Daily Life Functioning Research Articles

Effects of 3D-printed assistive device on daily life function in patients with neurological impairment: a pilot study

Purpose To explore the effects of customized 3D-printed assistive technology (AT) on functional performance and feasibility in patients with neurological impairment. Methods Patients with neurological impairment were recruited and randomized into customized 3D-printed assistive device group (group 1; n = 17) or standard device group (group 2; n = 14). The device was designed to assist their writing, spoon using, and typing. Each patient underwent 4-week intervention with the device (30 min per session, twice a week). Results We observed significant differences in shoulder abduction (p = .00), external rotation (p = .01), and internal rotation (p = .02) in group 1. And significant differences in abduction (p = .05) and external rotation (p = .05) between the 2 groups. Group 1 achieved significant improvements in writing without AT (p = .04) and with AT (p = .02), spoon use without AT (p = .02) and with AT (p = .03), and hemiplegia-side typing with AT (p = .00). Group 2 achieved significant improvements in writing without AT (p = .01), hemiplegia-side typing without AT (p = .01), and bil-side typing with AT (P = .05). Moreover, no significant differences were noted in other outcome measures. Conclusions This study demonstrated that customized 3D-printed AT can improve shoulder active motion for patients with neurological impairment. A positive effect in functional hand tasks after AT intervention. Offering customized AT with specific training could enhance the efficacy of interventions. The feasibility of using 3D printing technology to produce customized AT, which has the potential to be cost-effective and efficient.

The effects of the mirror therapy on shoulder function in patients with breast cancer following surgery: a randomized controlled trial.

Shoulder dysfunction is one of the most bothersome questions for breast cancer survivors. Studies show that mirror therapy can improve shoulder function in patients with a limited shoulder range of motion and shoulder pain. Here, this article reports the results of a randomized controlled trial investigating the effects of the mirror therapy on shoulder function in patients with breast cancer following surgical treatments. Totally, 79 participants were divided to two groups receiving active range-of-motion upper limb exercise based on the mirror therapy or active range-of-motion upper limb exercise respectively for 8 weeks. Shoulder range of motion, Constant-Murley Score, Disabilities of Arm, Shoulder, and Hand Questionnaire, Tampa Scale of Kinesiophobia, Visual analog scale, and grip strength were measured at baseline (T0), 2 weeks (T1), 4 weeks (T2), and 8 weeks (T3). The effects of the intervention on shoulder function were analyzed in generalized estimation equation, from group, time, and the interactions between group and time based on the data from participants who completed at least one post-baseline observation RESULTS: At least one post-baseline observation was performed by 69 participants (n=34 mirror group, n=35 control group). 28(82.35%) participants in the mirror group adhered to the exercise compared to 30(85.71%) in the control group. Generalized estimation equation model showed group had main effects on forward flexion (Waldχ²=6.476, P=0.011), with the Cohen's d=0.54. The effects of the group on abduction, Constant-Murley Score, and Disabilities of Arm, Shoulder, and Hand Questionnaire were significant when fix the effects of the time. At 8 weeks, participants in the mirror group showed an improvement in abduction compared to the control group (P=0.005), the Cohen's d was 0.70. At 8 weeks, participants in the mirror group had a higher Constant-Murley Score than control group (P=0.009), with Cohen's effect size value of d=0.64. The mirror group showed a greater improvement on the Disability of Arm, Shoulder, and Hand Questionnaire than control group at 2 weeks, 4 weeks, and 8 weeks (P≤0.032), but with a weak effect size value of all (r≤0.32). Group had main effects on Tampa Scale of Kinesiophobia (Waldχ²=6.631, P=0.010), with the Cohen's effect size value of d=0.56. Mirror therapy improved shoulder flexion, abduction, shoulder function in daily life, and arm function and symptom of the affected shoulder in patients with breast cancer following surgical treatment, while decreasing fear of movement/(re)injury. Mirror configuration needs to be improved in further research to increase its feasibility. Breast cancer survivors can try mirror therapy as a practical and effective method in shoulder rehabilitation for a promotion on effects. ClinicalTrial.gov Identifier: ChiCTR2000033080.

