1,721,019 research outputs found
Evaluation of the Edmonton Functional Assessment Tool (EFAT2) within palliative care: a pilot study
No full textBackground There is increasing need for rehabilitation in both cancer and palliative care. However, there are few validated outcome measures that are suitable for measuring functional performance in this population. The present study evaluated the validity, sensitivity and reliability of the Edmonton Functional Assessment Tool (EFAT2) within a UK palliative care setting.Methods Eleven participants aged 65 years and over (mean age 76.5 ± 6.7 years) receiving rehabilitation in a palliative care inpatient setting were studied. Concurrent validity was assessed by comparing EFAT2 with the Barthel Index. Inter-rater reliability of EFAT2 was examined using a sample of four participants recruited from a cancer care ward.ResultsA significant negative correlation was observed between the Barthel Index and EFAT2 (r = -0.765,p = 0.01) and both measures were found to be sensitive as determined by Cohen’s effect size (EFAT2 = 0.60, Barthel Index = 0.72). High inter-rater reliability was noted for EFAT2 (ICC3, 1 = 0.85) and the agreement between scores was confirmed by Bland–Altman analysis.Conclusions EFAT2 showed concurrent validity with the Barthel Index when used to assess the effects of rehabilitation on participants with advanced cancer. The tool was sensitive to change and was found to be reliable when used by different raters. The findings indicate that EFAT2 might be an appropriate outcome measure to use within the palliative care setting. However, the feasibility of using EFAT2 needs to be explored and larger studies are required to confirm its reliability
Effect of limb dominance on peak torque and angle of peak torque of hamstrings in recreational female football players
No full textPurpose: To investigate whether there is a significant difference between the peak torque and angle of peak torque of the hamstrings in a group of recreational female football players. Methods: A convenience sample of 17 females aged 18-22 years from a university ladies football team. Peak torque and angle of peak torque of both hamstrings were measured using a Biodex system 2 isokinetic dynamometer in concentric and eccentric mode at an angular velocity of 60°/sec. The related t-test was used to test for significant differences between limbs. Results: Muscle strength differences ranging between 0.9% - 38.3% (Concentric: 9.7±7.7; Eccentric: 15.4±9.3) were noted. However, no significant differences were found between the dominant and non dominant limb (peak torque concentric p=0.068, eccentric p= 0.063; angle of peak torque concentric p= 0.449, eccentric p=0.246). Conclusions: In a group of recreational football players, limb dominance did not significantly affect peak torque or angle of peak torque at 60°/secs. However, noteworthy strength imbalances were observed in a number of participants, indicating that clinicians need to be cautious when using the uninjured limb as a baseline measure. Implications: The findings highlight that caution may be exercised when using the peak torque and angle of peak torque of the contralateral limb as a target for rehabilitation.<br/
Does rapid mobilisation as part of an enhanced recovery pathway improve length of stay, return to function and patient experience post primary total hip replacement? A randomised controlled trial feasibility study
No full textPurpose: Day-zero ambulation may enable patients to recover and leave hospital quicker following total hip replacement (THR). The present randomised control feasibility study investigated the efficacy of day-zero ambulation as a physiotherapeutic intervention. Methods: Thirty-six non-blinded adults aged 44–85 (Mean 67.1; SD 9.6 years) undergoing primary, uncomplicated THR were block randomized to either a control group (n = 18) with standard post-operative physiotherapy or an intervention group (n = 18) incorporating walking on the same day as the operation. Outcomes were length of hospital stay (LOS), time to reach functional milestones and achieve all physiotherapy discharge criteria, post-operative pain scores, complications and patient experience. Results: Participants treated with day-zero ambulation had reduced median hospital LOS of 1 day (p =.096), and median reduced times to reaching functional milestones of 39.7 h quicker to transfer to a chair (p <.001), 24.5 h quicker to walk 10 m (p =.009) and 26.4 h quicker to independently ascend and descend stairs (p =.01). Participants in the intervention group were deemed physiotherapy ready to leave hospital significantly earlier than control group (1.04 days, p =.015). Conclusions: Day-zero ambulation appears safe and may have clinically relevant effects in speeding patient functional recovery and facilitating earlier discharge from hospital.Implications for Rehabilitation Day-zero ambulation following total hip replacement (THR) appears safe. Preliminary data suggest that day-zero mobilisation following THR could be efficacious and support the need for a fully powered randomised controlled trial. There may be a clinically relevant effect in speeding patient functional recovery and facilitating an earlier discharge from hospital.</p
An investigation of the association between grip strength and hip and knee joint moments in older adults
