Moliner
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - María D Navarro
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - Enrique Noé
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - Joan Ferri
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
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21
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Manrique-Guzman S, Lerma A, Larocque-Guzman CM, Revilla-Pacheco FR, Herrada-Pineda T, Moscardini-Martelli J, Lerma C. Cross-cultural adaptation and validation of the Spanish version of the Oswestry disability index for Mexican population. Disabil Rehabil 2023:1-8. [PMID: 37439008 DOI: 10.1080/09638288.2023.2232303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
PURPOSE This study aimed to adapt a Spanish translation of the Oswestry Disability Index (ODI) into a cross-cultural version for the Mexican population. The objectives were to verify the validity and reliability of the adapted ODI and to compare pain perception between patients with and without obesity. MATERIAL AND METHODS We included 102 patients with low back pain from two neurosurgery departments in Mexico. The ODI questionnaire was translated and culturally adapted. Validity and construct were evaluated using exploratory factor analysis, and the external convergent validity was assessed by correlating ODI scores with pain intensity, age, and obesity. Test-retest reliability was calculated using the intraclass correlation coefficient, and confirmatory analysis was employed to validate the factorial structure. RESULTS Patients with obesity were older and had higher pain scores than patients without obesity. The exploratory analysis of the ODI in Mexican Spanish showed good reliability (Cronbach's alpha of 0.923) and validity (factorial loading range, 0.681 - 0.818). The confirmatory analysis showed almost null or very low discrepancy between the proposed model and the real data. CONCLUSIONS A Spanish translation of ODI was cross-culturally adapted for the Mexican population. The Mexican version of the ODI showed good reliability and validity in Mexican culture.
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Affiliation(s)
- Salvador Manrique-Guzman
- Neurosurgery Department. Angeles Interlomas Hospital, State of Mexico, Mexico
- Center for Health Sciences Research (CICSA), Health Sciences Faculty, Anahuac University, State of Mexico, Mexico
| | - Abel Lerma
- Center for Health Sciences Research (CICSA), Health Sciences Faculty, Anahuac University, State of Mexico, Mexico
- Health Sciences Institute, Autonomous University of Hidalgo State, Tilcuautla Hidalgo, Mexico
| | | | - Francisco R Revilla-Pacheco
- Neurosurgery Department. Angeles Interlomas Hospital, State of Mexico, Mexico
- Center for Health Sciences Research (CICSA), Health Sciences Faculty, Anahuac University, State of Mexico, Mexico
| | | | - Júlia Moscardini-Martelli
- Center for Health Sciences Research (CICSA), Health Sciences Faculty, Anahuac University, State of Mexico, Mexico
| | - Claudia Lerma
- Center for Health Sciences Research (CICSA), Health Sciences Faculty, Anahuac University, State of Mexico, Mexico
- Department of Electromechanical Instrumentation, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico
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22
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Morita ÂK, Tavella Navega M. Women with patellofemoral pain show changes in trunk and lower limb sagittal movements during single-leg squat and step-down tasks. Physiother Theory Pract 2023:1-9. [PMID: 37387682 DOI: 10.1080/09593985.2023.2228396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
BACKGROUND Changes in the trunk and lower limbs' sagittal movements may cause patellofemoral pain (PFP) because they influence the forces acting on this joint. OBJECTIVES To compare trunk and lower limb sagittal kinematics between women with and without PFP during functional tests and to verify whether sagittal trunk kinematics are correlated with those of the knees and ankles. METHODS A total of 30 women with PFP and 30 asymptomatic women performed single-leg squat (SLS) and step-down (SD) tests and were filmed by a camera in the sagittal plane. The trunk inclination angle, forward knee displacement, and ankle angle were calculated. RESULTS The PFP group exhibited less trunk flexion (SLS, p = .006; SD, p = .016) and greater forward knee displacement (SLS, p = .001; SD, p = .004) than the asymptomatic group; there was no significant difference in ankle angle (SLS, p = .074; SD, p = .278). Correlation analysis revealed that decreased trunk flexion was associated with increased forward knee displacement (SLS, r = -0.439, p = .000; SD, r = -0.365, p = .004) and ankle dorsiflexion (SLS, r = -0.339, p = .008; SD, r = -0.356, p = .005). CONCLUSION Women with PFP present kinematic alterations of the trunk and knee in the sagittal plane during unipodal activities. Furthermore, the trunk and lower limb sagittal movements were interdependent.
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Affiliation(s)
- Ângela Kazue Morita
- Center for Education and Health Studies, Faculty of Philosophy and Sciences, São Paulo State University (UNESP). Avenue Hygino Muzzi Filho, Marília, São Paulo, Brazil
- Postgraduate Program in Human Development and Technologies, Institute of Biosciences, São Paulo State University (UNESP). Avenue 24-A, Rio Claro, São Paulo, Brazil
| | - Marcelo Tavella Navega
- Postgraduate Program in Human Development and Technologies, Institute of Biosciences, São Paulo State University (UNESP). Avenue 24-A, Rio Claro, São Paulo, Brazil
- Department of Physical Therapy and Occupational Therapy, Faculty of Philosophy and Sciences, São Paulo State University (UNESP). Avenue Hygino Muzzi Filho, Marília, São Paulo, Brazil
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23
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Sanchez-Boluarte SS, Aguirre-Quispe W, Tacunan-Cuellar J, Sanchez-Boluarte AN, Segura-Chavez D. Disability evaluation in patients with Guillain-Barre syndrome and SARS-CoV-2 infection. Front Neurol 2023; 14:1191520. [PMID: 37483451 PMCID: PMC10356584 DOI: 10.3389/fneur.2023.1191520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Several cases of Guillain-Barre syndrome (GBS) associated with SARS-CoV-2 infection have been described. This study illustrated the demographic, clinical, and neurophysiological characteristics of patients with GBS and COVID-19, as well as associated factors with disability at discharge. Materials and methods A retrospective analytical observational study was conducted. It included patients diagnosed with GBS admitted in a national reference center in Peru between 2019 and 2021. Epidemiological, clinical, neurophysiological, and cerebrospinal fluid data were analyzed. A multivariate analysis, using the generalized linear model, was performed, considering the presence of disability at discharge as the dependent variable. Results Eight-one subjects diagnosed with GBS were included. The mean age was 46.8 years (SD: 15.2), with a predominance of males (61.73%). The most frequent clinical presentation was the classic sensory-motor form in 74 cases (91.36%) with AIDP (82.35%) as the most frequent neurophysiological pattern in the group with COVID-19, while AMAN pattern predominated (59.26%) in those without COVID-19 (p = <0.000). The disability prevalence ratio at discharge between subjects with COVID-19 and those without COVID-19 was 1.89 (CI 1.06-3.34), p = 0.030, adjusted for age, sex, and neurophysiological subtype. Conclusion The neurophysiologic subtype AIDP, and a higher disability were associated with the presence of COVID-19.
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Affiliation(s)
| | - Wilfor Aguirre-Quispe
- Neurosciences, Clinical Effectiveness and Public Health Research Group, Universidad Científica del Sur, Lima, Peru
| | - Jhon Tacunan-Cuellar
- Department of Neurophysiology, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | - Darwin Segura-Chavez
- Department of Neurophysiology, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
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Shekhar S, Rao R, Nirala SK, Naik BN, Singh C, Pandey S. Prevalence of acute low back pain with risk of long-term disability and its correlates among medical students: A cross-sectional study. J Educ Health Promot 2023; 12:179. [PMID: 37404938 PMCID: PMC10317279 DOI: 10.4103/jehp.jehp_1460_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/09/2022] [Indexed: 07/06/2023]
Abstract
BACKGROUND Low back pain (LBP) is responsible for the highest number of years lived with disability globally. There is a paucity of data regarding the same among medical students. So, this study was planned to estimate the prevalence of acute LBP having a high propensity to develop into chronic one as well as to determine associated correlates among medical students. MATERIALS AND METHODS This cross-sectional study was conducted among 300 medical students at a tertiary hospital using an Acute Low Back Pain Screening Questionnaire (ALBPSQ) to identify individuals with LBP and having a high risk of developing a long-term disability. ALBPSQ is a 21-question-based biopsychosocial screening instrument for identifying patients at risk of chronicity. ALBPSQ scores have been found to be significantly associated with pain and functional disability. Descriptive statistics, bivariate analysis, and multiple binary logistic regression have been performed through SPSS-22 software. RESULTS The prevalence of LBP having the propensity to develop into a long-term disability was found to be 14.3% (95% CI: 10.6-18.8). In bivariate analysis, higher age, no exercise, higher screen time, mental stress, studying in bed, abnormal posture, alcohol intake, tobacco use, positive family history, greater screen time per day, and more time spent in a sitting posture are significant with LBP. Stress ((adjusted odds ratio) AOR: 4.37, 95% CI: 1.79-10.68)), abnormally bent standing posture (AOR: 3.6, 95% CI: 1.3-10.6), and positive family of LBP (AOR: 3.6, 95% CI: 1.3-10.1) were found to be independent predictors of LBP among medical students. CONCLUSION Among medical students, every 15 out of 100 have a low back problem with chances of long-term disability. These students require early intervention to avoid long-term disability. Abnormal stooping posture, psychological stress, and positive family history of low pain might independently lead to LBP.
