Duration of daily life activities in persons with and without obsessive-compulsive disorder

Persons with obsessive-compulsive disorder (OCD) are often impaired in their daily level of functioning due to their time-consuming obsessions and/or compulsions. To date, however, studies are lacking that quantify how much time persons with OCD actually spend on activities of daily living. Therefore, the current study assessed 13 daily life activities (in minutes) with a self-report questionnaire in 299 persons with OCD at admission to inpatient treatment and 300 age- and sex-matched persons without OCD. A majority of persons with OCD indicated that they experienced obsessions and/or compulsions when leaving (84%) and cleaning (70%) the apartment, grocery shopping (66%), changing clothes (66%), and showering with (62%) and without (63%) shampooing. Persons with OCD who experienced obsessions and/or compulsions during a given daily life activity-but not those who did not experience obsessions and/or compulsions during these activities-reported longer durations for performing 10 of the 13 activities than persons without OCD. For most activities, longer durations related weakly but significantly to higher OCD symptom severity. Results indicate that the duration of daily life activities seems to depend more on whether persons with OCD experience obsessions and/or compulsions during a specific activity and less on whether a person is diagnosed with OCD in general. Future studies may use other assessment methods that allow for tracking the duration in daily life in real time.

Enhancing cognitive flexibility and working memory in individuals with mild cognitive impairment: Exploring the impact of virtual reality on daily life activities

Mild Cognitive Impairment (MCI) serving as a transitional stage between normal aging and dementia. This study aimed to explore the impact of virtual reality (VR) on enhancing cognitive flexibility, working memory, and daily life activities. Forty participants diagnosed with MCI were randomly assigned to either an intervention group (N = 20) or a control group (N = 20). Evaluations were at baseline, post-training, and three months post-training using various cognitive assessment tools. Results showed that the VR-based cognitive rehabilitation significantly improved instrumental activities of daily living performance, visual and verbal working memory, and reduced anxiety and depression symptoms. While cognitive flexibility did not exhibit significant improvement, these findings highlight VR interventions as a potential avenue for improving cognitive and functional aspects, and alleviating psychological symptoms in individuals with MCI. Further research with larger sample sizes and extended follow-up periods is recommended to establish the long-term effectiveness of such interventions.

The Chinese version of the self-efficacy scale for daily life activities among older adults: translation, validity and reliability

OBJECTIVE

To translate and cross-culturally adapt the Self-efficacy Scale for Daily Life Activities among Older Adults (SSDLAOA) into Chinese, as well as to examine the psychometric properties of the Chinese version of the SSDLAOA (C-SSDLAOA) in a Chinese community-based older adult population.

METHODS

This study used a cross-sectional survey. The psychometric properties of the C-SSDLAOA were evaluated among 355 older adults recruited from three communities in Huzhou, including internal reliability, test-retest reliability, face validity, content validity, construct validity, and concurrent validity.

RESULTS

The C-SSDLAOA was consistent with the original version, which consisted of five dimensions and 23 items. The confirmatory factor analysis indicated a good fit for each indicator (χ2 /df=1.387, RMSEA = 0.043, CFI = 0.967, TLI = 0.962, and SRMR = 0.042). The Cronbach's alpha was 0.909, and the test-retest reliability was 0.966, with good internal consistency and stability. The content validity index of the items ranged from 0.83 to 1.00, while the content validity index of the scale was 0.96. The correlation between the C-SSDLAOA and GSES was 0.886, with good concurrent validity.

CONCLUSIONS

The C-SSDLAOA is a reliable and valid instrument for assessing self-efficacy for daily life activities in Chinese community-dwelling older adults.

Assessment of COVID-19 lockdown effect on early Alzheimer Disease progression

INTRODUCTION

Recently, many aspects of daily life have changed due to the COVID-19 pandemic. Patients with Alzheimer Disease (AD) could be more vulnerable to those daily life changes as experts expected. Mainly, the lockdown involved reduced social contact and cognitive stimulation. So, it could affect the AD expression, increasing the patients' disabilities development.

