scholarly journals Step Test Scores Are Related to Measures of Activity and Participation in the First 6 Months After Stroke

2009 ◽  
Vol 89 (10) ◽  
pp. 1061-1071 ◽  
Author(s):  
Vicki Stemmons Mercer ◽  
Janet Kues Freburger ◽  
Shuo-Hsiu Chang ◽  
Jama L. Purser
Keyword(s):  
Motor Control ◽  
Lower Extremity ◽  
Physical Function ◽  
Gait Speed ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Stroke Recovery ◽  
Step Test ◽  
Additional Step

Background: The Step Test (ST) is a measure of dynamic standing balance and paretic–lower-extremity motor control in patients with stroke. Little is known about the extent to which impairments assessed by the ST relate to activity and participation during stroke recovery.Objective: The purpose of this study was to determine relationships between ST scores and measures of activity and participation during the first 6 months after stroke.Design: This was a prospective cohort study.Methods: Thirty-three individuals (18 men, 15 women) with a diagnosis of a single, unilateral stroke participated in the study. Participants were tested one time per month from 1 to 6 months poststroke. The ST was considered an impairment-level measure. Self-selected gait speed and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) Physical Function Index (PFI) were used to assess physical function. Three domains (mobility, basic and instrumental activities of daily living, participation) of the Stroke Impact Scale were used to assess self-reported disability. Regression analyses were conducted to examine the bivariate associations between ST scores and each physical function and disability measure at each time point (1–6 months).Results: The ST scores were positively associated with both physical function measures. The associations were stronger for self-selected gait speeds (R2=.60–.79) than for the PFI scores (R2=.32–.60). During the first 6 months after stroke, each additional step with the paretic lower extremity on the ST corresponded to a 0.07-m/s to 0.09-m/s increase in gait speed, and each additional step with the nonparetic lower extremity was associated with a 0.07-m/s to 0.08-m/s gait speed increase. The impairment-disability associations were weaker than the impairment-physical function associations.Limitations: Limitations of the study include a relatively small sample size and lack of examiner blinding with regard to participant characteristics.Conclusions: Impairments in balance and paretic–lower-extremity motor control, as measured by the ST, relate to physical function and disability during the first 6 months following stroke.

Validating the Factor Structure of the Stigma of Suicide Scale–Short Form Spanish Version Among Healthcare Students

Crisis ◽  
2020 ◽  
pp. 1-5
Author(s):  
Ruthmarie Hernández-Torres ◽  
Paola Carminelli-Corretjer ◽  
Nelmit Tollinchi-Natali ◽  
Ernesto Rosario-Hernández ◽  
Yovanska Duarté-Vélez ◽  
...  
Keyword(s):  
Factor Structure ◽  
Structural Equation ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Spanish Version ◽  
Equation Modeling ◽  
Cross Sectional ◽  
Healthcare Students ◽  
Spanish Speaking

Abstract. Background: Suicide is a leading cause of death among Spanish-speaking individuals. Suicide stigma can be a risk factor for suicide. A widely used measure is the Stigma of Suicide Scale-Short Form (SOSS-SF; Batterham, Calear, & Christensen, 2013 ). Although the SOSS-SF has established psychometric properties and factor structure in other languages and cultural contexts, no evidence is available from Spanish-speaking populations. Aim: This study aims to validate a Spanish translation of the SOSS-SF among a sample of Spanish-speaking healthcare students ( N = 277). Method: We implemented a cross-sectional design with quantitative techniques. Results: Following a structural equation modeling approach, a confirmatory factor analysis (CFA) supported the three-factor model proposed by Batterham and colleagues (2013) . Limitations: The study was limited by the small sample size and recruitment by availability. Conclusion: Findings suggest that the Spanish version of the SOSS-SF is a valid and reliable tool with which to examine suicide stigma among Spanish-speaking populations.

