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Results for “Physical Functional Performance”

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At least 919 records · Page 51Linked to original sources

PubMed1994

Age and functional correlations of markers of coagulation and inflammation in the elderly: functional implications of elevated crosslinked fibrin degradation products (D-dimers).

OBJECTIVE: To measure markers of inflammation in a cohort of young and old subjects and relate these findings to the functional level of the individuals. DESIGN: For the pilot study, blood samples were obtained from 18 young (age 20-35 years) and 18 old (age 68-83 years) subjects. The main study population included community-dwelling subjects between the ages of 70 and 79. The group consisted of 282 subjects with minimal physical limitations, 17 subjects from the middle third, and 16 from the lower third of physical function rankings. METHODS: Plasma markers were measured by ELISA techniques, and certain biochemical values were obtained through routine clinical tests performed by a commercial laboratory. RESULTS: D-Dimers were higher for physically impaired subjects in all groups, but most prominently among black females, who also had significantly higher D-Dimer levels in every functional group. To inquire whether higher D-Dimers were associated with markers of inflammation, we also examined the macrophage metabolite, neopterin, the neutrophil product, elastase complexed to antitrypsin (E/a), and the albumin globulin ratio (A/G ratio). No differences were found in neopterin or E/a levels on the basis of gender, race, or functional status. The A/G ratio was significantly lower in functionally impaired subjects. CONCLUSION: These preliminary findings demonstrate racial/ethnic and gender differences in D-Dimers in a population of community-dwelling elderly, and suggest that factors influencing hemostasis may be particularly relevant to physical functional status in black women. A sample containing more subjects with lower physical function will be needed to establish the relationship between inflammation, altered hemostasis, and physical function decline.

Adult↗

PubMed1993

Immunologic and psychologic therapy for patients with chronic fatigue syndrome: a double-blind, placebo-controlled trial.

PURPOSE: To evaluate the potential benefit of immunologic therapy with dialyzable leukocyte extract and psychologic treatment in the form of cognitive-behavioral therapy (CBT) in patients with chronic fatigue syndrome (CFS). PATIENTS AND METHODS: Immunologic and psychologic treatments were administered to 90 adult patients who fulfilled diagnostic criteria for CFS in a double-blind, randomized, and placebo-controlled study. A four-cell trial design allowed the assessment of benefit from immunologic and psychologic treatment individually or in combination. Outcome was evaluated by measurement of global well-being (visual analogue scales), physical capacity (standardized diaries of daily activities), functional status (Karnofsky performance scale), and psychologic morbidity (Profile of Mood States questionnaire), and cell-mediated immunity was evaluated by peripheral blood T-cell subset analysis and delayed-type hypersensitivity skin testing. RESULTS: Neither dialyzable leukocyte extract nor CBT (alone or in combination) provided greater benefit than the nonspecific treatment regimens. CONCLUSIONS: In this study, patients with CFS did not demonstrate a specific response to immunologic and/or psychologic therapy. The improvement recorded in the group as a whole may reflect both nonspecific treatment effects and a propensity to remission in the natural history of this disorder.

Adolescent↗

PubMed2003

Methods to assess and improve the physical parameters associated with fall risk in older adults.

BACKGROUND: Falls are common among older adults. Many physical parameters including reduced postural stability, decreased dynamic balance, gait disorders, strength deficits, difficulty standing from a chair, and other impairments have been shown to be strongly associated with fall risk in the elderly. ASSESSMENTS: To identify those at risk for falls, tools that accurately measure physical performance parameters associated with falls are essential. Several tools are available to measure these parameters including clinical evaluations, functional performance tests, and questionnaires. The article describes many of the tools that can be used to evaluate the physical parameters associated with fall risk in older adults. CONCLUSIONS: The described instruments can help in identifying those who are most likely to fall, and those who would benefit from targeted interventions. The final part of the article includes a brief discussion of the potential role of exercise training interventions to improve these physical parameters and prevent falls.

Accidental Falls↗

PubMed2003

Treatment of hepatocellular carcinoma: is there an optimal strategy?

