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PubMedDate not supplied

Physical function and fear of falling after hip fracture rehabilitation in the elderly.

OBJECTIVE: The purpose of this study was to determine the relationship between physical function and fall-related self-efficacy in older patients with a hip fracture who are undergoing an intensive rehabilitation program. DESIGN: We used a prospective cohort study over 12 mo to determine the effect of a specialized hip fracture rehabilitation program in a geriatric hospital on physical function and fear of falling. Fifty-six patients were admitted consecutively from acute care. Physical function was assessed using the Functional Independence Measure, and fall-related self-efficacy was measured using two scales: the Falls-Efficacy scale and the Activities-Specific Balance Confidence scale. We also used the Vitality scale to measure quality of life. All measures, represented by change scores, were determined at the beginning and end of the patients' rehabilitation programs. RESULTS: Significant improvement in physical function and fall self-efficacy was observed. The Vitality scale was also improved after rehabilitation. The Falls-Efficacy scale appeared to be more sensitive to change than the Activities-Specific Balance Confidence scale, whereas no correlation was found between changes in the fall-related self-efficacy measures and the Functional Independence Measure. CONCLUSIONS: These findings may represent a discrepancy between attention of the rehabilitation program on functional outcomes and less emphasis on confidence building behaviors. Restrictions in function from a fear of falling may negate any gains made through rehabilitation, and this could limit the long-term success of these programs and patient outcomes after hip fracture.

Accidental Falls↗

PubMed1987

Assessing physical function in the elderly.

This article emphasizes the complexity underlying the assessment of physical function. The concept of physical function is multidimensional; individuals or groups can be assessed; the assessments can be either preintervention measures or outcome measures. Six issues of measurement are discussed: verbal report versus behavior; self-reported versus proxy-reported information; capacity versus performance; assumptions in Activities of Daily Living and Instrumental Activities of Daily Living measurement; differences between items and instruments; and the search for a summary index. Specific instruments are reviewed.

Activities of Daily Living↗

PubMed2003

Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors.

OBJECTIVE: To identify factors that predict a poor physical function outcome over 3 years in individuals with knee osteoarthritis (OA), in an effort to aid in the development of strategies to prevent such functional limitations and consequential disability. METHODS: Community-recruited individuals with knee OA underwent baseline, 18-month, and 3-year assessments of candidate risk factors and physical function. Risk factors were age, body mass index (BMI), knee pain intensity (on a visual analog scale [VAS]), local mechanical and neuromuscular factors (varus-valgus laxity, malalignment, proprioceptive inaccuracy, quadriceps strength, hamstring strength), activity level (Physical Activity Scale for the Elderly, amount of aerobic exercise), and psychosocial factors (Short-Form 36 [SF-36] mental health and role-functioning emotional subscales, self-efficacy using the Arthritis Self-Efficacy Scale physical function subscale, and social support using the Medical Outcomes Study Social Support Survey). Outcome was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function scale and rate of chair-stand performance. Participants were grouped by quintile of baseline WOMAC score. The baseline to 3-year outcome was considered "good" when function improved by 1 or more quintiles or remained within the 2 highest function groups, and was considered "poor" when function declined by 1 or more quintiles or remained within the 3 lowest function groups. The same approach was taken for chair-stand outcome. Logistic regression was used to evaluate both the baseline level and the baseline to 18-month change in each factor as a predictor of physical function outcome over 3 years, adjusting for age, BMI, knee pain intensity, disease severity, and additional potential confounders. RESULTS: Factors that significantly increased the likelihood of a poor WOMAC outcome were baseline laxity (crude odds ratio [OR] 1.48/3 degrees, 95% confidence interval [95% CI] 1.02-2.14), BMI (OR 1.26/5 units, 95% CI 1.01-1.57), knee pain intensity (OR 1.21/20 mm on VAS, 95% CI 1.00-1.47), and baseline to 18-month increase in knee pain (OR 1.32/20 mm on VAS, 95% CI 1.06-1.65). Factors that significantly protected against a poor WOMAC outcome were better baseline mental health (OR 0.62/5 points, 95% CI 0.44-0.87), self-efficacy (OR 0.79/5 points, 95% CI 0.67-0.93), and social support (OR 0.86/10 points, 95% CI 0.75-0.98), and greater amount of aerobic exercise (OR 0.75/60 minutes each week, 95% CI 0.63-0.89). Factors that increased the likelihood for a poor function outcome by the chair-stand performance rate were age and proprioceptive inaccuracy, and factors that reduced the likelihood for poor chair-stand outcome were strength (attenuated after adjusting for pain intensity or self-efficacy), self-efficacy, and aerobic exercise. Individuals who sustained high function and those who sustained low function over the 3 years were described. CONCLUSION: Factors placing individuals with knee OA at greater risk of a poor function outcome by at least 1 of the 2 function measures included the local factors laxity and proprioceptive inaccuracy, as well as age, BMI, and knee pain intensity. Factors protecting against a poor function outcome included strength, the psychosocial factors mental health, self-efficacy, and social support, and the activity level measured by the amount of aerobic exercise per week. The identification of these factors provides possible targets for rehabilitative and self-management strategies to prevent disability.

