Functional Performance Tests Research Articles

Functional Performance Tests Reveal Promising Results at 6 Months After Shoulder Stabilization Surgery.

Although athletes are mostly allowed to return to play 6 months after shoulder stabilization surgery, there are inadequate data about their functional status during this period. Performance tests would reveal insufficiency in the functional capacity of shoulder 6 months after stabilization surgery. Prospective cohort study. Level 3. A total of 32 male athletes with arthroscopic anterior capsulolabral repair (AACR) were included in the study. Shoulder internal and external rotator (IR-ER) strength was assessed using isokinetic dynamometer at 60°/s and 180°/s angular velocities preoperatively and 6 months postoperatively. Shoulder function was assessed with closed kinetic chain upper extremity stability (CKCUES) test, Y balance test-upper quarter (YBT-UQ), and unilateral seated shot-put test (USSPT) at 6 months postoperation. Western Ontario shoulder instability index (WOSI) and Tampa scale of kinesiophobia (TSK) were used for the self-assessment of the shoulder. Mixed-model ANOVA was used to analyze the changes in the IR-ER strength on both shoulders. Limb symmetry index (LSI) was calculated for the IR-ER strength, YBT-UQ, and USSPT scores. Shoulder IR strength was higher at 6 months postoperatively compared with preoperatively. The LSI was 76.4% and 76.6% for ER strength, and 94.2% and 94% for IR strength at 60°/s and 180°/s angular velocities, respectively, at the postoperative 6 month timepoint. The mean CKCUES test score was 21.8 ± 2.6 touches and the LSI was 94.7% for the YBT-UQ and 102.5% for the USSPT. WOSI (P < 0.001) and TSK (P = 0.001) scores were significantly lower at 6 months postoperatively. Functional status of the patients with shoulder stabilization surgery improved considerably 6 months after surgery, yet they did not fully recover function. Exercise programs focusing on shoulder ER strength and shoulder performance should be emphasized after stabilization surgery.

Development, validity, and test-retest reliability of a new neurocognitive functional performance test: The choice-reaction hop test

ObjectivesTo validate a choice-reaction hop test (CRHT) by assessing differences in timing versus the side-hop test (SHT), and to determine the CRHT's test-retest reliability. DesignTest-retest reliability. SettingLaboratory. ParticipantsForty-nine healthy adults participated (16 female; age = 22.7 ± 3.4 years; height = 174.9 ± 9.1 cm; mass = 75.4 ± 14.8 kg). Main outcome measuresParticipants completed three trials each of the SHT and the CRHT in a counterbalanced order. Participants returned one-week later to repeat the CRHT. The fastest and the mean of the three trials were compared. ResultsParticipants took significantly longer to complete the CRHT (Mean across 3 trials = 21.4 ± 3.4s, Fastest trial = 19.7 ± 3.0s) compared to the traditional SHT (10.4 ± 2.0s, p < 0.001). The CRHT demonstrated good-excellent test-retest reliability across testing days for both the mean across 3 trials (r = 0.890, p < 0.001, SEM = 1.13) and the fastest trial (r = 0.828, p < 0.001, SEM = 1.24). ConclusionCompared to the SHT, the CRHT took longer to complete indicating its ability to stress neurocognitive function during an FPT. The CRHT demonstrated good-excellent test-retest reliability, which may allow it to be a useful measure in serial evaluations such as during rehabilitation benchmarking. The CRHT may be an effective FPT to assess combined physical and neurocognitive function to assist clinicians in evidence-based decision-making.

