scholarly journals Patients with autosomal dominant spinocerebellar ataxia have more risk of falls, important balance impairment, and decreased ability to function

2013 ◽  
Vol 71 (8) ◽  
pp. 508-511 ◽  
Author(s):  
Carolina Yuri P. Aizawa ◽  
Jose Luiz Pedroso ◽  
Pedro Braga-Neto ◽  
Marilia Rezende Callegari ◽  
Orlando Graziani Povoas Barsottini
Keyword(s):  
Disease Severity ◽  
Spinocerebellar Ataxia ◽  
Rating Scale ◽  
Significant Risk ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Balance Impairment ◽  
Risk Of Falls ◽  
Severe Ataxia ◽  
Autosomal Dominant Spinocerebellar Ataxia

OBJECTIVES: To assess balance and ability to function in patients with spinocerebellar ataxia. METHODS: A total of 44 patients with different spinocerebellar ataxia types 1, 2, 3, and 6 were evaluated using the Tinetti balance and gait assessment and the functional independence measure. The scale for the assessment and rating of ataxia and the international cooperative ataxia rating scale were used to evaluate disease severity. RESULTS: Most patients showed significant risk of falls. The balance scores were significantly different in spinocerebellar ataxia types. A significant positive correlation between balance and disease severity was found. CONCLUSION: Patients with spinocerebellar ataxia have important balance impairment and risk of falls that influence the ability to function such as self-care, transfers, and locomotion. Furthermore, the more severe ataxia is, the more compromised are postural balance, risk of falls, and ability to function.

Dance, functioning and quality of life in children with Down syndrome and autism spectrum disorder dance, functioning and quality of life in Down syndrome and autism spectrum disorder

2021 ◽  
pp. 135910452110617
Author(s):  
Evanilza T. Adorno ◽  
Daiany C de J. Dos Santos ◽  
Beatriz M. DeJesus ◽  
Adrielle A. Passos ◽  
Lavínia Teixeira-Machado
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Down Syndrome ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Children With Down Syndrome

This study investigated dance practice in psychosocial and functional aspects, and quality of life in children with Down syndrome and autism spectrum disorder. Children with DS and ASD, between 3 and 12 years old, attended a dance program during 16 sessions/lessons, lasting 60 min, twice a week, in suitable place. Functional Independence Measure (FIM), Childhood Autism Rating Scale SF-36 quality of life survey, and Knowledge, Attitude and Practice Inquiry (KAP Inquiry) were applied before and after dance classes. Eleven participants concluded the study. Functional independence changes were observed in relation to self-care, sphincter control, locomotion, and communication domains. Children’ “quality of life” reported by parents showed changes in functional capacity, vitality, mental health, physical and social aspects, and general state of health domains. These findings suggest that regular dance practice can underlie psychosocial adjustments in children with DS and ASD.

The Functional Independence Measure and the Functional Assessment Measure (FIM + FAM) as an effective tool for the evaluation of functional status in stroke rehabilitation

2021 ◽  
Author(s):  
L. Shuranova ◽  
J. Vacková
Keyword(s):  
Functional Assessment ◽  
Clinical Decision Making ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Hospital Treatment ◽  
Common Cause ◽  
Assessment Measure ◽  
Rehabilitation Period

The Functional Independence Measure and Functional Assessment Measure (FIM + FAM) is an effective, efficient, and objective tool for tracking changes in the motor, cognitive, and psychosocial functions of patients over the entire treatment and rehabilitation period. It is estimated that in the Czech Republic (CR), stroke is the third most common cause of death and the most common cause of adult disability. To develop faster, better, and more cost‑effective stroke treatments and reduce or mitigate functional losses and restrictive situations, it is very important that patients be objectively evaluated, relative to their functional abilities, as soon as possible after a stroke. A critical part of stroke treatment is to calculate the length of in‑hospital treatment and estimate the length of the rehabilitation period after the stroke. Contemporary methods for evaluating and analyzing a patient’s condition are based on test results and evidence.The FIM offers a more sensitive rating scale compared to BI due to the presence of cognitive items and is used worldwide for assessment during the acute stage of the disease. Thus, it is an efficient instrument for setting therapy goals and evaluating the effects of rehabilitation. Not only can it assist the therapist in clinical decision making, but it also functions as a tool for evaluating rehabilitation outcomes. Based on this test, short‑term and long‑term rehabilitation plans can be determined. At the end of the rehabilitation process, assessing the patient’s functional condition helps to predict the specific long‑term rehabilitation services the patient will need as they return to society and regain their quality of life.

