Relationship between anxiety and static and dynamic balance disorder in subjects with cerebrovascular accident (stroke) diagnosis.

Background: According to the World Health Organization, cerebrovascular accident (Stroke) is defined as an acute neurological dysfunction that occurs due to a change in the brain circulation, resulting in signs and symptoms that compromise specific brain sites, persisting for more than 24 hours. There is a range of symptoms that stroke causes, in which motor changes become the most evident and feared symptoms by the patient, as they are the causes of several functional limitations, directly interfering with activities of daily living and possibly causing psychological disorders. Anxiety disorder is one of the psychological disorders that the subject after stroke may have. This disorder is characterized as a state of discouragement, distress and fear, which causes a series of symptoms, such as tachycardia, muscle tension, chronic pain, among others. These emotional and physical changes may be beneficial or harmful to the regularization of the disorders that stroke causes. Objective: To analyze the interference of anxiety on the static and dynamic balance of patients diagnosed with stroke. Methods: Fifteen patients with stroke, aged 40 to 80 years, were assessed using the Hospital Anxiety and Depression Scale, Timed Up and Go test for dynamic balance and the Berg Scale for static balance. Data were tabulated in Excel and analyzed using SPSS. Results: Significant values were found for the correlation between anxiety and balance, in which the results analyzed showed that the balance of patients with stroke can be negatively exacerbated due to the anxiety that affects them. Conclusion: It can be concluded from these results that anxiety can alter the balance of stroke patients and thus, it is shown the importance of a multidisciplinary treatment from the first moment to leverage the treatment.

Download Full-text

Relationship between anxiety and static and dynamic balance disorder in subjects with cerebrovascular accident (stroke) diagnosis

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2020.18.774 ◽

2020 ◽

Vol 18 ◽

pp. 1-5

Author(s):

Ana Paula Lemos Ferreira ◽

Danillo Barbosa

Keyword(s):

Dynamic Balance ◽

Multidisciplinary Treatment ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Timed Up And Go ◽

Balance Disorder ◽

Postural Imbalance ◽

The Subject ◽

First Moment

Background: Sensory systems are responsible for maintaining balance, being vision, vestibular and somatosensory, and all these systems suffer changes in patients with stroke sequelae and studies bet that anxiety is likely to influence the inability of the subject to use these systems, enhancing the postural imbalance in stroke patients. Objective: To analyze the interference of anxiety on the static and dynamic balance of patients diagnosed with stroke. Methods: Fifteen patients with stroke, aged 40 to 80 years, were assessed using the Hospital Anxiety and Depression Scale, Timed Up and Go test for dynamic balance and the Berg Scale for static balance. Data were tabulated in Excel and analyzed using SPSS - Statistical Package for Social Science (version 20.0). Results: Significant values were found for the correlation between anxiety and balance, in which the results analyzed showed that the balance of patients with stroke can be negatively exacerbated due to the anxiety that affects them. Conclusion: It can be concluded from these results that anxiety can alter the balance of these patients and thus, it is shown the importance of a multidisciplinary treatment from the first moment to leverage the treatment.

Download Full-text

WHODAS 2.0-BO

Revista de Saúde Pública ◽

10.11606/s1518-8787.2019053000586 ◽

2019 ◽

Vol 53 ◽

pp. 19

Author(s):

Michele Lacerda Pereira Ferrer ◽

Monica Rodrigues Perracini ◽

Flávio Rebustini ◽

Cassia Maria Buchalla

Keyword(s):

