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PubMed1988

Effects of chronic exposure to ethanol on the physical and functional properties of the plasma membrane of S49 lymphoma cells.

The effects of chronic exposure to ethanol on the physical and functional properties of the plasma membrane were examined with cultured S49 lymphoma cells. The beta-adrenergic receptor-coupled adenylate cyclase system was used as a probe of the functional properties of the plasma membrane. Steady-state fluorescence anisotropy of diphenylhexatriene and the lipid composition of the plasma membrane were used as probes of the physical properties of the membrane. Cells were grown under conditions such that the concentration of ethanol in the growth medium remained stable and oxidation of ethanol to acetaldehyde was not detected. Chronic exposure of S49 cells to 50 mM ethanol or growth of cells at elevated temperature resulted in a decrease in adenylate cyclase activity. There were no changes in the density of receptors or in the affinity of beta-adrenergic receptors for agonists or antagonists following chronic exposure to ethanol. The fluorescence anisotropy of diphenylhexatriene was lower in plasma membranes prepared from cells that had been treated with 50 mM ethanol than in membranes prepared from control cells. However, this change was not associated with changes in the fatty acid composition or the cholesterol to phospholipid ratio of the plasma membrane. There was a small but statistically significant decrease in the amount of phosphatidylserine and an increase in the amount of phosphatidylethanolamine. These changes cannot account for the decrease in anisotropy. In contrast to the effect of ethanol, a decrease in adenylate cyclase activity following growth of S49 cells at 40 degrees C was not associated with a change in anisotropy.

Adenylyl Cyclases↗

PubMed1999

Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis.

Vertebral fractures may be minor or lead to pain, decreased physical function, immobility, social isolation and depression, which together contribute to quality of life. A Working Party of the European Foundation for Osteoporosis has developed a specific questionnaire for patients with vertebral fractures. This questionnaire, QUALEFFO, includes questions in the domains pain, physical function, social function, general health perception and mental function. QUALEFFO was validated in a multicenter study in seven countries. The study was done in 159 patients aged 55-80 years with clinical osteoporosis, i.e., back pain and other complaints with at least one vertebral fracture and lumbar bone mineral density T-score <-1. Patients with a recent vertebral fracture were excluded because of unstable disease. Controls were age- and sex-matched, and did not have chronic back pain or vertebral fractures. Subjects with conditions exerting a major influence on quality of life were excluded. The QUALEFFO was administered twice within 4 weeks and compared with a generic questionnaire, the Short Form 36 of the Medical Outcomes Study (SF-36). Standard spinal radiographs were made for assessment of vertebral height. Seven questions were removed from the analysis because of low response rate, linguistic ambiguities or redundancy. The 41 remaining questions were analyzed for repeatability, internal consistency and the capacity to discriminate between patients with vertebral fractures and controls. Comparison with the SF-36 was performed within similar domains by conditional logistic regression and by receiver operating characteristic (ROC) curves. The repeatability of QUALEFFO was good (kappa statistics 0.54-0.90) and 26 of 41 questions had a kappa score >/=0.70. The internal consistency of the five domains was adequate, with Crohnbach alpha around 0.80. All except five questions discriminated significantly between patients and controls. The median scores of QUALEFFO were significantly higher in patients with vertebral fractures than in controls in all five domain (p<0. 001), which is consistent with decreased quality of life in patients with osteoporosis. Spinal radiographs were assessed using the McCloskey-Kanis algorithm. According to this, 124 patients (78%) had vertebral fractures of >/=3 SD severity, in contrast with 7 controls (4%). Significant correlations existed between scores of similar domains of QUALEFFO and the SF-36, especially for pain, physical function and mental function. All five domains within each questionnaire discriminated significantly between fracture cases and controls. The odds ratios for pain and social function were greater for QUALEFFO, while general health perception was more discriminating using the SF-36. The ROC curve analysis of QUALEFFO indicated that all five domains were significantly predictive of vertebral fractures. When comparing similar domains of the two questionnaires, QUALEFFO domains demonstrated significantly better performance for pain, physical function and social function. The QUALEFFO total score and SF-36 physical composite score showed similar performance. In conclusion, QUALEFFO is repeatable, coherent and discriminates well between patients with vertebral fractures and control subjects. The results of this study confirm the decreased quality of life in patients with vertebral fractures.

