1
|
Sugita Y, Ohnuma T, Kogure E, Hara T. Factors associated with life-space mobility restriction in home-care older adults receiving home-visit rehabilitation: A cross-sectional multi-center study in Japan. Geriatr Gerontol Int 2023; 23:722-728. [PMID: 37678841 DOI: 10.1111/ggi.14657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/30/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023]
Abstract
AIM Life-space mobility (LSM) restriction is a serious issue among older adults using home-visit rehabilitation (HR). This study evaluated physical function, transportation, and other factors not comprehensively tested in previous studies and examined factors associated with the restriction of LSM among older adults using HR. METHODS This cross-sectional multi-center study recruited 88 HR users (49 men, 39 women, mean age 79.0 [±7.8] years) living in urban and rural areas from August to October 2020. We administered the Life-Space Assessment (LSA), the Self-Efficacy Scale on Going out among community-dwelling Elderly (SEGE), grip strength, a 30-s chair stand test, Bedside Mobility Scale, Functional Independence Measure, Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE) test. Participants were divided into two groups based on the cut-off value of the LSA scores. In the logistic regression analysis, the dependent variable was LSA scores ≤30, and the independent variables were measured based on objective evaluation items and adjusted for confounding factors (age, sex, and frequency of use of day-care services). RESULTS Restriction of LSM was significantly associated with FAI (odds ratio [OR] = 0.817, 95% confidence interval [CI] = 0.706-0.945), HACE facilitators (OR = 1.558, 95% CI = 1.168-2.079), and living alone (OR = 12.822, 95% CI = 1.202-136.716). CONCLUSION Restriction of LSM is associated with environmental factors, such as assistive devices and household composition, and ability to engage in instrumental activities of daily living. Our findings indicate a great need for focusing on these factors among home-care older adults receiving HR. Geriatr Gerontol Int 2023; 23: 722-728.
Collapse
Affiliation(s)
- Yuta Sugita
- Nishinasuno General Home Care Center, Tochigi, Japan
| | - Takeshi Ohnuma
- Rehabilitation Progress Center Incorporated, Tokyo, Japan
| | | | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi, Japan
| |
Collapse
|
2
|
Kamizato C, Osawa A, Maeshima S, Kagaya H, Arai H. Activity level by clinical severity and sex differences in patients with Alzheimer disease and mild cognitive impairment. Psychogeriatrics 2023; 23:815-820. [PMID: 37487570 DOI: 10.1111/psyg.13001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND To determine how to maintain activity in persons with dementia and mild cognitive impairment, we examined the daily activity level by different degrees of clinical severity and sex differences in patients with Alzheimer's disease and mild cognitive impairment. METHODS This study included 92 patients with Alzheimer's disease and 33 patients with mild cognitive impairment who visited our rehabilitation department. The Frenchay Activities Index was used to assess the level of activity. RESULTS Women had high Frenchay Activities Index scores for household activities, such as meal preparation, washing clothes, and light housework, whereas men had high Frenchay Activities Index scores for social occasions and walking outside. Although activity decreased with the severity of dementia in women, there was no difference in men. Additionally, a negative correlation was observed between the number of people living together and activity in women. CONCLUSIONS To maintain and improve activities in persons with Alzheimer's disease and mild cognitive impairment, it is important to suggest activities that fit the lifestyle of the individual and family caregivers and to provide lifestyle instructions that consider sex differences.
Collapse
Affiliation(s)
| | - Aiko Osawa
- National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Hitoshi Kagaya
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
3
|
Amano T, Tamari K. Derivation of a screening tool for predicting the risk of falls in community-dwelling older adults with knee osteoarthritis. Int J Rehabil Res 2022; 45:336-342. [PMID: 36083591 DOI: 10.1097/mrr.0000000000000547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to derive a screening tool for predicting the risk of falls in community-dwelling older adults with knee osteoarthritis. This prospective cohort study was conducted in four orthopedic clinics. The main outcome measure was falls or nonfalls for 5 months, and the predictors were sex, age, BMI, Kellgren-Lawrence grade, laterality, number of comorbidities, pharmacotherapy, physical therapy period, use of a cane, household, previous history of falls, visual analog scale for pain, one-leg standing test (OLST), five times sit-to-stand test (FTSST), and Frenchay activities index. Ninety outpatients (74 females and 16 males) with a mean (SD) age of 73.1 (9.3) years completed a 5-month follow-up. According to the binomial logistic regression analysis, previous history of falls [odds ratio (OR), 6.85; P = 0.019], OLST (OR, 5.97; P = 0.048), and FTSST (OR, 12.93; P = 0.034) were identified as risk factors for falls, and the clinical prediction rule was derived from these variables. The pretest probability of fallers in this study was 21.1% (19 of 90 participants). When the total screening tool score was three points (the participant scored one point for each item: previous history of falls, yes; OLST, ≤6.84 s; FTSST, ≥8.77 s), the positive likelihood ratio was 16:19, and the posttest probability increased to 81.3%. Therefore, this simple screening tool possesses potential clinical utility for identifying patients with knee osteoarthritis at high risk of falls in the future because it demonstrated sufficient diagnostic test accuracy.
Collapse
Affiliation(s)
- Tetsuya Amano
- Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, Hamamatsu and
| | - Kotaro Tamari
- Department of Physical Therapy, Faculty of Health and Medical Science, Teikyo Heisei University, Toshima, Japan
| |
Collapse
|
4
|
Stolarz I, Baszak EM, Zawadka M, Majcher P. Functional Status, Quality of Life, and Physical Activity of Senior Club Members-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1900. [PMID: 35162920 PMCID: PMC8835297 DOI: 10.3390/ijerph19031900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 12/02/2022]
Abstract
This study aims to assess the functional status, quality of life, and physical activity (PA) of the elderly who are members of senior social clubs. The study included 63 participants (65-95 years old) who were members of a seniors club. The study utilized the following instruments: Barthel scale, Lawton's scale of Instrumental Activities of Daily Living (IADL), WHO Quality of Life-BREF questionnaire, author's survey questionnaire containing questions about the type of PA. Duration of membership in the senior club has a statistically significant effect on Barthel index score (F = 19.68, p < 0.001) and Lawton's IADL scale results (F = 17.59, p < 0.001). All four domains of life quality were strongly related to the duration of attendance to senior clubs. Participants who attended the senior club for more than five years were more likely to report a longer PA duration than participants who attended the senior club for less than 5 years (Chi2 = 25.84, p < 0.001). Attendance to senior social clubs has a strong positive impact on functional status, quality of life, and PA of the elderly. Moreover, our study identified numerous social-demographic factors associated with PA, quality of life, and functional status of senior club members.
