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1.
BMC Musculoskelet Disord ; 25(1): 427, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38824507

RESUMO

BACKGROUND: There has long been discussion regarding the impact of medial malleolar osteotomies (MMO) as an adjunctive treatment for osteochondral lesions of the talus (OCLT). MMO may improve the visibility and accessibility of the talus, but they also pose a risk of periprocedural morbidity. There is a lack of research about the prevalence and consequences of MMO in the surgical treatment of OCLT. METHODS: This study retrospectively evaluated data from the German Cartilage Register (KnorpelRegister DGOU) from its implementation in 2015 to December 2020. The impact of MMO on patient-reported outcome measures (PROMs) was investigated. Wherever possible, subgroups were built and matched using a propensity score which matched a group undergoing OCLT without MMO. Matching included age, sex, weight, localization of the OCLT, the international cartilage repair society (ICRS) grading, surgical procedure and preoperative symptoms using the Foot and Ankle Ability Measure (FAAM) and the Activities of Daily Living Subscale (ADL). RESULTS: The prevalence of MMO in the operative treatment of OCLT was 15.9%. Most of the osteotomies were performed in OCL of the medial talar dome (76.8%) and in more serious lesions with an ICRS grade of III (29.1%) and IV (61.4%). More than half of the osteotomies (55.6%) were performed during revision surgery. A matched pair analysis of n = 44 patients who underwent AMIC® via arthrotomy and MMO vs. arthrotomy alone showed no significant differences in patient-reported outcome measures (PROMs, i.e. FAAM-ADL, and FAOS) at 6,12 and 24 months. CONCLUSIONS: MMO are mostly used in the treatment of severe (≥ ICRS grade 3) OCL of the medial talar dome and in revision surgery. Functional and patient-reported outcome measures are not significantly affected by MMO compared to arthrotomy alone. TRIAL REGISTRATION: The German Cartilage Register (KnorpelRegister DGOU) was initially registered at the German Clinical Trials Register ( https://www.drks.de , register number DRKS00005617, Date of registration 03.01.2014) and was later expanded by the ankle module.


Assuntos
Osteotomia , Medidas de Resultados Relatados pelo Paciente , Sistema de Registros , Tálus , Humanos , Feminino , Masculino , Osteotomia/métodos , Osteotomia/efeitos adversos , Tálus/cirurgia , Estudos Retrospectivos , Adulto , Alemanha/epidemiologia , Pessoa de Meia-Idade , Resultado do Tratamento , Cartilagem Articular/cirurgia , Adulto Jovem , Incidência , Articulação do Tornozelo/cirurgia , Atividades Cotidianas , Adolescente , Recuperação de Função Fisiológica
2.
Front Public Health ; 12: 1375106, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827624

RESUMO

Introduction: Depressive symptoms are often experienced by patients with arthritis and are correlated with poor health outcomes. However, the association between depressive symptoms and multidimensional factors (sociodemographic characteristics, health conditions, health behaviors, and social support) among older patients with arthritis in China remains poorly understood. This study aimed to explore the prevalence of depressive symptoms in older patients with arthritis in eastern China and identify the associated factors. Methods: We analyzed data of 1,081 older patients with arthritis using secondary data from 2014 to 2020 from a community-based ongoing study initiated in 2014 in eastern China. The prevalence of depressive symptoms was calculated, and univariate and multilevel logistic regression analyses were used to identify the associated factors. Results: The mean age of older patients with arthritis was 69.16 ± 7.13 years; 42.92% were men and 57.08% were women. The prevalence of depressive symptoms in older patients with arthritis was 14.99% (95% confidence interval: 12.91-17.26%), about 1.8 times higher than that in older adults without arthritis (8.49%, p < 0.001). Multilevel logistic regression identified perception of poor economic status (odds ratio [OR] = 5.52, p < 0.001), multimorbidity (OR = 1.96, p = 0.001), limitations in activities of daily living (OR = 2.36, p = 0.004), and living alone (OR = 3.13, p = 0.026) as factors positively associated with depressive symptoms. Patients diagnosed with arthritis at an older age had lower odds of experiencing depressive symptoms (OR = 0.67, p = 0.046). Conclusion: Screening for depressive symptoms is essential among older patients with arthritis, especially those who perceive themselves as having a poor economic status, are diagnosed at an earlier age, have multimorbidity, have limitations in activities of daily living, and live alone. The associations of age at arthritis diagnosis and dietary behaviors with depressive symptoms require further research.


Assuntos
Artrite , Depressão , Humanos , Masculino , Feminino , Idoso , China/epidemiologia , Artrite/epidemiologia , Depressão/epidemiologia , Prevalência , Pessoa de Meia-Idade , Fatores de Risco , Estudos Transversais , Apoio Social , Idoso de 80 Anos ou mais , Modelos Logísticos , Atividades Cotidianas , Fatores Socioeconômicos
3.
J Aging Stud ; 69: 101226, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38834246

RESUMO

BACKGROUND: Supporting ageing in place, quality of life and activity engagement are public health priorities for people living with dementia, but little is known about the needs and experiences of community-dwelling people with rarer forms of dementia with lesser known symptoms. Posterior cortical atrophy (PCA) is a rare form of dementia usually caused by Alzheimer's disease but which is characterised by diminished visual processing (rather than a dominant memory problem), which poses challenges for maintaining independence and accessing appropriate support. METHODS: This study used a comparative qualitative design and focussed ethnographic methods to explore experiential differences in activity engagement for 10 people with the most common, memory-led presentation of Alzheimer's disease and 10 people with posterior cortical atrophy within their everyday home environments. RESULTS: While the data collection revealed much rich variation in individual and contextual factors, some tentative high-level differences in the experiences of everyday activities could be drawn out, seemingly attributable to the different diagnoses' differing dominant symptoms. These included people with posterior cortical atrophy being less likely to use environmental cues to initiate activities, and more likely to withhold from asking for support because of preserved insight into the impact of this on carers. This lack of initiation of activities could be misinterpreted as apathy. People with posterior cortical atrophy also were discouraged from engaging in activities by disorientation within the home, and difficulties localising, identifying and manipulating objects. People with the more common, memory-led presentation of Alzheimer's disease exhibited more memory-based difficulties with engaging with activities such as forgetting planned activities, where to locate the items required for an activity and the steps involved. Despite these distinct symptom-led challenges, all participants and their family members demonstrated resourcefulness and resilience in making creative adaptations to support continued engagement in everyday activities, supporting the widely reported management strategies of people with dementia of the Alzheimer's type more generally. CONCLUSIONS: These findings offer helpful insights into some the differing impacts dementia related visual and memory impairments can have on everyday activity engagement, which will be helpful for others navigating these challenges and the health and social care practitioners working with people affected by these conditions. The findings also highlight the vast individual variation in the multitude of individual and contextual factors involved in everyday activity engagement, and suggest important areas for future work utilising methods which are similarly high in ecological validity and accessibility as the home-based focussed ethnographic methods utilised here.


