FUNCTIONAL INDEPENDENCE OF PEDIATRIC PATIENTS WITH MUCOPOLYSACCHARIDOSES

ABSTRACT Objective: To measure the functional independence to perform activities of daily living of pediatric patients diagnosed with mucopolysaccharidoses. Methods: A descriptive cross-sectional study was carried out with the population of pediatric patients with a confirmed enzymatic diagnosis of mucopolysaccharidoses, enrolled in the Orthopedics outpatient clinic of a hospital in the State of Bahia. The data were collected between October 2016 and March 2017, based on the documentary analysis of the assessment forms used in the department. The variables of this study comprised sex, age, type of MPS and level of functional independence, measured by the Functional Independence Measure scale. Results: Twenty-six patients participated in the study. These were predominantly male (61.5%), with a mean age of 10 ± 4.5 years, affected by MPS VI (73.1%). In the motor domain, the mean score was 65 (± 19.9 points); the cognitive domain obtained a mean score equal to 28 (± 8.2 points); and the total FIM score was 93 (± 26.5). Conclusion: Impaired functional independence was observed among children and adolescents with mucopolysaccharidoses. Tasks related to dressing, toileting, bathing, problem solving and social interaction were those that required the most assistance and/or supervision. Level of Evidence IV, Case Series.

Download Full-text

Assessment and Trends in the Methodological Quality of the Top 50 Most Cited Articles in Shoulder Instability

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120967082 ◽

2020 ◽

Vol 8 (12) ◽

pp. 232596712096708

Author(s):

Avinesh Agarwalla ◽

Kaisen Yao ◽

Anirudh K. Gowd ◽

Nirav H. Amin ◽

J. Martin Leland ◽

...

Keyword(s):

Bone Loss ◽

Shoulder Instability ◽

Methodological Quality ◽

Surgical Techniques ◽

Case Series ◽

Cross Sectional Study ◽

Retrospective Case ◽

Level Of Evidence ◽

Cross Sectional ◽

Number Of Citations

Background: Citation counts have often been used as a surrogate for the scholarly impact of a particular study, but they do not necessarily correlate with higher-quality investigations. In recent decades, much of the literature regarding shoulder instability is focused on surgical techniques to correct bone loss and prevent recurrence. Purpose: To determine (1) the top 50 most cited articles in shoulder instability and (2) if there is a correlation between the number of citations and level of evidence or methodological quality. Study Design: Cross-sectional study. Methods: A literature search was performed on both the Scopus and the Web of Science databases to determine the top 50 most cited articles in shoulder instability between 1985 and 2019. The search terms used included “shoulder instability,” “humeral defect,” and “glenoid bone loss.” Methodological scores were calculated using the Modified Coleman Methodology Score (MCMS), Jadad scale, and Methodological Index for Non-Randomized Studies (MINORS) score. Results: The mean number of citations and mean citation density were 222.7 ± 123.5 (range, 124-881.5) and 16.0 ± 7.9 (range, 6.9-49.0), respectively. The most common type of study represented was the retrospective case series (evidence level, 4; n = 16; 32%) The overall mean MCMS, Jadad score, and MINORS score were 61.1 ± 10.1, 1.4 ± 0.9, and 16.0 ± 3.0, respectively. There were also no correlations found between mean citations or citation density versus each of the methodological quality scores. Conclusion: The list of top 50 most cited articles in shoulder instability comprised studies with low-level evidence and low methodological quality. Higher-quality study methodology does not appear to be a significant factor in whether studies are frequently cited in the literature.

Download Full-text

Prevalência, desempenho cognitivo e funcionalidade de idosos com Doença de Alzheimer em instituições de longa permanência de Bento Gonçalves

PAJAR - Pan-American Journal of Aging Research ◽

10.15448/2357-9641.2017.1.26051 ◽

2017 ◽

Vol 5 (1) ◽

pp. 23 ◽

Cited By ~ 2

Author(s):

