Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 49.954
Filtrar
1.
Nutrients ; 13(7)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34371988

RESUMO

PURPOSE: (1) To determine the contribution of diet, time spent outdoors, and habitual physical activity (PA) on vitamin D status in men with cerebral palsy (CP) compared to physical activity matched controls (TDC) without neurological impairment; (2) to determine the role of vitamin D on musculoskeletal health, morphology, and function in men with CP compared to TDC. MATERIALS AND METHODS: A cross-sectional comparison study where 24 active, ambulant men with CP aged 21.0 ± 1.4 years (Gross Motor Function Classification Score (I-II) and 24 healthy TDC aged 25.3 ± 3.1 years completed in vivo assessment of musculoskeletal health, including: vastus lateralis anatomical cross-sectional area (VL ACSA), isometric knee extension maximal voluntary contraction (KE iMVC), 10 m sprint, vertical jumps (VJ), and radius and tibia bone ultrasound (US) Tus and Zus scores. Assessments of vitamin D status through venous samples of serum 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone, dietary vitamin D intake from food diary, and total sun exposure via questionnaire were also taken. RESULTS: Men with CP had 40.5% weaker KE iMVC, 23.7% smaller VL ACSA, 22.2% lower VJ, 14.6% lower KE iMVC/VL ACSA ratio, 22.4% lower KE iMVC/body mass (BM) ratio, and 25.1% lower KE iMVC/lean body mass (LBM) ratio (all p < 0.05). Radius Tus and Zus scores were 1.75 and 1.57 standard deviations lower than TDC, respectively (p < 0.05), whereas neither tibia Tus nor Zus scores showed any difference compared to TDC (p > 0.05). The 25(OH)D was not different between groups, and 90.9% of men with CP and 91.7% of TDC had low 25(OH)D levels when compared to current UK recommendations. The 25(OH)D was positively associated with KE iMVC/LBM ratio in men with CP (r = 0.500, p = 0.020) but not in TDC (r = 0.281, p = 0.104). CONCLUSION: Musculoskeletal outcomes in men with CP were lower than TDC, and despite there being no difference in levels of 25(OH)D between the groups, 25 (OH)D was associated with strength (KE iMVC/LBM) in the CP group but not TDC. The findings suggest that vitamin D deficiency can accentuate some of the condition-specific impairments to musculoskeletal outcomes.


Assuntos
Paralisia Cerebral/fisiopatologia , Dieta/efeitos adversos , Exercício Físico/fisiologia , Deficiência de Vitamina D/fisiopatologia , Vitamina D/análise , Adolescente , Adulto , Antropometria , Composição Corporal , Estudos de Casos e Controles , Paralisia Cerebral/complicações , Registros de Dieta , Avaliação da Deficiência , Exposição Ambiental/análise , Humanos , Masculino , Estado Nutricional , Hormônio Paratireóideo/sangue , Luz Solar , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/etiologia , Adulto Jovem
2.
Med Lav ; 112(4): 279-291, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446684

RESUMO

BACKGROUND: The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure is a widely used patient reported outcome measure. OBJECTIVE: The aim of this study is to evaluate the quality of translation procedures and assessment of the psychometric properties of cross-cultural adaptations of the DASH. METHODS: We reviewed the literature to identify all published studies of cultural adaptations of the DASH questionnaire. For the quality assessment, we used Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures, Quality Criteria for Psychometric Properties of Health Status Questionnaire and COSMIN Checklist for Cross-Cultural Validity. RESULTS: We included 25 articles with 26 versions of the DASH. Only the Puerto Rican version followed all six of the processes of cross-cultural adaptation. None of the versions assessed all eight measurement properties for Quality Criteria for Psychometric Properties of Health Status Questionnaire and none of them had a positive rating from agreement, internal consistency, responsiveness and interpretability. All the studies got a poor rating according to the COSMIN checklist. DISCUSSION: None of the versions got a good rating from all three checklists. We observed that supplementary tests for the adaptations are necessary, especially for assessing agreement, responsiveness and interpretability. We concluded that all versions need more research on psychometric properties.


