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PubMed1995

Psychophysiologic factors contributing to functional performance in people with COPD: are there gender differences?

The purpose of this study was to compare the functional performance profiles of men and women with chronic obstructive pulmonary disease, describe the extent to which physiologic impairment, physical symptoms, and psychosocial resources contribute in a cumulative manner to performance, and outline the extent to which these contributions differ across gender. Secondary data analyses were employed. Although women (n = 45) reported more functional difficulty than men (n = 44) in 9 of 12 Sickness Impact Profile categories, the differences were not significant. Using hierarchical regression procedures, physiologic, symptomatic, and interactive variables predicted total (R2 = .64) and physical performance (R2 = .52), while symptomatic and psychosocial variables predicted psychosocial performance (R2 = .53). Results indicate that models of functional performance may be different for men and women.

Adaptation, Psychological↗

PubMedDate not supplied

The impact of long-term moderate physical activity on functional performance, bone mineral density and fracture incidence in elderly women.

BACKGROUND: Earlier studies have shown that physical exercise and a higher workload increase muscle strength and improve gait and balance at all ages for both sexes. Published studies have, so far, failed to investigate the functional performance of elderly individuals concerning their long-term physical activity and variables of daily living. OBJECTIVE: To compare elderly women who participate in long-term, moderate exercise programmes with two age-matched groups of women from an urban and a rural community. METHODS: All participants answered a questionnaire about health, social circumstances and fractures. We measured the vibration threshold of the lower extremities, bone mineral density of the distal radius and functional performance such as muscle strength, balance and gait. RESULTS: The elderly, active groups performed significantly better in all functional tests and had sustained fewer fractures than the urban control group. When the comparison was made with the rural control group the differences were less obvious. The active group rated their health as better than both the control groups. CONCLUSION: Elderly women, who continue with moderate exercise programmes over many years, sustain fewer fractures and have better muscle strength, balance, gait and health ratings than women in general. Whether this is the result of the exercise or inherited characters, remains to be proved.

Aged↗

PubMed2002

Functional performance following selective posterior rhizotomy: long-term results determined using a validated evaluative measure.

OBJECT: Selective posterior rhizotomy (SPR) may result in considerable benefit for children with spastic cerebral palsy. To date, however, there have been few studies in which validated functional outcome measures have been used to report surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine long-term functional performance outcomes in patients who underwent lumbosacral dorsal rhizotomy performed using intraoperative electrophysiological monitoring. METHODS: The study population was composed of children with debilitating spasticity who underwent SPR and were evaluated by a multidisciplinary team preoperatively and at 6 months and 1 year postoperatively. Quantitative standardized assessments of activities of daily living (ADL) were obtained using the Pediatric Evaluation of Disability Inventory (PEDI). Of 57 patients who met the entry criteria for the study, 41 completed the 3-year assessments and 30 completed the 5-year assessments. Statistical analysis demonstrated significant improvement in the mobility and self-care domains of the functional skills dimension at 1 year after SPR. The preoperative and 1-, 3-, and 5-year postoperative scaled scores for the mobility domain were 56, 64, 77.2, and 77.8, respectively. The scaled score for the self-care domain increased from 59 presurgery to 67.9, 81.6, and 82.4 at the 1-, 3-, and 5-year postoperative assessments, respectively. CONCLUSIONS: The results of this study support the presence of significant improvements in functional performance, based on PEDI scores obtained 1 year after SPR. The improvements persisted at the 3- and 5-year follow-up examinations. The authors conclude that SPR performed using intraoperative stimulation is valuable in the augmentation of motor function and self-care skills essential to the performance of ADL.

Activities of Daily Living↗

PubMed1992

[The strength and functional performance of patients with Duchenne muscular dystrophy based on natural history].

Duchenne muscular dystrophy (DMD) is a disease of progressive muscular weakness and wasting. This study is designed to evaluate the muscle strength and functional performance of patients with DMD during the natural progression of this disease. This study comprises a sample of 35 subjects who were confirmed to have DMD. Manual muscle testing (MMT) was used to evaluate muscle strength, the Brooke functional scale to rate the motor function of the upper extremity, and the Vignos functional scale to rate the motor function of the lower limbs. The results showed a significant positive correlation between age and the decrement in strength, i.e. a one year increment in age led to a 3.9% decrease in the average muscle strength. The strength loss always occurred in a typical pattern proceeding from the lower extremities to the upper extremities, and from the proximal to the distal parts. There was a significant negative correlation between muscle strength and both the Brooke and Vignos functional scales. These findings may suggest that decreased muscle strength results in a progressive worsening of the functional performance of the extremities. In addition, the Brooke scale is significantly correlated with the Vignos scale through the natural course of DMD. The high percentage (90.5%) of subjects without the long leg braces needed for ambulation indicates an inadequate rehabilitation care for DMD patients in this country.

