scholarly journals Provision and Perception of Physiotherapy in the Nonoperative Management of Degenerative Cervical Myelopathy (DCM): A Cross-Sectional Questionnaire of People Living With DCM

2020 ◽  
pp. 219256822096135
Author(s):  
Max B. Butler ◽  
Oliver D. Mowforth ◽  
Abdul Badran ◽  
Michelle Starkey ◽  
Timothy Boerger ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Nonoperative Management ◽  
Japanese Orthopaedic Association ◽  
Multivariate Logistic Regression Analysis ◽  
Demographic Characteristics ◽  
Symptom Duration ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
International Guidelines ◽  
Degenerative Cervical Myelopathy

Study Design: Cross-sectional survey. Objectives: Degenerative cervical myelopathy (DCM) is a common syndrome of acquired spinal cord impairment caused by canal stenosis secondary to arthritic changes of the spine. International guidelines consider physiotherapy an option for mild, stable DCM; however, few studies have been conducted on nonoperative management. The objective was to determine current usage and perceptions of nonoperative physiotherapy for DCM. Methods: Persons with DCM were recruited to a web-based survey. Participants with complete responses that had not received surgery were included (n = 167). Variables included symptom duration, treatment history, current disability, and demographic characteristics. Results: Disease and demographic characteristics were equivalent between those who did and did not receive physiotherapy. In all, 19.5% of physiotherapy recipients reported subjective benefit from physiotherapy. Those perceiving benefit had significantly higher mJOA (modified Japanese Orthopaedic Association) scores, lower neck pain scores, and shorter symptom duration. In multivariate logistic regression analysis, those with mild DCM were more likely to perceive benefit than those with severe DCM, as were those with moderate DCM (to a lesser extent). Individuals whose diagnosis was delayed 1 to 2 years were less likely to perceive benefit than those that waited 0 to 6 months. Conclusions: The provision of nonoperative physiotherapy in the management of DCM is inconsistent and appears to differ from international guidelines. Few patients perceived benefit from physiotherapy; however, this was more likely in those with mild DCM and in those with shorter symptom durations. Further work is needed to establish the appropriate role of physiotherapy for this population.

scholarly journals Recovery priorities in degenerative cervical myelopathy: a cross-sectional survey of an international, online community of patients

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031486 ◽  
Author(s):  
Benjamin Davies ◽  
Oliver Mowforth ◽  
Iwan Sadler ◽  
Bizhan Aarabi ◽  
Brian Kwon ◽  
...  
Keyword(s):  
Sexual Function ◽  
Cervical Myelopathy ◽  
Online Survey ◽  
Functional Disability ◽  
Hand Function ◽  
Japanese Orthopaedic Association ◽  
Future Research ◽  
Cross Sectional ◽  
Disease Characteristics ◽  
Degenerative Cervical Myelopathy

ObjectivesTo establish the recovery priorities of individuals suffering with degenerative cervical myelopathy (DCM).DesignA cross-sectional, observational study.SettingPatients from across the world with a diagnosis of DCM accessed the survey over an 18-month period on Myelopathy.org, an international myelopathy charity.Participants481 individuals suffering from DCM completed the online survey fully.Main outcome measuresFunctional recovery domains were established through qualitative interviews and a consensus process. Individuals were asked about their disease characteristics, including limb pain (Visual Analogue Scale) and functional disability (patient-derived version of the modified Japanese Orthopaedic Association score). Individuals ranked recovery domains (arm and hand function, walking, upper body/trunk function, sexual function, elimination of pain, sensation and bladder/bowel function) in order of priority. Priorities were analysed as the modal first priority and mean ranking. The influence of demographics on selection was analysed, with significancep<0.05.ResultsOf 659 survey responses obtained, 481 were complete. Overall, pain was the most popular recovery priority (39.9%) of respondents, followed by walking (20.2%), sensation (11.9%) and arm and hand function (11.5%). Sexual function (5.7%), bladder and bowel (3.7%) and trunk function (3.5%) were chosen less frequently. When considering the average ranking of symptoms, while pain remained the priority (2.6±2.0), this was closely followed by walking (2.9±1.7) and arm/hand function (3.0±1.4). Sensation ranked lower (4.3±2.1). With respect to disease characteristics, overall pain remained the recovery priority, with the exception of patients with greater walking impairment (p<0.005) who prioritised walking, even among patients with lower pain scores.ConclusionsThis is the first study investigating patient priorities in DCM. The patient priorities reported provide an important framework for future research and will help to ensure that it is aligned with patient needs.

