Functional Independence Measure Scale Research Articles

Comparison of the expanded disability status scale and the functional independence measure in patients with multiple sclerosis

Objective: This study aimed to evaluate scales that are used to follow up on the condition and course of rehabilitation for an objective assessment of patients with multiple sclerosis. The most commonly used scale is the Expanded Disability Status Scale (EDSS) for obtaining information on neurological impairments. The main disadvantage of this scale is that it focuses a lot on the ability to walk and is not adequately sensitive for detecting the changes in the patient in time. The Functional Independence Measure (FIM) is the most commonly used scale in rehabilitation. It evaluates the ability of patients to perform daily activities, for example, feeding and dressing. In the study, we focused on the comparison of EDSS and FIM to ascertain the applicability of FIM in patients with multiple sclerosis. 
 Methods: We performed a cross-sectional study of 38 patients with multiple sclerosis by talking to the patients and reviewing the medical documentation where the EDSS evaluation was conducted. Then, we evaluated the patient using the FIM scale. The data were processed using the IBM SPSS Statistics 25 software and displayed graphically using the Microsoft Excel program. 
 Results: The statistical analysis showed a strong negative correlation between EDSS and FIM (r = -0.731). The motor part of the FIM scale had a strong negative correlation with EDSS (r = -0.732). The cognitive part had a weak negative correlation (r = -0.262). The sex and the duration of the disease did not impact the FIM evaluation significantly. The age had a moderately strong negative correlation (r = -0.396). 
 Conclusion: We proposed that FIM was a useful scale for the routine evaluation of patients in the clinical environment.

COMPARING INPATIENT REHABILITATION AND HOME-BASED REHABILITATION PRACTICES FOLLOWING ACUTE STROKE: A PROSPECTIVE CONTROLLED STUDY

OBJECTIVE: The aim of this study is to evaluate whether home-based rehabilitation (HBR) is as effective as inpatient rehabilitation in patients with acute stroke as well as to identify patients at increased risk of mortality/morbidity during rehabilitation.MATERIAL AND METHODS: The present study included 64 patients with acute stroke who were referred from the neurology service and intensive care units to an inpatient rehabilitation unit (n=28) or HBR programs (n=36). Brunnstrom motor stages, Functional Independence Measure and Stroke Impact Scale scores of all patients were recorded before treatment and 12 weeks after therapy. Evaluation parameters were compared between 2 groups. The presence of any morbidity/mortality that developed during rehabilitation period were recorded. Afterward, all the patients were divided into 3 groups as inpatient, HBR and patients with mortality/morbidity and evaluation parameters before therapy were compared among the groups.RESULTS: At third month, while there was no significant change in all quality of life subscales following HBR, the improvement in all quality of life subscales following inpatient rehabilitation, except for the memory and emotion subscales were significant. At the end of 12th week; 5 (13.90%) of the 36 patients were died, and another 5 (13.90%) had developed a new cerebrovascular disease in HBR group. The memory, communication and emotion subscales scores of 10 patients with mortality/morbidity were significantly lower than the patients without mortality/morbidity in other 2 groups.CONCLUSIONS: To better manage difficult clinical encounters, the physician needs to well identify acute stroke patients who will be referred to inpatient rehabilitation or home exercise group. When choosing a rehabilitation program, physicians may also consider the mortality/morbidity related to memory, communication and emotional scores.