scholarly journals Overview of Traumatic Brain Injury Patients at a Tertiary Trauma Centre

2005 ◽  
Vol 32 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Elaine de Guise ◽  
Mitra Feyz ◽  
Joanne LeBlanc ◽  
Sylvain-Luc Richard ◽  
Julie Lamoureux
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
Scale Score ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Term Care ◽  
Traumatic Amnesia ◽  
Post Traumatic

ABSTRACT:Objective:The goal of this study was to provide a general descriptive and cognitive portrait of a population with traumatic brain injury (TBI) at the time of their acute care stay.Material and methods:Three hundred and forty-eight TBI patients were assessed. The following data were collected for each patient: age, level of education, duration of post-traumatic amnesia, Galveston Orientation Amnesia Test score, Glasgow Coma Scale score, results of cerebral imaging, Neurobehavioral Rating Scale score, the Functional Independence Measure cognitive score and the Glasgow Outcome Scale score.Results:The clinical profile of the population revealed a mean age of 40.2 (±18.7) and a mean of 11.5 (±3.6) years of education. Most patients presented with frontal (57.6%) and temporal (40%) lesions. Sixty-two percent had post-traumatic amnesia of less than 24 hours. Seventy percent presented with mild TBI, 14% with moderate and 15% with severe TBI. The cognitive deficits most frequently observed on the Neurobehavioral Rating Scale were in the areas of attention, memory and mental flexibility as well as slowness and mental fatigability. Most patients had good cognitive outcome on the Functional Independence Measure and scores of 2 and 3 were frequent on the GOS. Forty-five percent of the patients returned home after discharge, 51.7% were referred to in or out patient rehabilitation and 3.2% were transferred to long-term care facilities.Conclusion:Because of the specialized mandate of acute care institutions, the information provided here concerning characteristics of our TBI population is essential for more efficient decision-making and planning/programming with regards to care and service delivery.

scholarly journals Correlation of cardiovascular and respiratory comorbidities with motor functional independence in the elderly after hip fracture

2021 ◽  
Vol 74 (1-2) ◽  
pp. 20-24
Author(s):  
Natasa Radosavljevic ◽  
Dejan Nikolic ◽  
Sofija Radosavljevic ◽  
Mirko Grajic ◽  
Ksenija Boskovic
Keyword(s):  
Hip Fracture ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Severity Index ◽  
The Elderly ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Significant Difference ◽  
Different Levels

Introduction. The aim of the study was to evaluate the correlation between different levels of examined comorbidities using the Cumulative Illness Rating Scale for Geriatrics and motor Functional Independence Measure test in the elderly after hip fracture. Material and Methods. The study included 203 geriatric patients, 65 years of age and older, who were referred to a rehabilitation program at the Institute for Rehabilitation after hip fracture. The following comorbidities were analyzed: cardiac, vascular, and respiratory. The motor component of Functional Independence Measure was used to assess functional recovery. The Cumulative Illness Rating Scale for Geriatrics was used to calculate the comorbidity index. The patients were assessed on 4 different occasions: on admission, on discharge, 3 months after discharge, and 6 months after discharge. The short-term and long-term efficiency of rehabilitation treatment was measured. Results. There is a significant difference in motor Functional Independence Measure scores between different levels of vascular (p = 0.010) and respiratory (p = 0.047) comorbidities only on admission, while at other times of observation no significant difference (p > 0.05) was found. The highest level of correlation was found in level 3 comorbidity severity index for cardiac comorbidity (discharge/3 months) (Pearson?s correlation - R = 0.938) and vascular comorbidity (discharge/3 months) (R = 0.912), and level 2 comorbidity severity index for respiratory comorbidity (discharge/3 months) (R = 0.941). Conclusion. Rehabilitation treatment of the elderly after hip fracture plays a significant role both in short-term and long-term recovery, particularly in the functional domains even in persons with significant comorbidities. Early inclusion and an individually designed rehabilitation program with continuous monitoring of the elderly after hip fractures results in functional improvement and better quality of life.