Adolescent↗

PubMed1989

Effect of an inhibitive weight-bearing mitt on tone reduction and functional performance in a child with cerebral palsy.

A single-subject, ABA design was used to determine the effects of an upper extremity inhibitive weight-bearing cast on tone reduction and functional performance in a child with cerebral palsy. The subject was a 17-month-old boy diagnosed with spastic hemiplegia. Passive range of motion in the hand was measured with a grip circumference measuring cone; tone in the hand was estimated by hand surface area as determined by a tracing of the hand while the child was bearing weight on the affected hand; and functional performance of the affected arm was observed during play with two balls. All measures increased during the intervention phase. Gains in passive range of motion and hand area remained throughout the post-intervention phase. The inhibitive weight-bearing mitt was found to be an effective adjunct to neurodevelopmental treatment for this child.

Journal Article↗

PubMed2003

The effects of bungy weight training on muscle function and functional performance.

Eccentric strength training is thought to be important for improving functional performance. A form of training that may enhance the eccentric training stimulus is the attachment of a rubber bungy to the strength-training apparatus in such a way that the return velocity and, therefore, the force required to decelerate the load at the end of the eccentric phase are increased. To determine the effects of elastic bungy training, we performed two studies. In the first, we examined the electromyographic (EMG) and kinematic characteristics of three different squat techniques: traditional squat, non-bungy jump squat and bungy jump squat. In the second study, we examined whether jump squat training with and without the attachment of a rubber bungy to an isoinertial supine squat machine affects muscle function, multidirectional agility, lunge ability and single leg jump performance. The EMG activity of the vastus lateralis and gastrocnemius muscles was recorded. An instrumented isoinertial supine squat machine was used to measure maximal strength and various force, velocity and power measures in both studies. Participants were randomly assigned to one of three groups: a control group and two weight-trained groups, one of which performed bungy squat jumps and one of which performed non-bungy squat jumps. The two experimental groups performed 10 weeks of ballistic weight training. The kinematic and EMG characteristics of the bungy and non-bungy squat techniques differed significantly from those of the traditional squat on all the variables measured. The only difference between the bungy squat and non-bungy squat training was greater EMG activity during the later stages (70-100%) of the eccentric phase of the bungy squat condition. The 10 weeks of bungy squat and non-bungy squat jump weight training were found to be equally effective in producing improvements in a variety of concentric strength and power measures (10.6-19.8%). These improvements did not transfer to improved performance for the single leg jump and multidirectional agility. However, bungy weight training did lead to a significant improvement in lunge performance (21.5%) compared with the other groups.

Adult↗

PubMed1997

Effects of rest interval on isokinetic strength and functional performance after short-term high intensity training.

OBJECTIVES: The ability to maximally generate active muscle tension during resistance training has been established to be a primary determinant for strength development. The influence of intrasession rest intervals may have a profound effect on strength gains subsequent to short-term high intensity training. The purpose of this study was to examine the effects of rest interval on strength and functional performance after four weeks of isokinetic training. METHODS: Fifteen healthy college aged individuals were randomly assigned to either a short rest interval group (group 1, n = 8) or a long rest interval group (group 2, n = 7). Subjects were evaluated for quadriceps and hamstring isokinetic strength at 60 (five repetitions) and 180 (30 repetitions) degrees/second and functional performance with the single leg hop for distance test. One leg of each subject was randomly assigned to a four week, three days/week isokinetic strength training programme for concentric knee extension and flexion performed at 90 degrees/second. Subjects in group 1 received a 40 second rest interval in between exercise sets, whereas subjects in group 2 received a 160 second rest period. RESULTS: A two factor analysis of variance for the pre-test--post-test gain scores (%) showed significantly greater improvements for isokinetic hamstring total work and average power at 180 degrees/second for the trained limb of subjects in group 2 than their contralateral non-trained limb and the subjects in group 1. Significantly greater improvements for the single leg hop for distance were also found for the trained limbs of subjects in both groups as compared with the non-trained limbs. CONCLUSIONS: The findings indicate that a relatively longer intrasession rest period resulted in a greater improvement in hamstring muscle strength during short term high intensity training.

