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PubMed2004

Associations between anticipated support, physical functioning, and education level among a nationally representative sample of older adults.

OBJECTIVE: The purpose of this study is to determine the extent to which levels of anticipated support reported by older adults are associated with functional disability. In addition, level of education is tested as a modifier of this relationship. METHOD: Survey data were collected from a nationwide sample of 1,103 adults aged 60 to 95. Ordinary least squares regression analysis was used to test a range of model specifications involving anticipated support and functional disability. RESULTS: Levels of anticipated support are inversely associated with functional disability. Risk for functional disability is confined mostly to those reporting lower than average levels of anticipated support. This association is particularly strong with respect to instrumental support and among those older adults with low levels of education. DISCUSSION: These findings expand our understanding of the benefits of social relationships by suggesting that the perception of access to social support may enhance physical functioning in older age.

Activities of Daily Living↗

PubMed1989

Years of life with good and poor mental and physical function in the elderly.

A population of Roman Catholic sisters (nuns) were divided into a high education group (i.e. at least a Bachelor's degree) and a low education group (i.e. less than a Bachelor's degree). Prevalence data on 132, 75-94 year old, sisters indicated that the high-educated had better mobility and hand coordination, stronger handgrip, better distant and near visual acuity, and fewer mental impairments than the low-educated group. Life table analyses on 154 sisters indicated that the high-educated lived an average of 3.28 years longer after age 75 than the low-educated. Years of life with relatively good and poor mental and physical function after age 75 were estimated by a mathematical model that used mortality and prevalence data. According to the model, high-educated sisters lived an average of 3.57 years longer with good function and 0.29 of a year less with poor function than low-educated sisters.

Activities of Daily Living↗

PubMed1988

Toxicity, physical function and everyday activity reported by patients with inoperable non-small cell lung cancer in a randomized trial (chemotherapy versus radiotherapy).

In a randomized trial, patients with inoperable non-small cell lung cancer with limited disease were randomly given either radiotherapy (42 Gy) or combination chemotherapy with cisplatin, 70 mg/m2, and etoposide, 100 mg/m2, given every third week with a maximum of 4 cycles. The patients were asked to fill in a questionnaire concerning psychosocial well-being, medical and treatment related symptoms, physical function and everyday activity. Of the chemotherapy patients 61% reported nausea 5 weeks after their last chemotherapy session and 44% had spells of vomiting. Only 14% of the radiotherapy patients had nausea and 5% vomited 14 weeks after start of treatment. Of the radiotherapy patients 64% experienced dysphagia compared to 8% of the chemotherapy patients 6 weeks after the start of treatment.

Carcinoma, Non-Small-Cell Lung↗

PubMed2002

A double-blind, placebo-controlled, randomized clinical trial of recombinant human chorionic gonadotropin on muscle strength and physical function and activity in older men with partial age-related androgen deficiency.

Despite partial androgen deficiency, the safety and efficacy of androgen therapy in older men remains controversial because controlled studies of testosterone have given equivocal results. Human chorionic gonadotropin (hCG) can be conveniently and infrequently self-administered, and it increases not only circulating testosterone but also estradiol and other testicular steroids. We evaluated the efficacy and safety of 3 months of treatment with sc recombinant hCG (r-hCG, Ovidrel) on muscle mass, strength, mobility, and physical activity in ambulant, community-dwelling men more than 60 yr old having partial androgen deficiency (testosterone < or = 15 nmol/liter, twice). Forty eligible men (mean age, 67 yr; range, 60-85 yr) were randomized to receive r-hCG (5000 IU, 250 microg) or placebo by twice weekly sc self-injection and were studied before treatment, monthly during treatment, and 1 month after treatment. All completed the study, and treatment groups were well matched. r-hCG significantly increased body weight (approximately 1 kg; P < 0.05) and lean body mass ( approximately 2 kg; P < 0.001) and reduced fat mass (approximately 1 kg, P < 0.05). However, anthropometric measures of skinfold thickness (biceps, triceps, subscapular, suprailiac) and circumferences (midarm, waist, hip, and midthigh), including the waist-hip ratio, did not change significantly. Shoulder and knee strength (peak torque), as measured by isokinetic and isometric dynamometry, was not significantly increased, nor was physical activity (accelerometry and Physical Activity Scale for Elderly self-report) or gait and balance (modified Guralnik and Frailty and Injuries: Cooperative Studies of Intervention Techniques performance batteries) altered. Total and free testosterone and estradiol were markedly (150%; P < 0.001) and stably increased, whereas LH, FSH, and urea were significantly decreased. Testis volume was significantly decreased (approximately 5 ml; P < 0.05). There were no significant changes in hemoglobin, osteocalcin, or prostate-specific antigen, and the International Prostate Symptom Score did not change. Three men developed nipple tenderness that did not progress to gynecomastia. We conclude that 3 months of treatment with twice weekly r-hCG demonstrates sustained androgenic effects on hormones and muscle mass but has no effect on muscle strength or physical functioning.

