Disability Status In Patients Research Articles

Acute ischemic stroke complicating tavi. predictors, outcomes, and treatment associated outcomes

Abstract Introduction Despite the great strides made since the emergence of TAVI two decades ago, periprocedural ischemic stroke remains a major concern. The aims of this study were to describe the incidence, characteristic and outcomes of patients presenting with acute ischemic stroke complicating TAVI (AISCT), and to compare conservative therapy vs. neurointervention, in eligible patients. Material and method We analyzed consecutive TAVI procedures performed in our medical center between 2008 and 2021. Patients with and without AISCT were compared. Outcomes of neurointervention to treat AISCT were compared to conservative therapy. Primary outcomes were mortality at 1 and 3 year and neurologic disability status at 3 months. Results and discussion Of 1145 eligible patients who underwent TAVI between 2008-2019, 29 (2.5%) had AISCT within 30 days. All-cause mortality was significantly higher in the AISCT group in 30-days (13.8% vs. 2.9%, p<0.01), 1-year (27.9% vs. 8.1%, p<0.01), and 3-years (50.1% vs. 25.1%, p<0.01), as compared to the AISCT negative group. Lower body mass index (OR- 1.11, 95%CI 1.01-1.21, p=0.03) prior ischemic stroke (OR- 2.80, 95%CI 1.23-6.01, p<0.01) and frailty (OR- 2.98, 95%CI 1.27-6.49, p<0.01) emerged as independent risk factors for stroke. Out of the 38 patients who suffered AISCT between 2008-2021, 7 underwent neurointervention. The majority of AISCT were observed within the first 24-hours following TAVI (p<0.01). All-cause mortality following severe stroke was significantly higher (p<0.01) compare to mild or moderate stroke. There were no significant differences in mortality between the two groups, however, patients with moderate severity stroke (NIHSS score 6-14) undergoing neurointervention enjoyed a higher rate of disability free survival at 3-months compared to patients treated conservatively. (100% compared to 50% respectively, p=NS). Conclusion AISCT was associated with increased morbidity and mortality. Neurointervention, as compared to conservative therapy, may improve disability status in patients with moderate or severe stroke.

Impact of Disability Status on Mortality in Patients with Gastric Cancer: A Nationwide Study Focusing on Regional Disparities.

Disparities in mortality according to disability status require investment, as individuals with disabilities form the largest subset of the vulnerable population. This study aimed to investigate the association between mortality and disability status in patients with gastric cancer as well as how regional disparities modify this relationship. Data were obtained from the National Health Insurance claims database in South Korea for the period of 2006-2019. The outcome measures were all-cause 1-year, 5-year, and overall mortality. The main variable of interest was disability status, categorized into "no disability", "mild disability", and "severe disability". A survival analysis based on the Cox proportional hazards model was conducted to analyze the association between mortality and disability status. Subgroup analysis was conducted according to region. Of the 200,566 study participants, 19,297 (9.6%) had mild disabilities, and 3243 (1.6%) had severe disabilities. Patients with mild disabilities had higher 5- and overall mortality risks, and those with severe disabilities had higher 1-year, 5-year, and overall mortality risks than those without disabilities. These tendencies were generally maintained regardless of the region, but the magnitude of the differences in the mortality rates according to disability status was higher in the group residing in non-capital regions than in the group living in the capital city. Disability status was associated with all-cause mortality in patients with gastric cancer. The degree of the differences in mortality rates among those with "no disability", "mild disability", and "severe disability" was augmented in the group residing in non-capital regions.

COVID-19 clinical outcomes by patient disability status: A retrospective cohort study

