Activities Of Daily Living Research Articles

The relationship between activities of daily living and speech impediments based on evidence from statistical and machine learning analyses

IntroductionSpeech impediments (SIs) are increasingly prevalent among middle-aged and older adults, raising concerns within public health. Early detection of potential SI in this demographic is critical. This study investigates the potential of Activities of Daily Living (ADL) as a predictive marker for SI, utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which includes 10,136 individuals aged 45 and above. The Barthel Index (BI) was used to assess ADL, and the correlation between ADL and SI was examined through statistical analyses. Machine learning algorithms (Support Vector Machine, Decision Tree, and Logistic Regression) were employed to validate the findings and elucidate the underlying relationship between ADL and SI.BackgroundSI poses significant challenges to the health and quality of life of middle-aged and older adults, increasing the demands on community-based and home care services. In the context of global aging, it is crucial to investigate the factors contributing to SI. While the role of ADL as a potential biomarker for SI remains unclear, this study aims to provide new evidence supporting ADL as an early predictor of SI through statistical analysis and machine learning validation.MethodsData were derived from the 2018 CHARLS national baseline survey, comprising 10,136 participants aged 45 and above. ADL was evaluated using the BI, and SI was assessed based on the CHARLS records of “Speech impediments.” Statistical analyses, including independent sample t-tests, chi-square tests, Pearson and Spearman correlation tests, and hierarchical multiple linear regression, were conducted using SPSS 25.0. Machine learning algorithms, specifically Support Vector Machine (SVM), Decision Tree (DT), and Logistic Regression (LR), were implemented in Python 3.10.2.ResultsAnalysis of demographic characteristics revealed that the average BI score in the “With Speech impediments” group was 49.46, significantly lower than the average score of 85.11 in the “Without Speech impediments” group. Pearson correlation analysis indicated a significant negative correlation between ADL and SI (r = −0.205, p < 0.001). Hierarchical multiple linear regression confirmed the robustness of this negative correlation across three models (B = −0.001, β = −0.168, t = −16.16, 95% CI = −0.001 to −0.001, p = 0.000). Machine learning algorithms validated the statistical findings, confirming the predictive accuracy of ADL for SI, with the area under the curve (AUC) scores of SVM-AUC = 0.648, DT-AUC = 0.931, and LR-AUC = 0.666. The inclusion of BI in the models improved the overall predictive performance, highlighting its positive impact on SI prediction.ConclusionThe study employed various statistical methodologies to demonstrate a significant negative correlation between ADL and SI, a finding further corroborated by machine learning algorithms. Impairment in ADL increases the likelihood of SI occurrence, underscoring the importance of maintaining ADL in middle-aged and older populations to mitigate the risk of SI.

Neuromorphic compliant control facilitates human-prosthetic performance for hand grasp functions

Abstract Current bionic hands lack the ability of fine force manipulation for grasping fragile objects due to missing human neuromuscular compliance in control. This incompatibility between prosthetic devices and the sensorimotor system has resulted in a high abandonment rate of hand prostheses. To tackle this challenge, we employed a neuromorphic modeling approach, biorealistic control, to regain human-like grasping ability. The biorealistic control restored muscle force regulation and stiffness adaptation using neuromorphic modeling of the neuromuscular reflex units, which was capable of real-time computing of model outputs. We evaluated the dexterity of the biorealistic control with a set of delicate grasp tasks that simulated varying challenging scenarios of grasping fragile objects in daily activities of life, including the box and block task, the glass box task, and the potato chip task. The performance of the biorealistic control was compared with that of proportional control. Results indicated that the biorealistic control with the compliance of the neuromuscular reflex units significantly outperformed the proportional control with more efficient grip forces, higher success rates, fewer break and drop rates. Post-task survey questionnaires revealed that the biorealistic control reduced subjective burdens of task difficulty and improved subjective confidence in control performance significantly. The outcome of the evaluation confirmed that the biorealistic control could achieve superior abilities in fine, accurate, and efficient grasp control for prosthetic users.

The eFEct of an Anti-Inflammatory Diet for Knee oSTeoarthritis (FEAST) Trial: Baseline Characteristics and Relationships With Dietary Inflammatory Index.

