Functional Goals Research Articles

Treatment of Acquired Deforming Hypertonia with Botulinum Toxin in Older Population: A Retrospective Study.

Acquired deforming hypertonia (ADH) affects the daily care of numerous nursing home residents. The aim of this study was to analyze the practice, aims, and effectiveness of botulinum toxin injections (BTxis) in the treatment of older patients with contractures, an indication for which BTxis are still underused. Data were extracted retrospectively from medical records regarding population, contractures, and injections. A prospective analysis was conducted to evaluate treatment goals set by goal attainment scaling (GAS) at T0 and at T1, to evaluate the therapeutic effects. We also recorded the occurrence of side effects, using a telephone questionnaire. This study included 41 patients older than 70 years who had received one or more BTxis for the first time between January 2018 and December 2021. Most of the older people we included lived in an institution (66%), manifested severe dependence, and presented significant morbi-mortality (37% of the patients died in the year after the last injection). The main objectives of these injections were purely comfort, without any functional goals. The GAS scores suggested effectiveness for comfort GAS scores. No complications were recorded. This study highlights the BTxis potential to address the needs of a larger number of older patients with ADH.

“But if you do not keep doing it, you won’t maintain”. A qualitative study on the perspectives of speech-language pathologists on maintenance of therapy gains in aphasia

ABSTRACT Background Maintaining therapy gains in the long term is necessary for therapy to be considered successful. Yet, this topic has received limited attention in aphasia rehabilitation research. Unfortunately, for some people with chronic aphasia, maintaining the gains achieved in therapy can be difficult and many experience reduced communicative functioning over time. Understanding the perspectives of speech-language pathologists (SLPs) on maintenance is vital. As key agents in aphasia therapy, their views are crucial for understanding current practice, identifying service gaps, and informing future research on the maintenance of therapy gains. Aim The aim of this research was to explore speech-language pathologists’ perspectives on maintaining therapy gains in chronic aphasia and to understand their beliefs about the factors that influence the maintenance of gains made during aphasia rehabilitation. Methods & Procedures In-depth semi-structured interviews were conducted with seven SLPs who worked with people with chronic aphasia. Inductive thematic data analysis was used to identify themes. Outcomes & Results Six themes were identified, representing SLPs’ beliefs about maintenance and their perceptions of factors important for preserving therapy gains in aphasia rehabilitation. These were: 1) Ongoing communication activity; 2) Meaningful person-centred goals; 3) The challenge of translating functional goals to participation; 4) Individual capacity and resource availability; 5) Home support; and 6) Services. The results illustrate the complexity and interplay of factors that may both facilitate and hinder the maintenance of therapy gains. Conclusions SLPs in this study believe that aphasia rehabilitation interventions should involve meaningful, personalised, enjoyable real-life experiences to optimise maintenance of therapy gains. Moreover, they believe that maintenance must be at the centre of aphasia rehabilitation research and clinical practice, requiring new models of care for chronic aphasia. These insights may provide direction for the development of future interventions and services to enhance long-term maintenance for people with chronic aphasia.

Surgical techniques to treat thumb spasticity in children and adults: A systematic review

Upper limb spasticity surgery is an area of increasing interest and advances have been made in assessment and management, however treatment of the thumb remains a challenge. This systematic review evaluated current techniques to treat thumb spasticity. A search of three databases identified 14 articles between 2005 and 2023. Studies were assessed for methodological quality and found to be low-to-moderate in most cases. Data was extracted but synthesis limited by heterogeneity in patient groups, procedures, and outcome reporting. Lengthening of the flexor pollicis longus, release of intrinsic muscles, and augmentation of antagonists, often by re-routing of extensor pollicis longus, were reported most frequently. Thirteen studies (92.9 ​%) demonstrated improved thumb spasticity, position, or function, and complications were uncommon, though deformities recurred in up to 30 ​%. Poor quality evidence precluded definitive conclusions on safety and efficacy. Future investigators should focus on standardising outcome reporting, with an emphasis on functional goals.

