scholarly journals The impact of altered hands function on working ability of patients with systemic sclerosis

2020 ◽  
Vol 77 (1) ◽  
pp. 70-78
Author(s):  
Predrag Vidakovic ◽  
Nemanja Damjanov

Background/Aim. Hand impairment in systemic sclerosis (SSc) patients is the most frequent manifestation of this progressive disease and often cause problems in daily activities and working ability. The correlation of altered hand functions in patients with SSc and their impact on working ability is not fully explained. The objective of this study is to assess the impact of altered hand functions of patients with SSc on their working ability. Methods. We assessed 20 patients with SSc (17 females, 3 males), with mean age of 45.5 ? 11.9 years (min 29, max 69, Med 44.0 years). The movements of fingers, wrist and forearm were examined by measuring active range of motion of the hand and fingers, muscle strength of the fingers, the skin lesions by modified Rodnan score, the function of the fingers, hands and forearms by the Hand Mobility in Scleroderma (HAMIS) test, as well as the condition of the capillaries in the fingers by capillaroscopy and working capacity by Work Ability Index (WAI). Results. Reduced strength on at least one tested muscle, was established in all patients, thickening of the skin on the hands in 14/20 (70%) and the fingers in 19/20 (95%), ?scleroderma type? capillary changes in 15/17 (85%), decreased range of motion in finger joints in 16/20 (80%) of the patients. Also, 14/20 (70%) of subjects reported problems at work [decrease performance achieved in 8/20 (40%), reduction of working hours in also 8/20 (40%), leaving out some of the work in 14/20 (70%), and investing of extra effort in 15/20 (75%)]. By means of WAI, work ability assessment questionnaire, it was found that the working capacity was reduced in 11/20 (55%) of our patients. None of the patients was in the group of the most serious cases, the ?poor? category; in the ?moderate? category there were 6/20 (30%), while 5/20 (25%) of the patients were in the group with minimally reduced working capacity (?good? category). There was a statistically significant correlation between the thickened skin on the fingers (p < 0.05), reduced muscle strength in the fingers (p < 0.002) and limited mobility of the individual finger joints (p < 0.05), with information on reduced working capacity obtained by means of WAI questionnaire and with answers to questions about problems at work. Conclusion. The thickened skin on the fingers, reduced fingers muscle strength and limited mobility of certain finger joints in patients with SSc cause decreasing working capacity for all jobs that include manual activities.

2021 ◽  
Vol 63 (2) ◽  
pp. 93-98
Author(s):  
Agnieszka Przedborska ◽  
Mateusz Szymczak ◽  
Małgorzata Kilon ◽  
Łukasz Kikowski ◽  
Jan Raczkowski

Introduction: Rheumatoid arthritis (RA) is a chronic disease that leads to disability of patients. The use of the whole-body cryotherapy treatment for RA patients provides analgesic and anti-inflammatory effects and improves their efficiency. Aim: Assessment of the effect of the whole-body cryotherapy treatment on the functional state of knee joints for patients with RA. Material and Method: The study was conducted on a group of 30 RA patients, who underwent a series of 10 whole-body cryotherapy treatment. The effectiveness and efficiency of the applied therapy was assessed on the basis of: the VAS scale, the Laitinen scale, the assessment of the range of motion, muscle strength with the MicroFet dynamometer and the Up and Go test. Results: As a result of the applied whole-body cryotherapy treatment, a reduction in the intensity of pain, measured with the VAS scale and the Laitinen scale, and a reduction in the duration of morning stiffness by about 55% were found. There was an increase in the range of motion and muscle strength. The time needed to perform the Up and Go test was reduced by 17%. Conclusions: The whole-body cryotherapy treatment is an effective analgesic method of physiotherapy for patients with RA. It provides an improvement in the functional state, increases the range of motion, muscle strength and improves the gait function.


