Level Of Functional Ability Research Articles

Driving Cessation and Mental Health in Persons With Dementia: A Preliminary Study

The driving safety of persons with dementia (PwD) is an important public-health issue worldwide. Driving is closely related to personal autonomy, self-esteem, and independence. When PwD lose their driving privileges, this may lead to negative effects on mental health. The purpose of this study was to evaluate the relationship between driving cessation and mental health in PwD. A cross-sectional design with convenient sampling was used, Data were collected using structured questionnaires. Participants were all PwDs who were recruited from a medical center in northern Taiwan. A total of 78 PwD were recruited. Two-fifths (41%) of the participants were still driving, with motorcycle the most common vehicle used. The participants who had retired from driving were older, and most did not have a spouse, were less socially active, had a lower mean level of functional ability, and perceived a lower association between driving and quality of life. Driving cessation was found to be positively correlated with age and the instrumental activities of daily living. Depression and anxiety levels in former drivers were higher than in current drivers, although the differences were not significant. Among PwD, depression and anxiety is higher in former drivers. It is suggested that a prospective study should be conducted, that driving safety issues for PwD should be addressed in public health education, and that standards of driving safety for PwD should be developed and enacted.

Physical Activity and the Improvement of Autonomy, Functional Ability, Subjective Health, and Social Relationships in Women over the Age of 60

Regarding functional ability, autonomy, promotion of social relationships and health, little scientific evidence has been found of physical practice in active women over 60 years of age. Hence, the goal of this study was to assess the functional abilities and autonomy, social relationships and subjective health of physically active older women according to the level of activity practiced. The IPAQ and CUBRECAVI scales were applied to a sample of 257 women between 61 and 93 years old (M = 69.44, SD = 4.61). Statistically significant outcomes were obtained in functional ability and autonomy according to their level of physical activity (p = 0.001): greater satisfaction and frequency of social relationships with a mild level of physical activity (p = 0.011), and statistically significant differences in the degree of satisfaction with their health according to the level of physical activity they practice (p < 0.001). The results showed that those with high physical activity obtained better levels of functional abilities and autonomy. Additionally, dissatisfaction with one’s own health is associated with low levels of physical activity. In conclusion, it could be said that the practice of mild physical exercise in older women encourages greater autonomy and functional ability for activities of daily living, which results in independence in everyday life in addition to fostering social links as well as gaining a better satisfaction with their own health, with the socio-emotional benefits that this can bring.

Identifying Clinically Relevant Functional Strata to Direct Mobility Preservation Among Patients Hospitalized With Medical Conditions

ObjectiveTo develop a system to guide interpretation of scores generated from the newly developed item response theory (IRT)-based Functional Assessment in Acute Care Multidimensional Computerized Adaptive Test (FAMCAT), which assesses 3 important domains of function: Mobility, Daily Activities, and Applied Cognition. DesignCross-sectional data was used to inform a modified Delphi approach to establish FAMCAT cutpoints delineating various functional ability levels. SettingLarge midwestern academic teaching hospital. ParticipantsPatients hospitalized to an inpatient medical service (N=2049). InterventionsNot applicable. Main Outcome MeasuresFAMCAT Basic Mobility, Daily Activity, and Applied Cognition scores. ResultsIRT-based score estimation data was successfully integrated with expert clinical feedback using a modified Delphi process to arrive at consensus yielding 4 functional level strata (ranging from bed-based mobility to independent mobility) for both the FAMCAT Mobility and Daily Activity scales; 1 cutpoint was supported to delineate 2 functional strata for Applied Cognition. ConclusionsMeaningful cutpoints were established for each FAMCAT domain using a data-informed, modified Delphi process for achieving consensus. The resulting FAMCAT interpretation guide may be used to develop an ability-matched mobility preservation program and identify patients who may require a higher level of supervision based on the resulting FAMCAT scores.

Neighbourhood physical environment, intrinsic capacity, and 4-year late-life functional ability trajectories of low-income Chinese older population: A longitudinal study with the parallel process of latent growth curve modelling.

BackgroundKnowledge of how intrinsic capacity (IC) and neighbourhood physical environment shape functional ability (FA) trajectories in later life remains understudied. We investigated four-year trajectories of IC and their impact on FA trajectories and the association between neighbourhood physical environment and FA trajectories among community-dwelling older adults in Hong Kong, China.MethodsWe conducted a four-wave longitudinal study from 2014 to 2017 in Hong Kong with 2,081 adults aged 65 and above. FA was assessed by The Chinese Lawton Instrumental Activities of Daily Living Scale. We used cognition, affect, locomotion, sensory capacity, and vitality to capture the multiple domains of IC. Neighbourhood physical environment attributes included green space, land use diversity, and availability of facilities, assessed within 200- and 500-meter buffers of respondents’ homes. We used the parallel process of latent growth curve model.FindingsIC (Unstandardized coefficient, β = −0.02, p<0.001) and FA (β = −0.20, p<0.001) each decreased significantly over time. Individuals with declines in IC experienced a faster decline in FA over time. Green space within a 200-meter buffer (β = 1.15, p = 0.023), the number of leisure (β = 0.03, p = .0.043) and public transport (β = 0.08, p = .0.003) facilities within a 500-meter buffer slowed the rate of FA decline.InterpretationThe level of FA decreased over time in later life. Changes in IC shaped FA trajectories. Increased residential green space and the number of leisure and public transport facilities in the neighbourhood may help slow FA decline over time.FundingThe Hong Kong Housing Society.