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Affiliation(s)
- Saket Shekhar
- Department of Community Medicine, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Rajath Rao
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Santosh Kumar Nirala
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Bijaya Nanda Naik
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Chandramani Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Sanjay Pandey
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
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González Aroca J, Díaz ÁP, Navarrete C, Albarnez L. Fear-Avoidance Beliefs Are Associated with Pain Intensity and Shoulder Disability in Adults with Chronic Shoulder Pain: A Cross-Sectional Study. J Clin Med 2023; 12:jcm12103376. [PMID: 37240482 DOI: 10.3390/jcm12103376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 05/28/2023] Open
Abstract
Shoulder pain is one of the most common musculoskeletal conditions, and for people over 40 years old, it represents the musculoskeletal pain with the greatest impact on quality of life. Psychological factors, such as fear-avoidance beliefs, are associated with musculoskeletal pain, and several studies suggest that they can influence various treatment outcomes. Our objective was to explore the cross-sectional association between fear-avoidance beliefs and shoulder pain intensity and disability in subjects with chronic shoulder pain. A cross-sectional study was conducted, and 208 participants with chronic unilateral subacromial shoulder pain were recruited. The shoulder pain and disability index assessed pain intensity and disability. The Spanish fear-avoidance components scale assessed the presence of fear-avoidance beliefs. The association between fear-avoidance beliefs and pain intensity and disability was analyzed by means of multiple linear regression models and proportional odds models, reporting odds ratios and 95% confidence intervals. Shoulder and pain disability scores were significantly associated with fear-avoidance beliefs (p < 0.0001, adjusted R-square 0.93, multiple linear regression). There was no evidence of an association between sex and age in this study. The regression coefficient for shoulder pain intensity and disability score was 0.67446. The proportional odds model showed an odds ratio of 1.39 (1.29-1.50) for shoulder pain intensity and disability total score. This study suggests that greater levels of fear-avoidance beliefs are associated with greater levels of shoulder pain and disability in adults with chronic shoulder pain.
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Affiliation(s)
| | | | - Carlos Navarrete
- Department of Mathematics, Faculty of Science, University of La Serena, La Serena 1700000, Chile
| | - Loreto Albarnez
- School of Kinesiology, University of La Serena, La Serena 1700000, Chile
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26
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O'Brien KK, Erlandson KM, Brown DA, Carusone SC, Vera JH, Bergin C, Avery L, Bayoumi AM, Hanna SE, Harding R, Solomon P, St Clair-Sullivan N, O'Shea N, Murray C, Boffito M, Da Silva G, Torres B, McDuff K, Davis AM. Episodic Disability Questionnaire (EDQ) measurement properties among adults living with HIV in Canada, Ireland, United Kingdom, and United States. Res Sq 2023:rs.3.rs-2758163. [PMID: 37066168 PMCID: PMC10104244 DOI: 10.21203/rs.3.rs-2758163/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background The Episodic Disability Questionnaire (EDQ) is a generic 35-item patient-reported outcome measure of presence, severity and episodic nature of disability. We assessed the measurement properties of the Episodic Disability Questionnaire (EDQ) with adults living with HIV. Methods We conducted a measurement study with adults living with HIV in eight clinical settings in Canada, Ireland, United Kingdom, and United States. We electronically administered the EDQ followed by three reference measures (World Health Organization Disability Assessment Schedule; Patient Health Questionnaire; Social Support Scale) and a demographic questionnaire. We administered the EDQ only 1 week later. We assessed the internal consistency reliability (Cronbach's alpha; >0.7 acceptable), and test-retest reliability (Intra Class Correlation Coefficient; >0.7 acceptable). We estimated required change in EDQ domain scores to be 95% certain that a change was not due to measurement error (Minimum Detectable Change (MDC95%)). We evaluated construct validity by assessing 36 primary hypotheses of relationships between EDQ scores and scores on the reference measures (> 75% hypotheses confirmed indicated validity). Results 359 participants completed the questionnaires at time point 1, of which 321 (89%) completed the EDQ approximately 1 week later. Cronbach's alpha for internal consistency ranged from 0.84 (social domain) to 0.91 (day domain) for the EDQ severity scale, and 0.72 (uncertainty domain) to 0.88 (day domain) for the EDQ presence scale, and 0.87 (physical, cognitive, mental-emotional domains) to 0.89 (uncertainty domain) for the EDQ episodic scale. ICCs for test-retest reliability ranged from 0.79 (physical domain) to 0.88 (day domain) for the EDQ severity scale and from 0.71 (uncertainty domain) to 0.85 (day domain) for the EDQ presence scale. Highest precision was demonstrated in the severity scale for each domain (MDC95% range: 19-25 out of 100), followed by the presence (MDC95% range: 37-54) and episodic scales (MDC95% range:44-76). Twenty-nine of 36 (81%) construct validity hypotheses were confirmed. Conclusions The EDQ possesses internal consistency reliability, construct validity, and test-retest reliability, with limited precision when administered electronically with adults living with HIV across in clinical settings in four countries. Given the measurement properties, the EDQ can be used for group level comparisons for research and program evaluation in adults living with HIV.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marta Boffito
- Chelsea and Westminster Hospital NHS Foundation Trust
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27
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Nietosvaara NN, Sommarhem AJ, Stenroos A, Nietosvaara AY, Grahn P. Factors affecting hand cosmesis and the aesthetic impact of surgery on congenital hand differences in Finland. J Hand Surg Eur Vol 2023; 48:333-340. [PMID: 36448515 PMCID: PMC10012396 DOI: 10.1177/17531934221139698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
We assessed the appearance and cosmetic impact of surgery in congenitally different hands in Finland. A questionnaire was sent to 1165 respondents (786 female) with a mean age of 33 years (range 3-84). Participants were shown nine image pairs and seven pairs of pre- and postoperative images twice in a random order and asked to choose the more cosmetically pleasing one. We found that the appearance and number of fingers had an important aesthetic role, with higher number and more normal appearing digits consistently scoring higher than its counterpart (range 59-99%). Postoperative appearances were perceived as better than preoperative ones in syndactyly (98%), thumb duplication (92%), cleft hand (93%) and radial dysplasia (99%). Toe transfer and pollicization had little impact on cosmesis. This study demonstrated that surgery could improve cosmesis in congenitally different hands and overall, most respondents prefer an appearance that is as close as possible to normality. Level of evidence: IV.
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Affiliation(s)
- Noora N Nietosvaara
- Department of Pediatric Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Finland.,Department of Surgery, Central Hospital of South Karelia, Lappeenranta, Finland.,Department of Pediatric Surgery, Kuopio University Hospital, University of Eastern Finland, Finland
| | - Antti J Sommarhem
- Department of Surgery, Central Hospital of South Karelia, Lappeenranta, Finland
| | - Antti Stenroos
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Finland
| | - Aarno Y Nietosvaara
- Department of Pediatric Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Finland.,Department of Pediatric Surgery, Kuopio University Hospital, University of Eastern Finland, Finland
| | - Petra Grahn
- Department of Pediatric Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Finland
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28
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Balkman GS, Morgan SJ, Amtmann D, Baylor C, Hafner BJ. Development of a candidate item bank for measuring mobility of lower limb orthosis users. PM R 2023; 15:445-455. [PMID: 36270012 PMCID: PMC10119328 DOI: 10.1002/pmrj.12916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/20/2022] [Accepted: 10/06/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Orthoses are often prescribed to improve mobility of people with chronic health conditions that affect lower limb function. Patient-reported survey instruments can be used to measure aspects of mobility that cannot be easily assessed in clinical or research settings. A population-specific item bank could be designed to measure aspects of mobility that are most important to lower limb orthosis users and used to evaluate the effects of orthoses. OBJECTIVE To develop items for a new survey instrument to measure mobility of lower limb orthosis users. DESIGN Survey items were developed using a qualitative item review process. SETTING Focus groups were held by video conferencing. Cognitive interviews were conducted by telephone. PARTICIPANTS Focus group and cognitive interview participants were adults with at least 6 months of experience using a lower limb orthosis that extended from the foot to a level above the ankle. METHODS Research methods included focus groups with lower limb orthosis users, an item generation and reduction process that involved a stakeholder advisory panel, and cognitive interviews with target respondents. RESULTS A total of 1180 extant items were identified in a literature review. Focus group participants (n = 29) provided feedback that informed the suitability of a construct definition and conceptual model. An advisory panel contributed to the selection of 118 candidate items for measuring orthotic mobility. Feedback from cognitive interview participants (n = 30) informed removal or revision of problematic items, resulting in a candidate bank of 100 mobility items. CONCLUSIONS The rigorous qualitative methods applied here resulted in a large set of candidate items that spanned a range of situations relevant to moving with a lower limb orthosis. Next steps include administration of the candidate items to a large sample of lower limb orthosis users and calibration of the item bank.
