Multiple relationships between cognition-motor impairment and activity-based clinical outcome measures in 218 hemiplegic stroke patients

2021 ◽  
pp. 1-11
Author(s):  
Seon Ah Jeong ◽  
Chanhee Park ◽  
Seung Jun Oh ◽  
Joshua (Sung) H. You
Keyword(s):  
Clinical Outcome ◽  
Lower Extremity ◽  
Structure Function ◽  
Outcome Measures ◽  
Structure Functions ◽  
World Health ◽  
Multiple Relationships ◽  
Body Structure ◽  
Significant Difference ◽  
Activity Domain

BACKGROUND: The World Health Organization has developed the International Classification of Functions, Disabilities, and Health (ICF) model providing a theoretical basis for physical therapy diagnosis and interventions related to health conditions. However, the multiple relationship between body structure/function and activity domain variables is unknown on the cognition, spasticity, trunk and lower extremity recovery of the sensorimotor function and activity. OBJECTIVE: Our study aimed to determine the relationship between body structure/functions and body activity domain variables in adults with stroke. METHODS: A total of 218 hemiplegic survivors (102 females, mean age 64.98±13.53) were recruited from the Chungdam Hospital Center for our retrospective study. We used Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment for lower extremity (FMA-LE), Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), Modified Barthel Index (MBI), and Trunk Impairment Scale (TIS) as clinical outcome measures. The Pearson correlation coefficient was used to determine the multiple relationships among the variables at P <  0.05. RESULTS: The correlations between body structure/function domain (MMSE, FMA-LE, MAS) and activity domain variables (BBS, MBI, and TIS) were significant, rending from pre -intervention r = –0.216 to 0.766 and post-intervention r = –0.213 to 0.776, P <  0.05, except for MMSE and MAS. CONCLUSIONS: Establishing a significant difference between body structure/functions and activity domain variables in our research implies important multiple relationships between cognitive function, lower extremity function, lower extremity spasticity, and balance, and performance of ADL and trunk control coordination after stroke.

scholarly journals The added value of cognition-targeted exercise versus symptom-targeted exercise for multiple sclerosis fatigue: A randomized controlled pilot trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258752
Author(s):  
Azza Alketbi ◽  
Salah Basit ◽  
Nouran Hamza ◽  
Lori M. Walton ◽  
Ibrahim M. Moustafa
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Outcome ◽  
Outcome Measures ◽  
Recruitment Rate ◽  
Control Group ◽  
Entire Study ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Intervention Protocol

Background Fatigue is considered one of the most common symptoms of multiple sclerosis (MS) and lacks a current standardized treatment. Therefore, the aim of this study was to examine the feasibility and effectiveness of a cognition-targeted exercise versus symptom-targeted exercise for MS fatigue. Methods In this Pilot, parallel-group, randomized controlled trial, sixty participants with multiple sclerosis, were randomly assigned to either a Cognition-Targeted Exercise (CTE) (N = 30, mean age 41) or a Symptom-Targeted Exercise (STE) (N = 30, mean age 42). The participants in the experimental group received eight, 50-minute sessions of weekly Cognitive Behavior Therapy (CBT) in addition to a CTE Program; whereas, participants in the control group received eight, 50-minute sessions of weekly CBT in addition to the standardized physiotherapy program (STE Program). Feasibility was assessed through recruitment rate, participant retention, adherence and safety, in addition to clinical outcome measures, including: (1) Modified Fatigue Impact Scale (MFIS), (2) Work and Social Adjustment Scale (WSAS), (3) Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS). All outcome measures were assessed at baseline (pretreatment), following completion of the eight visit intervention protocol, and at 3-months follow-up. Results The recruitment rate was 60% and 93% of participants completed the entire study. The recruited participants complied with 98% of the required visits. No adverse events were recorded. A Generalized Estimation Equation Model revealed a significant difference over time as an interaction term during the post and follow up visit for all clinical outcome measures (p < .001). Conclusion The addition of CTE to CBT exhibited positive and more lasting influence on MS fatigue outcomes compared to Symptom-Targeted Exercise (STE). Feasibility and efficacy data from this pilot study provide support for a full-scale RCT of CTE as an integral component of Multiple Sclerosis fatigue management.

