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1.
BMC Health Serv Res ; 22(1): 617, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35534853

RESUMO

BACKGROUND: The first aim of this study was to investigate the impact of providing an additional four hours of Saturday occupational therapy to patients receiving Saturday physiotherapy in an inpatient setting on length of stay, functional independence, gait and balance. The second aim was to conduct an economic evaluation to determine if the introduction of a Saturday occupational therapy service in addition to physiotherapy resulted in a net cost savings for the rehabilitation facility. METHODS: A prospective cohort study with a historical control was conducted in an Australian private mixed rehabilitation unit from 2015-2017. Clinical outcomes included the Functional Independence Measure (Motor, Cognitive, Total), gait speed (10 Meter Walk test) and five balance measures (Timed Up and Go test, Step test, Functional Reach, Feet Together Eyes Closed and the Balance Outcome Measure of Elder Rehabilitation). Economic outcomes were rehabilitation unit length of stay and additional treatment costs. RESULTS: A total of 366 patients were admitted to the rehabilitation unit over two 20-week periods. The prospective cohort (receiving Saturday occupational therapy and physiotherapy) had 192 participants and the historical control group (receiving Saturday physiotherapy only) had 174 participants. On admission, intervention group participants had higher cognitive (p < 0.01) and total (p < 0.01) Functional Independence Measure scores. Participation in weekend therapy by the intervention group was 11% higher, attending more sessions (p < 0.01) for a greater length of time (p < 0.01) compared to the historical control group. After controlling for differences in admission Functional Independence Measure scores, rehabilitation length of stay was estimated to be reduced by 1.39 (p = 0.08) days. The economic evaluation identified potential cost savings of AUD1,536 per patient. The largest potential savings were attributed to neurological patients AUD4,854. Traumatic and elective orthopaedic patients realised potential patient related cost savings per admission of AUD2,668 and AUD2,180, respectively. CONCLUSIONS: Implementation of four hours of Saturday occupational therapy in addition to physiotherapy results in a more efficient service, enabling a greater amount of therapy to be provided on a Saturday over a shorter length of stay. Provision of multidisciplinary Saturday rehabilitation is potentially cost reducing for the treating hospital.


Assuntos
Terapia Ocupacional , Adulto , Idoso , Austrália , Estudos de Coortes , Humanos , Pacientes Internados , Tempo de Internação , Modalidades de Fisioterapia , Equilíbrio Postural , Estudos Prospectivos , Estudos de Tempo e Movimento
2.
Trials ; 23(1): 375, 2022 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-35526010

RESUMO

BACKGROUND: A hip fracture is a serious event for older adults, given that approximately 50% do not regain their habitual level of physical function, and the mortality rate is high, as is the number of readmissions. The gap in healthcare delivery, as separated into two financial and self-governing sectors, might be a contributing cause of inferior rehabilitation and care for these patients. Therefore, we aim to assess the effect of continuous and progressive rehabilitation and care across sectors for older adults after hip fracture. METHODS/DESIGN: The project is designed as a stepped-wedge cluster randomised controlled trial. The study population of patients are older adults 65 years of age and above discharged after a hip fracture and healthcare professionals in primary and secondary care (municipalities and hospitals). Healthcare professionals from different sectors (hospital and municipalities) will be engaged in the empowerment-orientated praxis, through a workshop for healthcare professionals with knowledge sharing to the older adults using a digital health application (app). The rehabilitation intervention consists of 12 weeks of progressive resistance exercises initiated 1-2 days after discharge. To improve communication across sectors, a videoconference involving the patient and physiotherapists from both sectors will be conducted. On day, 3 after discharge, an outreach nurse performs a thorough assessment including measurement of vital signs. A hotline to the hospital for medical advice is a part of the intervention. The intervention is delivered as an add-on to the usual rehabilitation and care, and it involves one regional hospital and the municipalities within the catchment area of the hospital. The primary outcome is a Timed Up and Go Test 8 weeks post-surgery. DISCUSSION: Using a stepped-wedge design, the intervention will be assessed as well as implemented in hospital and municipalities, hopefully for the benefit of older adults after hip fracture. Furthermore, the collaboration between the sectors is expected to improve. TRIAL REGISTRATION: The study is approved by the Regional Scientific Ethics Committees of Southern Denmark (S-20200070) and the Danish Data Protection Agency (20-21854). Registered 9 of June 2020 at ClinicalTrials.gov, NCT04424186 .