Aged↗

PubMed1996

Evaluating physical functional outcomes: one category of the NOC system.

All professional health care disciplines are now being held accountable to demonstrate the outcomes they produce. It is imperative that nurses demonstrate the difference they make in patient care to justify the cost of professional nursing. Standardized language is needed to aggregate data and report information on nursing interventions and associated outcomes. The Nursing Outcomes Classification (NOC) system is the first comprehensive classification of nursing-sensitive patient outcomes. In this review, the development of this classification system with specific results related to physical functional status and implications of NOC for nursing practice are discussed.

Activities of Daily Living↗

PubMed2003

[A follow-up study on mental and physical function function among stroke patients: comparisons between admission and discharge status in a rehabilitation-specialized hospital].

PURPOSE: To assess results of a 5 year-follow-up, in terms of disability, depression, quality of life, and social network in cases of stroke patients. This report deal with results at admission and discharge (in average, from 2.5 to 6 months of the onset) in a rehabilitation-specialzed hospital. OBJECT AND METHOD: The subjects were 87 stroke patients hospitalized in the Ibaraki Prefectural University Hospital. They were 64 men and 23 women, and their age were between 42 and 79 with an average of 59 years. Systematic evaluation for mental and physical functions was conducted at admission and discharge, and it is intended that the evaluation will be repeated 1, 2, 3 and 5 years from the stroke onset. RESULTS: There were substantial improvements in motor functions, general intelligence, and the status of dementia during the hospitalization. Activities of daily living and degrees of job execution and satisfactory were also improved. The prevalence of depression remained 40%, and the acceptance of limb paralysis or reduced quality of life did not change. Social network scores declined. DISCUSSION: Lack of improvement of depressive status and quality of life, and deterioration social network may increase the rist of major difficulties after discharge of stoke patients. Prevention programs at hospital may be necessary to cope with these potential problems.

Activities of Daily Living↗

PubMed2000

Physical function among older adults with knee pain: the role of pain coping skills.

OBJECTIVE: To evaluate the association between pain coping skills and disability among older adults with knee pain. METHODS: Baseline measures from 394 older adults with knee pain and disability who participated in a 30-month observational study were analyzed. Pain coping skills were correlated with self-reported disability and walking distance after controlling for covariates of disability. RESULTS: Pain coping skills were significantly associated with disability (P < 0.05) and distance walked (P < 0.05). Less catastrophic thinking and prayer, greater ignoring and reinterpretation of pain sensations, and stronger perceptions of pain control were associated with less disability and better physical function. CONCLUSION: Pain coping skills used by older adults with osteoarthritis and knee pain may play a significant role in determining disability.

Activities of Daily Living↗

PubMed1999

Reduction of morning stiffness and improvement in physical function in fibromyalgia syndrome patients treated sublingually with low doses of human interferon-alpha.

One hundred and twelve fibromyalgia syndrome (FMS) patients were randomized into one of four demographically similar groups (n = 28/group). Sequential primary FMS patient volunteers were to receive daily sublingual placebo or interferon-alpha (IFN-alpha) at 15, 50, or 150 IU. After a screening evaluation, analgesic or sedative hypnotic medications were withdrawn. Two weeks later, daily IFN-alpha or placebo was initiated with follow-up evaluations at 2-week intervals ending with week 6. One primary, three secondary, and seven tertiary variables were assessed. Study outcome was based on improvement in the tender point index (TPI). The TPI did not improve with any IFN-alpha dose. However, significant improvement was seen in morning stiffness and in physical function with the 50 IU IFN-alpha (p < 0.01). None of the other outcome means changed significantly and no adverse events were attributable to IFN-alpha therapy.

Administration, Sublingual↗

PubMed2006

Hyaluronate improves pain, physical function and balance in the geriatric osteoarthritic knee: a 6-month follow-up study using clinical tests.

