Activities Of Daily Living In Patients Research Articles

Transcranial Direct Current Stimulation for Global Cognitive Functioning and Ability in Daily Life Activities in Poststroke Cognitive Impairment: A Systematic Review and Meta-analysis.

The aim of the study is to determine the efficacy of transcranial direct current stimulation on global cognition and ability in daily life activities of patients with poststroke cognitive impairment. Nine electronic databases were searched from their respective inceptions through January 2022. We included the randomized controlled trials that used transcranial direct current stimulation for poststroke cognitive impairment and included at least one global cognitive function or ability in daily life activities outcome indicators. Two reviewers appraised the risks of bias through the Cochrane Collaboration's tool and performed the meta-analysis. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Twenty-two studies (1198 participants) were included. Most studies had no significant bias in the quality of the methodology. Meta-analyses found that compared with the control group, transcranial direct current stimulation increased Montreal cognitive assessment, Mini-mental state examination, Loewenstein occupational therapy cognitive assessment, total effective rate of cognition, modified Barthel Index, and decreased P300 latency (all P < 0.05). These results showed transcranial direct current stimulation can improve cognitive function and ability in daily life activities in poststroke cognitive impairment. The transcranial direct current stimulation may have a significant rehabilitation effect on global cognitive functioning and ability in daily life activities of patients with poststroke cognitive impairment.

Psychometric properties of the French Hot Flash Related Daily Interference Scale (HFRDIS)

Objective Hot flashes are one of the major symptoms of climacteric syndrome. Despite the high prevalence of these symptoms, few questionnaires assessing the impact of hot flashes on quality of life have been validated. The aim of this study was to validate a French version of the Hot Flash Related Daily Interference Scale (HFRDIS) in a sample of French women. Methods In this prospective study, data were obtained from two groups of women aged between 40 and 60 years from both women without breast cancer and women under hormone therapy for breast cancer between March 2021 and February 2022. Translation was made by an official English–French translator using the forward–backward method. Results One hundred and sixty-seven women completed the HFRDIS questionnaire. The scree plots confirmed unidimensional structure. Cronbach’s α coefficient was 0.92 [0.90–0.94] similar to the original version. The intra-class correlation coefficients of each item ranged between 0.58 and 0.71 Concordance of the scores of each item with those obtained during the validation of the original version of the HFRDIS was confirmed. Conclusion The validation results show that the French version of the HFRDIS questionnaire is a valid tool to evaluate the impact of hot flashes on the daily life activities of patients.

Визначення стану базових активностей повсякденного життя у пацієнтів з морбідним ожирінням як аспект ефективності програми фізичної терапії

The main reasons for the restriction of activities of daily life in individuals with morbid obesity are limited mobility due to deterioration in flexibility and strength, deterioration in balance, and concomitant pathology of the musculoskeletal system. The data available in the current literature predominantly highlight disorders of activities of daily life in obese elderly people. At the same time, there are almost no studies highlighting the limitations of activities of daily life in morbid obesity, as well as the gender characteristics of these limitations. The purpose of the study was to determine the nature of daily life activity disturbances in men and women with morbid obesity and the effectiveness of their correction by means of physical therapy against the background of different levels of therapeutic alliance. Materials and methods. 74 adults of the second adult age (39.6 ± 1.4 years) were examined with a morbid obesity established by body mass index (more than 40) (43 women and 21 men). According to the results of determining the therapeutic alliance, they were divided into two groups. The comparison group consisted of individuals with a low level of therapeutic alliance who refused to actively participate in the program of weight loss. The main group consisted of patients with a high level of therapeutic alliance, they underwent a correction program using dietary and lifestyle modifications, therapeutic exercises, massage, acupuncture, psychocorrection lasting one year. The main principle of the program was an individual approach taking into account the physical capabilities, comorbidities, psycho-emotional state of the patient with constant monitoring of body functions against the background of maintaining a high level of therapeutic alliance. The performance of daily life activities was characterized by the dynamics of the Barthel index parameters. Results and discussion. In patients with morbid obesity, a deterioration in the performance of daily life activities (according to the Barthel index) was revealed. The use of kinesitherapy against the background of a decrease in body weight as a part of a physical therapy program allowed the patients to restore their independence when performing activities of daily life (according to the Barthel index). The low level of therapeutic alliance led to poor implementation or non-implementation of the recommendations provided (aimed at reducing body weight, increasing physical activity), which was associated with a lack of improvement in the performance of daily life activities. Conclusion. As a result of one-year implementation of the developed program of physical therapy, a statistically significant (p&lt;0.05) improvement in the studied indicators of daily life activities in patients with morbid obesity and restoration of functional independence in this indicator was determined compared to the initial result