Adult↗

PubMed1993

Muscular and functional performance characteristics of individuals wearing prophylactic knee braces.

The efficacy of prophylactic knee bracing has been refuted with regard to reducing the incidence and/or severity of injuries to the knee joint. This is thought to be a result of the prophylactic knee brace's ineffectiveness in protecting the knee joint from valgus loads. Furthermore, discrepancies exist regarding the prophylactic knee brace's detrimental effect on functional performance. The purpose of this study was to measure the effect of the prophylactic knee brace on selected isokinetic muscular characteristics and forward sprint speed. Twenty physically active, healthy, male college students with no prior history of brace use participated in this study. The subjects were randomly tested both with and without the prophylactic knee brace worn on various performance parameters. The dependent measures assessed included peak torque (PT) and torque acceleration energy (TAE) at 60 and 240 degrees /s. A 40-yard forward sprint was selected to assess sprint speed. A paired t-test analysis revealed mean values which were significantly less for PT at 60 degrees /s (p < .05), 240 degrees /s (p < .01), and TAE at 240 degrees /s (p < .05) with the prophylactic knee brace applied during knee extension. Analysis also revealed slower times for sprint speed (p < .01), while the subjects were wearing the prophylactic knee brace. Muscular strength (PT) and power (TAE) scores were not correlated (p > .05) with sprint speed. This study suggests that wearing the prophylactic knee brace may consequently inhibit muscular and functional performance of the athlete, but that specific population has yet to be studied.

Journal Article↗

PubMed2007

Contraction force specificity and its relationship to functional performance.

Best practice for improving strength and power through resistance strength training has been the subject of much research and subsequent conjecture. Much of the conjecture can be attributed to methodological discrepancies. The type of dynamometry used in testing, the training experience of research participants, the specific technique employed in a lift, and the methods of collection and calculation all impact on the final variables of interest. This review examines contraction force specificity by first addressing the methodological issues surrounding our interpretation of the results. Then we address the kinematics and kinetics associated with single and multiple repetitions in relation to the development of strength, power, and functional performance. This discussion provides the delimitations for analysis of subsequent training studies. Finally, recommendations are formulated with the aim of assisting assessment and training practice as well as providing directions for future research. The results of this review suggest that the enhancements in performance resulting from resistance training are context specific in experienced resistance-trained participants. Thus, specific conditioning could be required to achieve improvements in functional performance in this group.

Biomechanical Phenomena↗

PubMed1993

Functional performance measures: are they superior to self-assessments?

BACKGROUND: It has been suggested that performance measures of functional status have several advantages over self-report measures for both clinical and research purposes, including: greater patient acceptability, interpretability, reproducibility, sensitivity to change, and the focus on actual ability rather than presumed capability. This article challenges this assumed superiority of "objective," "behavioral" measures by directly comparing self-assessments and blindly rated performance assessments on a specific item by task basis, using an identical rating format. METHODS: A set of 14 performance tasks, consisting of a range of functional abilities (including simulations of cooking and sweeping), was administered to 99 community-dwelling older adults (aged 60-92) who had previously completed a 50-item instrumental activities of daily living (IADL) questionnaire. A subsample was retested 2 weeks later, and reassessed at 1 year. RESULTS: Of 182 subjects willing and able to complete the IADL questionnaire, only 99 attempted at least one of the performance tasks. Tasks that took longer to complete were not necessarily associated with a greater number of errors, nor did accuracy ratings correspond well with difficulty ratings. Good correspondence (greater than 80% agreement) between observed and perceived difficulty was found for only one-third of the item/task matchings. Generally, the rater tended to underestimate difficulty relative to subjective assessments. CONCLUSIONS: Relative to questionnaires, performance measures were not found to be psychometrically superior, more acceptable to respondents, easier to administer, or easier to interpret. Neither type of measure by itself distinguishes between motivation and capability, reflects adaptations made in everyday living, or accounts for personal preferences or reasons for difficulty.

Activities of Daily Living↗

PubMed2000

Knee strength and lower- and higher-intensity functional performance in older adults.