OBJECTIVE

The aim of this study is to evaluate the effect of COVID-19 lockdown on cognitive impairment progression in early AD patients.

METHODOLOGY

The participants were patients with mild cognitive impairment due to AD (MCI-AD) from the Neurology Unit (La Fe Hospital), who were neuropsychologically evaluated (cognitive impairment, daily activity tests) twice over 2 years. They were classified into a case group (n = 21), evaluated before and after lockdown condition, and a control group (n = 20), evaluated entirely before the lockdown condition.

RESULTS

All the participants showed increasing cognitive impairment and functional deterioration over the 2-year period of evaluation (p < 0.05). However, a faster worsening was not observed as a consequence of the COVID-19 pandemic and the lockdown condition. In fact, the statistical significance observed between the two study groups for daily life activities showed that the worsening was even lesser in the group evaluated under the lockdown condition.

CONCLUSION

Medium-term effects of COVID-19 lockdown could not involve an acceleration of the cognitive decline in MCI-AD patients in a 2-year evaluation period. In addition, the least worsening observed for daily living activities in the case group was probably due to the change in routines. Therefore, the common assumption of cognitive worsening of AD progression due to the lockdown in comparison with normal disease progression was not demonstrated in this study, at least for MCI-AD cases. However, more longitudinal studies are required to evaluate long-term effects in these patients.

Testing the mood brightening hypothesis: Hedonic benefits of physical, outdoor, and social activities in people with anxiety, depression or both

BACKGROUND

The mood brightening hypothesis postulates that people with depressive symptoms report more positive affect (PA) and less negative affect (NA) than healthy controls after rewarding daily life activities. Whether mood brightening also occurs in people with anxiety symptoms remains unclear. This study examined effects of physical activity, being outdoors, and social activity on PA and NA across different levels of depression and anxiety symptoms in the general Dutch population.

METHODS

Participants completed an electronic diary on their smartphone, thrice daily over 30 days, to assess activities and affect (n = 430; 22,086 assessments). We compared five groups based on their scores on the Depression, Anxiety and Stress Scales: asymptomatic participants, participants with mild symptoms of depression and/or anxiety, depression symptoms, anxiety symptoms, and comorbid depression and anxiety symptoms. Multilevel linear regression models with interaction terms were used to compare the association between activities and affect in these five groups.

RESULTS

All activities were associated with increased PA and reduced NA in all groups. We found a mood brightening effect in participants with depression, as physical activity and being outdoors were associated with reduced NA. Participants with depression had increased PA and reduced NA when in social company compared to asymptomatic participants. No mood brightening effects were observed in participants with anxiety or comorbid depression and anxiety.

LIMITATIONS

Our sample included mainly women and highly educated subjects, which may limit the generalizability of our findings.

CONCLUSION

Mood brightening is specific to depression, and typically stronger when in social company.

Comparison of herbal medicines and pain relief medications in the treatment of primary dysmenorrhoea among female medical students at Taibah University

Objectives

Dysmenorrhoea is a common gynaecological problem that affects many women during their reproductive years. The objectives of this study were to describe the different treatments used for primary dysmenorrhoea (PD) among medical students at Taibah University, and to investigate the link between pain severity and daily life activities in relation to the type of dysmenorrhoea treatment.

Methods

A cross-sectional study was conducted on 301 female medical students through an 18-item self-administered electronic questionnaire to screen for students with PD. The questionnaire included sociodemographic characteristics, details of self-management methods (types and adverse events), daily life domains affected by pain, and the Visual Analogue Scale score for the pain (wherein a score ≥7 indicated severe pain). Chi-square test, a multivariate regression model, and correlation analysis were used for data analysis.