Assuntos
Comparação Transcultural , Avaliação da Deficiência , Inquéritos e Questionários , Braço , Pessoas com Deficiência , Mãos , Humanos , Psicometria , Reprodutibilidade dos Testes , Ombro
3.
Med Probl Perform Art ; 36(3): 150-162, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34464961

RESUMO

OBJECTIVE: To translate, culturally adapt, and validate the psychometric characteristics of the Italian version of the Dance Functional Outcome Survey (DFOS-IT) in adult dancers. DESIGN: Clinical measurement study. METHODS: The DFOS-IT was forward translated, reconciled, backward translated, and reviewed by an expert committee to establish optimal correspondence with the original English DFOS. We examined test-retest reliability in 58 dancers within a 10-day period, using intraclass correlation coefficients (ICC2,1). In a sample of 265 healthy and injured dancers, the following were examined: 1) construct validity, comparing the DFOS-IT to SF-36 using Pearson correlations; 2) exploratory factor analysis and internal consistency; and 3) sensitivity, by generating receiver operating characteristic curves and determining area under the curve (AUC). In a subgroup of 44 dancers, we determined internal responsiveness across three time-points using repeated measures ANOVA (p<0.05). Injured dancers' scores were analyzed for floor and ceiling effects. RESULTS: The DFOS-IT demonstrated very high test-retest reliability (ICC≥0.98). Single-factor loading in exploratory factor analysis supported unidimensionality of the scale, with high internal consistency (a=0.93). DFOS-IT total, activities of daily living (ADL), and Dance Technique scores had strong construct validity compared with scores on the SF-36 PCS (r≥0.71). There was excellent sensitivity, with high AUC values (AUC≥0.80). There were significant differences across time for DFOS-IT scores (p<0.001), demonstrating responsiveness to change, and no floor or ceiling effects. CONCLUSION: The DFOS-IT is a valid, reliable, and responsive tool that can be used as an outcome and screening measure for Italian adult ballet and modern dancers following lower extremity or low back injury.


Assuntos
Atividades Cotidianas , Avaliação da Deficiência , Adulto , Comparação Transcultural , Humanos , Itália , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
4.
Spine (Phila Pa 1976) ; 46(18): E998-E1005, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34435993

RESUMO

STUDY DESIGN: A pilot, two-group pretest-posttest randomized controlled, single blinded study. OBJECTIVE: Our study aim was to compare the changes in low back pain level, fear avoidance, neurodynamic mobility, and function after early versus later exercise intervention following a unilateral lumbar microdiscectomy. SUMMARY OF BACKGROUND DATA: Exercise is commonly recommended to patients following a lumbar microdiscectomy although controversy remains as to the timing and protocols for exercise intervention. METHODS: Forty patients were randomly allocated to early (Group 1) or later (Group 2) exercise intervention group. The low back pain and fear avoidance were evaluated using Oswestry Low Back Pain Disability Questionnaire, Numeric Pain Rating Scale, and Fear-Avoidance Beliefs Questionnaire. The neurodynamic mobility and function were recorded with Dualer Pro IQ Inclinometer, 50-foot walk test, and Patient-Specific Functional Scale. Two-sided t test for continuous variables and chi-square or Fisher exact test for categorical variables were used to compare the two groups' demographic data. The Wilcoxon signed-rank and rank-sum tests were used to compare the changes and the differences, respectively, in low back pain, fear avoidance, neurodynamic mobility, and function between baseline (before surgery) and postoperative repeated measurements (at 1-2, 4-6, and 8-10 wks after surgery) within each study group, after exercise intervention. RESULTS: Both groups showed a significant decrease in low back pain levels and fear avoidance as well as a significant improvement in neurodynamic mobility and function at 4 and 8 weeks after surgery. However, no significant difference was reported between the two groups. CONCLUSION: Our study results showed that early exercise intervention after lumbar microdiscectomy is safe and may reduce the low back pain, decrease fear avoidance, and improve neurodynamic mobility and function. A randomized controlled trial is needed to evaluate the early exercise intervention's effectiveness after lumbar microdiscectomy, and thus validate our findings.Level of Evidence: 4.


Assuntos
Terapia por Exercício , Dor Lombar , Avaliação da Deficiência , Discotomia , Exercício Físico , Humanos , Dor Lombar/cirurgia , Projetos Piloto , Resultado do Tratamento
5.
BMC Musculoskelet Disord ; 22(1): 732, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34452608

