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Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of unknow etiology. Male sex is a well stablished risk factor, but other factors such as early and adult life expositions show contradictory evidence. Aim: to explore the link of clinical, sociodemographic, and occupational factors with ALS patients in Spain and the impact of these factors in functionality. Methods: A cross-sectional study was conducted with ALS patients and healthy controls. Registered variables were smoking, arterial hypertension, diabetes mellitus type 2, previous cancer to reproductive organs or breast, occupational exposure, and early life exposures. Functionality in ALS patients was compared according to each exposure. Results: The ALS group consisted of 59 participants and the control group of 90 participants. ALS patients showed a significant association with previous cancer (p = 0.011), occupational exposure (p < 0.001), and older siblings (p = 0.029). ALS patients presented significant differences in BMI according to hypertension and older-sibling factors. Moreover, respiratory function was affected in patients with previous cancer (p = 0.031). Conclusions: Occupational exposure and previous cancer to reproductive organs or breast could be linked to ALS patients. In addition, hypertension and previous cancer could affect their BMI and respiratory function. Other factors such as longer smoking periods and exposition to older siblings could also characterize ALS patients. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the impact of haemophilia A without inhibitors on humanistic outcomes in patients and caregivers. Herein, we report a cross‐sectional analysis of the baseline data of persons with haemophilia (PWH) participating in the prospective study HEMOLIFE. Methods: These data are part of a prospective, observational, and multicentre study currently being conducted in 20 hospitals in Spain by haematologists. We included subjects 12 years or older diagnosed with haemophilia. The evaluations included the Maladjustment Scale, Haemophilia–Specific Quality of Life Questionnaire for Adults (HaemoQol)/HaemoQol Short Form (Children), haemophilia‐specific version of the Work Productivity and Impairment Questionnaire plus the Classroom Impairment Questionnaire (WPAI+CIQ:HS), Haemophilia Activity List (HAL)/Paediatric Haemophilia Activities List (pedHAL), visual analogue scale (VAS) for evaluating pain, Coping Pain Questionnaire–Reduced (CAD‐R), and Hospital Anxiety and Depression Scale (HADS). Results: A total of 81 PWH were recruited at 18 centres; 66 PWH were ≥18 years (i.e., adults), and PWH 15 were <18 years (i.e., paediatric patients). Out of the 79 evaluable subjects, 16 (20%) showed an impact of haemophilia on daily life, and the areas most affected were "leisure time" (58% showed maladjustment) and "work/studies" (47% showed maladjustment). Patients reported a higher impact of haemophilia on quality of life (mean [SD] of the transformed score) in the dimensions of "sport" (49.4 [28.6]), "physical health" (40.5 [25.8]) and "future" (37.7 [28.9]). In adults, according to HAL scores, greater impairment of function was observed in "lying/sitting/kneeling/standing," "function of legs" and "leisure activities and sports," with mean normalized scores of 64.7, 65.1 and 69.0, respectively. Productivity was mostly impacted by presenteeism. The pain was infrequent and moderate. According to the HADS scores, nine (11.5%) patients had clinical anxiety and depression. Conclusion: PWH without inhibitors exhibited impairments in adjustment, quality of life and functionality, especially related to leisure and sports activities, and exhibit relevant levels of anxiety and depression. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the relationship between clinical severity and functionality, occupational performance, and health-related quality of life in patients hospitalized with pulmonary embolism. Pulmonary embolism patients were grouped by clinical severity using the Pulmonary Embolism Severity Index. Those scoring ≥160 were in the high-severity group (HSG); those scoring < 160 in the low–moderate group (LMSG). The main variables were functionality assessed by the World Health Organization Disability Assessment Schedule (WHODAS), self-perception of occupational performance assessed by the Canadian Occupational Performance Measure (COPM), pain and fatigue assessed by a Visual Analogue Scale (VAS), and health-related quality of life assessed by the EuroQol-5Dimensions (EQ-5D). Patients were evaluated at hospital admission and at 1-month and 3-month follow-up. At admission, there were significant differences between groups in the WHODAS and health-related quality of life in favor of the LMSG. At 1-month and at 3-month follow-up, there were significant differences between the LMSG and HSG in WHODAS, COMP, NRS pain, fatigue and EQ-5D scores in favor of the LMSG. An association exists between clinical severity and mid-term functionality, self-perception of occupational performance, pain, fatigue, and health-related quality of life in PE patients. [ABSTRACT FROM AUTHOR]

