Activities Of Daily Living Research Articles

EFFECTIVENESS OF VIRTUAL REALITY (VR) REHABILITATION IN IMPROVING BALANCE AND GAIT ON POST-ISCHEMIC STROKE PATIENTS

Background: Stroke remains a major global health challenge, ranking as the second leading cause of death and the third leading cause of combined death and disability worldwide. The burden of stroke continues to rise, particularly in low- and middle-income countries, with significant impacts on mortality, disability, and healthcare costs. Innovative rehabilitation strategies are essential to address the growing need for effective post-stroke recovery. Introduction: Stroke is characterized by a sudden disruption of blood flow to the brain, resulting in neurological impairments. The global burden has increased substantially, with a 70% rise in incident strokes and an 86% increase in prevalence from 1990 to 2021. Traditional rehabilitation faces limitations in engagement and outcomes, prompting exploration of technologies like virtual reality (VR) to enhance recovery, especially for balance and gait in post-ischemic stroke patients. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, comparing VR-based interventions with conventional rehabilitation in post-stroke patients. Data extracted included patient demographics, stroke characteristics, VR intervention specifics, control interventions, and validated outcome measures for motor function, balance, gait, cognition, and activities of daily living (ADLs). Results: The literature consistently demonstrates that VR is a valuable adjunct to traditional rehabilitation, significantly improving balance, gait, and patient motivation in post-ischemic stroke populations. Fully immersive VR, especially when combined with conventional therapy, enhances motor recovery and functional outcomes. Conclusion: VR is a promising adjunct therapy for improving balance and gait in post-ischemic stroke patients, offering engaging environments and real-time feedback that enhance motor relearning and motivation. Although not universally superior to conventional therapy, VR provides meaningful benefits when customized and integrated with standard care.

How socioeconomic status shapes health outcomes following severe falls: a cross-sectional analysis.

Falls are a major health concern, leading to severe injuries, fatalities, and increased risk of future falls. Severe falls, requiring medical care, necessitate targeted interventions. Socioeconomic status (SES), measured by income and education, influences health outcomes, with lower SES linked to greater multimorbidity and reduced physical activity. While SES broadly impacts fall risk, limited research explores its effects following severe falls. Therefore, this study aims to evaluate the associations between socioeconomic status (SES) and health outcomes in older adults following a fall with presentation to the emergency department (ED). We analyzed data from the SeFallED study, comprising individuals over the age of 60, who presented to the ED following a recent fall, without requiring subsequent hospitalization. Income and education were used to characterize SES. Health outcomes include mental and functional performance, physical activity, mental well-being, and utilization of the health system. Linear and logistic regression models, adjusted for age and sex, were used to assess associations with health outcomes, incorporating multicollinearity checks, residual diagnostics, and bias-corrected bootstrapping to ensure robustness and reproducibility. In this cross-sectional study of 172 older adults (median age 74 years) following a severe fall, education was positively associated with functional and mental outcomes, including Activities of Daily Living (ADLs), cognitive status, hand grip strength, and physical performance (p < .001). Regression analysis, adjusting for age and sex, revealed that higher education was significantly associated with better ADLs, cognitive status, hand grip strength, and physical performance, while income showed no significant associations with these outcomes. This study revealed that the associations with mental and functional health outcomes in older adults following a severe fall were the strongest for education, rather than income. Higher education was associated with better performance. Income showed limited associations but was negatively correlated with concerns about falling. Age and sex were critical covariates, influencing key health outcomes. These findings provide insights that may be relevant for future research and considerations in studies involving older adults presenting to EDs. DRKS00025949 https://drks.de/search/en/trial/DRKS00025949 , Registered on 4th November, 2021.

