Subjective Disability Research Articles

Age-Related Features of Clinical and Neurological Characteristics and Pathogenetic Therapy in Patients with Multiple Sclerosis

INTRODUCTION: Multiple sclerosis (MS) is a neurological demyelinating disease of the central nervous system manifested by pronounced heterogeneous symptoms. Peculiarities of the onset, progression rate, and severity of syndromes are different in different age groups. An increase in the frequency of exacerbations, high degree of disability of patients in different age groups evidence insufficient effectiveness of the conducted pathogenetic therapy. Due to a wide choice of multiple sclerosis disease modifying drugs (MSDMDs), it is important to study the clinical and neurological characteristics of patients with MS in different age groups with the aim of further developing an individual approach to treatment. AIM: To study clinical and neurological features and effectiveness of pathogenetic therapy of MS in patients of different age groups. MATERIALS AND METHODS: A prospective analysis of the data of neurological examination and results of magnetic resonance imaging of 100 patients of different age groups with relapsing-remitting MS, who received outpatient treatment in Kursk Regional Multidisciplinary Clinical Hospital, was conducted in the period of stable remission. RESULTS: The leading syndromes in patients with relapsing-remitting course of MS were cerebellar (78%) and pyramidal (70%) syndromes, besides, dysfunction of the cranial nerves (71%) was also observed. A quantitative parameter of explicitness of pelvic disorder syndrome predominated in middle-aged and elderly patients compared to young ones (p 0.001). Cognitive disorders were more often (14%) recorded in middle-aged and elderly patients (p 0.001). The use of glatiramer acetate permitted to reduce the degree of disability in young subjects (p 0.05); in patients of the middle age group, the most effective was a timely transition from interferon beta to ocrelizumab (p 0.05). The use of first-line MSDMDs (interferon-beta) in elderly patients demonstrated low effectiveness (p 0.05). CONCLUSION: In middle-aged and elderly patients with equal timing of MS onset, the neurological deficit is more expressed than in young ones. First-line pathogenetic therapy, in particular, glatiramer acetate, is more effective in young patients, while patients of middle age are recommended an early transition to second-line MSDMDs.

Individualized Versus General Exercise Therapy in People with Subacromial Pain Syndrome: A Randomized Controlled Trial

ObjectiveTo evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity and disability in subjects with chronic subacromial pain syndrome (SAPS). DesignRandomized Controlled Trial (IRCT20221126056621N1) SettingRehabilitation clinics ParticipantsThirty-eight participants with chronic SAPS (aged 52.23(8.47), 60 %woman). InterventionsThe participants were randomly allocated to one of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for four weeks. Main Outcome MeasuresThe primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI). ResultsFollowing completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean [CI]: 9.17 [0.31 to 18.03], p=0.04), with a large effect size [0.68]. The reduction of PAR remained significantly lower in the intervention group than in the control group after four months of follow-up (mean [CI]: 18.29 [9.09 to 27.48], p=0.00) with a large effect size [1.27]. Disability significantly decreased at two month (mean=14.58, p=0.002 on SPADI index; mean=10.26, p=0.006 on DASH index) and four month (mean=19.85, p=0.00 on SPADI index; mean=12.09, p=0.001 on DASH index) follow ups in the intervention group compared to the control group. ConclusionIndividualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS.

Association between MRI measurements of lumbar spine alterations and self-reported outcomes of pain and disability in subjects with non-specific low back pain.