This study aims to: (i) describe the results of recruitment into the eFfEct of an Anti-inflammatory diet for knee oSTeoarthritis (FEAST) randomized controlled trial (RCT); (ii) report baseline characteristics of randomized participants and compare these with four large international cohorts; and (iii) explore cross-sectional associations between dietary inflammatory index (DII®) scores and baseline clinical characteristics. The FEAST RCT compares an anti-inflammatory dietary programme and standard care low-fat dietary programme for adults aged 45-85 years with knee osteoarthritis (OA). At baseline, participants provided medical history (medical comorbidities, symptomatic musculoskeletal sites), completed questionnaires (demographic characteristics, Knee injury and OA Outcome Score (KOOS)) and a 3-day food diary. Both DII® and energy-adjusted DII (E-DIITM) scores were calculated based on 3-day food diary data and was used to quantify the effect of diet on systemic inflammation. Associations between DII/E-DII and KOOS subscales, symptomatic musculoskeletal sites, and comorbidities was assessed using linear and negative binomial regression. 1121 individuals were screened to identify 182 eligible individuals, from which 144 participants (64% female, 36% male) enrolled, with a mean ± SD age 65 ± 8 years and body mass index 30.3 ± 6.2 kg/m2. Overweight (41%) and obesity (45%) was common. Two-thirds (62%) had ≥1 medical comorbidity, most commonly hypertension (26%). Musculoskeletal pain in sites other than the index knee was reported in 79%, most commonly in the lower back (42%). Mean DII and E-DII scores were 0.58 ± 1.49 and -0.31 ± 1.41, respectively. No associations were found between DII/E-DII and KOOS subscales except for activities of daily living (ADL), number of medical comorbidities and symptomatic MSK sites, and BMI. The FEAST cohort is comparable to other knee OA cohorts, supporting generalizability of the results. Despite a relatively pro-inflammatory diet at baseline, DII/E-DII was not associated with KOOS subscales, number of comorbidities or symptomatic musculoskeletal sites.

Role of visual function and performance of activities of daily living in cognitive function in patients with mild cognitive impairment: a cross-sectional study

BackgroundMild cognitive impairment (MCI) is a precursor to dementia, with many patients showing early decline in activities of daily living (ADLs). However, the role of visual impairment in this process is underexplored despite evidence suggesting it may accelerate cognitive decline. Current research does not understand how visual dysfunction affects cognitive abilities and how ADLs might moderate this relationship. This gap is crucial because early interventions targeting visual impairments could potentially delay progression to dementia, offering new avenues for supporting MCI patients.ObjectiveThis study investigates the relationship between visual function and cognitive abilities in patients with MCI. Specifically, it seeks to determine how different aspects of visual function, such as visual field indices and visual acuity, correlate with various cognitive domains measured by standardized assessments. Additionally, the study aims to examine the role of ADLs as a potential moderating factor in this relationship. By analyzing how ADL performance influences the strength and direction of the association between visual impairments and cognitive function, this research intends to identify key areas where visual deficits may contribute to cognitive decline in MCI.MethodsThis is a cross-sectional study. Two hundred and seventy four elderly patients were diagnosed with MCI from various communities in Taicang City, Jiangsu Province, China. Most participants were women (68.6%), and the average age was 69 years. Notable comorbidities included hypertension (41.6%) and diabetes (33.2%), indicating a higher burden of health conditions than typical older adult populations. Visual function, Montreal Cognitive Assessment (MoCA), and the ADLs were measured. Pearson's correlation coefficients were used to examine the unadjusted associations between visual function measures and cognitive performance. Multivariable linear regression models were employed to further explore these relationships and to assess the moderating role of ADLs.ResultsSignificant positive correlations were found between visual function and cognitive performance, particularly with Visual Function Index (VFI) showing a strong initial correlation with the total MoCA score (r = 0.61, p < 0.001), which was attenuated after adjusting for ADL (β = 0.06, p = 0.23). Maximum Visual Field (Max VF) was positively correlated with language skills (r = 0.13, p < 0.05). The negative correlation of Minimum Visual Field (Min VF) with cognitive performance became positive after ADL adjustment (β = 0.12, p = 0.04).ConclusionsThese findings suggest that visual function plays a crucial role in the cognitive and functional abilities of patients with MCI. Early interventions targeting visual impairments may help mitigate cognitive decline and improve the quality of life for these patients.

Cognitive Rehabilitation to Remediate Attention and Memory in Patients with Complicated Mild Traumatic Brain Injury: A Case Series

