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Banky M, Tirosh O, Davey R, Mentiplay BF, Clark RA, Olver JH, Williams G. Controlling modified Tardieu scale assessment speeds to match joint angular velocities during walking impacts spasticity assessment outcomes. Clin Rehabil 2023; 37:1684-1697. [PMID: 37431534 DOI: 10.1177/02692155231187203] [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: 07/12/2023]
Abstract
OBJECTIVE To investigate whether tailoring the speed of the Modified Tardieu Scale to reflect an individual's joint angular velocity during walking influences spasticity assessment outcomes. DESIGN Observational trial. SETTING Inpatient and outpatient neurological hospital department. SUBJECTS Ninety adults with lower-limb spasticity. INTERVENTIONS N/A. MAIN MEASURES The Modified Tardieu Scale was used to assess the gastrocnemius, soleus, hamstrings and quadriceps. The V1 (slow) and V3 (fast) movements were completed as per standardised testing. Two additional assessments were completed, reflecting joint angular velocities during walking based on (i) a healthy control database (controlled velocity) and (ii) the individual's real-time joint angular velocities during walking (matched velocity). The agreement was compared using Cohen's and Weighted Kappa statistics, sensitivity and specificity. RESULTS There was poor agreement when rating trials as spastic or not spastic at the ankle joint (Cohen's Kappa = 0.01-0.17). Trials were classified as spastic during V3 and not spastic during the controlled conditions in 81.6-85.1% of trials when compared to stance phase dorsiflexion angular velocities and 48.0-56.4% when compared to swing phase dorsiflexion angular velocities. The severity of muscle reaction demonstrated poor agreement at the ankle (Weighted Kappa = 0.01-0.28). At the knee, there was a moderate-excellent agreement between the V3 and controlled conditions when rating a trial as spastic or not spastic (Cohen's Kappa = 0.66-0.84) and excellent agreement when comparing severity (Weighted Kappa = 0.73-0.94). CONCLUSION The speed of assessment impacted spasticity outcomes. It is possible that the standardised protocol may overestimate the impact spasticity has on walking, especially at the ankle.
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Affiliation(s)
- Megan Banky
- Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Oren Tirosh
- School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Rebecca Davey
- Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia
| | - Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | - Ross A Clark
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Queensland, Australia
| | - John H Olver
- Epworth Monash Rehabilitation Medicine Unit, Melbourne, Australia
| | - Gavin Williams
- Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
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Jiménez-Barrios M, González-Bernal J, Cubo E, Gabriel-Galán JM, García-López B, Berardi A, Tofani M, Galeoto G, Matthews MJA, Santamaría-Peláez M, González-Santos J. Functionality and Quality of Life with Parkinson's Disease after Use of a Dynamic Upper Limb Orthosis: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4995. [PMID: 36981905 PMCID: PMC10049252 DOI: 10.3390/ijerph20064995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/04/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Parkinson's disease (PD) is a chronic, neurodegenerative movement disorder, whose symptoms have a negative impact on quality of life and functionality. Although its main treatment is pharmacological, non-pharmacological aids such as the dynamic elastomeric fabric orthosis (DEFO) merit an evaluation. Our objective is to assess the DEFO in upper limb (UL) functional mobility and in the quality of life of PD patients. A total of 40 patients with PD participated in a randomized controlled crossover study, and were assigned to a control group (CG) and to an experimental group (EG). Both groups used the DEFO for two months, the experimental group the first two months of the study and the control group the last two. Motor variables were measured in the ON and OFF states at the baseline assessment and at two months. Differences from the baseline assessment were observed in some motor items of the Kinesia assessment, such as rest tremor, amplitude, rhythm or alternating movements in the ON and OFF states with and without orthosis. No differences were found in the unified Parkinson's disease rating scale (UPDRS) or the PD quality-of-life questionnaire. The DEFO improves some motor aspects of the UL in PD patients but this does not translate to the amelioration of the standard of functional and quality-of-life scales.