PURPOSE: This study characterizes the linear relations among knee strength, work capacity, and lower- and higher-intensity measures of functional performance in ambulatory, high-functioning older adults. METHODS: Sixty-two seniors (average age = 73.4 +/- 7.3 yr) participated in the study. Isokinetic measures included the peak flexion/extension torque produced during five continuous repetitions and the total flexion/extension work performed during 20 repetitions (60 degrees x s(-1)). Functional measures included lower-intensity tests (timed 8-foot and 50-foot walking tests at the participants' "normal" pace, and a standing reach task) and higher-intensity tests (a timed 50-foot "brisk" walk, timed chair stands, and a timed stair climb). RESULTS: Isokinetic strength and work capacity measures explained between 41% and 54% of the variance in the higher-intensity functional models and only between 31% and 33% of the variance in the lower-intensity models. The strength of the associations, approximated by the beta coefficients of the strength and work terms, was also greater for the higher-intensity functional tasks. CONCLUSIONS: Further research is warranted to determine whether exercises that increase knee strength and work capacity, improve brisk walking, stair climbing, and chair standing capabilities in older adults.

Aged↗

PubMed2006

Examination of postconcussion-like symptoms in healthy university students: relationships to subjective and objective neuropsychological function performance.

This study examined postconcussion-like symptoms in a group of university students and explored their relationships to neuropsychological function performance. A sample of 124 students was recruited. All of the participants received the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and completed a comprehensive set of neuropsychological tests. They reported a relatively high base rate of postconcussion-like symptoms. The most frequently endorsed items were "fatigue" (76.9%), "longer time to think" (60.3%), "poor concentration" (58.7%), "sleep disturbance" (50.4%), and "frustration" (46.3%). There were no significant differences between low symptom reporters and high symptom reporters, except for self-reported dysexecutive problems. A comparison of the healthy high symptom reporters and a convenient sample of traumatic brain injury patients revealed that the patients performed significantly worse on neuropsychological functions than the high symptom reporters, despite non-significant differences between symptom endorsement. Our findings demonstrate that: (a) the base rate of postconcussion-like symptoms in a group of healthy university students is relatively high and (b) postconcussion symptom (PCS) is not related to neuropsychological functions in normal people.

Adult↗

PubMed2003

No influence of short-term exposure to 50-Hz magnetic fields on cognitive performance function in human.

OBJECTIVES: To examine whether 50-Hz magnetic fields acutely influence cognitive performance function in humans. METHODS: The exposure experiment was conducted in a wooden room with three-axis coils. Twenty young subjects were exposed to circularly polarized 50-Hz/20-mu T magnetic fields for 55 min, during which they were requested to perform four cognitive performance tests for evaluation of simple reaction time, time and accuracy of choice reaction, time perception, and figure perception. RESULTS: No subject detected the existence of the field. Statistical analysis revealed no significant influence of the exposure on the results of the tests. CONCLUSIONS: The results indicate that extremely low-frequency electromagnetic fields in the occupational environment are unlikely to interfere with human brain function so much as to lower working efficiency or accuracy.

Adult↗

PubMed1997

Effects of familiarity of task and choice on the functional performance of younger and older adults.

An experiment was conducted to compare the functional performance of younger and older adults on familiar and unfamiliar tasks under 2 conditions of perceived control. Specifically, the relation between age and motor and process skills was examined. The familiar tasks were simple cooking tasks, whereas the unfamiliar tasks were contrived, meaningless tasks developed for this study. Younger and older adults did not differ in the ratings of the familiarity of the tasks, but results from 2 Age x Task x Choice analyses of variance demonstrated a significant age difference for motor and process skills under all conditions. This suggests that older adults demonstrate age-related decline, even with activities that take motivational, experiential, and ecological validity components into account. For the process skills scale, there was also a significant main effect for choice. These results support the concept that perceived control may improve performance, but not differentially for older adults; that is, younger and older adults both demonstrated improved process performance when given their choice of tasks.

Activities of Daily Living↗

PubMed1998

When is the dyspnea worth it? Understanding functional performance in people with alpha-1 antitrypsin deficiency.