Maintaining quality of life of people at older ages: factors affecting the utilization of preventive care

Abstract Background Maintaining and improving quality of life (QOL) in older people are among the goals of clinical management, achieved mainly through preventive care. Objective To analyze the association of individual-level disability and country-level health funding characteristics with the utilization of preventive care measures, including flu vaccines, eye exams, and dental care. Design and setting Data from the cross-sectional SHARE study (pre-COVID wave 8) were analyzed using a multi-level econometric approach. Explanatory variables included Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) disability reported by individuals and government health expenditure (GHE). Subjects The study included 46,498 participants 50 years and older residing in 27 high/middle income countries. Results Preventive care utilization greatly varied between countries; flu vaccinations ranged from 3–60%, eye exams from 17–77%, and dental care from 14–86%. Disability prevalence ranged from 7 to 26%. Individual-level analysis revealed a negative correlation between disability and all preventive care measures. Country-level analysis showed a positive and significant correlation between GHE and preventive care. The disability and GHE interaction analysis showed that for eye exams and dental care, higher GHE and lower disability led to higher utilization of preventive care. Contrastingly, in the case of flu vaccines in high GHE countries, higher disability correlated with higher care utilization. Conclusions Our findings emphasize the role of healthcare funding in enhancing preventive care use among older adults, though disparities remain for those with disabilities. Tailored policies addressing disability and healthcare investment can improve QOL through accessible preventive care among disabled populations.

Repetitive transcranial magnetic stimulation for treating post-stroke depression: a systematic review and network meta-analysis

Abstract Objective To systematically evaluate the effects of different modes of repetitive transcranial magnetic stimulation (rTMS) on depression in post-stroke depression (PSD) patients using the network meta-analysis method. Methods PubMed, Web of Science, Cochrane Library, Embase, Wanfang Data, CNKI, VIP, and CBM were searched for randomized controlled trials on rTMS for PSD from the time the database was constructed until April 20th, 2024. Two researchers independently conducted screenings to extract the relevant literature. The meta-analysis was performed using RevMan 5.4.1 software. Network meta-analysis of depression scores was performed using Stata 17.0 software and R 4.4.1 software. Results Twelve studies involving four different rTMS modalities were included. The results of the meta-analysis revealed that rTMS significantly improved depression (SMD = -1.47, 95% CI [-1.97, -0.97]) and activity of daily living (ADL) (SMD = 0.78, 95% CI [0.52, 1.04]) in patients with PSD. The follow-up results revealed that rTMS significantly improved depression in the long term (SMD = -1.74, 95% CI [-2.32, -1.17]). The results of the network meta-analysis revealed that dual-rTMS (SMD = -2.33, 95% CI [-3.16, -1.50]), HF-rTMS (SMD = -1.62, 95% CI [-2.11, -1.13]), iTBS (SMD = -1.57, 95% CI [-2.56, -0.57]), and LF-rTMS (SMD = -0.80, 95% CI [-1.36, -0.23]) significantly improved depression compared with sham stimulation. The SUCRA values in descending order were dual-rTMS (95.9%) &gt; HF-rTMS (65.0%) &gt; iTBS (61.9%) &gt; LF-rTMS (27.1%). Conclusions Twenty minutes of 4-week dual-rTMS on the DLPFC of PSD patients may produce better therapeutic effects. High-quality, large-sample, standardized RCT trials can be conducted to further test the scientific validity of the findings.

Impact of body mass index on clinical presentation and prognosis in myasthenia gravis.

The literature lacks consistent information on the correlation between baseline body mass index (BMI), clinical presentation, and prognosis in patients with myasthenia gravis (MG). This observational multicenter prospective cohort study included patients with MG from February 2017 to June 2023, categorizing them by baseline BMI. The primary outcome was the time to generalization of ocular MG. Secondary outcomes included the time to Activities of Daily Living (ADL) response and Minimal Symptom Expression (MSE). Kaplan-Meier curves and multivariable Cox proportional hazards regression models were used to assess the impact of BMI on these outcomes. Out of 940 MG patients (510 women) included, 524 had a low BMI and 416 had a high BMI, with a median age of 50.00 years. Patients in the high BMI group were significantly older (p < 0.001), had a lower percentage of females (p < 0.001), and had a shorter disease duration (p = 0.014) compared to those with a low BMI. They also had higher rates of ocular onset (p < 0.001), ocular MG classification (p = 0.001), and acetylcholine receptor antibody seropositivity (p = 0.007), but a lower incidence of thymectomy (p = 0.027). During a median follow-up of 33.00 months, the adjusted Cox models revealed that a higher baseline BMI was associated with an increased risk of ocular MG generalization (HR 1.06; 95% CI 1.01-1.11; p = 0.026), but not with ADL response (HR 0.99; 95% CI 0.95-1.04; p = 0.779) or MSE (HR 0.97; 95% CI 0.92-1.02; p = 0.240). A higher baseline BMI was associated with an increased risk of ocular MG generalization but not with ADL response or MSE.