Optimization of workpiece processing based on the orthogonal double-chain differential evolution algorithm

Abstract An orthogonal double-chain differential evolution (ODCDE) algorithm is proposed to optimize the problem’s parameters for workpiece processing. ODCDE improves the differential evolution structure by changing the parcels into the orthogonal chains in the adaptive search range of the solution, which can avoid falling into local optimum, improve the solution precision, and speed up the convergence speed. The superiority of the proposed algorithm was proved by the function performance test on three sets of bench functions, which reached the first place in the set of 23 functions with other 11 optimal algorithms, ranked the second in the CEC2017 functions with other more recent 5 algorithms, and ranked the seventh in the CEC2011 functions with other 11 algorithms including AMO, SFS, and GSK algorithms. Finally, two kinds of optimal workpiece processing, the tubular column design and the multipass milling, are studied, and the results show that our algorithm performs better than other methods.

Quality of life, level of physical activity and functional tests in actively working adults and older people

The population of actively working older people is growing rapidly. The relationship between quality of life, levels of physical activity and functionality in this population is not entirely clear. To determine the association between quality of life, levels of physical activity and functional tests in actively working adults and older people. Cross sectional assessment of 138 adults aged 40 to 50 years (53% women) and 119 older people aged 60 to 75 years (53% women) who were actively working in two public services. Quality of life was measured with the SF-36 questionnaire and usual physical activity was assessed with the International Physical Activity Questionnaire (IPAQ-short). Handgrip strength, the timed up and go (TUG) and chair stand test (CST) were used as functional tests. Compared to older people, adults had better physical functional tests (P < 0.01). Older people had better scores in the mental health component (MHC) of quality of life (p < 0.05). In adults, the physical health component of quality of life (CSF) had a positive association with physical activity (Spearman Rho (rs)= 0.270; p = 0.01), grip strength (rs = 0.330; p < 0.01) and the TUG (rs = -0.229; p < 0.01). In older patients, CSM and CST were positively correlated (rs = 0.201; P = 0.029). In both groups, a correlation was observed between CSM, grip strength (adults rs = 0.283; p < 0.01; older people rs = 0.211; P = 0.02) and with TUG (adults rs = -0.197; P = 0.021; older people rs = - 0.212; p = 0.02). There is a positive correlation between quality of life and level of physical activity in working adults, which is not observed in older people. Adequate performance in physical functional tests is positively correlated with better quality of life (CSF and CSM) in adults and only with the mental health component in older people.

Cross-cultural adaptation of the Taiwan Chinese version of the Falls Efficacy Scale-International for community-dwelling elderly individuals

BackgroundThe Falls Efficacy Scale-International (FES-I) is a commonly used questionnaire to evaluate concerns about falling. We adapted a Taiwan Chinese version (FES-ITC) and evaluated its reliability and validity in community-dwelling elderly individuals. The discriminative validity was tested in relation to several known risk factors for fear of falling (FOF).MethodsThe questionnaire was adapted through translation, back-translation, and expert review processes. A convenience sample of 135 community-dwelling elderly individuals (at least 60 years old) completed the adapted questionnaire, and 31 of them had a retest within 7–10 days. Cronbach’s α and an intraclass correlation coefficient (ICC) were used to evaluate the internal consistency and test–retest reliability. Principal component factor analysis was performed to assess the factor-construct validity. The discriminative validity was tested in relation to demographic features, fall-related history and performances on three functional tests: timed up and go, four-stage balance and 30-s chair stand tests. Effect sizes were computed. Correlation coefficients between physical functional performance and FES-ITC scores were computed. Receiver operating characteristic curves were used to determine the cutoff point for the score to differentiate high and low concern of falling.ResultsThe FES-ITC questionnaire had high internal consistency (Cronbach’s α = 0.94) and excellent test–retest reliability (ICC = 0.94). Principal component factor analysis yielded a two-factor model, with several items requiring high demand on postural control loading on factor 2. FES-ITC scores discriminated individuals with different ages, reporting FOF, reporting falls in the past year and using walking aids. However, FES-ITC scores did not differ between the participants who were at risk of falling and those who were not at risk based on functional test performance and there was no correlation found between them.ConclusionThe FES-ITC was highly reliable and had adequate construct and discriminative validity. The lack of correlation between FES-ITC scores and functional test performance implied the presence of FOF even in individuals with good functional performance. Further follow up studies are warranted to verify the predictive validity of the FES-ITC.