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Affiliation(s)
| | | | - Esther Cubo
- Neurology Service, Burgos University Hospital, 09006 Burgos, Spain
| | | | | | - Anna Berardi
- Department of Human Neurosciences, University of la Sapienza, 00188 Rome, Italy
| | - Marco Tofani
- Department of Human Neurosciences, University of la Sapienza, 00188 Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, University of la Sapienza, 00188 Rome, Italy
| | - Martin J. A. Matthews
- Faculty of Health, School of Health Professions Peninsula Allied Health Centre, University of Plymouth, Derriford Rd., Plymouth PL6 8BH, UK
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Exercise for People with Acquired Brain Injury: An ICF Perspective. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12083862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Exercise is an important element in the process of recovery from an acquired brain injury (ABI). However, specific guidance for exercise prescription and interventions in this population are missed. The aim of this study was to establish the key parameters to design and implement exercise programs based on the International Classification of Functioning, Disability, and Health (ICF) domains. A panel of experts that consisted of 13 professionals from neuro-rehabilitation centers evaluated the key parameters of this original proposal. The Heinemann methodology was used for all qualitative analyses. Additionally, Cronbach’s alpha was applied to the statistical analyses. According to the results, Cronbach’s alpha (0.97) indicated excellent internal consistency, and the experts perceptions ratified the proposed criteria to develop exercise programs for people with ABI. The proposed key parameters for the development of exercise programs for people with ABI based in ICF domains (body functions, activity—participation and environmental factors) bring a new, solid, and innovative tool for methodological design of these programs in sub-acute and chronic rehabilitation settings.
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Giangiardi VF, Perracini MR, da Silva ML, Setti GBR, Curzio LE, Vegas M, Alouche SR. Functional Outcomes Associated With Independence in Walking Among People With Hereditary Ataxias: An Exploratory Cross-sectional Study. Phys Ther 2022; 102:6506304. [PMID: 35079839 DOI: 10.1093/ptj/pzac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 08/14/2021] [Accepted: 11/21/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to identify functional outcomes related to independence in walking among people affected by hereditary ataxias. METHODS Sixty participants were selected by convenience in a list provided by an organization of people with ataxia. Sociodemographic and clinical data were collected using a semistructured questionnaire. The Assessment and Rating of Ataxia was used to assess and rate cerebellar ataxia. Changes in body structure and function, limitation in activities, and restriction in participation were evaluated with specific outcome measures. Participants were classified as independent in walking if they were able to walk without walking aids or human assistance and as dependent in walking if they have been using walking aids (sticks, crutches, or walkers) for more than 6 months, using a wheelchair for locomotion most of the day, or both. Multivariate logistic regression analyses were conducted hierarchically and in blocks considering upper limbs function, balance systems, sensory functions, postural control, walking, independence, cognition, and perception as independent variables. The prevalence ratio for walking independence was determined. RESULTS The final regression model pointed out that gait capacity assessed by the 6-Minute Walk Test and dexterity assessed by the Box and Blocks test were the main markers related to walking independence in individuals with hereditary ataxias. CONCLUSION The distance covered in 6 minutes of walking (walking endurance) and upper extremity dexterity can be used to better assess the progression of cerebellar disease related to walking independence in individuals with hereditary ataxias. IMPACT This study supports early detection of individuals who are at risk of loss of walking independence and an optimized rehabilitation plan.
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Affiliation(s)
- Vivian Farahte Giangiardi
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Monica Rodrigues Perracini
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Liliane da Silva
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Milena Vegas
- School of Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Sandra Regina Alouche
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
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5
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Pérez-Rodríguez M, Gutiérrez-Suárez A, Barakat R, Pérez-Tejero J. Benefits of physical exercise programs toward people with acquired brain injury: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28601. [PMID: 35119003 PMCID: PMC8812640 DOI: 10.1097/md.0000000000028601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Exercise has proven to be a tool improving health related quality of life in people with acquired brain injury (ABI) as part of multidisciplinary team during the subacute and chronic phase. While intervention studies and revisions have been increased in recent years, there is no consensus about the type, frequency and variables of control in exercise interventions. Besides, this collective need programs that respond to different functional levels, given the heterogeneity of people with ABI, not only because of the etiology, but also because of the severity differences over their deficits. The aim of this systematic review and meta-analysis is to summarize the evidence regarding the relationship between exercise and health related quality of life in subacute and chronic phase. METHODS A protocol of systematic review and meta-analysis will examine the benefits of physical exercise (PE) toward people with ABI will be conducted. A comprehensive search will be conducted in the following electronic databases: MEDLINE, The Cochrane Library, CINAHL, SportDiscus, and Web of Science from inception to July 2020. Independent review authors will evaluate the title and abstract for each trial and disagreements will be solved by discussion with a third author if necessary. Standard pairwise meta-analysis, including heterogeneity analysis, subgroup analysis, and sensitivity analysis, will be performed using the Stata software. The quality evaluation of this study will be completed using the Cochrane collaboration risk of bias tool and the risk of bias assessment will be conducted by the World Health Organization grading of recommendations, assessment, development, and evaluation. The review will be reported in accordance to the preferred reporting items for systematic reviews and meta-analyses statement. RESULTS AND CONCLUSSION This systematic review and meta-analysis protocol will provide an overview regarding the benefits of PE on functioning, social participation and quality of life toward people with ABI. The variability of outcomes across PE from the selected studies will provide important information for future trial designs. Results of the proposed review will inform practice and the design of future clinical trials. This study will summarize all the selected trials aimed at estimating the effectiveness of applying physical activity programs to ABI users.Systematic review registration number: PROSPERO CRD42020191779.