RESUMO

BACKGROUND: Persistent shoulder pain causes considerable disruption of the individual's life and imposes high costs on healthcare and society. Well-informed treatment and referral pathways are crucial as unsuccessful interventions and longer duration of symptoms minimizes the likelihood of success in future interventions. Although physiotherapy is generally recommended as first line treatment, no prognostic model or clinical prediction rules exists to help guide the treatment of patients with persistent shoulder pain undergoing physiotherapy. Thus, the objective of this study was to develop a prognostic model to inform clinical decision making and predict change in symptoms and function in patients with persistent shoulder pain. METHODS: This was a prospective cohort study of 243 patients with persistent shoulder pain referred to outpatient physiotherapy rehabilitation centres. Data was collected at baseline and six-month follow-up. The outcome was change in shoulder symptoms and function as measured by the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) from baseline to 6 months follow up. Potential predictors were included in a multivariable linear regression model which was pruned using modified stepwise backwards elimination. RESULTS: The final model consisted of seven predictors; baseline QuickDASH score, employment status, educational level, movement impairment classification, self-rated ability to cope with the pain, health-related quality of life and pain catastrophizing. Together these variables explained 33% of the variance in QuickDASH-change scores with a model root mean squared error of 17 points. CONCLUSION: The final prediction model explained 33% of the variance in QuickDASH change-scores at 6 months. The root mean squared error (model SD) was relatively large meaning that the prediction of individual change scores was quite imprecise. Thus, the clinical utility of the prediction model is limited in its current form. Further work needs be done in order to improve the performance and precision of the model before external validity can be examined along with the potential impact of the model in clinical practice. Two of the included predictors were novel and could be examined in future studies; movement impairment classification based on diagnosis and health-related quality of life.


Assuntos
Qualidade de Vida , Dor de Ombro , Avaliação da Deficiência , Humanos , Prognóstico , Estudos Prospectivos , Dor de Ombro/diagnóstico , Dor de Ombro/terapia
6.
BMC Pediatr ; 21(1): 359, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429090

RESUMO

BACKGROUND: Back pain in childhood and adolescence increases the risk for back pain in adulthood, but validated assessment tools are scarce. The aim of this study was to validate the Young Spine Questionnaire (YSQ) in a German version (G-YSQ) in children and adolescents. METHODS: Children and adolescents between 10 and 16 years (N = 240, 166 females, mean age = 13.05 ± 1.70 years), recruited in chiropractic practices and schools, completed the G-YSQ (translated according to scientific guidelines) and the KIDSCREEN-10 (assessing health-related quality of life) at three time points. Test-retest reliability was determined calculating intraclass correlation coefficients [ICC(3,1)] using start and two week-data. Construct validity was investigated testing a priori hypotheses. To assess responsiveness, the patients additionally filled in the Patient Global Impression of Change (PGIC) after three months and the area under the curve (AUC) of receiver operating curves was calculated. RESULTS: The ICC(3,1) was 0.88 for pain intensity and pain frequency, indicating good reliability, 0.68 for week prevalence and 0.60 for point prevalence, indicating moderate reliability. Pain intensity, frequency and prevalence differed between patients and controls (p < 0.001) and, except point prevalence, between older (> 12 years) and younger control participants (p < 0.01). Health-related quality of life of participants with severe pain (in one or several spinal regions) was lower (KIDSCREEN-10, total score: F(4,230) = 7.26, p < 0.001; KIDSCREEN-10, self-rated general health: H(4) = 51.94, p < 0.001) than that of participants without pain or with moderate pain in one spinal region. Thus, altogether these findings indicate construct validity of the G-YSQ. The AUC was 0.69 (95 % CI = 0.57-0.82) and 0.67 (95 % CI = 0.54-0.80) for week and point prevalence, respectively, indicating insufficient responsiveness of the G-YSQ. CONCLUSIONS: Apart from the question on point prevalence, construct validity and sufficient test-retest reliability was shown for the G-YSQ. However, its responsiveness needs to be improved, possibly by asking for pain frequency during the last week instead of (dichotomous) week prevalence. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02955342, registered 07/09/2016, https://clinicaltrials.gov/ct2/results?cond=&term=NCT02955342&cntry=CH&state=&city=Zurich&dist= .


Assuntos
Avaliação da Deficiência , Qualidade de Vida , Adolescente , Adulto , Criança , Feminino , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
7.
J Orthop Sports Phys Ther ; 51(8): CPG1-CPG102, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34338006

RESUMO

Work rehabilitation refers to the process of assisting workers to remain at work or return to work (RTW) in a safe and productive manner, while limiting the negative impact of restricted work, unemployment, and work disability. The primary purpose of this clinical practice guideline (CPG) is to systematically review available scientific evidence and provide a set of evidence-based recommendations for effective physical therapy evaluation, treatment, and management of individuals experiencing limitations in the ability to participate in work following injury or illness. J Orthop Sports Phys Ther 2021;51(8):CPG1-CPG102. doi:10.2519/jospt.2021.0303.