Aged↗

PubMed2003

The influence of differing social ties on decline in physical functioning among older people with and without chronic diseases: the Longitudinal Aging Study Amsterdam.

BACKGROUND AND AIMS: Global social support measures have been shown to be related to several health outcomes. However, little is known about the effects of differing social ties and their support on the risk for decline in physical functioning among older people, without as compared with those with chronic diseases. This study examines whether differing types of social ties and support differentially mitigate the negative effects of chronic diseases on decline in physical functioning. METHODS: Using data from two cycles of the Longitudinal Aging Study Amsterdam (N=2357), logistic regression analyses adjusted for baseline functioning, age, gender, and incidence of chronic diseases were conducted, to assess the effect of differing social ties for subgroups with different numbers of chronic diseases. Information about the presence of differing social ties included partner status and numbers of daughters, sons, other family members, and non-kin relationships. Social support included instrumental and emotional support, and the experience of loneliness. Decline in physical functioning was determined by substantial change after three years on a 6-item self-report scale. RESULTS: Although having a partner had a protective effect on decline in physical functioning in people without chronic diseases at baseline, this was not the case for those with chronic diseases. Total network size had an adverse effect in older people without chronic diseases, but a positive effect when chronic diseases were present, mainly due to a positive effect of the number of daughters and non-kin relationships. CONCLUSIONS: Our results provide evidence that differing types of social relationships and the support they provide, differentially influence decline in physical functioning in older people, with or without chronic diseases.

Aged↗

PubMed2004

Quadriceps activation failure as a moderator of the relationship between quadriceps strength and physical function in individuals with knee osteoarthritis.

OBJECTIVE: To determine if quadriceps activation failure (QAF) moderates the relationship between quadriceps strength and physical function in individuals with knee osteoarthritis (OA). METHODS: Quadriceps strength and QAF were measured in 105 subjects (80 females) with radiographically confirmed knee OA using a burst-superimposition maximum voluntary isometric quadriceps torque test procedure. Subjects performed the Get Up and Go test as a physical performance measure of function and completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as a self-report measure of function. A principal component analysis was performed to combine the Get Up and Go score and the WOMAC subscores into a single function score. Hierarchical regression analysis was performed to examine the ability of 3 models to predict physical function (strength = function; strength + QAF = function; strength + QAF + [strength x QAF] = function). Partial F tests were used to compare differences in R(2) values between each model. RESULTS: Each model independently predicted the principal component score for function. Adding the strength x QAF interaction term with strength to the model resulted in the highest prediction of function. The strength x QAF interaction indicated that subjects with lower levels of quadriceps strength and higher levels of QAF had lower levels of function than those with comparable levels of weakness but low levels of QAF. CONCLUSION: The magnitude of QAF serves to moderate the relationship between quadriceps strength and physical function. Physical function may be more severely affected by weakness of the quadriceps muscles in individuals with knee OA who have higher degrees of QAF than those who may have quadriceps weakness, but do not have QAF.

Exercise Test↗

PubMed2004

How neighborhoods and physical functioning are related: the roles of neighborhood socioeconomic status, perceived neighborhood strain, and individual health risk factors.

BACKGROUND: Increasing attention is being paid to the impact of neighborhood residence on individual health status. PURPOSE: This study examined pathways through which low neighborhood socioeconomic status (SES) and associated subjective neighborhood characteristics may be associated with self-reported physical functioning. METHODS: A sample of 658 adults responded to a questionnaire survey sent to residents of lower and higher SES neighborhoods. Measures of neighborhood social cohesion and problems were obtained and individual deprivation, social integration, sense of control, and financial strain were assessed with standard measures. Physical functioning was assessed with the MOS 36-item Short Form health survey. RESULTS: Structural equation modeling analyses showed that living in a lower socioeconomic neighborhood was associated with greater perceived neighborhood strain, which, in turn, was associated with poorer physical functioning. Lower neighborhood SES and greater perceived neighborhood strain were associated with poorer physical functioning of individuals through less social integration, less perceived control, and greater financial strain. Individual deprivation was also related to less social integration, less perceived control, and greater financial strain. CONCLUSIONS: Neighborhood SES and associated perceptions of neighborhoods are associated with physical functioning to some extent through the shaping of the social and psychological experiences of individuals living within them.