Assuntos
Atividades Cotidianas , Doença de Alzheimer , Antropologia Cultural , Atrofia , Humanos , Doença de Alzheimer/psicologia , Feminino , Masculino , Idoso , Idoso de 80 Anos ou mais , Pesquisa Qualitativa , Qualidade de Vida/psicologia , Córtex Cerebral/patologia , Vida Independente
4.
BMC Public Health ; 24(1): 1492, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834967

RESUMO

OBJECTIVES: To assess the influence of loneliness on the healthy life expectancy of older adults in China and its gender disparities across different health indicators, in order to provide insights for enhancing the health status and subjective well-being of the older population. METHOD: We conducted a cohort analysis using four waves of weighted samples (2008, 2011, 2014, and 2018) from the Chinese Longitudinal Healthy Longevity Survey, encompassing 15,507 respondents aged 65-99. Physical and subjective health were assessed through activity of daily living (ADL) and self-rated health (SRH), respectively. Utilizing loneliness status as a time-variant variable, we employed the multi-state interpolated Markov Chain to explore the associations between loneliness and age-specific life expectancy (LE), healthy life expectancy (HLE), and the proportion of healthy life expectancy in life expectancy (HLE/LE). RESULTS: Compared to the non-lonely population, both LE and HLE were lower among lonely individuals. Regarding gender differences, the HLE/LE for females in the lonely population was consistently lower than that for males. The impact of loneliness on the health of older adults varied by measurement indicators and gender. Specifically, based on ADL results, the decline in HLE/LE was greater for females, with a decline of 53.6% for lonely females compared to 51.7% for non-lonely females between the ages of 65 and 99. For males, the decline was 51.4% for lonely males and 51.5% for non-lonely males. According to SRH, the gender difference in the decline of HLE/LE due to loneliness was less apparent. For males, the change in HLE/LE for non-lonely individuals was 3.4%, compared to 4.2% for lonely individuals, whereas for females, the change was 3.7% for non-lonely individuals and 4.4% for lonely individuals. CONCLUSION: Loneliness exerts varied effects on health across different measurement indicators and gender demographics. Targeted health promotion interventions are imperative to mitigate these negative impacts, particularly emphasizing the enhancement of subjective well-being and physical functioning, especially among older adult females.


Assuntos
Expectativa de Vida , Solidão , Humanos , Solidão/psicologia , Masculino , Feminino , China/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Longitudinais , Atividades Cotidianas/psicologia , Disparidades nos Níveis de Saúde , Fatores Sexuais
5.
Codas ; 36(4): e20220319, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38836826

RESUMO

PURPOSE: To analyze the correlation between swallowing, language and cognition performance and describe the sociodemographic data of elderly people without previous neurological disorders. METHODS: Analytical cross-sectional study, with non-probabilistic sample for convenience and data collection by telecall. The aspiration screening test (Yale Swallow Protocol) was used to identify and exclude elderly people at risk of aspiration. Then, sociodemographic data were collected, and instruments were applied: activity of daily living (IADLs), risk of dysphagia (EAT-10), cognitive screening (Mini Mental State Examination - MMSE) and language (Montreal-Toulouse Language Battery - MTL-Brazil). RESULTS: The sample consisted of 32 elderly people from the Federal District, with a mean age of 69.00±7.73 years and schooling of 10.00±5.60 years. The scores on the EAT-10, MMSE and MTL Battery instruments were altered in four, 22 and 26 elderly, respectively, indicating, in this case, risk of dysphagia, suggestion of cognitive alteration and language alteration. Regarding food, of the total sample, 13 seniors (40%) complained of needing modified food, as well as 10 of these also obtained MMSE scores suggestive of cognitive alteration. When comparing the groups with and without complaints and/or risk of dysphagia, there was no statistically significant difference in relation to sociodemographic, cognitive and language variables. Binary logistic regression models also showed no statistically significant results. CONCLUSION: The present study, when correlating the swallowing, language and cognition findings, did not obtain statistically significant results. It was observed that the elderly with swallowing complaints also showed results suggestive of cognitive and language changes in the tests performed, but there was no statistically significant difference in relation to the elderly without complaints or swallowing changes.


OBJETIVO: Analisar a correlação entre o desempenho de deglutição, linguagem e cognição e descrever os dados sociodemográficos de idosos sem alterações neurológicas prévias. MÉTODO: Estudo transversal analítico, com amostra não-probabilística por conveniência e coleta de dados por telechamada. Foi aplicado o teste de triagem de broncoaspiração (Yale Swallow Protocol) para identificação e exclusão dos idosos com risco de broncoaspiração. Em seguida, realizou-se coleta de dados sociodemográficos e aplicação dos instrumentos de: atividade de vida diária (AIVDs), risco de disfagia (EAT-10), rastreio cognitivo (Mini Exame do Estado Mental ­ MEEM) e linguagem (Bateria Montreal-Toulouse de Linguagem ­ MTL-Brasil). RESULTADOS: A amostra foi composta por 32 idosos do Distrito Federal, com média de idade de 69,00±7,73 anos e de escolaridade de 10,00±5,60 anos. Os escores nos instrumentos EAT-10, MEEM e Bateria MTL apresentaram-se alterados em quatro, 22 e 26 idosos, respectivamente, indicando, nesse caso, risco de disfagia, sugestão de alteração cognitiva e alteração da linguagem. Sobre a alimentação, do total da amostra, 13 idosos (40%) apresentaram queixa de necessidade de comida modificada, bem como 10 desses também obtiveram escore no MEEM sugestivo de alteração cognitiva. Ao comparar os grupos com e sem queixa e/ou risco de disfagia, não houve diferença estatisticamente significante em relação às variáveis sociodemográficas, cognitivas e de linguagem. Os modelos de regressão logística binária também evidenciaram resultados sem significância estatística. CONCLUSÃO: O presente estudo, ao correlacionar os achados de deglutição, linguagem e cognição, não obteve resultados estatisticamente significantes. Observou-se que os idosos com queixa de deglutição também apresentaram resultados sugestivos de alteração cognitiva e de linguagem nos testes realizados, mas não houve diferença estatisticamente significante em relação aos idosos sem queixa ou alteração de deglutição.


