Functional Activity Limitations Research Articles

Physical Health Among Black Immigrants by Region of Birth: A Test of the Racial Context Hypothesis.

We test the Racial Context Hypothesis by examining the association between racial context of origin and five physical health outcomes (self-rated health, activity limitation, functional activity limitation, lifetime hypertension, and lifetime cancer) among U.S.-born Black Americans and Black immigrants in the United States. This cross-sectional study used 2000 through 2018 waves of the National Health Interview Survey (NHIS). Our subsample was limited to adults 18years of age or older who self-identified as Black and selected a distinct global region of birth if not U.S. born (N = 212,269). We employed zero-order logistic regression models to estimate the relationships between each measure of health and racial context by region of birth. Supporting the Racial Context Hypothesis, we found Black immigrants from racially mixed (Mexico, Central America, the Caribbean, South America) and majority-Black contexts (Africa) had lower odds of being in fair or poor self-rated health [aOR 0.786; 0.616; 0.611], reporting any activity limitation [aOR = 0.537; 0.369; 0.678], reporting functional activity limitation [aOR 0.619; 0.425; 0.678], reporting lifetime hypertension diagnosis [aOR 0.596; 0.543; 0.618], and reporting lifetime cancer diagnosis [aOR 0.771; 0.326; 0.641] compared to U.S.-born Black Americans. After controlling for sociodemographic and socioeconomic covariates, Black immigrants from majority-White contexts (Europe) did not significantly differ from U.S.-born Black Americans on these five physical health measures. This study expands our understanding of the "Black immigrant advantage" by showing that Black immigrants from predominantly Black and racially mixed regions rated their health status as poor or fair less often, experienced less activity or functional activity limitations, and had a lower risk of lifetime hypertension and cancer compared to U.S.-born Black Americans. The significant associations persisted even after controlling for sociodemographic and socioeconomic characteristics. Black immigrant health is not homogenous, and the racial context of origin Black immigrants come from has an association with their health outcomes.

Relationship between quadriceps muscle architecture and lower limb strength and physical function in older adults community-dwelling individuals: a cross-sectional study.

Factors related to muscle architecture may lead to functional limitations in activities of daily living in the older adults. This study aimed to investigate the relationship between quadriceps femoris (QF) architecture and physical function in older adults community-dwelling people. The study included 25 community-dwelling older adults participants aged over 60 years (14 women and 11 men) who were not engaged in regular physical activity. The rectus femoris (RF) and vastus intermedius (VI) muscle thicknesses as well as the RF cross-sectional area (CSA) were assessed using 2D ultrasonography. The 30 Seconds Chair Stand test (30sCST) and Timed Up and Go Test (TUG) were used to assess lower body muscle power and functional mobility, respectively. The QF muscle architecture showed moderate and large correlations with the 30sCST (r range = 0.45-0.67, p < 0.05) and TUG (r range = 0.480-0.60, p < 0.05). RF thickness was a significant (p < 0.01) independent predictor of 30sCST (R 2 = 0.45) and TUG (R 2 = 0.36). VI thickness was a significant (p < 0.05) independent predictor of 30sCST (R 2 = 0.20) and TUG (R 2 = 0.231). RF CSA was a significant independent predictor of the 30sCST (R 2 = 0.250, p < 0.05) and TUG (R 2 = 0.27, p < 0.01). Multiple linear regression models explained 38% of the 30sCST variance and 30% of the TUG variance in the older adults group. Quadriceps muscle group directly affects basic activities of daily living in the older adults. Ultrasound measurements, which are non-invasive tools, are extremely valuable for understanding the limitations of activities of daily living in the older adults.