Adolescent↗

PubMed2003

Effect of strength and power training on physical function in community-dwelling older adults.

BACKGROUND: The performance of daily tasks, such as stair climbing or lifting an object, requires both muscle strength and power. Age-associated reductions in strength and power can affect an older adult's ability to complete daily tasks such as stair climbing and lifting a child. METHODS: The purposes of this study were to determine whether power training was more efficacious than strength training for improving whole-body physical function in older adults and to examine the relationship between changes in anaerobic power and muscle strength and changes in physical function. Thirty-nine men and women (mean age +/- SD = 72.5 +/- 6.3 years) with below-average leg extensor power were randomly assigned to control (C, n = 15), strength-training (ST, n = 13) or power-training (PT, n = 11) groups. The ST and PT groups met 3 days per week for 16 weeks; the C group maintained usual activity and attended three lectures during the course of the study. Primary outcome measures included the Continuous Scale Physical Functional Performance test, maximal strength, and anaerobic power. RESULTS: After baseline was controlled for, the Continuous Scale Physical Functional Performance test total score was significantly greater for the PT group than for the ST (p =.033) and C (p =.016) groups. Maximal strength was significantly greater for the ST group than for the C group (p =.015) after the intervention. There was no significant difference between groups for peak anaerobic power. CONCLUSIONS: Power training was more effective than strength training for improving physical function in community-dwelling older adults.

Activities of Daily Living↗

PubMed2004

A pilot study to examine the effects of a mindfulness-based stress-reduction and relaxation program on levels of stress hormones, physical functioning, and submaximal exercise responses.

OBJECTIVE: Stress has been cited as a causal factor in heart disease. The objective of this study was to examine the effects of an 8-week mindfulness-based stress-reduction program on the resting levels of stress hormones, physical functioning, and submaximal exercise responses in women with heart disease. SUBJECTS: Random selection with the numbers 1 and 2 were used to assign 18 women (60 +/-6.3 years old) with documented histories of heart disease to a treatment group (n = 9) or a control group (n = 9). Speilberger's state anxiety scores for the treatment (M = 37.88; standard deviation (SD) = 10.91) and control group (M = 43.22; SD = 12.26) were not significantly different prior to the start of the study. However, their scores fell in the upper percentile rank for normal adults in their age category. INTERVENTION: The intervention was provided one night each week for 2 hours over a period of 8 weeks. The intervention included didactic, inductive, and experiential modes of learning regarding stress responses and mindfulness skill-development training. DESIGN: Pre-post test hormonal measurements and physical function were analyzed using a 2 (group) by 2 (time) analysis of variance (ANOVA) with repeated measures following the 8-week program. Submaximal exercise responses were also compared between the treatment group and the control group following the 8-week program. A 2 (group) by 3 (time) ANOVA with repeated measures was used to analyze the data. SETTINGS/LOCATION: Weekly meetings were held on a university medical school campus. Submaximal exercise responses were recorded while participants cycled on a stationary bike in an applied physiology laboratory following the 8-week program. RESULTS: There were no significant main effects or interaction for the resting levels of stress hormones or physical functioning. There were no significant interactions for the submaximal exercise responses, however, there were significant main effects between groups for ventilation [F(2,32) = 7.65, p < .01, f = 0.8], and between group [F(1,16) = 8.84, p < .01, f = 0.8] and time [F(2,32) = 10.42, p < .01, f = 0.9], for breathing frequency. CONCLUSION: While the 8-week stress reduction program for women with heart disease did not show significant interactions between groups for resting levels of stress hormones, physical functioning, or submaximal exercise responses, there was a significant difference in breathing patterns between the 2 groups during exercise following the mindfulness-based stress-reduction program. There was also a trend for change in the intervention group in the resting levels of cortisol and physical function scores that was not seen in the control group. Future studies could use the effect size generated from this pilot study to calculate the number of subjects needed for adequate power to detect significant differences between groups.