Daniela Fernandes Tonholi ◽

Gisele Oltramari

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Performance ◽

Junior High School ◽

Functional Independence Measure ◽

The Elderly ◽

Functional Independence ◽

Cross Sectional Study ◽

Functional Evaluation ◽

Cross Sectional

Aims: To determine the prevalence, cognitive performance and functionality of elderly people with Alzheimer's disease in long-stay institutions for the elderlyin the city of Bento Gonçalves. Methods: Cross-sectional study including 24 elderly residents in long-stay institutions for the elderly, sociodemographic datawere obtained, and the elderly were subjected to functional evaluation by the Functional Independence Measure and evaluation of cognitive performancethrough the mental state the Mini (MMSE). Results: Most of the residents were female (83%), as 54.2% schooling had completed junior high school, mostof the elderly (70.8%) was admitted by the will of the family, 100% of the elderly showed cognitive performance bad, and the smaller the more dependentcognitive performance was the individual. Conclusion: institutionalized elderly with Alzheimer's disease had negative results on cognitive performance,as well as deficits in their ability to perform activities of daily living, thus altering their functionality.Keywords: aging; functionality; cognition; Alzheimer Disease; long-stay institutions.

Download Full-text

Establishing User Error on the Patient-Reported Component of the American Shoulder and Elbow Surgeons Shoulder Score

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120910094 ◽

2020 ◽

Vol 8 (3) ◽

pp. 232596712091009

Author(s):

Jonathan Bourget-Murray ◽

Ariana Frederick ◽

Lisa Murphy ◽

Jacqui French ◽

Shane Barwood ◽

...

Keyword(s):

Total Error ◽

Cross Sectional Study ◽

Patient Reported Outcome ◽

Error Rates ◽

Sectional Study ◽

Level Of Evidence ◽

Cross Sectional ◽

Total Error Rate ◽

Patient Reported ◽

The Mean

Background: The American Shoulder and Elbow Surgeons (ASES) score is a patient-reported outcome (PRO) questionnaire developed to facilitate communication among international investigators and to allow comparison of outcomes for patients with shoulder disabilities. Although this PRO measure has been deemed easy to read and understand, patients may make mistakes when completing the questionnaire. Purpose: To evaluate the frequency of potential mistakes made by patients completing the ASES score. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A prospective cross-sectional study was performed for 600 ASES questionnaires completed by patients upon their first visit to 1 of 2 clinic locations (Australian vs Canadian site). Two categories of potential errors were predefined, and then differences in error rates were compared based on demographics (age, sex, and location). To determine whether these methods were reliable, an independent, third reviewer evaluated a subset of questionnaires separately. The interrater reliability was evaluated through use of the Cohen kappa. Results: The mean patient age was 49.9 years, and 63% of patients were male. The Cohen kappa was high for both evaluation methods used, at 0.831 and 0.918. On average, 17.9% of patients made at least 1 potential mistake, while an additional 10.4% of patients corrected their own mistakes. No differences in total error rate were found based on baseline demographics. Canadians and Australians had similar rates of error. Conclusion: To ensure the accuracy of the ASES score, this questionnaire should be double checked, as potential mistakes are too frequently made. This attentiveness will ensure that the ASES score remains a valid, reliable, and responsive tool to be used for further shoulder research.

Download Full-text

Mentoring for urologists

Journal of Clinical Urology ◽

10.1177/2051415818802440 ◽

2018 ◽

Vol 12 (2) ◽

pp. 158-162 ◽

Cited By ~ 1

Author(s):

Tim Terry ◽

Nancy Redfern ◽

Gordon French

Keyword(s):

