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PubMed1996

Tendon transfers and functional electrical stimulation for restoration of hand function in spinal cord injury.

Spinal cord injury at the C5 and C6 level results in loss of hand function. Electrical stimulation of paralyzed muscles is one approach that has demonstrated significant capacity for restoring grasp and release function. One potential limitation of this approach is that key muscles for stimulation may have lower motor neuron damage, rendering the muscles unexcitable. We have used surgical modification of the biomechanics of the hand to overcome this limitation. Tendon transfer of paralyzed but lower motor neuron intact muscles can compensate for potential function lost owing to muscles with lower motor neuron damage. Such procedures have been performed to provide finger extension, thumb extension, finger flexion, and wrist extension. Additional surgical procedures have been performed to enhance the function provided with electrical stimulation. These are side-to-side synchronization of the finger flexor and extensor tendons, the flexor digitorium superficialis Zancolli-lasso procedure, and thumb interphalangeal joint arthrodesis. These procedures have been performed in 11 patients with C5 and C6 level spinal injuries and functional electrical stimulation neuroprostheses. In these patients, 41 different functional electrical stimulation-related procedures were performed and 38 gave the desired result after surgery. One procedure resulted in no increase or decrease in function or muscle output, and two procedures resulted in a decrease in muscle force or joint range of motion. The issues that must be considered in performing functional electrical stimulation-related tendon transfers are discussed.

Electric Stimulation Therapy↗

PubMed2003

Everyday functioning in young children with cerebral palsy: functional skills, caregiver assistance, and modifications of the environment.

Everyday functioning is described in 95 children with cerebral palsy (CP; 55 males and 40 females; mean age 58 months, SD 18 months, range 25 to 87 months) using the three scales of the Pediatric Evaluation of Disability Inventory (PEDI): Functional Skills, Caregiver Assistance, and Modifications of the Environment. Types of CP in the children were hemiplegia, (n=19), spastic/ataxic diplegia, (n=44), spastic quadriplegia, (n=16), dyskinetic, (n=9), and mixed (n=7). Symptoms were grouped by severity according to the Gross Motor Function Classification System (GMFCS): 23% were classified at level I, 21% at level II, 10% at level III, 23% at level IV, and 23% level V. A large variability in functioning in mobility, self-care, and social function was seen because of the heterogeneity of children with CP. Limitations in achievement of activities, need for assistance, and use of assistive devices increased progressively with GMFCS level. Furthermore, these children differed to a great extent from the normative sample of the PEDI. Stepwise regression analysis showed that the GMFCS was a good predictor of everyday functioning with age and learning problems as significantly contributing factors, particularly in self-care and social function. In conclusion, the three scales of the PEDI represent different but strongly related aspects of everyday functioning in young children with CP.

Activities of Daily Living↗

PubMed2001

Proximal stomach function in systemic sclerosis: relationship with autonomic nerve function.

Gastrointestinal involvement is frequent in patients with systemic sclerosis (SSc); however, studies on the proximal stomach and its regulation are lacking. It has been hypothesized that the primary event in the pathogenesis of gastrointestinal involvement in SSc is an early neural lesion. This study investigates proximal stomach function and its relation to autonomic nerve function in SSc. Twenty SSc patients classified in to clinical subsets, underwent measurement of proximal stomach function with and without glucagon by electronic barostat and an assessment of autonomic nerve function. SSc patients were not significantly different from 11 controls for gastric compliance (59.5+/-5.0 vs 47.7+/-4.2 ml/mm Hg, P = 0.1). The pressure-volume curves in each participant with and without glucagon were significantly different (P < 0.001). A significant positive association was found between gastric compliance and autonomic nerve function (P < 0.05). The change in gastric compliance during glucagon administration was significant-associated with autonomic function (P < 0.05). The perception cumulative scores did not differ between SSc patients and control subjects (P = 0.2). In conclusion, proximal stomach function is associated with autonomic nerve function in SSc patients. This confirms the frequent association of motility disorders with autonomic dysfunction in SSc.

Adult↗

PubMed1998

Quantitative determination of the extent of neutralization of carboxylic acid functionality in carbopol 974P NF by diffuse reflectance fourier transform infrared spectrometry using Kubelka-Munk function.