AbstractAttention and memory deficits are frequently observed in individuals suffering from mild traumatic brain injury (MTBI), particularly in those exhibiting neurostructural abnormalities, commonly referred to as complicated mild traumatic brain injury (C-MTBI). The present case series employed customized cognitive retraining interventions and compensatory techniques designed to enhance attention, memory, and activities of daily living (ADL) of C-MTBI patient. Scores on Glasgow Coma Scale (GCS) and neuroimaging abnormalities detected via computed tomography (CT) or magnetic resonance imaging (MRI) were used to categorize the cases as C-MTBI. All four cases in the present case series were selected using purposive sampling technique. Cognitive dysfunction of the cases was evaluated utilizing the PGI Battery of Brain Dysfunction (PGI-BBD), while assessment of ADL was measured through the Hindi version of the Cognitive Symptom Checklist (CSC). Patients with C-MTBI underwent cognitive rehabilitation (CR) specifically tailored to address the unique requirements and characteristics of their nature of cognitive deficits. Cognitive retraining sessions were systematically organized on a biweekly basis, complemented by an additional weekly session focused on compensatory strategies, which were conducted face to face or through telephonic/video conferencing. All four cases completed CR sessions and after competition of the CR sessions, cognitive functions and ADL were reassessed using the PGI-BBD and CSC, respectively. The present case series highlights the effectiveness of CR program combining cognitive retraining and compensatory strategies in improving attention, memory, and ADLs of C-MTBI patients. All four cases demonstrated significant improvements in cognitive functioning and ADL measures following the CR program, supporting its applicability and therapeutic value.

Effects of cognitive stimulation group programs in patients with mild Alzheimer’s disease

Objectives: This study examined the effects of a cognitive stimulation group program on cognitive functions, depression, activities of daily living (ADL), and quality of life in patients with mild Alzheimer’s disease (AD). Methods: Sixty patients with mild AD were randomized into the experimental or control groups (30 in each). Both groups underwent conventional occupational therapy for 30 minutes, followed by a 50-minute session of a cognitive stimulation group program for the experimental group and a cognitive workbook group program for the control group. Interventions for both groups were carried out for 4 weeks, five times a week, and once a day. Results: After the interventions, both groups showed significant differences in cognitive functions, depression, ADL, and quality of life ( p < 0.01, p < 0.001), with the experimental group demonstrating slightly higher scores in all assessment items. Significant intergroup differences were found in the scores for memory, the shortened Korean version of the Boston Naming Test, the Elderly Seoul Verbal Learning Test, the Korean version of the Trail Making Test Part A (depression), the Korean version of the Instrumental ADL scale, and quality of life ( p < 0.05, p < 0.01, p < 0.001). Conclusion: It has been shown that the cognitive simulation group program can be an effective intervention method to reduce the depression of mild AD patients and improve cognitive function, ADL, and quality of life. In addition, it is significant that various enjoyable activities were organized for each cognitive domain to induce active participation and motivation of the subjects. It is expected that this study can be usefully used as a guideline for the treatment of AD patients in the future.

Comparison of the efficacy of different protocols of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function, activities of daily living, and neurological function in patients with early stroke: a systematic review and network meta-analysis.

The application of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in patients with early stroke has recently received considerable attention, but the optimal protocol remains inconclusive. This study intends to evaluate and compare the effects of different protocols of tDCS and rTMS on improving motor function, activities of daily living (ADL), and neurological function in patients with early stroke, and to comprehensively assess their efficacy and safety. MEDLINE, Embase, Cochrane Library, and Web of Science were searched. Risk of bias (RoB) was assessed using the Cochrane Risk of Bias 2.0 tool, and Bayesian NMA was conducted using R4.3.1 and Stata16. The results of NMA showed that after early intervention, bilateral application of high- and low-frequency rTMS (BL-rTMS) performed best in improving the upper extremity motor function at the end of intervention (SUCRA: 92.8%) and 3 months (SUCRA: 95.4%). Besides, low-frequency rTMS (LF-rTMS) performed best in improving the lower extremity motor function (SUCRA: 67.7%). BL-rTMS was the most effective in ameliorating the ADL at the end of intervention (SUCRA: 100%) and 3 months (SUCRA: 85.6%). In terms of the NIHSS scores, BL-rTMS had the highest probability of being the most effective measure at the end of intervention (SUCRA: 99.7%) and 3 months (SUCRA: 97.05%). Besides, LF-rTMS (0%), 5Hz-rTMS (0%), and intermittent theta-burst stimulation (iTBS) (0%) all exhibited a good safety profile. BL-rTMS is the optimal stimulation protocol for improving upper extremity motor function, ADL, and neurological function in early stroke, with long-term efficacy.

The Impact of Anuloma Viloma Pranayama on Pulmonary Function in Individuals with Reduced Lung Reserve Post-COVID-19: A Narrative Review

Objective: The primary objective of this literature review was to investigate the effects of Anuloma Viloma Pranayama (AVP) on individuals with reduced lung reserve resulting from COVID-19. Introduction: The COVID-19 pandemic has emerged as a significant public health crisis, often leading to severe respiratory complications in affected individuals. Patients frequently experienced dyspnea, which rapidly progressed to acute respiratory distress syndrome (ARDS), septic shock, and other critical conditions. These complications have been associated with diminished pulmonary function, reduced respiratory muscle strength, and a decline in activities of daily living (ADL) and quality of life (QoL). Methodology: A comprehensive electronic search of published research articles was conducted using databases such as Google Scholar, PubMed and others. The search aimed to identify studies evaluating the effects of AVP on individuals with compromised lung reserve due to COVID-19. Studies meeting the inclusion criteria, including randomized controlled trials, systematic reviews, meta-analyses, and pilot studies, were selected for this literature review. Results: This review explored the mechanisms through which AVP influences lung function and found that it significantly benefits COVID-19 patients by enhancing pulmonary reserve and improving their overall quality of life. Conclusion: The findings of this study suggest that AVP can serve as a complementary intervention to improve pulmonary reserve in COVID-19 patients. Regular practice of this breathing technique may help mitigate pulmonary complications and enhance overall well-being, with no reported adverse effects.