The incidence of hepatocellular carcinoma is increasing worldwide and now it accounts for as many as 1 million deaths annually, representing the third cause of cancer-related death. Surveillance programmes in the population at risk, namely cirrhotic patients, aim to detect tumours at an early stage when benefit from effective therapy may be provided. Patients with early tumours (single tumours measuring less than 5 cm or with less than 3 nodules measuring less than 3 cm in size) constitute the early stage category. These patients may be treated with surgical resection, transplantation, or percutaneous ablation, and the 5-year survival rate will exceed 50%. Patients with more advanced disease constitute the intermediate-advanced stage. Intermediate stage includes individuals without cancer-related symptoms and absence of vascular invasion and/or extrahepatic spread. They may achieve a 50% survival rate at 3 years that can be expanded by transarterial chemoembolization. Symptomatic patients with more advanced disease have a survival rate of less than 20% at 3 years. In this group of patients the efficacy of new agents should be assessed in phase II trials or randomized controlled trials versus no treatment to determine the impact of any therapy on survival. Finally, patients with end-stage disease with heavily impaired liver function (Child-Pugh class C) or severe physical impairment (performance status 3-4) die within 6 months and should receive only symptomatic treatment.

Carcinoma, Hepatocellular↗

PubMed2000

A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. EORTC Quality of Life Group.

This study tests the reliability and validity of the European Organization for Research and Treatment of Cancer (EORTC) head and neck cancer module (QLQ-H&N35) and version 3.0 of the EORTC Core Questionnaire (QLQ-C30) in 622 head and neck cancer patients from 12 countries. The patients completed the QLQ-C30, the QLQ-H&N35 and a debriefing questionnaire before antineoplastic treatment or at a follow-up. 232 patients receiving treatment completed a second questionnaire after treatment. Compliance was high and the questionnaire was well accepted by the patients. Multitrait scaling analysis confirmed the proposed scale structure of the QLQ-H&N35. The QLQ-H&N35 was responsive to differences between disease status, site and patients with different Karnofsky performance status, and to changes over time. The new physical functioning scale (with a four-point response format) of version 3.0 of the QLQ-C30 was shown to be more reliable than previous versions. Thus, the QLQ-H&N35, in conjunction with the QLQ-C30, appears to be reliable, valid and applicable to broad multicultural samples of head and neck cancer patients.

Adult↗

PubMed2004

Practical aspects of functional capacity evaluations.

Physicians, employers, insurers, and benefits adjudicators often rely upon functional capacity evaluations (FCEs) to determine musculoskeletal capacity to perform physical work, often with legal or occupational consequences. Despite their widespread application for several decades, a number of scientific, legal, and practical concerns persist. FCEs are based upon a theoretical model of comparing job demands to worker capabilities. Validity of FCE results is optimal with accurate job simulation and detailed, intensive assessments of specific work activities. When test criteria are unrelated to job performance, or subjective evaluation criteria are employed, the validity of results is questionable. Reliability within a subject over time may be adequate to support the use of serial FCE data collection to measure progress in worker rehabilitation. Evaluation of sincerity of effort, ability to perform complex or variable jobs, and prediction of injury based upon FCE data is problematic. More research, especially studies linking FCE results to occupational outcomes, is needed to better define the appropriate role for these evaluations in clinical and administrative settings.

Humans↗

PubMed2002

Sensitization to horse hair, symptoms and lung function in grooms.

OBJECTIVE: This study aimed to investigate the rate of occupational sensitization to horse hair in grooms and whether occupational exposure to horse hair increases respiratory and allergic symptoms and affects lung function in grooms or not. METHODS: This is a cross-sectional study. Two hundred grooms were randomly selected among 1000 grooms working in Veliefendi Hippodrome of Istanbul. One hundred and twenty-five subjects agreed to enter the study. Ninety-two workers who worked in the different parts of this hippodrome enrolled as the control group. A detailed questionnaire including respiratory and allergic symptoms was filled in, physical examination, skin prick tests and pulmonary function tests were performed. RESULTS: Sensitization to horse hair was 12.8% in grooms and 4.3% in controls. The difference was statistically significant (P = 0.0035). Asthma was found in 14.4% of the grooms and 5.4% of the controls, allergic rhinitis in 42.4% of the grooms and 18.4% of the controls, allergic conjunctivitis in 35.2% of the grooms and 15.2% of the controls, and allergic skin diseases in 32.8% of the grooms and 13% of the controls. The differences were statistically significant (P = 0.043, P = 0.0002, P = 0.001 and P = 0.0008, respectively). The means of FEV1, FEV1/FVC and FVC parameters were significantly lower in the groom group (P = 0.006, P = 0.001 and P = 0.003, respectively). In the multivariate analysis, being in the groom group and working years were found to be predictive factors for impairments of lung function (P < 0.001 and P = 0.002, respectively). CONCLUSION: Occupational exposure to horse increases the sensitization to horse hair, induces asthma and allergic symptoms and also impairs lung functions.