Assuntos
Cognição , Transtornos de Deglutição , Fatores Socioeconômicos , Humanos , Estudos Transversais , Idoso , Feminino , Masculino , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/fisiopatologia , Cognição/fisiologia , Brasil , Deglutição/fisiologia , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Idioma , Atividades Cotidianas , Testes de Estado Mental e Demência , Avaliação Geriátrica/métodos , Testes Neuropsicológicos
6.
Nihon Ronen Igakkai Zasshi ; 61(2): 145-154, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-38839313

RESUMO

OBJECTIVE: To examine the relationship between difficulties experienced by family in supporting elderly patients with diabetes and these patients' higher-level functions. METHODS: The subjects were outpatients with diabetes ≥65 years old at Ise Red Cross Hospital and their family members. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to assess patients' higher-level functions. The Japanese version of the Diabetes Caregiver Activity and Support Scale (D-CASS-J) was used to measure difficulties experienced by family in supporting elderly patients with diabetes. Using a multiple regression analysis with TMIG-IC scores (instrumental ADL, intellectual activity, and social participation) as the dependent variable and D-CASS-J scores (based on the highest scoring Q1 group among the three quartiles of D-CASS-J scores) as the explanatory variables, standardized regression coefficients (ß) for higher-level functions on the family's perceived support difficulties were calculated. RESULTS: In total, 429 patients (254 male patients and 175 female patients) were included in the analysis. For male patients, the adjusted beta values for TMIG-IC scores in Q2 and Q3 were -0.039 (P=0.649) and -0.352 (P<0.001), respectively, and the adjusted beta values for the instrumental ADL scores were -0.064 (P=0.455), -0.192 (P=0.047), -0.090 (P=0.375), and -0.360 (P=0.002) for the Intellectually Active scores, respectively, and the adjusted beta for social role scores were 0.054 (P=0.581) and -0.261 (P=0.019), respectively. However, there was no association between the patients' higher-level functions and family support difficulties among female patients. CONCLUSIONS: Difficulty experienced by the family in supporting elderly male patients with diabetes is associated with reduced higher-level functioning.


Assuntos
Diabetes Mellitus , Humanos , Masculino , Feminino , Idoso , Diabetes Mellitus/psicologia , Família/psicologia , Atividades Cotidianas , Idoso de 80 Anos ou mais , Cuidadores/psicologia , Apoio Social
7.
Trials ; 25(1): 355, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38835062

RESUMO

INTRODUCTION: About 17-80% stroke survivors experience the deficit of upper limb function, which strongly influences their independence and quality of life. Robot-assisted training and functional electrical stimulation are commonly used interventions in the rehabilitation of hemiplegia upper extremities, while the effect of their combination remains unclear. The aim of this trial is to explore the effect of robot-assisted upper limb training combined with functional electrical stimulation, in terms of neuromuscular rehabilitation, compared with robot-assisted upper limb training alone. METHODS: Individuals (n = 60) with the first onset of stroke (more than 1 week and less than 1 year after stroke onset) will be considered in the recruitment of this single-blinded, three-arm randomized controlled trial. Participants will be allocated into three groups (robot-assisted training combined with functional electrical stimulation group, robot-assisted training group, and conventional rehabilitation therapies group) with a ratio of 1:1:1. All interventions will be executed for 45 min per session, one session per day, 5 sessions per week for 6 weeks. The neuromuscular function of the upper limb (Fugl-Meyer Assessment of upper extremity), ability of daily life (modified Barthel Index), pain (visual analogue scale), and quality of life (EQ-5D-5L) will be assessed at the baseline, at the end of this trial and after 3 months follow-up. Two-way repeated measures analysis of variance will be used to compare the outcomes if the data are normally distributed. Simple effects tests will be used for the further exploration of interaction effects by time and group. Scheirer-Ray-Hare test will be used if the data are not satisfied with normal distribution. DISCUSSION: We expect this three-arm randomized controlled trial to explore the effectiveness of robot-assisted training combined with functional electrical stimulation in improving post-stroke upper limb function compared with robot-assisted training alone. TRIAL REGISTRATION: Effect of upper limb robot on improving upper limb function after stroke, identifier: ChiCTR2300073279. Registered on 5 July 2023.


Assuntos
Terapia por Estimulação Elétrica , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Robótica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Extremidade Superior , Humanos , Reabilitação do Acidente Vascular Cerebral/métodos , Extremidade Superior/inervação , Método Simples-Cego , Terapia por Estimulação Elétrica/métodos , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , Pessoa de Meia-Idade , Resultado do Tratamento , Feminino , Idoso , Masculino , Adulto , Fatores de Tempo , Atividades Cotidianas , Hemiplegia/reabilitação , Hemiplegia/etiologia , Hemiplegia/fisiopatologia , Terapia por Exercício/métodos , Terapia Combinada
8.
BMC Geriatr ; 24(1): 494, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840051