BackgroundPeople with disabilities might experience worse clinical outcomes of SARS-CoV-2 infection, but evidence is limited. ObjectiveTo investigate if people with disabilities requiring assistance are more likely to experience severe COVID-19 or death. MethodsData from the Johns Hopkins COVID-19 Precision Medicine Analytics Platform Registry (JH-CROWN) included 6494 adult patients diagnosed with COVID-19 and admitted between March 4, 2020–October 29, 2021. Severe COVID-19 and death were defined using the occurrence and timing of clinical events. Assistive needs due to disabilities were reported by patients or their proxies upon admission. Multivariable-adjusted Cox proportional hazards models were used to examine the associations between disability status and severe COVID-19 or death. Primary models adjusted for demographics and secondary models additionally adjusted for clinical covariates. ResultsIn this clinical cohort (47–73 years, 49% female, 39% Black), patients with disabilities requiring assistance had 1.35 times (95% confidence interval [CI]:1.01, 1.81) the hazard of severe COVID-19 among patients <65 years, but not among those ≥65 years, equating to an additional 17.5 severe COVID-19 cases (95% CI:7.7, 28.2) per 100 patients. A lower risk of mortality was found among patients <65 years, but this finding was not robust due to the small number of deaths. ConclusionsPeople with disabilities requiring assistance aged <65 years are more likely to develop severe COVID-19. Although our study is limited by using a medical model of disability, these analyses intend to further our understanding of COVID-19 outcomes among people with disabilities. Also, standardized disability data collection within electronic health records is needed.

Imputation of missing values within WHODAS 2.0 data collected from low back pain patients using the response function approach

Purpose To investigate the impact of missing data and imputation with the response function (RF) approach on bias and precision of disability estimates as well as reliability of scale of WHO Disability Assessment Schedule 2.0. Material and methods Data were collected by face-to-face interviews and self-report surveys from 284 respondents with low back pain. Hypothetical datasets were created by using person and item parameters of real data. A simulation study was devised to assess the ability parameters and reliability measures on incomplete and imputed datasets. Rasch model was used to evaluate latent trait levels. Imputation was carried out using the response function method. Results Almost the same level of bias and MSE was reached. While the missing rate increases, the Person separation index slightly reduced, still exceeded 0.94 and Cronbach alpha values have similar mean values of 0.99 with larger variations. After deletion of four items of "work or school activities" in domain 5, reliability measures reduced the lowest. Conclusion Construct validity is preserved. Problems regarding the compliance of the items with the target group still persist. When researchers encounter missingness in data collected with WHODAS 2.0, the response function can be usefully implemented to impute missing values to improve the reliability of disability level estimates. Implications for rehabilitation The Turkish version of the 36-item WHODAS is reliable and valid for assessing health and disability status in patients with low back pain. A critical issue is a systematic nonresponse was highly observed in items related to “work/school life activities” which are allowed to be skipped and excluded from the scoring according to WHODAS 2.0 training manual. Imputation of missing values within four items of "work or school activities" in domain 5 using the response function approach showed satisfactory reliability for the estimation of disability in adults with low back pain. This study showed missing data imputations with response function can be implemented by a statistician as contribute to a missing data management process better tailored to clinicians' interpretations.

Association of Pain with Plasma C5a in Patients with Neuromyelitis Optica Spectrum Disorders During Remission.

ObjectiveTo investigate the association of pain with plasma C5a levels and other related inflammatory cytokines in neuromyelitis optica spectrum disorders (NMOSD) patients during remission.Participants and MethodsNMOSD patients (n = 87) and healthy controls (HC; n = 44) were consecutively recruited between January 2017 and April 2018. Plasma complement 5 (C5), C5a, interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1β levels were detected. Visual Analogue Scale (VAS), ID pain scale, 24-item Hamilton Depression Scale (HAMD), Multiple Sclerosis Impact Scale (MSIS-29), and Kurtzke Expanded Disability Status Scale (EDSS) were used to evaluate the degree and types of pain, the existence of depression and anxiety, and the life quality and disability status of patients. Binary logistic regression equation was used to assess the association of pain with plasma C5a levels.ResultsAmong the 87 NMOSD patients, 40 complained of pain that in 67.5% (27/40) of cases had a neuropathic component (ID pain ≥2). Plasma C5a, IL-6, TNF-α, and IL-1β levels were significantly elevated in NMOSD patients than in HC. Plasma C5 levels were negatively correlated with the time from sampling to the last relapse or disease onset. NMOSD patients with pain had higher plasma C5a levels, and they suffered from a higher disability, more anxiety, and worse life quality compared to those patients without pain. In NMOSD patients with pain, there were not significant differences between plasma levels of C5, C5a, IL-6, TNF-α, or IL-1β, regardless of neuropathic pain or not. Binary logistic regression showed that the OR of plasma C5a level was 1.002, with gender and EDSS score were identified as independent factors associated with pain in NMOSD.ConclusionNMOSD patients during remission had elevated C5a and related inflammatory cytokines levels in peripheral blood. Elevated C5a may have a unique role in the pathogenesis of pain in NMOSD patients.