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Affiliation(s)
- Marta Pérez-Rodríguez
- Department of Health and Human Performance, Universidad Politécnica de Madrid, Spain
| | - Andrea Gutiérrez-Suárez
- Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Universidad de A Coruña, A Coruña, Spain
| | - Ruben Barakat
- Department of Social Sciences applied to Physical Activity Sport and Leisure, Universidad Politécnica de Madrid, Spain
| | - Javier Pérez-Tejero
- Department of Health and Human Performance, Universidad Politécnica de Madrid, Spain
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Jonsdottir J, Bowman T, Casiraghi A, Ramella M, Montesano A. Functional profiles derived from the ICF Generic set and the responsiveness and validity of the Generic-6 set's Functioning score among persons after stroke. Eur J Phys Rehabil Med 2022; 58:16-25. [PMID: 34542256 PMCID: PMC9980530 DOI: 10.23736/s1973-9087.21.06706-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The International Classification of Functioning, Disability and Health (ICF) parsimonious Generic set can provide identification of functional profiles and recovery after rehabilitation in persons post stroke. AIM To explore concurrent validity of the ICF Generic-6_Functioning score with the Barthel Index (BI) and responsiveness after rehabilitation in persons post stroke. Further, the feasibility of applying the ICF Brief Stroke Core set in routine rehabilitation recovery was evaluated. DESIGN Prospective study. SETTING Inpatient rehabilitation setting. POPULATION Persons post stroke. METHODS The study included 71 persons post stroke (mean age 66.8 [standard deviation 14.5], mean onset 199.3 [565.3] days, BI score improvement: 17/100), N.=44 acute stroke (<3 months, stroke subacute [SA]_group) and N.=27 chronic stroke (>3 months, Stroke chronic [SC]_group). The Brief Stroke core set, including the Generic set, was used for classification at admission and at discharge using the five grade qualifiers. The median value of the groups' qualifiers on the Generic set (excluding item 850) was used to form a Functioning score (Generic-6 FS). Responsiveness was assessed with effect sizes (ES) and confidence intervals (CI). The concurrent validity of the Generic-6 FS was explored with the BI as a gold standard using Spearman's correlation coefficient. P was set at 0.05. RESULTS The Generic-6 FS proved responsive with ES being moderate for the Generic-6 FS and the BI for the whole group (0.48, CI 0.14-0.82 and 0.67, CI -1.02--0.32 respectively). ES of the Generic-6 FS was significant only for the SA_group (0.62, CI 0.27-0.96. Correlation between the Generic-6 FS and the BI at baseline and discharge were respectively r=-0.59 and r=0.60, while correlation between change values was lower (r=0.44). The Generic-6 FS did not distinguish between the SA_group and the SC_group. Classification with the ICF brief stroke core set was feasible with 89% of the persons being classified both at admission and discharge. CONCLUSIONS ICF classification of persons post stroke during rehabilitation recovery was feasible. The Generic-6 FS detected changes in functioning and health in persons recovered for rehabilitation after stroke and distinguished between different recovery rates of persons in the acute and chronic phase after stroke.
