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This study aims to perform the cross-cultural adaptation to European Portuguese of the Composite Physical Function Scale and to assess its validity and reliability in a sample of community-dwelling older adults. The scale was translated into European Portuguese, back translated, and piloted in a sample of 16 representative individuals. Its validity and reliability were tested in an independent sample of 114 community-dwelling older adults (52 were tested twice to assess test–retest reliability). The results showed that the scale had good internal consistency (α =.90), construct validity (ρ =.71) and measurement error (78.8% agreement), and excellent test–retest reliability (κ =.98). However, a ceiling effect was found as 28% of the participants achieved the highest possible score. Although the scale has good measurement properties, the presence of ceiling effects is indicative that this tool is not able to distinguish higher levels of intrinsic capacity within community-dwelling older adults. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONAs the global population aged 60+ grows, ensuring mobility and independence for older adults is a critical public health goal. This paper examines barriers to life-space mobility in older adults and explores wearable lower limb exoskeletons (LLEs) and green exercise as innovative solutions.Literature search and interdisciplinary expert input were utilized.Life-space mobility, the physical space individuals move through daily, is often restricted by physical and environmental barriers, leading to increased dependency, depression, and reduced quality of life. LLEs offer promising support by compensating for decreased intrinsic capacities, thus facilitating outdoor mobility. Green exercise (i.e., physical activity in nature) provides mental and physical health benefits, further promoting mobility and well-being.Combining LLEs with green exercise may create powerful rehabilitation modalities, addressing both physical and mental aspects of aging. Integrating life-space mobility research into exoskeleton development and rehabilitation programs ensures these solutions meet real-world needs, supporting Healthy Aging by maintaining functional ability. Future research should focus on user-centered development of optimized exoskeleton designs for outdoor use, developing tailored rehabilitation programs, and educating healthcare professionals and caregivers to maximize benefits. This integrated approach holds potential to significantly improve life-space mobility and quality of life for the aging population.Life-space mobility, the physical space a person moves through daily, tends to decrease with increasing age due to physical and cognitive decline.(Assistive) lower limb exoskeletons could help older adults overcome physical and environmental barriers, enhancing their ability to engage in physical activity and enhance life-space mobility.Green exercise, which can benefit both mental health and rehabilitation effectiveness, may be even more effective when combined with lower limb exoskeletons.Rehabilitation professionals should consider lower-limb exoskeletons as a promising tool to promote exercise and physical activity beyond indoor laboratory settings.Life-space mobility, the physical space a person moves through daily, tends to decrease with increasing age due to physical and cognitive decline.(Assistive) lower limb exoskeletons could help older adults overcome physical and environmental barriers, enhancing their ability to engage in physical activity and enhance life-space mobility.Green exercise, which can benefit both mental health and rehabilitation effectiveness, may be even more effective when combined with lower limb exoskeletons.Rehabilitation professionals should consider lower-limb exoskeletons as a promising tool to promote exercise and physical activity beyond indoor laboratory settings. [ABSTRACT FROM AUTHOR]

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Background: Eating performance is the functional ability to get food into the mouth and chew/swallow it. Nursing home residents with dementia commonly experience compromised eating performance and subsequent consequences. Prior work examined the association between resident eating performance and their cognitive and functional ability. Yet, the associations between resident eating performance and behavioral and psychological symptoms, psychotropic medication use, and comorbidities are less studied. This study aimed to examine the association between eating performance and cognition, functional ability, behavioral and psychological symptoms, psychotropic medication use, and comorbidities in nursing home residents with dementia. Methods: This was a secondary analysis using baseline data from two randomized controlled trials, testing the impact of Function Focused Care on function and behavioral symptoms in 882 residents with moderate-to-severe dementia (mean age 86.55 years, 71% female, 30% non-white, 68.5% severe dementia) from 67 nursing homes in two states between 2014 and 2020. Eating performance (dependent variable) was measured using the single self-feeding item of Barthel Index. Independent variables included cognitive impairment, functional ability (Barthel Index total score excluding the self-feeding item score), behavioral and psychological symptoms (agitation, depression, resistiveness-to-care), psychotropic medication use (anti-depression, sedative, anti-psychotics, anti-seizure, anti-anxiety), and comorbidities. Results: Nearly 39% of residents were dependent in eating. On average, residents had five documented comorbidities (SD = 3.06, range = 0–12) and were on approximately one psychotropic medication (SD = 1.25, range = 0–5). Eating performance was associated with cognitive impairment (OR = 0.53, 95% CI = 0.35, 0.79, p =.002), functional ability (OR = 1.05, 95% CI = 1.04, 1.06, p <.001), depressive symptoms (OR = 0.94, 95% CI = 0.89, 0.98, p =.007), and anxiolytic use (OR = 0.64, 95% CI = 0.42, 0.99, p =.046). Conclusions: Findings supported that better eating performance was associated with less cognitive impairment, higher functional ability, fewer depressive symptoms, and less anxiolytic use. Targeted interventions to accommodate to cognitive function, optimize functional ability, minimize anxiolytic use, and manage depressive symptoms are encouraged to support eating performance in residents with dementia. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to develop and validate a functional ability index (FAI) that incorporates aspects of intrinsic capacity and environmental factors of older individuals based on the World Health Organization framework of healthy ageing. Methods Data of 7016 participants ≥60 years participating in the baseline survey of China Health and Retirement Longitudinal Study was used for the development and internal validation of the FAI. External validation was performed in a separate cohort of 1295 older individuals aged ≥60 years. Functional independency was considered the primary outcome and additional proxies of healthy ageing were considered as secondary outcomes. Cluster dendrogram was used to identify the distinct hierarchical clusters of all included variables for inclusion in the FAI. Backward elimination logistic regression model was implemented to identify the most significant variables associated with independency to be included in the FAI. Results The FAI score ranged from 0 to 19 and individuals having FAI ≥ 12 were more likely to be independent and at lower risk of negative outcomes. For each unit increase in the FAI the risk of having independency increased by 30%–58% cross-sectionally in the two cohorts, whilst the 2-year risk of independency increased by 20%. The FAI demonstrated a C-statistic of 0.73 (95% confidence interval, 0.72 and 0.75) for the primary outcome. Conclusions The FAI we developed effectively measured the functional ability status of community dwelling older individuals. FAI could serve as a tool for evaluating older individual's functional ability in routine health assessment. [ABSTRACT FROM AUTHOR]

Purpose: Children with cerebral palsy (CP) have limited postural control and functional ability. TheraTogs was reported to improve postural stability. However, studies involving the functional ability and quality of life are limited. We aimed to investigate the effects of TheraTogs use as an orthotic garment and strapping system on the balance and functional ability of children with spastic diplegic CP and if wearing TheraTogs improves their quality of life. Patients and Methods: A total of 34 children (aged 5– 8 years) with spastic diplegic cerebral palsy participated in this study. The control group received conventional physical therapy (CPT), whereas the study group received CPT in addition to wearing TheraTogs. Balance, lower limb strength, and functional abilities were examined using the Biodex balance system, 30-s chair rise test, and Pediatric Evaluation of Disability Inventory-PEDI). Results: The measured parameters of postural stability significantly improved in both groups post-treatment (p< 0.05). The study group showed significant improvement in balance and lower limb strength compared to the traditional physical therapy group (p < 0.05). Both groups showed significant improvement in functional skill mobility (0.001 and 0.01 for control and study groups respectively) and caregiver assistance mobility scores (p=0.001 and < 0.001 for control and study groups respectively); however, there was no significant improvement in self-care ability with TheraTogs. The 30s sit-to-stand showed increased number of sit to stands in both groups post treatment (p=< 0.001 for both groups) and the study group showed significant improvement compared to the control group (p=0.01). Conclusion: The findings in this study suggest that both conventional physical therapy and TheraTogs are beneficial in improving balance and functional ability. TheraTogs could be utilized as a useful posture orthosis to help improve the balance and functional strength of children with spastic diplegic cerebral, palsy indicating improved quality of life. [ABSTRACT FROM AUTHOR]