scholarly journals Walk and Run Test in Patients with Degenerative Compression of the Cervical Spinal Cord

2021 ◽  
Vol 10 (5) ◽  
pp. 927
Author(s):  
Zdenek Kadanka ◽  
Zdenek Kadanka ◽  
Tomas Skutil ◽  
Eva Vlckova ◽  
Josef Bednarik
Keyword(s):  
Cervical Spinal Cord ◽  
Japanese Orthopaedic Association ◽  
Cord Compression ◽  
Cervical Cord ◽  
Cross Sectional ◽  
Severity Of Disability ◽  
Degree Of Disability ◽  
Degenerative Cervical Myelopathy ◽  
Cardinal Symptoms ◽  
Run Test

Impaired gait is one of the cardinal symptoms of degenerative cervical myelopathy (DCM) and frequently its initial presentation. Quantitative gait analysis is therefore a promising objective tool in the disclosure of early cervical cord impairment in patients with degenerative cervical compression. The aim of this cross-sectional observational cohort study was to verify whether an objective and easily-used walk and run test is capable of detecting early gait impairment in a practical proportion of non-myelopathic degenerative cervical cord compression (NMDCC) patients and of revealing any correlation with severity of disability in DCM. The study group consisted of 45 DCM patients (median age 58 years), 126 NMDCC subjects (59 years), and 100 healthy controls (HC) (55.5 years), all of whom performed a standardized 10-m walk and run test. Walking/running time/velocity, number of steps and cadence of walking/running were recorded; analysis disclosed abnormalities in 66.7% of NMDCC subjects. The DCM group exhibited significantly more pronounced abnormalities in all walk/run parameters when compared with the NMDCC group. These were apparent in 84.4% of the DCM group and correlated closely with disability as quantified by the modified Japanese Orthopaedic Association scale. A standardized 10-m walk/run test has the capacity to disclose locomotion abnormalities in NMDCC subjects who lack other clear myelopathic signs and may provide a means of classifying DCM patients according to their degree of disability.

scholarly journals Change in Functional Impairment, Disability, and Quality of Life Following Operative Treatment for Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 7 (3_suppl) ◽  
pp. 53S-69S ◽  
Author(s):  
Michael G. Fehlings ◽  
Lindsay A. Tetreault ◽  
Shekar Kurpad ◽  
Darrel S. Brodke ◽  
Jefferson R. Wilson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Functional Impairment ◽  
Cervical Myelopathy ◽  
Surgical Intervention ◽  
Japanese Orthopaedic Association ◽  
Duration Of Symptoms ◽  
Degenerative Cervical Myelopathy ◽  
The Impact

Study Design: Systematic review. Objectives: The primary objective of this systematic review was to define the change in impairment, disability, and pain following surgical intervention in patients with degenerative cervical myelopathy (DCM). Secondary objectives included to assess the impact of preoperative disease severity and duration of symptoms on outcomes and to summarize complications associated with surgery. Methods: A systematic literature search was conducted to identify prospective studies evaluating the effectiveness and safety of operative treatment in patients with DCM. Outcomes of interest were functional status, disability, pain, and complications. The quality of each study was evaluated using the Newcastle-Ottawa Scale, and the strength of the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. Results: Of the 385 retrieved citations, 32 met inclusion criteria and are summarized in this review. Based on our results, pooled standard mean differences showed a large effect for improvement in Japanese Orthopaedic Association or modified Japanese Orthopaedic Association score from baseline at short-, medium-, and long-term follow-up: 6 to 12 months (1.92; 95% confidence interval [CI] = 1.41 to 2.43), 13 to 36 months (1.40; 95% CI = 1.12 to 1.67), and ≥36 months (1.92; 95% CI = 1.14 to 2.69) (moderate evidence). Surgery also resulted in significant improvements in Nurick, Neck Disability Index, and Visual Analogue Scale scores (low to very low evidence). The cumulative incidence of complications was low (14.1%; 95% CI = 10.1% to 18.2%). Conclusion: Surgical intervention for DCM results in significant improvements in functional impairment, disability, and pain and is associated with an acceptably low rate of complications.

