Intervenciones para adultos con dependencia funcional y sus cuidadores durante la pandemia de COVID-19 / Interventions for functionally dependent adults and their caregivers during the COVID-19 pandemic

La pandemia de COVID-19 ha afectado a la población, perjudicando especialmente a los miembros de aquellos grupos sociales en situación de mayor vulnerabilidad. Estas poblaciones específicas, como aquellas con alguna dependencia funcional, podrían verse más afectadas por los efectos de la pandemia del COVID-19. Por lo tanto, el objetivo de este artículo fue describir las intervenciones para preservar la salud general, mantener la función y la independencia y prevenir la infección por COVID-19 para los adultos con dependencia funcional (ADF). Se realizó una búsqueda sistemática en bases de datos. Se revisaron los títulos y los resúmenes de cada publicación para determinar su relevancia. Dos revisores independientes accedieron a los artículos de texto completo para determinar su elegibilidad después de la selección inicial. Las búsquedas se realizaron en septiembre de 2021 y se actualizaron en enero y julio de 2022. La información encontrada se clasificó en 3 categorías: 1) ADF durante la pandemia de COVID-19; 2) ADF durante la pandemia de COVID-19 según una condición específica (condiciones neurológicas, discapacidades/deficiencias sensoriales y deterioro cognitivo), y 3) Adultos mayores con dependencia funcional. Los adultos con dependencia enfrentaron dificultades y barreras durante la pandemia por COVID-19. Las autoridades de cada país deben garantizar que los ADF tengan acceso a los servicios de rehabilitación en tiempos de crisis sanitaria. Además, es necesario aumentar la capacidad de los servicios de rehabilitación en tiempos de crisis como pandemias. De igual manera, se sugiere el fortalecimiento de estrategias como la telerehabilitación para evitar el deterioro o agravamiento de la funcionalidad de las personas dependientes. (AU)

The COVID-19 pandemic has affected the world population, especially people from social groups in a situation of greater vulnerability among people with some functional dependency. Therefore, the aim of this review was to describe interventions during the pandemic to preserve general health, maintain function and independence, and prevent COVID-19 infection for functionally dependent adults (FDA). A systematic search in databases was carried out. Titles and abstracts of each publication were reviewed for relevance. Full-text articles were accessed by two independent reviewers. The information found was classified into three categories: 1) FDA during the COVID-19 pandemic, 2) FDA during the COVID-19 pandemic according to a specific condition (neurological conditions, sensory disabilities/impairments, and cognitive impairment), and 3) Older adults with functional dependence. The FDAs have faced difficulties and barriers during the COVID-19 pandemic. Strengthening strategies such as telerehabilitation is suggested to avoid deterioration or aggravation of the functionality of dependent people. (AU)

Evidence of heat sensitivity in people with Parkinson's disease.

Examining how heat affects people with Parkinson's disease is essential for informing clinical decision-making, safety, well-being, and healthcare planning. While there is evidence that the neuropathology associated with Parkinson's disease affects thermoregulatory mechanisms, little attention has been given to the association of heat sensitivity to worsening symptoms and restricted daily activities in people with this progressive disease. Using a cross-sectional study design, we examined the experiences of people diagnosed with Parkinson's disease in the heat. Two-hundred and forty-seven people completed an online survey (age: 66.0 ± 9.2 years; sex: male = 102 (41.3%), female = 145 (58.7%)), of which 195 (78.9%) reported becoming more sensitive to heat with Parkinson's disease. Motor and nonmotor symptoms worsened with heat in 182 (73.7%) and 203 (82.2%) respondents, respectively. The most commonly reported symptoms to worsen included walking difficulties, balance impairment, stiffness, tremor, fatigue, sleep disturbances, excess sweating, difficulty concentrating, and light-headedness when standing. Concerningly, over half indicated an inability to work effectively in the heat, and nearly half reported that heat impacted their ability to perform household tasks and social activities. Overall, heat sensitivity was common in people with Parkinson's disease and had a significant impact on symptomology, day-to-day activities and quality of life.

