Level Of Functional Ability Research Articles

Skeletal muscle symptoms and quantitative MRI in females with dystrophinopathy.

The dystrophinopathies primarily affect males; however, female carriers of pathogenic dystrophin variants can develop skeletal muscle symptoms. This study aimed to evaluate muscle involvement and symptoms in females with dystrophinopathy using quantitative magnetic resonance imaging (MRI), functional assessments, and patient-reported outcomes. Controls and females with dystrophinopathy with muscle symptoms of pain, weakness, fatigue, or excessive tightness were enrolled in this cross-sectional study. Participants underwent lower extremity MRI to quantify muscle inflammation, replacement by fat, and disease asymmetry. Cardiac MRI, functional ability, muscle symptoms, and serum creatine kinase levels were also evaluated. Six pediatric females with dystrophinopathy (mean age: 11.7 years), 11 adult females with dystrophinopathy (mean age: 41.3 years), and seven controls enrolled. The mean fat fraction was increased in females with dystrophinopathy compared to controls in the soleus (0.11 vs. 0.03, p = .0272) and vastus lateralis (0.16 vs. 0.03, p = .004). Magnetic resonance spectroscopy water T2, indicative of muscle inflammation, was elevated in the soleus and/or vastus lateralis in 11 of 17 individuals. North Star Ambulatory Assessment score was lower in the dystrophinopathy group compared to controls (29 vs. 34 points, p = .0428). From cardiac MRI, left ventricle T1 relaxation times were elevated in females with dystrophinopathy compared to controls (1311 ± 55 vs. 1263 ± 25 ms, p < .05), but ejection fraction and circumferential strain did not differ. Symptomatic females with dystrophinopathy quantitatively demonstrate muscle replacement by fat and inflammation, along with impairments in functional ability and cardiac function. Additional research is needed to evaluate how symptoms and muscle involvement change longitudinally.

Holistic and Personalized Strategies for Managing in Elderly Type 2 Diabetes Patients.

Due to increased life expectancy and lifestyle changes, the prevalence of diabetes among the elderly in Korea is continuously rising, as is the associated public health burden. Diabetes management in elderly patients is complicated by age-related physiological changes, sarcopenia characterized by loss of muscle mass and function, comorbidities, and varying levels of functional, cognitive, and mobility abilities that lead to frailty. Moreover, elderly patients with diabetes frequently face multiple chronic conditions that elevate their risk of cardiovascular diseases, cancer, and mortality; they are also prone to complications such as hyperglycemic hyperosmolar state, diabetic ketoacidosis, and severe hypoglycemia. This review examines the characteristics of and management approaches for diabetes in the elderly, and advocates for a comprehensive yet personalized strategy.

Role of Individual Social Capital in the Association of Physical Frailty With Functional Ability Among Older Adults

ObjectivesRich social capital is regarded as an individual's social asset, which may contribute to the maintenance of functional ability, even in a state of frailty. This study examined the moderating role of individual social capital in the association between physical frailty and functional ability among older adults. DesignA cross-sectional study. Setting and ParticipantsIn total, 522 community-dwelling older adults aged ≥60 years were recruited from among visitors to public facilities, including community cultural centers and gymnasiums in Aichi, Japan. MethodsFunctional ability was assessed using the 5-item subscale of the Tokyo Metropolitan Institute of Gerontology Index of Competence that assesses instrumental self-maintenance, including transportation, finance management, and shopping. Physical frailty was defined by the Fried Frailty Phenotype Questionnaire, including 5 items of fatigue, resistance, ambulation, inactivity, and weight loss, and the participants were classified into 3 groups: non-frailty, pre-frailty, and frailty. Individual social capital was assessed for 2 dimensions: the cognitive dimension (perceptions of community social cohesion) and the structural dimension (informal socializing and social participation). ResultsThe participants’ mean age (SD) was 74.1 (6.5) years and 78.0% were women. Among the participants, non-frailty was 46.6%, pre-frailty was 47.0%, and frailty was 6.5%. Multivariable linear regression analysis revealed that physical frailty was associated with lower levels of functional ability compared with non-frailty [pre-frailty: β (95% CI) = −0.07 (−0.22 to 0.08), P = .374; frailty: β = −0.67 (−0.99 to −0.35), P < .001]. However, individual structural social capital showed a negative interaction with physical frailty against low functional ability, indicating a moderating association (P = .027). Conclusions and ImplicationsHigh levels of individual structural social capital mitigated the adverse association between physical frailty and functional ability. Fostering rich social capital may preserve the functional ability of frail older adults, helping their independent lives in the community.