Objective This study aimed to investigate the relationship between psychological factors and clinical outcomes of therapeutic exercise after 3 months in individuals undergoing total knee arthroplasty (TKA). Another aim of this study was to evaluate the effect of 3 months of therapeutic exercise on the psychological factors of these patients. Materials & Methods This quasi-experimental study involved 29 patients with an average age of 62.76 years who had undergone TKA for their first knees. These patients performed therapeutic exercises for three months. Pain intensity and range of motion (ROM) of flexion and extension were assessed 3 times: before surgery, at the beginning of physiotherapy and 12 weeks after therapeutic exercises. Patients' functional ability and psychological indicators were evaluated in two phases: Before surgery and at the end of the 12th week. Clinical outcomes, including pain, knee ROM, and functional ability, were assessed using the visual analog scale, goniometer and Oxford knee score, respectively. The depression index was assessed with the Beck depression inventory (BDI) second version, anxiety with the state-trait anxiety index, fear of movement with the tampa scale of kinesiophobia (TSK) questionnaire and pain catastrophizing with the pain catastrophizing scale questionnaire. Results The results showed that two psychological indices, including trait anxiety and pain catastrophizing, had a significant negative correlation with the clinical outcomes of physiotherapy after TKA. The higher the trait anxiety before surgery was, the lower the pain reduction during the activity (r=-0.574, P=0.002) and the lower the improvement in functional abilities (r=-0.402, P=0.038). Also, the higher the index of preoperative pain catastrophizing, the lower the pain reduction during activity (r=-470, P=0.013) and the lower the improvement in functional abilities (r=-0.436, P=0.023). No significant correlation was found between other psychological indicators before surgery and the clinical outcomes of physiotherapy. On the other hand, among the psychological factors, trait anxiety (P=0.01) and fear of movement (P=0.01) were significantly improved after 3-month therapeutic exercise. Conclusion Psychological factors can play an essential role in predicting the clinical outcomes of physiotherapy after TKA. In addition, the improvement of psychological factors after therapeutic exercises may indicate that these psychological problems can be improved by reducing pain and achieving better ROM during treatment, so psychological factors are not considered an obstacle to surgery. [ABSTRACT FROM AUTHOR]

Acute coronary syndrome is a chronic illness that influences physical and psychological health and well-being and requires continuous treatment and effective self-care. This two-group quasi-experimental study investigated the effectiveness of the Self-Care Support Program for People with Acute Coronary Syndrome. Sixty participants were purposively recruited from medical wards of a university-affiliated hospital in Bangkok, Thailand. A Self-Care Support Program based on Orem's self-care theory was integrated with a motivational interviewing approach. The experimental group (n = 30) received the 4-week intervention program with the usual care, while the comparison group (n = 30) received only usual care. Instruments for data collection included a Demographic and Health Data Form, the Self-Care Behavior for Acute Coronary Syndrome Questionnaire, the Veterans Specific Activity Questionnaire, and the Rehospitalization Record Form. Data analysis was performed using descriptive statistics, Chi-square test, Fisher's exact test, and two-way repeated measures analysis of variance. Results revealed that the experimental group had significantly improved self-care behavior and functional ability immediately and four weeks after program completion (week 8), compared to the comparison group. There was no difference in rehospitalization between the two groups. Nurses with advanced skills in motivational training can use this program to promote effective self-care practices, improve functional ability, and reduce rehospitalization. Further study using randomized controlled trials and other settings is needed before it can be widely used. [ABSTRACT FROM AUTHOR]

Objectives: The focus of patients’ attention during the physiotherapy program has been reported to affect the rehabilitation goals. The study aimed to investigate the effectiveness of an external focus of attention (EFA) on static balance and functional ability in individuals with chronic ankle instability (CAI). Methods: Fourteen subjects with CAI, aged from 19 to 25 years, were randomly assigned to two groups: external and internal focus of attention (IFA) group. The outcome measures of the study were static balance and functional ability. A pre-intervention evaluation was performed. Following instructions to an external or an IFA, subjects practiced on a balance board 3 times per week for 4 weeks. At the end of each week, they performed evaluation tests, including a time balance test, foot lift test, side hop test, figure-8 test, and star excursion balance test (SEBT). Parametric (mixed analysis of variance) and non-parametric analysis (the Mann–Whitney and Friedman tests) were performed between measurements and groups. Results: The intervention program showed a statistically significant improvement in static balance and functional ability in both groups. The results indicated the main effect of time (F(2.488, 29.855)=43.880, P

Abstract Background Eating performance is the functional ability to get food into the mouth and chew/swallow it. Nursing home residents with dementia commonly experience compromised eating performance and subsequent consequences. Prior work examined the association between resident eating performance and their cognitive and functional ability. Yet, the associations between resident eating performance and behavioral and psychological symptoms, psychotropic medication use, and comorbidities are less studied. This study aimed to examine the association between eating performance and cognition, functional ability, behavioral and psychological symptoms, psychotropic medication use, and comorbidities in nursing home residents with dementia. Methods This was a secondary analysis using baseline data from two randomized controlled trials, testing the impact of Function Focused Care on function and behavioral symptoms in 882 residents with moderate-to-severe dementia (mean age 86.55 years, 71% female, 30% non-white, 68.5% severe dementia) from 67 nursing homes in two states between 2014 and 2020. Eating performance (dependent variable) was measured using the single self-feeding item of Barthel Index. Independent variables included cognitive impairment, functional ability (Barthel Index total score excluding the self-feeding item score), behavioral and psychological symptoms (agitation, depression, resistiveness-to-care), psychotropic medication use (anti-depression, sedative, anti-psychotics, anti-seizure, anti-anxiety), and comorbidities. Results Nearly 39% of residents were dependent in eating. On average, residents had five documented comorbidities (SD = 3.06, range = 0–12) and were on approximately one psychotropic medication (SD = 1.25, range = 0–5). Eating performance was associated with cognitive impairment (OR = 0.53, 95% CI = 0.35, 0.79, p = .002), functional ability (OR = 1.05, 95% CI = 1.04, 1.06, p

Objectives: To screen hospitalized older adults for sarcopenia and ascertain whether correlations exist between heart rate variability (HRV), peripheral muscle strength, functional ability, independence, and nutritional aspects in this population. Methods: Observational study of hospitalized adults aged > 60 years who were clinically stable and able to complete the study assessments. HRV, functionality, peripheral muscle strength, independence, level of physical activity, nutritional aspects, and risk of death were assessed. The Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney tests and Spearman correlations were used for statistical analysis; significance was accepted at p < 0.05. Results: The sample comprised 40 older adults, of whom only nine (22.50%) did not meet criteria for sarcopenia. HRV in participants with sarcopenia correlated positively with level of physical activity (rs 0.92, p = 0.001) and nutritional condition (rs 0.79, p = 0.001), and negatively with mortality (rs -0.59, p = 0.04) (rs 0.79, p = 0.001). In older adults without sarcopenia, HRV correlated positively with independence (rs 0.83, p = 0.001) and muscle strength (rs 0.67, p = 0.04). Conclusion: Most hospitalized older adults meet criteria for sarcopenia. In this population, better autonomic control of the heart is associated with greater independence, muscle strength, physical activity level, and better nutritional status, while worse HRV is associated with a higher risk of mortality.