Adolescent↗

PubMed2006

Intravenous regional block with lidocaine for treatment of complex regional pain syndrome.

OBJECTIVES: The goal of this article is to report the successful treatment of a patient with complex regional pain syndrome (CRPS) type 1 involving the hand with the use of an intravenous regional block. METHODS: The patient was a 35-year-old woman who developed CRPS during conservative therapy for a metacarpal fracture. An intravenous regional block with lidocaine alone, using a two-tourniquet technique, was delivered 10 times for at least 40 minutes. The first five treatments were given twice a week and the next five were delivered weekly. All affected joints, including the wrist, were manipulated without undue force. Functional physical measurements were assessed, including range of motion and performance of fine and gross motor tasks. RESULTS: The visual analog scale scores for pain declined from 10 to 0 after treatment. Use of a pen, a pair of chopsticks, and a hammer improved, and edema decreased. CONCLUSIONS: Intravenous regional block with lidocaine was well tolerated and associated with relief in this case of CRPS type 1.

Adult↗

PubMed2006

Internet-based rehabilitation for individuals with chronic pain and burnout: a randomized trial.

This study investigates utilization of the Internet in the rehabilitation of people on long-term sick leave with chronic pain and/or burnout. Fifty-five people were randomly assigned to two groups: a treatment group (n = 27) that participated in a rehabilitation course over the Internet and a waiting list group (n = 28). The goals were to improve participants' health and increase quality of life, and, for those who were not on permanent disability pensions, to increase work capacity, if possible. A 20-week program, based on 19 films on different themes, was supplemented with written material and a Socratic dialogue over the Internet. Upon completion of the rehabilitation course, statistically significant improvements were observed in the treatment group in comparison to the waiting list group, for variables such as depression, pain, vitality, social function, performance problems involving work or other activities due to physical illness and the presence of stress symptoms. Thirteen of 23 individuals (57%) also increased their work capacity. The number needed to treat regarding recovering from anxiety and depression was 2. For increased work capacity, the number needed to treat was 3. Rehabilitation of people on long-term sick leave carried out over the Internet is a good complement to other rehabilitation programs.

Adult↗

PubMed1996

Functional health status and instrumental activities of daily living performance in noninstitutionalized elderly people.

The purpose of this descriptive correlational study was to examine the relationship between functional health status and the performance of instrumental activities of daily living (IADL) in a group of noninstitutionalized elderly people. A convenience sample of 47 subjects who were 70 years of age or older participated by completing three questionnaires: the Health Status Questionnaire, the Multidimensional Functional Assessment IADL Scale and a demographic questionnaire. Lawton's (1985) theoretical model of person-environment interaction provided the conceptual framework for the study. Three functional status variables reached statistical significance (0.001) with IADL performance: social functioning (r = -0.6045); health perception (r = -0.6984); and physical functioning (r = -0.6635) suggesting that these are important indicators of overall health status, and that a decline in each could contribute to increased IADL dependency. The IADLs of housekeeping, shopping, and transportation correlated significantly (0.001) with functional health status, implying that, as health declines in elderly people, they may require more assistance with IADLs, in order to remain more independent in the community. The results have implications for nursing administrators and nursing educators with regard to developing health promotion strategies related to independence of elderly people, community health and social policy.

Activities of Daily Living↗

PubMed2006

927T>C polymorphism of the cysteinyl-leukotriene type-1 receptor (CYSLTR1) gene in children with asthma and atopic dermatitis.

Asthma and atopic dermatitis share several common features and Cysteinyl-leukotrienes are mediators that participate in the pathogenesis of both diseases. Recently, a new polymorphism (927T>C) has been identified in cysteinyl-leukotriene type-1 receptor (CYSLTR1) gene. This gene is found on the X chromosome. The aim of this study was to analyze this SNP in a population of children with asthma and atopic dermatitis. In this study, 166 individuals, 79 adult controls (CTR) and 87 children with asthma (AA) were included. Forty-one patients with asthma presented atopic dermatitis (AA-AD). Adults were chosen as controls to confirm lack of development of asthma and allergy during childhood. Standardized history, physical examination, skin prick tests, and lung function measurements were performed in all patients. The 927T>C CYSLTR1 SNP was analyzed by direct sequencing after PCR amplification. In males (53 individuals), the C allele was significantly more common among AA-AD patients (47%) than in CTR (8%) (Fisher's p < 0.005; Monte Carlo p < 0.008; OR:9.78; 95%CI: 1.73-55.30). When comparing AA-AD vs. AA-NAD (patients with asthma but not atopic dermatitis), significant differences were observed, (47% vs. 15%, Fisher's p = 0.014; Monte Carlo p = 0.022; OR: 4.97; 95%CI: 1.29-19.13). No differences in allele distribution were observed between these disease sub-groups in females. The 927T>C is a silent SNP; however, it could affect transcription or translation or may be linked to an unidentified, functional polymorphism and thus may pre-dispose male children to asthma and atopic dermatitis in our population. Further studies are needed to confirm these findings.