Adolescents with hemophilic knee arthropathy can improve their gait characteristics, functional ability, and physical activity level through kinect-based virtual reality: A randomized clinical trial

BackgroundHemophilic arthropathy is caused by recurrent intra-articular bleeding, most commonly in the knee joints. In terms of physical impact, this arthropathy causes significant disability and hampers the physical activity and functionality of he affected individuals. ObjectiveThis study intended to examine the effect of a physical rehabilitation program incorporating Kinect-based virtual reality (KBVR) on gait characteristics, functional ability, and physical activity level in adolescents diagnosed with hemophilic knee arthropathy (HKA) Materials and methodsIn a randomized clinical trial, 56 boys, aged 10–14 years, with moderate HKA, were randomly allocated into two groups. The control group (n = 28) received conventional physical therapy (CPT), while the KBVR group (n = 52) received a 30-min KBVR exercise program in addition to the CPT. Training was conducted three times/week for 12 successive weeks. Gait characteristics (step length, cadence, velocity, peak knee extension moment during stance, and knee flexion amplitude during swing) were assessed using a gait analysis system, the functional ability was assessed through the 6-min walk test, and physical activity level assessed by the Adolescents' Physical Activity Questionnaire on the pre- and post-treatment occasions. ResultsThe KBVR group achieved more favorable changes in the gait characteristics [step length (P = 0.015), cadence (P = 0.004), velocity (P = 0.024), peak knee extension moment during stance (P = 0.018), and Knee flexion amplitude during swing (P = 0.032)], functional capacity (P = 0.002), and physical activity levels (P = 0.007) compared to the control group. ConclusionThe use of KBVR exercises within a rehabilitation program is a potentially effective therapeutic option for the total care of adolescents with HKA.

Factor structure of the functional state of qualified wrestlers at the stage of special basic training

Changing the rules of wrestling competitions leads to an increase in tension and intensity of competitive activity. This requires wrestlers to have a high level of functional fitness. Therefore, monitoring the functional state of qualified wrestlers is necessary for correcting the training process. In article the factor structure of the functional state of qualified wrestlers at the stage of special basic training was considered. The parameters of heart rate variability, mental states and neurodynamics characteristics were studied. Purpose of work to determine the factor structure of the functional state of qualified wrestlers at the stage of specialized basic training. Methodology. The 31 qualified wrestlers, age 14-16 took part in the study. The analysis revealed a relative autonomic balance between the sympathetic and parasympathetic parts of the autonomic nervous system in the examined athletes. In addition, qualified wrestlers have an optimal mental state that corresponds to the balance of excitation and inhibition processes and optimization of decision-making processes under time constraints. It was revealed that the structure of the functional state of qualified wrestlers includes complex characteristics that support the main elements of the functional system, ensuring the adaptation of the athletes’ body to the training process. The resulting factor structure indicates two factors: “morphofunctional” and “neurodynamic”. The first factor reflects the level of functional readiness and the level of training of wrestlers. In fact, the first factor is the basis of the formation of the functional state of highly qualified wrestlers, which reflects the main factors of the functional system responsible for the formation of the functional state of wrestlers. The second factor reflects the wrestlers’ ability to optimally perceive and process information from the environment under conditions of physical and neuropsychic stress. Conclusions. Respectively, for optimization of functional state in qualified wrestlers should be considered level of functional fitness and ability of athlete to perception and information processing.