Feeling Close from a Distance: Pilot Study of a Hybrid Intervention to Promote Functional Goals of Autistic Adolescents and Young Adults

Abstract Date Presented 03/22/24 SPAN-ASD is a short-term hybrid intervention for autistic adolescents and young adults. The current study presents its efficacy in achieving autonomous personal goals and their perceived self-efficacy regarding those goals. Primary Author and Speaker: Einat Yaar Additional Authors and Speakers: Eynat Gal, Gary Bedell, Liron Lamash

Adaptive Approaches to Exercise Rehabilitation for Postural Tachycardia Syndrome and Related Autonomic Disorders

Exercise is a well-documented, nonpharmacologic treatment for individuals with autonomic dysfunction and associated orthostatic intolerance, such as postural tachycardia syndrome and related disorders. Exercise has been shown to increase blood volume, reverse cardiovascular deconditioning, and improve quality of life. Current first-line standard of care treatment for autonomic dysfunction combines graded approaches to exercise with medications and lifestyle modifications. However, current exercise rehabilitation protocols for postural orthostatic tachycardia syndrome contain rigid timelines and progression paradigms that often threaten tolerability and adherence. In addition, they fail to account for clinical variables potentially critical to care and lack guidance for individualization, limiting accessibility to patients with co-morbidities that affect exercise appropriateness and safety. Therefore, we introduce an adaptive approach to exercise prescription for orthostatic intolerance that allows patient-specific modifications to meet functional goals for a wider spectrum of patients, thus improving adherence. The proposed approach integrates iterative physiological and symptomatic assessments to provide flexible, yet structured, exposure to aerobic exercise and strength training to improve functional capacity and tolerance of daily activities for patients with postural tachycardia syndrome and related autonomic disorders.

Collaborative goal setting in palliative rehabilitation: a case report

BackgroundPalliative rehabilitation amalgamates the principles of palliative care and rehabilitation to enhance patients’ quality of life by optimizing physical function and maximizing autonomy despite advancing illness. Alongside providing non-pharmacological symptom management, it emphasizes personalized goal-setting tailored to individual needs. This case illustrates the transformative impact targeted physiotherapy interventions can have on patients’ physical function, morale and motivation in spite of their expected deterioration.Case presentationAn 85-year-old male with angioimmunoblastic T cell lymphoma was admitted to home hospice care. He was referred for physiotherapy to optimize his function and mobility despite his short prognosis. A conversation guide was used throughout the duration of therapy to identify personal goals, prescribe and review the use of appropriate interventions, and discuss future therapeutic plans. Within a month he achieved his functional goals, experienced reduced physical dependency, and had increased satisfaction in his ability to participate more actively in self-care. This also resulted in significant improvements in his confidence, mood, and overall well-being. Engaging the patient actively in his care and management journey provided him with significant motivation and hope.ConclusionThe case study highlights the vital role of physiotherapists in facilitating transparent communication among patients, healthcare providers, and caregivers throughout palliative rehabilitation. Through open dialogue and utilizing conversation guides, physiotherapists help understand patient preferences, goals, and motivation. This patient-centred approach ensures that therapeutic interventions align with individual needs, enhancing overall patient care and the provision of holistic palliative care.