This study aims to elucidate the association between MRI measurements of spine alterations and self-reported outcomes of pain and disability in individuals with non-specific low back pain, using a comprehensive perspective based on machine learning algorithm. 246 consecutive subjects were assessed. Pain severity in cervical, lumbar, and leg regions was determined using visual analogue scale, and functional disability was acquired by Oswestry Disability Index. Sagittal and axial MRI scans of the thoracolumbar spine were evaluated. Severity of disc degeneration, spinal canal stenosis, and presence of vertebral endplate lesions based on two different classification schemes involving the extent and the shape of defects were quantified at the levels from T12L1 to L5S1. The following parameters describing the lumbar region as a whole were calculated: maximum value along spinal levels, sum of values along levels, number of levels characterized by severe condition. The association with pain and disability was assessed by generalized multiple linear regression modelling. Disc degeneration was identified as a predictor of disability and partially of pain, whereas canal stenosis was found associated with changes in pain in the leg region. Partial correlation values ranged from 0.11 to 0.32. Endplate lesions did not show significant associations. A partial association between MRI measurements and self-reported outcomes of pain and disability was confirmed. Disc degeneration was the most correlated with the reported indexes, while canal stenosis mainly affected the pain levels in the leg region. The presence of endplate lesions did not demonstrate any significant relationships.

Impact of Trunk Stabilization Training on Cricketers with Chronic Non-Specific Low Back Pain

Background: The endeavour of this study was to check the impact of trunk stabilization training on cricketers suffering from chronic non-specific low back pain. Objectives: The objectives of the study was to examine the effects of trunk stabilizing exercises in cricketers with chronic low back pain for the change in level of pain, disability and improvement of endurance of trunk muscles. Methods: The related literature was searched and reviewed for the efficacy of interventions, reliability and validity of outcome measures. Quasi-experimental approach was chosen for conducting the study with pre-intervention and post-intervention evaluation of the outcomes. Convenient sampling and random allocation in to groups were used to select and assign the sample that comprised of 15 subjects in each groups out of total sample size of 30. Standardized tools such as VAS for evaluating the pain, modified Oswestry LBP disability questionnaire for evaluating disability trunk stabilization exercises to check improvement of endurance of trunk muscles were utilized. Trunk stabilization exercises with warm up, stretching and cool down were given to group A (experimental group). Hitting pads and back care advice was given in the form of a leaflet to the group B (control group). Results: The data were analysed with help of SPSS version 21. Paired t-test was done for intra group analysis and un-paired t-test for intergroup analysis. The results of the study suggested that there was significant difference between the difference in mean values of pain, disability and endurance between the group-A&B. The findings also suggested that there was significant difference within group-A and group-B for pain, disability and endurance. Conclusion: This study concluded that on both groups, the significant reductions were seen in pain, disability and endurance of subjects after 8 weeks of intervention. However, there was more reduction in pain, disability and endurance in group-A (experimental group)

Quantifying the Burden of Unmet Upper Extremity Care Need in Low-Middle Income Countries: A Four-Country, Cluster-Randomized Study

Currently, no nationally implementable survey exists to identify the burden of hand and upper extremity conditions at the household level in low-middle income countries (LMICs). This study describes a randomized cluster survey approach to estimating the burden of hand and upper extremity conditions in four LMICs using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey. Additionally, this study identifies factors associated with responses of unmet surgical need at the multinational level. The SOSAS instrument is a cluster-randomized, cross-sectional, countrywide survey of households administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014. We identified nationwide trends for sociodemographic, anatomic, condition type, mechanism, prevalence, subjective disability, and barriers to care for upper extremity survey responses. A multivariable model identified factors associated with unmet upper extremity need across the four nations. Across the four countries, 13,763 individuals participated in the survey, with 883 conditions of the upper extremity identified (7.4% of all surgical conditions surveyed). Fractures accompanied many of the injuries (32.3%). Although most conditions were acquired, congenital conditions comprised 11% of all etiologies. Overall, open fire/explosion was the most common mechanism (22.9%). Rwandans had the highest proportion of individuals seeking care (91.0%) and receiving care (88.6%). Sierra Leone indicated the fewest seeking and receiving care (71% and 63%, respectively). Chronic injuries were significantly associated with receiving care, whereas illiteracy and worsening subjective disability were barriers to receiving care. In this survey of upper extremity conditions from four LMICs, upper extremity conditions primarily resulted from fire/explosions, and many reported sustaining a fracture. Illiteracy and more disabling conditions decreased the odds of receiving care by 30% to 40%, respectively. The SOSAS survey may provide a reproducible means to evaluate the unmet need for upper extremity care across similar LMICs.