Adding the Neuromuscular Taping to Nerve Mobilization Interventions on the Hand Functional Abilities in Carpal Tunnel Syndrom

Carpal tunnel syndrome (CTS) is a collection of symptoms and signs of disease caused by the squeezing of the median nerve in the carpal tunnel in the wrist. This CTS condition is one of the most common types of neuropathy. This syndrome arises with symptoms of pain, numbness, and weakness in the hands due to compression of the median nerve. Carpal tunnel syndrome is a syndrome associated with repetitive motion and a fixed position for a long duration so it affects the blood supply to the hands and causes pain. This study aimed to determine the effectiveness of adding neuromuscular taping intervention to the nerve mobilization which was previously usually given to Hand Functional Ability in carpal tunnel syndrome. A case study with pre and post-test research a design that compares the Hand Functional Ability values before and after being measured with a measuring instrument Wrist hand Disability Index (WHDI) to provide additional Neuromuscular Taping intervention in conditions of carpal tunnel syndrome for 3 weeks. Analysis of differences scores with WHDI in the sample group with a significance value of 0.023 which shows &lt; 0.05, which means there is an effect of giving additions Neuromuscular Taping Intervention in Nerve Mobilization noted changes in Hand Functional Ability levels in Carpal Tunnel Syndrome patients.

Sports Classification and Athletes With Intellectual Disabilities: Measuring Health Status Using a Questionnaire Based on the International Classification of Functioning, Disability and Health.

Most people with intellectual disabilities have comorbid health conditions, which will impact optimization of sporting performance. Classification is used in Paralympic events to ensure that those with similar levels of functional ability compete fairly against each other. An evidence-based approach needs to be developed for athletes with intellectual disabilities to be classified in relation to their overall functional capacity into competition groups of similar ability. This research builds on previous work using the taxonomy of The International Classification of Functioning, Disability and Health (ICF) to group athletes with intellectual disabilities into comparable competition groups as an approach to Paralympic classification. Three groups of athletes-Virtus, Special Olympics, and Down syndrome-are compared using the ICF questionnaire indicating functional health status in relation to sporting performance. The questionnaire was found to discriminate between athletes with Down syndrome and other athletes, and an approach to using a cutoff score to develop competition classes is explored.

Relationship between Bioelement Concentrations in the Human Body and Psycho-Functional Variables Observed in Neurotic Disorders

Introduction: Trace elements are involved in brain functioning, ensuring basic neurochemical processes in the central nervous system and neuropsychological functions. Trace element deficiency is a challenge in northern regions, where acclimatization-related lack of many essential elements is aggravated by adverse health effects of a combination geochemical and anthropogenic factors. Objective: To establish relationships between the elemental profile of the body and some psychophysiological characteristics of young residents of the continental part of the Magadan Region as a model presumably healthy part of the population. Materials and methods: Fifty-five lyceum students, including 25 girls and 30 boys (mean age = 17.6 ± 0.25 years), living in the town of Susuman, Magadan Region, were examined. Concentrations of 25 trace elements (Al, As, B, Be, Ca, Cd, Co, Cr, Cu, Fe, Hg, I, K, Li, Mg, Mn, Na, Ni, P, Pb, Se, Si, Sn, V, and Zn) were measured in hair samples of the subjects using inductively coupled plasma atomic emission spectrometry (ICP-AES). Psychophysiological indicators were examined using the NS-Psychotest hard &amp; software unit. The I.N. Gurvich questionnaire was applied to study neuropsychic adaptation (NPA) and anxiety levels were determined using the Spielberger-Hanin test. Results: The correlation analysis showed the highest number of links between lithium and psycho-functional variables in all students, which is consistent with the opinion of experts on the role of this element in reducing neurological manifestations, stress, and depression. The female group demonstrated relationships between the indicator of situational anxiety and those of the functional state of the central nervous system: functionality level (r = –0.56), reaction stability (r = –0.63), and functional ability level (r = –0.61), p &lt; 0.01. Cluster analysis was represented by four clusters, the largest of which included calcium and indicators of velocity of neural responses, the second – indicators of alexithymia, potassium, sodium, magnesium and phosphorus, the third grouped zinc and velocity of a simple visual motor response, and the fourth combined indicators of a simple visual motor response and choice reaction. Conclusion: The survey revealed a higher risk of neurotic disorders, cognitive impairment, and chronic stress in the adolescents against the background of the region-attributed deficiency in such trace elements as manganese, iodine, cobalt, and selenium and high levels of iron and silicon. Endemic hypothyroidism and diabetes mellitus are likely to develop with age in northerners due to high frequency of thyroid-specific bioelement deficiencies and disorders of chromium and vanadium metabolism.