The Falls Efficacy Scale International is a valid measure to assess the concern about falling and its changes induced by treatments

2021 ◽  
pp. 026921552110621
Author(s):  
Antonio Caronni ◽  
Michela Picardi ◽  
Valentina Redaelli ◽  
Paola Antoniotti ◽  
Giuseppe Pintavalle ◽  
...  
Keyword(s):  
Differential Item Functioning ◽  
Rasch Analysis ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Balance Impairment ◽  
Motor Disability ◽  
Item Functioning ◽  
Before And After ◽  
Neurological Patients

Objective To test with the Rasch analysis the psychometric properties of the Falls Efficacy Scale International, a questionnaire for measuring concern about falling. Design Longitudinal observational study, before–after rehabilitation. Setting Inpatient rehabilitation. Subjects A total of 251 neurological patients with balance impairment. Interventions Physiotherapy and occupational therapy aimed at reducing the risk of falling. Main measures Participants (median age, first–third quartile: 74.0, 65.5–80.5 years; stroke and polyneuropathy: 43% and 21% of the sample, respectively) received a balance assessment (Falls Efficacy Scale International included) pre- and post-rehabilitation. Rasch analysis was used to evaluate the Falls Efficacy Scale International. Differential item functioning, which assesses the measures’ stability in different conditions (e.g. before vs. after treatment) and in different groups of individuals, was tested for several variables. Results Patients suffered a moderate balance impairment (Mini-BESTest median score; first–third quartile: 15; 11–19), mild–moderate concern about falling (Falls Efficacy Scale International: 28; 21–37) and motor disability (Functional Independence Measure, motor domain: 70.0; 57.0–76.5). Falls Efficacy Scale International items fitted the Rasch model (range of infit and outfit mean square statistics: 0.8–1.32 and 0.71–1.45, respectively) and the questionnaire's reliability was satisfactory (0.87). No differential item functioning was found for treatment, gender, age and balance impairment. Differential item functioning was found for diagnosis and disability severity, but it is shown that it is not such as to bias measures. Conclusions Falls Efficacy Scale International ordinal scores can be turned into interval measures, i.e. measures of the type of temperature. Being differential item functioning-free for treatment, these measures can be safely used to compare concern about falling before and after rehabilitation, such as when interested in assessing the rehabilitation effectiveness.

scholarly journals Effects of using the Nintendo Wii Fit Plus Platform in the sensorimotor training of gait disorders in Parkinson’s disease

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Giovanna Barros Gonçalves ◽  
Marco Antônio A. Leite ◽  
Marco Orsini ◽  
João Santos Pereira
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Gait Disorders ◽  
Lower Limbs ◽  
Stair Climbing ◽  
Sensorimotor Training ◽  
Nintendo Wii

The use of the Nintendo Wii has been considered a good alternative in the motor rehabilitation of individuals with Parkinson’s disease (PD), requiring simultaneous interaction to develop strategies for physical, visual, auditory, cognitive, psychological and social activities in the performing of virtual activities, resulting in improvement in functional performance and gait. The aim of this study was to analyze the effect of virtual sensorimotor activity on gait disorders in people with PD. Fifteen subjects with a clinical diagnosis of PD were submitted to the Unified Parkinson’s Disease Rating Scale (UPDRS III), Schwab and England Activities of Daily Living Scale (SE), Functional Independence Measure (FIM), and biomechanical gait analysis using digital images taken with a video camera before and after the treatment program. The activities with the Nintendo Wii virtual platform were standardized into three categories: aerobics, balance and Wii plus exercises. Participants carried out separate virtual exercises for 40 min, twice a week, for a total of 14 sessions. The program improved sensorimotor performance in PD gait, with an increase in stride length and gait speed, in addition to a reduction in motor impairment, especially in items of rigidity and flexibility of the lower limbs evaluated by UPDRS III, and greater functional independence, as evidenced in the SE and FIM scales. Improvements in items related to locomotion and stair climbing were also observed. The training was effective in motor recovery in chronic neurodegenerative diseases, showing improvement in motor performance and functional independence in individuals with PD.

scholarly journals Quality of models of scales of consciousness level, functional state, and General somatic severity in patients with consequences of brain damage in intensive care and rehabilitation department.

