Effects of neuromuscular electrical stimulation on exercise capacity, muscle strength and quality of life in COPD patients: A Systematic Review with Meta-Analysis

Objective To determine the effects of neuromuscular electrical stimulation on disabilities and activity limitation of individuals affected by chronic obstructive pulmonary disease. Data sources MEDLINE, PEDro database, Cochrane Controlled Trials Register, and SciELO, were searched from inception until October 2021. Review methods Inclusion criteria were patients with COPD, randomized controlled trials comparing neuromuscular electrical stimulation alone or combined conventional pulmonary rehabilitation and neuromuscular electrical stimulation versus control or sham or pulmonary rehabilitation in disabilities and activity limitation in COPD. There were no mandatory language or publication date restrictions. Two reviewers selected studies independently. Weighted mean differences and 95% confidence intervals were calculated. Results 32 studies met the study criteria, including 1.269 participants. Neuromuscular electrical stimulation improved exercise capacity (MD 1.10, 95% CI: 0.33, 1.86, N = 147), and muscle strength (0.53, 95% CI: 0.20, 0.87, N = 147) compared to sham group. Combined neuromuscular electrical stimulation and conventional rehabilitation improved exercise capacity (MD 34.28 meters, 95% CI: 6.84, 61.73, N = 262) compared to conventional rehabilitation alone. No adverse events were reported. Conclusions Neuromuscular electrical stimulation resulted in small improvement in disabilities and activity limitation (below the MCID) in COPD. Thus, the inclusion of neuromuscular electrical stimulation in rehabilitation programs must consider the cost Because of inadequate methodological conduction and reporting of methods, some studies were of low quality.

A review on tools for measuring activity limitation in diabetic peripheral neuropathy

The burden of diabetic peripheral neuropathy (DPN) ranges from 10.5% to 32.2% and up to half of the diabetic patients will eventually develop neuropathy in the course of their disease. The present paper reviews the existing tools and measures for assessing activity limitation as a result of DPN; using a not exhaustive search strategy, limited to PubMed. The tools available for the assessment of activity limitation as a consequence of DPN are based on International Classification of Functioning, Disability and Health (ICF) and are equally effective. The researcher must make the choice based on cultural validation and specific study objectives. Researchers should select a set of tools and procedures that are appropriate for study purposes, study settings and strive to use them consistently.

Effects of virtual reality in improving upper extremity function after stroke: A systematic review and meta-analysis of randomized controlled trials

Objective To investigate the effect of virtual reality on arm motor impairment, activity limitation, participation restriction, and quality of life in patients with stroke. To determine potential moderators that affect the efficacy of virtual reality. Data sources CINAHL, Medline, PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, and Wanfang Data from inception to October 23, 2021. Review methods Randomized controlled trials that investigated the effect of virtual reality on arm recovery in adult patients with stroke compared to conventional therapy or sham control were included. Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study. Results Forty studies with 2018 participants were identified. Quality of included studies was fair to high. Virtual reality exhibited better effects on overall arm function ( g = 0.28, p < 0.001), motor impairment ( g = 0.36, p < 0.001) and activity limitation (daily living) ( g = 0.24, p < 0.001) compared with the control group. No significant improvement was observed in participation restriction and activity limitation (specific task). The result for quality of life was described qualitatively. Subgroup analyses demonstrated that immersive virtual reality produced a greater beneficial effect ( g = 0.60, p < 0.001). Patients with moderate to severe arm paresis could make more progress after training ( g = 0.71, p < 0.001). Conclusion Virtual reality is recommended for improving motor impairment and activities of daily living after stroke and is favorable to patients with moderate to severe paresis. An immersive design could produce greater improvement.

Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain

Purpose The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH). Methods We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (N = 13,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables. Results GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53–31.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42–17.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest. Conclusions GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.