Longitudinal Analysis of the ASES and Constant-Murley Scores, and the Internal Rotation/Shift and Jobe Tests Following Arthroscopic Repair of Supraspinatus Lesions.

It is essential to investigate patients post-surgery using functional surveys like the American Shoulder and Elbow Surgeons Shoulder (ASES) and the Constant-Murley shoulder (CMS) scores, as well as clinical tests, such as the Internal Rotation and Shift (IRO/Shift) and Jobe tests. In this study, 51 out of an initial 87 patients underwent an arthroscopic supraspinatus repair (22 single-row, 16 double-row, 13 debridement). Testing occurred pre-surgery, and 3 and 6 months post-surgery. Both surveys showed significant improvements over time among all 87 patients, but there were no differences between groups (lesion/no lesion) (p > 0.815) or time × group (p > 0.895). The IRO/Shift test showed a stronger ability to distinguish between both groups (positive vs. negative) with respect to the ASES and CMS scores over time, but the Jobe test did not (p > 0.100). Improvements in the CMS scores and the Jobe test were lower following repair compared to the ASES and IRO/Shift test. Most patients returned to adequate levels of functional abilities at 6 months post-surgery. The time required to return to activities of daily living and negative clinical tests was longer for the double-row repair patients compared to the single-row and debridement groups. In conclusion, both the functional surveys and the clinical tests demonstrated improvements following surgery.

Parkinson's Disease and Diabetes Mellitus: Individual and Combined Effects on Motor, Cognitive, and Psychosocial Functions.

Understanding the effects of multimorbidity on motor and cognitive function is important for tailoring therapies. Individuals with diabetes mellitus (DM) have a greater risk of developing Parkinson's disease (PD). This study investigated if individuals with comorbid PD and DM experienced poorer functional ability compared to individuals with only PD or DM. A cross-sectional analysis of 424 individuals: healthy older adults (HOA), n = 170; PD without DM (PD-only), n = 162; DM without PD (DM-only), n = 56; and comorbid PD and DM (PD+DM), n = 36. Motor, motor-cognitive, cognitive, and psychosocial functions and PD motor symptoms were compared among groups using a two-way analyses of covariance with PD and DM as factors. The PD-only and DM-only participants exhibited slower gait, worse balance, reduced strength, and less endurance. Motor-cognitive function was impaired in individuals with PD but not DM. DM-only participants exhibited impaired inhibition. Individuals with comorbid PD+DM had worse PD motor symptoms and exhibited impaired attention compared to the PD-only group. Having PD or DM was independently associated with poorer physical and mental quality of life, depression, and greater risk for loss of function. Both PD and DM have independent adverse effects on motor function. Comorbid PD+DM further impairs attention compared to the effect of PD-only, suggesting the importance of therapies focusing on attention. Understanding the functional ability levels for motor and cognitive domains will enhance the clinical care for PD, DM, and PD+DM.

The gender-specific reactions of student's central nervous system to physical loads