Assuntos
Doenças Profissionais/terapia , Saúde do Trabalhador , Traumatismos Ocupacionais/terapia , Modalidades de Fisioterapia , Retorno ao Trabalho , Avaliação da Deficiência , Humanos
8.
PLoS One ; 16(8): e0256433, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34432847

RESUMO

BACKGROUND: Endometriosis is a chronic pain condition in premenopausal women. Pain is mainly characterized by pain intensity and may induce disability in all areas of daily life. Nevertheless, pain is influenced by emotional and social factors as well. Social distancing measures or quarantine, as reaction to rapidly rising infections with the COVID-19 virus due to the SARS-CoV-2 pandemic, were implemented across Europe to prevent the spread of the virus and social distancing measures were imposed by the German government by beginning of March 2020 with initiation of the lockdown by the end of March 2020. The objective of this study was to assess, how social distancing measures during the lockdown impacted the various aspects of pain perception in a group of chronic pain patients, such as women suffering from endometriosis. METHODS: Between 6th to 27th April 2020, an online questionnaire was activated at internet platforms of endometriosis patients support groups. Participants were asked retrospectively at one time point about their visual pain intensity measured by the visual analogue scale (VAS) and pain disability via pain disability index (PDI) prior to initiation of social distancing measures in Germany (VASP, PDIP), as well as the pain intensity and pain disability since implementation of social distancing measures (VASI, PDII). Differences of VAS and PDI previous and after implementation of social distancing measures were displayed as ΔVAS and ΔPDI. Pain experience and social support were assessed by a 5-point Likert scale. RESULTS: 285 participants completed at least one question regarding pain intensity, disability, pain experience or social support. Dysmenorrhea, the symptom with the highest level of pain assessed by VAS, decreased significantly during the SARS-CoV-2 pandemic compared to the time period prior to social isolation (45.30% respondents experienced improvemenet vs 40.50% who experienced worsening; p = 0.025). The global physical impairment improved significantly (improvement of pain induced disability in 48.20% vs 40.90% with worsening of pain symptoms; p = 0.032) after the implementation of social distancing measures. Pain experience was negatively affected by social distancing measures, since frequency of pain awareness increased in 43.6% (p<0.001) of participants and 30.0% (p<0.001) more participants experienced pain as a threat. Verbalization of pain experience was reduced in 36.6% (p = 0.001) of participants and 14.6% (p = 0.91), 21.9% (p<0.001) and 31.5% (p<0.001) of participants reported less social support from their partner, family and friends. CONCLUSIONS: Physical pain and disability on one hand and emotional and social pain experience on the other were differentially affected by the emerged emotional, social and health care constraints related to the SARS-CoV-2 pandemic.


Assuntos
COVID-19/epidemiologia , Dor Crônica/etiologia , Endometriose/patologia , Apoio Social , Adulto , COVID-19/virologia , Estudos Transversais , Avaliação da Deficiência , Endometriose/complicações , Feminino , Alemanha/epidemiologia , Humanos , Internet , Medição da Dor , Percepção da Dor , Pandemias , Quarentena , Estudos Retrospectivos , SARS-CoV-2/isolamento & purificação , Isolamento Social , Inquéritos e Questionários
9.
BMC Musculoskelet Disord ; 22(1): 666, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372820

RESUMO

BACKGROUND: Chronic back pain is known to be associated with altered tactile acuity. Tactile acuity is measured using the Two-Point Discrimination (TPD) test in both clinical and research settings. In subjects with chronic low back pain, the TPD threshold (TPDT) is increased and is associated with persistent pain. It remains unknown, however, whether TPDT is also altered in cases of clinical acute pain, or whether it could be used as a predictor of future pain and disability at an early stage of LBP. The main objective of this study was to investigate the predictive value of baseline TPDT for pain and disability at 3 and 6 months after the onset of acute LBP. The TPDT in acute low back pain (LBP) and the development of TPDT over 6 months has also been assessed. METHODS: LBP participants (n = 124) with acute LBP (< 4 weeks) were included. Subjects were examined within 4 weeks of pain onset and followed-up after 3 and 6 months of pain onset. Horizontal and vertical TPDTs of the lower back were collected. Linear mixed models were subsequently used to evaluate the association of TPDT with pain and disability over time. RESULTS: The vertical TPDT showed a mean (SD) of 4.9 cm (1.6) and the horizontal TPDT a mean (SD) of 6.0 cm (1.5) at baseline. The vertical TPDT altered from baseline up to 6 months from 4.9 to 4.6 cm and the horizontal TPDT from 6.0 to 5.4 cm. The association between the TPDT and the Oswestry Disability Index (ODI) after 6 months was moderate. Linear mixed models revealed no association between TPDT, pain and disability over the progression of LBP. CONCLUSION: TPDTs appear to be raised in subjects with acute LBP. However, our study revealed no predictive capability of the TPDT for disability and pain. No comparisons are possible in the absence of similar studies, indicating the need for further research is in this area.