Abstract Background Axial spondyloarthritis (axSpA) significantly impacts patients’ lives. The ASAS-OMERACT guideline was formulated for the multidimensional evaluation of axSpA patients, employing a specific set of tools. Given the pivotal role of patient perception, comprehensive correlation among these tools, especially concerning quality of life, may provide a clinically relevant perspective and enhance treatment efficacy in the early stages of the disease. This study aims to investigate the correlation among disease activity, functional ability, and quality of life in early-treated axSpA patients. In addition, the association between high disease activity and clinical characteristics was explored. Methods This cross-sectional study was conducted in a tertiary hospital in Thailand. Patients diagnosed with axSpA according to ASAS classification criteria and receiving treatment from rheumatologists within three years of onset of symptoms were included. Clinical and laboratory data were retrieved from a hospital database. Disease activity was assessed using the Ankylosing Spondylitis Disease Activity Score with ESR or CRP (ASDAS-ESR/CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Spinal mobility was measured using the Bath Ankylosing Spondylitis Metrology Index (BASMI), while quality of life and function were evaluated using the ASAS Health Index (ASAS-HI) and Bath Ankylosing Spondylitis Functional Index (BASFI), respectively. The correlation between these measurements was analyzed using the Pearson correlation coefficient (r). Additionally, factors associated with high disease activity (ASDAS/CRP > 2.1) were explored using multivariate regression analysis. Results Sixty-six patients (41 males; mean age 49.3 ± 13.3 years) were enrolled between April to December 2022. Disease activity (ASDAS-CRP) was significantly inversely correlated with spinal mobility (BASMI), function (BASFI), and quality of life (ASAS-HI). High disease activity was associated with obesity (BMI ≥ 30 kg/m^2) and a longer duration of symptoms before treatment (≥ 2 years). Conclusion In early-treated axSpA patients, ASDAS-CRP showed significant correlations with functional ability, quality of life, and spinal mobility. High disease activity was associated with obesity and a longer pre-treatment symptom duration in our study. Early treatment may enhance patients’ function, mobility, and quality of life, with weight reduction being possibly beneficial for obese axSpA patients. Clinical trial number Not applicable.

Purpose of Review: Sarcopenia, generally characterized by the age-related reduction in muscle strength, lean/muscle mass and functional ability, is also associated with reduced bone mass and strength and impaired brain health and function. One potential intervention which has received much 'hype' over the past few decades to countermeasure these negative consequences of biological aging is creatine monohydrate supplementation. Recent Findings: From a skeletal muscle perspective, the combination of creatine monohydrate supplementation and resistance training provides 'hope' for older adults as it improves measures of lean mass, regional (limb) muscle thickness, upper- and lower-body muscle strength and functional ability. Further, there is some evidence that creatine (supplementation or habitual diet) provides a ray of 'hope' for improving some aspects of cognitive function. The majority of research suggests that creatine is more 'hype' than 'hope' for improving measures of bone mass in older adults. Summary: Creatine monohydrate supplementation provides some anti-sarcopenic benefits for older adults. [ABSTRACT FROM AUTHOR]

Objective This study aimed to investigate the relationship between psychological factors and clinical outcomes of therapeutic exercise after 3 months in individuals undergoing total knee arthroplasty (TKA). Another aim of this study was to evaluate the effect of 3 months of therapeutic exercise on the psychological factors of these patients. Materials & Methods This quasi-experimental study involved 29 patients with an average age of 62.76 years who had undergone TKA for their first knees. These patients performed therapeutic exercises for three months. Pain intensity and range of motion (ROM) of flexion and extension were assessed 3 times: before surgery, at the beginning of physiotherapy and 12 weeks after therapeutic exercises. Patients’ functional ability and psychological indicators were evaluated in two phases: Before surgery and at the end of the 12th week. Clinical outcomes, including pain, knee ROM, and functional ability, were assessed using the visual analog scale, goniometer and Oxford knee score, respectively. The depression index was assessed with the Beck depression inventory (BDI) second version, anxiety with the state-trait anxiety index, fear of movement with the tampa scale of kinesiophobia (TSK) questionnaire and pain catastrophizing with the pain catastrophizing scale questionnaire. Results The results showed that two psychological indices, including trait anxiety and pain catastrophizing, had a significant negative correlation with the clinical outcomes of physiotherapy after TKA. The higher the trait anxiety before surgery was, the lower the pain reduction during the activity (r=-0.574, P=0.002) and the lower the improvement in functional abilities (r=-0.402, P=0.038). Also, the higher the index of preoperative pain catastrophizing, the lower the pain reduction during activity (r=-470, P=0.013) and the lower the improvement in functional abilities (r=-0.436, P=0.023). No significant correlation was found between other psychological indicators before surgery and the clinical outcomes of physiotherapy. On the other hand, among the psychological factors, trait anxiety (P=0.01) and fear of movement (P=0.01) were significantly improved after 3-month therapeutic exercise. Conclusion Psychological factors can play an essential role in predicting the clinical outcomes of physiotherapy after TKA. In addition, the improvement of psychological factors after therapeutic exercises may indicate that these psychological problems can be improved by reducing pain and achieving better ROM during treatment, so psychological factors are not considered an obstacle to surgery.

Abstract Aims This study aimed to evaluate the impact of frailty and living function domains based on the Kihon Checklist (KCL), a questionnaire for a comprehensive frailty assessment, on prognosis in patients with acute heart failure (AHF). Methods and results The Kochi Registry of Subjects with Acute Decompensated Heart Failure (Kochi YOSACOI) study was a prospective multicentre cohort study enrolling 1061 patients hospitalized for AHF from May 2017 to December 2019 in Japan. We divided patients into three groups according to the severity of frailty using the KCL and compared clinical outcomes after discharge. The primary endpoint was all‐cause death, and the secondary outcomes were cardiovascular death, heart failure (HF) rehospitalization, and the composite event of cardiovascular death and HF rehospitalization. Of 936 patients (median age, 81 years; 48.9% women) who could be assessed for frailty, we identified frailty in 501 patients (53.5%), prefrailty in 290 patients (31.0%), and non‐frailty in 145 patients (15.5%). Compared with prefrail and non‐frail patients, frail patients were older (83 vs. 79 and 72 years, P

Abstract Background Tetraplegia is a debilitating sequela of spinal cord injury (SCI). However, comprehensive approaches for determining the influence of various factors on activities of daily living (ADL) in patients with tetraplegia are limited. Therefore, this study aimed to determine the influence of physical factors on ADL in patients with tetraplegia after adjusting for demographic, SCI-related, and cognitive factors. Methods This retrospective cross-sectional study enrolled 201 patients with tetraplegia who underwent inpatient rehabilitation at the National Rehabilitation Center in South Korea between 2019 and 2021. Patients’ mean age was 50.5 years (standard deviation, 16.3), and 170 (84.6%) were men. The Korean Spinal Cord Independence Measure III (K-SCIM III) was used as the main outcome measure to assess patients’ ADL ability. Hierarchical multiple regression modeling was conducted with K-SCIM as the dependent variable to examine the level of functioning and relative influencing factors. Results Upper-extremity motor score (UEMS), upper-extremity spasticity and sitting balance scores were significant predictors of self-care; lower-extremity motor score (LEMS), musculoskeletal pain of shoulder, and sitting balance were significant predictors of respiratory and sphincter management; UEMS, LEMS, and sitting balance score were significant predictors of mobility; and UEMS, LEMS, musculoskeletal pain of shoulder, and sitting balance scores were significant predictors of the K-SCIM III total score after adjustment for demographic, SCI-related, and cognitive factors. Conclusions Physical factors had the greatest impact on all subscores and the K-SCIM III total score. Upper- and lower-extremity muscle strength and sitting balance significantly affected functional ability across all subscores.