Results

The prevalence of PD among respondents was 71.8%. Medications were used by more than half of the respondents (51.9%), and were mainly non-steroidal anti-inflammatory drugs (53.5%) and paracetamol (47.5%). Among the participants, 14.1% used herbal medicines, cinnamon (55.7%), chamomile (40.7%), and ginger (33.3%). Other pain relief modalities were used by 34% of participants. Most students with a history of PD (80.6%) reported effects on their daily activities, mainly mood disturbance. Students using medications were more likely to have severe pain (72.7%) and an affect on daily activities (92.9%) than those using herbal medicines (44.4% and 88.9%, respectively) and other treatments (47.7% and 70.8%, respectively) (p < 0.001).

Conclusions

Medications were more commonly used than herbal medicines and other relief methods. Effects of PD on daily life activities were observed among most students treated with medications. We recommend health promotion programmes to increase the awareness regarding different pain relief methods.

Effects of coexisting upper gastrointestinal symptoms on daily life and quality of life in patients with gastroesophageal reflux disease symptoms

BACKGROUND AND AIM

Gastroesophageal reflux disease (GERD) is a common disease encountered in daily medical care and clinical problem which hampers daily life and reduces quality of life (QOL). The coexistence of GERD-related symptoms with the typical GERD symptoms, such as heartburn or acid regurgitation, and various upper abdominal symptoms is frequently observed in patients with GERD. However, the effect of these coexisting symptoms on the daily life and QOL of patients with GERD has not been clarified. Therefore, the effects of the various upper abdominal symptoms coexisting with GERD on the daily life and QOL of such patients were compared.

METHODS

A total of 113 newly diagnosed patients who visited our hospital with typical GERD symptoms were assessed using the modified frequency scale for the symptoms of GERD (MFSSG), gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), and short-form 8-item health survey (SF-8) questionnaires. The "gastroesophageal reflux symptom" (7 items) and "dyspepsia symptom" (7 items) groups were divided into two "typical symptoms" and two "atypical symptoms" for a total of four categories. The Pearson's correlation coefficient and multiple regression analysis were used to evaluate the correlations between each symptom category and dissatisfaction for daily life [eating, sleeping, daily activities, mood, as well as dissatisfaction for daily life-symptom subscale (SS), which is the average of the four items in the GERD-TEST, the physical component summary [PCS] and mental component summary [MCS] of the SF-8, and the influence of each symptom category on the daily life and QOL.

RESULTS

The incidences of each symptom category in patients with GERD were high: typical GERD (100%), atypical GERD symptoms (67.3%), typical functional dyspepsia (FD) (71.7%), and atypical FD (75.2%). Pearson's correlation analysis demonstrated significant correlations between each symptom category and living status (dissatisfactions of eating, sleeping, daily activities, daily life-SS) and almost all items in SF-8 (PCS, MCS) (P < 0.05). Multiple regression analysis indicated the largest influences of each symptom category on living status and QOL in descending order: dissatisfaction for eating (atypical FD, typical FD), daily activities (atypical FD, typical FD, typical GERD), mood (atypical FD), daily life-SS (atypical FD, typical FD), PCS (typical FD), and MCS (atypical FD) (P < 0.05).

CONCLUSION

Coexisting FD symptoms, particularly atypical FD symptoms, had a large influence on the impairments of daily life and decreases in QOL. Daily medical care of GERD requires attention to coexisting symptoms and their treatment instead of just focusing on the chief complaints by patients.

Daily life activities in patients with Alzheimer's disease or semantic dementia: Multitasking assessment

The aim of the present study was to compare patients with mild to moderate Alzheimer's disease (AD) or semantic dementia (SD) on their cognitive processes and the severity of their daily life activity impairments. Three types of tasks were administered to patients (SD = 15; AD = 31) and 30 healthy controls (HC): 1) informant-based scales and questionnaires, 2) a neuropsychological assessment exploring executive functions, episodic and semantic memory, and 3) a new original test featuring multi-step naturalistic actions and multitasking: the Sequential Daily Life Multitasking (SDLM). We predicted that patients with AD would mainly exhibit task perplexity, associated with episodic and executive deficits on the SDLM, while the behavior of patients with SD would mostly be characterized by object perplexity, associated with semantic memory deficits. Results showed that patients with AD or SD were impaired across all neuropsychological tests, particularly episodic memory in AD and semantic memory in SD. General performance on the SDLM also appeared dramatically impaired in both patient groups, and correlated with results of questionnaires about instrumental activities and memory impairments. However, specific qualitative measurements on the SDLM did not allow us to pinpoint different patterns of errors and behavior in patients with AD versus SD. We suggest that the inability of patients in both groups to perform the SDLM may derive from a constellation of disorders or else from more subtle impairment of cognitive and conative processes that requires further exploration.

