Activities Of Daily Living Research Articles

Feasibility and psychometric properties of Integrated Care for Older People Screening Tool for Taiwanese (ICOPES-TW) cognitive screening test.

Intrinsic capacity, a concept proposed by the World Health Organization, includes multidimensions to better understand older adults' health conditions for successful healthy aging. One of the key dimensions of intrinsic capacity is cognition. The present study aimed to examine if the cognitive test in Integrated Care for Older People Screening Tool for Taiwanese (ICOPES-TW) is a suitable instrument for screening cognition impairment. Older adults from community or medical center settings in Tainan were recruited (n=553; mean±SD age=75.80±8.32; 60.8% females). All participants were administered the ICOPES-TW cognitive test, the Mini-Mental State Examination (MMSE), Lawton's Instrumental Activities of Daily Living (IADL), and Barthel Index (BI) in an in-person interview conducted by a well-trained research assistant. The ICOPES-TW cognitive test was highly correlated with the MMSE total score (r=-0.752) and moderately correlated with IADL (r=-0.426) and BI scores (r=-0.390). When using a cutoff score of 1 for the ICOPES-TW cognitive test, its accuracy to identify cognitive impairment defined by the MMSE was 60% (sensitivity=0.98, specificity=0.41). When using cutoff score of 2, the accuracy was 83% (sensitivity=0.69, specificity=0.90). Moreover, the ICOPES-TW cognitive test had similar properties to the MMSE in terms of known-group validity (distinguishing different age and educational level groups). Using ICOPES-TW cognitive test with appropriate cutoff point in different healthcare settings could help providers and researchers quickly identify if an older adult has a cognitive impairment. However, the screening ability of ICOPES-TW cognitive test was deemed fair but future studies are recommended to help improve it.

Training in the Use of Myoelectric Prostheses Through the Combined Application of Immersive Virtual Reality, Cross-education, and Mirror Therapy

ABSTRACT Introduction During the rehabilitation process (RHB) of the patient with traumatic upper-limb amputation, the use of immersive virtual reality (IVR) facilitates the incorporation of the prosthesis into the body schema. This reinforces and enhances sensorimotor and cognitive stimulation to improve motor learning and motor patterns, while normalizing global gestures. Objectives The aims of this study were to implement retraining of gestural acquisition and prosthetic control in patients with upper-limb injuries and amputations through IVR, and to then incorporate this in the normalization of functional patterns in activities of daily living (ADLs) with the work of “cross-education” as well as the therapy of observation of actions—mirror therapy to enhance the joint effect of the approach with IVR. Methods Standard sessions were established for transradial and transhumeral trauma patients with upper-limb amputation and traumatic injuries within the rehabilitation treatment. During the sessions, games and virtual environment were used. The software ran in desktop mode using a “Leap Motion” or for immersive versions of 3D glasses (Oculus Rift S). Results The application of IVR in combination with conventional treatment obtained significant benefits for functionality. These included learning correct motor execution as well as motivational and emotional state with distal traumatic injuries and upper-limb amputations with or without myoelectric prosthesis, obtaining 5.6 on average on the GROC (global rating of change) scale. Conclusions Immersive virtual reality shows benefit for the normalization of motor learning of functional patterns in DLA and on the emotional, motivational level of the patient. Clinical Relevance The integrated combination of cross-education, mirror therapy, and immersive virtual reality may represent greater acquisition of motor patterns in the prosthetic training of patients with upper-limb amputation.

Sounds of Nature and Hearing Loss: A Call to Action.

The ability to monitor surrounding natural sounds and scenes is important for performing many activities in daily life and for overall well-being. Yet, unlike speech, perception of natural sounds and scenes is relatively understudied in relation to hearing loss, despite the documented restorative health effects. We present data from first-time hearing aid users describing "rediscovered" natural sounds they could now perceive with clarity. These data suggest that hearing loss not only diminishes recognition of natural sounds, but also limits people's awareness of the richness of their environment, thus limiting their connection to it. Little is presently known about the extent hearing aids can restore the perception of abundance, clarity, or intensity of natural sounds. Our call to action outlines specific steps to improve the experience of natural sounds and scenes for people with hearing loss-an overlooked aspect of their quality of life.