Collapse
Affiliation(s)
- Ilona Stolarz
- Department of Rehabilitation and Physiotherapy, Chair of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ewelina Magdalena Baszak
- Student Science Club of Physioprophylaxis, Department of Rehabilitation and Physiotherapy, Chair of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Magdalena Zawadka
- Department of Sports Medicine, Chair of Clinical Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Piotr Majcher
- Department of Rehabilitation and Physiotherapy, Chair of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| |
Collapse
|
5
|
Maeshima S, Osawa A, Kondo I, Kamiya M, Ueda I, Sakurai T, Arai H. Differences in instrumental activities of daily living between mild cognitive impairment and Alzheimer's disease: A study using a detailed executive function assessment. Geriatr Gerontol Int 2021; 21:1111-1117. [PMID: 34643324 DOI: 10.1111/ggi.14295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/13/2021] [Accepted: 09/21/2021] [Indexed: 12/01/2022]
Abstract
AIM Executive dysfunction is pathognomonic for dementia and impedes the activities of daily living (ADL). This study aimed to examine the relationship of dementia severity with executive dysfunction and ADL in mild cognitive impairment and dementia. METHODS This single-center study enrolled 86 patients (men, 40; women, 46; mean age, 76.1 ± 7.5 years) referred for cognitive and physical rehabilitation between October 2015 and September 2020. The Clinical Dementia Rating (CDR) was 0.5, 1, and ≥2 in 45, 30, and 11 patients, respectively. The presence and severity of executive dysfunction were assessed using the Behavioral Assessment of the Dysexecutive Syndrome-Japanese version (BADS). The ADL and instrumental ADL (IADL) were assessed using the Barthel Index and Frenchay Activities Index (FAI), respectively. We examined the relationship between CDR severity and overall BADS profile score and its sub-items, and that between the overall BADS profile score and IADL. RESULTS The cognitive and executive functional assessment scores differed significantly depending on the CDR severity. The CDR severity and overall BADS profile score exhibited significant correlations. The BADS found cognitive impairment in 31%, 70%, and 100% of patients with CDR0.5, CDR1, and CDR≥2, respectively. The FAI score differed according to the CDR severity in women but not in men. The overall profile and age-adjusted BADS scores were strongly correlated with the IADL in women but not in men. CONCLUSIONS The greater the severity of executive dysfunction, the greater the difficulty in performing ADL. This effect was more pronounced in women and may predict dementia progression. Geriatr Gerontol Int 2021; ••: ••-••.
Collapse
Affiliation(s)
| | - Aiko Osawa
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Izumi Kondo
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masaki Kamiya
- Division of Rehabilitation Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ikue Ueda
- Division of Rehabilitation Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
6
|
Iwasawa T, Fukui S, Kawakami M, Kawakami T, Kataoka M, Yuasa S, Fukuda K, Fujiwara T, Tsuji T. Factors related to instrumental activities of daily living in persons with chronic thromboembolic pulmonary hypertension. Chron Respir Dis 2021; 18:14799731211046634. [PMID: 34592826 PMCID: PMC8489748 DOI: 10.1177/14799731211046634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Instrumental activities of daily living (IADL) are significantly related to quality of life and mortality among individuals with heart disease. However, few reports have examined IADL in persons with chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to clarify factors related to IADL in persons with CTEPH. This retrospective, observational study enrolled 163 persons with CTEPH (mean ± standard deviation age = 65 ± 13 years; 68% female) admitted to the Department of Cardiology at Keio University Hospital between January 2015 and July 2019. The Frenchay Activities Index (FAI) was used to assess IADL. Age, sex, body mass index, World Health Organization functional class (WHO-FC), cardiac function (mean pulmonary arterial pressure, mean right atrial pressure, pulmonary capillary wedge pressure, and cardiac index), pulmonary function (percentage vital capacity, percentage forced expiratory volume in 1 s, diffusion capacity of carbon monoxide (DLCO)/alveolar volume (VA)), physical function (knee extension strength and walking speed), and 6-min walking distance (6MWD) were assessed. Multiple regression analysis was performed to identify factors significantly associated with FAI. Mean FAI was 25 ± 8. Univariate analysis showed that sex, WHO-FC, DLCO/VA, walking speed, and 6MWD were correlated with FAI. Multiple regression analysis showed that 6MWD (sβ = 0.338, 95% CI 0.014–0.034, p < .001), sex (sβ = 0.268, 95% CI 2.238–7.165, p < .001), and DLCO/VA (sβ = 0.257, 95% CI 1.011–3.528, p < .001) were significantly correlated with FAI (R2 = 0.261). IADL were associated with exercise tolerance, sex, and DLCO/VA in persons with CTEPH. In the future, more details of IADL are expected to be clarified by analyzing individual components of IADL and investigating social background characteristics, including living environment.