RESUMO

BACKGROUND: Intrinsic capacity (IC) is proposed by the World Health Organization (WHO) to promote healthy aging. Although some studies have examined the factors influencing IC, few studies have comprehensively confirmed lifestyle factors on IC, especially IC impairment patterns. The present study aimed to identify the patterns of IC impairment and explore the lifestyle and other factors associated with different patterns of IC impairment. METHODS: This cross-sectional study was conducted in a Chinese geriatric hospital. IC was evaluated in five domains according to the recommendations of WHO: cognition, locomotion, vitality, sensory and psychological domains. The sociodemographic and health-related characteristics of participants were assessed.The health promoting lifestyle was evaluated using the Health-Promoting Lifestyle Profile-II scale, including nutrition, health responsibility, interpersonal relationships, physical activity, spiritual growth and stress management. We applied latent class analysis to identify IC impairment patterns and compared basic activities of daily living, instrumental activities of daily living, frailty, quality of life and falls among different IC impairment patterns. Multinomial logistic regression analysis was conducted to identify factors influencing the IC impairment patterns. RESULTS: Among 237 participants included, the latent class analysis identified three patterns of IC impairment: 44.7% high IC (Class 1), 31.2% intermediate IC mainly locomotor impairment (Class 2) and 24.1% low IC mainly cognitive impairment (Class 3). Older adults in class 1 had the best function ability and quality of life, while class 3 had the highest levels of disability and frailty, the poorest quality of life and a higher prevalence of falls. Compared with class 1, older adults with advanced age (OR = 22.046, 95%CI:1.735-280.149), osteoporosis (OR = 3.377, 95%CI:1.161-9.825), and lower scores in physical activity (OR = 0.842, 95%CI:0.749-0.945), stress management (OR = 0.762, 95%CI:0.585-0.993) and social support (OR = 0.897, 95%CI:0.833-0.965) were more likely to belong to the class 2. Simultaneously, compared with class 1, older adults with advanced age (OR = 104.435, 95%CI:6.038-1806.410), stroke (OR = 3.877, 95%CI:1.172-12.823) and lower scores in physical activity (OR = 0.784, 95%CI:0.667-0.922) and social support (OR = 0.909, 95%CI:0.828-0.998) were more likely to be class 3. In addition, compared with class 2, older adults with a lower score in nutrition (OR = 0.764, 95%CI:0.615-0.950) were more likely to belong to the class 3. CONCLUSIONS: This study provides evidence that there are heterogeneous IC impairment patterns in older adults and identifies various associated factors in each pattern, including age, stroke, osteoporosis, social support and lifestyle behaviors such as nutrition, physical activity and stress management. It informs stakeholders on which modifiable factors should be targeted through public health policy or early intervention to promote IC and healthy aging in older adults.


Assuntos
Atividades Cotidianas , Análise de Classes Latentes , Humanos , Masculino , Feminino , Estudos Transversais , Idoso , Idoso de 80 Anos ou mais , Avaliação Geriátrica/métodos , Hospitalização , China/epidemiologia , Qualidade de Vida/psicologia , Estilo de Vida , Fragilidade/epidemiologia , Fragilidade/diagnóstico , Fragilidade/psicologia
9.
BMC Geriatr ; 24(1): 492, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840066

RESUMO

BACKGROUND: There is limited understanding regarding prospective associations of insomnia symptoms and trajectories with functional disability. We aimed to investigate the associations of insomnia symptoms and trajectories with functional disability. METHOD: A total of 13 197 participants were eligible from the Health and Retirement Study. Insomnia symptoms included non-restorative sleep, difficulty initiating sleep, early morning awakening, and difficulty maintaining sleep. We also identified four distinct trajectories of insomnia symptoms: low, decreasing, increasing, and high insomnia symptoms. Functional status was assessed through activities of daily living (ADL) and instrumental activities of daily living (IADL). RESULTS: Participants experiencing one (HR, 1.21; 95% CI, 1.13-1.29), two (HR, 1.43; 95% CI, 1.29-1.57), or three to four (HR, 1.41; 95% CI, 1.25-1.60) insomnia symptoms had a higher risk of ADL disability than asymptomatic respondents. Similarly, participants with one or more insomnia symptoms had a higher risk of IADL disability. Furthermore, using the trajectory with low insomnia symptoms as the reference, decreasing insomnia symptoms (HR, 1.22; 95% CI, 1.12-1.34), increasing insomnia symptoms (HR, 1.21; 95% CI, 1.05-1.41), and high insomnia symptoms (HR, 1.36; 95% CI, 1.18-1.56) were all associated with an increased risk of ADL disability. CONCLUSION: Both a single measurement and dynamic trajectory of insomnia symptoms are associated with the onset of ADL disability. Increased awareness and management of insomnia symptoms may contribute to the prevention of functional disability occurrence.


Assuntos
Atividades Cotidianas , Distúrbios do Início e da Manutenção do Sono , Humanos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Feminino , Masculino , Estudos Prospectivos , Idoso , Pessoa de Meia-Idade , Pessoas com Deficiência , Estudos de Coortes , Avaliação da Deficiência , Fatores de Risco
10.
JMIR Aging ; 7: e50107, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38848116

RESUMO

BACKGROUND: Assistive technologies can help people living with dementia maintain their everyday activities. Nevertheless, there is a gap between the potential and use of these materials. Involving future users may help close this gap, but the impact on people with dementia is unclear. OBJECTIVE: We aimed to determine if user-centered development of smartwatch-based interventions together with people with dementia is feasible. In addition, we evaluated the extent to which user feedback is plausible and therefore helpful for technological improvements. METHODS: We examined the interactions between smartwatches and people with dementia or people with mild cognitive impairment. All participants were prompted to complete 2 tasks (drinking water and a specific cognitive task). Prompts were triggered using a smartphone as a remote control and were repeated up to 3 times if participants failed to complete a task. Overall, 50% (20/40) of the participants received regular prompts, and 50% (20/40) received intensive audiovisual prompts to perform everyday tasks. Participants' reactions were observed remotely via cameras. User feedback was captured via questionnaires, which included topics like usability, design, usefulness, and concerns. The internal consistency of the subscales was calculated. Plausibility was also checked using qualitative approaches. RESULTS: Participants noted their preferences for particular functions and improvements. Patients struggled with rating using the Likert scale; therefore, we assisted them with completing the questionnaire. Usability (mean 78 out of 100, SD 15.22) and usefulness (mean 9 out of 12) were rated high. The smartwatch design was appealing to most participants (31/40, 76%). Only a few participants (6/40, 15%) were concerned about using the watch. Better usability was associated with better cognition. The observed success and self-rated task comprehension were in agreement for most participants (32/40, 80%). In different qualitative analyses, participants' responses were, in most cases, plausible. Only 8% (3/40) of the participants were completely unaware of their irregular task performance. CONCLUSIONS: People with dementia can have positive experiences with smartwatches. Most people with dementia provided valuable information. Developing assistive technologies together with people with dementia can help to prioritize the future development of functional and nonfunctional features.