Potential Disease-Modifying Effects of Ganglioside GM1 Pulse Treatment on Spinocerebellar Ataxia Type 3, a Parallel-Group, Double-Blind, Randomized, Controlled Trial.

Spinocerebellar ataxia type 3 (SCA3) is an autosomal dominant inherited neurodegenerative disorder for which there is currently no cure, nor effective treatment strategy. Our aim was to investigate the safety and efficacy of high-dose ganglioside GM1 (ganglioside-monosialic acid) pulse treatment in patients with SCA3. Patients were randomly allocated to receive either high-dose GM1 (400 mg on the first day followed by 200 mg/day), low-dose GM1 (40 mg/day), or placebo (normal saline) for 4 weeks. The primary outcome, assessed by measuring the change in the Scale for the Assessment and Rating of Ataxia (SARA) scores from baseline to 12 weeks post-treatment, is central to evaluating treatment efficacy. Secondary outcomesincluded changes in the International Cooperative Ataxia Rating Scale (ICARS) score, Barthel Index of Activities of Daily Living (ADL), and plasma and cerebrospinal fluid (CSF) GABA levels. Safety was assessed in all treated patients. A total of 48 patients with SCA3 were enrolled in this study. After 12 weeks, data from 43 patients were included in the efficacy analysis (intention-to-treat analysis). The least-squares mean change in the SARA score from baseline to 12 weeks post-treatment was -3.80 (standard error [SE], 0.39; 95% confidence interval [CI], -4.58 to -3.02) in the high-dose GM1 group, 0.34 (SE, 0.40; 95% CI, -0.46 to 1.13) in the low-dose GM1 group, and 0.73 (SE, 0.40; 95% CI, -0.07 to 1.52) in the placebo group, respectively. Secondary outcomes showed improvements in the ICARS score, Barthel Index of ADL, and plasma and CSF GABA levels in the high-dose GM1 group compared to the low-dose GM1 and placebo groups. All treatments were well-tolerated and safe. High-dose GM1 treatment significantly ameliorated ataxic symptoms in patients with SCA3. © 2024 International Parkinson and Movement Disorder Society.

Correlation between proprioception, functionality, patient-reported knee condition and joint acoustic emissions.

Non-invasive assessment of joint status using acoustic emissions (AE) is a growing research area that has the potential to translate into clinical practice. The purpose of this study is to investigate the correlation of the knee's AE with measures of proprioception, self-assessment, and performance, as it can be hypothesised that, AE parameters will correlate with joint function metrics due to AE being recorded during interaction of the articular surfaces. Threshold to detect passive motion (TTDPM), Knee Osteoarthritis Outcome Scores (KOOS) and 5 times sit-to-stand test (5STS) were collected from 51 participant. Knee AE were recorded during cycling with 30 and 60 rpm cadences using two sensors in different frequency ranges and three modes of AE event detection. Weak (0.297, p = 0.048) to moderate (0.475, p = 0.001) Spearman's correlations were observed between longer 5STS time and AE parameters (i.e. higher median absolute energy, signal strength, longer AE event rise time and duration). Similarly, AE parameters shown correlation with lower KOOS, especially in the "Function in Sports and Recreation" and "Activities of Daily Living" subscales with correlation coefficients for higher median amplitude up to 0.441, p = 0.001 and 0.403, p = 0.004, respectively. The correlation with the TTDPM was not detected for most of the AE parameters. Additionally, a lower frequency sensor and 60 rpm cadence AE recordings showed higher correlations. Considering that this study included subjects from the general population and the number of participants with KOOS <70 was relatively small, higher correlations might be expected for clinically confirmed OA cases. Additionally, different ICCs might be expected for alternative signal parameters and proprioception assessment methods. Overall, the study confirms that AE monitoring offers an additional modality of joint assessment that reflects interaction between cartilage surfaces and can complement orthopaedic diagnostics, especially in the context of remote monitoring, drug testing, and rehabilitation.