Validity of the Chinese version of the weekly calendar planning activity (WCPA) on assessing executive function in adults with stroke.

The weekly calendar planning activity (WCPA) is a performance-based assessment of executive function (EF) via a cognitively-based instrumental activity of daily life (C-IADL). This study aimed to examine the validity of the Chinese version of the WCPA in adults with stroke and to explore the characteristics of cognitive strategy use among the population. Fifty-eight hospitalized patients with stroke aged 26-82 years and 53 controls completed the WCPA, two neuropsychological tests and instrumental activity of daily life (IADL) scale. Participants with stroke were subdivided into a stroke cognitive impaired group (Stroke-CI) and a general stroke group (Stroke-NCI) based on the Montreal Cognitive Assessment. Results showed that the WCPA was able to discriminate between Stroke-CI with controls and the Stroke-NCI group with controls. We found significant limitations in stroke patients' ability to use strategies. Concurrent and ecological validities were demonstrated through correlations between the neuropsychological test scores, IADL and the WCPA performance. This study provides initial evidence for the validity of the Chinese version of the WCPA-10 for adults with stroke and suggests the need to use performance-based tests even in patients with normal cognitive screening test results. The WCPA could provide useful information for strategy-based interventions for adults with stroke.

Health-Related Quality of Life of Post-Stroke Patients in a Public Hospital.

This study aimed to identify the correlation between influencing factors of activities of daily living (ADLs), mental health, and health-related quality of life (HRQoL) among post-stroke patients who enrolled in a transitional care service in a public hospital. This cross-sectional study involved 67 stroke patients who were enrolled in a transitional care service and visited the outpatient clinic at a public hospital in Seoul between March and December 2022. Their general characteristics, ADLs, mental health, and HRQoL were assessed. The data were analyzed using independent samples t-tests, analysis of variance, and Pearson correlation analysis, and the influencing factors were analyzed using regression analysis. HRQoL showed a statistically significant difference between patients living in different types of arrangements (t = 2.50, p = 0.015), and patients scores on the modified Rankin Scale (t = 7.08, p < 0.001). HRQoL was also significantly correlated with ADLs and mental health in stroke patients (r = -0.59, p < 0.001; r = -0.41, p < 0.001, respectively). Meanwhile, stroke severity (ß = -0.30, p = 0.002), living arrangements (ß = -0.30, p = 0.009) and ADLs (ß = -0.45, p < 0.001) were found to influence HRQoL (F = 6.87, p < 0.001, R2 = 0.47). Reduced dependence for ADLs, improvements in symptoms consequent to stroke, and support related to living arrangements contributed to improved HRQoL and interventions for post-stroke patients in the transitional care service of a public hospital.

Exploring Control Authority Preferences in Robotic Arm Assistance for Power Wheelchair Users.

This paper uses mixed methods to explore the preliminary design of control authority preferences for an Assistive Robotic Manipulator (ARM). To familiarize users with an intelligent robotic arm, we perform two kitchen task iterations: one with user-initiated software autonomy (predefined autonomous actions) and one with manual control. Then, we introduce a third scenario, enabling users to choose between manual control and system delegation throughout the task. Results showed that, while manually switching modes and controlling the arm via joystick had a higher mental workload, participants still preferred full joystick control. Thematic analysis indicates manual control offered greater freedom and sense of accomplishment. Participants reacted positively to the idea of an interactive assistive system. Users did not want to ask the system to only assist, by taking over for certain actions, but also asked for situational feedback (e.g., 'How close am I (the gripper)?', 'Is the lid centered over the jug?'). This speaks to a future assistive system that ensures the user feels like they drive the system for the entirety of the task and provides action collaboration in addition to more granular situational awareness feedback.

Association of Nutritional Risk With Gait Function and Activities of Daily Living in Older Adult Patients With Hip Fractures.

