Functional Performance In Patients Research Articles

Effects of ELDOA and post-facilitation stretching technique on pain and functional performance in patients with piriformis syndrome: A randomized controlled trial.

Piriformis syndrome (PS) is a neuro-muscular condition, which is often underdiagnosed in clinical settings. This study will determine the effects of myofascial stretching Elongation Longitudinaux Avec Decoaption Osteo Articulaire (ELDOA) and post-facilitation stretching of the piriformis muscle in patients with PS. We aimed to compare the effects of ELDOA and post-facilitation stretching of the piriformis muscle on pain, muscle length and functional performance in patients with PS. A randomized clinical trial was conducted with 40 PS patients including both males and females, between the ages of 30-70. Patients were randomly assigned to the ELDOA or post-facilitation group after assessments with the Numeric Pain Rating Scale (NPRS), Lower Extremity Functional Scale (LEFS), Piriformis Length Test and Straight Leg Raise (SLR). The assessments were done at baseline and at the end of the sixth week of treatment. The patients treated with ELDOA demonstrated significant improvement in pain (pre = 7.00 ± 2.75, post = 3.00 ± 1.75), piriformis length (pre = 27.6 ± 5.54, post = 36.8 ± 3.13), SLR (pre = 36.40 ± 7.24, post = 67.5 ± 8.36) and LEFS (pre = 26.90 ± 12.24, post = 58.10 ± 8.62), as compared with the group treated with post-facilitation stretching: pain: pre = 6.00 ± 1.00, post = 2.00 ± 1.50; piriformis length: pre = 28.55 ± 4.03, post = 38.8 ± 2.70; SLR: pre = 40.60 ± 7.48, post = 74.25 ± 5.19, and LEFS: pre = 25.20 ± 7.66, post = 66.30 ± 7.27). It can be concluded that the post-facilitation stretching technique shows more improvement in pain, muscle length, SLR, and LEFS in patients with PS as compared to ELDOA.

Muscle thickness and functional performance of patients with Parkinson’s disease

Abstract The aims of this study were: a) to check if there is difference between muscle thickness measured by ultrasonography at three different sites, elbow flexors and knee extensors of patients with Parkinson's disease (PD); b) to check if there is correlation between muscle thickness and functional performance in patients with PD. Muscle thickness was assessed by ultrasonography at three anatomical sites in elbow flexors (proximal - EF1, medial, EF2, and distal - EF3) and knee extensors (proximal - EK1, medial - EK2, and distal - EK3), as well as functional performance assessment (chair stand and arm curl) of 31 patients with PD. The results suggest that EF3 muscle thickness was significantly (p> 0.05) lower than EF2 and EF1. Muscle thickness of knee extensors was statistically different in the anatomical points of rectus muscles and vastus medialis muscles (EK1>EK2>EK3). There was no correlation between muscle thickness and functional performance of lower (r= 0.17; p= 0.35) and upper limbs (r= -0.17; p= 0.34) of PD patients. The results indicate that the anatomical point has significant influence on the muscle thickness of elbow flexors and knee extensors of patients with PD. Thus, the careful determination of the evaluation of muscle thickness sites is a key variable when the goal is to quantify muscle thickness in patients with PD.

Effect of fluoroscopically guided corticosteroid injection versus oral nonsteroidal anti-inflammatory drugs for treatment of coccydynia: A randomized, controlled, single-blind study

