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PubMed1991

Physical therapy diagnosis and the relationship between impairments and function.

Physical therapy diagnosis refers to both a process and a particular label within a classification scheme. This article reviews the development of the concept of diagnosis in physical therapy and evaluates the clinical utility of using the World Health Organization's International Classification of Impairments, Disabilities, and Handicaps (ICIDH) as a taxonomy for physical therapy. In place of the ICIDH, a model developed by Nagi is suggested. If this model is applied to physical therapy, the relationship between impairments and functional limitations is identified as the primary diagnostic focus of physical therapy. Exploration and expansion of this model may best serve the development of a classification scheme for physical therapy diagnosis.

Activities of Daily Living↗

PubMed2002

Oral bacteria influenced by the functional status of the elderly people and the type and quality of facilities for the bedridden.

AIMS: To analyse the relationship between oral bacteria and the health and functional status of the elderly. METHODS AND RESULTS: The bacteria species in the oral cavity of the elderly were examined. It was found that the bedridden subjects staying at two hospitals for long-term (HOBR) showed significantly lower detection rates of commensal bacteria species and significantly higher detection rates of Pseudomonas aeruginosa, of methicillin-resistant Staphylococcus aureus (MRSA) and of coagulase(-) Staph. aureus than those living independently (the independent). In addition, the detection rate of Haemophilus parainfluenzae in NUBR was discovered to be higher than that found in the independent. In HOBR, the detection rate of Ps. aeruginosa was significantly higher among in-patients who required continual care than those in need of partial care, while the detection rate of MRSA was significantly higher among in-patients with low serum albumin than those with normal serum albumin. CONCLUSIONS: Oral bacteria examination analysis proved that the risks of infection of some pathogenic bacteria species were correlated with functional status, physical function and nutritional state. SIGNIFICANCE AND IMPACT OF THE STUDY: Our study suggests that the oral bacteria, especially pathogenic bacteria were influenced by the functional status of the elderly and the type and quality of the facilities for the bedridden, physical function and nutritional state.

Activities of Daily Living↗

PubMed1993

An evaluation of the physical and functional characteristics of infant resuscitators.

Self-inflating resuscitators (SIRs) are commonly used to assist ventilation in the newborn. Despite their widespread use, there is limited information available on the functional and physical characteristics of SIRs. We studied five new infant bag-valve units to compare their physical characteristics, including reservoir, accumulator, and dead space volumes (VD), pressure relief mechanism (PRM), inspiratory resistance (RI), and functional mechanics including stroke volume (SV), fraction of delivered oxygen (FDO2), and cycle frequency at -5 degrees C, 20 degrees C, and 49 degrees C, using a test lung apparatus and experienced respiratory therapists. In addition, deficiencies and features that may render them less than ideal were sought. All SIRs met minimum standards for reservoir and accumulator volumes, RI (< 20 cmH2O/L/sec), SV (20-70 ml), and FDO2 (> 90%) as determined by the Canadian Standards Association (CSA) and the American Society for Testing of Materials (ASTM). However, the following deficiencies were noted: 1) MPR and Pulmanex had no PRM (ASTM requirement); 2) MPR could not cycle at -5 degrees C; 3) the VDs for Pulmanex (10 ml) and MPR (15 ml) were high; 4) the CPR connector broke during normal use, and the MPR connector frequently disconnected; 5) the Laerdal expiratory valve was incompetent; and 6) the Laerdal and CPR could be misassembled for use. Our study shows that some commercially available SIRs do not meet all CSA and ASTM standards and may not be ideal in specific clinical situations. The choice of a SIR may be dictated by the clinical situation in which its use is intended.

Equipment Design↗

PubMed2003

What are the clinical factors that affect quality of life in adult asthmatics?