Comparative outcomes of laparoscopic transcystic duct vs traditional laparoscopic bile duct exploration: A multicentre randomised trial

AbstractAimThis multicentre randomised controlled trial aimed to compare post‐operative complications and recovery outcomes between these two approaches.Patients and methodsEighty patients with symptomatic choledocholithiasis were randomly assigned to undergo either laparoscopic transcystic (LTCBDE; n = 40) or traditional (LCBDE; n = 40) common bile duct exploration. The primary outcome measures were post‐operative complications within 3 months, while the secondary outcomes included operative time, intraoperative blood loss, recurrence of bile duct stones, and time to return to activities of daily living (ADLs). Logistic regression models were used to identify predictors of complications and recurrence.ResultsThe LTCBDE group had significantly shorter operative times (117.55 vs 136.05 min, P < .001) and reduced intraoperative blood loss (51.25 vs 61.45 mL, P < .001). Both groups had a 20% rate of post‐operative complications (P = .614). Septic complications were higher in LCBDE compared with LTCBDE (20% vs 7.5%, P = .105). Time to return to ADL was shorter in the LTCBDE group (33.4 vs 39.75 days, P = .007). Diabetes mellitus independently predicted post‐operative complications (adjusted odds ratio 4.397, P = .014) and revision surgery (adjusted odds ratio 22.592, P = .006). Recurrence rates were similar between groups (P = .363).ConclusionLTCBDE is associated with shorter operative times, reduced blood loss, and faster recovery than LCBDE, without an increase in post‐operative complications. LTCBDE may be the preferred option for the treatment of choledocholithiasis.

Timed “up and go” to identify physically inactive individuals with interstitial lung disease

Objective: To investigate the relationship between the timed "up and go" (TUG) test and physical activity in daily life (PADL) in patients with interstitial lung disease (ILD) and propose a cutoff point to identify physically inactive individuals. Methods: Participants performed the TUG test at a usual pace (TUGusual) and at a fast pace (TUGfast). Exercise capacity was assessed by the six-minute walk test, lung function was assessed by whole-body plethysmography, quadriceps strength was assessed by maximal voluntary isometric contraction, and PADL was assessed by an activity monitor worn for six consecutive days. PADL variables included number of steps/day, time spent/day in activities of different intensities, and time spent/day in different postures. A ROC curve was plotted to identify physically inactive individuals on the basis of daily steps (5,000 steps/day) and moderate to vigorous physical activity (MVPA; 30 min/day). Results: Fifty-three ILD patients (26 women, with a mean age of 60 ± 11 years) were included in the study. TUGusual and TUGfast correlated moderately with the number of steps/day and time spent/day in light physical activity and MVPA (-0.60 < r < -0.41; p < 0.05 for all). ROC curves for TUGusual showed that the cutoffs of = 9.25 s and = 7.9 s can identify physically inactive individuals on the basis of 5,000 steps/day (AUC: 0.73; sensitivity, 76%; specificity, 70%) and 30 min/day of MVPA (AUC: 0.85; sensitivity, 90%; specificity, 75%). Participants who performed worse on TUGusual (i.e., = 9.25 s) showed lower peripheral muscle strength, exercise capacity, and PADL. Conclusions: Performance on TUGusual and TUGfast correlates moderately with PADL in patients with ILD. A TUGusual performance = 9.25 s appears to be able to identify physically inactive individuals in this population.

Impact of High-Intensity Interval Exercise With Elastic Bands Versus Continuous Moderate-Intensity Aerobic Exercise on Glycemic Control in People With Type 1 Diabetes.