Aged↗

PubMed2002

[Influence of lifestyle, biological and other factors on subjective evaluation of physical functioning].

OBJECTIVE: To assess the strength of relationship between various lifestyle, biological, psychosocial factors, chronic conditions, pain and subjective physical performance, evaluated by "Physical functioning" scale from "Rand-36 Health Survey" questionnaire. MATERIAL AND METHODS: We used a standardized generic health related quality of life questionnaire. The study population was based on the original sample, formerly explored during the study, carried out by the Department of Propedeutics to Internal Medicine. It enroled 575 primary care patients from seven small towns located in Kaunas region. The effect exerted by various factors on ratings of subjective physical performance was evaluated by means of multiple logistic regression. Ratings of the "Pain" scale, as well as subjective rating of change in health during preceding year were included in the analysis. RESULTS: The biggest influence on rating of physical functioning was exerted by reported deterioration in health during preceding year and severity of pain. Among biological factors, age, diastolic blood pressure (>80 mmHg), body mass index (> or =35) and FEV1 (%) were adversely related to subjective ratings of physical health. Smoking status, chronic respiratory conditions, disablement group, perceived lack of social support, reported shortage of food expenditures and being pensioned off, all remained significant predictors of worsened physical functioning. CONCLUSIONS: Perceived physical health is affected by both objective biological and subjective factors related to the history of disease as well as psychosocial factors. These should be taken into account when planning clinical trials where health-related quality of life is intended to be analyzed among outcomes of interest.

Aged↗

PubMed1995

Concordant and discrepant views of patients' physical functioning.

OBJECTIVE: Although considerable research has been done on patient-physician interaction, few studies have examined discrepancies between patients and physicians in their assessments of the patient's physical functioning. One recent study reports such discrepancies between rheumatologists and 41% of their rheumatoid arthritis patients. This article reports data replicating that study and examining the relationships between such discrepancies and a number of other variables. METHODS: This is a longitudinal study of 158 patients with rheumatoid arthritis who were interviewed 4 times over a 2-year period and who reported their levels of physical functioning on the Arthritis Impact Measurement Scales. At the time of the fourth interview, the rheumatologists rated each patient's physical functioning on the revised criteria published by the American College of Rheumatology. RESULTS: Rheumatologists' assessments of their patients' physical functioning were discrepant with the patient's assessment for 35% of these patients. Twenty-seven patients were rated as worse than they rated themselves and 28 were rated as better. There were no differences between the concordant and the two discrepant groups in demographic or health status characteristics.

Activities of Daily Living↗

PubMed2006

Predictors of physical functioning among adults with severe mental illness.

OBJECTIVES: Living conditions and treatment-related factors contribute to high rates of comorbid medical illness among adults with severe mental illness and undermine their physical well-being. This study examined physical functioning scores for this population and compared them with national norms. METHODS: A total of 309 residential care clients completed interviews. Diagnostic and sociodemographic variables were examined for significant associations with physical functioning, which was assessed with the Medical Outcomes Health Survey Short Form 36 (SF-36), and selected variables were entered into a hierarchical multiple regression analyses. Cross-sectional comparisons examined differences in scores between ten-year age groups in this sample and in the national data for men and women. RESULTS: In the final regression model, male gender, younger age, having earned income in the past six months, having less lifetime smoking, and having an admission diagnosis other than depression or schizophrenia spectrum disorders predicted better physical functioning. Functioning scores for the sample deviated from the national normed scores. Differences in functioning increased with each ten-year increment in age; study participants' functioning resembled that of cohorts ten to 20 years older. CONCLUSIONS: Determinants of physical functioning in this sample included well-known demographic predictors of health outcomes. The more striking finding was a deviation from normative data that began for study participants at the age of 25 years, indicating an early onset of limitations. The consistent trend of poorer functioning with each successive age group raises questions about the pace of physical decline among adults with mental illness that may be addressed in longitudinal studies.

Adolescent↗

PubMed2004

Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study.