Aged↗

PubMed1992

The utility of the arthritis impact measurement scales for patients with psoriatic arthritis.

The Arthritis Impact Measurement Scales (AIMS) consists of 9 scales that measure physical function, pain and psychosocial function. It has been validated for use in various forms of arthritis, but not in psoriatic arthritis (PsA). The AIMS was administered to 145 patients attending our PsA clinic. We carried out simultaneous assessment of clinical measures of function, measures of disease activity, and measures of disease severity. Most scales of physical function were moderately to highly correlated with clinical measures of function (r = 0.33-0.57; p = 0.0001), measures of disease activity (r = 0.24-0.53, p = 0.003-0.0001), and measures of disease severity (r = 0.23-0.6; p = 0.02-0.0001). The pain scale was highly correlated with clinical measures of function and measures of disease activity (r = 0.38-0.58; p = 0.0001) but not with measures of disease severity. Of the psychosocial scales, the depression scale was moderately correlated with clinical measures of function (r = 0.27-0.3; p = 0.001-0.0001). Our data suggest that the physical function and pain scales are good indicators of overall function and disease activity and are valid for use in PsA.

Activities of Daily Living↗

PubMed2005

Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome.

OBJECTIVE: Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are associated with substantial physical disability. Determinants of self-reported physical disability are poorly understood. This investigation uses objective ambulatory activity monitoring to compare patients with FM and/or CFS with controls, and examines associations of ambulatory activity levels with both physical function and symptoms during activities of daily life. METHODS: Patients with FM and/or CFS (n = 38, mean +/- SD age 41.5 +/- 8.2 years, 74% women) completed a 5-day program of ambulatory monitoring of physical activity and symptoms (pain, fatigue, and distress) and results were compared with those in age-matched controls (n = 27, mean +/- SD age 38.0 +/- 8.6 years, 44% women). Activity levels were assessed continuously, ambulatory symptoms were determined using electronically time-stamped recordings at 5 time points during each day, and physical function was measured with the 36-item Short Form health survey at the end of the 5-day monitoring period. RESULTS: Patients had significantly lower peak activity levels than controls (mean +/- SEM 8,654 +/- 527 versus 12,913 +/- 1,462 units; P = 0.003) and spent less time in high-level activities when compared with controls (P = 0.001). In contrast, patients had similar average activity levels as those of controls (mean +/- SEM 1,525 +/- 63 versus 1,602 +/- 89; P = 0.47). Among patients, low activity levels were associated with worse self-reported physical function over the preceding month. Activity levels were inversely related to concurrent ambulatory pain (P = 0.031) and fatigue (P < 0.001). Pain and fatigue were associated with reduced subsequent ambulatory activity levels, whereas activity levels were not predictive of subsequent symptoms. CONCLUSION: Patients with FM and/or CFS engaged in less high-intensity physical activities than that recorded for sedentary control subjects. This reduced peak activity was correlated with measures of poor physical function. The observed associations may be relevant to the design of behavioral activation programs, because activity levels appear to be contingent on, rather than predictive of, symptoms.

Adult↗

PubMed2006

Quality of life and exercise performance in patients in sinus rhythm versus persistent atrial fibrillation: a Veterans Affairs Cooperative Studies Program Substudy.