Engaging in physical exercise is recommended to enhance cardiovascular health and manage blood sugar levels in people with type 1 diabetes (T1D). The impact of high-intensity interval exercise with elastic bands (EB-HIIE) versus continuous moderate-intensity aerobic exercise (CONT) on glycemic control is different in men with T1D. Crossover study design. Level 3. Participants (39 men with T1D) underwent either an EB-HIIE or a CONT session in randomized order, with a separation of ≥72 hours to avoid carry-over effects. Changes in glucose values during exercise were measured simultaneously from venous blood (YSI) and interstitial fluid (Dexcom G6 glucose sensor). Subsequent 24-hour glucose was monitored using the glucose sensor. Blood glucose was lower in CONT vs EB-HIIE (P < .01). Post hoc analysis revealed clinically relevant differences during exercise (-35.1 mg/dl; P = .02), at its end (-49.5 mg/dl; P < .01), and at 10 and 20 minutes after completion (-51.2 mg/dl; P < .01 and -45.9 mg/dl; P < .01, respectively). Time-in-range 24 hours after exercise completion was significantly higher with EB-HIIE than with CONT (66.5% vs 59.3%), although both were significantly better than the previous 24 hours before exercise (50%). Results suggest that EB-HIIE is a safe training method for male adults with diabetes, resulting in euglycemia during and immediately after exercise and improving glucose outcomes in the subsequent 24 hours. This study provides new evidence and practical information on how to implement safe physical activity in daily life of patients with diabetes. EB-HIIT exhibited lower hypoglycemia risk during exercise and better glycemic control in the subsequent 24 hours. In contrast, practicing CONT exercise is associated with higher risk of hypoglycemia. Healthcare providers should take this information into account when prescribing exercise.

Patient perspectives on acromegaly disease burden: insights from a community meeting

ObjectiveA profound mismatch between biological and symptom control in acromegaly creates a high disease burden despite achieving optimal biological control. There is a great need to learn more about the perspectives of patients living with acromegaly.MethodsAcromegaly Community hosted a virtual meeting in January 2021 and prepared a detailed report capturing participants’ input on acromegaly symptoms and current and future treatment approaches. The findings of this report are reviewed and summarized in this study.ResultsFatigue/muscle weakness (92%) and joint pain/arthritis (90%) are the two most common and troublesome symptoms reported by meeting participants. Acromegaly negatively impacts all aspects of daily living: social interaction (49%); exercise (42%); sports/recreational activities (39%); household activities (38%); attending school or job (38%); family relationships (33%); and walking (26%). Anxiety/depression is experienced by 75% of respondents. Eighty-three percent of patients underwent pituitary surgery, and over 71% of patients require medical therapy. Patients desire future improvements in medication efficacy, tolerability, and administration; mental health resources for themselves and their families; and other multimodal approaches to address their physical symptoms, specifically hunger, weight gain, muscle weakness, and joint pains.ConclusionAcromegaly patients experience significant physical and psychological burdens despite biochemical control, highlighting the need for comprehensive and patient-centered care. In particular, the impacts on activities of daily living (ADLs) and heavy psychosocial and socioeconomic burdens are striking. We advocate for periodic screening for impacted ADLs, multidisciplinary teams to proactively address these symptoms, and call for further research on under-evaluated aspects of the disease.

Co-designing to develop computational thinking skills in Nigeria K-12 using scratch

Abstract The need to integrate the teaching and learning of computational thinking (CT) in K-12 education has been on the rise since it was identified as a skill for solving 21st-century problems. The co-design pedagogical approach has shown great potential in promoting effective communication of CT to both university and K-12 students with the support of different educational tools in different contexts. To ensure Nigerian secondary school (K-12) students develop CT skills, a four-day co-design CT activities workshop was organized. Co-design pedagogy and constructivism theory were deployed in this study with students co-designing COVID-19 disease spread game for learning CT. A mixed method was adopted to investigate student’s interest, attitudes, understanding of CT, and their learning experience from implementing CT-based prototype using Scratch. This study recruited 40 students from two different secondary schools in Nigeria as participants. The result revealed that student’s interest in learning CT was aroused through the use of co-design pedagogy and Scratch (μ = 4.55, σ = 0.815). Similarly, students attitude toward CT after the intervention study shows positive (μ = 4.50, σ = 0.716). This study paved way for student’s skills development in teamwork and collaborative learning, communication, idea sharing, personal skill development, game design, and understanding of programming. This study instigates thinking ideation, inspires the application of CT concepts in daily life activities, and improves problem-solving skills. This study promotes and advocates for the application of co-design pedagogy to foster the teaching and learning of CT in a Nigerian context. This study contributes to knowledge by promoting the use of Scratch as a tool for co-designing in learning CT, proposing a four-phase co-design application flow for the integration of co-design pedagogy with Scratch for learning CT in the Nigerian K-12 context and suggesting ways to implement the teaching and learning of CT in K-12 education.

Spousal Caregiving Types and Cognitive Trajectories Among Middle-Aged and Older Adults in China.