The aim of the study was to present the prevalence of clinical signs and symptoms among female computer users above 45 years, both in a group with self-reported neck/shoulder trouble (NS cases) and in a group without such trouble (NS controls). The hypothesis was that computer users with self-reported neck/shoulder trouble have more clinical findings than those not reporting trouble, and that a corresponding pattern holds true for physical function. In total 42 and 61 questionnaire-defined NS cases and NS controls participated and went through a clinical examination of the neck and upper extremities and five physical function tests: maximal voluntary contraction (MVC) of shoulder elevation, abduction, and handgrip, as well as endurance at 30% MVC shoulder elevation and a physical performance test. Based on clinical signs and symptoms, trapezius myalgia (38%), tension neck syndrome (17%) and cervicalgia (17%) were the most frequent diagnoses among NS cases, and were significantly more frequent among NS cases than NS controls. A total of 60% of the subjects with reported trouble had one or several of the diagnoses located in the neck/shoulder. Physical function of the shoulder was lower in subjects with self-reported trouble as well as in the subgroup of NS cases with clinical diagnoses. In conclusion, the present clinical diagnoses and physical function tests differed between NS cases and NS controls, and are therefore recommended to be included as quantitative objective measures in assessing musculoskeletal health. Physical function tests should be further developed in order to be able to detect pre-stages of work-related disorders for preventive strategies.

Case-Control Studies↗

PubMed1997

Evaluation of the MOS SF-36 Physical Functioning Scale (PF-10): II. Comparison of relative precision using Likert and Rasch scoring methods.

This study examined the relative precision (RP) of two methods of scoring the 10-item Physical Functioning Scale (PF-10) from a large sample of patients (n = 3445) of the Medical Outcomes Study. Based on a Likert scaling model, the PF-10 summated scoring method was compared with a Rasch Item Response Theory (IRT) scaling model in which raw scores were transformed into a latent trait variable of physical functioning. Potential differences between scoring methods were hypothesized to be attributed to: (1) the logarithmic nature of the Rasch transformation; (2) the unevenness of the PF-10 item distributions; and (3) reduction of within-group variance. RP ratios favored the Rasch model in discriminating between patients who differed in disease severity. The Rasch and Likert scoring models performed similarly for tests involving sensitivity to change over a two-year follow-up period. In all comparisons, differences between methods were most apparent in clinical groups whose scores most approximated the extremes of the score distribution. Further research is necessary to test for differences between scoring models in discrimination and sensitivity to change among clinical groups whose scores are sufficiently spread across the continuum of physical functioning, in particular patients with either very high or low physical functioning. The Rasch model of scoring may have important implications for the clinical interpretation of individual scores at all ranges of the scale.

Data Interpretation, Statistical↗

PubMed2003

Contextualizing depression and physical functioning in battered women: adding vulnerability and resources to the analysis.

This investigation examined the relationships between physical, psychological, and sexual abuse along with vulnerability appraisals, positive and negative social relations, and socioeconomic resources on battered women's depression symptomatology and physical functioning. Women were recruited following an incident of partner violence that resulted in a police-report or the filing of a protection order. Participants were surveyed using a standardized questionnaire. Bivariate correlations and multiple regressions were used to examine the relationships between predictors as well as the cumulative and unique contributions of each variable set in explaining depression and physical functioning. Findings indicate that vulnerability appraisals, social relations, and socioeconomic resources significantly explain women's depression and physical functioning over and above the unique effect of specific types of partner violence. Given that women's physical and mental health are important aspects of assisting women with safety planning and violence cessation strategies, implications for assessment and interventions for battered women are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Longer term benefits of treating rheumatoid arthritis: assessment of radiographic damage and physical function in clinical trials.

Evidence from randomized controlled trials with newly approved DMARD therapies have proven efficacy by American College of Rheumatology [ACR] response criteria, Disease Activity Scores [DAS] and radiographic measures of disease progression. Treatment over 2 years duration results in clinically meaningful improvements in physical function, by the Health Assessment Questionnaire [HAQ] and health related quality of life [HRQOL], using the medical outcomes short form 36 [SF-36]. Changes in HAQ are evident within one month, maximal at 3-6 months, and sustained over 24 months, reflected by improvements in social functioning, role emotional and the general health profile as well as physical domains of SF-36. Trials with the new DMARDs, as well as MTX, indicate that long term benefits in radiographic damage and physical function can be inferred from treatment data over 12 months. "Successful" patients who continue to do well will derive benefit from treatment for as long as 3 to 5 years. Recent RCTs indicate that combination therapy, initiated together, offers more improvement in radiographic progression and physical function than monotherapy, although the trial data cannot yet tell us which DMARD may be most beneficial in a given patient. Once treatment with any one agent--biologic or synthetic--is initiated, the addition of a second agent should occur rapidly, if for example active disease persists 8 or 12 weeks later, without waiting for documented treatment failure. If this treatment paradigm is followed, along with regular assessments of radiographic damage and physical function, then patients may more likely derive long term clinical benefit than with traditional approaches.

