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Employment status is considered a determinant of health, yet returning to work is frequently a challenge after lower limb amputation. No studies have documented if working after lower limb amputation is associated with functional recovery. The study's purpose was to examine the influence of full-time employment on functioning after lower limb amputation. Multisite, cross-sectional study of 49 people with dysvascular lower limb amputation. Outcomes of interest included performance-based measures, the Component Timed-Up-and-Go test, the 2-min walk test, and self-reported measures of prosthetic mobility and activity participation. Average participant age was 62.1 ± 9.7 years, 39% were female and 45% were persons of color. Results indicated that 80% of participants were not employed full-time. Accounting for age, people lacking full-time employment exhibited significantly poorer outcomes of mobility and activity participation. Per regression analyses, primary contributors to better prosthetic mobility were working full-time (R2 ranging from 0.06 to 0.24) and greater self-efficacy (R2 ranging from 0.32 to 0.75). This study offers novel evidence of associations between employment and performance-based mobility outcomes after dysvascular lower limb amputation. Further research is required to determine cause-effect directionalities. These results provide the foundation for future patient-centered research into how work affects outcomes after lower limb amputation. Lower limb amputation can pose barriers to employment and activity participation, potentially affecting the quality of life. This study found that the majority of people living with lower limb amputation due to dysvascular causes were not employed full-time and were exhibiting poorer prosthetic outcomes. Healthcare practitioners should consider the modifiable variable of employment when evaluating factors that may affect prosthetic mobility. The modifiable variable of self-efficacy should be assessed by healthcare professionals when evaluating factors that may affect prosthetic mobility. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is expected to bring a surge of survivors in need of post-acute rehabilitation. Preliminary research and clinical guidelines suggest patients recovering from critical illness associated with COVID-19 will present compromised function similar to acute respiratory distress syndrome (ARDS) and ICU-acquired weakness (ICUAW). However, information regarding physical therapy and progressions of physiological and functional outcomes is currently limited. This case report describes the course of recovery of a patient without significant preexisting medical conditions. The patient RW (male, age 56) tested positive for COVID-19, and was admitted to ICU for 29 days. After weaning off mechanical ventilation after 2 months of hospitalization, he was transferred to our post-acute rehabilitation facility to recover from the residual effects. Physical therapy evaluation showed that while the patient was cognitively alert, he exhibited impaired general strength and activity intolerance due to severe exertional dyspnea. The patient received physical therapy aimed at improving his functional capacity. During his 16-day stay, the patient was able to significantly improve his capacities (i.e. 600% increase in 30-second chair stand test, 69.5% improvement in walking distance in 6-minute walk test, and 132.4% longer time to exhaustion during level ground ambulation). Dyspnea remained the main factor that limited his activities. This case demonstrated that post-acute physical therapy appeared to be effective and safe in improving function after critical illness due to COVID-19 for this patient. Physical therapists are encouraged to closely monitor respiratory parameters such as heart rate, oxygen saturation, and levels of dyspnea during treatment for patient response and decisions regarding activity progression. [ABSTRACT FROM AUTHOR]

Indoor sport rock climbing has been increasing in popularity both recreationally and competitively. Despite this increase in popularity, the physiological responses to sport climbing as an exercise to specific muscle groups are not well defined. The purpose of this study was to quantify the change in handgrip strength over a 30-minute bout of continuous climbing, specifically in intermediate-level sport climbers. Ten intermediate rock climbers (age = 27 ± 2 years; climbing experience: 7.3 ± 1.5 years) completed baseline handgrip strength and forearm girth measurements. Each participant ascended one of two 5.9 difficulty routes as many times as possible in 30 minutes. After each ascent, heart rate was obtained, and handgrip strength and forearm girth were measured. Data were analyzed using repeated-measures ANOVA with significance set at α< 0.05. Dominant arm handgrip strength decreased by 22%, and non-dominant handgrip strength reduced by 23%. Dominant and non-dominant forearm girth increased by 4.5% and 4.4%, respectively. Weak but significant negative correlations were observed between handgrip strength and forearm girth in dominant (r = -0.311, p = 0.001) and non-dominant limbs (r = -.491, p = 0.001). These results indicate a relationship between increased forearm girth and decreases in muscular strength. Since handgrip strength decreases substantially during a 30-min climb in intermediate rock climbers, this population would be advised to carefully monitor recovery time between bouts. [ABSTRACT FROM AUTHOR]

Age-related decline in vision may contribute to the development of fear of falling (FOF) behavior and reduced mobility, which are related to increased fall risk in older adults. To investigate the inter-relationship between vision impairment, physical mobility performance, and FOF behavior in community-dwelling older adults. A total of 400 participants from community centers (267 females; age = 74.8 (6.4), range = 65–97 years) participated in this cross-sectional study. Presence of age-related eye diseases (e.g. macular degeneration, cataracts, glaucoma, and retinopathy) and visual acuity (VA) was assessed. Physical mobility and FOF avoidance behavior were assessed using the Timed Up-and-Go (TUG) test and the Fear of Falling Avoidance Behavior Questionnaire (FFABQ). The inter-relationships between parameters were analyzed using mediation model analysis. Significant decreases in mobility performance were observed in those with eye disease (eye disease = 9.56 [5.2] sec, no eye disease = 8.54 [2.75] sec; p =.037) and FOF avoidance behavior (avoiders = 12.87 [6.04] sec, non-avoiders = 8.51 [3.56] sec; p <.001). Furthermore, FOF behavior was found to significantly influence the inter-relationship between presence of eye disease and TUG performance (p =.004). VA alone had no significant effect on mobility (p =.69). The presence of eye disease and the associated FOF behavior was related to decreased mobility and potentially increased fall risk. We recommend clinicians to inquire about the presence of eye disease and FOF behavior to identify risk factors related to falls in older adults. [ABSTRACT FROM AUTHOR]

Objective: To examine how insertion and presence of intramuscular fine-wire electromyography electrodes (IFWEs) in lumbar multifidus affect paraspinal muscle strength, endurance, and activation in persons with and without recurrent lower back pain (RLBP) during activities that require high levels of muscle contraction.Design: Case-control with randomization of conditions.Setting: Clinical research laboratory.Participants: Forty participants age 18 to 40 years were recruited (18 female; mean age = 25.5 years); 20 with a history of RLBP were compared to a matching control group of 20 without RLBP.Interventions: Each participant was tested under three conditions over three sessions. On Session 1, the baseline condition, we assessed muscle performance without IFWE insertion. On Sessions 2 and 3, participants were randomly alternated between two experimental conditions: (1) wire-in, in which the IFWE was inserted and remained within the muscle during testing; and (2) wire-out, in which the IFWE was inserted and immediately removed.Main Outcome Measurements: Lumbar spinal extensor peak strength, endurance, and normalized electromyography (EMG) amplitude during the endurance test.Results: Individuals with RLBP showed a significant decrease in peak strength during conditions that involved IFWE insertion and tend to experience more pain during muscle testing. Both groups exhibited similar levels of performance and muscle activation during the endurance test.Conclusion: Our findings indicate that individuals with RLBP exhibited reduced lumbar extensor strength in response to IFWE insertion to the deep paraspinal muscles. This behavior is different from those without RLBP. Researchers should carefully consider the use of IFWE in individuals with RLBP during high exertion activities. [ABSTRACT FROM AUTHOR]