Stroke rehabilitation outcome in an inpatient neurological rehabilitation unit

<p>To examine the rehabilitation outcome of patients who have suffered a stroke and subsequently received priority rehabilitation in hospital inpatient care, with a focus on changes in functional status.</p>. <p>Retrospective descriptive study. Functional impairment was measured at admission and discharge using the Barthel Index and the Functional Independence Measure scale. The subjects of the study were patients admitted to the Brain Injury Rehabilitation Unit of the National Institute of Medical Rehabilitation for inpatient rehabilitation with a stroke diagnosis between January 1 and December 31, 2018.&nbsp;</p>. <p>Eighty-six stroke patients were treated in 2018 at the unit. Data were available for 82 patients (35 women and 47 men). Fifty-nine patients with acute stroke participated at primary rehabilitation and 23 patients with chronic stroke were involved in secondary rehabilitation. Ischaemic stroke was diagnosed in 39 cases and haemorrhagic stroke in 20. Patients were admitted for rehabilitation on the mean of 36th day (range: 8-112) after stroke and length of stay at rehabilitation unit was 84 days (14-232). The mean age of the patients was 56 years (range 22-88). Speech and language therapist treatment was necessary for 26 patients with aphasia, for 11 patients with dysarthria, and for 12 dysphagic patients. Neuropsychologic examination and training was necessary at 31 patients, severe neglect was found in 9 cases, ataxia was found in 14 cases. As a result of rehabilitation Barthel Index changed from 32 to 75, and the FIM scale from 63 to 97. At the end of the rehabilitation the majority (83%) of the stroke patients could be discharged to home, 64% became independent in daily living activities, and 73% of them regained the ability to walk. &nbsp;</p>. <p>The rehabilitation of stroke patients transferred from the acute wards who received priority rehabilitation was successful as a result of the rehabilitation activities carried out in the ward as part of a multidisciplinary team approach. The successful rehabilitation of patients with above average functional impairment from the acute ward is attributed to almost 40 years of experience and well-organised multidis&shy;ciplinary teamwork.</p>.

Research on the possibilities of a therapeutic approach through physical interventions with Laser MLS (Multiwave Locked System) in post-combustion pathology (burns and severe burns)

Abstract: Introduction. Depending on their severity, most of the burns are "particularly disabling injuries", which is why a constant improvement of current therapeutic interventions is necessary [1]. The patient describes the severe burn as the "ultimate agony" placing an important responsibility on the medical staff to achieve a satisfactory level of recovery and reintegration into society [2]. "Burns negatively influence the main aspects of life", but also the quality of life [3]. Laser therapy has stood out in recent years in stimulating the healing process of burn patients [4]. The role of this study is to highlight the therapeutic effects of the MLS LASER in the case of burns and severe burns. Methods. We previously carried out a systematic review of the related literature through the method of filtering and selecting profile documentary material, widely used and accepted at the international level: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Thus, we searched, using contextually, combinations/syntaxes of search keywords in the following international databases: Elsevier, PubMed, PMC, PEDro, articles published in English in ISI indexed journals Web of Knowledge/Science, during 01.01.2021-31.12.2021. Results and discussion. Seven of the selected articles have been included in our systematic literature review. The evolution of burn injuries materialized through improvements, will hopefully be achievable, both through direct observation and through the favorable dynamic progress of the scores of the quantification scales used: (VSS – Vancouver Scar Scale, VAS – Visual Analogue Scale, 5-D ITCH Scale, according to the model of the American Spinal Injury Association Impairment Scale – AIS - for sensitivity disorders, 3-step scale, ROM – Range of motion, MMT – Manual Muscle Test Scale, The Barthel Index, FIM – Functional Independence Measure scale, ADL, Timed up and go test, Walk Speed, Berg Balance Scale, Six-Minutes Walk Test). If it will be possible, sufficiently sustained medium/long-term follow-up of the cases included in our doctoral research will also be measured by the frequency of readmissions. Conclusions. Through this research, which is part of the doctoral study, we hope to be able to deepen aspects related to both the still existing limits and the identifiable possibilities for optimizing the conceptual and practical approach to patients with such pathologies. Keywords: Burns, MLS LASER, Burn wound, Burn Rehabilitation, Multiwave Locked System.

Functional and motor evaluation in a Brazilian Huntington’s disease cohort

Introduction. This study compared the results of motor performance obtained using three clinical scales for the assessment of Huntington’s disease (HD) progression, such as the Functional Independence Measure (FIM), Modified Barthel Index (MBI), and Unified Huntington's Disease Rating Scale (UHDRS), evaluating the motor performances of Brazilian HD participants and Reference Group (RG). Method. This was a cross-sectional, observational quantitative study. Sensitivity and specificity of the MBI and FIM scales were calculated using UHDRS as a reference scale. Results. The mean age at HD onset was 41.6±8.3 years, with a median value of disease time of 11 years. The mean age of the RG (n=22) was 51.5±7.6 years, and the HD group (n=22) 51.5±8.4 years. Females from the HD group were more severely affected in their functional and motor capacities as compared to the RG (p&lt;.001). Conclusions. To the authors knowledge, this is the first study applying the FIM to participants with HD. Therefore, FIM and MBI can be applied to assess the HD functional performance, since when we compared the UHDRS functional sections we observed similar results (p&lt;.01). The FIM and MBI scales are easy to administer and can be used to assess the functional performance of HD patients. Furthermore, they may be effective tools in rehabilitation programs, but further studies of these scales are warranted.