PURPOSE: The purpose of this study was to develop an analytical method for the quantitative determination of the extent of neutralization of the carboxylic acid function in Carbopol 974P NF using Diffuse Reflectance Fourier Transform Infrared Spectroscopy (DRIFT) with Kubelka-Munk function analysis. METHODS: Carbopol 974P NF is a high molecular weight, chemically crosslinked polymer of acrylic acid, that has the C=O stretching band of the unionized carboxylic acid function at 1695 cm(-1). The quantitative determination of the extent of neutralization of the carboxylic acid function in Carbopol 974P NF is based upon the asymmetrical C=O stretching of the carboxylate anion at 1570 cm(-1) measured by DRIFT spectroscopy. RESULTS: To overcome spectral differences arising from sample preparation (powders, granules and tablets) and in an effort to increase the precision of the analytical method, the following approaches were used: (1) an internal standard, (2) first derivative of the spectrum to eliminate the effect of baseline drift and (3) the ratio of the first derivative of the C=O stretch of the carboxylate anion peak (1570 cm(-1)) in the neutralized Carbopol 974P NF to that of the peak of the internal standard (866 cm(-1)). The above data treatment techniques proved to be superior to the usual methods of peak height or peak area. The calibration curve of the ratio of the first derivative (1570 cm(-1)/866 cm(-1)) was a linear function of the mass of sodium carboxylate over the range from 0.0% to 100.0% neutralization of the carboxylic acid function in Carbopol 974P NF (Fig. 1a). No particle size or sample preparation effects were noted within the experimental error. CONCLUSIONS: DRIFT spectroscopy using the Kubelka-Munk function is a powerful tool for the routine determination of the extent of neutralization of the carboxylic acid function in Carbopol 974P NF in complex pharmaceutical formulations.

Acrylates↗

PubMed2002

Is vision function related to physical functional ability in older adults?

OBJECTIVES: To assess the relationship between a broad range of vision functions and measures of physical performance in older adults. DESIGN: Cross-sectional study. SETTING: Population-based cohort of community-dwelling older adults, subset of an on-going longitudinal study. PARTICIPANTS: Seven hundred eighty-two adults aged 55 and older (65% of living eligible subjects) had subjective health measures and objective physical performance evaluated in 1989/91 and again in 1993/95 and a battery of vision functions tested in 1993/95. MEASUREMENTS: Comprehensive battery of vision tests (visual acuity, contrast sensitivity, effects of illumination level, contrast and glare on acuity, visual fields with and without attentional load, color vision, temporal sensitivity, and the impact of dimming light on walking ability) and physical function measures (self-reported mobility limitations and observed measures of walking, rising from a chair and tandem balance). RESULTS: The failure rate for all vision functions and physical performance measures increased exponentially with age. Standard high-contrast visual acuity and standard visual fields showed the lowest failure rates. Nonstandard vision tests showed much higher failure rates. Poor performance on many individual vision functions was significantly associated with particular individual measures of physical performance. Using constructed combination vision variables, significant associations were found between spatial vision, field integrity, binocularity and/or adaptation, and each of the functional outcomes. CONCLUSIONS: Vision functions other than standard visual acuity may affect day-to-day functioning of older adults. Additional studies of these other aspects of vision and how they can be treated or rehabilitated are needed to determine whether these aspects play a role in strategies for reducing disability in older adults.

Activities of Daily Living↗

PubMed2001

The reliability of the wolf motor function test for assessing upper extremity function after stroke.

OBJECTIVE: To examine the reliability of the Wolf Motor Function Test (WMFT) for assessing upper extremity motor function in adults with hemiplegia. DESIGN: Interrater and test-retest reliability. SETTING: A clinical research laboratory at a university medical center. PATIENTS: A sample of convenience of 24 subjects with chronic hemiplegia (onset >1yr), showing moderate motor impairment. INTERVENTION: The WMFT includes 15 functional tasks. Performances were timed and rated by using a 6-point functional ability scale. The WMFT was administered to subjects twice with a 2-week interval between administrations. All test sessions were videotaped for scoring at a later time by blinded and trained experienced therapists. MAIN OUTCOME MEASURE: Interrater reliability was examined by using intraclass correlation coefficients and internal consistency by using Cronbach's alpha. RESULTS: Interrater reliability was.97 or greater for performance time and.88 or greater for functional ability. Internal consistency for test 1 was.92 for performance time and.92 for functional ability; for test 2, it was.86 for performance time and.92 for functional ability. Test-retest reliability was.90 for performance time and.95 for functional ability. Absolute scores for subjects were stable over the 2 test administrations. CONCLUSION: The WMFT is an instrument with high interrater reliability, internal consistency, test-retest reliability, and adequate stability.