Assuntos
Fraturas do Quadril , Equilíbrio Postural , Idoso , Terapia por Exercício/métodos , Fraturas do Quadril/diagnóstico , Fraturas do Quadril/reabilitação , Humanos , Alta do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos de Tempo e Movimento
3.
J Assoc Physicians India ; 70(4): 11-12, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35443551

RESUMO

Hyponatremia prevalence is 22.2% in the geriatric age group as compared to 6% for other patients. Symptomatology of hyponatremia is subtle and is often interpreted as age-related in the geriatric patients. We use various Comprehensive Geriatric Assessment (CGA) parameters to analyze the impact of improvement in serum sodium levels. MATERIAL: We utilized four simple CGA parameters, the new Hindi Mental State Examination (HMSE) for assessing the cognition, Barthel index of activities of daily living (ADL) for the level of independence, Timed up and go test (TUG test) for risk of fall evaluation, and handgrip strength (HG) by hand dynamometer for frailty. All parameters were analyzed at admission and at discharge, and their relation with the severity of hyponatremia in 100 geriatric patients (>60 years) was seen. Equal number of hyponatremic geriatric patients were taken, matched for comorbidity, reason for presentation, and age. OBSERVATION: Mean age of the study population was 68.1 ± 5.8 years, with a male: female ratio of 3:1. Baseline sodium level in hyponatremia and normonatremia groups were 129.7 ± 5.1 and 139 ± 3.4 meq/L (P=2.4) respectively. All CGA parameters tested showed lower values among hyponatremic patients compared to normonatremic patients, although only ADL (71.6 ± 12.3 v/s 76.7 ± 11.5, P=0.001) and HMSE (23.4 ± 3.1 v/s 24.4 ± 2.4, P=0.01) were statistically significant. All parameters were worse in the severe hyponatremia group (Na<125 meq/L) compared to moderate (Na=125-130 meq/L) and mild (Na=130-135 meq/L), but significant only for TUG (17.9 ± 3.4 v/s 16.4 ± 4.2 v/s 14.6 ± 3.5, P=0.003, higher value being worse) and HMSE (21.1 ± 4.0 v/s 22.6 ± 2.8 v/s 24.1 ± 2.5, P=0.0007). Improvement in ADL, TUG, and HMSE scores with serum sodium improvement was significantly higher in the hyponatremia group (8.8 ± 10.1, 2.2 ± 2.5, and 1.7 ± 2.3 respectively) when compared to the normonatremic reference group (4.7 ± 9.0, 1 ± 2.0, and 0.7 ± 1.3 respectively, P<0.05). Although HG improvement was also greater, the difference was not statistically significant. CONCLUSION: Ours is the first study utilizing HMSE for assessing the cognition in the Indian patients. Hyponatremic patients have poor baseline CGA parameter values, and severity of hyponatremia correlates with poor motor and cognitive functions. Improvement in serum sodium levels improve CGA parameters. Hyponatremia correction should be prioritized in the elderly as it significantly impacts the quality of life in the elderly.


Assuntos
Hiponatremia , Atividades Cotidianas , Idoso , Feminino , Avaliação Geriátrica , Força da Mão , Humanos , Hiponatremia/diagnóstico , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Qualidade de Vida , Sódio , Centros de Atenção Terciária , Estudos de Tempo e Movimento
4.
BMC Musculoskelet Disord ; 23(1): 391, 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35477445

RESUMO

STUDY DESIGN: Retrospective cohort study. BACKGROUND: Current evaluation of patients with adult spinal deformity (ASD) is mainly based on radiographic parameters derived from X-rays. However, due to their static nature, X-rays fall short of assessing the dynamic functionalities including balance, gait, and the risk of falling. This study aimed to determine the functionalities of ASD patients by measuring functional mobility tests (FMTs) and compared the relationships between patient-reported outcomes (PROs) with FMTs and radiographic parameters to determine whether FMTs are useful evaluation tools for the evaluation of patients with ASD. METHODS: This age- and sex-matched case-control study included 66 patients with ASD and 66 patients with LSS, all of whom were scheduled to undergo spinal surgery. All patients were evaluated with four FMTs including alternate step test (AST), six-meter walk test (SMT), sit-to-stand test (STS), and timed up and go test (TUGT). Correlations of the PROs with FMTs and static radiographic parameters were analyzed. RESULTS: The baseline characteristics were not significantly different between the two groups. However, compared with patients with LSS, those with ASD showed significantly poorer performance on all four FMTs, spending significantly more time performing the SMT, STS, and TUGT (P = 0.046, 0.045, and 0.015, respectively). The results of the four FMTs were significantly correlated with the ODI (Oswestry Disability Index) scores only in the ASD group and not in the LSS group. CONCLUSIONS: FMTs were appropriate tools for assessing the dynamic functionalities of patients with ASD. FMTs might play a bridging role between static radiographic parameters and subjective PROs when treating patients with ASD.


