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At least 217 records · Page 12Linked to original sources
PubMed1994

Mortality and physical functioning in epidemiologic studies of three older populations.

Mortality experienced in the first three years of follow-up for three Established Populations for Epidemiologic Studies of the Elderly (EPESE) is examined in relation to the participants' self-reported functional ability. In East Boston, Massachusetts (N = 3,812), Iowa and Washington Counties, Iowa (N = 3,673), and New Haven, Connecticut (N = 2,812), noninstitutionalized persons aged 65 and older were asked a series of questions to determine their functional status. These measures, used in logistic regression analyses of the mortality data, showed that an increased number of reported disabilities significantly increased the risk of mortality over and above the effects of the age and sex of the participant, or the methodological differences among the sites. Disabilities in gross mobility (e.g., ability to walk a half mile, climb stairs, or perform heavy work around the house) were more strongly related to mortality than were measures of activities of daily living.

Aged↗
PubMed1999

Improvement of physical functioning of morbidly obese patients who have undergone a Lap-Band operation: one-year study.

BACKGROUND: The Netherlands has a population of 20,000 morbidly obese patients, an average of 350 of whom per year undergo a stomach reduction operation involving the surgical placement of a Lap-Band. The quality of life (OOL) of a sample of female patients who underwent this operation was studied in a 1-year postoperative study. METHODS: The Medical Outcome Study Short Form-36 (MOS SF-36) was used to assess 1-year postoperative quality of life among a sample of 39 female patients aged 19-53 years. QOL was measured at most 20 h preoperatively and 1 year postoperatively using a randomized pretest/posttest design. Statistical data, after transformation, were analyzed with SPSS Version 7.5 for Windows 95. RESULTS: The response rate of 92.9% of patients polled was good, in contrast to earlier findings with this measuring instrument. Mean body mass index (BMI) declined from 40.86 kg/m2 preoperatively to 33.14 kg/m2 1 year postoperatively. QOL improved on all scores in the MOS SF-36. Internal consistency of the scales used was high. CONCLUSIONS: The response rate to the MOS SF-36 questionnaire was high. The surgical placement of a Lap-Band resulted in a significant improvement of QOL (1 year postoperatively) on all scores used. The internal consistency of the scales used was high.

Adult↗
PubMed2000

Independent effects of peripheral nerve dysfunction on lower-extremity physical function in old age: the Women's Health and Aging Study.

OBJECTIVE: To determine the role of peripheral nerve dysfunction (PND) in the disablement pathway. RESEARCH DESIGN AND METHODS: Vibration perception threshold (VPT) was measured in 894 women aged > or = 65 years, and those with normal peripheral nerve function and with mild, moderate, and severe PND were identified. Lower-extremity impairments included quadriceps strength (kilograms) and three progressively difficult balance tasks (able/unable). Functional limitations included rising from a chair (able/unable) and usual pace and fast-paced walking speeds (meters/second). Level of PND was related to impairments and functional limitations in linear and logistic regression models that controlled for potentially confounding factors, including reported diabetes. RESULTS: Level of PND was associated with impaired balance (adjusted odds ratios: 2.21, 1.95, and 3.02 for mild, moderate, and severe PND, respectively, relative to normal, P < 0.05). PND was also associated with decrements in both usual and fast-paced walking speeds (-0.08, -0.08, and -0.15 m/s for usual pace and -0.13, -0.12, and -0.24 m/s for fast-paced walking speed for women with mild, moderate, and severe PND, respectively; P < 0.01 for all). Reported diabetes was not associated with these outcomes in the presence of PND. Some, but not all, of the association between PND and functional limitations was explained by the relationship between PND and impairments. CONCLUSIONS: PND is significantly associated with both lower-extremity impairments and functional limitations in older women, and PND appears to have independent effects on functional limitations. The independent effect of diabetes on these outcomes may be limited when PND is considered. Further research is needed to determine if PND is causally related to disability in old age.

Aged↗
PubMed1999

[Functional physical complaints. Guideline for diagnosis and treatment of somatoform disorders].

Although physical symptoms are the main reason why people go to the doctor, in many cases no unequivocal underlying organic disturbances are to be found, not even during subsequent visits to the doctor (Kroenke & Mangelsdorff, 1989). Frequently, the patient's previous history contains pointers for other physical complaints that also had no unequivocal organic etiology. This group of patients, who often present their problem in a very complaining fashion, are considered by many physicians to be difficult, bothersome, and ungrateful. Until quite recently it was assumed that the chances of successful treatment in these patients were poor. Accordingly, an American standard textbook of psychiatry recommends, as the main aim of the treatment, avoiding iatrogenic harm (Barsky, 1988). The present article wishes to make it clear that such a pessimistic assessment of the therapeutic outcome is no longer warranted. A positive effect can now be achieved with ambulatory psychotherapeutic measures both in the offices of general practitioners or internists, and in hospitals offering integrative-psychosomatic treatment on an inpatient basis.