Fat infiltration and muscle hydration improve after high-intensity resistance training in women with sarcopenia. A randomized clinical trial

BackgroundResistance training is recommended for preventing sarcopenia, but the benefits for the quality and quantity of muscle mass are uncertain. ObjectiveTo assess the effects of high-intensity resistance training (HIRT) on clinical and magnetic resonance imaging (MRI) parameters in women with sarcopenia. MethodsA researcher-blinded randomized clinical trial was conducted. Community-dwelling older women with sarcopenia were randomized to six months of HIRT or a control group (CG). Body composition was assessed with bioimpedance equipment, and participants underwent strength and functional performance tests (short physical performance battery [SPPB] and gait speed). MRI scans of the thigh were taken to quantify muscle mass and quality. ResultsThirty-eight women completed the study (20 in the HIRT group). Sarcopenia remitted in 50 % of the HIRT group. HIRT elicited a significant group × time interaction effect for muscle mass (p = 0.027; Ƞ2 = 0.129), muscle mass index (p = 0.023; Ƞ2 = 0.135), fat mass (p = 0.048; Ƞ2 = 0.103) and all strength variables (p < 0.05; Ƞ2 > 0.120). Moreover, the HIRT group obtained higher scores on the SPPB (mean difference [MD] 1.2; p = 0.005) and the 5 times sit-to-stand test (MD = 0.7; p = 0.009). Regarding MRI parameters, infiltrated microscopic fat decreased significantly (HIRT: MD = −0.01; p < 0.05), while hydration (T2) decreased in the CG (MD = 3.6 ms; p = 0.053) at six months. There were significant between-group differences at six months for water diffusion (HIRT: 1.09 × 10−3 mm2/s vs CG: 1.26 × 10−3 mm2/s) and total muscular volume (HIRT: 832.4 L vs CG: 649.2 L). ConclusionsHIRT led to the remission of sarcopenia in half of the older women, as seen in muscle mass, strength, and functional performance and MRI biomarkers, with significant increases in muscle quality. Registered in ClinicalTrials.govNCT03834558.

Functional performance in runners after knee surgery: Differences between limbs and relationships with pain and confidence

Introduction: Single leg functional performance tests, such as hop for distance and side hop tests, are commonly used assessments in rehabilitation following knee surgery as they are linked to self-reported function and quality of life. Little is known about how such tests differ between surgical and non-surgical limbs in those who return to running following knee surgery, and how much pain and/or confidence during the test impacts performance. Therefore, we aimed to explore differences in single leg functional performance between surgical and non-surgical limbs in runners with a history of knee surgery, and to explore how pain and confidence relates to performance.

Association between Sedentary Behavior and Cognitive Performance in Middle-Aged and Elderly Adults: Cross-Sectional Results from ELSA-Brasil.

This study aimed to verify the association between Sedentary Behavior (SB) and performance on cognitive function tests in middle-aged and elderly adults. This cross-sectional study included 6505 participants (55.2% women) of ELSA-Brasil, with a median age of 61 years. The different types of SB considered were sitting time and screen time. The scores obtained in the memory, language, and executive function tests were used to assess cognitive performance (CP). The association between SB and CP was assessed using linear regression. For men, sitting time was associated with better performance in memory, language, and executive function tests. Screen time on the weekend, showed a favorable association with performance in the executive function test. Occupational screen time on weekdays was positively associated with language test performance. For women, sitting time and occupational screen time were positively associated with performance on memory tests. SB was favorably associated with performance in language tests and executive function tests. SB seems to favor CP in this population without evident dementia and with a high level of education. The type of SB (mentally active or passive) and the schooling seem to be of particular interest for cognitive performance.