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Affiliation(s)
- Geoffrey S. Balkman
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Sara J. Morgan
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
- Gillette Children’s Specialty Healthcare, St. Paul, MN
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Brian J. Hafner
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
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29
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Liguori S, Moretti A, Toro G, Paoletta M, Palomba A, Barra G, Gimigliano F, Iolascon G. Pain and Motor Function in Myotonic Dystrophy Type 1: A Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:5244. [PMID: 37047859 PMCID: PMC10094252 DOI: 10.3390/ijerph20075244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
Pain is an underestimated finding in myotonic dystrophy type 1 (DM1). We provide a characterization of pain in terms of functional implications through a multidimensional assessment in patients with DM1, focusing on gender differences. We assessed pain through the Brief Pain Inventory (BPI) and its indexes (the Severity Index (SI) and the Interference Index (II)), balance/gait (the Tinetti Performance-Oriented Mobility Assessment (POMA)), functional abilities (the Functional Independence Measure (FIM)), and fatigue (the Fatigue Severity Scale (FSS)). We divided our sample into a mild (<4) and a moderate-severe group (≥4) based on BPI indexes. A between-group analysis was performed. We recruited 23 males and 22 females with DM1. A statistically significant difference was found for the FSS and the BPI-SI ≥ 4, and for all outcomes in the BPI-II ≥ 4 (p ≤ 0.003). In the female group, all outcomes except for the FIM were statistically significantly worse (p ≤ 0.004). Dividing our sample into four groups based on gender and the BPI, a statistically significant difference was found for FSS between the two groups with BPI-II ≥ 4 (with worsen score in the female one) (p < 0.002). Pain in DM1 patients is highly reported and gender related, with increased fatigue and poor balance/gait in the female group.
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Affiliation(s)
- Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via De Crecchio n. 4, 80138 Naples, Italy; (S.L.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via De Crecchio n. 4, 80138 Naples, Italy; (S.L.)
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via De Crecchio n. 4, 80138 Naples, Italy; (S.L.)
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via De Crecchio n. 4, 80138 Naples, Italy; (S.L.)
| | - Angela Palomba
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via De Crecchio n. 4, 80138 Naples, Italy; (S.L.)
| | - Giuseppe Barra
- Post Intensive Functional Rehabilitation Unit, Istituto di Diagnosi e Cura Hermitage Capodimonte, 80131 Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie n. 1, 80138 Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via De Crecchio n. 4, 80138 Naples, Italy; (S.L.)
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Geed S, Grainger ML, Mitchell A, Anderson CC, Schmaulfuss HL, Culp SA, McCormick ER, McGarry MR, Delgado MN, Noccioli AD, Shelepov J, Dromerick AW, Lum PS. Concurrent validity of machine learning-classified functional upper extremity use from accelerometry in chronic stroke. Front Physiol 2023; 14:1116878. [PMID: 37035665 PMCID: PMC10073694 DOI: 10.3389/fphys.2023.1116878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/15/2023] [Indexed: 04/11/2023] Open
Abstract
Objective: This study aims to investigate the validity of machine learning-derived amount of real-world functional upper extremity (UE) use in individuals with stroke. We hypothesized that machine learning classification of wrist-worn accelerometry will be as accurate as frame-by-frame video labeling (ground truth). A second objective was to validate the machine learning classification against measures of impairment, function, dexterity, and self-reported UE use. Design: Cross-sectional and convenience sampling. Setting: Outpatient rehabilitation. Participants: Individuals (>18 years) with neuroimaging-confirmed ischemic or hemorrhagic stroke >6-months prior (n = 31) with persistent impairment of the hemiparetic arm and upper extremity Fugl-Meyer (UEFM) score = 12-57. Methods: Participants wore an accelerometer on each arm and were video recorded while completing an "activity script" comprising activities and instrumental activities of daily living in a simulated apartment in outpatient rehabilitation. The video was annotated to determine the ground-truth amount of functional UE use. Main outcome measures: The amount of real-world UE use was estimated using a random forest classifier trained on the accelerometry data. UE motor function was measured with the Action Research Arm Test (ARAT), UEFM, and nine-hole peg test (9HPT). The amount of real-world UE use was measured using the Motor Activity Log (MAL). Results: The machine learning estimated use ratio was significantly correlated with the use ratio derived from video annotation, ARAT, UEFM, 9HPT, and to a lesser extent, MAL. Bland-Altman plots showed excellent agreement between use ratios calculated from video-annotated and machine-learning classification. Factor analysis showed that machine learning use ratios capture the same construct as ARAT, UEFM, 9HPT, and MAL and explain 83% of the variance in UE motor performance. Conclusion: Our machine learning approach provides a valid measure of functional UE use. The accuracy, validity, and small footprint of this machine learning approach makes it feasible for measurement of UE recovery in stroke rehabilitation trials.
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Affiliation(s)
- Shashwati Geed
- Department of Rehabilitation Medicine, Georgetown University, Washington, DC, United States
- MedStar National Rehabilitation Hospital, Washington, DC, United States
| | - Megan L. Grainger
- MedStar National Rehabilitation Hospital, Washington, DC, United States
| | - Abigail Mitchell
- MedStar National Rehabilitation Hospital, Washington, DC, United States
| | | | - Henrike L. Schmaulfuss
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States
| | - Seraphina A. Culp
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States
| | - Eilis R. McCormick
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States
| | - Maureen R. McGarry
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States
| | - Mystee N. Delgado
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States
| | - Allysa D. Noccioli
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States
| | - Julia Shelepov
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States
| | - Alexander W. Dromerick
- Department of Rehabilitation Medicine, Georgetown University, Washington, DC, United States
- MedStar National Rehabilitation Hospital, Washington, DC, United States
| | - Peter S. Lum
- MedStar National Rehabilitation Hospital, Washington, DC, United States
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States
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Dazzi MDAR, Sá CDSCD. Gait and Sit-To-Stand Motor Compensation Strategies in Children and Adolescents With Duchenne Muscular Dystrophy. Percept Mot Skills 2023; 130:221-238. [PMID: 36121164 DOI: 10.1177/00315125221128129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Duchenne Muscular Dystrophy (DMD), the most common form of muscular dystrophies, is characterized by progressive and generalized muscle weakness. The weakness of the trunk and other muscle groups leads these patients to perform motor compensation strategies to maintain their lower limb functionality for gait quality and for tasks such as getting up from a sitting position. In this cross-sectional observational study, we described and quantified trunk, gait, and sit-to-stand motor compensation strategies in different stages of this disease. Thirty-one ambulatory 5-18-year-old children and adolescents with a diagnosis of DMD, underwent cognitive assessment with the Mental Mini-Examination (MMSE) and motor assessment with the Vignos scale, Segmental Assessment of Trunk Control (SATCo-BR), Timed Up and Go test (TUG Test), and 10-m walk test. We found strong correlations between trunk and gait compensations, and identified motor compensation strategies characteristic of certain DMD classifications. Also, these lower limb and trunk compensations related to disease staging (Vignos) such that compensations were fewer for patients at relatively better disease staging.
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Affiliation(s)
| | - Cristina Dos Santos Cardoso De Sá
- Doutora do Curso de Fisioterapia, Departamento de Ciências do Movimento Humano, 58804Universidade Federal de São Paulo, São Paulo, Brazil
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Costa MDSS, Gomez RS, Lages GRC, Américo ADFQ, Abreu JMGD, Faria FR, Azevedo LM. Evaluation of functionality and socioeconomic status of patients with chronic pain. Rev Assoc Med Bras (1992) 2023; 69:308-313. [PMID: 36888771 PMCID: PMC9983481 DOI: 10.1590/1806-9282.20221093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/26/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE This study aimed to evaluate the influence of chronic pain on functionality and its consequences on work and patient income. METHODS A total of 103 patients from the Multidisciplinary Pain Center of the Clinics Hospital of Universidade Federal de Minas Gerais were interviewed between January 2020 and June 2021, applying questionnaires on mobile devices. Socioeconomic data, multidimensional characterization of pain, and instruments for assessing pain functionality and intensity were analyzed. Pain intensity was categorized as mild, moderate, or intense for comparative analysis. Ordinal logistic regression was used to identify risk factors and variables that jointly influence the outcome of pain intensity. RESULTS The patients had a median age of 55 years, were predominantly female, married or in a stable relationship, white race, and completed high school. The median family income was R$2,200. Most patients were retired due to disability and pain-related causes. Functionality analysis showed severe disability directly associated with pain intensity. The financial impacts observed were correlated with the pain intensity of the patients. Age was a risk factor for pain intensity, while sex, family income, and duration of pain served as protective factors. CONCLUSION Chronic pain was associated with severe disability, decreased productivity, and exit from the labor market, with a negative impact on financial condition. Age, sex, family income, and duration of pain were directly associated with pain intensity.