Symptom prevalence in patients with advanced heart failure and its association with quality of life and activities of daily living.

Quality of life (QOL) and functional status are two key outcomes for patients with advanced heart failure (HF). We examined the association of eleven symptoms with QOL and functional status impairment in patients with advanced HF. This was a retrospective analysis of baseline data from a multi-center, cluster-randomized controlled trial (NCT01459744) which enrolled patients with an implanted cardioverter-defibrillator and advanced HF at high-risk for mortality. Study instruments included the Condensed Memorial Symptom Assessment Scale, the Kansas City Cardiomyopathy Questionnaire QOL subscale, and the number of activities of daily living (ADL) patients had difficulties with. The study included 413 subjects. In generalized linear models which were adjusted for baseline characteristics, the total number of symptoms was significantly associated with worse QOL, as was the presence of each individual symptom, except constipation. Lack of energy demonstrated the strongest negative association with QOL. Similarly, the total number of symptoms was associated with a higher number of ADL difficulties (i.e., worse functional status). The presence of pain, lack of energy and drowsiness was individually associated with more ADL difficulties. Among patients with advanced HF, a higher number of symptoms and specific individual symptoms were associated with worse QOL and functional status.

The optimal treatment duration for inspiratory muscle strengthening exercises in stroke patients: a double-blinded randomized controlled trial

ABSTRACT Background Little is known about the ideal duration of inspiratory muscle training in stroke patients. Objective The aim of this study was to assess the effects of short-term and long-term inspiratory muscle strengthening exercises in stroke patients. Methods This study was a prospective, double-blind, randomized controlled trial involving 50 stroke patients. Based on baseline maximum inspiratory pressure (MIP) values, participants were divided into two strata: those with severely weak inspiratory muscle (stratum A) and those with moderately weak inspiratory muscle (stratum B). Within each stratum, individuals were randomly assigned to either the 4-week exercise group, the 8-week exercise group, or the sham group. The exercise groups underwent inspiratory muscle strengthening exercises. The MIP, 6-minute walk test (6MWT), and the Nottingham Extended Activities of Daily Living (NEADL) Index were assessed at baseline, 8, 12, and 24 weeks. Results Subjects in Stratum A exhibited notably greater improvement after 8 weeks of training compared to those in Stratum B. Furthermore, both Stratums displayed significantly greater improvement following 8 weeks of training compared to sham training. In Stratum B cases, a significantly higher level of improvement was noted with the 4-week training in comparison to the sham training. A significant increase in NEADL index and 6MWT score was observed during the 24-week follow-up period. Conclusion For individuals with moderately weak inspiratory muscle strength, a 4-week exercise program proves sufficient in enhancing inspiratory muscle strength, walking capacity, and daily life activities. However, individuals with severely weak inspiratory muscle strength benefit more from an 8-week treatment.

The relationship between childhood hunger experiences and activities of daily living disability: a mediating role of depression.

Hunger is an important public health issue. This study aims to explore the impact of childhood hunger experiences (CHEs) on activities of daily living (ADL) disability and to discover the mediating role of depression on this correlation. Data were derived from the China Health and Retirement Longitudinal Study 2011, 2013, 2015, 2018, and 2020. Depression was assessed using the Centre for Epidemiological Studies Depression Scale. ADL disability, basic ADL (BADL) disability and instrumental ADL (IADL) disability were assessed using the ADL scale. The relationships between CHEs, depression and ADL disability were estimated using probit methods, and the mediating effect of depression was estimated using the stepwise regression test and bootstrap methods. A total of 9,905 sample were included in the study. The study found that CHEs increased ADL disability by approximately 9.1% (β = 0.091, 95% CI: 0.028, 0.154), and increased the probability of IADL disability by approximately 8.0% (β = 0.080, 95% CI: 0.016, 0.144). CHEs increased ADL disability by approximately 29.8% (β = 0.298, 95% CI: 0.202, 0.393) in samples under 60 years of age. CHEs indirectly increased ADL (β = 0.062, 95% CI: 0.000, 0.124) by increasing the probability of depression. CHEs predicted ADL disability, and depression mediated this correlation. There is a need to focus on the impact of CHEs on mental and physical health. In particular, focusing on mental health is necessary to prevent impairment of physical functioning.

