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Results for “Physical Functional Performance”

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At least 793 records · Page 44Linked to original sources

PubMed2002

A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia.

BACKGROUND: Decline in physical functional ability is an intrinsic component of the dementia syndrome. Reductions in muscle mass and strength represent a major factor in the loss of functional ability Although resistance exercise has been studied as a method for maintaining/recovering function in populations of frail older adults, people with dementia have been systematically excluded because of uncertainty about the reliability of outcome measurements. OBJECTIVE: The purpose of this study was to determine the test-retest reliability of a battery of established performance-based measures of strength and function among subjects with dementia. SETTING: A hospital-affiliated adult day-care facility. SUBJECTS: Twelve of 28 older subjects with dementia of various etiologies were available for two assessments prior to implementation of a resistance-exercise intervention. METHODS: Subjects underwent an assessment of lower extremity strength and physical function consisting of two recorded trials of bilateral isometric strength of the knee extensor, hip flexor, and dorsiflexor muscles, as well as hand grip strength; repeated chair stands, evaluation of usual- and maximal safe-gait speed over a 6-m course, and the Timed-Up-and-Go Test. The entire assessment was repeated approximately 1 week later. An average of the trials for each measurement was computed for each of the two assessment periods, and intraclass correlation coefficients (ICCs) for these paired measurements were estimated using STATA. RESULTS: ICCs ranged from .56 for left iliopsoas to .77 for left dorsiflexors among the strength measures whereas measures of function ranged from .80 for number of steps in usual gait to .95 for time of fast gait. CONCLUSIONS: Performance-based measures of strength and function can be reliably assessed in older people with dementia, although measures of function appear to be more reliable than measures of strength.

Activities of Daily Living↗

PubMedDate not supplied

Prostate cancer and health-related quality of life: a review of the literature.

With the established effectiveness of diverse treatments for prostate cancer, identification of the physical and psychosocial consequences of the disease and various treatments becomes critical. We review the literature on the effects of prostate cancer and its treatment on health-related quality of life (HRQoL). Studies show that prostate cancer and its treatment affect both disease-specific HRQoL (i.e. urinary, sexual, and bowel function) as well as general HRQoL (i.e. energy/vitality, performance in physical and social roles). Yet, these effects appear to differ across stage of disease and type of treatment. We outline evidence from three sources: (1) studies that compare men with the disease with an age-matched sample of men without the disease, (2) studies that assess men with the disease across time, and (3) cross-sectional studies that highlight predictors of HRQoL. Future research directions are discussed.

Aged↗

PubMed2000

Correlates of delayed referral for the diagnosis of dementia in an outpatient population.

BACKGROUND: Early diagnosis of dementia is critical, but there is usually a time lag between onset of symptoms and referral for neuropsychological testing and dementia diagnosis. We aimed to identify factors correlated with this delayed referral. METHODS: We studied 140 patients with cognitive deterioration referred to the Memory Clinic of the Catholic University (Rome) between 1995 and 1996. Alzheimer's disease or multi-infarct dementia was diagnosed according to National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria and Hachinski ischemic score. Global cognitive and neuropsychological functions were assessed with the Mini-Mental State Exam (MMSE) and the Mental Deterioration Battery. The performance on the Activities of Daily Living was used to measure physical function. The time between onset of signs of cognitive deterioration and referral for diagnosis (time to diagnosis: TTD) was estimated through a semistructured interview of the caregiver. Independent correlates of TTD were identified after adjustment for potential confounders and stratifying patients based on level of physical function. RESULTS: Of 127 eligible patients, 63% had Alzheimer's disease, 26% multi-infarct dementia, and 11% had dementia of other types. Mean age was 73.9 +/- 8.2 years, and 59% of patients were females. The mean TTD was 13.8 +/- 10.8 months and did not differ by gender, household composition, or type of dementia. For patients with normal physical function, increased age (beta = .50), female sex (beta = .51), and low MMSE score (beta = .36) were associated with longer TTD. Among patients with physical impairment, only MMSE score showed an association with TTD, but it was of opposite direction (beta = -.31). These associations were consistent by type of dementia. CONCLUSIONS: Age, gender, and degree of cognitive impairment are important correlates of the time between onset of signs/symptoms and referral for dementia diagnosis. These factors are independent of the type of dementia but are influenced by the level of physical function.