Impact of seizures and their prophylaxis with antiepileptic drugs on rehabilitation course of patients with traumatic or hemorrhagic brain injury.

To determine whether, in patients undergoing rehabilitation after traumatic or hemorrhagic brain injury, seizures and the use of antiepileptic drugs (AEDs) negatively impact on functional outcome, and, in turn, whether prophylactic AED therapy can prevent the development of seizures. Observational retrospective study. Highly specialized inpatient neurorehabilitation clinic. Patients with traumatic brain injury (TBI), or hemorrhagic stroke (HS) consecutively admitted to our neurorehabilitation unit between January 1, 2009, and December 31, 2018. Patients' demographic data, neurological status (Glasgow Coma Scale), and rehabilitation outcome (Functional Independence Measure scale), both assessed on admission and on discharge, associated neurosurgical procedures (craniectomy, or cranioplasty), AED use, early or late seizures occurrence, and death during hospitalization. Of 740 patients, 162 (21.9%) had seizures, and prophylactic AEDs were started in 192 (25.9%). Multivariate logistic regression identified severity of brain injury as a risk factor for acute symptomatic seizures (ASS) in HS (OR = 1.800, 95%CI = 1.133-1.859, p = 0.013), and for unprovoked seizures (US) in TBI (OR = 1.679, 95%CI = 1.062-2.655, p = 0.027). Prophylaxis with AEDs reduced ASS frequency, but, if protracted for months, was associated with US occurrence (HS, p < 0.0001; TBI, p = 0.0002; vs. untreated patients). Presence of US (β = -0.12; p < 0.0001) and prophylaxis with AEDs (β = -0.09; p = 0.002), were associated with poor functional outcome, regardless of age, severity of brain insult, and HS vs. TBI subtype. Severity of brain injury and occurrence of seizures during neurorehabilitation are the main driver of poor outcome in both HS and TBI. The possible detrimental role on the epileptogenic and functional outcome played by seizures prophylaxis with AEDs, nonetheless useful to prevent ASS if administered over the first week after the brain injury, warrants further investigation.

Cost-effectiveness of a community-based integrated care model compared with usual care for older adults with complex needs: a stepped-wedge cluster-randomised trial

ObjectiveTo assess the cost of implementation, delivery and cost-effectiveness (CE) of a flagship community-based integrated care model (OPEN ARCH) against the usual primary care.DesignA 9-month stepped-wedge cluster-randomised trial.Setting and participantsCommunity-dwelling...

THE RELATIONSHIP BETWEEN FUNCTIONAL LEVEL, PHYSICAL ACTIVITY LEVEL, DEPRESSION AND QUALITY OF LIFE IN GERIATRIC INDIVIDUALS DURING THE COVID-19 PANDEMIC PERIOD

