scholarly journals Effect of Ankle Plantar Flexor Spasticity Level on Balance in Patients With Stroke: Protocol for a Cross-Sectional Study

10.2196/16045 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e16045
Author(s):  
Ashraf Mahmoudzadeh ◽  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Ebrahim Sadeghi-Demneh ◽  
Omid Motamedzadeh ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Mixed Model ◽  
Univariate Analysis ◽  
Secondary Outcome ◽  
Plantar Flexor ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Eyes Closed

Background The lower limb spasticity after stroke can affect the balance and gait of patients with stroke. Objective The aim of this study is to assess the effects of ankle plantar flexor spasticity level on balance in patients with stroke. Methods Patients with stroke were recruited from neurology and physiotherapy clinics in Tehran, Iran. Based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS), the eligible patients with stroke were divided into 2 groups: high spasticity (MMAS score≥2) and low spasticity (MMAS score<2). The primary outcome measures were the MMAS scores, Activities-Specific Balance Confidence questionnaire scores, eyes-open and eyes-closed posturography measures, and Timed Up and Go test results. The secondary outcome measures were the ankle passive range of motion and ankle joint proprioception. The t test, mixed model univariate analysis of variance, and Spearman rank correlation were used for statistical analysis. Results Data collection and statistical analysis are complete. The interpretation of results is underway. We expect the results to be published in winter 2020. Conclusions We believe that patients with high ankle plantar flexor spasticity after stroke will demonstrate greater balance dysfunction, which will worsen with impaired proprioception, passive range of motion, and eyes closed. International Registered Report Identifier (IRRID) RR1-10.2196/16045

scholarly journals Effect of Ankle Plantar Flexor Spasticity Level on Balance in Patients With Stroke: Protocol for a Cross-Sectional Study (Preprint)

2019 ◽  
Author(s):  
Ashraf Mahmoudzadeh ◽  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Ebrahim Sadeghi-Demneh ◽  
Omid Motamedzadeh ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Mixed Model ◽  
Univariate Analysis ◽  
Secondary Outcome ◽  
Plantar Flexor ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Eyes Closed

BACKGROUND The lower limb spasticity after stroke can affect the balance and gait of patients with stroke. OBJECTIVE The aim of this study is to assess the effects of ankle plantar flexor spasticity level on balance in patients with stroke. METHODS Patients with stroke were recruited from neurology and physiotherapy clinics in Tehran, Iran. Based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS), the eligible patients with stroke were divided into 2 groups: high spasticity (MMAS score≥2) and low spasticity (MMAS score&lt;2). The primary outcome measures were the MMAS scores, Activities-Specific Balance Confidence questionnaire scores, eyes-open and eyes-closed posturography measures, and Timed Up and Go test results. The secondary outcome measures were the ankle passive range of motion and ankle joint proprioception. The t test, mixed model univariate analysis of variance, and Spearman rank correlation were used for statistical analysis. RESULTS Data collection and statistical analysis are complete. The interpretation of results is underway. We expect the results to be published in winter 2020. CONCLUSIONS We believe that patients with high ankle plantar flexor spasticity after stroke will demonstrate greater balance dysfunction, which will worsen with impaired proprioception, passive range of motion, and eyes closed. INTERNATIONAL REGISTERED REPORT RR1-10.2196/16045

scholarly journals Effect of ultraprocessed food intake on cardiometabolic risk is mediated by diet quality: a cross-sectional study

2021 ◽  
pp. bmjnph-2020-000225
Author(s):  
Jennifer Griffin ◽  
Anwar Albaloul ◽  
Alexandra Kopytek ◽  
Paul Elliott ◽  
Gary Frost
Keyword(s):  
Food Intake ◽  
Energy Intake ◽  
Food Consumption ◽  
Outcome Measures ◽  
Diet Quality ◽  
Cardiometabolic Risk ◽  
Saturated Fat ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Occupational Cohort