Effect of Cognitive Orientation to Daily Occupational Performance (CO-OP) on Motivation of Children with Cerebral Palsy: A Pilot Clinical Randomized Controlled Trial

ABSTRACT Children with cerebral palsy (CP) may experience challenges with motivation to engage in motor activities during rehabilitation sessions, which can impact therapy outcomes. This study investigated the effect of the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention on the motivation and achievement of motor-based goals in rehabilitation sessions for children with CP. In this pilot randomized trial, eighteen children aged 8–13 years with CP participated and were randomly assigned to either the CO-OP or bottom-up usual care group. The CO-OP group received 12 performance-based cognitive intervention sessions. The CO-OP intervention significantly enhanced the motivation of children with CP to engage and participate in therapeutic activities, as evidenced by the Pediatric Motivation Scale (PMOT) and its four sub-scales (p < 0.05, based on repeated measures ANOVA). Moreover, the Goal Attainment Scale (GAS) T-scores were higher for both posttest and follow-up assessments in the CO-OP group compared to the bottom-up usual care group. Additionally, independent sample t-test results demonstrated a significant difference in the mean scores of the Canadian Occupational Performance Measure (COPM) between the two groups. The Cognitive Orientation to daily Occupational Performance (CO-OP) intervention successfully enhanced the motivation and facilitated the achievement of motor-based goals from the patient perspective in children with CP. The client-centered approach, focusing on meeting the basic psychological needs of the participants, contributed to improved therapy outcomes in terms of functional abilities, goal attainment, and engagement in daily activities. These findings highlight the potential of the CO-OP intervention as an effective approach for enhancing motivation and improving therapy outcomes in children with CP.

Effectiveness of Family-Professional Collaboration on Functional Goals Achievement of Children with Cerebral Palsy and Caregivers' Quality of Life and Burden: A Randomized Comparative Study.

Background: Family-professional collaboration is important to enhance the outcomes for children with cerebral palsy and their caregivers. Aims: This study examined the effect of implementing a family-professional collaboration practice model on children with cerebral palsy and their caregivers. Materials and methods: A randomized, single-blind comparative study included 28 physical therapists, 44 children with cerebral palsy between the ages of 2 and 12 years old, and their caregivers. Physical therapists in the experimental group received training in how to implement collaboration in their therapy sessions over the course of two sessions (3 h each). The children's achievement goal-range rate was measured using the Goal Attainment Scaling, the caregivers' quality of life was assessed using the World Health Organization Quality of Life-Brief, and the caregiver burden was evaluated using the Zarit Burden Interview. Results: All children showed improvement on the Goal Attainment Scaling change rate (p = 0.002), with no significant differences between groups (p < 0.44). However, a group × time interaction was observed. The Children Goal Attainment Scaling rate decreased between the two assessment sessions for children in the control group, while the Goal Attainment Scaling change rate was steady for the experimental group. There were no main effects of time and group or interaction of time × group reported on World Health Organization Quality of Life-Brief domains and no main effect of time on the Zarit Burden Interview, but there was a main effect between groups (p = 0.03), with partial eta square = 0.11 in favor of the experimental group. Conclusions: The family-professional collaboration practice model could be a potential practice to positively improve the outcomes in children with cerebral palsy and their caregivers.

Security and Trust in the 6G Era: Risks and Mitigations

The ubiquitous diffusion of connected devices in every context of the daily life of citizens, public bodies, and companies is stimulating the creation of new applications that require very high wireless communication performances. To fulfill this need, the sixth generation of communication standards (6G) is planned to roll out by 2030. While structuring this new standard, it is crucial to take into account the security aspects given the impact of the technologies that will rely on its reliability and resiliency. In this paper, we provide an overview of the technologies that will be used in 6G to achieve the required functional goals for the development of key applications. Then, we proceed to discuss the threats and the solutions to make the communications infrastructure secure and reliable, and finally, we elaborate on the concept of how to achieve trust in this scenario.

Design and Development of Component Library for Component-based University Orientation Management System

In the last few years, the orientation and management system of the universities has become more data-driven, information-based and intelligent. This article focuses on designing and implementing an orientation management system for universities. It analyses the actual needs of orientation work and determines the functional goals and design principles of the system. The text focuses on the design and development process of component libraries. This includes component classification, naming conventions, interface design, and re-usability and extensibility design. These aspects provide strong support for the construction of the system. This article elaborates on the methods and processes of system testing and evaluation. Comprehensive testing is conducted to verify the system’s functions and performance, ensuring that it meets actual needs. The research results presented in this article provide a constructive reference for the construction of orientation management systems in universities and lay a solid foundation for the optimization and upgrading of future systems.