Neuropsychological correlates of cerebellar volumes in multiple sclerosis: an MRI volumetric analysis study.

The hallmark of Multiple Sclerosis (MS) pathophysiology is the damage to the myelin sheath around axons. The cerebellum is a predilection site for demyelination with a well-recognized role in motor and a rather understudied contribution to cognitive functions. The aim of this study is to investigate patterns of cerebellar grey and white matter pathology, expressed as reduced volume, as well as cortical thickness and their potential contribution to cognitive performance and disability status of patients with MS. 24 patients with MS underwent extensive neuropsychological assessment using paper and pencil tests and the Brain Health Assessment (BHA) tablet-based battery. Cerebellar lobular volumes and thickness were calculated using a volumetric analysis with automated segmentation of the cerebellum and its lobules. The main findings are a reduction of cerebellar grey matter (CGMV) and white matter volumes (CWMV) in lobule X and a widespread cerebellar cortical thinning in patients. Overall disease severity and neurological disability, assessed with the Expanded Disability Status Severity Scale, was correlated with fatigue and information processing speed tasks, but not with CGMV and CWMV. CWMV and CGMV of lobule I-II was negatively correlated with information processing speed, as well as visuospatial memory tests and, finally, inverse cortical thinning associations were noted between the whole cerebellum, lobule I-II, lobule III, lobule VI, Crus I, lobule VIIIA and information processing speed and verbal fluency tasks. The inverse associations observed may represent a compensatory mechanism activated in MS engaging additional high-level cortical areas functionally interconnected with the damaged cerebellum, in order to cope with the cognitive demands of a task.

Assessment of neck pain, low back pain and disability in patients isolated at home due to mild-COVID-19: a cross-sectional study

Purpose: Neck pain (NP), low back pain (LBP) and related disability status in patients with COVID-19 have been not known yet. Therefore, pain and related disability status in patients with mild COVID-19 was investigated in current study.&#x0D; Methods: Patients with mild-COVID-19 (n=45, 40.64±17.18 yr) were included in current study. Pain perception (Numeric Rating Scale) and disability status (Neck Disability Index (NDI), Oswestry Disability Index (ODI)) were evaluated remotely on the online forms at pre-COVID-19, isolation, and post-COVID-19 periods between 18 February 2021 and 9 May 2021.&#x0D; Results: NP existed in 9 (20%) patients (resting: 0.96±2.29, activity: 1.02±2.42) at pre-COVID-19, 16 (35.6%) patients (resting: 1.93±3.02, activity: 2.27±3.52) at isolation and 6 (13.3%) patients (resting: 0.62±1.81, activity: 0.87±2.31) at post-COVID-19 periods (p

Employment and disability status in patients with functional (psychogenic nonepileptic) seizures.

PurposeWe investigated the rate of employment in patients with functional seizures (FS) in a follow‐up study. We also investigated the rate of receiving disability benefits in these patients. Finally, we investigated factors that are potentially associated with their employment status.MethodsIn this long‐term study, all patients with FS, who were diagnosed at Shiraz Comprehensive Epilepsy Center, Iran, from 2008 to 2018, were investigated. In a phone call interview to the patients in February 2020, we tried to obtain the following information: seizure outcome, employment status, receiving disability benefits, and their current drug regimen, if any. The first call was made in the evening and after working hours. In case of no response, we made two more attempts in the following weeks to contact the patients during different time periods of the day.ResultsEighty‐ four patients participated. Thirty‐one patients (37%) were employed, and 53 people (63%) were not; at the first visit, the rate of employment was 23%. Female sex (Odds Ratio [OR]: 12.18; 95% Confidence Interval [CI]: 3.51–42.18; p = .0001), taking psychiatric drugs (OR: 4.93; 95% CI: 1.17–20.73; p = .02), and being employed previously (OR: 0.19; 95% CI: 0.04–0.77; p = .02) were independently significantly associated with the current employment status. Three patients (4%) reported receiving disability social benefits, two women and one man.ConclusionThis study highlights that unemployment is a serious issue in patients with FS and psychiatric comorbidities play a significant role in the employment status in these patients.