Objective: To investigate the association of nutritional risk with gait function and activities of daily living (ADLs) in older adult patients with hip fractures. Methods: The retrospective data of older adult patients diagnosed with hip fractures who visited the recovery-phase rehabilitation ward between January 2019 and December 2022 were reviewed. Nutritional risk was evaluated using the Geriatric Nutritional Risk Index; gait function and ADLs were assessed using the modified Harris Hip Score subitem and Functional Independence Measure, respectively. Multivariate linear regression and path analysis with structural equation modeling were used to examine the factors associated with ADLs and the associations among the study variables. Results: This study included 206 participants (172 females and 34 males; mean age, 85.0±7.3 years). In the multivariate analysis, gait function (ß=0.488, p<0.001), cognitive function (ß=0.430, p<0.001), and surgery (ß=-0.143, p<0.001) were identified as independent factors. Pathway analysis revealed that nutritional risk was not directly correlated with ADLs but was directly associated with gait and cognitive functions. Gait and cognitive functions, in turn, were directly related to ADLs. Conclusion: Nutritional risk was found to be associated with ADLs through an intermediary of gait and cognitive functions.

Domain-specific cognitive impairments, mood and quality of life 6 months after stroke.

PURPOSE: To identify which acute and 6-month domain-specific cognitive impairments impact mood, participation, and stroke-related quality of life 6 months post-stroke. MATERIALS AND METHODS: A prospective cohort of 430 stroke survivors completed the Oxford Cognitive Screen (OCS) acutely and 6 months post-stroke. Participants completed the Stroke Impact Scale (SIS) and Hospital Depression and Anxiety Scale (HADS) at 6 months. Multivariable regression analyses assessed whether severity of, and domain-specific, cognitive impairment acutely and at 6 months was associated with composite 6-month SIS scores, each SIS subscale, and HADS scores. RESULTS: Increased severity of acute and 6-month cognitive impairment was associated with lower 6-month SIS composite scores independent of age, sex, education years, and stroke severity (both p < 0.001). Domain-specific impairments in memory (p < 0.001) and attention (p = 0.002) acutely, and language (p < 0.001), memory (p = 0.001) and number processing (p = 0.006) at 6 months showed the strongest associations with worse SIS composite scores. Severity of acute and 6-month cognitive impairment was associated with poorer functioning in each SIS subscale, and greater levels of depression (acute p = 0.021, 6-months p < 0.001), but not anxiety (p = 0.174, p = 0.129). CONCLUSIONS: Both acute and 6-month domain-specific cognitive impairments, particularly in memory, were found to negatively impact overall functional and mood outcomes 6 months post-stroke.

At 6 months follow-up, stroke survivors reported the greatest challenges in participation and emotional well-being, suggesting that these specific areas may be worth prioritising.Healthcare professionals involved in post-stroke rehabilitation should prioritize assessing and addressing the severity of post-stroke cognitive impairment as it significantly influences functioning.Implementing targeted interventions particularly for memory deficits could be instrumental in improving overall functional and mood outcomes in stroke survivors.

Exploring the Intersectionality of Place and Gender Among Older Adults in Ghana: An Examination of Women's Disability Disadvantage.

Background and Objectives: Ghana's older adult population is growing rapidly and is projected to double by 2050. It is well-documented that social, health, and housing factors influence segmented aging trajectories that lead to disparate rates of disability. However, little is known about how the intersection of place (i.e., urban and rural) and gender (i.e., woman and man) inform rates of disability among older Ghanaians. We seek to examine this gap in the literature through an intersectional approach. Research Design and Methods: Using logistic regression with Wave 1 (2007/2008) data from the World Health Organization's Study on global AGEing and adult health (SAGE) Ghana, we investigate the prevalence of reporting activities of daily living (ADL) disability among respondents ages 50+ (n = 4,106). To document gender differences by place, we compute separate adjusted odds ratio models among urban and rural respondents. We also control for health, social, and housing factors that might explain gender differences. Results: Compared to urban men, urban women's ADL disability disadvantage was explained by marital status, particularly widowhood. In contrast, rural women consistently reported an ADL disability disadvantage when compared to rural men. Additionally, we found that the morbidity profiles of those who reported ADL disability differed by place and that certain ADL difficulties (i.e., bed transferring and toileting) were especially common among women respondents. Discussion and Implications: Women, regardless of urban or rural residence, were especially vulnerable to ADL disability. Marital status, particularly widows, explained the difference in disability risk between urban men and urban women. This finding suggests that urban women's risk of ADL disability is attenuated during the partnership. Also, we speculate that varied morbidity associations with ADL disability are due to different stressors in urban versus rural environments. These findings also generate further interest in about rural women's disability disadvantage.

