Activities Of Daily Living Assessment Research Articles

Accelerated functional losses in ageing congenital Minamata disease patients

Severe methylmercury poisoning occurred in Minamata and neighboring communities in Japan during the 1950s and 1960s. A considerable number of children were born with conditions resembling cerebral palsy, later known as congenital Minamata disease. Although surviving patients are now in their 50s or 60s, few assessments of functional capacities in daily living have been performed. We assessed the changes in Activities of Daily Living (ADL) status of 11 patients over a 10-year period. For assessment of ADL, we applied the Barthel Index (BI) and the Functional Independence Measure (FIM). We obtained the patients' current and previous status information by interview of their caregivers or from medical records and then compared them using the Wilcoxon signed-rank test. Both ADL measures, including the status related with cognition, had significantly declined during the 10 years. The same was true for the overall BI score (p = 0.01). Similarly, all functions of the FIM scores declined (i.e., self-care, sphincter control, mobility, locomotion, communication, and social cognition), and for FIM physical and cognition subscores as well as FIM total score, the declines were statistically significant. The present study indicates that the ADL status of congenital Minamata disease patients, now in their 50s or 60s, has substantially declined during the last 10 years; a decline that was much steeper in comparison with expectation in subjects of similar ages, but in agreement with accelerated ageing also reported in subjects with cerebral palsy, past polio infection, or epilepsy. While already incapacitated due to the prenatal methylmercury poisoning, their accelerated ageing may suggest that patients with developmental neurotoxicity have less reserve capacity to compensate for normal ageing. These patients will need continuous and increasing medical and welfare support in the community.

Surviving out-of-hospital cardiac arrest: The neurological and functional outcome and health-related quality of life one year later

BackgroundData on long-term functional outcome and quality of life (QoL) after out-of-hospital cardiac arrest (OHCA) are limited. We assessed long-term functional outcome and health-related QoL of OHCA survivors regardless of arrest aetiology. MethodsAll adult unconscious OHCA patients treated in 21 Finnish ICUs between March 2010 and February 2011 were followed. Barthel Index (BI), activities of daily living (ADL), accommodation, help needed and received, working status, car driving and self-experienced cognitive deficits were assessed in 1-year survivors (N = 206, 40.9% of the original FINNRESUSCI cohort) with a structured telephone interview. Health-related QoL and more complex ADL-functions were evaluated by EQ-5D and instrumental ADL questionnaires. ResultsGood outcome, defined as Cerebral Performance Categories 1 or 2, had been reached by 90.3% of survivors. The median BI score was 100, and 91.3% of survivors were independent in basic ADL-functions. The great majority of survivors were living at home, only 8.7% lived in a sheltered home or needed institutionalized care. Of home-living survivors 71.4% scored high in instrumental ADL assessment. The majority (72.6%) of survivors who were working previously had returned to work. Health-related QoL was similar as in age- and gender-adjusted Finnish population. ConclusionsLong-term functional outcome was good in over 90% of patients surviving OHCA, with health-related quality of life similar to that of an age and gender matched population.

The ADL taxonomy for persons with mental disorders – adaptation and evaluation

Background: There is a lack of occupation-focused instruments to assess Activities of Daily Living (ADL) that are intended for persons with mental disorders. The ADL Taxonomy is an instrument that is widely-used within clinical practice for persons with physical impairment. The aim of this study was to adapt the ADL Taxonomy for persons with mental disorders and evaluate its validity.Methods: An expert group of Occupational Therapists (OTs) from psychiatric care adapted the ADL Taxonomy to fit the client group, including creating three new items. OTs in psychiatric care collected client data and evaluated the instrument for usability. Rasch analysis was used to evaluate the contruct validity of 16 activities separately.Results: The OTs collected 123 assessments from clients with various mental disorders. Ten activities had excellent, and four had acceptable, psychometric properties with regard to item and person fit and unidimensionality. The activity managing the day/time gave complex results and would benefit from further development. The OTs found the test version intelligible, relevant and easy to use.Conclusions: The ADL Taxonomy for persons with mental disorders has 16 activities with three to six actions each, and is now ready for clinical use.