Objectives: This study investigates the longitudinal association between spousal caregiving types and cognitive trajectories among middle-aged and older Chinese adults, with a focus on gender differences. Method: Data from the China Health and Retirement Longitudinal Study (CHARLS) (2011-2018) were analyzed, covering 4568 couples aged 45 and above. Caregiving types were Activities of Daily Living (ADLs) caregiving, Instrumental Activities of Daily Living (IADLs) caregiving, and both ADLs/IADLs caregiving. Cognitive function was assessed using tests of memory, orientation, numeric ability, and visuospatial ability. Latent growth curve modeling was used to examine associations between caregiving types and cognitive trajectories. Results: Spouses who only provided IADLs caregiving had slower cognitive decline compared to those who did not provide caregiving, regardless of gender. However, those who provided ADLs caregiving had faster cognitive decline compared to non-caregivers, especially in women. Discussion: These findings highlight the importance of caregiving types as well as the gendered effects of caregiving on cognitive trajectories.

A Cross Sectional Study to Assess the Sleep Disturbance and Activities of Daily Living and Their Predictors among Older Adults Visiting Medical Out Patient Department of Selected Hospitals of Bagalkot

Background of the Study: Healthy aging according to the WHO is a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course. Older adults may experience mobility problems due to age-related changes in muscles, bones, and joints. Depression, anxiety, and social isolation are prevalent among older adults. Sleep disturbances can significantly impact mood and emotional well-being in older adults. Mood swings, depression, and anxiety. This may result in difficulties with mobility, self-care tasks, and overall functional independence. Hence the investigator felt the need to conduct “A cross sectional study to assess the sleep disturbance and activities of daily living and their predictors among older adults visiting medical outpatient department of selected hospitals of Bagalkot.” Aim: To assess the sleep disturbance and activities of daily living among older adults. Methods: Quantitative non-experimental approach with Cross sectional descriptive survey research design was used for the study to accomplish the objectives. Sleep Quality Scale (SQS), The Lawton Instrumental Activities of Daily Living Scale were used to collect data. A sample of 100 older adults aged above 60 years and visiting medical OPD’s of selected hospitals of Bagalkot was selected by Non probability Purposive Sampling Technique. The data collected were analyzed using descriptive and Inferential Statistics. Results: Findings shows that, there was a significant negative correlation (r= -0.546, P&lt;0.01) between sleep disturbance and activities of daily living of older adults. Sleep disturbance was significantly associated with Religion[χ2=9.09, P&lt;0.0026], Marital Status[χ2=6.43, P&lt;0.0112],Number of Children[χ2=10.77, P&lt;0.001], Family Monthly Income[χ2=15.52, P&lt;0.0001],Residential Status[χ2=10.39, P&lt;0.0013],Type of Family[χ2=8.42, P&lt;0.0037],Chronic Illness[χ2=15.2, P&lt;0.0001],Exercise Habits[χ2=9.09, ...

Recovery trajectories after major abdominal surgery: A retrospective pooled cohort study.

Recovery from major surgery can be difficult to predict given the many factors involved in treating disease and restoring preoperative function. Postoperative recovery metrics such as length of stay, complications, and mortality are typically described. However, large data quantities for patient-reported recovery are scarce. In this retrospective study, we aimed to describe the multidimensional recovery trajectory of patients undergoing major abdominal surgery 4-8 weeks after surgery and explore factors related to incomplete overall recovery. We retrospectively analysed pooled cohort data of adults undergoing elective major abdominal surgery between 2018 and 2024 across three tertiary-level hospitals. Recovery was measured at postoperative days 1, 3, 7, 14, weeks 4-8, and 3 months using the Postoperative Quality of Recovery Scale (PostopQRS). Physiological, nociceptive, emotive, activities of daily living (ADL), and cognitive domains were assessed, with recovery defined as a return to, or improvement of, preoperative baseline levels. Overall recovery was defined as recovery in all domains. Length of stay was assessed for patients who recovered overall, or did not recover, at postoperative weeks 4-8. Six hundred and fifty-three patients were included, with mean (SD) age of 57.8 (14.4) years. Of these, 36% were aged ≥65 years and 58% were male. The incidence of overall recovery at postoperative week 4-8 was 42%. Domain-level recovery at postoperative weeks 4-8 was 63% for nociception, 81% for emotion, 82% for ADLs, and 83% for cognition. Patients failing to achieve overall recovery at weeks 4-8 had longer mean (SD) lengths of stay compared to those who recovered (11.3 (10.3) vs. 7.3 (7.1) days, p < .001). The incidence of overall recovery at postoperative week 4-8 was 42%. Patients with incomplete overall recovery had longer lengths of stay. Multidimensional strategies to improve the recovery trajectory warrant further investigation. Major surgical procedures are often followed by a lengthy and difficult recovery period. Traditional measures such as mortality and complications are usually analysed, but this 653-patient study investigated patient-reported recovery scores after major abdominal surgery. Novel findings include that only 42% of patients have recovered fully in all recovery domains at weeks 4-8, and these patients also had longer hospital stays. Preoperative risk factors were analysed for associations with recovery trajectories.