Activities of Daily Living↗

PubMed1994

Quality of life of cancer patients with different prognoses.

This study examines differences and similarities in the quality of life of 253 cancer patients with good, medium and poor prognoses. Our main hypothesis was that patients with a good prognosis will experience a higher quality of life than patients with a medium or poor prognosis. A multivariate analysis of covariance of eight quality of life scales was performed with prognosis as a factor and with age, sex, and the duration of the illness as covariates. Significant main effects of prognosis were found for the general QOL-scale and for physical aspects of quality of life. There were, however, only marginal and non-significant effects of prognosis groups on social and psychological functioning. A final multivariate analysis confirms earlier findings that performance status shows a weak but significant relationship with the psychological functioning. Thus, the physical condition of the patient at the time of measurement seems to have some influence on the psychological functioning, whereas the severity of the disease as indicated by the classification into prognosis groups does not. These results question the general attitude that seriously ill cancer patients have reduced social and psychological well-being. An alternative interpretation is that the scales used to measure psychological aspects of quality of life are inadequately sensitive.

Adult↗

PubMed2006

Progressive resistance exercise for people with multiple sclerosis.

PURPOSE: This study aimed to determine if participation in a progressive resistance exercise (PRE) programme can: (1) increase the ability to generate maximal muscle force, (2) increase muscle endurance, (3) increase functional activity, and (4) improve overall psychological function of people with multiple sclerosis (MS). METHODS: A pre-post single group research design with a 4-week baseline familiarisation phase was used. Nine people (mean age 45.6 years, SD 10.7) with MS attended a gymnasium three times over 4 weeks for familiarization. Participants then completed a twice-weekly 10-week PRE programme, with two sets of 10 - 12 repetitions of each exercise. Outcome measures of muscle strength (1RM for arms and legs), muscle endurance (repetitions at half 1RM), walking speed, the 2-min walk test (2MWT), a timed stairs test, and the impact of MS on physical and psychological function were taken at weeks 2, 4, and 14. RESULTS: Participants attended 94.3% (SD 8.2%) of the training sessions, with no adverse events. After accounting for baseline stability, significant improvements (P < 0.05) were found in arm strength (14.4%), leg endurance (170.9%), fast walking speed (6.1%), and there was a trend for increased distance in the 2MWT (P = 0.06). The perceived impact of MS on physical function was reduced (P = 0.02). CONCLUSIONS: Adults with MS benefited from a PRE programme by improving muscle performance and physical activities, without adverse events. These findings suggest that PRE may be a feasible and useful fitness alternative for people with mild to moderate disability due to MS.

Adult↗

PubMed2001

Performing the exercise test.

Exercise testing is useful in assessing physical fitness, determining functional capacity, diagnosing ischemic heart disease, defining the prognosis of ischemic heart disease, developing an exercise prescription, and guiding cardiac rehabilitation. This article outlines the current indications, contraindications, and special considerations for exercise testing. Specific protocols are discussed along with physician responsibilities for performing this procedure. A summary of current testing equipment is included.

Cardiovascular Diseases↗

PubMed2002

The Performance Enhancement Project: improving physical performance in older persons.

