scholarly journals Maximizing the Functional Performance Outcomes of Patients Undergoing Rehabilitation by Maximizing their Overall Health and Wellbeing

2018 ◽  
Vol 65 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Elizabeth Dean
Keyword(s):  
Smoking Cessation ◽  
Alcohol Consumption ◽  
Body Mass ◽  
Functional Performance ◽  
Physical Therapists ◽  
Performance Outcomes ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs ◽  
Maximal Performance ◽  
Returning To Work

Abstract To maximize the performance of an athlete, a team of experts work together to ensure each athlete achieves the maximal benefit from their prescribed exercise conditioning programs. In addition to the exercise specialists, the athlete’s team frequently includes psychologists (who address performance anxiety, stress, and depression), counselors (who address smoking cessation, reduction or elimination of alcohol consumption if necessary, weight optimization, and optimal sleep), and nutritionists (who address optimal nutrition and body mass attributes). Such a collaborative approach has become standard practice for athletes aiming to excel in their sports. Despite unequivocal and compelling evidence, this paradigm has only weakly been transferred to the needs of patients participating in rehabilitation programs. These individuals, like the athlete, also need to achieve their highest level of functional performance and recovery for carrying out their activities of daily living, managing the needs of their families, and often returning to work. This article reviews the evidence-based literature and the implications of this multifaceted approach in rehabilitation programs. The augmented benefits to exercise training and conditioning (prescriptive activity/exercise and less sitting) along with their ‘effect sizes’ are described in the rehabilitation context, in conjunction with smoking cessation, reduced harmful alcohol consumption, optimal nutrition, optimal body mass, manageable stress, and optimal sleep. These factors can be viewed as physical performance enhancers both in individuals participating in rehabilitation whose aim is maximal performance and recovery and in athletes aiming for maximal performance in their sports. Thus, without targeted attention to these lifestyle factors, rehabilitation outcomes cannot be maximized. The evidence presented in this article has implications for health professionals including physical therapists and others who are practicing in rehabilitation settings and those working with individuals in need in the community.

Abstract P079: Alcohol Consumption and Risk of Diabetes in the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Xintong He ◽  
Natalie Daya ◽  
Casey M. Rebholz ◽  
Mariana Lazo ◽  
Elizabeth Selvin
Keyword(s):  
Body Mass Index ◽  
Alcohol Consumption ◽  
Body Mass ◽  
Lower Risk ◽  
Fasting Glucose ◽  
Diabetes Risk ◽  
Incident Diabetes ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Moderate alcohol consumption has been reported to be associated with lower risk for diabetes with some studies showing a U-shaped association. Whether and how the association might differ by gender or obesity status is controversial. Objective: To evaluate the prospective association between alcohol consumption and the long-term risk of diabetes in the Atherosclerosis Risk in Communities (ARIC) Study. Methods: A prospective analysis of 11,263 ARIC participants without prevalent diabetes (55% women, 81%white, mean age 54 years). Alcohol consumption was assessed at visit 1 (1987-1989). Participants were followed-up for incident diabetes defined by fasting glucose more than 126 mg/dL, non-fasting glucose more than 200 mg/dL, self-reported diagnosis of diabetes or use of diabetic medication. We used Cox models to estimate hazard ratios of diabetes risk by drinking categories in women and men, respectively. Results: During a median follow-up of 21 years, there were 3518 incident diabetes cases. In the fully adjusted model, compared to never drinkers, among women, 7-14 drinks/week was associated with a significantly lower risk of diabetes; whereas among men, 14-21 drinks/week was associated with a significantly lower risk ( Table ). There was a significant interaction between drinking categories and smoking status or between drinking categories and body mass index in women. Among women, a U-shaped association was mainly present among non-smokers, and significant decreasing risk is only found among normal-weight and overweight participants, but not obese participants. Conclusion: Low levels of alcohol intake (1-2 drinks per day for women and 2-3 drinks per day for men) are inversely associated with diabetes risk. The association is modified by smoking and body mass index in women.

scholarly journals Effect of body mass index on the association between alcohol consumption and the development of chronic kidney disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yusaku Hashimoto ◽  
Takahiro Imaizumi ◽  
Sawako Kato ◽  
Yoshinari Yasuda ◽  
Takuji Ishimoto ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Chronic Kidney Disease ◽  
Alcohol Consumption ◽  
Kidney Disease ◽  
Confidence Intervals ◽  
Body Mass ◽  
The Body ◽  
Hazard Ratios ◽  
Glomerular Filtration Rate Decline ◽  
Observation Period