Evaluating activities of daily living using an infrared depth sensor: KINECTTM

Purpose: With a growing proportion of elderly people in the population, the maintenance of activities of daily living (ADLs) in elderly people is crucial to keep medical costs down. We investigated the ADL measurement accuracy of KINECTTM and Kinect Studio. To eliminate the subjectivity of conventional methods, we numerically assessed motions with computer analysis.Methods: Eighteen actions that repeated “move” and “stationary” phases, including movement of arms, legs, head and torso were measured using KINECTTM. Errors and standard deviations of joint coordinates at the stationary points outputted from KINECT Studio were evaluated. Simultaneous measurements were performed with KINECTTM using conventional high-performance motion capture, and the output was treated as a true value for comparison.Results: In most motions, errors of the joint coordinates were within 100 mm; however, there were two cases where errors due to the skeleton-model estimation by KINECT Studio increased. Firstly, when a part of the body unexpectedly moved out of the infrared measurable area, and secondly, when parts of the body overlapped each other on the KINECTTM image.Conclusions: KINECTTM and Kinect Studio are effective for ADL assessment when positions that cause large errors are excluded. Since KINECTTM has sufficient precision, it should also be possible to develop a more appropriate ADL evaluation system with a new algorithm of skeleton-model estimation that does not depend on KINECT Studio.Implications for RehabilitationThe KINECTTM and Kinect Studio are effective for ADL assessment when positions that cause large errors are excludedWith an increasing proportion of elderly people in the population, the maintenance of activities of daily living (ADLs) in elderly people is crucial to keep medical costs downSystems such as the KINECTTM can support these goals

Item-level psychometrics of the ADL instrument of the Korean National Survey on persons with physical disabilities.

The aim of this study is to investigate the psychometrics of the 12 items of an instrument assessing activities of daily living (ADL) using an item response theory model. A total of 648 adults with physical disabilities and having difficulties in ADLs were retrieved from the 2014 Korean National Survey on People with Disabilities. The psychometric testing included factor analysis, internal consistency, precision, and differential item functioning (DIF) across categories including sex, older age, marital status, and physical impairment area. The sample had a mean age of 69.7years old (SD=13.7). The majority of the sample had lower extremity impairments (62.0%) and had at least 2.1 chronic conditions. The instrument demonstrated unidimensional construct and good internal consistency (Cronbach's alpha=0.95). The instrument precisely estimated person measures within a wide range of theta values (-2.22 logits<θ<0.27 logits) with a reliability of 0.9. Only the changing position item demonstrated misfit (χ2=36.6, df=17, p=0.0038), and the dressing item demonstrated DIF on the impairment type (upper extremity/others, McFadden's Pseudo R 2>5.0%). Our findings indicate that the dressing item would need to be modified to improve its psychometrics. Overall, the ADL instrument demonstrates good psychometrics, and thus, it may be used as a standardized instrument for measuring disability in rehabilitation contexts. However, the findings are limited to adults with physical disabilities. Future studies should replicate psychometric testing for survey respondents with other disorders and for children.

AMPLITUDE AND LATENCY OF AUDITORY BRAINSTEM RESPONSES CORRELATE WITH IMPAIRMENT IN ACTIVITIES OF DAILY LIVING IN HEALTHY ELDERS