The relationship between muscle power, functional performance, accelerometer-based measurement of physical activity and patient-reported outcomes in patients with hip osteoarthritis: A cross-sectional study

BackgroundPatients with unilateral hip osteoarthritis appear to have between-leg differences in leg extension power (LEP). The Nottingham Leg Extensor Power Rig provides reliable and valid results but requires sensitive equipment. It would be relevant to identify measures closely associated with this test. Objective(i) To investigate if LEP is lower in the affected leg compared to the non-affected leg. Furthermore, to investigate the associations between LEP and the measures: (ii) Functional performance, (iii) accelerometer-based measurement of physical activity and (iv) patient-reported outcome measures (PROM). DesignCross-sectional study including 60 patients (30 men, 30 women) with hip osteoarthritis scheduled for hip replacement. MethodThe counter movement jump and 10-m sprint tests were used to determine functional performance, accelerometer-sensors were used to determine physical activity and the Copenhagen Hip and Groin Outcome Score (HAGOS) was used to determine PROM. Results(i) LEP in the affected leg corresponded to 79% [95% CI 74%; 85%] of the non-affected leg, (ii) LEP was positively associated with functional performance tests (β 0.63 to 0.78, p < 0.05), (iii) positively associated although non-significantly with physical activity (β 0.16 to 0.23, p > 0.05) and (iv) positively associated with the six HAGOS subscales (β 0.25 to 0.54, p < 0.05). ConclusionFunctional performance tests may be used as feasible, inexpensive and fast ways to assess LEP in clinical settings. These results may suggest that interventions aimed at improving LEP can improve functional performance and PROM, but not physical activity. Future research is needed to confirm the causality of these cross-sectional findings. The clinical trial registration numbersDanish Data Protection Agency (1-16-02-640-14), ClinicalTrials.gov (NTC02301182) and approved by the Danish Biomedical Research Ethics Committee (1-10-72- 343-14) prior to data collection.

Effect of Running-Induced Fatigue on Tibial Acceleration and the Role of Lower Limb Muscle Strength, Power, and Endurance.

High-impact loads have been linked with running injuries. Fatigue has been proposed to increase impact loads, but this relationship has not been rigorously examined, including the associated role of muscle strength, power, and endurance. This study aimed to investigate the effect of fatigue on impact loading in runners and the role of muscle function in mediating changes in impact loading with fatigue. Twenty-eight trained endurance runners performed a fixed-intensity time to exhaustion test at 85% of V̇O 2max . Tibial accelerations were measured using leg-mounted inertial measurement units and sampled every minute until volitional exhaustion. Tests of lower limb muscle strength, power, and endurance included maximal isometric strength (soleus, knee extensors, and knee flexors), single leg hop for distance, and the one leg rise test. Changes in peak tibial acceleration (PTA, g ) were compared between time points throughout the run (0%, 25%, 50%, 75%, and 100%). Associations between the change in PTA and lower limb muscle function tests were assessed (Spearman's rho [ rs ]). PTA increased over the duration of the fatiguing run. Compared with baseline (0%) (mean ± SD, 9.1 g ± 1.6 g ), there was a significant increase at 75% (9.9 g ± 1.7 g , P = 0.001) and 100% (10.1 g ± 1.8 g , P < 0.001), with no change at 25% (9.6 g ± 1.6 g , P = 0.142) or 50% (9.7 g ± 1.7 g , P = 0.053). Relationships between change in PTA and muscle function tests were weak and not statistically significant ( rs = -0.153 to 0.142, all P > 0.05). Peak axial tibial acceleration increased throughout a fixed-intensity run to exhaustion. The change in PTA was not related to performance in lower limb muscle function tests.

The Effects of a Cognitively Challenging Physical Activity Intervention on School Children's Executive Functions and Motivational Regulations.