AB1284-HPR RELIABILITY OF STEP TEST IN SUBJECTS WITH TOTAL KNEE ARTHROPLASTY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1932.1-1933
Author(s):  
M. Eymir ◽  
E. Yuksel ◽  
B. Unver ◽  
K. Sevik ◽  
V. Karatosun
Keyword(s):  
Total Knee Arthroplasty ◽  
Motor Control ◽  
Lower Extremity ◽  
Knee Arthroplasty ◽  
Lower Limb ◽  
Standing Balance ◽  
Step Test ◽  
Retest Reliability ◽  
Total Knee ◽  
Test Retest Reliability

Background:Patients with TKA show impairments in standing balance up to 1 year after surgery. The impaired standing balance in TKA patients was found to be associated with falls risk and decreased functional level. Assessing of standing balance with objective and reliable assessments tools would therefore be extremely useful for determining accurate exercise program, and risks of falling, especially during the rehabilitative period when ambulation is at its most unsteady (1, 2). The stepping maneuver requires adequate strength and motor control to stabilize the body over the stance limb while the other leg is stepping, therefore the Step Test (ST) provides significant information for dynamic standing balance and lower limb motor control (3). The reliability of ST is reported in patient groups such as stroke, however, there is not any study that investigates the reliability of ST in patients with TKA in the current literature.Objectives:The purposes of this study were to determine the test-retest reliability and the minimal detectable change (MDC) of the ST in patients with TKA.Methods:40 patients with TKA due to knee osteoarthritis, operated by the same surgeon, were included in this study. Patients performed trials for ST twice on the same day. Between the first and second trials, patients waited for an hour on sitting position to prevent fatigue. The ST assesses an individual’s ability to place one foot onto a 7.5-cm-high step and then back down to the floor repeatedly as fast as possible for 15 seconds. The score is the number of steps completed in the 15-second period for each lower extremity. Scores for each lower extremity were recorded separately. Prior to the testing, the ST was demonstrated by the tester and all participants were allowed to a practice trial.Results:The ST showed an excellent test-retest reliability (ICC2,1=0.95) in this study. Standard error of measurement (SEM) and MDC95for ST were 0.37 and 1.02, respectively.Conclusion:This study found that the ST has an excellent test–retest reliability in patients with TKA. It is an effective and reliable tool for measuring dynamic standing balance and participant falls. As a performance-based clinical test, the ST is easy to score, can be applied in a short time as part of the routine medical examination. Therefore, inclusion of ST into a more comprehensive battery of performance-based measures of standing balance and lower limb motor control function in subjects with TKA should be considered.References:[1]Si, H. B., Zeng, Y., Zhong, J., et al. (2017). The effect of primary total knee arthroplasty on the incidence of falls and balance-related functions in patients with osteoarthritis. Scientific reports, 7(1), 1-9.[2]Moutzouri, M., Gleeson, N., Billis, E., et al. (2017). The effect of total knee arthroplasty on patients’ balance and incidence of falls: a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy, 25(11), 3439-3451.[3]Hill, K. D., Bernhardt, J., McGann, A. M., et al. (1996). A new test of dynamic standing balance for stroke patients: reliability, validity and comparison with healthy elderly. Physiotherapy Canada, 48(4), 257-262.Disclosure of Interests:None declared

The SCIA Questionnaire: standards for communities for children and adolescents – a tool for the evaluation of good practices

2019 ◽  
Vol 40 (1) ◽  
pp. 1-15
Author(s):  
Cinzia Guarnaccia ◽  
Anna Maria Ferraro ◽  
Maria Lo Cascio ◽  
Simone Bruschetta ◽  
Francesca Giannone
Keyword(s):  
Children And Adolescents ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Self Report ◽  
Community Treatment ◽  
Short Version ◽  
Therapeutic Communities ◽  
Evaluation Tool ◽  
Content Type

Purpose The purpose of this paper is to present the Italian validation of the standards for communities for children and adolescents (SCIA) Questionnaire, an evaluation tool of communities quality standards, based on the “Service Standards for Therapeutic Communities for Children and Young People – 2nd edition” of the Community of Communities (2009), that enables an empirical, multidimensional and complex evaluation of the therapeutic community (TC) “system”. It is a self-report that sets out and measures variables that allow to get an overview of organisational models and the possible development areas to improve the effectiveness of the protection of child and adolescents in community treatment. The validation and a preliminary analysis to develop a short version of the SCIA are presented. Design/methodology/approach The questionnaire (composed, in the extended form, by 143 items) was administered to 101 community workers, 20 males (19.8 per cent) and 81 females (81.2 per cent) aged between 24 and 61 years (M=36.20, SD=8.4). The analysis of reliability (Cronbach’s α) and a series of exploratory factor analysis allowed to eliminate redundant or less significant items. Findings The short form of the self-report consists of 67 items, divided into seven subscales, which explore different areas of intervention in TCs. Despite the limitations due to the small sample size, the utility of this tool remains confirmed by its clinical use and the development of good operating practices. Originality/value The SCIA Questionnaire responds to the need to adopt empirical variables in the process of evaluation of the communities. The SCIA is also a useful tool for clinical evaluation, as it allows a detailed observation of residential community treatment with children and adolescents that allows to analyse and monitor the structural and organisational aspects and the quality of practices that guide the interventions.