A study was conducted to determine the clinical factors that affect the quality of life in adult asthmatics. As part of their routine follow-up visit, 399 patients completed the SF-36 quality of life questionnaire, had peak expiratory flow rate readings (PEFR) taken and were interviewed to determine current symptom severity. The grade of severity of asthma was verified by the consultant physician in-charge. The mean age of the patients was 41.8 years and 31.8% of the patients were men. Most of the patients were Malay (64.7%), 89% had at least secondary level education and the mean duration of asthma was 17.6 years. The majority of patients had moderate or severe disease (43.6% and 55.9% respectively). For asthmatics with moderate or severe symptoms of chest tightness and/or shortness of breath, all domains of SF-36 scored significantly lower than those with mild symptoms, with the exception of the domain bodily pain. Patients with moderate/severe cough recorded significantly lower scores than those with mild cough for all domains except for bodily pain and social functioning. Only the physical functioning, role physical, general health and role emotional scores were significantly worse in those with a consultant grade of severe asthma compared to those with mild/moderate asthma. Patients with PEFR < 80% predicted had lower scores for the domains physical functioning, role physical and general health than those with PEFR > or = 80% predicted, but the scores for the other domains were similar in both groups. Quality of life is significantly impaired in adult asthmatics with current respiratory symptoms. However, consultant grade of severity of asthma and PEFR readings do not affect quality of life scores as much.

Adolescent↗

PubMed2002

Self-assessment in cancer patients referred to palliative care: a study of feasibility and symptom epidemiology.

BACKGROUND: Research in palliative care is considered difficult due to the poor health of patients. However, patient-provided data are essential for a thorough description of patient symptomatology and for the evaluation of care. METHODS: The authors examined the feasibility of a questionnaire-based study using the European Organization for Research and Treatment of Cancer quality-of-life instrument EORTC QLQ-C30, the Edmonton Symptom Assessment System (ESAS), and the Hospital Anxiety and Depression Scale (HADS) in cancer patients who were receiving palliative care. This report describes the symptomatology of participating patients and examines differences in symptomatology between patients in three palliative care functions: inpatient, outpatient, and palliative home care. RESULTS: Of 267 eligible patients who were referred to a department of palliative medicine, initial self-assessment questionnaires were obtained from 176 patients (65.9%). The 91 nonparticipants were older and had lower Karnofsky Performance status (KPS) values than the participants. Almost all participating patients suffered from impaired role function and physical function and had high levels of pain, fatigue, and other symptoms. According to the HADS, 47% of patients suffered from depression. Outpatients had better scores than inpatients and patients in palliative home care for physical function, role function, cognitive function, depression, and inactivity. CONCLUSIONS: It is possible to carry out a questionnaire-based study of symptomatology in consecutive cancer patients in palliative care, achieving rather complete data from the participants. The symptomatology in these patients was very pronounced. The questionnaires were able to detect clinically important differences between places of service.

Adult↗

PubMed1992

[Physical training in coronary patients with poor left ventricular function].

Physical training is beneficial in patients with coronary artery disease, and in those after myocardial infarction in whom left ventricular function and ejection fraction (LVEF) are relatively well preserved. However, little is known about the effect of physical training in coronary patients with impaired left ventricular function. 12 patients after myocardial infarction (range 42-60 years) with LVEF of 30% or less at rest were evaluated after 11 months of isotonic physical training. Mean LVEF increased from 28.0% to 33.0% (p less than 0.002) at rest and from 29.4% to 33.2% (p less than 0.002) on effort. Exercise tolerance increased 228 seconds by the end of the study (p less than 0.001); the double product at symptom limit effort increased (p less than 0.001) and the double product at the same work load decreased (p less than 0.002). During training there was no cardiovascular deterioration and all patients returned to work within a mean of 3.7 months. The results show that patients with severe left ventricular impairment should not necessarily be excluded from cardiac rehabilitation programs involving physical training.

Adult↗

PubMed1977

Membrane associated cytoplasmic mRNA in Artemia salina; functional and physical changes during development.

The physical and functional properties of the mRNA population from developing embryos of the brine shrimp Artemia salina were characterized. About 20% of the total poly(A)-rich mRNA in these embryos appears to be specifically associated with the membrane fraction throughout early development, and physically differs markedly from the free cytoplasmic mRNA. The membrane-associated mRNA fraction consists of two well-defined populations of molecular weight of 5.2x10(5) and 3.6x10(5), whose relative amount changes during the various stages of embryo development. The size of the poly(A) tail at the 3'-end of the mRNA molecules, as estimated by processive phosphorolysis, was found to consist of 180 and 210 adenosine residues for the two respective mRNA species. The in vitro translation products of the membrane-bound mRNA molecules are apparently similar to those of the free mRNA molecules.