Adolescent↗

PubMed2005

Orbital- and state-dependent functionals in density-functional theory.

Shortcomings of present density-functional methods are considered. Kohn-Sham and time-dependent density-functional methods using orbital- and state-dependent functionals for exchange-correlation energies, potentials, and kernels are discussed as possible remedy for some of these shortcomings. A view on the Kohn-Sham formalism is presented which differs somewhat from the one conventionally taken. The crucial step of constructing local multiplicative exchange-correlation potentials in Kohn-Sham methods based on orbital- and state-dependent functionals is discussed. The description of open-shell systems via a symmetrized Kohn-Sham formalism employing state-dependent exchange-correlation functionals is elucidated. The generalized adiabatic connection Kohn-Sham approach for the self-consistent treatment of excited states within a density-functional framework is considered. In the latter approach orbital- and state-dependent exchange-correlation functionals occur in a density-functional framework which is no longer based on the Hohenberg-Kohn theorem but on a more general relation between electron densities and local multiplicative potentials.

Journal Article↗

PubMed2003

The major peanut allergen, Ara h 2, functions as a trypsin inhibitor, and roasting enhances this function.

BACKGROUND: The widespread use of peanut products, the severity of the symptoms, and its persistence in afflicted individuals has made peanut allergy a major health concern in western countries such as the United States, United Kingdom, and Canada. In a previous study, the authors showed that the allergenic properties of peanut proteins are enhanced as a result of thermal processing. OBJECTIVE: The purpose of this investigation was to determine whether any specific functions are associated with the major peanut allergen, Ara h 2, and whether the functionality of this protein is influenced by processing. An assay was developed and used to assess structure/function changes in Ara h 2 induced by roasting and the effect of these alterations on the allergenic properties of this major peanut allergen. METHODS: A protein domain homology search was used to determine possible functions for Ara h 2. One of the putative functions (protease inhibition) was tested by means of appropriate enzyme assays and protein gel electrophoresis. Circular dichroism was used to compare the structural properties of Ara h 2 purified from raw and roasted peanuts. RESULTS: Ara h 2 purified from peanuts is homologous to and functions as a trypsin inhibitor. Roasting caused a 3.6-fold increase in trypsin inhibitory activity. Functional and structural comparison of the Ara h 2 purified from roasted peanuts to native and reduced Ara h 2 from raw peanuts revealed that the roasted Ara h 2 mimics the behavior of native Ara h 2 in a partially reduced form. CONCLUSIONS: The data indicate that thermal processing might play an important role in enhancing the allergenic properties of peanuts. Not only has it previously been shown to affect the structural and allergic properties of peanut proteins but also, for the first time, the functional characteristics of an allergen. These structural and functional alterations are likely to influence the allergenicity of peanuts.

2S Albumins, Plant↗

PubMed1999

Mutations in novel organic cation transporter (OCTN2), an organic cation/carnitine transporter, with differential effects on the organic cation transport function and the carnitine transport function.

Novel organic cation transporter (OCTN2) is an organic cation/carnitine transporter, and two missense mutations, L352R and P478L, in OCTN2 have been identified as the cause for primary carnitine deficiency. In the present study, we assessed the influence of these two mutations on the carnitine transport function and the organic cation transport function of OCTN2. The L352R mutation resulted in a complete loss of both transport functions. In contrast, the P478L mutation resulted in a complete loss of only the carnitine transport function but significantly stimulated the organic cation transport function. Studies with human OCTN2/rat OCTN2 chimeric transporters indicated that the carnitine transport site and the organic cation transport site were not identical. Because carnitine transport is Na(+)-dependent whereas organic cation transport is Na(+)-independent, we investigated the possibility that the P478L mutation affected Na(+) binding. The Na(+) activation kinetics were found to be similar for the P478L mutant and wild type OCTN2. We then mutated nine different tyrosine residues located in or near transmembrane domains and assessed the transport function of these mutants. One of these mutations, Y211F, was found to have differential influence on the two transport activities of OCTN2 as did the P478L mutation. However, the Na(+) activation kinetics were not affected. These findings are of clinical relevance to patients with primary carnitine deficiency because whereas each and every mutation in these patients is expected to result in the loss of the carnitine transport function, all of these mutations may not interfere with the organic cation transport function.

Animals↗

PubMed2002

Two highly conserved glutamate residues critical for type III sodium-dependent phosphate transport revealed by uncoupling transport function from retroviral receptor function.