scholarly journals Multicomponent Physical Exercise Training in Multimorbid and Palliative Oldest Adults

2021 ◽  
Vol 18 (17) ◽  
pp. 8896
Author(s):  
Cristina Blasco-Lafarga ◽  
Gema Sanchis-Soler ◽  
Pere Llorens
Keyword(s):  
Lower Limb ◽  
Gait Speed ◽  
Technical Assistance ◽  
Small Sample Size ◽  
Cognitive Status ◽  
Small Sample ◽  
Exercise Intolerance ◽  
Control Group ◽  
Old Patients ◽  
Lower Limb Strength

Exercise counteracts aging and pathology symptoms, but there is still scarce research on exercise programs for multimorbid and/or palliative old patients (MPO-Ps). In order to analyze whether the multicomponent physical–cognitive training is beneficial for this population, 17 MPO-Ps (81.59 ± 5.63 years) completed a >26 weeks home-based intervention (20–50 min/session, three sessions/week). Twenty-eight supervised and thirty-two autonomous sessions were gradually distributed along three phases: supervised training (ST), reduced supervision training (RST), and autonomous training (AT). Physical function (gait speed, hand grip and lower-limb strength, balance, and agility), mental status (MMSE), and autonomy in daily living (the Barthel Index) were assessed. Categorical analyses regarding the changes in the walking aids used in the test were added to improve the assessment of strength and agility along the intervention. Despite important study limitations, such as the small sample size and lack of a control group, and despite the MPO-Ps’ very low baseline fitness and initial exercise intolerance, they benefited from the dual-tasking approach, especially in autonomy, lower-limb strength, and balance. Agility improvements were shown only by categorical analyses. As expected, most benefits increased the supervision (ST phase). Gait speed and cognitive status maintained despite the total autonomy in training in the last phase. Further research with larger samples should confirm if multicomponent physical–cognitive exercise, individualized and tailored on daily-basis, together with technical assistance and medical supervision, benefits this MPO-Ps population, and if it can be prescribed to them with security, in spite some of them already being palliative patients.

Abstract P212: Admission National Institutes of Health Stroke Scale Associated With Higher Rates of Post Stroke Depression Independent of Imaging Characteristics

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Muhammad M Alvi ◽  
Ashley Petrone ◽  
Jessica Frey
Keyword(s):  
Small Vessel Disease ◽  
Small Sample Size ◽  
Small Sample ◽  
National Institutes Of Health ◽  
Stroke Recovery ◽  
Post Stroke ◽  
Imaging Characteristics ◽  
Significant Difference ◽  
Patient Health ◽  
Post Stroke Depression

Introduction: The etiology of post-stroke depression (PSD) is still not fully understood. It is well known that leukoaraiosis is associated with cognitive decline and depression, but currently unclear if lacunar strokes, thought to be caused by small vessel disease, have higher rates of PSD. A better understanding of PSD etiology can lead to improved treatment of PSD and subsequently better stroke recovery. Methodology: Out of 159 patients that were successfully contacted via phone within 3 months of discharge, there were 22 identified as having an acute stroke or TIA and scored ≥ 2 on the Patient Health Questionnaire (PHQ) assessment. MRI brain was reviewed for stroke size, location, periventricular and deep white matter fazekas score, number of microbleeds, and chronic lacunar strokes. Admission and discharge National Institutes of Health (NIH) stroke scale and stroke etiology were also recorded. Results: There was a significantly positive correlation between NIH score at admission and PHQ2 score (r = 0.184, p =0.044), demonstrating that patients with NIH ≥ 6 are 4.6 times more likely to develop PSD than a patient with NIH < 6 (Odds ratio (OR) = 4.6, CI [1.284-16.591]). There was no significant difference between PSD incidence in stroke size or location. Although not statistically significant, there was a suggestion of more PSD seen in cortical, cardioembolic, and cryptogenic strokes as well as fazekas score ≥ 2 and old lacunar infarcts. The table summarizes characteristics of the 7 TIA and 15 stroke patients suffering from PSD with PHQ ≥ 2: Conclusion: Initial NIH significantly predicted PSD irrespective of leukoaraiosis. This study was limited by the small sample size which could be due to under-diagnosis of PSD. In conclusion, admission NIH is associated with higher rates of PSD, but the underlying etiology is likely multifactorial given the suggestion of higher rates of PSD with higher fazekas score, and cortical, cardioembolic, and cryptogenic strokes.