Assuntos
Dor Aguda , Dor Lombar , Dor Aguda/diagnóstico , Dor Aguda/tratamento farmacológico , Dor Aguda/epidemiologia , Avaliação da Deficiência , Humanos , Dor Lombar/diagnóstico , Dor Lombar/tratamento farmacológico , Dor Lombar/epidemiologia , Estudos Prospectivos
10.
BMC Public Health ; 21(1): 1541, 2021 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384409

RESUMO

BACKGROUND: Studies have examined functional disability among older adults by combining Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). This study adds another dimension to ADL and IADL by combining various impairments such as hearing, vision, walking, chewing, speaking, and memory loss among older adults. This study examines functional disability among older adults in India as measured by ADL, IADL, along with various impairments. METHODS: This study utilized data from Building a Knowledge Base on Population Aging in India (BKPAI), a national-level survey and conducted across seven states of India. The study utilized three outcome variables, namely, ADL, IADL, and Impairments. Descriptive and bivariate analyses were used along with multivariate analysis to fulfil the objectives of the study. The concentration index was calculated for ADL, IADL, and impairments, and further, decomposition analysis was carried out for IADL. RESULTS: The results observed that nearly 7.5% of older adults were not fully independent for ADL. More than half (56.8%) were not fully independent for IADL, and nearly three-fourths (72.6%) reported impairments. Overall, ADL, IADL, and impairments were higher among older adult's aged 80+ years, older adults with poor self-rated health, and those suffering from chronic diseases. The likelihood of ADL (AOR = 6.42, 95% CI: 5.1-8.08), IADL (AOR = 5.08, 95% CI: 4.16-6.21), and impairment (AOR = 3.50, 95% CI: 2.73-4.48) were significantly higher among older adults aged 80+ years compared to 60-69 years. Furthermore, older adults who had poor self-rated health and suffered from chronic diseases were more likely to report ADL (AOR = 2.95, 95% CI: 2.37-3.67 and AOR = 2.70, 95% CI: 2.13-3.43), IADL (AOR = 1.74, 95% CI: 1.57-1.92 and AOR = 1.15, 95% CI: 1.04-1.15), and impairment (AOR = 2.36, 95% CI: 2.11-2.63 and AOR = 2.95, 95% CI: 2.65-3.30), respectively compared to their counterparts. Educational status and wealth explained most of the socio-economic inequality in the prevalence of IADL among older adults. CONCLUSION: It is recommended that the government advise older adults to adopt health-promoting approaches, which may be helpful. Further, there is a pressing need to deliver quality care to older adults suffering from chronic conditions.


Assuntos
Atividades Cotidianas , Pessoas com Deficiência , Idoso , Envelhecimento , Avaliação da Deficiência , Humanos , Índia/epidemiologia , Prevalência , Fatores Socioeconômicos
11.
J Bodyw Mov Ther ; 27: 176-180, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34391231

RESUMO

BACKGROUND: The BackAche Disability Index (BADIX) is a 2-section test: (a) the BackAche Index encompassing 5 active back movements, evaluated on a 4-point Likert-type rating scale; (b) the morning Back Stiffness Score, choosing the most fitting statement out of 6, upon awakening. OBJECTIVE: To perform a cross-cultural adaptation and evaluate the reliability and validity of the Hebrew version of BADIX. METHODS: Translation/retranslation of the English version of the BADIX was conducted, and the cross-cultural adaptation process performed. The Hebrew version BADIX was evaluated at two meetings, two weeks apart, in 51 female nurses (40 reported back pain and 11 reported no back problems). The Rolland Morris Disability Questionnaire (RMQ) and The Modified Oswestry Low Back Pain Disability Questionnaire (MODQ) were also evaluated. RESULTS: The mean age of the subjects was 45.34±11.11 years. Internal consistency calculated by the Cronbach's α coefficient was very high (α>0.9). A high degree of test-retest reliability was found, with an intraclass correlation coefficient (ICC) 95% CI) of 0.933 (0.839 - 0.973), and r=0.908. Concurrent validity of the BADIX domains with the RMQ and MODQ was found statistically significant and high (ρ=0.688, RMQ, and ρ=0.674, MODQ). CONCLUSIONS: The adapted and modified Hebrew version of the BADIX is reliable and measures the pain and mobility outcome of physical impairment and morning backache stiffness. It can be employed, in addition to self-reported outcome measures, by clinicians and researchers in quantitatively evaluating the clinical status and progression of patients with lower back pain in Hebrew-speaking populations.