EFFECT OF SCAPULAR TAPING ON PAIN, DISABILITY AND PROPRIOCEPTION IN SUBJECTS WITH SHOULDER IMPINGEMENT SYNDROME: A RANDOMIZED CONTROLLED TRIAL

Context: Shoulder Impingement Syndrome (SIS) is a common clinical condition in general practice and overhead athletes. Alterations in the scapular position can lead to shoulder impingement syndrome. The effect of exercises on shoulder impingement syndrome is studied but the effect of Kinesiotape is not well explored. Methods: A total of 42 participants were included in the study. The subjects were assessed for SPADI, pain, proprioception, lateral scapula slide test, and pectoral minor length test at the baseline and the subjects were randomly divided into two groups. The intervention group ([Formula: see text] = 18) received scapular taping and scapular exercises and the control group ([Formula: see text] = 17) received scapular exercises only. Post-outcome measures were taken at 4 weeks and 12 weeks during the intervention. Repeated measures ANOVA was used for the outcome measures and Bonferroni’s test was used to determine the pairwise comparisons at different measurement levels amongst experimental and control groups. Results: The study consisted of 17 males and 18 females. There was statistical significance in both groups ([Formula: see text] < 0.01) over the 4th and 12th weeks. Pain ([Formula: see text] < 0.01) and proprioception ([Formula: see text] = 0.017) was also statistically significant between both the groups at 4 weeks. Conclusion: This study concludes that scapular taping can be used as an adjunct with scapular involvement.

Unmet needs and barriers in venous thromboembolism education and awareness among people living with cancer: a global survey

BackgroundVenous thromboembolism (VTE) is a major preventable cause of morbidity, disability, and mortality in subjects with cancer. A global appraisal of cancer-associated VTE education and awareness is not available. ObjectivesTo evaluate VTE-related education, awareness, and unmet needs from the perspective of people living with cancer using a quantitative and qualitative approach. MethodsThis cross-sectional study used data from an online-based survey covering multidimensional domains of cancer-associated VTE. Data are presented descriptively. Potential differences across participant subgroups were explored. ResultsAmong 2262 patients with cancer from 42 countries worldwide, 55.3% received no VTE education throughout their cancer journey, and an additional 8.2% received education at the time of VTE diagnosis only, leading to 63.5% receiving no or inappropriately delayed education. When education was delivered, only 67.8% received instructions to seek medical attention in case of VTE suspicion, and 36.9% reported scarce understanding. One-third of participants (32.4%) felt psychologically distressed when becoming aware of the potential risks and implications connected with cancer-associated VTE. Most responders (78.8%) deemed VTE awareness highly relevant, but almost half expressed concerns about the quality of education received. While overall consistent, findings in selected survey domains appeared to numerically differ across age group, ethnicity, continent of residence, educational level, metastatic status, and VTE history. ConclusionThis study involving a large and diverse population of individuals living with cancer identifies important unmet needs in VTE-related education, awareness, and support across healthcare systems globally. These findings unveil multilevel opportunities to expedite patient-centered care in cancer-associated VTE prevention and management.

117 Standardizing Wearable-based Real-life Physical Activity Monitoring in Patients Undergoing Surgery for Degenerative Lumbar Disorders

INTRODUCTION: Assessment of function in patients with degenerative thoracolumbar disorders (DTD) has traditionally relied solely on the patient’s subjective perception of disability. There is a clear need to better understand an objective measure of physical activity impairment in this patient cohort. METHODS: This analysis is part of the Stanford SpineTrak study, a RCT to assess the feasibility of using a commercially available smartwatch (AppleWatch) to monitor outcome in patients with DTD. Mean preoperative physical activity 2 weeks before surgery was expressed as raw step count, as well as in standardized z-scores that wre referenced to age- and sex-specific values of a control population from a large public database. Step counts were assessed for convergent validity with established patient-reported outcome measures (PROMs) and impairment in activity was stratified into performance groups based on z-score cut-off values. RESULTS: Of 67 patients with DTD, 65 patients (62% female) with a mean age (SD) of 63.8 (12.8) years were available for analysis with a mean (SD) daily step count of 5215 (3868). Physical activity showed significant correlation with the ODI (r = 0.28, 95% CI -0.49-0.03), SF36-PCS (r = -0.34, 95% CI 0.11-0.54) and PROMIS-PF (r = -0.48, 95% CI 0.27-0.65). No, Mild, moderate, and severe impairment in activity performance were defined as corresponding z-scores of >0, 0 to -0.99, -1 to -1.99 and = -2, accounting for 20%, 29%, 43% and 8% of the study population. Each 1-step increase in activity impairment resulted in increased subjective disability as measured by the ODI, SF36-PCS and PROMIS-PF (all < 0.05). CONCLUSIONS: This study establishes a new wearable-based objective measure of real-life physical activity as well as corresponding standard scores that allow for a direct comparison of test results between individual patients and different study populations.