&lt;b&gt;PREVALENCE OF MUSCULOSKELETAL COMPLAINTS AMONG POST-MENOPAUSAL WOMEN IN TWIN CITIES&lt;/b&gt;

Background: Postmenopausal women experience a lot of health problems, often which musculoskeletal issues being very common. The drop in estrogen levels after menopause can bring on some problems like weaker muscles, bone loss, and weight gain affecting mental and physical health that leads to restrictions in daily life activities. Objective: The objective of this study was to find out the prevalence of musculoskeletal complains among postmenopausal women in twin cities. Methodology: This cross-sectional study was conducted in Rawalpindi and Islamabad, including housewives and OPD patients. A total of 370 postmenopausal women participated. Data on pain patterns were collected using the Nordic questionnaire. Data was analyzed using SPSS version26. Result: Most participants were aged 50-60 years. The most common pain areas over the past year were the lower back (54.3%), knees (52.7%), and upper back (34.9%). In the past 7 days, knee (48.0%) and lower back pain (47.0%) were most frequent. Lower back pain limited daily activities the most (50%), followed by knee pain (44.6%). Many women sought treatment for these pains, particularly for the lower back and knees (36%). Conclusion: Musculoskeletal pain, particularly in the lower back and knees, is far and wide among postmenopausal ladies. It influences day to day existence and leads numerous to look for clinical assistance. Further research is needed to improve treatment options.

How Does Social Participation Affect the Associations Between Depression, Life satisfaction, and IADL Disability in Middle-Aged and Older Adults? A Longitudinal Mediation and Moderation Model

ABSTRACT This study examined the longitudinal associations and mechanisms between Instrumental Activities of Daily Living (IADL) disability and depression among middle-aged and older adults. Using data from three waves (2015, 2018, 2020) of the China Health and Retirement Longitudinal Study (CHARLS), a cross-lagged model was employed. It revealed that IADL disability predicted depression, with life satisfaction as a mediator. Social participation trajectory moderated these longitudinal associations, with a higher trajectory reducing negative effects of IADL disability on depression by enhancing life satisfaction. The findings suggest that promoting social participation to improve life satisfaction may help prevent depression associated with IADL disability.

Disability Among Middle Aged and Older Immigrants: Differences by Citizenship, English Proficiency, and Years in United States.

ObjectivesUnited States (U.S.) immigrants are rapidly aging, although little is known on how acculturation influences their disability risk.MethodsWe pooled 2000-2018 data (n = 50,075) from the National Health Interview Survey (NHIS) to examine odds of activities of daily living (ADL) disability among middle aged (40-64) and older (65+) immigrants based on three acculturation indicators while accounting for various measures.ResultsAmong middle aged immigrants, citizenship was associated with higher odds of ADL disability after accounting for socioeconomic factors. Among both middle aged and older immigrants, English proficiency was associated with lower odds of ADL disability until accounting for socioeconomic factors. Among older immigrants, lower ADL disability odds were observed among those with English proficiency and greater U.S. duration.DiscussionAcculturation had heterogenous influences on ADL disability risk among aging U.S. immigrants, while the interplay of these mechanisms shaped varied outcomes.

Demographic differences in the correlation between leisure activities and IADL in widowed older adults - a network analysis.

Demographic differences in the correlation between leisure activities and IADL in widowed older adults - a network analysis.