Blepharoplasty Online: Critical Analysis of Content and Patient Comprehensibility

IntroductionPatients frequently turn to online information for decision-making factors about aesthetic procedures. The quality of online medical content is an essential supplement to clinical education. These resources assist patients in understanding the risks, benefits, and appropriateness of their desired procedure. This study examines the breadth and readability of online blepharoplasty information, elucidating its educational utility.MethodsA depersonalized Google search was conducted using the Startpage Search Engine, investigating key phrases, “blepharoplasty decision making factors”, “eye lift decision making factors”, and “eyelid lift decision making factors”. The first three pages of results for each search term, totaling 90 links were screened. Data were extracted for various decision-making factors, subspecialty, gender, and readability.ResultsTwenty-six websites met inclusion for analysis. Thirteen websites were plastic surgery based, five otolaryngology (ENT), five ophthalmology/oculoplastic, one oral-maxillofacial (OMFS), and two mixed-based practices. Most blepharoplasty webpages identified were that of private practice and male surgeons. Half were subspecialties other than plastic surgery. Thirteen common decision-making factors were identified. The most common factors addressed across all texts were recovery followed by cosmetic and functional goals. The least discussed were genetic factors. Average Readability exceeded the 12th grade. There were no significant differences in readability means among subspecialties.ConclusionThis study examines the online blepharoplasty sphere among US-based practices providing clinical education to patients. No appreciable differences among gender, subspecialty, and readability on decision-making factors were found, highlighting a consistency among surgeons. Most websites fell short of readability standards, however, emphasizing a need for clearer information to patients.No Level AssignedThis journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Diverse task-driven modeling of macaque V4 reveals functional specialization towards semantic tasks.

Responses to natural stimuli in area V4-a mid-level area of the visual ventral stream-are well predicted by features from convolutional neural networks (CNNs) trained on image classification. This result has been taken as evidence for the functional role of V4 in object classification. However, we currently do not know if and to what extent V4 plays a role in solving other computational objectives. Here, we investigated normative accounts of V4 (and V1 for comparison) by predicting macaque single-neuron responses to natural images from the representations extracted by 23 CNNs trained on different computer vision tasks including semantic, geometric, 2D, and 3D types of tasks. We found that V4 was best predicted by semantic classification features and exhibited high task selectivity, while the choice of task was less consequential to V1 performance. Consistent with traditional characterizations of V4 function that show its high-dimensional tuning to various 2D and 3D stimulus directions, we found that diverse non-semantic tasks explained aspects of V4 function that are not captured by individual semantic tasks. Nevertheless, jointly considering the features of a pair of semantic classification tasks was sufficient to yield one of our top V4 models, solidifying V4's main functional role in semantic processing and suggesting that V4's selectivity to 2D or 3D stimulus properties found by electrophysiologists can result from semantic functional goals.

INTERNAL AUDITORS AS CHANGE AGENTS: WHAT A DIFFERENCE A YEAR MAKES!