Fuzzy MCDM Model for Selection of Infectious Waste Management Contractors

Healthcare supply chains are under pressure to drive down costs because of digital business, shifting customer needs and new competition. Medical waste generated from medical facilities includes medical activities and daily-life activities of patients and their family members. According to statistics of the Department of Health Environmental Management, Vietnam currently has more than 13,500 medical facilities, including hospitals from central to provincial and district levels and private hospitals and medical facilities. Preventive medicine generates about 590 tons of medical waste/day and is estimated to be about 800 tons/day. Medical waste includes ordinary medical waste and hazardous medical waste; in which ordinary medical waste accounts for about 80%–90%, only about 10%–20% is hazardous medical waste including infectious waste and non-infectious hazardous waste. This is an environmental and occupational health issue that needs attention in developing countries like Vietnam. Handling large amounts of medical waste to ensure environmental and personal hygiene, doing so inefficiently creates potential hazards to the environment and increases operating costs. However, hospitals lack objective criteria and methods to evaluate and select the most optimal infectious medical waste, relying instead on their own subjective assessment and prior experience. Therefore, the author proposed a fuzzy multicriteria decision making (MCDM) model including Fuzzy Analytic hierarchy process (FAHP) and the Weighted Aggregated Sum-Product Assessment (WASPAS) for infectious medical waste contractors’ selection in this research. The proposed Fuzzy MCDM method is in-tended to provide a more efficient, accurate method in the selection of infectious medical waste contractors than subjective assessment methods, thus reduce potential risks to hospitals. The results of this study can be applied to evaluate and select contractors in other industries.

Comparison of Activity-Based Home Program and Cawthorne-Cooksey Exercises in Patients With Chronic Unilateral Peripheral Vestibular Disorders

ObjectiveThis study aimed to investigate the effects of an activity-based home program and an exercise-based home program on dizziness severity, balance, and independent level of daily life activities in patients with dizziness due to chronic unilateral peripheral vestibular disorders. DesignA single-blind randomized controlled trial. SettingUniversity dizziness management clinics. ParticipantsIndividuals (N=75) between 18 and 65 years of age who had chronic unilateral peripheric vestibular disorders and vestibular rehabilitation indication. InterventionParticipants were randomly divided into 3 groups: an activity-based home program (group 1/activity group), an exercise-based home program (group 2/exercise group), and a control group (group 3). After an initial assessment, all groups participated in the patient education program. In addition, the activity-based home program was administered to the first group, while the Cawthorne-Cooksey home exercise program was administered to the second group. Main Outcome MeasuresVisual analog scale (VAS), Vestibular Disorders Activities of Daily Living Scale (VADL), and computerized dynamic posturography before and immediately after the treatment program. ResultsA statistically significant improvement was found in the activity and exercise groups in terms of VAS, VADL, Sensory Organization Test (SOT) 5, SOT 6, and SOT (composite) scores compared with the control group (P<.05). A statistically significant improvement was found in the activity group in terms of the instrumental subscale of VADL, SOT 5, SOT 6, and SOT (composite) scores compared with the exercise group. ConclusionsThe activity-based home program was more effective in improving the home management task, the occupational task, and balance than the exercise-based home treatment program in patients with chronic peripheral vestibular disorders.

