SEARCH · PubMed Health

Results for “Physical 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 631 records · Page 35Linked to original sources

PubMedDate not supplied

Correlates with comfort and function after total shoulder arthroplasty for degenerative joint disease.

Although most patients are improved after shoulder arthroplasty, the degree of improvement is variable. The factors contributing to this variability are not well understood. In particular, little information is available regarding the preoperative characteristics of the patient that may influence the quality of the result. This study correlated patient demographics, preoperative health status, and preoperative shoulder function with 3 outcome metrics: comfort, physical role function, and shoulder-specific function. One hundred thirty-four shoulders having total shoulder arthroplasty for degenerative glenohumeral joint disease had an average follow-up of 3.4 +/- 1.8 years. The SF-36 Comfort score improved from 39 to 61 (P < .0001). The SF-36 Physical Role Function score improved from 30 to 52 (P < .0001). The average number of Simple Shoulder Test functions performable (out of 12) improved from 4 to 9 (P < .0001). The strongest correlates with postoperative comfort included preoperative physical function (P < .0001), general health (P < .0001), and social function (P < .001). The strongest correlates with postoperative physical role function included preoperative physical function (P < .0001) and general health (P < .001). The strongest correlates with postoperative shoulder function included male gender (P < .0001), and preoperative physical function (P < .0001), social function (P < .0001), mental health (P < .0001) and shoulder function (P < .0001). These data indicate that the overall well-being of the patient before surgery is strongly correlated with the quality of the outcome from total shoulder arthroplasty for degenerative glenohumeral joint disease.

Adult↗

PubMed2002

Effect of statin (HMG-Co-A-Reductase Inhibitor) use on 1-year mortality and hospitalization rates in older patients with cardiovascular disease living in nursing homes.

OBJECTIVES: To quantify the effect of statins on 1-year mortality, hospitalizations, and decline in physical function among patients with cardiovascular disease (CVD) aged 65 and older living in nursing homes. DESIGN: Retrospective cohort study. SETTING: All Medicare/Medicaid certified nursing homes (N = 1,492) in Maine, New York, Mississippi, and South Dakota. PARTICIPANTS: We identified 51,559 older patients with CVD from a population database that merged sociodemographic data and functional, clinical, and drug treatments from more than 300,000 newly admitted nursing home residents from 1992 to 1997. Statin users (n = 1,313) were matched with nonusers (n = 1,313) in the same facilities. MEASUREMENTS: All-cause mortality, hospitalization, combined endpoint of mortality or hospitalization, and decline in physical function were determined at 1 year, and survival analysis was performed. RESULTS: Prevalence of statin use in this frail older cohort with CVD was 2.6%. Statin use varied by age, gender, comorbid condition, medication use, and cognitive and physical function. One-year mortality was 229/1,000 person-years in the statin group and 404/1,000 person-years in the nonusers, with an adjusted hazard rate ratio (HRR) of 0.69, 95% confidence interval (CI) = 0.58-0.81. The estimated number needed to treat was seven (95% CI = 5-13). This association with improved all-cause mortality was evident for women and men and for age groups 75 to 84, and 85 and older. CONCLUSION: Statin therapy is associated with improved clinical outcomes, including reduction in 1-year all-cause mortality, and the combined endpoint of death or hospitalization in a frail older population with CVD. Some caution should be taken in interpreting these results because potential bias from residual confounding could affect these results.

Activities of Daily Living↗

PubMed1993

Nursing implications. Functional status of older persons with schizophrenia.

1. Older persons with schizophrenia underreport medical symptoms and overrate physical well-being. 2. Changes in mental functioning and ability to perform activities of daily living are often the first signs of physical illness. 3. Completing a drug inventory for tardive dyskinesia and extrapyramidal side effects should be ongoing. 4. Social assessment and intervention should focus on the well part of the person.

Activities of Daily Living↗

PubMed2006

Management of shoulder hemiarthroplasty in a patient with rheumatoid arthritis.