Risk factors of dementia cognitive symptoms among older patients in Vietnam: A cross-sectional study

Background. Dementia has emerged as a significant contributor to declining quality of life and stands as a prominent factor in the increase of disability and dependency among elderly populations globally. This study aimed to explore the relationship between cognitive symptoms of dementia and their risk factors in individuals aged 60 years and older among Vietnamese outpatients who visited Geriatrics Clinic at University Medical Center of Ho Chi Minh city, Vietnam. Methods. 387 participants who were aged ≥ 60 years old were included in the cross-sectional study. Cognitive impairment was assessed by using the Mini Mental State Evaluation (MMSE) questionnaire. The functional limitations in activities of daily living (ADL) and Instrumental Activities of Daily Living (IADL), multimorbidity, and polypharmacy were also evaluated. Frailty was determined by The Canadian Study of Health and Aging Clinical Frailty Scale. Suffering dementia was determined when MMSE score was below 24 and IADL score less than 8. Results. People with dementia cognitive symptoms accounted for 22.74 % of the cohort. The percentage increased with age, and was higher in women than in men. Factors that increased the odds of having dementia symptoms were of older age, female, multimorbidity, Frailty Scale &gt; Grade 4 and ADL dependency. Conclusions. Age, female gender, multimorbidity, frailty and ADL dependency were considered as risk factors of dementia cognitive symptoms among the Vietnamese people aged 60 years and older.

Categories of the Patient-Specific Functional Scale Activities in Chronic Neck Pain and Their Relationship to the Neck Disability Index.

Intoduction: Common outcome measures for chronic neck pain are the Patient-Specific Functional Scale (PSFS) and the neck disability index (NDI). The primary aim was to categorize the top-rated, patient-selected functional activity limitations of the PSFS to determine if there were consistent limited functional activities for individuals with chronic neck pain and how these compared to the constructs of activities on the NDI. The secondary aim was to determine the relationship between scores for individuals who completed both the NDI and PSFS. Design: A retrospective review of data extracted from the electronic medical record, EPIC, within two hospital-based outpatient physical therapy clinics within a health care system. Methods: Retrospective analysis was performed on individual's characteristics, self-selected functional activity limitations, and total scores of the PSFS and NDI. Most common categories of self-selected functional activity limitations were developed by practicing physical therapists. These functional activity limitation categories of the PSFS were compared to the activities of the NDI. Mean PSFS total scores were correlated with the NDI total scores with Spearman's test. Results: Participants were individuals with chronic neck pain from January 2013-September 2018 (n = 2283). Movement-based activities accounted for 60.8% of the functional activity limitations of the PSFS with the top functional activity limitations being cervical motion and exercise (32%). The PSFS total score moderately correlated with NDI (r = -0.50, p = <0.01) which may relate to the differences in constructs of the NDI and the top patient-selected PSFS functional activity limitations found in this analysis. Conclusion: The results suggest that individuals with chronic neck pain present with similar categories of self-selected functional activity limitations that differ from activities of the NDI. Additional research is needed to improve outcome measures to capture patient-selected functional activity limitations and an individual's pain experience.

Comparative Effects of Dynamic Neuromuscular Stabilization Exercises on Lumbar Proprioception, Movement Control and Functional Activity Limitation in Movement Control Impairment Subgroup of Non-Specific Chronic Low Back Pain: RCT Interim Analysis

Comparative Effects of Dynamic Neuromuscular Stabilization Exercises on Lumbar Proprioception, Movement Control and Functional Activity Limitation in Movement Control Impairment Subgroup of Non-Specific Chronic Low Back Pain: RCT Interim Analysis

SELF-PERCEPTIONS OF AGING AMONG VERY OLD PARENTS AND THEIR OLD CHILDREN IN KOREA

Abstract Research has documented the health consequences of how individuals view their own age-related changes and aging (i.e., self-perceptions of aging) in later life. However, less is known about how individuals’ self-perceptions of aging are shaped by their intergenerational experiences. This study aims to examine very old parents’ and their old children’s self-perceptions of aging within the dyads—where parents and children age together. Utilizing data from 105 dyads of parents (aged 81+) and their children (aged 65+) in South Korea, we examined how parents’ and children’s health status and care experiences are associated with their self-perceptions on aging. On average, parents reported less positive self-perceptions of aging than their children; parents’ self-perceptions of aging were positively correlated with their child’s self-perceptions of aging. A path model found that care experiences within the parent-child dyads were significantly associated with self-perceptions of aging for both parents and children—such that more caregiving burden was associated with less positive self-perceptions of aging for children and higher levels of satisfaction with received care from the child were associated with more positive self-perceptions of aging for parents. However, health status was significant only for parents; that is, parents with fewer functional limitations in activities of daily living tended to show more positive self-perceptions of aging. The findings highlight the interdependence of self-perceptions of aging within the parent-child dyads in very late life, suggesting that care experiences within the prolonged relationship constellation should be considered to enhance older adults’ views on age-related gains and loss.