scholarly journals Exploring Outcome Measures for Exercise Intervention in People with Parkinson’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
L. A. King ◽  
A. Salarian ◽  
M. Mancini ◽  
K. C. Priest ◽  
J. Nutt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Structure Function ◽  
Outcome Measures ◽  
Exercise Intervention ◽  
Postural Sway ◽  
Exercise Program ◽  
Body Structure ◽  
Type Of Exercise

Background. It is widely believed that exercise improves mobility in people with Parkinson’s disease (PD). However, it is difficult to determine whether a specific type of exercise is the most effective. The purpose of this study was to determine which outcome measures were sensitive to exercise intervention and to explore the effects of two different exercise programs for improving mobility in patients with PD.Methods. Participants were randomized into either the Agility Boot Camp (ABC) or treadmill training; 4x/week for 4 weeks. Outcome measures were grouped by the International Classification of Function/Disability (ICF). To determine the responsiveness to exercise, we calculated the standardized response means.t-tests were used to compare the relative benefits of each exercise program.Results. Four of five variables at the structure/function level changed after exercise: turn duration (P=0.03), stride velocity (P=0.001), peak arm speed (P=0.001), and horizontal trunk ROM during gait (P=0.02). Most measures improved similarly for both interventions. The only variable that detected a difference between groups was postural sway in ABC group (F=4.95;P=0.03).Conclusion. Outcome measures at ICF body structure/function level were most effective at detecting change after exercise and revealing differences in improvement between interventions.

Does qualitative radiologic assessment of tumor response measure up to traditional quantitative scoring methods?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17034-17034
Author(s):  
R. Gottlieb ◽  
A. M. Litwin ◽  
T. L. Mashtare ◽  
G. Wilding ◽  
C. L. Raczyk ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Tumor Response ◽  
Proportional Hazards Model ◽  
Hepatic Metastases ◽  
Cox Proportional Hazards ◽  
Response To Therapy ◽  
Cox Proportional Hazards Model ◽  
World Health ◽  
Qualitative Assessment ◽  
Significant Difference

17034 Background: The Response Evaluation Criteria in Solid Tumors (RECIST) and World Health Organization (WHO) radiologic metrics are the standards for tumor response to therapy. However these methods are difficult to use and are limited in their prediction of clinical outcome. We hypothesize a simpler qualitative assessment of tumor response by CT is as reproducible and predictive of clinical outcome as the RECIST and WHO methods. Methods: This was a retrospective evaluation of 23 patients (11 males, 12 females, mean age 56.1 years, range 40–81 years) with biopsy proven metastatic colo-rectal carcinoma treated at our institution between 2002 and 2006 who did not have their primary tumor resected. Only patients with two consecutive CT examinations separated by at least three weeks were included. Two board certified radiologists, blinded to the other's reads, independently interpreted all CT examinations measuring up to five hepatic lesions on both CT examinations using RECIST and WHO criteria and qualitatively assessing all hepatic metastases, categorizing them as increased, decreased, or unchanged between scans. Clinical outcome, using time to progression of disease (TTP), was measured, utilizing a Cox proportional hazards model, to compare the predictive value of all three scoring systems for those patients starting first line chemotherapy (11 patients) at the time of our analysis. Results: Qualitative assessment resulted in agreement in 21/23 patients (91.3%, kappa = 0.78) classifying hepatic metastases as any increase (2 patients), any decrease (17 patients), or no change (2 patients) between scans compared with agreement in 20/23 patients (87.0%) for RECIST (kappa = 0.62) and WHO ( kappa = 0.67) methods placing patients into partial response (2 patients by RECIST and WHO), stable disease (17 patients by RECIST, 16 patients by WHO), and disease progression (1 patient by RECIST, 2 patients by WHO)categories by accepted criteria. No significant difference in prediction of TTP between methods was found. Conclusions: Our pilot data suggests our qualitative scoring system may be at least as reproducible and predictive of patient clinical outcome as the RECIST and WHO methods. No significant financial relationships to disclose.