Antirheumatic Agents↗

PubMed2000

Comparison of changes in physical functioning of elderly patients with new diagnoses of cancer.

BACKGROUND: Controversy surrounds the impact of site of cancer and treatments on functioning of elderly cancer patients. OBJECTIVES: This research determines (1) whether age, gender, comorbid conditions, site and stage of cancer, and treatments are related to losses in physical functioning at 4 observations during the year after diagnosis; (2) whether symptoms are a mediating variable between treatment and function; and (3) which indicators account for true change in functioning in the year after diagnosis. METHODS: An inception cohort of 907 patients aged > or =65 years and newly diagnosed with breast, colon, lung, or prostate cancer were accrued from 24 community oncology programs. Stage and treatment data were obtained from medical records. Physical functioning was measured with the SF-36 subscale. Interviews were conducted at 6 to 8, 12 to 16, 26 to 30, and 52 weeks after diagnosis. RESULTS: Men scored 10 points higher on physical function than women at all observation points. Patients with > or =3 comorbid conditions scored lower in functioning. Interactions between site of cancer and treatment modalities were observed. Pain, fatigue, and numbers of symptoms were independent predictors of loss of function. Surgery, female gender, and number of symptoms predicted reliable change in function. CONCLUSIONS: Elderly patients with cancer report levels of function similar to other chronic conditions. Scores on physical function varied by site of cancer; the pattern of change was similar among sites. Age, comorbidity, treatment modalities, and symptom reports each had an independent effect on loss of functioning. Untreated breast cancer patients had lower functioning, suggesting a possible treatment bias.

Aged↗

PubMed2005

Relationship of quality of life and physical function measures with disease activity in children with systemic lupus erythematosus.

The objective of this study is to assess relationship of systemic lupus erythematosus (SLE) activity with quality of life (QOL) and physical function and determine which is more closely correlated with SLE activity in children; and identify factors critical to children's QOL. In this cross-sectional study, children with SLE and parents completed corresponding versions of physical function (Childhood Health Assessment Questionnaire CHAQ), and QOL (Pediatric Quality of Life Inventory-PedsQL Generic/Rheumatology modules) questionnaires. SLE Disease Activity Index (SLEDAI), Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI), severity, self-concept and socioeconomic status (SES) were measured. For 24 children, CHAQ scores significantly correlated with SLEDAI (rho = 0.4, p = 0.04), SDI (rho = 0.6, p = 0.004), and associated with severity (p = 0.03). PedsQL scores did not significantly correlate with above parameters. Higher self-concept/SES correlated (p < 0.05) with better physical function and QOL. For 19 parents, the only significant correlation was between SLEDAI and Worry domain-Rheumatology module (rho = 0.5, p = 0.01). Lack of strong correlation of disease activity with QOL and physical function suggests that they are different constructs with partial overlap, and should be considered collectively while evaluating the impact of SLE on children/families. Self-concept and SES should be assessed while measuring QOL in children. Larger sample is required to confirm results.

Adolescent↗

PubMed2004

Predictors of physical function in patients with peripherial arterial disease and claudication.

Limitation of walking due to claudication is the hallmark of peripheral arterial disease. The purpose of this secondary analysis was to identify biobehavioral predictors of physical function in peripheral arterial disease patients that included walking ability, gender, age, disease severity, environmental factors (social support), and medical comorbidity (arthritis). All subjects performed an exercise treadmill test to determine initial and absolute claudication distance. The sample consisted of 97 peripheral arterial disease patients, 71 (73%) men and 26 (27%) women, with a mean age of 73+/-8 years (range 52-90 years). Initial claudication distance occurred at 171.88+/-136.35 m. Absolute claudication distance was 421.03+/-286.37 m. A simultaneous multiple regression analysis was performed to determine predictors of physical function. The model accounted for 35% of the variance (p<0.001) and included personal characteristics (age, gender, years of education), severity of disease by ankle-brachial index, environmental factors of social support (marital status), absolute claudication distance, and arthritis. Education (p=0.011), absolute claudication distance (p=0.014), social support (p=0.026), arthritis (p=0.028), and age (p=0.033) were the strongest predictors of physical function. This study identifies biobehavioral factors that place peripheral arterial disease patients at greater risk for reduced physical function and provides a rationale for interventions that improve walking ability.

Activities of Daily Living↗