Dual-tasking in older women: physical activity or else?

The interplay between gender, Physical Activity (PA), and Dual Tasking (DT) in older adults is unclear. This study aimed to address DT based on gender and PA level. One-hundred and twenty older adults (81 women and 39 men) participated. Timed up and go test and spatiotemporal gait measures were collected in single and DT conditions. Participants were grouped according to gender and PA level. Physical activity did not explain gender differences, women were slower and had shorter stride lengths when DT regardless of PA level. Findings indicate the necessity for tailored PA and functional interventions to improve women's performance.

Perceptions and performance of exercise in people with knee osteoarthritis in the Middle East: are they different to countries in the developed world? A qualitative study in Jordan.

Background: Culture and lifestyle could justify the variability in clinical patterns of knee osteoarthritis (OA) and was reported to affect exercise adherence.Objective: To explore perceptions and aspects influencing exercise adherence in people with knee OA in Jordan (a developing country) as they might be different from those reported in the developed world.Methods: Fourteen participants were included in the study (13 females, one male). One focus group and seven in depth semi-structured interviews were conducted. The discussions were audio-taped and transcribed. Framework analysis was used and data were interpreted using the socio-ecological model.Results: At the individual level, knowledge of the role of exercise in knee OA and personal factors influenced exercise performance and adherence. At the sociocultural level, cultural attitudes and beliefs and social interaction affected exercises adherence. At the organizational/political level, suboptimal service delivery process, inappropriate delivery of home exercises, accessibility of services affected exercise adherence. Opportunities for improving service delivery were also reported. At the environmental level, geography and weather affected adherence.Conclusions: Understanding the interaction of health-related behavior with individual, social/cultural, organizational, and environmental aspects would improve exercise adherence and equip physiotherapists with knowledge and resources to facilitate the implementation of patient-centered services.

Determining trainees' knowledge of surgical anatomy: A specialist's perspective.

OBJECTIVES: Intraoperative identification of anatomical structures can potentially reduce the risk of surgical complications. This study aims to report specialists' perspectives about the anatomical structures that third-year residents should be able to identify during surgical operations. In addition, the factors which may influence specialists' opinions are discussed. MATERIALS AND METHODS: This qualitative cross-sectional study was conducted on obstetricians and gynaecologists between 1/2/2019 and 30/10/2019. The specialists practising in a hospital with a residency programme were included, and were asked to rate the importance of structures that a third-year resident should be able to identify during operations. We performed a comparison of responses based on specialists' age, gender, practice type, years of experience, and surgical workload. RESULTS: One hundred and sixty-five specialists were recruited with a response rate of 69.3%. The mean age of respondents was 46.1 years, and they had a mean experience of 13.4 years. Furthermore, 86.6% of specialists rated all the anatomical structures as "more important". The importance of surgical structures, as rated by specialists, was not related to gender, years of experience, or surgical workload. The importance of 63% of the anatomical structures was rated higher by junior specialists than senior specialists. CONCLUSION: Knowledge of anatomical structures is vital for gynaecologic residency training. Specialist's perceptions of the importance of various anatomical structures reflect their understanding of the training requirements. Our results highlighted the important anatomical structures that third-year residents are expected to identify during surgical operations. Future research may establish a reference for the core anatomy knowledge essential for each training year.

Knowledge of Knee Osteoarthritis and Its Impact on Health in the Middle East: Are They Different to Countries in the Developed World? A Qualitative Study.

Knowledge of knee osteoarthritis (OA) and its management options affects adherence to treatment, symptoms, and function. Many sociocultural differences exist between Jordan, as a representative of the Middle East, and the developed world which might influence the knowledge of the pathology and its impact on health. Objectives. To explore the knowledge of the pathology and the experience of people diagnosed with knee OA living in Jordan. Methods. Qualitative study design using a triangulation method of both focus groups and in-depth semistructured interviews. Fourteen participants were included (13 females and one male). One focus group and seven in-depth semistructured interviews were conducted. Discussions were audiotaped and transcribed. Framework analysis was used, and data were mapped to the International Classification of Functioning, Disability and Health framework. Results. The themes are as follows: (1) body functions and structures included two subthemes: physical changes and psychological impact; (2) activity limitation and participation restriction included three subthemes: factors influencing the activities, cultural and social perspectives to activity limitation, and participation restriction; (3) personal factors included three subthemes: knowledge and personal interpretation of disease process, knowledge of management options to relief symptoms, and influence of personal factors on activity and participation; and (4) environmental factors included three subthemes: service delivery process, ineffective communication across the care pathway, and facilitators and barriers. Conclusions. Knowledge of the disease was lacking as a consequence of inappropriate service delivery and culture. Activity limitations and participation restrictions are similar in Jordan to other cultures in addition to limitations in religious, employment, and transportation activities. The results demonstrate that the effect of knee OA varies among different cultures and highlight the role of healthcare professionals worldwide in understanding the impact of culture on health. They also increase the awareness of healthcare professionals, specifically in Jordan, on the limitations in delivered services and the importance of education.