Reliability and validity of a graphical computerized adaptive test Longshi scale for rapid assessment of activities of daily living in stroke survivors.

Stroke survivors frequently experience difficulties in daily activities, such as bathing, feeding, and mobility. This study aimed to evaluate the reliability and validity of a computer-adaptive test-Longshi scale (CAT-LS) for assessing activities of daily living (ADL) in stroke survivors. This cross-sectional study collected data using an electronic application. The ADL function of stroke survivors in rehabilitation departments of hospitals was assessed using both the CAT-LS and BI. Correlations between the CAT-LS and Barthel index (BI) and concurrent validity were evaluated using Pearson's correlation test and multiple linear regression. Interrater reliability was evaluated using the intraclass correlation coefficient based on a two-way random effect. The internal consistency of the CAT-LS was assessed using Cronbach's coefficient (α) and corrected item-total correlations. Overall, 103 medical institutions in China were used in this study. In total, 7151 patients with stroke were included in this study. The CAT-LS classified patients into three ADL groups (bedridden, domestic, and community) with significantly different BI scores (P < 0.05). The CAT-LS results obtained using the decision-tree scoring model were consistent with the scores for each BI item. A strong correlation was observed between CAT-LS and BI (Pearson's r: 0.6-0.894, P < 0.001). The CAT-LS demonstrated good internal consistency (Cronbach's α, 0.803-0.894) and interrater reliability (ICC, 0.928-0.979). CAT-LS is time-efficient and requires < 1 min to administer. The CAT-LS is a reliable and valid tool for assessing ADL function in stroke survivors and can provide rapid and accurate assessments that reduce the burden on healthcare professionals. Further validation of this tool in other populations and settings is necessary.Study registration number: No.: ChiCTR2000034067; http://www.chictr.org.cn/showproj.aspx?proj=54770 .

Clinical Features and Prognostic Analysis of MuSK-Antibody-Positive Myasthenia Gravis versus Double-Seropositive Myasthenia Gravis: A Single-Center Study from Central South China.

Purpose: To decipher the discrepancies between muscle-specific kinase antibody-positive myasthenia gravis (MuSK-MG) and double-seropositive myasthenia gravis (DSP-MG), and to determine prognostic factors for minimal manifestation status (MMS) achievement in MG patients with MuSK autoantibodies (MuSK-Ab). Patients and Methods: A total of 34 MG patients seropositive for MuSK-Ab were enrolled in this study. The demographic and clinical features were compared between MuSK-MG (n = 28) and DSP-MG (n = 6) patients, and factors affecting MMS induction in all patients with MuSK-Ab were identified using Cox regression analysis. Results: Compared to MuSK-MG patients, those with DSP-MG had similar clinical characteristics, except that they had a lower frequency of bulbar muscle involvement at nadir (50% vs 92.9%; P = 0.029) and higher proportions of comorbidities with diabetes mellitus (33.3% vs 0%; P = 0.027) and thymic abnormalities (33.3% vs 0%; P = 0.027). Higher MG Activities of Daily Living (MG-ADL) scores (HR = 0.16, 95% CI: 0.037-0.7, P = 0.015) and axial muscle involvement at nadir (HR = 0.39, 95% CI: 0.16-0.94, P = 0.035) were negative prognostic factors for MMS achievement in patients with MuSK-Ab regardless of acetylcholine receptor antibody (AChR-Ab) positivity. Multivariable Cox regression analysis further established higher MG-ADL scores at the nadir (HR = 0.19, 95% CI: 0.04-0.94; P = 0.042) as an independent risk factor for MMS achievement. Conclusion: DSP-MG was comparable to MuSK-MG and could be considered a single entity in our cohort. In all MG patients with MuSK-Ab, a higher MG-ADL score at nadir may herald a lower chance of MMS achievement, with no observed potential effect of AChR-Ab presence.