Assuntos
Marcha , Equilíbrio Postural , Adulto , Estudos de Casos e Controles , Humanos , Estudos Retrospectivos , Estudos de Tempo e Movimento
5.
Artigo em Inglês | MEDLINE | ID: mdl-35457440

RESUMO

Previous studies have frequently reported that those with a driver's license have better physical and cognitive functions than those without. However, there are many people in the world who do not need or who cannot have a driver's license. We hypothesized that if the non-driver's license group had the same or better physical and cognitive functioning as the driver's license group, they could lead healthy lives without the risk of functional decline or loss of functioning due to surrendering their licenses or giving up driving. The subjects were 47 community-dwelling older adults. We measured their physical function and cognitive function and performed psychological assessment via the following tests: grip strength, Timed Up and Go test, walking speed, Five Times Sit to Stand test, Functional Reach test, Two-Step Test, Mini-Mental State Examination, Trail Making Test, Modified Falls Efficacy Scale, Geriatric Depression Scale, and University of California Los Angeles Loneliness Scale. In previous studies, it has been said that having a driver's license provides good physical, cognitive, and psychological functions. However, in this study, loneliness and executive function were strongly influenced by age and sex, and no direct relationship to a driver's license was suggested. Rather, non-driver license holders may be relieved because there is no risk of accidents due to driving, and there is no possibility of a suddenly decline in physical or cognitive function due to revocation of a driver's license.


Assuntos
Condução de Veículo , Equilíbrio Postural , Idoso , Condução de Veículo/psicologia , Cognição , Humanos , Licenciamento , Projetos Piloto , Estudos de Tempo e Movimento
6.
Foot (Edinb) ; 51: 101876, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35462089

RESUMO

OBJECTIVES: To evaluate the Structural Index Score (SIS) - a clinical foot deformity assessment index developed for RA, and to compare its results with foot function, disability and physical performance tests. METHODS: In this cross-sectional study, 104 patients with foot pain were evaluated according to SIS score, subscales (Forefoot SIS and Rearfoot SIS) and items. Results were compared with the Foot Function Index (FFI), the Health Assessment Questionnaire Disability Index (using lower limbs items: LL-HAQ), and physical performance tests: Berg Balance Scale (BBS), the Timed Up and Go test (TUG) and the 5-Time Sit down-to-Stand up Test (SST5). RESULTS: There was a weak correlation of SIS score with FFI and LL-HAQ. Rearfoot SIS was correlated with FFI, LL-HAQ and worse performance in BBS, TUG and SST5. Regarding Rearfoot SIS items, the ankle ROM was correlated to all studied outcomes, the calcaneus varus/valgus was correlated with FFI (total, pain and disability subscales) and the planus/cavus deformity with FFI-pain, HAQ-DI and LL-HAQ. Forefoot SIS did not correlate with any outcome measures. In relation to Forefoot SIS items, hallux valgus was associated with foot function (FFI-total, pain and disability subscales), the MTPs joints subluxation was correlated with FFI-disability subscale, and the 5th MTP exostosis was associated with FFI-pain. CONCLUSION: SIS score was correlated to impaired foot function (FFI) and disability (LL-HAQ). Rearfoot SIS was correlated to worse performance on FFI, LL-HAQ, BBS, TUG and SST5. SIS score index can be a useful tool to evaluate the rheumatoid foot deformities, but a better graduation of foot deformities should add sensitivity to this method.


Assuntos
Artrite Reumatoide , Avaliação da Deficiência , Artrite Reumatoide/diagnóstico , Estudos Transversais , , Humanos , Dor , Desempenho Físico Funcional , Equilíbrio Postural , Inquéritos e Questionários , Estudos de Tempo e Movimento
7.
J Neurol Sci ; 437: 120266, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35486971

RESUMO

BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is primarily characterized by cognitive impairment and gait disturbance. Our objective was to evaluate the clinical characteristics of iNPH and the association between cerebral blood flow (CBF), measured using single-photon emission computed tomography (SPECT), and both cognitive and gait disturbances in iNPH patients. METHODS: We compared cognitive and motor functions and neuroimaging findings between 29 iNPH patients and 35 age-matched Parkinson's disease (PD) patients. We examined the associations between cognitive and motor dysfunctions and CBF in iNPH patients using 99mTc-ECD SPECT subtraction imaging data from a database of healthy control subjects. RESULTS: The cognitive function of iNPH patients, as measured by the Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB), was significantly poorer than that of PD patients; however motor function of the legs based on the Unified PD Rating Scale (UPDRS) part III was similar across groups. Impairment in cognitive function based on the MMSE and FAB was significantly correlated with motor dysfunction of the legs on the UPDRS part III and the 3-m Timed Up and Go test. Furthermore, 99mTc-ECD SPECT subtraction imaging revealed lower CBF in the bilateral lingual gyrus of iNPH patients with severely impaired cognitive and motor functions than healthy control subjects. CONCLUSION: Patients with iNPH have severely impaired cognitive function; however, motor dysfunction of the legs is similar to PD patients. The cognitive and gait disturbances of iNPH are significantly interrelated, which may be associated with an impaired brain network that includes the bilateral lingual gyrus.