Assuntos
Demência , Tecnologia Assistiva , Smartphone , Design Centrado no Usuário , Humanos , Demência/psicologia , Demência/terapia , Demência/reabilitação , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Inquéritos e Questionários , Atividades Cotidianas/psicologia , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/reabilitação , Disfunção Cognitiva/terapia , Pessoa de Meia-Idade , Aplicativos Móveis
11.
J Rehabil Med ; 56: jrm40026, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38850055

RESUMO

OBJECTIVE: To determine the physical strain of walking and assess its relationship with daily steps and intensity of daily activity in people with neuromuscular diseases. DESIGN: Cross-sectional study. SUBJECTS/PATIENTS: Sixty-one adults with neuromuscular diseases. METHODS: Physical strain of walking, defined as oxygen consumption during comfortable walking relative to peak oxygen uptake. Daily step count and daily time spent in moderate and vigorous physical activity were assessed using accelerometry and heart rate measurements, respectively. Regression analyses assessed the relationships between log daily step count and log daily time spent in moderate and vigorous physical activity, and physical strain of walking. RESULTS: The mean (standard deviation) physical strain of walking was 73 (20)% Log daily step count and physical strain were negatively associated (ß = -0.47). No association was found with log daily time spent in moderate and vigorous physical activity. CONCLUSIONS: The highly increased physical strain of comfortable walking indicates that walking is very demanding for people with neuromuscular diseases and is associated with a reduction in daily step activity. The absence of a relationship between intensity of activities and physical strain indicates that, despite a reduction in daily step activity, strenuous daily activities may still be performed.


Assuntos
Acelerometria , Atividades Cotidianas , Doenças Neuromusculares , Consumo de Oxigênio , Caminhada , Humanos , Doenças Neuromusculares/reabilitação , Doenças Neuromusculares/fisiopatologia , Caminhada/fisiologia , Estudos Transversais , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Consumo de Oxigênio/fisiologia , Frequência Cardíaca/fisiologia , Idoso , Exercício Físico/fisiologia
12.
J Clin Apher ; 39(3): e22129, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38850074

RESUMO

INTRODUCTION: Plasma exchange (PE) is considered a Category II option for the treatment of acute attacks and relapse cases of neuromyelitis optica spectrum disorder (NMOSD). However, neurologists are also considering intravenous immunoglobulins (IVIg) as an add-on therapy for this disorder. AIMS: The aim of this study is to evaluate the efficacy of PE in acute attacks of NMOSD when compared with IVIg, in terms of improvement in the Expanded disability status scale (EDSS) and activities of daily living (ADL) scale score and levels of anti-Aquaporin P4 (AQP4) antibody in seropositive patients. METHODS: We enrolled 43 NMOSD patients in two groups: Group 1 (n = 29) received steroids and PE, and Group 2 (n = 14) received steroids with IVIg. The baseline EDSS and ADL scores were recorded and compared with scores at the end of therapy, 4 weeks, and 3 months after. Also, anti-AQP4 antibody was measured at baseline and post-therapy in seropositive patients of both groups. RESULTS: We observed a significant difference in EDSS (p = 0.00) and ADL score (p = 0.00) at day 10 and 3 months in both groups. However, no significant difference in EDSS, as well as ADL score from baseline (p = 0.83; p = 0.25) to 3 months (p = 0.85; p = 0.19), was observed when delta change of score at 3 months was compared across the two groups (p = 0.39; p = 0.52). We observed improved visual acuity in both groups with mild improvement in findings of magnetic resonance imaging at 3 months. We observed a significant decline in AQP4 antibody concentration (at day 10) in group 1 seropositive patients (p = 0.013) with improved EDSS (p = 0.027) and ADL scores (p = 0.026) of these patients. CONCLUSIONS: PE should be considered as a choice of an add-on therapy in anti-AQP4 antibody-positive NMOSD patients compared with IVIg as it is more effective in reducing antibody concentrations.


Assuntos
Aquaporina 4 , Imunoglobulinas Intravenosas , Neuromielite Óptica , Troca Plasmática , Humanos , Neuromielite Óptica/terapia , Imunoglobulinas Intravenosas/uso terapêutico , Imunoglobulinas Intravenosas/administração & dosagem , Troca Plasmática/métodos , Feminino , Adulto , Masculino , Aquaporina 4/imunologia , Pessoa de Meia-Idade , Atividades Cotidianas , Resultado do Tratamento , Autoanticorpos/sangue
13.
Arq Neuropsiquiatr ; 82(5): 1-8, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38857888

RESUMO

BACKGROUND: The Activities of Daily Living Questionnaire (ADLQ) focuses on assessing the ability to perform activities of daily living (ADLs) based on the self-perception of individuals with Parkinson's disease (PD). A Brazilian Portuguese version of the questionnaire is available (ADLQ-Brazil), and further investigation is needed to fully assess its measurement properties. OBJECTIVE: To investigate construct and concurrent validity of the telephone-based administration of the ADLQ-Brazil with community individuals with PD. METHODS: There were 50 adults with PD (mean age: 68 ± 9.5 years) invited to answer the ADLQ-Brazil on two randomized occasions, face-to-face and by telephone, 7 to 10 days apart. Clinical-based measures including the Movement Disorder Society-Sponsored Revision of the Unified Parkinson Disease Rating Scale, Timed Up and Go Test, Nine Hole Peg Test, Mini-Balance Evaluation Systems Test, Apathy Scale, Beck Depression Inventory, Modified Fatigue Impact Scale, and Parkinson Disease Quality of Life Questionnaire were applied during the first session, to establish construct validity. RESULTS: The total scores on the ADLQ-Brazil were significantly associated with the clinical-based measures, thus providing evidence of construct validity. No significant differences were observed between the mean scores obtained with the face-to-face and telephone-based administration of the questionnaire (95%CI = 0.997). A high level of agreement was found in the total scores obtained between both applications of the ADLQ-Brazil (95%CI = 0.994-0.998), and most of the individual items had, on average, moderate agreement. CONCLUSION: The findings provide psychometric support for the ADLQ-Brazil as a telephone interview to assess the performance of ADLs in individuals with PD.