Language Codes, Topic Preferences and Identity Construction: The Case of Gendered Language on Social Media

This study on exploring the use of gendered language on social media is a qualitative-quantitative analysis of the male and female differences in the language codes, topic preferences, and identity construction. In-depth understanding of the gendered use of language in Facebook was investigated with a purposive sampling of 90 status updates taken from the posts of respondents who are enrolled in one of the premier public high schools in Cagayan Valley. Anchored on Thematic Analysis by Braun and Clarke (2006), the language codes, topic preferences and gender-based identity construction were explored. Findings reveal that both male and female who are active users of Facebook are multilingual whenever they go online. The discussion on the variety of topics speaks of the diversity of the interest of those involved in the communication platform. The interactivity that Facebook provides makes it a medium through which people define themselves by sharing what is going on in their lives or how they are feeling. This makes Facebook a forum where extension of a person’s real-life identity radiates. Moreover, the use of language by male and female are influenced by their social network in Facebook. Through Facebook status updates, male and female do not only express their emotions but also share details about their daily life activities as to what they were doing or what was going on in their lives at that moment. Thus, trainings and seminars among students and teachers on upholding preservation of culture and language must be part of the curriculum to promote youth empowerment, gender fair language and awareness of cyber-bullying, are hereby recommended to develop communicative competence leading to deeper understanding of one another.

Introduction and preliminary psychometric evaluation of the assessment of functional capacity interview for older adults

Measures of complex functional decision-making capacity can greatly aid in assessing mild cognitive impairment (MCI) and facilitating early intervention in dementia care. We examined the ability of the Assessment of Functional Capacity Interview (AFCI) to detect functional differences among older adults who were cognitively unimpaired (CU), or who presented with subjective cognitive decline (SCD) or MCI. A sample of 97 older adults (CU; n = 30, Mage = 74.64 ± 7.42 years; SCD; n = 34, Mage = 72.56 ± 6.43 years; MCI; n = 33, Mage = 78.28 ± 7.55 years) underwent neuropsychological testing and responded to the Financial Capacity Instrument (FCI-SF). Informants completed the Assessment of Functional Capacity (AFCI), an instrument of functional decision-making capacity, and responded to the Social Vulnerability Scale (SVS15) and Amsterdam Instrumental Activity of Daily Living (A-IADL-Q-SV), a measure of functional status, for comparison. According to informant-reported responses, the CU group had significantly lower AFCI total (and domain) scores, H(2) = 27.59, p<.001, relative to MCI. Additionally, the CU group had significantly lower AFCI scores in the Home and Personal Safety domain relative to the SCD group, H(2) = 14.06, p<.05. In the overall sample, AFCI total scores were associated with FCI-SF, SVS15, and A-IADL-Q-SV scores and cognitive measures. Our results demonstrate that the AFCI is sensitive to impairment in safety, social, financial, and medical functioning in MCI and is associated with measures of cognitive functioning and social vulnerability in older adults. Incorporating this instrument as a supplement to cognitive screening instruments may aid in the prevention of hazardous decision-making in older adults.

Fuzzy Logic and Machine Learning Algorithms for Detection and Classification of Falls and Activities of Daily Living

This article analyses the movements of young and elderly people using data collected from an accelerometer and a gyroscope. This study proposes Type I fuzzy logic (FL) and several machine learning (ML) algorithms for the detection and classification of daily life movements and falls. The results obtained demonstrate that a fuzzy logic system can efficiently integrate data from an accelerometer and a gyroscope to classify falls and movements in daily life with 97.4% accuracy. When ML classifiers are used, the performance across several algorithms is also very high.