Background: Coccydynia is a major cause of coccyx pain that can result in chronic pain as well as reduced functional performance in patients. The aim of this study was to compare the efficacy of fluoroscopically guided corticosteroid injection with an oral nonsteroidal anti-inflammatory drug (NSAID) to relieve coccyx pain. Methods: In a clinical trial study, 28 patients with coccydynia who were randomly divided into two groups and matched based on sex, age, and body mass index. One group was treated with celecoxib 200 mg (every 12 hr) for 1 mo along with regular use of a tailbone pillow while sitting on hard surfaces. The second group received local periarticular injection of methylprednisolone acetate 40 mg along with lidocaine 1%, which was fluoroscopically guided. The patients were followed for 4 mo. Results: There was a significant difference in pain severity of the patients when compared with their condition at the beginning of the study in each group (P<0.001). The final pain severity of NSAID group and steroid group was 37.9±14.2 mm and 38.7±16.1 mm, respectively, which was not significantly different. Also the trend of pain severity was similar between the two groups. Conclusions: Corticosteroid injection for coccydynia treatment at least has the same advantages of oral NSAID medication. Regarding its single-dose administration and reasonable price, it can be considered as an alternative modality in treatment of this disease if the target patient is selected correctly. Level of Evidence: Level I.

Associations Of Personality Traits With The Capacity-Performance Discrepancy Of Functional Outcome In Patients With Schizophrenia.

ObjectiveFunctional capacity, which indicates one’s ability to perform everyday living tasks, contributes to real-world functional performance in patients with schizophrenia. However, functional capacity is sometimes not comparable with functional performance in clinical settings. We hypothesized that specific personality traits are related to this capacity-performance discrepancy of functional outcome.MethodsThe measures in this study were the UCSD Performance-based Skills Assessment Brief (UPSA-B) for functional capacity, the Social Functioning Scale (SFS) for functional performance, and the Temperament and Character Inventory-140 (TCI-140) for personality traits. A total of 94 stable outpatients with schizophrenia were divided into four groups based on combinations of their UPSA-B and SFS cut-off points, as follows: a high capacity and high performance (HH) group, a high capacity but low performance (HL) group, a low capacity but high performance (LH) group, and a low capacity and low performance (LL) group.ResultsThere were no significant differences in demographics among the four groups. The LH group showed a significantly lower harm avoidance level than the LL group. The HL group showed a significantly lower persistence level than the HH group.ConclusionLower harm avoidance may enhance functional performance, and lower persistence can limit functional performance, regardless of the primary levels of functional capacity in patients with schizophrenia. Novel and individualized psychosocial treatments considering the individual’s personality traits seem to be helpful for maximizing their functional performance in the community.

Altered Motor and Motor Perceptual Cognitive Imagery Task-Related Activation in Diabetic Peripheral Neuropathy: Insights From Functional MRI.

To compare central nervous system (CNS) activation in patients with and without diabetic peripheral neuropathy (DPN) during motor and motor imagery tasks and to correlate activation with functional performance. Twenty-six participants (13 with DPN, 13 without DPN) underwent functional MRI during three tasks: ankle dorsi plantar flexion (motor task [MT]) and motor imagery tasks of walking on a smooth surface (SMIT) and rough surface (RMIT). Functional assessment included gait analysis, ankle muscle strength, and ankle range of motion. The tasks activated the sensorimotor, motor preparation, visual processing, and decision-making regions. Activation was significantly lower in patients with DPN than in those without DPN during MT and SMIT but not RMIT. Poor functional performance in patients with DPN was associated with greater activation in motor preparation regions. In patients with DPN, CNS responses appear muted compared with patients without DPN, but they remain capable of enhancing CNS activation when tasks are more challenging or when functional deficits are substantial.

Can Fear of Movement, Depression and Functional Performance be a Predictor of Physical Activity Level in Patients With Knee Osteoarthritis?

This study aims to explore whether fear of movement, depression and functional performance are predictors of physical activity levels in patients with knee osteoarthritis (OA). A total of 200 patients (80 males, 120 females; mean age 53.23±5.99 years; range, 40 to 65 years) with knee OA participated in this cross-sectional, correlational-design study. Oxford Knee Score (OKS) was used to evaluate physical function and pain through patient perspective. Six-Minute Walk Test (6-MWT) was used to evaluate functional performance. International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess subjective physical activity level. A 17-item of the self-reported Tampa Scale for Kinesiophobia (TSK) questionnaire was used to determine the fear of movement level. Beck Depression Inventory (BDI) was used as a self-reported measure for depression level. Spearman correlation analysis and the linear regression model with R-square (R2) were used to correlate and explain the total variance. International Physical Activity Questionnaire-Short Form was significantly correlated to OKS (r=-0.550), 6-MWT (r=-0.561), TSK (r=-0.693) and BDI (r=-0.429) in patients with OA (p<0.001). Linear regression analysis revealed that OKS, 6-MWT test, TSK and BDI were independently associated with IPAQ-SF in predicting physical activity level in patients with knee OA (p≤0.001; R2=0.621). This study increases the understanding of the predictors of physical activity level related to fear of movement, depression and functional performance in patients with knee OA. Improving physical activity levels in OA population is necessary to implement early treatment strategies before the disease progresses and more costly solutions are needed.