Systematic Review ◽

Case Series ◽

General Medical Council ◽

Cross Sectional Study ◽

Medical Council ◽

Level Of Evidence ◽

Cross Sectional ◽

Trained Staff ◽

The Uk ◽

Based Medicine

Trainee and established urologists are familiar with ‘generic mentoring’ as a potpourri of helping aids that include supervision, coaching, buddying, career advice, counselling and patronage to enable mentees to develop professionally. However, most are unfamiliar with ‘developmental mentoring’ as a highly specific learnt technique through which mentors help mentees, by interactive dialogue, to choose their own agendas and arrive at their own solutions to career/professional/personal opportunities or difficulties as distinct from the paternalistic mentor approach typified by the downward flow of information generated by ‘generic mentoring’. This paper is a systematic review of developmental mentoring as pertains to urologists in the UK, and reports outcomes of 1-hour taster sessions between Egan-trained mentors and urologists offered at British Association of Urological Surgeons (BAUS) annual general meetings since 2013. Both the General Medical Council and the Royal College of Surgeons of England imply that ‘mentoring’ is mandatory for both trainees and trained urologists, but fail to clarify what they mean by a ‘mentor’, which potentially creates a void in providing ‘developmental mentoring’ since the later requires specific training and is costly to provide. Currently, most ‘developmental mentoring’ is performed by trained staff in Local Education and Training Boards or National Health Service Trusts. BAUS has an opportunity to offer ‘developmental mentoring’ through a portal on its website to manage opportunities and difficulties experienced by its members. Level of evidence: This paper is a systematic review as pertains to the place of mentoring in current urological practice. By its nature, it has reviewed previous narrative reviews and its highest level of evidence is a contemporary paper from 2016, which was a comparative cross-sectional study; other case series were reviewed. Overall, this amounts to level 4 with a recommendation of C as per the Oxford Centre for Evidence-based Medicine Levels of Evidence.

Download Full-text

ERECTOR SPINAE AND SCOLIOSIS IN A POPULATION WITH CEREBRAL PALSY: A PRELIMINARY STUDY

Coluna/Columna ◽

10.1590/s1808-185120181701155345 ◽

2018 ◽

Vol 17 (1) ◽

pp. 14-18

Author(s):

OSAMA J. ALÍ-MORELL ◽

FÉLIX ZURITA-ORTEGA ◽

BERENICE FERNÁNDEZ-ESTÉVEZ ◽

BEATRIZ PADILLA-OBISPO ◽

ROBERTO MARTÍNEZ-PORCEL

Keyword(s):

Cerebral Palsy ◽

Case Series ◽

Muscular Activity ◽

Population Level ◽

Vestibular Stimulation ◽

Cross Sectional Study ◽

Erector Spinae ◽

Level Of Evidence ◽

Cross Sectional ◽

Cobb Method

ABSTRACT Objective: To verify the relation of muscular response to the vestibular stimulation of the erector spinae, specifically longissimus thoracis and iliocostalis lumborum, with the origin of scoliosis in a population of individuals with level V cerebral palsy of the Gross Motor Function Classification System (GMFCS). Methods: Cross-sectional study of 12 individuals aged between four and 14 years. The muscular activity of the longissimus thoracis and iliocostalis lumborum was recorded by electromyography in the presence of anteroposterior and lateral imbalances, comparing it with that obtained in sitting position without imbalances. Scoliosis was assessed by radiological study following Cobb method. Results: Statistically significant differences were found between correct responses of both muscles to anteroposterior imbalances and absence of right thoracolumbar scoliosis (p=0.005; p=0.028), left thoracic scoliosis (p=0.005; p=0.046) and right lumbar scoliosis (p=0.005; p=0.046). Conclusions: The symmetry of muscular responses to anteroposterior imbalances, both of longissimus thoracis and iliocostalis lumborum, seems to be one of the factors that prevent the development of spine deviations in this population. Level of evidence: IV. Type of Study: Case series

Download Full-text

Correlation between balance and the level of functional independence among elderly people

Sao Paulo Medical Journal ◽

10.1590/s1516-31802012000200005 ◽

2012 ◽

Vol 130 (2) ◽

pp. 97-101 ◽

Cited By ~ 22

Author(s):

Melina Galetti Prata ◽

Marcos Eduardo Scheicher

Keyword(s):

Elderly People ◽

Functional Independence ◽

Berg Balance Scale ◽

Cross Sectional Study ◽

Community Dwelling ◽

Daily Activities ◽

Cross Sectional ◽

Persons With Disabilities ◽

Physical Independence ◽

The Mean

CONTEXT AND OBJECTIVE: As the overall number of elderly people increases there is a corresponding rise in the number of older persons with disabilities. In order to examine whether there is any relationship between balance and activities of daily living, we evaluated balance and daily activities among elderly people living in the community. DESIGN AND SETTING: Cross-sectional study at Universidade Estadual Paulista (Unesp), Marília, São Paulo, Brazil. METHODS: The study included 70 community-dwelling elderly people aged 65 and over. Balance was evaluated using the Berg Balance Scale (BBS) and physical independence in daily activities was evaluated using the Barthel Index (BI). The Spearman correlation coefficient was used to examine the relationship between the parameters evaluated. Significance was set at the level of 5% (P < 0.05). RESULTS: The population's mean age was 70.5 ± 5 years. The mean BBS score was 50.9 ± 4.1, whereas the mean BI score was 98.1 ± 2.8. Statistically significant relationships were found between the BBS and BI (r = 0.41; P = 0.0004); between age and BI (r = -0.24; P = 0.04); and between age and BBS (r = -0.57; P = 0.0001). CONCLUSIONS: The results showed that among elderly people, there are correlations between age, balance and independence level.

