PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “functional performance”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources

The eggshell of Drosophila melanogaster: IX. Synthesis and morphogenesis of the innermost chorionic layer.

Synthesis and morphogenesis of the innermost chorionic layer (ICL) was investigated by conventional EM methods, freeze-fracturing, tissue culture in Robb's medium, and EM autoradiography. Both autoradiography and fine structure results have shown that ICL-components are secreted prior to other chorion proteins. Their secretion starts on stage 12a but the first layer of ICL molecules is visible at stage 12b. Its thickness is gradually increased during the next stages, taking first, a bilaminar form along with the inner endochorion. Later, at the end of choriogenesis, ICL is detached from the endochorion and takes its final thickness and configuration, consisting of a 3-dimensional crystal, about 40 nm thick. The isolated ICL in conditions of air water interface is a monolayer crystal 10 nm thick. Studies on chorion mutants showed that the amount of protein secreted by the follicle cells is independent to the process of crystallisation. These data show how a proteinaceous extracellular substance is gradually assembled to form a 3-D crystal and how it can be organised to perform functions such as the physiological resistance of the insect eggs against water loss or water uptake, whenever they are laid on substrates with extreme environmental conditions. These functions are performed by ICL in conjunction with the underlying wax layer.

Animals↗

Physical therapy to improve functioning of older people in residential care facilities.

BACKGROUND AND PURPOSE: The purpose of this study was to determine the effectiveness of an individualized physical therapy mobility training program on the gait, balance, and functional performance of elderly individuals living in residential care facilities. SUBJECTS: Twenty-seven elderly individuals with impaired balance and difficulty performing at least one functional activity participated in the study. The subjects ranged in age from 71 to 97 years (mean = 87.1, SD = 6.7). METHODS: Balance and gait speed were assessed at baseline and following physical therapy that consisted of exercises to improve specific functional limitations. Outcomes were reassessed 1 month following completion of the physical therapy. RESULTS: Gait and balance outcomes were analyzed using a one-way repeated-measures analysis of variance. Improvement was obtained in balance, which was maintained at 1 month follow-up. Gait speed did not improve to a level of statistical significance. CONCLUSION AND DISCUSSION: After physical therapy, subjects improved in balance and functional performance. An improvement in gait speed may require a longer duration of treatment.

Activities of Daily Living↗

Neuromuscular electrical stimulation. An overview and its application in the treatment of sports injuries.

In sports medicine, neuromuscular electrical stimulation (NMES) has been used for muscle strengthening, maintenance of muscle mass and strength during prolonged periods of immobilisation, selective muscle retraining, and the control of oedema. A wide variety of stimulators, including the burst-modulated alternating current ('Russian stimulator'), twin-spiked monophasic pulsed current and biphasic pulsed current stimulators, have been used to produce these effects. Several investigators have reported increased isometric muscle strength in both NMES-stimulated and exercise-trained healthy, young adults when compared to unexercised controls, and also no significant differences between the NMES and voluntary exercise groups. It appears that when NMES and voluntary exercise are combined there is no significant difference in muscle strength after training when compared to either NMES or voluntary exercise alone. There is also evidence that NMES can improve functional performance in a variety of strength tasks. Two mechanisms have been suggested to explain the training effects seen with NMES. The first mechanism proposes that augmentation of muscle strength with NMES occurs in a similar manner to augmentation of muscle strength with voluntary exercise. This mechanism would require NMES strengthening protocols to follow standard strengthening protocols which call for a low number of repetitions with high external loads and a high intensity of muscle contraction. The second mechanism proposes that the muscle strengthening seen following NMES training results from a reversal of voluntary recruitment order with a selective augmentation of type II muscle fibres. Because type II fibres have a higher specific force than type I fibres, selective augmentation of type II muscle fibres will increase the overall strength of the muscle. The use of neuromuscular electrical stimulation to prevent muscle atrophy associated with prolonged knee immobilisation following ligament reconstruction surgery or injury has been extensively studied. NMES has been shown to be effective in preventing the decreases in muscle strength, muscle mass and the oxidative capacity of thigh muscles following knee immobilisation. In all but one of the studies, NMES was shown to be superior in preventing the atrophic changes of knee immobilisation when compared to no exercise, isometric exercise of the quadriceps femoris muscle group, isometric co-contraction of both the hamstrings and quadriceps femoris muscle groups, and combined NMES-isometric exercise. It has also been reported that NMES applied to the thigh musculature during knee immobilisation improves the performance on functional tasks.(ABSTRACT TRUNCATED AT 400 WORDS)

Athletic Injuries↗

A telecommunications system to manage patients with chronic disease.