Role of cognitive resources on everyday functioning among oldest-old physically frail

BACKGROUND

Everyday functioning becomes a challenge with aging, particularly among frail oldest-old adults. Several factors have been identified as influencing everyday activities realization, including physical and cognitive functioning. However, the influence of cognitive resources as a compensatory factor in the context of physical frailty deserves further consideration.

AIMS

This study aims to investigate in older adults physically frail the possible compensatory role of cognitive resources to perform everyday tasks.

METHODS

Two groups of community-dwelling old participants (n = 26 per group) matched for their age and cognitive resources, have been drawn according to their level of physical functioning. Two measures of everyday functioning have been assessed: one self-reported by the participant (the IADL scale) and one performance-based measure (the TIADL tasks).

RESULTS

Participants performed equally the TIADL tasks irrespective of their physical condition. Contrariwise, participants with low physical functioning reported more everyday difficulties than their counterparts with a high level of physical functioning. Additionally, regressions analyses revealed differential influence of cognitive resources on performance and reported measures of everyday functioning.

DISCUSSION

Our data suggests that cognitive resources are more strongly involved in the performance-based IADL measure in situation of physical frailty. Additionally, for participants with low physical functioning, lower cognitive resources are associated with more perceived difficulties in everyday life.

CONCLUSION

These results highlight the compensatory role of cognitive resources in physically frail older adults, and suggest that an overestimation of everyday difficulties compared to performance on IADL tasks is an early indicator of physical decline and cognitive compensation.

Caloric Adequacy in the First Week of Mechanically Ventilated Patients has No Impact on Long-term Daily Life Activities

Aim and objective

The aim and objective of this study is to test the effect of an optimized caloric supply in the first week of intensive care unit (ICU) stay in mechanically ventilated patients on the ability to perform their activities of daily living (ADL) in the long-term.

Materials and methods

A prospective observational study comparing patients who achieved an adequate caloric target (≥80%) vs those whose target was inadequate (<80%). The primary outcome under study is the instrumental ADL (IADL) scale after 6 months of discharge.

Results

Ninety-two patients were evaluated in the ICU and 50 were alive at 6 months. Follow-up was lost for 3 patients and 47 patients were evaluated at ICU and after 6 months. Thirty-four patients reached the energetic target and 13 did not reach it. There was no significant variation in IADL.

Conclusion

The energy adequacy in the first week of hospitalization was achieved by most survivors; however, this conduct does not seem to have influenced the ability to perform ADL after 6 months of discharge.

How to cite this article

Dariano AP, Couto CFL, Rubin BA, Viana MV, Friedman G. Caloric Adequacy in the First Week of Mechanically Ventilated Patients has No Impact on Long-term Daily Life Activities. Indian J Crit Care Med 2020;24(12):1206–1212.

A dataset build using wearable inertial measurement and ECG sensors for activity recognition, fall detection and basic heart anomaly detection system

This paper defines two major data sets 1) from wearable inertial measurement sensors and 2) wearable ECG SHIMMER™ sensors. The first dataset is devised to benchmark techniques dealing with human behavior analysis based on multimodal inertial measurement wearable SHIMMER™ sensors unit during research studies "Fall Detection System for the Elderly Based on the Classification of Shimmer Sensor Prototype Data" [2] and "A novel fall detection algorithm for elderly using SHIMMER wearable sensors" [3]. The SHIMMER inertial sensor is a lightweight sensing device, incorporated with tri-axial accelerometer, a tri-axial gyroscope and tri-axial magnetometer, mounted on the waist of the subjects. The second dataset is developed to assess the feasibility of using SHIMMER™ wearable third generation ECG sensors for identification of basic heart anomalies by remote ECG analysis. The experimental protocol was carried out according to the Timed Up and Go (TUG) test [1], which is mainly used in fall detection and fall risk assessment systems specially designed for elderly. Three daily life activities such as standing still, walking and sitting on chair and getup were performed along with fall activity in controlled environment. This dataset is available on Data in Brief Dataverse [4] and a data repository [5].