AbstractThe influence of body mass or metabolic capacity on the association between alcohol consumption and lower risks of developing chronic kidney disease (CKD) is not fully elucidated. We examined whether the body mass index (BMI) affects the association between drinking alcohol and CKD. We defined CKD as an estimated glomerular filtration rate decline < 60 mL/min/1.73 m2 and/or positive proteinuria (≥ 1+). Participants were 11,175 Japanese individuals aged 40–74 years without baseline CKD who underwent annual health checkups. Daily alcohol consumption at baseline was estimated using a questionnaire, and the participants were categorized as “infrequent (occasionally, rarely or never),” “light (< 20 g/day),” “moderate (20–39 g/day),” and “heavy (≥ 40 g/day).” Over a median 5-year observation period, 936 participants developed CKD. Compared with infrequent drinkers, light drinkers were associated with low CKD risks; adjusted hazard ratios (95% confidence intervals) were 0.81 (0.69–0.95). Stratified by BMI (kg/m2), moderate drinkers in the low (< 18.5), normal (18.5–24.9), and high (≥ 25.0) BMI groups had adjusted hazard ratios (95% confidence intervals) of 3.44 (1.60–7.42), 0.75 (0.58–0.98), and 0.63 (0.39–1.04), respectively. Taken together, the association between alcohol consumption and CKD incidence was not the same in all the individuals, and individual tolerance must be considered.

scholarly journals Prevalence and Determinants of High Blood Pressure among Adolescents: A School based Study in Rural Area of Hooghly District, West Bengal

2021 ◽  
Vol 8 (11) ◽  
pp. 205-210
Author(s):  
Malay Kumar Das ◽  
Rabindranath Sinha ◽  
Aparajita Dasgupta
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Food Intake ◽  
Alcohol Consumption ◽  
Body Mass ◽  
High Blood Pressure ◽  
Fast Food ◽  
Non Communicable Diseases

Introduction: The World Health Organization has already warned of increasing non-communicable diseases among adolescents as a major public health problem. The importance of this age group also lies in the fact that many serious diseases in adulthood have their roots in adolescence. Method: A pre-designed and pre-tested questionnaire was used in class-room setting to collect information from students regarding presence of risk factors of non-communicable diseases. The respondents were also subjected to anthropometric measurements and blood pressure examination using standard operating procedures. Results: A total of 761 students of class VI-XII participated in the study of which 61.4% were boys and rests were girls. High blood pressure among boys and girls were 19.9% and 22.1% were respectively. In Bivariate analysis age > 15 years (median) (OR= 2.11), fast food intake (>3 times/week) (OR= 1.66), Alcohol consumption (OR= 2.22), less physical activity (OR=1.54), increased body mass index (OR=2.53), significantly associated with high blood pressure. In Multivariate analysis age (AOR= 2.25), fast food intake (AOR= 1.50), Alcohol consumption (OR= 2.23), less physical activity (AOR=1.71), increased body mass index (AOR=2.42) remains significant predictor. Conclusion: Detecting the risk factors of high blood pressure prevalent in the population is of utmost importance to achieve a healthy population. Formulation and dissemination of need--based, culturally acceptable and age appropriate scientific messages for school students should be conducted more proactively. Keywords: Adolescents, Blood pressure, Risk factor, Rural school.

scholarly journals The Impact of Nutritional Status and Body Mass Index on Rehabilitation Outcomes in Patients Receiving Home-Based Medical Care

2020 ◽  
Vol 3 (2) ◽  
pp. 15
Author(s):  
Kanako Eiwa ◽  
Naomi Nakayama ◽  
Yumi Takami ◽  
Shuko Iwasaki ◽  
Yoshinori Hino ◽  
...  
Keyword(s):  
Body Mass Index ◽  
At Risk ◽  
Nutritional Status ◽  
Medical Care ◽  
Body Mass ◽  
Functional Independence ◽  
The Body ◽  
Rehabilitation Outcomes ◽  
Home Based ◽  
The Impact