Motor and Physical Function Impairments as Contributors to Slow Gait Speed and Mobility Difficulty in Middle-Aged and Older Adults

2022 ◽  
Author(s):  
Yurun Cai ◽  
Qu Tian ◽  
Alden L Gross ◽  
Hang Wang ◽  
Jian-Yu E ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Physical Function ◽  
Gait Speed ◽  
Manual Dexterity ◽  
Standing Balance ◽  
Equation Modeling ◽  
Chair Stand ◽  
Usual Gait Speed ◽  
Mobility Difficulty

Abstract Background Motor function impacts ability to perform daily activities and maintain independence. Yet, the interrelatedness of upper and lower extremity motor impairments and the magnitude of their contribution to slow gait and mobility difficulty are not well investigated. Methods Participants in the Baltimore Longitudinal Study of Aging (N=728, aged 50-99) completed motor and physical function tests including grip and knee extension strength, pegboard, finger tapping, standing balance, chair stands, fast-paced 400m walk, and usual gait speed. Slow gait was defined as usual gait speed &lt;1.0m/s. Mobility difficulty was defined as self-reported difficulty walking ¼ mile or climbing stairs. Structural equation modeling (SEM) examined the interrelationships of motor measures and their contributions to slow gait and mobility difficulty, adjusting for demographics and comorbidities. Results Poorer manual dexterity (-0.571 standard deviation (SD) units, p&lt;0.001) and lower muscle strength (upper and lower extremity) (-0.447 SD units, p=0.014) were most strongly associated with slow gait speed, followed by slower chair stand pace (-0.195 SD units, p=0.002) and greater lap time variation (0.102 SD units, p=0.028). Lower muscle strength (-0.582 SD units, p=0.001) was most strongly associated with mobility difficulty, followed by slower chair stand pace (-0.322 SD units, p&lt;0.001), slower gait speed (-0.247 SD units, p&lt;0.001), and poorer standing balance (-0.190 SD units, p=0.043). Conclusions Components of manual dexterity and strength were the strongest correlates of slow gait and mobility difficulty in mid-to-late life. Longitudinal studies examining relationships between changes in these motor parameters and mobility are needed to elucidate possible causal effects.

Relationship of Personality to Dissociation and Childhood Trauma in Borderline Personality Disorder

CNS Spectrums ◽  
2003 ◽  
Vol 8 (10) ◽  
pp. 755-762 ◽  
Author(s):  
Daphne Simeon ◽  
Dorothy Nelson ◽  
Rachela Elias ◽  
Jennifer Greenberg ◽  
Eric Hollander
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Trauma ◽  
Short Form ◽  
Small Sample Size ◽  
Borderline Personality ◽  
Small Sample ◽  
Emotional Neglect ◽  
Childhood Trauma Questionnaire ◽  
The Relationship