OBJECTIVES: The purpose of this study was to determine quality of life (QOL) and exercise performance (EP) in patients with persistent atrial fibrillation (AF) converted to sinus rhythm (SR) compared with those remaining in or reverting to AF. BACKGROUND: Restoration of SR in patients with AF improving QOL and EP remains controversial. METHODS: Patients with persistent AF were randomized double-blind to amiodarone, sotalol, or placebo. Those not achieving SR at day 28 were cardioverted and classified into SR or AF groups at 8 weeks (n = 624) and 1 year (n = 556). The QOL (SF-36), symptom checklist (SCL), specific activity scale (SAS), AF severity scale (AFSS), and EP were assessed. RESULTS: Favorable changes were seen in SR patients at 8 weeks in physical functioning (p < 0.001), physical role limitations (p = 0.03), general health (p = 0.002), and vitality (p < 0.001), and at 1 year in general health (p = 0.007) and social functioning (p = 0.02). Changes in the scores for SCL severity (p = 0.01), functional capacity (p = 0.003), and AFSS symptom burden (p < 0.001) at 8 weeks and in SCL severity (p < 0.01) and AF symptom burden (p < 0.001) at 1 year showed significant improvements in SR versus AF. Symptomatic patients were more likely to have improvement. The EP in SR versus AF was greater from baseline to 8 weeks (p = 0.01) and to 1 year (p = 0.02). The EP correlated with physical functioning and functional capacity except in the AF group at 1 year. CONCLUSIONS: In patients with persistent AF, restoration and maintenance of SR was associated with improvements in QOL measures and EP. There was a strong correlation between QOL measures and EP.

Activities of Daily Living↗

PubMed2001

Quality of life assessment in patients undergoing endovascular or conventional AAA repair.

PURPOSE: To compare health-related quality of life outcomes in a cohort of abdominal aortic aneurysm (AAA) patients treated concurrently with either a conventional or endoluminal intervention. METHODS: Between December 1997 and April 1999, 51 AAA patients treated by either open or endovascular techniques were enrolled in this prospective study. Conventional therapy was performed in 26 patients (19 men; mean age 70.4 +/- 6.0 years) with anatomical features unsuitable for the endovascular approach. Twenty-five patients (23 men; mean age 70.7 +/- 7.2 years) underwent endoluminal AAA exclusion using either the Ancure or bifurcated Enduring stent-grafts. The Medical Outcomes Study Short-Form 36-item health survey was administered preoperatively and at 1, 4, 8, and > or = 52 weeks after discharge. RESULTS: At 1 week, both groups showed significant reductions (p < 0.001) in mean scores compared to baseline in 4 dimensions (physical function, social function, role-physical, and vitality), but the decline was more pronounced in patients having open repair. Endoluminal patients returned to their baseline scores by the 4th postoperative week, whereas complete recovery to baseline in the conventional patients was delayed to the 8th week. CONCLUSIONS: Patients treated endoluminally exhibit better physical and functional scores as early as 1 week after discharge; they also return to baseline status significantly earlier than the conventional group. These findings document the perceived advantage of endovascular therapy over conventional AAA treatment.

Aged↗

PubMed2001

Evaluation of the quality of life in Brazilian women with fibromyalgia, through the medical outcome survey 36 item short-form study.

PURPOSE: The purpose of this study is to assess the impact of Fibromyalgia (FM) on the female patient's quality of life who attended the Rheumatology Outpatient Unit of Sorocaba Hospital Complex and compare it to the quality of life of healthy control group, through the Medical Outcome Study Short-form 36 item Survey (SF36). SUBJECTS: 32 women who fitted the American College of Rheumatology Classification Criteria for Fibromyalgia and 28 healthy women. MATERIALS AND METHODS: The groups were submitted to 'Medical Outcome Study 36 Item Short-form Survey' (SF36). This questionnaire is composed of 8 scales about several aspects of the quality of life. RESULTS: The SF36 scales in the Fibromyalgia group presented the following results: general health--43.3; functional ability--39.4; bodily pain--26.5; physical functioning--14.8 (0-75); vitality--38.5 (5-85); emotional functioning--32.2; mental health--44.2; social functioning--45.1. The SF36 scales in the control group presented the following results: general health--73.2; functional ability--86.6; bodily pain--68.9; physical functioning--82.4; vitality--59.6; emotional functioning--78.5; mental health--67.4; social functioning--77.9. Significant statistics variations in all evaluated scales were presented by the survey group. CONCLUSION: Fibromyalgia has had a negative impact on the quality of life.