Purpose: to study the response of the central nervous system and the characteristics of neurophysiological processes in students of both genders during physical load.&#x0D; Material &amp; Methods: in the study participated 58 female and 82 male students. All participants were classified as individuals with high level of physical activity according to survey data. The general health of students and their demand to participate in this study were determined by interview and examination. The reaction of the central nervous system was studied using a reflexometer according to the method proposed by T. Loskutova. The method is based on the analysis of the statistical distribution of multiple measurements of the simple visual-motor reaction time and represents a quantitative characteristic of the functional state of the central nervous system. Reflexometry was carried out at a relative resting state and at the 5th minute of recovery period after a physical load in the bicycle test, carried out according to the method proposed by D. Davidenko et al. The analysis of the obtained data was performed using Microsoft Excel 2016 and SPSS 20.0 statistical package.&#x0D; Results: analysis of the obtained reflexometry data, which reflects the probabilistic and statistical principle of brain function, demonstrate insignificant fluctuations in the functional state of the brain in the majority of the examined students in a relative resting state, which were within the normal range. In accordance with the criteria for assessing the general functional state of the brain, a high and medium level of reaction stability is inherent in 76.8% male and in 84.2% female students. It should be noted that there were students who had indicators pointing to disturbances of the mechanisms of stabilization of nervous processes (3.4% female and 7.3% male students), a high degree of intensity of tonic nonspecific effects (10.3% female and 6.1% male students) and the inability to maintain an appropriate functional level (6.9% females and 9.8% males). A second assessment of the general functional state of the brain of students revealed that the average group values of indicators of the general functional state of the brain are within the age and gender norms. A certain tendency to an insignificant decrease in the stability of the reaction in both groups of subjects was noted (p=0.918 – in male students, p=0.537 – in female students), which indicates the stationary nature of the system. The stability of the functional level of the system (p=0.821) and the level of functional abilities (p=0.748) was maintained in the group of examined students. Indicators of the functional level of the system (p=0.411) and the functional abilities (p=0.467) decreased in the group of female students, indicating a deterioration in the functional state of the nervous system influenced by the dosed physical load. High and medium levels of reaction stability are characteristic of 72.4% female and 75.8% male students. It should be noted that the number of female students with pathologically low levels of reaction stability increased to 8.6%, and, conversely, the number of males with a similar level decreased to 3.7%.&#x0D; Conclusions: changes in the functional state of the brain by the majority of criteria be assessed as an activation response that allows fluctuations within 25%. This reaction is characteristic of 51% of female and 63% of male students. Deviations in the range of ±25–50% are considered stress reactions and were noted in 31% and 24% of the females and males examined, respectively. Cases of overstrain with possible disruption of adaptation were recorded in 19% of female students and 12% of male students. By the majority of criteria of functional capabilities of the CNS and its reactions to dosed physical activity, the gender predominance of males was established, characterized by slightly higher stability (p=0.574), the level of CNS activation (p=0.294) and greater ability to form an adequate system of adaptation (p=0.451) to educational loads and significantly higher absolute and relative physical performance.

Life course partnership history and objectively measured physical functional ability in Danish middle-aged adults

BackgroundPartnership break-up and living alone is associated with several negative health-related outcomes. Little is known about the association with physical functional ability in a life course perspective. The aim of...

Analysis of Socio-Demographic Factors on Functional Ability of Daily Living Activity in Ischemic Stroke Clients at Blud RSUD dr. Doris Sylvanus Palangka Raya

The prevalence of stroke worldwide is 33 million, which is 16.9 people had stroke in 2010, causing 11.3% of deaths worldwide as second leading global cause of death under heart disease. In Central Kalimantan, prevalence of stroke based on diagnosis by health professionals is 0.53%. According to districts it ranges from 0.21% -1.58% and Palangka Raya City has a stroke prevalence of 0.85%. Stroke causes brain vascularization disorders, motor dysfunction that causes the patient limitations, thereby increasing the risk of complications. A person with movement disorders will have an impact on their daily activities. Aims of this study to determine the socio-demographic factors that affect the level of functional ability of clients in performing daily living activities (ADL) of ischemic stroke clients at dr. Doris Sylvanus Palangka Raya hospital. This study used a cross sectional study approach. This reresearch would see an overview of each variable to be studied using the Barthel index instrument and data from the socio-demographic respondents. The results showed that socio-demographic factors that significantly influence and influence the functional ability of client ADL are age and occupational variables, while other variables, namely gender, marital status and education, do not affect the ADL functional status of respondents.