The application of Strategy-based Training to Enhance Memory (STEM) in multiple sclerosis: A pilot RCT

New learning and memory (NLM) impairments are common in multiple sclerosis (MS), negatively impacting daily life. Few studies seek to remediate these deficits to improve everyday functioning. Self-generation, spaced learning and retrieval practice have been shown to improve NLM in healthy persons and have been incorporated into an 8-session treatment protocol, Strategy-based Training to Enhance Memory (STEM). STEM teaches participants about each of the techniques, how to apply them in daily life and provides practice. Participants are taught to restructure a memory-demanding situation to optimize self-generation, spaced learning and retrieval practice. This pilot double-blind, placebo-controlled, randomized clinical trial (RCT) tested the efficacy of STEM in 20 learning-impaired participants with clinically definite MS (9 treatment, 11 control). Significant treatment effects were noted on self-report measures of daily functioning (primary outcome). Objective neuropsychological testing approached significance, showing a medium-large effect on verbal NLM. Results suggest that STEM may improve everyday functioning in individuals with MS. A full-scale RCT is warranted to validate findings in a larger sample so that findings may be generalized to the broader MS community.

Relevance of grasp types to assess functionality for personal autonomy

STUDY DESIGN

Cross-sectional research design.

INTRODUCTION

Current assessment of hand function is not focused on evaluating the real abilities required for autonomy.

PURPOSE OF THE STUDY

To quantify the relevance of grasp types for autonomy to guide hand recovery and its assessment.

METHODS

Representative tasks of the International Classification of Functioning, Disability and Health activities in which the hands are directly involved were recorded. The videos were analyzed to identify the grasps used with each hand, and their relevance for autonomy was determined by weighting time with the frequency of appearance of each activity in disability and dependency scales. Relevance is provided globally and distinguished by hand (right-left) and bimanual function. Significant differences in relevance are also checked.

RESULTS

The most relevant grasps are pad-to-pad pinch (31.9%), lumbrical (15.4%), cylindrical (12%), and special pinch (7.3%) together with the nonprehensile (18.6%) use of the hand. Lumbrical grasp has higher relevance for the left hand (19.9% vs 12%) while cylindrical grasp for the right hand (15.3% vs 7.7%). Relevancies are also different depending on bimanual function.

DISCUSSION

Different relative importance was obtained when considering dependency vs disability scales. Pad-to-pad pinch and nonprehensile grasp are the most relevant grasps for both hands, whereas lumbrical grasp is more relevant for the left hand and cylindrical grasp for the right one. The most significant difference in bimanual function refers to pad-to-pad pinch (more relevant for unimanual actions of the left hand and bimanual actions of the right).

CONCLUSIONS

The relative importance of each grasp type for autonomy and the differences observed between hand and bimanual action should be used in medical and physical decision-making.

LEVEL OF EVIDENCE

N/A.

Decubitus Ulcer Development: An Investigation on Its Effect and Evidence in Home Care Patients

Background and Aims:

Decubitus ulcer (DU) is one of the commonly observed health problems among home care patients. As well as deteriorating social, physical, and psychological conditions of the patients, it is a cause of severe economic loss due to long-term bed occupancy and high care costs. This study aimed to examine the factors which affect the development of decubitus ulcer among home care patients and provide extensive data to the literature.