2020 ◽  
pp. 303-314
Author(s):  
Yuri Yuri. Y. Kiryachkov ◽  
Marina V. Petrova Marina V.Petrova ◽  
Igor V. Pryanikov Igor V. Pryanikov ◽  
Dmitry L. Kolesov Dmitry L. Kolesov ◽  
Alexander L. Parfenov Alexander L. Parfenov ◽  
...  
Keyword(s):  
Functional Status ◽  
Brain Damage ◽  
Functional State ◽  
Glasgow Outcome Scale ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Level Of Consciousness ◽  
Vegetative Status

Aims: development and substantiation of a typical scheme for the clinical use of scales of the level of consciousness, general somatic and functional status of patients with of brain damage. Methods: Included 118 patients on 20-50 days after traumatic brain injury, anoxic damage; consequences of acute cerebral circulatory disorders, and neurosurgical operations. In groups of patients who are in a coma, vegetative status, a state of minimal consciousness and a state of clear consciousness, the analysis of the statistical quality of clinical scales was carried out: scales of consciousness: the Glasgow coma Scale (GCS); FOUR (Full Outline of UnResponsiveness); CRS-R-Coma Recovery Scale-Revised; the Glasgow outcome Scale (COS); the extended scale of the Glasgow coma (COSE - Glasgow outcome scale extended); Rancho Los Amigos scale-scale of consciousness and interaction with the environment (the Rancho Los Amigos scale - RLAS); Functional status scales: DRS (the Disability Rating Scale); modified Rankin Scale mRS; Barthel Activities of Daily Living (ADL) Index; functional independence measure-FIM; Karnovsky Index; Rivermead Mobility Index self-assessment of everyday life opportunities in Merton and Sutton (checklist self-maintenance. Merton and Sutton community NHS trust); Scales of General somatic severity: assessment of multi-organ dysfunction on the APACHE II scale (Acute Physiology and Chronic Health Evaluation); APACHE IV scale; SAPS II scale (Simplified Acute Physiology Score); SOFA scale (Sequential Organ Failure Assessment). The functional state of the ANS was recorded using HRV parameters by recording 5-minute RR intervals of the electrocardiogram. Results: There are 4 groups of patients who are in a state of coma, vegetative status, a state of minimal consciousness and a state of clear consciousness. In 67 patients out of 118 examined (56.8%) the parameters of ANS functional activity are in the zone of pathological (sympathetic/parasympathetic hyperactivity) values. Conclusions: Various scales of the level of consciousness, functional and general somatic severity of patients objectively differ in clinical significance in the gradation of coma - vegetative status - minimal consciousness - clear consciousness.

scholarly journals Association of the Level of Neurofilament Light With Disease Severity in Patients With Spinocerebellar Ataxia Type 2

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012945
Author(s):  
Lu Yang ◽  
Ya-Ru Shao ◽  
Xiao-Yan Li ◽  
Yin Ma ◽  
Yi Dong ◽  
...  
Keyword(s):  
Disease Severity ◽  
Spinocerebellar Ataxia ◽  
Single Molecule ◽  
Rating Scale ◽  
Age Of Onset ◽  
Medical Center ◽  
Spinocerebellar Ataxia Type ◽  
Spinocerebellar Ataxia Type 2 ◽  
Neurofilament Light

Background and Objectives:Few biochemical markers have been identified in spinocerebellar ataxia type 2 (SCA2). This study aimed to determine the levels of neurofilament light (NfL) in patients with SCA2 and identify whether they were associated with disease severity.Methods:Participants were recruited from one medical center in China, and individuals with SCA2 were genetically diagnosed. NfL levels were assessed using the single molecule array method. Disease severity was evaluated using the Scale for the Assessment and Rating of Ataxia (SARA), the International Cooperative Ataxia Rating Scale (ICARS), and the Inventory of Non-Ataxia Symptoms (INAS). Cerebellum and brainstem volumes were calculated using neuroimaging measurements. We used Pearson’s correlation and partial correlation for correlation analyses.Results:Forty-nine manifest patients with SCA2, 10 preclinical individuals with SCA2 and 92 controls were enrolled. A high consistency was identified between serum and CSF NfL (r = 0.868, p < 0.0001). In individuals with SCA2, levels of serum NfL were associated with disease severity (SARA, r = 0.425, p = 0.003; ICARS, r = 0.383, p = 0.009; INAS, r = 0.390, p = 0.007; cerebellum volume, r = - 0.393, p = 0.024) after adjustment for age. NfL levels were higher close to the expected age of onset in preclinical individuals with SCA2 (R2 = 0.43, p = 0.04).Discussion:Levels of serum NfL were correlated with disease intensity in individuals with SCA2, and were higher close to the estimated age of onset in preclinical SCA2. Therefore, NfL is a potential serum biomarker of disease severity in SCA2.Classification of Evidence:This study provides Class II evidence that elevated NfL levels are associated with disease severity in individuals with SCA2.