This study examined the effects of a physical education intervention consisting of cognitively challenging physical activity games on school children’s executive functions and motivational regulations. Ninety-nine fourth- and fifth-grade children participated in this two-group, repeated measures, quasi-experimental study with a cross-over design. Children’s executive functions (measured with the design fluency and Stroop and flanker tests) and motivational regulations were measured pre- and post-intervention and one month later. At post-test, the experimental group children outperformed the waiting-list control group children in all design fluency test conditions and accuracy in the Stroop and flanker tests. Both groups improved from pre- to post-intervention their speed (reaction time) in the Stroop and flanker tests. The waiting-list control group children, after receiving the intervention, improved their performance in the executive function tests except for Stroop test accuracy and flanker test speed. The positive effects were reduced significantly one month after the end of the intervention but remained significantly higher compared to pre-intervention. No intervention effects were found for the motivational regulations. These results showed that the intervention had positive effects on children’s executive functions and supported the new shift of designing physical activity programs for developing combinedly children’s physical and cognitive development.

Comparative Effects of Dynamic Stretching and Ice Bag Application On the Physical Performance in Recreational Basketball Players: A Randomized Crossover Study

Introduction: Researchers found that cryotherapy at the ankle joint heightened adjacent muscle activity and reflex amplitude, which facilitated greater force production at the ankle complex. Furthermore, cryotherapy appears to increase musculoarticular stiffness, which has been associated with heightened muscular performance at a joint. Aim and objective: the aim of the study is to examine the influence of dynamic stretching and IBA technique on the physical performance. Methodology: Total 20 healthy male basketball athletes encompassing two groups participated in the current study. The study consisted of two groups, Group A (ice bag application) and Group B (dynamic stretching). Cold compress was applied over the anterior thigh, posterior thigh, and calf. Subjects were assigned to Group A, and Group B, using Convenience sampling method. Each candidate performed the 5 minutes of jogging before taking intervention. All subjects performed three functional performance tests: Vertical Jump Test, Agility T-test &amp; 20-meter sprint. Each participant attended an orientation session to become familiar with the testing procedures. Subjects were randomly assigned into two groups and exposed to a crossover study design. The experiment was performed on two separate occasions whereby one group received the dynamic stretching in the first session, while the other group uses the cryotherapy first. After 48 hours, (cooling session) on the next occasion, the groups were changed and the second group receives the cryotherapy, while the first group performs dynamic stretching. On both occasions, the dynamic stretching and cryotherapy interventions were the same. Between the sessions, the subjects will not allow to participate in any kind of vigorous physical activity. Results: The present study showed an increase in performance of recreational Basketball players by the combination of 5 minutes of warm up plus 6 min of dynamic stretching on the vertical jump height and 20-meter sprint.

Teaching Management System and Algorithm Implementation Based on Big Data Fuzzy K-Means Clustering

In this paper, the clustering algorithm of big data fuzzy K-means is used to research and analyze the teaching management system. Since the values of the indicator variables of bad units are usually significantly different in smooth areas and discontinuous areas, we cluster the indicators of local areas through K-means clustering, so that only good units or bad units are included in each class. The server is deployed on the campus and is networked with the teaching computers of each classroom. Teachers log in to the class rate management system before or during class, log in to their respective users, select the corresponding class, and make corresponding attendance records according to the attendance of students in the class. The system automatically counts the number of expected arrivals, attendance, late arrivals, leave requests, and absenteeism for the class. Teachers can also fill in information feedback for this class: a list of absenteeism, classroom discipline, student learning status, teaching suggestions, and teaching testimonials. The development environment built by this system is a combination of PHP + MYSQL, which reasonably planned according to the overall needs. The development mode adopts the top-down model, which runs through the whole process from system development to testing to application. The most used floating point number encoding is the decimal floating point number encoding. The relationship of each module of the virtual reality teaching management system is sorted out, the overall framework of the virtual reality teaching management system is established, and the design of the business flow diagram of the management system is completed. This paper also uses Oracle database technology to further explain the design process of designing the system database. Finally, combined with the system design and implementation, the system test is completed from two aspects: system function test and performance test.

Influence of Graft Type on Lower Extremity Functional Test Performance and Failure Rate After Anterior Cruciate Ligament Reconstruction.