Assuntos
Disfunção Cognitiva , Hidrocefalia de Pressão Normal , Doença de Parkinson , Circulação Cerebrovascular , Disfunção Cognitiva/complicações , Disfunção Cognitiva/etiologia , Marcha , Humanos , Hidrocefalia de Pressão Normal/complicações , Hidrocefalia de Pressão Normal/diagnóstico por imagem , Lobo Occipital , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico por imagem , Equilíbrio Postural , Estudos de Tempo e Movimento
8.
Age Ageing ; 51(4)2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35397159

RESUMO

BACKGROUND: to investigate the efficacy of addition of inspiratory muscle training (IMT) to the whole body vibration (WBV) on functional outcomes, physical performance, muscle strength and metabolism in pre-frail older women. METHODS: this study was a randomized double-blind trial. Forty-two older women aged 60-80 years who meet the Cardiovascular Health Study frailty criteria for pre-frailty were randomly allocated to IMT + WBV, IMTsham + WBV or Sham groups. IMT + WBV group received 12 weeks of both trainings, whereas IMTsham + WVB received 12 weeks of WBV alone. Sham group received 12 weeks of IMT with a low fixed load and were positioned at the vibratory platform without therapeutic effect. Participants were evaluated before and after the intervention for the following outcomes: 6-min walk test distance (6MWD), balance using Tinetti test, functional mobility using timed up and go test (TUG), handgrip strength (HGS) and peripheral muscle metabolism (glucose and lactate levels). RESULTS: after the training, both groups IMT + WBV and IMTsham + WBV improved 6MWD [mean percentage changes = 20.31 (SD = 14.62) and 13.02 (SD = 12.14), respectively] compared with Sham [0.27 (SD = 6.51)], P <0.01. There was also a significant decrease of mean percentage changes on time of the TUG for IMT + WBV [-21.87 (SD = 7.87)] and IMTsham + WBV [-11.15 (SD = 13.64)] compared with Sham [-4.25 (SD = 13.25)], P <0.01. IMT + WBV group improved balance when compared with IMTsham + WBV and Sham groups (P <0.05 and < 0.01, respectively). HGS and levels of lactate and glucose were similar between groups. CONCLUSIONS: the addition of IMT to the WBV was effective to improve functionality, balance and physical performance in pre-frail older women.


Assuntos
Fragilidade , Equilíbrio Postural , Idoso , Feminino , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/terapia , Glucose , Força da Mão , Humanos , Ácido Láctico , Força Muscular/fisiologia , Músculos , Equilíbrio Postural/fisiologia , Estudos de Tempo e Movimento , Vibração/uso terapêutico
9.
J Frailty Aging ; 11(2): 182-189, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35441196

RESUMO

BACKGROUND: The association of sarcopenia with cognitive function in its specific domains remains poorly understood. OBJECTIVES: To investigate the association of sarcopenia and its components with neuropsychological performance among patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). DESIGN: Cross-sectional design. SETTING: A memory clinic in Japan. PARTICIPANTS: The study included 497 MCI/684 AD patients aged 65-89 years. MEASUREMENTS: Patients were assessed for muscle mass by bioelectrical impedance analysis, muscle strength by hand grip strength (HGS), and physical performance by timed up and go test (TUG). Sarcopenia was defined as presence of both low muscle strength and low muscle mass. The patients underwent neuropsychological tests, including logical memory, frontal lobe assessment battery, word fluency test, Raven's colored progressive matrices, digit span, and the Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog). RESULTS: The prevalence of sarcopenia in men and women was 24.1% and 19.5%, respectively. In multiple regression analyses adjusting for confounders, unlike in men, sarcopenia was associated with memory function in women (ADAS-cog, memory domain, coefficient = 1.08, standard error (SE) = 0.36), which was thought likely due to the relationship between HGS and memory function (immediate recall of logical memory, coefficient = 0.07, SE = 0.03; ADAS-cog, memory domain, coefficient = -0.10, SE = 0.03). Of the components of sarcopenia in both sexes, HGS and TUG were associated with visuospatial function and frontal lobe function, respectively. CONCLUSIONS: The specific association of sarcopenia and its components with cognitive domains may provide the key to elucidating the muscle-brain interactions in AD.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Sarcopenia , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/epidemiologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Estudos Transversais , Feminino , Força da Mão/fisiologia , Humanos , Masculino , Equilíbrio Postural , Sarcopenia/complicações , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Estudos de Tempo e Movimento
10.
J Clin Neurosci ; 100: 184-191, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35487026

RESUMO

Transcranial direct current stimulation (tDCS) delivered to the dorsolateral prefrontal cortex (DLPFC) can improve mobility among people with Parkinson's disease (PD). Previous studies suggest that delivering tDCS during task performance might be beneficial. However, only a few studies explored the effect of combining tDCS with task. We investigated the effect of stimulating the DLPFC using anodal tDCS while performing a timed up and go (TUG) test and its sustained effects. In this sham-controlled, cross-over, and double-blind study, twenty participants with PD (age = 67.8 ± 8.3 years and 6 females) completed two sessions (anodal or sham tDCS), conducted in the randomized and counterbalanced manner, with at least a 1-week gap. Stimulation involved transferring 2 mA current through the DLPFC for 30 min. Single-trial of TUG test was performed under single- and dual-task conditions before, during, immediately after, 15 and 30 min after stimulation ceased. We estimated durations of completing different components of TUG. Phoneme verbal fluency task was given as the cognitive distractor during the dual-tasking. An improvement was observed in cognitive performance due to the tDCS condition (d = 0.7, p < 0.01) over time. However, we found no effect of tDCS condition on iTUG related outcomes under single- or dual-task conditions. In conclusion, DLPFC stimulation combined with task improved cognitive performance only, and the improvement was sustained after tDCS ceased. Future studies may investigate stimulating multiple brain regions to improve motor and cognitive performance.