Effect of Rehabilitation Training on the Recovery of Hemiplegic Limb in Patients with Cerebral Infarction

The purpose of this study is to explore the effect of rehabilitation training on limb recovery of patients with cerebral infarction hemiplegia and the improvement of daily life activities of patients. In this study, 46 patients with cerebral infarction hemiplegia are selected as the research subjects. All of them receive rehabilitation training within 0 to 24 h after the acute phase of cerebral infarction and the patient’s vital signs are stable. After rehabilitation training for 2 w and 4 w, the motor function and daily life activity of hemiplegic limbs are evaluated, and the muscle strength recovery of patients is evaluated after rehabilitation training for 2 mo. The results show that after rehabilitation training, the muscle strength of hemiplegic patients with cerebral infarction is obviously restored, and the motor function of hemiplegic limbs and the ability of daily activities are significantly improved. Therefore, it can be concluded that rehabilitation training is conducive to promoting the recovery of limb motor function in patients with cerebral infarction hemiplegia and improving the life ability of patients, which has the promotion value. In the future research, large sample, multi-center randomized clinical control trial should be carried out to provide more reliable and effective rehabilitation mode for limb recovery of patients with cerebral infarction hemiplegia.

Daily life activities in patients with Alzheimer’s disease or semantic dementia: Multitasking assessment

The aim of the present study was to compare patients with mild to moderate Alzheimer's disease (AD) or semantic dementia (SD) on their cognitive processes and the severity of their daily life activity impairments. Three types of tasks were administered to patients (SD = 15; AD = 31) and 30 healthy controls (HC): 1) informant-based scales and questionnaires, 2) a neuropsychological assessment exploring executive functions, episodic and semantic memory, and 3) a new original test featuring multi-step naturalistic actions and multitasking: the Sequential Daily Life Multitasking (SDLM). We predicted that patients with AD would mainly exhibit task perplexity, associated with episodic and executive deficits on the SDLM, while the behavior of patients with SD would mostly be characterized by object perplexity, associated with semantic memory deficits. Results showed that patients with AD or SD were impaired across all neuropsychological tests, particularly episodic memory in AD and semantic memory in SD. General performance on the SDLM also appeared dramatically impaired in both patient groups, and correlated with results of questionnaires about instrumental activities and memory impairments. However, specific qualitative measurements on the SDLM did not allow us to pinpoint different patterns of errors and behavior in patients with AD versus SD. We suggest that the inability of patients in both groups to perform the SDLM may derive from a constellation of disorders or else from more subtle impairment of cognitive and conative processes that requires further exploration.

Are Daily Life Activities of Patients with Proximal Femoral Tumor Resection Prosthesis as Good as those of Patients Undergoing Total Hip Prosthesis for Non-Tumor Causes?

The Barthel Index of Activities of Daily Life (ADL) is a scale used to evaluate performance in daily life activities and investigate the reason and resulting relationships in a comprehensive, non-biased manner. The aim of this study was to compare the daily life activities of patients who underwent proximal femoral tumor resection prosthesis assessed by the Barthel Index with the activities of daily living of patients with a total hip prosthesis performed for non-tumor reasons. Twenty-eight patients were included in the study. Sixteen patients underwent hip prosthesis for reasons other than tumor (femur proximal avascular necrosis, coxarthrosis, etc.) and 12 underwent wide resection and femur proximal tumor resection prosthesis due to primary malignant bone tumor or metastasis in the proximal femur. The Barthel Index was used to evaluate their life quality at 3 months. A total of 28 patients (mean age 60.9±1.4 yrs, range 19.0-84.0, 17 female and 11 male patients) were included into the study. Mean ADL score was 84.5±20.6 (5-100.0). While only one patient was totally dependent in terms of daily life activities, 8 other patients were totally independent. When the patient groups were categorized by degree of dependency according to the ADL scores, it was found that dependency states of the two surgery groups were similar in distribution (p=0.212, p=0.703, and p=1.000 respectively). Functional recovering levels were good in the patients who underwent a surgery for proximal femoral tumor resection prosthesis; there was no significant difference when we compared the functional level after total hip prosthesis applied for non-tumor reasons.