ObjectiveTo examine the effect of the consumption of ultraprocessed food on diet quality, and cardiometabolic risk (CMR) in an occupational cohort.DesignCross-sectional.SettingOccupational cohort.Participants53 163 British police force employees enrolled (2004–2012) into the Airwave Health Monitoring Study. A total of 28 forces across the UK agreed to participate. 9009 participants with available 7-day diet record data and complete co-variate data are reported in this study.Main outcome measuresA CMR and Dietary Approaches to Stop Hypertension score were treated as continuous variables and used to generate measures of cardiometabolic health and diet quality. Secondary outcome measures include percentage of energy from fat, saturated fat, carbohydrate, protein and non-milk extrinsic sugars (NMES) and fibre grams per 1000 kcal of energy intake.ResultsIn this cohort, 58.3%±11.6 of total energy intake was derived from ultraprocessed (NOVA 4) foods. Ultraprocessed food intake was negatively correlated with diet quality (r=−0.32, p<0.001), fibre (r=−0.20, p<0.001) and protein (r = −0.40, p<0.001) and positively correlated with fat (r=0.18, p<0.001), saturated fat (r=0.14, p<0.001) and nmes (r=0.10, p<0.001) intake . Multivariable analysis suggests a positive association between ultraprocessed food (NOVA 4) consumption and CMR. However, this main effect was no longer observed after adjustment for diet quality (p=0.209). Findings from mediation analysis indicate that the effect of ultraprocessed food (NOVA 4) intake on CMR is mediated by diet quality (p<0.001).ConclusionsUltraprocessed food consumption is associated with a deterioration in diet quality and positively associated with CMR, although this association is mediated by and dependent on the quality of the diet. The negative impact of ultraprocessed food consumption on diet quality needs to be addressed and controlled studies are needed to fully comprehend whether the relationship between ultraprocessed food consumption and health is independent to its relationship with poor diet quality.

scholarly journals Government management capacities and the containment of COVID-19: a repeated cross-sectional study across Chinese cities

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041516
Author(s):  
Wenchao Li ◽  
Jing Li ◽  
Junjian Yi
Keyword(s):  
Outcome Measures ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Travel Restrictions ◽  
Government Management ◽  
The Government ◽  
Laws And Policies ◽  
Novel Coronavirus

ObjectivesBetter understanding of the dynamics of the COVID-19 (2019 novel coronavirus disease) pandemic to curb its spread is now a global imperative. While travel restrictions and control measures have been shown to limit the spread of the disease, the effectiveness of the enforcement of those measures should depend on the strength of the government. Whether, and how, the government plays a role in fighting the disease, however, has not been investigated. Here, we show that government management capacities are critical to the containment of the disease.SettingWe conducted a statistical analysis based on cross-city comparisons within China. China has undergone almost the entire cycle of the anticoronavirus campaign, which allows us to trace the full dynamics of the outbreak, with homogeneity in standards for statistics recording.Primary and secondary outcome measuresOutcome measures include city-specific COVID-19 case incidence and recoveries in China.ResultsThe containment of COVID-19 depends on the effectiveness of the enforcement of control measures, which in turn depends on the local government’s management capacities. Specifically, government efficiency, capacity for law enforcement, and the transparency of laws and policies significantly reduce COVID-19 prevalence and increase the likelihood of recoveries. The organisation size of the government, which is not closely related to its capacity for management, has a limited role.

scholarly journals Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049926
Author(s):  
Sandra Angelika Mümken ◽  
Paul Gellert ◽  
Malte Stollwerck ◽  
Julie Lorraine O'Sullivan ◽  
Joern Kiselev
Keyword(s):  
Older Adults ◽  
Construct Validity ◽  
Outcome Measures ◽  
Total Sample ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Life Space ◽  
Cross Sectional ◽  
The Past ◽  
Community Dwelling Older Adults

ObjectivesTo develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.DesignCross-sectional validation study.SettingTwo study centres in urban and rural German outpatient hospital settings.ParticipantsIn total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measuresThe final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.ResultsIn the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.ConclusionThe LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration numberDRKS00019023.