Assuntos
Doença de Parkinson , Estimulação Transcraniana por Corrente Contínua , Idoso , Cognição/fisiologia , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/terapia , Equilíbrio Postural , Córtex Pré-Frontal/fisiologia , Análise e Desempenho de Tarefas , Estudos de Tempo e Movimento
11.
Am J Speech Lang Pathol ; 31(3): 1284-1296, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35363996

RESUMO

PURPOSE: The purpose of this study was to improve our understanding as to which factors determine online, spoken sentence production abilities of adults with latent aphasia in a discourse context. METHOD: Discourse samples of the story of Cinderella elicited from AphasiaBank were analyzed with speech analysis software. Participants comprised people with latent and anomic aphasia as well as neurotypical controls (10 per group). Durations of pauses (silent and filled) were analyzed according to (a) the location they occurred (between or within sentences), (b) the syntactic complexity of sentences (simple, complex), and (c) sentence length (number of words). Statistical comparisons were conducted using mixed-effect models. RESULTS: The two clinical groups (latent and anomic) differed from controls in the duration of pauses, both between and within sentences. Syntactic complexity did not exert an effect on either of the two clinical groups as compared with controls. As compared with controls, both clinical groups paused more before long in comparison with short sentences. CONCLUSION: Reduction in processing speed, which affects the ability to simultaneously maintain multiple linguistic and other cognitive demands associated with planning and monitoring of utterances, is a major factor that compromises sentence production in spoken discourse in latent aphasia. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19448726.


Assuntos
Afasia , Adulto , Anomia , Afasia/diagnóstico , Afasia/psicologia , Humanos , Idioma , Fala , Estudos de Tempo e Movimento
12.
PLoS One ; 17(4): e0249052, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35486663

RESUMO

INTRODUCTION: Vision is critical for children's development. However, prevalence of visual impairment (VI) is high in students with special educational needs (SEN). Other than VI, SEN students are prone to having functional deficits. Whether visual problems relate to these functional deficits is unclear. This study aimed to assess the impact of vision on visual processing functions and balance in SEN students through a community service. METHODS: Visual acuity (VA) and contrast sensitivity were measured in a total of 104 (aged 14.3±4.3) SEN students as the visual outcomes, followed by retinoscopy. Visual processing function assessment included facial expression recognition by card matching examiner's facial expression matching, and visual orientation recognition. Dynamic balance, by Timed Up and Go test, and static standing balance (postural sway in double-legged standing with feet-together and tandem-stance for open-eye and closed-eye conditions) were assessed. Static balance was presented in terms of the maximal medial-lateral and antero-posterior sways. RESULTS: Of the 104 students, 62 (59.6%) were classified as visually impaired according to WHO classification of visual impairment based on presenting distance acuity. Ocular problems (e.g. optic nerve anomaly, uncorrected/ under-corrected refractive errors) and neurological anomalies were the major causes of vision loss. VA was positively associated with visual processing functions (all p ≤ 0.01), as SEN students with better vision tended to perform better in visual orientation and facial expression recognition tasks, as well as dynamic balance function (p = 0.04). For the static balance, postural sway and VA showed a positive relationship under open-eye and tandem stance conditions. However, the relationship between postural sway and VA became negative under closed-eye and tandem stance conditions. CONCLUSION: This study found a high prevalence of SEN students with visual impairment, in which many of them were undetected. Optometric examination is important to improve their visual function to minimize the effect of vision on functional performance. Vision is critical in visual processing as well as playing an important role in maintaining balance in SEN students.


Assuntos
Equilíbrio Postural , Baixa Visão , Criança , Humanos , Estudantes , Estudos de Tempo e Movimento , Transtornos da Visão , Baixa Visão/epidemiologia , Acuidade Visual
13.
Artigo em Inglês | MEDLINE | ID: mdl-35409991

