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PubMedDate not supplied

Assessment of physical function in aging rodents: a strategy for improving preclinical testing.

Geriatric medicine has recently focused on the biological mechanisms contributing to disability in the activities of daily living (ADLs), with special emphasis given to the study of sarcopenia, an age-related decline in muscle mass. Explaining the etiology of sarcopenia may provide useful information for the development of targeted interventions, especially those that are pharmacological in nature. However, exploratory studies aimed at evaluating the long-term effects of a particular intervention are costly and time consuming in a clinical setting. Therefore there is a need for preclinical testing of the efficacy of pharmacotherapies. This review provides (1) example of factors that contribute to the incidence of disability; (2) the conceptualization of a widely accepted human model of disability applied to an animal model; and (3) information on the potential advantages that may be realized from such translational research.

Activities of Daily Living↗
PubMed2001

Pain, coping, emotional state and physical function in patients with chronic radicular neck pain. A comparison between patients treated with surgery, physiotherapy or neck collar--a blinded, prospective randomized study.

PURPOSE: To describe and explore the relationships between pain, emotional state and coping strategies in patients with chronic radicular neck pain before and after surgery or conservative treatments. METHODS: We randomize 81 conseutive patients with cervical radicular pain and nerve root compression, verified by MRI, to either surgical decompression with fusion or physiotherapy or neck collar. Emotional state was both measured with Mood Adjective Check List. Hospital Anxiety and Depression Scale and with a Coping Strategies Questionnaire. Pain was measured with VAS and function with Disability Index Rating. Measurements were made before treatment, and follow ups after 3 and 12 months post treatment. RESULTS: We found generally a low emotional state with anxiety, depression and sleep-disturbances not only connected to pain. Pain improved faster in the surgery group but after one year no differences were seen. Surgery and physiotherapy improved function with heavy work compared to collar after 3 months. Many patients used active coping before treatment, but after treatment more passive coping strategies were found. CONCLUSION: We recommend a multidisciplinary rehabilitation with cognitive behavioural therapy and psychological interventions.

Adaptation, Psychological↗
PubMed2004

Sexual orientation, health risk factors, and physical functioning in the Nurses' Health Study II.

OBJECTIVES: To examine associations between sexual orientation and breast cancer risk factors, cardiovascular disease (CVD) risk factors, mental health status, and health-related functioning. METHODS: We compared participants in the Nurses' Health Study II (NHSII) reporting a lesbian or bisexual orientation with those reporting a heterosexual orientation, with heterosexuals serving as the reference group for all comparisons. Prevalence of health behaviors and conditions was adjusted for differences in the distribution of age, ancestry, and region of residence by standardizing to the distribution of the overall cohort. Multivariate prevalence ratios were calculated to compare lesbians and bisexuals with heterosexuals using binomial regression with the log link function. Means of health conditions were measured using continuous scales standardized to the distribution of the overall cohort. Differences in means comparing lesbians and bisexuals with heterosexuals were tested by multivariate linear regression. All comparisons were adjusted for age, ancestry, and region of residence. RESULTS: Based on information from 90,823 women aged 32-51 in 1995, those reporting a sexual orientation of lesbian (n = 694) had a higher prevalence of risk factors for breast cancer, including nulliparity and high daily alcohol intake, compared with heterosexual women. Lesbians also had a higher prevalence of several risk factors for CVD, including higher body mass index (BMI) and elevated prevalence of current smoking. Lesbians were more likely to report depression and the use of antidepressants. Key results for health risk factors were similar for lesbians and bisexual women (n = 317). CONCLUSIONS: Lesbian and bisexual women were found to have a higher prevalence of several important risk factors for breast cancer, CVD, and poor mental health and functioning outcomes. Most of these risk factors are modifiable, and appropriate interventions could play an important role in improving the health status of lesbian and bisexual women.

Adult↗
PubMed1993

Gender differences in factors associated with change in physical functioning in old age: a 6-year longitudinal study.

We compared 356 older men and women and found that income, education, and marital status had significantly stronger associations with 6-year change in functioning for men; internal health locus of control was stronger for women. Large but not significant differences occurred for age, perceived health, and days going out per week (stronger for women) plus exercise and smoking (stronger for men). We found no difference for ethnicity, chronic conditions, and social contacts. Gender specific models incorporating factors amenable to change predicted significantly higher follow-up functioning for those with positive health behaviors, supporting the value of preventive interventions.

Aged↗
PubMed1995

The association between physical function and psychological problems in children with juvenile chronic arthritis.