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Azimi A, Doosti R, Vali Samani SM, Roostaei B, Gashti SH, Navardi S, Ghajarzadeh M. Psychometric Properties of the Persian Version of the PARADISE-24 Questionnaire. Int J Prev Med 2021; 12:50. [PMID: 34447492 PMCID: PMC8356966 DOI: 10.4103/ijpvm.ijpvm_300_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 01/08/2020] [Indexed: 12/03/2022] Open
Abstract
Background: Patients with multiple sclerosis (MS) suffer from a wide range of psychological problems. Application of a valid and reliable tool for psychosocial assessment is required for Iranian patients. The aim of this study is to determine the psychometric properties of the Persian version of the PARADISE-24 questionnaire in Iranian patients with multiple sclerosis. Methods: One hundred and thirteen multiple sclerosis cases were enrolled in this study. Participants were asked to answer the valid and reliable Persian version of the fatigue severity scale, social support scale, Pittsburg sleep quality index, and hospital anxiety and depression scale and translated version of the PARADISE-24 questionnaire. Twenty cases filed the questionnaire 2 weeks later to assess reliability. The intraclass correlation coefficient, Cronbach's alpha, correlation coefficients, and multiple regression analysis were used. Results: Mean age and mean duration of the disease were 35.8 ± 9.9 and 8.7 ± 5.6 years, respectively. The intraclass correlation coefficients ranged from 0.8 to 0.94 and Cronbach's alpha values (Cronbach's alpha was calculated as 0.91 for the whole questionnaire) were also significant. There were significant correlations between PARADISE-24 score and expanded disability status scale (r = 0.42, P < 0.001), fatigue severity scale (r = 0.62, P < 0.001), anxiety (r = 0.43, P < 0.001) and Pittsburg sleep quality index scores (r = 0.46, P < 0.001). Regression analysis by considering PARADISE-24 as dependent and other variables as independent showed that expanded disability status scale, fatigue severity scale, anxiety score, and Pittsburg sleep quality index were positive predictors of PARADISE-24 score. Conclusions: Persian version of PARADISE-24 questionnaire is a valid and reliable instrument for evaluating psychosocial aspects in patients with multiple sclerosis.
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Affiliation(s)
- Amirreza Azimi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rozita Doosti
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Bita Roostaei
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Hamtaei Gashti
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Navardi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Ghajarzadeh
- Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran
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Arman S. What are the effects of ketogenic diets on drug-resistant epilepsy? A Cochrane Review summary with commentary. Dev Med Child Neurol 2020; 62:1121-1123. [PMID: 32808681 DOI: 10.1111/dmcn.14643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sina Arman
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Liguori S. Is topiramate effective and tolerated in young people with juvenile myoclonic epilepsy? A Cochrane Review summary with commentary. Dev Med Child Neurol 2020; 62:895-896. [PMID: 32557590 DOI: 10.1111/dmcn.14598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
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10
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Gimigliano F. Is clobazam monotherapy effective and safe in people with focal or generalized seizures? A Cochrane Review summary with commentary. Dev Med Child Neurol 2020; 62:670-672. [PMID: 32246466 DOI: 10.1111/dmcn.14539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/13/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania 'Luigi Vanvitelli', Napoli, Italy
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11
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Oral A. How effective are self-management interventions for children with epilepsy? A Cochrane Review summary with commentary. Dev Med Child Neurol 2020; 62:551-553. [PMID: 32249941 DOI: 10.1111/dmcn.14522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Abstract
BACKGROUND Standardized data collection for traumatic brain injury (TBI) (including concussion) using common data elements (CDEs) has strengthened clinical care and research capacity in the United States and Europe. Currently, Ontario healthcare providers do not collect uniform data on adult patients diagnosed with concussion. OBJECTIVE The Ontario Concussion Care Strategy (OCCS) is a collaborative network of multidisciplinary healthcare providers, brain injury advocacy groups, patient representatives, and researchers with a shared vision to improve concussion care across the province, starting with the collection of standardized data. METHODS The International Framework of Functioning Disability and Health was selected as the conceptual framework to inform the selection of CDEs. The CDEs recommended by the OCCS were identified using key literature, including the National Institute of Neurological Disorders and Stroke-Zurich Consensus Statements for concussion in sport and the Ontario Neurotrauma Foundation Concussion/mTBI clinical guidelines. RESULTS The OCCS has recommended and piloted CDEs for Ontario that are readily available at no cost, clinically relevant, patient friendly, easy to interpret, and recognized by the international scientific community. CONCLUSIONS The implementation of CDEs can help to shift Ontario toward internationally recognized standard data collection, and in so doing yield a more comprehensive evidence-based approach to care while also supporting rigorous research.