Animals↗

PubMedDate not supplied

Quality of life on home parenteral nutrition or after intestinal transplantation.

AIM: We compared the health related quality of life (HRQOL) of stable patients on home parenteral nutrition (HPN) and of patients who underwent successful intestinal transplantation (ITx). METHODS: HRQOL was evaluated by the non-disease-specific Short Form 36 instrument, which examines eight specific domains and scores them on a scale of 0% to 100%. Patient scores were standardized for the sex-matched and age-matched group scores of the healthy population by calculating the Z-score (reduced value: Z-score < -1). RESULTS: Eighteen patients on HPN and 12 patients who underwent ITx were studied. The two groups did not differ for primary intestinal disease, cause of intestinal failure, presence of a stoma, body mass index, and employment and marital status. HPN Z-scores were physical functioning -2.3, physical role -1.5, body pain -1.0, general health -1.2, vitality -0.5, social functioning -0.9, emotional role -0.7, and mental health 0.0. ITx Z-scores were physical functioning -1.7, physical role -0.8, body pain 0.0, general health -0.4, vitality 0.0, social functioning -0.4, emotional role -0.3, and mental health 0.0. Only the body pain Z-scores differed significantly (P = .012). CONCLUSIONS: The value of the physical components of the SF-36 was reduced in all the components in the HPN patients and in the physical functioning component in the ITx patients. The mental health components were normal in both. Successful ITx showed a better subjective physical health feeling than stable HPN.

Adult↗

PubMed2005

Physical and functional properties of intact and ground pale broiler breast meat.

The functional and physical properties of intact and ground meat were determined during 4 replicate trials on a total of 180 pale [lightness (L*) > 53] and normal (46 < L* < 53) boneless, skinless breast fillets collected from 2 commercial processing plants. At 24 h postmortem, L*, redness (a*), yellowness (b*), and pH were determined on each fillet. The left fillet from each breast was ground and used to determine cook loss (CL) and Allo-Kramer (AK) shear on meat patties as well as moisture uptake (MU) and CL on meat slurries before and after adjustment to the normal meat pH of 5.9. The right fillet from each breast was kept intact and used to determine expressible moisture (EM), CL, and AK shear on the intact meat. Compared with normal fillets, pale fillets exhibited significantly higher L* values, lower ultimate pH (5.67 vs. 5.94), higher AK (3.5 vs. 2.9 kg/g), higher EM, lower MU, and higher CL measured on the intact fillets, ground meat patties, and meat slurries. Adjustment of the pH of the pale meat slurries to normal meat pH (5.9) resulted in a higher MU (11.05 vs. 3.69%), indicating a partial restoration of protein functionality. These results indicate that wide differences in raw broiler breast meat color, mainly due to differences in the muscle pH, are related to important variations in the water-holding and binding capacities of the meat. The effect of low meat pH can be partially ameliorated in ground meat by pH adjustment.

Animals↗

PubMed2005

Surviving cancer: a comparison of 5-year disease-free breast cancer survivors with healthy women.

Women with breast cancer are one of the largest groups of cancer survivors. This research examined whether breast cancer has a long-term impact on quality of life (QOL) by comparing 5-year disease-free survivors to age-matched controls and by comparing women who sustained a recurrence to disease-free survivors. Controls were recruited using the neighborhood control methodology. QOL (physical, emotional, social, and spiritual) was assessed during in-person interviews. There were no differences between disease-free survivors (n = 267) and controls (n = 187) on many indicators of QOL. However, survivors reported more difficulties with physical functioning, more physical symptoms, and more faith than did controls (all ps < 0.05). Compared to disease-free survivors, survivors with a recurrence (n = 37) had a worse QOL on most indices, less positive affect, more general fatigue, and more intrusive and avoidant thoughts (all ps < 0.05). There were no differences between the two groups of survivors on indices of marriage, work experiences, or spirituality. These findings suggest that the QOL of long-term survivors who remain disease-free is comparable to that of women their age with the exception of physical functioning. Women who sustain a recurrence suffer an impaired QOL in some, but not all, domains.