Background: Shoulder injuries are substantial problems in overhead athletes, and more studies are necessary to deepen the knowledge on this type of injury. The objective of this study was to compare the overall function and performance of female overhead athletes with and without a previous history of shoulder injuries. Methods: In this cross-sectional study, female overhead athletes with and without a previous shoulder injury were included. Muscular impairment, the stability of the shoulder, strength, scapular dyskinesia, functionality and sports performance were evaluated. A total of 50 females were included. Results: There were significant differences in strength (p = 0.046) and stability (p = 0.039) between groups, with a poorer score in the group with a history of shoulder injury. Regarding scapular dyskinesia, significant differences were also observed between groups (p = 0.048), with higher levels of dyskinesia in the group with previous shoulder injury. Also, muscular impairment showed significant differences between groups for the three muscles evaluated (p < 0.005). Additionally, the group without a previous shoulder injury presented with a significantly greater score in functionality (p = 0.046) and sports performance (p = 0.004). Conclusion: In conclusion, previous shoulder injuries are an important factor to take into account in female overhead athletes. Players with a history of shoulder injury present clinical impairments during the game, leading to poorer functional status and performance in sport. [ABSTRACT FROM AUTHOR]

This study aimed to detect the functional and emotional impact of COVID‐19 lockdown on institutionalized older adults with sarcopenia during a 15‐month follow‐up. A prospective longitudinal cohort study was conducted in a nursing home. Participants were screened for sarcopenia, and those with a score of ≥4 points according to SARC‐F questionnaire were included. Assessments were performed pre‐lockdown (T1), 12 months (T2) after, and at a 15‐month follow‐up (T3). Functional measurements included chair stand test, handgrip, biceps brachii and quadriceps femoris strengths, appendicular skeletal mass, gait speed, Short Physical Performance Battery, and Timed Up‐and‐Go test. Emotional assessments included Short‐Form Health Survey, Geriatric Depression Scale—Short Form, and the Mini‐Mental State Examination. The analyzed sample showed a reduction in bicep strength, and other upper and lower limb strength variables showed a decreasing trend with no changes regarding muscle mass. Physical performance showed a change, specifically a deterioration in the subtest related to balance. Cognitive and emotional components were affected and quality of life was decreased. It is of paramount importance to focus on sarcopenic older adults since their characteristics can deteriorate when isolation measures are conducted. [ABSTRACT FROM AUTHOR]

Institutionalized individuals with intellectual disabilities have few opportunities to participate in instrumental activities of daily living (IADLs), which probably affects higher cognitive functions, or vice versa. The objectives of this study were to evaluate the possible difference in the ability to perform IADLs and executive functioning between individuals with and without intellectual disabilities and to determine if executive functions are associated with the performance of IADLs in people with intellectual disabilities. This was a multi-center cross-sectional study, conducted between July 2019 and May 2020. Participants with intellectual disabilities were recruited from four centers for people with intellectual disabilities. Adults without these disabilities were gathered from several community centers. The sample consisted of 90 individuals with moderate intellectual disabilities and 79 individuals with no intellectual disability. Executive functions were evaluated using the Wechsler Adult Intelligence Scale—WAIS-IV, the INECO Frontal Screening test, the Semantic Verbal Fluency Test, and the Behavioural Assessment of the Dysexecutive Syndrome—BADS—Scale. The performance of the IADLs was assessed by the Lawton and Brody Scale. The results showed that the higher the function in instrumental activities, the lower the impairment of executive functions. Executive functions accounted for 81% of the total variance in the ability to perform the IADLs. In conclusion, individuals with moderate intellectual disabilities demonstrated limitations in executing the IADLs, which were partially associated with low performance in executive functions. This information could help in the development of evidence-based intervention programs and facilitate the formulation of appropriate support strategies to enhance participation in these activities. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the impacts of the restrictions implemented in LTCF during the COVID-19 pandemic on the psychological and functional status of older adults. Design: A retrospective multicentre study is designed. We hypothesize that the negative effects of the restrictions will lead to a higher rate of decline between the measures taken immediately before and after the lockdown than between the two measures taken before the lockdown. Setting and participants: 365 participants recruited in four Spanish LTCFs in Galicia and Valencia. Methods: Impacts of restrictions on cognitive (MMSE), affective (GDS) and functional status (Barthel index, Tinetti) were analyzed by Linear Mixed Models with random intercepts, random slopes, and personal and contextual factors as covariates. Results: Social measures covaried significantly with the cognitive and functional status but did not predict longitudinal change. MMSE, Barthel index and Tinetti scores decreased significantly across pre- and post-lockdown measurement times, but only the Tinetti scores showed a specific impact of the restrictions. Conclusions: Only performance-based functional measures showed the real impact of restrictions. The findings highlight the importance of having data from several pre-lockdown measurements to enable identification of changes that can be causally attributed to the restrictions. The findings also support the resilience of older adults in mitigating the effect of the restrictions. [ABSTRACT FROM AUTHOR]

Improvements in diagnosis and treatment of head and neck cancer (HNC) patients have resulted in improved long-term survival rates. However, a variety of symptoms and comorbidities, often secondary to the cancer and its treatments, are experienced by a relevant number of survivors. So, the aim of this study was to determine the global functional impairment in HNC survivors 1 year after radiotherapy treatment. A descriptive case-control study was performed. HNC survivors were recruited from San Cecilio Clinical University Hospital in Granada. The main variables included were functionality and quality of life. 30 HNC survivors were included in our study. Significant differences were found in the WHO-DAS 2.0 test, with a worse score in the HNC group in most subscales (p < 0.05), and poorer scores in the COMP test, performance (p < 0.001) and satisfaction (p < 0.001). Significant differences were also found in most QLQ-30 subscales (p < 0.05) and the QLQ-H&N35. In regard to the EQ-5D, significant differences were found between groups, with worse results in the HNC group (p < 0.05). HNC survivors presented a poorer global function and a worse quality of life and health status 1 year after the radiotherapy treatment. Moreover, a good correlation was found between functionality and quality of life outcomes. A worse quality of life and health status are shown in head and neck survivors 1 year after radiotherapy. Global functionality is related to quality of life outcomes in head and neck cancer survivors. There is a need to recognise the need for and to provide longer term rehabilitation. [ABSTRACT FROM AUTHOR]

Background: The diversity of patients' symptomatology among people seeking treatment on community-based mental health services poses significant challenges to traditional models of care. Recent approaches favor identifying transdiagnostic factors that allow a better understanding of patient heterogeneity and designing more effective and quality interventions. This study examines the heterogeneity of patients with internalizing symptoms based on profiles identified with cognitive and motivational control variables. Differences between these profiles on dimensional measures of psychopathology and quality of life are examined., Methods: 263 patients were selected by non-probabilistic sampling procedures on mental health services in the province of Huelva (Spain). A latent class analysis on the standardized scale scores of The Behavioral Inhibition/Behavioral Activation System Scales and the Effortful Control Scale of the Adult Temperament Questionnaire Short-Form was conducted. Profiles were compared on the scores of the Inventory of Depression and Anxiety Symptoms-II, the WHO Disability Assessment Schedule II, and the Health Assessment Questionnaire SF-36., Results: The four latent profile solution is the one that showed the best fit indicators and substantive interpretability, with a kappa of 0.94 in the cross-validation procedure with 75% of the sample. No sex differences were found between the profiles (χ 3  5.17, p = .160). Profiles #1 and #3, both characterized by an imbalance between low activation and high inhibition, had lower well-being, lower functionality, and quality