Psychometric Properties of the Polish Version of the 36-Item WHODAS 2.0 in Patients with Low Back Pain.

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is considered by the World Health Organization (WHO) to be a useful tool for assessing the functioning and disability of the general population as well as the effectiveness of the applied interventions. Until this study, no data regarding the validity of the 36-item WHODAS 2.0 in chronic low back pain (LBP) in Poland have been explored. This study was conducted on 92 patients suffering from chronic LBP admitted to the rehabilitation ward. The Polish version of the 36-item WHODAS 2.0, the Sf-36 Health Survey (SF-36), the Oswestry Disability Index (ODI), the Hospital Anxiety and Depression Scale (HADS) and the Visual Analogue Scale (VAS) questionnaires were applied to assess patients. The scale score reliability of the entire tool for the study population was very high. The Cronbach’s alpha test result for the entire scale was 0.92. For the overall result of the WHODAS 2.0, the Intraclass Correlation Coefficient (ICC1,2) was 0.928, which confirmed that the scale was consistent over time. The total result and the vast majority of domains of the 36-item WHODAS 2.0 correlated negatively with domains of the SF-36 questionnaire; thus, a higher WHODAS 2.0 score was associated with a lower score on the SF-36 questionnaire. We found that the minimal clinically important difference (MCID) for the total WHODAS 2.0 score in patients after rehabilitation for LBP was 4.87. Overall, the results indicated that the Polish version of the 36-item WHODAS is suitable for assessing health and disability status in patients with LBP.

Naturalistic follow-up study of rehospitalization rates and assigned disability status of patients with first-episode schizophrenia spectrum psychosis in South East Latvia: preliminary results

Background Patients with first-episode schizophrenia spectrum psychosis (FEP) are at risk of not visiting an out-patient psychiatrist and are assigned disability status within a short period after diagnosis. Objective The aim of this study was to conduct a naturalistic follow-up of FEP patients to explore their use of mental healthcare services and the rate of assigned disability status after FEP. Methods This was the first study in Latvia to include all consecutive patients with FEP admitted to the largest regional hospital in South East Latvia, Daugavpils Psychoneurological Hospital (DPNH). Patients received standard treatment in a real-world environment. The mean follow-up time was 33 months (Min = 20 months, Max = 40 months). Results From the 94 consecutive FEP patients admitted to DPNH (1 January 2016 to 31 December 2017), 68 participated and provided informed consent to be followed up. During the first 12 months after discharge from the acute psychiatric ward, 23% (n = 14) never visited a psychiatrist, and 6.5% (n = 4) had a single visit to get prescription for medication. Furthermore, 36.1% (n = 22) had a rehospitalization during the first 12 months. At the end of follow-up period, 34.4% (n = 21) of patients were assigned disability status within a median time of 8 months (IQR 4.5‒20.0). Conclusion Approximately, one-third of patients did not continue treatment as out-patients after FEP. One-third of FEP patients were assigned disability status. We suggest that Latvia needs improved treatment options for FEP patients, such as early intervention.

Emotional and disability status in patients with chronic low back pain

Objective: to analyze the prevalence of psychological disorders (anxiety, depression, stress) and the relationship of these factors with functional disability in patients with chronic low back pain. Study design: cross-sectional descriptive and observational study. Setting: the physiotherapy outpatient clinic of the Northen University of Paraná, Londrina, Paraná, Brazil. Methods: 84 individuals were recruited, being 43 elderly (20 with low back pain and 23 control subjects) and 41 adults (21 with low back pain and 20 control subjects). In order to assess the psychological aspects, Beck Inventories of Depression and anxiety as well as Lipp Stress Inventory were used. To evaluate the funcionality, Roland Morris Questionnaire was chosen. The evaluation of the pressure pain threshold was performed using algometer emg systems®. To analyse was considered a significance level of 5% (p&lt;0.05). Results: It was observed that people with low back pain have higher scores of depression, anxiety, stress and functional disability compared to the control group (p&lt;0.05). Among adults, an inverse relationship between anxiety and disability (p&lt;0.05) was observed. In subjects with low back pain positive correlation was observed between anxiety and functional disability and, between the depression and functional disability (p&lt;0.05). In addition, no association was found between stress and functional disability in patients with low back pain (p&lt;0.05). Conclusion: suggest that in patients with low back pain worsening of functionality is anxiety and stress and elderly people with low back pain has higher levels of stress, depression, anxiety and function disability.