It was evidenced in a multiple-case study that the pattern of interaction between Chief Audit Executives and Senior Management is a key determinant of Internal Audit effectiveness. There are notable differences among Internal Audit Functions. The effectiveness of Internal Audit is largely determined by “soft factors.” Therefore, where Senior Management, possibly pushed by the supervisory board or the owner himself, truly supports the Internal Audit Function and wants it to look at the right matters, its effectiveness will be fundamentally different from cases where the management and/or board is passive, and does not push the Internal Audit Function to become effective by unearthing matters they may not wish to be found. In the upper echelon of Management, interaction with the chief stakeholder/s typically happens frequently, in a timely manner, and the communication is geared toward problem-solving. The relationship is strongly based on shared goals, shared knowledge, and mutual respect. At the other end of this spectrum, interaction with the chief stakeholder/s happens in-frequently, is typically delayed, and the communication is rather geared toward finger-pointing. In this context, functional goals prevail, knowledge is preferably exclusive, and relations can be impaired by disrespect. This article provides conceptual and practical insights into features within the more immediate control of the Chief Audit Executives, helping or hindering Internal Audit effectiveness. Self-perception and external perception can differ greatly. Positioning and communication are instrumental when identifying successful Internal Audit Functions; these make a fundamental difference as to whether the Internal Audit Function is positioned as police, servant, consultant, doctor or change agent. Practical insights then demonstrate what a difference a year makes. Guided by the change agent, the more effective Internal Audit Function can prove also with hard data that there are fewer overdue findings, that reports are delivered more swiftly, and quantum leaps of productivity can be achieved.

Teletherapy as an Alternate Model for Therapeutic Interventions for Children with Neurodevelopmental Disabilities in a Low-resource Setting in Jharkhand, India

Abstract Background: This project was a collaboration between a community-based organization in rural India and a professional organization providing training and teletherapy support. The objective was to address the human resource gaps in rural areas for delivering therapeutic interventions to children with neurodevelopmental disabilities (NDD) in low-resource settings. Objective: To empower health workers in rural areas with the skills necessary to provide need-based therapeutic interventi ons to children with developmental disabilities through training and teletherapy. Methods: The project began with an initial training phase consisting of 10 online training sessions. This was followed by five additional need-based online training sessions over a 9-month period. Thirty-one children with NDD (15 girls and 16 boys) were enrolled and tracked using the Canadian Occupational Performance Measure (COPM). A total of 750 need-based therapy interventions, including physiotherapy, occupational therapy, and speech therapy, were provided by professional therapists via teletherapy. Results: The children showed significant improvement in the functional goals set from baseline to midline and end line. A one-way repeated-measures ANOVA test revealed a significant positive impact of teletherapy on the functional goals planned for the sample (P &lt; 0.5). Conclusion: Teletherapy demonstrated a positive impact on achieving functional goals for children with NDD in rural Jharkhand. It is recommended as an effective model to address human resource gaps and provide family-centered therapeutic support in low-resource rural areas.

RESULTS OF THE ECHO-R TRIAL – A PRAGMATIC, TELEHEALTH-DELIVERED EXERCISE INTERVENTION FOR WOMEN WITH RECURRENT OVARIAN CANCER

INTRODUCTION &amp; AIMS Wide-spread and equitable uptake of exercise into standard cancer care will require evidence of safety and efficacy across all cancer and treatment types. People with rarer cancers, lower survival prospects, and higher morbidity have been under-represented in exercise oncology trials. The ECHO-R trial for women with recurrent ovarian cancer aimed to address this research gap, evaluating the efficacy of a 6-month telephone-delivered, exercise intervention consistent with ESSA exercise oncology prescription guidelines. METHODS 50 women scheduled to receive chemotherapy for recurrent ovarian cancer were recruited to the pre-post exercise trial with assessments at baseline and post-intervention (6 months post-baseline). The intervention was delivered via 12 telephone sessions, with the option of five additional study-funded, in-person sessions with a community-based AEP. The intervention had a global target of 150 minutes of moderate-intensity multimodal exercise per week, with actual volume and prescription individualised at each session, dependent on functional capacity, goals, and barriers. Outcomes included feasibility (volume of exercise completed) and harms profile (occurrence of adverse outcomes) of the intervention, changes in patient-reported outcomes (quality of life [QoL; FACT-O], fatigue [FACT-Fatigue] and neurotoxicity [FACT-GOG-NTX]), and objective assessment of aerobic function (6-minute-walk test), muscular endurance (30-second sit-to-stand) and strength (hand grip). RESULTS The average volume of exercise completed did not meet the target (median 100 min/week, min: 0; max 527). QoL, fatigue, neurotoxicity, aerobic function, muscular endurance, and strength remained stable between the pre and post-intervention assessments. There were no serious adverse events. CONCLUSION Recurrent ovarian cancer is an incurable disease, characterised by declining QoL and physical capacity. Findings from this study suggest that maintenance of QoL and physical function is possible through participation in an exercise intervention, even if exercise targets are not met. Physical activity guidelines may need to reflect this.