Foot Mobilization and Exercise Program Combined with Toe Separator Improves Outcomes in Women with Moderate Hallux Valgus at 1-Year Follow-up

2018 ◽  
Vol 108 (6) ◽  
pp. 478-486 ◽  
Author(s):  
Sahar Ahmed Abdalbary
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Hallux Valgus ◽  
Outcome Measures ◽  
Mixed Model ◽  
Exercise Program ◽  
Angular Measurements ◽  
Foot Joint ◽  
Abduction Strength

Background: Few studies have documented the outcome of conservative treatment of hallux valgus deformities on pain and muscle strength. We sought to determine the effects of foot mobilization and exercise, combined with a toe separator, on symptomatic moderate hallux valgus in female patients. Methods: As part of the randomized clinical trial, 56 women with moderate hallux valgus were randomly assigned to receive 36 sessions for 3 months or no intervention (waiting list). All patients in the treatment group had been treated with foot joint mobilization, strengthening exercises for hallux plantarflexion and abduction, toe grip strength, stretching for ankle dorsiflexion, plus use of a toe separator. Outcome measures were pain and American Orthopedic Foot and Ankle Society (AOFAS) scores. Objective measurements included ankle range of motion, plantarflexion and abduction strength, toe grip strength, and radiographic angular measurements. Outcome measures were assessed by comparing pretreatment, posttreatment, and 1-year follow-up after the intervention. Mixed-model analyses of variance were used for statistical assessment. Results: Patients who were treated with 3 months of foot mobilization and exercise combined with a toe separator experienced greater improvement in pain, AOFAS scores, ankle range of motion, hallux plantarflexion and abduction strength, toe grip strength, and radiographic angular measurements than those who did not receive an intervention 3 months and 1 year postintervention (P &lt; .001 for all comparisons). Conclusions: These results support the use of a multifaceted conservative intervention to treat moderate hallux valgus, although more research is needed to study which aspects of the intervention were most effective.

scholarly journals Willingness of patients to use unused medication returned to the pharmacy by another patient: a cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024767 ◽  
Author(s):  
Charlotte Bekker ◽  
Bart van den Bemt ◽  
Toine CG Egberts ◽  
Marcel Bouvy ◽  
Helga Gardarsdottir
Keyword(s):  
Outcome Measures ◽  
Patient Characteristics ◽  
Secondary Outcome ◽  
High Educational Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Included Patient ◽  
Willingness To Use ◽  
High Educational ◽  
Patient Willingness

ObjectivesRedispensing by pharmacies of medication unused by another patient could contribute to optimal use of healthcare resources. This study aimed to assess patient willingness to use medication returned by another patient and patient characteristics associated with this willingness.DesignCross-sectional survey.SettingA total of 41 community and 5 outpatient pharmacies in the Netherlands.ParticipantsTotal of 2215 pharmacy visitors.Primary and secondary outcome measuresPatients completed a questionnaire regarding their willingness to use medication returned unused to the pharmacy by another patient, assuming quality was guaranteed. Secondary outcome measures included patient sociodemographic characteristics that were associated with patient willingness, analysed using logistic regression analysis and reported as ORs with 95% CIs.ResultsOf the 2215 patients (mean (SD) age 50.6(18.0) years; 61.4% female), 61.2% were willing to use medication returned unused to the pharmacy by another patient. Patients who were unwilling mostly found it risky. Men were more willing to use returned medication (OR 1.3 95% CI 1.1 to 1.6), as did patients with a high educational level (OR 1.8 95% CI 1.3 to 2.5), those who regularly use 1–3 medications (OR 1.3 95% CI 1.1 to 1.7), those who returned medication to the pharmacy for disposal (OR 1.5 95% CI 1.0 to 2.3) and those who ever had unused medication themselves (OR 1.3 95% CI 1.1 to 1.6)). Patients with non-Dutch cultural background were less willing to use returned medication (OR 0.395% CI 0.3 to 0.4)).ConclusionsWhen quality is guaranteed, a substantial proportion of patients are willing to use medication returned unused to the pharmacy by another patient. This suggests that implementation of redispensing may be supported by patients.