Progressive supranuclear palsy is a form of atypical Parkinsonism. People living with Progressive Supranuclear Palsy have various symptoms, such as movement and cognitive disorders, which mainly affect balance and functional ability with an increased risk of falls, dexterity, and dementia. The role of exercise at the early stage of progressive supranuclear palsy remains unclear. The aim of the present study was to examine the effectiveness of an exercise program at the early stage of progressive supranuclear palsy. A patient with a diagnosis of progressive supranuclear palsy within the past year followed a supervised 12-week exercise program (two times per week) by a physiotherapist, with a session lasting about 40 min at a private physiotherapy clinic. Functional status, balance, quality of life, anxiety, and depression were assessed four times with valid instruments and tests. The results from the timed-up-and-go test demonstrated an improvement in performance (MCID value = 3.4). Improvements were observed in the scores of the Parkinson's Disease Questionnaire-39 (MCID value = 0.6). Finally, an improvement was reported in the score of the anxiety factor of the hospital anxiety and depression scale (MCID value = 1.5). Physiotherapy appears to improve functional capacity, quality of life, and mental health. Further research is needed to confirm these results with a large sample size in combination with other complementary therapies such as mental imagery. [ABSTRACT FROM AUTHOR]

Background Functional ability is the important prerequisite to live independently and achieve aging in place, which depends on the complex interaction of intrinsic and extrinsic factors. Identifying the trends and influencing factors of functional ability would contribute to the accurate assessment and intervention of geriatric health. This study aimed to disentangle the moderating effect of 3 types of social support, namely objective support, subjective support, and support utilization, on the relationship between frailty and functional ability trajectories. Methods This was a secondary analysis using data from a prospective 3-wave study with a sample of 777 Chinese community-dwelling older adults. Social support was assessed using the Social Support Rating scale. Frailty was assessed using the FRAIL scale. Functional ability was measured by the Lawton Instrumental Activities of Daily Living scale. Latent growth curve models were implemented to test their relationships. Results Objective support but not subjective support or support utilization moderated on the relationship between frailty and functional ability slope. Functional ability decline over time was buffered by objective support among robust individuals but exacerbated among (pre)frail individuals. Conclusions The moderating effect of social support on the relationship between frailty and functional ability trajectory varies by support types, which reminded that social support may be a promising intervention target to maintain functional independence for frail individuals, opening up a new perspective on social support in the field of disability prevention. Effective interventions should particularly address objective support in conjunction with empowering the frail older population to optimize the trajectory of functional ability. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the psychometric property of a newly developed functional abilities screening tool for children with cerebral palsy (CP) in special education units. Materials and Methods: This study was designed as a cross-sectional study. The tool for cerebral palsy screening of functional abilities in school (CPS-FAS) was established by surveying 28 pediatric physical therapists and holding focus group discussions with them. The CPS-FAS tool was used to evaluate content validity, reliability, and discriminative ability with 30 school-age children with CP at levels 1-3 of the Gross Motor Function Classification System (GMFCS). Results: The CPS-FAS generation process established 21 activity-problem screening items for children with CP, which had good content validity (index of item-objective congruence (IOC) = 1), good internal consistency (α = 0.92), and showed significant differences between GMFCS levels 1 and 3 (p > 0.001) and GMFCS levels 2 and 3 (p > 0.001). Conclusion: The CPS-FAS tool can be applied to school-age children with CP in a special education unit to screen such children for activity problems that affect school living without environmental obstruction and language barriers, and it only takes a short time (10-15 minutes) to complete. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to evaluate the impact of frailty and living function domains based on the Kihon Checklist (KCL), a questionnaire for a comprehensive frailty assessment, on prognosis in patients with acute heart failure (AHF). Methods and results: The Kochi Registry of Subjects with Acute Decompensated Heart Failure (Kochi YOSACOI) study was a prospective multicentre cohort study enrolling 1061 patients hospitalized for AHF from May 2017 to December 2019 in Japan. We divided patients into three groups according to the severity of frailty using the KCL and compared clinical outcomes after discharge. The primary endpoint was all‐cause death, and the secondary outcomes were cardiovascular death, heart failure (HF) rehospitalization, and the composite event of cardiovascular death and HF rehospitalization. Of 936 patients (median age, 81 years; 48.9% women) who could be assessed for frailty, we identified frailty in 501 patients (53.5%), prefrailty in 290 patients (31.0%), and non‐frailty in 145 patients (15.5%). Compared with prefrail and non‐frail patients, frail patients were older (83 vs. 79 and 72 years, P < 0.001), were more likely to be women (53.9% vs. 43.1% and 43.4%, P = 0.005), and were more likely to have a history of previous HF hospitalization (35.4% vs. 25.3% and 19.6%, P < 0.001) and multimorbidity (90.8% vs. 81.0% and 73.8%, P < 0.001). Frail patients had a lower rate of discharge to home (79.7% vs. 94.8% and 96.5%, P < 0.001). During the 2 year follow‐up period, frail patients had a higher incidence rate of all‐cause death, cardiovascular death, and HF rehospitalization (log‐rank P < 0.001, P < 0.001, and P = 0.003, respectively). After adjusting for other prognostic factors, multivariate analysis showed that frailty was associated with all‐cause death [adjusted hazard ratio (HR): 2.917, 95% confidence interval (CI): 1.326–6.417, P = 0.008] and cardiovascular death (adjusted HR: 7.026, 95% CI: 1.700–29.030, P = 0.007). Among all domains of the KCL, the cognitive function domain was associated with a higher risk of all‐cause death (P = 0.004) and cardiovascular death (P < 0.001). The depression domain remained associated with a higher risk of HF rehospitalization (P = 0.045). The risk for all‐cause death increased with an increase in total KCL score (adjusted HR: 1.819, 95% CI: 1.300–2.547, P < 0.001). Conclusions: The KCL is a useful tool for risk stratification of adverse outcomes in patients with AHF. Functional declines in psycho‐emotional domains including cognitive function and depressed mood contribute to adverse outcomes. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodResultsConclusionThis study investigates factors associated with the person with dementia and the caregiver to identify those associated with an increased risk of transition to a care home.IDEAL data were collected at baseline and at 12- and 24-month follow-up for 1545 people with dementia and 1305 caregivers. Modified Poisson regressions with an offset for ‘person years at risk’ were used. Person with dementia factors explored were personal characteristics, cognition, health, self- and informant-rated functional ability, and neuropsychiatric symptoms. Caregiver factors explored were personal characteristics, stress, health, and quality of the dyadic relationship.A 5% people moved into care. Risk of moving into a care home was higher among people with dementia who were ≥80 years, among people with Parkinson’s disease dementia or dementia with Lewy bodies, and among those without a spousal caregiver. Poorer cognition and more self-rated or informant-rated functional difficulties increased the risk of moving into care.Factors related to increased dementia severity and greater disability are the primary influences that place people with dementia at greater risk of moving into a care home. Strategies that help to maintain everyday functional ability for people with dementia could help delay people with dementia moving into care. [ABSTRACT FROM AUTHOR]