Collapse
Affiliation(s)
- Tatsuya Iwasawa
- Department of Rehabilitation Medicine, 34787Keio University Hospital, Tokyo, Japan.,Department of Rehabilitation Medicine, 34787Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shogo Fukui
- Department of Rehabilitation Medicine, 34787Keio University Hospital, Tokyo, Japan.,Graduate School of Health Management, Keio University, Tokyo, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kawakami
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Masaharu Kataoka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Shinsuke Yuasa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Toshiyuki Fujiwara
- Department of Rehabilitation Medicine, 34787Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
7
|
Identifying Activity Limitation and Decline in Quality of Life in Patients with Knee Osteoarthritis Who Are Scheduled to Undergo Total Knee Arthroplasty. J UOEH 2021; 43:33-39. [PMID: 33678784 DOI: 10.7888/juoeh.43.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This study examines factors associated with activity limitation and the decline in quality of life in patients with knee osteoarthritis (OA), and to determine standard values that would be useful for understanding the disease state. We assessed individual factors, the modified version of the Self-Rating Frenchay Activities Index (SR-FAI), and the Japanese Knee Osteoarthritis Measure (JKOM) of 661 participants. Multiple regression analyses were used to examine the relationship between dependent and explanatory variables. Standard values were calculated after stratifying based on factors related to each dependent variable through multiple regression analyses. Among the participants aged 60-74/75-89 years, the standard values for the modified SR-FAI were 23/19 and 20/18 points for K-L grades III and IV in the males, and 29/23 and 26/21 points in the females, respectively. The standard values for the JKOM were 35/49 and 45/59 points for K-L grades III and IV in the males and 41/52 and 47/60 points in the females, respectively. These standard values are a useful index for interpreting the degree of activity limitation and satisfaction reduction in patients with knee OA, and could help in clinical decision making for healthcare providers.
Collapse
|
8
|
Khalil H, Allataifeh E, Kanaan S, Al-Sharman A, Al Mhdawi K, El-Salem K. Translation, cross cultural adaptation, and construct validation of the Arabic version of the Frenchay Activities Index in people with multiple sclerosis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1909. [PMID: 34008919 DOI: 10.1002/pri.1909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 02/08/2021] [Accepted: 04/18/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND PURPOSE Assessing functional status in people with multiple sclerosis (PwMS) has a major role in determining how to help patients to reach their optimal level of living independently in the community. The Frenchay Activity Index (FAI) is a commonly used scale to evaluate functional status in rehabilitation research and practice settings. The aim of this study was to translate the FAI into the standard Arabic language through the process of cross-cultural adaptation and to explore the internal consistency and construct validity of the produced Arabic version of FAI (A-FAI) among a sample of Arabic-speaking PwMS. METHOD The English version of the FAI was translated into Arabic according to the published guidelines. Cronbach's α was used to assess the internal consistency of the A-FAI, and principal factor analysis was conducted to explore the construct validity. RESULTS Hundred and six subjects participated in the study. The A-FAI has acceptable internal consistency as Cronbach's α was 0.70. The principal factor analysis revealed that the instrument has four main factors: domestic chore, leisure, hobbies, and work, rather than the original three factors scale. DISCUSSION The A-FAI has acceptable internal consistency and validity. A-FAI provides essential information about the participation level in instrumental activities of daily living activities among PwMS speaking the Arabic language.
Collapse
Affiliation(s)
- Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Eman Allataifeh
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Saddam Kanaan
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alham Al-Sharman
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khader Al Mhdawi
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid El-Salem
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
9
|
Amano T, Tamari K, Suzuki N. Cross-Validation of a Screening Tool to Distinguish Between Fallers and Nonfallers in Community-Dwelling Older Adults With Knee Osteoarthritis. Arch Phys Med Rehabil 2020; 102:598-603. [PMID: 33309679 DOI: 10.1016/j.apmr.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/05/2020] [Accepted: 12/02/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This study aimed to cross-validate a previously developed knee osteoarthritis falls (KOAF) screening tool to distinguish between fallers and nonfallers among community-dwelling older adults with knee osteoarthritis (OA). DESIGN Cross-sectional survey study. SETTING Three independent orthopedic clinics. PARTICIPANTS Older outpatients with knee OA (N=86; 71 women, 15 men; mean age, 75.2±6.2y). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The primary outcome was to identify fallers and nonfallers among outpatients with OA based on their history of falls within the past year. We investigated factors including sex, age, body mass index, Kellgren-Lawrence grade, affected side (bilateral or unilateral knee OA), number of comorbidities, pharmacotherapy, physical therapy, pain, and activity as individual predictors of falls. Participants performed the one-leg standing test and the 5 times sit-to-stand test to determine motor function. Sensitivity, specificity, likelihood ratio, and post-test probability of the KOAF screening tool were calculated using receiver operating characteristic (ROC) curve analysis. RESULTS The results of the one-leg standing test and 5 times sit-to-stand test differed significantly between the 2 groups (P<.05). ROC curve analysis showed that the area under the curve was 0.88 (95% confidence interval, 0.80-0.96; P<.001). The post-test probability of falls was 83.3% (positive likelihood ratio, 11.54) when the total score of KOAF screening tool was 2 points and 2.6% (negative likelihood ratio, 0.06) when the total score of KOAF screening tool was less than 1 point. CONCLUSIONS Cross-validation results for the KOAF screening tool were better, confirming that the screening tool could distinguish between fallers and nonfallers with high accuracy. Our findings suggest that this simple screening tool could be readily used in clinical practice and could aid in clinical decision-making through providing choices for physical therapy evaluation and recommendations for physical therapy programs.
Collapse
Affiliation(s)
- Tetsuya Amano
- Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, Hamamatsu, Shizuoka, Japan.