One-Step Cartilage Repair of Full-Thickness Knee Chondral Lesions Using a Hyaluronic Acid-Based Scaffold Embedded With Bone Marrow Aspirate Concentrate: Long-term Outcomes After Mean Follow-up Duration of 14 Years.

One-step cell-based techniques of cartilage repair that lead to restoration of durable chondral tissue and long-term maintenance of joint function are cost-effective and ideal for routine use. To examine the long-term clinical outcomes, after a mean follow-up duration of 14 years, of cartilage repair in the knee using a hyaluronic acid-based scaffold in association with bone marrow aspirate concentrate (HA-BMAC) and to evaluate the effect of age, lesion characteristics, and associated treatments on the outcome of this cartilage repair method. Case series; Level of evidence, 4. Patients were followed prospectively for a mean duration of 14.0 years after undergoing treatment of knee full-thickness articular cartilage injury using HA-BMAC. Clinical evaluation consisted of the patient-reported scoring tools of the visual analog scale and the Knee injury and Osteoarthritis Outcome Score, which were completed preoperatively and at the time of final follow-up. A total of 26 patients with a mean age of 48.3 years (17 male, 9 female) and median chondral lesion size of 6.6 cm2 (range, 1-27 cm2) were followed prospectively. There were 3 treatment failures, and 1 patient who underwent medial compartment unicompartmental arthroplasty 12 years after HA-BMAC treatment of patellar chondral injury. Of the 22 remaining patients, after a mean final follow-up duration of 14.0 years (range, 12-16 years), the median visual analog scale score of 0.6 was significantly decreased from the preoperative median score of 5.0 (P < .001). The median Knee injury and Osteoarthritis Outcome Score Pain (92), Symptoms (86), Activities of Daily Living (96), Sports (85), and Quality of Life (88) subscale values were all increased compared with the preoperative scores (P≤ .001). There was no correlation of clinical outcome score and body mass index. One-step cartilage repair of full-thickness chondral defects in the knee using an HA-BMAC led to successful long-term clinical outcomes and maintenance of joint junction after a mean follow-up duration of 14 years. Long-term clinical success in active, nonobese patients has been uniformly demonstrated across a wide range of patient ages and lesion types, including cases of multicompartment involvement, treatment of associated conditions, and large or bipolar chondral lesions.

Exploring geriatric assessment-driven rehabilitation referral patterns and its influence on functional outcomes and survival in older adults with advanced cancer.

Older adults with advanced cancer experience functional disability that warrants rehabilitation services; however, evidence indicates inconsistencies in referral. The purpose was to (1) identify predictors of geriatric assessment (GA)-driven referrals to rehabilitation services and (2) explore associations between referral and change in function, health-related quality of life (HRQoL), and overall survival among older adults with advanced cancer. This was a secondary analysis (NCT020107443, UG1CA189961) of a nationwide GA clinical trial. Patients were older adults with advanced cancer who had at least one GA-defined physical performance or functional status impairment. Primary outcomes were oncologist-initiated discussion about or referral to rehabilitation services after the GA (Aim 1) and decline in activities of daily living (ADL), Instrumental ADL (IADL), and HRQoL within 3 months, and overall survival at 1 year (Exploratory Aims). Analyses included multivariable logistic regression and Cox proportional hazards models. Demographic and clinical factors were controlled for by using 1:1 propensity score matching. In total 265 patients were analyzed. After adjustment, impaired cognition (odds ratio [OR] = 2.25, p = 0.01), Karnofsky score indicating disability (OR = 2.86, p < 0.01), and receipt of monoclonal antibodies (OR = 1.95, p = 0.04) were associated with higher odds of referral. In contrast, polypharmacy was associated with lower odds of referral (OR = 0.31, p < 0.01). Referred patients were less likely to decline in ADL (OR 0.30, p = 0.07) and IADL (OR 0.64, p = 0.35), but more likely to decline in HRQoL (OR 1.20, p = 0.67) and have worse survival (HR 1.18, p = 0.62). Cancer treatment, polypharmacy, cognition, and disability status likely influence oncologists' decision to refer for rehabilitation. Referral was not independently associated with change in functional disability, HRQoL, or survival. Future studies should evaluate patients' utilization of rehabilitation services post-referral and determine whether dose/timing of rehabilitation services influence clinical outcomes.