Traducción al español] Beneficios de la hidroterapia en pacientes con enfermedad pulmonar obstructiva crónica: resultados adicionales de un ensayo clínico aleatorizado

The objective of this article was to assess the effect of hydrotherapy on the functional status, dyspnea, BODE index, and quality of life in patients with COPD. A randomized, controlled clinical trial was carried out with 24 COPD patients, randomly divided in two groups: 1) aquatic training group (ATG), participating in an aquatic training (AT) program of intermittent (moderate/high) intensity that took place three times a week, for 8 weeks; and 2) control group (CG), which received guidance on a healthy lifestyle and did not participate in supervised exercises. The variables (functional status, dyspnea, BODE index, and quality of life) were assessed before and after the intervention period. The level of significance was established in 5%. Results show that the ATG presented significant improvements in daily life activities (LCADL total Δ score: -10.1, p = .01), in functional status (PFSDQ-M, total Δ score: -16.9, p = .01), dyspnea (ΔMRC: -1.37, p = .003), BODE index (Δ: -1.25, p = .048) and quality of life (total Δ score: -7.4, p = 0.02). The CG did not show any significant changes. As a conclusion, intermittent aquatic aerobic training of moderate/high intensity fostered a clinically relevant improvement for most patients with COPD in terms of quality of life, limitations in daily life activities, dyspnea, and in the BODE mortality predictor index.

Self-reported vision impairment and depressive symptoms among older adults: a longitudinal mediation analysis.

Though vision impairment (VI) is a strong predictor for late-life depression, the underlying mechanisms remain unclear, particularly in low-income and middle-income countries. This study aims to investigate the contribution of underlying pathways in mediating the association between self-reported VI and depression among Chinese older adults. We included three waves of data from the China Health and Retirement Longitudinal Study. Our analytical cohort consists of 7528 participants aged 45 years or older with an average follow-up of 5 years. Mediation analyses using the inverse odds ratio weighting approach were conducted to explore the mediating effects of social engagement, limitations in physical activity, and healthcare access. Participants with self-reported VI had 31% higher odds (95% CI of adjusted OR: 1.12, 1.54) of depression than those with normal vision. In the mediation analysis, the mediation effects of social engagement and physical activity were 6.3% and 21.3%, respectively, while the mediation effect via healthcare access did not differ significantly from 0. The cumulative total indirect effects stemming from these three mediating pathways were estimated at β=0.09 (95% CI: 0.04, 0.15), accounting for 26.2% of the total effect. Our findings suggest that the association of self-reported VI with depressive symptoms was partially mediated by social engagement and physical activity limitations. Therefore, promoting social engagement and rehabilitation services in activities of daily living (ADL) and instrumental ADL are potential interventions to improve mental health status among visually impaired older adults.

Effect of Intravenous Immunoglobulin or Plasmapheresis in Myasthenic Crisis and Worsening Myasthenia Gravis Compared With or Without Rescue Treatment.

Effect of Intravenous Immunoglobulin or Plasmapheresis in Myasthenic Crisis and Worsening Myasthenia Gravis Compared With or Without Rescue Treatment.

Neurologic outcomes in patients with skeletal dysplasias undergoing cervical fusion and occipitocervical fusion.