Context and Neuroendocrine Interplay in the Lab and Everyday Experiences: From Early Life to Adulthood

Context and Neuroendocrine Interplay in the Lab and Everyday Experiences: From Early Life to Adulthood

Research on the Impact of Rural Economic Development on Welfare Policies for Poor Children

Children are the future of our country and the hope of our nation. It is the common aspiration of the entire society to ensure that every child can thrive. With the advancement of urbanization and the continuous increase in the scale of rural young and middle-aged labor entering cities for work, the issue of left-behind children in rural areas has attracted widespread attention from all sectors of society. Due to working outside for a long time, there is less time for communication and communication with children, insufficient care and assistance for children, and omissions in their daily life and psychology, resulting in an increase in welfare issues for left-behind children in rural areas. These left-behind children lack the care and care of their families, which makes their daily life, health, education, safety and other functions unable to be guaranteed, and children's welfare resources cannot be shared. The welfare problems of children are gradually worsening. How to properly take care of this group is a necessary question for achieving rural revitalization and development. In response to the actual situation in poverty-stricken rural areas, child protection should adhere to the principles of seeking truth from facts, long-term effectiveness, systematic organization, multi-party assistance, and carrying out measures according to one's abilities and promoting progress layer by layer. This article takes left-behind children in rural areas as the research object and analyzes the impact of rural economic development on welfare policies for left-behind children.

A scoping review of older patients' health-related quality of life, recovery and well-being after intensive care.

In the present study, we aimed to determine how Health-Related Quality of Life (HRQoL), recovery (function and capacity in daily life) and well-being are followed up and characterised in persons ≥65 years of age who were being cared for in an intensive care unit (ICU). A scoping review. CINAHL, MEDLINE (Ovid) and PsycINFO databases were searched in October 2021. 20 studies met the inclusion criteria. The scoping review followed the principles outlined by Arksey and O'Malley, and the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) checklist and Joanna Briggs Institute (JBI) framework were used. Results are presented under five subheadings: Study characteristics, Type of studies, Methods for follow-up, health-related quality of life, and Recovery. Time seems to be an important factor regarding HRQoL among older patients being cared for in an ICU, with most elderly survivors perceiving their HRQoL as acceptable after 1 year. Nevertheless, several studies showed patients' willingness to be readmitted to the ICU if necessary, indicating that life is worth fighting for. Due to the design of the study, this study involves no patient or public contribution.

Results of a low cost dance intervention for cognitive reablement in dementia

AbstractBackground, dance therapy may offer a solution to reduce morbidity, restore aspects of cognitive ability (even if only temporarily), and potentially reduce the total cost of care to individuals and the health care system. But more reliable data on the effectiveness of dance therapy within the dementia community is neededMethodFour female participants with severe major neurocognitive disorders and loss of Activities of Daily Living (ADL) function were included. Participants were selected by the facility’s life enrichment director based on their likelihood to consistently participate in the dance intervention. Loss of ADL function was confirmed by chart review in the facility’s electronic medical record monthly functional tracking summaries. The dance intervention was done for 30 minutes three days a week for four weeks. Though not by design, Participant 4 chose not to dance and served as a tacit “control” in our review. Popular music from the 1950s, country music, and/or Christmas music was played for the duration of each dance session. The participants were evaluated by an MMSE at the beginning of the month before starting the intervention and immediately following after the final dance session.ResultAverage Change in MMSE: 3.375 points. Participant 4 decreased in MMSE score, and participant 1,2, and 3 all improvedConclusionour intervention demonstrates the feasibility of dance therapy as a potentially effective, low‐cost cognitive reablement strategy that may improve function in those already suffering with dementia and loss of independence. Future studies should be prospectively designed, ideally contain a control group, and be statistically powered to explore the role of frequency, intensity, and duration on outcomes.