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Affiliation(s)
| | - Renato Santiago Gomez
- Universidade Federal de Minas Gerais, Department of Sciences Applied to Surgery - Belo Horizonte (MG), Brazil
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Çelenlioğlu AE, Şencan S, Saçaklıdır R, Can Öztürk E, Gündüz OH. Cervical Radiculopathy Impact Scale: Translation, cross-cultural adaptation, reliability and validity of the Turkish version. Arch Rheumatol 2022; 37:574-583. [PMID: 36879564 PMCID: PMC9985382 DOI: 10.46497/archrheumatol.2022.9639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/12/2022] [Indexed: 03/08/2023] Open
Abstract
Objectives The aim of this study was to translate and cross-culturally adapt the English version of the Cervical Radiculopathy Impact Scale (CRIS) and to investigate the validity and reliability of the Turkish version of the CRIS. Patients and methods Between October 2021 and February 2022, a total of 105 patients (48 males, 57 females; mean age: 45.4±11.8 years; range, 36.5 to 55.5 years) who were diagnosed with cervical radiculopathy due to disc herniation were included. Disability and quality of life were evaluated with the Neck Disability Index (NDI), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), and Short Form-12 (SF-12). Pain severity was evaluated using the Numerical Rating Scale (NRS) in three subscales (neck pain, pain radiating to the arm, and numbness in the finger, hand, or arm). The internal consistency for CRIS was assessed using the Cronbach alpha and test-retest reliability by intraclass correlation coefficients (ICCs). Explanatory factor analyses were performed for construct validity. To examine the content validity, the correlations among the three subgroup scores of CRIS and the other scale scores were analyzed. Results The internal consistency of CRIS was found to be high (α=0.937). A high reliability was obtained for test-retest reliability for the three subscales of CRIS (Symptoms, Energy and postures, Actions and activities) (ICC: 0.950, 0.941, 0.962, respectively; p<0.001). All three subscale scores of CRIS were correlated with the NDI, QuickDASH, SF-12 (physical and mental) and NRS scores (r=0.358-0.713, p<0.001). Factor analysis showed that the scale had five factors. Conclusion The CRIS is a valid and reliable instrument for Turkish patients with cervical radiculopathy due to disc herniation.
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Affiliation(s)
- Alp Eren Çelenlioğlu
- Department of Pain Medicine, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Türkiye
| | - Savaş Şencan
- Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Faculty of Medicine, Istanbul, Türkiye
| | - Rekib Saçaklıdır
- Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Faculty of Medicine, Istanbul, Türkiye
| | - Ekim Can Öztürk
- Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Faculty of Medicine, Istanbul, Türkiye
| | - Osman Hakan Gündüz
- Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Faculty of Medicine, Istanbul, Türkiye
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34
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Cores EV, Steinberg J, Cuesta C, Curbelo MC, Osorio MA, Bauer JJ, Politis DG. Tracking the impact of multiple sclerosis on employment status: the development of a questionnaire. Arq Neuropsiquiatr 2022; 80:929-934. [PMID: 36351418 PMCID: PMC9770074 DOI: 10.1055/s-0042-1755344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) has a negative effect on employment status. OBJECTIVE To present the preliminary results of a special questionnaire designed to collect employment information on patients with MS. METHODS The questionnaire on the impact of MS on employment status was completed by 63 patients. Fatigue, cognition, and depression were also evaluated, and 33 healthy participants were recruited as a control group. RESULTS Regarding the patients' employment status, we found rates of 31.7% of full-time employment, 28.6% of part-time employment, 7.9% of unemployment due to MS, 4.8% of housewives, 1.6% retirement due to age, 15.9% of retirement due to disability, 7.9% of medical leave due to MS, and 1.6% of medical leave for other reasons. The rate of unemployment among the patients was significantly higher compared with that of the control group. Out of 38 working patients, 31% had been absent from work for the previous 3 months due to MS, and 50% had to make changes in their work to remain employed. Out of the 19 unemployed patients, 78% said that walking difficulties were the cause of unemployment, while 52% thought cognitive impairment was the cause. CONCLUSIONS The questionnaire provides a record of the employment status of patients with MS and describes the impact on work from their point of view.
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Affiliation(s)
- Evangelina Valeria Cores
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.,Hospital Interzonal de Agudos “Eva Perón”, Laboratorio de Deterioro Cognitivo, Buenos Aires, Argentina.,Universidad de Buenos Aires, Faculty of Psychology, Buenos Aires, Argentina.,Address for correspondence Evangelina Valeria Cores
| | - Judith Steinberg
- Hospital Británico, Demyelinating Diseases Area, Buenos Aires, Argentina.
| | - Carolina Cuesta
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.,Hospital Interzonal de Agudos “Eva Perón”, Laboratorio de Deterioro Cognitivo, Buenos Aires, Argentina.,Universidad de Buenos Aires, Faculty of Psychology, Buenos Aires, Argentina.
| | | | - Mabel Alicia Osorio
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.,Hospital Interzonal de Agudos “Eva Perón”, Laboratorio de Deterioro Cognitivo, Buenos Aires, Argentina.
| | | | - Daniel Gustavo Politis
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.,Hospital Interzonal de Agudos “Eva Perón”, Laboratorio de Deterioro Cognitivo, Buenos Aires, Argentina.,Universidad de Buenos Aires, Faculty of Psychology, Buenos Aires, Argentina.
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35
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Vicente-Campos D, Sanchez-Jorge S, Chicharro JL, Becerro-de Bengoa-Vallejo R, Rodriguez-Sanz D, García AR, Rivoire M, Benet A, Boubekeur S, Calvo-Lobo C. POWERbreathe ® Inspiratory Muscle Training in Amyotrophic Lateral Sclerosis. J Clin Med 2022; 11:jcm11226655. [PMID: 36431132 PMCID: PMC9698064 DOI: 10.3390/jcm11226655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
Abstract
Inspiratory muscle training may benefit respiratory function, cardiocirculatory parameters, quality of life and functionality in neuromuscular diseases. This pilot study aimed to demonstrate the POWERbreathe® inspiratory muscle training effects on maximum inspiratory pressure (PImax), heart rate (HR) and HR variability, as well as the quality of life impairment and functionality in patients with Amyotrophic Lateral Sclerosis (ALS). A pilot single-blinded, non-randomized controlled clinical trial was carried out. A total of 20T ALS patients were enrolled and divided into experimental (n = 10) and control (n = 10) groups. The experimental group received POWERbreathe® inspiratory muscle training in conjunction with usual care, and the control group received only usual care for 8 weeks. PImax (measured by POWERbreathe® KH1), HR and HR variability (evaluated by Polar H7), quality of life impairment [measured by the Amyotrophic Lateral Sclerosis Assessment Questionnaire—40 items (ALSAQ-40)] and functionality [assessed by the ALS Functional Rating Scale Revised (ALSFRS-R)] were collected at baseline and after 8 weeks of intervention. We detected statistically significant differences (p < 0.05) with an effect size ranging from medium to large (Cohen’s d = 0.72−1.37); relative to the control group, the experimental group had an increased PImax (mean difference = 10.80 cm H2O; 95% CI = 3.42−18.17) and ALSFRS-R score (mean difference = 5.30 points; 95% CI = −0.03−10.63) and reduced HR (mean difference = −8.80 beats-per-minute; 95% CI = −20.27−2.67) and R-R interval (mean difference = 78.30 ms; 95% CI = 2.89−153.70). POWERbreathe® inspiratory muscle training, in addition to usual care, may improve inspiratory strength and heart rate in patients with ALS. These results encourage larger and longer trials investigating potential clinically relevant benefits of inspiratory muscle training to these patients over the disease course.