OBJECTIVE AND SIGNIFICANCE: To examine functional performance in people with emphysema because of alpha-1 antitrypsin (AAT) deficiency. A severe deficiency of AAT affects 1:3,500 to 1:1,670 Americans who can develop debilitating emphysema in the third to fifth decades of life. DESIGN: Exploratory. POPULATION: People with a severe deficiency of AAT. SAMPLE AND DEMOGRAPHICS: Thirty-three patients (21 men) with a mean age of 47 (SD = 7) years. YEARS: Data were collected 1993-1996. METHODS: Activities patients identified as important on the dyspnea subscale of the Chronic Respiratory Disease Questionnaire were categorized and interpreted within the context of an integrity framework (i.e., effectiveness--or connectedness-related). FINDINGS: Patients identified over 25 activities. Effectiveness activities, such as bathing, were mentioned most frequently (78%). Connectedness activities, such as playing with children, were mentioned less often (22%) but were ranked more important. Two patients reviewed and supported the content validity of the framework. CONCLUSIONS: Results offer insight into the activities patients with genetic emphysema choose to perform and the factors that influence the decision that "the dyspnea is worth it." IMPLICATIONS: Identifying the activities people with AAT deficiency choose to perform and understanding why these activities are meaningful can guide interventions to help patients maintain a sense of integrity.

Activities of Daily Living↗

PubMed1994

Functional performance of young children after traumatic brain injury: a 6-month follow-up study.

OBJECTIVES: A follow-up study is reported of 40 children between the ages of 1 month and 5.6 years who had sustained a brain injury either with (n = 11) or without (n = 29) additional injuries. METHOD: Children and their families were assessed at both 1 and 6 months after hospital discharge with standardized measures of functional performance and family functioning, including the Child Behavior Checklist, the Pediatric Evaluation of Disability Inventory, and the Impact on Family Scale. In addition to within-group analyses, functional outcome was compared to that of a group of 17 children who had sustained non-central nervous system injuries. RESULTS: Mean scores for both groups of injured children were within the average range at both 1-month and 6-month follow-up testing. There was a general trend toward improved performance across the follow-up period, although only a few of these changes reached statistical significance. The effect of the injury as reported by the family was significantly associated with children's function as reflected by number of behavior problems and increased need for caregiver assistance. CONCLUSION: Results point to the need for systematic follow-up of young children after brain injury using sensitive measures to enable early identification of children whose further development may be at risk and to provide support to families whose children are displaying changes in functional behavior.

Brain Injuries↗

PubMedDate not supplied

Effects of occupational therapy services on fine motor and functional performance in preschool children.

PURPOSE: This study examined how performance components and variables in intervention influenced fine motor and functional outcomes in preschool children. METHOD: In a sample of 44 preschool-aged children with fine motor delays who received occupational therapy services, eight fine motor and functional performance assessments were administered at the beginning and end of the academic year. Data on the format and intervention activities of each occupational therapy session were recorded for 8 months. RESULTS: The children received a mean of 23 sessions, in both individual and group format. Most of the sessions (81%) used fine motor activities; 29% addressed peer interaction, and 16% addressed play skills. Visual motor outcomes were influenced by the number of intervention sessions and percent of sessions with play goals. Fine motor outcomes were most influenced by the therapists' emphasis on play and peer interaction goals; functional outcomes were influenced by number of sessions and percent of sessions that specifically addressed self-care goals. CONCLUSION: The influence of play on therapy outcomes suggests that a focus on play in intervention activities can enhance fine motor and visual motor performance.

Child↗

PubMed2003

[Comparison of functional performance among children with Down syndrome and children with age-appropriate development at 2 and 5 years of age].

OBJECTIVE: To compare the functional performance of Down's syndrome (DS) children with normally developing children (ND), at 2 and 5 years of age. METHOD: Forty children were allocated into four groups (n=10): 1) children with DS with 2 years of age; 2) children with DS with 5 years of age; 3) normal children with 2 years of age; 4) normal children with 5 years of age. Children were evaluated with the functional test PEDI, which quantifies children's performance (skills and independence) in three domains: self-care, mobility and social function. Two-way ANOVA was used to compare group means and to test interaction effects age x pathology. Pre-planned contrast analyses were used to identify the significant bivariate comparisons. RESULTS: Main factors (age and pathology) were significant in the three domains of skills and independence performances. The interaction factor age x pathology was significant in self-care and mobility skills, as well as in children's independence in mobility and social function. Contrast analyses showed that at two years of age, normal children's performance is superior to DS's children in all three domains of functional skills and independence. However, at five years of age, significant group differences were only observed in the domains of self-care and social function skills, and independence. CONCLUSION: Results show the areas of performance where the delay presented by DS children was functionally manifested, at two and five years of age. Data indicate that the observed group differences were influenced by age, keeping themselves changeable across the development.

Activities of Daily Living↗