&lt;p&gt;&lt;strong&gt;Objective:&lt;/strong&gt; This study aims to have information about the functional levels, physical activity levels, depression levels, and quality of life of geriatric individuals in the restrictions experienced during the pandemic period and to examine the relationship between these variables. &lt;strong&gt;Materials and Methods:&lt;/strong&gt; In this cross-sectional study, a total of 116 participants whose ages ranged from 65 to 87 years (overall sample: M = 72.44, SD = 5.75) were recruited via a snowball sampling strategy to answer to an online questionnaire. The four instruments used were The Functional Independence Measurement scale, Geriatric Depression Scale, The International Physical Activity Questionnaire-Short Form, The World Health Organization Quality of Life Module for the Elderly. &lt;strong&gt;Results:&lt;/strong&gt; A significant regression model, F (3/110) = 23.16, p &amp;lt; 0.001, and 37% of the variance in the dependent variable (R2 adjusted = 0.37) explained by the independent variables. Accordingly, level of functional independence positively and significantly predicts quality of life, β = 0.44, t(110) = 5.43, p &amp;lt; 0.0001, pr2 = 0.21. Physical activity level positively and significantly predicts quality of life, β=0.2, t(110)=2.48, p = 0.015, pr2 = 0.05. Depression negatively and significantly predicts quality of life, β = -0.2, t(110) = -2.56, p = 0.012, pr2 = 0.06. &lt;strong&gt;Conclusion:&lt;/strong&gt; Physical activity and functional independence levels significantly affect the quality of life positively, and depression affects the quality of life significantly negatively.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0320/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Long-Term Outcomes of Patients with Primary Brain Tumors after Acute Rehabilitation: A Retrospective Analyses of Factors.

Although primary brain tumors are relatively rare, they cause significant morbidity and mortality due to the high rates of neurological impairment. The purpose of this study was to examine the physical and functional outcomes of patients with primary brain tumors who had undergone inpatient rehabilitation. This was a retrospective study which recruited 163 patients who had been admitted for inpatient rehabilitation. Rehabilitation outcomes, including the Functional Independence Measure (FIM) and Glasgow Outcome Scale (GOS), were recorded up to 1 year post-discharge. The majority of patients (79.1%) had low-grade (WHO Class I-II) tumors, 35 (21.5%) were diagnosed with GBM and 52 (31.9%) had recurrent brain tumors. Rehabilitation outcomes were sustained, with 125 (76.7%) and 113 (69.3%) patients having a GOS of ≥4 at 6 months and 1 year after discharge, respectively. A GOS of ≥4 at 1 year was negatively associated with high-grade tumors (p < 0.001) and radiotherapy (p = 0.028), and positively associated with a higher discharge FIM motor score (p < 0.001) and the presence of a caregiver after discharge (p = 0.034). Our study demonstrates significant positive functional benefits from 4 weeks of inpatient neuro-oncological rehabilitation for patients with primary brain tumors, as well as the importance of supportive care from caregivers.

Research Progress on Responsiveness of Activities of Daily Living Scales of Patients with Stroke

Stroke is characterized with high morbidity, high disability rate and high mortality rate. Motor dysfunction after stroke often leads to decreased activities of daily living (ADL) and affects the quality of life of patients. It is of great significance to select a scale with good responsiveness in clinical and scientific work to reflect the changes of ADL abilities of patients sensitively. In this paper, we summarized the assessment items, characteristics and target population of the Barthel index (BI), functional independence measure (FIM) and modified Rankin scale (mRS), which were commonly used at home and abroad for ADL evaluation of stroke patients, and analyzed the responsiveness of these three scales in stroke patients at different stages of disease. For acute stroke patients, the responsiveness of BI and mRS scale was lower than that of FIM scale. For subacute stroke patients, BI, FIM and mRS Scales all showed good responsiveness, but due to the simple evaluation content, BI scale had a "ceiling" effect and its responsiveness was lower than mRS scale. For patients in chronic stage of stroke, their physical function recovery has almost reached a plateau, and their ADL ability recovery mainly focuses on family and social life, but BI, FIM and mRS scale lack evaluation items about family and social life, resulting in poor responsiveness. Frenchay activities index (FAI) and Longshi Scale (LS) have added IADL evaluation content to the commonly used ADL scales. However, the FAI and LS scales are not widely used, and there is still a lack of relevant studies on their responsiveness. In the future studies, the application of FAI and LS scales in patients with different stages after stroke will be strengthened, and the study on their responsiveness will be carried out, in order to provide a stronger basis for the development of rehabilitation training plan and evaluation of training effect for patients with stroke.

Predictive Validity of the Postural Assessment Scale for Stroke (PASS) to Classify the Functionality in Stroke Patients: A Retrospective Study.