Background: Dementia involves the loss of cognitive abilities and represents a decline from the prior level of function, which impairs functional abilities in day-to-day life. The purpose of the present study is to examine the effectiveness of an exercise program on the muscle strength and range of motion of the upper limbs, the functional status, and the depression of elderly people with early stage dementia. Methods: The sample consisted of 60 elderly people with early stage dementia who were randomly divided into a control and an experimental group of 30 participants each. The experimental group received a 12-week Otago exercise program with 45 min duration of each session. The control group received usual care without doing exercise. The outcome measures of muscle strength and range of motion of the upper limbs, the functional status, and the depression were assessed by valid instruments and tests at the beginning and at the end of the intervention program. Repeated measures one-way ANOVA and Mann–Whitney tests examined the differences between the two groups at the end of the 12-week exercise program. Results: Statistically significant differences were found between the experimental and control groups in the entire outcome measures (functional ability F = 9.35 p < 0.05; muscle strength right hand F = 32.33, p < 0.05 left hand U = 95.50 p < 0.01; e.g., range of motion shoulder extension U = 104.00 p < 0.01), except depression. Conclusions: Both muscle strength and range of motion of the upper limbs, as well as the functional ability, were improved by the exercise program. Further research is needed to investigate the present results, in particular to explore the long-term cognitive, behavioral, and functional status outcomes of exercise in the early stages of dementia. [ABSTRACT FROM AUTHOR]

Background: In this new era of cancer management, the quality of life (QOL) is given more importance than the quantity of life. QOL evaluation studies are widely used in oncology to assess the patient's performance in different cancer types and treatment modalities. Objective: To evaluate cancer patients' QOL after various chemotherapy cycles. Methods: An observational study was performed on cancer patients receiving chemotherapy in the daycare setting of a South Indian Tertiary Care Hospital for 6 months. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questionnaire was employed to study the QOL. Results: Precisely, 102 patients participated in the study, out of which the majority were in the 51 to 60 age group (24%). Female participants (65%) were more. Functional scale domains especially physical ability (P = 0.004), role (P = 0.033), and emotional functioning (P = 0.01) were significantly decreased in patients treated with 4 to 6 chemotherapy cycles. Cognitive ability (P = 0.043) significantly improved in patients treated with more than 6 chemotherapy cycles. Dyspnea (P = 0.036) was significantly increased in patients treated with 4 to 6 chemotherapy cycles and decreased significantly with the further addition of chemotherapy cycles. Conclusion: Dyspnea is a commonly observed symptom among cancer patients and is often neglected by physicians. Chronic dyspnea can negatively impact a patient's functional ability. Cancer symptoms such as dyspnea should also be given priority and need appropriate treatment. Based on the findings, further interventions can be made to improve the functional ability of cancer patients. Also, studies can be conducted to correlate with cancer rehabilitation programs to improve functional ability and complete the entire chemotherapy cycle. [ABSTRACT FROM AUTHOR]

Objectives: Determine whether levels of anxiety and depression, cognitive ability, and self-quarantining during and prior to the pandemic predict decreases in perceived functional ability. Design and Setting: Longitudinal data collected from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study (2020) and core CLSA study (Follow-Up 1; 2014-2018). Participants: 17 541 CLSA participants. Measurements: Self-quarantining behaviours from questionnaires administered at Baseline (April 2020), Monthly, and Exit (December 2020) time points of the CLSA COVID-19 Questionnaire Study, levels of anxiety and depression at Baseline, perceived change in functional ability at Exit, and performance on neuropsychological tests (Rey Auditory Verbal Learning Task, Mental Alternation Task, Animal Fluency Test) and functional ability (Older Americans Resources and Services [OARS] Multidimensional Assessment Questionnaire) from the core CLSA study. Results: Greater cognitive ability pre-pandemic (B = −.003, P <.01), higher levels of anxiety (B = −.024, P <.01) and depressive symptoms (B = −.110, P <.01) at Baseline, and higher frequency of engaging in self-quarantining throughout the COVID-19 survey period (B = −.098, P <.01) were associated with perceived loss in functional ability at Exit. Self-quarantining behaviour was associated with perceived loss in functional ability only at average and high levels of depressive symptoms (B = −.013, P <.01). Conclusions: Older adults with higher cognitive and lower functional ability prior to the pandemic were at greater risk of decreased perceived functional ability during the first year of the pandemic, as were those who experienced greater levels of anxiety and depressive symptoms during the pandemic. Strategies/interventions to preserve functional ability in older adults with cognitive independence prior to future pandemics are warranted. [ABSTRACT FROM AUTHOR]

Background: Tetraplegia is a debilitating sequela of spinal cord injury (SCI). However, comprehensive approaches for determining the influence of various factors on activities of daily living (ADL) in patients with tetraplegia are limited. Therefore, this study aimed to determine the influence of physical factors on ADL in patients with tetraplegia after adjusting for demographic, SCI-related, and cognitive factors. Methods: This retrospective cross-sectional study enrolled 201 patients with tetraplegia who underwent inpatient rehabilitation at the National Rehabilitation Center in South Korea between 2019 and 2021. Patients' mean age was 50.5 years (standard deviation, 16.3), and 170 (84.6%) were men. The Korean Spinal Cord Independence Measure III (K-SCIM III) was used as the main outcome measure to assess patients' ADL ability. Hierarchical multiple regression modeling was conducted with K-SCIM as the dependent variable to examine the level of functioning and relative influencing factors. Results: Upper-extremity motor score (UEMS), upper-extremity spasticity and sitting balance scores were significant predictors of self-care; lower-extremity motor score (LEMS), musculoskeletal pain of shoulder, and sitting balance were significant predictors of respiratory and sphincter management; UEMS, LEMS, and sitting balance score were significant predictors of mobility; and UEMS, LEMS, musculoskeletal pain of shoulder, and sitting balance scores were significant predictors of the K-SCIM III total score after adjustment for demographic, SCI-related, and cognitive factors. Conclusions: Physical factors had the greatest impact on all subscores and the K-SCIM III total score. Upper- and lower-extremity muscle strength and sitting balance significantly affected functional ability across all subscores. [ABSTRACT FROM AUTHOR]

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This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in this analysis, articles must have had participants with an average age ≤21, focus on children with neuromuscular disabilities, and primarily examine relationships between muscle mass and any functional or health outcomes measure. Studies including typically developing children were used to contrast and enhance findings. Thirty-two studies were included, with 10,129 unique individuals represented: seventeen studies focused on healthy/typically developing children; seven on children with cerebral palsy; three on children with Duchenne muscular dystrophy; two on children with sarcopenia; and one study each on children with osteoporosis, congenital muscular dystrophy, and other various neurologic disorders. Thirteen studies assessed functional outcomes, ten assessed bone outcomes, and nine assessed other cardiovascular/metabolic outcomes. All of the included studies demonstrated relationships between muscle mass and respective outcomes in varying measures. The results of this review demonstrate that there is a consistently recognized relationship between muscle mass and important health outcomes in children, supporting clinically targeting muscle mass as a means to optimize desired outcomes. [ABSTRACT FROM AUTHOR]

Objective Hip osteoarthritis is a common cause of disability and surgery is often unavoidable. Patient satisfaction is high and functional ability improves after surgery. However, residual impairment and pain are common. Degenerative changes in tendons and muscles are probable causes. The aim of this study is to investigate gluteus medius (GMED) tendon degeneration in relation to muscle strength, physical function and walking distance before and one year after total hip replacement.Material and methods In total, 18 patients were examined pre- and post-operatively, of whom 15 were available in the final analysis. Muscle strength, physical function and walking distance were assessed. Tendon biopsies were assessed microscopically, and the total degeneration score (TDS) was calculated.Results A correlation between the TDS and muscle strength was found for the hamstrings, GMED and quadriceps pre- or post-operatively. No correlations were found between the TDS and functional ability. Functional ability and muscle strength improved significantly after surgery.Conclusion Our results indicate a correlation between tendon degeneration and the muscle strength of the hip and knee in patients with hip OA and one year after THR. To minimise post-operative residual discomfort, rehabilitation programs should probably be modified over time to match the pre- and post-operative needs. Further studies are needed.This study was registered at https://www.researchweb.org/is/vgr/project/279039 (in Swedish).

Dementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers. [ABSTRACT FROM AUTHOR]

Background: With the vision of healthy aging, the Egyptian Academy of Bone and Muscle Health followed an established guideline development process to create the Egyptian 24-h movement clinical guideline for adults aged 50 years and older adults. This guideline highlights the significance of movement behaviors across the whole 24-h day. Online databases (PubMed, Embase, and Cochrane Library) were searched for relevant peer-reviewed studies that met the a priori inclusion criteria. Results: A total of 53 studies met the inclusion criteria. Leveraging evidence from the review of the literature led to the development of 27 statements answering the 5 key questions. Results revealed a major change in the previous basic understandings as it shifts away from focussing on a sole movement behavior to the combination of all the movement behaviors. Based on this, the final guideline was developed providing evidence-based recommendations for a "Healthy 24-Hour Day", comprising a mix of light-intensity and moderate-to-vigorous-intensity physical activity, sleep, and sedentary behavior. Conclusion: The developed guidelines are meant to help in the decision-making process and are intended for use by adults and older both nationally and internationally; also, for endorsement by the policy-makers. Dissemination and implementation efforts would impact positively on both health professionals and researchers and would also be useful to interested members of the public sector. [ABSTRACT FROM AUTHOR]

The first objective was to evaluate clinical data from a multi-component fall prevention program. The second objective was to explore the relationship between physical function and fear of falling (FoF) Adults (N = 287, mean age = 76 years) who participated in the Building Balance Program between 2011–2020 were assessed with five physical function measures and two FoF measures. Repeated measures ANOVA controlling for age and sex were performed to assess change from baseline. Linear regressions were conducted to evaluate how physical function explained variations in FoF There were significant improvements between pre and post-program Berg Balance Scale (BBS) scores (p <.001), Timed-Up and Go (TUG) times (p <.001), 30 second Chair-Stand (30 CST repetitions) (p <.001), Functional Reach (FR) distance (p <.001), gait speed (p <.001), single item-FoF score (p <.001), and short Falls Efficacy Scale-International (FES-I score) (p <.001). After controlling for sex on all regression analyses, age, and pre-program gait speed explained variations in pre-program short FES-I scores (Adjusted R2 = 0.19). Age, pre-program BBS and 30 CST repetitions explained variations in pre-program level of FoF (Adjusted R2 = 0.25). Variations in post-program short FES-I scores (Adjusted R2 = 0.17) were explained by age, post-program TUG times and FR distance after controlling for age and sex. Robust regressions indicated variations in post-program level of FoF explained by age, post-program TUG and FR distance with a two-way interaction between age and FR A multi-component fall prevention program improved physical function and decreased FoF. A small association between physical function and FoF similar between pre- and post-program conditions was identified. [ABSTRACT FROM AUTHOR]

Mild cognitive impairment (MCI) confers a higher risk of developing dementia. While largely preserved, instrumental activities of daily living (IADLs) may be affected to varying degrees by MCI. The Memory Support System (MSS) is a curriculum and calendar/note-taking system that has proven effective in sustaining independence in IADLs for individuals with MCI and in protecting mood among care partners. Until recently, the MSS has only been utilized among English- and Spanish-speaking samples. This study investigated the use of a translated and culturally adapted MSS in four Frenchspeaking, community-dwelling participants with MCI and their support partners. Measures of treatment adherence, daily function, self-efficacy for memory, quality of life, mood, anxiety, and caregiver burden were assessed at baseline, treatment end, and eight-week follow-up. By treatment end and follow-up, participants with MCI showed improvement in adherence to the MSS calendar, IADLs, everyday abilities requiring memory and planning, self-efficacy, depression and anxiety symptoms, and quality of life. Care partners showed improvement in quality of life and depressive symptoms, while their caregiver burden and anxiety symptoms generally remained unchanged. Findings suggest that, with appropriate training, Francophones with MCI can and will use the MSS, and that MSS training may contribute to daily functioning and aspects of participant and care partner well-being. [ABSTRACT FROM AUTHOR]

The global aging population faces significant health challenges, including an increasing vulnerability to disability due to natural aging processes. Wearable lower limb exoskeletons (LLEs) have emerged as a promising solution to enhance physical function in older individuals. This systematic review synthesizes the use of LLEs in alignment with the WHO's healthy aging vision, examining their impact on intrinsic capacities and functional abilities. We conducted a comprehensive literature search in six databases, yielding 36 relevant articles covering older adults (65+) with various health conditions, including sarcopenia, stroke, Parkinson's Disease, osteoarthritis, and more. The interventions, spanning one to forty sessions, utilized a range of LLE technologies such as Ekso®, HAL®, Stride Management Assist®, Honda Walking Assist®, Lokomat®, Walkbot®, Healbot®, Keeogo Rehab®, EX1®, overground wearable exoskeletons, Eksoband®, powered ankle–foot orthoses, HAL® lumbar type, Human Body Posturizer®, Gait Enhancing and Motivation System®, soft robotic suits, and active pelvis orthoses. The findings revealed substantial positive outcomes across diverse health conditions. LLE training led to improvements in key performance indicators, such as the 10 Meter Walk Test, Five Times Sit-to-Stand test, Timed Up and Go test, and more. Additionally, enhancements were observed in gait quality, joint mobility, muscle strength, and balance. These improvements were accompanied by reductions in sedentary behavior, pain perception, muscle exertion, and metabolic cost while walking. While longer intervention durations can aid in the rehabilitation of intrinsic capacities, even the instantaneous augmentation of functional abilities can be observed in a single session. In summary, this review demonstrates consistent and significant enhancements in critical parameters across a broad spectrum of health conditions following LLE interventions in older adults. These findings underscore the potential of LLE in promoting healthy aging and enhancing the well-being of older adults. [ABSTRACT FROM AUTHOR]

Objectives Carpal tunnel syndrome (CTS) is common among office workers and limits functional hand ability and the ability to work. Carpal tunnel syndrome prevention programs implementation are still insufficient among office workers. In view of the fact that physical activity is the best method of preventing musculoskeletal complaints the aim of the study was to evaluate the effectiveness of prevention exercises protocol for hand and wrist pain among office workers. Material and Methods Study group consists form 62 office workers, reporting complaints of hand and wrist pain. Exercise group it was 49 subjects who performed the exercise protocol and the non-exercise group consisted of 13 subjects. An exercises program, consisting of 7 exercises. The program was planned for daily routine during 8 weeks. The effectiveness of the exercise program was assessed by physical parameters (hand grip and pinch grip strength, force of forearm muscles) and questionnaires ( Visual Analog Scale pain scale, Carpal Tunnel Syndrome Symptom Severity Scale , and Carpal Tunnel Syndrome Functional Status Scale functional hand assessment questionnaires) were performed. Assessment was performed before and after the intervention. Results Statistical analysis of the data showed significant changes in the value of measured hand grip of the right hand (Z = –2.85, p < 0.01). For pinch grip, changes were significant for both the right (Z = –2.12, p < 0.05) and the left hands (Z = –2.35, p < 0.05). Functional performance improved significantly in bought groups. There was no statistically significant change in the intensity of experienced pain. Conclusions The results of the study indicate that performing a preventive exercise program regularly has an effect on increasing forearm muscle strength in a group of office workers. Office workers with symptoms of CTS who exercised regularly had higher results in hand grip and pincer grip strength. Exercises do not affect the level of pain complaints, which may indicate a more complex etiology of pain perception in this study group. Int J Occup Med Environ Health. 2024;37(1):45–57