Effects of Sensomotor Communication System Based Exercises on Static Balance and Self-esteem in 7-12 Years Old Karate Pupils

Karate is a martial art that require a high level of motor and functional abilities, discipline and mental concentration as well. Practicing Kata improves self-awareness and focus, but is not always included in a class agenda. The author’s of sensomotor communication system based exercises have combined principles of movement from martial arts for body awareness. The purpose of this study was to examine the effects of 12 weeks intervention program of sensomotor communication system based exercises on static balance and self-esteem in karate pupils. In the study 24 karate pupils in the age of 7-12 were included. Training years in karate varied from 1 to 4 years of practice. To assess static balance the Flamingo balance test was used, to evaluate self-esteem, a modified Rosenger self-esteem scale was used. The findings of this study showed a positive effect on static balance and a minor positive effect on self-esteem in karate pupils after the intervention. Sensomotor communication system based exercises could be used for balance and self-esteem improvement. Also, being a more understandable and clearer exercise system, the sensomotor communication exercise program could be a Kata alternative for younger children practicing karate.

The Effect of Early Mobilization and Body Positioning on Functional Ability in Patients with Acute Ischemic Stroke

There are many physical problems in post-stroke conditions which is decreased functional ability. This study aimed to determine the effect of early mobilization and body positioning on functional ability in acute stroke patients. The study design used a single blinding, randomized, and controlled trial. The sample consisted of 20 acute ischemic stroke patients selected randomly and equal distribution between the group of early mobilization and body positioning (ages 45-70, MMT 2+ and given exercises ranging from 24-48 after the attack) and the control group (age 45-70, MMT 2+ and given passive exercises 24-48 after the attack) for seven days in hospital care. All patients were evaluated with Glasgow Coma Scale, Mini-Mental State Exam, and Barthel Index. Paired t-tests and independent t-tests have been used to evaluate and differentiate between groups. The study results showed the treatment group (early mobilization and body position training) to a level of functional ability p&lt;0.05 (p=0.000) and the mean -65. The control group (passive exercise) to the level of functional ability p&lt;0.05 (p=0.000) and the mean-28. The difference effect between the group (early mobilization and body position training) with the control group (passive exercise) on the level of functional ability p&lt;0.05 (p=0.000) with a mean difference was 36.9. Early mobilization and body position training are other approaches that can improve functional abilities in patients with acute ischemic stroke

Exercise for acutely hospitalised older medical patients.

Exercise for acutely hospitalised older medical patients.

THE EFFECT OF STRENGTHENING EXERCISE ON THE QUADRICEPT AND HAMSTRING MUSCLES ON CHANGING FUNCTIONAL KNEES FOR PATIENTS WITH KNEE OSTEOARTHRITIS

Introduction Osteoarthritis is a failure to repair damage in the joints caused by excessive mechanical stress. This disease is chronic, degenerative, non-inflammatory, and slowly progressive, one of which is characterized by decreased function. Osteoarthritis is a form of osteoarthritis that affects people in old age or adulthood. The cause of osteoarthritis is not known with certainty, but age, gender, race, genetics, obesity, and physical activity are risk factors that lead to pathological changes and affect the decreased functional ability. This decrease in functional ability in osteoarthritis can be overcome by isometric exercise.Methods: The research design used was a pre-experimental design with an approach of pretest-posttest one group design. The sampling technique used was total sampling, with a total of 20 respondents aged 40–70 years. Exercise with a frequency of 2 times a week for 8 weeks at an intensity of 3 repetitions for 15 minutes. The measuring instrument in this study used WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index). Normality test using the Shapiro-Wilk test, hypothesis testing using the Wilcoxon Test.The results showed the level of functional ability before being given the intervention had an average value of 2.30 and after being given the intervention had an average value of 1.40. Statistical test results showed p-value = 0.000 (p 0.005). This shows that there is an effect of isometric exercise on changes in functional abilities of patients with Samarinda knee osteoarthritis at AW Sjahranie Hospital.Conclusion: Giving isometric exercise to the quadriceps and hamstrings has an effect on improving the functional ability of the knee in patients with osteoarthritis.

Application of Exploratory Factor Analysis and Item Response Theory to Validate NHANES ADL Scale in Patients Reporting Rheumatoid Arthritis.