2011 ◽  
Vol 21 (1) ◽  
pp. 61-72 ◽  
Author(s):  
Juliane Vogler ◽  
Lily O'Hara ◽  
Jane Gregg ◽  
Fiona Burnell

Background: With the current challenge of rapidly aging populations, practices such as yoga may help older adults stay physically active, healthy, and fulfilled. Methods: The impact of an 8-week Iyengar yoga program on the holistic health and well-being of physically inactive people aged 55 years and over was assessed. Thirty-eight older adults (mean age 73.21 ± 8.38 years; 19 intervention, 19 control) engaged in either twice-weekly yoga classes or continued their usual daily routines. Physical health measures were muscle strength, active range of motion, respiratory function (FEV1), resting blood pressure, and immune function (salivary IgA and lysozyme). Self-perceived general,physical, mental, spiritual, and social health and well-being were assessed with the Life's Odyssey Questionnaire and the SF12v2™ Health Survey. Results: Muscle strength, active range of motion, physical well-being, and aspects of mental well-being (emotional well-being and self-care) improved significantly in the yoga group (p &lt; .05). Median changes in most of these variables were also significantly different from those in the control group. Conclusions:Participation in Iyengar yoga programs by older people is beneficial for health and well-being, and greater availability of such programs could improve quality of life.


2007 ◽  
Vol 67 (4) ◽  
pp. 471-477 ◽  
Author(s):  
M van der Esch ◽  
M Steultjens ◽  
J Harlaar ◽  
N Wolterbeek ◽  
D Knol ◽  
...  

Objective:To assess the relationship between knee varus–valgus motion and functional ability, and the impact of knee varus–valgus motion on the relationship between muscle strength and functional ability in patients with osteoarthritis (OA) of the knee.Methods:Sixty-three patients with knee OA were tested. Varus–valgus motion was assessed by optoelectronic recording and three-dimensional motion analysis. Functional ability was assessed by observation, using a 100 m walking test, a Get Up and Go test, and WOMAC questionnaire. Muscle strength was measured by a computer-driven isokinetic dynamometer. Regression analyses were performed to assess the relationships between varus–valgus motion and functional ability, and to assess the impact of varus–valgus motion on the relationship between muscle strength and functional ability.Results:In patients with high varus–valgus range of motion, muscle weakness was associated with a stronger reduction in functional ability (ie, longer walking time and Get Up and Go time) than in patients with low varus–valgus range of motion. A pronounced varus position and a difference between the left and right knees in varus–valgus position were related with reduced functional ability.Conclusions:In patients with knee OA with high varus–valgus range of motion, muscle weakness has a stronger impact on functional ability than in patients with low varus–valgus range of motion. Patients with knee OA with more pronounced varus knees during walking show a stronger reduction in functional ability than patients with less pronounced varus knees or with valgus knees.


2021 ◽  
Author(s):  
Madhu Lakhwani ◽  
Pratik Phansopkar

Abstract Background: In the outpatient setting, plantar fasciitis has been the most frequent cause of heel pain. A sharp insidious pain under the heel and along the medial border of the plantar fascia up to its insertion at the calcaneus are signs of plantar fasciitis. The most common cause of biomechanical changes in PF is calf muscle tightness. Percussive Therapy is a relatively new technique that uses a mechanical system, such as the Theragun, to provide percussive massage.(17) Therefore, this Research will explore the current literature regarding the effect of massage gun device on Pain, Range of Motion, Muscle Strength and Functional Outcomes in Patients with Plantar Fasciitis.Methodology:In the study, 48 patients diagnosed with Plantar fasciitis will be enrolled for a week. One group will receive conventional therapy and the other group will receive a percussive therapy treatment via Theragun for a week. Pain, flexibility, ROM and Muscle strength will be evaluated using to standard technique.Discussion:The goal of this Interventional study is to examine the impact of Percussive Massage Therapy in Patients with Plantar Fasciitis. The study findings would help prospective patients with Plantar Fasciitis, which may include a newly designed method of rehabilitation.The clinical trial registry-India(CTRI) registration number for this trial is CTRI/2021/05/033460.