To assess neurologic function after cervical or occipitocervical spinal decompression and fusion in patients with skeletal dysplasias, and to compare the incidence of reoperation between cervical vs. occipitocervical fusion and between postoperative bracing vs. no postoperative bracing. We retrospectively reviewed data from 15 patients (mean age, 27 ± 22years) with skeletal dysplasias (achondroplasia, chondrodysplasia punctata, osteogenesis imperfecta, Morquio syndrome, Hurler syndrome) who underwent cervical (n = 12) or occipitocervical (n = 3) decompression and fusion from 1997 to 2021 and had minimum 2-year follow-up (mean, 5.4years). We assessed radiographic evidence of fusion, reoperation, and neurologic function (measured by the Barthel Index for Activities of Daily Living, which ranges from 0 [completely dependent] to 100 [fully independent]). Chi-squared tests compared outcomes between cervical vs. occipitocervical fusion and postoperative bracing vs. no bracing. Among the 9 patients with Barthel Index values, mean values were 49 ± 29 preoperatively, 51 ± 29 postoperatively, and 53 ± 27 at medium-term follow-up, reflecting a lack of worsening in neurologic function. Five of 15 patients underwent reoperation. We found no difference in the incidence of reoperation between cervical and occipitocervical fusion (p = .49) or between braced and non-braced patients (p = .85). For patients with skeletal dysplasia, cervical and occipitocervical decompression and fusion can prevent worsening of neurological function. Fusion to the occiput and postoperative bracing were not associated with differences in the incidence of reoperation. Cervical spine abnormalities in patients with skeletal dysplasias, and the stenosis and instability they can cause, can be addressed with rigid internal fixation.

Association between triglyceride-glucose index and activities of daily living disability among middle-aged and older patients with arthritis: longitudinal evidence from CHARLS

ObjectiveTo investigate the longitudinal association between the triglyceride-glucose (TyG) index and activities of daily living (ADL) disability in middle-aged and older adults with arthritis.MethodsWe analyzed data from the China Health and Retirement Longitudinal Study (CHARLS, 2015–2018), including 2,695 arthritis patients without baseline ADL disability. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. ADL disability was defined as a score of ≥ 1 based on combined basic and instrumental ADL assessments. Multivariable Cox proportional hazards models were employed to analyze the association, with potential non-linear relationship explored using restricted cubic splines.ResultsOver a median follow-up of 35.98 months, 369 participants (13.69%) developed ADL disability. In fully adjusted models, each 1-unit increase in TyG index was associated with a 26% elevated risk of ADL disability (Hazard ratio [HR] = 1.26, 95% confidence interval [CI]: 1.05–1.51). Compared to the Low TyG, the moderate-High TyG and High TyG showed 40% (HR = 1.40, 95%CI: 1.02–1.92) and 64% (HR = 1.64, 95%CI: 1.18–2.29) increased risks, respectively (P-trend = 0.003). Restricted cubic spline analysis revealed that higher levels of TyG index (&amp;gt; 8.65) were associated with progressively higher ADL disability risk. Subgroup analyses indicated greater risk amplification in younger patients (&amp;lt; 60 years: High TyG vs. Low TyG HR = 1.98, 95%CI: 1.09–3.60). Sensitivity analyses showed that these associations remained statistically significant across multiple analytic approaches, including analyses of unimputed data (HR = 1.43, 95% CI: 1.10–1.86), weighted Cox models, directed acyclic graph-based minimum adequate adjustment, and competing-risks models.ConclusionElevated TyG index shows a significant independent association with ADL disability in arthritis patients. These findings provide mechanistic support for the “metabolic-joint axis” hypothesis and suggest that metabolic monitoring might facilitate identification of individuals with elevated risk profiles of functional decline. The TyG index may serve as an economical risk assessment tool in primary care settings.

Identification of optimal cutoffs for obesity and lipid-related indices in screening activities of daily living disability in Chinese middle-aged and elderly adults