Does adding an integrated physical therapy and neuromuscular electrical stimulation therapy to standard rehabilitation improve functional outcome in elderly patients with pneumonia? A randomised controlled trial

Objective: To compare the effects of an integrated programme of physical and electrical therapy to standard rehabilitation to improve physical and functional performance in elderly patients with pneumonia. Design: Randomized clinical trial. The study was registered in the ClinicalTrial.gov website (identifier: NCT02515565). Setting: University Hospital. Subjects: In total, 185 elderly patients with pneumonia were eligible for the study, of which 95 were finally randomized. Interventions: Patients were randomized to a control group which received the standard treatment or to an intervention group which received additionally an integrated programme of physical and electrical therapy. Main measures: Demographic and clinical information was acquired. Pulmonary function, length of hospital stay, handgrip strength, independence levels and comorbidities were assessed as descriptive outcomes. The main outcome measure was functional and physical performance, evaluated with the short physical performance battery. Secondary outcome measures were respiratory symptoms including dyspnoea, fatigue and cough. Results: Mean age of patients was 74.92 (11.03) years in the intervention group and 72.53 (9.24) years in the control group. Significant between groups differences (P < 0.05) were found in short physical performance battery chair stand test (2.17 (0.97) vs. 0.58 (0.61)) and total score (5.91 (3.61) vs. 4.15 (3.15)). The intervention group showed better performance than the control group in both cases. Fatigue (32.04 (18.58) vs. 46.22 (8.90)) and cough (18.84 (2.47) vs. 17.40 (3.67)) showed higher improvement in the intervention group, and significant differences were observed between the groups. Conclusion: An integrated programme of physical and electrical therapy during hospitalization improves physical and functional performance in patients with pneumonia.

A comparison of the Effect of Quadriceps Taping versus Patellar Taping on Balance and Functional Performance in Patients with Knee Osteoarthritis

Abstract Backgrounds Osteoarthritis (OA) is primarily a disease of cartilage destruction. Knee OA is the most common type of arthritis which can be treated with kinesio taping (KT). Purpose The current study was aimed to compare the effect of quadriceps muscle taping vs. patellar taping on balance and functional performance in patients with knee OA. Patients and Methods 40 patients with knee OA aged from 40 to 65 years entered this interventional study. Eligible participants were randomly divided into 2 groups, the Quadriceps taping group, and patellar taping group. The balance was measured using the modified star excursion balance test (SEBT), functional reach test (FRT), and Berg balance scale test (BBST). Also, functional activity was evaluated using the step test. All variables measured before, immediately after and 24 hr after the intervention in both groups. Results Within-group comparison in both groups showed that KT therapy improved modified SEBT, FRT and step test scores immediately after and 24 h after the intervention compared to baseline, and the difference was more significant 24 h after the intervention compared to immediately after the intervention. However, BBS score was not different in assessed times compared to baseline in both groups. The results of between-group analyses of variables showed no significant differences between the two groups in assessed times. Besides, repeated measure ANOVA showed that time significantly influenced modified SEBT, FRT, and step test. However, there was no group effect on assessed variables. Conclusion Both quadriceps and patellar taping positively influenced balance and functional level of the patients with knee OA. Also, there is no superiority between these 2 methods.

Is there a relation between rotator cuff injury and core stability?