Is dynamic spino-pelvic alignment during gait associated with lumbar function in patients with degenerative lumbar spinal stenosis?

IntroductionStatic spine and pelvic posture has been reported to be associated with symptoms in patients with lumbar spinal stenosis (LSS), but it is unknown whether dynamic alignment of the spine and pelvis is associated with lumbar function in daily life. This study aims to investigate the relationship between dynamic alignment of the spine and pelvis during gait and lumbar function in daily life in patients with LSS. MethodsWe evaluated lumbar function in daily life using the Oswestry Disability Index (ODI), trunk and hip muscle strength as physical function, static spinal alignment, and dynamic spinal/pelvic alignment during gait. The relationship between the ODI score and physical function or static and dynamic alignment was examined. ResultsA total of 35 preoperative patients with LSS participated in this study. ODI score significantly correlated with trunk extension strength (r = −0.578, p = 0.000), hip extension strength (r = −0.472, p = 0.004), maximum spinal flexion angle during gait (r = −0.473, p = 0.004) and maximum pelvic anterior tilt angle (r = 0.510, p = 0.002). Multiple regression analysis showed that trunk extension strength (standardized β; - 0.309), hip extension strength (standardized β; −0.287), maximum spinal flexion angle (standardized β; - 0.306) and maximum pelvic anterior tilt angle (standardized β; 0.271) significantly affected the ODI score, with adjusted coefficient of determination of 0.529. ConclusionThe results of this study showed that the patients with LSS with weak hip or trunk extensor muscles, a greater angle of pelvic tilt or a less spinal flexion during gait had a lower lumbar function in daily life.

Symptoms and Risk Factors of Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder can be characterized by impaired attention, hyperactivity or excessive motor activity, and impulsivity, which is disproportionate to age and the most common behavioral disorder in children and adolescents. Hyperactivity or excessive motor activity means an individual may seem to move about constantly, including in conditions when it is not appropriate, or excessively fidget, tap, or talk. Attention deficit hyperactivity disorder frequently occurs with specific and global developmental and learning problems that include autistic spectrum disorders, difficulties with speech and language, motor co-ordination, and reading, as well as with a range of psychiatric disorders, notably oppositional defiant disorder, conduct disorder, and tic disorders. Long-term outcomes of attention deficit hyperactivity disorder can be dangerous because they elevate the rates of serious accidental injury, medicine addiction, depression, school or occupational failure, and involvement in the criminal justice system. Hyperactivity or excessive motor activity can be characterized by being unable to concentrate on tasks, being unable to sit still, excessive physical movement, excessive talking, interrupting conversations, and acting without thinking. Attention deficit hyperactivity disorder is associated with impairments in cognitive, academic, familial, and finally occupational domains of daily life functioning. Impaired social functioning can manifest as rejection by peers and conflicts with other children and adults. Attention deficit hyperactivity disorder is commonly associated with highly familial disorder, environmental and other modifiable risk factors such as prenatal substance exposures, heavy metal and chemical exposures, nutritional factors, and lifestyle and psychosocial factors.

Green sleep: Immediate residential greenspace and access to larger green areas are associated with better sleep quality, in a longitudinal population-based cohort