Adaptation, Physiological↗

PubMed2005

[Health-related quality of life in Japanese patients with ischemic heart disease: a multicenter cooperative investigation assessed using SF-36].

OBJECTIVES: To investigate the quality of life (QOL) of Japanese patients with ischemic heart disease. METHODS: The QOL data of 753 patients with chronic and stable ischemic heart disease was assessed using SF-36 Japanese version 1.2 and compared with Japanese national norms. Physical (PCS) and Mental Component Summary (MCS) scores were calculated to examine the correlation with patient background. Patients were also asked about subjective symptoms during the QOL investigation. RESULTS: Mean age was 63.6 +/- 7.5 years old and the male/female ratio was 85.7/14.3. About one third (30.7%) of the patients were symptomatic and about half (52.6%) had a history of myocardial infarction. Compared to Japanese national norms, physical functioning, role-physical, social functioning, general health and role-emotional were lower, and body pain, vitality and mental health were higher. PCS was significantly lower and MCS was significantly higher in aged patients than in younger patients (p < 0.0001, p < 0.0001). PCS and MCS were significantly lower in the symptom (+) group than in the symptom (-) group (p = 0.0009, p < 0.0001). PCS decreased as the number of anti-angina medications for the patients increased (p = 0.0002). PCS was significantly lower and MCS was significantly higher in the beta blocker (+) group than in the beta blocker (-) group (p < 0.0001, p < 0.03). Multivariate logistic regression analysis showed that age ( > or = 63 years old), symptom (+), duration of disease (> or = 3 years) and beta blocker (+) influenced the QOL. CONCLUSIONS: The QOL level of patients with ischemic heart disease was found to depend on the clinical condition and treatment, so the optimal treatment for ischemic heart disease must be established to improve QOL.

Adrenergic beta-Antagonists↗

PubMed1998

Measuring health status in British patients with rheumatoid arthritis: reliability, validity and responsiveness of the short form 36-item health survey (SF-36).

The objective was to assess the performance of the SF-36 health survey (SF-36) in a sample of patients with rheumatoid arthritis (RA) stratified by functional class. The eight SF-36 subscales and the two summary scales (the physical and mental component scales) were assessed for test retest reliability, construct validity and responsiveness to self-reported change in health. In 233 patients with RA, the SF-36 scales were: reliable (intra-class correlation coefficients 0.76-0.93); correlated with American College of Rheumatology (ACR) core disease activity measures [Spearman r = -0.12 (erythrocyte sedimentation rate) to -0.89 (Modified Health Assessment Questionnaire)]; and responsive to improvements in health (standardized response means 0.27-0.9). The distribution of scores on four of the eight subscales (physical function, role limitations physical, role limitations emotional and social function) was clearly non-Gaussian. Very marked floor effects were noted with the physical function scale, and both ceiling and floor effects with the other three subscales. The two SF-36 physical and mental component summary scales are reliable, valid and responsive measures of health status in patients with RA. Six of the eight subscales meet standards required for comparing groups of patients, and the physical function and general health scales may be suitable for monitoring individuals. The two scales measuring role limitations have poor measurement characteristics. The SF-36 pain and physical function scales may be suitable for use as patient self-assessed measures of pain and physical function within the ACR core disease activity set.

Activities of Daily Living↗

PubMed2001

Validation of the Childhood Health Assessment Questionnaire in the juvenile idiopathic myopathies. Juvenile Dermatomyositis Disease Activity Collaborative Study Group.