Background: Home-based medical care is expanding rapidly in Japan.Objectives: We aimed to identify the factors associated with outcomes of therapy in patients receiving home-visit rehabilitation.Methods: One hundred twenty-one patients receiving home-based rehabilitation were investigated. Nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF). The Functional Independence Measure (FIM) was employed to assess the activities of daily living (ADL). The body mass index (BMI), medical history, and orthopedic disease-related pain were also recorded. The primary outcome was the improvement in FIM scores in one year.Results: A total of 19 (17%) patients were malnourished and 58 (48%) were at risk of malnutrition. Malnourished patients had a lower FIM score at initiation than those at risk of malnutrition or with normal nutritional status. Only changes in patients’ BMI and MNA-SF scores over one year were significantly associated with improved FIM scores (p = 0.0079 and p = 0.0049, respectively). No association was noted with the other factors.Conclusions: This is the first report to demonstrate that changes in MNA-SF scores and BMI are significantly associated with rehabilitation outcomes in home-based care. Nutritional management is essential along with rehabilitation to improve ADL in the long-term home care setting.

scholarly journals The impact of Body Mass Index on functional rehabilitation outcomes of working-age inpatients with stroke

2021 ◽  
Vol 57 (2) ◽  
Author(s):  
Alejandro GARCÍA-RUDOLPH ◽  
John D. KELLEHER ◽  
Blanca CEGARRA ◽  
Joan SAURÍ RUIZ ◽  
Vasudevan NEDUMPOZHIMANA ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Functional Rehabilitation ◽  
Rehabilitation Outcomes ◽  
Working Age ◽  
The Impact

scholarly journals Relationship of Occupation to Blood Pressure Among Middle-Aged Japanese Men-The Significance of The Differences in Body Mass Index and Alcohol Consumption -

1998 ◽  
Vol 8 (4) ◽  
pp. 216-226 ◽  
Author(s):  
Yutaka Takashima ◽  
Asao Yoshida ◽  
Katsuki Kokaze ◽  
Ysuhide Orido ◽  
Shoichiro Tsugane ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Alcohol Consumption ◽  
Body Mass ◽  
Middle Aged ◽  
Japanese Men ◽  
Relationship Of

Influence of Cognitive Impairment on Rehabilitation Received and Its Mediating Effect on Functional Recovery

2021 ◽  
pp. 1-12
Author(s):  
Ilona Dutzi ◽  
Michael Schwenk ◽  
Marietta Kirchner ◽  
Eva Jooss ◽  
Jürgen M. Bauer ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Status ◽  
Mediating Effect ◽  
Future Research ◽  
Rehabilitation Outcome ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs ◽  
Observational Cohort ◽  
The Relationship ◽  
State Examination

Background: Cognitive impairment (CI) has been reported to negatively impact rehabilitation outcomes. Knowledge about differences in rehabilitation received in dependence of CI as a potential mediating factor is limited. Objective: To analyze whether CI affects amount and frequency of rehabilitation received and if associations between CI and rehabilitation outcome are mediated by the provided amount of therapy. Methods: Observational cohort study in ward-based geriatric rehabilitation consecutively including 373 patients (mean age 82.0±6.69 years, mean MMSE 23.66±5.31). Outcome measures were amount, frequency, and type of multi-professional therapy sessions and rehabilitation outcome assessed with the Barthel Index (BI). Cognitive status was measured with the Mini-Mental-State Examination (MMSE) classifying three patient subgroups according to cognitive status were considered. Results: Patients with more severe CI received least total therapy hours (TTH) (MMSE <  17, 13.67±6.58 versus MMSE 17–26, 16.12±7.19 and MMSE >  26, 17.79±8.88 h, p = 0.014) and were less often included in occupational therapy (MMSE <  17, 48.9%versus MMSE 17–26, 65.5%and MMSE >  26, 71.4%, p = 0.019) and group-based physiotherapy (MMSE <  17, 73.3%versus MMSE 17–26, 88.5%and MMSE >  26, 81.2%, p = 0.027). Regression models showed that CI negatively impacted TTH (β= 0.24, p = 0.003) and rehabilitation outcome (β= 0.41, p = 0.008). In the mediation model, TTH accounted for 23.18%(p <  0.001) of the relationship between CI and rehabilitation outcome. Conclusion: Cognitive impairment negatively impacted rehabilitation received. The lower TTH partly mediated the negative association between CI and rehabilitation outcome. Future research should identify specific barriers to therapy provision and optimal length, intensity, and dosage of rehabilitation programs to optimize rehabilitation outcomes in CI.