The analysis of the predictive validity of a scale allows us to establish objectives in rehabilitation and to make decisions in the clinical setting. The objective of this study was to determine the validity of the Postural Assessment Scale for Stroke (PASS) to predict functionality at each stage of recovery in stroke patients. Methods: A retrospective study was carried out collecting data from patients admitted to a neurorehabilitation hospital. All patients having suffered a stroke less than two months before hospital admission were included in the study. The balance was measured with the PASS scale and the functionality with the Functional Independence Measure (FIM) scale. Simple linear regressions were performed to model the relationship between the PASS and FIM scores in the acute, subacute and chronic stages (6 and 12 months), as well as between the PASS scores at admission and the FIM values in the chronic stage. Results: The PASS scale showed a good predictive validity (R2 values from 0.54 to 0.87; β values from 1.99 to 2.62; p < 0.001) for FIM scores at acute, subacute and chronic stages, with lower goodness-of-fit for PASS scores at admission and FIM scores at 12 months (R2 = 0.383; β = 1.61 (0.96–2.26); p < 0.001). Cut-off points in the PASS scale to predict high functional level were 17.5 for the acute stage and 16.5 for the subacute and chronic stages. A score of 8.5 on the PASS scale measured in the acute phase predicted a high functional level at 12 months. Conclusion: The PASS scale is a useful tool to classify the functionality of stroke patients in the acute, subacute and chronic phases. The PASS score upon admission into the hospital can predict the functionality of the stroke patients after 12 months. However, future studies should be carried out to corroborate our findings with larger sample sizes.

Outcome of short‐term physiotherapy intervention program on early stage of multiple sclerosis ‐ A case report

INTRODUCTIONMultiple sclerosis is a chronic autoimmune progressive disease of demyelination of central nervous system with subsequent axonal damage. The symptoms are due to central nervous system lesions resulting from loss of oligodendrocytes, which myelinates CNS leading to tingling and numbness of limbs and reactive gliosis with no cure for the disease. But CNS diseased effects are often controlled through rehabilitation.OBJECTIVE OF THE STUDYThe aim of this study is to observe the importance of early physiotherapy rehabilitation along with immunosuppressants to suppress and reduce the symptoms and slows down the disease process beginning from the initial day of hospitalization to six weeks which causes progression in the patient reducing the incapacity and improves functional measures and quality of life in multiple sclerosis patients. Muscle weakness, and spasticity, balance and coordination can be improved through stretching and strengthening exercises.METHODPatient strictly followed intervention for a period of six weeks under the supervision of Physiotherapist. Intervention includes strengthening, aerobic conditioning, flexibility exercises, coordination exercise, balance exercises, gait training using assistive devices, sensory, functional, bowel and bladder control training. Interventions were gradually progressed up to the patient every week according to their symptoms. Patient was assessed in 1st and 7th week using the outcome measures namely Functional independence measure (FIM) and Short Form survey‐12 (SF‐12) assessing the impact of health on patient’s everyday quality of life.RESULTSAfter the 7th week re‐assessment, it has been shown there is a difference in the value of outcome measures. FIM level has improved from 3‐moderate assistance with helper to 6‐modified independence without helper. SF‐12 physical score showed marked improvement from 48.020307 to 56.57706 while SF‐12 mental score change showed very minor change.CONCLUSIONMultiple sclerosis disease impairment is primarily a consequence of disease progress, but it can be aggravated by reduced physical activity leading to muscle weakness, decreased ROM, spasticity. Exercise and training have been shown to improve the above said deteriorations in multiple sclerosis patients and certainly can be alleviated.Score through FIM and Health survey scale are tabulated as follows Outcome measure Preintervention Postintervention FIM, Functional Independent Measure (in scales) 3‐‐ Moderate Assistance(&gt;= 50%): Helper‐Modified Dependance 6‐‐ Modified, Independence (Device): No Helper SF‐12, Quality of life measure PCS‐12 (Physical Score): 48.020307 MCS‐12 (Mental Score): 59.04606 PCS‐12 (Physical Score): 56.57706 MCS‐12 (Mental Score): 60.75781

The effect of manual lymphatic drainage on postoperative recovery process following total knee arthroplasty