Both autografts and allografts are used to reconstruct the anterior cruciate ligament (ACL) after injury; however, it is unclear whether graft source affects lower extremity functional test performance or failure rate in an active military population. To compare lower extremity functional test performance and graft failure rates between ACL grafts [allograft, hamstring, bone-patellar tendon-bone (BTB)]. Cross-sectional. Level 2. Ninety-eight cadets entering a US Service Academy with a history of unilateral ACL reconstruction (ACLR) agreed to participate. Before basic training, participants completed 4 lower extremity functional tests. Active injury surveillance was conducted within the study cohort to identify all subsequent graft failures. Cadets with hamstring autografts outperformed the BTB and allograft groups on the Lower Quarter Y-Balance Test-Posteromedial direction and single-leg hop test, respectively. No differences were detected by graft type for the other functional tests. The incidence of subsequent ipsilateral graft failures in patients with autograft was 8.11%. No failures were observed in the allograft group during the follow-up period. After controlling for sex, joint hypermobility, and time since injury and surgery, the risk of graft failure was 9.8 times higher for patients with a hamstring autograft than with a BTB (P = 0.045). After ACLR, graft type appears to influence some single-limb measures of lower extremity function and the risk of subsequent failure. Hamstring autografts demonstrated better functional performance but increased risk of graft failure. Surgeons need to weigh the pros and cons of all graft options in relation to the patient's lifestyle. Regardless of graft type, individuals with an ACLR may require additional rehabilitation to regain neuromuscular control during dynamic single-limb tasks and mitigate graft failure.

No correlation between performance tests, clinical measurements and data from patient-reported outcome measures (PROM) in children reconstructed for anterior cruciate ligament injury.

To investigate if patient-reported outcome measures (PROMs), functional tests and clinical measures correlate well in children after reconstruction of the anterior cruciate ligament (ACL). It was hypothesized that these outcomes correlate, so it is sufficient to report only one of them. A consecutive group of children (< 16years old) who had an ACL reconstruction, were prospectively followed and assessed after 1-year with Pedi-IKDC and KOOS-Child, instrumented laxity measurement, range of motion, extension strength and four performance tests. Relations between the different outcomes were calculated by partial correlation coefficient analysis, controlling for gender, age, height, and weight. Outcomes were available for 141 of 163 children. There were only few positive and weak correlations between performance tests and PROM scores and between clinical measurements and PROM scores. There were weak to strong correlations between the scores from Pedi-IKDC and the scores from each of the five domains of KOOS-Child and a weak to moderate correlation between the different domains of KOOS-Child. Similar correlations were found between the different performance tests. For children who had their ACL reconstructed there was no clinically important correlation between scores obtained by PROMs, a battery of functional performance tests and instrumented laxity of the knee at 1-year follow-up. This is an argument for always to include and report all three types of outcomes. Level II.

Differences in the course of rehabilitation and outcomes for publicly insured pediatric patients after anterior cruciate ligament reconstruction

ObjectiveExamine the effect of insurance type on physical therapy (PT) utilization and outcomes within pediatric and adolescent patients after anterior cruciate ligament reconstruction. DesignMulticenter retrospective cohort study. MethodsPT visits and functional hop test performance were extracted into a shared database. The average number of PT visits per week was assessed overall and by time period. Independent samples t-test examined the effect of insurance on PT utilization and the effect of insurance status on the odds of passing single-legged hop tests was assessed using multivariable logistic regression. ResultsA total of 281 patients (15.7 ± 1.9, 42% female) were included in this analysis. Of these, 128 (45%) had public insurance. Publicly insured patients experienced a longer delay from surgery to hop test (8.3vs7.7 months, p = 0.009), attended overall fewer PT visits per week (0.92vs1.04, p = 0.005), with most of the decreased frequency occurring between weeks 7–24. Insurance status had a significant effect on the odds of passing the single leg hop test (2.72; 95%CI, 1.27–5.81). ConclusionPublicly insured patients average a lower number of weekly PT visits, experienced a longer delay from surgery to hop testing and were 2.7 times less likely to pass the single leg hop for distance test.