In Vitro Verification of Simulated Daily Activities Using Implant-Specific Kinematics from In Vivo Measurements

The mechanism and boundary conditions used to drive experimental joint simulators have historically adopted standardized profiles developed from healthy, non-total knee arthroplasty (TKA) patients. The purpose of this study was to use implant-specific in vivo knee kinematics to generate physiologically relevant boundary conditions used in the evaluation of cadaveric knees post-TKA. Implant-specific boundary conditions were generated by combining in vivo fluoroscopic kinematics, musculoskeletal modeling-generated quadriceps loading, and telemetric knee compressive loading during activities of daily living (ADL) to dynamically drive a servo-hydraulic knee joint simulator. Ten cadaveric knees were implanted with the same TKA components and mounted in the knee simulator to verify the resulting load profiles against reported fluoroscopic kinematics and loading captured by an ultra-congruent telemetric knee implant. The cadaveric simulations resulted in implant-specific boundary conditions, which accurately recreate the in vivo performance of the like-implanted knee, with Root Mean Square Error (RMSE) in femoral low point kinematics below 2.0 mm across multiple activities of daily living. This study demonstrates the viability of in vivo fluoroscopy as the source of relevant boundary conditions for a novel knee loading apparatus, enabling dynamic cadaveric knee loading that aligns with clinical observations to improve the preclinical development of TKA component design.

Effect of visual biofeedback on fine motor function and activity daily of life in stroke patients: A pilot study

IntroductionMany stroke patients suffer from dysfunction in their upper limbs, which can lead to difficulties in performing activities of daily living (ADL) as well as social and work interactions. This is particularly true for patients whose dominant side has been affected. The aim of the current study was to explore how effective visual biofeedback could improve fine motor function in the hand and ADL for people suffering from a stroke. MethodsTen individuals who had experienced a stroke with aged from 60 to 74 years old (mean: 64.3 years) were randomly divided into two groups. Patients in study group (n: 5) received 15 sessions of visual biofeedback therapy along with routine occupational therapy. Control group (n: 5) received only routine occupational therapy. Fine motor function was measured by Fugl Meyer Scale (FMS), box and block test (BBT), and Purdue pegboard test (PPBT). Also, ADL was measured by functional independence measure (FIM). These clinical outcomes were evaluated before, after, and 1.5 months following the interventions. ResultsThe results showed that the study group experienced a significant increase in fine motor function after receiving visual biofeedback, compared to the control group. The ADL also improved in both the study and control groups after the intervention, but there was no significant difference between the two groups during the intervention and follow-up stages for ADL. ConclusionIt seems that combining biofeedback with routine occupational therapy could be a promising method to enhance fine motor function in individuals with stroke.

The effect of the interaction between intrinsic capacity and social support on the trajectories of activities of daily living in older adults