ANTECEDENTES: O Questionário de Atividades da Vida Diária (Activities of Daily Living Questionnaire, ADLQ, em inglês) tem como foco avaliar a capacidade de realizar atividades da vida diária (AVDs) com base na autopercepção de indivíduos com doença de Parkinson (DP). Uma versão do questionário em português do Brasil está disponível (ADLQ-Brasil), sendo necessárias mais investigações para avaliar suas propriedades de medidas. OBJETIVO: Investigar as validades de construto e concorrente da aplicação por telefone do ADLQ-Brasil com indivíduos da comunidade com DP. MéTODOS: Foram 50 adultos com DP (média de idade: 68 ± 9,5 anos) convidados a responder o ADLQ-Brasil em duas ocasiões aleatórias, presencialmente e por telefone, com intervalo de 7 a 10 dias. Instrumentos clínicos incluindo a Escala Unificada de Avaliação da Doença de Parkinson, o teste Timed Up and Go, o teste Nine Hole Peg, a versão reduzida do teste de equilíbrio Mini-Balance Evaluation Systems, a Escala de Apatia, o Inventário de Depressão de Beck, a Escala de Impacto de Fadiga Modificada e o Questionário de Qualidade de Vida na Doença de Parkinson foram aplicados na primeira sessão para estabelecer a validade de construto. RESULTADOS: Os escores totais do ADLQ-Brasil foram significativamente associados às medidas clínicas, fornecendo, assim, evidências de validade de construto. Não foram observadas diferenças significativas entre as pontuações médias obtidas entre a aplicação presencial e por telefone do questionário (IC95% = 0,997). Foi encontrado alto nível de concordância entre os escores totais do ADLQ-Brasil obtidos nas duas aplicações (IC95% = 0,994­0,998) e a maioria dos itens individuais apresentou, em média, concordância moderada. CONCLUSãO: Os achados fornecem suporte psicométrico para o ADLQ-Brasil como entrevista telefônica para avaliação do desempenho de AVDs em indivíduos com DP.


Assuntos
Atividades Cotidianas , Doença de Parkinson , Telefone , Humanos , Doença de Parkinson/psicologia , Doença de Parkinson/fisiopatologia , Masculino , Idoso , Feminino , Inquéritos e Questionários/normas , Pessoa de Meia-Idade , Brasil , Reprodutibilidade dos Testes , Qualidade de Vida , Psicometria , Idoso de 80 Anos ou mais , Índice de Gravidade de Doença
14.
Front Public Health ; 12: 1358106, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38859896

RESUMO

Objective: To analyse whether the accumulation of early adverse experiences among individuals of different generations has an impact on disabilities and evaluate the cumulative effects of disadvantages in rural older adults in China. Methods: A Binary Logit Model was used to analyse the life course effects of the disability dilemma among rural older adults. Results: Regarding Activities of Daily Life (ADLs), there was no significant difference between older adults that experienced 1 adverse events and the control group. The probability of older adults experiencing difficulties in 2, 3, 4, or more types of ADLs was 1.486 times, 2.173 times, and 3.048 times higher than that of the control group, respectively. Regarding Instrumental Activities of Daily Life (IADLs), there was no significant difference between the population that experienced 1 or 2 adverse events and the control group. The probability of experiencing difficulties in 3, 4, or more types of IADLs was 1.527 times and 1.937 times higher than that of the control group, respectively. Early adverse events had a cumulative disadvantageous effect on disability in older adults. The longer the duration of adverse experiences, the higher the risk of disability in old age. Education had a significant mitigating effect on health risks. Conclusion: Pay attention to early factors in the life course, strengthen the promotion of health prevention concepts, and pay attention to the moderating and relieving effects of education on health. We should also gradually improve the rural disability care system and family health security capabilities in China's rural areas.


Assuntos
Atividades Cotidianas , Pessoas com Deficiência , População Rural , Humanos , China , Idoso , População Rural/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Masculino , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade
15.
Am J Occup Ther ; 78(4)2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38861552

RESUMO

IMPORTANCE: Veterans receiving inpatient psychiatric services with limitations in activities of daily living (ADLs) benefit from occupational therapy, yet disparities in access are unknown. OBJECTIVE: To investigate whether ADL limitations, an indicator of occupational therapy need, was associated with inpatient psychiatric occupational therapy utilization in the Veterans Health Administration (VHA) and whether this relationship differs by facility characteristics. DESIGN: Secondary analysis of VHA data. Modified Poisson regression modeled occupational therapy utilization as a function of ADL limitations, facility characteristics, and covariates. Interactions estimated whether the relationship between ADL limitations and occupational therapy utilization differed across facility characteristics. SETTING: VHA inpatient psychiatric setting. PARTICIPANTS: Veterans receiving VHA inpatient psychiatric care from 2015 to 2020 (N = 133,844). OUTCOMES AND MEASURES: Occupational therapy utilization. RESULTS: Veterans with ADL limitations were more likely to receive occupational therapy. Veterans receiving care in facilities with higher complexity and greater inpatient psychiatric care quality were more likely to receive occupational therapy. Additionally, Black veterans were less likely to receive occupational therapy relative to their White, non-Hispanic counterparts. Interactions indicated that the extent to which ADL limitations drove access to occupational therapy utilization was weaker within facilities with higher complexity and care quality. CONCLUSIONS AND RELEVANCE: Veterans with ADL limitations were more likely to access inpatient psychiatric occupational therapy, suggesting that such services are generally allocated to veterans in need. However, findings indicate disparities in access across patient-level (e.g., Black race) and facility-level (e.g., facility complexity) factors, informing efforts to eliminate barriers to accessing these valuable services. Plain-Language Summary: This is the first study, to our knowledge, to examine disparities in access to inpatient psychiatric occupational therapy in the Veterans Health Administration (VHA). The study findings show that access to inpatient psychiatric occupational therapy is partly driven by the needs of the patient. However, nonclinical factors, such as a patient's race and the characteristics of the facility at which they receive care (complexity, number of psychiatric beds available, and the quality of psychiatric care), are also important drivers of access. Identifying factors influencing access to these valuable services is the first step in developing strategies that reduce barriers to access for veterans in need.