OBJECTIVE: To examine the validity of the Childhood Health Assessment Questionnaire (CHAQ) in patients with juvenile idiopathic inflammatory myopathy (IIM). METHODS: One hundred fifteen patients were enrolled in a multicenter collaborative study, during which subjects were assessed twice, 7-9 months apart. Physical function was measured using the CHAQ. Internal reliability was assessed using adjusted item-total correlations and item endorsement rates. Construct validity was assessed by comparing predicted and actual correlations of the CHAQ with other measures of physical function and disease activity. Responsiveness was assessed by calculating effect size (ES) and standardized response mean (SRM) in a group of a priori defined "improvers." RESULTS: Item-total correlations were high (rs range = 0.35-0.81), suggesting all items were related to overall physical function. Manual muscle testing and the Childhood Myositis Assessment Scale correlated moderate to strongly with the CHAQ (r = -0.64 and -0.75, both p < 0.001). Moderate correlations were also seen with the physician global assessment of disease activity (rs = 0.58, p < 0.001), parent global assessment of overall health (rs = -0.65, p < 0.001), Steinbrocker function class (rs = 0.69, p < 0.001), and global skin activity (rs = 0.40, p < 0.001), while global disease damage and skin damage had low correlations (rs = 0.13 and 0.07, p > or =0.17). Responsiveness of the CHAQ was high, with ES = 1.05 and SRM = 1.20. CONCLUSION: In this large cohort of patients with juvenile IIM, the CHAQ exhibited internal reliability, construct validity, and strong responsiveness. We conclude that the CHAQ is a valid measure of physical function in juvenile IIM, appropriate for use in therapeutic trials, and potentially in the clinical care of these patients.

Adolescent↗

PubMed2004

The contribution of daily experiences and acute exercise to fluctuations in daily feeling states among older, obese adults with knee osteoarthritis.

This study examined the contribution of daily experiences and acute exercise to fluctuations in feeling states of older, obese adults with knee osteoarthritis and explored the role of perceived physical function and general health perceptions as moderator variables. Using an experience sampling procedure, a total of 964 feeling state assessments were recorded and coded into samplings that occurred either on a nonexercise day or prior to or following scheduled activity on an exercise day. Multilevel modeling analyses controlling for the influence of subjective stress, contemporaneous pain reports, and diurnal variations revealed that physical exhaustion was higher immediately following exercise. Analyses of the moderator variables demonstrated that general health perceptions and perceived physical function accounted for significant portions of between-subject variance with more positive perceptions of each variable being related to higher levels of pleasant feeling states and lower feelings of physical exhaustion. However, perceived physical function and general health perceptions did not influence feeling states that emerged in conjunction with physical activity. The present findings suggest that whereas daily fluctuations in feeling states are influenced by perceived physical function and general health perceptions, older adults with knee OA do not exhibit the improvements in feeling states that have often been observed following acute exercise in younger, more physically active populations.

Adult↗

PubMed1998

Design of protein function by physical perturbation method.

Based on three-dimensional structure of proteins, a rational strategy to design the protein function by physical perturbation method was proposed and tested on one of the well-examined enzymes, thermolysin for higher catalytic activity. An attempt was made to change the electrostatic potential and the dynamic property of three-dimensional structure around the active sites by single-amino-acid mutations, and the physical property of the mutants was then evaluated. Several mutants were found to have remarkably higher enzymatic activity than wild type. The multiple mutation was introduced and the logarithm of the activity was found to be almost additive. A ten times higher active mutant was realized by simultaneously introducing three single-mutations. This strategy can be easily extended to not only other enzymes but also other kinds of proteins than enzymes to modify or control the protein function based on their three-dimensional structures.

Amino Acid Substitution↗

PubMed2004

Inflammatory and thrombotic blood markers and walking-related disability in men and women with and without peripheral arterial disease.

