Clinical Trial Evaluating Quality of Life in Patients with Intra-Oral Halitosis

Halitosis is considered to be extremely unattractive in the context of social interactions. The main research objective of this study was to evaluate whether intra-oral halitosis may impact patients’ quality of life (QOL). One hundred generally healthy adult participants complaining about oral malodor and diagnosed with intra-oral halitosis were enrolled in this study. For halitosis diagnosis, a gas chromatography (GC) analysis by the Oral Chroma portable device was used. QOL assessment was based on the Short Form 36-item Health Survey (SF-36). The respondents had the highest scores in the physical functioning (PF), activity limitations caused by emotional problems (RE) and activity limitations caused by physical problems (RP) domains, and the weakest in the general health perception (GH), vitality (VT) and emotional wellbeing (MH) ones. The total volatile sulfur compounds (VSCs) level was negatively correlated with SF-36 domains. The SF-36 domains’ scores decreased the higher the level of VSC was. The respondents assessed their QOL to be at its best in physical functioning and activity limitations caused by emotional and physical problems and the worst in general health perception, vitality and emotional wellbeing. The strongest correlation between halitosis and decreased QOL was found in the social functioning (SF), vitality, emotional wellbeing and general health perception domains.

A comparison of balance and fall risk in patients with unilateral and bilateral total knee arthroplasty

BACKGROUND: Static or dynamic postural control cannot be fully restored in patients with knee osteoarthritis, even after total knee arthroplasty (TKA), which may contribute to an increased risk of falls in the elderly. OBJECTIVE: To evaluate balance and the fall risk before and after TKA in patients with bilateral knee osteoarthritis. Secondary outcomes were patient-reported and performance-based activity limitations. METHODS: A total of 45 patients were separated into two groups as unilateral TKA (UTKA, n= 24) and bilateral TKA (BTKA, n= 21) groups. All the patients received standard postoperative physical therapy for 3 months. Balance and fall risk (Biodex Balance System SD), patient-reported and performance-based functionality (WOMAC, 30-second chair-stand test, 9-step stair climbing test and 40-meter fast-paced walk test) and Short Form-12 (SF-12) were evaluated at preoperatively, and at 3 months postoperatively. RESULTS: There was no difference between the groups in postoperative fall risk and balance (p> 0.05). The BTKA group obtained better results in the sit-to-stand test and SF-12 physical dimension (p< 0.05). CONCLUSIONS: UTKA and BTKA interventions and the standard postoperative rehabilitation were seen to improve balance and quality of life, and reduce the fall risk, patient-reported and performance-based activity limitations. However, despite improvements in balance, the risk of falling persists.

The Role of Optimism on the Relationship Between Activity Limitations and Life Satisfaction Among Middle-Aged and Older Adults in the United States: A Growth Curve Model of Changes Over Time

Activity limitations can diminish life satisfaction. This study explored the role of optimism on the relationship between changes in activities of daily living and instrumental activities of daily living (ADL/IADL) limitations and life satisfaction over time among middle-aged and older adults. Growth curve modeling accounting for intra- and inter-individual changes in life satisfaction was applied to the 2008–2018 waves of the Health and Retirement Study Leave Behind Survey subsample ( n = 39,122 person-years). After controlling for sociodemographic factors, physical functioning decline adversely affected life satisfaction ( βADL = −0.12, βIADL = −0.13, p < 0.001), but the negative consequences reduced slightly through optimism ( βADL = −0.11, βIADL = −0.12, βoptimism = 0.47, p < 0.001). Increasing optimism could reduce the negative consequences of ADL/IADL limitations on life satisfaction among middle-aged to older adults.

Utility of the Late Life Function and Disability Instrument (LLFDI) in rehabilitation services for older adults

Introduction The Late Life Function and Disability Instrument (LLFDI) is a valid self-report tool that quantifies disability based on activity limitations and participation restrictions in everyday life. Both the original longer tool (LLFDI) and the shorter computer adaptive version (LLFDI-CAT) offer practitioners a method for measuring function independent or in conjunction with performance-based assessment. Objectives: Examine scores of the LLFDI and LLFDI-CAT for measuring disability in older adults who are receiving rehabilitation services in community and institution settings. Method: A secondary data analysis was conducted comparing scores from occupational therapy evaluations with older adults from 3 groups: 1) older adults in primary care using the LLFDI; 2) older adults in primary care using the LLFDI-CAT; older adults in a skilled nursing facility (SNF) using the LLFDI-CAT. Results Mean scores for Activity Limitation and Participation Restriction were lowest for older adults in a SNF indicating greater disability. A one-way Analysis of variance on ranks showed a main effect for Activity Limitation, χ2 (2) = 22.267, p &lt; 0.001, and Participation Restriction, χ2 (2) = 60.372, p &lt; 0.001. Post-hoc analyses revealed significant differences between groups based on tool (i.e. LLFDI vs. LLFDI-CAT) for Activity Limitations and setting (i.e. primary care vs. SNF) for Participation Restriction. Conclusion The LLFDI-CAT may be the preferred instrument to measure disability in older adults across treatment settings. Additional research is warranted to understand how personal and environmental factors influence LLFDI-CAT outcomes.