FATIGUE SCIENCE INFORMING LONG COVID RECOVERY: A CASE STUDY

CASE SETTING 42-year-old female client referred for unmanaged long covid symptoms, six months following severe acute COVID-19 infection. Referred by an occupational therapist under Life Insurance to restore health and function for return to work (RTW). Experiencing cognitive and physical fatigue, muscular aches, breathlessness, post-exertional malaise, reduced cognitive capacity and exacerbated asthma symptoms at referral. Reduced functional capacity to perform activities of daily living and usual work duties and hours. TREATMENT/REHABILITATION PROVIDED 14 hours of exercise physiology was delivered by telehealth over nine months, during fortnightly or monthly consultations. Additional multidisciplinary collaboration occurred with occupational therapist, return to work co-ordinator, and general practitioner. The intervention consisted of educational coaching sessions on the physiology of fatigue, pacing strategies, individualised wellness strategies (sleep, mindfulness/relaxation, exercise, diet), relapse planning, and RTW planning. A commercially available wearable device obtained 24/7 biometric data, which tracked resting heart rate variability (rHRV), resting heart rate, respiratory rate, and sleep performance. rHRV objectively measured fatigue. Wellness strategies were coached from analysing the impact of client behaviours on rHRV trends. Two functional goals of housework and socialising were established. RESULTS Validated inventories measured self-reported improvements in; fatigue symptoms: 12-item SPHERE-12, range: 0-68 points [42 baseline; 4 final]; function: two 11-item patient-specific functional scale [housework, socialising], range: 0-20 points [5 baseline; 19 final]; and quality of life: 16-item quality of life scale, range: 0-112 [54 baseline; 79 final]. rHRV improved [10ms baseline, 56ms final]. RTW improved from four days/week to five days/week in her pre-disability role as a client manager. REFLECTIONS/LEARNINGS rHRV provided an objective marker of fatigue. The subject responded positively to rHRV monitoring. Real time biometric data enables individualised fatigue coaching including behaviour change, wellness and planning/pacing strategies. This approach improved fatigue and restored function to perform daily activities and RTW.

VIRTUAL-REALITY PAIN SCIENCE POSITIVELY IMPACTS PAIN AND FUNCTION, RETURN TO WORK, CUSTOMER EXPERIENCE AND RETURN ON INVESTMENT: A CASE STUDY

CASE SETTING 52-year-old male client referred for post-operative cervical-spine two-level fusion rehabilitation, two-years following a motor accident. History of prior motor accident five-years earlier with cervical-spine discectomy resolving symptoms. Referred under compensable insurance policy with 13-years claim benefit remaining. Referral objective to restore health and function for return-to-work (RTW). Experiencing intolerable neck pain with reduced left arm function, pain medication side effects, and low mood. Loss of hope resulting from significant pain post-operatively, whereas prior surgery resolved similar symptoms. Not working at referral. Pre-disability work was full-time self-employed barista. TREATMENT/REHABILITATION PROVIDED Six hours of EXPHYS BETTER Pain VR program, consisting of virtual-reality (VR) pain science coached by an exercise physiologist (AEP) over 10-weeks, face-to-face, within the pain mechanism and bio-psycho-social models. Learning consisted of VR modules and workbook with practical application of six key target pain concepts: pain is always real, doesn’t accurately measure tissue health, relies on context, is a protector, has a buffer zone, and can be retrained. Two functional goals of self-care and cooking were established, and RTW. RESULTS Validated inventories demonstrated self-reported improvements in; pain intensity: 11 item numerical pain rating scale, range: 0-10 points [8 referral; 1 closure]; and function; two 11-item patient-specific functional scale [self-care, cooking], range: 0-20 points) [2 referral; 16 closure]. Work mindset improved from pre-contemplation [referral] to maintenance [closure]. Work capacity improved from no capacity to full capacity. Work status improved from not working to working pre-disability hours and duties. Insurance claim closed. Direct return-on-investment of $300 for every $1 spent on the EXPHYS BETTER Pain VR Program. Client net promotor score (NPS) was promoter (10/10), and customer satisfaction (CSAT) was very satisfied (5/5). REFLECTIONS/LEARNINGS Virtual-reality pain science, delivered by an AEP within the pain mechanisms model, positively impacts pain and function, RTW, and customer experience, with demonstrated return-on-investment.

