Evaluation of Recovery of Activities of Daily Living in Patients with Sequelae from Cerebral Vascular Disease

Summary Bulgaria ranks first in the world in incidence, morbidity and death associated with cerebrovascular disease. The aim of the study was to investigate, follow-up and register recovery of activities of daily living (using the toilet and maintaining personal hygiene) in patients with sequelae from cerebrovascular disease in a subacute stage, who underwent physiotherapy and rehabilitation. Sixty-one patients were included and followed up. They were given tailored physiotherapy and rehabilitation. This included kinesitherapy, occupational therapy and electrotherapy. All the patients filled in self-assessment questionnaires before and after the rehabilitation course. Major parameters were assessed, irrespective of the limb affected -dominant or non-dominant. Results were analyzed using the Wilcoxon rank test. At the end of the rehabilitation course, the Wilcoxon curves were driven to the right, confirming improvement concerning independence, irrespective of involvement of dominant or non-dominant limb.

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Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-021-01856-0 ◽

2021 ◽

Author(s):

Alexander M. Keppler ◽

Jenny Holzschuh ◽

Daniel Pfeufer ◽

Johannes Gleich ◽

Carl Neuerburg ◽

...

Keyword(s):

Activities Of Daily Living ◽

Gait Speed ◽

Daily Living ◽

Step Length ◽

Care Hospital ◽

Self Assessment ◽

Postoperative Rehabilitation ◽

Femur Fractures ◽

Prospective Study Design

Abstract Background Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns. Methods Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up. Results During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (p < 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (p < 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level. Conclusions Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the “fast track” concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice. Level of evidence Prospective cohort study, 2.

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Multimorbidity, Disadvantage, and Trends in Disability-Free Life Expectancy: The CFAS Studies

Innovation in Aging ◽

10.1093/geroni/igaa057.2200 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 641-641

Author(s):

Andrew Kingston ◽

Holly Bennett ◽

Louise Robinson ◽

Lynne Corner ◽

Carol Brayne ◽

...

Keyword(s):

Cognitive Function ◽

Life Expectancy ◽

Longitudinal Data ◽

Activities Of Daily Living ◽

Daily Living ◽

Health Conditions ◽

Disadvantaged Groups ◽

Disability Free Life Expectancy ◽

Reported Health

Abstract The combined contribution of multi-morbidity and socio-economic position (SEP) to trends in disability free life expectancy (DFLE) is unknown. We use longitudinal data from the Cognitive Function and Ageing Studies (CFAS I: 1991; CFAS II: 2011), with two year follow up. Disability was defined as difficulty in activities of daily living, and SEP as area-level deprivation. Multi-morbidity was constructed from nine self-reported health conditions and categorised as 0-1, 2-3, 4+ diseases. In 1991 and 2011, shorter total and disability-free years were associated with greater multi-morbidity. Between 1991 and 2011, gains in life expectancy and DFLE were observed at all levels of multi-morbidity, the greatest gain in DFLE being 4 years for men with 0-1 diseases. As multi-morbidity is more prevalent in more disadvantaged groups, further analyses will investigate whether SEP differences remain at all levels of multi-morbidity.

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The effect of a 24-week training focused on activities of daily living, muscle strengthening, and stability in idiopathic inflammatory myopathies: a monocentric controlled study with follow-up

Arthritis Research & Therapy ◽

10.1186/s13075-021-02544-5 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Maja Špiritović ◽

Barbora Heřmánková ◽

Sabína Oreská ◽

Hana Štorkánová ◽

Olga Růžičková ◽

...

Keyword(s):