Diagnosis, Differential↗
PubMed2001

[Diagnosis and treatment of somatoform disorders (functional physical complaints)].

In modern classification systems, unexplained physical symptoms without an organic origin are labelled "somatoform disorders". This syndrome is very frequent and causes a lot of treatment costs as well as indirect costs (such as workers' compensation and others). In the past, effective treatment strategies were lacking. However, consideration of modern scientific results has made it possible to develop treatment approaches which find the acceptance of the patients and which are highly effective. A hierarchical approach is presented suggesting the following steps: a) Primary care: The consideration of management rules in primary care can prevent the chronicity of somatoform symptoms. b) Brief psychological and psychopharmacological treatments: Modern cognitive-behavioural approaches can help to cope with the symptoms and to improve the subjective well-being. First results for pharmacological treatments are encouraging. c) Integrative inpatient treatment including intense psychotherapeutic and psychosomatic ingredients. Experts' judgements of course and prognosis in somatoform disorders should consider the following features: Duration and multiplicity of the complaints; comorbidity with other psychiatric and physical disorders; disability in different areas of life such as at work, family, leisure time; individual coping strategies; treatment approaches in the past.

Combined Modality Therapy↗
PubMed1992

Thalamic hand: a late onset sequela of stroke and its influence on physical function after rehabilitation: two cases report.

Thalamic hemorrhage or infarction is one of the common causes of stroke. People who suffer from this type of cerebrovascular disease may develop thalamic syndrome which includes sensory disturbance, motor deficit and psychological problems. In this report, we introduce two cases of thalamic hemorrhage followed up for more than a half year after stroke. Delayed rigidity and choreodystonic type of involuntary movement over their paretic hand developed gradually. The metacarpophalangeal joints of the affected hand were kept flexed and the proximal and distal interphalangeal joints became extended. Thalamic hand is demonstrated in the appended pictures. Once the patient develops a thalamic hand, activities of daily living will be affected due to poor hand performance despite of high motor recovery stage. Early recognition and proper rehabilitation program for the patients with thalamic hand are emphasized.

Cerebral Hemorrhage↗
PubMed1990

[The standard hip--evaluation of physical function and health care utilization following hip fracture].

All 441 cases of hip fracture admitted to Sahlgrenska sjukhuset, Göteborg, during a one-year period were followed in accordance with a form developed by the Swedish Medical Research Council. Osteosynthesis was the method used in over 97 per cent of the cases. There were 336 women, mean age 80.0 (+/- 9.9) years, and 105 men, mean age 77.1 (+/- 11.8). A rehabilitation programme for non-institutionalised patients (68 per cent of the total of 441) reduced the length of stay at the orthopaedic department from 22 days to an average of 15 days in 1986, and the proportion of patients able to return home was increased from 81 per cent in 1982 to 90 per cent in 1987-88. Thus, the use of rehabilitation or nursing home facilities was reduced, and the length of stay there was reduced. The findings of the study also showed the rehabilitation to be time-consuming, and that few hip fracture patients ever regain complete pre-fracture function. Therefore it is suggested that the follow-up should be extended to cover a longer period than four months. Otherwise, the form is well designed, and its use improves the comparability of different studies.

Activities of Daily Living↗
PubMedDate not supplied

A study of social health and physical function of government retirees in Delhi.

Education and income-wise retirees were better than an average Indian. However they had still to fulfil certain financial obligations involving heavy expenditures. Family setting continued to play important part in their daily lives. Their perceived level of utility towards society (95.32%) was high and drug habits were not a problem. Functionally majority had productive capacity. As a strategy to keep dependent population at low levels, it was very much possible to utilise their services as not only they were functionally capable but they were also educated and had work experience. The existing family set up should be encouraged and maintained by all possible means and trends seen in developed countries prevented so as to keep our elderly socially, psychologically and emotionally healthy. This will reduce the need for geriatric institutions.

Aged↗
PubMed1987

Impact of cataract surgery with lens implantation on vision and physical function in elderly patients.

We conducted a prospective study of 293 elderly patients undergoing cataract surgery with intraocular lens implantation to determine the impact of the surgery on vision and on subjective and objective measures of patient function. Visual acuity in the surgical eye improved from a mean of 20/100 before surgery to 20/40 four months after surgery; improvement was maintained at one year. Positive changes occurred in some subjective measures of patient function, such as reported activities of daily living and patient report of vision-dependent activities, but these changes were modest. The most marked changes in patient function occurred in objective measures of function. Mental status had improved not quite significantly at four months but significantly at one year. Timed manual performance improved dramatically and significantly at four months and one year. Cataract surgery was associated with improved vision and improved objective function in most patients by four months after surgery, and these improvements were maintained at one year.

Activities of Daily Living↗