OBJECTIVE: To determine the effects of center-based exercise on physical performance in older persons at risk for decline in physical functioning. DESIGN: Randomized controlled trial. SETTING: Senior centers. PARTICIPANTS: A total of 155 community-dwelling persons, 78.7% women, ages 70 years and older (mean +/- standard deviation, 77.0+/-4.5y), with mobility impairments. INTERVENTION: Intervention volunteers (n=80) exercised at a center (endurance, strength, balance, flexibility) 3 times weekly, for months 1 to 6; once weekly, for months 7 to 12 with home exercise 2 sessions a week; and at home only, for months 13 to 18. Home control volunteers (n=75) were instructed in home endurance exercise. MAIN OUTCOME MEASURES: MacArthur battery, Physical Performance Test (PPT-8), and 6-Minute Walk Test (6MWT) at baseline and 3, 6, 12, and 18 months. RESULTS: MacArthur battery scores improved in intervention compared with home control at 3, 6, and 12 months (repeated-measures analysis of variance: group x time, P<.05) but not 18 months. PPT-8 and 6MWT did not improve. Intervention group assignment, younger age, and better baseline physical function and self-perceived health were independent predictors of long-term MacArthur battery score improvement. CONCLUSIONS: Compared with home control, center-based exercise improved gait, chair rise time, and balance over 1 year. Improvements were not sustained with transition to home exercise for months 13 to 18. Classes may be necessary to maintain improvements in older persons attending center-based exercise.

Activities of Daily Living↗

PubMed1990

Age-related changes in skeletal muscle function.

This review examines current evidence for the existence of aging processes in skeletal muscle fibers. Experimental data demonstrating changes with age in nerve-muscle interaction, excitation-contraction coupling, mechanical properties and muscle energetics are discussed, with emphasis on factors in addition to aging which might account for the observed results. The effects of dietary restriction, exercise and disease on age-related changes in muscle function are also discussed. Results of recent studies highlight the need to establish the health status of subjects and animals used for aging research as well as the need to obtain data from a wide variety of muscles. Although marked decline of muscle performance with age is documented by early studies, recent work indicates that at least some muscles of healthy individuals and animals do not show an age-related decline in function or an impaired ability to respond to exercise. Decreased physical performance in the elderly may be due to factors extrinsic to aged skeletal muscle fibers.

Aging↗

PubMed1988

Slow potential correlates of frontal function, psychosis, and negative symptoms.

The contingent negative variation (CNV) was used to study cortical activation in frontal and central areas in psychotic and nonpsychotic patients. Psychotic patients showed a higher frontal relative to central CNV amplitude than nonpsychotic patients, a finding that was correlated with performance on a test of frontal function. Negative symptom ratings (physical anhedonia and social closeness) were correlated with relatively low frontal versus central CNV amplitude, but only in psychotic patients.

Adult↗

PubMedDate not supplied

Neuromuscular performance in normal and anterior cruciate ligament-deficient lower extremities.

The neuromuscular function of the lower extremity in 40 normal and 100 anterior cruciate ligament-deficient volunteers was evaluated by physical examination, KT-1000 arthrometer measurements, isokinetic strength and endurance testing, subjective functional assessment, and an anterior tibial translation stress test. A specially designed apparatus delivered an anteriorly directed step force to the posterior aspect of the leg while anterior tibial translation was monitored and electromyographic signals were recorded at the medial and lateral quadriceps, medial and lateral hamstrings, and gastrocnemius muscles. Testing was done at 30 degrees of knee flexion with the foot fixed to a scale to monitor weightbearing, while the tibia remained unconstrained. Results indicate that muscle timing and recruitment order in response to anterior tibial translation are affected by anterior cruciate ligament injury. These alterations in muscle performance change with time from injury, correlate with an individual's physical activity level, affect subjective functional parameters, and are directly related to the degree of dynamic anterior tibial laxity seen with stress testing.

Adult↗

PubMed2006

Psychological pain treatment in fibromyalgia syndrome: efficacy of operant behavioural and cognitive behavioural treatments.