Older Adults ◽

Depression Scale ◽

Health Perception ◽

World Health ◽

Average Score ◽

Mobility Impairment ◽

Timed Up And Go ◽

Cross Sectional ◽

Whodas 2.0 ◽

Mobility Test

OBJECTIVE: To examine the normative data of WHODAS 2.0-BO for older Brazilians (World Health Disability Assessment Schedule – Brazilian version for older people) and its distribution according to sex, age, health, subjective health perception, performance in a mobility test and presence of chronic diseases and depression. METHODS: Cross-sectional study, with 350 participants with 60 years of age or older, men and women, patients of a geriatric specialized center for medical consultations or rehabilitation. The older adults were evaluated using a semi-structured questionnaire containing demographic and clinical data (WHODAS 2.0-BO) and the geriatric depression scale (GDS), having been subsequently subjected to a mobility test (Timed Up and Go). The data were analyzed via their distribution in percentiles of the population and via analysis of variance. RESULTS: Two-hundred and sixty-six (76%) participants were women, and the average age was 71.8 (DP = 6.7) years old. The average score in WHODAS 2.0-BO was 4.3 (DP = 5.2) points, the highest value found having corresponded to 33 points. The average time for the Timed Up and Go test was 10.0 (SD = 3.2) seconds. About 30% of the older adults did not report any difficulties in the tasks evaluated by WHODAS 2.0-BO and half of the sample scored up to two points. CONCLUSIONS: A score corresponding to 12 points in the 90 percentile on a scale from zero to 40 was observed, which suggests severe disability. The score in WHODAS 2.0-BO increased with the advance in age, as well as in the presence of comorbidities, negative health perception, depression, high blood pressure, visual and hearing impairment and mobility impairment.

Download Full-text

Disability, Frailty and Depression in the community-dwelling older adults with Osteosarcopenia

BMC Geriatrics ◽

10.1186/s12877-021-02022-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ki-Soo Park ◽

Gyeong-Ye Lee ◽

Young-Mi Seo ◽

Sung-Hyo Seo ◽

Jun-Il Yoo

Keyword(s):

Older Adults ◽

Short Form ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

Normal Group ◽

World Health ◽

Common Disease ◽

Using Data ◽

Health Organization

Abstract Background The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. Methods This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values according to Osteosarcopenia were large, and GDSSF (0.096) was medium Conclusions Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.

Download Full-text

Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6010001 ◽

2020 ◽

Vol 6 (1) ◽

pp. 1

Author(s):

Boushab Mohamed Boushab ◽

Mohamed Salem Ould Ahmedou Salem ◽

Ali Ould Mohamed Salem Boukhary ◽

Philippe Parola ◽

Leonardo Basco

Keyword(s):

Renal Failure ◽

Respiratory Distress ◽

Severe Malaria ◽

Falciparum Malaria ◽

Clinical Features ◽

Signs And Symptoms ◽

Plasmodium Falciparum Malaria ◽

Severe Anaemia ◽

World Health ◽

Health Organization

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

Download Full-text

Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

SAGE Open Medical Case Reports ◽

10.1177/2050313x21997194 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2199719

Author(s):

Juan Carlos Palomo-Pérez ◽

Maria Elisa Vega-Memije ◽

David Aguilar-Blancas ◽

Erik González-Martínez ◽

Lucia Rangel-Gamboa

Keyword(s):

Respiratory Symptoms ◽

Case Series ◽

Signs And Symptoms ◽

Skin Lesions ◽

World Health ◽

Medical Community ◽

Atypical Pneumonia ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Mexican Patients

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

Download Full-text

Effect of SARS-CoV-2 (COVID-19) Pandemic and Lockdown on Body Weight, Maladaptive Eating Habits, Anxiety, and Depression in a Bariatric Surgery Waiting List Cohort

Obesity Surgery ◽

10.1007/s11695-021-05257-5 ◽

2021 ◽

Author(s):

Umberto Albert ◽

Pasquale Losurdo ◽

Alessia Leschiutta ◽

Serena Macchi ◽

Natasa Samardzic ◽

...

Keyword(s):

Bariatric Surgery ◽

Eating Behaviors ◽

Eating Habits ◽

Depression Scale ◽

Food Habit ◽

World Health ◽

Anxiety And Depression ◽

Considerable Proportion ◽

Obesity Class ◽

Maladaptive Eating

Abstract Purpose On January 30, 2020, the World Health Organization declared COVID-19 as a “public health emergency of international concern.” The primary aim of the study was to evaluate weight and food habit changes during COVID-19 outbreak. The secondary endpoint was to explore the psychological factors, arising during the pandemic, influencing weight and dietary variations. Materials and Methods A survey composed of four different items was conducted by telephone interview: (1) anthropometric data and type of procedure, (2) Hospital Anxiety and Depression Scale (HADS), (3) maladaptive eating behaviors, and (4) personal feelings moved by the COVID-19 spread and lockdown. Results Fifty-six patients were enrolled. No significant changes in weight, BMI, and maladaptive eating habits were observed. A significant reduction in the anxiety index score was observed. In 17.8% of cases, a change in obesity class was reported, and among these patients, a substantial modification in bariatric procedures was planned (60%). Conclusion This study showed no effect on weight and BMI nor on rates of maladaptive eating habits associated with quarantine/social isolation among severely obese individuals waiting for the bariatric surgery. At the end of lockdown, a considerable proportion of patients modified their initial obesity class, and in selected cases, it could represent a criteria for rearrangement of the planned bariatric procedure. In obese patients, the lockdown and social distancing generated a reduction of fear of confronting and being negatively judged by others. This psychological aspect was assessed with the reduction of the HADS score.