Strong core stabilization not only minimizes the load on the vertebral column, but also improves strength and endurance of peripheral joints, and enables the energy transfer to distal segments. Despite the current interest surrounding core stability, none of the studies investigated the effect of core stability on the formation of rotator cuff tear or healing after repair. To determine the relationship between core stability and upper extremity functional performance in patients who underwent rotator cuff repair surgery and to compare those with healthy subjects of similar age. Patients who underwent rotator cuff repair (RC repair group, n= 58 patient) and healthy subjects of the similar age group (control group, n= 114) were included in the study. The mean age was 55.03 ± 9.84 years in the RC repair group and 52.71 ± 6.31 years in the control group. The RC repair group took standardized rehabilitation. The rehabilitation program did not include core strength and stability exercise. Core endurance was assessed with Flexor Endurance, Prone Bridge and Supine bridge test. Disabilities of the Arm, Shoulder and Hand (DASH), Short Form-36 (SF-36) and the Close Kinetic Chain Upper Extremity Stability (CKCUES) test were used to evaluate the upper extremity functional performance. The core endurance (prone and supine bridge test) of the control group was statistically significantly better than the RC repair group (p⩽ 0.005). The DASH-T, SF-36 and CKCUES scores of the control group were also statistically significantly better. The neuromuscular system should be considered as a whole, and addition of the core stabilization exercises to an effective rehabilitation program after RC repair surgery may be beneficial.

Effects of task-oriented training on upper extremity functional performance in patients with sub-acute stroke: a randomized controlled trial.

[Purpose] The present study aimed to determine the effects of a task-oriented training on paretic upper extremity functional performance in patients with subacute stroke. [Participants and Methods] Twenty-eight subacute stroke sufferers (mean age: 50.07, standard deviation 9.31 years; mean time since stroke 11.11, standard deviation 6.73 weeks) were randomly allocated to task-oriented training (n=14) or conventional exercise program (n=14) group. They were trained as a hospital-based, individualized training 1 hour a session, 5 sessions a week for 4 weeks. Wolf Motor Function Test (primary outcome), motor portion of Fugl-Meyer assessment upper extremity, and hand function domain of Stroke Impact Scale were assessed at baseline, after 2 and 4 weeks of training. [Results] All participants completed their training programs. At all post-training assessments, the task-oriented training group showed significantly more improvements in all outcomes than the conventional exercise program group. No serious adverse effects were observed during or after the training. [Conclusion] Task-oriented training produced statistically significant and clinically meaningful improvements of paretic upper extremity functional performance in patients with subacute stroke. These beneficial effects were observed after 2 weeks (10 hours) of training. Future investigation is warranted to confirm and expand these findings.

Effectiveness of Active Release Technique Versus Myofacial Release Technique on Patients with Plantar Faciitis: A Comparitive Study

Background: Plantar fasciitis is one of the most common causes of heel pain. The pain and discomfort associated with this disorder affect physical mobility and function dramatically. There are various conservative treatment strategies known to enhance symptoms of the condition including ice, heat, taping, electrical modalities, night splints, orthotics, stretching and strengthening. In addition, there are a number of soft tissue techniques such as Myofascial Release Technique (MFR) and Active Release Technique (ART) that may be effective in Plantar Fasciitis. Objective: To find out and compare the effectiveness of Active Release Technique versus Myofascial Release Technique on pain and functional performance in patients with plantar fasciitis. Methodology: Thirty patients who met the selection criteria were chosen for the study after receiving their informed consent. Participants were assigned randomly into two groups (Group A and Group B). Group A received the ART, whereas Group B received the MFR technique. Both groups jointly received ultrasound therapy and plantar fascia stretching exercise. The assessment of Numerical Pain Ratting Scale (NPRS) and Patient Specific Functional Scale (PSFS) is made before and after the six day treatment schedule. Result: Statistically significant improvements in NPRS (Z=3.44, P=0.001) and PSFS (t=10.2, P=0.001) were observed in group A patients. Statistically significant improvements in NPRS (Z=3.44, P=0.001) and PSFS (t=9.4, P=0.001) were noted in group B patients. When comparing group A and group B, NPRS (Z=2.59, P=0.009) showed significant differences between two groups and PSFS (t=1.92, P=0.06) was insignificant. Conclusion: The study concluded that both the Active release technique and the Myofascial release technique are effective in reducing pain and improving functional performance in patients with plantar fasciitis. However, the pain reduction in the Active release technique group is significantly higher than in the Myofacial release technique group, but the functional performance shows similar effects in both groups