No full textGrip strength is a predictor of health outcomes but with differing rates of age-related decline in muscle strength, it is unclear whether handgrip is a reliable indicator of lower limb moments. This study investigated the relationship between grip strength and lower extremity moments in community- dwelling older adults. Eighty-two healthy volunteers aged 60–82 years (mean age 73.2 years) performed maximal voluntary contractions of knee and hip extensors and flexors at three positions and at neutral position for hip abductors and adductors using a custom-built dynamometer. Grip strength was measured using an electronic Jamar dynamometer. The relative reduction in muscle strength of 80s age category compared to 60-year-olds ranged from 14% for grip strength to 27% for hip abductors. Peak torque of flexors and extensors of the knee and hip joints were significantly correlated with grip strength and Pearson’s correlation coefficients ranged from 0.56 to 0.78 with the highest correlations observed between knee moments and grip strength. ‘‘Good’’ correlation was found but only 31–60% of the variation in grip strength could be related to changes in joint torques. Hence the assumption that grip strength is an indicator of strength in the lower limb would seem unjustified in the healthy older adul
Rééducation après arthroplastie prothétique de l'articulation interphalangienne proximale: une revue structurée de la littérature
No full textProximal interphalangeal (PIP) joint arthroplasty is an unsolved biomechanical challenge despite advances in materials and new implant designs. This leads to a high rate of complications. Moreover, there is heterogeneity in postoperative management according to the literature. The present structured review examined the therapeutic strategies utilized by physiotherapists to restore a functional finger chain and prevent postoperative complications following PIP joint replacement. Patients undergoing primary total PIP joint arthroplasty of the index, ring, middle or little finger were included. Articles published from 2008 onwards, in French or English, and reporting on PIP joint replacement and postoperative management, were included. Therapeutic strategies were organized according to the surgical approach. Details of splint strategies, mobilization and muscle strengthening and management of postoperative complications were collected. Forty-eight studies, 3 of which provided a description of surgical techniques, were included. In relation to hand function, most authors advocated joint mobilization (n = 45) and some recommended muscle strengthening (n = 4). Static (n = 43) and dynamic splints (n = 14) and buddy taping (n = 12) were frequently recommended to prevent and manage postoperative complications. Few studies (n = 13) reported wound assessment or control of postoperative edema. Precise recommendations concerning therapeutic strategies following PIP joint arthroplasty cannot be made based on available evidence. Specific protocols for rehabilitation following PIP joint replacement need to be clarified in future research.</p
Muscle strength, functional endurance and health related quality of life in older female golfers
No full textFactors influencing length of stay and discharge destination of patients with hip fracture rehabilitating in a private care setting
No full textBackground: Rehabilitation after a hip fracture has long-term importance, prompting some patients to utilise private services. Insufficient data regarding private rehabilitation in the UK can cause ambiguity and potential problems for all involved. Aim: The present study, involving patients with hip fractures rehabilitating in a private UK care setting, examined relationships between length of stay (LoS), discharge destination (DD) and 12 predictor variables. Methods: The variables included the retrospective measurement of the Functional Independence Measure. The variables were informed by a literature review and patient and public involvement. Retrospective data from the records of patients with hip fractures were utilised. Data were analysed using Spear-man’s rho, Mann–Whitney U, Kruskal–Wallis H and chi-squared tests as appropriate. Odds ratios, distribution quartiles and survivor analysis were also utilised. Results: The median length of stay (LoS) was 20.5 days: 82% returned home, 6.5% died and 11.5% remained as long-term residents. Significant relationships existed between LoS and age (p = 0.004), comorbidities (p = 0.001) and FI-Madmission (p = 0.001). DD was associated with age (p = 0.007), delirium (p = 0.018), comorbidities (p = 0.001) and both FIMpre-fracture and FIMadmission (p = 0.000). Conclusions: Factors associated with length of stay were identified, but further research incorporating multiple sites is required for greater predictor precision. Discharge destination was evident by 90 days, facilitating long-term planning.</p
Muscle strength, functional endurance and health related quality of life in active older female golfers
No full textBackground: Grip strength is a reliable predictor of whole body strength in older adults, but muscle characteristics of people with different activity levels have not been studied previously. The present study examined the relationship between grip strength (GS), quadriceps peak torque (QPT), functional endurance, and health-related quality of life (HRQoL) in older female golfers.