There is increasing epidemiological evidence showing an association between presbycusis or age-related hearing loss and cognitive decline in elderly people. The Health ABC Study has shown that presbycusis subjects with audiometric hearing thresholds (PTA) worse than 40 dB are more likely to develop cognitive decline. Before the development of audiometric hearing loss, aged subjects could have communication problems, a clinical entity known as hidden hearing loss (HHL). The amplitudes and latencies of auditory brainstem responses (ABR) at supra-thresholds levels have been used as objective measures to detect HHL. Objective: To study whether supra-thresholds ABR responses are associated with impairment in activities of daily living (ADL) in healthy elders. 52 Persons from the ANDES study ≥65 years without dementia (MMSE>24) with normal hearing thresholds (PTA<20dB, n=13), with mild (PTA 20–39dB, n=29) or moderate presbycusis (PTA≥40dB, n=10), were evaluated with a comprehensive neuropsychological assessment, questionnaires of ADL and with auditory measurements including: PTA, and amplitudes and latencies of ABR waves I and V obtained at supra-thresholds levels. Neuropsychological and ADL data were compared between groups of hearing impairment, and lineal regressions between these data and different auditory assessment were performed. Those with moderate presbycusis (n=10) had more perseverative errors in the Wisconsin card sorting task (ANOVA, F(2)=3.4, p=0.04) than the other groups, without any other differences in the neuropsychological or ADL assessment (Table 1). Instrumental ADL impairments were correlated with latencies of bilateral ABR waves V: shopping (right: r=0.44, p=0.001; left: r=0.63, p<0.001), work (right: r=0.33, p=0.02; left: r=0.3, p<0.03) and house hold (right: r=0.29, p=0.04; left: r=0.39, p<0.006). Once excluding those with moderate presbycusis, we found significant correlations in the latencies of left wave V for house hold (r=0.38, p=0.013) and for communication (r=0.36, p=0.019). In addition, the amplitudes of wave I from the left ear were correlated with impairment in traveling (r=-0.40, p=0.013) and technology (r=-0.45, p=0.005). Supra-thresholds ABRs are good predictors of ADL impairments in elderlies without evident cognitive or hearing impairment. These results reinforce the study of other risk factors for cognitive decline in the elderly. Funded by Anillo ACT1403, Fondecyt 1140423, Fondecyt 1161155.

Exercise or Social Intervention for Nursing Home Residents with Dementia: A Pilot Randomized, Controlled Trial.

To compare the effects of exercise with those of a structured nonphysical intervention on ability to perform activities of daily living (ADLs) and physical and cognitive function of persons with dementia (PWDs) living in nursing homes (NH). Cluster-randomized pilot-controlled trial. Seven French NHs. PWDs living in NHs. NHs were randomized to an exercise group (4 NHs, n=47) or structured social activity group (3 NHs, n=50) for a 24-week intervention performed twice per week for 60minutes per session. The main endpoint was ADL performance (Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory for Severe Alzheimer's Disease Scale (ADCS-ADL-sev); range 0-54, higher is better); secondary endpoints were overall cognitive function (Mini-Mental State Examination (MMSE)) and performance-based tests of physical function (Short Physical Performance Battery (SPPB), usual gait speed). Ninety-one participants with at least one postbaseline ADL assessment were included in efficacy analysis. Groups differed at baseline in terms of sex, neuropsychiatric symptoms, and nutritional status. Multilevel analysis adjusted for baseline differences between groups found no significant difference between effects of exercise and social activity (group-by-time interaction), with adjusted mean differences at 6months of 1.9 points for ADCS-ADL-sev and 0.55 points for MMSE favoring social activity and 0.6 points for SPPB and 0.05m/s favoring exercise. Adverse events did not differ between groups, except that the social activity group had more falls than the exercise group. A larger, longer trial is required to determine whether exercise has greater health benefits thannonphysical interventions for institutionalized PWDs.

Characteristics associated with residential aged care, respite and transitional aged care placement for older people following an injury-related hospitalisation in Australia

Objective: This study examines characteristics associated with permanent residential aged care (RAC), respite RAC and transitional care (TC) placement for older individuals following an injury-related hospitalisation.&#x0D; Method: A retrospective analysis of individuals aged ≥65 years who had an injury-related hospitalisation and who had a linked record in RAC, TC or activities of daily living (ADL) data between 1 July 2008 and 30 June 2013 in New South Wales, Australia. Comorbidities were identified using diagnosis classifications and a 1-year lookback period. All hospital episodes of care related to the injury were linked to form a period of care. Both new and existing admissions to RAC were examined. Multinominal logistic regression was used to examine the factors associated with new admissions to permanent RAC, respite RAC and TC compared to return to the community.&#x0D; Results: Of 191,301 injury-related hospitalisations, 41,085 (21.5%) individuals either returned or were new admissions to permanent (87.2%) or respite (12.8%) RAC and 3,218 (1.7%) individuals were admitted to TC. There were 3,864, 4,314 and 2,630 new admissions to permanent RAC, respite RAC and TC, respectively. Of the injury hospitalisations, 70,796 (37.0%) individuals had an ADL assessment. Compared to individuals who returned to the community, individuals newly admitted to permanent RAC were four times as likely to have dementia (OR: 4.36; 95%CI 4.15-4.57), those admitted to respite RAC were twice as likely to have dementia (OR: 2.37; 95%CI 2.21-2.54) and people admitted to TC people were less likely to have dementia (OR: 0.60; 95%CI 0.53-0.68). Individuals with shoulder and upper arm injuries were twice as likely (OR: 2.31; 95%CI 1.98-2.68) and individuals with knee and lower leg injuries were one and a half times as likely (OR: 1.87; 95%CI 1.60-2.18) to be admitted to TC. Overall, individuals who were admitted to permanent or respite RAC had a higher likelihood of experiencing limitations associated with their physical, cognitive or social abilities, with individuals admitted to TC having a higher likelihood of having limitations maintaining personal hygiene and mobility compared to individuals returning to the community.&#x0D; Conclusion: An understanding of the profile of which older individuals are using RAC (permanent or respite) or TC services can usefully inform current and future aged care service use.