Background: Knee joint has great importance on daily living activities thus gonarthrosis does affect quality of life of patients very dramatically. Total knee arthroplasty (TKA) is accepted as gold standard in order to cope with pain, deformity and instability especially in patients with gonarthrosis who are in terminal stage. Physical therapy and rehabilitation programs are known to increase the success of this surgical procedure. As edema around knee joint is one of the major postoperative complications, which prolong recovery process, it is important to use therapeutic modalities against this problem.&#x0D; Objective: In this study it was aimed to evaluate the effectiveness of manual lymphatic drainage (MLD) following TKA on edema, range of motion, pain, independence of daily living activities, gait distance and knee functionality.&#x0D; Material and Method: 16 patients with TKA were divided into two groups while one of them is applied standard postoperative rehabilitation procedure (exercise therapy, cryotherapy and positioning) and the other group had MLD therapy on the second and fourth days of the postoperative process for thirty minutes and in one session during the day in addition to standard protocol. On post-op 2nd, 4th, and 6th days, the volumetric changes were calculated based on a formula of Sitzia et al. for each 4 cm segment of the lower extremity, active ROM and knee posture at rest were measured by a universal goniometer, pain by using visual analog scale (VAS), walking distance by calculating total walking distance in a day, independence level in daily living activities by using Functional independence measurement (FIM) scale. In addition, Lysholm knee score was calculated on postoperative 15th day in order to evaluate functionality of knee joint.&#x0D; Results: At postoperative 2nd day, 4th day and 6th day, the mean of FIM (p=0.972, p=0.575, p=0.398, respectively), active ROM (p=0.288, p=0.522, p=0.622, respectively), knee posture (p=0.870, p=0.521, p=0.445, respectively), gait distance (p=1.000, p=0.258, p=0.113, respectively), volume of the operated lower extremity (p=0.451, p=0.384, p=0.268, respectively), VAS for pain daytime (p=0.192, p=0.488, p=0.506, respectively) and night (p=0.137, p=0.562, p=0.748, respectively) were similar in both MLD and non-MLD groups. The mean of Lysholm score was 46.25±24.50 in MLD group and 61.12±17.70 in non-MLD group (p=0.186).&#x0D; Conclusion: Although there is no significant difference between groups, the effectiveness of MLD can be showed in studies which will be performed with a larger sample size.

Effect of a weekly functional independence measure scale on the recovery of patient with acute stroke: A retrospective study.

Excessive assistance may decrease stroke patients' physical activity and make them more dependent on assistance. We have structured a system that provides an ADL (activities of daily living) educational program that focuses on stroke patients' toileting in our daily clinical practice. Here, we investigated the effect of a functional independence measure (FIM) scale on the recovery of patients with acute stroke.We retrospectively collected the data of 407 stroke patients from the medical record system of our emergency hospital in Tsukuba, Japan. The enrolled stroke patients (n = 373) were divided into FIM and control groups. Both groups received the standard treatment, but for the FIM group, ward and rehabilitation staff calculated the toilet FIM score for patients 1 ×/wk. The FIM scale measures the amount of assistance a patient needs to perform activities of daily living and is often used in rehabilitation settings. The rehabilitation staff then instructed the ward staff about better assistance methods based on each patient's physical function and executive dysfunction. We evaluated the usefulness of the FIM scale was based on the patients' FIM scores at discharge and improvements in their scores.The recoveries of the total, motor, and cognitive FIM scores recovery at discharge were significantly greater in the FIM group compared with the control group (68.0 vs 45.0, P = .004; 41.0 vs 24.0, P = .005; and 24.0 vs 20.0, P = .007, respectively). The use of the FIM scale contributes to the patients' recovery of physical function and cognitive function.The FIM scale can contribute to stroke patients' recovery of activities of daily living.