Assuntos
Dor Lombar , Adulto , Dor nas Costas , Avaliação da Deficiência , Feminino , Humanos , Dor Lombar/diagnóstico , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
12.
J Bodyw Mov Ther ; 27: 307-313, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34391250

RESUMO

INTRODUCTION: Breast cancer affects women of different ages, and comorbidities resulting from treatment can affect postural stability. The study aimed to evaluate the influence of age and lymphedema on the postural balance of women undergoing breast cancer treatment. METHODS: The study included 77 women undergoing breast cancer treatment, divided into different groups: 37 young adult women divided into 17 with lymphedema (GYL) and 20 young adults without lymphedema (GY); 40 elderly women, 20 elderly women with lymphedema (GEL) and 20 elderly women without lymphedema (GE). Mini Balance Evaluation Systems Test (Mini BESTest) and Falls Efficacy Scale - International (FES-I) were used. RESULTS: Mini BESTest and FES-I between the groups showed that GE and GEL had a significant difference to GY. Mini BESTest Total and Time Up and Go TUG-Double Task showed that GE has a significant difference to GYL, with GE and GEL having lower scores. Moderate negative correlation in the GEL between FES-I and Mini BESTest. In the age correlation between the Mini BESTest, FES-I, TUG, and double task TUG, a moderate positive correlation was observed for TUG. GEL showed a moderate positive correlation for FES-I and double-task TUG, strong for TUG, and moderate negative correlation with Mini BESTest. Correlation of the volume difference between the limb affected and not affected by lymphedema and the FES-I, Mini BESTest, TUG, and TUG double task, GYL showed moderate negative correlation for TUG. CONCLUSION: Age and lymphedema influenced the dynamic postural balance of women undergoing breast cancer treatment.


Assuntos
Neoplasias da Mama , Linfedema , Acidentes por Quedas , Idoso , Neoplasias da Mama/complicações , Neoplasias da Mama/terapia , Avaliação da Deficiência , Feminino , Humanos , Equilíbrio Postural , Psicometria , Reprodutibilidade dos Testes
13.
J Bodyw Mov Ther ; 27: 710-716, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34391311

RESUMO

BACKGROUND: The aim of this study was to determine whether muscle strength of the lower limb and trunk during the acute phase after stroke are predictors of motor function and disability 90 days after hospital discharge. METHODS: This prospective study used a nonconcurrent design to evaluate stroke patients at two time points: a) first 72 h: hip abduction and ankle dorsiflexion (HAAD) score, trunk sitting control, clinical evaluation, demographic profile, and stroke severity using the National Institutes of Health Stroke Scale (NIHSS); b) 90 days after hospital discharge: modified Rankin scale (mRS). The participants were divided into two groups: good outcome (mRS 0-2) and worse outcome (mRS>2), and the differences between them were assessed statistically. Clinical and demographic variables were included in the multiple logistic regression analysis. The ROC curve was used to illustrate the clinical sensitivity and specificity of the HAAD score cutoff for the outcomes. RESULTS: Thirty-seven patients were included: 16 with mRS≤2 and 21 with mRS>2. Patients in the worse outcome group were older (p = 0.02) and presented with higher NIHSS scores (p = 0.002), lower HAAD scores (p < 0.001), higher pain sensation (p = 0.04), greater altered perception (p = 0.008), and no trunk control in the sitting position (p = 0.004). A lower HAAD score (OR = 0.09; 95%CI: 0.14-0.53; p < 0.001) and the absence of trunk control in the sitting position (OR = 0.55; 95%CI:0.54-0.95; p < 0.001) were associated with unsatisfactory outcomes. CONCLUSION: A HAAD score <6 and the absence of trunk control while sitting during the first 72 h are predictors of worse long-term disability in stroke patients.


Assuntos
Tornozelo , Acidente Vascular Cerebral , Estudos de Coortes , Avaliação da Deficiência , Humanos , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
14.
Washington, D.C.; PAHO; 2021-08-05.
em Inglês | PAHO-IRIS | ID: phr-54593

RESUMO

This summary report provides a synopsis of the key messages and the agreed set of strategic actions to advance the enactment, implementation, and enforcement of NCD risk factor policies through laws and regulations in the Caribbean at the country and regional levels. It should be read together with the full Subregional Workshop Report available at https://iris.paho.org/handle/10665.2/53821.