ObjectiveSleep is pivotal to health, wellbeing and functioning in daily life, but sleep difficulties are common and may be affected by modifiable qualities in the residential surrounding environment, in terms of greenspace. However, population-based studies on individual-level greenspace and sleep are limited. The objective of the current study was thus to investigate prospective associations between fine-grained individual-level residential greenspace and sleep, and moderating effects of life style (physical activity, work status) and sex, in a nationwide population-based Swedish cohort. MethodsParticipants of the Swedish Longitudinal Occupational Survey of Health (SLOSH)—a population-based sample of adults in Sweden—were studied during 2014–2018 (19,375 individuals; 43,062 observations). Residential greenspace land cover, and coherent green area size, were assessed via high resolution geographic information systems, at 50, 100, 300, 500 and 1000 m buffers around residences. Prospective greenspace and sleep associations were assessed via multilevel general linear models, adjusting for demographic, socioeconomic (individual and neighborhood), life style and urban factors. ResultsHigher greenspace availability in the immediate residential surroundings (50 m and 100 m buffer zones) was associated with less sleep difficulties, even after adjustment for confounders. Greenspace effects were generally greater among non-working individuals. Among the physically active, and among non-working, greenspace and green area size further away from home (300, 500 and 1000 m, i.e. dependent on mobility) were also associated with less sleep difficulties. ConclusionsResidential greenspace in the immediate residential surroundings is associated with significantly less sleep difficulties. Greenspace further away from home was associated with better sleep especially among the physically active, and non-working individuals. The results highlight the importance of greenspace in the immediate residential-surrounding environment for sleep, and the need to integrate health and environmental policies, urban planning and greening.

Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis.

Menopausal symptoms are common in midlife women and have broad impacts on their daily functioning and quality of life. Black cohosh extracts have been widely used to relieve menopausal symptoms. However, the comparative benefits of different combined black cohosh regimens remain inconclusive. The aim of the current updated meta-analysis is to address the comparative efficacies of different black cohosh regimens in improving menopausal symptoms. Random-effect model pairwise meta-analysis of randomized controlled trials was conducted to investigate the treatment effect on menopausal symptoms by the black cohosh extract both alone or combined with other related active ingredients. The outcomes studied were changes in menopausal symptoms after treatment with black cohosh extracts in menopausal women. Twenty-two articles including information on 2,310 menopausal women were included in the analyses. Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges' g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges' g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges' g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo. However, black cohosh did not significantly improve anxiety (Hedges' g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges' g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131). The dropout rate for black cohosh products was similar to that for placebo (odds ratio = 0.911, 95% CI = 0.660 to 1.256, P = 0.568). This study provides updated evidence regarding the potentially beneficial effects of black cohosh extracts for relieving menopausal symptoms in menopausal women.

Association of daily-life functioning and obesity in individuals with schizophrenia and controls

Early weight gain following the diagnosis of schizophrenia (SCZ) has been associated with improved daily functioning. However, in the general population and in other psychiatric conditions such as bipolar disorder, increased body mass index (BMI) has been associated with worse functioning. The data on this association in chronic individuals with SCZ is still scarce. To address this gap in knowledge, our objective was to evaluate the association between BMI and psychosocial functioning in chronic outpatients with SCZ and in healthy individuals. Six-hundred individuals (n = 600), 312 with schizophrenia (SCZ) and 288 individuals with no personal or family history of severe mental illness (CTR), underwent weight, height and psychosocial functioning score (FAST) assessment. Linear regression models tested the association between FAST as dependent variable and BMI as independent variable, controlling for age, sex, use of clozapine and years of illness. In the CTR group, the highest BMI could predict a worse result in FAST, explaining about 22% of the variation found (Model: AdjR2 = 0.225 F(3,284) = 28.79 p < .001; BMI main effect: β = 0.509 t = 9.240 p < .001). In the SCZ group, there was no statistically significant association. Our findings corroborate the perception that increased BMI is associated with worse functioning status in the general population. In chronic SCZ, whatsoever, there is no association. Our findings suggest that patients with higher BMI in the SCZ group may compensate for the possible impairment of functionality due to increased body weight, through improved adherence and responsiveness to prescribed psychopharmacological treatment, leading to better control of psychiatric symptoms.