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Affiliation(s)
- Davinia Vicente-Campos
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Sandra Sanchez-Jorge
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
- Correspondence: ; Tel.: +34-913-51-03-03
| | - J. L. Chicharro
- Grupo FEBIO, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | | | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Arianne R. García
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Marie Rivoire
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Astrid Benet
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Sofía Boubekeur
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - César Calvo-Lobo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Aguilar-Zafra S, del Corral T, Valera-Calero JA, Martín-Casas P, Plaza-Manzano G, López-de-Uralde-Villanueva I. Development of the Web-Based Spanish Version of the Barthel Index in Patients with Multiple Sclerosis. Int J Environ Res Public Health 2022; 19:ijerph192113965. [PMID: 36360845 PMCID: PMC9657693 DOI: 10.3390/ijerph192113965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND The aims of this study were to develop a web-based Spanish form of the Barthel index (BI), to evaluate its psychometric properties and stability over time (test-retest), and to determine minimal detectable change (MDC) in patients with multiple sclerosis (MS). METHODS Participants answered the BI on two forms (web-based and face-to-face interview), 7-10 days apart. The internal consistency was evaluated using Cronbach's alpha, and intraclass correlation (ICC) and kappa (κ) coefficients were used to investigate the agreement between both forms. RESULTS 143 participants were included. The Spanish web-based form of the BI showed excellent agreement between both forms for each item (κ = 0.86 (0.79 to 0.92), and for total score (κ = 0.87 (0.81 to 0.93); ICC = 0.99 (0.98 to 0.99). The internal consistency was good-excellent (Cronbach's alpha = 0.89 (0.86-0.91)). The stability over time was adequate, the agreement of each item was κ = 0.63 (0.52-0.74)), and for total score (ICC = 0.97), determining a MDC95 of 12.09 points. CONCLUSIONS The Spanish web-based form of the BI is a valid and reliable tool to assess functionality and can be applied in both formats in patients with MS. A total score difference of more than 12 points was found to indicate a deterioration or improvement in the patient's functionality.
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Affiliation(s)
- Sandra Aguilar-Zafra
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Téxum S.L Physiotherapy Center, 28821 Madrid, Spain
| | - Tamara del Corral
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-91-394-15-17
| | - Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physical Therapy, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Cortesi PA, Fornari C, Capra R, Cozzolino P, Patti F, Mantovani LG. Multiple Sclerosis Progressive Courses: A Clinical Cohort Long-Term Disability Progression Study. Value Health 2022; 25:1489-1498. [PMID: 35484029 DOI: 10.1016/j.jval.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/02/2022] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Improving the understanding of multiple sclerosis (MS) mechanism and disability progression over time is essential to assess the value of healthcare interventions. Poor or no data on disability progression are available for progressive courses. This study aims to fill this gap. METHODS An observational cohort study of patients with primary MS (PPMS) and secondary progressive MS (SPMS) was conducted on 2 Italian MS centers disease registries over an observational time of 34 years. Annual transition probabilities among Expanded Disability Status Scale (EDSS) states were estimated using continuous Markov models. A sensitivity analysis was performed in relation to clinical characteristic associated to disability progression. RESULTS The study cohort included 758 patients (274 PPMS and 434 SPMS) with a median follow-up of 8.2 years. Annual transition probability matrices of SPMS and PPMS reported different annual probabilities to move within EDSS levels. Excluding EDSS associated to relapse events or patient with relapses, the annual probability of staying stable in an EDSS level increased in both disease courses even not significantly. CONCLUSIONS This study provides estimates of annual disability progression as EDSS changes for PPMS and SPMS. These estimates could be a useful tool for healthcare decision makers and clinicians to properly assess impact of clinical interventions.
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Affiliation(s)
- Paolo A Cortesi
- Research Centre on Public Health (CESP), University of Milano-Bicocca, Monza, Italy
| | - Carla Fornari
- Research Centre on Public Health (CESP), University of Milano-Bicocca, Monza, Italy.
| | - Ruggero Capra
- Multiple Sclerosis Centre, Spedali Civili di Brescia, Montichiari, Italy
| | | | - Francesco Patti
- Department of Medical, Surgical Science and Advanced Technology "GF Ingrassia," University of Catania, Catania, Italy
| | - Lorenzo G Mantovani
- Research Centre on Public Health (CESP), University of Milano-Bicocca, Monza, Italy; IRCCS Multimedica, Sesto San Giovanni, Italy
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Prager BC, Broder SM, Natowicz MR. A picture is worth a thousand words: A proposal to incorporate video into the evaluation of adults with intellectual or developmental disability living outside the home. Front Public Health 2022; 10:887714. [PMID: 36091544 PMCID: PMC9451026 DOI: 10.3389/fpubh.2022.887714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/15/2022] [Indexed: 01/21/2023] Open
Abstract
Adults with intellectual or developmental disability (IDD) comprise 1-2% of the population worldwide. IDD is a significant risk factor for premature morbidity or mortality. This is likely due in part to preventable health conditions, which are modifiable with the intervention of direct care providers in areas including nutrition, promotion of an active lifestyle and effective identification of health or functional deterioration. Adults with IDD are also at increased risk for neglect or mistreatment, a finding that has been documented across multiple countries and in a variety of care settings. Contributing factors include resource availability, lack of person-centered care, management culture and care worker training. Practical and economical interventions may address the known disparities and challenges facing the large community of adults with IDD. To promote person-centered care, improve record-keeping/documentation, and aid in protecting the health and safety of this vulnerable population, we propose incorporation of a video into the evaluation of adults with IDD living outside the home.
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Affiliation(s)
- Briana C. Prager
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, United States,Medical Scientist Training Program, Case Western School of Medicine, Cleveland, OH, United States
| | - Sherri M. Broder
- Department of Bioethics, Case Western Reserve University, Cleveland, OH, United States
| | - Marvin R. Natowicz
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, United States,Pathology and Laboratory Medicine, Genomic Medicine, Neurological and Pediatrics Institutes, Cleveland Clinic, Cleveland, OH, United States,*Correspondence: Marvin R. Natowicz
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Jaquet P, Legouy C, Le Fevre L, Grinea A, Sinnah F, Franchineau G, Patrier J, Marzouk M, Wicky PH, Alexis Geoffroy P, Arnoult F, Vledouts S, de Montmollin E, Bouadma L, Timsit JF, Sharshar T, Sonneville R. Neurologic Outcomes of Survivors of COVID-19-Associated Acute Respiratory Distress Syndrome Requiring Intubation. Crit Care Med 2022; 50:e674-e682. [PMID: 35132020 PMCID: PMC9275804 DOI: 10.1097/ccm.0000000000005500] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe 3-6-month neurologic outcomes of survivors of COVID-19-associated acute respiratory distress syndrome, invasively ventilated in the ICU. DESIGN A bicentric prospective study during the two first waves of the pandemic (March to May and September to December, 2020). SETTING Two academic hospital ICUs, Paris, France. PATIENTS Adult COVID-19-associated acute respiratory distress syndrome survivors, invasively ventilated in the ICU, were eligible for a neurologic consultation between 3 and 6 months post ICU discharge. INTERVENTIONS Follow-up by face-to-face neurologic consultation. MEASURES AND MAIN RESULTS The primary endpoint was favorable functional outcome defined by a modified Rankin scale score less than 2, indicating survival with no significant disability. Secondary endpoints included mild cognitive impairment (Montreal Cognitive Assessment score < 26), ICU-acquired weakness (Medical Research Council score < 48), anxiety and depression (Hospital Anxiety and Depression score > 7), and posttraumatic stress disorder (posttraumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders 5 score > 30). Of 54 eligible survivors, four non-French-speaking patients were excluded, eight patients were lost-to-follow-up, and one died during follow-up. Forty-one patients were included. Time between ICU discharge and neurologic consultation was 3.8 months (3.6-5.9 mo). A favorable functional outcome was observed in 16 patients (39%) and mild cognitive impairment in 17 of 33 patients tested (52%). ICU-acquired weakness, depression or anxiety, and posttraumatic stress disorder were reported in six of 37 cases (16%), eight of 31 cases (26%), and two of 27 cases (7%), respectively. Twenty-nine patients (74%) required rehabilitation (motor, cognitive, or psychologic). ICU and hospital lengths of stay, tracheostomy, and corticosteroids were negatively associated with favorable outcome. By contrast, use of alpha-2 agonists during ICU stay was associated with favorable outcome. CONCLUSIONS COVID-19-associated acute respiratory distress syndrome requiring intubation led to slight-to-severe functional disability in about 60% of survivors 4 months after ICU discharge. Cognitive impairment, muscle weakness, and psychologic symptoms were frequent. A large multicenter study is warranted to allow identification of modifiable factors for improving long-term outcome.