Veränderungen der Lebensqualität von Glaukompatienten über einen Zeitraum von 8 Jahren

Zusammenfassung Hintergrund Die Lebensqualität von Glaukompatienten wird von vielen Faktoren beeinflusst. Insbesondere die Aktivität wird durch die chronische Erkrankung beeinträchtigt. Diese Studie evaluiert Veränderungen der Lebensqualität über Aktivitätseinschränkungen in einem Zeitraum von 8 Jahren. Methoden Dreiundvierzig Patienten mit glaukomatösem Papillenschaden wurden in diese retrospektive longitudinale Beobachtungsstudie eingeschlossen. Veränderungen des Intraokulardrucks (IOD) und der bestkorrigierten Sehschärfe (BCVA) sowie Gesichtsfeldparameter, Anzahl der den Intraokulardruck (IOD) senkenden Medikation und der durchgeführten augendrucksenkenden Operationen wurden über einen Zeitraum von 8 Jahren erhoben. Die Lebensqualität und Aktivitätseinschränkung der Patienten wurden mit dem Rasch-kalibrierten Fragebogen „Glaucoma Activity Limitation 9“ (GAL-9) bei Einschluss und 8 Jahre später erhoben. Ergebnisse Die Sehschärfe des besseren Auges änderte sich von 0,16 ± 0,22 auf 0,21 ± 0,14 logMAR, die des schlechteren Auges von 0,27 ± 0,25 auf 1,39 ± 1,1 logMAR. Die mittlere Defekttiefe im Gesichtsfeld („mean deviation“ [MD]) des besseren Auges entwickelte sich von −2,39 ± 4,55 dB auf −4,83 ± 5,09 dB, die des schlechteren Auges von −8,86 ± 5,86 dB auf −12,05 ± 8,07 dB. Die Werte des kalibrierten GAL‑9 zeigten eine Veränderung von −2,39 ± 2,14 auf −1,38 ± 2,78 (negativere Werte in der spezifischen Rasch-Analyse bedeuten eine bessere Lebensqualität), was im Summenscore einer Änderung des Gesamtwertes von 79,17 ± 19,63 auf 69,22 ± 27,95 entspricht. Diese Veränderungen korrelierten signifikant mit der MD in der Folgeuntersuchung nach 8 Jahren, insbesondere am schlechteren Auge (r = 0,43). Auch in einer Regressionsanalyse konnte der Einfluss der MD auf die Entwicklung der Lebensqualität gut vorhergesagt werden. Zusammenfassung Die Lebensqualität bei an Glaukom erkrankten Patienten nimmt im Laufe der Zeit signifikant ab. Veränderungen des Gesichtsfeldes, insbesondere am schlechteren Auge, haben einen großen Einfluss. Sorgfältige Therapie, gerade des Auges mit ausgeprägterem glaukomatösem Schaden, ist daher von großer Wichtigkeit.

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.

What Was the Impact of COVID-19 Pandemic on Low Back Pain? Data from the PAMPA Cohort, Brazil.

Background: To evaluate how COVID-19 pandemic impacted low back pain (LBP) outcomes in southern Brazil. Methods: Data from the Prospective Study about Mental and Physical Health (PAMPA) Cohort were analyzed. Adults were recruited between June and July 2020 in the Rio Grande do Sul state using online-based strategies. Participants responded a self-reported, online questionnaire on LBP with two timepoints: before (retrospectively) and during COVID-19 pandemic. We assessed the presence of LBP, LBP-related activity limitation (no/yes), and LBP intensity (0 to 10 [strongest pain]). Results: From a total sample of 2,321 respondents (mean age: 37.6 ± 13.5; 75.4% women), the prevalence of LBP did not change significantly from before (74.7% [95%CI 72.3; 76.9]) to during the COVID-19 pandemic (74.2% [95%CI 71.9; 76.3]). However, an increased pain levels (β: 0.40; 95%CI 0.22; 0.58) and a higher likelihood for activity limitation due to LBP was observed during the pandemic (PR 1.14; 95%CI 1.01; 1.29). Longitudinal analyzes showed that age, gender, BMI, chronic diseases, physical activity and anxiety and depression symptoms, were associated with LBP during the COVID-19 pandemic. Conclusion: Although the prevalence of LBP did not change during the COVID-19 pandemic, LBP-induced impairment in daily activities and LBP intensity was higher during than before the pandemic. Sociodemographic and lifestyle characteristics were associated with increased LBP and related outcomes.