Matrix Metalloproteinase-9 Gene Polymorphisms in South-West Iranian Multiple Sclerosis (MS) Patients

Background: Matrix metalloproteinases (MMPs) play important role in Multiple Sclerosis (MS), an autoimmune and neuro-inflammatory disease. It has been demonstrated that two important polymorphisms, the –1562 C/T and microsatellite (CA)n near the –90 position in the promoter region of MMP-9 gene are associated with increased MMP-9 expression, through influencing transcriptional process in MS, also some autoimmune diseases as well as cancers. In this study, the possible association of these gene polymorphisms with MS susceptibility, severity as well as age of onset in samples from south-west of Iran were examined. Methods: Polymorphisms for two regions, –1562 C/T (rs3918242) and –90 (CA)n repeat was analyzed in 170 south-west Iranian patients with MS and 200 healthy controls. Results: Results suggested that a genetic polymorphism of the MMP-9 promoter region may influence the susceptibility to MS. Significant increase frequencies of the –1562 T and long (CA)n alleles were found in patients with MS compared to controls. Carriers of two polymorphisms were younger age at disease onset. The disability status of patients, moreover, has been consistently increased by the association of T variants. Conclusion: This study suggests that genotypes and alleles of MMP-9 –1562 C/T gene as well as (CA)n polymorphisms are associated with higher MS susceptibility due to increased MMP-9 protein levels. This finding, therefore, supports the hypothesis of a significant role of this gene in the disease.

Spanish Version of the Whiplash Disability Questionnaire in Adults With Acute Whiplash-Associated Disorders

ObjectiveThe purpose of this study was to develop and validate a Spanish version of the Whiplash Disability Questionnaire (WDQ) for the Spanish population with acute whiplash-associated disorder (WAD). MethodsThis was a cross-sectional questionnaire validation study. Adults with acute WAD (grade I to III) were enrolled within 3 weeks of their injury. A blinded forward and back translation of the WDQ was made from English to Spanish, and the resulting back-translation version was compared with the original. Patients with WAD completed the Spanish version of the 13-item WDQ. The developed questionnaire was assessed using psychometric statistical analysis including correlation with the numerical rating score for pain, Northwick Park Neck Pain Questionnaire, Neck Disability Index, and 36-item Short Form Health Survey. ResultsFifty-six patients completed the questionnaire, the mean age was 33.9 years (standard deviation [SD] = 10.5), and 76.8% were women. Participants were enrolled 13.9 days (SD 4.9) after the injury, with 14.3% presenting with WAD grade I and 85.7% with WAD grade II. The mean WDQ score was 62 (SD = 31). Two factors were detected, and the factor structure remained stable after translation. Positive correlations were identified between the total WDQ score and the numerical rating score, Neck Pain Questionnaire, and Neck Disability Index results, with a strong negative correlation with the 36-item Short Form Health Survey. ConclusionThe Spanish version of WDQ is psychometrically reliable and a valid instrument to measure the disability status in patients with acute WAD within the clinic.

Predictive Validity of the Neuropsychological Assessment Battery-Screening Module for Assessing Real-World Disability in Patients with Mild Traumatic Brain Injury

The present study set out to examine the ecological validity of the Neuropsychological Assessment Battery-Screening Module (NAB-S) and to examine more specifically, whether performance on this test battery is related to real-world disability status in patients who have sustained a mild traumatic brain injury (mTBI) as a consequence of a motor vehicle collision (MVC). Seventy-nine patients were recruited from a random sample of litigating patients who incurred an mTBI and were referred for a neuropsychological examination due to subjective complaints of cognitive function. Of the total sample, 54 patients were categorized into the non-disabled group and 25 patients were categorized into the disabled group using the 4th edition of the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (AMA; 1993). A multivariate analysis of variance revealed that performance on the NAB-S significantly differed between the two groups, and that memory and attention domains provided a more discriminative index of disability than general neuropsychological functions. In addition, discriminant function analyses revealed that the NAB-S correctly classified 73% of patients according to their group membership. The current findings provide evidence for the ecological validity of the NAB-S as a reliable index of real-world disability status as defined by the AMA Guides.