Londrina Activities of Daily Living Protocol: Reproducibility, Validity, and Reference Values in Physically Independent Adults Age 50 Years and Older.

It is important to assess activities of daily living (ADL) in older adults due to impairment of independence and quality of life. However, there is no objective and standardized protocol available to assess this outcome. Thus, the aim of this study was to verify the reproducibility and validity of a new protocol for ADL assessment applied in physically independent adults age ≥50 y, the Londrina ADL protocol, and to establish an equation to predict reference values of the Londrina ADL protocol. Ninety-three physically independent adults age ≥50 y had their performance in ADL evaluated by registering the time spent to conclude the protocol. The protocol was performed twice. The 6-min walk test, which assesses functional exercise capacity, was used as a validation criterion. A multiple linear regression model was applied, including anthropometric and demographic variables that correlated with the protocol, to establish an equation to predict the protocol's reference values. In general, the protocol was reproducible (intraclass correlation coefficient 0.91). The average difference between the first and second protocol was 5.3%. The new protocol was valid to assess ADL performance in the studied subjects, presenting a moderate correlation with the 6-min walk test (r = -0.53). The time spent to perform the protocol correlated significantly with age (r = 0.45) but neither with weight (r = -0.17) nor with height (r = -0.17). A model of stepwise multiple regression including sex and age showed that age was the only determinant factor to the Londrina ADL protocol, explaining 21% (P < .001) of its variability. The derived reference equation was: Londrina ADL protocolpred (s) = 135.618 + (3.102 × age [y]). The Londrina ADL protocol was reproducible and valid in physically independent adults age ≥50 y. A reference equation for the protocol was established including only age as an independent variable (r2 = 0.21), allowing a better interpretation of the protocol's results in clinical practice.

Pre-diagnosis health-related quality of life, surgery, and survival in women with advanced epithelial ovarian cancer: A SEER-MHOS study

ObjectiveHealth-related quality of life (HRQOL) has been found to be associated with overall survival in women with ovarian cancer. However, previous studies assessed HRQOL after surgery within clinical trial populations only. The study goal was to determine the association of pre-cancer diagnosis HRQOL with the likelihood of receiving surgery and with overall survival in a national, population-based cohort of older women with advanced ovarian cancer. MethodsThe Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) database was queried to identify 374 women aged 65years and older with advanced stage epithelial ovarian cancer from 1998 to 2011. Responses to the Short Form 36 (SF-36) and Veterans-RAND-12 (VR-12), two single-item global health questions, and Activities of Daily Living (ADLs) were abstracted. Multivariable models were used to quantify associations of HRQOL and ADL assessments with surgery and overall survival, adjusted for demographic and clinical characteristics. ResultsOf 374 women with a HRQOL assessment prior to diagnosis, 199 (53%) underwent surgery. Increases in physical and mental HRQOL domains were significantly associated with receipt of surgery. The relationship between HRQOL domains and overall survival were not statistically significant. For ADLs, only difficulty in toilet use was significantly associated with survival. ConclusionIn this population-based sample of older women with advanced epithelial ovarian cancer, pre-diagnosis HRQOL was predictive of receiving surgery, but not of overall survival.