STUDY DESIGN: Case report. BACKGROUND: Rehabilitation after shoulder hemiarthroplasty for rotator cuff tear arthropathy (RCTA) represents a significant challenge to physical therapists. Limited goals have been defined for this patient population and include no pain or slight pain at rest, moderate pain with vigorous activity, shoulder external rotation active range of motion (AROM) greater than 20 degrees, and shoulder abduction AROM greater than 90 degrees. CASE DESCRIPTION: The patient was a 60-year-old female elementary school teacher with functional class III adult-onset rheumatoid arthritis, who came to physical therapy 2 weeks after undergoing a hemiarthroplasty for RCTA of the right shoulder. Physical therapy included 33 treatment sessions involving 4 to 11 exercises each session. All sessions were performed under the direct supervision of a physical therapist utilizing specially designed equipment. Physical therapy emphasized early active assisted elevation range of motion (ROM), graded progressive exercise, and functional training. All exercises were performed in a pain-free ROM or a ROM that did not increase shoulder pain. OUTCOMES: Following physical therapy, subjective pain scale at rest was 0/10 and during vigorous activity 1/10 to 2/10. Shoulder AROM was normal and shoulder rotation and elevation strength was good. There was a significant improvement in shoulder proprioception and the patient demonstrated a negative belly press test for subscapularis muscle integrity. Additionally, the patient's score on the self-report section of the American Shoulder and Elbow Surgeons Assessment Form increased from 0% at the initial examination to 70% at discharge. DISCUSSION: Despite limited expectations, this patient achieved normal shoulder ROM and near normal shoulder strength after 14 weeks of physical therapy. Overall, an early, aggressive, progressively graded exercise program appears to be a safe and effective form of treatment after shoulder hemiarthroplasty for RCTA.

Arthritis, Rheumatoid↗

PubMed1996

Cognitive performance after strenuous physical exercise.

Stimulating as well as detrimental effects of exercise on cognitive functioning have been reported. In the present study, 15 endurance-trained athletes (aged 18 to 42 years) performed a bicycle ergometer endurance test at 75% of their maximal work capacity (Wmax). Psychomotor and cognitive tests were administered before and immediately after exercise. These consisted of simple reaction time (RT), 3-choice RT and Stimulus-Response (S-R) incompatible RT tasks, a finger-tapping task, and the Stroop test. Simple RT tasks, but also the more complex S-R in compatible RT, and Color Word Interference in the Stroop test showed an increase in speed of performance after exercise relative to baseline. An enhanced activation was probably responsible for this better performance on psychomotor and cognitive tests. Since performance on the most complex task, the Interference subtest of the Stroop, was especially improved after exercise, the expectancy of the subjects of a potential positive effect of exercise was thought to have been responsible.

Adolescent↗

PubMed1999

The consequences of treatment and disease in patients with primary CNS non-Hodgkin's lymphoma: cognitive function and performance status. North Central Cancer Treatment Group.

Per protocol, patients with primary CNS non-Hodgkin's lymphoma in an intergroup phase II trial conducted by the North Central Cancer Treatment Group and the Eastern Cooperative Oncology Group had their cognitive functions measured using the Folstein and Folstein Mini-Mental Status Examination (MMSE) and their physical functions measured using the Eastern Cooperative Oncology Group Performance Score (PS) at study entry, at each treatment evaluation, and at quarterly intervals thereafter until disease progression or death. Of the 53 eligible participants who began therapy, 46 (87%) had baseline MMSE scores recorded, 36 (68%) had at least one follow-up MMSE, and 32 (60%) had both, while 52 (98%) had baseline PS, 49 (92%) had at least one follow-up PS, and 48 (91%) had both. Patterns of MMSE and PS values over time were studied in each individual, in the group as a whole, in the 20 patients who completed the study regimen, in the 23 who survived more than a year, and in patients who were classified as nonprogressors at each key evaluation. For each patient, all recorded values were plotted versus time, with dates of disease progression and death included, to look for signs of decline in cognitive or physical function preceding adverse events. Long-term declines in scores of both cognitive and physical function were observed in many treated patients with primary CNS non-Hodgkin's lymphoma. Nearly all patients who were alive more than 52 weeks after study entry had a demonstrable decline in cognitive and physical functionality. Such declines may occur before disease progression is documented; they may also occur in some patients who have long-term follow-up without evidence of disease progression. Declining MMSE and PS was a poor predictor of disease progression. There was no association of PS and toxicity. The data from this study demonstrated the considerable difficulties we encountered conducting an ancillary study such as this within a multicenter clinical trial. Firstly, the test instruments written into the protocol were unable to tell if the declines seen were due to disease, treatment, co-morbidity, or other factors. Secondly, the missing data created difficulties in interpreting outcome.