Willingness and uptake of the COVID-19 testing and vaccination in urban China: an online cross-sectional survey at early 2021 (Preprint)

2021 ◽  
Author(s):  
Suhang Song ◽  
Shujie Zang ◽  
Liubing Gong ◽  
Cuilin Xu ◽  
Leesa Lin ◽  
...  
Keyword(s):  
Online Survey ◽  
Demographic Characteristics ◽  
Urban China ◽  
Low Risk ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Period ◽  
Two Measures ◽  
Higher Educational Attainment ◽  
To Receive

BACKGROUND Regular testing and vaccination are effective measures to mitigate the ongoing COVID-19 pandemic. Few studies have focused on COVID-19 testing and vaccination uptake may change as the pandemic continues. OBJECTIVE To examine willingness and uptake of COVID-19 testing and vaccination during a low-risk period of the COVID-19 pandemic in urban China. METHODS A cross-sectional online survey was conducted among 2244 adults in urban China. Descriptive analyses were performed to compare the respondents’ willingness and uptake of COVID-19 testing and vaccination. Multivariate logistic regressions were fitted to investigate the factors associated with willingness and uptake of the two measures. RESULTS In early 2021, 52.45% of the respondents had received or scheduled a COVID-19 test at least once, and a majority (95.63%) were willing to receive testing. 63.28% of the respondents had received/scheduled or were willing to receive a COVID-19 vaccine. Willingness and uptake of COVID-19 testing were not associated with socio-demographic characteristics, except for occupation. Being of older age, migrants, having higher educational attainment and secure employment were associated with a higher uptake of COVID-19 vaccination among the surveyed respondents, while willingness to vaccinate was consistent across socio-demographic characteristics among those who had not been vaccinated. CONCLUSIONS Chinese adults expressed almost universal willingness of COVID-19 testing and relatively low willingness of COVID-19 vaccination at the low-risk period of the COVID-19 pandemic, independent from their socio-demographic characteristics. Maintaining willingness of COVID-19 vaccination is key especially when the pandemic evolved into a low-risk period.

Workplace bullying: an examination of power and perpetrators

2019 ◽  
Vol 48 (2) ◽  
pp. 324-341 ◽  
Author(s):  
Helen De Cieri ◽  
Cathy Sheehan ◽  
Ross Donohue ◽  
Tracey Shea ◽  
Brian Cooper
Keyword(s):  
Workplace Bullying ◽  
Online Survey ◽  
Response Rate ◽  
Health Workers ◽  
Demographic Characteristics ◽  
Healthcare Sector ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Practical Implications

Purpose The purpose of this paper is to apply the concept of power imbalance to explain workplace and demographic characteristics associated with bullying by different perpetrators in the healthcare sector. Design/methodology/approach All 69,927 members of the Australian Nursing and Midwifery Federation (Victoria) were invited to participate in an online survey in 2014; 4,891 responses were received (7 per cent response rate). Participants were asked about their exposure to workplace bullying (WPB) by different perpetrators. The questionnaire addressed demographic characteristics and perceptions of workplace characteristics (workplace type, leading indicators of occupational health and safety (OHS), prioritisation of OHS, supervisor support for safety and bureaucracy). Analysis involved descriptive statistics and regression analyses. Findings The study found that the exposure of nurses and health workers to bullying is relatively high (with 42 per cent of respondents experiencing WPB in the past 12 months) and there are multiple perpetrators of bullying. The research revealed several demographic predictors associated with the different types of perpetrators. Downward and horizontal bullying were the most prevalent forms. Workplace characteristics were more important predictors of bullying by different perpetrators than were demographic characteristics. Research limitations/implications There are limitations to the study due to a low response rate and the cross-sectional survey. Practical implications Practical implications of this study emphasise the importance of focussed human resource strategies to prevent bullying. Originality/value The key contribution of this research is to draw from theoretical explanations of power to inform understanding of the differences between perpetrators of bullying. The study highlights the workplace characteristics that influence bullying.