2018 ◽  
Vol 2 (3) ◽  
pp. 57
Author(s):  
Mohamat Iskandar

Background: Non-hemorrhagic stroke patients experience hemiparesis, an improper handling results in joint contractures. Discharge planning combined with a range of motion (ROM) training given to patients and their families are expected to improve muscle strength in patients after returning from the hospital. Aims: This study is to identify the effectiveness of discharge planning in increasing muscle strength. Methods: This is a quasi-experimental study with a pre-posttest design. A total of 34 respondents were selected by cluster random sampling technique, from RAA Soewondo Pati General Hospital of Pati, Central Java, Indonesia. The respondents were divided equally into two groups; an intervention group (N = 17) was given a discharge planning program together with stroke information and range of motion (ROM) training while the control group (N = 17) received a standard discharge planning available in the hospital. Further, Muscle Rating Scale (MRS) was employed to assess the muscle strength on the 2nd, 7th, and 14th day after discharge planning presented to the nonhemorrhagic stroke patients. Results: This present study clearly acknowledges the standard discharge planning program available in the hospital improve the muscle strength of the upper and lower extremity in the nonhemorrhagic stroke patients just 2nd day after the care (pretest), and the significant improvement was observed until the day 14. Moreover, combining the care with ROM training at the intervention group faster the recovery and the muscle strength improved significantly at the 7th day and continue increase at the day 14. Looking to the muscle strength since the 2nd day to the day 14, respectively the muscle strength of upper and lower limb at the control group improved at the point of 0.588 and 0.882, while at the group received the ROM training reached the value of 1.472 and 1.412. Conclusions: The ROM training combined to the current discharge planning program will faster the muscle strength recovery of the nonhemorrhagic stroke patients. This research provide insight how family plays important role to the success in monitoring the rehabilitation and recovery progress. 


Author(s):  
Roxana Steliana Miclaus ◽  
Nadinne Roman ◽  
Ramona Henter ◽  
Silviu Caloian

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 392.1-392
Author(s):  
E. Pigatto ◽  
M. Schiesaro ◽  
M. Caputo ◽  
M. Beggio ◽  
P. Galozzi ◽  
...  