Adult↗

PubMed1991

Peripheral abnormalities in chronic heart failure.

Exercise intolerance is a major cause of morbidity in chronic heart failure (CHF) and has traditionally been attributed to skeletal muscle hypoperfusion during exercise. However, intrinsic abnormalities in skeletal muscle biochemistry and histology may also play an important role in the pathophysiology of exertional fatigue in CHF. Studies using 31P nuclear magnetic resonance (NMR) spectroscopy have demonstrated early skeletal muscle metabolic changes during exercise including excessive acidification and phosphocreatine depletion. Patients with CHF show muscle fibre atrophy with transformation of type I to II fibres accompanied by a decrease in oxidative enzyme capacity. Most of the drugs currently used to treat patients with CHF do not improve oxygen availability within exercising muscle or exercise capacity although some of them increase blood flow to skeletal muscle or alter the pattern of blood flow distribution. Physical training programmes improve exercise performance, ventilation, autonomic function and symptomatic status in CHF. Training can also increase cardiac output and reduce peripheral vascular resistance with concomitant increases in blood flow to exercising muscle and reduced arterial and venous lactate. 31P-NMR studies in patients with CHF have demonstrated significantly less acidification and phosphocreatine depletion during exercise after physical training. Animal studies suggest that the NMR changes in skeletal muscle of CHF depend on both the severity of heart failure and physical deconditioning, whereas training may reverse or prevent these alterations.

Exercise↗

PubMed2004

Back and neck pain exhibit many common features in old age: a population-based study of 4,486 Danish twins 70-102 years of age.

STUDY DESIGN: Cross-sectional and longitudinal analysis of data comprising 4486 Danish twins 70-102 years of age. OBJECTIVES: To describe the 1-month prevalence of back pain, neck pain, and concurrent back and neck pain and the development of these over time, associations with other health problems, education, smoking, and physical, and mental functioning. SUMMARY OF BACKGROUND DATA: Back pain and neck pain are prevalent symptoms in the population; however, there is little research addressing these conditions in older age groups. METHODS: Extensive interview data on health, lifestyle, social, and educational factors were collected in a nationwide cohort-sequential study of 70+-year-old Danish twins. Data for back pain, neck pain, lifetime prevalence of a comprehensive list of diseases, education, and self-rated health were based on self-report. Physical and mental functioning were measured using validated performance tests. Data including associated factors were analyzed in a cross-sectional analysis for answers given at entry into the study, and longitudinal analysis was performed for participants in all four surveys. RESULTS: The overall 1-month prevalence for back pain only was 15%, for neck pain only 11%, and for concurrent back and neck pain 11%. The prevalence varied negligibly over time and between the age groups, and 63% of participants in all surveys had no episodes or only one episode of back or neck pain. Back pain and neck pain were associated with a number of other diseases and with poorer self-rated health. Back and neck pain sufferers had significantly lower scores on physical but not cognitive functioning. CONCLUSIONS: Back pain and neck pain are common, intermittent symptoms in old age. Back pain and neck pain are associated with general poor physical health in old age.

