Activity Limitations and Participation Restrictions in People With Upper Extremity Peripheral Nerve Disorders: Relationships With Quality of Life

2012 ◽  
Vol 25 (4) ◽  
pp. e14
Author(s):  
Vicki Kaskutas ◽  
Ching-Hsien Chung
Author(s):  
Christina Lemhöfer ◽  
Christian Sturm ◽  
Dana Loudovici-Krug ◽  
Norman Best ◽  
Christoph Gutenbrunner

Abstract Background In COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptoms (now called Post-COVID-Syndrome) may have an impact on functioning and may also hinder to participation in social life in affected people. However, little is known about developing such syndrome a for patients with mild and moderate COVID-19 who did not need hospitalization or intensive care. Methods A cross-sectional study in 1027 patients with mild or moderate COVID-19 was performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life, was used. Descriptive statistics were calculated. Results In all, 97.5% of patients reported one symptom in the infection stage, such as fatigue, respiratory problems, limitations of the senses of taste and smell, fear and anxiety and other symptoms. In this time period, 84.1% of the participants experienced activity limitations and participation restrictions such as carrying out daily routines, handling stress, getting household tasks done, caring for/supporting others, and relaxing and leisure concerns. In all, 61.9% of participants reported persisting symptoms more than 3 months after infection. These were fatigue, sleep disturbances, respiratory problems, pain, fear and anxiety, and restrictions in movement; 49% of the participants reported activity limitations and participation restrictions. Predominately, these were handling stress, carrying out daily routines, looking after one’s health, relaxing and leisure activities and doing house work. The impacts on quality of life and vocational performance were rather low. Conclusion The results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not severe and do not lead to frequent or serious issues with quality of life or work ability.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ketki D. Raina ◽  
Jon C. Rittenberger ◽  
Margo B. Holm ◽  
Clifton W. Callaway

Objective. The study aim was to characterize the time-course of recovery in impairments, activity limitations, participation restrictions, disability, and quality of life during the first year after cardiac arrest. Secondarily, the study described the associations between the instruments used to measure each of these domains.Methods. Measures of global disability (Cerebral Performance Category, CPC, Modified Rankin Scale, mRS), quality of life, activity limitations, participation restrictions, and affective and cognitive impairments were administered to 29 participants 1, 6, and 12 months after cardiac arrest.Results. Global measures of disability indicated recovery between one month and one year after cardiac arrest (mean CPC: 2.1 versus 1.69,  P<0.05; mean mRS: 2.55 versus 1.83,P<0.05). While global measures of disability were moderately associated with participation, they were poorly associated with other measures. The cohort endorsed depressive symptomatology throughout the year but did not have detectable cognitive impairment.Conclusions. Recovery from cardiac arrest is multifaceted and recovery continues for months depending upon the measures being used. Measures of global disability, reintegration into the community, and quality of life yield different information. Future clinical trials should include a combination of measures to yield the most complete representation of recovery after cardiac arrest.


2021 ◽  
Author(s):  
Christina Lemhöfer ◽  
Christian Sturm ◽  
Dana Loudovici-Krug ◽  
Norman Best ◽  
Christoph Gutenbrunner

Abstract BackgroundIn COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptom (now called long-COVID) may have an impact on functioning and my hinder affected people to participate in social life. However, little is known if and to what extent patients with mild and moderate COVID-19 who did not need hospitalization or intensive care develop such a syndrome.MethodsA cross-sectional study in 1027 patients with mild or moderate COVID-19 has been performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) that includes Short Form 36 health questionnaire (SF-36) on health-related quality of life, was performed. Descriptive statistics were calculated. Results97.5 % of patients reported one symptom in infection phase such as fatigue, respiratory problems, limitations of the sense of taste and smell, as well as fear and anxiety and other symptoms. In this phase 84.1% of participants experienced activity limitations and participation restrictions such as carrying out daily routine, handling stress, getting household tasks done, care/support for others, and relaxing and leisure.61.9% of participants reported persisting symptoms after more than 3 months after infection. These were among others fatigue, sleep disturbances, respiratory problems pain, fears and anxiety, and restrictions in movement. 49% of the participants reported on activity limitations and participation restrictions. Predominately these were handling stress, carrying out daily routine, looking after one’s health, relaxing and leisure activities as well as doing house work.The impact on quality of life and vocational performance were rather low.ConclusionThe results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not very severe and do not lead to frequent or severe issues with quality of live or work ability.