Influence of 2 Digital Exercise Modules of a Multimodular System on Balance and Leg Strength Under Consideration of Use Adherence: Prospective Cohort Study.

BackgroundTo empower healthy aging, digital solutions embed multiple modules for physical activity, cognitive health promotion, and social engagement. Integrating new empowering technologies such as digital exercise monitoring requires assessment measures and analysis procedures, considering variable compliance of users with different modules.ObjectiveThis study aims to assess the influence of a tablet-based and a feedback system–based exercise module on balance and leg strength by considering use adherence instead of the use of the entire multimodular system.MethodsIn the prospective cohort study within the fit4AAL project, 83 users (n=67, 81% women; n=16, 19% men; mean age 66.2, SD 2.3 years) used the 2 digital exercise modules of a multimodular physical activity promotion system for >18 weeks. A data-driven clustering method based on the average use frequency of the exercise modules determined the number of user types that met the World Health Organization–recommended training frequency of at least twice per week. On the basis of this use adherence, statistical analysis was performed with features of functional performance tests (unipedal stance, 30-second chair rise, Y-balance, and hurdle step tests). The tests were conducted 6 months before the intervention, immediately before the intervention, and after the intervention, comparing the baseline phase with the 3 feedback use groups of the study (using only the tablet, the tablet and the feedback system, or only the feedback system).ResultsOf the 83 users, 43 (52%) met the World Health Organization–recommended frequency of muscle-strengthening activities. Overall, the feedback use groups achieved, on average, more chair rises in 30 seconds than the baseline group (P=.01; moderate effect size of 0.07). Of the 43 users, 26 (60%) additionally used the feedback system–based exercise module. They improved in balance compared with the users using either the tablet or the feedback system (P=.02). In addition, they improved their leg strength within the group (P=.04) and compared with the baseline (P=.01).ConclusionsThe additional use of a feedback system showed a tendency to positively maintain and influence the already exceptionally high functional performance of older adults. Considering use adherence in future multimodular system studies is crucial to assess the influence of single and combined use of exercise modules on functional performance.

Prevalence and Risk Factors for Anxiety and Depression in Thai People with Parkinson’s Disease: A Cross-Sectional Study in Buriram Hospital

Background: Anxiety and depression are non-motor symptoms commonly found in patients with Parkinson’s disease (PD). Objective: To investigate the prevalence of anxiety and depression in patients with PD, including factors related to their anxiety and depression. Materials and Methods: Forty-four PD patients of the present cross-sectional study were observed between August 1, 2021 and September 30, 2021. Anxiety and depression were assessed using the hospital anxiety and depression scale (HADS). A score of 8 or more on both HADS anxiety subscale (HADS-A) and HADS depression subscale (HADS-D) denoted significant symptoms of anxiety and depression among the PD patients. Descriptive statistics were used to analyze the prevalence and demographic data. The authors used binary logistic regression, linear regression, and Spearman’s rank correlation coefficient to analyze the factors associated with anxiety and depression. Results: From the 44 Thai PD patients, the prevalence of anxiety and depression were 27.3% and 31.8%, respectively. The anxiety related factors were PD duration of 10 years or more (OR 7.50, 95% CI 1.16 to 48.56), levodopa equivalent dose (LED) of 600 mg/day or more (OR 7.00, 95% CI 1.50 to 32.72), total Unified Parkinson’s Disease Rating Scale (UPDRS) (β=0.46, 95% CI 0.18 to 0.74), UPDRS part II (β=0.32, 95% CI 0.02 to 0.61), and UPDRS III (β=0.37, 95% CI 0.08 to 0.66). The depression related factors were total UPDRS (β=0.39, 95% CI 0.11 to 0.68), and UPDRS part II (β=0.33, 95% CI 0.03 to 0.62). Conclusion: Results indicate that anxiety and depression are associated with disease severity among individuals with PD. Therefore, physicians who treat PD patients with high disease severity should be aware of and screen for these emotional problems to facilitate appropriate management. Keywords: Anxiety; Depression; Disease severity; Functional performance test; Hospital anxiety and depression scale; Parkinson’s disease

