scholarly journals Association between Gait Variability and Gait-Ability Decline in Elderly Women with Subthreshold Insomnia Stage

Author(s):  
Taesang Lee ◽  
Myeounggon Lee ◽  
Changhong Youm ◽  
Byungjoo Noh ◽  
Hwayoung Park

This study investigates the gait characteristics of elderly women, aged more than 65 years, with subthreshold insomnia stage at various walking speeds. A total of 392 participants (insomnia: 202 and controls: 190) wearing shoe-type inertial measurement units completed walking tests on a treadmill for a duration of 1 min at slower, preferred, and faster speeds. The insomnia group indicated lower pace parameters (range of Cohen’s d: 0.283–0.499) and the single support phase (Cohen’s d: 0.237), greater gait variability (range of Cohen’s d: 0.217–0.506), and bilateral coordination (range of Cohen’s d: 0.254–0.319), compared with their age-matched controls; the coefficient of variance (CV) of the stance phase at the faster speed condition was a crucial variable for distinguishing between insomnia and control groups. In addition, the insomnia group demonstrated insufficient gait adaptation at the slower and preferred speeds, as indicated by the CVs of the stride length, stride time, and step time. In particular, participants with worsened insomnia symptoms or sleep problems showed that these worse gait patterns may increase the potential risk of falling in elderly women. Thus, elderly women with subthreshold insomnia stage need to improve their sleep quality to enhance their physical functions.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cecilia Lundholm ◽  
Bronwyn K. Brew ◽  
Brian M. D’Onofrio ◽  
Emma Caffrey Osvald ◽  
Henrik Larsson ◽  
...  

AbstractAsthma may negatively affect children’s school performance, such as grades and exam results. Results from previous studies have shown varying results and may have suffered from confounding and other biases. We used a Swedish population-based cohort of 570,595 children with data on asthma (including severity and control) in Grades 7–8 and 9, school performance from Grade 9 (grade point sum, non-eligibility for upper secondary school and national test results) and measured confounders from national registers. We used sibling comparisons to account for unmeasured familial factors. Children with asthma and severe asthma performed slightly better in school than children without asthma when adjusting for measured confounders, but the associations were attenuated in sibling comparisons. In contrast, children with uncontrolled asthma performed slightly worse (e.g. Grade 9: βadj = −9.9; 95% CI −12.8 to −7.0; Cohen’s d = 0.16). This association remained for uncontrolled asthma in Grade 9 in sibling comparisons (Grade 9: β = −7.7 points; 95% CI −12.6 to −2.6; Cohen’s d = 0.12), but not for Grades 7–8. The attenuation of estimates when controlling for familial factors using sibling comparisons suggests that the differences were due to familial factors, rather than being causal. The remaining associations in sibling comparisons between uncontrolled asthma in Grade 9 and school performance are consistent with a causal association.


2021 ◽  
Vol 9 (3) ◽  
Author(s):  
Adeola Sanni ◽  
Robert Lynall ◽  
Deborah Backus ◽  
Kevin McCully

Background/Purpose: Multiple sclerosis (MS) is a progressive neurological disease that results in increased fatigue, decreased muscle function, and impaired gait and balance. The purpose of this study was to evaluate the relationship between lower leg muscle function and changes in gait and balance immediately and 20 minutes after 6mins walk-induced fatigue. Methods: Six persons with MS (Patient-Determined Disease Steps 3-5) participated in the study. Perceived fatigue and demographic information were taken at baseline. Muscle fatigability and mitochondria capacity was measured in the lower leg muscles before walking. Reported fatigue (VAFS, 0-10), gait variability, gait asymmetry, and static balance were measured before and immediately after a self-paced 6 minutes treadmill walk with slight elevation, and after 20 minutes of rest. Results: Participant’s baseline MFIS score ranged from 14 - 71. There was a 173% increase in reported fatigue scores after walking. Gait was impaired with a ~26% increase in gait variability and ~40% increase in gait asymmetry immediately after walking (Cohen’s D = 0.4, 0.3 respectively). There was also ~69% increase in balance postural sway with eyes opened and a ~20% increase with eyes closed (Cohen’s D = 0.5, 0.2 respectively). Gait and balance remained impaired after 20 minutes of rest. The decline in gait parameters after walking had a negative correlation with muscle endurance (r=-0.80, p=0.03), and mitochondrial capacity (r=-0.92, p<0.01). The changes in gait and balance were more evident in participants with a higher disability. Conclusions: Six minutes of self-paced walking with slight elevation worsened gait and balance among people with MS (PwMS), which did not completely recover after 20 minutes of rest. The changes in gait after walking were associated with lower leg muscle function. Lower leg muscle function might be an important intervention target to improve gait and balance fall risk among PwMS.