scholarly journals Association between socioeconomic status and prevalence of non-communicable diseases risk factors and comorbidities in Bangladesh: findings from a nationwide cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025538 ◽  
Author(s):  
Tuhin Biswas ◽  
Nick Townsend ◽  
Md Saimul Islam ◽  
Md Rajibul Islam ◽  
Rajat Das Gupta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Outcome Measures ◽  
Adult Population ◽  
Multivariable Analysis ◽  
Communicable Diseases ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Non Communicable Diseases

ObjectivesThis study aimed to examine the prevalence and distribution in the comorbidity of non-communicable diseases (NCDs) among the adult population in Bangladesh by measures of socioeconomic status (SES).DesignThis was a cross-sectional study.SettingThis study used Bangladesh Demographic and Health Survey 2011 data.ParticipantsTotal 8763 individuals aged ≥35 years were included.Primary and secondary outcome measuresThe primary outcome measures were diabetes mellitus (DM), hypertension (HTN) and overweight/obesity. The study further assesses factors (in particular SES) associated with these comorbidities (DM, HTN and overweight/obesity).ResultsOf 8763 adults,12% had DM, 27% HTN and 22% were overweight/obese (body mass index ≥23 kg/m2). Just over 1% of the sample had all three conditions, 3% had both DM and HTN, 3% DM and overweight/obesity and 7% HTN and overweight/obesity. DM, HTN and overweight/obesity were more prevalent those who had higher education, were non-manual workers, were in the richer to richest SES and lived in urban settings. Individuals in higher SES groups were also more likely to suffer from comorbidities. In the multivariable analysis, it was found that individual belonging to the richest wealth quintile had the highest odds of having HTN (adjusted OR (AOR) 1.49, 95% CI 1.29 to 1.72), DM (AOR 1.63, 95% CI 1.25 to 2.14) and overweight/obesity (AOR 4.3, 95% CI 3.32 to 5.57).ConclusionsIn contrast to more affluent countries, individuals with NCDs risk factors and comorbidities are more common in higher SES individuals. Public health approaches must consider this social patterning in tackling NCDs in the country.

scholarly journals Investigation of Balance in Old People Residing in Nursing Homes Using Clinical Assessments

2020 ◽  
Vol 3 (1) ◽  
pp. 11-16
Author(s):  
Sogol Zeinali ◽  
◽  
Zahra Olyaei ◽  
Benyamin Kor ◽  
Maryam Binesh ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Postural Sway ◽  
Age Groups ◽  
Clinical Test ◽  
Old People ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Clinical Assessments ◽  
Eyes Closed ◽  
Eyes Open

Background and Objectives: Balance problems are the main cause of falls and fall-related complications in the elderly. The objective of this study was to investigate the balance in old people residing in nursing homes using clinical assessments. Methods: A total of 54 people participated in this cross-sectional study. Timed Up and Go (TUG) was used to assess balance regarding mobility impairments. The modified Clinical Test Of Sensory Interaction on Balance (CTSIB) was also used to assess balance regarding sensory problems. This test was used in 4 conditions: standing with eyes open on a firm surface, standing with eyes closed on a firm surface, standing with eyes open on a compliant foam, and standing with eyes closed on a compliant foam. Data analysis was done by SPSS V. 18 software. Results: The mean time for the completion of TUG was significantly higher than standard scores in all age groups (P<0.05). Postural sway during standing with eyes closed on the ground, eyes open and eyes closed on the foam was more than standing with eyes open on the ground (P<0.001). Postural sway in standing with eyes closed on the foam was more in comparison with standing with eyes closed on the ground and eyes open on the foam (P<0.001). Conclusion: Elderly people living in nursing homes had poorer motor skills to maintain balance. They also showed greater dependence on visual and sensory systems to maintain balance.

scholarly journals Relevance of anthropometric measurements as predictors of prevalent diabetes type 2: a cross-sectional study on a Norwegian population