Adolescent↗

PubMedDate not supplied

Patients' perceptions of health, chronic illness, and nursing diagnoses.

This descriptive, exploratory study sought to determine how persons with chronic health problems define their experiences of health and illness and to collect information from these subjects regarding their ability to identify their health problems on the list of NANDA-approved nursing diagnoses. A convenience sample of 19 subjects was interviewed using qualitative triangulation methods. Subjects defined experiences of health in terms of their abilities to perform functions independently. Illness was defined primarily in terms of physical symptoms. Thirteen subjects identified self-initiated activities oriented toward alleviation of physical symptoms as strategies for helping themselves get better or feel better when "sick." Subjects were able to use nursing diagnoses to identify their health problems, selecting 61 of the 106 NANDA-approved diagnoses. Data related to subject-selected diagnoses are compared with available NANDA diagnoses by taxonomy category and nurse-interviewer diagnoses. Moving, Perceiving, and Valuing were the taxonomy categories that were most frequently identified by this sample. A new nursing diagnosis of altered nutrition: regimentation (in timing, amounts, and types of food), as well as the need for additional diagnostic development in the areas of urinary frequency, disrupted relationships, and medications were identified by the subjects. Finally, the researchers propose the development of nursing diagnoses that foster health promotion and illness prevention based on the health orientation of this sample, despite their chronic health problems.

Adult↗

PubMed1998

Latex immunoassays: comparative studies on covalent and physical immobilization of antibodies. II. IgG.

Latex particles coated with IgG, currently used for immunoassay tests, are not colloidally stable under physiological conditions. Post-treatment of sensitized polystyrene microspheres with different substances (BSA, surfactants) to increase colloidal stability has been often used to solve this problem. We propose the possibility of stabilizing the antibody-latex conjugates by hydration forces at high ionic strength. On the other hand. immobilization of the proteins may be performed either by physical adsorption or by covalent binding to functionalized surface groups. In this second part of these series we have studied the immunoreactivity of IgG antibody partly covalently bound and physically adsorbed, and the results were compared to those obtained with F(ab')2 fragments in Part I.

Adsorption↗

PubMed2005

The Leu7Pro polymorphism of preproNPY is associated with decreased insulin secretion, delayed ghrelin suppression, and increased cardiovascular responsiveness to norepinephrine during oral glucose tolerance test.

CONTEXT: Neuropeptide Y (NPY) plays a role in angiogenesis, cardiovascular regulation, and hormone secretion. The leucine7 to proline7 (Leu7Pro) polymorphism of preproNPY is associated with vascular diseases and has an impact on hormone levels in healthy subjects. OBJECTIVE: The current study investigated the role of the Leu7Pro polymorphism in metabolic and cardiovascular autonomic regulation. DESIGN AND SUBJECTS: A 5-h oral glucose tolerance test was performed on 27 healthy volunteers representing two preproNPY genotypes (Leu7/Pro7 and Leu7/Leu7) matched for age, sex, body mass index and physical activity. MAIN OUTCOME MEASURES: Simultaneously we performed cardiovascular autonomic function tests and plasma measurements of sympathetic transmitters, glucose, insulin, and ghrelin. RESULTS: The subjects with Leu7/Pro7 genotype had decreased plasma NPY, norepinephrine (NE), and insulin concentrations and insulin to glucose ratios. The suppression of ghrelin concentrations after glucose ingestion was delayed in these subjects. They also had increased heart rate variability indices and baroreflex sensitivity. However, they displayed significant negative association of NE concentration with variability of low-frequency R-R-intervals and with baroreflex sensitivity. CONCLUSIONS: The Leu7Pro polymorphism of preproNPY is related to decreased level of basal sympathetic activity, decreased insulin secretion, and delayed ghrelin suppression during oral glucose tolerance test. The increased responsiveness of autonomic functions to NE associated with the polymorphism may be connected to increased cardiovascular vulnerability.