ObjectiveThe aim of this study was to investigate the efficacy of 13 obesity- and lipid-related indices in screening and predicting activities of daily living (ADL) disability, as well as to determine the optimal cutoffs for these indices in the middle-aged and elderly population in China.MethodsThis study was based on cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS), which included 4,784 participants aged 45 years and older. Thirteen obesity- and lipid-related indices, including body mass index (BMI), waist circumference (WC), the waist–height ratio (WHtR), the visceral adiposity index (VAI), the body shape index (ABSI), the body roundness index (BRI), the lipid accumulation product (LAP), the conicity index (CI), the Chinese visceral adiposity index (CVAI), the triglyceride–glucose (TyG) index and its correlation index (TyG–BMI, TyG–WC, TyG–WHtR), were analyzed. Unadjusted and adjusted correlations between these indices and ADL disability were assessed via logistic regression analyses, and the area under the curve (AUC) of each index as a predictor of ADL ability was calculated via receiver operating characteristic (ROC) curves to compare the predictive efficacy and determine the optimal cutoff value.ResultsAfter adjustment for confounders, all 13 obesity- and lipid-related indices were independently associated with the risk of ADL disability (p &amp;lt; 0.05). All 13 indices had predictive value for ADL disability according to the ROC analysis (all AUCs &amp;gt; 0.7). The LAP index exhibited the highest predictive efficacy in men (AUC = 0.793, 95% CI: 0.704–0.882, and optimal cutoff = 35.669), and BMI was optimal in women (AUC = 0.721, 95% CI: 0.678–0.765, and optimal cutoff = 26.142). The TyG-BMI performed well in both sexes (men AUC = 0.790, female AUC = 0.720). The risk of ADL disability increased significantly with each unit increase in obesity and lipid indices.ConclusionAll 13 obesity- and lipid-related indices were effective predictors of ADL disability risk in Chinese middle-aged and older adults. LAP and BMI emerged as the best predictors of ADL disability in men and women, respectively. These indices can serve as simple screening tools to identify the risk of ADL disability and facilitate early intervention.

Multiple medicines and incidence of functional disability among older adults according to age groups: A JAGES 2013-2019 longitudinal study

Objectives The use of multiple medicines that increase frailty and functional disability among older adults is a significant public health concern. However, no study has analyzed whether the intake of multiple medicines increases functional disability according to age. The number and severity of diseases and frailty that are positively correlated with medicines have not been considered. In this longitudinal study, we aimed to investigate whether multiple medicines increased functional disability incidence according to age groups (65-74 and ≥75 years) after adjusting for disease status and frailty.Methods Data from the 2013 Japan Gerontological Evaluation Study (JAGES)-collected during a follow-up period of approximately six years-were used. Individuals aged ≥65 years who were activities of daily living (ADL) dependent, using an unknown number of medicines, and experiencing functional disabilities at the time of response were excluded. A total of 12,752 functionally independent older adults from 14 municipalities were included in this study. The outcome variable was whether the participants had functional disabilities. The explanatory variable was the intake of multiple medicines (reference group, no medicines; exposure group, 1-2, 3-4, or ≥5 medicines). As covariates, 12 variables were considered potential confounding factors between the intake of multiple medicines and functional disabilities. A survival analysis (Cox's proportional hazards model) was used to calculate the hazard ratio (HR), 95% confidence interval (CI), and p-value (5% significance level). After confirming the association between multiple medicines and age groups (65-74 and ≥75 years), participants were analyzed according to age groups. Multiple imputation methods were used for the missing variables.Results Among the 65-74 and ≥75 years age groups, the incidence of functional disabilities was 10.3% and 37.6%, respectively. The interaction between multiple medicines and age was significant (P < 0.05). During the follow-up period, the HR (95% CI, P-value) for functional disability incidence with the intake of multiple medicines was higher compared to that of the reference group, as follows: for 3-4 and ≥5 medicines among individuals aged 65-74 years, 1.31 (1.01-1.69, 0.042) and 1.89 (1.44-2.49, <0.001), respectively; and for ≥5 medicines among individuals aged ≥75 years, 1.43 (1.19-1.72, <0.001).Conclusion The study findings indicate that multiple medicines administered to community-dwelling older adults increase their susceptibility to functional disabilities. However, individuals aged 65-74 years with a lower disease status and frailty percentages may be attentive when using multiple medicines. Guidelines for appropriate medicine use among older adults emphasize the importance of healthcare workers in medical institutions and community pharmacies. These workers should also address the issue of multiple medicines among individuals aged 65-74 years.

Urban‒rural disparities in unmet care needs among disabled older adults across regions in China: Evidence from national representative longitudinal survey.

Urban‒rural disparities in unmet care needs among disabled older adults across regions in China: Evidence from national representative longitudinal survey.