Assuntos
Atividades Cotidianas , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Terapia Ocupacional , United States Department of Veterans Affairs , Humanos , Estados Unidos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Veteranos , Pacientes Internados , Transtornos Mentais/reabilitação , Idoso , Serviços de Saúde Mental/estatística & dados numéricos
16.
Acta Ortop Mex ; 38(3): 197-201, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38862151

RESUMO

INTRODUCTION: severe, rigid hip abduction deformity in individuals with cerebral palsy (CP) is an exceptionally uncommon condition. This posture hinders the positioning in the wheelchair and the completion of basic activities of daily living (ADL). Addressing such severe deformities can be quite challenging. MATERIAL AND METHODS: a 14-year-old male, with spastic-dystonic quadriplegic CP, developed rigid and severe flexion-abduction contractures in both hips, characterized by 90 degrees of flexion and 100 degrees of abduction. These contractures severely impeded his ability to comfortably use a wheelchair and even pass through doorways. Performing basic ADLs became a significant challenge for both the patient and his caregivers. RESULTS: the treatment approach involved a two-stage surgical procedure, one for each hip, with a two-month interval between them. An extensive release of the fascia latae, gluteus maximus, external rotators, and hip flexors; in combination with a proximal femur osteotomy were performed. To maintain the corrections achieved, long-leg casts connected with two bars were employed, followed by orthotic support and physiotherapy. Following the procedure, lower limb adduction was achieved, and the patient and caregivers were highly satisfied, as ADLs and basic caregiving had been greatly facilitated. CONCLUSIONS: while the available literature on the management of severe rigid abduction hip contractures in non-ambulatory CP patients is limited, and treatment options are often complex, the present case underscores the effectiveness of a comprehensive approach involving soft tissue release and bone surgery. Achieving a more favorable wheelchair positioning and facilitating basic ADLs and care represents a significant success for patients and families.


INTRODUCCIÓN: la deformidad severa y rígida en abducción de cadera en individuos con parálisis cerebral (PC) es una condición infrecuente. Esta postura dificulta el posicionamiento en la silla de ruedas y la realización de actividades básicas de la vida diaria (AVD). El tratamiento de estas deformidades tan severas puede ser todo un reto. MATERIAL Y MÉTODOS: varón de 14 años, con PC tetrapléjica espástica-distónica, que desarrolló contracturas rígidas y severas de flexión-abducción en ambas caderas, caracterizadas por 90 grados de flexión y 100 grados de abducción. Estas contracturas impedían gravemente su capacidad para utilizar cómodamente una silla de ruedas e incluso pasar por las puertas. La realización de actividades básicas de la vida diaria se convirtió en un reto importante tanto para el paciente como para sus cuidadores. RESULTADOS: el tratamiento consistió en una intervención quirúrgica en dos fases, una para cada cadera, con un intervalo de dos meses entre ellas. Se realizó una amplia liberación de la fascia lata, el glúteo mayor, los rotadores externos y los flexores de la cadera; en combinación con una osteotomía proximal del fémur. Para mantener las correcciones conseguidas, se emplearon escayolas de pierna larga conectadas con dos barras, seguidas de soporte ortésico y fisioterapia. Tras la intervención, se consiguió la aducción de los miembros inferiores y el paciente y los cuidadores se mostraron muy satisfechos, ya que se habían facilitado en gran medida las AVD y los cuidados básicos. CONCLUSIONES: aunque la bibliografía disponible sobre el tratamiento de las contracturas rígidas graves de la cadera en abducción en pacientes no deambulantes con PC es limitada, y las opciones de tratamiento suelen ser complejas, el presente caso subraya la eficacia de un enfoque integral que incluye la liberación de los tejidos blandos y la cirugía ósea. Conseguir una posición más favorable en la silla de ruedas y facilitar las AVD básicas y los cuidados representa un éxito significativo para los pacientes y sus familias.


Assuntos
Paralisia Cerebral , Contratura de Quadril , Humanos , Paralisia Cerebral/complicações , Masculino , Adolescente , Contratura de Quadril/etiologia , Contratura de Quadril/cirurgia , Índice de Gravidade de Doença , Atividades Cotidianas , Contratura/cirurgia , Contratura/etiologia
17.
Support Care Cancer ; 32(7): 419, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38850341

RESUMO

PURPOSE: In current clinical practice, recommendations regarding restrictions in daily life for children with cancer are often lacking or not evidence-based. Critically reviewing the evidence and formulating recommendations are therefore of great importance as social restrictions (e.g., swimming, school attendance, sports) can impair the quality of life of these children severely. Therefore, our aim was to develop a clinical practice guideline for clinicians, children, and their parents regarding social restrictions in children with cancer. METHODS: A comprehensive multidisciplinary panel was assembled, comprising 21 professionals and patient representatives. A systematic literature review was performed, including dual appraisal of all citations. The GRADE methodology was used to extract, summarize, and assess the evidence. Multiple in-person meetings were held to rank outcomes, discuss evidence, complete evidence-to-decision frameworks, and formulate recommendations. Final recommendations were unanimously supported by all panel members. RESULTS: Six studies, including 758 children, formed the evidence base for the recommendations. Given the scarcity of the available evidence and various designs of studies in children with cancer, additional evidence was extracted from adult oncology guidelines, and shared expert opinions were utilized. In total, 14 recommendations were formulated of which multiple result in changes in current policy and standard of practice in the Netherlands. Topics covered in this guideline are swimming, having pets, visiting the zoo or farm, performing sports or high-velocity events, attending school or kindergarten, and use of public transport. This guideline is not intended to provide recommendations for patients after end of treatment, for palliative care settings, or for children undergoing a stem cell transplantation. CONCLUSIONS: In this clinical practice guideline, we provide recommendations regarding restrictions in daily life in children with cancer. These include evidence-based recommendations and, in the absence of sufficient evidence, recommendations based on expert evidence. With these recommendations, we provide guidance for clinicians, children, and parents and contribute to improving quality of life for children with cancer.