Translation and Psychometric Properties of the Arabic Version of Michigan Neuropathy Screening Instrument in Type 2 Diabetes.

OBJECTIVE: To translate the patient questionnaire section of the Michigan Neuropathy Screening Instrument (MNSI) into Arabic, examine the reliability of the translated version, and provide descriptive data on a sample of patients with type 2 diabetes. METHODS: Researchers used the translation-back translation method to obtain MNSI Arabic. The test was then applied on 76 patients with type 2 diabetes. A subgroup of 25 patients answered MNSI Arabic twice to examine reliability. RESULTS: The intraclass correlation coefficient was 0.87, revealing good reliability of MNSI Arabic. The most common symptoms patients complained of were numbness (62%), prickling feelings (57%), burning pain (47%), and pain with walking (46%). CONCLUSION: Similar to the original MNSI version, our study demonstrates that the Arabic version of the MNSI questionnaire is a reliable tool for screening the symptomatic neuropathy status in patients with type 2 diabetes. Availability of this tool in Arabic will provide valuable and easy-to-obtain screening information regarding diabetic peripheral neuropathy that may help delay its complications by promoting early management.

Functional Balance and Gait Characteristics in Men With Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.

The purpose of this cross-sectional study was to compare gait characteristics and functional balance Babilities in men with LUTS secondary to benign prostatic hyperplasia (BPH) to those of community-dwelling older adults under different conditions of increasing difficulties, and to aid health-care providers to identify those patients with decreased level of activity and increased risk of falls. We recruited a group of 43 men diagnosed with symptomatic BPH and a control group of 38 older men. Participants performed the timed up and go and 10-m walking tests under different conditions-namely, single task, dual-task motor, and dual-task cognitive. Time to complete the tests and spatial and temporal gait parameters were compared between groups and conditions via mixed-design ANOVA. Under dual-task conditions, individuals in both groups performed significantly worse compared to the single functional balance and walking tasks. As the complexity of the walking task increased-from dual-task motor to dual-task cognitive-significant differences between groups emerged. In particular, men with BPH performed worse than older adults in tasks demanding increased attentional control. Results suggest that dual-task decrements in functional balance and gait might explain decreased level of physical activity and increased risk of falls reported in men with LUTS. Health-care providers for men with LUTS due to BPH should assess for abnormal gait and remain vigilant for balance problems that may lead to decreased mobility and falls. The dual-task approach seems a feasible method to distinguish gait and balance impairments in men with BPH.

The effect of optotype size and velocity parameters on the performance of healthy young adult subjects on the gaze stabilization test.

HYPOTHESIS: The purpose of the current study was to examine the influence of the optotype (the letter E) size, presentation time, and head velocity on gaze stabilization test (GST) performance. BACKGROUND: The gaze stabilization test is a functional measure of the vestibulo-ocular reflex. METHODS: Twenty-one healthy young subjects (mean age, 26 ± 4; range, 21-34, 10 male subjects) performed the computerized GST. Testing was repeated several times using different combinations of the optotype size and presentation time over a wide range of head velocities (<60 to >220 degrees per second). The sizes examined were 0.20, 0.25, and 0.30 logMAR above the subject's static visual acuity (SVA). The presentation times examined were 20, 30, and 40 ms above the subject's minimum perception time (mPT). RESULTS: Performance varied considerably based on the optotype parameters used in the GST. The optotype combination of SVA + 0.20 logMAR and mPT + 20 ms was the most difficult combination with the average of all subjects' performance less than 64% at all velocities. The optotype combination SVA + 0.30 logMAR and mPT + 40 ms was the easiest combination with subjects being able to correctly identify the optotype at any head velocity with greater than 70% average accuracy. Increasing the head velocity in any size/time combination caused deterioration in subjects' performance. CONCLUSION: Our study findings show that optotype parameters have significant influence on subjects' performance on the GST.

The reliability and response stability of dynamic testing of the vestibulo-ocular reflex in patients with vestibular disease.