| | - Kotaro Tamari
- Department of Physical Therapy, Faculty of Health and Medical Science, Teikyo Heisei University, Toshima, Tokyo, Japan
| | - Nobuharu Suzuki
- Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, Hamamatsu, Shizuoka, Japan
| |
Collapse
|
10
|
Fukui S, Kawakami M, Otaka Y, Ishikawa A, Yashima F, Hayashida K, Muraoka K, Liu M. Activities of daily living among elderly persons with severe aortic stenosis. Disabil Rehabil 2019; 43:338-344. [PMID: 31204521 DOI: 10.1080/09638288.2019.1624838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine the level of limitations in activities of daily living (ADL) and instrumental ADL, and identify related factors to instrumental ADL among elderly persons with severe aortic stenosis (AS). MATERIALS AND METHODS We prospectively enrolled 112 consecutive elderly persons (mean age, 84.6 ± 4.4 y) with severe AS. We assessed ADL and instrumental ADL using the Barthel index (BI) and the Frenchay activities index (FAI), respectively. Cardiac, physical, cognitive and kidney functions, nutritional status, medical histories, and comorbidities were assessed. A multiple logistic analysis was developed to explore related factors to the FAI. RESULTS The medians (ranges) of BI and FAI were 100 (15-100) and 21 (0-38), respectively. The multiple logistic analysis revealed that a history of heart failure (sβ = -0.189), a history of cerebrovascular disease (sβ = -0.233), the short physical performance battery score ≤ 8 (sβ = -0.272), the mini-mental state examination score ≤ 23 (sβ = -0.168) were significantly related to the FAI (p < 0.05). CONCLUSIONS Physical frailty, a history of heart failure, cerebrovascular disease, and cognitive decline were independently related to declined instrumental ADL. IMPLICATIONS FOR REHABILIATION Activities of daily living was well-preserved among elderly persons with severe aortic stenosis. Instrumental activities of daily living varied among patients with aortic stenosis and was sometimes impaired. Physical frailty, a history of heart failure, and a history of cerebrovascular disease were independently associated with instrumental activities of daily living in elderly persons with severe aortic stenosis.
Collapse
Affiliation(s)
- Shogo Fukui
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Aiko Ishikawa
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Fumiaki Yashima
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Kaori Muraoka
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Meigen Liu
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
11
|
Yoshimitsu K, Tabira T, Kubota M, Ikeda Y, Inoue K, Akasaki Y. Factors affecting the self-rated health of elderly individuals living alone: a cross-sectional study. BMC Res Notes 2017; 10:512. [PMID: 29073932 PMCID: PMC5658978 DOI: 10.1186/s13104-017-2836-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 10/19/2017] [Indexed: 11/22/2022] Open
Abstract
Objective In Japan, the number of elderly individuals living alone is continuing to increase as society ages. Although studies have considered quality of life, life expectancy, and gender differences in elderly individuals living alone, only a few have considered the health and lifestyle of these individuals. Therefore, we aimed to investigate the factors that affect the self-rated health of elderly individuals living alone to understand this group and how best to offer them support. Results We include 113 individuals. There was a significant difference (P < 0.05) in some characteristics (e.g., age, chronic illness, frequency of hospital visits in 1 month, and caregivers), activities of daily living (e.g., motor tasks), and instrumental activities of daily living (e.g., household affairs, heavy housework, outdoor household, and outdoor activities).
Collapse
Affiliation(s)
- Koji Yoshimitsu
- Department of Basic Occupational Therapy, Faculty of Medicine, School of Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Takayuki Tabira
- Department of Basic Occupational Therapy, Faculty of Medicine, School of Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Masatomo Kubota
- Department of Basic Occupational Therapy, Faculty of Medicine, School of Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yuriko Ikeda
- Department of Basic Occupational Therapy, Faculty of Medicine, School of Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Kazuhiro Inoue
- Department of Basic Occupational Therapy, Faculty of Medicine, School of Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yasuaki Akasaki
- Department of Basic Occupational Therapy, Faculty of Medicine, School of Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| |
Collapse
|
12
|
Miller WC, Deathe AB, Harris J. Measurement properties of the Frenchay Activities Index among individuals with a lower limb amputation. Clin Rehabil 2016; 18:414-22. [PMID: 15180125 DOI: 10.1191/0269215504cr728oa] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To assess the reliability and validity of the original and a modified version of the Frenchay Activities Index (FAI) among individuals with a lower limb amputation. Design: Two week test-retest design. Setting: South Western Ontario Amputee Program, London, Ontario, Canada. Subjects: Consecutive sample of 84 individuals, primarily men (78.6%), mean age 56.5 years with a unilateral transtibial (71.4%) or transfemoral amputation related to traumatic (59.5%) or vascular causes. Interventions: All subjects completed a questionnaire containing the FAI and other scales, the 2-minute walk and timed up and go tests during a regularly scheduled clinic visit. Fifty-five subjects completed a second FAI which was mailed to them two weeks later. Twenty-nine others completed the second FAI upon return for testing related to another project. Main measures: FAI, Activity-specific Balance Confidence Scale, Prosthetic Evaluation Questionnaire-Mobility Scale, 2-minute walk, timed up and go and walking device aid use. Results: Relative reliability for the FAI (intraclass correlation coefficient (ICC) = 0.79) and FAI-18 (ICC = 0.78) was acceptable, however bias between measurements was detected. Hypothesized relationships (p B=0.001) between both FAI versions and the Activity-specific Balance Confidence Scale, Prosthetic Evaluation Questionnaire-Mobility Scale, 2-minute walk and timed up and go test were observed. Significant group differences were observed for amputation cause, mobility device use, age and years as an amputee. Neither version distinguished between amputee level or gender groups. Conclusions: The original and modified FAI are valid and reliable tools for unilateral amputees. Reliability is adequate to detect group but not individual level differences. Additional FAI-18 items did not substantially improve the ability to detect between-amputation-group differences.
Collapse
Affiliation(s)
- W C Miller
- School of Rehabilitation Sciences, University of British Columbia and Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada.