Type III sodium-dependent phosphate (NaP(i)) cotransporters, Pit1 and Pit2, have been assigned housekeeping P(i) transport functions and suggested involved in chondroblastic and osteoblastic mineralization and ectopic calcification. Both proteins exhibit dual function, thus, besides being transporters, they also serve as receptors for several gammaretroviruses. We here show that it is possible to uncouple transport and receptor functions of a type III NaP(i) cotransporter and thus exploit the retroviral receptor function as a control for proper processing and folding of mutant proteins. Thus exchanging two putative transmembranic glutamate residues in human Pit2, Glu(55) and Glu(575), with glutamine or with lysine severely impaired or knocked out, respectively, P(i) transport function, but left viral receptor function undisturbed. Both glutamates are conserved in type III NaP(i) cotransporters, in fungal NaP(i) cotransporters PHO-4 and Pho89, and in other known or putative phosphate permeases from a number of species and are the first residues shown to be critical for type III NaP(i) cotransport. Their putative transmembranic positions together with the presented data are consistent with Glu(55) and Glu(575) being parts of a cation liganding site or playing roles in conformational changes associated with substrate transport. Finally, the results also show that Pit2 retroviral receptor function per se is not dependent on Pit2 P(i) transport function.

Amino Acid Substitution↗

PubMed2004

A Na+/Cl- -coupled GABA transporter, GAT-1, from Caenorhabditis elegans: structural and functional features, specific expression in GABA-ergic neurons, and involvement in muscle function.

GABA functions as an inhibitory neurotransmitter in body muscles and as an excitatory neurotransmitter in enteric muscles in Caenorhabditis elegans. Whereas many of the components of the GABA-ergic neurotransmission in this organism have been identified at the molecular and functional levels, no transporter specific for this neurotransmitter has been identified to date. Here we report on the cloning and functional characterization of a GABA transporter from C. elegans (ceGAT-1) and on the functional relevance of the transporter to the biology of body muscles and enteric muscles. ceGAT-1 is coded by snf-11 gene, a member of the sodium-dependent neurotransmitter symporter gene family in C. elegans. The cloned ceGAT-1 functions as a Na(+)/Cl(-)-coupled high-affinity transporter selective for GABA with a K(t) of approximately 15 microm. The Na(+):Cl(-):GABA stoichiometry for ceGAT-1-mediated transport process is 2:1:1. The transport process is electrogenic as evidenced from GABA-induced inward currents in Xenopus laevis oocytes that express ceGAT-1 heterologously. The transporter is expressed exclusively in GABA-ergic neurons and in two other additional neurons. We also investigated the functional relevance of ceGAT-1 to the biology of body muscles and enteric muscles by ceGAT-1-specific RNA interference (RNAi) in rrf-3 mutant, a strain of C. elegans in which neurons are not refractory to RNAi as in the wild type strain. The down-regulation of ceGAT-1 by RNAi leads to an interesting phenotype associated with altered function of body muscles (as evident from changes in thrashing frequency) and enteric muscles (as evident from the rates of defecation failure) and also with altered sensitivity to aldicarb-induced paralysis. These findings provide unequivocal evidence for a modulatory role of GABA and ceGAT-1 in the biology of cholinergic neurons and in the function of body muscles and enteric muscles in this organism.

Amino Acid Sequence↗

PubMed2002

Functional foods: psychological and behavioural functions.

It is easier to demonstrate the consistent effects of foods on satiety than on cognitive performance. This is understandable since the satiety system incorporates physiological signalling systems that mediate the effects of foods on function. Specific manipulations of proteins, carbohydrates and fats have the potential to act as functional foods for appetite control. Because of the importance of the optimal functioning of cognitions for survival, these functions are quite strongly protected against short-term dietary and physiological perturbances. Therefore, food manipulations may be better detected through the degree of effort exerted to maintain performance rather than via changes in the actual performance itself. This procedure has not been widely used hitherto. The concept of biomarkers may have to be interpreted differently from research on physiological systems or clinical endpoints. For satiety, adjustments in the profile of hunger could serve as a biomarker or surrogate endpoint. For cognitions, correlated physiological variables may be more difficult to measure than the functional endpoint itself. Changes related to unitary functions (such as tracking) could serve as biomarkers for more complex, integrated skills (such as car driving). Since food manipulations may affect multiple functions, the challenge is to design foods with good satiety control that do not impair mental performance; or alternatively to engineer foods that optimise cognitive performance without compromising satiety. This rapidly developing field has great potential for close collaboration between academia and industry in the production of commercially successful products that show clear improvements in human functioning with the capacity to protect against disease or impairment.