Identifying Facilitators and Barriers in Quebec Schools to Promote Inclusive Physical Education

Inclusive physical education allows the development of social skills, attitudes, and awareness of peers about functional limitations and enhances the leadership skills of all children. However, the positive experience of children with functional limitations in inclusive physical education can be impacted by programs inadequate to their abilities and the limited training and knowledge of physical educators about teaching in consideration of their needs. The objective of this study was to identify the facilitators and barriers experienced by physical educators to include children with functional limitations in physical education in Quebec schools. A cross-sectional descriptive study with an online survey was conducted with physical education teachers and daycare educators. Descriptive statistics were used to analyze the data. A total of 149 participants (n = 130 physical education teachers) responded to the survey. Most respondents (79.5%) included children with functional limitations in activities with their classmates. However, 39.4% of respondents reported feeling not informed and not equipped to facilitate inclusion. This study identified the facilitators and barriers to physical education for children with functional limitations from the perspectives of physical educators, in Quebec schools, and the role of the latter to encourage inclusion.

Impact of Task Oriented Training on Activities of Daily Living in Post Stroke Rehabilitation: A Single Arm Randomised Controlled Trial

Introduction: There are several complications following the stroke including reduced functional independence, inability to maintain adequate posture, alterations in daily activities and several others. Physical therapy intervention aims at improving the stated complications targeting the task-oriented approach. This study investigated the effect of task-oriented training in post stroke patients on activities of daily living. Methodology: In this single-arm randomized controlled trial, 10 post-stroke males with hemiparesis and functional limitations in activities of daily living (ADL) were recruited following informed consent. The study implemented a structured intervention including activities like Forward Reach and Grasping Pen in sitting, Ball squeeze, stacking rings, piling up the Cones, Pegboard activities, Ball kicking, and Stepping drill. Each activity had a different dosage based on the specific drill performed. Pre and post-test evaluations were conducted on Day 0 and Day 21, utilizing the Functional Independence Measure (FIM) and Barthel Index (BI). Results: Within the group comparisons revealed statistically significant differences (p&lt; 0.05). The pre and post-test readings for FIM were evaluated as 52.50±15.130 and 69.0±11.972 respectively and for BI were observed as 61.0±14.870 and 74.50±7.619 respectively. Conclusion: Task-oriented training is an effective and viable method for enhancing functional independence and strength in activities of daily living (ADLs) in patients with hemiparesis following stroke.

Neurophysiological underpinnings of an intensive protocol for upper limb motor recovery in subacute and chronic stroke patients.

Upper limb (UL) motor impairment following stroke is a leading cause of functional limitations in activities of daily living. Robot-assisted therapy supports rehabilitation, but how its efficacy and the underlying neural mechanisms depend on the time after stroke is yet to be assessed. We investigated the response to an intensive protocol of robot-assisted rehabilitation in sub-acute and chronic stroke patients, by analyzing the underlying changes in clinical scores, electroencephalography (EEG) and end-effector kinematics. We aimed at identifying neural correlates of the participants' upper limb motor function recovery, following an intensive 2-week rehabilitation protocol. Prospective cohort study. Inpatients and outpatients from the Neurorehabilitation Unit of Pisa University Hospital, Italy. Sub-acute and chronic stroke survivors. Thirty-one stroke survivors (14 sub-acute, 17 chronic) with mild-to-moderate UL paresis were enrolled. All participants underwent ten rehabilitative sessions of task-oriented exercises with a planar end-effector robotic device. All patients were evaluated with the Fugl-Meyer Assessment Scale and the Wolf Motor Function Test, at recruitment (T0), end-of-treatment (T1), and one-month follow-up (T2). Along with clinical scales, kinematic parameters and quantitative EEG were collected for each patient. Kinematics metrics were related to velocity, acceleration and smoothness of the movement. Relative power in four frequency bands was extracted from the EEG signals. The evolution over time of kinematic and EEG features was analyzed, in correlation with motor recovery. Both groups displayed significant gains in motility after treatment. Sub-acute patients displayed more pronounced clinical improvements, significant changes in kinematic parameters, and a larger increase in Beta-band in the motor area of the affected hemisphere. In both groups these improvements were associated to a decrease in the Delta-band of both hemispheres. Improvements were retained at T2. The intensive two-week rehabilitation protocol was effective in both chronic and sub-acute patients, and improvements in the two groups shared similar dynamics. However, stronger cortical and behavioral changes were observed in sub-acute patients suggesting different reorganizational patterns. This study paves the way to personalized approaches to UL motor rehabilitation after stroke, as highlighted by different neurophysiological modifications following recovery in subacute and chronic stroke patients.