Download Full-text

COVID-19 Impact on Medical Practice in Sub-Saharan Africa; The Need to Guard Against Medical Negligence: A Case Report in a Health Care Facility in Kumasi, Ghana

Clinical Pathology ◽

10.1177/2632010x211025308 ◽

2021 ◽

Vol 14 ◽

pp. 2632010X2110253

Author(s):

Paul Poku Sampene Ossei ◽

William Gilbert Ayibor ◽

John Taylor ◽

Lawrence Agyemang ◽

Kwabena Owusu Aninkora ◽

...

Keyword(s):

Laboratory Tests ◽

Respiratory Infections ◽

Care Facility ◽

Health Care Facility ◽

Signs And Symptoms ◽

Sub Saharan Africa ◽

World Health ◽

African Countries ◽

Diagnostic Dilemma ◽

Negative Results

With the novel coronavirus disease 2019 (COVID-19) still in pandemic mode, according to the World Health Organization (WHO), the African continent has experienced continued growth in the total tally. According to the Africa Centers for Disease Control and Prevention (CDC), the virus has spread to almost all 54 recognized African countries. Figures from the CDC indicate that the highly affected countries include South Africa, Egypt, Nigeria, Algeria, Morocco, and Ghana (with more than 55 000 cases and 400 deaths as of the time of writing). The WHO and the United Nations have projected the ongoing pandemic could push medical practitioners toward high rates of clinical misdiagnosis. So far, the coronavirus pandemic has been more devastating and life-threatening than the usual seasonal flu. As of the time of writing, here is presently no proven vaccine or treatment for the disease, with the vaccines still under development; hence, a timely and accurate diagnosis could prove critical. Patients can also receive supportive care earlier if they are diagnosed early. Considering the fact that the coronavirus infection mimics the signs and symptoms of normal flu and other respiratory infections, a problem now emerges, where these symptoms are treated as manifestations of the deadly virus. This has caused a diagnostic dilemma in the absence of laboratory tests with new cases adding to the pool daily. In Ghana, many patients on suspicion of flu-like symptoms are sometimes denied the care so deserved due to the stigma associated with the disease, often in cases where laboratory tests are absent. This study is a postmortem report of a client who died while on admission at a private medical facility. It was an unconfirmed case of COVID-19, and the client was left unattended to and died, having spent 8 days on the ward. His test report was not done initially, but the diagnosis was purely based on suspicion. Nasopharyngeal swabs conducted on the fifth day of admission proved negative. Results became available on the day of the client’s demise. Postmortem findings established the actual cause of death, and it was not COVID-19 related.

Download Full-text

Effects of proprioception training program on balance among patients with diabetic neuropathy: a quasi experimental trial

Journal of the Pakistan Medical Association ◽

10.47391/jpma.286 ◽

2021 ◽

pp. 1-12

Author(s):

Humaira Iram ◽

Muhammad Kashif ◽

Hafiz Muhammad Junaid Hassan ◽

Salma Bunyad ◽

Samra Asghar

Keyword(s):

Diabetic Neuropathy ◽

Dynamic Balance ◽

Berg Balance Scale ◽

Exercise Group ◽

Walk Test ◽

Timed Up And Go ◽

Functional Reach ◽

Functional Reach Test ◽

Quasi Experimental ◽

Eyes Open

Abstract Objective: To determine the effects of proprioception training in improving balance in patients with diabetic neuropathy. Methods: A quasi-experimental design study was conducted at the Safi Hospital Faisalabad for eight weeks from August to December 2019. Out of, 38, 19 patients were placed in exercise group (10 males, 9 females; mean age 64 ± 7.7 years; range 60 to 83 years) and 19 patients were placed in controls group (12 males, 7 females; mean age 63 ± 8.2 years) were included in this study through consecutive sampling technique. Proprioception Training was given to exercise group twice a week for eight weeks and the diabetes awareness campaign was given once a week to the control group. Static and dynamic balance were assessed by using One Leg Standing (OLS) Test with eyes open and closed, Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUGT) and 10-M Walk Test (10-MWT). The data was collected before and after treatment and was compared using independent sample t-test. Results: The finding of the study showed that OLS score with eyes open improved significantly with p<0.05 and does not show improvement with eyes closed p =.073. The dynamic balance from the Berg Balance Scale, Functional Reach Test, Timed Up and Go Test and 10-M Walk Test revealed significant improvement after the balance exercises with p<0.05 Conclusion: It is concluded that proprioception training exercises are effective in improving balance among patients with Diabetic neuropathy. Continuous...