Affect↗

PubMedDate not supplied

The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner's sexual functions?

The aims of this prospective study were to compare sexual functioning between women with male partners who have erectile dysfunction (ED) and women without partners with ED and also to investigate the effect of the treatment of male ED on female partner's sexual function. The study included 87 women and their male partners. We divided the women into two groups: 38 women with male partners complaining of ED (ED group) and 49 women with male partners who have no ED (control group). Of the men with ED, 30 were treated with penile prosthesis implantation (n = 17) or oral sildenafil citrate (n = 13). We evaluated all the men with the International Index of Erectile Function (IIEF; Rosen, Cappelleri, Smith, Lipsky, & Pena, 1999), physical examination, and color penile Doppler ultrasound. We evaluated female sexual function with the Female Sexual Function Index (FSFI; Rosen et al., 2000) to assess sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. We compared female sexual function scores between the women of the male partners with and without ED and also compared before both groups and after the treatment of male partners in the ED group. Additionally, we compare the scores according to the type of treatment given to the male partners. Sexual arousal (p = 0.009), lubrication (p = 0.001), orgasm (p = 0.006), satisfaction (p = 0.000), pain (p = 0.039), and total score (p = 0.003) were highly significantly lower in the ED group than in the control group, although sexual desire did not differ between the two groups (p = 0.515). We investigated the effect of male ED on female sexual functions and found no statistically significant differences in the presence of organic type impotence, older age, and lower erection scores on the IIEF (p = 0.53, p = 0.15, and p = 0.1, respectively). After the treatment of male ED, we observed significant improvement in sexual arousal (p = 0.001), lubrication (p = 0.002), orgasm (p = 0.000), satisfaction (p = 0.000), and pain (p = 0.002) in the women. These findings suggest that female sexual function is affected by male erection status and may improve after the treatment of male sexual dysfunction.

Adult↗

PubMed2004

Prediction of Saccharomyces cerevisiae protein functional class from functional domain composition.

MOTIVATION: A key goal of genomics is to assign function to genes, especially for orphan sequences. RESULTS: We compared the clustered functional domains in the SBASE database to each protein sequence using BLASTP. This representation for a protein is a vector, where each of the non-zero entries in the vector indicates a significant match between the sequence of interest and the SBASE domain. The machine learning methods nearest neighbour algorithm (NNA) and support vector machines are used for predicting protein functional classes from this information. We find that the best results are found using the SBASE-A database and the NNA, namely 72% accuracy for 79% coverage. We tested an assigning function based on searching for InterPro sequence motifs and by taking the most significant BLAST match within the dataset. We applied the functional domain composition method to predict the functional class of 2018 currently unclassified yeast open reading frames. AVAILABILITY: A program for the prediction method, that uses NNA called Functional Class Prediction based on Functional Domains (FCPFD) is available and can be obtained by contacting Y.D.Cai at y.cai@umist.ac.uk

Algorithms↗

PubMed2000

High urinary catecholamine excretion predicts mortality and functional decline in high-functioning, community-dwelling older persons: MacArthur Studies of Successful Aging.

PURPOSE: Catecholamine release is a marker of stress, and high plasma norepinephrine levels have been associated with increased mortality. The predictive value of high urinary catecholamine excretion for functional decline and mortality in healthier older persons has not been determined. SUBJECTS AND METHODS: We used data from the MacArthur Studies of Successful Aging to determine the effects of high urinary catecholamine excretion on 3- and 7-year mortality and functional decline. In 1988, 765 high-functioning older subjects provided complete overnight urine samples for norepinephrine and epinephrine, and 199 of these provided repeat samples in 1991. Subjects who were in the top tertile of urinary norepinephrine or epinephrine excretion in 1988 were considered high excreters; those in the top tertile in both 1988 and 1991 were considered sustained high excreters. We used bivariate and multivariate analysis to examine the relations between high catecholamine excretion and mortality and Rosow-Breslau functional decline in 1991 and 1995. RESULTS: In multivariate analyses, subjects with high baseline urinary excretion of epinephrine, norepinephrine, or either catecholamine were at higher risk for mortality and functional decline at 3 and 7 years, although the magnitude of risk (adjusted odds-ratios ranged from 1.1 to 3.1) varied depending upon specific catecholamine and outcome measure. Subjects who had sustained high urinary norepinephrine excretion were also at increased risk for 4-year mortality or functional decline. CONCLUSIONS: High urinary catecholamine excretion in high-functioning, community-dwelling older persons likely reflects subclinical sympathetic stimulation and is a marker of increased risk for functional decline and mortality.