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Affiliation(s)
- Pierre Jaquet
- UFR de médecine, Université de Paris, Paris, France
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
| | - Camille Legouy
- Médecine intensive-réanimation, CH Saint Anne, F-75014 Paris, France
| | - Lucie Le Fevre
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
| | - Alexandra Grinea
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
| | - Fabrice Sinnah
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
| | - Guillaume Franchineau
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
| | - Juliette Patrier
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
| | - Mehdi Marzouk
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
| | - Paul-Henri Wicky
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
| | - Pierre Alexis Geoffroy
- Department of Psychiatry and Addictive Medicine, AP-HP, Hospital Bichat - Claude Bernard, 75018 Paris, France
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000 Strasbourg, France
| | - Florence Arnoult
- Physiologie-Explorations Fonctionnelles, FHU APOLLO, DMU DREAM, AP-HP Hôpital Bichat-Claude Bernard, F-75018 Paris, France
| | - Serafima Vledouts
- Neurophysiologie clinique, service de Physiologie - Explorations Fonctionnelles, AP-HP, Hôpital Bichat-Claude Bernard, F-75018 Paris, France
| | - Etienne de Montmollin
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
- Université de Paris, INSERM UMR1137, Team 5, F-75018 Paris, France
| | - Lila Bouadma
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
- Université de Paris, INSERM UMR1137, Team 5, F-75018 Paris, France
| | - Jean-François Timsit
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
- Université de Paris, INSERM UMR1137, Team 5, F-75018 Paris, France
| | - Tarek Sharshar
- Médecine intensive-réanimation, CH Saint Anne, F-75014 Paris, France
| | - Romain Sonneville
- Médecine intensive - réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, F-75018 Paris, France
- Université de Paris, INSERM UMR1148, Team 6, F-75018 Paris, France
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van Balen EC, Hassan S, Smit C, Driessens MHE, Beckers EAM, Coppens M, Eikenboom JC, Hooimeijer HL, Leebeek FWG, Mauser-Bunschoten EP, van Vulpen LFD, Schols SEM, Rosendaal FR, van der Bom JG, Gouw SC. Socioeconomic participation of persons with hemophilia: Results from the sixth hemophilia in the Netherlands study. Res Pract Thromb Haemost 2022; 6:e12741. [PMID: 36051543 PMCID: PMC9414229 DOI: 10.1002/rth2.12741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/11/2022] [Accepted: 04/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background and objectives Treatment availability and comprehensive care have resulted in improved clinical outcomes for persons with hemophilia. Recent data on socioeconomic participation in the Netherlands are lacking. This study assessed participation in education, in the labor market, and social participation for persons with hemophilia compared with the general male population. Methods Dutch adults and children (5–75 years) of all hemophilia severities (n = 1009) participated in a questionnaire study that included sociodemographic, occupational, and educational variables. Clinical characteristics were extracted from electronic medical records. General population data were extracted from Statistics Netherlands. Social participation was assessed with the PROMIS Ability to Participate in Social Roles and Activities short form, with a minimal important difference set at 1.0. Results Data from 906 adults and children were analyzed. Participation in education of 20 to 24 year olds was 68% (general male population: 53%). Educational attainment was higher compared with Dutch males, especially for severe hemophilia. Absenteeism from school was more common than in the general population. The employment‐to‐population ratio and occupational disability were worse for severe hemophilia than in the general population (64.3% vs. 73.2% and 14.7% vs. 4.8%, respectively), but similar for nonsevere hemophilia. Unemployment was 5.4% (general male population: 3.4%). Absenteeism from work was less common (38% vs. 45.2%). Mean PROMIS score was similar to or higher than in the general population (54.2; SD 8.9 vs. 50; SD 10). Conclusion Socioeconomic participation of persons with nonsevere hemophilia was similar to the general male population. Some participation outcomes for persons with severe hemophilia were reduced.
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Affiliation(s)
- Erna C van Balen
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands
| | - Shermarke Hassan
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands
| | - Cees Smit
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands
| | | | - Erik A M Beckers
- Department of Hematology Maastricht University Medical Centre Maastricht The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine Amsterdam Cardiovascular Sciences Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
| | - Jeroen C Eikenboom
- Department of Internal Medicine Division of Thrombosis and Hemostasis Leiden University Medical Center Leiden The Netherlands
| | - Hélène L Hooimeijer
- Department of Paediatrics University Medical Center Groningen Groningen The Netherlands
| | - Frank W G Leebeek
- Department of Hematology Erasmus University Medical Center Erasmus MC Rotterdam The Netherlands
| | - Evelien P Mauser-Bunschoten
- Center for Benign Haematology Thrombosis and Haemostasis Van Creveldkliniek University Medical Center Utrecht University Utrecht Utrecht The Netherlands
| | - Lize F D van Vulpen
- Center for Benign Haematology Thrombosis and Haemostasis Van Creveldkliniek University Medical Center Utrecht University Utrecht Utrecht The Netherlands
| | - Saskia E M Schols
- Department of Hematology Radboud university medical center Nijmegen The Netherlands.,Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht Nijmegen The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands
| | - Johanna G van der Bom
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands.,Center for Clinical Transfusion Research Sanquin Research/LUMC Leiden The Netherlands
| | - Samantha C Gouw
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands.,Pediatric Hematology Emma Children's Hospital Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
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Takara KS, Alamino Pereira de Viveiro L, Moura PA, Marques Pasqual A, Pompeu JE. Roland-Morris disability questionnaire is bidimensional and has 16 items when applied to community-dwelling older adults with low back pain. Disabil Rehabil 2022:1-7. [PMID: 35798682 DOI: 10.1080/09638288.2022.2096127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To explore the evidence of the internal structure validity of the Roland-Morris Disability Questionnaire in older adults with low back pain. METHODS This was a cross-sectional study of psychometric testing involving 528 older adults with low back pain. Internal structure validity was explored by exploratory factor analysis and semi-confirmatory factor analysis. Reliability was verified using Kuder-Richardson Formula 20, Cronbach's alpha, and McDonald's omega. Replicability was observed by the generalized H index. RESULTS Roland-Morris Disability Questionnaire displayed two factors that assess "functional capacity" and "mobility". Eight items were excluded for presenting cross-loading (2 and 10), inadequate loading factors and communalities (18, 24, 13, and 12), or did not relate to the latent construct (15 and 22). Semi-confirmatory factor analysis indicated that the questionnaire had a good fitness model [X2 = 153.698 (p = 0.00001); RMSEA = 0.037; RMSR = 0.06; WRMR = 0.04; NNFI = 0.987; GFI = 0.979; AGFI = 0.971]. Reliability was acceptable (KR-20 = 0.79; Cronbach's alpha = 0.86; McDonald's Omega = 0.85), but replicability was poor in both factors (G-H factor 1 = 0.816-0.655; G-H factor 2 = 0.889-0.775). CONCLUSIONS The most appropriate version of the Roland-Morris Disability Questionnaire to apply to older adults with low back pain has 16 items and assesses functional capacity and mobility. IMPLICATIONS FOR REHABILITATIONThe RMDQ-16 is the most appropriate version of the RMDQ to use in older adults with LBP;The RMDQ-16 is bidimensional and assesses "functional capacity" and "mobility";The poor replicability of the RMDQ-16 indicates that it will probably not be stable across studies, but it can be useful in a clinical setting.
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Affiliation(s)
- Kelly Sayuri Takara
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Larissa Alamino Pereira de Viveiro
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Albuquerque Moura
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Amélia Marques Pasqual
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - José Eduardo Pompeu
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Bernardo Figueirêdo B, Reinaux C, Fuzari H, Sarmento A, Fernandes J, Dornelas de Andrade A. Chest wall volumes, diaphragmatic mobility, and functional capacity in patients with mucopolysaccharidoses. Disabil Rehabil 2022:1-10. [PMID: 35695376 DOI: 10.1080/09638288.2022.2084777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE We investigated respiratory muscle strength, diaphragm mobility, lung function, functional capacity, quality of life, body composition, breathing pattern, and chest wall (VT,CW) and compartmental volumes of Mucopolysaccharidosis (MPS) patients and compared these variables with matched healthy individuals. METHODS A cross-sectional study with data analyzed separately according to age group. A total of 68 individuals (34 MPS and 34 matched-healthy subjects) were included. Six-minute walking test assessed functional capacity and ultrasound assessed diaphragm mobility during quiet spontaneous breathing (QB). Optoelectronic plethysmography assessed VT,CW and breathing pattern during QB in two different positions: seated and supine (45° trunk inclination). RESULTS Body composition, lung function, respiratory muscle strength, and functional capacity were reduced in MPS (all p < 0.01). Diaphragm mobility was only reduced in adolescents (p = 0.01) and correlated with body composition and breathing pattern. Upper chest wall compartmental volumes were significantly lower in MPS, while abdominal volume only differed significantly in adolescents. Percentage contribution (%) of upper ribcage compartments to tidal volume was reduced in MPS children, whereas %AB was significantly increased compared with healthy subjects. CONCLUSION Lung function, respiratory muscle strength, functional capacity, diaphragm mobility, and quality of life are reduced in MPS compared with matched healthy subjects. VT,CW was mainly reduced due to pulmonary and abdominal ribcage impairment. Implications for RehabilitationReduction in respiratory muscle strength, functional capacity, diaphragm excursion and low lung volumes were found in individuals with Mucopolysaccharidoses (MPS).Chest wall volumes and the upper chest wall compartmental volumes during quiet spontaneous breathing are reduced in MPS.Assessment and monitoring of the respiratory system for individuals with MPS should be performed periodically through standardized assessments to enable identification of changes and early intervention by rehabilitation protocols.This study may provide the necessary basis for carrying out respiratoty rehabilitation protocols that can improving chest wall mechanics with breathing exercise in this group.