Poor Self-Rated Health and Associated Factors among Older Persons in Malaysia: A Population-Based Study.

This study aims to determine the prevalence of poor self-rated health (SRH) in Malaysia and its association with sociodemographic characteristics, lifestyle behavior, chronic diseases, depression, and functional limitations in activities of daily living (ADLs) among older persons. Cross-sectional. Setting, participants, and outcome measures: We used data from the National Health and Morbidity Survey 2018, a nationwide community-based study. This study was conducted using a two-stage stratified cluster sampling design. Older persons were defined as persons aged 60 years and above. SRH was assessed using the question "How do you rate your general health?" and the answers were "very good", "good", "moderate", "not good", and "very bad". SRH was then grouped into two categories; "Good" (very good and good) and "Poor" (moderate, not good, and very bad). Descriptive and logistic regression analyses were conducted using SPSS version 25.0. The prevalence of poor SRH among older persons was 32.6%. Poor SRH was significantly related to physical inactivity, depression, and limitations in activities of daily living (ADLs). Multiple logistic regression revealed that poor SRH was positively associated with those who had depression (aOR 2.92, 95% CI:2.01,4.24), limitations in ADLs (aOR 1.82, 95% CI: 1.31, 2.54), low individual income (aOR 1.66, 95% CI:1.22, 2.26), physical inactivity (aOR 1.40, 95% CI:1.08, 1.82), and hypertension (aOR 1.23, 95% CI:1.02, 1.49). Older persons with depression, limitations in ADLs, low income, physical inactivity, and hypertension were significantly associated with poor SRH. These findings provide information to aid health personnel and policymakers in the development and implementation of health promotion and disease prevention programs, as well as adequate evidence in planning different levels of care for the older population.

초고령부모와 노인자녀의 노화에 대한 인식

Research has consistently reported the importance of self-perceptions on aging for older adults’ health and well-being. However, less is known about how intergenerational experiences are shaping how older adults view age-related changes and aging itself. This study aims to examine how very old parents(81+) and their old children(65+) view their own aging and whether their health status and care experiences are associated with self-perceptions on aging within the prolonged relationship constellation—where parents and children age together. We analyzed data from 105 dyads of parents and their children in South Korea. Very old parents reported less positive self-perceptions of aging than their children; very old parents’ self-perceptions of aging were positively correlated with their child’s self-perceptions of aging. A path model predicting parents’ and children’s self-perceptions of aging showed that own subjective experiences of care within the dyads were significant for both parents’ and children’s self-perceptions of aging, while own health status was significant only for parents’ self-perceptions of aging. For old children, more caregiving burden was associated with less positive self-perceptions of aging; for very old parents, higher levels of satisfaction with care received from the child and fewer functional limitations in activities of daily living were associated with more positive self-perceptions of aging. The findings highlight the interdependence of self-perceptions of aging within the parent-child dyads in very late life, suggesting that care experiences within the prolonged relationship constellation should be considered to enhance older adults’ views on age-related gains and loss.

Assessment of neuropathic pain, functional activity limitation and quality of life of people affected by leprosy in an endemic area in Northeast Brazil: a cross-sectional study.