Patients’ experiences of treatment-relevant processes in multimodal pain rehabilitation for severe complex regional pain syndrome – a qualitative study

Purpose Complex regional pain syndrome (CRPS) is a longstanding condition with spontaneous and evoked pain, that usually occurs in an upper or lower extremity. Although it often resolves within the first year, it may for a minority progress to a chronic and occasionally severely disabling condition. The aim of this study was to explore patients’ experiences and perceived effects of a specific treatment, designed for patients with severe and highly disabling CRPS, in order to identify possible treatment-relevant processes. Methods The method used was a qualitative design, using semi-structured interviews with open-ended questions to capture participants’ experiences and perceptions. Ten interviews were analyzed using applied thematic analysis. Results Despite the fact that participants had a severe conditions, including nerve damage and a long duration of illness, they reported having been helped to increase flexible persistence, reduce fear and avoidance, and improve connections. This helped participants to significant improvements in daily life functioning. Conclusions The participants described distinct possible treatment-relevant processes leading to a substantial improvement in everyday life. The results imply that there is hope for this group that has been severely disabled for many years. This may help guide future clinical treatment trials.

Long-Term Follow-Up of Daily Life Functioning After Pediatric Intensive Care Unit Admission

To investigate the long-term impact of pediatric intensive care unit (PICU) admission on daily life functioning while exploring the potential mediating role of neurocognitive outcome. This cross-sectional observational study compared children aged 6-12years with previous PICU admission (age ≤1year) for bronchiolitis requiring mechanical ventilation ("patient group," n=65) to demographically comparable healthy peers ("control group," n=76). The patient group was selected because bronchiolitis is not expected to affect neurocognitive functioning in itself. Assessed daily life outcome domains were behavioral and emotional functioning, academic performance, and health-related quality of life (QoL). The role of neurocognitive outcomes in the relationship between PICU admission and daily life functioning was assessed by mediation analysis. The patient group did not differ from the control group regarding behavioral and emotional functioning but performed poorer on academic performance and school-related QoL (Ps≤.04, d=-0.48 to -0.26). Within the patient group, lower full-scale IQ (FSIQ) was associated with poorer academic performance and school-related QoL (Ps≤.02). Poorer verbal memory was associated with poorer spelling performance (P=.002). FSIQ mediated the observed effects of PICU admission on reading comprehension and arithmetic performance. Children admitted to the PICU are at risk for long-term adverse daily life outcomes in terms of academic performance and school-related QoL. Findings suggest that lower intelligence may contribute to academic difficulties after PICU admission. Findings underline the importance of monitoring daily life and neurocognitive functioning after PICU admission.

Long-term safety and maintenance of response with esketamine nasal spray in participants with treatment-resistant depression: interim results of the SUSTAIN-3 study

Patients with treatment-resistant depression (TRD) have higher rates of relapse and pronounced decreases in daily functioning and health-related quality of life compared to patients with major depressive disorder who are not treatment-resistant, underscoring the need for treatment choices with sustained efficacy and long-term tolerability. Adults with TRD who participated in ≥1 of 6 phase 3 “parent” studies could continue esketamine treatment, combined with an oral antidepressant, by enrolling in phase 3, open-label, long-term extension study, SUSTAIN-3. Based on their status at parent-study end, eligible participants entered a 4-week induction phase followed by an optimization/maintenance phase, or directly entered the optimization/maintenance phase of SUSTAIN-3. Intranasal esketamine dosing was flexible, twice-weekly during induction and individualized to depression severity during optimization/maintenance. At the interim data cutoff (01 December 2020), 1148 participants were enrolled, 458 at induction and 690 at optimization/maintenance. Mean (median) cumulative duration of maintenance esketamine treatment was 31.5 (37.7) months (totaling 2769 cumulative patient-years). Common treatment-emergent adverse events (≥20%) were headache, dizziness, nausea, dissociation, somnolence, and nasopharyngitis. Mean Montgomery–Åsberg Depression Rating Scale (MADRS) total score decreased during induction, and this reduction persisted during optimization/maintenance (mean [SD] change from the baseline to the endpoint of each phase: induction −12.8 [9.73]; optimization/maintenance +1.1 [9.93]), with 35.6% and 46.1% of participants in remission (MADRS total score ≤12) at induction and optimization/maintenance endpoints, respectively. Improvement in depression ratings generally persisted among participants who remained in maintenance treatment, and no new safety signal was identified during long-term treatment (up to 4.5 years) using intermittent-dosed esketamine in conjunction with daily antidepressant.