Unique Needs and Challenges Experienced by Young People With Stroke: An International Qualitative Analysis.

Stroke in young adults has a lifelong impact on activities of daily life, including driving, leisure, and community-based activities; social participation; and reduced productivity. The needs of young people with stroke (YPwS) are likely to vary across different countries, and the development of age-adapted information and interventions is therefore critical in addressing those needs. This study aims to (1) identify the unmet needs of people with stroke aged 18 to 55 years across countries with varied income levels and cultural backgrounds and (2) determine their preferred means to access knowledge and information about stroke in the young. This international needs analysis used a phenomenologic qualitative design to gain in-depth perspectives about the experiences of YPwS. Participants were recruited from 9 countries of varied socioeconomic status. We interviewed 44 participants with stroke (men: 22; women: 21; transman: 1; mean age: 44.2 ± 8.5 years) living in the community (range of time since stroke: 0.5-10 years). The semistructured interview focused on lived stroke experience, unmet needs, helpful strategies to meet individual needs, hopes, and dreams. The interview was recorded, conducted in the participants' native language, and transcribed verbatim. Data were analyzed using inductive thematic analysis. Four main themes emerged from the interviews: (1) heterogeneity of unmet needs specific to YPwS, (2) invisible disability, (3) lack of age-specific stroke information, and (4) call for accessible information resources available in different formats. The results highlighted the need to provide long-term and contextually tailored support to YPwS, aligned with their recovery goals and age-specific needs. Initiatives such as peer-support groups, self-management or peer-mentoring programs, information resources in various formats, and participation in research projects could help address the unique needs of this population. Our results emphasize the importance of raising awareness of stroke in the young and the unique challenges of this population. Future research could focus on the development of stroke care pathways specific to YPwS.

TELEHEALTH PROGRAM CREATES EXERCISE HABIT FOR NON-ADHERENT PATIENT WITH ORTHOSTATIC INTOLERANCE

INTRODUCTION Orthostatic Intolerance (OI) impacts patients’ ability to perform activities of daily living (ADLs) often leading to symptom exacerbation and significant deconditioning over time. Exercise aids symptom control by increasing cardiac output and venous return. Creating and maintaining an exercise routine often requires additional supports. CASE PRESENTATION A 15-year-old female was referred for a 6-month history of postural dizziness and presyncope. At the initial clinic visit, orthostatic testing was completed which showed a 27-bpm increase in heart rate. Baseline ECG showed sinus rhythm with normal intervals and review of systems was unremarkable. Patient history, symptoms and testing were noted to be consistent with OI. Initial interventions included general exercise resources and education materials, such as a daily aerobic walking plan (begin with 5-minute duration and increase by 5 minutes/week until 60 minutes total is achieved per day). Quarterly to bi-yearly clinic follow-ups showed no improvement in symptoms, despite reinforcing exercise recommendations and education at each visit. Follow up repeat testing, predicted aerobic capacity assessment, muscular endurance assessment, and surveys were completed. Exercise physiologist (ExP) initiated telehealth exercise sessions. OUTCOME Prior to intervention, patient physical activity consisted of walking at work. ExP conducted eleven telehealth exercise sessions over a 3-month period (30 min duration, 2 times/week). Sessions included education on form, safety, exercise components, &amp; intensity progression. Resistance exercises were completed with real-time supervision and feedback. Following completion of the telehealth program, testing showed decrease in symptom severity (-110%), increase in predicted aerobic capacity (+28%), maintenance of lower extremity muscular endurance (-6%), decrease in fatigue (-62%), and maintenance of mobility (-27%). One month post completion of telehealth intervention patient remained adherent to exercise prescription of aerobic exercise (2 times/week) &amp; strength training (2 times/week). DISCUSSION Early clinic education emphasized the importance of exercise for this patient; however, neither education nor clinic resources resulted in adherence to an exercise routine. Virtually delivering high quantity, synchronized exercise sessions, allowed the patient to experience improvement in functional capacity and reduction in symptom intensity. Virtual delivery of exercise medicine sessions can be applied to multiple clinical conditions and wider delivery to varied patient populations should be explored.

Development and validation of clinical prediction model for functional independence measure following stroke rehabilitation.