This study investigated the prevalence of neuropathic pain (NP) among people affected by leprosy and its effects on functional limitation and health-related quality of life (HRQoL) in an endemic area in Northeast Brazil. This is a cross-sectional study of 122 leprosy patients. Functional limitation and HRQoL were assessed using the Screening of Activity Limitation and Safety Awareness (SALSA) and WHO Quality-of-Life (WHOQoL-BREF) scales, respectively. Participants were assessed for the presence of pain and completed the Douleur Neuropathique 4 and the Brief Pain Inventory scales. The prevalence of NP was 59%. Participants with NP had higher SALSA scores than those without pain (median; IQR: 42; 32-49.5 vs 27.5; 24-34; p=0.002). Increasing SALSA scores were related to decreasing WHOQoL-BREF scores in the physical (r=-0.54; p<0.001), psychological (r=-0.33; p=0.002) and environmental (r=-0.22; p=0.01) domains, but not in the social domain (r=-0.14; p=0.10). Individuals with NP had the lowest scores in all domains compared with individuals without pain. Appropriate tools and training of clinicians for diagnosing NP in leprosy patients are necessary for their appropriate management and better HRQoL outcomes.

Assessment and Physiotherapeutic Intervention for Patellofemoral Pain and Muscle Performance DeficitsA Case Report

Patellofemoral pain can lead to knee pain, mobility and muscle performance deficits. It is caused by mechanical and chemical imbalances within the patellofemoral joint. Physiotherapeutic intervention plays an important role in managing these deficits. In this case, physiotherapeutic interventional prescription was used on the basis of the International Classification of Functioning, Disability, and Health (ICF) model. Assessment based on the ICF is a framework for describing and organising information on functioning and disability. A 55-year-old female with right peripatellar pain was examined using the ICF model for patellofemoral pain and muscle performance deficits. The components observed were correlated with the ICF model. On the basis of ICF-based assessment results, body function diminished in the form of decreased muscle strength and knee Range Of Motion (ROM) with the presence of pain. Functional activity limitations are present in the form of squatting and stair climbing. Other associated findings are mild patellofemoral swelling and quadriceps wasting. This case study found that muscle performance deficits caused by patellofemoral pain can be managed by eight weeks of ICF-based physiotherapeutic intervention that follows physiotherapeutic elements of prescription.

Physical Rehabilitation of Patient with Infrarenal Section Abdominal Aortic Aneurysm Presenting with Hydrocele and Inguinal Hernia: A Case Report

Infrarenal Abdominal Aortic Aneurysm (AAA) is an abnormal dilation of distal abdominal aorta. The risk factors are age older than 60 years, smoking, hypertension and caucasian ethnicity. Testicular pain is an uncommon clinical presentation. There is a high prevalence of inguinal hernia in patients with infrarenal AAA. The purpose of the present case report is to describe the functional activity limitation in a patient affected by an infrarenal AAA presenting as a symptom of inguinal hernia and groin pain despite successful infrarenal AAA repair with aortofemoral bypass surgery and bilateral inguinal hernia repair. A 62-year-old male patient, presented with pain in the groin region and mild swelling over the scrotal region, which was severely limiting his activities of daily living. A Computerised Tomography (CT) angio abdomen revealed a fusiform aneurysm on the distal abdominal aorta and a saccular aneurysm of bilateral common iliac arteries. Given the minimum of four days of referral waiting time to receive treatment for infrarenal AAA, the patient underwent surgery and was followed by the postoperative physiotherapy intervention. The rehabilitation programme started five days postsurgery. The treatment goals directed mainly decreasing postoperative pulmonary complications and improving functional mobility. The present case report contributes new light on the possible pathogenesis and timely management. It reports the unexpected and unusual presentation of the disease and unveiling the link between the presentation of infrarenal AAA and inguinal hernia and hydrocele.

Determine the Functional Limitations in Activities of Daily Living Through Short Physical Performance Battery Test Among Asthmatic Adults

Background: To determine the functional restrictions in functional activities of daily lives in middle aged asthmatic adults and association of BMI with limitations in their daily life activities. Method: An observational cross sectional study was carried out at pulmonology opd of Shalamar hospital. A sample of 36 diagnosed asthmatic adults of middle aged with moderate to severe allergic asthma was taken. A Purposive sampling technique was used to conduct the study. Prediction of functional limitations in everyday activities through Short Physical Performance Battery test was determined. Three series of tests named balance test, gait speed test, repeated chair stand test were conducted which were the part of short physical performance battery test. Each test scored 4 and there was the total of 12 score. Those subjects who had less than 10 score were at risk of limitations in their daily life activities in future. Result: Sample of 30 participants were included for this study from age 35 to 55. Out of which 13 participants were of normal weight with BMI of less than 23.9 and 17 were overweight with the BMI ranges from 24.0 to 30.0. Participants with greater BMI were at the high risk of mortality. The results showed that the 13 subjects were overweight had the high risk of mortality, 13 had the risk of functional limitations in activities of daily living and 4 had the good functional status. There was statistical difference between the BMI and Short Physical Performance Battery test score. (P value= 0.001) Conclusion: This study concluded that middle aged asthmatic adults with moderate allergic asthma had greater risk of functional limitations and high risk of mortality due to the disease effect. This study also showed that the predictive value of functional limitations was more pronounced in females with greater BMI than males. Keywords: Allergic asthma, Activities of daily living, Functional Limitations, Short Physical Performance Battery test,