The present study focused on the evaluation of the effects of operant behavioural (OBT) and cognitive behavioural (CBT) treatments for fibromyalgia syndrome (FMS). One hundred and twenty-five patients who fulfilled the American College of Rheumatology criteria for FMS were randomly assigned to OBT (n = 43), CBT (n = 42), or an attention-placebo (AP) treatment (n = 40) that consisted of discussions of FMS-related problems. Assessments of physical functioning, pain, affective distress, and cognitive and behavioural variables were performed pre-treatment and post-treatment as well as 6 and 12 months post-treatment. Patients receiving the OBT or CBT reported a significant reduction in pain intensity post-treatment (all Fs > 3.89, all Ps < 0.01). In addition, the CBT group reported statistically significant improvements in cognitive (all Fs > 7.95, all P < 0.01) and affective variables (all Fs > 2.99, all Ps < 0.02), and the OBT group demonstrated statistically significant improvements in physical functioning and behavioural variables (all Fs > 5.99, all Ps < 0.001) compared with AP. The AP group reported no significant improvement but actually deterioration in the outcome variables. The post-treatment effects for the OBT and CBT groups were maintained at both the 6- and 12-month follow-ups. These results suggest that both OBT and CBT are effective in treating patients with FMS with some differences in the outcome measures specifically targeted by the individual treatments compared with an unstructured discussion group. The AP group showed that unstructured discussion of FMS-related problems may be detrimental.

Adult↗

PubMed2005

Risk factors of bronchial hyperresponsiveness in children with wheezing-associated respiratory infection.

The objectives of this study were to identify possible risk factors of bronchial hyperesponsiveness (BHR) in children up to 5 years of age with wheezing-associated respiratory infection (WARI), and to study the prevalence of BHR. Children up to 5 years of age with WARI were enrolled in the study. The parents or caregivers of children were asked about their demographic data and clinical histories. Physical examination and clinical score assessment were performed. Pulmonary function tests, i.e., tidal breathing flow volume (TBFV), were performed to measure tidal breathing parameters before and after salbutamol nebulization. If volume at peak tidal expiratory flow/expiratory tidal volume and time to peak expiratory flow/total expiratory time increased > or = 20%, or tidal expiratory flow at 25% of tidal volume/peak tidal expiratory flow increased > or = 20% after nebulization therapy, BHR was diagnosed. The number in the positive BHR group was used to calculate the prevalence of BHR, and clinical features were compared with those of the negative BHR group. Categorical data were analyzed for statistical significance (P < 0.05) by chi-square test or Fisher's exact test, or Student's t-test, as appropriate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for those with statistical significance. One hundred and six wheezing children underwent pulmonary function tests before and after salbutamol nebulization. With the aforementioned criteria, 41 cases (38.7%) were diagnosed with BHR. History of reactive airway disease, (OR, 6.31; 95% CI, 1.68-25), maternal history of asthma (OR, 3.45; 95% CI, 1.34-9), breastfeeding less than 3 months (OR, 3.18; 95% CI, 1.26-8.12), and passive smoking (OR, 3; 95% CI, 1.15-7.62) were significant risk factors of BHR. The eosinophil count was significantly higher in the BHR (+) group particularly, in children 1-5 years of age (P < or = 0.01). Patchy infiltrates were more commonly found in patients with negative BHR but not statistically significant. In conclusion, a history of reactive airway disease, maternal history, breastfeeding less than 3 months, and passive smoking were significant risk factors for BHR.

Administration, Inhalation↗

PubMed2003

Living with chronic renal failure: patients' experiences of their physical and functional capacity.