Muscle Strength ◽

Activities Of Daily Living ◽

Daily Living ◽

Substantial Proportion ◽

Controlled Study ◽

Idiopathic Inflammatory Myopathies ◽

Inflammatory Myopathies ◽

Local Inflammatory Response ◽

Secondary Outcomes

Abstract Background The structural and functional changes of the skeletal muscles in idiopathic inflammatory myopathies (IIM) caused by inflammation and immune changes can be severely disabling. The objective of this study was to assess the effect of a 24-week program combining a supervised training of activities of daily living (ADL), resistance, and stability with home exercise for improving muscle function, compared to a daily home-based exercise representing the regular outpatient care. Methods Fifty-seven patients with IIM were consecutively and non-selectively enrolled in an intervention (IG, n = 30) or control (CG, n = 27) group. Both groups were provided a standard-of-care pharmacological treatment and follow-up. Only the IG underwent the supervised intervention twice a week for 1 h per session. At baseline, 12, 24, and 48 weeks, all patients were assessed by an assessor blinded to the intervention for primary outcomes: muscle strength (Manual Muscle Testing of eight muscle groups [MMT-8]) and endurance (Functional Index-2 [FI-2]), and secondary outcomes: stability and body composition. Secondary outcomes also included questionnaires evaluating disability (Health Assessment Questionnaire [HAQ]), quality of life (Short Form 36 [SF-36]), depression (Beck’s Depression Inventory-II [BDI-II]), and fatigue (Fatigue Impact Scale [FIS]), and analysis of the systemic and local inflammatory response and perceived exertion to assess the safety of the intervention. Results Twenty-seven patients in the IG and 23 in the CG completed the entire program and follow-up. At week 24, compared to deterioration in the CG, we found a significant improvement in the IG in muscle strength (mean % improvement compared to baseline by 26%), endurance (135%), disability (39%), depression (26%), stability (11%), and basal metabolism (2%) and a stabilization of fitness for physical exercise. The improvement was clinically meaningful (a 24-week change by >20%) in most outcomes in a substantial proportion of patients. Although the improvement was still present at 48 weeks, the effect was not sustained during follow-up. No significant increase in the systemic or local expression of inflammatory markers was found throughout the intervention. Conclusions This 24-week supervised intervention focused on ADL training proved to be safe and effective. It not only prevented the progressive deterioration, but also resulted in a significant improvement in muscle strength, endurance, stability, and disability, which was clinically meaningful in a substantial proportion of patients. Trial registration ISRCTN35925199 (retrospectively registered on 22 May 2020).

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Neuropsychological screening performance and the association with activities of daily living and instrumental activities of daily living in dementia: baseline and 18- to 24-month follow-up

International Journal of Geriatric Psychiatry ◽

10.1002/gps.2709 ◽

2011 ◽

Vol 27 (2) ◽

pp. 197-204 ◽

Cited By ~ 26

Author(s):

Linda Monaci ◽

Robin G. Morris

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Neuropsychological Screening ◽

Instrumental Activities ◽

Screening Performance

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Obesity, Apolipoprotein E ε4, and Difficulties in Activities of Daily Living Among Older Adults: a 6-Year Follow-up Study

Annals of Behavioral Medicine ◽

10.1007/s12160-016-9848-y ◽

2016 ◽

Vol 51 (2) ◽

pp. 251-260 ◽

Cited By ~ 2

Author(s):

Li-Jung Chen ◽

Andrew Steptoe ◽

Po-Wen Ku

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Apolipoprotein E ◽

Daily Living ◽

Follow Up Study

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Frenotomy in Infants with Tongue-Tie and Breastfeeding Problems

Journal of Human Lactation ◽

10.1177/0890334418816973 ◽

2018 ◽

Vol 35 (4) ◽

pp. 706-712 ◽

Cited By ~ 2

Author(s):

Anjana Srinivasan ◽

Alex Al Khoury ◽

Svetlana Puzhko ◽

Carole Dobrich ◽

Meira Stern ◽

...

Keyword(s):

Medical Community ◽

Rank Test ◽

Signed Rank ◽

Wilcoxon Signed Rank Test ◽

Before And After ◽

Signed Rank Test ◽

Breastfeeding Counseling ◽

The Right ◽

Breastfeeding Problems ◽

Numeric Rating

Background: Infant tongue-tie can cause breastfeeding problems, which may be improved by frenotomy. However, controversy exists among the medical community. Research aim: To examine the influence of frenotomy on infants with posterior ankyloglossia, by quantifying the changes in breastfeeding and maternal nipple pain using standardized tools. Methods: Newborns ( N = 30) below 12 weeks of age were recruited from the Herzl–Goldfarb Breastfeeding Clinic between April 2014 and April 2015. Diagnosis of posterior ankyloglossia was made clinically. Frenotomy was performed. Mothers received breastfeeding counseling before and after the procedure. Pain and breastfeeding were assessed before the procedure, immediately after the procedure, and after 2 days, 7 days and 14 days. Breastfeeding was assessed using the LATCH Tool and by subjective questioning. Maternal nipple pain was assessed using the Numeric Rating System. Results: No complications were reported with frenotomy. There was a significant improvement in LATCH score immediately post-frenotomy, with an increase in median scores from 7.5 to 8.5 ( p < .0001, Wilcoxon signed rank test). There was a significant decrease in median pain score immediately post-frenotomy, from 3.0 on the left nipple and 3.25 on the right nipple, to 0 bilaterally ( p < .0001, Wilcoxon signed rank test). Subjective improvement in breastfeeding was reported by 90% of mothers immediately after frenotomy and 83% of mothers at Day 14. Conclusion: Frenotomy for posterior ankyloglossia may improve breastfeeding and nipple pain.