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You M, Fang W, Wang X, Yang T. Modelling of the ICF core sets for chronic ischemic heart disease using the LASSO model in Chinese patients. Health Qual Life Outcomes 2018; 16:139. [PMID: 29996874 PMCID: PMC6042460 DOI: 10.1186/s12955-018-0957-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 06/13/2018] [Indexed: 11/30/2022] Open
Abstract
Background This study aimed to examine the associations among the International Classification of Functioning, Disability, and Health (ICF) core sets relevant to chronic ischemic heart disease (CIHD) using the least absolute shrinkage and selection operator (LASSO) model based on the ICF core sets scale in Chinese patients. Methods This was a prospective study of 120 patients with CIHD selected from January 2013 to June 2014 at the Fada Institute of Forensic Medicine & Science (Beijing, China). Functioning was qualified using the ICF core sets checklist for CIHD (Chinese version). The variables of core set categories of the ICF assessment scale for CIHD were entered into the LASSO model for mining dependencies among those variables. Graphical modeling was applied using LASSO generalized linear models. Results “Muscle endurance functions”, “sensations associated with cardiovascular and respiratory functions”, “blood vessel functions”, and “heart functions” were the most injured in CIHD status. “Recreation and leisure” and “intimate relationships” were the most affected in CIHD status. “General social support services, systems, and policies” and “acquaintances, peers, colleagues, neighbors, and community members” were important for the outcome of functional status of the CIHD patient. “Economic self-sufficiency” and “family relationships” of the CIHD patient were not undermined in most cases. Conclusions Graphical modeling can be used to describe associations between different areas of functioning in CIHD patients. The results suggest that these associations could be used as basis to improve rehabilitation and provide a deeper understanding of functioning in Chinese CIHD patients. Electronic supplementary material The online version of this article (10.1186/s12955-018-0957-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Meng You
- Collaborative Innovation Center of Judicial Civilization, Key Laboratory of Evidence Science, China University of Political Science and Law, Ministry of Education, 25 Xitucheng Road, Beijing, 100040, China
| | - Wen Fang
- Beijing Jiaotong University, Beijing, China
| | - Xu Wang
- Collaborative Innovation Center of Judicial Civilization, Key Laboratory of Evidence Science, China University of Political Science and Law, Ministry of Education, 25 Xitucheng Road, Beijing, 100040, China
| | - Tiantong Yang
- Collaborative Innovation Center of Judicial Civilization, Key Laboratory of Evidence Science, China University of Political Science and Law, Ministry of Education, 25 Xitucheng Road, Beijing, 100040, China.
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Raggi A, Corso B, De Torres L, Quintas R, Chatterji S, Sainio P, Martinuzzi A, Zawisza K, Haro JM, Minicuci N, Leonardi M. Determinants of mobility in populations of older adults: Results from a cross-sectional study in Finland, Poland and Spain. Maturitas 2018; 115:84-91. [PMID: 30049352 DOI: 10.1016/j.maturitas.2018.06.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/21/2018] [Accepted: 06/30/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To identify the determinants of mobility among people aged 50+ from Finland, Spain and Poland. STUDY DESIGN Observational cross-sectional population study. MAIN OUTCOME MEASURES A mobility score was based on responses to items referring to body movements, walking, moving around and using transportation. Determinants of mobility were entered in hierarchical regression models in the following order: sociodemographic characteristics, health habits, chronic conditions, description of general state of health, vision and hearing, social networks, built environment. RESULTS Complete data were available for 3902 participants (mean age 65.1, SD 9.8). The final model explained 64.7% of the variation in mobility. The most relevant predictors were: pain, age and living in Finland, presence of arthritis, stroke and diabetes, high-risk waist circumference, physical inactivity, and perceiving the neighborhood environment as more exploitable. CONCLUSIONS Our results provide public health indications that could support concrete actions to address the modifiable determinants of mobility. These include the identification and treatment of pain-related problems, increasing the level of physical activity and the improvement of neighborhood features in terms of presence of general utility places or means of transportation. These factors can be modified with short- to medium-term interventions and such a change could improve the mobility of ageing population, with evident benefits for health.
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Affiliation(s)
- Alberto Raggi
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy.
| | - Barbara Corso
- National Research Council, Neuroscience Institute, Padova, Italy.
| | - Laura De Torres
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy.
| | - Rui Quintas
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy.
| | - Somnath Chatterji
- World Health Organization, Information, Evidence and Research Unit, Geneva, Switzerland.
| | - Päivi Sainio
- National Institute for Health and Welfare, Ageing, Disability and Functioning Unit, Helsinki, Finland.
| | - Andrea Martinuzzi
- E. Medea Scientific Institute, Conegliano-Pieve di Soligo Research Centre, Conegliano Veneto, Italy.
| | - Katarzyna Zawisza
- Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College. Krakow, Poland.