Correlation research of elderly inpatients′ ADL assessment and frailty index

Objective To compare the correlation of two assessment methods, frailty index(FI) and activity of daily living(ADL), which were used to evaluate the health condition in elderly hospitalized patients of 75 years old or over. Methods The cross section study was conducted from September 2014 to February 2015, which included data from participants aged 75 and over(n=88) in Fuxing Hospital Affiliated to Capital Medical University. Patients′ general healthy condition were evaluated by FI rating scale according to Rockwood frailty index rating scale and Barthel index of daily life activities rating scale respectively. Results Spearman correlation analysis showed that FI was negatively correlated with ADL(r=-0.810, P<0.001). Conclusions Both ADL and FI can reflect the health condition in elderly hospitalized patients(aged 75 or over), and ADL is simple, convenient and easy to evaluate and patients′ compliance is favorable. Key words: Elderly; Hospitalized patient; Activity of daily living; Frailty index

Assessment of Activities of Daily Living, Self-Care, and Independence.

Activities of daily living (ADL) comprise the basic actions that involve caring for one's self and body, including personal care, mobility, and eating. In this review article, we (1) review useful clinical tools including a discussion on ways to approach ADL assessment across settings, (2) highlight relevant literature evaluating the relationship between cognitive functioning and ADLs, (3) discuss other biopsychosocial factors affecting ADL performance, (4) provide clinical recommendations for enhancing ADL capacity with an emphasis on self-care tasks (eating, grooming, dressing, bathing and toileting), and (5) identify interventions that treatment providers can implement to reduce the burden of ADL care.

Development of a Proxy-Free Objective Assessment Tool of Instrumental Activities of Daily Living in Mild Cognitive Impairment Using Smart Home Technologies.

Background: The assessment of activities of daily living (ADL) is essential for dementia diagnostics. Even in mild cognitive impairment (MCI), subtle deficits in instrumental ADL (IADL) may occur and signal a higher risk of conversion to dementia. Thus, sensitive and reliable ADL assessment tools are important. Smart homes equipped with sensor technology and video cameras may provide a proxy-free assessment tool for the detection of IADL deficits.Objective:The aim of this paper is to investigate the potential of a smart home environment for the assessment of IADL in MCI.Method: The smart home consisted of a two-room flat equipped with activity sensors and video cameras. Participants with either MCI or healthy controls (HC) had to solve a standardized set of six tasks, e.g., meal preparation, telephone use, and finding objects in the flat.Results: MCI participants needed more time (1384 versus 938 seconds, p < 0.001) and scored less total points (48 versus 57 points, p < 0.001) while solving the tasks than HC. Analyzing the subtasks, intergroup differences were observed for making a phone call, operating the television, and retrieving objects. MCI participants showed more searching and task-irrelevant behavior than HC. Task performance was correlated with cognitive status and IADL questionnaires but not with participants’ age.Conclusion: This pilot study showed that smart home technologies offer the chance for an objective and ecologically valid assessment of IADL. It can be analyzed not only whether a task is successfully completed but also how it is completed. Future studies should concentrate on the development of automated detection of IADL deficits.

Validity of the Katz Index to assess activities of daily living by informants in neuropathological studies.

To analyze the evidences of construct validity of the Katz Index for the retrospective assessment of activities of daily living (ADL) by informants, to assist neuropathological studies in the elderly. A cross-sectional study analyzed the functional ability of ADL measure by the Katz Index, of 650 cases randomly selected from the Brazilian Brain Bank of the Ageing Brain Study Group (BBBABSG) database. Sample was divided in two subsamples for the analysis (N=325, each) and then stratified according to cognitive decline assessed by the Clinical Dementia Rating Scale (CDR). Factor analyses with calculations of internal consistency and invariance were performed. Factor analysis evidenced a unidimensional instrument with optimal internal consistency, in all subgroups. Goodness of fit indices were obtained after two treatments of covariance, indicating adequacy of the scale for assessing ADL by informants. The scale is invariant to cognitive decline meaning that it can be used for subjects with or without cognitive impairment. Katz Index is valid for the retrospective assessment of basic ADL by informants, with optimal reliability.

Construct Validity of the Chinese Version of the Activities of Daily Living Rating Scale III in Patients with Schizophrenia.