ObjectivesThis study explored the effect of the interaction between intrinsic capacity and social support on the activities of daily living in the older adults. MethodsA total of 3,124 older adults participated in the study. Data on the assessment of intrinsic capacity as well as activities of daily living (ADL) and social support were collected. The latent growth curve model (LGCM) was used to examine the effect of the interaction between social support and intrinsic capacity on the activities of daily living in the older adults. ResultsA total of 3,730 older adults were included at baseline, and 3,124 older adults completed the 4-year follow-up. The ADL score of the older adults showed a significant downward trend with time over 4 years (β=-0.115, P<0.05). In the elderly population with high intrinsic capacity, the ADL of individuals with low levels of social participation decreased significantly over time (β=-0.114, P=0.012). In the elderly group with low intrinsic capacity, the ADL of individuals with low levels of social participation (β=-0.245, P=0.005) and high levels of life care (β=-0.167, P=0.001) decreased significantly over time. ConclusionThis is the first longitudinal study to explore the effects of interactions among intrinsic capacity, social participation and family support on the trajectory of ADL in the older adults from the perspective of the life course. Social participation can effectively improve functional ability of older adults with low intrinsic capacity. Life care is beneficial for maintaining the functional ability of older adults with intact intrinsic capacity, but it accelerates the deterioration of the functional ability of older adults with low intrinsic capacity.

Impact of Right Ventricular Function on Cardiopulmonary Exercise Capacity in Mitral Regurgitation Patients Undergoing Transcatheter Mitral Valve Intervention

Transcatheter mitral valve interventions (TMVI) has been proven to reduce symptom burden and improve outcome in patients with severe mitral regurgitation (MR). However, the impact of right ventricular function (RVF) on exercise capacity in MR patients is less well understood. Cardiopulmonary exercise testing (CPET) is the most comprehensive approach to assess maximum exercise capacity. Submaximal exercise capacity (SEC), assessed by constant work rate exercise time testing (CWRET), is presumed to be relevant in daily life activities, and gives a more differentiated physiological insight into the nature of exercise intolerance. Thus, 28 MR patients underwent CPET and CWRET (at 75% of maximum work rate in the initial incremental exercise test) prior to TMVI and 3-months post-procedurally. Patients´ mean age was 75.0±8.7 years and 32.1% were female. One patient presented with a MR reduction of less than 2 grades. RVF was at least moderately impaired in 25% of the patients. SEC of these patients was lower, but did not significantly differ (416.4s±359.6 vs. 296.1±216.5s; p=) from patients without RVF-deterioration. At follow up, the SEC improved significantly (from 337.4±262.2s to 517.4±393.5s; p=0.006). Maximum oxygen uptake (peakVO2) showed a positive trend, but no statistically significant difference (10.3±3.1ml/min/kg vs. 11.3±3.4ml/min/kg; p=0.06). RVF improved in 35.7% of the patients and these patients showed a significantly higher SEC increase (471.7±153.9s vs. 82.7±47.0s, p=0.003). SEC is significantly increased in MR patients undergoing TMVI, reflecting an improvement especially regarding daily life activities. This may be related to TMVI´s beneficial effect on right ventricular remodeling.

Effect of Upper Robot-Assisted Training on Upper Limb Motor, Daily Life Activities, and Muscular Tone in Patients With Stroke: A Systematic Review and Meta-Analysis.

Upper limb rehabilitation robot is a relatively new technology, but its effectiveness remains debatable due to the inconsistent results of clinical trials. This article intends to assess how upper limb rehabilitation robots help the functional recovery of stroke patients. PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies to explore the effect of upper limb rehabilitation robots on upper limb motor function, muscle tone, and daily living activities. Eighteen trials with 573 stroke patients met the inclusion criteria. The results showed that compared to conventional rehabilitation training, patients who received upper limb robotic therapy (RT) had significantly improved Fugl-Meyer Upper Extremity Motor Assessment (FMA-UE) scores (weighted mean differences [WMD]: 5.27, 95% confidence intervals [CI]: 3.36, 7.17), Action Research Arm Test (ARAT) scores (WMD: 4.07, 95% CI: -4.14, 12.28), Modified Barthel Index (MBI) scores (WMD: 9.55, 95% CI: 6.37, 12.73), and modified Ashworth Scale (MAS) scores (WMD: -0.28, 95% CI: -0.50, 0.06), with no significant heterogeneity. Upper limb robot-assisted training is superior to conventional training in terms of improving upper limb motor impairment, ability to perform daily living activities, and muscle tone recovery, which supports the application of robots in clinical practice.