Effects of Static and Dynamic Stretching on Injury Prevention in High School Soccer Athletes: A Randomized Trial

2015 ◽  
Vol 24 (3) ◽  
pp. 229-235 ◽  
Author(s):  
Alan A. Zakaria ◽  
Robert B. Kiningham ◽  
Ananda Sen
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Outcome Measures ◽  
Static Stretching ◽  
Back Injuries ◽  
Warm Up ◽  
Dynamic Stretching ◽  
Significant Difference ◽  
Soccer Teams ◽  
Cluster Randomized

Objective:To determine if there is any benefit to static stretching after performing a dynamic warm-up in the prevention of injury in high school soccer athletes.Design:Prospective cluster randomized nonblinded study.Setting:12 high schools with varsity and junior varsity boys’ soccer teams (24 soccer teams) across the state of Michigan.Participants:Four hundred ninety-nine student-athletes were enrolled, and 465 completed the study. One high school dropped out of the study in the first week, leaving a total of 22 teams.Interventions:Dynamic stretching protocol vs dynamic + static (D+S) stretching protocol.Main Outcome Measures:Lower-extremity, core, or lower-back injuries per team.Results:Twelve teams performed the dynamic stretching protocol and 10 teams performed the D+S stretching protocol. There were 17 injuries (1.42 ± 1.49 injuries/team) among the teams that performed the dynamic stretching protocol and 20 injuries (2.0 ± 1.24 injuries/team) among the teams that performed the D+S protocol. There was no statistically significant difference in injuries between the 2 groups (P = .33).Conclusions:There is no difference between dynamic stretching and D+S stretching in the prevention of lower-extremity, core, and back injuries in high school male soccer athletes. Static stretching does not provide any added benefit to dynamic stretching in the prevention of injury in this population before exercise.

Serum Retinol and β-carotene Levels and Risk Factors for Cardiovascular Disease in Morbid Obesity

2010 ◽  
Vol 80 (3) ◽  
pp. 159-167 ◽  
Author(s):  
Gabriela Villaça Chaves ◽  
Gisele Gonçalves de Souza ◽  
Andréa Cardoso de Matos ◽  
Dra. Wilza Abrantes Peres ◽  
Silvia Elaine Pereira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Morbid Obesity ◽  
Serum Levels ◽  
World Health ◽  
Morbidly Obese ◽  
Serum Retinol ◽  
Significant Difference ◽  
Β Carotene

Objective: To evaluate retinol and β-carotene serum levels and their relationship with risk factors for cardiovascular disease in individuals with morbid obesity, resident in Rio de Janeiro. Methodology: Blood serum concentrations of retinol and β-carotene of 189 morbidly obese individuals were assessed. The metabolic syndrome was identified according to the criteria of the National Cholesterol Education Program (NCEP) and World Health Organization (WHO). Lipid profile, insulin resistance, basal insulin, glycemia, blood pressure, and anthropometry and their correlation with retinol and β-carotene serum levels were evaluated. Results: Metabolic syndrome diagnosis was observed in 49.0% of the sample. Within this percentage the levels of β-carotene were significantly lower when body mass index increased. Serum retinol didn't show this behavior. Serum retinol inadequacy in patients with metabolic syndrome (61.3%), according to WHO criterion, was higher (15.8%) than when the whole sample was considered (12.7%). When metabolic syndrome was diagnosed by NCEP criterion, β-carotene inadequacy was higher (42.8%) when compared to the total sample (37.5%). There was a significant difference between average β-carotene values of patients with and without metabolic syndrome (p=0.048) according to the classification of the NCEP. Lower values were found in patients with metabolic syndrome. Conclusion: Considering the vitamin A contribution in antioxidant protection, especially when risk factors for cardiovascular disease are present, it is suggested that great attention be given to morbidly obese. This could aid in prevention and treatment of cardiovascular disease, which affects a significant part of the population.