Download Full-text

Relationship between lower-limb muscle strength and functional independence among elderly people according to frailty criteria: a cross-sectional study

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2014.1325669 ◽

2014 ◽

Vol 132 (5) ◽

pp. 282-289 ◽

Cited By ~ 16

Author(s):

Fernanda Sotello Batista ◽

Grace Angélica de Oliveira Gomes ◽

Maria José D'Elboux ◽

Fernanda Aparecida Cintra ◽

Anita Liberalesso Neri ◽

...

Keyword(s):

Muscle Strength ◽

Lower Limb ◽

Functional Independence ◽

Cross Sectional Study ◽

Limb Muscle ◽

Sectional Study ◽

Cross Sectional ◽

Elderly Outpatients ◽

The Mean ◽

Frailty Criteria

CONTEXT AND OBJECTIVE: Muscle strength and functional independence are considered to be determinants of frailty levels among elderly people. The aim here was to compare lower-limb muscle strength (LLMS) with functional independence in relation to sex, age and number of frailty criteria, and to ascertain the influence of these variables on elderly outpatients' independence.DESIGN AND SETTING: Quantitative cross-sectional study, in a tertiary hospital.METHODS: The study was conducted on 150 elderly outpatients of both sexes who were in a cognitive condition allowing oral communication, between October 2005 and October 2007. The following instruments were used: five-times sit-to-stand test (FTSST), Functional Independence Measurement (FIM) and Lawton's Instrumental Activities of Daily Living Scale (IADL). Descriptive, comparative, multivariate, univariate and Cronbach alpha analyses were performed.RESULTS: The mean time taken in the FTSST was 21.7 seconds; the mean score for FIM was 82.2 and for IADL was 21.2; 44.7% of the subjects presented 1-2 frailty criteria and 55.3% > 3 criteria. There was a significant association between LLMS and functional independence in relation to the number of frailty criteria, without homogeneity regarding sex and age. Functional independence showed significant influence from sex and LLMS.CONCLUSION: Elderly individuals with 1 or 2 frailty criteria presented greater independence in all FTSST scores. The subjects with higher LLMS presented better functional independence.

Download Full-text

Accidental falls in the elderly and their relation with functional capacity

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692012000500015 ◽

2012 ◽

Vol 20 (5) ◽

pp. 927-934 ◽

Cited By ~ 11

Author(s):

Jack Roberto Silva Fhon ◽

Suzele Cristina Coelho Fabrício-Wehbe ◽

Thais Ramos Pereira Vendruscolo ◽

Renata Stackfleth ◽

Sueli Marques ◽

...

Keyword(s):

Functional Capacity ◽

Functional Independence Measure ◽

Prevalence Ratio ◽

Female Gender ◽

The Elderly ◽

Functional Independence ◽

Cross Sectional Study ◽

Cross Sectional ◽

Gender And Age ◽

Elderly Health

AIM: This study aimed to determinate the prevalence of falls in the elderly and its relationship with the functional capacity. METHOD: This is an epidemiological and cross-sectional study; a two-stage cluster sample of 240 male and female subjects aged over 60 years was used. Data were collected from November 2010 to February 2011. The following questionnaires were used: socio-demographic profile, assessment of falls, Functional Independence Measure, Lawton and Brody Scale. Significance was set at 0.05. To identify the occurrence of falls and their relation with functional capacity, the prevalence ratio and prevalence odds ratios were used, as well as multiple logistic regression. RESULTS: Average age was 73.5 years (±8.4); 25% 80 years or more, with preponderance of female gender; 48.8% attended school between 1-4 years. The average was 1.33 falls (±0.472), with prevalence in women and elderly between 60 and 79 years old; the most frequently sites were the backyard and bathroom. Strong correlation between the level of functional independence and instrumental activities and age was found, but no relation between elderly victims of falls and the gender and age variables. CONCLUSION: Women who suffered falls related to functional independence were predominant, which can be prevented through elderly health promotion strategies, a policy that serves to offer living conditions to people in the aging process.