Performance and Reproducibility of the Continuous Scale Physical Functional Performance 10 Test in Patients With Chronic Obstructive Pulmonary Disease: A CONTROLLED CROSS-SECTIONAL STUDY.

To compare the performances of patients with chronic obstructive pulmonary disease (COPD) and healthy individuals on the Continuous Scale Physical Functional Performance 10 (PFP10) test and, second, to test the reproducibility of the PFP10 test in these participants. In a prospective, cross-sectional study, 28 patients with COPD (67 ± 9 y, FEV1: 44.3 ± 16.9% pred) and 12 healthy volunteers (healthy group) matched by age, body mass index, and sex were included. The participants performed 2 PFP10 tests 5 d apart. Main outcome measure was performance on the PFP10 test and included total score, score for specific domains, and total time to perform the PFP10 test. The functional performance of patients with COPD was worse than that of the healthy group on PFP10 total scores (43.9 ± 12.6 vs 63.5 ± 9.4, respectively; P < .001; effect size: 1.78) and time to complete the tasks (207.9 ± 36.1 sec vs 153.2 ± 12.1 sec, respectively; P < .001, effect size: 2.27). In addition, the COPD group had significantly worse performance in the domains of upper-body strength, lower-body strength, balance and coordination, and endurance. The test was highly reproducible (ICC: 0.98; 95% CI, 0.96-0.99 for both groups), and the mean difference (upper and lower limits of agreement) of the total scores was -3 (-9 to 3). The PFP10 test is a suitable and reproducible test for determining decreases in the functional performance of patients with COPD compared with healthy individuals.

Functional performance in patients with COPD: association with treatment regimen, GOLD group, lung function, and symptom burden in a cross-sectional study.

BackgroundData suggesting that low physical activity levels are associated with increased mortality and exacerbations in patients with COPD have led to increasing interest in the role of physical activity in COPD. This study evaluated self-reported functional performance, a measure of physical activity impairment, according to current treatment regimen, lung function, symptoms, and Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 groups in a large sample of patients with COPD.MethodsThis multicenter, cross-sectional, observational study (study identifier: D5970R00003) included patients with COPD (≥40 years) in the USA. A self-completion questionnaire captured demographics and patient-reported outcomes, including the Functional Performance Inventory-Short Form (FPI-SF). Diagnosis and treatment history (including spirometry results) were extracted from medical charts. Multiple linear regression was used to determine the relationship between FPI-SF and FEV1 % predicted, and FPI-SF and COPD assessment test (CAT) score.ResultsOverall, 1,775 patients participated (classified as GOLD 2017 group A, 14.8%; B, 46.6%; C, 2.6%; D, 36.0%). Physical activity impairment affected patients across all treatment regimens and GOLD groups (mean FPI-SF total score: 2.1), with the greatest impairment within FPI-SF observed for domains requiring most physical exertion, “physical exercise” and “maintaining the household” (mean FPI-SF scores: 1.7 and 1.8, respectively). Patients receiving loose triple therapy and those in GOLD group D had the highest impairment (mean FPI-SF total scores: both 1.9), and the lowest FEV1 % predicted (55.5% and 54.7%, respectively). FPI-SF total score correlated with FEV1 % predicted and more strongly with CAT score (all P<0.05).ConclusionThe stronger correlation between FPI-SF and CAT scores compared to FPI-SF and FEV1 % predicted suggests that symptoms may have a greater impact on patients’ functional performance than lung function. Further longitudinal studies are required to establish a correlation between the effect of treatment on symptoms, lung function, and physical activity.