Does more education mean less disability in people with dementia? A large cross-sectional study in Taiwan

BackgroundWHO Disability Assessment Schedule 2.0 (WHODAS 2.0) is a feasible tool for assessing functional disability and analysing the risk of institutionalisation among elderly patients with dementia. However, the data for...

Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines.

Multiple sclerosis (MS) is a unique neurological disease with a broad spectrum of clinical presentations that are time- and disease course-related. MS plaque location (intracranial and/or spinal) is a key feature in the pathophysiology of disease-related lower urinary tract symptoms (LUTS). The prevalence of these symptoms in MS patients is very high, with nearly 90% of them experiencing some degree of voiding dysfunction and/or incontinence. LUTS rarely present as primary MS manifestations and usually appear 6-8 years after the initial diagnosis. Symptom severity usually correlates with the disability status of patients. Patient assessment comprises clinical and advanced investigations. Each patient should be evaluated uniquely, after taking into account his/her symptoms, disease course and length, comorbidities, physical status, and medications. Basic investigation includes detailed history-taking, physical examination, and post-void residual volume measurement. Advanced evaluation consists of imaging and specific testing, with pivotal importance on urodynamic study.

Prevalence of Disability and Associated Factors among Registered Leprosy Patients in All Africa Tb and Leprosy Rehabilitation and Training Centre (ALERT), Addis Ababa, Ethiopia.

Delay in leprosy diagnosis and treatment causes disabilities due to nerve damage, immunological reactions and bacillary infiltration. Leprosy disability leads not only to physical dysfunction and activity limitation but also disrupts social interaction of affected individuals by creating stigma and discrimination. This study was aimed at assessing leprosy disability status in patients registered at All African TB and Leprosy Rehabilitation and Training Centre. Medical records of leprosy patients registered from September 11, 2010 to September 10, 2013 G.C were reviewed. Prevalence of disability calculated, bivariate and multiple logistic regressions were used to determine crude and adjusted odds ratios with 95% confidence interval. The overall prevalence of disability was found to be 65.9% from all categories of patients (40.2% Grade I and 25.7% Grade II). The Prevalence among the new category was 62.8% (39.1% Grade 1 and 23.7% Grade 2). Those ageed above 30 years, with duration of symptoms 6-12 months and above 24 months, with sensory loss, nerve damage and reversal reaction were more likely to develop disability. In this study the prevalence of disability, both Grade I and II, is very high. Disability was associated with age, duration of symptom, sensory loss, signs of nerve damage and reversal reaction. These risk factors indicate the existence of delay in diagnosis and treatment of leprosy cases. Therefore, the national leprosy control program should investigate leprosy case detection and diagnosis system in the country and work on improving early case detection and prevention of disability.

Cognitive disorders in patients with deep disability after surgery on intracranial aneurysmal hemorrhage

The characteristics of cognitive impairment in patients with deep disability after surgery on intracranial aneurysmal hemorrhage almost aren’t identified. Aim. To determine the state of cognitive functions in patients with severe disability after surgery on intracranial aneurysmal hemorrhage. Methods. The study included 328 patients with intracranial aneurysmal hemorrhages. 257 patients underwent intracranial surgery - arterial aneurysm clipping, 71 patients are operated by endovascular method. Immediate responses to the treatment are assessed at the end of inpatient treatment and 6 months after discharge on a scale of consequences Glasgow (GOS). Late results of the treatment were assessed by the modified Rankin scale 2.5 years after surgery. Deep disability status of patients is considered for GOS-2 (persistent vegetative state) or 3 points (severe disability) and for Rankin - 4 (Moderately severe disability) or 5 points (Severe disability). Cognitive impairment and ability to communicate was assessed using the MMSE scale. Result. Quality of life in patients with deep disability changed over time. Immediately after surgery the average score for the MMSE amounted to 10.3 points, 6 months – 13.6, 2.5 years – 21.8. Violation of a guide at the time and place was much pronounced almost the entire time of observation. The function of the perception of information 2.5 years after surgery fully recovered in 72 % of patients. Only in 6 months after surgery 100% of patients with deep disability were dysfunction of concentration and arithmetic. This function completely restored only 2.5 years after surgery in 28 % of patients. The largest number of patients who completely regenerated memory function was observed 2.5 years after surgery. After 2.5 years of observation in 12 % of patients was observed a complete regeneration of reading function. Realization of three-phase commands in most patients remained broken in all time of observation. Conclusions. Despite the presence of significant neurological deficits and dependence on others, general condition of cognitive functions within 2.5 years after surgery in patients with deep disability after surgery on intracranial aneurysmal hemorrhage is improved. Patients with deep disability after surgery on intracranial aneurysmal hemorrhages it is observe violation of all cognitive functions measured on MMSE scale. The most problematic in terms of restoring is function of realization of three-phase command