BackgroundThe Chinese version of the Activities of Daily Living Rating Scale III (ADLRS-III), which has 10 domains, is commonly used for assessing activities of daily living (ADL) in patients with schizophrenia. However, construct validity (i.e., unidimensionality) for each domain of the ADLRS-III is unknown, limiting the explanations of the test results.PurposeThis main purpose of this study was to examine unidimensionality of each domain in the ADLRS-III. We also examined internal consistency and ceiling/floor effects in patients with schizophrenia.MethodsFrom occupational therapy records, we obtained 304 self-report data of the ADLRS-III. Confirmatory factor analysis (CFA) was conducted to examine the 10 one-factor structures. If a domain showed an insufficient model fit, exploratory factor analysis (EFA) was performed to investigate the factor structure and choose one factor representing the original construct. Internal consistency was examined using Cronbach’s alpha (α). Ceiling and floor effects were determined by the percentage of patients with the maximum and minimum scores in each domain, respectively.ResultsCFA analyses showed that 4 domains (i.e., leisure, picture recognition, literacy ability, communication tools use) had sufficient model fits. These 4 domains had acceptable internal consistency (α = 0.79-0.87) and no ceiling/floor effects, except the leisure domain which had a ceiling effect. The other 6 domains showed insufficient model fits. The EFA results showed that these 6 domains were two-factor structures.ConclusionThe results supported unidimensional constructs of the leisure, picture recognition, literacy ability, and communication tool uses domains. The sum scores of these 4 domains can be used to represent their respective domain-specific functions. Regarding the 6 domains with insufficient model fits, we have explained the two factors of each domain and chosen one factor to represent its original construct. Future users may use the items from the chosen factors to assess domain-specific functions in patients with schizophrenia.

Cross-Validity and Reliability of the Age Scale for Assessing Activities of Daily Living among Japanese Community-Dwelling Adults Aged 75 Years or Older

The aim of this study was to evaluate the validity and reliability of the age scale for assessing activities of daily living (ADL) among community-dwelling adults aged 75 years or older. Participants comprised 89 older Japanese: 47 men (79.1±3.8 years) and 42 women (78.9±3.7 years). The ADL age (ADLA) equation is an instrument that estimates participants’ physical functioning regarding ADL using data obtained previously from 1006 subjects. The equation is as follows: ADLA for women = 0.447 (chronological age) -5.49ADLS + 44.17; and ADLA for men = 0.519CA – 4.27ADLS + 38.26. Validity was evaluated using cross-validation, and reliability was evaluated using internal consistency and test-retest methods. The correlation between the ADLA and chronological age (CA) in the cross-validation samples (r = 0.62 women, r = 0.61 men) was not significantly different from the relationship observed in the original sample (r = 0.72 women p = 0.636, and r = 0.75 men p = 0.571). Cronbach's alpha (&lt; ) value (internal consistency) for the total ADLA was 0.97 for men and 0.92 for women, whereas the intra-class correlation coefficient (ICC) value (test-retest reliability) was 0.96 for men and 0.91 for women. The results suggest that the ADLA is a reliable and valid tool for the assessment of ADL with satisfactory psychometric properties and that is applicable for persons aged 75 years and older in Japan.

Age Scale for Assessing Activities of Daily Living

The purpose of this study was to develop an age scale for assessing activities of daily living (ADL) among community-dwelling adults aged 75 years or older. Participants were 1006 older Japanese: 312 men (79.6 ± 4.3 years) and 694 women, (79.9 ± 5.5 years). Participants completed a battery of 8 performance tests related to ADL and the Barthel index (BI) questionnaire. Spearman rank-order correlation analysis was applied to obtain the correlation of the 8 ADL performance tests with the total BI score. Three variables were high rank-order correlated with BI, secondly those items were subjected to the principal component analysis. The weighted combination of the principal component scores was summed. Resulting in an ADL score (ADLS), women = 0.075 X1 – 0.082 X2 – 0.063 X3 + 0.124, men = 0.051 X1 – 0.105 X2 – 0.099 X3 + 0.249, where X1 = hand-grip strength, X2 = timed up and go, X3 = five-chair sit to stand. Individual ADLS was transformed to an ADL age scale (ADLA). The estimation was – 5.493 ADLS + 79.90 for women, and – 4.272 ADLS + 79.57 for men. Due to the distortion at the regression edges, the equation was corrected as suggested by Dubina et al. ADLA women after correction was = 0.447 (chronological age: CA) – 5.49ADLS + 44.17, men = 0.519CA – 4.27ADLS + 38.26. ADLA can be used to identify or monitor the characteristics of the ADL levels of physical abilities in older Japanese aged 75 years or older.