OBJECTIVE: To investigate the effects of intraarticular hyaluronic acid (HA) (Artzal, Seikagaku Corp., Japan) in geriatric participants with unilateral knee osteoarthritis (OA). METHOD: This was a prospective, observer-blind study with 6 months follow-up done in the setting of an outpatient rehabilitation department in a university-affiliated tertiary care medical center. Sixty-eight patients, aged 65 years or above, with symptoms and radiographic evidence of unilateral knee OA for at least 6 months were recruited. Patients received five weekly intraarticular injections of Artzal into symptomatic knees. Fifty-six participants completed the study. Fifty age-, body mass- and gender-matched healthy individuals were selected as control. Visual analog scale (VAS), Lequesne index and four balance tests including single-leg stance test (SLS), function reach test (FRT), timed "Up-and-Go" test (TUG) and Berg balance scale (BBS) were assessed before injection and at each follow-up visit in the OA group. Four balance tests were obtained on healthy participants for data comparison. RESULTS: Before Artzal injections, the OA group showed significantly worse VAS, Lequesne index and four balance tests scores than did the control group (P < 0.001). Significant improvement in all outcome measures were noted at 1 week, 1, 3 and 6 months post the fifth injection compared with baseline before injection. Local adverse events were reported in four patients (7.1%). CONCLUSION: Significant improvement in pain, physical function and balance tests was demonstrated after five weekly Artzal injections in geriatric patients with knee OA. The effect had rapid onset at 1 week and may last for 6 months.

Activities of Daily Living↗

PubMed2006

[The evaluation of the relationships between physical factors and effects of exercise intervention on physical functions in community-dwelling older people].

AIM: It is necessary to determine the effect of exercise on each individual in order to target a person for an exercise regimen intended to prevent specific health defects in the elderly. The purpose of this study was to evaluate the relationship between physical conditions and changes in functional measurements after exercise intervention. METHODS: Two hundred seventy-six subjects aged 60 years and older practiced exercise intervention for three months. The measurements were maximal walking speed, one-leg standing with eyes opened or closed, functional reach test, timed up and go test, sit and reach, handgrip strength, and knee extensor strength. We evaluated the associations between physical measurements and changes in functional measurements. RESULTS: Except for one-leg standing with eyes closed, all measurements of physical function were significantly improved after exercise intervention. The changes in functional measurements showed significant negative correlations with the initial physical performance measurements, except for maximal walking velocity. CONCLUSIONS: These results provided valuable information on more effective strategies for improving or maintaining physical functions of community-dwelling older people. Comprehensive approaches that adapt the methods of training to the fitness level of each subject are needed to effectively improve the physical function of older people.

Activities of Daily Living↗

PubMedDate not supplied

Comparison of total parenteral nutrition and an oral, semielemental diet on body composition, physical function, and nutrition-related costs in patients with malabsorption due to acquired immunodeficiency syndrome.

BACKGROUND: The nutrition management of patients with malabsorption syndromes due to acquired immunodeficiency syndrome (AIDS) is problematic. The aim of this study was to compare the effects of total parenteral nutrition (TPN) and an oral, semielemental diet (SED) on body weight, body composition, quality of life, survival, and medical costs in AIDS patients with malabsorption. METHODS: This was a prospective, randomized, open-label study performed in outpatients. Twenty-three AIDS subjects (TPN group, 12; SED group, 11) with cryptosporidiosis, microsporidiosis, or malabsorption of unknown cause were randomized and followed. Subjects were prescribed equivalent amounts of formulas of similar composition for 3 months. Monthly estimations of caloric intake, body weight, body composition by bioimpedance analysis, and quality of life were recorded. Nutritional variables were analyzed by repeated-measures analysis of covariance, with the baseline measure as the covariate. Nutrition-related medical costs, survival, and indices of absorptive and immune function were compared, RESULTS: Subjects had lost an average of 1.5 and 1.0 kg body wt/mo for TPN and SED during the 6 months before study entry (p < not significant). The TPN group consumed more total calories than the SED group (p < .05). Weight change during therapy was significantly different from pretreatment in both groups (p < .01 for TPN, p = .023 for SED). The TPN group gained more weight than the SED group (p = .057) and significantly more fat (p = .02), but the changes in body cell mass were similar in the two groups. Changes in weight and body composition correlated with caloric intake but not the mode of feeding. The SED group scored significantly better than the TPN group on a physical functioning subscale of quality of life (p < .01). Survival was similar in the two groups. TPN therapy cost almost four times more than SED. Peripheral blood CD4+ lymphocyte numbers were unaffected by either therapy. Intestinal function was not affected by either therapy. CONCLUSIONS: An oral SED may reverse weight loss and wasting in AIDS patients with malabsorption.