Download Full-text

LONGITUDINAL DEVELOPMENT OF THE SPINE AND SPINAL CORD IN HUMAN FETUSES

Coluna/Columna ◽

10.1590/s1808-185120201901221678 ◽

2020 ◽

Vol 19 (1) ◽

pp. 8-12

Author(s):

PATRICIO MANZONE ◽

JUAN ARMANDO GUIDOBONO ◽

DANIEL FORLINO

Keyword(s):

Spinal Cord ◽

Case Series ◽

Lumbar Vertebra ◽

Cross Sectional Study ◽

Foramen Magnum ◽

Longitudinal Growth ◽

Human Fetuses ◽

Level Of Evidence ◽

Cross Sectional ◽

The Difference

ABSTRACT Objective The spinal cord extends from the foramen magnum to the sacrum in the human fetus at the beginning of the 2nd quarter. However, the medullary cone is located at or above the level of the second lumbar vertebra at birth. The objective is to determine the difference between the rates of longitudinal growth of the spinal cord and the spine in human fetuses from the 13th to the 22nd week of gestation (WoG) using magnetic resonance imaging (MRI). Methods Descriptive observational cross-sectional study of 24 stillbirths (13 ♂, 11 ♀), between the 13th and 22nd WoG, using spinal MRI. We recorded spine and spinal cord lengths in millimeters from the foramen magnum to the coccyx for the former and to the medullary cone for the latter. We identified the position of the medullary cone according to vertebral level and its correlation with the gestational age and the literature. Results The spinal cord increased in length from 50 to 93 mm, the spine from 57 to 137 mm, and the medullary cone rose from S1 to L2. The rate of growth was 1.2 mm/day for the spine and 0.6 mm/day for the spinal cord. Conclusions Discordance in the rate of normal longitudinal growth of the spine and spinal cord caused the medullary cone to rise from S1 level to L2 in the second trimester of pregnancy. These results allow an understanding of normal development and certain congenital malformations. Level of evidence IV; Case series.

Download Full-text

OVERLAPPING OF FUNCTIONAL ESOPHAGEAL DISORDERS AND IRRITABLE BOWEL SYNDROME, IN MUSICIANS AND ATHLETES

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220182401169835 ◽

2018 ◽

Vol 24 (1) ◽

pp. 69-72

Author(s):

Sebastian Nedelcut ◽

Daniel-Corneliu Leucuta ◽

Dan Lucian Dumitrascu

Keyword(s):

Associated Factors ◽

Functional Gastrointestinal Disorders ◽

Case Series ◽

Cross Sectional Study ◽

Control Group ◽

Level Of Evidence ◽

Cross Sectional ◽

Functional Heartburn ◽

Irritable Bowel Disease ◽

Irritable Bowel

ABSTRACT Introduction: Functional gastrointestinal disorders (FGIDs) are the most common disorders in the general population. These disorders can overlap, decreasing the quality of life. Objective: We analyzed the prevalence of functional esophageal disorders (FED) and irritable bowel disease (IBS), and their overlapping and associated factors in musicians and athletes. Methods: A cross-sectional study was conducted using FGID and associated factors questionnaires administered to four groups: instrumentalists, singers, athletes, and a control group of healthy volunteers. Results: Of the 161 subjects, 62 (38.51%) had only FED, 76 (47.2%) had only IBS, and 23 (14.29%) had FED-IBS overlap. Subjects with FED-IBS overlap had more severe symptoms of IBS, especially hard and lumpy stools and constipation, compared to those with IBS alone. IBS subtype was more frequent in the overlap group, while not specified IBS type was less frequent. Regarding FED, we found that subjects with FED-IBS overlap had more functional heartburn and less functional dysphagia symptoms. There was a higher risk of overlap in instrumentalists and smokers. Conclusions: FED and IBS are frequently encountered in musicians and athletes. Subjects with FED-IBS overlap presented more frequent and severe symptoms. Instrumentalists and smokers are at higher risk of overlap. Level of Evidence IV; Case series.

Download Full-text