Multi-Center Study of Thromboplastin Calibration Precision – Influence of Reagent Species, Composition, and International Sensitivity Index (ISI)

1993 ◽  
Vol 69 (01) ◽  
pp. 035-040 ◽  
Author(s):  
A M H P van den Besselaar ◽  
R M Bertina
Keyword(s):  
Oral Anticoagulants ◽  
International Normalized Ratio ◽  
The Other ◽  
World Health ◽  
Rabbit Brain ◽  
Sensitivity Index ◽  
Bovine Plasma ◽  
Significant Difference ◽  
The Mean ◽  
International Sensitivity Index

SummaryFour thromboplastin reagents were tested by 18 laboratories in Europe, North-America, and Australasia, according to a detailed protocol. One thromboplastin was the International Reference Preparation for ox brain thromboplastin combined with adsorbed bovine plasma (coded OBT/79), and the second was a certified reference material for rabbit brain thromboplastin, plain (coded CRM 149R). The other two thromboplastin reagents were another rabbit plain brain thromboplastin (RP) with a lower ISI than CRM 149R and a rabbit brain thromboplastin combined with adsorbed bovine plasma (RC). Calibration of the latter two reagents was performed according to methods recommended by the World Health Organization (W. H. O.).The purpose of this study was to answer the following questions: 1) Is the calibration of the RC reagent more precise against the bovine/combined (OBT/79) than against the rabbit/plain reagent (CRM 149R)? 2) Is the precision of calibration influenced by the magnitude of the International Sensitivity Index (ISI)?The lowest inter-laboratory variation of ISI was observed in the calibration of the rabbit/plain reagent (RP) against the other rabbit/plain reagent (CRM 149R) (CV 1.6%). The highest interlaboratory variation was obtained in the calibration of rabbit/plain (RP) against bovine/combined (OBT/79) (CV 5.1%). In the calibration of the rabbit/combined (RC) reagent, there was no difference in precision between OBT/79 (CV 4.3%) and CRM 149R (CV 4.2%). Furthermore, there was no significant difference in the precision of the ISI of RC obtained with CRM 149R (ISI = 1.343) and the rabbit/plain (RP) reagent with ISI = 1.14. In conclusion, the calibration of RC could be performed with similar precision with either OBT/79 or CRM 149R, or RP.The mean ISI values calculated with OBT/79 and CRM 149R were practically identical, indicating that there is no bias in the ISI of these reference preparations and that these reference preparations have been stable since their original calibration studies in 1979 and 1987, respectively.International Normalized Ratio (INR) equivalents were calculated for a lyophilized control plasma derived from patients treated with oral anticoagulants. There were small but significant differences in the mean INR equivalents between the bovine and rabbit thromboplastins. There were no differences in the interlaboratory variation of the INR equivalents, when the four thromboplastins were compared.

Usefulness of positron emission tomography for differentiating gliomas according to the 2016 World Health Organization classification of tumors of the central nervous system

2020 ◽  
Vol 133 (4) ◽  
pp. 1010-1019 ◽  
Author(s):  
Hiroaki Takei ◽  
Jun Shinoda ◽  
Soko Ikuta ◽  
Takashi Maruyama ◽  
Yoshihiro Muragaki ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Pet Imaging ◽  
Who Classification ◽  
Standardized Uptake Value ◽  
Emission Tomography ◽  
World Health ◽  
Pet Tracers ◽  
Positron Emission ◽  
Significant Difference ◽  
The Mean