RESUMO

Identification of possible sarcopenia, which is a simple assessment of sarcopenia, has been proposed for the earlier detection of sarcopenia in primary care settings; however, there are no studies comparing the differences in characteristics of older adults with possible sarcopenia or sarcopenia. This study aimed to compare the characteristics of "possible sarcopenia" in real-world primary care and "sarcopenia" in research settings. A total of 2129 older adults were enrolled from the Korean Frailty and Aging Cohort Study. Possible sarcopenia and sarcopenia were defined using Asian Working Group for Sarcopenia 2019; the possible sarcopenia for real-world primary care was defined by a combination of case findings using low calf circumference or the SARC-F questionnaire and 5-times chair stand test, without considering the measurement of handgrip strength. The prevalence of possible sarcopenia was higher in women than in men; however, that of sarcopenia was higher in men than in women (all, p < 0.001). Older men and women with possible sarcopenia had a lower education level, longer time taken for the Timed Up and Go test, more severe mobility limitation, lower scores on the EuroQol-5 dimension and 12-item short-form survey for physical health, and more cognitive dysfunction than those with sarcopenia did (all, p < 0.05). In conclusion, the participants with possible sarcopenia differed from those with sarcopenia in some characteristics. Identifying differences in characteristics may be helpful to screening and earlier diagnosis of sarcopenia in real-world primary care, as well as in research, which can lay the foundations for personalized lifestyle intervention in diet and exercise.


Assuntos
Sarcopenia , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Avaliação Geriátrica/métodos , Força da Mão , Humanos , Masculino , Equilíbrio Postural , Atenção Primária à Saúde , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Estudos de Tempo e Movimento
14.
Sensors (Basel) ; 22(8)2022 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-35458888

RESUMO

This study aimed to evaluate the effect of a horse-riding simulator (HRS) with virtual reality (VR) on gross motor function, balance control, and body composition in children with spastic cerebral palsy (CP). Seventeen preschool and school-aged children with spastic CP were included; 10 children in the intervention group (HRS group) received 30 min of HRS with VR training twice a week for a total of 16 sessions in addition to conventional physiotherapy. Seven children in the control group were instructed to perform home-based aerobic exercises twice a week for 8 weeks in addition to conventional physiotherapy. Gross motor function measure (GMFM) and body composition were evaluated before the first session and after the last session. Before and after the 2-month intervention, Pediatric Balance Scale and Timed Up and Go test were evaluated for the HRS group. GMFM scores and body composition changed significantly in the HRS group (p < 0.05). However, no significant differences were observed in the control group. Changes in the GMFM total scores, GMFM dimension D scores, and skeletal muscle mass significantly differed between the HRS and control groups (p < 0.05). HRS with VR may be an effective adjunctive therapeutic approach for the rehabilitation of children with CP.


Assuntos
Paralisia Cerebral , Realidade Virtual , Animais , Composição Corporal , Criança , Pré-Escolar , Cavalos , Humanos , Destreza Motora , Equilíbrio Postural/fisiologia , Estudos de Tempo e Movimento
15.
Arch Osteoporos ; 17(1): 66, 2022 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-35420317

RESUMO

Vitamin D deficiency is still an important subject due to its significant effects on various tissues and functions. We found a relationship between vitamin D deficiency and increase in adipose tissue thicknesses. This situation reveals the importance of vitamin D supplementation, the harms of weight gain and obesity, and the importance of a balanced diet. PURPOSE: Although the relationship between vitamin D (VitD) levels with body composition and physical/cognitive functions have been investigated in various studies, however, there is no study evaluating all these parameters together. In accordance with, we aimed to evaluate the relationship between VitD deficiency with body composition (i.e., skin, subcutaneous fat, and muscle thicknesses) and physical/cognitive functions. METHODS: A total of 203 adults (78 M, 125 F, aged 19-91 years) who had recent 25-OH-vitamin D measurements were included. Ultrasonographic (US) measurements (skin, subcutaneous fat, and muscle thicknesses) were made from the dorsum of the hand, and anterior sides of forearm, arm, and thigh. Handgrip strength, gait speed, Timed Up and Go Test, and Chair Stand Test were evaluated. Additionally, cognitive status was also evaluated with Mini-Mental State Exam. RESULTS: Subjects were classified as VitD deficient group (< 20 ng/ml, N = 125) and control group (≥ 20 ng/ml, N = 78). The groups were not significantly different as regards age, gender, and anthropometric measurements (all p > 0.05). Subcutaneous fat tissues were thicker in the VitD deficient group (all p < 0.05). All the other US measurements and functional/cognitive tests were not significantly different between the groups (all p > 0.05). According to linear regression analyses, body mass index (BMI) was independently related with all subcutaneous fat thicknesses in both genders, and VitD deficiency was related with all subcutaneous fat thicknesses in females and anterior forearm subcutaneous fat thickness in males (all p < 0.05). CONCLUSION: We imply that together with BMI, VitD deficiency is independently related with increased regional subcutaneous fat tissue. We also underscore the role of US measurements for evaluation of body composition in related clinical scenarios.