Twenty-nine children with juvenile chronic arthritis, aged from 7 to 16 yr were studied using the Juvenile Arthritis Functional Assessment Report for Children and Parents questionnaires (JAFAR-C and JAFAR-P). The results showed that JAFAR-C and JAFAR-P were highly correlated (P < 0.001) with each other and also with a predicted JAFAR score (P < 0.05). The JAFAR score correlated with the arthritic joint count at the time of the study (P < 0.01), Steinbrocker classification (P < 0.001), pain score (P < 0.01) and stiffness score (P < 0.005). Evidence of psychological dysfunction was found in eight of the 29 children (27%). Six children (21%) scored 13 or more on the Rutter A(2) for parents and one patient scored more than nine on the Rutter B(2) for teachers. Only one child had a score on the Birleson self-rating scale that was high enough to suggest a likely diagnosis of depression. The median Lipsitt self-concept scale score was 86, that expected for a healthy population. There was no correlation between the psychological scores and any of the other functional measurements, although the numbers affected were small. There was no significant difference between type of arthritis at onset with regard to any of the scores obtained.

Activities of Daily Living↗
PubMedDate not supplied

Quality of life after burn injury: the impact of joint contracture.

We sought to investigate quality of life, and to specifically assess how joint contracture affects it, in patients with burn injuries. The study is involved 22 adults with burn injuries. Patients were divided into two groups according to the presence (n = 11) or absence (n = 11) of any joint contracture. Patient age, sex, date of burn injury, burn type, location, and extent of burn (TBSA) were recorded for each case. Each individual underwent a thorough musculoskeletal system examination, with special focus on range of motion of the joints. Quality of life was evaluated using the Short Form 36 (SF-36). Eight (36.4%) of the patients were women, and 14 (63.6%) were men, and their mean age (+/- SE) was 24.7 +/- 4.68 years. The mean interval from injury to the study assessment was 21.45 +/- 14.69 months. Eleven patients (50%) had at least one joint contracture. The patients with one or more contractures had significantly lower scores for the SF-36 subscales of physical functioning, physical role limitations, bodily pain, and vitality (P = .05, P = .01, P = .04, and P = .02, respectively). In the 22 patients overall, TBSA was negatively correlated with the scores for the SF-36 subscales vitality and emotional role limitations (r = -.586 and r = -.805, respectively). Joint contracture does impact burn patients' quality of life, especially with respect to physical functioning, physical role limitations, bodily pain, and vitality. In addition, the amount of BSA burned is correlated with psychosocial problems and poorer quality of life, regardless of whether joint contractures develop.

Adult↗
PubMed2003

Measures of health-related quality of life and physical function.

Outcome measures may be seen as windows, each of which provides a different perspective on a single view, the impact of a disease or disorder on the patient concerned. A comparison of the orthopaedic literature in 1991 with that in 2001 suggests that the intervening decade saw an increasing interest in the use of patient-based measures in clinical outcome studies, particularly randomized controlled trials. The tool most commonly used to determine the patient's point of view was the generic Short Form-36 (SF-36). Other measures included regional assessments such as the Musculoskeletal Functional Assessment, or the Disability of the Arm, Shoulder and Hand. The Western Ontario McMaster Osteoarthritis Index (WOMAC) (hip and knee), the Simple Shoulder Test (shoulder) and the Roland-Morris Questionnaire or Oswestry Disability Index (low back) were the most common joint-specific measures. Each of the questionnaires reported was supported by evidence of reliability and validity, and in most cases one or more studies had shown responsiveness in at least musculoskeletal disorders. We provide a brief description of the most common tools, and review the evidence that orthopaedic research is making increased use of measures of health status and function.

Disability Evaluation↗
PubMedDate not supplied

Measuring physical function in children with spina bifida and dislocated hips: the Spina Bifida Hips Questionnaire.

The objective of this study was to develop a questionnaire to evaluate the activities of daily living that are important to children with spina bifida and dislocated hips and their families. Ninety-six items were generated from a review of the literature and interviews with clinicians, parents, and children with spina bifida and dislocated hips. Items were rated independently for "importance" and "severity" by the children and their parents. The 26 most important and severe items were formatted into a self-administered questionnaire, the Spina Bifida Hips Questionnaire (SBHQ). Parents and children completed 2 weeks apart the SBHQ, the Activities Scale for Kids (ASK), and the Pediatric Outcomes Data Collection Questionnaire (PODCQ). The SBHQ showed excellent test-retest reliability (intraclass correlation = 0.97). Construct validity was established by correlations with the ASK (r = 0.79, P < 0.01) and the PODCQ (r = 0.84, P < 0.01). In conclusion, the SBHQ is a valid and reliable questionnaire for the evaluation of treatment outcomes for children with spina bifida and dislocated hips.

Activities of Daily Living↗
PubMed2004

Body-weight change and physical functioning among young old adults.

OBJECTIVES: The main purpose of this study is to examine if body weight change is a potential risk factor for the onset of functional impairment across time among various functional domains. METHODS: Using longitudinal data from the Health and Retirement Study, logistic regression models on the onset of functional impairment over three time points are estimated for young old adults. RESULTS: Results indicate that weight gain is associated with greater risk of lower body mobility impairment. An increase in body mass index of greater than 5% increases the likelihood of the onset of lower body mobility functional impairment. DISCUSSION: Study findings support the promotion of healthy weight management. Future studies in this area may want to investigate effective interventions that contribute to healthy weight maintenance among this cohort.

Activities of Daily Living↗