The purpose of the study was to investigate the test-retest reliability and response stability of the Dynamic Visual Acuity (DVA) and Gaze Stabilization Test (GST) in patients with vestibular disorders. Twenty-nine patients with vestibular disease (16-78 years) participated. Subjects performed the GST and DVA in pitch and yaw planes, twice in one session and once after 7-10 days. The GST output is the maximum head velocity at which the patient was able to identify orientation of the letter E. The DVA output is the change in visual acuity when moving the head compared to static acuity. Subjects indicated their level of dizziness and visual blurring using a visual analog scale. Within- and between-sessions intraclass correlation coefficients ranged between 0-0.5 for the DVA and GST measures, with better correlations for within-session assessments. Response stability (standard error of measurement / mean) of the GST ranged between 21-32% and the DVA ranged between 25-69% with vertical DVA being most influenced by measurement error. Subjects' symptoms did not correlate with performance on either test. The current test protocol needs refinement to enhance reliability and stability in persons with vestibular disorders.

The reliability, stability, and concurrent validity of a test of gaze stabilization.

The gaze stabilization test (GST) is a computerized test of the vestibulo-ocular reflex that reports maximum head velocity while maintaining fixed visual acuity. The GST thus assesses the vestibulo-ocular reflex differently from the dynamic visual acuity test (DVAT). The purpose of this study was to assess the reliability, stability, and validity of the GST in a healthy young and older population. Forty subjects (20 older adults with mean (SD) age of 76.3 (5.3) and 20 young controls with mean (SD) age of 25.2 (3.2)) performed the GST and DVAT assessments. The version of the GST used in this study has a tunneled mirror system to ensure a consistent participant distance of 4 m from the computer screen. All subjects repeated trials within 30 minutes of initial testing. Twenty subjects (10 from each age group) returned 7-10 days later to repeat the GST and DVAT assessments. Vestibular symptoms were assessed before and after GST and DVAT assessments. The mean (SD) GST scores for the older group were 123 (33) deg/s in the yaw plane and 108 (27) deg/s in the pitch plane. For the young group, mean (SD) GST scores were 157 (34) deg/s in the yaw plane and 141(25) deg/s in the pitch plane. There was a significant between-group difference for GST scores in both yaw and pitch planes (p< 0.01). The intraclass correlation coefficient (ICC) for GST scores performed on the same day was 0.75 in the yaw plane and 0.69 in the pitch plane. The ICC including the 20 subjects who repeated the GST within 7-10 days was 0.59 in the yaw plane and 0.54 in the pitch plane. In general, GST was more stable than DVAT. GST was more stable in younger vs. older subjects whereas DVAT was more stable in older vs. younger subjects. Concurrent validity, determined by Spearman correlation coefficients between GST and DVAT loss results were -0.62 in the yaw plane and -0.38 in the pitch plane (p< 0.02). These results suggest that the gaze stabilization test (GST) has good same-day test-retest reliability and stability in healthy young and older adults. The moderate correlation between same-day GST and DVAT loss scores suggest the two tests may be measuring similar, but different constructs.

Perceptual and motor inhibition in individuals with vestibular disorders.

BACKGROUND AND PURPOSE: Vestibular dysfunction has been shown to be associated with altered cognitive function. The purpose of this study was to examine changes in cognitive function in participants with vestibular disease during the course of vestibular physical therapy. METHODS: Twenty-two participants (mean age = 52, standard deviation = 11) with previously diagnosed vestibular disorders were tested at the beginning and end of rehabilitation. The Motor and Perceptual Inhibition Test (MAPIT) was used to assess manual reaction times when responding to various stimuli presented on a computer screen. Additional physical performance measures and questionnaires related to dizziness, fear of falling, and activities of daily living were used to quantify change during the 6-week intervention period. The repeatable battery for the assessment of neuropsychological status (a measure of memory and executive function) was used to ensure that participants did not have memory or executive function deficits. RESULTS: Overall, there were no significant differences in MAPIT score before versus after physical therapy intervention, however there were some participants who demonstrated improvements in motor inhibition (MI) and perceptual inhibition (PI) scores. Interstingly, 8 of the 9 participants with abnormal caloric test findings had improvements on 2 of the PI scores. Overall 50% to 64% of the participants demonstrated improvement in the 4 different MAPIT scores. There were improvements in physical performance and self-report measures at the end of the 6-week physical therapy intervention program. DISCUSSION/CONCLUSION: Individuals with vestibular disorders may show improvement in MI and PI after a 6-week physical therapy intervention program; those with abnormalities on caloric and rotational chair tests appear especially likely to experience improvement in PI. Additional study is needed to determine whether individuals with vestibular disorders have remediable deficits in MI and PI.