The effect of peripheral neuropathy on daily life activities in patients receiving chemotherapy

Objective: The aim of this study is to determine the relationship between pain and pain related factors associated with peripheral neuropathy and daily life activities in patients receiving chemotherapy.Methods: The study used a descriptive and cross-sectional design to examine 80 patients who came to the outpatient chemotherapy unit of two university hospitals to receive chemotherapy drugs such as taxane, platinum analogs and vinca alkaloids. The data were collected by using face-to-face interview method through “General Information Form”, “S-LANSS Pain Scale” that is a bedside test for distinctive diagnosis of neuropathic pain and “Health Assessment Questionnaire (HAQ)” which is a scale prepared by the researcher and measures daily activities to evaluate physical disability.Results: In the group with neuropathic pain, HAQ scores (p = .003; p &lt; .01) and S-LANSS scores (p = .005; p &lt; .01) of the patients who did not have hand-foot complaints prior to the treatment but experienced hand-foot discomfort with the beginning of chemotherapy treatment, were found to be statistically significantly higher. There was a statistically significant positive relation between HAQ score and S-LANSS pain score at the level of 61.2% (r = 0.612; p = .001; p &lt; .01).Conclusions: It was concluded that the symptoms of Chemotherapy-Induced Peripheral Neuropathy (CIPN) and related pain and pain-related factors negatively affect the level of doing daily life activities.

Neurophysiological signals for estimation of the result of latissimus dorsii muscle transfer to biceps brachii in patients with arthrogryposis

Background. One of the leading causes of restriction in daily-living activities in patients with arthrogryposis is severe hypoplasia (or aplasia) of the biceps brachii. Latissimus dorsii muscle transfer to the biceps brachii is one of the most used methods for the reconstruction of active elbow flexion in patients with arthrogryposis.&#x0D; Aim. The aim of the study is to identify neurophysiological correlates for evaluating the result of the transposition of the latissimus dorsii muscle to the biceps in patients with multiple congenital arthrogryposis.&#x0D; Materials and methods. From 2011 to 2018, we performed monopolar latissimus dorsii muscle transfer to the biceps for the restoration of active elbow flexion in 30 patients with arthrogryposis (44 upper extremities). The follow-up results were studied in 14 cases. For this purpose, we used clinical examination, surface electromyography (sEMG), and statistical analysis. The patients were examined before and from 1 month to 96 months (7 months; 224.5 months) after the surgery. The age of patients was from 1 to 10 years at the time of surgery (4.89 2.42 years).&#x0D; Results. Our study showed that the age of the child at the time of surgery does not significantly change the index of activation of the latissimus dorsii muscle. A decrease of coactivation of the latissimus dorsii muscle in the long term after surgery correlates with an increase in the strength of the displaced latissimus dorsii muscle, and an improvement in active flexion in the elbow. If the value of the index of coactivation of the latissimus dorsii muscle is less 42%, the muscle strength after surgery reaches 4 points. It was found that the index of coactivation of the latissimus dorsii muscle does not depend on the level of segmental damage to the spinal cord. However, the strength of the muscle depends on the level of spinal cord damage.&#x0D; Conclusion. The determination of the index coactivation of the latissimus dorsii muscle after surgery can be used to evaluate the results of the latissimus dorsii muscle transfer to the biceps in patients with arthrogryposis. The index of activation of the latissimus dorsii muscle must be less than 42% for effective elbow active flexion.

M101. PREVELANCE USE OF TECHNOLOGICAL DEVICES AND INTERNET AMONG PATIENTS DIAGNOSED WITH SCHIZOPHRENIA AND SCHIZOAFFECTIVE DISORDER