The care of patients with chronic disease is a large and growing problem in the United States and other industrialized countries.' it is expensive, and the quality of care received by patients is often sub-optimal, resulting in poor health outcomes. We developed a totally automated computer-controlled telecommunications system, called TLC, that provides--frequent, close monitoring of patients with chronic disease and reports the results to the patients' physicians on a timely basis, so that they can intervene appropriately. TLC also monitors the patients' important self care activities, such as medication-taking, and provides education and counseling to improve the patients' performance of these activities. The system operates through regularly scheduled telephone conversations with patients' in their homes. An evaluation of a TLC chronic disease application for patients with hypertension demonstrated that use of the system was associated with significant improvement of the patients' adherence to their medication regimens and significantly improved blood pressure control. These results show that it is possible to design an information science-based health care delivery system that performs functions usually performed only by health care professionals, and suggests that information science will become an important means of delivering health care services in the next millennium.

Chronic Disease↗

The effect of oral nutritional supplements on habitual dietary quality and quantity in frail elders.

BACKGROUND: Frail institutionalized elders have a high prevalence of nutritional risk factors, undernutrition, weight loss, and nutrition-related morbidity and excess mortality. Little information is available on effective means to intervene in this setting. HYPOTHESES: We tested the hypothesis that addition of multinutrient oral supplements to the diet of frail elders would improve their overall nutritional status and functional level. METHODS: Fifty nursing home residents aged 88+/-1 yr. were followed for 10 weeks in the course of a randomized controlled trial of supplementation with a multinutrient liquid supplement vs. a non-nutritive placebo drink. Three-day food weighing was used to analyze their habitual dietary intake before and during the final week of the intervention. Nutritional status was further assessed with nutritional biochemistries, anthropometric measurements, and body composition analysis as well as physical and functional performance tests. RESULTS: The nutritional supplement was consumed with high compliance, but did not significantly augment total caloric intake. Supplementation was associated with significant reductions in total energy, protein, fat, water, fiber, and many vitamins and minerals in the habitual diet of these nursing home residents. Nutritional status improved in terms of folate levels in serum, but no other measured vitamin or mineral indices. Body composition analysis revealed a small gain in weight, increases in fat stores, but no improvement in lean tissue mass associated with supplemention. No physical performance or functional gains were associated with supplementation. CONCLUSION: Short-term nutritional supplementation in elders at nutritional risk is offset by simultaneous reduction in voluntary food intake. It seems likely that changing other components of energy expenditure such as physical activity levels or basal metabolism may be required to produce overall improvements in nutritional intake in this setting.

Aged↗

The relationship between impairments in joint function and disabilities in independent function in children with systemic juvenile idiopathic arthritis.

OBJECTIVE: Knowledge about the impact of joint impairment on functional ability is needed in planning care and setting treatment goals in children with juvenile idiopathic arthritis (JIA). We investigated the relationship between joint impairments and upper and lower limb function. METHODS: Twenty-one children with systemic JIA with an average age of 9.2 years and a mean disease duration of 4.8 years participated in this study. Joint impairments were assessed by the following variables: joint counts on swollen (JCS) and tender (JCT) joints and the loss of joint motion as determined by the Joint Alignment and Motion scale (JAM). Functional performance and functional ability were determined by the Juvenile Arthritis Functional Assessment Scale (JAFAS) and Childhood Health Assessment Questionnaire (CHAQ), respectively. The relationship between impairments and functional disabilities was studied at the level of (1) the complete instruments, (2) upper and lower limb function separately, and (3) the individual joints and items. RESULTS: Regarding complete instruments, the Spearman rank correlation between functional disabilities and loss of joint motion was moderate to good (JAM/CHAQ rs = 0.66, JAM/JAFAS rs = 0.77). A fair correlation was found between functional disabilities and the joint count on swollen joints (JCS/CHAQ rs = 0.45, JCS/JAFAS rs = 0.52), but no significant relationship was found with the number of tender joints (JCT/CHAQ rs = 0.02, p > 0.05, and JCT/JAFAS rs = 0.14, p > 0.05). At the extremity level (upper and lower limb function), the relationship between functional disabilities and the loss of joint motion appeared to be stronger in the leg than in the arm. At the level of the individual joints and questionnaire items, loss of joint motion in hip or shoulder joint appeared to be the most important factor in predicting limitation in leg or arm function. CONCLUSION: Our study shows that with respect to joint impairments, loss of joint motion is the strongest indicator of functional disability in children with systemic JIA. Loss of joint motion has a greater effect on lower limb function.