| | | | | |
Collapse
|
13
|
Prakash V, R Patel S, Hariohm K, S Soni V, Alagumoorthi G. Importance of squatting and sitting on the floor: perspectives and priorities of rural Indian patients with stroke. Top Stroke Rehabil 2016; 23:240-4. [DOI: 10.1080/10749357.2016.1151693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
14
|
Roth EJ, Lovell L. Community Skill Performance and Its Association with the Ability to Perform Everyday Tasks by Stroke Survivors One Year Following Rehabilitation Discharge. Top Stroke Rehabil 2014; 14:48-56. [PMID: 17311790 DOI: 10.1310/tsr1401-48] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Stroke survivors experience functional loss in basic activities of daily living (ADLs) and in everyday community activities or instrumental activities of daily living (IADLs). Historically there has been a greater focus by rehabilitation professionals on basic ADLs than on IADLs. PURPOSE The purpose of this study was to describe the relationship between the ability to perform ADLs and community activities in a large group of stroke patients measured 1 year following rehabilitation discharge. METHOD A structured survey was administered by telephone. Outcome measures were the Frenchay Activities Index (FAI), a measure of IADL, and the FIM, a measure of disability. RESULTS Visual inspection of the relationship between FAI scores and FIM scores revealed that the data largely followed a curvilinear pattern. Curve estimation regression models were used to determine the line of best fit. A cubic function was found to give a good fit with an R2 of 0.644. The three activities in which stroke patients most frequently engaged were social outings, walking outside for more than 15 minutes, and local shopping. The three activities in which stroke patients engaged the least were gainful work, gardening outside, and household/car maintenance. CONCLUSION A score of approximately 80 or greater on the FIM was associated with a substantially increased level of participation in home and community activities.
Collapse
Affiliation(s)
- Elliot J Roth
- Rehabilitation Institute of Chicago, Rehabilitation Research and Training Center on Technology Promoting Integration for Stroke Survivors: Overcoming Societal Barriers, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | | |
Collapse
|
15
|
Hsieh YW, Lin KC, Wu CY, Lien HY, Chen JL, Chen CC, Chang WH. Predicting clinically significant changes in motor and functional outcomes after robot-assisted stroke rehabilitation. Arch Phys Med Rehabil 2013; 95:316-21. [PMID: 24113336 DOI: 10.1016/j.apmr.2013.09.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/12/2013] [Accepted: 09/19/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the predictors of minimal clinically important changes on outcome measures after robot-assisted therapy (RT). DESIGN Observational cohort study. SETTING Outpatient rehabilitation clinics. PARTICIPANTS A cohort of outpatients with stroke (N=55). INTERVENTIONS Patients with stroke received RT for 90 to 105min/d, 5d/wk, for 4 weeks. MAIN OUTCOME MEASURES Outcome measures, including the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), were measured before and after the intervention. Potential predictors include age, sex, side of lesion, time since stroke onset, finger extension, Box and Block Test (BBT) score, and FMA distal score. RESULTS Statistical analysis showed that the BBT score (odds ratio[OR]=1.06; P=.04) was a significant predictor of clinically important changes in the FMA. Being a woman (OR=3.9; P=.05) and BBT score (OR=1.07; P=.02) were the 2 significant predictors of clinically significant changes in the MAL amount of use subscale. The BBT score was the significant predictor of an increased probability of achieving clinically important changes in the MAL quality of movement subscale (OR=1.07; P=.02). The R(2) values for the 3 logistic regression models were low (.114-.272). CONCLUSIONS The results revealed that patients with stroke who had greater manual dexterity measured by the BBT appear to have a higher probability of achieving clinically significant motor and functional outcomes after RT. Further studies are needed to evaluate other potential predictors to improve the models and validate the findings.
Collapse
Affiliation(s)
- Yu-wei Hsieh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Taiwan Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Keh-chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Taiwan Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan.
| | - Hen-yu Lien
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jean-lon Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-chi Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-han Chang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
| |
Collapse
|
16
|
Mutai H, Furukawa T, Araki K, Misawa K, Hanihara T. Long-term outcome in stroke survivors after discharge from a convalescent rehabilitation ward. Psychiatry Clin Neurosci 2013; 67:434-40. [PMID: 23941061 DOI: 10.1111/pcn.12075] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 01/12/2013] [Accepted: 05/26/2013] [Indexed: 01/24/2023]
Abstract
AIM The aim of this study was to investigate the long-term mortality, daily living activities, social activity, and symptoms of depression, in post-stroke patients discharged to their homes from a convalescent rehabilitation ward, and to determine the relationship between demographic variables and long-term outcome. METHODS This study included 252 consecutive stroke patients (140 men; mean age, 72.4 ± 10.8 years) who had been admitted to a convalescent rehabilitation ward for inpatient rehabilitation. Follow-up assessment was made by postal questionnaire for up to >1 year after discharge, and included the modified Rankin scale, Frenchay activities index (FAI), and Geriatric Depression Scale. RESULTS Of the 192 respondents (76.2%), 160 (83.3%) were living at home. Eighty-three (51.8%) were independent. Cumulative post-stroke mortality at 1 and 3 years was 3.7% and 19.4%, respectively.Mean total FAI score was 26.5 ± 10.9, suggesting that social inactivity was common. The estimated prevalence of depression was 21.6%. Coronary artery disease and motor functional independence measures were significantly associated with mortality, whereas age, recurrent stroke, severity of paralysis, and motor functional independence measures were significant predictors of independence. In the cross-sectional logistic model, depression symptoms were inversely associated with FAI score. CONCLUSIONS The mortality rate of patients discharged to their home following inpatient rehabilitation is relatively low. Social inactivity and depression symptoms, however, remain common during the chronic phase, and the severity of depression and restriction of participation were interrelated.
Collapse
Affiliation(s)
- Hitoshi Mutai
- Department of Rehabilitation, Azumino Red Cross Hospital, Azumino; School of Health Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | | | | | | | | |
Collapse
|
17
|
Imam B, Miller WC. Reliability and validity of scores of a Chinese version of the Frenchay Activities Index. Arch Phys Med Rehabil 2011; 93:520-6. [PMID: 22209474 DOI: 10.1016/j.apmr.2011.07.197] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 07/25/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To develop a Chinese version of the Frenchay Activities Index (FAI-C) and evaluate the reliability and validity of its scores. DESIGN A 2-week test-retest study. SETTING Chinese community in Vancouver, BC, Canada. PARTICIPANTS Data were collected using a convenience sample of Chinese immigrants living in Vancouver, BC, Canada. Of the 73 participants, data from 66 participants were included in the analysis. The total sample included 2 subsamples: community dwelling (n=32), and assisted-living (n=34). Participants were 65 years or older, lived in Canada for more than 5 years, and were able to read Chinese. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE FAI-C scores. RESULTS Test-retest reliability of the FAI-C scores assessed using an intraclass correlation coefficient was .86 (95% confidence interval [CI], .79-.92) for the total sample, .89 (95% CI, .78-.94) for the community-dwelling subsample, and .71 (95% CI, .50-.85) for the assisted-living subsample. The minimal detectable difference at the 95% CI was 8.64. Correlations between the FAI-C and the Reintegration to Normal Living Index (r=.61, P<.01), Activities-specific Balance Confidence Scale (r=.55, P<.01), and Timed Up & Go test (r=-.68, P<.01) were in the a priori hypothesized direction and magnitude. CONCLUSIONS The FAI-C scores are reliable and there is support for validity. This tool enables us to measure social participation level in the Chinese-speaking population.