OBJECTIVES: To determine whether higher circulating levels of thrombotic and inflammatory markers are associated with greater disability. DESIGN: Cross-sectional. SETTING: Academic medical center. PARTICIPANTS: A total of 346 men and women with peripheral arterial disease (PAD) and 203 without PAD. MEASUREMENTS: Disability measures were the Walking Impairment Questionnaire (WIQ) distance, speed, and stair-climbing scores and the 36-item Short-Form (SF-36) physical functioning score. The SF-36 and WIQ are scored on a 0 to 100 scale (100=best). RESULTS: In persons with PAD, higher D-dimer levels were associated with lower WIQ speed scores (P<.001), lower stair-climbing scores (P<.04), and poorer SF-36 physical functioning scores (P<.01), adjusting for known and potential confounders. In participants without PAD, higher D-dimer levels were associated with lower WIQ distance scores (P<.03), lower speed scores (P<.05), and poorer SF-36 physical functioning scores (P<.02). Higher high-sensitivity C-reactive protein (hsCRP) levels were associated with lower WIQ distance (P<.02) and speed scores (P<.001) in persons without PAD. Most of these associations were attenuated after additional adjustment for objectively measured functional limitations. CONCLUSION: Higher circulating D-dimer and hsCRP levels are associated with greater disability in walking and physical functioning in individuals with and without PAD. Physiological changes that result in walking disability may mediate these associations.

Aged↗

PubMed2000

Health effects of involuntary job loss among older workers: findings from the health and retirement survey.

OBJECTIVES: To estimate the health consequences of involuntary job loss among older workers in the United States. METHODS: Using longitudinal data from the 1992 and 1994 waves of the Health and Retirement Survey, multivariate regression models were estimated to assess the impact of involuntary job loss on both physical functioning and mental health. Our analysis sample included 209 workers who experienced involuntary job loss between survey dates and a comparison group of 2,907 continuously employed workers. RESULTS: The effects of late-life involuntary job loss on both follow-up physical functioning and mental health were negative and statistically significant (p < .05), even after baseline health status and sociodemographic factors were controlled for. Among displaced workers, reemployment was positively associated with both follow-up physical functioning and mental health, whereas the duration of joblessness was not significantly associated with either outcome. DISCUSSION: The findings provide evidence of a causal relationship between job loss and morbidity among older workers. This relationship is reflected in both poorer physical functioning and mental health for workers who experience involuntary job loss. In addition to the economic consequences of worker displacement, there may be important health consequences of job loss, especially among older workers.

Activities of Daily Living↗

PubMed2002

Physical impairment and disability: relationship to performance of activities of daily living in community-dwelling older men.

BACKGROUND AND PURPOSE: The decline of physical function of older adults, associated with loss of independent living status, is a major public health concern. The purpose of this study was to examine the relationship of physical impairment and disability to performance of activities of daily living (ADL) among community-dwelling older adults. SUBJECTS AND METHODS: Eighty-three community-dwelling older men who were referred to a comprehensive outpatient geriatric evaluation program (mean age=75.5 years, SD=7.0, range=64-97) were examined. Measurements of physical impairment (muscle force production, flexibility, and fitness) and physical disability (gait speed, stride length, risk for recurrent falls, and physical function) were recorded. RESULTS: A stepwise linear regression was used to determine the relationship of physical impairments and disability measures with ADL. The results indicated that walking speed, fall risk, and muscle force contributed independently to the characterization of the activities of daily living of the community-dwelling older men studied (adjusted R2=.68; F=56.81; df=3,80; P<.001). Using a principal components factor analysis, 4 domains were identified that explained 68.2% of the variance in performance of ADL: (1) mobility/fall risk=26.5%, (2) coordination=15%, (3) fitness=14.7%, and (4) flexibility=12.0%. DISCUSSION AND CONCLUSION: The identification of domains of physical function may be useful to physical therapists in the development of interventions targeted for physical impairments and disabilities that contribute to deficits in performance of ADL. Targeting interventions for physical impairments and disabilities related to function may improve the effectiveness of physical therapist interventions and reduce the loss of independence among community-dwelling older people.

Activities of Daily Living↗

PubMed2003

Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: a randomized controlled trial.