ABSTRACTBackground:Dissociation is a prominent feature in some individuals with borderline personality disorder (BPD), yet our understanding of the meanings and implications of prominent dissociation in BPD remains limited. The purpose of this study was to investigate the relationship between dissociation and childhood trauma in BPD and to explore the relationships of dissociation and trauma to various personality features of BPD.Methods:Twenty BPD subjects and 24 healthy comparison subjects of similar age and gender were administered the Dissociative Experiences Scale, the Childhood Trauma Questionnaire—short form, the Tridimensional Personality Questionnaire, the Defense Style Questionnaire, the Relationship Style Questionnaire, and the Schema Questionnaire.Results:The BPD group exhibited greater dissociation and childhood trauma, as well as greater pathology in most personality variables, compared with the healthy group. Dissociation in BPD was not significantly related to total childhood trauma, but only to emotional neglect, which accounted for 23% of the variance in dissociation scores.Conclusion:Within the BPD group, dissociation was associated with fearful attachment and immature defenses, while total childhood trauma and emotional neglect were associated with overconnection and disconnection schemata. This is a preliminary study with a small sample size, yet the correlates of dissociation in BPD merit further investigation.

scholarly journals Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 ◽  
Author(s):  
Xiangling Ye ◽  
Zehua Chen ◽  
Zhen Shen ◽  
Guocai Chen ◽  
Xuemeng Xu
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Physical Function ◽  
Grip Strength ◽  
Inflammatory Cytokines ◽  
Large Scale ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Small Sample ◽  
Cochrane Library

Purpose: Rheumatoid arthritis (RA) is a pervasive inflammatory autoimmune disease that seriously impairs human health and requires more effective non-pharmacologic treatment approaches. This study aims to systematically review and evaluate the efficacy of yoga for patients with RA.Methods: Medline (through PubMed), Cochrane Library, EMBASE (through SCOPUS), and Web of Science database were screened through for articles published until 20 July 2020. Randomized controlled trials (RCTs) of yoga in patients with RA were included. Outcomes measures were pain, physical function, disease activity, inflammatory cytokines, and grip strength. For each outcome, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.Result: Ten trials including 840 patients with RA aged 30–70 years were identified, with 86% female participants. Meta-analysis revealed a statistically significant overall effect in favor of yoga for physical function (HAQ-DI) (5 RCTs; SMD = −0.32, 95% CI −0.58 to −0.05, I2 = 15%, P = 0.02), disease activity (DAS-28) (4 RCTs; SMD = −0.38, 95% CI −0.71 to −0.06, I2 = 41%, P = 0.02) and grip strength (2 RCTs; SMD = 1.30, 95% CI 0.47–2.13, I2 = 63%, P = 0.002). No effects were found for pain, tender joints, swollen joints count or inflammatory cytokines (i.e., CRP, ESR, IL-6, and TNF-α).Summary: The findings of this meta-analysis indicate that yoga may be beneficial for improving physical function, disease activity, and grip strength in patients with RA. However, the balance of evidence showed that yoga had no significant effect in improving pain, tender joints, swollen joints count, and inflammatory cytokines in patients suffering from RA. Considering methodological limitations, small sample size, and low-quality, we draw a very cautious conclusion in the results of the estimate of the effect. High-quality and large-scale RCTs are urgently needed in the future, and the real result may be substantially different.

scholarly journals Physical Function Does Not Predict Care Assessment Need Score in Older Veterans

2017 ◽  
Vol 38 (3) ◽  
pp. 412-423 ◽  
Author(s):  
Monica C. Serra ◽  
Odessa Addison ◽  
Jamie Giffuni ◽  
Lydia Paden ◽  
Miriam C. Morey ◽  
...  
Keyword(s):  
High Risk ◽  
Physical Function ◽  
Short Form ◽  
Functional Limitations ◽  
Step Test ◽  
Veterans Health ◽  
High Risk Patients ◽  
Care Assessment ◽  
Risk Patients ◽  
Four Square

Objective: The Veterans Health Administration’s Care Assessment Need (CAN) score is a statistical model, aimed to predict high-risk patients. We were interested in determining if a relationship existed between physical function and CAN scores. Method: Seventy-four older (71 ± 1 years) male Veterans underwent assessment of CAN score and subjective (Short Form–36 [SF-36]) and objective (self-selected walking speed, four square step test, short physical performance battery) assessment of physical function. Results: Approximately 25% of participants self-reported limitations performing lower intensity activities, while 70% to 90% reported limitations with more strenuous activities. When compared with cut points indicative of functional limitations, 35% to 65% of participants had limitations for each of the objective measures. Any measure of subjective or objective physical function did not predict CAN score. Conclusion: These data indicate that the addition of a physical function assessment may complement the CAN score in the identification of high-risk patients.

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