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, University of Barcelona, CIBERSAM, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
| | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy.
| | - Matilde Leonardi
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy.
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Bouça-Machado R, Lennaerts-Kats H, Bloem B, Ferreira JJ. Why Palliative Care Applies to Parkinson's Disease. Mov Disord 2018; 33:750-753. [DOI: 10.1002/mds.27309] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 12/04/2017] [Accepted: 12/22/2017] [Indexed: 11/11/2022] Open
Affiliation(s)
- Raquel Bouça-Machado
- Instituto de Medicina Molecular; Lisbon Portugal
- CNS-Campus Neurológico Sénior; Torres Vedras Portugal
| | - Herma Lennaerts-Kats
- Radboud University Medical Center, Department of Neurology, Department of Anaesthesiology, Pain and Palliative Care; Nijmegen The Netherlands
| | - Bastiaan Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology; Nijmegen The Netherlands
| | - Joaquim J. Ferreira
- Instituto de Medicina Molecular; Lisbon Portugal
- CNS-Campus Neurológico Sénior; Torres Vedras Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine; University of Lisbon; Portugal
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Bouça-Machado R, Maetzler W, Ferreira JJ. What is Functional Mobility Applied to Parkinson's Disease? JOURNAL OF PARKINSON'S DISEASE 2018; 8:121-130. [PMID: 29480225 PMCID: PMC5836402 DOI: 10.3233/jpd-171233] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 12/17/2022]
Abstract
Although yet poorly defined and often misused, the concept of functional mobility has been used in research studies as a more global and ecological outcome of patients' health status. Functional mobility is a person's physiological ability to move independently and safely in a variety of environments in order to accomplish functional activities or tasks and to participate in the activities of daily living, at home, work and in the community. Parkinson's disease (PD) has a direct impact on patients' motor control and on mobility in general. Even with optimal medical management, the progression of PD is associated with mounting impairments at different levels of body function, causing marked limitations in a wide variety of activities, as well as a severe disability and loss of autonomy. Despite this, for everyday functioning PD patients need to have a good functional mobility that allow them to get around effortlessly in a reasonable amount of time to access to the same environments as others. This paper reviewed the concept of functional mobility applied to PD. This was done through an International Classification of Functioning and Disability (ICF) perspective. Recommendations to address the known factors that contribute to a poor functional mobility were outlined while suggestions for clinical practice and research were made.
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Affiliation(s)
- Raquel Bouça-Machado
- Instituto de Medicina Molecular, Lisbon, Portugal
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Joaquim J. Ferreira
- Instituto de Medicina Molecular, Lisbon, Portugal
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal
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Psychosocial difficulties of individuals with multiple sclerosis: the PARADISE-24 questionnaire. Int J Rehabil Res 2016; 39:339-345. [PMID: 27631722 DOI: 10.1097/mrr.0000000000000194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study is to identify the most relevant psychosocial difficulties (PSDs) experienced by persons with multiple sclerosis (PwMS); to evaluate the relation between an overall level of PSDs measured with the PARADISE-24 and other variables; to assess which factors may predict PARADISE-24 overall score. Adults PwMS were consecutively enrolled and completed a battery of eight self-reported instruments (i.e. SCQ, EUROHIS-QOL 8, BRS, BFI-10, JSPE, OSS-3, WHODAS-12, PARADISE-24). A clinical evaluation was performed for each patient and the Expanded Disability Status Scale (EDSS) score was determined by neurologists. A total of 80 PwMS, mean age 41.0, 65% women, 62% married, and 76.3% working, 86.3% relapsing-remitting MS, with an EDSS median score of 1.5, took part in the study. The mean disease duration was 7.7 years. The most frequently reported PSDs involved motor and emotional functioning. Free of charge access to medicines; health treatments and family, friends and health professionals' assistance represented the most important facilitators. WHODAS-12 and EUROHIS-QOL 8 were excluded from regression because of their strong correlation with PARADISE-24. EDSS, BRS, OSS-3, and neuroticism were the main predictors of the PARADISE-24 score. Despite MS heterogeneity, a common pattern of PSDs can be observed among PwMS. The level of physical impairment and personal resilience were the main predictors of the overall level of PSDs in PwMS, with a lower but significant additional role played by social support and personality traits. Attention to PSDs and their predictors, using PARADISE-24, can help clinicians to plan tailored and personalized rehabilitation programs.
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