Activities of Daily Living↗

Psychosocial effects of an exercise program in older persons who fall.

Falling is associated with psychosocial sequelae that may influence functional performance and fall risk. Exercise can improve psychosocial factors. To address the research questions (1) Do psychosocial variables differ among persons with and without falls? and (2) Among persons who fall, can exercise improve psychosocial variables? we evaluated psychosocial and functional performance variables in older persons with and without recent falls. A pretest and posttest design with a nonequivalent control group was used. Community-residing elderly individuals participated, 66 had falls in the past year (fallers) and 77 had no falls (nonfallers). Participants completed measures of self-esteem, depression, psychological impact, and functional performance at baseline and 6 weeks. Baseline descriptive characteristics for fallers and nonfallers were similar. Fallers then completed a 6-week exercise program. Exercise benefited fallers' self-esteem, depression, mobility, social role, social activity, and anxiety. Nearly 40% of fallers were clinically depressed before exercise and 24% were depressed after (p = 0.04). Psychosocial variables correlated significantly with quality of functional performance (p < 0.019). Among fallers, moderate exercise produced a significant improvement in psychosocial variables and functional performance (p < 0.045).

Accidental Falls↗

Assessing functioning and self-care abilities in Alzheimer disease research.

Functional performance is a critical outcome to examine in dementia. The authors review some of the limitations of current research on functional performance and identify a conceptual framework for outcomes research. When considering conceptual frameworks to apply to functional assessment for outcomes research, five broad issues emerge: variability in definitions, an assumed equality between functional performance and capacity, measurement of global task abilities but not abilities for task components, lack of a contextual perspective, and use of a physical disability framework that excludes cognitive disability. When selecting assessment methods, researchers also must consider the implications of informant-based instruments and performance-based instruments. The authors also discuss a conceptual framework for evaluating current functional performance assessment instruments.

Activities of Daily Living↗

Xenopus Cdc6 performs separate functions in initiating DNA replication.

Cdc6 performs an essential role in the initiation of eukaryotic DNA replication by recruiting the minichromosome maintenance (MCM) complex onto DNA. Using immunodepletion/add-back experiments in Xenopus egg extracts, we have determined that both Walker A (ATP binding) and Walker B (ATP hydrolysis) motifs of Xenopus Cdc6 (Xcdc6) are essential, but have distinct functional roles. Although Walker B mutant protein binds chromatin well, Walker A mutant protein binds chromatin poorly. Neither Walker A nor Walker B mutant protein, however, load appreciable MCM onto DNA. Herein, we provide evidence that Cdc6 functions as a multimer: 1) mutant and wild-type Xcdc6 form multimers; 2) either mutant protein is dominant negative when added before wild-type Xcdc6, but stimulates DNA replication when added simultaneously with wild-type Xcdc6; and 3) the two mutants restore DNA replication when added together, in the absence of wild-type Xcdc6. Our findings suggest that ATP may play a key regulatory role within this multimer: its binding to Cdc6 promotes chromatin association and its hydrolysis facilitates MCM loading. Moreover, ATP binding and hydrolysis may occur in trans between Cdc6 subunits within the complex.

Adenosine Triphosphatases↗

PET regional cerebral blood flow change during working and declarative memory: relationship with task performance.

Functional and anatomical relationships between working and declarative memory were investigated by contrasting regional cerebral blood flow (rCBF) change during standard working (Wisconsin Card Sorting Test, WCST) and declarative memory (Paired Associate Recognition Test, PART) tasks using identical stimulus-response modalities. The tasks and a resting baseline were administered to 30 participants (16 men, 14 women) during successive 10-min positron emission tomography 15O-water measures of rCBF. For both tasks, rCBF increased over baseline in inferior frontal and occipitotemporal regions, with more consistent dorsolateral prefrontal activation for WCST than PART. Additional orbitofrontal increases and dorsomedial decreases were seen for the PART. Activation patterns diverged when performance was considered. For the WCST, high performers activated dorsolateral and inferior frontal regions, whereas top PART performers activated only the occipitotemporal region. These results suggest operation of a frontotemporal network subserving both types of memory function that becomes more focal as performance increases.

Adolescent↗

Posture of the trunk in the sagittal plane is associated with gait in community-dwelling elderly population.