Effects of Scapular Interventions on Pain and Disability in Subjects with Neck Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Musculoskeletal neck pain is the fourth common cause of disability worldwide. Scapula dysfunction can subsequently lead to neck pain. Previous literature could not establish the effectiveness of scapular stabilization exercises on neck pain due to the different definitions used for exercise in different studies. There is a need for quality evidence examining the effectiveness of scapular interventions on pain and disability in patients with neck pain. PubMed, EMBASE, Scopus, Cochrane, OVID, and PEDro were searched from 1 April 2011 to 31 March 2022. We included randomized controlled trials that focused on scapular interventions and other active strategies in the management of neck pain. The following outcomes were assessed: pain, disability, and quality of life. PEDro scale was used to assess the risk of bias and the data pooled was analyzed using standardized mean difference. The 5 trials included in the review assessed (116 participants) the effects of scapular interventions in patients with chronic nonspecific neck pain. Risk of bias for one study was low and that for the others was moderate. The meta-analysis showed that there was a significant difference between the combined effect of neck and scapula interventions and only neck interventions group (Standardized mean difference -1.51, 95% CI [-2.79, -0.23], z=2.32, p=0.02). On assessing the effect of scapula interventions on disability, the results revealed that there was no significant (p=0.40) impact. Moderate quality evidence was found for the combined effect of scapular and neck interventions in reducing pain in patients with neck pain. However, it was not effective in improving the disability.

Isolated Lumbar Extension Resistance Training Is Effective at Improving Extension Power and Disability in Subjects with Diagnosed Lumbar Multifidus Dysfunction

Isolated Lumbar Extension Resistance Training Is Effective at Improving Extension Power and Disability in Subjects with Diagnosed Lumbar Multifidus Dysfunction

Efficacy of transcutaneous electrical nerve stimulation versus ultrasound on pain and disability in subjects with osteoarthritis of knee joint

Efficacy of transcutaneous electrical nerve stimulation versus ultrasound on pain and disability in subjects with osteoarthritis of knee joint

Effect of Diaphragmatic Breathing Exercise on Hamstring Length and Functional Disability in Subjects with Chronic Low Backache: A Quasi-experimental Study

Effect of Diaphragmatic Breathing Exercise on Hamstring Length and Functional Disability in Subjects with Chronic Low Backache: A Quasi-experimental Study

Standardizing Physical Activity Monitoring in Patients With Degenerative Lumbar Disorders.