Machine learning models for predicting multimorbidity trajectories in middle-aged and elderly adults

Multimorbidity has emerged as a significant public health issue in the context of global population aging. Predicting and managing the progression of multimorbidity in the elderly population is crucial. This study aims to develop predictive models for multimorbidity trajectories in middle-aged and elderly populations and to identify the key factors influencing the progression of multimorbidity. First, a time-series clustering method was used to construct the multimorbidity trajectories. Then, predictive models based on machine learning techniques were developed to forecast the progression of different trajectories and identify key risk factors. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) database, including 12,198 middle-aged and elderly individuals (aged 45 and above). Four distinct multimorbidity progression patterns were identified: Stable Low-Risk Group (45.26%), Progressively Worsening Group (14.35%), Moderate Stability Group (31.90%) and Consistently Deteriorating Group (8.49%). Among the predictive models, the XGBoost model achieved the best performance, with an accuracy of 0.664 (95%CI: 0.648-0.681), a macro ROC–AUC of 0.825 (95%CI: 0.816-0.834), a micro ROC–AUC of 0.884 (95%CI: 0.876-0.892), and a log loss of 0.806 (95%CI: 0.781-0.831). Other models, including Random Forest, Support Vector Machine, Logistic Regression, and Artificial Neural Networks, showed similar accuracy and ROC–AUC values. The study identified three key factors—baseline disease counts, self-rated Activities of Daily Living (ADL), and self-rated health status—as critical predictors of multimorbidity trajectories.

Level of Functional Independence in Post-stroke Patients: A Descriptive Study

Abstract Background: Stroke is the second-largest cause of mortality and the third-greatest cause of disability worldwide. Strokes affect an estimated 15 million people each year and account for 7.26% of all fatalities in India. Aims: The aim of the study was to assess the level of functional independence in post stroke patients and to determine an association of functional independence in post stroke patients with selected socio demographic variables. Patients and Methods: A non experimental descriptive study was conducted in the neurology unit of a tertiary care hospital with 90 post stroke patients selected from non probability purposive sampling technique. Data were collected with the help of socio demographic questionnaire and Barthel index (BI) tool to measure functional independence and Activities of Daily Living. Descriptive and inferential statistics were used for data analysis. Results: On admission, stroke patients’ mean Glasgow Coma Scale (GCS) scores were 13.5 ± 2.44, and their average age was 55.38 ± 16.58 years. Within 4.5 h of the onset of their stroke symptoms, only 46.7% of patients arrive at the hospital. Patients were ischemic in 86.7% of cases and haemorrhagic in 13.3% of cases. The mean and standard deviation of the BI score were 28 ± 29.55 on day 1, 42 ± 29.00 on day 7 and 73 ± 28.72 on day 30. Significant associations were found between BI score and educational status, thrombolysis therapy, gender and GCS score on day 1; gender and GCS score on day 7 and gender, types of strokes, thrombolysis therapy and GCS score on day 30 at P &lt; 0.05. Conclusion: The study results reveal that after the stroke, the BI score and level of functional independence improve gradually with time after the stroke. There was a significant association of functional independence and socio demographic variables.

Sleep Architecture, Muscle Function, and Daily Life Activities in Patients with Sarcopenia

Abstract To examine associations between polysomnography, muscle mass and strength, and daily life activity index (DLAI) in patients with sarcopenia.We measured polysomnography, muscle mass and strength, and DLAI in 16 patients with sarcopenia and 26 controls &gt; 60 years old and then compared variables and correlations in the patients with sarcopenia.We found no differences in polysomnography between patients with sarcopenia and controls. Among patients with sarcopenia, latency to rapid eye-movement (REM) sleep was positively correlated with weight, REM %, and total sleep time was positively correlated with grip strength. Latency of REM sleep was negatively correlated with body mass index, NREM sleep, and apnea index was negatively correlated with grip strength. Daily life activity index correlated positively with grip strength.Patients with sarcopenia showed significant correlations between polysomnography and weight, body mass index, and grip strength, suggesting a complex relationship involving sleep architecture, muscle function, and DLAI that deserves more research.