Assuntos
Doença Crônica , Obesidade , Consumo de Bebidas Alcoólicas , Rotulagem de Produtos , Abandono do Uso de Tabaco , Programas Nacionais de Saúde , Avaliação da Deficiência , Indicadores de Morbimortalidade , Programas e Políticas de Nutrição e Alimentação , Diabetes Mellitus , Saúde Mental , Fatores de Risco , Região do Caribe
15.
Int J Ment Health Nurs ; 30(5): 1274-1288, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34291551

RESUMO

The World Health Disability Assessment Scale (WHODAS-2.0) has widely been accepted as the standard measure of disability. However, psychometric testing is mostly performed in developed countries. This paper aims to assess the psychometric properties (reliability, validity) of the WHODAS-2.0 among consumers of mental health services in Ghana. Two translators (expert in English language and Akan language) performed forward and backward translation of the WHODAS-2.0 from English language to Ghanaian language (Twi). A total of 510 consumers of mental health services were recruited consecutively to complete the WHODAS-2.0 using RedCAP. Confirmatory factor analysis was used to analyse the data. All domains in the 6-factor solutions had excellent internal consistency (ω = 0.90-0.98), sufficient convergent validity and had satisfactory discriminant validity except for domain on participation. The CFA model confirmed that the data had a good model fit, CFI = 0.97, TLI = 0.96, RMESA = 0.05, RMR = 0.03; NFI = 0.94; χ2  = 1243.8, df = 529, P < 0.001. Although the WHODAS 2.0 had satisfactory psychometric properties and was thus considered to be a reliable and valid measure for assessing disability and level of functioning in consumers of mental health services, researchers and clinicians should re-consider items within the participation domain. Also, practitioners are encouraged to integrate the WHODAS-2.0 into the collection of data on clinical outcomes, as well as, collecting data on government social protection intervention programmes for consumers.


Assuntos
Avaliação da Deficiência , Serviços de Saúde Mental , Gana , Humanos , Psicometria , Reprodutibilidade dos Testes , Organização Mundial da Saúde
16.
J Stroke Cerebrovasc Dis ; 30(9): 105941, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34217068

RESUMO

OBJECTIVE: Phase angle, an assessment of muscle quality, might be a possible predictor of physical function in patients with an acute stroke; however, the evidence for the same is limited. Therefore, this study aimed to investigate whether phase angle is associated with improved physical function at discharge. METHODS: In this observational cohort study, we determined the phase angle in patients with an acute stroke using a portable, noninvasive multifrequency bio-impedance device. The primary objective was the assessment of physical function using the Functional Independence Measure motor (FIM-motor) at discharge in the acute phase. The secondary outcome was home discharge. Multiple regression analysis was used to determine the association between phase angle, FIM-motor score, and home discharge. RESULTS: The study included 129 patients (78 men; mean age 75.2 years). Multiple linear regression analysis showed that the phase angle was independently associated with FIM-motor score at discharge in all models (Model 1: ß= 0.27, p < 0.001; Model 2: ß = 0.234, p < 0.001; Model 3: ß = 0.201, p = 0.017). However, multiple logistic regression analysis showed that the phase angle was not associated with home discharge (p = 0.464). CONCLUSIONS: The phase angle at the onset of a stroke, is an independent predictor of physical function at discharge in the acute phase. Our findings highlight the importance of determining the phase angle in patients with an acute stroke.


Assuntos
Composição Corporal , Músculo Esquelético/fisiopatologia , Sarcopenia/diagnóstico , Acidente Vascular Cerebral/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Impedância Elétrica , Feminino , Estado Funcional , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Atividade Motora , Tamanho do Órgão , Valor Preditivo dos Testes , Prognóstico , Recuperação de Função Fisiológica , Sarcopenia/fisiopatologia , Sarcopenia/terapia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral , Fatores de Tempo
17.
J Stroke Cerebrovasc Dis ; 30(9): 105927, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34252826

RESUMO

OBJECTIVES: An assessment of the comparative incidence of fatal or disabling stroke may influence choice of intervention for patients with severe aortic stenosis. We explored whether transcatheter aortic valve implantation (TAVI) is associated with a lower incidence of fatal or disabling stroke, compared to surgical aortic valve replacement (SAVR). MATERIALS & METHODS: We classified stroke into two categories; fatal or disabling, or non-disabling, and completed meta-analyses for each. We explored randomised controlled trials to assess the effect publication year, predicted operative risk, and route of TAVI access. RESULTS: There was no difference between treatment groups per 100 person years of follow up for disabling or non-disabling stroke outcomes. In a stratified analysis by year of publication, there was a lower rate of fatal or disabling stroke with TAVI in trials published after 2015, compared to those published in 2015 or before (p-interaction = 0.01 at 30 days). Higher proportions of transfemoral route access (>90%), more common in recent trials, were associated with a lower rate of fatal or disabling stroke (p-interaction = 0.03 at 30 days). Lower average surgical risk scores were associated with lower rates of fatal or disabling stroke (p = 0.02 at 30 days). CONCLUSION: We found that treatment of aortic stenosis with TAVI compared with SAVR was not associated with an overall reduced risk in fatal or disabling stroke. Subgroup analyses suggested a lower risk of fatal or disabling stroke with TAVI in situations which reflect contemporary practice.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Acidente Vascular Cerebral/epidemiologia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/mortalidade , Estenose da Valva Aórtica/fisiopatologia , Avaliação da Deficiência , Feminino , Implante de Prótese de Valva Cardíaca/instrumentação , Implante de Prótese de Valva Cardíaca/mortalidade , Humanos , Incidência , Masculino , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Fatores de Tempo , Substituição da Valva Aórtica Transcateter/instrumentação , Substituição da Valva Aórtica Transcateter/mortalidade , Resultado do Tratamento
18.
J Stroke Cerebrovasc Dis ; 30(9): 105928, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34256199