BACKGROUND AND PURPOSE: The purposes of this study were: (1) to assess the effectiveness of a 16-week progressive program of home-based, videotape-based, low-impact aerobic exercise on physical function and signs and symptoms of fibromyalgia in previously sedentary women aged 20 to 55 years and (2) to compare the effects of 1 long exercise bout versus 2 short exercise bouts per training day (fractionation) on physical function, signs and symptoms of fibromyalgia, and exercise adherence. SUBJECTS: One hundred forty-three sedentary women were randomly assigned to 1 of 3 groups: a group who trained using a long bout of exercise (LBE group, n=51), a group who trained using short bouts of exercise (SBE group, n=56), and a group who performed no exercise (NE group, n=36). METHODS: The SBE group exercised twice daily, and the LBE group worked out once daily. Both groups progressed in total daily training duration from 10 to 30 minutes, 3 to 5 times a week, for 16 weeks. Physical and psychological well-being, symptoms, and self-efficacy were evaluated using a multivariate analysis of variance. RESULTS: Dropout rates for the NE, SBE, and LBE groups were 14%, 38%, and 29%, respectively. The NE group differed from the LBE group in disease severity, self-efficacy, and psychological well-being (midtest, efficacy analysis) and from the SBE group in disease severity and self-efficacy (posttest, efficacy analysis). Exercise adherence was greater for the LBE group than for the SBE group between weeks 5 and 8 of the training program. No other differences between exercise groups were found. DISCUSSION AND CONCLUSION: Progressive, home-based, low-impact aerobics improved physical function and fibromyalgia symptoms minimally in participants who completed at least two thirds of the recommended exercise. Fractionation of exercise training provided no advantage in terms of exercise adherence, improvements in fibromyalgia symptoms or physical function. High attrition rates and problems with exercise adherence were experienced in both exercise groups.

Adult↗

PubMed2004

The longitudinal occurrence and impact of comorbid chronic pain and chronic depression over two years in continuing care retirement community residents.

OBJECTIVE: To describe the longitudinal course of depressive symptoms and pain experienced by continuing care retirement community (CCRC) residents and to investigate the impact of comorbid chronic activity-limiting pain and chronic high depressive symptoms on physical functioning and health service use. METHODS: This longitudinal study of 169 CCRC residents involved five assessments (baseline and four in-person interviews at 6-month intervals). The Geriatric Depression Scale (GDS), questions drawn from the McGill Pain Questionnaire, and self-report data on physical functioning and health care use were assessed. Individuals reporting activity-limiting pain and those with GDS scores > or =11 at three or more assessments were considered to have chronic pain or chronic depression, respectively. The analysis sample included 169 CCRC residents. Multivariate logistic regression was used to test hypotheses. RESULTS: Pain and depressive symptoms were characterized by longitudinal stability. Of the sample, 37% met the criteria for chronic activity-limiting pain, 21% met the criteria for chronic high depressive symptoms, and 13% were comorbid. Adjusting for age and health conditions, those with chronic activity-limiting pain were five times more likely than those in the lowest pain group to persistently be in the worst two quartiles of physical functioning, as were those with even one GDS score >5. The odds of poor physical functioning were 11.2 times greater in those with comorbid chronic pain and depression. Comparable greater odds were seen in this sample for frequency of medical care visits (adjusted odds ratio AOR]=12.4) and consistently high use of all medical services (AOR=3.5). CONCLUSIONS: Pain and depressive symptoms were both common and appeared remarkably stable over time. Depressive symptoms contributed significantly to the prediction of impairment associated with pain, and identification and treatment of such symptoms, even minor symptoms, could reduce pain-related impairment and health care costs in the elderly.

Activities of Daily Living↗

PubMed2001

Components of quality of life for persons with a quadriplegic and paraplegic spinal cord injury.

This investigation determined the themes that represented quality of life for persons with a spinal cord injury. Fifteen people (6 females, 9 males; 7 persons with quadriplegia, 8 with paraplegia) participated in this study, which used naturalistic inquiry methodologies. Results showed that quality of life for this population, regardless of severity of impairment, consisted of nine themes: (a) physical function and independence, (b) accessibility, (c) emotional well-being, (d) stigma, (e) spontaneity, (f) relationships and social function, (g) occupation, (h) finances, and (i) physical well-being. The themes of life quality were similar for quadriplegics and paraplegics; however, physical function and independence and physical well-being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life.

Activities of Daily Living↗