Relationship between neurogenic bowel dysfunction severity and functional status, depression, and quality of life in individuals with spinal cord injury

Objectives/Context To evaluate the relationship between severity of neurogenic bowel dysfunction (NBD) and functional status, depression, and quality of life in individuals with spinal cord injury (SCI) and to determine the factors associated with developing moderate-to-severe NBD. Design Cross-sectional study. Setting University hospital rehabilitation outpatient clinic. Participants Individuals with traumatic SCI, at least one year post-injury (N = 92). Interventions Not applicable. Main Outcome Measures Neurogenic Bowel Dysfunction Score, Functional Independence Measure (FIM), Beck Depression Inventory (BDI), and Short Form-36 (SF-36). Results In the current sample, we found that half of the individuals with SCI had moderate-to-severe NBD. Individuals with moderate and severe NBD had lower motor FIM (P = 0.008 and P = 0.006, respectively) and SF-36 physical functioning (PF) scale (P = 0.020 and P = 0.031, respectively) scores than individuals with very minor NBD. There was no difference in the BDI scores among individuals with different levels of NBD. Individuals with American Spinal Injury Association Impairment Scale (AIS) A injuries were more likely to develop moderate-to-severe NBD than those with AIS C (odds ratio (OR) = 6.52; 95% confidence interval (CI) 1.13–37.79; P = 0.005) or AIS D (OR = 17.19; 95% CI 3.61–81.82; p < 0.001) injuries. Conclusion Individuals with moderate-to-severe NBD had higher levels of dependency in activities of daily living and lower SF-36 PF scale scores than individuals with very minor NBD. Among individuals with SCI, completeness of injury was a significant factor for developing moderate-to-severe NBD.

Recovery and long term functional outcome in people with critical illness polyneuropathy and myopathy: a scoping review

BackgroundIntensive care unit acquired weakness (ICUAW), embraces an array of disorders labeled “critical illness polyneuropathy” (CIP), “critical illness myopathy” (CIM) or “critical illness polyneuromyopathy” (CIPNM). Several studies have addressed the various characteristics of ICUAW, but the recovery is still unclear.ObjectiveThe present review investigated the recovery and the long-term functional outcome of subjects with ICUAW, whether the types of ICUAW have different outcomes and whether there is any supporting evidence.MethodsLiterature search was performed from MEDLINE/PubMed, CINAHL, EMBASE, PeDro, Web of Science and Scopus. Inclusion criteria were: i) sample size including five or more subjects; ii) subjects who suffered from ICUAW and/or CIP, CIM and CIP/CIM; iii) ICUAW ascertained by EMG. Follow-ups longer than one year were defined as long-term.ResultsTwenty-nine studies met the inclusion criteria. In total, 788 subjects with ICUAW were enrolled: 159 (20.1%) died and 588 (74.6%) were followed. Of all the included patients, 613 (77.7%) had CIP, 82 (10.4%) CIM and 56 (7.1%) CIP/CIM. Overall, 70.3% of the subjects with ICUAW fully recovered. Seven (24.1%) studies had a follow-up longer than 1 year (range 2–8) with 173 (21.9%) subjects enrolled globally and 108 followed. Of these subjects, 88.8% gained full recovery. Most of the studies did not use proper functional scales and only 4 and 3 studies employed the Barthel scale and the Functional Independence Measure (FIM) scale. Differentiation between the types of ICUAW was performed in 7 studies, but only 3 studies reported that subjects with CIM had a better prognosis and earlier recovery than subjects with CIP/CIM.ConclusionsSubjects with ICUAW could achieve good recovery and could improve at follow-up. However, the quality of the published studies due to short follow-ups and the paucity of defined outcome measures require confirms.

Factors Predicting Pressure Injury Incidence in Older Adults Following Elective Total Hip Arthroplasty: A Longitudinal Study.

To identify the factors associated with pressure injury (PI) development in older adult patients who underwent elective total hip arthroplasty (THA). A nonexperimental longitudinal prospective study was conducted with a sample of 40 patients undergoing elective THA. Patients were evaluated for PI at hospital admission, 24 hours postsurgery, at discharge, and 1 month after surgery. The incidence of PIs (category 1 or category 2) in this study was 7.9% 24 hours after surgery and 24.3% at discharge. The most common PI location was the sacrum/coccyx or the ischial tuberosity. This study found significant relationships between PIs and female sex (odds ratio [OR], 8.75), body fat mass percentage (OR, 1.15), and the motor score from a Functional Independence Measure scale (OR, 0.89). Finally, the following variables were also associated with PIs (P < .1): skeletal muscle mass (OR, 0.82), lower limb with osteoarthritis weight (OR, 0.61), lower limb without osteoarthritis weight (OR, 0.62), and geriatric depression scale (OR, 1.12). This work identifies those patients at higher risk of PI, enabling targeted prevention and treatment in the population of patients undergoing elective THA. The findings of this study are in line with extant literature and suggest that women with a higher percentage of body fat and less mobility had a higher risk of PI.