BackgroundEffective use of technology makes human life much easier nowadays. This use has become widespread in health and has gained functionality in many areas. Using technology-based interventions, it is possible to minimize the loss of psychosocial functionality and cognitive disability in schizophrenia, in which social cognitive disability is one of the most basic symptom clusters. The aim of this study is to determine the prevalence of technological devices and internet usage in patients with schizophrenia and schizoaffective disorder, to determine the attitude of patients towards technological devices and internet usage and the relation between technology, internet usage with clinical variables such as psychosocial functioning, positive and negative symptoms.MethodsData were collected from the patients who applied to Dokuz Eylül University Medicine Faculty Schizophrenia Outpatient Clinic. Eighty-three schizophrenia patients and 13 schizoaffective disorder patients who meet the schizophrenia and schizoaffective disorder diagnostic criteria of DSM-5 were included in the study. The sociodemographic data registration form was completed. A questionnaire was developed for the purposes of the research to evaluate the use of technology. The level of psychosocial functioning was assessed using the Personal and Social Performance Scale (PSP), and the positive and negative symptom severity was evaluated using the Positive and Negative Syndrome Scale (PANSS).ResultsThe study found that 86% of patients owned mobile phone, 67% of patients used internet access, 67% of patients owned computer. 61% patients were using any kind of mobile application and 47% patients were using social media application. The most prevelant mobile applications among patients were facebook and whatsapp (48%). Younger patiens were using internet more than elders in a day (r=-0,395, p<0,001). Negative syptom scores were statistically lower among patients who were using mobile phones (M= 16,05, t=-2,50, p=0,014), internet connection in mobile phone (M=15,26, t=-2,93, p=0,004), using mobile application (M=15,47, t=-2,93, p=0,008), facebook (M=15,31, t=-2,32, p=0,022), whatsapp (M=14,77, t=-3,40, p=0,001), messenger (M=14,94, t=-2,33, p=0,022), messaging applications (M=14,96, t=-3,36, p=0,001), social media applications (M=15,04, t=-2,78, p=0,006) and who make video conversation (M=15,52, t=-2,21, p=0,029) than patients who were not using. PSP score of patients who were using mobile phone (M=50,62, t=2,34, p=0,021), internet access in mobile phone (M=57, t=3,07, p=0,003), mobile application (M=51,90, t=2,16, p=0,033), facebook (M=53,47, t=2,63, p=0,010), whatsapp (M=54,68, t=2,43, p=0,001), messenger (M=54,69, t=2,62, p=0,010), messaging applications (M=54,24, t=3,50, p=0,001), social media applications (M=54,29, t=3,10, p=0,003), and making video conversation (M=53,05, t=2,74, p=0,007) were statistically higher than the patients who were not using. There is also statistically significant relation between application usage and sub-items of PANSS.DiscussionThis study indicated that younger schizophrenia patients having less negative symptoms and increased psychosocial functionality was likely to use technological devices and mobile applications more. Patients may use applications more if they have been developed to facilitate their daily lives. Mobile applications and social media may affect the daily life activities of patients more intensively. In addition, using mobile applications may help patients to cope with their symptoms and improve psychosocial functioning.

Effect of visual feedback training using mirror neuron theory on limb function and activities of daily living in patients with hemiplegia during early stroke

Objective To explore the effect of visual feedback training using mirror neuron theory in patients with hemiplegia in early stroke. Methods From July 2014 to July 2017, 122 early stroke patients with hemiplegic stroke in the First People's Hospital of Wenling were selected in the study.After the patients' condition was stable, visual feedback training based on mirror neuron theory was performed.The functional status of upper limbs before and after treatment was evaluated by the simplified Fugl-Meyer motor function evaluation.The modified Ashworth scale was used to evaluate the upper limb muscle tension before and after treatment.The Barthel index was used to evaluate the ability of daily living activities before and after treatment. Results The FMA score of patients after treatment was (35.74±11.24)points, which was significantly higher than that before treatment [(28.81±9.68)points, t=5.160, P=0.000]. The BI score after treatment was (76.24±14.77)points, which was significantly higher than before treatment[(52.93±12.28)points, t=13.404, P=0.000]. After treatment, the muscle tension of the flexor elbow muscle group was (1.57±0.76)grades, which was significantly lower than before treatment [(3.24±0.72)grades, t=17.619, P=0.000]. The forearm pronation muscle group muscle tension grade was (2.14±0.96)grades, which was significantly lower than before treatment [(3.28±0.75)grades, t=10.336, P=0.000]. Conclusion Visual feedback training based on mirror neuron theory can help improve the upper limb function of patients with hemiplegia in early stroke, alleviate the symptoms of paralysis, improve the ability of daily living activities of patients, and has positive effect on promoting their rehabilitation. Key words: Cerebrovascular disorders; Feedback, psychological; Mirror neurons; Early hemiplegia; Upper limb function; Activity of daily living

MON-PO408: Effect of Nutrition Status on Patient Activities of Daily Living in Digestive Cancer Patients

MON-PO408: Effect of Nutrition Status on Patient Activities of Daily Living in Digestive Cancer Patients