of life. When comparing profile #2 (featuring the highest inhibitory control) lower scores on most internalizing scales are observed, specially claustrophobia, social anxiety, panic mania. Profile #4 (low control, high activation, and high inhibition) showed greater scores on both mania and euphoria and lower scores on emotional role.2  5.17, p = .160). Profiles #1 and #3, both characterized by an imbalance between low activation and high inhibition, had lower well-being, lower functionality, and quality of life. When comparing profile #2 (featuring the highest inhibitory control) lower scores on most internalizing scales are observed, specially claustrophobia, social anxiety, panic mania. Profile #4 (low control, high activation, and high inhibition) showed greater scores on both mania and euphoria and lower scores on emotional role., Conclusions: We identified four distinctive profiles that had overly increased behavioral inhibition (as expected in internalizing disorders) and differed in the degree of imbalance between inhibition and activation systems, and between motivational systems and top-down cognitive control. The profile characterized by high activation and reduced cognitive (inhibitory) control was the one showing greater mood-related symptoms and lower levels of quality of life. These profiles could be generated by treatment providers to guide clinical management in an evidence-based manner., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Stroke is the fourth leading cause of death in Europe, represents one of the most common causes of disability in adult patients, and involves considerable short- and long-term social and healthcare costs. The effectiveness of deep dry needling (DDN) on affected arm functionality was assessed throughout 8 weeks of treatment in patients with stroke in the subacute phase. Methods: Eighty patients were included in this two-group non-randomised study after a propensity score analysis was carried out. Both groups received standard physiotherapy treatment on the affected arm. The needling group also received six sessions of DDN during the 8-week period. Patients were evaluated before and after each session using the Fugl-Meyer upper extremity (FM UE) scale, the modified modified Ashworth scale (MMAS), the resistance to passive movement scale (REPAS) and a 10-point numeric pain rating scale (NPRS 10). The Brunnstrom recovery stage was recorded at the beginning and at the end of the study, and the EuroQoL quality of life survey was completed at the beginning of the study, after the first month of treatment and at the end of the study. Results: Patients treated with DDN showed a reduction in spasticity measured using the REPAS (p < 0.001) and the MMAS (p < 0.05). There was also an improvement in the Brunnstrom recovery stages (p < 0.05). Conclusion: The addition of a specific DDN treatment to a standard physiotherapy treatment appeared to lead to a higher reduction in spasticity in the affected arm; however, it did not provide additional changes in functionality, pain and quality of life. Further studies with a randomised controlled trial design are required to confirm our findings. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze and compare the role of a water-based exercise program versus a combination of water and callisthenic exercises on postural control, functional independence, and freezing of gait (FOG) in patients with mild to moderate Parkinson disease. Methods: Twenty-five community-dwelling participants with idiopathic Parkinson disease were recruited. Of these, 9 participants took part in a water-based program of physical exercises and the other 16 participants took part in a combined program that consisted of callisthenic exercises plus an aquatic exercise session. Both programs were 16 weeks in duration. The clinical evaluation assessed the festination by means of the FOG score test; postural control was verified by means of the balance test of the short physical performance battery, and the Spanish validated version of the Unified Parkinson's Disease Rating Scale part 2 was used to assess functional independence. Participants were evaluated before and after 16 weeks of both proposed programs. Results: The results showed improvement in FOG for both groups, although a significant main effect was observed only in the patients who performed the callisthenic exercise plus an aquatic exercise program. Postural control did not show significant improvements after both proposed physical exercise programs as soon as functional autonomy. Our preliminary results suggest that training sessions with the combination of water plus callisthenic exercises may be a useful physical rehabilitation strategy for individuals with mild to moderate Parkinson disease who have FOG. [ABSTRACT FROM AUTHOR]