2019 ◽  
Vol 111 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Cara F Ruggiero ◽  
Emily E Hohman ◽  
Leann L Birch ◽  
Ian M Paul ◽  
Jennifer S Savage

ABSTRACT Background The Intervention Nurses Start Infant Growing on Healthy Trajectories (INSIGHT) study's responsive parenting (RP) intervention, initiated in early infancy, prevented the use of nonresponsive, controlling feeding practices and promoted use of structure-based feeding among first-time parents compared with controls. Objectives We sought to examine the spillover effect of the RP intervention on maternal feeding practices with their secondborn (SB) infants enrolled in an observational-only study, SIBSIGHT, and to test the moderating effect of spacing of births. Methods SB infants of mothers participating in the INSIGHT study were enrolled into the observation-only ancillary study, SIBSIGHT. SBs were healthy singleton infants ≥36 weeks of gestation. Infant feeding practices (i.e., food to soothe, structure vs. control-based practices) were assessed using validated questionnaires: Babies Need Soothing Questionnaire, Infant Feeding Styles Questionnaire, and the Structure and Control in Parent Feeding Questionnaire. Results SBs (n = 117 [RP: 57, control: 60]; 43% male) were delivered 2.5 ± 0.8 y after firstborns (FBs). At age 1 y, the Structure and Control in Parent Feeding Questionnaire revealed that the mothers in the RP group used more consistent feeding routines (4.19 [0.43] compared with 3.77 [0.62], P = 0.0006, Cohen's D: 0.69) compared with control group mothers. From the Infant Feeding Styles Questionnaire, RP group mothers also used less nonresponsive, controlling feeding practices such as pressuring their SB infant to finish (1.81 [0.52] compared with 2.24 [0.68], P = 0.001, Cohen's D: 0.68) compared with controls. In contrast to our hypotheses, no differences were detected in bottle-feeding practices such as putting to bed with a bottle/sippy cup or adding cereal to the bottle, despite observing study group differences in FBs. Spacing of births did not moderate intervention effects. Conclusions RP guidance given to mothers of FBs may prevent the use of some nonresponsive, controlling feeding practices while establishing consistent feeding routines in subsequent siblings.


2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Efrosini Papaconstantinou ◽  
Carol Cancelliere ◽  
Leslie Verville ◽  
Jessica J. Wong ◽  
Gaelan Connell ◽  
...  

AbstractSleep problems are common and may be associated with persistent pain. It is unclear whether non-pharmacological interventions improve sleep and pain in adults with comorbid sleep problems and musculoskeletal (MSK) pain. We conducted a systematic review on the effectiveness of non-pharmacological interventions on sleep characteristics among adults with MSK pain and comorbid sleep problems. We searched MEDLINE, EMBASE, CINAHL, Cochrane Central and PsycINFO from inception to April 2, 2021 for randomized controlled trials (RCTs), cohort, and case-control studies. Pairs of independent reviewers critically appraised and extracted data from eligible studies. We synthesized the findings qualitatively. We screened 8459 records and identified two RCTs (six articles, 467 participants). At 9 months, in adults with insomnia and osteoarthritis pain, cognitive behavioral therapy for pain and insomnia (CBT-PI) was effective at improving sleep (Insomnia Severity Index, ISI) when compared to education (OR 2.20, 95% CI 1.25, 3.90) or CBT for pain (CBT-P) (OR 3.21, 95% CI 1.22, 8.43). CBP-P vs. education was effective at increasing sleep efficiency (wrist actigraphy) in a subgroup of participants with severe pain at baseline (mean difference 5.45, 95% CI 1.56, 9.33). At 18 months, CBT-PI, CBT-P and education had similar effectiveness on sleep and pain or health outcomes. In adults with insomnia and knee osteoarthritis, CBT-I improved some sleep outcomes including sleep efficiency (diary) at 3 months (Cohen’s d 0.39, 95% CI 0.24, 1.18), and self-reported sleep quality (ISI) at 6 months (Cohen’s d − 0.62, 95% CI -1.01, − 0.07). The intervention was no better than placebo (behavioural desensitization) for improving other sleep outcomes related to sleep onset or pain outcomes. Short-term improvement in sleep was associated with pain reduction at 6 months (WOMAC pain subscale) (sensitivity 54.8%, specificity 81.4%). Overall, in two acceptable quality RCTs of adults with OA and comorbid insomnia, CBT-PI/I may improve some sleep outcomes in the short term, but not pain outcomes in the short or long-term. Clinically significant improvements in sleep in the short term may improve longer term pain outcomes. Further high-quality research is needed to evaluate other non-pharmacological interventions for people with comorbid sleep problems and a range of MSK conditions.