Assuntos
Força da Mão , Deficiência de Vitamina D , Adulto , Composição Corporal , Cognição , Feminino , Humanos , Masculino , Equilíbrio Postural , Estudos de Tempo e Movimento , Vitamina D
16.
Neurorehabil Neural Repair ; 36(6): 346-359, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35387509

RESUMO

BACKGROUND: Decreased automaticity is common among individuals with neurodegenerative disease and is often assessed using dual-task (DT) paradigms. However, the best methods for assessing performance changes related to DT demands remain inconclusive. OBJECTIVE: To investigate the reliability and validity of a novel battery of DT measures (DT Effect-Battery (DTE-B)) encompassing three domains: task-specific interference, task prioritization, and automaticity. METHODS: Data for this retrospective cross-sectional study included 125 participants with Parkinson's disease (PD), 127 participants with Alzheimer's disease (AD), and 84 healthy older adults. Reliability analyses were conducted using a subset of each population. DTE-B measures were calculated from single and DT performance on the Timed Up and Go test and a serial subtraction task. Construct validity was evaluated via associations within the DTE-B and with theoretically supported measures as well as known-groups validity analyses. RESULTS: Good to excellent reliability was found for DTE-B measures of task interference (motor and cognitive DT effects) (ICCs≥.658) and automaticity (combined DT effect (cDTE)) (ICCs≥.938). Evidence for convergent validity was found with associations within the hypothesized constructs. Known-groups validity analyses revealed differences in the DTE-B among the healthy group and PD and AD groups (ps≤.001), excepting task prioritization (ps≥.061). CONCLUSIONS: This study provides evidence to support the DTE-B as a reliable measure of multiple constructs pertinent to DT performance. The cDTE demonstrated evidence to support its validity as a measure of automaticity. Further investigation of the utility of the DTE-B in both PD and AD, as well as other populations, is warranted.


Assuntos
Doença de Alzheimer , Compostos de Cádmio , Doenças Neurodegenerativas , Doença de Parkinson , Pontos Quânticos , Idoso , Estudos Transversais , Marcha , Humanos , Doenças Neurodegenerativas/complicações , Doença de Parkinson/complicações , Equilíbrio Postural , Reprodutibilidade dos Testes , Estudos Retrospectivos , Telúrio , Estudos de Tempo e Movimento , Caminhada
17.
Trials ; 23(1): 335, 2022 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-35449020

RESUMO

BACKGROUND: Current hyponatraemia guidelines are divided on the use of tolvaptan in hospitalised patients with moderate to severe hyponatraemia, due to an uncertain risk-benefit ratio. We will conduct a randomised trial to test the hypothesis that early use of tolvaptan improves the rate of serum sodium correction and clinical outcomes compared with current standard first-line therapy, restriction of fluid intake, without increasing the risk of serum sodium overcorrection. METHODS: We will enrol hospitalised patients with euvolaemic or hypervolaemic hyponatraemia and serum sodium of 115-130 mmol/L at Austin Health, a tertiary care centre in Melbourne, Australia. Participants will be randomised 1:1 to receive either tolvaptan (initial dose 7.5 mg) or fluid restriction (initial limit 1000 ml per 24 h), with titration of therapy based on serum sodium response according to a pre-determined protocol over a 72-h intervention period. The primary endpoint will be the between-group change in serum sodium over time, from study day 1 to day 4. Secondary endpoints include serum sodium increment in the first 24 and 48 h, proportion of participants with normalised serum sodium, length of hospital stay, requirement for serum sodium re-lowering with intravenous dextrose or desmopressin, cognitive and functional measures (Confusion Assessment Method Short form, Timed Up and Go test, hyponatraemia symptom questionnaire), 30-day readmission rate, treatment satisfaction score and serum sodium 30 days after discharge. The trial will be overseen by an independent Data Safety Monitoring Board. Serum sodium will be monitored every 6-12 h throughout the study period, with pre-specified thresholds for commencing intravenous 5% dextrose if serum sodium rise targets are exceeded. DISCUSSION: We seek to inform future international guidelines with high-quality data regarding the utility and safety of tolvaptan compared to standard therapy fluid restriction in patients with moderate-severe hyponatraemia in hospital. If tolvaptan use in this patient group is endorsed by our findings, we will have established an evidence-based framework for tolvaptan initiation and monitoring to guide its use. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Registry ACTRN12619001683123 . Registered on December 2 2019.


Assuntos
Hiponatremia , Antagonistas dos Receptores de Hormônios Antidiuréticos/efeitos adversos , Glucose/uso terapêutico , Humanos , Hiponatremia/diagnóstico , Hiponatremia/tratamento farmacológico , Equilíbrio Postural , Sódio , Estudos de Tempo e Movimento , Tolvaptan/efeitos adversos
18.
Sci Rep ; 12(1): 3414, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35233066