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Affiliation(s)
- Bárbara Bernardo Figueirêdo
- Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil.,Laboratory of Immunopathology Keizo Asami (LIKA), Federal University of Pernambuco, Recife, Brazil
| | - Cyda Reinaux
- Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Helen Fuzari
- Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - António Sarmento
- Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Juliana Fernandes
- Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Armèle Dornelas de Andrade
- Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil.,Laboratory of Immunopathology Keizo Asami (LIKA), Federal University of Pernambuco, Recife, Brazil
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Chae JS, Kim WJ, Lee GY, Choi YJ. Evaluation of lung function and clinical features of interlaminar cervical epidural steroid injections: a randomized controlled trial. J Int Med Res 2022; 50:3000605221108101. [PMID: 35766053 PMCID: PMC9247383 DOI: 10.1177/03000605221108101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Interlaminar cervical epidural steroid injections (ICESIs) are commonly used to treat axial neck pain and cervical radicular pain. However, local anesthetics can spread to and block the phrenic nerve and upper segments of the thoracic spinal cord where the sympathetic innervation of the lungs emerges. Therefore, changes in lung function may occur following ICESIs. METHODS The primary outcome measure was the pulmonary function test (PFT) result 30 minutes before and after ICESI with ropivacaine (0.1875% or 0.25%). The secondary outcome measure was the comparison of the pain scores and functional disability between the two concentrations of ropivacaine 4 weeks after the ICESIs. RESULTS Fifty patients were randomly assigned to either the R1 (0.1875% ropivacaine) or R2 (0.25% ropivacaine) group. No significant difference was observed between the pre-ICESI and 30-minute post-ICESI PFT results within each group, and no difference was observed between the two groups. After 4 weeks of treatment, both groups showed a significant decrease in pain scores and functional disability; however, no significant differences were observed between the two groups. CONCLUSIONS This study showed no significant change in lung function after ICESIs in either group and no local anesthetic concentration-based difference in the clinical efficacy of the ICESIs.
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Affiliation(s)
- Ji Seon Chae
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Won-Joong Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Gi Year Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Yong Ju Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
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Ganesh A, Fraser JF, Gordon Perue GL, Amin-Hanjani S, Leslie-Mazwi TM, Greenberg SM, Couillard P, Asdaghi N, Goyal M. Endovascular Treatment and Thrombolysis for Acute Ischemic Stroke in Patients With Premorbid Disability or Dementia: A Scientific Statement From the American Heart Association/American Stroke Association. Stroke 2022; 53:e204-e217. [PMID: 35343235 DOI: 10.1161/str.0000000000000406] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Patients with premorbid disability or dementia have generally been excluded from randomized controlled trials of reperfusion therapies such as thrombolysis and endovascular therapy for acute ischemic stroke. Consequently, stroke physicians face treatment dilemmas in caring for such patients. In this scientific statement, we review the literature on acute ischemic stroke in patients with premorbid disability or dementia and propose principles to guide clinicians, clinician-scientists, and policymakers on the use of acute stroke therapies in these populations. Recent clinical-epidemiological studies have demonstrated challenges in our concept and measurement of premorbid disability or dementia while highlighting the significant proportion of the general stroke population that falls under this umbrella, risking exclusion from therapies. Such studies have also helped clarify the adverse long-term clinical and health economic consequences with each increment of additional poststroke disability in these patients, underscoring the importance of finding strategies to mitigate such additional disability. Several observational studies, both case series and registry-based studies, have helped demonstrate the comparable safety of endovascular therapy in patients with premorbid disability or dementia and in those without, complementing similar data on thrombolysis. These data also suggest that such patients have a substantial potential to retain their prestroke level of disability when treated, despite their generally worse prognosis overall, although this remains to be validated in higher-quality registries and clinical trials. By pairing pragmatic and transparent decision-making in clinical practice with an active pursuit of high-quality research, we can work toward a more inclusive paradigm of patient-centered care for this often-neglected patient population.
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Unsgaard-Tøndel M, Nordstoga AL. Are Work Demand, Support and Control Associated with Work Ability and Disability during Back Pain Treatment? A Prospective Explorative Study. Int J Environ Res Public Health 2022; 19:ijerph19063154. [PMID: 35328841 PMCID: PMC8950009 DOI: 10.3390/ijerph19063154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 12/02/2022]
Abstract
Background: Low back pain is a multifactorial disease with consequences for work ability and social participation. Improved integration of the work domain in health care management is needed. The aim of this study was to explore the relation between working conditions with outcome of low back pain treatment. Methods: Observational study of 41 patients attending physiotherapy for low back pain. Work demands, support and control were registered at baseline and work ability and disability also at baseline, with follow up after three and nine months. We used mixed-effects models to estimate the longitudinal associations between working conditions and outcome. Results: Higher work demands were related to reduced work ability (−1.1 points, 95% CI: −2.1 to −0.1) and slightly increased disability (5.6 points, 95% CI: 0.5 to 10.7). Lack of social support from colleagues was associated with reduced work ability (−2.7 points, 95% CI: −0.2 to 1.5) and disability (14.0 points, 95% CI: 4.9 to 23.1). Conclusions: This explorative study found associations between work demands and support, and work ability and disability outcome. Screening for psychosocial working conditions may influence the work ability and disability treatment outcome. The results need replication in larger samples and may indicate that patients seeking primary care management for low back pain should be screened for work demands, support and control.
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Affiliation(s)
- Monica Unsgaard-Tøndel
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology NTNU, N-7491 Trondheim, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology NTNU, N-7491 Trondheim, Norway;
- Trondheim Municipality, Department of Physiotherapy, N-7004 Trondheim, Norway
- Correspondence: ; Tel.: +47-7341-2509
| | - Anne Lovise Nordstoga
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology NTNU, N-7491 Trondheim, Norway;
- Department of Physical Medicine and Rehabilitation, St Olavs Hospital, Trondheim University Hospital, N-7006 Trondheim, Norway
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Bernardo Figueirêdo B, de Sousa Dantas D, Oliveira TG, Cavalcanti GD, Reinaux C, Dornelas de Andrade A. Functioning profiles of individuals with Mucopolysaccharidosis according to the International Classification of Functioning. Eur J Phys Rehabil Med 2022; 58:127-136. [PMID: 34468112 PMCID: PMC9980536 DOI: 10.23736/s1973-9087.21.06881-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The classification of health problems of persons with Mucopolysaccharidosis (MPS) based on the International Classification of Functioning, Disability and Health (ICF) may contribute to better understanding the disease impacts. The ICF is a useful tool to describe disabilities and functioning, especially in diseases with multisystemic involvement. AIM To identify and classify the health needs of persons with non-neuronopathic MPS according to the ICF. DESIGN A cross-sectional study. SETTING Department of Physical Therapy (Federal University, Brazil). POPULATION Persons with non-neuronopathic MPS. METHODS Semi-structured interviews covering all components of the ICF were conducted to know the patients' perspectives of their health problems (patient-reported outcomes). The speeches were transcribed verbatim and analyzed by researchers to identifying meaningful concepts. Then, the concept units were linked to ICF components and the magnitude of the problem to ICF qualifiers. Data are shown by descriptive statistics and separated into two groups: children and adolescents, and adults. RESULTS A total of 60 different ICF categories were used to classify participants' functioning. A total of 28 and 51 categories was necessary to classify the health problems of children and adults, respectively. Additionally, 16 categories related to contextual factors were used, of which eight and 12 were identified as facilitators by children, adolescents, and adults, respectively. The main problems were related to supportive functioning of arms or legs (b7603), pain in the body part (b2801), respiratory functions (b440), and voice functions (b310). Limitations in the activity and participation component were related to walking (d450), fine hand use (d440), washing oneself (d510), and dressing (d540). Recreation and leisure (d920) was restricted to approximately half of the studied population. CONCLUSIONS People with MPS face impairments of body structures and functions, activity limitations and restrictions to participation. Environmental factors may be act as facilitators of these problems. CLINICAL REHABILITATION IMPACT The ICF is a useful tool to classify the health problems of people with non-neuropathic MPS. The planning of rehabilitation programs needs to covers all components of functioning to provide a biopsychosocial model of care. The ICF categories may direct health professionals to more effective targets.