Background: Several instruments are used for measuring functional limitations among rheumatoid arthritis (RA) patients. However, these instruments are incongruously assessed for their psychometric properties. The National Health and Nutritional Examination Survey (NHANES) uses a generic questionnaire to assess the activities of daily living (ADL) to measure functional limitations among its participants. The psychometric properties of the NHANES-ADL scale were evaluated using a patient examination and survey data. Methods: NHANES-ADL scale was assessed for its internal consistency and factor structure. Scale reliability was assessed with Cronbach's alpha reliability coefficient. Principal component analysis with Promax rotation was used to obtain factor structure. Confirmatory factory analysis was used to calculate fit indices. The graded item response theory model was used to estimate item discrimination, difficulty, and test information. Results: Our sample included 1132 individuals with RA. Exploratory factor analyses of 19-item NHANES ADL scale produced one factor solution and accounted for 35% of variance. The Cronbach alpha of this scale was 0.92. The results of graded item response model indicated items performing well discriminating high and low level of functional ability. A higher slope (α) reflected stronger ability of items to discriminate across the continuum. Conclusions: The NHANES ADL scale showed good reliability, single dimensionality, and validity in RA patients. Studies should explore its test-retest reliability and its ability to reliably measure functional change over time in the future.

Envisioning the use of in-situ arm movement data in stroke rehabilitation: Stroke survivors' and occupational therapists' perspectives.

BackgroundThe key for successful stroke upper-limb rehabilitation includes the personalization of therapeutic interventions based on patients’ functional ability and performance level. However, therapists often encounter challenges in supporting personalized rehabilitation due to the lack of information about how stroke survivors use their stroke-affected arm outside the clinic. Wearable technologies have been considered as an effective, objective solution to monitor patients’ arm use patterns in their naturalistic environments. However, these technologies have remained a proof of concept and have not been adopted as mainstream therapeutic products, and we lack understanding of how key stakeholders perceive the use of wearable technologies in their practice.ObjectiveWe aim to understand how stroke survivors and therapists perceive and envision the use of wearable sensors and arm activity data in practical settings and how we could design a wearable-based performance monitoring system to better support the needs of the stakeholders.MethodsWe conducted semi-structured interviews with four stroke survivors and 15 occupational therapists (OTs) based on real-world arm use data that we collected for contextualization. To situate our participants, we leveraged a pair of finger-worn accelerometers to collect stroke survivors’ arm use data in real-world settings, which we used to create study probes for stroke survivors and OTs, respectively. The interview data was analyzed using the thematic approach.ResultsOur study unveiled a detailed account of (1) the receptiveness of stroke survivors and OTs for using wearable sensors in clinical practice, (2) OTs’ envisioned strategies to utilize patient-generated sensor data in the light of providing patients with personalized therapy programs, and (3) practical challenges and design considerations to address for the accelerated integration of wearable systems into their practice.ConclusionsThese findings offer promising directions for the design of a wearable solution that supports OTs to develop individually-tailored therapy programs for stroke survivors to improve their affected arm use.

Disturbed sleep and patterns of psychiatric symptoms and function in a school-based sample of adolescents.

Sleep problems are common in adolescence and often related to psychopathology and impaired functioning. However, most studies have used summative scores, and little is known about how adolescents with disrupted sleep perceive their specific symptoms and dysfunctions. This study explored differences in levels of psychiatric symptoms and functional ability between Swedish adolescents with and without self-reported disturbed sleep in a school-based sample. Swedish adolescents (n = 618, mean age 15.7+/-1.9yrs) answered the PROMIS pediatric measures for fatigue, anxiety, depression, pain interference, anger, physical activity and peer and family relationships. Logistic regression analyses were performed to assess differences between respondents with and without disturbed sleep. Disturbed sleep was associated with higher levels of symptoms of fatigue, anxiety, depression, anger and pain interference, as well as lower functional abilities in terms of physical activity and peer- and family relationships. Adolescents reporting disturbed sleep generally displayed a pattern of impaired executive functioning, internal emotional distress and school- and sleep related worry and dysfunction, as compared to physical disability, aggressive behavior, stress and generalized worry. The present study adds to the understanding of how disturbed sleep and specific psychiatric symptoms and functional ability are interrelated, which may also have clinical implications.