Adult↗

PubMed1995

Diagnosis and outpatient management of congestive heart failure.

Congestive heart failure causes substantial patient morbidity and mortality in the United States. Symptoms and physical findings can be helpful in diagnosis but have limited sensitivity and specificity. Objective measurement of ventricular function is essential in virtually all patients in whom a diagnosis of heart failure is suspected. Reversible causes of heart failure must be sought. Outpatient management includes education and counseling, emphasis on and assessment of compliance with diet, and pharmacologic treatment. Angiotensin-converting enzyme inhibitors are the mainstay of treatment but are underused, and maximal doses are not given apparently because of concern about side effects. Diuretic therapy should be administered only as needed to manage fluid overload. Calcium channel blockers are relatively contraindicated in patients with impaired ventricular function. Patient follow-up should be guided by the results of the medical history and physical examination. Routine serial testing of ventricular function and exercise performance is discouraged.

Ambulatory Care↗

PubMed1992

Clinical depression is associated with impaired recovery from stroke.

OBJECTIVE: To examine the effect of clinical depression on recovery from stroke. METHOD: We examined a cohort of inpatients with stroke initially at two months after their stroke and again 14 months later. Patients were included if they: (i) provided informed consent; (ii) were able to understand the interview questions; and (iii) survived to follow-up without suffering another stroke or major medical illness. Of 61 consecutive patients, 49 met these criteria. Depression was diagnosed using a structured clinical interview. Three aspects of recovery were measured: (i) functional status; (ii) activities of daily living; and (iii) cognitive performance. RESULTS: Twenty (41%) of the 49 patients were depressed at initial assessment. There were no significant differences in demographic, clinical, stroke or lesion characteristics between the depressed and non-depressed patients. At follow-up, depressed patients improved less than non-depressed patients in functional status (mean change from baseline, 23% versus 48%) (P = 0.001) and cognitive performance (-1% versus 11%) (P = 0.096). Mean recovery in activities of daily living was not different between the two groups (33% versus 32%) but more of the depressed patients deteriorated over time (20% versus 0%) (P = 0.047). CONCLUSION: Clinical depression occurring soon after stroke is associated with impaired recovery when patients are assessed 14 months later. Depression has a negative effect on recovery in functional status and cognitive performance and may produce deterioration in physical capacity in a number of patients. Physicians would be well advised to be alert for depression and intervene early. Effective treatment of depression may enhance stroke rehabilitation.

Activities of Daily Living↗

PubMed1999

[Diagnosis and treatment of heart failure within the community].

Congestive heart failure causes substantial morbidity and mortality. Symptoms and physical findings can help in diagnosis, but have limited sensitivity and specificity. Objective measurement of ventricular function is essential in virtually all patients in whom heart failure is suspected; reversible causes of heart failure must be sought. Out-patient management includes education and counseling, emphasis on and assessment of compliance with diet, and pharmacological treatment. Angiotensin-converting enzyme inhibitors are the mainstay of treatment but are underused, and maximal doses are not given, apparently because of concern about side-effects. Diuretics should be administered only as needed to manage fluid overload. Calcium channel blockers are relatively contraindicated in patients with impaired ventricular function. Patient follow-up should be guided by results of the medical history and physical examination. Routine serial testing of ventricular function and exercise performance is discouraged.

Counseling↗

PubMedDate not supplied

Hearing in the elderly: a population study.

An epidemiological study comparing speech audiometry with self-assessed hearing disability and an analysis of other factors influencing the quality of life was conducted. In the Veneto region (Italy), a representative sample of 2700 independently living individuals of 65 years of age and older was selected for the study. All participants were administered a comprehensive questionnaire and a brief examination at their home, including a general physical examination, speech audiometry, Sanders' Speech Disability test, part I and III, Mini Mental State Examination, CES-D scale for depression, visual acuity, self-reported diseases and physical function. Auditory function was worst in the older individuals: auditory performance was within acceptable limits up to the 75-79 age group, while it rapidly deteriorates in the older groups. This trend is consistent with self-reported auditory disability (Sanders' test). A detailed analysis of the type of errors made in the speech audiometry was conducted for each subject. Speech audiometry is a good indicator of real hearing difficulties faced by the elderly, and it might be preferred to pure-tone audiometry, since hearing deficits with age are not always limited to an increased detection threshold, but include other aspects of hearing such as distortion of sounds, comprehension of speech and noise discrimination.

Age Distribution↗