Patients and Methods:

This study was conducted with on home care patients aged over 40 years old who were registered at Etimesgut Ankara Sehit Sait Erturk State Hospital. Following the face-to-face interviews with the patients at home, the scores of Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), Daily Life Activities (DLA), and Geriatric Depression Scale (GDS) were recorded. Development of DU was monitored through routine examinations in the home care patients. It was encountered how SGA, MNA, DLA and GDS functioned in predicting the development of DU using logistic regression during effort and also how status of equipment and presence of comorbid diseases affected its development.

Results:

It was determined that malnutrition affected development of DU by decreasing mobility while the presence of psychological problems increased the risk for development. Furthermore, number of comorbid diseases and status of health equipment used by the patients were found effective in the development of DU.

Conclusion:

It is obvious that decreased inability of independent mobility in DLA increase the risk for malnutrition and consequently two assessments show a negative impact on psychology of the patient.

[Treatment of Stroke Patients with Shoulder-wrist Syndrome by Acupoint Catgut Embedding and Surface Electromyogram Biofeedback Therapy]

OBJECTIVE

To observe the clinical effectiveness of acupoint catgut embedding and surface electromyogram biofeedback therapy (sEMGBF) in the treatment of stroke patients complicated with shoulder-hand syndrome (SHS).

METHODS

A total of 90 stroke patients with SHS were randomly divided into acupoint catgut embedment (ACE), sEMGBF and ACE+sEMGBF (combined treatment) groups (n=30 cases/group). The catgut embedment was performed at Jianliao (LI 14), Jianyu (LI 15), Quchi (LI 11), Waiguan (TE 5) on the affected side, once every 3 weeks, twice altogether. The electromyographic biofeedback therapy (30-50 Hz, pulse duration 200 µs, 6 s-on and 10 s-off, appropriate strength) was applied to the skin area co-vering the deltoid muscle, flexor muscle of wrist and wrist extensor for 20 min, once per day, 5 times/week, for 6 weeks. The total effective rate was assessed by using Liao's and Zhu's methods (1996), the pain severity assessed using visual analogue scale (VAS), and Fugl-Meyer assessment (FMA, 66-points) scale and the patients' activities of daily living function (ADL, 100-points) were also scored.

RESULTS

Before treatment, the VAS, FMA and ADL points of the three groups were not significantly different (P>0.05). After the treatment, the total effective rate (93.33%), FMA and ADL scores of the combined treatment group were significantly higher than those of the ACE and sEMGBF groups (P<0.05), while the VAS score of the combined treatment group was significantly lower than those of the ACE and sEMGBF groups (P<0.05). The total effective rates, FMA and ADL scores of the ACE and sEMGBF groups were comparable (P>0.05). The VAS score of the ACE group was markedly lower than that of the sEMGBF group (P<0.05).

CONCLUSION

The combined administration of ACE and sEMGBF has a better therapeutic effect for stroke patients complicated with SHS relevant to simple ACE and simple sEMGBF therapy in improving the upper limb function, relieving pain, and enhancing the daily life quality.

Learning Needs of Gynecologic Cancer Survivors

To define the learning needs of patients with gynecological oncology. The study was performed as a descriptive study. A total of 92 patients were participated. Data were collected using Patient Learning Needs Scale (PLNS). The Pearson correlation test, independent sample t test, and analysis of one-way of variance (ANOVA) followed by Tukey's-B post hoc tests were used for statistical analyses by the SPSS 15.0 software package. The mean age of women's was 50.37 ± 12.20 years. The women's diagnoses were cervical (45.7 %), ovarian (27.2 %), and endometrial (19.6 %) cancers. The most frequently stated learning needs topics were coping with pain (47.8 %), daily living activities (46.2 %), and psychological support (44.6 %). The mean PLNS score of women was 212.56 ± 35.83. The mean subscales scores of PLNS were 34.06 ± 7.29 for medicines, 38.34 ± 6.74 for daily living activities, and 24.68 ± 5.41 for community subscales. Women who graduated from elementary school needed more education than the women with higher education (p < 0.001). Learning needs level of the women are high and related to increase quality of life, medicine usage, complications of treatment, skin problems, pain management, and supportive care. As a healthcare professional, we should plan and develop educational programs in order to adequately inform patients about their learning needs.

