4 results on '"Audrey Cohen"'
Search Results
2. Physical and Cognitive Function Assessment to Predict Postoperative Outcomes of Abdominal Surgery
- Author
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Nima Toosizadeh, Miguel Peña, Martha Ruiz, Bellal Joseph, Jane Mohler, Audrey Cohen, Hossein Ehsani, and Mindy J. Fain
- Subjects
medicine.medical_specialty ,Longitudinal study ,Aftercare ,Logistic regression ,Article ,Upper Extremity ,Cognition ,Predictive Value of Tests ,Abdomen ,Covariate ,Humans ,Medicine ,Longitudinal Studies ,Effects of sleep deprivation on cognitive performance ,Geriatric Assessment ,Aged ,business.industry ,Patient Discharge ,Test (assessment) ,Treatment Outcome ,Physical therapy ,Surgery ,Observational study ,business ,Abdominal surgery - Abstract
Background Current evaluation methods to assess physical and cognitive function are limited and often not feasible in emergency settings. The upper-extremity function (UEF) test to assess physical and cognitive performance using wearable sensors. The purpose of this study was to examine the (1) relationship between preoperative UEF scores with in-hospital outcomes; and (2) association between postoperative UEF scores with 30-d adverse outcomes among adults undergoing emergent abdominal surgery. Methods We performed an observational, longitudinal study among adults older than 40 y who presented with intra-abdominal symptoms. The UEF tests included a 20-sec rapid repetitive elbow flexion (physical function), and a 60-sec repetitive elbow flexion at a self-selected pace while counting backwards by threes (cognitive function), administered within 24-h of admission and within 24-h prior to discharge. Multiple logistic regression models assessed the association between UEF and outcomes. Each model consisted of the in-hospital or 30-d post-discharge outcome as the dependent variable, preoperative UEF physical and cognitive scores as hypothesis covariates, and age and sex as adjuster covariates. Results Using UEF physical and cognitive scores to predict in-hospital outcomes, an area under curve (AUC) of 0.76 was achieved, which was 17% more sensitive when compared to age independently. For 30-d outcomes, the AUC increased to 0.89 when UEF physical and cognitive scores were included in the model with age and sex. Discussion Sensor-based measures of physical and cognitive function enhance outcome prediction providing an objective practicable tool for risk stratification in emergency surgery settings among aging adults presenting with intra-abdominal symptoms.
- Published
- 2021
3. Cognitive Demands Influence Upper Extremity Motor Performance During Recovery From Acute Stroke
- Author
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Steven C. Cramer, Kristin Parlman, Samuel B. Snider, Kimberly Erler, Lee H. Schwamm, Nicole Lam, Leigh R. Hochberg, Jessica Ranford, Anna K. Bonkhoff, Jennifer Freeburn, David Lin, Julie DiCarlo, Seth P. Finklestein, and Audrey Cohen
- Subjects
0301 basic medicine ,Male ,Weakness ,medicine.medical_specialty ,Clinical Sciences ,computer.software_genre ,Article ,Lesion ,Upper Extremity ,03 medical and health sciences ,Grip strength ,0302 clinical medicine ,Physical medicine and rehabilitation ,Cognition ,Clinical Research ,Voxel ,medicine ,Humans ,Stroke ,Neurorehabilitation ,Acute stroke ,Aged ,Neurology & Neurosurgery ,business.industry ,Rehabilitation ,Neurosciences ,Recovery of Function ,Middle Aged ,medicine.disease ,Brain Disorders ,030104 developmental biology ,Cognitive Sciences ,Female ,Neurology (clinical) ,medicine.symptom ,business ,computer ,030217 neurology & neurosurgery ,Psychomotor Performance - Abstract
ObjectiveTo test the hypothesis that cognitive demands influence motor performance during recovery from acute stroke, we tested patients with acute stroke on 2 motor tasks with different cognitive demands and related task performance to cognitive impairment and neuroanatomic injury.MethodsWe assessed the contralesional and ipsilesional upper extremities of a cohort of 50 patients with weakness after unilateral acute ischemic stroke at 3 time points with 2 tasks: the Box & Blocks Test, a task with greater cognitive demand, and Grip Strength, a simple and ballistic motor task. We compared performance on the 2 tasks, related motor performance to cognitive dysfunction, and used voxel-based lesion symptom mapping to determine neuroanatomic sites associated with motor performance.ResultsConsistent across contralesional and ipsilesional upper extremities and most pronounced immediately after stroke, Box & Blocks scores were significantly more impaired than Grip Strength scores. The presence of cognitive dysfunction significantly explained up to 33% of variance in Box & Blocks performance but was not associated with Grip Strength performance. While Grip Strength performance was associated with injury largely restricted to sensorimotor regions, Box & Blocks performance was associated with broad injury outside sensorimotor structures, particularly the dorsal anterior insula, a region known to be important for complex cognitive function.ConclusionsTogether, these results suggest that cognitive demands influence upper extremity motor performance during recovery from acute stroke. Our findings emphasize the integrated nature of motor and cognitive systems and suggest that it is critical to consider cognitive demands during motor testing and neurorehabilitation after stroke.
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- 2021
4. Nonlinear analysis of the movement variability structure can detect aging-related differences among cognitively healthy individuals
- Author
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Nima Toosizadeh, Audrey Cohen, Talia Tax, Hossein Ehsani, Jane Mohler, and Mehran Asghari
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Adult ,medicine.medical_specialty ,Aging ,Adolescent ,Coefficient of variation ,Movement ,Biophysics ,Experimental and Cognitive Psychology ,Audiology ,Stability (probability) ,Article ,Upper Extremity ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Cognition ,Normal cognition ,medicine ,Humans ,Orthopedics and Sports Medicine ,Elbow flexion ,Gait ,Mathematics ,Aged ,Significant difference ,030229 sport sciences ,General Medicine ,Biomechanical Phenomena ,Sample entropy ,Nonlinear system ,Healthy individuals ,030217 neurology & neurosurgery - Abstract
Studying the dynamics of nonlinear systems can provide additional information about the variability structure of the system. Within the current study, we examined the application of regularity and local stability measures to capture motor function alterations due to dual-tasking using a previously validated upper-extremity function (UEF). We targeted young (ages 18 and 30 years) and older adults (65 years or older) with normal cognition based on clinical screening. UEF involved repetitive elbow flexion without counting (ST) and while counting backward by one (DT1) or three (DT3). We measured the regularity (measured by sample entropy (SE)), local stability (measured by the largest Lyapunov exponent (LyE)), as well as conventional peak-dependent variability measures (coefficient of variation of kinematics parameters) to capture motor dynamic alterations due to dual-tasking. Within both groups, only SE showed significant differences between all pairs of UEF condition comparisons, even ST vs DT1 (p = 0.007, effect size = 0.507), for which no peak-dependent parameter showed significant difference. Among all measures, the only parameter that showed a significant difference between young and older adults was LyE (p 0.001, effect size = 0.453). Current findings highlight the potential of nonlinear analysis to detect aging-related alterations among cognitively healthy participants.
- Published
- 2020
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