Acquired Immunodeficiency Syndrome↗

PubMed1982

[The influence of sodium nitrite upon the physical functions of mice].

Male mice of ICR-strain (four weeks old) were divided into seven groups, of each five animals. Sodium nitrite (NaNO2), dissolved in the physiological saline solution, was administered orally at doses of 250, 220, 110, 80, 50 and 5 mg per kg, everyday during successive seven days to each group. The forced running distance was monitored by means of the treadmill (Eiken-model) during the period of the administration and recovery. All the mice which received 250 mg/kg dose died after the single shot. The capability of muscular exercise was found decreased particularly in the groups which received 110 and 80 mg/kg of NaNO2. Mean methemoglobin level (Met-Hb) in the blood of male mice was about 1.0%. Mean Met-Hb levels were increased to about 1.2% and 3.8% after the oral administration of NaNO2 at the dose of 110 mg/kg everyday for successive 7 and 21 days, respectively. Met-Hb levels were measured by means of modified Evelyn-Malloy's method. In the groups which received 110 mg/kg or less, no significant changes in the body weight as well as the other physical functions were observed, as compared with those received only physiological saline solutions.

Animals↗

PubMedDate not supplied

Oxymorphone extended-release tablets relieve moderate to severe pain and improve physical function in osteoarthritis: results of a randomized, double-blind, placebo- and active-controlled phase III trial.

OBJECTIVE: To compare oxymorphone extended release (ER) and placebo on indices of pain, function, and safety in patients with chronic osteoarthritis (OA) pain. DESIGN: In this multicenter, double-blind, placebo- and active-controlled, parallel-group, dose-ranging study, patients were randomized to oxymorphone ER 20 mg (N = 121), oxymorphone ER 40 mg (N = 121), oxycodone controlled release 20 mg (N = 125), or placebo (N = 124) every 12 hours. The primary efficacy end point was change in arthritis pain intensity (visual analog scale, 0-100) from baseline to week 3 for the oxymorphone ER 40 mg group versus placebo. RESULTS: The primary end point was achieved: the week 3 oxymorphone ER least squares mean difference (LSMD) from placebo was -9.0 (95% confidence interval [CI]: -16.2 to -1.8; P = 0.015). Secondary efficacy analysis showed similar improvements at week 4 (LSMD from placebo, -10.3 [95% CI: -17.7 to -2.8]; P = 0.007) and with oxymorphone ER 20 mg at week 3 (LSMD from placebo, -7.7 [95% CI: -15.0 to -0.4]; P = 0.039) and week 4 (LSMD from placebo, -7.5 [95% CI: -15.0 to 0.0]; P = 0.050). Weeks 3 and 4 pain intensity decreased by approximately 30-40%. Oxymorphone ER 20 and 40 mg improved from baseline on the Western Ontario and McMaster Universities Osteoarthritis Composite Index and pain and physical function subscales at week 4. Adverse events in all opioid groups included mild to moderate nausea, constipation, and somnolence. CONCLUSIONS: In this short-term study, oxymorphone ER was superior to placebo for relieving pain and improving function in patients with moderate to severe chronic OA pain, and is an alternative to other sustained-release opioids.

Analgesics, Opioid↗

PubMed2005

Emotional support levels can predict physical functioning and health related quality of life among elderly Taiwanese with hip fractures.

INTRODUCTION: There has been increasing interest in the role emotional support plays on recovery and the perceptions of health. However, the vast majority of studies have been based on data from Western nations. Little is known about hip-fractured elders in Asian countries. This study has examined the influences of emotional support on functional recovery, and health-related quality of life (HRQoL) among elderly patients in Taiwan. METHODS: Data were gathered from 126 hip fractured elders, in a teaching hospital in northern Taiwan. Eleven items from the Medical Outcome Study (MOS) Social Support Survey were administered, in order to measure emotional support at 1 month after discharge. The Chinese Barthel Index (CBI), Lawton and Brody's instrumental activities of daily living (IADL) scale, and MOS Short Form-36 Taiwan version were administered at the end of months 1, 3, and 6 after discharge. RESULTS: After controlling for covariates, greater levels of emotional support predicted a better recovery of the activities of daily living (ADL) (beta=0.23, P=0.04) and IADL (beta=0.03, P=0.03), and better HRQoL in seven of eight dimensions (P ranged from <0.0001 to 0.04), except social function, emotional role , and physical role during the first 6 months after hospital discharge. CONCLUSIONS: Emotional support can have a significant impact on the recovery of self- care ability, and different aspects of HRQoL during the first 6 months after discharge for hip fractured elders in Taiwan. Clinical implications were made, on the basis of these findings.