Predictors of Return to Normal Neurological Function After Surgery for Moderate and Severe Degenerative Cervical Myelopathy: An Analysis of A Global AOSpine Cohort of Patients

Neurosurgery ◽  
2019 ◽  
Vol 85 (5) ◽  
pp. E917-E923 ◽  
Author(s):  
Rafael De la Garza Ramos ◽  
Aria Nouri ◽  
Jonathan Nakhla ◽  
Murray Echt ◽  
Yaroslav Gelfand ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Multiple Logistic Regression Analysis ◽  
Japanese Orthopaedic Association ◽  
Area Under The Curve ◽  
Neurological Function ◽  
International Studies ◽  
Patient Counseling ◽  
Multicenter Studies ◽  
Degenerative Cervical Myelopathy ◽  
Walking Time

Abstract BACKGROUND Multiple studies have established the safety and efficacy of surgical intervention for degenerative cervical myelopathy (DCM). Although the main goal of surgery is symptom stabilization, a subset of patients achieves remarkable improvements. OBJECTIVE To identify predictors of return to normal neurological function after surgery for moderate or severe DCM. METHODS This is an analysis of 2 prospective multicenter studies (the AOSpine CSM-North America and CSM-International studies) conducted between 2005 and 2011. For patients with complete preoperative magnetic resonance imaging (MRI) and 2-yr follow-up, characteristics were compared between those who achieved a modified Japanese Orthopaedic Association (mJOA) score of 18 at 2 yr (no signs of myelopathy) vs controls. Only patients with baseline mJOA ≤ 14 (moderate and severe myelopathy) were included to minimize ceiling effects. RESULTS A total of 51 patients (20.3%) out of 251 with moderate or severe baseline myelopathy achieved an mJOA score of 18 at 2 yr. On stepwise multiple logistic regression analysis, T1-weighted (T1W1)-hypointensity (odds ratio [OR] 0.10; 95% confidence interval [CI], 0.01-0.79; P = .03) and longer walking time on the 30-m walking test (OR 0.95; 95% CI, 0.92-0.99; P = .03) were independent predictors of outcome, with an area under the curve of 0.71 for the model. CONCLUSION In this study, T1W-hypointensity on MRI and longer walking time were found to predict a less likelihood of achieving return to normal neurological function after surgery for moderate or severe DCM. These findings may provide useful information for patient counseling and perioperative expectations.

scholarly journals The Risk of Sexually Transmitted Infection and Its Influence on Condom Use among Pregnant Women in the Kintampo North Municipality of Ghana

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Martha Ali Abdulai ◽  
Frank Baiden ◽  
Samuel Afari-Asiedu ◽  
Lawrence Gyabaa-Febir ◽  
Kwame Kesse Adjei ◽  
...  
Keyword(s):  
High Risk ◽  
Condom Use ◽  
Pregnant Women ◽  
Sexually Transmitted Infection ◽  
Secondary Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Survey ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted

Sexually transmitted infection (STI) affects the reproductive health of both men and women worldwide. Condoms are important part of the available preventive strategies for STI control. The lack of proper risk-perception continues to impede women’s ability to negotiate condom use with their partners. This paper is the outcome of secondary analysis of data collected in a cross-sectional survey that explored the perception of risk of STI and its influence on condom use among 504 pregnant women attending antenatal clinic at two health facilities in the Kintampo North Municipality. Consecutively, three Focus Group Discussions were conducted among 22 pregnant women which was analyzed using thematic analysis technique. Multivariate logistic regression analysis was used to identify possible predictors of condom use and risk of STI. Respondents mean age was 26.0±5.9 years. 47% of respondents self-identified themselves as high risk for contracting STI, 50% of whom were married. High risk status (OR = 2.1, 95% CI: 1.1–4.4), ability to ask for condoms during sex (OR = 0.3, 95% CI: 0.1–0.73), and partner’s approval of condom use (OR = 0.2, 95% CI: 0.01–0.05) were independent predictors of condom use. Condom use (OR 2.9 (1.5–5.7); p=0.001) and marital status (engaged, OR 2.6 (1.5–4.5); p=0.001) were independent predictors of risk of STI. Women who self-identified themselves as high risk for STI successfully negotiated condom use with their partners. This is however influenced by partner’s approval and ability to convince partner to use condoms. Self-assessment of STI risk by women and the cooperation of male partners remain critical.