Activities of Daily Living↗

PubMed1998

Functional and physical interaction between Rad24 and Rfc5 in the yeast checkpoint pathways.

The RFC5 gene encodes a small subunit of replication factor C (RFC) complex in Saccharomyces cerevisiae and has been shown to be required for the checkpoints which respond to replication block and DNA damage. Here we describe the isolation of RAD24, known to play a role in the DNA damage checkpoint, as a dosage-dependent suppressor of rfc5-1. RAD24 overexpression suppresses the sensitivity of rfc5-1 cells to DNA-damaging agents and the defect in DNA damage-induced Rad53 phosphorylation. Rad24, like Rfc5, is required for the regulation of Rad53 phosphorylation in response to DNA damage. The Rad24 protein, which is structurally related to the RFC subunits, interacts physically with RFC subunits Rfc2 and Rfc5 and cosediments with Rfc5. Although the rad24Delta mutation alone does not cause a defect in the replication block checkpoint, it does enhance the defect in rfc5-1 mutants. Furthermore, overexpression of RAD24 suppresses the rfc5-1 defect in the replication block checkpoint. Taken together, our results demonstrate a physical and functional interaction between Rad24 and Rfc5 in the checkpoint pathways.

Cell Cycle Proteins↗

PubMed2004

Inhibition of p63 transcriptional activity by p14ARF: functional and physical link between human ARF tumor suppressor and a member of the p53 family.

The ARF/MDM2/p53 pathway is a principal defense mechanism to protect the organism from uncontrolled effects of deregulated oncogenes. Oncogenes activate ARF, which interacts with and inhibits the ubiquitin ligase MDM2, resulting in p53 stabilization and activation. Once stabilized and activated, p53 can either induce or repress a wide array of different gene targets, which in turn can regulate cell cycle, DNA repair, and a number of apoptosis-related genes. Here we show that, unlike p53, p63, a member of the p53 family, directly interacts with p14(ARF). Through this interaction ARF inhibits p63-mediated transactivation and transrepression. In p63-transfected cells, ARF, which normally localizes into nucleoli, accumulates in the nucleoplasm. Based on these observations, we suggest that stimuli inducing p14(ARF) expression can, at the same time, activate p53 and impair p63 transcriptional activity, altering the pattern of p53 target gene expression. Here we show, for the first time, a physical and functional link between the p14(ARF) tumor suppressor protein and p63, a member of the p53 family.

Animals↗

PubMed2006

Association between anemia and quality of life in a population sample of individuals with chronic obstructive pulmonary disease.

BACKGROUND: Several studies investigated the association of anemia with health related quality of life (HRQL) in patients with chronic disease. However, there is little evidence regarding the association of anemia with HRQL in patients with chronic obstructive pulmonary disease (COPD). METHODS: This is a post-hoc analysis of a study which enrolled a population of adults aged 35-79 randomly selected from residents of Erie and Niagara Counties, NY, between 1996 and 2000. In addition to demographic information and physical measurements, we obtained spirometry data and hemoglobin levels. We used modified Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria to define COPD, and World Health Organization (WHO) criteria to define anemia. To assess HRQL we used the Short Form-36 (SF-36) to assess physical functioning (PF), physical component summary (PCS) measures and mental component summary (MCS) measures. RESULTS: In the entire study population (n = 2704), respondents with anemia had lower scores on the physical functioning domain [45.4 (SD10.9) vs. 49.2 (SD 9.1); p < 0.0001]. Among patients with COPD (n = 495) the PF scores (39.9 vs. 45.4) and the PCS (41.9 vs. 45.9) were significantly lower in individuals with anemia compared to those without. In multiple regression analysis, the association between hemoglobin and PCS was positive (regression coefficient 0.02, p = 0.003). There was no significant association of hemoglobin with PF scores or the mental component summary measure after adjusting for covariates in patients with COPD. CONCLUSION: In patients with moderate to very severe COPD anemia may be associated with worse HRQL. However, co-morbidities may explain part or all of this association in these patients.