OBJECTIVES: The purpose of this study was to evaluate whether abnormal posture of the trunk in the sagittal plane would affect gait and functional performance in the elderly. BACKGROUND: There have been very few reports on whether posture of the trunk is related to gait and functional performance. METHODS: The study group included 237 participants with a mean age of 80.0 years (range 65-94 years). The posture of the trunk in a standing position of the sagittal plane was classified into five groups. We investigated the relationship between the trunk posture in the sagittal plane and age with gait parameters and functional performance such as timed up & go test and functional reach. RESULTS: In the elderly subjects of normal posture, there was no difference between those in the 65-79 years age group and those in the 80 years and older age group in terms of any gait parameters. Walking abilities were significantly decreased in the abnormal posture groups. Among the abnormal posture groups, elderly in the lumbar kyphosis group had walking disabilities that did not differ between age groups, whereas gait disturbance in the thoracic kyphosis group showed a positive relation with age. CONCLUSIONS: Posture of the trunk in the sagittal plane was associated not only with the distance and time parameter of gait, but also with functional performance in the elderly.

Aged↗

Changes in postural sway and performance of functional tasks during rehabilitation after traumatic brain injury.

OBJECTIVE: To investigate changes in postural sway while standing, walking parameters, and performance of functional tasks during rehabilitation in a group of traumatic brain injury (TBI) patients. DESIGN: Descriptive. SETTING: Inpatient brain injury rehabilitation unit. PARTICIPANTS: Thirteen subjects undergoing rehabilitation after severe TBI. OUTCOME MEASURES: Two assessments were performed, 2 to 6 weeks apart that included the following: postural sway in three stance conditions; temporal and spatial parameters of walking; functional assessments of walking, standing up, reaching while standing, and stair climbing. RESULTS: There were significant reductions in postural sway in all stance conditions (p < .05) and significant increases in velocity of walking (p < .05), stride length (p < .01), and left and right step lengths (p < .01). Performance on all functional tasks improved (p < .05) except for functional reach. There were no significant correlations between changes in postural sway and changes in walking parameters or functional assessments. CONCLUSION: This study demonstrated significant improvements in postural sway, walking parameters, and functional tasks during a relatively short period of rehabilitation after severe TBI. Improvements in standing balance appear to be independent of improvements in walking performance, suggesting that different mechanisms underlie improved control of these tasks.

Adolescent↗

Association of executive function and performance of dual-task physical tests among older adults: analyses from the InChianti study.

BACKGROUND: previous studies have reported an association between cognitive function and physical performance, particularly among older adults. OBJECTIVE: to examine the association between executive function and performance difference on complex versus usual walking tasks in a sample of non-demented older adults. DESIGN: population-based epidemiological study of older people residing in the Chianti area (Tuscany, Italy). PARTICIPANTS: 737 community-dwelling individuals aged 65 years and older. METHODS: gait speed (m/s) was measured during the performance of complex walking tasks (walking/talking, walking/picking-up an object, walking/carrying a large package, walking over obstacles, walking with a weighted vest) and reference walking tasks (7 m usual pace, 7 m fast pace and 60 m fast pace). Executive function was assessed using the Trail Making Test (TMT). Other measures included Mini-Mental State Examination (MMSE), sociodemographic characteristics and selected physiological impairments. RESULTS: gait speed for the selected reference and complex walk tasks was consistently lower among participants with poor executive function. Per cent decline in gait speed compared with the reference task differed by executive function for certain tasks (e.g. walking/obstacles: 30 versus 24% decline in low versus high executive function respectively, P = 0.0006) but not for others. CONCLUSIONS: poor executive function is associated with measures of gait, including specific challenges. Overall, the results showed that the cost associated with the addition of a challenge to the basic walking task differs by executive function and the nature of the task. Further research is needed to determine whether improvement in executive function abilities translates to better performance on selected complex walking tasks.

Activities of Daily Living↗

Chronic obstructive pulmonary disease: strategies to improve functional status.

People with chronic obstructive pulmonary disease (COPD) experience deterioration in functional status, therefore improving functional status is a major goal of treatment. We reviewed interventions to improve functional status in people with COPD published from 1980 through September 1996. Randomized controlled clinical trials were reviewed to document outcomes in terms of functional capacity and functional performance for the following interventions: pharmacologic therapy including theophylline, inhaled bronchodilators, steroids, antianxiolytics and antidepressants; general exercise strategies including exercise training, exercise and comprehensive pulmonary rehabilitation, and upper extremity training; inspiratory muscle therapy including inspiratory muscle training and inspiratory muscle rest; nutritional therapy; oxygen therapy; and specialized nursing care. Improvements for functional capacity were documented in terms of strength of the inspiratory muscles and upper extremities, walking tests, and peak oxygen uptake. Most interventions were targeted to enhance functional capacity, and few were aimed at enhancing functional performance. Further research is needed to examine the relationship between functional capacity and functional performance and to design and test interventions to improve functional performance.

