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Results for “Physical Functional Performance”

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PubMed2003

Can older cancer patients tolerate chemotherapy? A prospective pilot study.

BACKGROUND: To the authors' knowledge, few data currently are available regarding the tolerance to chemotherapy in older cancer patients. This prospective pilot study evaluated the changes in functional, mental, nutritional, and comorbid status, as well as the quality of life (QOL), in geriatric oncology patients receiving chemotherapy. METHODS: Sixty patients age > or = 70 years who were undergoing cancer chemotherapy were recruited in a university-based comprehensive cancer center. Changes in physical function were measured by the Eastern Cooperative Oncology Group performance status (ECOG PS) and Instrumental Activities of Daily Living (IADLs), mental health changes were measured by the Mini-Mental State Examination and the Geriatric Depression Scale (GDS), comorbidity was measured by Charlson's index and the Cumulative Illness Rating Scale-Geriatric, nutrition was measured by the Mini-Nutritional Assessment, and QOL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G). Changes were assessed at baseline and at the end of treatment (EOT). Grade 4 hematologic and Grade 3-4 nonhematologic toxicities were recorded. RESULTS: Thirty-seven patients (63%) completed both assessments. Older cancer patients demonstrated a significant decline in measurements of physical function after receiving chemotherapy, as indicated by changes in scores on the IADL (P = 0.04) and on the physical (P = 0.01) and functional (P = 0.03) subscales of the FACT-G. They also displayed worse scores on the GDS administered postchemotherapy (P < 0.01). Patients who experienced severe chemotoxicity had more significant declines in ECOG PS (P = 0.03), IADL (P = 0.03), and GDS (P = 0.04), and more gain in the social well-being subscale (P = 0.02) of the FACT-G, than those who did not experience severe chemotoxicity. However, changes in most scores were small in magnitude clinically. No significant change was found between baseline and EOT in nutrition, comorbidity, and other aspects of the FACT-G. CONCLUSIONS: Older cancer patients undergoing chemotherapy may experience toxicity but generally can tolerate it with limited impact on independence, comorbidity, and QOL levels. It is important to recognize and monitor these changes during geriatric oncology treatment.

Activities of Daily Living↗

PubMed1993

Social functioning and general well-being in patients treated with clean intermittent catheterization.

Social role function, health perceptions and general well-being were studied longitudinally over 1 yr in 149 males and 153 females performing clean intermittent catheterization (CIC). The evaluation included urological assessments and self-rating instruments (Revised Physical Battery, General Health Questionnaire--28 items, State Anxiety Inventory and CIC Pain and Discomfort Scale). Twenty-six percent reported major improvement in their overall quality of life, while 7% reported a wish to be dead and away from it all. Females with infranuclear lesions and detrusor myopathies scored higher on unpleasant health perceptions, state anxiety and physical discomfort by performing CIC than males. In males, the social role function 1 yr later was predicted by initial anxiety and urinary tract infections, whereas in females by initial anxiety only. Discomfort by CIC was predicted by initial infection in males, and by none or moderate medical comorbidity, initial depression and infection in females.

Adaptation, Psychological↗

PubMed2005

A randomized phase II trial of capecitabine and two different schedules of irinotecan in first-line treatment of metastatic colorectal cancer: efficacy, quality-of-life and toxicity.