Improving forensics: Characterizing injuries among community-dwelling physically abused older adults.

Physical elder abuse affects a substantial number of older adults, leaving victims at increased risk for negative health outcomes. Improved detection of abuse-related injuries may increase victim access to professional support, but providers report difficulties distinguishing between accidental and abuse-related injuries, due in part to victims' pre-existing health conditions and medication use. To describe the spectrum and characteristics of injuries among physically abused older adults and identify injury characteristics associated with abuse. Case-control study. Physically abused adult protective services clients were interviewed in their home; non-abused comparison group participants were interviewed in an outpatient geriatrics clinic. Sample included 156 community-dwelling adults aged 65 and older, including 57 physically abused and 99 non-abused individuals. Self-reported abuse history was confirmed through independent case assessment by a LEAD (Longitudinal, Expert All-Data) panel of clinicians with family violence expertise. Full-body assessments were conducted, documenting injury incidence, diagnosis, and location. We also collected sociodemographic characteristics, level of social support, functional ability, medical history, and medication use. Physically abused older adults were more likely to be injured upon assessment (79.0% vs 63.6%; p < 0.05) and have a greater number of injuries ( vs , p < 0.05). Injuries seen more often among abused individuals included: upper extremity ecchymoses (42.1% vs 26.3%; p < 0.05), abrasions (31.6% vs 11.1%; p < 0.01), and areas of tenderness (8.8% vs 0.0%; p < 0.01); and head/neck/maxillofacial ecchymoses (15.8% vs 2.0%; p < 0.01) and tenderness (15.8% vs 0.0%; p < 0.001). Lower extremity abrasions (12.3%) were common but unrelated to abuse status. While physical abuse does not always result in physical injury, victims more commonly display head/neck/maxillofacial ecchymoses or tenderness and upper extremity abrasions, ecchymoses, or tenderness. Detection of these injuries among older adults warrants further interview and examination.

The effect of functioning on Quality of Life Inventory-Disability measured quality of life is not mediated or moderated by parental psychological distress.

The measurement of quality of life (QOL) in children with intellectual disability often relies upon proxy report via caregivers. The current study investigated whether caregiver psychological distress mediates or moderates the effects of impairment on their ratings of QOL in children with intellectual disability. Caregivers of 447 children with an intellectual disability reported their child's day-to-day functioning, their own psychological distress using the Kessler Psychological Distress Scale, and the Quality of Life Inventory-Disability (QI-Disability), a measure of QOL for proxy report of a child's observable behaviours that indicate quality of life. Linear regression was used to assess the effects of the child's functional abilities on their QI-Disability score and causal mediation analysis to estimate the extent to which these effects were mediated by caregivers' psychological distress. A minority of caregivers (n = 121, 27.1%) reported no psychological distress. Lower day-to-day functional abilities, such as being fully dependent on others to manage their personal needs were associated with lower total QOL scores. There was no significant mediation effect of caregiver psychological distress on the association between child functioning and total QOL scores. Moderation analyses revealed small and largely nonsignificant interaction coefficients, indicating that caregiver psychological distress did not influence the strength of the relationship between child functioning and total QOL scores. Caregiver psychological distress did not mediate or moderate the relationship between the level of functional abilities and QOL in children with intellectual disability. QI-Disability measured observable child behaviours which may reduce the influence of caregiver factors on the accurate measure of QOL for children with intellectual disability.

Effects of vertical and horizontal plyometric exercises on explosive capacity and kinetic variables in professional long jump athletes

Background and Study Aim. Athletic jumps are specific cyclically-acyclic movements that despite the good performance of the techniques require from competitors a high level of motor, specific-motor and functional abilities. The aim of this study was to examine the response effect of vertical and horizontal plyometric training on explosive capacity and kinetic variables in long jump athletes. Material and Methods. The participants of this study were twenty professional jumpers (22.5 ± 4.2 years; 178.4 ± 9.8 cm; 70.3 ± 7.6 kg) who were divided into two groups: experimental (plyometric training) and control (standard training). They participated in the last track and field championship in country, moreover, three of them participated in the last Asian games, and one athlete participated in the world track and field championship. The experiments were conducted on June-July 2019 in twenty professional athletes. All tests were performed after a standard warm up protocol. The place of camera was always determined wisely around the jumping field to attain best photography. Organizing and controlling the imaging and motor analysis processes were done by a biomechanics expert. Results. Post training results in experimental group showed more improvement in 30 m sprint, vertical jump, horizontal velocity at take-off, and long jump completion, comparing the control group. Significant between group differences in all variables were detected post training. No significant post training improvements in flight time and take off duration were reported in control group. Conclusion. Vertical and horizontal plyometric training protocol was shown to be more effective in promoting improvement in explosive capacity than kinetic variables.