Frailty and sociodemographic and health factors, and social support network in the brazilian elderly: A longitudinal study.

To identify and analyze the sociodemographic and health factors and the social support network of the elderly associated with frailty in the assessments carried out between 2007/2008 and 2018. This is a longitudinal study with elderly people aged ≥65 years living in the community. The instruments used were those for Demographic Profile, the Mini Mental State Examination, the Functional Independence Measure, Lawton and Brody Scale, Geriatric Depression Scale, Minimum Relationship Map for the Elderly, and Edmonton Frail Scale. Descriptive analysis and linear regression were used, all tests with p < 0.05. Of the 189 elderly in the study period (2007/2008-2018), most were 80 years old and over, with an average of 82.31 years old; they were women, with no partner, who lived with other family members and were retired. In the final analysis, regardless of age and sex, a decrease in functional independence, an increase in depressive symptoms, an increase in the number of self-reported illnesses, and an increase in the frailty score were observed. The factors that were associated with the increase in frailty of the elderly during the study period were age, female sex, and no partner. The health team, which includes nurses, shall be aware of changes and develop care plans to prevent or avoid their progression.

Physiotherapy in Long Term Physical and Mental Health of People Recovered from COVID 19: A Systematic Review Protocol

The objective of the study to design a protocol on the effectiveness of physiotherapy on long term physical and mental health of recovered patients from coronavirus disease 2019. Methods: The following electronic databases will be searched from inception to December 2021: PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Databases, and other databases. We will include all published documents regarding this topic. Two separate individuals will analyse studies and select accordingly after removal of duplicate studies. Then, final screening, assessment of quality of the articles and data analysis will be done. Meta-analyses, subgroup analysis, and descriptive analysis will be performed based on the included data conditions. Results: Methodological heterogeneity analysis of current evidence will be provided from Physical health outcomes like Barthel Index or Functional Independence measure scale and questionnaires describing health status like Physical Health Questionnaire and Mental health outcomes like SRQ-20, Hamilton Depression scale or Hamilton Anxiety scale. Conclusion: This study will provide the evidence regarding the importance of physiotherapy in future physical and mental health of recovered COVID-19 patients, when performed during treatment of disease in acute hospital management. PROSPERO registration number: CRD42020190863 KEY WORDS: Coronavirus disease 2019, Protocol, Rehabilitation, Review.

Home Rehabilitation System in Chronic Stroke: An Observational Study in Central Italy.

By 6 months following a stroke, approximately 65% of stroke survivors cannot incorporate into daily activities, resulting completely dependent. The aim of this study is to assess the overall outcome in psychological and physical well-being, increase in residual abilities, reintegration and social inclusion for people with chronic disabilities resulting from stroke, after home rehabilitation. We assessed the functional outcome of a group of 600 patients with disability related to several pathological conditions and undergoing home rehabilitation therapy (twice a week for 40 sessions per year) as granted by the Public Health. We evaluated the outcome with Barthel and Functional Independence Measure (FIM) scales. Furthermore, in a group of 73 persons with chronic stroke we also carried out an overall evaluation, by using specific rating scales (FIM, Stroke Impact Scale, Motricity Index, Tinetti Balance Scale, 10-m Walking Test, 6-min Walking Test, 5 Repetitions Sit-to-Stand Test, and Hamilton Depression Scale) after 120 days (114 ± 6) from the end of the home rehabilitation program. The results highlighted a statistically significant improvement between T0 and T1 and a significant worsening between T1 and T2 (follow-up at 3 months). Hamilton Depression Scale is the only parameter that significantly improves both at the time T1 and T2. Territorial rehabilitation system should consider some fundamental aspects: centrality of the person and the individual health project; identification of specific and personalized rehabilitation plan and prognosis based on the results of a follow-up; ultra-specialization of interventions; multidisciplinary team; highlight of the emerging needs; and coordination of the different care pathways.