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046162
Author(s):  
Anton Hasselgren ◽  
Biraj Man Karmacharya ◽  
Ann-Katrin Stensdotter
Keyword(s):  
Diabetes Mellitus ◽  
Outcome Measures ◽  
Diabetes Mellitus Type 2 ◽  
Diabetes Mellitus Type ◽  
Secondary Outcome ◽  
Anthropometric Indices ◽  
Cross Sectional ◽  
Norwegian Population ◽  
Potential Association

ObjectivesThe objective was to determine the predictive potential of anthropometric indices to screen prevalent diabetes mellitus type 2 in a Norwegian population.DesignThis is a cross-sectional design to determine the potential association of waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), waist circumference (WC) and body mass index (BMI) with prevalent diabetes mellitus type 2 through logistic regression analysis. Receiver operating characteristic (ROC) curves were used to determine the predictive potential of the anthropometric indices. Youden’s index was applied to determine the optimal cut-off points for each anthropometric index.SettingThis study used cross-sectional data from the populations-based Health Study in Nord-Trøndelag which invited all citizens in the county above 20 years of age.ParticipantsThis study included all those who were non-pregnant and had complete data (N=50 042), 98.5% of the participants. The sample is to be considered representative for the population of Norway.Primary and secondary outcome measuresOR and ROC of the potential association between diabetes mellitus type 2 and anthropometric indices were the main planned and performed outcome measures.ResultsThe results suggest that the anthropometric indices performed differently within the Norwegian population with WHR and WHtR being the stronger predictor with (ROC) of 0.746 (0.735 to 0.757) and 0.741 (0.730 to 0.752). The predictive potential for the investigated anthropometric indices was generally stronger for women than men.ConclusionAnthropometric indices of size BMI and the highly correlated WC are less associated with prevalent diabetes mellitus type 2 than WHR (WC adjusted for hip circumference) or WHtR (WC adjusted for height) in a Norwegian population.

scholarly journals Post-operative Experience following Caesarean Section in a Nigerian Obstetric Population

2021 ◽  
Vol 2 (1) ◽  
pp. 60-65
Author(s):  
Jamila A Garba ◽  
Abubakar A Panti ◽  
Ahmed Yakubu ◽  
Eze A Ukwu ◽  
Ahmed T Burodo ◽  
...  
Keyword(s):  
Pain Relief ◽  
Caesarean Section ◽  
Outcome Measures ◽  
Elective Caesarean Section ◽  
Cross Sectional Study ◽  
Emergency Caesarean Section ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Emergency Caesarean

Background: Caesarean section is the most significant obstetrics operative intervention globally. Good postoperative experience after caesarean section is important because there is need for the mother to recover from surgery and take care of her baby. The aim of this study was to assess the experience of women that had caesarean section in the first 24 hours postoperatively. Materials/methods: This was a cross-sectional study conducted among women that had elective and emergency caesarean section. They were followed up to 24 hours post-operative. The primary outcome measures were pain score and satisfaction. Secondary outcome measures were time of mobilization, time of commencement of oral feeds and time of initiation of breastfeeding. Data analysis was carried out using Statistical Package for Social Sciences version 22. Results: The median pain scores among those that had emergency and elective caesarean section ranged between 2 and 3 at all points of pain assessment. The satisfaction was good among 66.1% that had emergency caesarean section and 71.2% among those that had elective caesarean section. However, the difference was not statistically significant (χ2 = 0.546, p = 0.761). More than 90% of the participants that had either emergency or elective caesarean section did not ambulate within the first 24 hours after caesarean section and there was no association between the time of ambulation and the type of caesarean section (χ2 = 0.005, p = 0.941). Conclusion: The participants had adequate pain relief and majority were satisfied with the pain relief. However, the optimum satisfaction was not achieved. The participants did not ambulate early and did not initiate breast-feeding early. Recommendation: Further research is recommended to assess other factors that affect patient's satisfaction and ambulation so as to improve on patient's postoperative care.

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