MRI Markers and Functional Performance in Patients With CIS and MS: A Cross-Sectional Study.

Introduction: Brain atrophy is a widely accepted marker of disease severity with association to clinical disability in multiple sclerosis (MS). It is unclear to which extent this association reflects common age effects on both atrophy and function.Objective: To explore how functional performance in gait, upper extremities and cognition is associated with brain atrophy in patients with Clinically Isolated Syndrome (CIS) and relapsing-remitting MS (RRMS), controlling for effects of age and sex.Methods: In 27 patients with CIS, 59 with RRMS (EDSS ≤3) and 63 healthy controls (HC), 3T MRI were analyzed for T2 lesion count (T2C), volume (T2V) and brain volumes [normalized brain volume (NBV), gray matter volume (NGMV), white matter volume (NWMV), thalamic volume (NThalV)]. Functional performance was measured with short maximum walking speed (SMSW speed), 9-hole peg test (9HPT) and symbol digit modalities test (SDMT). Linear regression models were created for functional variables with stepwise inclusion of age, sex and MR imaging markers.Results: CIS differed from HC only in T2C and T2V. RRMS differed from HC in NBV, NGMV and NThalV, T2C and T2V, but not in NWMV. A strong association with age was seen in HC, CIS and RRMS groups for NBV (r = −0.5 to −0.6) and NGMV (r = −0.6 to −0.8). Associations with age were seen in HC and RRMS but not CIS for NThalV (r = −0.3; r = −0.5), T2C (rs = 0.3; rs = 0.2) and T2V (rs = 0.3; rs = 0.3). No effect of age was seen on NWMV. Correlations of functional performance with age in RRMS were seen for SMSW speed, 9HPTand SDMT (r = −0.27 to −0.46). Regression analyses yielded significant models only in the RRMS group for 9HPT, SMSW speed and EDSS. These included NBV, NGMV, NThalV, NWMV, logT2V, age and sex as predictors. NThalV was the only MRI variable predicting a functional measure (9HPTr) with a higher standardized beta than age and sex (R2 = 0.36, p < 1e-04).Conclusion: Thalamic atrophy was a stronger predictor of hand function (9HPT) in RRMS, than age and sex. This underlines the clinical relevance of thalamic atrophy and the relevance of hand function as a clinical marker even in mildly disabled patients.

Exercise Capacity and Functional Performance in Patients With an HVAD Left Ventricular Assist Device (LVAD): Development 6 Month After Discharge From Cardiac Rehabilitation

Exercise Capacity and Functional Performance in Patients With an HVAD Left Ventricular Assist Device (LVAD): Development 6 Month After Discharge From Cardiac Rehabilitation

Cardio-respiratory fitness and functional performance in patients with a recent diagnosis of colorectal cancer.

804 Background: Physical capability describes the ability to do the physical tasks of everyday living. Oncologists usually evaluate physical capability through anamnesis generating a performance status (PS) score. Some authors have proposed the use of cardiorespiratory reserve, muscular strength and objective evaluation of physical activity to avoid the subjective, unreliable and non-reproducible condition of PS. Methods: Patients with a recent diagnosis of colorectal cancer who accepted to participate were evaluated at the hospital setting. Walking speed was evaluated through both one-mile walk test and six-minute walk test. VO2max was calculated through the Kilne formula. Muscular strength was measured through dynamometry (hand-grip) and “sit to stand” test. Physical activity was objectively evaluated with accelerometers. Fatigue was evaluated through the PERFORM questionnaire (12-60). ECOG was evaluated by the medical oncologist. Results: 100 pats were recruited between March 15 and Jul 17. ECOG O/1/2 (80/14/2). 40 (40 %) were metastatic. Mean age 66 (25-81), Sex M/F; 68/32. Conclusions: Objective evaluation of physical condition is feasible at the hospital setting. There were no differences in BMI, heart rate, fatigue, muscular strength and objective functional performance (weekly PA) between localized and metastatic CRC. In metastatic pts with an excellent ECOG-PS the time to walk one mile and the estimated VO2max could be more sensitive than ECOG to evaluate the functional capacity impairment. In pts with cancer the One- mile walk test could be superior to the Six-minute walk to estimate the cardiorespiratory fitness. The objective evaluation of physical condition is a useful additional tool to select pts for aggressive therapies. [Table: see text]