Humans↗

Feasibility of distractive auditory stimuli on upper extremity training in persons with chronic obstructive pulmonary disease.

OBJECTIVE: To determine the feasibility of distractive auditory stimuli (DAS) used during an upper extremity training (UET) program on perceived dyspnea, functional performance, and health-related quality of life. In addition, to determine the appropriate music tempo used during the UET. DESIGN: Experimental, randomized, 3-group design with testing at baseline and 4 weeks. SETTING: Outpatient. PATIENTS: Thirty patients (13 male and 17 female) with moderate to severe chronic obstructive pulmonary disease (FEV1 41.27% +/- 18% predicted). INTERVENTION: Moderate DAS group (n = 10) and slow DAS group (n = 10) subjects were instructed to perform UET for up to 15 minutes 3 to 5 times a week using DAS (walkman, audiocassettes). The control group (n = 10) received the same instructions, but no DAS. MEASURES AND RESULTS: Primary outcome measures were perceived dyspnea, functional performance using the 6-minute peg and ring board (6MRPB) count and health-related quality of life. In addition, all subjects recorded the time of UET performance using self-report (daily logs). A significant increase was seen in 6MRPB count (P = .002) between groups. Moderate DAS subjects increased 6MPRB count 46 +/- 21 rings and slow DAS subjects increased 46 +/- 20 rings from baseline to 4 weeks whereas control subjects increased only 5 +/- 4 rings. No significant differences were noted for the remaining variables. CONCLUSION: Subjects who used DAS (music) while performing UET improved functional performance whereas controls failed to continue improvement. The DAS is a feasible adjunct to UET that may have the potential to augment the effectiveness of pulmonary rehabilitation training.

Acoustic Stimulation↗

Evaluating the reliability and validity of the Questionnaire for Lung Transplant Patients.

CONTEXT: The Questionnaire for Lung Transplant Patients was designed for clinical use by the pulmonary transplant team in the routine evaluation of lung transplant recipients. Using the self-administered questionnaire, recipients check symptoms that they have had since their last evaluation and rate their shortness of breath, cough, and activity tolerance. OBJECTIVE: To determine whether the questionnaire meets reliability and validity standards for empirical measurement. METHODS: Demographics and disease-severity characteristics were examined in a cross-sectional survey of 37 recipients. Test-retest and intraclass correlation methods were used to estimate stability, and the Cronbach alpha was used to estimate internal consistency. Criterion validity was examined by using The Modified Symptom Frequency/Symptom Distress Scale, Functional Performance Inventory, and visual analog scales for cough and shortness of breath as criterion measures. Construct validity was examined to assess the predicted negative correlation between symptoms and functional performance. RESULTS: The questionnaire and its subscales were internally consistent (Cronbach alpha = 0.82, 0.76, 0.80, and 0.96), and the questionnaire was stable (r = 0.70) and reliable (intraclass correlations = 0.80 and 0.90). Significant correlations were found between the questionnaire and all criterion measures (r = 0.50-0.93). Significant correlations in the predicted negative direction were found between the respiratory subscale and functional performance (r = -0.51) and between cough (r = -0.51) and shortness of breath (r = -0.68) ratings and functional performance. CONCLUSIONS: The Questionnaire for Lung Transplant Patients is reliable and valid, and it provides scientifically sound information for clinical and empirical evaluation of symptoms and their effects on activity tolerance after lung transplantation.

Evaluation Studies as Topic↗

Age effects on the neural correlates of episodic retrieval: increased cortical recruitment with matched performance.

Functional neuroimaging investigations have revealed a range of age-related differences in the neural correlates of episodic memory retrieval. Typically, whereas activity is reduced in older compared with younger adults in some regions, other regions are engaged exclusively, or to a greater extent, in older adults. It is unclear whether such differences merely represent the neural correlates of the lower levels of memory performance and impaired recollection typical of older adults. This issue was addressed in the present event-related functional magnetic resonance imaging study. The level of recollection was matched between groups of healthy younger and older adults for a subset of picture items in a source memory task by manipulating the number of study presentations. Contrasts of the activity elicited by old items attracting correct source judgments and correctly identified new items revealed that the 2 groups recruited many of the same brain regions. However, a striking pattern of age-related differences was also observed. In older adults, retrieval-related increases in activity were more widespread and of greater magnitude than in the young. Moreover, regions demonstrating retrieval-related decreases in activity were almost absent in the older participants. These findings suggest an age-related decline in the efficiency with which neural populations support cognitive function.

Adolescent↗