Skin Barrier Function Assessment: Electrical Impedance Spectroscopy Is Less Influenced by Daily Routine Activities Than Transepidermal Water Loss.

BACKGROUND: Skin barrier function assessment is commonly done by measuring transepidermal water loss (TEWL). An important limitation of this method is the influence of intrinsic and extrinsic factors. Electrical impedance spectroscopy (EIS) is a lesser-established method for skin barrier function assessment. Some influential factors have been described, but no guidelines exist regarding the standardization of these measurements. OBJECTIVE: To evaluate the effect size of daily routine activities on TEWL and EIS, as well as their correlation with age and anatomical differences. METHODS: Healthy participants (n=31) were stratified into three age groups (18-29, 30-49, and ≥50 years). In a climate-controlled room, EIS and TEWL measurements were performed on the left and right volar forearm and abdomen. RESULTS: Body cream application decreased TEWL and EIS values after 15 and 90 minutes. Skin washing decreased TEWL for 15 minutes and EIS values for at least 90 minutes. TEWL was increased 5 minutes after moderate to intense exercise. Coffee intake increased TEWL on the abdomen after 60 minutes. TEWL and EIS values did not correlate with participants' age and no anatomical differences were observed. No correlation was observed between TEWL and EIS. CONCLUSION: Body cream application and skin washing should be avoided at least 90 minutes prior to measurements of TEWL and EIS. Exercise and coffee intake should also be avoided prior to TEWL measurements. EIS may be a promising tool for skin barrier function assessment as it is less affected by daily routine activities than TEWL.

Work Productivity and Activities of Daily Living in Working Patients with Uveitis.

PURPOSE: To assess self-reported impairment of work productivity and activities of daily living and the indirect costs of absenteeism in a sample of working patients with uveitis and to examine their association with sociodemographic, occupational, and clinical variables. METHODS: We conducted a cross-sectional, cross-association study. Participants completed the self-administered Work Productivity and Activity Impairment Questionnaire uveitis 2.0 to assess absenteeism, presenteeism, overall work impairment, and impairment in activities of daily living. Clinical data were collected from the patients' medical records or instruments used to evaluate clinical parameters in practice. Indirect costs of absenteeism were assessed by the "lost wages method." Two clinical groups were established for this study. Bivariate and multivariate analyses were performed to assess the associations between variables. RESULTS: The final sample comprised 60 participants. Factors significantly associated with increased overall work impairment in the multivariate linear regression analysis were active uveitis (coefficient, 31.5; 95% confidence interval [CI], 16.1 to 46.9; p < 0.001) and presence of ocular comorbidities (coefficient for absence, -16.4; 95% CI, -31.1 to -1.8; p = 0.03). Factors significantly associated with increased impairment in activities of daily living were active uveitis (coefficient, 32.1; 95% CI, 18.2 to 46.0; p < 0.001), presence of ocular comorbidities (coefficient for absence, -23.5; 95% CI, -36.1 to -11.0; p < 0.001), and absence of nonocular comorbidities (coefficient 16.1; 95% CI, 3.9 to 28.3; p = 0.01). CONCLUSIONS: Active uveitis and ocular comorbidities are significantly associated with increased overall work impairment and impairment in activities of daily living in working patients with uveitis.

Cardiopulmonary Response in Post-COVID-19 Individuals: A Cross-Sectional Study Comparing the Londrina Activities of Daily Living Protocol, 6-Minute Walk Test, and Glittre Activities of Daily Living Test.