Methods: Twenty-nine healthy female golfers (mean age 69.1 years, SD 3.4) participated. The ISOCOM and JAMAR dynamometers were used to assess QPT and GS, respectively. Functional endurance tests included 1-min sit-to-stand test (1MSTS), 30-s wall press (30SWP), and 2-min stair climb (2MSC). HRQol was assessed using the SF-36 questionnaire.
Results: Mean GS and QPT were 27.5 ± 4 kg/f and 103.7 ± 25.1 N m, respectively. Mean scores for the 1MSTS, 30SWP, and 2MSC were 31 ± 7.7, 17.4 ± 3.5, and 237.5 ± 48.6 repetitions, respectively. GS was moderately correlated with QPT (r = 0.44), 1MSTS (r = 0.36), and 2MSC (r = 0.36), but had weak correlation with 30SWP (r = 0.003). Moderate correlation was observed between quadriceps peak torque and the 1MSTS (r = 0.50; p = 0.01), 2MSC (r = 0.44; p = 0.02) and 30SWP (r = 0.33). 30SWP and 2MSC had moderate correlations with PF r = 0.41 (p = 0.03) and r = 0.61 (p < 0.0005) and general physical well-being r = 0.47 (p = 0.01) and r = 0.39 (p = 0.04), respectively.
Conclusion: Quadriceps strength was more closely associated with functional endurance than grip strength. A single strength measure may not reflect overall muscle characteristics in active older females, and hence, assessment of both upper and lower limb strengths may be appropriate
Measurement of ageing effects on muscle tone and mechanical properties of rectus femoris and biceps brachii in healthy males and females using a novel hand-held myometric device
Full text linkBackgroundAge and gender effects on muscle tone and mechanical properties have not been studied using hand-held myometric technology. Monitoring changes in muscle properties with ageing in community settings may provide a valuable assessment tool for detecting those at risk of premature decline and sarcopenia.ObjectiveThis study aimed to provide objective data on the effects of ageing and gender on muscle tone and mechanical properties of quadriceps (rectus femoris) and biceps brachii muscles.MethodsIn a comparative study of 123 healthy males and females (aged 18-90 years; n=61 aged18-35; n=62 aged 65-90) muscle tone, elasticity and stiffness were measured using the MyotonPRO device.ResultsStiffness was greater and elasticity lower in older adults for BB and RF (p<0.001). Tone was significantly greater in older adults for BB but not for RF when data for males and females were combined (p=0.28). There were no gender differences for BB in either age group. In RF, males had greater stiffness (young males 292 vs females 233 N/m; older males 328 vs females 311 N/m) and tone (young 16.4 vs 13.6 Hz; older 16.7 vs 14.9 Hz). Elasticity in RF was lower in young males than females but did not differ between the older groups (both males and females log decrement 1.6).ConclusionsStiffness and tone increased with ageing and elasticity decreased. These findings have implications for detecting frailty using a novel biomarker. Age and gender differences are important to consider when assessing effects of pathological conditions on muscle properties in older people
- …