Aged↗

PubMed1993

Effects of physical therapy on functional status of nursing home residents.

Nursing home residents typically have decreased functional and physical status and high health care utilization and costs. This randomized trial evaluates whether physical therapy is beneficial for frail debilitated long-stay residents of nursing homes. Subjects are recruited from a cohort of academic and community nursing home residents who have resided in the nursing home for greater than 3 months and are over age 60 and dependent in at least two activities of daily living. Subjects randomized to the intervention group receive one-on-one physical therapy sessions three times weekly for 4 months, while control group subjects receive structured social visits three times weekly to control for potential Hawthorne effects. Physical therapy sessions generally last 30 minutes and consist of functional activity and general conditioning exercises; these exercises are individually tailored to the subject's level of physical and functional disability. Prime outcome variables are physical function assessed by an observer-administered, performance-based instrument and self-perceived health status assessed by the Sickness Impact Profile. Health care utilization and associated costs are calculated for the following areas: the nursing home, hospitalizations, outpatient visits and procedures, medications, and the intervention. A cost-effectiveness ratio dividing incremental health care utilization and physical therapy intervention costs by the observed improvement in physical function is calculated. It is expected that results of this study can be used to help determine whether long-stay nursing home residents should be eligible for physical therapy.

Activities of Daily Living↗

PubMed2006

Complications of nonoperative management of pediatric blunt hepatic injury: Diagnosis, management, and outcomes.

BACKGROUND: Nonoperative management (NOM) of blunt hepatic injury is the standard of care in the hemodynamically stable pediatric patient, but it is not without pitfalls. The purpose of this study is to assess the incidence and types of complications associated with NOM in terms of diagnosis, management, and outcomes. METHODS: A retrospective study of pediatric patients with blunt hepatic injuries admitted from 1991 through 1997 to a Level I pediatric trauma center was conducted. All stable patients were initially managed nonoperatively according to the Isolated Liver Laceration Critical Pathway. Surveillance was performed by physical examination and tracking of hematocrit and liver function test (LFT) results. Follow-up ultrasound (US) or computed tomography (CT) were performed as clinically indicated. RESULTS: In all, 185 patients with nonoperatively managed blunt hepatic injuries were identified during a 7-year period. Over 90% (168/185) were successfully managed nonoperatively without adverse sequelae. Ten patients (5.4%) died: seven as a result of head injury; three as a result of multisystem organ failure; none directly attributable to their hepatic injuries. Complications occurred in seven patients (3.8%) with Grades III or IV right lobe liver lacerations and included biloma (5), hepatic artery pseudoaneurysm with hemobilia (1), and necrotic gallbladder (1). All seven patients (100%) had fever, persistent or worsening right upper quadrant pain, feeding intolerance, and persistently elevated LFTs. Complications were diagnosed by CT or US. Nonoperative treatment of complications was successful in four of the seven patients (57.1%) and consisted of percutaneous drain placement only (1), percutaneous drain placement and endoscopic retrograde cholangiopancreatography (ERCP)-guided stent placement (2) and angioembolization (1). Three patients (42.9%) required laparotomy, one for management of a concomitant pancreatic pseudocyst. CONCLUSION: Complications of NOM of pediatric blunt hepatic injury are rare, but may include biloma, hepatic artery pseudoaneurysm, and necrotic gallbladder. Complications occur only with Grade III or greater injuries and are accompanied by fever, right upper quadrant pain, feeding intolerance, and persistently elevated LFTs. The clinician must maintain a high index of suspicion for the development of complications and have a low threshold for obtaining a CT or US for diagnosis. Interventional radiology techniques, angiography, and ERCP are useful adjuncts to nonoperative management, but some patients may still require laparotomy for management of complications.

Adolescent↗

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↗

PubMed2000

The developmental sequelae of nonorganic failure to thrive.