Download Full-text

Effects of square stepping exercise in patients with sequel of cerebrovascular accident

Fisioterapia em Movimento ◽

10.1590/0103-5150.027.002.ao08 ◽

2014 ◽

Vol 27 (2) ◽

pp. 229-237

Author(s):

Grazieli Silva Túbero ◽

Sebastião Gobbi ◽

Camila Vieira Ligo Teixeira ◽

Jessica Rodrigues Pereira ◽

Ryosuke Shigematsu ◽

...

Keyword(s):

Cognitive Functions ◽

Verbal Fluency ◽

Depression Scale ◽

Cognitive Status ◽

The Body ◽

Wilcoxon Test ◽

Cerebral Stroke ◽

Timed Up And Go ◽

Body Balance ◽

Stepping Exercise

Introduction Cerebral stroke is the interruption of blood flow to the brain and can be classified into hemorrhagic and ischemic. It may result in serious body balance and cognition complications. Kinesiotherapy is a privileged means of rehabilitation.Objective Verify the effects of Square Stepping Exercise (SSE) on cognitive functions, depressive symptoms and the body balance of cerebral stroke sequel patients.Methods Thirteen brain stroke sequel patients were divided into two groups: SSE (SSEG n = 8) and conventional physiotherapy group (PG, n = 5). The SSEG participated only of the SSE training protocol, while the PG participated of its physical therapy routine group, both for 4 months. They were evaluated using the Mini Mental State Examination (MMSE), the Brief Cognitive Screening Battery (BBRC), the Geriatric Depression Scale (GDS),Berg Balance Scale(BBS) and Timed Up and Go(TUG).Results The U Mann Whitney test showed no significant differences between groups. In intragroup analysis, the Wilcoxon test showed significant improvement in global cognitive status for PG (p < 0.042), and for SSEG there were positive results for verbal fluency (p < 0.04) and in TUG for number of steps (p < 0.04) and the time (p < 0.02).Conclusion The SSE seems to benefit dynamic balance, influencing gait agility, cognition related to verbal fluency and may have contributed to maintain other cognitive functions.

Download Full-text

Documented Evidence of Depression in Medical and Nursing Case-Notes and Its Implications in Acutely Ill Geriatric Inpatients

International Psychogeriatrics ◽

10.1017/s1041610298005274 ◽

1998 ◽

Vol 10 (2) ◽

pp. 163-172 ◽

Cited By ~ 13

Author(s):

Ajit Shah ◽

Tamal De

Keyword(s):

Geriatric Medicine ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Signs And Symptoms ◽

Screening Procedure ◽

Medically Ill ◽

Brief Assessment ◽

Medical Inpatients ◽

Elderly Inpatients ◽

The Impact

Depression is common among acutely ill elderly medical inpatients. Identification of such depression by the geriatric medicine staff would allow early treatment. The impact of a depression screening procedure on documentation of depressive signs and symptoms in the medical and nursing case-notes was examined. Thirty-five sets of medical and nursing case-notes of medically ill elderly inpatients, for whom data from the Brief Assessment Schedule and the short Geriatric Depression Scale (GDS) were also available, were examined for documentation of signs and symptoms of depression, prescription of antidepressants, and referred to the psychogeriatric service. Depressive signs and symptoms were documented in only a few medical (29%) and nursing (11%) case-notes. Only a small number of depressed patients were prescribed antidepressants (20%) or were referred to the psychogeriatric service (13%). The frequency of documentation of depressive signs and symptoms after the screening procedure with the short GDS was associated with subsequent prescription of antidepressants and referral to the psychogeriatric service. The screening procedure itself may increase the general awareness of depressive signs and symptoms and affect its management. These results require replication.

Download Full-text