Adult↗

PubMed1999

Outcomes after hip or knee replacement surgery for osteoarthritis. A prospective cohort study comparing patients' quality of life before and after surgery with age-related population norms.

OBJECTIVE: To compare the health-related quality of life of people with osteoarthritis before and after primary total hip and knee replacement surgery with that of the general Australian population. DESIGN: A prospective cohort study. SETTING: Three Sydney hospitals, public and private. PARTICIPANTS: Patients with osteoarthritis undergoing primary total hip (n = 59) and knee (n = 92) joint replacement surgery. MAIN OUTCOME MEASURE: Medical Outcomes Study Short Form (SF-36) scores before and 12 months after joint replacement surgery (compared with population norms). RESULTS: Patients in each age group showed a significant improvement in health-related quality of life after joint replacement surgery in most scales of the SF-36, particularly physical function, role physical and bodily pain. SF-36 scores for the 42 hip-replacement patients aged 55-74 years improved to equal or exceed the population norm on all scales. SF-36 scores of the 52 knee replacement patients aged 55-74 years improved, but physical function and bodily pain scores remained significantly worse than the population norm. SF-36 scores for both hip (n = 17) and knee (n = 40) replacement patients aged 75 years and over improved significantly, becoming similar to population norms for this age group. CONCLUSIONS: Total hip or knee replacement for osteoarthritis significantly improves patient health and well-being at 12 months after surgery. Age alone should not be a barrier to surgery.

Aged↗

PubMed1994

Physical and functional association of Src-related protein tyrosine kinases with Fc gamma RII in monocytic THP-1 cells.

Aggregation of Fc gamma RII (CD 32), a low affinity receptor for immunoglobulin G (IgG), on the monocytic cell line THP-1 induces protein tyrosine kinase (PTK) activity. Several distinct cellular proteins, including Fc gamma RII itself, are phosphorylated on tyrosine following cross-linking of the receptor. Fc gamma RII lacks intrinsic PTK activity. In this report we demonstrate that a kinase activity was coprecipitated with Fc gamma RII in THP-1 cells. The kinetics of the receptor-associated kinase activity paralleled the appearance of tyrosine phosphorylation events observed following Fc gamma RII activation of THP-1 cells. Several proteins were associated with the receptor. Reimmunoprecipitation analysis demonstrated that lyn gene products were among the proteins coprecipitated with Fc gamma RII. p59hck (Hck) and p56lyn (Lyn) were the most abundant Src-related PTKs (Src-PTKs) in THP-1 cells. Enzymatic activity of both kinases, as measured by an in vitro kinase assay, was increased following specific cross-linking of Fc gamma RII. Furthermore, Fc gamma RII was specifically associated with both enzymes following its engagement and served as a substrate for both of these kinases. The association of Fc gamma RII with Src-PTK was specific for Fc gamma RII activation of THP-1 cells, since activation of cells via the high affinity Fc gamma receptor, Fc gamma RI (CD 64), did not result in association of Fc gamma RII with Hck or Lyn. Our data demonstrate a functional and physical association of Fc gamma RII with Hck and Lyn consistent with the involvement of Src-PTK in Fc gamma RII-mediated signal transduction.

Amino Acid Sequence↗

PubMed2003

Improved fitness narrows the symptom-reporting gap between older men and women.