Novel Technology-driven Approaches to Enhance Mobility and Reduce Falls in OlderAdults.

Each year, 3 out of every 10 older adults will suffer at least one fall. Approximately 10% of these falls will induce physical injury, and a portion of these injuries will impact the hip or head and significantly alter the individual’s trajectory of health from that point forward (1). And, even if the “faller” is fortunate enough to avoid physical harm, they will most likely walk away from the fall with diminished confidence in their balance and reduced willingness to engage in the same levels of physical and social activity (2). Thanks to the considerable research effort, we now know that the vast majority of falls are caused by interactions between well-defined—and often modifiable—characteristics of the individual older adult, the tasks they complete, and the environment in which they carry out these activities of daily living (1,3). Unfortunately, however, it remains a significant challenge for clinicians and their patients to act upon this knowledge. This is due to at least 3 obstacles. First, it continues to be extremely difficult to identify the presence of risk factors in a timely manner, especially those that manifest rapidly in response to relatively acute changes in one’s health status (4). Second, there is a relative lack of accessible interventions that can be personalized to effectively mitigate identified risk factors for a given individual, accounting for their unique set of health and living circumstances (5). Third, even if risk factors are identified, and an intervention is prescribed, it is then difficult to monitor the patient’s adherence to the intervention, their progression over time, and the extent to which the intervention impacts their function and fall risk in daily life (6).

How well do you think you remember your personal past? French validation of the Autobiographical Recollection Test (ART) and exploration of age effect

ABSTRACT This study aimed to validate a French version of the Autobiographical Recollection Test (ART), a 21-item self-report questionnaire developed by Berntsen, D., Hoyle, R. H., & Rubin, D. C. (2019; The Autobiographical Recollection Test (ART): A measure of individual differences in autobiographical memory. Journal of Applied Research in Memory and Cognition, 8(3), 305–318) examining the subjective quality people attribute to their autobiographical memories. It measures seven distinct but correlated dimensions of memories’ quality varying between individuals: vividness, narrative coherence, reliving, rehearsal, visual imagery, scene, and life-story relevance. 373 participants aged from 18 to 87 years old were invited to complete the questionnaire by rating on a 7-point Likert scale the degree to which they agree with each item. Demographic data and information about their perception of their memory functioning and satisfaction were also collected. Confirmatory factor analysis confirmed the initial seven-factor structure of the ART. Moreover, results showed desirable psychometric properties, with good internal consistency (.94) and test-retest reliability (.83). This scale was also correlated with participants’ perception of memory functioning in daily life. However, there was no correlation with age, confirming prior studies showing that the subjective quality of autobiographical memories does not decline with age. This study thus provides proof of the good psychometric properties of the French version of the ART and promotes its use to explore the subjective quality of autobiographical memories in clinical populations.

Occupational therapy in multiple sclerosis

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Main objective To assess the benefits and harms of occupational therapy interventions for improving daily functioning, participation, and quality of life in people with multiple sclerosis. Secondary objectives To assess whether the effects of occupational therapy interventions differ according to the format of intervention delivery (individually versus group) and to the location of service delivery (outpatient, inpatient, or home‐based therapy).