To develop and internally validate a clinical prediction model that includes balance ability and nutritional indices for the motor-functional independence measure (M-FIM) at 90 days post-stroke stroke. This retrospective, single-center study included 566 patients with stroke undergoing rehabilitation at our rehabilitation hospital. The primary outcome was the M-FIM score of >61 at 3 months post-strokes onset. Stepwise conditional forward selection was first used to identify predictors for the achievement of M-FIM>61 at 90 days post-stroke, from 25 potential predictors at admission. The selected predictors were dichotomized with cut-off values to establish scoring systems, resulting in the B-ADL model, which includes postural balance (B), albumin level, age, arm function (A), days since stroke onset (D), and level of activities of daily living (ADL) (L). For internal validation, we corrected the optimism of the area under the curve of receiver operating characteristic curve (AUROC) induced by overfitting the original data using the bootstrap validation method. Calibration capacity was assessed using a calibration plot. We developed a clinical model to predict the M-FIM at 90 days post-stroke onset. The AUROC of the B-ADL model was 0.92 (sensitivity, 93.7%; specificity, 89.7%). The B-ADL model showed high accuracy with an AUROC of 0.970 in the internal validation. The scoring system in the validation cohort had a cut-off value of 5.5/12 points to predict the achievement of M-FIM>61 (AUROC: 0.950; 95% CI 0.930-0.970). The B-ADL model accurately predicted M-FIM >61 at 90 days post-stroke on the day of admission to the recovery rehabilitation ward. The B-ADL model is useful for optimizing rehabilitation programs and resource allocation, allowing for targeted interventions after stroke.

Safety and efficacy of nipocalimab in adults with generalised myasthenia gravis (Vivacity-MG3): a phase 3, randomised, double-blind, placebo-controlled study.

Given burdensome side-effects and long latency for efficacy with conventional agents, there is a continued need for generalised myasthenia gravis treatments that are safe and provide consistently sustained, long-term disease control. Nipocalimab, a neonatal Fc receptor blocker, was associated with dose-dependent reductions in total IgG and anti-acetylcholine receptor (AChR) antibodies and clinically meaningful improvements in the Myasthenia Gravis Activities of Daily Living (MG-ADL) scale in patients with generalised myasthenia gravis in a phase 2 study. We aimed to assess the safety and efficacy of nipocalimab in a phase 3 study. Vivacity-MG3 was a phase 3, randomised, double-blind, placebo-controlled, phase 3 study conducted at 81 outpatient centres with expertise in myasthenia gravis in 17 countries in Asia-Pacific, Europe, and North America. Adults (aged ≥18 years) with generalised myasthenia gravis inadequately controlled with standard-of-care therapy (MG-ADL score ≥6) were randomly assigned (1:1) to either nipocalimab (30 mg/kg loading dose then 15 mg/kg every 2 weeks for maintenance dosing) or placebo infusions every 2 weeks, added to standard-of-care therapy in both groups, for 24 weeks. Randomisation was stratified by antibody status, day 1 MG-ADL total score, and region. The sponsor, investigators, clinical raters, and participants were masked to treatment assignment. The primary endpoint was the difference between nipocalimab and placebo based on least-squares mean change from baseline in MG-ADL total score averaged over weeks 22, 23, and 24 in the intention-to-treat population of patients who were antibody-positive (for AChR, anti-muscle-specific tyrosine kinase [MuSK], or anti-low-density lipoprotein receptor-related protein 4 [LRP4]). Adverse events were assessed in patients who received at least one dose of study drug. This study is registered at ClinicalTrials.gov, NCT04951622; the double-blind phase is completed and an open-label extension phase is ongoing. Between July 15, 2021, and Nov 17, 2023, 199 patients were enrolled, and 196 patients received study drug (98 in the nipocalimab group and 98 in the placebo group); of these, 153 (77 in the nipocalimab group and 76 in the placebo group) were antibody-positive. The least-squares mean change in MG-ADL score from baseline to weeks 22, 23, and 24 was -4·70 (SE 0·329) in the nipocalimab group versus -3·25 (0·335) in the placebo group (difference -1·45 [95% CI -2·38 to -0·52]; p=0·0024). The incidence of adverse events was similar between groups (82 [84%] of 98 in both the nipocalimab and placebo groups), including infections (42 [43%] of 98 in the nipocalimab group and placebo group) and headache (14 [14%] of 98 in the nipocalimab group and 17 [17%] of 98 in the placebo group). Serious adverse events were reported for nine (9%) of 98 patients in the nipocalimab group and 14 (14%) of 98 patients in the placebo group, three of which had a fatal outcome (nipocalimab: myasthenic crisis; placebo: cardiac arrest and myocardial infarction). Results from the completed double-blind phase of Vivacity-MG3 support the role of nipocalimab, added to standard-of-care therapies, as a safe treatment for sustained disease control over 6 months for a broad population of patients with generalised myasthenia gravis who are antibody-positive. The ongoing open-label extension phase should provide longer term sustained safety and efficacy data with nipocalimab. Janssen Research & Development, LLC, a Johnson & Johnson company.