BACKGROUND AND PURPOSE: Several studies have shown that patients with chronic renal failure have reduced physical exercise capacity compared with the expected norm. There are, however, few qualitative studies showing ways in which patients experience their condition in terms of physical and functional capacity, and the limitations this imposes on their daily lives. The aim of the present study was to describe and analyse ways in which patients with chronic renal failure, in the pre-dialysis phase and patients undergoing haemodialysis or peritoneal dialysis, experienced their physical and functional capacity in their daily lives. METHOD: Semi-structured interviews were used to collect data, which were then analysed according to a contextual analysis within a phenomenographic approach. RESULTS: Analysis yielded a system of categories describing patients' experiences of mental and physical fatigue, physical and functional capacity, in terms of effect on performance and endurance, and their experience of temporal stress, in terms of lack of time as well as lack of peace in their daily lives. CONCLUSIONS: The results of the study will contribute to our understanding of how these patients experience their daily lives, and will help when meeting patients with chronic renal failure. This knowledge enables physiotherapists to focus rehabilitation training on problem areas that are important to patients themselves.

Activities of Daily Living↗

PubMed1994

Another brick in the wall? Recent developments concerning the yeast cell envelope.

To a yeast, the cell wall is an important living organelle performing a number of vital functions, including osmotic and physical protection, selective permeability barrier, immobilized enzyme support and cell-cell recognition and adhesion. Our basic model of wall structure involves attachment of secreted mannoproteins to a fibrillar inner layer of beta-glucan. Recent work has emphasised the importance of chitin in lateral walls, examined the mechanisms of attachment of mannoproteins to the various cell wall glucan fractions and elucidated the pathway of beta-glucan synthesis, by means of resistance to glucan-binding killer toxins. The conventional view of wall structure has been challenged by the discovery of a class of GPI-anchored, serine/threonine-rich wall-proteins. It has been suggested, that these proteins are anchored in the plasma membrane, spanning the wall with extended O-glycosylated structures and protruding out into the medium. Examination of these proteins shows a diversity of structures, sizes and behaviour that makes it improbable that these represent a new class of wall proteins. The possible roles of one of these proteins associated with flocculation, Flo1p, are discussed.

Cell Wall↗

PubMed2005

Ultrasonography for the endocrine surgeon: a valuable clinical tool that enhances diagnostic and therapeutic outcomes.

BACKGROUND: Surgeon-performed ultrasonography (U/S) has revolutionized many subspecialties by broadening the diagnostic and interventional scope of practice. We report our experience on the impact of surgeon-performed U/S in an endocrine surgery practice. METHODS: Prospectively maintained records of patients from November 1999 to November 2004 were reviewed to establish patterns and outcomes of U/S practice. Surgeon-performed neck U/S was done routinely at the initial clinic visit and incorporated into resident/fellow education. RESULTS: A total of 5703 U/S were performed on endocrine patients with thyroid 42%, parathyroid 57%, and adrenal 1% disorders. Diagnostic fine-needle aspiration biopsy (FNA) was achieved with low sampling errors (<7%). When U/S identified thyroid nodules coexisting with hyperparathyroidism, preoperative FNA correctly established benign thyroid diagnosis and minimized need for thyroidectomy. U/S successfully imaged abnormal parathyroid glands when (99)Tc-sestamibi scans were negative. U/S data significantly changed treatment plans in nearly two thirds of thyroid cancer patients. Surgical residents readily mastered essential U/S skills. CONCLUSIONS: Surgeon-performed U/S is a highly specific tool for identification of endocrine disease in the neck. It is learned readily and performed accurately, and functions as an informative extension of physical examination. Because it substantially benefits patient care and impacts surgical decision making, neck U/S is recommended highly as a valuable adjunct to endocrine surgical practice.

Ambulatory Care↗

PubMed2003

Assessment of driving performance in patients with relapsing-remitting multiple sclerosis by a driving simulator.