Background:Gastrointestinal (GI) involvement is very common in patients with Systemic Sclerosis (SSc). The pathophysiology of GI manifestations has not yet been defined. Cell-mediated immunological reactions appear to lead to endothelial damage resulting in fibrosis. The risk of developing malnutrition reinforces the need to better understand GI pathophysiology in these patients.Objectives:The study aimed to evaluate GI symptoms (GIT 2.0) and malnutrition status (MUST) and to determine specific bacterial changes in gut microbiome by investigating the possible presence of positive hot spots in bacterial species in SSc patients and their potential role in the disease progression. We also evaluated serum levels of adipokines and cytokines involved in the pathogenesis of SSc and their role, in addition to gut microbiome, in predicting the onset of GI involvement and malnutrition in SSc patients.Methods:We enrolled 25 scleroderma patients (EULAR/ACR 2013 criteria). UCLA-SCTC GIT 2.0 questionnaire to evaluate GI symptoms and MUST to investigate the risk of malnutrition were used. Gut microbiome was analyzed and the samples were subjected to extraction for the 16S rRNA gene (Earth Microbiome Project and the NIH-Human Microbiome Project). The microbiome was investigated at phenotypic and genotypic level. Serum levels of cytokines and adipokines (adiponectin and leptin) were evaluated by ELISA.Results:79.9% of patients had GERD and 63.5% abdominal distension at GIT 2.0 questionnaires. 48% of patients had moderate risk of malnutrition (MUST=2) and 12% had high risk (MUST=3). Gut microbioma: 19 patients (76%) had low similarity and 11 (44%) low diversity compared to the healthy population. The prevailing enterotypes of gut microbiome was Bacteroides (80%) and Prevotella (20%). The genotypic evaluation showed a reduced concentration of: gluten-digesting (Lactobacillus); lactose-digesting (Faecalibacterium); vitamin K-producing (Enterococcus, Desulfovibrio and Veillonella); acetaldehyde-degrading bacteria. 24 patients (96%) showed a reduction in bacteria devoted to maintaining weight control (Bifidobacterium and Ruminococcus). The patients had an altered intestinal permeability with less mucolytic bacteria (Bacteroides) and reduced production of LPS (Enterobacter and Escherichia). Low levels of butyrate (Eubacterium and Clostridium), acetate and propionate were found for SCFA-producing bacteria. Potentially pathogenic bacteria were also investigated: Salmonella was found in 14 (56%), Klebsiella in 9 (36%) and Enterococcus Faecalis in 3 (12%) patients. 11 (44%) patients had elevated serum levels of IL10 and IL12; 4 (16%) had high value of leptin. Correlation was found in patients who had a reduced concentration of gluten-digesting bacteria and MUST. Elevated MUST was correlated with serological increase in IL17A and IFN-α. Serum levels of IL12 and IL10 were found to correlate with specific bacteria alterations: high concentration of acetaldehyde-producing bacteria and low levels of acetaldehyde-degrade bacteria (also correlated with high serum levels of IL6), mucolytic bacteria and producers of hydrogen sulphide, acetate and propionate. Finally, reduced levels of mucolytic bacteria and acetate producing bacteria correlated with high serum leptin levels.Conclusion:The relationship between the gut microbiome and SSc seems to be multifactorial. In our study genotypic changes of gut microbioma might play a role in damaging the permeability of the mucosa and increasing risk of malnutrition. The evaluation of gut microbiome and cytokine profile is probably going to be of value in the follow-up of SSc. However, further studies are needed to clarify the impact of GI dysbiosis on the immune system in SSc.References:[1]Patrone V. et al. Gut microbiota profile in systemic sclerosis patients with and without clinical evidence of gastrointestinal involvement, Sci Rep. 2017; 7: 14874Disclosure of Interests:None declared


Author(s):  
Joo Yeol Jung ◽  
Pong Sub Youn ◽  
Dong Hoon Kim

AbstractThis study was performed to evaluate the effects of Mirror therapy combined with EMG-triggered Functional Electrical Stimulation on upper extremity function in patient with Chronic Stroke. A total of 24 chronic stroke patients were divided into 3 groups. Group I (n=8) was given with traditional physical therapy (TPT), group II (n=7) was given with traditional physical therapy and mirror therapy (MT), and group III (n=9) was given with traditional physical therapy and mirror therapy in conjunction with EMG-triggered Functional Electrical Stimulation (EMGFES-MT). Each group performed one hour a day 5 times a week for 6 weeks.We obtained the following result between before and after treatments about changes of elbow flexion muscle strength (EFMS), elbow extension muscle strength (EEMS), wrist flexion muscle strength (WFMS), wrist extension muscle strength (WEMS), elbow flexion range of motion (EFROM), elbow extension range of motion (EEROM), wrist flexion range of motion (WFROM), wrist extension range of motion (WEROM), grip strength (GS) and upper extremity function.Each group showed a significant difference in EFMS, EEMS, WFMS, WEMS, EFROM, EEROM, WFROM, WEROM, GS and upper extremity function (p<0.05) EMFES-MT group revealed significant differences in EEMS, WEROM, grip strength and upper extremity function as compared to the other groups (p<0.05). No difference was found in the change of spasticity among the 3 groups.Our results showed that EMFES-MT was more effective on elbow, WFMS, WEMS, AROM, grip strength and upper extremity function in patients with chronic stroke. We suggest that this study will be able to be used as an intervention data for recovering upper extremity function in chronic stroke patients


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 407
Author(s):  
Laetitia Lengelé ◽  
Olivier Bruyère ◽  
Charlotte Beaudart ◽  
Jean-Yves Reginster ◽  
Médéa Locquet

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).


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