Hidrotherapy

Objective. The aim of this study was to compare the evolution of daily life activities of patients suffering from sequels of strokes who were submitted to hydrotherapy, conventional kinesiotherapy and those with no physiotherapeutic intervention. Method. A total of 152 patients of both genders were selected according to their arrival in the service and were submitted to hydrotherapy in isolation or together with classical kinesiotherapy, over six months. The 45-minute hydrotherapy and classical kinesiotherapy sessions were performed at least three times weekly. Functional activity was evaluated every three months to identify: the dependence, semi-dependence or independence on routine activities. Analysis of the functional activity was assessed by means of the Barthel index. Results. Of the 152 patients, 118 satisfied inclusion criteria. The participants were divided into three groups: 72 (61%) underwent conventional kinesiotherapy, 32 (27.1%) hydrotherapy followed by conventional kinesiotherapy and 14 (11.9%) had no physiotherapeutic interventions. The conventional kinesiotherapy with hydrotherapy group improved in relation to both the degree of independence and lighter motor sequels (p=0.001). The neurological deficit remained greater in the non-treatment group than in the others (p=0.01). Conclusion. The hydrotherapy may be considered a good coadjuvant procedure for patients with sequels due to stroke.

Imaging correlates of hand motor performance in multiple sclerosis: A multiparametric structural and functional MRI study

Background: Hand motor impairment has considerable effects on daily-life activities of patients with multiple sclerosis (pwMS). Understanding its anatomo-functional substrates is relevant to provide more specific therapeutic interventions. Objectives: To investigate the association between hand motor performance and anatomo-functional magnetic resonance imaging (MRI) abnormalities in pwMS. Methods: A total of 134 healthy controls (HC) and 366 pwMS underwent the Nine-Hole-Peg-Test (9HPT), structural and resting state (RS) functional MRI. Multivariate analyses identified the independent predictors of hand motor performance. Results: PwMS versus HC showed widespread gray matter atrophy, microstructural white matter abnormalities, and decreased RS functional connectivity in motor and cognitive networks. Predictors of worse right-9HPT (R2 = 0.52) were decreased right superior cerebellar peduncle and right lemniscus fractional anisotropy (FA) (p ⩽ 0.02), left angular gyrus atrophy (p < 0.003), decreased RS connectivity in left superior frontal gyrus, and left posterior cerebellum (p < 0.001). Worse left 9HPT (R2 = 0.56) was predicted by decreased right corticospinal FA (p = 0.003), atrophy of left anterior cingulum and left cerebellum (p ⩽ 0.02), decreased RS connectivity of left lingual gyrus and right posterior cerebellum in cerebellar and executive networks (p ⩽ 0.02). Conclusion: Structural and functional abnormalities of regions involved in motor functions contribute to explain motor disability in pwMS. The integration of clinical and advanced MRI measures contributes to improve our understanding of multiple sclerosis clinical manifestations.