OBJECTIVE: To compare the driving performance using a driving simulator with physical and cognitive functions as measured by the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients suffering from the relapsing-remitting form of multiple sclerosis (RRMS). METHODS: 31 RRMS patients (18 women, 13 men, mean age 35.6 +/- 8.3 years, EDSS 2.8 +/- 1.4) were compared with 10 healthy controls (8 men, 2 woman, age 45.1 +/- 7.8 years). RESULTS: Compared with controls, the accident rate (5.3 +/- 3.8 vs. 1.3 +/- 1.5, p < 0.001) and concentration faults (21.1 +/- 15.5 vs. 7.1 +/- 2.6, p < 0.01) of RRMS patients using the driving simulator were increased. While there was no correlation with the EDSS score, the accident rate was correlated with the MSFC (r = -0.5, p < 0.05). Regarding the three dimensions of the MSFC, accidents were related to the number of correct answers and Z-score in the paced auditory serial addition test (PASAT) as a measure for cognitive function (r = -0.33, p < 0.05). CONCLUSION: The current study demonstrates the need to focus also on driving skills in MS patients. The risk of accidents should be evaluated after relapses in particular. However, there are great interindividual differences. In the MSFC, most deficits could be evaluated in the PASAT. As there was a significant correlation between the accident rate in the driving simulator and the PASAT results, accidents seem to be more influenced by cognitive decline than by physical impairment. This indicates that the MSFC is a broader, more dimensional scale than the EDSS and should be preferred in the case of driving assessment. At the present time, the driving simulator seems to be a useful instrument judging driving ability, especially in cases with ambiguous neuropsychological results.

Adult↗

PubMed1982

Sudden death in hypertrophic cardiomyopathy: a profile of 78 patients.

The clinical profile of 78 patients with hypertrophic cardiomyopathy who died suddenly (or experienced cardiac arrest and survived) was analyzed. At the time of cardiac catastrophe, 71% of the patients were younger than 30 years of age, 54% were without functional limitation and 61% were performing sedentary or minimal physical activity. Nineteen of the 78 patients (24%) were taking propranolol in apparently adequate dosages, indicating that this drug does not provide absolute protection against sudden death. No clinical or morphologic variable was particularly reliable in identifying patients at risk for sudden death. Forty-eight of 62 patients (77%) who died suddenly had a markedly increased ventricular septal thickness of 20 mm or more; however, mean septal thickness was similar in patients who died suddenly (25.2 +/- 0.9 mm) and in age- and sex-matched control patients with hypertrophic cardiomyopathy who have survived (23.6 +/- 0.8 mm). An abnormal ECG was present as often in patients who died suddenly as in control patients who have survived, (51 or 53, 96%). In addition, no particular cardiac symptom or hemodynamic variable (such as the magnitude of left ventricular outflow tract obstruction under basal conditions or left ventricular end-diastolic pressure) was characteristic of the patients with hypertrophic cardiomyopathy who died suddenly.

Adolescent↗

PubMedDate not supplied

Quality of life as a therapeutic end-point. An analysis of therapeutic trials in hypertension.

The term 'quality of life' is finding increasing use in the popular press and the medical community. In both areas, its use often lacks precision: a comprehensive and universal definition probably does not exist. Indeed, the precise elements contributing probably vary from person to person and from time to time. There is broad agreement that 5 major areas always need assessment, including physical and emotional state, performance of social roles, intellectual function and general feelings of well-being or life satisfaction. A wide range of instruments has been employed in a large number of studies on the effects of antihypertensive agents on quality of life in the patient with hypertension. Hypertension represents a special problem in which the patient is thought to be free of related symptoms, and treatment designed to improve natural history brings with it the burden of adverse reactions. Although some insights have been gained on the relative influence of various therapeutic regimens on the quality of life of treated patients, in many of the studies too little consideration has been given to the use of instruments that have been validated in the patient population to be studied, to the power of the study and its design, to the contribution of confounding variables such as age and gender, and to evidence that short term trials (measured in weeks) can miss important changes that occur over months in a process where treatment is life-long. For these reasons, we believe, the literature on the subject is burdened by many reports that describe no difference among treatment regimens where important differences might exist. On the positive side, important advances have been made in our understanding of the elements that contribute to quality of life and in approaches to its assessment.

Humans↗