OBJECTIVEPositron emission tomography (PET) is important in the noninvasive diagnostic imaging of gliomas. There are many PET studies on glioma diagnosis based on the 2007 WHO classification; however, there are no studies on glioma diagnosis using the new classification (the 2016 WHO classification). Here, the authors investigated the relationship between uptake of 11C-methionine (MET), 11C-choline (CHO), and 18F-fluorodeoxyglucose (FDG) on PET imaging and isocitrate dehydrogenase (IDH) status (wild-type [IDH-wt] or mutant [IDH-mut]) in astrocytic and oligodendroglial tumors according to the 2016 WHO classification.METHODSIn total, 105 patients with newly diagnosed cerebral gliomas (6 diffuse astrocytomas [DAs] with IDH-wt, 6 DAs with IDH-mut, 7 anaplastic astrocytomas [AAs] with IDH-wt, 24 AAs with IDH-mut, 26 glioblastomas [GBMs] with IDH-wt, 5 GBMs with IDH-mut, 19 oligodendrogliomas [ODs], and 12 anaplastic oligodendrogliomas [AOs]) were included. All OD and AO patients had both IDH-mut and 1p/19q codeletion. The maximum standardized uptake value (SUV) of the tumor/mean SUV of normal cortex (T/N) ratios for MET, CHO, and FDG were calculated, and the mean T/N ratios of DA, AA, and GBM with IDH-wt and IDH-mut were compared. The diagnostic accuracy for distinguishing gliomas with IDH-wt from those with IDH-mut was assessed using receiver operating characteristic (ROC) curve analysis of the mean T/N ratios for the 3 PET tracers.RESULTSThere were significant differences in the mean T/N ratios for all 3 PET tracers between the IDH-wt and IDH-mut groups of all histological classifications (p < 0.001). Among the 27 gliomas with mean T/N ratios higher than the cutoff values for all 3 PET tracers, 23 (85.2%) were classified into the IDH-wt group using ROC analysis. In DA, there were no significant differences in the T/N ratios for MET, CHO, and FDG between the IDH-wt and IDH-mut groups. In AA, the mean T/N ratios of all 3 PET tracers in the IDH-wt group were significantly higher than those in the IDH-mut group (p < 0.01). In GBM, the mean T/N ratio in the IDH-wt group was significantly higher than that in the IDH-mut group for both MET (p = 0.034) and CHO (p = 0.01). However, there was no significant difference in the ratio for FDG.CONCLUSIONSPET imaging using MET, CHO, and FDG was suggested to be informative for preoperatively differentiating gliomas according to the 2016 WHO classification, particularly for differentiating IDH-wt and IDH-mut tumors.

The effect of positive thinking training on the quality of life of parents of adolescent with thalassemia

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Adeleh Sadeghloo ◽  
Parna Shamsaee ◽  
Elham Hesari ◽  
Golbanhar Akhondzadeh ◽  
Hamid Hojjati
Keyword(s):  
Quality Of Life ◽  
Emotional Health ◽  
Intervention Group ◽  
T Test ◽  
World Health ◽  
Positive Thinking ◽  
Significant Difference ◽  
And Control ◽  
Paired T Test

Abstract Introduction Thalassemia, as the most common chronic hereditary blood disorder in humans, can impose many adverse effects on parents and their affected children. On the other hand, positive thinking is the method or the result of a positive focus on a constructive issue, so by teaching positive thinking, we can improve physical and social function, and promote emotional health and overall quality of life. The aim of this study was to determine the effect of positive thinking training on the quality of life of parents of adolescents with thalassemia. Methods This quasi-experimental study was performed on 52 parents of adolescents with thalassemia who attended Taleghani Hospital in Golestan province, Iran in 2017. Samples were randomly assigned into two groups of intervention and control. The positive thinking training (based on the theory of Martin Seligman) was carried out in the intervention group in 10 (45–60 min) sessions over a 5-week period. Data collection tools in this study were the World Health Organization (WHO) quality of life questionnaire (WHOQOL-BREF) and a demographic information questionnaire. Data were analyzed by SPSS-16 software using independent t-test, the paired t-test and a covariance test. Results The results of paired t-test showed a significant difference in the score of quality of life in intervention group before and after the intervention (p < 0.001). However, this test did not show any significant difference in the control group (p = 0.11). The covariance test, after removing the pre-test score, showed a significant difference between the intervention and control groups in terms of the score of quality of life, so that 13% of the changes after the intervention were due to the intervention (p = 0.009, η = 0.13). Conclusion The positive thinking training increased the quality of life of parents of adolescents with thalassemia. Therefore, using this program can be an effective way of improving the quality of life of parents. Thus, positive thinking training is suggested to be used as an effective strategy for increasing the quality of life of parents with ill children.

scholarly journals Post-Stroke Depression and Its Effect on Functional Outcomes during Inpatient Rehabilitation

2021 ◽  
Author(s):  
Gurumayum Sonachand Sharma ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Naveen Bangarpet Prakash
Keyword(s):  
Outcome Measures ◽  
Functional Outcomes ◽  
Rating Scale ◽  
Tertiary Care ◽  
Depression Scale ◽  
Inpatient Rehabilitation ◽  
University Hospital ◽  
Post Stroke ◽  
Significant Difference ◽  
Post Stroke Depression

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.

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