PURPOSE: Functional differences between the sexes are well documented. The causes of functional decline are complex, but in general, women report more functional decline and have a greater prevalence of disabling chronic conditions than do men. The role of exercise training in attenuating functional decline has not been studied extensively. Therefore, the purpose of this study was to compare sex differences in adaptations to exercise training in measures of physical function (physical performance and self-report) and symptom reporting. METHODS: Men and women (n = 114, ages 65-90) performed purely aerobic exercises (walking or stationary cycling) or a combination of aerobic plus spinal flexibility exercises for 1 hour 3 days a week for 3 months in a supervised, hospital-based setting. Outcome measures assessed in a blinded fashion at baseline and 3 months included physical performance (10-meter walk time, timed bed mobility, 360-degree turn time), self-reported physical function and disability (Nagi and Rosow-Breslau disability questions and SF-36 Physical Function Scale), and symptoms (number of symptoms, pain, shortness of breath, fatigue, and muscle weakness). RESULTS: At baseline, men had better physical performance scores and fewer functional limitations and reported fewer symptoms than women. Following exercise training, women, but not men, improved in most measures of physical function and reported fewer symptoms. The absence of change among the men is most likely due to ceiling effect measures of physical function among the men. CONCLUSIONS: We conclude that among functionally impaired women, exercise training has a positive effect on physical disability and symptom reporting. Exercise training attenuated the gap in self-reported symptoms between men and women in this study.

Aged↗

PubMed2006

A nonrandomised controlled trial of endovenous laser therapy and surgery in the treatment of varicose veins.

Endovenous laser therapy (EVLT) is a minimally invasive treatment for varicose veins. This study compares early quality-of-life (QoL) outcomes following EVLT and surgery. Two nonrandomized groups were studied: an EVLT group with 70 patients, median age 49 (interquartile range [IQR] 35-58) years, and a surgery group with 62 patients, median age 49 (IQR 35-61) years. Patients were assessed prior to and at 1, 6, and 12 weeks following the procedure using the Short Form 36 (SF-36), the Aberdeen Varicose Veins Questionnaire (AVVQ), and the Venous Clinical Severity Score (VCSS). Follow-up at 1, 6, and 12 weeks was 100%, 77%, and 70% following EVLT and 100%, 85%, and 47% following surgery. SF-36 scores were significantly better in the EVLT group at 1 week (Physical Functioning, Role Physical, Bodily Pain, Vitality, and Social Functioning domains) and at 6 weeks (Physical Functioning and Role Physical). At 12 weeks, no significant differences were evident between the groups. AVVQ scores were significantly better in the EVLT group at 6 and 12 weeks. VCSS scores were significantly improved in both groups at 12 weeks. EVLT and surgery provide similar QoL improvements in patients with varicose veins. EVLT, however, removes the QoL limitations experienced by patients in the early postoperative period.

Activities of Daily Living↗

PubMed2006

The relationship between activity and pain in patients 6 months after lumbar disc surgery: do pain-related coping modes act as moderator variables?

BACKGROUND: In LBP patients, the relationship between pain and physical activity remains unclear. Whereas a negative relationship between pain and self-reported physical activity was found, this relation disappeared in the case of overt behavioral data (e.g., accelerometer). Cognitive-behavioral models of the development of chronic pain suggest subgroups with signs of physical underuse and overuse. AIMS: To examine if patients with pain-related adaptive, endurance and fear-avoidance coping differ in pain, self-reported physical function and overt physical activity 6 months after disc surgery. METHODS: 24 patients completed questionnaires (Von Korff chronic pain grade (CPG), Kiel pain inventory (KPI), Funktionsfragebogen Hannover-Rücken FFbH-R) and underwent an 8-h accelerometer assessment in their daily life (physical activity level (PAL), number of constant postures (CP)). The KPI differed between adaptive coping (AC) (N=9), fear avoidance coping (FAC) (N=1) and endurance coping (EC) (N=14). RESULTS: In the whole group, pain intensity was negative related to self-reported physical activity whereas PAL and CP displayed no correlation with pain. EC patients showed significantly higher pain scores and lower self-reported physical functioning compared to AC but the same level of PAL and furthermore, a significantly higher number of CPs in daily life. The visual inspection of the FAC patient revealed also high pain, low physical functioning and low overt physical activity. CONCLUSIONS: The assessment of pain-related coping modes yielded an important differentiation between subgroups of LBP patients 6 months after surgery. Endurance copers displayed signs of overuse in their daily behavior in spite of pain than adaptive copers. The one fear avoidance coper tends to do less physical activity in the sense of underuse.

Adaptation, Psychological↗