Objectives: To examine loneliness in old age and whether intergenerational reciprocity and WHO functional ability predicted loneliness. Methods: Using the China Health and Retirement Longitudinal Study Wave 4 (2018) database (CHARLS), logistic regression models were adopted to investigate the relationships. Results: The prevalence of loneliness was 28% in older people in China. Corresponding to the five domains of functional abilities, providing financial support to adult children (adj. OR 0.83, 95% CI 0.70–0.99), self‐perceived health (adj. OR 1.30, 95% CI 1.19–1.41), having a retirement pension (adj. OR 0.73, 95% CI 0.57–0.93), the ability to decide on taking medications (adj. OR 1.32, 95% CI 1.10–1.58), as well as being able to get up from a chair (adj. OR 1.15, 95% CI 1.02–1.3), and having paid work (adj. OR 0.72, 95% CI 0.54–0.95) were associated with less loneliness. On the contrary, infrequent contact (once a month) with adult children (adj. OR 1.18, 95% CI 1.01–1.38), troubling body pain (adj. OR 1.16, 95% CI 1.10–1.23) and falling since the last interview (adj. OR.23, 95% CI 1.04–1.45) were positively associated with loneliness. Conclusions: In this study, functional abilities of meeting basic needs, making decisions, being mobile and contributing to the support of adult children and society were protective factors for experiencing loneliness in late life. We need to rethink interventions for addressing loneliness in the context of healthy ageing and specific cultural values, taking into account not only providing services to older adults but also supporting them to gain values by contributing to society. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid Arthritis (RA) is the commonest type of inflammatory arthritis and commonly affects the hands, feet, wrists, ankles and knees. For some people, the foot is the first area of the body to present with signs and symptoms of RA. This study aimed to determine frequency of foot disorders in RA patients, find relation between RA disease activity and foot disorders and find out their impact on functional ability and quality of life. Patients and methods: This study included a total of 300 RA patients. They were 240 females and 60 males, their ages ranged from 18-74 years. All patients were subjected to the following; full history taking, complete clinical examination, and disease activity assessment by modified DAS28. Measurement of foot pain and disability was done using Manchester Foot Pain and Disability Index (MFPDI). Measurement of functional ability of foot was done using Foot and Ankle Ability Measure (FAAM). Measurement of quality of life in RA patients was done using Rheumatoid Arthritis Quality of Life (RAQoL). Laboratory investigations included complete blood count (CBC), erythrocyte sedimentation rate (ESR), creactive protein (CRP), rheumatoid factor (RF) titre, and anti-cyclic citrullinated peptide (anti-CCP Ab) titre. Results: We found that178 patients (59.3%) had foot complaint. Among the studied RA patients, there were 122 patients (46.7%) had ankle affected, 91 patients (30.3%) had subtalar affected, 73 patients (24.3%) had interphalangeal affected, 70 patients (23.3%) had midtarsal affected and 64 patients (21.3%) had metatarsophalangeal affected. 31.6% of the study patients had foot deformities. RA patients who had older age, high disease activity, high BMI and long disease duration were more susceptible to foot disorders. There were high significant differences between RA patients with foot disorders and those without foot disorders regarding physical function and quality of life. Patients with high disease activity had more foot pain and disability, also they had more impairment of physical function and quality of life. Conclusion: Significant high frequency of foot disorders among RA patients. It affected 59.3% of the studied RA patients. 31.6% had foot deformities. RA patients with high risk of developing foot disorders had high BMI, high disease activity and longer disease duration. Foot disorders had great impact on functional ability and quality of life in RA patients. [ABSTRACT FROM AUTHOR]

Background The United Nations Decade of Healthy Ageing 2021–2030 suggests nations should monitor functional ability as an indicator of healthy ageing progress. Functional ability is the attribute of people to do something they value and consists of five domains. We examined its validity in terms of a construct, cross-validation across multiple waves' data, and predictivity for subsequent well-being. Methods Using panel data from 35,093 community-dwelling adults aged ≥65 years from the Japan Gerontological Evaluation Study, we performed factor analyses to explore the construct of functional ability domains in both 2013 and 2016. A modified Poisson regression analysis was employed to test their associations with well-being (subjective health and happiness) in 2019. Results The mean age (standard deviation) of participants was 72.1 (5.0) years, and 52.0% were women. A total of 85.0% reported good subjective health, and 50.6% reported high happiness levels. Factor analyses with 31 logically checked candidate items from 2016 data suggested a three-factor model comprising 24 items, which were compatible with the 2013 data results. Based on the World Health Organization's original domains, we named domains as domain #1: ability to build and maintain relationships; domain #2: ability to meet basic needs + ability to move around and domain #3: ability to learn, grow and make decisions + ability to contribute. All three domains predicted both subjective health and happiness in 2019. Conclusions Empirical data from Japan supports the functional ability concept among older individuals. Validating this concept with data from other nations is warranted. [ABSTRACT FROM AUTHOR]

Aims: The study objective was to explore how upper extremity impairments (UEIs) affect the everyday life and work‐life of people with type 1 diabetes (T1D) and to compare them to a control group without T1D to determine if there are diabetes‐specific consequences of UEIs. Methods: In a controlled cross‐sectional study, a survey was distributed across all regions of Denmark. A total of 2174 people with T1D and 827 controls were included in the study population. The survey addressed UEI symptoms, employment status, functional disability, mental well‐being and diabetes distress. Data were analysed using multivariable logistic and linear regression. Results: Upper extremity impairments were associated with a higher rate of work absence and modification, but no more so for people with T1D than for the control group. Among people with T1D, UEIs were significantly associated with worse mental well‐being and diabetes distress, and across all outcomes including functional disability, additive effects were found with an increasing number of coexisting impairments. The impact of UEIs on functional disability was more severe for the T1D group than the control group, but this was primarily due to differences in the number of coexisting impairments. Conclusions: Upper extremity impairments have significant negative implications for the work‐life and everyday life of people with T1D, and interventions to reduce UEIs and their impact among this group are highly relevant. [ABSTRACT FROM AUTHOR]