중둔근 강화 운동을 포함한 무릎관절 재활 운동 프로그램이 무릎관절 전치환술 환자의 무릎관절 기능장애 및 근기능에 미치는 영향

This study was conducted to investigate the effect of exercise programs, including gluteus medius muscle strengthening on knee joint function score, strength, and pain for 12 weeks at the beginning after total knee replacement. The subjects were selected for 14 patients, 7 were randomly distributed to the general rehabilitation exercise group and 7 to the gluteus medius exercise group. The subjects performed exercise three times a week, 30 to 50 minutes per session. In K-WOMAC, the gluteus medius exercise group was applied significantly decreased(p=.016), and there was a significant difference in both groups in the post-measurement between groups(p=.034). In VAS, both groups showed a significant decrease (p=.002), (p=.007) compared to prior and post(p=.047). In muscle function of the knee joint, both groups significantly increased in extension(p=.031) and flexion(p=.039) strength(60°/sec) and muscle endurance (180°/sec) compared to prior and post measurements(p=.018), (p=.039). It is considered that if the gluteus medius muscle strengthening exercise is applied to patients with total knee replacement, it is believed that basic data can be provide for rapid recovery after surgery and improvement of function in daily life by improving knee joint dysfuction, muscle function, and pain.

Impacts of Remote Physical Exercises on Functional Status and Mobility among Community-Dwelling Pre-Disabled Seniors during the Covid-19 Lockdown.

To assess whether remote physical exercise interventions helped maintain function in daily life, level of physical activities, basic mobility and frailty status in pre-disabled seniors during the first Covid-19 lockdown. This is an interventional study conducted from May 2020 to May 2021. Community-dwelling older adults in 2 Canadian cities. 84 pre-disabled seniors. 12-week physical exercise programs (1 hour/ 3 times/ week) in kinesiologist-guided groups using Zoom or phone-supervised individual booklet-based home-program (n=44) vs. Control (usual life habits; n=40). Functional status in daily activities (OARS scale); Daily level of aerobic (TAPA-1) and strengthening/flexibility (TAPA-2) physical activities; Basic mobility abilities (SPPB: balance, lower limbs strength, walking speed; Timed Up-and-Go) and Frailty (SOF index) were assessed at baseline and at 3, 6, 9 and 12-month follow-ups. The participants' mean age was 78.5 ± 7.2 and 76.5 % were women. There was a group * time effect for the OARS scale (p=0.02), the TAPA-1 (p=0.06) and the TAPA-2 (p=0.007) scores. For these outcomes, scores significantly improved during the first 3 months of follow-up and then stabilised in the intervention group whereas they remained constant in the control group over time. There was an overall time effect for the SPPB (p=0.004), the 4-m walking speed (p=0.02) and for the SOF index (p=0.004), with no between-group differences. Finally, no effect was observed for the TUG. Remote home-based physical exercise interventions and monitoring during the first Covid-19 lockdown seemed to have helped maintain seniors' level of physical activities without impacting on basic mobility abilities. Further studies are needed to identify parameters of remote exercise programs that can improve daily function and mobility in this population.

Impaired Awareness in People with Severe Alcohol-Related Cognitive Deficits Including Korskoff's Syndrome: A Network Analysis.

Impaired awareness of one's own functioning is highly common in people with Korsakoff's syndrome (KS). However, it is currently unclear how awareness relates to impairments in daily functioning and quality of life (QoL). We assessed how impaired awareness relates to cognitive, behavioral, physical, and social functioning and QoL by applying a network analysis. We used cross-sectional data from 215 patients with KS or other severe alcohol-related cognitive deficits living in Dutch long-term care facilities (LTCFs). Apathy has the most central position in the network. Higher apathy scores relate positively to reduced cognition and to a greater decline in activities of daily living and negatively to social participation and the use of antipsychotic drugs. Impaired awareness is also a central node. It is positively related to a higher perceived QoL, reduced cognition and apathy, and negatively to social participation and length of stay in the LTCF. Mediated through apathy and social participation, impaired awareness is indirectly related to other neuropsychiatric symptoms. Impaired awareness is closely related to other domains of daily functioning and QoL of people with KS or other severe alcohol-related cognitive deficits living in LTCFs. Apathy plays a central role. Network analysis offers interesting insights to evaluate the interconnection of different symptoms and impairments in brain disorders such as KS.