BACKGROUND: To determine the efficacy, impact on quality-of-life (QoL) and tolerability of two different irinotecan administration schedules in combination with capecitabine as first-line treatment of metastatic colorectal cancer. PATIENTS AND METHODS: We carried out a randomized phase II trial to select one of the following treatment regimens for further investigation: weekly irinotecan at a dose of 70 mg/m(2) days 1, 8, 15, 22, 29 (arm A) or 3-weekly irinotecan at a dose of 300/240 mg/m(2) day 1 and days 22 (arm B) in combination with capecitabine 1000 mg/m(2) twice daily days 1-14 and days 22-35 every 6 weeks. RESULTS: Seventy-five patients with good performance status entered the trial. The two arms were well balanced for relevant patient and disease characteristics. The most frequent toxic effects were grade 3/4 diarrhea (arm A: 34%, B: 19%), grade 3/4 neutropenia (A: 5%, B: 19%) and grade 2/3 alopecia (A: 26%, B: 65%). Other grade 3/4 toxic effects were rare (<5%). Response rates were 34% [95% confidence interval (CI) 20% to 51%] in arm A and 35% (95% CI: 20% to 53%) in arm B. Median time to progression was 6.9 (4.6-10.1) and 9.2 (7.9-11.5) months and median overall survival was 17.4 (12.6-23.0+) and 24.7 (16.3-26.4+) months. Patients with an objective tumor response reported better physical well-being (P < 0.01), mood (P < 0.05), functional performance (P < 0.05) and less effort to cope (P < 0.05) compared with the non-responders and stable disease patients. CONCLUSIONS: The primary end point of this study was the objective response rate and based on the statistical design of the trial, the 3-weekly irinotecan schedule was selected over weekly irinotecan administration. The 3-weekly irinotecan schedule also seemed advantageous in terms of grade 3/4 diarrhea, time to progression, overall survival and patient convenience, but the study was not designed to detect differences in these parameters. In addition, tumor response was shown to have a beneficial effect on QoL indicators.

Adult↗

PubMed1975

[Effects of rapeseed oil on production of corticosterone by rats subjected to stresses (physical effort, cold].

Investigations were carried out on male Wistar rats from an own animal farm of the Institute of Food and Nutrition. The animals were kept on two types of diet containing 50 p. 100 of calories from rapeseed or sunflower oil. The investigations on the effect of rapeseed oil on functional changes of rat adrenals in animals exposed to graded physical exercise were performed on 40 rats aged 3.5 months at the beginning of the experiment. The animals were divided into two groups and were given during 6 weeks diets containing rapeseed or sunflower oil. Then, each group was divided into two subgroups. Administering further these diets one subgroup was left without physical exercise during 7 days, the 2nd group was exposed to graded physical exercise during 45 min. daily during 7 days. Physical exercise was graded by means of special rotating drums driven electrically and provided with running-tracks. Each rat had a daily run of 630 m., and during 7 days this distance was 4 410 m. The investigations on the effect of rapeseed oil on functional changes of rat adrenals in animals exposed to low temperature were performed on 40 rats aged 3.5 months at the beginning of experiment. After 6 weeks on diets each of the two groups was divided into two subgroups. Administering further the same diets one group was left in the laboratory and the other subgroup was placed for 2 weeks in a room at 4 degrees C. After the experiment the animals were decapitated and their adrenals and plasma were taken for corticosterone determinations by the fluorimetric method. Differences were demonstrated in the effects of rapeseed oil and sunflower oil during these stresses. During graded physical exercise the corticosterone level in the adrenals of rats kept on diet with rapeseed oil was unchanged, while it rose significantly in the group receiving sunflower oil. In the plasma the corticosterone level increased during physical exercise in both groups, but in the group receiving rapeseed oil this increase was lower. During exposure to low temperature the adrenal corticosterone level decreased in the group receiving rapeseed oil and was unchanged in the group on sunflower oil. In the plasma the corticosterone level increased on exposure to low temperature in both groups but less in the group receiving rapeseed oil as compared with the group on sunflower oil.

Adrenal Glands↗

PubMed2000

Employment and social issues in adults with cerebral palsy.

OBJECTIVE: To assess the social and employment status of adults with cerebral palsy. DESIGN: Detailed medical history, physical examination, and functional rating in the PULTIBEC system were performed on all study participants; they also responded to a standardized social adaptation questionnaire. SETTING: Outpatient clinic. SUBJECTS: Volunteer participants (n = 101), all with cerebral palsy, between the ages of 27 and 74 years, living independently in the community. RESULTS: More than 80% wished that their physician knew more about cerebral palsy. The majority (84%) felt their parents overprotected them in childhood. More than 90% desired more sexual education. More than half (67%) lived independently, 34% with and 33% without attendant. Of the 53% who were competitively employed, 22% earned an income high enough that advancement would cause financial loss through termination of disability benefits. Speech deficits severely compromised functional verbal communication in 50%. Type of employment correlated more with adequate cognition than with physical or communicative impairments. CONCLUSIONS: Compared with earlier studies, the present study showed more adults with cerebral palsy achieving competitive employment and independent living, despite moderate to severe physical disability. Advances in rehabilitation technology, better home support services, and legal mandates in education and environmental access may have facilitated positive change for persons with cerebral palsy. Further studies are encouraged with emphasis on longitudinal designs.