Collapse
Affiliation(s)
- Bita Imam
- GF Strong Rehabilitation Centre, Vancouver, BC, Canada
| | | |
Collapse
|
18
|
Kamei T, Hashimoto S, Kawado M, Seko R, Ujihira T, Konagaya M. Change in activities of daily living, functional capacity, and life satisfaction in Japanese patients with subacute myelo-optico-neuropathy. J Epidemiol 2010; 20:433-8. [PMID: 20827034 PMCID: PMC3900819 DOI: 10.2188/jea.je20090184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background There have been few reports on longitudinal change in activities of daily living (ADL), functional capacity, and life satisfaction in patients with subacute myelo-optico-neuropathy (SMON). Methods A total of 1309 SMON patients 40 to 79 years of age underwent a medical examination conducted by the SMON Research Committee during the period from 1993 through 1995 (baseline) in Japan; 666 (51%) were followed-up after 12 years and were thus eligible for analysis. We calculated scores for ADL, functional capacity, and life satisfaction at baseline, and at 3, 6, 9, and 12 years after baseline, using data from medical examinations conducted in 1993 through 2007. The Barthel Index, the Tokyo Metropolitan Institute of Gerontology Index of Competence, and the patient’s response to the question “Are you satisfied with life?” were used to assess ADL, functional capacity, and life satisfaction, respectively. Results As compared with baseline, the mean scores for ADL, functional capacity, and life satisfaction were all significantly lower after 12 years in men and women, with the exception of life satisfaction in women. The change in scores for functional capacity from baseline to year 12 was significantly associated with change in life satisfaction; however, the changes in ADL and age at baseline were not. Conclusions We observed decreases in ADL, functional capacity, and life satisfaction among SMON patients. Our results suggest that a decrease in life satisfaction can be prevented by maintaining or improving functional capacity.
Collapse
Affiliation(s)
- Tetsuya Kamei
- Faculty of Medical Management and Information Science, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan.
| | | | | | | | | | | |
Collapse
|
19
|
Takahashi M, Saeki S, Hachisuka K. Characteristics of disabilities in patients with subacutemyelo-optico-neuropathy living at home: Satisfaction in daily life and short form-36. Disabil Rehabil 2009; 31:1902-6. [DOI: 10.1080/09638280902846376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
20
|
Han CW, Lee EJ, Kohzuki M. Validity and reliability of the Frenchay Activities Index for community-dwelling elderly in South Korea. TOHOKU J EXP MED 2009; 217:163-8. [PMID: 19282650 DOI: 10.1620/tjem.217.163] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The speed of population aging in South Korea is projected as the fastest in the world, and a long-term care insurance law has been just enacted. Therefore, it is important to estimate the number of the disabled community-dwelling elderly in South Korea. The Frenchay Activities Index (FAI) is a scale to measure higher level of physical function or activities that are necessary for independence in the community, i.e., instrumental activities of daily living (IADL). The FAI has undergone the most intensive evaluation, but there are only a few studies to establish its validity and reliability for community-dwelling elderly. In addition, a Korean version of the FAI has not been developed yet. The purpose of this study was to develop a Korean version of the FAI and analyze the related factors with IADL, using data from 770 community-dwelling elderly people in Deajeon, Korea. In the results, the reliability was acceptable (Cronbach's alpha coefficient = 0.796). The content and discriminative validity were found to be satisfactory. In the results of the factor analysis, a reasonable four-component solution (domestic chores, outdoor work, leisure and hobby) was found. The related factors to IADL were age, gender, education level, and living conditions. The present findings suggest that the Korean version of the FAI would be useful as a measure of IADL and the results of the factor analysis might reflect socio-cultural differences, such as illiteracy, low socioeconomic level, and sex roles of the Korean elderly.
Collapse
Affiliation(s)
- Chang-Wan Han
- School of Health and Welfare, Woosong University, Daejeon, Korea
| | | | | |
Collapse
|
21
|
Asakawa Y, Usuda S, Mizukami M, Imura S. Moderator and Mediator Effects of Personal Factors in Patients with Stroke. J Phys Ther Sci 2009. [DOI: 10.1589/jpts.21.55] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yasutsugu Asakawa
- Gunma University Graduate School of Health Sciences
- Department of Physical Therapy, Nippon Engineering College
| | | | - Masafumi Mizukami
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences
| | - Shigeyuki Imura
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences
| |
Collapse
|
22
|
Nagayoshi M, Iwata N, Hachisuka K. Factors associated with life satisfaction in Japanese stroke outpatients. Disabil Rehabil 2008; 30:222-30. [PMID: 17852205 DOI: 10.1080/09638280701255266] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To measure life satisfaction in Japanese stroke outpatients and randomly-sampled community residents and to investigate variables influencing their life satisfaction. METHOD Data on the demographic and clinical profiles, Satisfaction in Daily Life (SDL), other measurements, were obtained from 869 stroke outpatients (552 males, 317 females) and 748 community-dwelling elderly (360 males, 388 females), aged 55 years and older. Differences in categorical variables and continuous variables were tested by chi-square test and ANCOVA with age as the covariate, respectively. RESULTS The 11 SDL items were subjected to a factor analysis, which extracted two factors. Factor 1 (F1), labeled as 'satisfaction with one's own abilities', included satisfaction with housework, self-care, gait, physical health, hobby and leisure, social intercourse and mental health. Factor 2 (F2), 'satisfaction with external factors', included satisfaction with partner/ family relationship, economic state and social security, and house facilities. Both F1 and F2 scores were significantly lower for stroke outpatients (M = 19.7 and 10.9, respectively) than for community-dwelling elderly (M = 28.2 and 12.0, respectively) (p < 0.001). Living conditions were significantly associated with F2, but not with F1. Males living alone scored lowest on F2 than the others for both groups. Among stroke outpatients, both F1 and F2 scores differed significantly by the type of hemiparesis and the severity of aphasia. CONCLUSIONS SDL of stroke outpatients, which was lower than community-dwelling elderly, differed by the type of hemiparesis, the severity of aphasia, and living conditions. The effects of living conditions might vary with gender.