Kinesiophobia, fear of fall, neuropathic pain and navicular drop in rheumatoid arthritis- a correlation study

Background: Rheumatoid arthritis (RA) is one of the most common chronic health conditions and a leading cause of pain; joint damage and disability. Fear of fall and kinesiophobia are associated with activity limitations in RA patients because of pain and stiffness which affects the quality of life. Kinesiophobia and fear of fall are associated with pain. The pathogenics and chronicity of RA can lead to neuropathic pain. Hence the aim of this study was to assess pronation of foot and evaluate if there is any correlation between fear of fall, kinesiophobia and neuropathic pain in patients with rheumatoid arthritis.Methods: Subjects in the age group of 30-50 years were included after passing the EULAR criteria and were assessed for navicular drop by using the navicular drop test. Later they were assessed for fear of fall, kinesiophobia and neuropathic pain using fall efficacy scale, Tampa scale and LANSS questionnaire respectively.Results: Significant co-relation was found between kinesiophobia and fear of fall (p value =0.0046) and there were non-significant co-relations between all other factors.Conclusions: Participants with RA showed significant navicular drop where left subtalar joint was more affected than right. According to the LANSS score subjects showed lower concerns of neuropathic pain. Maximum number of subjects displayed high concerns of kinesiophobia and fear fall which proves the significant association between the factors.

Disability in Leprosy: Daily Activities and Social Participation in Indonesia

ABSTRACT Leprosy is one of the eight neglected diseases. The purpose of this study was to explain the effect of leprosy disability on daily physical activity, and social participation of leprosy clients in Malang and Sumberglagah Hospital, Mojokerto. The study used a cross sectional design. Respondents amounted to 100 people who have met the inclusion and exclusion criteria with purposive sampling technique. Data analysis used Rho Spearman test to measure activity and participation variables. Spearman Rho test for leprosy on activity limitations showed p = 0.000. Spearman Rho test of leprosy on limited participation showed p = 0.000. Activities are limited, and participation is mostly due to the degree 2 disability experienced. The second most common disability conditions are curly fingers, deformities, and foot ulcers. Preventive efforts of the health office, especially the health centre, should provide health promotion media through the provision of foot exercises.

The impact of Post-COVID-Syndrome on functioning – results from a community survey in patients after mild and moderate SARS-CoV-2-infections in Germany

Background In COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptoms (now called Post-COVID-Syndrome) may have an impact on functioning and may also hinder to participation in social life in affected people. However, little is known about developing such syndrome a for patients with mild and moderate COVID-19 who did not need hospitalization or intensive care. Methods A cross-sectional study in 1027 patients with mild or moderate COVID-19 was performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life, was used. Descriptive statistics were calculated. Results In all, 97.5% of patients reported one symptom in the infection stage, such as fatigue, respiratory problems, limitations of the senses of taste and smell, fear and anxiety and other symptoms. In this time period, 84.1% of the participants experienced activity limitations and participation restrictions such as carrying out daily routines, handling stress, getting household tasks done, caring for/supporting others, and relaxing and leisure concerns. In all, 61.9% of participants reported persisting symptoms more than 3 months after infection. These were fatigue, sleep disturbances, respiratory problems, pain, fear and anxiety, and restrictions in movement; 49% of the participants reported activity limitations and participation restrictions. Predominately, these were handling stress, carrying out daily routines, looking after one’s health, relaxing and leisure activities and doing house work. The impacts on quality of life and vocational performance were rather low. Conclusion The results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not severe and do not lead to frequent or serious issues with quality of life or work ability.

The Effectiveness of Acceptance and Commitment-Based Therapy on the Immune Function and Activity Limitations in Patients With Irritable Bowel Syndrome

Introduction: Irritable bowel syndrome is the most common, costly, and disabling dysfunction of the gastrointestinal tract. Mental disorders can be one of the main factors in the onset, continuation, or exacerbation of gastrointestinal signs and symptoms in people with this syndrome. Commitment and acceptance therapy is a mixture of four approaches of awareness, acceptance, commitment, and behavior change, and its overall goal is to achieve psychological flexibility to move towards thought-based behavior. This treatment focuses less on reducing symptoms and more on improving the quality of life. Objective: This study aimed to determine the effectiveness of acceptance and commitment-based therapy on the immune function and activity limitations in patients with irritable bowel syndrome. Materials and Methods: This study was a quasi-experimental research with a pre-test, post-test design and a control group. Thirty patients with irritable bowel syndrome were randomly selected from those referred to a hospital clinic in Tabriz City, Iran. They were randomly divided into the intervention and control groups (15 in each group). The intervention group received acceptance and commitment group therapy for 8 sessions, while the control group did not receive any intervention. Both groups were assessed before and after the intervention, and in the follow-up phase using the activity limitations subscale of quality of life questionnaires (to measure activity limitations) and stool calprotectin test to assess safety performance. Data analysis was performed using descriptive statistics indices (mean and standard deviation) and analysis of variance with repeated measures, Bonferroni test, and analysis of covariance to test the study hypotheses. Results: The Mean±SD age of the intervention group was 34.53±18.38 years, and the Mean±SD age of the control group was 42.80±17.97 years. The significance levels of Levene’s and the Shapiro-Wilk test for all variables were greater than 0.05. Based on the results, the Mean±SD score of the activity limitations variable in the intervention group was 7.53±4.24 in the pre-test, 17.66±3.41 in the post test, and 17.26±3.65 in the follow-up. According to the results, activity limitations (P=0.027) and safety performance (P=0.034) were significantly different before and after the intervention. Conclusion: The present study’s findings show that acceptance and commitment-based therapy can play an influential role in improving patients’ immune function and promoting their activity limitations. Therefore, this treatment is recommended as a complementary therapy in patients with irritable bowel syndrome.