Objectives: Carpal tunnel syndrome (CTS) is common among office workers and limits functional hand ability and the ability to work. Carpal tunnel syndrome prevention programs implementation are still insufficient among office workers. In view of the fact that physical activity is the best method of preventing musculoskeletal complaints the aim of the study was to evaluate the effectiveness of prevention exercises protocol for hand and wrist pain among office workers. Material and Methods: Study group consists form 62 office workers, reporting complaints of hand and wrist pain. Exercise group it was 49 subjects who performed the exercise protocol and the non-exercise group consisted of 13 subjects. An exercises program, consisting of 7 exercises. The program was planned for daily routine during 8 weeks. The effectiveness of the exercise program was assessed by physical parameters (hand grip and pinch grip strength, force of forearm muscles) and questionnaires (Visual Analog Scale pain scale, Carpal Tunnel Syndrome Symptom Severity Scale, and Carpal Tunnel Syndrome Functional Status Scale functional hand assessment questionnaires) were performed. Assessment was performed before and after the intervention. Results: Statistical analysis of the data showed significant changes in the value of measured hand grip of the right hand (Z = -2.85, p < 0.01). For pinch grip, changes were significant for both the right (Z = -2.12, p < 0.05) and the left hands (Z = -2.35, p < 0.05). Functional performance improved significantly in bought groups. There was no statistically significant change in the intensity of experienced pain. Conclusions: The results of the study indicate that performing a preventive exercise program regularly has an effect on increasing forearm muscle strength in a group of office workers. Office workers with symptoms of CTS who exercised regularly had higher results in hand grip and pincer grip strength. Exercises do not affect the level of pain complaints, which may indicate a more complex etiology of pain perception in this study group. Int J Occup Med Environ Health. [ABSTRACT FROM AUTHOR]

Objective: Turf toe is a common sports injury that may affect mobility and functional ability. For complete recovery, rehabilitation modalities are required to overcome these issues. This study investigated whether kinesio taping (KT) would reduce pain, improve gait performance, and enhance the functional capacity of turf toe patients undergoing physical therapy. Methods: sixty patients with grade II turf toe (age; 25–30 years) assigned randomly into three treatment groups; KT applied alongside an exercise program conducted three times/week for 12 successive weeks. (KT group; n = 20), placebo taping plus exercise (Placebo group; n = 20), or exercise only (Control group; n = 20). Pain, gait parameters, and functional ability assessed using VAS, 3D gait analysis, and 6MWT respectively pre- and post-treatment. Results: There was a significant post-treatment decrease in VAS score in the KT group lower than the control or placebo group and a significant increase in 6MWT distance in the KT group higher than the control or placebo group (p 0.05). Conclusions: The findings of the study demonstrated that KT is a useful complementary modality to exercise in patients with turf toe, as it may result in more favorable improvements to pain, gait characteristics, and functional abilities. Further studies should be conducted to assess the long-term effects, different KT application methods, and tailored treatment protocols on turf toe.

Abstract Objective In this study, we aimed to explore the effectiveness of systematic nursing care based on health empowerment theory on the self-care and functional abilities of patients with spinal fractures. Methods We selected a total of 50 patients with spinal fractures from our hospital and randomly divided them into the control group and the observation group, with 25 patients in each group. Patients in the control group received conventional nursing care, while those in the observation group received systematic nursing care grounded in the health empowerment theory. We recorded and compared the self-care ability, functional ability, knowledge about the condition, and pain scores of patients in the two groups before and after the nursing intervention. Results There was no significant difference in the baseline characteristics between the two groups (P > 0.05), and there was no significant difference in self-care ability, functional ability, knowledge about the condition, or the visual analog scale (VAS) score between the two groups before treatment (P > 0.05). After treatment, outcomes in the observation group in terms of self-care ability, functional ability, and knowledge about the condition were significantly better than those in the control group (P

The aim of this project was to examine older adults and their next-of-kins’ experiences of using smart home technology. The technology unobtrusively monitors the older adult’s physical functional ability to undertake their daily activities at home. Using a case study approach, the participants comprised three family units: three older adults with a history of long-term co-morbidities and who lived alone, along with their next-of-kin (n=4). The older adults were all female aged between 72- 82 years of age, while the four next-of-kin were all females aged between 40 and 55 years of age. Participants experiences of using the smart home technology was evaluated at three- and eight-months post-installation via in-depth one-to-one interviews with the older adults and their next-of-kin. The older adults described how the smart home sensors reduced their levels of anxiety because they were ‘not feeling alone’. Likewise, their next-of-kin described how the sensors gave them an insight to their older relatives’ activities of daily living, as well as the challenges they experienced. The findings highlighted the benefit of smart home technologies in terms of helping older adults and their next-of-kin monitor their daily activities, reduce social isolation, and adopt positive health and behavioural changes.

Abstract Background Understanding health and developing trends among the older population is essential for countries to tackle the challenges of an ageing population and formulate relevant policies. Facilitating healthy ageing is an essential strategy to address the issues arising among the aged. The concept of healthy ageing is defined as “the process of developing and maintaining the functional ability that enables wellbeing in old age (WHO),“ where “functional ability comprises the health-related attributes that enable people to be and to do what they have reason to value.“ People have different ageing pathways depending on their genetic profile and different life course health risk exposures. Therefore, ageing, more specifically healthy ageing, largely depends on individual lifestyle choices. This study examines the association between lifestyle behaviours and healthy ageing among older adults in India. Methods Based on the first round of LASI in 2017-18, we conceptualized healthy ageing within the WHO functional ability framework. We developed a Healthy Ageing Index (HAI), which incorporates physiological health, functional health, cognitive functions, psychological well-being, and social engagement. We used principal component analysis to generate a composite score for HAI. We then used multiple linear regression to demonstrate the association between lifestyle behaviours and HAI. Result The mean HAI was 82.8%, indicating that the study population is healthier. The study findings show that smoking and drinking are more prevalent among males, rural residents, illiterate individuals, those currently employed, and those belonging to the poorest wealth quintile. Engaging in physical activity is associated with better health outcomes (β = 2.36; 95% CI: 2.16–2.56). Conclusion This study emphasizes the importance of adopting a healthier lifestyle to achieve healthy ageing. Health behaviours are modifiable, so our results highlight the need for policy interventions to promote a healthier lifestyle from an early age.

Progressive supranuclear palsy is a form of atypical Parkinsonism. People living with Progressive Supranuclear Palsy have various symptoms, such as movement and cognitive disorders, which mainly affect balance and functional ability with an increased risk of falls, dexterity, and dementia. The role of exercise at the early stage of progressive supranuclear palsy remains unclear. The aim of the present study was to examine the effectiveness of an exercise program at the early stage of progressive supranuclear palsy. A patient with a diagnosis of progressive supranuclear palsy within the past year followed a supervised 12-week exercise program (two times per week) by a physiotherapist, with a session lasting about 40 min at a private physiotherapy clinic. Functional status, balance, quality of life, anxiety, and depression were assessed four times with valid instruments and tests. The results from the timed-up-and-go test demonstrated an improvement in performance (MCID value = 3.4). Improvements were observed in the scores of the Parkinson’s Disease Questionnaire-39 (MCID value = 0.6). Finally, an improvement was reported in the score of the anxiety factor of the hospital anxiety and depression scale (MCID value = 1.5). Physiotherapy appears to improve functional capacity, quality of life, and mental health. Further research is needed to confirm these results with a large sample size in combination with other complementary therapies such as mental imagery.

This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in this analysis, articles must have had participants with an average age ≤21, focus on children with neuromuscular disabilities, and primarily examine relationships between muscle mass and any functional or health outcomes measure. Studies including typically developing children were used to contrast and enhance findings. Thirty-two studies were included, with 10,129 unique individuals represented: seventeen studies focused on healthy/typically developing children; seven on children with cerebral palsy; three on children with Duchenne muscular dystrophy; two on children with sarcopenia; and one study each on children with osteoporosis, congenital muscular dystrophy, and other various neurologic disorders. Thirteen studies assessed functional outcomes, ten assessed bone outcomes, and nine assessed other cardiovascular/metabolic outcomes. All of the included studies demonstrated relationships between muscle mass and respective outcomes in varying measures. The results of this review demonstrate that there is a consistently recognized relationship between muscle mass and important health outcomes in children, supporting clinically targeting muscle mass as a means to optimize desired outcomes.