2021 ◽  
Author(s):  
Yi-chang Chen ◽  
Keh-chung Lin ◽  
Shu-Hui Yeh ◽  
Chih-Hung Wang ◽  
Ay-Woan Pan ◽  
...  

Abstract Background: Joint contractures and degenerative osteoarthritis are the most common joint diseases in the elderly, can lead to limited mobility in the elderly with diseases, can exacerbate symptoms, such as pain, stiffness and disability, and can interfere with social participation and quality of life, affecting mental health. However, relevant studies on this topic are very limited. The purpose of this study is to investigate the relationship of demographic characteristics and joint contracture categories and sites with the quality of life, activity limitations, and participation restrictions of elderly residents in long-term care facilities.Methods: A cross-sectional observational study. Elderly individuals with joint contractures who were residents in long-term care facilities were recruited. The World Health Organization (WHO) Quality of Life and the WHO Disability Assessment Schedule 2.0 were used to survey the participants. Correlations, multiple linear regressions, and multiple analyses of variance, with joint contractures as the response variable, were used in the statistical analysis.Results: The final statistical analysis included 232 participants. The explanatory power of contracture sites on activities and participation had a moderate strength of association (η2 = .113). Compared with elderly residents with joint contractures and osteoarthritis in isolated upper limbs, elderly residents with joint contractures and osteoarthritis in both the upper and lower limbs had significantly worse activity and participation limitations. There were no significant differences in activity and participation between elderly residents with joint contractures affecting isolated upper limbs and elderly residents with joint contractures affecting isolated lower limbs (F1,226 = 2.604 and F1,226 =.674, n.s.). Osteoarthritis had the greatest impact on activity limitations and participation restrictions of elderly residents with joint contractures affecting both upper and lower limbs (F1,226 = 6.251, p = .014).Conclusions: Elderly residents in long-term care facilities who are minorities and have non-mainstream religious beliefs, history of stroke and osteoarthritis are at high risk of developing activity limitations and participation restrictions. Moreover, compared with other contractile sites, regardless of osteoarthritis, elderly residents with joint contractures affecting both upper and lower limbs had the most substantial activity limitations and participation restrictions.Trial registration: This study has been registered in the Chinese Clinical Trial Registry, Registration number and date: ChiCTR2000039889


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S77-S77
Author(s):  
Jill M Cancio ◽  
Matthew Borgia ◽  
Leopoldo C Cancio ◽  
Linda Resnik

Abstract Introduction Burns with upper extremity (UE) amputation present a unique rehabilitation challenge. The purpose of this study of UE amputees who are active prosthesis users was to compare outcomes for those with and without burns. Methods This is part of a larger nationwide study of U.S. military members and veterans with UE amputations. In-person data were collected at 5 sites. An therapist measured passive and active range of motion (PROM, AROM); administered the Quick Disability of the Arm, Shoulder, and Hand; Community Reintegration of Injured Service Members-Computer Adaptive-Test; Trinity Amputation and Prosthetic Experience Scale; health-related quality of life (VR-12); Activities Measure for Upper Extremity Amputees; Southampton Assessment Procedure; 9-Hole Peg Test; and Jebsen-Taylor Hand Function Test (JTHF); and recorded residual and phantom pain; timing of prosthesis receipt; and current prosthesis use. The IRB approved this study. Results Data were collected on 126 individuals with UE amputation, of whom 105 had data on etiology and were included. Of these, 13 (12.4%) had burns (B) vs non-burn (NB). The majority were unilateral amputees (69% B, 90% NB). Most were transradial (TR) amputees (B 84.6%, NB 66.3%) as opposed to transhumeral (TH). A minority received their prosthetics within the first 3 months post-amputation (11.1% B, 28.8% NB) (p=0.15). Average age was 57.6 (SD 15.6) years for NB and 53.0 (20.6) years for B. Mean time since amputation was 22.5 (18.0) years for NB and 25.2 (17.3) years for B. The following non-significant differences in outcomes between B and NB were observed. Thirty-nine percent of B were employed full-time vs 18.9% of NB (p=0.15). The primary prosthesis was, for NB, a body-powered prosthesis (66.7%); for B, myoelectric (50%) or body-powered (50%). For unilateral UE amputees, there were no differences between B and NB on performance testing for dexterity and functional tasks or in self-reported disability, quality of life or prevalence or intensity of pain. B trended towards more moderate to severe PROM deficits with shoulder forward flexion (TH B 50%, TH NB 23.1% [p=0.444]; TR B 20%, TR NB 5.6% [p=0.197]) and shoulder abduction (TH B 50%, TH NB 26.9% [p=0.497]; TR B 30%, TR NB 16.4% [p=0.376]). Also, TR amputees with burns trended towards more PROM deficits with elbow flexion (B 20%, NB 6.9% [p=0.212]) and elbow extension (B 20%, NB 8.6% [p=0.272]). AROM deficits also trended greater in B. Conclusions We did not observe differences in physical function, pain levels, or quality of life between those with and without burns. Further studies with larger samples are needed, to include analysis of burn location, burn size, hospital length of stay, and rehabilitation care.