МЕДСЕСТРИНСЬКА ОЦІНКА ЯКОСТІ ЖИТТЯ ХВОРИХ НА БРОНХІАЛЬНУ ОБСТРУКЦІЮ РІЗНОГО ГЕНЕЗУ

Хронічне обструктивне захворювання легень (ХОЗЛ) належить до прогресуючих захворювань суспільства і є провідною причиною смертності населення у багатьох економічно розвинених країнах світу, що становить значиму медичну і соціальну проблему, не обминає стороною жоден прошарок суспільства. Сучасні методи діагностики ХОЗЛ та арсенал лікарських засобів не завжди досягають стійких ремісій, що погіршує якість життя хворих, тому пошук доступних, дешевих методів реабілітації пацієнтів є актуальним.Мета дослідження – медсестринське дослідження та оцінка якості життя хворих на бронхіальну обструкцію різного генезу до та після навчальних програм, а також розробка рекомендацій щодо удосконалення догляду і профілактики хвороби при даній патології в умовах Тернопільського обласного протитуберкульозного диспансеру (ТОПТД) та навчання хворих правилам якісного життя.Матеріали і методи. Дослідження складалося з 3 етапів. Перший етап – аналіз історій хвороб пацієнтів із ХОЗЛ та туберкульозом легень (ТБЛ), які мали бронхообструктивний синдром (БОС) та їх анкетування. Другий етап – на основі отриманих даних адаптування та застосування уже відомих навчальних програм до специфіки ТОПТД для пацієнтів із специфічними та неспецифічними ураженнями легень. Третій етап – оцінка якості життя у хворих до та після навчально-реабілітаційного процесу. Ретроспективно проведено аналіз 60-ти історій хвороб пацієнтів із легеневою бронхообструкцією в період за 2015– 2016 рр., з них – 30 хворі на ХОЗЛ, інші 30 – на ТБЛ.Результати досліджень та їх обговорення. У процесі комплексного лікування, навчання і реабілітації хворих із БОС різного генезу, поряд з оцінкою тяжкості клінічного перебігу захворювання, дослідженням вентиляційної функції легень варто визначати рівень якості життя пацієнтів. У пацієнтів із бронхообструкцією відзначається значне погіршення якості життя, яке виявляється у зниженні повсякденної життєвої активності пацієнтів і зумовлене впливом симптомів захворювання на фізичну, психічну й емоційну сфери пацієнтів. При ранньому включенні у комплексне лікування індивідуальних програм тривалої фізичної реабілітації і психокорекції можна досягти тривалого поліпшення якості життя хворих та істотно змінити психоемоційний статус пацієнтів, зменшуючи рівень депресії і тривоги.Висновки. Оптимальною формою реабілітації стаціонарних хворих на ХОЗЛ та ТБЛ, поліпшення якості життя пацієнтів є активна навчальна робота з пацієнтами, яка повинна включати програми групового й індивідуального навчання їх, боротьбу з тютюнокурінням, корекцію порушень психологічного стану та фізичні реабілітаційні заходи, а також підвищення толерантності до фізичного навантаження у хворих із БОС.

KRONİK OBSTÜRÜKTİF AKCİĞER HASTALARINDA YORGUNLUĞUN GÜNLÜK VE ENSTRÜMENTAL YAŞAM AKTİVİTELERİ ÜZERİNE ETKİSİ

OZET Amac: Bu arastirma, kronik obstruktif akciger hastaligi olan bireylerde yorgunlugun gunluk ve enstrumental yasam aktiviteleri uzerine etkisini belirlemek amaci ile yapilmistir. Yontem: Tanimlayici nitelikteki bu arastirma 4 Mayis – 30 Eylul 2015 tarihleri arasinda, bir devlet hastanesinin gogus hastaliklari klinigine ve poliklinige basvuran 140 hasta ile yapilmistir. Arastirmada “Tanitici Bilgiler Formu”, “Gunluk Yasam Aktiviteleri Olcegi”, “Enstrumental Gunluk Yasam Aktiviteleri Olcegi” ve “KOAH ve Astim Yorgunluk Olcegi” kullanilmistir. Verilerin degerlendirilmesinde tanimlayici istatistiksel yontemler uygulanmistir. Bulgular: Calismaya katilan hastalarin %62.9’unun 65 ve uzeri yasta, %68.6’sinin erkek, %92.9’unun evli ve %56.4’unun sigarayi biraktigi saptanmistir. Hastalarin onemli bir kisminin dispne ve yorgunluk yasadigi, basta enstrumental gunluk yasam aktiviteleri olmak uzere gunluk yasam aktivitelerinde yardima gereksinim duyduklari belirlenmistir. Ayrica yasanan yorgunlugun hastalarin gunluk ve enstrumental yasam aktivitelerini bagimsiz yapabilme duzeylerini olumsuz yonde etkiledigi gorulmustur (p<0.001). Sonuc: Bu calismada hastalarin dispne ve yorgunluk duzeylerinin yuksek oldugu, gunluk ve enstrumental yasam aktivitelerininde yorgunluga bagli olarak olumsuz etkilendigi belirlenmistir. Anahtar Kelimeler: kronik obstruktif akciger hastaligi, yorgunluk, gunluk yasam aktiviteleri ABSTRACT The Effects Of Fatigue On The Daily Life Activities Of Patients With Chronic Obstructive Pulmonary Disease Aim: This study was conducted with the aim of determining the effect of fatigue on daily and instrumental life activities in individuals with chronic obstructive pulmonary disease. Method: This descriptive study was conducted between 4 May and 30 September 2015 with 140 patients who consulted to a chest disease clinic and polyclinic of a state hospital. The study data were collected using an “Introductory Information Form”, “Daily Life Activities Scale”, “Instrumental Activities of Daily Living Scale”, and “Chronic Obstructive Pulmonary Disease and Asthma Fatigue Scale”. The data were analyzed using descriptive statistics. Results: Of the patients in the study, 62.9% were aged 65 or older, 68.6% were males, 92.9% were married, and 56.4% had given up smoking. The study found that a significant propotion of the patients had dyspnea and fatigue and needed help with daily life activities, especially for the instrumental activities of daily living. It has also been observed that living fatigue has a negative effect on the ability of patients to perform independent activities of daily and instrumental life. Conclusion: In this study was determined that dyspnea and fatigue levels of patients were high, daily and instrumental life activities were negative affected due to fatigue. Keywords: Chronic obstructive pulmonary disease, fatigue, daily life activities