scholarly journals Evaluation of Cognitive Dysfunction, Functional Independence and Depression Severity Changes during Rehabilitation in Patients after Cerebral Stroke

2019 ◽  
Vol 2 (17) ◽  
Author(s):  
Gintarė Mankė ◽  
Lina Varžaitytė ◽  
Aistė Berkutė ◽  
Erika Karkauskienė
Keyword(s):  
Cognitive Dysfunction ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Cerebral Stroke ◽  
Depression Severity ◽  
Mild Depression ◽  
Before And After ◽  
The Mean ◽  
Long Term Prognosis

 Research background. Cognitive impairment and depression are frequent residual consequences of stroke. They have a large impact on the quality of life and long-term prognosis. The aim is to estimate changes of cognitive dysfunction, functional independence and depression severity before and after rehabilitation in patients after cerebral stroke. Methods. We used Mini-Mental State Examination (MMSE) to estimate cognitive dysfunction, Functional Independence Measure (FIM) – motor and cognitive functions, Montgomery–Asberg Depression Rating Scale (MADRS) – depression severity. Results. There were 14 research participants from Neurorehabilitation department in Hospital of LUHS Kauno klinikos who met with criteria for inclusion and were not included by criteria for exclusion. Before rehabilitation the meanscore of MMSE – 19.93 – mild cognitive dysfunction, the mean score of FIM – 57.71 – medium supervision needed, the mean score of MADRS – 17.71 – mild depression. After rehabilitation the mean score of MMSE – 23.86 – mild cognitive dysfunction, the mean score of FIM – 92.07 – supervision needed, the mean score of MADRS – 10.50 – mild depression. We determined that six women had medium cognitive dysfunction while men did not have it. Conclusions. Cognitive function after rehabilitation signifcantly got better but mild cognitive dysfunction remained. Functional independence improved after rehabilitation and most patients only needed supervision. Mild depression remained after rehabilitation but the score signifcantly reduced. Females had more severe cognitive dysfunctions.Keywords: cerebral stroke, post-stroke depression, cognitive dysfunction, functional independency.

scholarly journals Efficacy of pulmonary rehabilitation in severe and critical-ill COVID-19 patients: a controlled study

2020 ◽  
Author(s):  
Gilbert Büsching ◽  
Zhongxing Zhang ◽  
Jean Paul Schmid ◽  
Thomas Sigrist ◽  
Ramin Khatami
Keyword(s):  
Pulmonary Rehabilitation ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Controlled Study ◽  
Control Group ◽  
P Value ◽  
Fisher Exact Test ◽  
Rehabilitation Outcomes ◽  
Critical Ill

AbstractSevere and critical ill COVID-19 patients frequently need acute care hospitalization including mechanical ventilation at ICU due to acute respiratory distress. A high proportion of these patients will develop ICU-acquired weakness and a need for rehabilitation. However data on rehabilitation outcomes in these patients are scarce and the efficacy of rehabilitation remains essentially unclear. We therefore compared the rehabilitation outcomes between COVID-19 patients with pneumonia and other patients with common pneumonia to assess their rehabilitation efficacies.We retrospectively compared the performances of six-min walk test (6MWT), chronic respiratory questionnaire (CRQ), and functional independence measure (FIM) at the discharge from pulmonary rehabilitation between 51 Covid-19 patients and 51 patients with common pneumonia using linear regression controlled for baseline values at entrance, age, sex and cumulative Illness rating scale. Fisher exact test was applied to test whether the odd ratios (ORs) of non-improvement/improvement in 6MWT (>30-m) and CRQ (>10-point) at discharge were different between the two groups.Covid-19 patients had similar performances at discharge in 6MWT (P-value=0.14), CRQ (P-value=0.55), and 4.2-point higher (P-value=0.004) in FIM compared to the control group. No differences in the outcomes were found between severe and critical COVID-19 patients. The OR of non-improvement/improvement in 6MWT was 0.30 (P-value=0.13) between COVID-19 and control groups; but the odd of non-improvement in CRQ tended to be 3.02 times higher (P-value =0.075) in COVID-19 group.In-house rehabilitation is effective and suitable for COVID-19 patients irrespective from disease severity. The discrepancy of high physical improvement and relatively low gains of disease related quality of life compared to control patients with common pneumonia is however remarkable. Further studies need to evaluate whether this discrepancy is an indicator of chronic disease development.

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