Focus on Patient in Virtual Reality-Assisted Rehabilitation

2018 ◽  
pp. 1422-1450 ◽  
Author(s):  
Stefano Mottura ◽  
Luca Fontana ◽  
Sara Arlati ◽  
Claudia Redaelli ◽  
Andrea Zangiacomi ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Emotional State ◽  
Models Of Care ◽  
Point Of View ◽  
Self Awareness ◽  
Patient Centered ◽  
Natural Interaction ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs

Since several years scientists are carrying on research about innovative systems, based on robotics, mechatronics devices and IT tools – especially the graphical ones – to support patients in rehabilitation programs for rescuing from various brain damages due to adverse events as stroke. Training sessions with a combination of robot and virtual reality (VR) lead to better rehabilitation outcomes than using only a robot and evidence from the field proved the importance of the use of VR interfaces in rehabilitation. The main aim of such a kind of environments is to monitor, motivate and drive the patient during the rehabilitation sessions. These systems mainly provide motor guidance and multimedia communication channels also measuring patients' performance and other observable variables. The approach implemented is usually based on gaming, where the patient has the key role to perform certain tasks or movements for controlling the game in the correct way and exercise the injured part. According to daily experience from physiotherapists, different aspects related to the physical and self-perceived patients' state revealed to have a fundamental role in influencing the rehabilitation session. Indeed, the treatment result depends not only on motor skills but also on patient's personal behavior and feelings that are not directly investigable, observable and measurable from outside. In other words this kind of elements can only be assessed by subjective measurements (as questions, interviews, narratives) revealing the point of view of the patient. Moreover, the emotional state has implications at different levels: on one hand, it is important to evaluate if the single rehabilitation session affects the emotional state of the patient, on the other, if the performance was influenced by this state. Some answers of a questionnaire administrated to post-stroke patients in a previous study underlined also the need for the patient to focus his/her attention on the trained body portion and the relevance of a visual feedback on movements to increase self-awareness on the action performed, avoiding any possible distraction derived from other kind of tasks and related visual/auditory stimuli. Patient-centered models of care are actually becoming increasingly common among rehabilitation clinical settings. They help to focus the therapy on improving the treatment of those deficiencies that most influence the quality of life of the patient. Another important aspect is represented by the relationship with the caregiver that in virtually assisted rehabilitation would not be direct anymore and will need to be mediated without completely loosing natural interaction. According to this patient centered vision, and in order to reduce possible side effects related to semi-automatic rehabilitation systems, it has been studied and developed a system which has not the aim of merely entertain the patient but to focalize the rehabilitation on him/her as a proactive character aware of what is happening and of the quality of the work performed.

Strength Measurement After Achilles Tendon Repair

2018 ◽  
Vol 12 (5) ◽  
pp. 471-479 ◽  
Author(s):  
Henrik C. Bäcker ◽  
Adrian J. Yenchak ◽  
David P. Trofa ◽  
J. Turner Vosseller
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Functional Performance ◽  
Outcome Measurement ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Performance Outcomes ◽  
Strength Measurement ◽  
Optimal Method ◽  
Strength Assessment

The goal of treatment after Achilles tendon rupture (ATR) is to restore appropriate tension to the tendon, so that normal baseline strength and functional soft-tissue length can be achieved. The assessment of plantarflexion strength has shown widespread variability. The purpose of this study is to document variations in strength assessment after the treatment of ATR in the literature. A comprehensive literature review was performed. In total, 2758 articles were found on Achilles tendon rupture and Achilles tendon strength measurement. The full text of articles including strength as a functional outcome measurement in the abstract were assessed. All objective strength measurements performed were reviewed and recorded for comparison. One-hundred articles were included in our study. In 78 articles, a dynamometer was used to measure strength, whereas in 22 articles, an endurance test (n=14) or formal gait assessment (n=8) was applied. When a dynamometer was used, there was wide variability in the various methods used including the incorporation of both isokinetic (n = 65) and isometric (n = 29) exercises utilizing varying degrees of knee flexion and patient testing position. Furthermore, the number of measurements at certain angular velocities varied. This study illustrates that no general consensus exists regarding an optimal method for measuring strength after ATR. The variability creates difficulty and challenges medical professionals’ ability to formulate consistent conclusions when determining functional performance outcomes. A more uniform way of measuring strength after ATR may allow for better comparisons between studies in the literature, potentially leading to a better understanding of strength. Levels of Evidence: Therapeutic, Level II

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