Pedagogical Competence in Bulgarian Higher Education in the Middle of the Twentieth Century

After the end of WWII, Bulgaria has become a part of the East Bloc for a long time. Under the strong influence of USSR, communist regime was imposed in Bulgaria and the country’s political, social and educational structures were radically changed by the ideology of this regime. The transformation in all educational institutions turns them into a strong factor about the building of socialism in Bulgaria. This reflects on the higher pedagogical education and the nature of the of the teachers' education, especially their pedagogical competence. The aim of this research is to present the processes to the transformation and the imposition of a new concept for the content of higher pedagogical education. The research is based on the original documents for educational policy and practice. The research centres on the characteristics of the communist (socialist) pedagogy. The detailed analysis shows that the political realities influence the conceptual set-up and functional goals of the higher pedagogical education.

Supporting Functional Goals in Spinal Muscular Atrophy: A Case Report of The Cognitive Orientation to Daily Occupational Performance (CO-OP) Approach

Supporting Functional Goals in Spinal Muscular Atrophy: A Case Report of The Cognitive Orientation to Daily Occupational Performance (CO-OP) Approach

Satisfaction rates, function, and return to activity following young adult total hip arthroplasty.

Young adults undergoing total hip arthroplasty (THA) largely have different indications for surgery, preoperative function, and postoperative goals compared to a standard patient group. The aim of our study was to describe young adult THA preoperative function and quality of life, and to assess postoperative satisfaction and compare this with functional outcome measures. A retrospective cohort analysis of young adults (aged < 50 years) undergoing THA between May 2018 and May 2023 in a single tertiary centre was undertaken. Median follow-up was 31 months (12 to 61). Oxford Hip Score (OHS) and focus group-designed questionnaires were distributed. Searches identified 244 cases in 225 patients. Those aged aged under 30 years represented 22.7% of the cohort. Developmental dysplasia of the hip (50; 45.5%) and Perthes' disease (15; 13.6%) were the commonest indications for THA. Preoperatively, of 110 patients, 19 (17.2%) were unable to work before THA, 57 (52%) required opioid analgesia, 51 (46.4%) were reliant upon walking aids, and 70 (63.6%) had sexual activity limited by their pathology. One patient required revision due to instability. Mean OHS was 39 (9 to 48). There was a significant difference between the OHS of cases where THA met expectation, compared with the OHS when it did not (satisfied: 86 (78.2%), OHS: 41.2 (36.1%) vs non-satisfied: 24 (21%), OHS: 31.6; p ≤ 0.001). Only one of the 83 patients (75.5%) who returned to premorbid levels of activity did so after 12 months. Satisfaction rates of THA in young adults is high, albeit lower than commonly quoted figures. Young adults awaiting THA have poor function with high requirements for mobility aids, analgesia, and difficulties in working and undertaking leisure activities. The OHS provided a useful insight into patient function and was predictive of satisfaction rates, although it did not address the specific demands of young adults undertaking THA. Function at one year postoperatively is a good indication of overall outcomes.