Objective: Hip fracture (HF) in the elderly carries high mortality and decreases functionality and quality of life after one year. The aim of this paper was to identify risk factors that influenced functionality (Barthel) and quality of life (EQ-5D) of the elderly with osteoporotic HF., Methods: A prospective observational study was made in people over 65 years of age with HF between October 2017 and November 2018. Clinical information was collected from the digital medical record and the scales were measured by telephone at four times: baseline, one month, six months and twelve months. Statistical analysis was made thanks to SPSS vs 25.0. Multivariate analysis was performed using a generalized linear model for repeated measures to determine the relationship of risk factors with functionality and quality of life., Results: Functionality showed significant differences (p<0.001) between baseline measurement and one month (90 points vs 50); baseline and at twelve months (90 vs 60 points); and that of the month and at twelve months (50 points vs 60). Quality of life also presented significant differences (p<0.001) between baseline and one month (0.587 vs 0.113); and baseline and twelve months (0.220). The functionality should be in transfused and with high surgical risk (p<0.05) and the quality of life will arrive in high surgical risk (p=0.017). Those older than 85 years were the ones who recovered the least after one year, as well as patients with delirium on admission and those who received transfusions. Patients with iron therapy recovered better at six months compared to those who did not and maintained this improvement at twelve months., Conclusions: Among the main risk factors are advanced age, male sex, transfused, high surgical risk, delirium on admission and malnutrition., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: Studies on the potential of smartphone apps for people with autism are currently increasing in number, given the large digital supply available and the benefits they offer. We analyzed the opinion of educators from Florence (Italy) and Granada (Spain) regarding the benefits and applicability of apps, frequency of their use, and the type of apps used for people with autism., Methods: The study involved 1261 professionals, of whom 286 worked with apps, using a non-experimental quantitative design, descriptive and frequency statistics, parametric inferential analyses (Student's t and one-factor ANOVA), and calculation of the effect size (Cohen's d and eta squared) and intrafactorial correlations., Results: Statistically significant differences were observed in respect of city, sex, age, years of experience, place of work, and type of teacher. The teachers from Granada found more benefits and applicability in apps, and revealed a slightly higher usage than those from Florence., Conclusions: It is an arduous but worthy task for professionals from schools and associations that work with people with autism to acquire the necessary knowledge to apply methodologies based on information and communication technology (ICT), as this will help achieve the integrated development of people with different capabilities.

Objective: The aim of the study was to analyze the feet of rheumatoid arthritis (RA) patients, to determine the degree to which both feet were affected, primarily analyzing the severity of RA in both feet looking at structure and morphology, and secondly looking at the symmetry in terms of the anthropometrics and posture., Method: This cross-sectional study was conducted from January to December 2018. The data from 229 patients with RA and with foot pain and no RA recruited (Granada, Spain) were analyzed. Two researchers independently interviewed the patients to obtain the study data. The clinical data were obtained using specific foot health and quality of life questionnaires and a validated platform for foot measurement. Anthropometric measurements were obtained by means of a foot measurement platform and the Foot Posture Index (FPI). The bivariate analysis was performed with the Student's t test and the non-parametric Wilcoxon test. The level of significance was established at p < 0.05., Results: In the RA group, anthropometric measurements revealed significant differences between the left and right feet in 13 of the 23 parameters considered, as follows: (non-load-bearing) foot length, length of the first metatarsophalangeal joint, maximum height of the internal longitudinal arch, and width of the midfoot ( p < 0.001, p = 0.038, p < 0.001, and p = 0.037 respectively); and Foot Posture Index ( p = 0.001)., Conclusions: In patients with RA, statistically significant differences were found in the Foot Posture Index and in several parameters related to foot structure and morphology. From this, we conclude that from a morphological, structural, and postural standpoint, a pattern of symmetric joint involvement should not be viewed as a specific criterion for RA in the foot.