This study addresses the imperative need for reliable assessment protocols in guiding rehabilitation interventions for individuals post-COVID-19, considering the enduring physiological effects of the virus. A cohort of 40 post-COVID-19 individuals underwent assessments using the Londrina ADL protocol, Glittre ADL test, and the 6-minute walk test (6MWT). Physiological parameters were recorded during and after each test, including heart rate, respiratory rate, and oxygen saturation. The post hoc comparisons between the pre-test and post-test cardiopulmonary response of the three tests showed significant differences, except diastolic blood pressure (6MWT vs. Londrina ADL protocol), heart rate (6MWT vs. Londrina ADL protocol), respiratory rate (6MWT vs. Londrina ADL protocol), blood oxygen level (SpO2) (6MWT vs. Londrina ADL protocol), dyspnea (Londrina ADL protocol vs. Glittre ADL test), and fatigue (Londrina ADL protocol vs. Glittre ADL test). The Londrina ADL protocol demonstrated cardio-pulmonary responses comparable to the Glittre ADL test, as well as the 6MWT, emphasizing its effectiveness in evaluating walking-related outcomes. The study concludes that the Londrina ADL protocol is a robust and practical tool for the routine clinical testing of daily living activities in post-COVID-19 individuals. While the 6MWT remains valuable for assessing walking-related outcomes, a combined approach employing the Londrina ADL protocol and 6MWT offers a comprehensive strategy for evaluating multifaceted functional capacities in this population.

A Novel Framework Based on Deep Learning Architecture for Continuous Human Activity Recognition with Inertial Sensors.

Frameworks for human activity recognition (HAR) can be applied in the clinical environment for monitoring patients' motor and functional abilities either remotely or within a rehabilitation program. Deep Learning (DL) models can be exploited to perform HAR by means of raw data, thus avoiding time-demanding feature engineering operations. Most works targeting HAR with DL-based architectures have tested the workflow performance on data related to a separate execution of the tasks. Hence, a paucity in the literature has been found with regard to frameworks aimed at recognizing continuously executed motor actions. In this article, the authors present the design, development, and testing of a DL-based workflow targeting continuous human activity recognition (CHAR). The model was trained on the data recorded from ten healthy subjects and tested on eight different subjects. Despite the limited sample size, the authors claim the capability of the proposed framework to accurately classify motor actions within a feasible time, thus making it potentially useful in a clinical scenario.

Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey.

BACKGROUND: The Comprehensive Geriatric Assessment (CGA) records geriatric syndromes in a standardized manner, allowing individualized treatment tailored to the patient's needs and resources. Its use has shown a beneficial effect on the functional outcome and survival of geriatric patients. A recently published German S1 guideline for level 2 CGA provides recommendations for the use of a broad variety of different assessment instruments for each geriatric syndrome. However, the actual use of assessment instruments in routine geriatric clinical practice and its consistency with the guideline and the current state of literature has not been investigated to date. METHODS: An online survey was developed by an expert group of geriatricians and sent to all licenced geriatricians (n = 569) within Germany. The survey included the following geriatric syndromes: motor function and self-help capability, cognition, depression, pain, dysphagia and nutrition, social status and comorbidity, pressure ulcers, language and speech, delirium, and frailty. Respondents were asked to report which geriatric assessment instruments are used to assess the respective syndromes. RESULTS: A total of 122 clinicians participated in the survey (response rate: 21%); after data cleaning, 76 data sets remained for analysis. All participants regularly used assessment instruments in the following categories: motor function, self-help capability, cognition, depression, and pain. The most frequently used instruments in these categories were the Timed Up and Go (TUG), the Barthel Index (BI), the Mini Mental State Examination (MMSE), the Geriatric Depression Scale (GDS), and the Visual Analogue Scale (VAS). Limited or heterogenous assessments are used in the following categories: delirium, frailty and social status. CONCLUSIONS: Our results show that the assessment of motor function, self-help capability, cognition, depression, pain, and dysphagia and nutrition is consistent with the recommendations of the S1 guideline for level 2 CGA. Instruments recommended for more frequent use include the Short Physical Performance Battery (SPPB), the Montreal Cognitive Assessment (MoCA), and the WHO-5 (depression). There is a particular need for standardized assessment of delirium, frailty and social status. The harmonization of assessment instruments throughout geriatric departments shall enable more effective treatment and prevention of age-related diseases and syndromes.