The contribution of functional cognition screening during acute illness hospitalization of older adults in predicting participation in daily life after discharge

BackgroundCognitive assessment in acutely hospitalized older adults is mainly limited to neuropsychological screening measures of global cognition. Performance-based assessments of functional cognition better indicate functioning in real-life situations. However, their predictive validity has been less studied in acute hospital settings. The aim of this study was to explore the unique contribution of functional cognition screening during acute illness hospitalization in predicting participation of older adults one and three months after discharge beyond traditional neuropsychological measures.MethodsThis prospective longitudinal study included 84 older adults ≥ 65 years hospitalized in internal medicine wards due to acute illness, followed by home visits at one month and telephone interviews at three months (n = 77). Participation in instrumental activities of daily living, social and leisure activities was measured by the Activity Card Sort. In-hospital factors included cognitive status (telephone version of the Mini-Mental State Examination, Color Trails Test), functional cognition screening (medication sorting task from the alternative Executive Function Performance Test), emotional status (Hospital Anxiety and Depression scale), functional decline during hospitalization (modified Barthel index), length of hospital stay, the severity of the acute illness, symptoms severity and comorbidities.ResultsFunctional cognition outperformed the neuropsychological measures in predicting participation declines in a sample of relatively high-functioning older adults. According to a hierarchical multiple linear regression analysis, the overall model explained 28.4% of the variance in participation after one month and 19.5% after three months. Age and gender explained 18.6% of the variance after one month and 13.5% after three months. The medication sorting task explained an additional 5.5% of the variance of participation after one month and 5.1% after three months, beyond age and gender. Length of stay and the Color Trails Test were not significant contributors to the change in participation.ConclusionsBy incorporating functional cognition into acute settings, healthcare professionals would be able to better detect older adults with mild executive dysfunctions who are at risk for participation declines. Early identification of executive dysfunctions can improve continuity of care and planning of tailored post-discharge rehabilitation services, especially for high-functioning older adults, a mostly overlooked population in acute settings. The results support the use of functional cognition screening measure of medication management ability in acute settings.

Functional Performance Tests, On-Ice Testing and Game Performance in Elite Junior Ice Hockey Players.

This study aimed to explore relationships between fitness, on-ice physical abilities and game performance among elite junior male ice hockey players. Twenty-one major junior ice hockey players (18.9 ± 1.4 years old) participated in the study. Measures including five fitness tests (anthropometric measures, pull up test, bench press test, broad jump, vertical jump) and three on-ice skating tests (multi-stage aerobic skating test, 44-m sprint test, and backward skating test) were assessed during their pre-season training camp. Game performance metrics (collected during the regular season) were collected using InStat software. Results of the (on-ice and off-ice) functional performance test protocol and on-ice tests were analyzed by evaluating correlation coefficients in multiple areas of game performance: 1) physical implication (body checks), 2) offensive contribution (expected goals for, types of zone entries), and 3) defensive actions (blocked shots, expected goals against). They revealed that performance in the broad jump test was associated with skating speed. Some significant correlations were also observed between on-ice test performance indicators such as received body checks, expected goals and blocked shots. In summary, results indicate that on-ice test protocols were associated with players’ performance in multiple aspects of the game. Partial correlation analyses revealed that some of these relationships were specific to the player's position. Forward skating was associated with forwards’ offensive play, and backward skating was specifically related with defensemen’s performance (offense and defense). The addition of on-ice physical tests appears essential for interpreting the results of ice hockey players' physical tests and integrating these results into players’ physical preparation and the in-season follow-up.