RESUMO

Previous studies have reported the presence of muscle weakness in women with fibromyalgia syndrome (FMS) which is considered a risk factor for developing earlier disability and dependence during activities of daily life (ADL). We aimed to assess the relationship between hand grip force with sociodemographic, clinical, disease-specific, cognitive, and physical function variables in women with FMS. One hundred twenty-six women with FMS completed demographic (age, gender, height, weight, body mass index), pain-related (pain history, pain intensity at rest and during ADL), disease-specific severity (Fibromyalgia Impact Questionnaire -FIQ-S-, Fibromyalgia Health Assessment Questionnaire -FHAQ-, EuroQol-5D, Pain Catastrophizing Scale -PCS-, Pittsburgh Sleep Quality Index-PSQI-, Pain Vigilance and Awareness Questionnaire -PVAQ-, and Central Sensitization Inventory -CSI-), psychological (Tampa Scale for Kinesiophobia, TKS-11; Pain Vigilance and Awareness Questionnaire, PVAQ; Pain Catastrophizing Scale, PCS), and physical function (hand grip force, and Timed Up and Go Test, TUG). Hand grip force was associated with height (r = -0.273), BMI (r = 0.265), worst pain at rest (r = -0.228), pain during ADL (r = -0.244), TUG (r = -0.406), FHAQ (r = -0.386), EuroQol-5D (r = 0.353), CSI (r = -0.321) and PSQI (r = -0.250). The stepwise regression analysis revealed that 34.4% of hand grip force was explained by weight (6.4%), TUG (22.2%), and FHAQ (5.8%) variables. This study found that hand grip force is associated with physical function indicators, but not with fear-avoidance behaviors nor pain-related features of FMS. Hand grip force could be considered as an easy tool for identifying the risk of fall and poorer physical health status.


Assuntos
Fibromialgia , Feminino , Força da Mão , Humanos , Dor , Equilíbrio Postural , Estudos de Tempo e Movimento
19.
BMJ Open ; 12(3): e055597, 2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-35236731

RESUMO

OBJECTIVE: To describe the pharmacists' workflow, including tasks and time spent, to better understand their work capacity. DESIGN: Cross-sectional, observational, time and motion study. SETTING: Community pharmacies in Western Australia and New South Wales, Australia. PARTICIPANTS: Currently registered and practising pharmacists were approached using snowball sampling and selected using purposive techniques to obtain balance representation of metropolitan and rural pharmacies, as well as high and low script volumes where possible. RESULTS: Twenty-four pharmacists across 15 pharmacies participated during the 135 sessions totalling over 274 hours of observation. Dispensing (30%), indirect patient services (17%), counselling (15%) and professional management activities (15%) were the top four duties pharmacists performed, while only 2% of time was spent on professional services such as pain clinics and influenza vaccinations. Tasks were frequently interrupted and often performed simultaneously. Breaks and consumer-contact times were limited. More time was spent on professional service activities in non-metropolitan pharmacies, in pharmacies with greater daily prescription volumes and those with one or more support pharmacists. CONCLUSIONS: This is the first study to quantify the pharmacists' tasks in Australian community pharmacies. Much time is being spent on dispensing, supply and management activities with little time for providing additional professional services. An extra supporting pharmacist is likely necessary to increase professional services. These findings could support future research around barriers and enablers of conducive workflows and of extended professional services.


Assuntos
Serviços Comunitários de Farmácia , Farmácias , Farmácia , Austrália , Estudos Transversais , Humanos , Farmacêuticos , Papel Profissional , Encaminhamento e Consulta , Estudos de Tempo e Movimento
20.
BMJ Open ; 12(3): e054792, 2022 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-35264352

RESUMO

INTRODUCTION: Sexual minority adolescents (SMA) report higher rates of anxiety, self-harm, depression and suicide than heterosexual peers. These disparities appear to persist into adulthood and may worsen for certain subgroups, yet the mechanisms that drive these concerns remain poorly understood. Minority stress theory, the predominant model for understanding these disparities, posits that poorer outcomes are due to the stress of living in a violently homophobic and discriminatory culture. Although numerous studies report associations between minority stress and behavioural health in adolescence, no study has comprehensively examined how minority stress may change throughout the course of adolescence, nor how stress trajectories may predict health outcomes during this critical developmental period. METHODS AND ANALYSIS: Between 15 May 2018 and 1 April 2019, we recruited a US national sample of diverse SMA (n=2558) age 14-17 through social media and respondent-driven sampling strategies. A subset of participants (n=1076) enrolled in the longitudinal component and will be followed each 6 months until 1 July 2022. Primary outcomes include symptoms of depression, anxiety and post-traumatic stress disorder; suicidality and self-harm and substance use. The key predictor is minority stress, operationalised as the Sexual Minority Adolescent Stress Inventory. We will use parallel cohort-sequential latent growth curve models to test study hypotheses within a developmental framework. ETHICS AND DISSEMINATION: All participants provided assent to participate, and longitudinal participants provided informed consent at the first follow-up survey after reaching age 18. All study procedures were reviewed and approved by the University of Southern California Social-Behavioral Institutional Review Board, including a waiver of parental permission given the potential for harm due to unintentional 'outing' to a parent during the consent process. The final anonymous data set will be available on request, and research findings will be disseminated through academic channels and products tailored for the lay community.


Assuntos
Minorias Sexuais e de Gênero , Adolescente , Adulto , Heterossexualidade , Humanos , Estudos Longitudinais , Estudos Prospectivos , Estudos de Tempo e Movimento
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