Activities of Daily Living↗

PubMed2006

Work status and chronic low back pain: exploring the International Classification of Functioning, Disability and Health.

PURPOSE: Exploring which variables are related to work status in patients with chronic low back pain (CLBP), classified according to the International Classification of Functioning, Disability and Health (ICF). METHOD: Ninety-two patients with CLBP filled out questionnaires inquiring after health status, impairments in body functions/structures, limitations in activities of daily living (ADL), participation in work, environmental and personal factors. Additionally, patients performed tests to measure physical fitness and performance of work-related activities. Univariate analyses were performed to investigate whether differences exist between working and non-working patients. Logistic linear regression analysis was performed to explain work status from the variables of functioning. RESULTS: Non-working patients had a lower self-reported physical and mental health, lower physical fitness, more self-reported limitations in ADL, lower education, more depressive symptoms and higher psycho neuroticism than working patients. Self-reported physical and mental health and educational level correctly classified 84.5% of the patients as working or non-working. Performance of work-related activities was not significantly related with work-status. CONCLUSIONS: The relation between work status and CLBP is multidimensional, as was illustrated by using the bio-psychosocial model of the ICF. Patients with a low educational level, a low self-reported physical or mental health were more likely to be non-working. Self-reported limitations and physical and mental health are more important in explaining work status than objective measurements of performance.

Activities of Daily Living↗

PubMed1981

Functional assessment for heavy physical labor.

It is proposed that assessment of a worker who performs manual labor must include specific tests of physical capability. Such tests must meet certain criteria to be accepted as medically, economically and legally justified. The medical and economic justification for such tests is recognized by all concerned with controlling the excessive costs and human suffering associated with over-exertion strain/sprain injury and illness in industry. The legal basis for such tests is not well established and will not exist until a documented history of success or failure is developed in the courts for different types of tests. It is hoped that as various tests are developed by medical departments the criteria stated in the first part of this article will be of assistance. As to the status of isometric strength testing for employee selection and placement, it is being implemented as part of the medical examination in a number of large industries as an experimental medical procedure. Data are being continually gathered to further validate and refine the procedures. It is discussed in this contest as one of several methods which needs to be considered and evaluated to reduce musculoskeletal injury and illness in industry.

Accidents, Occupational↗

PubMed1982

Physical activity in liver disease and liver function in sportsmen.

Patients with liver disease are often incorrectly restricted in their physical activity. Several studies have shown that physical activity is not detrimental to acute viral hepatitis but it is customary to advise rest in the initial phase of nausea, abdominal pain and fatigue. As soon as these symptoms decline the patient can take part in physical activity. As regards chronic hepatitis and cirrhosis there are divergent views. No restrictions are placed upon patients with chronic active hepatitis in remission. This is also true for the early stage of cirrhosis, while muscle atrophy in more prolonged cases will set a natural limit to the patient's performance. The effect of physical activity on patients with a porto-caval shunt has not been studied. In well trained sportsmen there is no evidence that physical activity within the limits of human performance has an unfavourable effect on liver function.

Adolescent↗

PubMed1997

Changes in physical capacity and sensory/psychomotor functions from 75 to 80 years of age and from 80 to 85 years of age--a longitudinal study.