The developmental sequelae of infant failure to thrive (FTT) were examined in an unreferred group of 6-year-olds with a history of severe nonorganic growth retardation, sampled from a 1-year birth cohort in an inner-city area of South London. Children who failed to thrive in infancy (weight below the third centile for at least 3 months) and their pairwise matched comparisons were originally studied at 15 months, and 42 cases and 42 controls (89.5% of the sample) were followed up. At 6 years, previously growth-retarded children were considerably smaller than matched comparisons, in terms of body mass index (BMI), and height and weight for age Z scores. History of FTT explained substantial variance in weight and BMI at 6 years, with maternal height also contributing to variation in height for age. Child cognitive functioning at 6 years was examined using the McCarthy Scales: cases had more limited quantitative and memory skills than comparisons, but there was no intergroup variation in general cognitive performance. In contrast to analyses of physical development, failure to thrive did not account for cognitive functioning; maternal IQ was the sole significant predictor of performance on all indices of child cognitive abilities. At 15 months, earlier growth faltering was linked to limitations in mental development, but these findings were not confirmed by the follow-up data: the timing of FTT was not related to cognitive abilities at 6 years. Results correspond to past research indicating that nonorganic failure to thrive is associated with persistent limitations in physical stature. There was little evidence of cognitive disadvantage for case group children at school age, suggesting that the adverse effects of early malnutrition on cognitive functioning appear to diminish over time.

Age Factors↗

PubMed1999

Impact of traumatic events and organizational response. A study of bank robberies.

This study explored how experiencing a traumatic event in the workplace affects employee physical health, mental health, personal functioning, and work performance. Post-event use of health care services and the effectiveness of critical incident stress debriefing sessions and other coping interventions were also examined. A retrospective self-report methodology and mailed survey were used with 141 employees of 42 different bank branches that had recently been robbed. The results found that most employees had multiple negative consequences from experiencing a bank robbery while at work. Psychological, physical, work, and personal areas were all affected by the robbery. Furthermore, more threatening incidents were associated with more severe consequences. Critical incident stress debriefing interventions delivered after robbery were rated as helpful by 78% of employees who attended. The implications for health care providers and organizations are discussed.

Adaptation, Psychological↗

PubMed2005

Lower cognitive test scores observed in alcohol abstainers are associated with demographic, personality, and biological factors: the PATH Through Life Project.

AIMS: To identify variables that explain the association between alcohol abstention and cognitive performance. We hypothesized that demographic and personality variables would be important for explaining the association in all age cohorts, but that health variables would be more important in the older age-cohorts. DESIGN: Three age cohorts (20-24, 40-44, 60-64 years) were sampled randomly, yielding a total of 7485 participants, with data from 602 alcohol abstainers and 4158 light or moderate drinkers used in this study. Setting The sample was drawn from the cities of Canberra and Queanbeyan, Australia. MEASUREMENTS: Scales measuring demographic, health and personality variables and cognitive and physical tests were administered. Participants drinking at hazardous or harmful levels were excluded from the analysis. FINDINGS: A range of demographic and physical function measures were found to explain partially the finding of abstainers having lower cognitive test scores. The effects of independent variables were largest in the 60-64-year-old age group with a trend for physical variables such as lung function and grip strength to become more important in the older age groups. In the 20-24-year-olds, the majority of the effect remained unexplained. CONCLUSION: There is evidence that poorer cognitive test performance by abstainers reflects in part selection effects and poorer physical functioning, but does not appear to be due to mental or physical health conditions or personality.