Association between symptom duration and intensity, disability, range of motion and modified pain perceptions amongst chronic low back pain patients

Background: Chronic low back pain (CLBP) is a multi-factorial condition which remains a costly health issue. However, our understanding of the association between commonly used outcome measurements (OM) and symptom behaviour is limited for this low back pain subgroup. Previous research has reported moderate to weak correlations between symptom behaviour, range of motion (ROM), and modified pain perceptions in general low back pain populations. However, longer symptom duration and resulting psychological factors in the CLBP population support the hypothesis that different associations exist between self-reported OM and ROM than in the general population. Purpose: To investigate the association between pain intensity on the visual analogue scale (VAS), range of motion, symptom duration (months), the Oswestry disability Index (ODI), the Roland Morris disability questionnaire (RM) and the Modified Somatic Perception Questionnaire (MSPQ) at baseline in a CLBP population. Methods: A cross-sectional study was conducted with CLBP patients (>12weeks with or without leg pain) (n=147) recruited from a hospital CLBP clinic. Participants completed the VAS, ODI, RM and MSPQ, and a physiotherapist measured ROM of the lumbar spine using a standard tape measure protocol. Data was analysed using SPSS statistical analysis software (version 20) (SPSS inc., Chicago, IL). Independent sample analysis was conducted to assess for significant differences (p<0.05) between genders, and Pearson product-moment correlation coefficients were calculated to identify potential correlations between all baseline OM. Results: Across all the OM, only lumbar extension ROM differed significantly between genders (u=1897, p=0.024). Correlation analysis showed that the disability OM of ODI and RM were not correlated. Weak correlations were reported between the RM and MSPQ scores (r(145) = 0.39, p<0.001), the VAS and ODI (r(145) = 0.39, p <0.001), and lumbar rotation to the right and symptom duration (r(145) = 0.18, p=0.031). Conclusion: The assumption that increased self-reported pain intensity may be associated with limited spinal movement and elevated modified somatic pain perceptions in CLBP patients was not supported by this study. Neither did this study indicate strong associations between psychological factors and self-reported disability. Except for right rotation, symptom duration was also not associated with any ROM, pain, disability, or modified somatic pain perception measures. Pain intensity was weakly correlated with disability on the ODI, and the MSPQ was weakly correlated with the RM score, which supports similar findings in previous research. The results suggest that pain levels do not dictate patient disability status, and that strong associations between psychological factors and self-reported disability are not substantiated. Implications: Absence of strong association between the OM highlights that clinicians should view multiple OM in the context of the patient presentation, rather than in isolation. The ODI may be a more reliable indicator of pain related functional status than the RM. Whereas the RM may be more appropriate when used in conjunction with the MSPQ.

Global Issues of Concern for Improving Functional Disability Status in Knee Osteoarthritis

Knee osteoarthritis is a common problem among elderly population caused by degenerative changes around knee. The degenerative changes involves a combination of mechanical, cellular and biochemical processes resulting in pain, muscle dysfunction, abnormal stress loading and sensorimotor dysfunctions affecting neuromusculoskeletal integrity. Although there are number of treatments techniques available but they lack specific guidelines. Hence, the present article aimed at understanding the Neurophysiological basis of pain & physical dysfunction to formulate Multi-Joint Coupling Intervention Strategy that would serve as an important guiding and therapeutic tool for health care practitioners in improving functional disability status of patients with early knee osteoarthritis.