The purpose of the study was to describe the performance of initially 75- and 80-year-old men and women in physical, sensory and psychomotor tests, to analyse longitudinal changes in these measures over a five-year follow-up period, and to ascertain if the performance in these measures is predictive for survival. At baseline, all 75- and 80-year-old men and women living in the town of Jyväskylä (n = 663) were invited to participate in the study. Five years later those who had participated at baseline, survived and were still resident in Jyväskylä (n = 432) were again invited. As expected, a better performance in men than in women was found in tests of maximal walking speed, stair mounting and maximal isometric muscle strength in both age groups. Men also had better performance in psychomotor tests and visual acuity whereas auditory functions and postural balance were on average better in women. In some measures the longitudinal changes in five years were more pronounced than suggested by the cross-sectional comparisons between the 75- and 80-year-olds at baseline (e.g. psychomotor speed). In some others the longitudinal changes were smaller than expected on the basis of the cross-sectional comparisons (e.g. isometric muscle strength). In sensory functions longitudinal changes corresponded well with the results of the cross-sectional comparisons. Poor physical capacity at baseline was a significant predictor of subsequent death during the follow-up among the women but much less among the men. For both sexes a low psychomotor speed at the baseline was indicative of a poor survival. It is concluded that the correspondence of the results obtained in cross-sectional comparisons with longitudinal changes varies from one function to another. This correspondence may also be influenced by mortality which is differentially associated with the physical, sensory and psychomotor functions analysed in the present study.

Aged↗

PubMed2006

Activity, activity, activity: rethinking our physical therapy approach to cerebral palsy.

This perspective outlines the theoretical basis for the presentation with the same name as the second part of this title, which was given at the III STEP conference in July 2005. It elaborates on the take-home message from that talk, which was to promote activity in children and adults with cerebral palsy and other central nervous system disorders. The author proposes that the paradigm for physical therapist management of cerebral palsy needs to shift from traditional or "packaged" approaches to a more focused and proactive approach of promoting activity through more intense active training protocols, lifestyle modifications, and mobility-enhancing devices. Increased motor activity has been shown to lead to better physical and mental health and to augment other aspects of functioning such as cognitive performance, and more recently has been shown to promote neural and functional recovery in people with damaged nervous systems. Although the benefits of fairly intense physical exercise programs such as strength training are becoming increasingly well recognized, few studies on the positive effects of generalized activity programs have been conducted in individuals with cerebral palsy. More research is needed and is currently under way to design and test the efficacy of activity-based strategies in cerebral palsy.

Adult↗

PubMed2005

Predictors of operative mortality and cardiopulmonary morbidity in the National Emphysema Treatment Trial.

OBJECTIVE: We sought to identify predictors of operative mortality, pulmonary morbidity, and cardiovascular morbidity after lung volume reduction surgery. METHODS: Univariate and multivariate logistic regression analyses were performed. Candidate predictors included demographic characteristics, physical condition characteristics, pulmonary function measures, measures of the distribution of emphysema as determined by radiologists and by means of computerized analysis of chest computed tomographic scans, and measures of exercise capacity, dyspnea, and quality of life. End points analyzed were operative mortality (death within 90 days of the operation), major pulmonary morbidities (tracheostomy, failure to wean, reintubation, pneumonia, and ventilator for > or =3 days), and cardiovascular morbidities (infarction, pulmonary embolus, or arrhythmia requiring treatment). RESULTS: Five hundred eleven patients in the non-high-risk group of the National Emphysema Treatment Trial underwent lung volume reduction. The incidence of operative mortality was 5.5%, major pulmonary morbidity occurred in 29.8% of patients, and cardiovascular morbidity occurred in 20.0% of patients. Predictors for these end points are as follows: [table: see text]. CONCLUSIONS: Although lung volume reduction can be performed in selected patients with acceptable mortality, the incidence of major cardiopulmonary morbidity remains high. The lone predictor for operative mortality of lung volume reduction was the presence of non-upper-lobe-predominant emphysema, as assessed by the radiologist. Pulmonary morbidity can be expected in elderly patients who have a low diffusing capacity for carbon monoxide and forced expiratory volume in 1 second. When assessing morbidity, the computer-assisted chest computed tomographic analysis proved useful only in predicting cardiovascular complications.

Aged↗

PubMed2005

Verbal and physical non-aggressive agitated behaviors in elderly persons with dementia: robustness of syndromes.