Rehabilitation needs of the survivors of the 2013 Ya'an earthquake in China.

To determine the physical, functional and psychosocial rehabilitation needs of the injured survivors of the 2013 earthquake in Ya'an, China. Cross-sectional survey. A total of 143 injured survivors (80 males, 63 females, mean age 41.4 years (standard deviation (SD) 20.2)) were recruited for the study. A questionnaire was designed to collect their demographic and environmental information. Manual muscle testing and active range of motion (AROM) were used to assess physical function. The Modified Barthel Index was used to assess activities of daily living (ADL) and the Post-Traumatic Stress Disorder - Self Rating Scale was used to assess psychological status. The rehabilitation needs of the injured survivors were identified based on the assessment results. Physical problems of the back and lower limbs were more severe than those of the upper limbs, as measured by MMT and AROM. Various degrees of dependence in ADL were measured in 74.2% of subjects, and psychological distress was present in more than 50% of subjects. Rehabilitation training prescribed by local therapists included functional training (74.8%), exercises (49.0%), provision of splints (44.8%), etc. Psychological interventions were re-commended to most of the patients. There were high levels of need for assistive devices, and home and community modifications. There is a high level of need for early rehabilitation in hospital, followed by continued home and community rehabilitation services, particularly for injured survivors who are returning to villages with very limited resources.

Quality of Life among Persons with Physical Disability in Udupi Taluk: A Cross Sectional Study.

Background:Disability is not just a health problem or attribute of individuals, but it reflects the problems individuals experience in their interaction with society and physical movements. Disabled persons remain neglected part of society and they also experience various barriers due to restriction of participation.Objectives:The aim was to assess the quality of life (QOL) of physically disabled persons, the impact of physical disability on activities of daily living (ADL) and to study the awareness about laws and facilities available for disabled persons.Materials and Methods:A cross-sectional community based study was conducted among 130 physical disabled persons who were selected using convenience sampling technique. The WHO BREF scale was used to assess QOL, while assessment of ADL was done using Barthel Index. Socio-demographic assessment was done using Udai Pareek scale. SPSS version 15.0 was used to analyze data. Categorical variables were expressed as frequencies and percentages. As per guidelines physical, psychological, social, and environmental domain scores for WHO BREF scale were calculated.Results:Among the study participants, 36.2% had a disability from birth that is, congenital. The second common cause of disability was found to be postpolio residual paralysis as it was found among 26.2% respondents. Other causes found were stroke/paralysis and accidents, in 19.2% and 18.5% respondents, respectively. Activities such as transfer, mobility, and stair climbing showed greater impact of physical disability. It was found that 11.5% respondents required help in one of the ADL. QOL score was found to be low under the psychological domain reflecting on negative feelings, bodily image, appearance, spirituality, and self-esteem of respondents.Conclusion:Physical disability had affected social participation as well as marriage of the respondents. However, it was found that very few of them are aware about facilities provided under persons with disability act.

Quantitative Assessment of ADL: A Pilot Study of Upper Extremity Reaching Tasks

Effective telerehabilitation technologies enable patients with certain physiological disabilities to engage in rehabilitative exercises for performing Activities of Daily Living (ADLs). Therefore, training and assessment scenarios for the performance of ADLs are vital for the promotion for telerehabilitation. In this paper we investigate quantitatively and automatically assessing patient’s kinematic ability to perform functional upper extremity reaching tasks. The shape of the movement trajectory and the instantaneous acceleration of kinematically crucial body parts, such as wrists, are used to compute the approximate entropy of the motions to represent stability (smoothness) in addition to the duration of the activity. Computer simulations were conducted to illustrate the consistency, sensitivity and robustness of the proposed method. A preliminary experiment with kinematic data captured from healthy subjects mimicking a reaching task with dyskinesia showed a high degree of correlation (Cohen’s kappa 0.85 withp&lt;0.05) between a human observer and the proposed automatic classification tool in terms of assigning the datasets to various levels to represent the subjects’ kinematic abilities to perform reaching tasks. This study supported the use of Microsoft Kinect to quantitatively evaluate the ability of individuals with involuntary movements to perform an upper extremity reaching task.