Role of Demographic and Clinical Factors in Cognitive Functioning of Persons with Relapsing-Remitting and Progressive Multiple Sclerosis

BACKGROUND

Age and time post-diagnosis can significantly impact cognitive and motor functions in multiple sclerosis (MS); however, studies often fail to account for these factors when assessing differences between disease courses.

OBJECTIVES

Examine differences between relapsing-remitting and progressive MS in cognition, motor function, and everyday activities, controlling for age, education, and time post-diagnosis.

METHODS

Twenty-one persons with relapsing-remitting MS (RRMS group), 21 with progressive MS (PMS group), and 21 healthy participants (HCs), matched on age, education, and time post-diagnosis, completed tests of cognitive abilities, motor functions, and everyday functional activities.

RESULTS

The two groups with MS did not differ on cognitive performance. Poorer performance in processing speed was noted in both MS groups in comparison with the HC group. Motor function was worse for the PMS group compared with the HC and RRMS groups. The RRMS group showed poorer upper limb functioning compared to the HC group. The PMS group had more difficulty with everyday activities as compared with both the RRMS and HC group.

CONCLUSIONS

When comparing differences in functioning between MS disease courses, attention should be paid to the demographic characteristics of the samples. (JINS, 2018, 24, 139-146).

Impact of Underlying Conditions on Zoster-Related Pain and on Quality of Life Following Zoster

BACKGROUND

Chronic conditions have been investigated as risk factors for developing zoster, but in patients suffering from zoster, the impact of underlying conditions in zoster-related pain and quality of life (QOL) remains unclear.

METHODS

We performed a post hoc analysis of a prospective cohort study in immunocompetent zoster patients aged 50 years or older, conducted by general practitioners in Italy between 2009 and 2010. Zoster symptoms, pain intensity and characteristics, and physical and mental health scores were assessed at baseline (zoster diagnosis) and at 1, 3, and 6 months of follow-up.

RESULTS

Among 413 patients enrolled in the study, 73% (303/413) suffered from underlying conditions of which 69% (209/303) were aged 65 or older. Cardiovascular diseases (75%), diabetes (24%), and respiratory diseases (17%) were most frequent. One to three months after onset, zoster patients with underlying conditions experienced more intense zoster-related pain than those without. QOL scores were significantly lower in patients with underlying conditions, and age-adjusted difference in QOL scores between the groups increased over time, demonstrating a slower recovery for patients with underlying conditions.

CONCLUSIONS

In addition to age, the main risk factor of zoster occurrence and severity, the presence of underlying conditions results in more painful and impactful zoster episodes, creating a significant burden for these patients.

Patient reported activities after reverse total shoulder arthroplasty in rotator cuff arthropathy patients

INTRODUCTION AND OBJECTIVE

Reverse total shoulder arthroplasty in rotator cuff arthropathy patients, improves anteversion and abduction, but not rotational, outcomes. The main aim of this study is to determine its repercussions on daily life activities in our patients.

MATERIAL AND METHODS

Between 2009 and 2011 we implanted 210 shoulder arthroplasties, 126 of them were reverse total shoulder arthroplasty in a rotator cuff arthropathy context. About 88% were women, with a mean age at time of surgery of 81 years, 95% were retired. The mean follow up was 53 months. The Constant scale, Visual Analogue Scale, Charlson Comorbidity Index, range of motion were measured for each patient and whether they could manage 40 daily life activities by means of a new questionnaire, classifying them according toshoulder functional demand.

RESULTS AND DISCUSSION

Mean normalized by sex and age Constant value was 81.2%. Mean Visual Analogue Scale and Charlson Index were 3.56 and 1.69 respectively. Improvement in anteversion and abduction, not in rotational range of motion. Limitation was found in low and high functional demand activities in 20% and 51% respectively, especially those which involved internal rotation.