Degenerative thoracolumbar disorders (DTDs) typically cause pain and functional impairment. However, little is known regarding the DTD impact on patient's real-life physical activity. The objective of this study is to validate a wearable measure of physical activity monitoring in patients with DTD and to create gender- and sex-specific performance thresholds that are standardized to the mean of a control population. A commercially available smartwatch (Apple Watch) was used to monitor preoperative physical activity in patients undergoing surgery for DTD. Mean preoperative physical activity 2 weeks before the scheduled surgery was expressed as raw step count. Standardized z-scores were referenced to age- and sex-specific values of a control population from a large public database. Step counts were assessed for convergent validity with established patient-reported outcome measures, and impairment in activity was stratified into performance groups based on z-score cutoff values. Sixty-five patients (62% female) with a mean (±SD) age of 63.8 (±12.8) years had a mean preoperative daily step count of 5556 (±3978). Physical activity showed significant correlation with patient-reported outcome measures, including Oswestry disability index (r = -0.26, 95% CI: -0.47-0.01), 36-Item Short Form Survey Physical Component Summary score (r = 0.30, 95% CI: 0.06-0.51), and Patient-Reported Outcomes Measurement Information System Physical Function (r = 0.49, 95% CI: 0.27-0.65). "No," "Mild," "moderate," and "severe impairment" in activity performance were defined as corresponding z-scores of >0, 0 to -0.99, -1 to -1.99, and ≤-2, accounting for 22%, 34%, 40%, and 5% of the study population. Each one-step category increase in activity impairment resulted in increased subjective disability as measured by the Oswestry Disability Index, 36-Item Short Form Survey Physical Component Summary, and Patient-Reported Outcomes Measurement Information System Physical Function (all P -values <.05). We establish the first wearable objective measure of real-life physical activity for patients with DTD, with the first age- and sex-adjusted standard scores to enable clinicians and researchers to set treatment goals and directly compare activity levels between individual patients with DTD and normal controls.

Association of Rehabilitation Care Duration and Functional Status of People with Chronic Stroke

Introduction: There is limited information on the status of international classification of functioning, disability, and health (ICF) framework in subjects with chronic stroke with varying duration of rehabilitation care. Accordingly, this study investigates whether the duration of rehabilitation care affects the status of ICF in subjects with chronic stroke.&#x0D; Materials and Methods: This was an observational cross-section study on 58 individuals with chronic stroke. The number of subjects who received rehabilitation care for less than 3 months and more than 3 months were 22 (group A) and 36 (group B), respectively. The ICF components of impairment of body functions and structure were assessed using the clock drawing test, the Beck depression inventory, and the Fugl-Meyer assessment of motor recovery after stroke. The activity limitation and participation using timed up and go test, the community integration questionnaire, and environmental factors were assessed by the Craig Hospital inventory of environmental factors.&#x0D; Results: The Fugl-Meyer assessment and the policy components of the Craig hospital inventory of environmental factors showed a significant difference between the groups. Longer duration of rehabilitation care only showed a positive effect on the Fugl-Meyer assessment scores. No other components of ICF showed any difference between the groups.&#x0D; Conclusion: The duration of rehabilitation impacts the impairments of body functions and body structures of ICF components. The study findings are limited and further studies are required before generalizing the results.

The correlation between clinical symptom and morphological parameters on magnetic resonance imaging in patients with spondylolisthesis levels L4/L5 and L5/S1.

Spondylolisthesis is one of the common causes of spinal pain. There is currently a lack of studies on the correlation between magnetic resonance imaging (MRI) and clinical symptoms of patients with spondylolisthesis. This study is aimed to find the correlation between clinical symptoms of L4/L5, L5/S1 lumbar spondylolisthesis, and imaging parameters on MRI. A retrospective study on 100 patients who were diagnosed with lumbar spondylolisthesis at the L4/L5, L5/S1 levels from August 2022 to February 2023. Parameters on MRI are measured the cross-sectional area of the dural sac (DSA), the cross-sectional area of the spinal canal (SCA), the ligamentum flavum cross-sectional area (LFA), and ligamentum flavum thickness (LFT), anterior-posterior diameter (APD), sliding distance (SD) at the spondylolisthesis level. Clinical symptoms were investigated according to the Visual Analogue Scale (VAS) for grading of pain and the subjective disability was assessed by the Oswestry Disability Index (ODI). There was no statistically significant difference between SD, APD, SCA, DSA, LFA, and LFT between the mild and moderate pain VAS and severe pain VAS groups. No correlation was found between VAS and SD, APD, SCA, DSA, LFA, and LFT. There is a negative correlation between ODI and APD, SCA, and DSA. The statistically significant difference in APD, SCA, and DSA indexes in the two groups with mild/moderate disability (ODI ≤40%) and the group with severe disability (ODI >40%). A higher DSA and SCA, APD are associated with lower ODI. Decreased APD, SCA, and DSA are all suggestive of decreased spinal function. However, the MRI findings did not correlate with the patient's clinical pain level.