Evaluation of activities and instrumental activities of daily living and correlated factors of traumatic brain injury patients in Vietnam.

Traumatic brain injury (TBI) is among the leading causes of death in Vietnam. Survivors of TBI suffer from functional and cognitive deficits. Understanding that Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) are crucial in measuring the treatment and health-related quality of life among patients with TBI. This study aims to evaluate ADLs and IADLs among the TBI population in Vietnam and determine the correlated factors to these two indices. A cross-sectional study was conducted on 212 patients with TBI in Vietnam from February to September 2020. ADLs and IADLs scales were applied. Depression, quality of sleep, and social support scales were used. Multivariate Tobit regression was adopted to identify factors associated with ADLs and IADLs. Patients who received first aid had higher ADLs scores than those who had not, by a statistical difference with a p value = 0.04. The mean ADLs score was 5.4 (SD = 1.4). The mean score of IADLs was 7.3 (SD = 1.7). Female patients (Mean = 7.6, SD = 1.1) performed better in IADLs than male patients (Mean = 7.1, SD = 1.9). Both ADLs and IADLs were affected strongly by depression and Injury Severity scores (p < 0.01), whereas IADLs were significantly correlated to caregiver types and quality of sleep (p < 0.01). Family support was observed as a negatively correlated factor to IADLs. Findings from the study provided evidence for authorities to adjust the health strategies among patients with TBI. Proper prehospital care, a basic low-cost hospital care model, and mental health counseling services should be considered when developing health interventions in Vietnam.

Height and Weight, Not Body Mass Index, Are Closely Associated With Activities of Daily Living in Japanese Older Adults.

Body mass index (BMI) is routinely used to ascertain health status, including activities of daily living (ADLs); however, the associations of ADLs with height and weight in older adults have not been elucidated. Therefore, we cross-sectionally investigated the correlations between ADLs and height, weight, and BMI in 155 participants aged 82 to 103 years and characterized the naïve Bayesian prediction for ADLs. Activities of daily living showed a significant negative correlation with height and weight and a positive correlation with age. In males, a shorter height was associated with an increased risk of falling and disability in phone calling independently, and losing weight was associated with an increased risk of disability in going out. Combining age, weight, and height improved the area under the receiver operating characteristic curve in the prediction of disability in going out and phone calling independently in males. Therefore, height and weight, not BMI, are potential predictors of ADL decline.

Timepoint for return to occupations post-burn injury using the Canadian Occupational Performance Measure (COPM).

INTRODUCTION: The Canadian Occupational Performance Measure (COPM) was implemented at a state-wide burns service to ensure compliance with current best evidence as outlined by the Australian and New Zealand Burns Association 'burn trauma rehabilitation: allied health practice guidelines'- Chapter 7 Measuring Post-Burn Recovery, as a standard outcome measure for individuals with an admission time greater than 24 h. The primary aim of this study is to determine if individuals have a minimal important change in performance and satisfaction with activities that were identified as problematic on the COPM prior to their acute discharge. Previous research confirmed the feasibility of using the COPM in the acute burn ward and recommended the most appropriate timepoint for re-measurement be confirmed, which is the secondary objective of this study. The benefits of confirming this timepoint include ensuring efficient use of clinicians' time without compromising the accuracy of the assessment and ensuring effective translation of the guidelines' recommendation. METHODS: A prospective longitudinal study was undertaken, where all individuals who previously completed a COPM prior to acute discharge were sought to complete a re-assessment while accessing outpatient services. Time frames for re-assessment were open. Only individuals who were actively receiving occupational therapy outpatient services were included. COPM assessments were completed in person where possible, particularly for participants who required an interpreter, with phone and video calls also used when needed. RESULTS: A total of 37 participants were included, with the timeframe between initial and post-COPM assessment ranging from 2 to 643 days. Outcomes plateaued at approximately 12 months (365 days) post-initial measurement (prior to discharge from acute ward). The most common occupational performance goals that participants identified were returning to work, sport, and driving. 86.5% of participants increased their satisfaction with these activities. The results of this study demonstrate improvements across the domains of performance and satisfaction occur for individuals with burns at approximately 3 months and 12 months post-injury. CONCLUSION: Based on this study, it is suggested that when using the COPM assessment in a tertiary burn setting, re-measurement be completed no earlier than 3 months and later than 12 months from burn injury, or upon discharge from the service. The findings from this study will be translated into clinical practice at this facility.