Collapse
Affiliation(s)
- Misako Nagayoshi
- Fukuoka City Handicapped Person's Welfare Center, 1-2-8 Nagahama, Chuo-ku, Fukuoka 810-0072, Japan.
| | | | | |
Collapse
|
23
|
Van Baalen B, Ribbers GM, Medema-Meulepas D, Pas MS, Odding E, Stam HJ. Being restricted in participation after a traumatic brain injury is negatively associated by passive coping style of the caregiver. Brain Inj 2008; 21:925-31. [PMID: 17729045 DOI: 10.1080/02699050701553197] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine whether the caregivers' coping style is associated with the functional outcome of the traumatic brain injury (TBI) patient 1 year post-injury. METHOD A cross-sectional study among patients with a TBI, including their primary caregivers. The study included 51 patients aged 17-64 years with a moderate-to-severe TBI and 51 caregivers (23 parents and 28 partners) aged 23-67 years. The coping preferences of the caregivers were assessed at minimum 6 and maximum 12 months post-injury, by filling out the Utrecht Coping List (UCL) and were related to limitations in activity, as measured with the Frenchay Activities Index and with restrictions in participation as measured with the Sickness Impact Profile-68 of TBI patients 1 year post-injury. The patients were interviewed at their homes; the caregivers received and returned the UCL by mail. RESULTS The patients' age and the caregivers' coping style are independently associated with restrictions in participation 1 year post-injury. CONCLUSIONS A passive coping style of the primary caregiver is negatively associated with the patient's functional outcome in terms of participation in society.
Collapse
Affiliation(s)
- B Van Baalen
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands.
| | | | | | | | | | | |
Collapse
|
24
|
Hsieh CL, Jang Y, Yu TY, Wang WC, Sheu CF, Wang YH. A Rasch analysis of the Frenchay Activities Index in patients with spinal cord injury. Spine (Phila Pa 1976) 2007; 32:437-42. [PMID: 17304134 DOI: 10.1097/01.brs.0000255095.08523.39] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective interview study. OBJECTIVE To determine whether items of the Frenchay Activities Index (FAI) measure Instrumental Activities of Daily Living (IADL), as a unidimensional construct, in patients with spinal cord injury (SCI). To examine whether the response categories of the FAI are useful in discerning the various ability levels of IADL. SUMMARY OF BACKGROUND DATA No known IADL scale has been designed for SCI patients. The FAI, to our knowledge, has never been validated in patients with SCI. METHODS A total of 233 persons with SCI participated in this study. The FAI was administered to the patients by interview at locations convenient for the participants. A Rasch analysis was used to examine the unidimensionality and appropriateness of the response categories of the FAI. RESULTS All but 2 items ("going outside" and "reading books") of the FAI fitted the model's expectations. The results of Rasch analysis indicated that the response categories for the remaining 13 items of the FAI should be collapsed to create more suitable response categories (4 items, into dichotomies, and the remaining 9 items, into trichotomies). Thus, a revised 13-item FAI was formed by deleting the 2 misfitting items and collapsing the response categories of the items. CONCLUSIONS This study demonstrated that the revised 13-item FAI assesses a single, unidimensional IADL for SCI patients living in the community. The revised FAI shows potential for assessment of IADL in SCI patients.
Collapse
Affiliation(s)
- Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University and Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
| | | | | | | | | | | |
Collapse
|
25
|
Shin JC, Kim EJ, Park CI, Park ES, Shin KH. Clinical features and outcomes following bilateral lower limb amputation in Korea. Prosthet Orthot Int 2006; 30:155-64. [PMID: 16990226 DOI: 10.1080/03093640600608074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The objectives of this study were to evaluate the clinical features and outcomes of 43 bilateral lower limb amputees. The clinical features obtained included the causes of amputation, level of amputation, concurrent medical problems, and stump condition. Outcome measures were obtained using the activities of daily living (ADL) index, the Frenchay Activities Index (FAI), and mobility grading with prostheses or wheelchair. Of 33 amputees who were prosthetic ambulators, 22 (67%), mainly bilateral trans-tibial (TT) amputees, were community ambulators, and participated in activities which included stair-walking, and six of 11 household ambulators were combination trans-femoral (TF) and TT amputees. Of 10 amputees who were wheelchair ambulators, only one was able to perform wheelchair transfers independently and five were independent wheelchair ambulators. Using the ADL index and FAI, there was no significant difference in scores according to the level of amputation (p > 0.05), but the scores of community prosthetic ambulators were significantly higher than those of wheelchair ambulators (p < 0.05). Age was found to be negatively correlated with ADL index and FAI scores (r = -0.518 vs. r = -0.550) (p < 0.01). This study concludes that overall independence in ADL after bilateral lower limb amputation improved with young age and prosthetic mobility.