A wearable textile-based pneumatic energy harvesting system for assistive robotics.

Wearable assistive, rehabilitative, and augmentative devices currently require bulky power supplies, often making these tools more of a burden than an asset. This work introduces a soft, low-profile, textile-based pneumatic energy harvesting system that extracts power directly from the foot strike of a user during walking. Energy is harvested with a textile pump integrated into the insole of the user’s shoe and stored in a wearable textile bladder to operate pneumatic actuators on demand, with system performance optimized based on a mechano-fluidic model. The system recovered a maximum average power of nearly 3 W with over 20% conversion efficiency—outperforming electromagnetic, piezoelectric, and triboelectric alternatives—and was used to power a wearable arm-lift device that assists shoulder motion and a supernumerary robotic arm, demonstrating its capability as a lightweight, low-cost, and comfortable solution to support adults with upper body functional limitations in activities of daily living.

Functional activity limitation of leprosy cases in an endemic area in Indonesia and recommendations for integrated participation program in society.

BackgroundLeprosy continues to be a health problem in Indonesia, with incidence reaching over 10,000 new cases by 2021. Leprosy-related disabilities cause limitation of patients’ activity and participation in social activities. To date, no studies have been conducted in Indonesia which investigates disability in terms of bodily function, structure impairment, limitations in performing daily activities, and restrictions in participation in social activities in leprosy patients. This study is aimed to determine the demographic and clinical characteristics that might affect functional activity limitations of leprosy patients in endemic areas in Indonesia.Methods and findingsA cross-sectional study was conducted on 267 retrospectively-diagnosed cases of leprosy. The Screening of Activity Limitation and Safety Awareness (SALSA) scale was used to measure functional activity limitation, which comprises five domains: vision, mobility, self-care, work with hands, and dexterity. Differences among variables were evaluated using Kruskal-Wallis and Mann-Whitney test. The mean age of participants was 51.89±13.66 years, the majority of which were men (62.5%), uneducated (48.3%), and classified as type 2 in the World Health Organization (WHO) disability grading for hands and feet (66.3% and 68.2%, respectively). Assessment using the SALSA Scale showed 28.5% of subjects were without limitation, 43.8% with mild limitation, 13.5% with moderate limitation, 9.4% with severe limitation, and 4.9% with extreme limitation. Significant differences in the total SALSA Scale were found between age groups (p = 0.014), educational level (p = 0.005), occupation (p<0.001), and WHO disability grades (p<0.001). Multivariate analysis showed that the most significant factor influencing the total score of SALSA was disability grading for feet (score = 0.31, p <0.001) followed by occupational status, disability grading for eyes, and age. Limitation of functional activity was significantly correlated to becoming unemployed with the odds 2.59.ConclusionPeople affected by leprosy are prone to have functional activity limitation, especially the elderly, uneducated, unemployed and those with multiple disabilities. If they can overcome their barriers in functional activities, they will have better occupational opportunities.

A Review on Osteoarthritis Knee Management via Contrast Bath Therapy and Physical Therapy.