Assuntos
Neoplasias , Qualidade de Vida , Humanos , Criança , Neoplasias/terapia , Atividades Cotidianas , Países Baixos
18.
Age Ageing ; 53(6)2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38851214

RESUMO

BACKGROUND: This review provides an overview of the psychometric properties of the short physical performance battery (SPPB), timed up and go test (TUG), 4 m gait speed test (4 m GST) and the 400 m walk test (400 m WT) in community-dwelling older adults. METHODS: A systematic search was conducted in MEDLINE, CINAHL and EMBASE, resulting in the inclusion of 50 studies with data from in total 19,266 participants (mean age 63.2-84.3). Data were extracted and properties were given a sufficient or insufficient overall rating following the COSMIN guideline for systematic reviews of patient-reported outcome measures. Quality of evidence (QoE) was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: The SPPB was evaluated in 12 studies, TUG in 30, 4 m GST in 12 and 400 m WT in 2. Reliability of the SPPB, TUG and 4 m GST was rated sufficient (moderate to good QoE). The measurement error of the SPPB was rated insufficient (low QoE). Criterion validity for the SPPB was insufficient in indicating sarcopenia (moderate QoE), while the TUG was sufficient and insufficient for determining mobility limitations (low QoE) and activities of daily living disability (low QoE), respectively. Construct validity of the SPPB, TUG, 4 m GST and 400 m WT was rated insufficient in many constructs (moderate to high QoE). Responsiveness was rated as insufficient for SPPB (high QoE) and TUG (very low QoE), while 4 m GST was rated as sufficient (high QoE). CONCLUSION: Overall, the psychometric quality of commonly used physical performance tests in community-dwelling older adults was generally rated insufficient, except for reliability. These tests are widely used in daily practice and recommended in guidelines; however, users should be cautious when drawing conclusions such as sarcopenia severity and change in physical performance due to limited psychometric quality of the recommended measurement instruments. There is a need for a disease-specific physical performance test for people with sarcopenia.This research received no specific grant from any funding agency and was registered a priori using the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022359725).


Assuntos
Avaliação Geriátrica , Vida Independente , Desempenho Físico Funcional , Psicometria , Sarcopenia , Humanos , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Idoso , Avaliação Geriátrica/métodos , Reprodutibilidade dos Testes , Idoso de 80 Anos ou mais , Masculino , Feminino , Pessoa de Meia-Idade , Atividades Cotidianas , Teste de Caminhada , Avaliação da Deficiência , Valor Preditivo dos Testes
19.
BMC Public Health ; 24(1): 1549, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851706

RESUMO

INTRODUCTION: People living with HIV (PLWH) live longer and face new health challenges resulting from the confluence of chronic HIV infection and the natural effect of aging and comorbidities. However, there is a dearth of information on the long-term impact of HIV infection on the health and wellbeing of PLWH in sub-Saharan Africa. This research aimed to fill this gap by reporting on physical, functional and social outcomes among PLWH treated at a referral center in Abidjan, Ivory Coast, and comparing them with those of a control group. METHODS: Body composition, functional capacity, sarcopenia, limitations in daily activities and social participation were assessed among 300 PLWH (aged ≥ 30 years) and 200 uninfected adults of similar age and sex. The associations between these outcomes and participants' socioeconomic characteristics, HIV history and physical activity level were assessed using generalized additive models adjusted for age and sex. RESULTS: The median age was 51 years, and the median antiretroviral therapy duration was 15 years. Compared to controls, PLWH reported higher levels of physical activity (p < 0.0001). They had a lower muscle index (adjusted p < 0.0001) and grip strength (adjusted p < 0.0001) but achieved similar performance on the 6-min walk test (6MWT, p = 0.2). Among PLWH, physical activity level was positively associated with better performance in the 6MWT (p = 0.006) and greater hand grip strength (p = 0.04). The difference in physical performance according to the level of physical activity appeared mainly after the age of 60. PLWH reported similar rates of activity limitations (p = 0.8), lower depression levels and greater scores for social functioning (p = 0.02). CONCLUSION: In this study, PLWH achieved high levels of physical activity, which may explain why they maintained good physical performance and social functioning despite having a higher risk of sarcopenia. These results have important implications for resource-limited health systems and show avenues for chronic care models. TRIAL REGISTRATION: This study was registered on the ClinicalTrials.gov website (NCT05199831, first registration the 20/01/2022).


Assuntos
Exercício Físico , Infecções por HIV , Humanos , Masculino , Feminino , Infecções por HIV/epidemiologia , Pessoa de Meia-Idade , Côte d'Ivoire/epidemiologia , Estudos Transversais , Atividades Cotidianas , Adulto , Idoso , Estilo de Vida , Sarcopenia/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Composição Corporal , Participação Social
20.
BMC Musculoskelet Disord ; 25(1): 460, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862936

RESUMO

BACKGROUND: Sit-to-stand (STS) is one of the most commonly performed functional movements in a child's daily life that enables the child to perform functional activities such as independent transfer and to initiate walking and self-care. Children with cerebral palsy (CP) often have reduced STS ability. The aim of this study was to describe STS performance in a national based total population of children with CP and its association with age, sex, Gross Motor Function Classification System (GMFCS) level, and CP subtype. METHODS: This cross-sectional study included 4,250 children (2,503 boys, 1,747 girls) aged 1-18 years from the Swedish Cerebral Palsy Follow-Up Program (CPUP). STS performance was classified depending on the independence or need for support into "without support," "with support," or "unable." "With support" included external support from, e.g., walls and furniture. Physical assistance from another person was classified as "unable" (dependent). Ordinal and binary logistic regression analyses were used to identify associations between STS and age, GMFCS level, and CP subtype. RESULTS: 60% of the children performed STS without support, 14% performed STS with support, and 26% were unable or needed assistance from another person. STS performance was strongly associated with GMFCS level and differed with age and subtype (p < 0.001). For all GMFCS levels, STS performance was lowest at age 1-3 years. Most children with GMFCS level I (99%) or II (88%) performed STS without support at the age of 4-6 years. In children with GMFCS level III or IV, the prevalence of independent STS performance improved throughout childhood. CP subtype was not associated with STS performance across all GMFCS levels when adjusted for age. CONCLUSIONS: Independent STS performance in children with CP is associated with GMFCS level and age. Children with CP acquire STS ability later than their peers normally do. The proportion of children with independent STS performance increased throughout childhood, also for children with GMFCS level III or IV. These findings suggest the importance of maintaining a focus on STS performance within physiotherapy strategies and interventions for children with CP, including those with higher GMFCS level.


Assuntos
Paralisia Cerebral , Humanos , Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/epidemiologia , Estudos Transversais , Masculino , Feminino , Criança , Pré-Escolar , Adolescente , Suécia/epidemiologia , Lactente , Postura Sentada , Posição Ortostática , Destreza Motora/fisiologia , Atividades Cotidianas
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