2020 ◽  
Vol 36 (08) ◽  
pp. 606-615
Author(s):  
Halley Darrach ◽  
Pooja S. Yesantharao ◽  
Sarah Persing ◽  
George Kokosis ◽  
Hannah M. Carl ◽  
...  

Abstract Background Postmastectomy secondary lymphedema can cause substantial morbidity. However, few studies have investigated longitudinal quality of life (QoL) outcomes in patients with postmastectomy lymphedema, especially with regard to surgical versus nonoperative management. This study prospectively investigated QoL in surgically versus nonsurgically managed patients with postmastectomy upper extremity lymphedema. Methods This was a longitudinal cohort study of breast cancer-related lymphedema patients at a single institution, between February 2017 and January 2020. Lymphedema Quality of Life Instrument (LyQLI) and RAND-36 QoL instrument were used. Mann–Whitney U and Fisher's exact tests were used for descriptive statistics. Wilcoxon's signed-rank testing and linear modeling were used to analyze longitudinal changes in QoL. Results Thirty-two lymphedema patients were recruited to the study (20 surgical and 12 nonsurgical). Surgical and nonsurgical cohorts did not significantly differ in clinical/demographic characteristics or baseline QoL scores, but at the 12-month time point surgical patients had significantly greater LyQLI overall health scores than nonsurgical patients (79.3 vs. 58.3, p = 0.02), as well as higher composite RAND-36 physical (68.5 vs. 38.3, p = 0.04), and mental (77.0 vs. 52.7, p = 0.02) scores. Furthermore, LyQLI overall health scores significantly improved over time in surgical patients (60.0 at baseline vs. 79.3 at 12 months, p = 0.04). Besides surgical treatment, race, and age were also found to significantly impact QoL on multivariable analysis. Conclusion Our results suggest that when compared with nonoperative management, surgery improved QoL for chronic, secondary upper extremity lymphedema patients within 12-month postoperatively. Our results also suggested that insurance status may have influenced decisions to undergo lymphedema surgery. Further study is needed to investigate the various sociodemographic factors that were also found to impact QoL outcomes in these lymphedema patients.


Hand Surgery ◽  
2006 ◽  
Vol 11 (03) ◽  
pp. 103-107 ◽  
Author(s):  
Izuru Kitajima ◽  
Kazureru Doi ◽  
Yasunori Hattori ◽  
Semih Takka ◽  
Emmanuel Estrella

To evaluate the subjective satisfaction of brachial plexus injury (BPI) patients after surgery based on the medical outcomes study 36-item short form health survey (SF-36) and to correlate their SF-36 scores with upper extremity functions. Four items were assessed statistically for 30 patients: SF-36 scores after BPI surgery were compared with Japanese standard scores; the correlation between SF-36 scores and objective joint functions; difference in SF-36 scores between each type of BPI; and influence of each joint function on the SF-36 scores. The SF-36 subscale: PF — physical functioning, RP — role-physical, BP — bodily pain, and the summary score PCS — physical component summary, were significantly inferior to the Japanese standard scores. SF-36 is more sensitive to shoulder joint function than to elbow and finger joint functions. Little correlation was found between SF-36 scores and objective evaluations of joint functions. Greater effort is needed to improve the quality of life (QOL) of BPI patients. This study showed that SF-36 is not sensitive enough to evaluate regional conditions. A region- or site-specific questionnaire is required to evaluate upper extremity surgery.


2009 ◽  
Vol 34 (9) ◽  
pp. 1682-1688 ◽  
Author(s):  
Ryan Bailey ◽  
Vicki Kaskutas ◽  
Ida Fox ◽  
Carolyn M. Baum ◽  
Susan E. Mackinnon

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