The effects of laminectomy surgery on pain, functional disability, sensitization and active trigger points in subjects with lumbar disc herniation

Objectives. To evaluate the effects of laminectomy surgery on pain, functional disability, sensitization and active trigger points in subjects with lumbar disc herniation.Methods. This study was a prospective pre‑post single group study. Seventy‑one patients (42 male and 29 female) have been enrolled in the research with an age range of 20–60 (48 ± 13.41). During 48 hours before surgery, patients were examined by a physiotherapist. Pain intensity were measured by visual analogue scale, disability by oswestry index (Persian version) and sensitivity level using pressure algometer. Three month after laminectomy, the patients were re‑examined for mentioned outcomes again.Results. The majority of the patients (23 cases, 32.4 %) revealed 3 active trigger points of the muscles before surgery. 60 subjects (84.5 %) experienced a gradual onset of leg pain without a trauma history. Lumbar multifidus (74.9 %), medial gastrocnemius (73.2 %), soleus (70.4) gluteus medius (62 %) were the most involved muscles with trigger points before laminectomy. On the other hand, after laminectomy medial gastrocnemius (54.9 %), lateral gastrocnemius (53.5 %), soleus (50.7 %), multifidus (39.4 %) and quadratus lumborum (39.4 %) were the most involved muscles with trigger points. The existence of trigger points in longissimus thoracis (p = 0.04), quadratus lumborum (p = 0.001), gluteus maximus (p = 0.04) and tibialis anterior (p = 0.02) were decreased significantly after laminectomy. Pain, disability and pain pressure threshold revealed significant differences before and after surgery.Discussion. The pattern of active trigger points of muscles was different before and after surgery. Multifidus and gastrocnemius were the most prevalent muscles with myofascial pain syndrome before and after surgery respectively.Conclusion. The present study revealed that pain, disability, number and prevalence of trigger points decreased after lumbar laminectomy. Nevertheless, pressure pain threshold of trigger points increased after surgery. The pattern of active trigger points of muscles was different before and after surgery. Multifidus and gastrocnemius were the most prevalent muscles with myofascial pain syndrome before and after surgery respectively. In fact, current results showed that active trigger points should be considered before and after laminectomy surgery

Impact of Psychiatric Morbidity on Quality of Life and Self-Esteem in Individuals With Permanent Orthopaedic Disability

ABSTRACT Introduction: Individuals with permanent orthopedic disability face many adversities and may suffer more from psychiatric illnesses as compared to the normal population. This may affect their self-esteem and quality of life. Aim: To study the impact of psychiatric morbidity on quality of life and self-esteem in subjects with permanent orthopedic disability. Methodology: The study was conducted by the Department of Psychiatry, of a tertiary care hospital from August 1, 2018, to August 1, 2019. A total of 50 subjects over the age of 18 years with permanent orthopedic disability were consecutively enrolled in the department of orthopedics. Orthopedical disability of subjects was assessed and diagnosed by one senior consultant of the Orthopaedics department. Clearance from the Institute’s Ethics Committee was obtained before the start of the study. Psychiatric morbidity was screened in the Mini International Neuropsychiatric Interview. Psychiatric diagnosis was confirmed by two senior consultants of the Psychiatry department and as per the International Classification of Diseases-10thedition-Clinical Description and Diagnostic Guidelines. Self-esteem and quality of life were assessed on Rosenberg Self-esteem Scale (RSES) and WHO- Quality of Life-BREF (WHO QoL Bref), respectively. Results: Statistically significant impact of presence of psychiatric morbidity on Question 1 (P = 0.010), Question 2 (P = 0.002), physical domain (P = 0.001), psychological domain (P = 0.001), social relationship domain (P = 0.001), and environmental domain (P = 0.001) of WHO-QoL-Bref was observed. Subjects with psychiatric illness had lower mean scores as compared to subjects without psychiatric illness. The impact of psychiatric morbidity was also statistically significant on RSES scores (P = 0.000). Conclusion: Psychiatric morbidity impacts the quality of life index and self-esteem negatively in individuals with a permanent orthopedic disability.