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Social isolation, loneliness and functional disability in Chinese older women and men: a longitudinal study

Age and Ageing ◽

10.1093/ageing/afaa271 ◽

2020 ◽

Author(s):

Lizhi Guo ◽

Li An ◽

Fengping Luo ◽

Bin Yu

Keyword(s):

Longitudinal Study ◽

Activities Of Daily Living ◽

Functional Status ◽

Social Isolation ◽

Daily Living ◽

Functional Disability ◽

Iadl Disability ◽

Older Populations ◽

New Onset

Abstract Objective This study investigated whether loneliness or social isolation is associated with the onset of functional disability over 4 years among Chinese older populations. Setting and Subjects This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Analyses were conducted with data from two waves (2011 and 2015) and were restricted to those respondents aged 50 and older and free of functional disability at baseline [n = 5,154, mean age (SD) = 60.72 (7.51); male, 52.3%]. Method Social isolation, loneliness and covariates were measured at baseline. Follow-up measures of new-onset ADL and IADL disability were obtained 4 years later. We stratified the sample by gender, and then used binary logistic regressions to evaluate the associations between baseline isolation, loneliness and new-onset ADL and IADL disability. Results For women, baseline social isolation was significantly associated with new-onset ADL (OR = 1.18, 95% CI = 1.07–1.30) and IADL (OR = 1.11, 95% CI = 1.01–1.21) disability; no significant association between loneliness and ADL or IADL disability was found. For men, neither social isolation nor loneliness was found to be significantly associated with ADL or IADL disability. Conclusion This longitudinal study found that social isolation, rather than loneliness, was significantly associated with functional disability over 4 years among women (but not men) in China. These findings expand our knowledge about the association between social relationships and functional status among non-Western populations.

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Neuroimaging risk factors for participation restriction after acute ischemic stroke: 1-year follow-up study

Journal of Investigative Medicine ◽

10.1136/jim-2020-001675 ◽

2021 ◽

pp. jim-2020-001675

Author(s):

Jian-Feng Qu ◽

Huo-Hua Zhong ◽

Wen-Cong Liang ◽

Yang-Kun Chen ◽

Yong-Lin Liu ◽

...

Keyword(s):

Ischemic Stroke ◽

White Matter ◽

Activities Of Daily Living ◽

Acute Ischemic Stroke ◽

Daily Living ◽

Male Gender ◽

Perivascular Spaces ◽

Participation Restriction ◽

Nihss Score

The aim of the present study was to determine the neuroimaging predictors of poor participation after acute ischemic stroke. A total of 443 patients who had acute ischemic stroke were assessed. At 1-year recovery, the Reintegration to Normal Living Index was used to assess participation restriction. We also assessed the Activities of Daily Living Scale and modified Rankin Scale (mRS) score. Brain MRI measurement included acute infarcts and pre-existing abnormalities such as enlarged perivascular spaces, white matter lesions, ventricular-brain ratio, and medial temporal lobe atrophy (MTLA). The study included 324 men (73.1%) and 119 women (26.9%). In the univariate analysis, patients with poor participation after 1 year were older, more likely to be men, had higher National Institutes of Health Stroke Scale (NIHSS) score on admission, with more histories of hypertension and atrial fibrillation, larger infarct volume, more severely enlarged perivascular spaces and MTLA, and more severe periventricular hyperintensities and deep white matter hyperintensities. Patients with participation restriction also had poor activities of daily living (ADL) and mRS score. Multiple logistic regression showed that, in model 1, age, male gender, NIHSS score on admission, and ADL on follow-up were significant predictors of poor participation, accounting for 60.2% of the variance. In model 2, which included both clinical and MRI variables, male gender, NIHSS score on admission, ADL on follow-up, and MTLA were significant predictors of poor participation, accounting for 61.2% of the variance. Participation restriction was common after acute ischemic stroke despite good mRS score. Male gender, stroke severity, severity of ADL on follow-up, and MTLA may be predictors of poor participation.Trial registration number ChiCTR1800016665.

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