Collapse
Affiliation(s)
- Ji Cheol Shin
- Department of Rehabilitation Medicine, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Gangbuk-gu, Seoul, Korea
| | | | | | | | | |
Collapse
|
26
|
|
27
|
Abstract
BACKGROUND The measures of clinical status used to predict costs must pay the most attention possible to medical conditions and clinical complexity. Length of stay (LOS), which has been used as a proxy for resource consumption, is not a direct measure of costs. Classification and regression trees, which are used in defining iso-resource groups, can be affected by overfitting and are based on a priori choices of the splitting attributes. Finally, current approaches are mainly concerned in estimating average group costs and do not attempt to estimate individual case costs. OBJECTIVES We sought to define comprehensive measures of clinical status and detailed measures of resource consumption. We also sought to predict individual inpatient rehabilitation costs through multiple regression models. RESEARCH DESIGN A prospective analysis was conducted of all rehabilitation cases admitted to 5 Italian inpatient facilities during a period of 12 months. All admissions underwent repeated Minimum Data Set-Post Acute Care (MDS-PAC) schedules to collect information on clinical status and treatment provided. We used factorial analysis to yield continuous variables representing clinical characteristics, and we priced treatments to obtain cost of stay. We used linear regression models to predict cost of stay and validated the model-based cost predictions by data-splitting. RESULTS We collected 9720 MDS-PAC schedules from 2702 hospital admissions. The multivariate regression models fitted costs reasonably well with r(2) values of at least 0.34. On cross-validation, the ability of the regression models to predict cost was confirmed. CONCLUSION We were able to estimate actual rehabilitation costs and define reliable regression models to predict costs from individual patient characteristics. Our approach identifies the contribution of any single patient characteristic to rehabilitation cost and tests the assumptions of the analysis.
Collapse
Affiliation(s)
- Carlo Saitto
- Department of Epidemiology, Local Health Authority RME, Rome, Italy
| | | | | | | | | |
Collapse
|
28
|
Schepers VP, Visser-Meily AM, Ketelaar M, Lindeman E. Prediction of Social Activity 1 Year Poststroke. Arch Phys Med Rehabil 2005; 86:1472-6. [PMID: 16003683 DOI: 10.1016/j.apmr.2004.11.039] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To develop an easy-to-use prediction rule for social activity 1 year poststroke that can identify patients at risk for social inactivity. DESIGN Inception cohort. SETTING Rehabilitation center. PARTICIPANTS Patients with a first-ever supratentorial stroke were selected in 4 Dutch rehabilitation centers. Data of 250 patients were available for analysis. Potential prognostic factors measured at admission were sex, age, marital status, prestroke employment status, educational level, type of stroke, hemisphere, motor impairment, trunk control, communication, and activities of daily living (ADL) dependency. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Social activity measured by the Frenchay Activities Index (FAI) at 1 year poststroke. RESULTS Multivariate backward linear regression analysis identified sex, age, marital status, motor impairment, communication, and ADL dependency as important predictors of the FAI score 1 year poststroke. An easy-to-use score chart was constructed that could identify patients at risk for social inactivity. The score chart proved to be well able to discriminate poor social functioning from moderate to good social functioning (area under the curve = .85). CONCLUSIONS Identifying patients at risk enables health care professionals to focus on the social activity of this patient subgroup at an early stage in the care process.
Collapse
Affiliation(s)
- Vera P Schepers
- Center of Excellence for Rehabilitation Medicine Utrecht, Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands.
| | | | | | | |
Collapse
|
29
|
Nagatomo I, Akasaki Y, Tominaga M, Hashiguchi W, Uchida M, Takigawa M. Abnormal behavior of residents in a long-term care facility and the associated stress of care staff members. Arch Gerontol Geriatr 2001; 33:203-10. [PMID: 15374016 DOI: 10.1016/s0167-4943(01)00182-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2001] [Revised: 06/08/2001] [Accepted: 06/11/2001] [Indexed: 11/20/2022]
Abstract
To survey the factors associated with abnormal behavior in 99 elderly residing in a special nursing home, we investigated the relationships between abnormal behavior and depression as well as impairments in cognition and activities of daily living (ADL), and the stress level of 28 care staff members. The clinical criteria for grading of dementia (intellectual level), the Cornell scale for depression in dementia (CSDD), the dementia behavior disturbance (DBD) scale, and rating of performance of ADL were used to assess behavioral and psychiatric symptoms in the elderly patients. Stress levels of care staff members were assessed using the 'burnout' scale. The DBD scale score correlated with the intellectual level, CSDD score, and three categories of ADL (urinary continence, faecal continence, and comprehension of conversation). The DBD scale score correlated negatively with one category of ADL (eating) in men, but did not correlate with ADL in women. No correlation was found between the burnout scale scores of care staff and either their age or work schedules. Present results showed that abnormal behavior in special nursing home residents correlated with depression as well as cognitive impairment. It is believed that the treatment and management of depression will decrease abnormal behaviors and improve their quality of life in special nursing home residents.
Collapse
Affiliation(s)
- I Nagatomo
- Department of Neuropsychiatry, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.
| | | | | | | | | | | |
Collapse
|
30
|
Abstract
OBJECTIVES To describe instruments that have been developed to quantify (aspects of) social outcomes in research on persons with a disability, and to evaluate the clinimetric characteristics of some of the more prominent and promising measures. DATA SOURCES Literature in social health, social psychiatry, developmental disabilities, independent living, gerontology, medical rehabilitation, and quality of life studies. STUDY SELECTION Social outcomes are defined as those changes or differences in the social functioning (broadly defined) of persons with disabilities that result directly or indirectly from impairments and functional limitations. Excluded were measures that focus on purely physical or psychologic aspects of functioning, apply to children only, or quantify 1 social domain only. DATA EXTRACTION For 16 instruments the distribution of items across the participation domains of the International Classification of Impairments, Activities, and Participation is presented, as well as a distribution of items by metrics used. For 5, clinimetric information from published studies were reviewed and summarized in letter grades. DATA SYNTHESIS Several instruments have broad coverage, acceptable respondent burden, and moderate to good reliability, validity, and sensitivity. CONCLUSIONS Social outcomes should be more routinely included in disability and rehabilitation research. Recommendations for selection and further development are made.
Collapse
Affiliation(s)
- M P Dijkers
- Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
| | | | | |
Collapse
|