Aged↗

PubMed1999

Performance-based and self-reported physical functioning in low-functioning older persons: congruence of change and the impact of depressive symptoms.

This prospective cohort study examines the impact of depressive symptoms on changes in self-reported physical functioning in 574 low-functioning older persons. The data were collected in two waves in 1993 and 1995. Initial levels of depressive symptoms were not predictive for subsequent change in self-reported physical functioning. Changes in self-reported physical functioning were only moderately associated with changes in performance-based physical functioning. The strongest congruence of measured change between self-reported and performance-based physical functioning was found in older persons with increased depressive symptoms. The results suggest that preventing an increase in depressive symptoms may help prevent further deterioration in physical functioning in poorly functioning older persons.

Aged↗

PubMed2001

Renal function outcome in unilateral hydronephrosis in newborn pigs. II. Function and volume of contralateral kidneys.

PURPOSE: We evaluated the compensatory response of contralateral kidney growth and function in pigs with unilateral hydronephrosis. MATERIALS AND METHODS: Unilateral partial ureteral obstruction causing severe hydronephrosis was induced at age 2 days in 12 piglets, while 10 underwent sham operation. At ages 4, 12 and 24 weeks single kidney function was assessed using 99mtechnetium diethylenetriaminepentaacetic acid differential uptake on renography combined with the glomerular filtration rate estimated from the plasma clearance of 99mtechnetium diethylenetriaminepentaacetic acid. Kidney size was measured in parallel by magnetic resonance imaging. RESULTS: At 4 weeks the glomerular filtration rate and volume of the contralateral kidneys did not differ from those in controls, although obstructed kidney function was significantly decreased. At 12 weeks the mean glomerular filtration rate plus or minus standard error of mean of the contralateral kidneys significantly increased to 1.60 +/- 0.11 versus 1.33 +/- 0.11 ml. per minute per kg. (p <0. 05), whereas kidney volume did not differ from that in sham operated controls. At 24 weeks the glomerular filtration rate and volume of the contralateral kidneys did not differ from those in controls. Glomerular filtration rate and volume of the contralateral kidneys did not correlate at 4 weeks but they correlated at 12 and 24 weeks (r = 0.94 and 0.89, respectively). CONCLUSIONS: Initially kidneys contralateral to obstructed kidneys with decreased function had no increased growth or function. Furthermore, function and volume of the contralateral kidneys were not associated at the early age. Thus, the results of our study imply that determining the size (growth) or function of the contralateral kidney at an early age does not predict function decrease in a partially obstructed kidney in this pig model.

Animals↗

PubMed2006

Assessment of long-term physical function in acute respiratory distress syndrome (ARDS) patients: comparison of the Charlson Comorbidity Index and the Functional Comorbidity Index.

OBJECTIVE: It is often important to adjust for the effect of comorbid diseases on patient outcomes. This study compares the association between physical function in acute respiratory distress syndrome patients with scores on two comorbidity indices, the Charlson Comorbidity Index, designed to predict mortality, and the Functional Comorbidity Index (FCI), which was designed to predict physical function. DESIGN: This is a prospective, longitudinal, observational study. A total of 73 survivors of acute respiratory distress syndrome were contacted at 3, 6, and 12 mos. Patient comorbidity was evaluated with the Charlson Comorbidity Index and the FCI. Physical function was measured using the Medical Outcomes Study 36-Item Short Form Health Survey Physical Function Subscale and the Physical Component Subscale scores. RESULT: Mean FCI and Charlson Comorbidity Index scores correlated fairly strongly (Spearman rho = 0.62, P < 0.001). FCI, but not the Charlson Comorbidity Index, scores correlated with the Physical Function Subscale and Physical Component Subscale scores. After controlling for other potentially confounding variables such as age and severity of illness through regression analysis, the FCI score was still significantly associated with both Physical Function Subscale and Physical Component Subscale scores. CONCLUSIONS: The FCI is a better method of measuring comorbidity with physical function as the outcome. This study illustrates the importance of choosing the most appropriate comorbidity index for the outcome of interest.

Activities of Daily Living↗