CONCLUSION

Reverse total shoulder arthroplasty treatment for RCA in the elderly, achieves adequate pain management and good functional outcomes. Nevertheless, an important risk of DLA limitation must be accepted in those which involve internal rotation or shoulder high functional demand.

An introductory study of common grasps used by adults during performance of activities of daily living

This paper presents the results of a descriptive survey on human grasps. Sixty-four videos were selected to represent tasks performed in the main areas of activities of daily living (ADL) (personal care, meal preparation, eating, housekeeping, etc.). All the participants were right-handed. Elementary grasps were identified for each hand, and the grasp type (from a 9-type classification), the hands involved, and the duration were registered for each case. The results show that the most commonly used grasps are: pinch, non-prehensile, cylindrical, lateral pinch and lumbrical. The presence of these grasps in the areas of ADL is, however, very different (e.g., pinch is widely used in food preparation and very little in driving). Some grasps were used more frequently with one hand or when both hands were used simultaneously (e.g., special pinch was hardly used by the left hand). Knowing the grasp types most frequently used in ADL is essential to be able to assess grasp rehabilitation processes or hand prostheses development.

Effect of the long-term care prevention project on the motor functions and daily life activities of the elderly

[Purpose] The purpose of this study was to verify the effects of the long-term care prevention project and develop an effective program. [Subjects] A total of 81 elderly people (age, 79 ± 5.1 years; height, 149.2 ± 9.2 cm; weight, 54.2 ± 11.4 kg). [Methods] Grip, knee extension muscular strength, 10 m walking speed, and Timed Up and Go time were measured for evaluation of motor functions, and the “Locomo 25”, a 25-question risk assessment questionnaire, was used as the judgment criterion for evaluation of daily life activities, with measurements being taken at the beginning of the project and after three months. [Results] In the motor functions evaluation, significant differences were observed in 10 m walking speed, Timed Up and Go time, and knee extension strength. In the daily life activities evaluation, scores for pain, rising movement, standing movement, indoor walking, outdoor walking, and fear of falling were significantly reduced. In addition, a significant correlation was also observed between motor functions and daily life activities. [Conclusion] The result of this study indicated that the long-term care prevention project is effective in maintaining or improving muscular strength and mitigating pain in the elderly and that it is an effective program for maintaining daily life activities. We were also able to show that it would be effective to develop programs with a low exercise intensity that can be performed on a continuing by the elderly.

Consistency of gait characteristics as determined from acceleration data collected at different trunk locations

Estimates of gait characteristics may suffer from errors due to discrepancies in accelerometer location. This is particularly problematic for gait measurements in daily life settings, where consistent sensor positioning is difficult to achieve. To address this problem, we equipped 21 healthy adults with tri-axial accelerometers (DynaPort MiniMod, McRoberts) at the mid and lower lumbar spine and anterior superior iliac spine (L2, L5 and ASIS) while continuously walking outdoors back and forth (20 times) over a distance of 20 m, including turns. We compared 35 gait characteristics between sensor locations by absolute agreement intra-class correlations (2, 1; ICC). We repeated these analyses after applying a new method for off-line sensor realignment providing a unique definition of the vertical and, by symmetry optimization, the two horizontal axes. Agreement between L2 and L5 after realignment was excellent (ICC>0.9) for stride time and frequency, speed and their corresponding variability and good (ICC>0.7) for stride regularity, movement intensity, gait symmetry and smoothness and for local dynamic stability. ICC values benefited from sensor realignment. Agreement between ASIS and the lumbar locations was less strong, in particular for gait characteristics like symmetry, smoothness, and local dynamic stability (ICC generally<0.7). Unfortunately, this lumbar-ASIS agreement did not benefit consistently from sensor realignment. Our findings show that gait characteristics are robust against limited repositioning error of sensors at the lumbar spine, in particular if our off-line realignment is applied. However, larger positioning differences (from lumbar positions to ASIS) yield less consistent estimates and should hence be avoided.