Adult↗

PubMed2001

The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To test the effects of a high intensity home-based progressive strength training program on the clinical signs and symptoms of osteoarthritis (OA) of the knee. METHODS: Forty-six community dwelling patients, aged 55 years or older with knee pain and radiographic evidence of knee OA, were randomized to a 4 month home based progressive strength training program or a nutrition education program (attention control). Thirty-eight patients completed the trial with an adherence of 84% to the intervention and 65% to the attention control. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index pain and physical function subscales. Secondary outcomes included clinical knee examination, muscle strength, physical performance measures, and questionnaires to measure quality of life variables. RESULTS: Patients in the strength training group who completed the trial had a 71% improvement in knee extension strength in the leg reported as most painful versus a 3% improvement in the control group (p < 0.01). In a modified intent to treat analysis, self-reported pain improved by 36% and physical function by 38% in the strength training group versus 11 and 21%, respectively, in the control group (p = 0.01 for between group comparison). In addition, those patients in the strength training group who completed the trial had a 43% mean reduction in pain (p = 0.01 vs controls), a 44% mean improvement in self-reported physical function (p < 0.01 vs controls), and improvements in physical performance, quality of life, and self-efficacy when compared to the control group. CONCLUSION: High intensity, home based strength training can produce substantial improvements in strength, pain, physical function and quality of life in patients with knee OA.

Aged↗

PubMedDate not supplied

Review of scheduled performance assurance inspections.

The frequency of inspection of the authors' scheduled maintenance program was reviewed and modified, using the work of Fennigkoh (1989). This work extended to 2,700 devices located at four hospital sites supported by a regional service. These devices included all clinical equipment, including diagnostic imaging and renal dialysis. Review of the inspection frequencies was necessary as part of the quality assurance program and to ensure consistency between similar devices. Equipment was first evaluated according to four criteria to determine if it should be on the scheduled performance assurance program. These criteria included: equipment function, physical risk to patients, maintenance requirements, and incident or related history. The frequency of inspection of included devices was then assessed according to an algorithm that looked at device maintenance requirements and manufacturers' recommendations. Devices were scheduled for inspection once, twice or, in rare cases, four times per year. The quality of the inspection program was enhanced by a systematic review. As an added bonus, the required staffing resources to comply with the scheduled performance assurance declined by 29%.

Biomedical Engineering↗

PubMed2004

Optimizing physical energy functions for protein folding.

We optimize a physical energy function for proteins with the use of the available structural database and perform three benchmark tests of the performance: (1) recognition of native structures in the background of predefined decoy sets of Levitt, (2) de novo structure prediction using fragment assembly sampling, and (3) molecular dynamics simulations. The energy parameter optimization is based on the energy landscape theory and uses a Monte Carlo search to find a set of parameters that seeks the largest ratio deltaE(s)/DeltaE for all proteins in a training set simultaneously. Here, deltaE(s) is the stability gap between the native and the average in the denatured states and DeltaE is the energy fluctuation among these states. Some of the energy parameters optimized are found to show significant correlation with experimentally observed quantities: (1) In the recognition test, the optimized function assigns the lowest energy to either the native or a near-native structure among many decoy structures for all the proteins studied. (2) Structure prediction with the fragment assembly sampling gives structure models with root mean square deviation less than 6 A in one of the top five cluster centers for five of six proteins studied. (3) Structure prediction using molecular dynamics simulation gives poorer performance, implying the importance of having a more precise description of local structures. The physical energy function solely inferred from a structural database neither utilizes sequence information from the family of the target nor the outcome of the secondary structure prediction but can produce the correct native fold for many small proteins.

Algorithms↗

PubMed1994

Characteristics of low back pain patients who do not complete physiotherapeutic treatment.

Patients' problems in following recommendations of health professionals is an issue of great concern. The purpose of the present study was to investigate whether patients with low back pain (n = 46) who dropped out of a treatment programme differed in characteristics measured prior to treatment from a matched comparison group (n = 46) who completed the programme. Data collected on work disability and sick leave, frequency, duration and intensity of pain, physical function, and personality characteristics were compared. The results indicated that the groups differed significantly on 3 of 16 variables. The non-completers had been on sick leave for a longer time period prior to treatment, experienced more intense pain and performed at a lower level on the test of physical function than those who completed the treatment programme.

Adult↗