Probable Respiratory Sarcopenia Decreases Activities of Daily Living in Older Patients Hospitalized with Respiratory Diseases: A Cross-sectional Study.

Objectives: Respiratory sarcopenia is characterized by low respiratory muscle mass and respiratory muscle strength, but its impact on activities of daily living (ADL) remains unknown. We aimed to investigate the association between respiratory sarcopenia and decreased ADL. Methods: This retrospective cross-sectional study included older inpatients (≥65 years old) with respiratory diseases who underwent rehabilitation. Because the evaluation of respiratory muscle mass is challenging, probable respiratory sarcopenia was defined according to low appendicular skeletal muscle index (<7 kg/m2 for men, <5.7 kg/m2 for women) and peak expiratory flow rate (<4.4 L/s for men, <3.21 L/s for women). ADL was assessed on the first day of rehabilitation using the baseline Barthel Index (BI). Results: Of 111 inpatients (median age 75 years; 57 women), 13 (11.7%) had probable respiratory sarcopenia. Forty-five patients (40.5%) had sarcopenia and 12 of these had probable respiratory sarcopenia. Pulmonary functions (Forced Vital Capacity and expiratory volume in 1 s) were significantly lower in patients with probable respiratory sarcopenia than those without. Spearman's rank coefficient analysis showed probable respiratory sarcopenia did not significantly correlate with age, phase angle, Charlson Comorbidity Index (CCI), or hemoglobin (Hb). Multivariate linear regression analysis with baseline BI revealed probable respiratory sarcopenia (ß -0.279 and P=0.004) was the significant factor after adjusting for age, sex, body mass index, chronic obstructive pulmonary disease, CCI, and Hb. Conclusions: Probable respiratory sarcopenia was independently associated with decreased ADL in patients aged 65 years and older who were hospitalized with respiratory diseases.

The Effects of Home Automation on Personal and Social Autonomies in Spinal Cord Injury Patients: A Pilot Study.

Background: Spinal cord injury (SCI) is a severe and progressive neurological condition caused by trauma to the nervous system, resulting in lifelong disability and severe comorbidities. This condition imposes serious limitations on everyday life, interfering with patients' social lives and compromising their quality of life, psychological well-being, and daily living activities. Rehabilitation is essential to helping SCI patients gain more independence in their daily routines. Home automation (HA) systems provide personalized support to users, allowing them to manage various aspects of their living environment, promoting independence and well-being. This study aims to demonstrate the efficacy of an HA system in enhancing personal and social autonomies in SCI patients, resulting in improved cognitive function and reduced anxiety-depressive symptoms compared to traditional training. Methods: We enrolled 50 SCI patients undergoing neurorehabilitation at IRCCS Centro Neurolesi (Messina, Italy). These patients were randomly assigned to one of two groups: a control group (CG) and an experimental group (EG). The CG received traditional training, while the EG underwent HA training. We evaluated the patients before (T0) and after (T1) rehabilitation using various scales, including the Montreal Cognitive Assessment (MoCA), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Anxiety (HRS-A), the 12-Item Short-Form Survey (SF-12), the Functional Independence Measure (FIM), Activities of Daily Living (ADL), Instrumental Activities of Daily Living Scale (IADL), and the EQ-5D-5L. Results: The effect of the experimental treatment showed an improvement in all patients test scores in the EG, especially regarding cognitive functions, mood disorders, activities of daily living, and quality of life. Conclusion: Our findings suggest that HA may be effective in improving daily autonomy and, in turn, alleviating mood disorders and enhancing psychological well-being.