scholarly journals Predicting the minimum clinically important difference in patients undergoing surgery for the treatment of degenerative cervical myelopathy

2016 ◽  
Vol 40 (6) ◽  
pp. E14 ◽  
Author(s):  
Lindsay Tetreault ◽  
Jefferson R. Wilson ◽  
Mark R. N. Kotter ◽  
Aria Nouri ◽  
Pierre Côté ◽  
...  
Keyword(s):  
Relative Risk ◽  
Cervical Myelopathy ◽  
Univariate Analysis ◽  
Japanese Orthopaedic Association ◽  
Minimum Clinically Important Difference ◽  
Duration Of Symptoms ◽  
Clinically Important Difference ◽  
Younger Age ◽  
Degenerative Cervical Myelopathy ◽  
Unstable Gait

OBJECTIVE The minimum clinically important difference (MCID) is defined as the minimum change in a measurement that a patient would identify as beneficial. Before undergoing surgery, patients are likely to inquire about the ultimate goals of the operation and of their chances of experiencing meaningful improvements. The objective of this study was to define significant predictors of achieving an MCID on the modified Japanese Orthopaedic Association (mJOA) scale at 2 years following surgery for the treatment of degenerative cervical myelopathy (DCM). METHODS Seven hundred fifty-seven patients were prospectively enrolled in either the AOSpine North America or International study at 26 global sites. Fourteen patients had a perfect preoperative mJOA score of 18 and were excluded from this analysis (n = 743). Data were collected for each participating subject, including demographic information, symptomatology, medical history, causative pathology, and functional impairment. Univariate log-binominal regression analyses were conducted to evaluate the association between preoperative clinical factors and achieving an MCID on the mJOA scale. Modified Poisson regression using robust error variances was used to create the final multivariate model and compute the relative risk for each predictor. RESULTS The sample consisted of 463 men (62.31%) and 280 women (37.69%), with an average age of 56.48 ± 11.85 years. At 2 years following surgery, patients exhibited a mean change in functional status of 2.71 ± 2.89 points on the mJOA scale. Of the 687 patients with available follow-up data, 481 (70.01%) exhibited meaningful gains on the mJOA scale, whereas 206 (29.98%) failed to achieve an MCID. Based on univariate analysis, significant predictors of achieving the MCID on the mJOA scale were younger age; female sex; shorter duration of symptoms; nonsmoking status; a lower comorbidity score and absence of cardiovascular disease; and absence of upgoing plantar responses, lower-limb spasticity, and broad-based unstable gait. The final model included age (relative risk [RR] 0.924, p < 0.0001), smoking status (RR 0.837, p = 0.0043), broad-based unstable gait (RR 0.869, p = 0.0036), and duration of symptoms (RR 0.943, p = 0.0003). CONCLUSIONS In this large multinational prospective cohort, 70% of patients treated surgically for DCM exhibited a meaningful functional gain on the mJOA scale. The key predictors of achieving an MCID on the mJOA scale were younger age, shorter duration of symptoms, nonsmoking status, and lack of significant gait impairment.

scholarly journals Work–home interference: Examining socio-demographic predictors in the South African context

2010 ◽  
Vol 8 (1) ◽  
Author(s):  
Marissa De Klerk ◽  
Karina Mostert
Keyword(s):  
South African ◽  
Survey Design ◽  
Demographic Characteristics ◽  
Cross Sectional Survey ◽  
Positive Interaction ◽  
Cross Sectional ◽  
Main Research ◽  
Demographic Predictors ◽  
Home Work ◽  
Positive Work