OBJECTIVE: More than a decade ago, different syndromes of agitation were identified in elderly nursing home residents, and it was found that these syndromes correlate with medical, cognitive, and psychosocial functioning. The present study was conducted to examine the robustness of two major syndromes, verbal agitation and physical non-aggressive agitation, as assessed via direct observations. METHODS: Study participants were 175 elderly persons with dementia recruited from 11 nursing home facilities in Maryland. Observations of the participants' behavior were conducted using the agitated behaviors mapping instrument. RESULTS: The profiles that emerged for physically agitated residents and for verbally agitated residents were remarkably similar to those originally reported. Specifically, verbally agitated behaviors correlated with female gender, with cognitive decline, poor performance of activities of daily living, impaired social functioning, and signs of depressed affect. Physically non-aggressive agitated behaviors correlated with cognitive impairment and with fewer concurrent medical diagnoses. CONCLUSIONS: Examining correlates of different syndromes of agitated behaviors may provide researchers with valuable information that can be used for in-depth analysis of both the characterization and etiology of agitation, thus paving the way for the development of interventions that target particular types of problem behaviors.

Activities of Daily Living↗

PubMed1977

[Physical performance in patients with focal infection ergospirometric stress-testing before and after tonsillectomy (author's transl)].

The diagnosis of a focal infection in 13 patients (6 men and 7 women, aged 18 to 36) was based on the findings of chronic tonsillitis and general complaints interpreted as focal symptoms. The patients underwent symptom-limited maximal stress-testing before and after tonsillectomy to rule out any impairment of physical performance on the basis of computer-assisted processing of ergospirometric data. It can be concluded that the actual data of maximal oxygen uptake (aerobic power), the phenomenon of adaptation to increasing work loads (derived from rating of the increase in oxygen uptake during rectangular-triangular bicycle ergometry), the on-line processed index of anaerobic power and the anaerobic threshold, as well as heart rate and arterial blood pressure regulation did not differ in these patients from findings in healthy subjects. Nor were these parameters altered by tonsillectomy. Tonsillar focal infection is unlikely to cause any impairment of physical performance with respect to parameters of cardio-respiratory and metabolic function.

Adaptation, Physiological↗

PubMed2004

Effects of active recovery between series on performance during an intermittent exercise model in young endurance athletes.

The purpose of our study was to compare time to exhaustion ( t(lim)) and time spent at a high level of oxygen uptake (V(.)O(2)) during two high-intensity short intermittent exercises (30 s-30 s) realized with or without series. Eleven young endurance-trained athletes [16.6 (0.4) years] took part in three field tests until exhaustion: (1) a maximal graded test to measure their maximal aerobic velocity (MAV) and maximal oxygen uptake (V(.)O(2max)); (2) and (3) two randomized intermittent exercises (30 s at 110% of MAV alternated with 30 s at 50% of MAV): one alternating repetitions non-stop (IE) and another including 4 min recovery every six repetitions (IEs). The mean t(lim) measured during IEs was significantly longer than IE [respectively 960.0 (102.0) s vs 621.8 (56.2) s]. The time spent at V(.)O(2max)( t(V(.)O2max)) and the time spent above 90% of V(.)O(2max)( t(90%V(.)O2max)) did not differ significantly according to the type of exercise: with or without series [respectively t(V(.)O2max) was 158.2 (59.7) s vs 178.0 (56.5) s and t(90% O2max) was 290.4 (84.3) s vs 345.0 (61.6) s] but when expressed as a relative value, t(90% O2max) during IEs was significantly lower than during IE [respectively 36.4 (10.4)% t(lim) vs 58.3 (8.7)% t(lim)]. Despite a significant decrease ( P<0.005) of time to achieve 90% of V(.)O(2max) at the start of each series during IEs [respectively 165.0 (43.1) s for the first series and 82.5 (15.8) s for the second series ( n=6)] the time spent under 90% of V(.)O(2max) limited the t(90%V(.)O2max) during each series. In conclusion, our results showed that intermittent exercise with series does not permit an increase in the time spent at a high level of V(.)O(2); however, the athletes performed more repetitions of short intense exercise.

Adaptation, Physiological↗

PubMed2004

Effects of anaerobic training in children with cystic fibrosis: a randomized controlled study.