Unilateral hand training on functional performance in patients with upper extremity trauma

Study DesignCase series. IntroductionUpper extremity (UE) trauma and subsequent immobilization affects functional performance. Purpose of the StudyDetermine the usefulness and feasibility of unilateral hand training (UHT) on improving functional performance in patients with UE trauma. MethodsNine participants received UHT within 10 days of immobilization. Functional performance, dexterity, grip, and pinch strength were measured at initial and 4-week visits. Qualitative interviews were coded to develop themes. ResultsAll Jebsen-Taylor hand function test subtests improved from pretest to post-test. Disabilities of the Arm, Shoulder and Hand scores of all 9 participants improved. Functional performance was more impaired for participants with dominant UE injury. Four themes emerged: participants were forced to alter or avoid most daily activities, had an increased dependency on others, took longer to perform activities, and felt UHT decreased the impact of UE trauma on function. DiscussionFunctional performance was impaired for all participants. Participants believed that UHT was useful and contributed to improved function. ConclusionThis case series tracked a comprehensive intervention based on a holistic activities of daily living framework that considered the nuances of individual complexities of immobilization following hand trauma. Knowledge from this study supports an early intervention like UHT to educate clients on effective strategies to improve immediate activities of daily living functioning and potentially prevent longer term impairments.

Translation of an evidence-based therapeutic exercise program for patients with peripheral artery disease

The purpose of this study was to implement and evaluate quality outcomes including referral, enrollment, and completion rates of a new peripheral artery disease (PAD)-specific supervised exercise therapy (SET) program within a preexisting clinical exercise wellness program and to evaluate the clinical effectiveness and patient-centered outcomes derived from 12weeks of PAD-specific SET. Recruited participants completed an individualized, minimally supervised, PAD-specific SET program based on the AHA-ACC guidelines. Exercise workloads (metabolic equivalents of task [METs]) were tracked and evaluated throughout the program. Short Physical Performance Battery, 6-minute walk test (6MWT) Walking Impairment Questionnaire, Short-Form 36 (SF-36), and Peripheral Artery Disease Quality of Life Questionnaire (PADQOL) were assessed before and after the program. Paired t-tests were used to examine differences between baseline and follow-up outcome variables. On average, participants (n=46) attended 23 (standard deviation [SD] 12.9) out of the possible 36 training sessions, for a 64% attendance rate. Among participants who used treadmill walking as the primary mode of exercise (n=40), the overall mean MET level just prior to program completion was 3.79 (SD 1.49), which represented an increase of 0.92 (34%) METs compared to baseline (P<.001). Total distance on the 6MWT increased 115 (11%) feet (P=.011), which is considered a clinically meaningful improvement. Significant improvements were noted in the PADQOL: symptoms and limitations in physical functioning (P=.007). This study demonstrates that a minimally staffed PAD-specific SET program can improve functional performance in patients with claudication due to PAD and serves as a foundation to help build a clinically effective, Centers for Medicare and Medicaid reimbursed PAD-specific rehabilitation program.

Selected Factors Against Functional Performance in Patients in the Early Period After Stroke

The main objective of the study was to evaluate the impact of selected clinical factors on functional performance in 693 patients in the early period after stroke. The level of functional performance of each patient was evaluated twice (before and after 4 weeks of rehabilitation) using the short ver

Effect of rehabilitation and prolotherapy on pain and functional performance in patients with chronic patellar tendinopathy

Effect of rehabilitation and prolotherapy on pain and functional performance in patients with chronic patellar tendinopathy