2017 ◽  
Vol 41 (S1) ◽  
pp. S139-S139
Author(s):  
V. Agyapong ◽  
M. Juhas ◽  
A. Ohinmaa ◽  
J. Omeje ◽  
K. Mrklas ◽  
...  

BackgroundDepression is projected to be the primary cause of disability worldwide by 2030. Our aim was to test the feasibility of a supportive text messaging mobile health intervention in improving treatment outcomes in depressed patients.MethodsWe performed a single-rater-blinded randomised trial involving 73 patients with Major Depressive Disorder. Patients in the intervention group (n = 35) received twice-daily supportive text messages for 3 months while those in the control group (n = 38) received a single text message every fortnight thanking them for participating in the study.ResultsAfter adjusting for baseline BDI scores, a significant difference remained in the three month mean BDI scores between the intervention and control groups: (20.8 (SD = 11.7) vs. 24.9 (SD = 11.5), F (1, 60) = 4.83, P = 0.03, ηp2 = 0.07). The mean difference in the BDI scores change was significant with an effect size (Cohen's d) of 0.67. Furthermore, after adjusting for baseline scores, a significant difference remained in the three month mean self-rated VAS scores (EQ-5D-5L scale) between the intervention and control groups, 65.7 (SD = 15.3) vs. 57.4 (SD = 22.9), F (1, 60) = 4.16, P = 0.05, ηp2 = 0.065. The mean difference in change mean self-rated VAS scores was also statistically significant with an effect size (Cohen's d) of 0.51.ConclusionsOur findings suggest that supportive text messages are a potentially useful psychological intervention for depression, especially in underserved populations. Further studies are needed to explore the implications of our findings in larger clinical samples.


2013 ◽  
Vol 2 (4) ◽  
pp. 199-215 ◽  
Author(s):  
Maria Klatte ◽  
Claudia Steinbrink ◽  
Kirstin Bergström ◽  
Thomas Lachmann

Defizite in der phonologischen Informationsverarbeitung werden heute als Kernsymptom der Lese-Rechtschreibstörung betrachtet. In Trainingsstudien mit betroffenen Kindern erwiesen sich Phonemwahrnehmungsfähigkeiten als trainierbar, und Programme, in denen Aufgaben zur phonologischen Bewusstheit mit der systematischen Vermittlung von Phonem-Graphem-Zuordnungen kombiniert wurden, zeigten Transfereffekte auf Lese- und Rechtschreibleistungen. Ausgehend von diesen Erkenntnissen wurde ein computerbasiertes Trainingsprogramm zur Förderung der Phonemwahrnehmung, der phonologischen Bewusstheit und der Graphem-Phonem-Zuordnungen für deutschsprachige Grundschulkinder mit Lese-Rechtschreibstörung entwickelt. Aufgrund der besonderen Relevanz der Vokallänge für die deutsche Orthographie enthält das Programm neben Aufgaben, die auf Konsonanten fokussieren, auch Vokallängenaufgaben. Bei der Konzipierung des Programms wurden etablierte, ursprünglich für andere Sprachen entwickelte Aufgaben an die deutsche Phonologie angepasst und in ein computerbasiertes Format übersetzt. Im Rahmen der vorliegenden Studie sollte überprüft werden, ob die konstruierten Trainingsaufgaben die spezifischen Defizite von Kindern mit Lese-Rechtschreibstörung wie intendiert abbilden. Hierzu wurden leseschwache Dritt- und Viertklässler (n = 35) mit mindestens durchschnittlichen Lesern derselben Klassenstufen (n = 75; Kontrollgruppe) hinsichtlich ihrer Leistungen in den Aufgaben verglichen. Die leseschwachen Kinder zeigten in allen Aufgaben schlechtere Leistungen als die Kontrollgruppe. Die Effektstärken der Gruppenunterschiede (Cohen's d) lagen im mittleren bis hohen Bereich (0.50 – 2.19). Die Ergebnisse bestätigen, dass die Aufgaben des Trainingsprogramms die spezifischen Defizite leseschwacher Kinder abbilden. Ein Training mit diesen Aufgaben erscheint daher grundsätzlich sinnvoll. Die Wirkungen eines solchen Trainings auf die schriftsprachlichen Leistungen von Kindern mit Lese-Rechtschreibstörung werden in zukünftigen Studien überprüft.