BACKGROUND: Children's physical activity patterns are characterized by short-term anaerobic activities. Anaerobic exercise performance in children with cystic fibrosis (CF) has received little attention compared to aerobic performance. This study investigated the effects of anaerobic training in children with CF. DESIGN AND METHODS: Twenty patients were randomly assigned to the training group (TG) [11 patients; mean (+/- SD) age, 13.6 +/- 1.3 years; mean FEV(1), 75.2 +/- 20.7% predicted] or the control group (CG) [9 patients; mean age, 14.2 +/- 2.1 years; FEV(1), 82.1 +/- 19.1% predicted]. The TG trained 2 days per week for 12 weeks, with each session lasting 30 to 45 min. The training program consisted of anaerobic activities lasting 20 to 30 s. The control subjects were asked not to change their normal daily activities. Body composition, pulmonary function, peripheral muscle force, habitual physical activity, aerobic and anaerobic exercise performance, and quality of life were reevaluated at the end of the training program, and again after a 12-week follow-up period. RESULTS: Patients in the TG significantly improved their anaerobic performance, aerobic performance, and quality of life. No significant changes were seen in other parameters, and no improvements were found in CG. After the follow-up period, only anaerobic performance and quality of life in TG were significantly higher compared to pretraining values. CONCLUSIONS: Anaerobic training has measurable effects on aerobic performance (although not sustained), anaerobic performance, and health-related quality of life in children with CF. Therefore, anaerobic training could be an important component of therapeutic programs for CF patients.

Adolescent↗

PubMed1999

Validation of the PASE in older adults with knee pain and physical disability.

PURPOSE: To examine the validity of the Physical Activity Scale for the Elderly (PASE) among individuals with disability. METHODS: A sample of 471 participants (mean age = 71.36) in an epidemiological study of chronic knee pain completed the PASE and self-report measures of knee pain, perceived physical function, satisfaction with physical function, and importance of physical function. A 6-min walk test and an isokinetic assessment of knee strength were also administered. RESULTS: PASE scores were significantly correlated in expected directions with performance on the 6-min walk, knee strength, frequency of knee pain during transfer, and perceived difficulty with physical functioning. Gender and age were identified as significant moderators of PASE scores and the scale's construct validity was supported by testing a conceptually driven hypothesis regarding patterns of physical activity. CONCLUSIONS: These results support the PASE's validity for the assessment of physical activity among older adults with pain and disability.

Aged↗

PubMed1992

Physical activity and anthropometric and functional characteristics of mildly malnourished Senegalese children.

This study examines the effects of chronic malnutrition on the functional capacities and physical activity patterns of a group of 100 healthy Senegalese children between the ages of 10 and 13 years. Anthropometric measurements, a sub-maximal step test, spirometric tests and testing of four motor skills (foot races, jumping, throwing, gripping) were conducted and their physical activity was monitored by recording of heart rate every minute for 6 hours. The weights of two-thirds of these children fell below -1 SD from the WHO/NCHS* norm for their ages, their test results were inferior to those of Western children, and the level of their physical activity appeared also to be low. When these children are divided on the basis of weight deficits for age into well nourished and malnourished groups, malnourished children register poorer functional performances than well nourished children, but no difference exists with respect to the intensity of physical activity. These results highlight the negative effect of malnutrition on children's physical performance. The consequences are disturbing as the subsistence in the Sahelian Region depends on substantial physical labour.

Adolescent↗

PubMedDate not supplied

The first camps in Turkey for asthmatic children: six years' experience.

The first asthma camp in Turkey was organized for one week in Iznik in September 1996. The camps were continued annually around the same time of the year in 1997, 1998, 2000, and in the consecutive years thereafter. The camp includes educational, sports and social activities. Children's knowledge about asthma and their attitudes towards physical and social activities were evaluated by a questionnaire. Pulmonary function tests were performed on the first and last day of the camp. There was no statistically significant difference between the mean spirometric values of the first and last day of the camp in spite of a vigorous physical and social program. Children enhanced their skills and knowledge about asthma and gained self-confidence in participating in sportive and social activities during the camp program. They did not experience any emergency room visit in the following year. In conclusion, a summer camping experience is very beneficial for asthmatic children in terms of both self-education and social and physical participation.

Adolescent↗