Efficacy of Breathing Exercises on daily living activities of patients with Chronic Obstructive Pulmonary Disease

Improving breathing pattern and reducing disease progression including exacerbation frequency is a target goal for all COPD patients. Aim of the present study to assess efficacy of breathing exercises on daily living activities of patients with Chronic Obstructive Pulmonary Disease. Research design: A quasi experimental design. Sample: A convenience sample of 70 patients with COPD. Tool consists of three Part I: Interviewing questionnaire to assess the socio-demographic data. Part II: Physical examination sheet. Part III: An assessment of patient’s difficulty of breathing during daily living activities (DLA). Results: Revealed statistical significant difference of the total mean scores before breathing exercise and after 3 months of breathing exercises training. Conclusion: There was positive efficacy of exercises on respiratory patient’s outcomes with chronic obstructive pulmonary disease as evident with improvement in performing the daily living activities. The study recommended that government officials as well as nongovernmental organizations should encourage and support home-based training especially for patients with insufficient income. Further experimental study is suggested to compare between two groups of COPD one apply breathing exercises and another take antibiotic to demonstrate effect of exercises intervention on of purulent sputum.

The striated muscles in pulmonary arterial hypertension: adaptations beyond the right ventricle.

Pulmonary arterial hypertension (PAH) is a fatal lung disease characterised by progressive remodelling of the small pulmonary vessels. The daily-life activities of patients with PAH are severely limited by exertional fatigue and dyspnoea. Typically, these symptoms have been explained by right heart failure. However, an increasing number of studies reveal that the impact of the PAH reaches further than the pulmonary circulation. Striated muscles other than the right ventricle are affected in PAH, such as the left ventricle, the diaphragm and peripheral skeletal muscles. Alterations in these striated muscles are associated with exercise intolerance and reduced quality of life. In this Back to Basics article on striated muscle function in PAH, we provide insight into the pathophysiological mechanisms causing muscle dysfunction in PAH and discuss potential new therapeutic strategies to restore muscle dysfunction.

Morbidity and mortality of surgically treated proximal humerus fractures

BackgroundThe aim of the present study is to analyze the factors associated with mortality and the capacity to perform daily life activities (DLA) in patients with surgically treated proximal humeral fractures. MethodsA retrospective study was conducted on 94 patients with a surgically treated proximal humeral fracture, with a mean follow-up of 8 years (2–12 years). A correlation analysis was performed to determine the relationship between the type of fracture, surgical technique, comorbidities and mortality and DLA. The Student's t test was used for statistical analysis. ResultsA total of 72 patients were identified, 18.6% of them died during follow-up, all diagnosed with some comorbidity. There was no correlation between mortality, type of fracture or the technique used.Most of the patients (85.4%) had comorbidities, and 79.5% were completely independent for DLA. Although there was no relationship with the type of fracture, there was a significant reduction in the performing of DLA in patients treated with hemiarthroplasty, and in patients with neurological disorders. ConclusionsThere was a mortality of 18.6% among patients with surgically treated proximal humerus fractures.The majority of surgically treated patients were fully independent for DLA at long-term follow-up.