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Affiliation(s)
- Bárbara Bernardo Figueirêdo
- Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil.,Postgraduate Program in Biology Applied to Health, Laboratory of Immunopathology Keizo Asami (LIKA), Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Diego de Sousa Dantas
- Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Taylline G Oliveira
- Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Giovanna D Cavalcanti
- Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Cyda Reinaux
- Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Armèle Dornelas de Andrade
- Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil - .,Postgraduate Program in Biology Applied to Health, Laboratory of Immunopathology Keizo Asami (LIKA), Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Kavaliunas A, Danylaitė Karrenbauer V, Binzer S, Hillert J. Systematic Review of the Socioeconomic Consequences in Patients With Multiple Sclerosis With Different Levels of Disability and Cognitive Function. Front Neurol 2022; 12:737211. [PMID: 35069404 PMCID: PMC8770980 DOI: 10.3389/fneur.2021.737211] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Multiple sclerosis (MS) is a challenging and disabling condition, predominantly affecting individuals in early adulthood. MS affects the physical, cognitive, and mental health of persons suffering from the disease as well as having a great impact on their financial status and quality of life. However, there is a lack of systematic approach toward assessing the socioeconomic consequences of MS. Our objective was to systematically review analytical observational studies investigating the socioeconomic consequences in persons with MS with different levels of physical disability and cognitive function. We conducted a systematic review on socioeconomic consequences of MS with a focus on employment-, income-, work ability-, and relationship-related outcomes in persons with MS with special focus on disability and cognition. Additionally, the educational characteristics were examined. From 4,957 studies identified, 214 were assessed for eligibility and a total of 19 studies were included in this qualitative assessment; 21 different outcomes were identified. All identified studies reported higher unemployment, higher early retirement, and higher risk of unemployment in relation to higher physical disability. Also, cognitive function was found to be a predictor of employment (unemployment). The studies pointed out significant correlations between greater disability and lower earnings and higher income from benefits. A study found the same correlation in relation to cognitive function. The studies reported higher work disability in relation to higher physical disability and lower cognitive function. In conclusion, this systematic review summarizes the pronounced differences in various socioeconomic outcomes between patients with MS with regards to their physical disability and cognitive function. In addition, we identified a lack of studies with longitudinal design in this field that can provide more robust estimates with covariate adjustments, such as disease modifying treatments.
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Affiliation(s)
- Andrius Kavaliunas
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Virginija Danylaitė Karrenbauer
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Neurology Medical Unit, Karolinska University Hospital, Huddinge, Sweden
| | - Stefanie Binzer
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Kolding Hospital, Kolding, Denmark
| | - Jan Hillert
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Neurology Medical Unit, Karolinska University Hospital, Huddinge, Sweden
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Moreno JD, Bennett LHV, Ferrite S. The use of the Washington Group on Disability Statistics questionnaires to identify hearing disability: a systematic review. Codas 2022; 34:e20200328. [PMID: 35043863 PMCID: PMC9769417 DOI: 10.1590/2317-1782/20212020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 07/14/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To investigate the use of instruments from the Washington Group on Disability Statistics (WG) to obtain data on hearing disability (HD). RESEARCH STRATEGIES We conducted searches in the PubMed, Scopus, Science Direct, Web of Science, Lilacs databases and the grey literature. The software "The State of the Art through Systematic Review" and "Mendeley" were used to assist in the bibliographic reference organization, selection, and storage. SELECTION CRITERIA we followed the guidelines proposed by the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" and we selected studies that met the following inclusion criteria: written in English or Portuguese, within the period of 2001 to 2017 and have used the WG hearing disability question. DATA ANALYSIS The variables analyzed into the studies were: WG module, country and year of data collection, sample size and composition, objective of the study, publication journal, HD estimate of prevalence and accuracy measures. RESULTS Sixty-five studies are included in the review, conducted with data from 30 countries. The WG Short Set of question was the most often used. Hearing disability prevalence ranged from 0.2 to 2.3% and only three studies estimated the accuracy of the instrument to identify HD. CONCLUSION The hearing disability question of WG has been used worldwide and mainly in developing countries. The short variation in the estimated prevalence measurements within studies seems favorable to the WG's goal of generate estimates that allow international comparison. However, the shortage of validity studies indicates the need for further investigations with this purpose.
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Affiliation(s)
- Jennifer Dantas Moreno
- Departamento de Fonoaudiologia, Universidade Federal da Bahia – UFBA - Salvador (BA), Brasil.
| | | | - Silvia Ferrite
- Departamento de Fonoaudiologia, Universidade Federal da Bahia – UFBA - Salvador (BA), Brasil.
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Piloti DTW, Ruiz VCD, Ribeiro MDC, de Almeida ST. Association between clinical evaluation and self perception of deglutition with motor disability scale in patients with multiple sclerosis. Codas 2022; 34:e20210026. [PMID: 35019079 PMCID: PMC9769428 DOI: 10.1590/2317-1782/20212021026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/04/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To investigate the association between the clinical evaluation and self-perception of deglutition with the motor disability scale in patients with Multiple Sclerosis. METHODS It is a cross-sectional, prospective study that was conducted with individuals with Multiple Sclerosis treated by the Neuroimmunology outpatient clinic of a hospital in southern Brazil. We reviewed the electronic medical records of patients to extract the score from the last Expanded Disability Status Scale. After the analysis of the inclusion criteria, and in clinical consultation, two protocols were applied: one of self-perception for the risk of dysphagia, through the Brazilian equivalence instrument of the Eating Assessment Tool; and the clinical evaluation of swallowing, with food, through the scale Gugging Swallowing Screen. The data were analyzed through tables, descriptive statistics and the tests: Fisher's Exact Association Test and Chi-square Test to assess the association between the results of the applied scales. We considered a maximum significance level of 5% (p <0.05). RESULTS It was possible to observe that there was a significant association between the scores of the Gugging Swallowing Screen scales with the Expanded Disability Status Scale of the patients. In addition, there was also a relation between the results of both protocols with the Expanded Disability Status Scale. CONCLUSION The patients with Multiple Sclerosis in this study presented oropharyngeal dysphagia, what was confirmed by the association between the clinical evaluation of swallowing and the results of the instrument of self-perception of swallowing and the motor disability scale.
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Affiliation(s)
- Dandara Tailuma Weiler Piloti
- Curso de Fonoaudiologia, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA - Porto Alegre (RS), Brasil.
| | - Vânia Carolina Devitte Ruiz
- Curso de Fonoaudiologia, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA - Porto Alegre (RS), Brasil.
| | - Marlise de Castro Ribeiro
- Departamento de Clínica Médica, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA - Porto Alegre (RS), Brasil.
| | - Sheila Tamanini de Almeida
- Departamento de Fonoaudiologia, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA - Porto Alegre (RS), Brasil.
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Kienbacher T, Fehrmann E, Tuechler K, Habenicht R, Mair P, Friedl A, Oeffel C, Ebenbichler G. Changes in the International Classification of Functioning, Disability, and Health Components "Activity/Participation" as Predicted Through Patient-Reported Outcomes Along With Comprehensive Back Pain Rehabilitation. Clin J Pain 2021; 37:812-819. [PMID: 34475338 PMCID: PMC8500373 DOI: 10.1097/ajp.0000000000000976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/21/2020] [Accepted: 08/11/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The World Health Organization (WHO) recommended the International Classification of Functioning, Disability and Health (ICF) but its use in clinical practice is sparse. This study investigated the limitations and restrictions in the most relevant brief ICF core set categories for chronic low back pain (cLBP) as automatically predicted from routinely measured outcomes using a novel, validated mapping algorithm. MATERIALS AND METHODS Of 2718 cLBP patients recruited, data from 1541 (64% females) were available from before and at the end of 6 months comprehensive outpatient rehabilitation. Assessments included the Roland Morris Disability Questionnaire (RMDQ) and Pain Disability Index (PDI) questionnaires, the percentage of patients with predicted limitations and restrictions in important activity and participation ICF categories, bodily functional measurements, pain intensity, and anxiety/depression (EQ-5D). RESULTS At baseline, both the RMDQ and the PDI measures were within the third of the lowest disability scores whilst 80% of the patients had limitations with "maintaining a body position" and 30% with "walking" ICF categories. Intervention-associated gains in the maximum isometric lumbar extension and flexion strength and the lumbar range of motion were significant overall, but improvements in patients' ICF limitations/restrictions varied. Anxiety/depression, lumbar range of motion, and extension strength all had a significant impact on the majority of the ICF categories, whereas flexion strength had none. DISCUSSION The rate of patients with predicted limitations/restrictions in activity/participation ICF core categories for cLBP partly mirrored disability levels and the impact of the body function scores on these limitations/restrictions in ICF categories was varied. Thus, assessing problems in the ICF activity/participation core categories is of relevance to clinical practice for both treatment goal setting and intervention planning. This may be achieved by computer-generated mapping without additional time burden.
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Affiliation(s)
| | - Elisabeth Fehrmann
- Karl Landsteiner Institute of Outpatient Rehabilitation Research
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Krems/Donau, Austria
| | - Kerstin Tuechler
- Karl Landsteiner Institute of Outpatient Rehabilitation Research
| | | | - Patrick Mair
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Krems/Donau, Austria
| | - Anna Friedl
- Karl Landsteiner Institute of Outpatient Rehabilitation Research
| | - Christian Oeffel
- Karl Landsteiner Institute of Outpatient Rehabilitation Research
| | - Gerold Ebenbichler
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna Medical University, Vienna
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