2019 ◽  
Author(s):  
Jan G. Voelkel ◽  
Dongning Ren ◽  
Mark John Brandt

The political divide is characterized by liberals and conservatives who hold strong prejudice against each other. Here we introduce one possible strategy for reducing political prejudice: political inclusion. We define political inclusion as receiving a fair chance to voice one’s opinions in a discussion of political topics with political outgroup members. This strategy may reduce political prejudice by inducing perceptions of the political outgroup as fair and respectful; however, such a strategy may also highlight conflicting attitudes and worldviews, thereby further exacerbating prejudice. In three preregistered studies (total N = 799), we test if political inclusion reduces or increases prejudice toward the political outgroup. Specifically, political inclusion was manipulated with either an imagined scenario (Study 1) or a concurrent experience in an ostensible online political discussion (Studies 2 &amp; 3). Across all studies, participants who were politically included by political outgroup members reported reduced prejudice toward their outgroup compared to participants in a neutral control condition (Cohen’s d [-0.27, -0.50]). This effect was mediated by perceptions of the political outgroup as fairer and less dissimilar in their worldviews. Our results indicate that political discussions that are politically inclusive do not cause additional prejudice via worldview conflict, but instead give others a feeling of being heard. It is a promising strategy to reduce political prejudice.


2020 ◽  
Author(s):  
Yushi Mo ◽  
Yan Luo ◽  
Hong Li ◽  
Dewei Xiao ◽  
Shuqing Liu ◽  
...  

BACKGROUND In face of the sudden epidemic of COVID-19, strict prevention and control measures had been urgently carried out all over China. Because of the long-term home quarantine, all kinds of people were affected by it. OBJECTIVE In order to understand the mental health of children during the pandemic of COVID-19, this study investigated the prevalence and characteristics of emotional and behavioral problems of children aged 1-11 in Guizhou. METHODS Based on the online survey platform, the survey link was pushed through Wechat in April 2020. Electronic questionnaires were used to investigate children's demographic characteristics, emotional or behavioral problems. RESULTS A total of 3505 valid questionnaires were received from 9 prefectures and cities in Guizhou Province. 39.67% of the children in the 1-2-year-old group had emotional problems. 17.63% of the children agd 3-5 years had behavioral or emotional problems. And 23.57% of the children agd 6-11 years havd behavioral problems. CONCLUSIONS During the home quarantine period of prevention and control of COVID-19, even young children were adversely affected. The prevalence of emotional and behavioral problems in children was high, which was mainly manifested as anxiety, difficulty in concentration and sleep problems.


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.


Author(s):  
Jieling Chen ◽  
Cho Lee Wong ◽  
Bernard Man Hin Law ◽  
Winnie Kwok Wei So ◽  
Doris Yin Ping Leung ◽  
...  

Summary Pneumoconiosis is a common occupational lung disease among construction workers. Educational interventions targeting specific ethnic groups of construction workers are of benefit for pneumoconiosis prevention. The aim of this study was to develop a multimedia educational intervention for pneumoconiosis prevention for South Asian construction workers, and to evaluate its feasibility, acceptability and effectiveness in increasing knowledge of pneumoconiosis, modifying beliefs about pneumoconiosis, and enhancing intention to implement measures for its prevention among the workers. This evaluation was performed using the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. A one-group design was adopted and intervention mapping was used to guide the process of intervention development, while the Health Belief Model guided the development of intervention content. The intervention was delivered at construction sites, ethnic minority associations and South Asian community centres. Data were collected via surveys completed at pre-intervention, post-intervention and 3 months after the intervention. A total of 1002 South Asian construction workers participated in the intervention. The participants reported a moderate-to-large increase in knowledge, perceived susceptibility, perceived severity, perceived benefits, cues to action and self-efficacy (Cohen’s d: 0.37–0.89), a small reduction in perceived barriers (Cohen’s d = 0.12) and a moderate improvement in attitudes and intention to practice (Cohen’s d: 0.45, 0.51) at post-intervention. A follow-up survey of 121 participants found that the implementation of preventive measures appeared to increase. Overall, the findings demonstrate that the implementation of a culturally adapted multimedia educational intervention could be an effective approach to improving knowledge, self-efficacy and intention regarding pneumoconiosis prevention among South Asian construction workers.


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