Objective: In spite of technical advances, hip fracture causes high mortality in the elderly. We wanted to know early surgery influence to mortality during admission, one year and after five years, as well as readmissions at one month and one year. We also wanted to know how dependence and Health-Related Quality of Life (HRQOL) evolved in the twelve months of follow-up and what factors were associated with poor patient evolution., Methods: A prospective observational study was made in patients over 65 years of age treated for osteoporotic hip fracture in a level III hospital between 2010- 2012, with consecutive sampling. We evaluated functionality (Barthel) and quality of life (EuroQol-5D) basal (before fracture), within 30 days, within six and twelve months; readmissions within the 30 days and within one year; and mortality during admission; within one and five years. We used the statistical program SPSS Version 25.0 for the statistical analysis., Results: We followed 327 patients of 82.9 (SD: 6.9) years of means, 258 (78.9%) were women. Fifty-four (45.9%) were treated within 24 hours and 237 (72.5%) within 48 hours. They returned 14 (4.3%) within the 30 days and 44 (13.5%) within the one year. There were 8 deaths during admission (2.4%) and 61 (19.2%) in the first year and 185 (54,6%) within five years. The pre-fracture quality of life was 0.43 median (0.24-0.74), at the month 0.15 (0.07-0.28), at six months 0.26 (0, 13-0.59) and at twelve 0.24 (0.15-0.58). The previous functionality was 85.0 (55.0-100) at the month 35.0 (20.0-60.0) and 60.0 (25.0-85.0) at six and twelve months. There were significant differences between all visits except between six and twelve months., Conclusions: The patients get worse significantly at the month of surgery and recover in the six months, remaining at twelve, without reaching the baseline value. The results in mortality and readmissions per year are worse for men and older. Early surgery does not reduce mortality, but re-admissions to the year.

Low back pain (LBP) is a common problem in manufacturing workers. Several strategies have been proposed in order to reduce the pain and/or improve functionality. Among them, lumbar supports are a common solution prescribed for lumbar pain relief. Most of the studies in the literature only consider subjective sensations of the workers for evaluation assessment. This study applies biomechanical tests (a flexion-relaxation test and a functional movement evaluation test) to analyse the effectiveness of flexible lumbar supports in functionality and disability versus placebo intervention, consisting of kinesiotape placed on the low back without any stress. 28 workers participated in the study, randomised in control and intervention groups with a two months' intervention. None of the biomechanical tests showed statistical differences in between-groups pre-post changes. No benefits of wearing a flexible lumbar support during the workday have been found in these assembly-line workers versus placebo intervention.

Background: The Barthel Index is one of the most employed questionnaires for the evaluation of functionality, but there is no information on its psychometric properties., Objective: The aim was to evaluate the reliability, validity, and responsiveness of the Spanish version of the Barthel Index., Methods: The data employed in this paper were obtained from four Spanish cohorts of elderly people of 60 years or older. We collected data on age, gender, education level, comorbidities, and questionnaires regarding functionality, health-related quality of life, depression, and social support., Results: The Cronbach's alpha coefficients were greater than 0.70. The confirmatory factor analysis provided satisfactory fit indexes and factor loadings. The correlation coefficients between the Barthel Index and the other questionnaires were lower than the Cronbach's alpha coefficients. Known-groups validity showed significant differences in the Barthel Index according to age, number of comorbidities, and gender. The standardized effect size and the standardized response mean were between 0.68 and 1.81., Discussion: This version of the Barthel Index has good reliability, its structural validity has been confirmed, and the questionnaire can discriminate between groups and detect changes at follow-up points., Conclusions: This questionnaire can be used in the evaluation of functionality and basic activities of daily living in elderly people with different conditions.