One of the body's main weight-bearing joints is the knee joint. For this reason, osteoarthritis typically involves it. Osteoarthritis of the knee joint is the condition in which sub-chondral sclerosis of bone occurs, narrowing of joint space is present, and osteophyte formation is seen at the edges of the bone; because of this, there is pain, reduced knee range of motion, and this leads to functional activity limitations. This prevalence is increasing because of a reduced active lifestyle; this is becoming usual in younger populations. Non-pharmacological management of this condition using contrast bath therapy given by different methods like using hot and cold water, towel compression, and smart knee pad device, causes alternate vasodilatation and vasoconstriction helps to reduce pain symptoms. Physical therapy exercises like stretching, strengthening hip and knee muscles, and balance training showed beneficial effects on a range of motion and activities. Articles using keywords were searched on Google Scholar and PubMed, 70 articles were seen of which eight were reviewed that meet the inclusion criteria. Contrast therapy helps to remove metabolic waste by improving blood flow thus reducing pain. Strengthening the hip and knee muscles helps to stabilize the knee joint, and balance exercises help to improve proprioception. From this review, it is concluded that contrast bath therapy is effective in reducing pain when given with different methods of application as compared to individual hot or cold treatment, and given with the help of a device will be more effective than the traditional method. Along with this strengthening of the knee and hip musculature, stretching and balance exercise helps to improve range and functional activity. Exercise and electrotherapy aid in symptom relief and slow the progression rate of this condition.

Weight Loss in Newly Admitted Nursing Home Residents WithObesity.

The prevalence of obesity (body mass index ≥ 30)among nursing home residents has been increasing, but there has been little research on weight change in this population. We examined resident characteristics associated with substantial weight loss among nursing home residents with obesity. Using data from the Minimum Data Set 3.0, this retrospective study included long-stay nursing home residents with obesity newly admitted to a facility in 2014 who had annual assessments in 2015. Substantial weight loss was defined as a loss of ≥10% body weight within a year. Multivariate regression analyses were conducted to identify factors associated with weight loss, including demographic characteristics, medical conditions, and functional limitations in activities of daily living (ADL). Among 59782 newly admitted nursing home residents with obesity, 23% experienced substantial weight loss during their first year in the nursing home. Moderate ADL dependency (odds ratio [OR]=1.42, 95% confidence interval [CI]: 1.31-1.53), severe ADL dependency (OR=1.83; 95% CI: 1.67-1.99), severe mobility impairment (OR=1.15; 95% CI: 1.04-1.23), and severe cognitive impairment (OR=1.13; 95% CI: 1.07-1.19), as well as cancer (OR=1.10; 95% CI: 1.01-1.20), heart failure (OR=1.06; 95% CI: 1.01-1.11), end-stage renal disease (OR=1.17; 95% CI: 1.11-1.23), and bowel incontinence (OR=1.19; 95% CI: 1.14-1.25) were associated with weight loss. Substantial weight loss is common among nursing home residents with obesity over a 1-year period following admission, and these residents have a greater burden of functional and cognitive impairment and specific medical conditions. These findings suggest the need to further elucidate the clinical implications of weight loss among this population.

Multidisciplinary Management of Arthrogryposis Multiplex Congenita Type 2A Case

Arthrogryposis multiplex congenita (AMC) is a congenital disorder characterized by nonprogressive multiple joint contractures affecting one or more areas of the body, muscle weakness, and fibrosis. This term includes a heterogeneous group of diseases, neurological, neuromuscular, and genetic or mechanical origin. Two types of classification have been developed: A clinical one (types I, II, and III) and an etiological one. A multidisciplinary approach is needed for better care and appropriate follow-up. It is a case of AMC type 2A. A girl, with an antecedent of low levels of amniotic fluid, presented at birth with multiple malformations and stiffness of several articulations: bilateral clubfoot, bilateral clubhand, temporomandibular joint involvement, postural torticollis, and congenital hip dislocation. She had also a small persistence of arterial canal and ambiguous external genitalia. The care was performed by a multidisciplinary team including a physiatrist, pediatric surgeon, physiotherapist, prosthetist, and orthotist. In infants with arthrogryposis, joint stiffness is maximal at birth. The first step is passive mobilizations before surgical joint treatment. Azbell et al. found in their study that at 9 months of age, many of this infant's impairments of body structure and function, functional activity limitations, and participation restrictions improved. The program of stretching, muscle strengthening, facilitation of motor skills, orthopedic intervention, and parent education may have contributed to this infant's progress. Prospective intervention studies exploring specific intervention strategies are needed to establish the plan of care for these patients. Arthrogryposis describes a set of joint contractures present from birth and nonprogressive. The common physiopathological mechanism is fetal immobility syndrome. Multidisciplinary care is necessary and should be early and continued to gain maximum autonomy and facilitate social integration.