RESUMO
This study examined whether individuals undergoing total hip arthroplasty who are self-rated as "highly active", demonstrated higher pre-operative activity levels than others. METHODS: 483 patients were retrospectively identified; 241 were "highly active" and 242 were not. They were compared using WOMAC, self-reported activity and 6-Minute Walk Test (6MWT). RESULTS: Self-reported highly active adults demonstrated statistically significant higher WOMAC scores (48.85 vs 43.79), increased mean number of activities performed and mean 6MWT (348.14â¯m vs 274.64â¯m). CONCLUSIONS: The positive correlation between subjective and objective measures of mobility increase our confidence in the latter as valid indicator of patient's preoperative activity level.
RESUMO
OBJECTIVE: The purpose of this study was to evaluate Canadian amyotrophic lateral sclerosis (ALS) centres with respect to: 1) the prevalence of Non-invasive positive pressure ventilation (NIPPV) and invasive mechanical ventilation via tracheostomy (TV) utilization, 2) the approach to NIPPV use, focusing upon the currently employed initiation criteria and 3) the barriers influencing NIPPV administration. METHODS: A descriptive survey research design aimed to obtain quantitative data and open-ended responses from an active physician at each of the 15 multidisciplinary Canadian ALS centres. RESULTS: The principal findings of this study were: 1) NIPPV and TV are used in 18.3% and 1.5% of patients at Canadian ALS centres, respectively, 2) symptoms of respiratory insufficiency, namely orthopnea (clinical significance rated at 9.00/10 +/- 1.48), dyspnea (8.27 +/- 1.95) and morning headache (7.55 +/- 1.21) are the most significant indicators for NIPPV initiation, 3) the primary barriers to NIPPV utilization are patient intolerance (70% of centres) and inaccessibility of respirologists and ventilation technologists (50% of centres). CONCLUSIONS: Variability in NIPPV use has an impact upon the management of Canadian ALS patients. The establishment of more definitive NIPPV initiation criteria, emphasizing respiratory symptoms, and the attenuation of barriers to NIPPV use should be targeted so as to ensure optimal care for all ALS patients.