Who is disabled? On whether the functional definition of disability targets the same individuals as the subjective definition

With the increased attention to disability as a vulnerability criterion in the Sustainable Development Goals, international organizations and NGOs within the international development sector have started to pay explicit attention to persons with disabilities, including the collection of data on persons with disabilities. The Washington Group Short Set of Questions, which focuses on functional limitations, has been gaining popularity as an assessment tool for disability. This set of questions reflects a categorization of disability that does not necessarily correspond with subjective disability assessments, such as the yes/no question (“do you have a disability?”) which many development actors have used in their assessment tools when they collect disability data This study compares the subjective and the functional limitations assessment tools for disability to answer the question: do they identify the same individuals as persons with disabilities? Based on a survey carried out amongst persons with disabilities in Cambodia, we included both the Washington Group Short Set and a subjective question asking respondents to self-identify their disability type. We find that, although all respondents self-identified as disabled, not all respondents would be considered disabled according to the Washington Group Short Set of questions. In addition, there is little overlap between specific disability types according to a subjective classification method and the domains of functioning measured through the Washington Group methodology. Our findings affirm that categorization as abled or disabled depends on the tool used. This is important, as the assessment approach chosen by those collecting disability data can shape the design choices of policies and programs, and determine who benefits.

Fear-Avoidance Beliefs Are Associated with Pain Intensity and Shoulder Disability in Adults with Chronic Shoulder Pain: A Cross-Sectional Study.

Shoulder pain is one of the most common musculoskeletal conditions, and for people over 40 years old, it represents the musculoskeletal pain with the greatest impact on quality of life. Psychological factors, such as fear-avoidance beliefs, are associated with musculoskeletal pain, and several studies suggest that they can influence various treatment outcomes. Our objective was to explore the cross-sectional association between fear-avoidance beliefs and shoulder pain intensity and disability in subjects with chronic shoulder pain. A cross-sectional study was conducted, and 208 participants with chronic unilateral subacromial shoulder pain were recruited. The shoulder pain and disability index assessed pain intensity and disability. The Spanish fear-avoidance components scale assessed the presence of fear-avoidance beliefs. The association between fear-avoidance beliefs and pain intensity and disability was analyzed by means of multiple linear regression models and proportional odds models, reporting odds ratios and 95% confidence intervals. Shoulder and pain disability scores were significantly associated with fear-avoidance beliefs (p < 0.0001, adjusted R-square 0.93, multiple linear regression). There was no evidence of an association between sex and age in this study. The regression coefficient for shoulder pain intensity and disability score was 0.67446. The proportional odds model showed an odds ratio of 1.39 (1.29-1.50) for shoulder pain intensity and disability total score. This study suggests that greater levels of fear-avoidance beliefs are associated with greater levels of shoulder pain and disability in adults with chronic shoulder pain.

Effect of scapular strengthening exercises on rounded shoulder and neck disability among college students of Delhi NCR

Abstract As a result of COVID-19 illness epidemic, a worldwide health emergency has been proclaimed. The educational sector, whose old systems have been replaced by online educational systems, was particularly impacted by the state of lockdown. Prolonged and frequent sitting in front of monitors, which, by maintaining the same posture for an extended period of time, causes cumulative trauma disorder. The purpose was to evaluate effect of four-week scapular strengthening exercises on neck disability and scapular position in subjects with rounded shoulders. In this experimental study, 30 college students between ages of 18 and 22 were enrolled. They were randomly divided into two groups, the Experimental group and the Control group, each having 15 participants. The experimental group received scapular strengthening exercises along with conventional treatment whereas the control group received conventional treatment only. Over the course of four weeks, both groups received training sessions three times a week. The neck impairment and scapular position were assessed before and after intervention. Both groups had made considerable improvements, although the experimental group experienced less pain and had a better scapular posture than the control group. Results demonstrated that the experimental group outperformed the control group statistically in terms of improvement in neck disability and rounded shoulder posture.