Orientation: The focus of this study was to investigate the relationship between socio-demographic characteristics and the work–home interaction in different occupational groups in South Africa.Research purpose: The main research aim of the study was to investigate the socio-demographic predictors of negative and positive work–home interaction of South African employees.Motivation for the study: Little information is known about the prevalence of work–home interaction within groups. This study is aimed at enabling the researcher and organisations to identify those groups that are at risk of negative interference and which are prone to positive interaction, to allow for the development of appropriate strategies and intervention programmes.Research design, approach and method: A cross-sectional survey design was used in the study. A sample (N = 2040) was taken from four South African industries (i.e. the police service, the earthmoving equipment industry, mining and nursing). A socio-demographic questionnaire and the Survey Work–Home Interaction-Nijmegen (SWING) were used.Main findings: The results indicated that robust predictors included occupation, gender and language for negative work–home interference; occupation, age and language for positive work–home interference; occupation and language for negative home–work interference; and occupation, age, education and language for positive home–work interference.Practical/managerial implications: The implications of the study are that negative and positive work–home interaction is uniquely associated with socio-demographic characteristics. Work–life balance initiatives should, therefore, be carefully tailored to address the needs of each socio-demographic group.Contribution/value-add: The findings of the study suggest answers to the management of the work–home interaction among various socio-demographic groups in organisations.

scholarly journals COVID-19 Related Misconceptions and Prevention Practices Among the Public in a Southeastern City in Nigeria

2021 ◽  
Vol 5 (2) ◽  
pp. 149-159
Author(s):  
Sorochi Iloanusi ◽  
Osaro Mgbere ◽  
Nchebe-Jah Raymond Iloanusi ◽  
Ismaeel Yunusa ◽  
Ekere J. Essien
Keyword(s):  
Public Health ◽  
Scientific Evidence ◽  
Demographic Characteristics ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Anambra State ◽  
The Public ◽  
Creative Commons ◽  
Study Population ◽  
The Government

Introduction: The COVID-19 pandemic brought several misconceptions that could hinder individuals from taking necessary measures to prevent infection, thus, undermining the public health containment efforts. We aimed to assess the prevalence of COVID-19 related misconceptions and their associations with demographic characteristics and prevention practices in Onitsha city in Anambra state, Nigeria. Methods: We analyzed data from a cross-sectional survey of 140 adult residents of Onitsha city in Anambra state, Nigeria, conducted in March 2020. Descriptive and inferential statistics were used to describe the study population and determine the associations between COVID-19 misconceptions, demographic characteristics, and implementation of COVID-19 prevention practices. Data management and statistical analyses were conducted using SAS JMP Statistical DiscoveryTM Software version 14.3 (SAS Institute, Cary, North Carolina, USA). Results: The participants’ average age was 34.5 (SD: ±10.9) years, and most were males (54.3%). Misconceptions about COVID-19 among the study population resulted in markedly reduced compliance with nearly all prevention practices. Some participants believed that COVID-19 would not spread in Nigeria (34.4%, p<0.0001), was not fatal (10.8%, p<0.0001), can be prevented and cured through spiritual means (48.2%, P <0.0001), use of herbs (13.6%, P <0.0001), use of antibiotics (11.4%, p<0.0001) and that COVID-19 vaccine was available (25.4%, p<0.01). Misconception about the possibility of COVID-19 spread was significantly associated with non-compliance to all prevention practices (P<0.05) except travel restrictions. Conclusions and Implications for Translation: Our study suggests the need for the government to tailor interventions targeting the common misconceptions in Onitsha in order to improve the public’s trust and compliance with recommended COVID-19 prevention practices. Misconception has become a significant public health challenge, primarily as its prioritization over scientific evidence and guidelines directly affects the pandemic preparedness and control efforts and may cause more people to be at risk of contracting COVID-19.   Copyright © 2021 Iloanusi et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Sign in / Sign up

Export Citation Format

Share Document