Activities of Daily Living↗

PubMed2003

Ongoing distress from emotional trauma is related to pain, mood, and physical function in a primary care population.

The relationship of trauma history to physical and emotional functioning in primary care pain patients was examined. Data were drawn from a mailed screening questionnaire for a larger study designed to evaluate an intervention for improving pain management in primary care. Results indicated that 50.4% of the pain patients reported experiencing at least one previous emotionally traumatic event. Further, 31% of patients with trauma history continued to be bothered by that experience. Finally, patients who continued to be significantly bothered by the trauma reported more pain, emotional distress, poorer social functioning, and more difficulty with engaging in their daily activities than did patients with either no trauma history or who had a trauma history but did not have bothersome thoughts of the trauma. These preliminary findings suggest that the experience of trauma alone was not related to additional impairments in physical and psychosocial functioning. However, the report that one continued to be bothered by thoughts of a trauma was associated with greater impairments in functioning.

Adult↗

PubMed1978

Smoking, lung function, physical performance and latent coronary heart disease in presumably healthy middle-aged men.

During a cardiovascular survey comprising 2014 presumably healthy men aged 40-59 years, latent (previously undetected) coronary heart disease (CHD), lung function and physical performance were related to differences in smoking habits. The survey examination classified 1 832 individuals as "normals" (without clinical signs/symptoms of CHD). Among the others, a strong supicion of CHD was found in 115, of whom 105 had diagnostic coronary angiography. No angiography was performed in another 35 individuals with slight, albeit typical angina pectoris. The remaining 42 men were excluded from this presentation for various reasons. The following findings were obtained: 1) in the 69 men with positive coronary angiography, the extent of coronary atheromatosis was positively related to the number of cigarettes smoked. 2) The smoking habits of the 35 individuals with slight angina pectoris but no angiography did not differ from those of the "normals". 3) Physical performance during a near maximal bicycle exercise test and lung function according to spirometry were strongly and negatively related to smoking (in "normals"). 4) Previous smokers and never-smokers among "normals" had almost identical lung function and physical performance.

Adult↗

PubMed1994

The development of a battery of measures for assessing physical functioning of chronic pain patients.

The physical performance of chronic pain patients is of major concern both for their assessment and for treatment evaluation. However, there are few widely used physical tests, a shortage of reliability and validity data on published tests, and an over-reliance on self-report or on clinical measures of dubious generalisability. A set of tests was designed to cover speed and endurance in walking, stair climbing, standing up from a chair, sit-ups, arm endurance, grip strength, and peak flow. Standard instructions and testing conditions were used by a trained tester on a population of chronic pain patients before and after a cognitive-behavioural chronic pain management programme. Reliability, validity, and acceptability of each test was examined, and recommendations made for their relative utility.

Adult↗

PubMed1999

Association between executive attention and physical functional performance in community-dwelling older women.

OBJECTIVES: Executive functions supervise the contents of working memory, where information from long-term memory is integrated with information in the immediate present. This study examined whether executive attentional abilities were uniquely associated with the performance of complex, instrumental activities of daily living (IADLs) in cognitively intact and physically high-functioning older women. METHODS: Participants were 406 community-residing, older women aged 70-80 years in the Women's Health and Aging Study (WHAS) II, screened to be physically high functioning and cognitively intact using the Mini-Mental State Exam. Hierarchical regression models, adjusted for demographic and disease variables, were used to evaluate the association of cognitive domains, including executive attention, memory, psychomotor speed, and spatial ability with summary measures of IADL (e.g., looking up and dialing a telephone number) and mobility-based ADL (e.g., walking 4 meters) function. RESULTS: Tests of executive attention were associated with performance on IADLs (6.6%) and, to a lesser degree, mobility-based ADLs (1%), adjusting for demographic and disease variables. In particular, the mental flexibility component of the Trail Making Test accounted for the majority of attentional variance in IADL performance. Older age, lower education, and African American race were also associated with poorer physical test performances. DISCUSSION: Executive difficulties in flexibly planning and initiating a course of action were selectively associated with slower performance of higher-order IADL tests, relative to other domains of cognition, in a high-functioning, community-based older cohort. These results suggest that executive functions may be important in mediating the onset and progression of physical functional declines.

Activities of Daily Living↗