TAVIGER : Intérêt d’une expertise coordonnée gériatrique et cardiologique dans le bilan d’éligibilité des patients âgés à un remplacement valvulaire aortique par voie percutanée

BackgroundTranscatheter aortic valve implantation (TAVI) is the gold standard treatment for aortic stenosis in the elderly. Pre-identification of patients likely to benefit from this procedure remains crucial. A standardised geriatric assessment is used to identify the major geriatric syndromes likely to influence postoperative outcomes. ObjectiveTo identify factors associated with lack of TAVI management and to compare one-year survival in TAVI vs. non-TAVI patients. MethodsRetrospective study, between 2016 and 2020, at the Arras hospital. Patients aged 70 years and older with symptomatic severe aortic stenosis who had undergone geriatric assessment were included. ResultsOne hundred and ninety-two (192) patients, mean age 82.3 years. The 1-year mortality rate was 18% in the TAVI group and 44% in the non-TAVI group (p < 0.001).Parameters associated with no TAVI were Euroscore (ESL) 1 (19.6 ± 10.9 vs. 23.2 ± 13.5, p = 0.020), malnutrition (14% vs. 35%, p = 0.004), walking speed < 0.8 m/s (39% vs. 75%, p = 0.001), Activities of Daily Life (ADL) score (5.4 ± 1 vs. 4.2 ± 1. 6, p < 0. 001) and Instrumental Activities of Daily Life (IADL) score (2.6 ± 1.2 vs. 1.8 ± 1.4, p = 0.002), Mini Geriatric Depression Scale (mini GDS) ≥ 1 (16% vs. 38%, p = 0.045), Mini Mental State Examination (MMSE) score (25.1 ± 3.5 vs. 21.6 ± 4.3 < 0.001). ConclusionsGeriatric syndromes are important determinants of TAVI candidacy. Cardiological surgical risk scores are not effective in discriminating between patients. Coordinated assessment may optimise selection. Therefore, geriatric assessment should be systematically performed as part of the pre-TAVI evaluation.

Depressive syndrome, cognitive impairment, and associated factors among community-dwelling aged persons in Cameroon.

Background: Depressive syndrome (DS) and cognitive impairment (CI) are associated with unsuccessful aging. However, little is known about Cameroon. This study aimed to assess the factors associated with DS and CI among older adults in Cameroon. Methods: A representative sample of 599 individuals aged ≥ 60 years was selected for this cross-sectional study. Sociodemographic and health data were also collected. DS and CI were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D) and Mini-Mental State Examination (MMSE), respectively. The Rosow Mobility Scale, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) scales were used to evaluate functional abilities. Chi-2, ANOVA, and multiple regression analyses were performed to assess the factors associated with DS and CI. The threshold of statistical significance was 5%. Results: The average age was 68.9±7.2 years, sex ratio M/F=0.93, and weight 68.5±14.7 kg. DS affected 14.5% of the population and the CI was 21.4%. In the multivariate analysis, DS was positively associated with male gender (Odds Ratio (OR)=1.7 [95% Confidence Interval (CI):1.1-2.7], p=0.031) and inactivity (OR=1.7 [95% CI:1.0-3.0], p=0.043). CI was positively associated with lack of education (OR=6.5 [95% CI:3.5-12.2], p<0.001), inactivity (OR=5.3 [95% CI:1.6-17.9], p=0.008), single (OR=3.7 [95% CI:1.2-11.3], p=0.023), and widowhood (OR=3.3 [95% CI:1.6-6.5], p=0.001), and negatively associated with no IADL (OR=0.3 [95% CI:0.2-0.6], p=0.001) and ADL disability (OR=0.5 [95% CI:0.2-0.9], p=0.032) limitations. Conclusions: The associated factors suggest that it might be of interest to fight inactivity and encourage early and long-term education to prevent DS and/or CI among older adults.