RESUMO

BACKGROUND: Dual transcranial direct current stimulation (dual tDCS) can be combined with stroke rehabilitation interventions to promote excitatory changes in the cerebral cortex. OBJECTIVE: To investigate how the combined intervention of dual tDCS and modified constraint-induced movement therapy (mCIMT) using both anodal and cathodal stimulation affects on the recovery of upper limb function in chronic stroke patients. METHODS: This study was a double-blind randomized controlled trial. A total of 30 patients were randomly assigned to the experimental group (dual tDCS and mCIMT) or control group (sham dual tDCS and mCIMT). The experimental and control group performed mCIMT immediately after applying dual tDCS for 20 min, but the control group also performed mCIMT after applying sham tDCS for 20 min in a state where no current flows. The total intervention period was performed 5 times a week for 4 weeks. The outcome was assessed using Fugle-Meyer Assessment (FMA) Motor Activity Log (MAL) Accelerometer. RESULTS: There was a significant improvement in AOU of MAL and usage of unaffected side in the experimental group compared to the control group, and the experimental group showed more than a small effect difference compared to the control group in the effect size of all evaluations. CONCLUSIONS: This study has clinical significance in that it presents the possibility of convergence intervention that considers the therapeutic efficiency in clinical practice.


Assuntos
Terapia por Exercício , Atividade Motora , Córtex Motor/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Estimulação Transcraniana por Corrente Contínua , Extremidade Superior/inervação , Idoso , Terapia Combinada , Avaliação da Deficiência , Método Duplo-Cego , Terapia por Exercício/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Recuperação de Função Fisiológica , República da Coreia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/efeitos adversos , Fatores de Tempo , Estimulação Transcraniana por Corrente Contínua/efeitos adversos , Resultado do Tratamento
19.
Artigo em Inglês | MEDLINE | ID: mdl-34261812

RESUMO

OBJECTIVE: To evaluate the clinical consequences of extended interval dosing (EID) of ocrelizumab in relapsing-remitting multiple sclerosis (RRMS) during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In our retrospective, multicenter cohort study, we compared patients with RRMS on EID (defined as ≥4-week delay of dose interval) with a control group on standard interval dosing (SID) at the same period (January to December 2020). RESULTS: Three hundred eighteen patients with RRMS were longitudinally evaluated in 5 German centers. One hundred sixteen patients received ocrelizumab on EID (median delay [interquartile range 8.68 [5.09-13.07] weeks). Three months after the last ocrelizumab infusion, 182 (90.1%) patients following SID and 105 (90.5%) EID patients remained relapse free (p = 0.903). Three-month confirmed progression of disability was observed in 18 SID patients (8.9%) and 11 EID patients (9.5%, p = 0.433). MRI progression was documented in 9 SID patients (4.5%) and 8 EID patients (6.9%) at 3-month follow-up (p = 0.232). Multivariate logistic regression showed no association between treatment regimen and no evidence of disease activity status at follow-up (OR: 1.266 [95% CI: 0.695-2.305]; p = 0.441). Clinical stability was accompanied by persistent peripheral CD19+ B-cell depletion in both groups (SID vs EID: 82.6% vs 83.3%, p = 0.463). Disease activity in our cohort was not associated with CD19+ B-cell repopulation. CONCLUSION: Our data support EID of ocrelizumab as potential risk mitigation strategy in times of the COVID-19 pandemic. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with RRMS, an EID of at least 4 weeks does not diminish effectiveness of ocrelizumab.


Assuntos
Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/uso terapêutico , COVID-19/complicações , Esclerose Múltipla Recidivante-Remitente/complicações , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Adulto , Antígenos CD19 , Linfócitos B/imunologia , Avaliação da Deficiência , Feminino , Humanos , Contagem de Linfócitos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...