Short Distance Sprint Performance in Elite Wheelchair Basketball Women Players: Influence of Functional Classification

The aim of this study was to analyse the short-distance sprint performance (SDSP) differences between functional International Wheelchair Basketball Federation (IWBF) classes in elite wheelchair basketball (WB) women players. Additionally, the association between WB experience and the IWBF functional classification score and SDSP was assessed. Sixteen WB women players belonging to the Spanish national WB team were grouped according to the functional IWBF classes: group 1 (class 1 and 1.5), group 2 (class 2 and 2.5), group 3 (class 3 and 3.5) and group 4 (class 4 and 4.5). Each participant completed 2 sets of 12-m wheeling sprints at maximum speed, and split times at 3, 5 and 12 m were recorded. Major significant differences were observed in SDSP between groups 1 and 4 (p <.05; effect size [ES] range: -2.27 – 4.02) and, while not significant, a clear trend in which the higher the functional IWBF classification the higher the SDSP was observed. Moreover, we found a significant strong association between the functional IWBF classification individual score and the SDSP (p < .05; rs range: 0.61 – 0.71). The SDSP test (split times at 3, 5 and 12 m) would therefore seem to be sufficiently sensitive to reflect the level of functional ability in elite WB women.

Understanding Attrition and Bolstering Retention in a Longitudinal Panel of Older Adults: ORANJ BOWL.

Background and ObjectivesAttrition from longitudinal studies can affect the generalizability of findings especially when studying developmental constructs such as successful aging.Research Design and MethodsUsing data from a 12-year (6-wave) panel of 5,688 older people (aged 50–74 at baseline), we compared people retained in the panel with people lost to follow-up on demographic characteristics and measures of successful aging. After instituting expanded retention strategies at Wave 6 (i.e., a team-based approach, social media, and paid web search engines), we compared different groups of people lost to follow-up (i.e., deceased and withdrawn due to lack of interest) and different types of completers (i.e., full completers vs. lost and reengaged completers).ResultsAt baseline, Wave 6 completers were significantly younger, less likely to be African American, more likely to be married, reported higher levels of income and education, were more likely to be working full-time, had less pain and fewer chronic illnesses, and reported higher levels of subjective successful aging and functional ability than those lost to follow-up. Analyses demonstrated differences across groups based on the reason for loss (i.e., deceased, impaired, and not interested). Participants who missed an interview but returned to the panel were significantly different from those who participated in all waves of data collection. Expanded retention efforts improved generalizability, as people returning to the panel reported lower levels of education, lower levels of income, and were more likely to be African American.Discussion and ImplicationsBiased attrition within longitudinal research affects the interpretation of study findings, especially when studying developmental outcomes. However, expanded retention strategies can reduce bias and loss and should be used to enhance retention efforts in longitudinal work.

Neighbourhood Physical Environment, Intrinsic Capacity and 4-Year Late-Life Functional Ability Trajectories: A Longitudinal Study With the Parallel Process of Latent Growth Curve Modelling

Background: Knowledge on how intrinsic capacity (IC) and neighbourhood physical environment shape functional ability (FA) trajectories in later life remains understudied. We investigated the 4-year trajectories of IC and their impact on FA trajectories, and the associations between neighbourhood physical environments and FA trajectories over time among older adults. Methods: We conducted a four-wave longitudinal study from 2014-2017 in Hong Kong with 2,081 adults aged 65 and above. FA was assessed by The Chinese Lawton Instrumental Activities of Daily Living. We used cognition, affect, locomotion, sensory capacity, and vitality to capture multi-domains of IC . Neighbourhood physical environment attributes included green space, land use diversity, and facilities availability, assessed within 200- and 500-meter buffers of respondents' homes. The parallel process of latent growth curve modelling was used. Findings: IC (β = -0·022, p<0·001) and FA (β = -0·196, p<0·001) each decreased significantly over time. Individuals with declines in IC experienced faster declines in FA over time. Green space within a 200-meter buffer (β = 1·15, p = ·023), the number of leisure facilities (β = 0·03, p = ·043) and public transport (β = ·08, p = ·003) with a 500-meter buffer slowed the decreasing FA rate. Interpretation: The level of FA decreased over time in later life. The changes of IC shaped FA trajectories. The more residential green space and the number of leisure facilities and public transport in the neighbourhood may help slow declines of FA over time. Funding Statement: This study was supported by the Hong Kong Housing Society. Declaration of Interests: The authors reported no potential conflict of interest. Ethics Approval Statement: The study has been approved by the Human Research Ethics Committee of the University of Hong Kong (Reference Number: EA050814 & EA1610004).

Instructional Guidelines for Patients with Pott’s Fracture to Improve Physical Activity and Functional Ability

Background: Pott`s fracture is one of the most common lower limb fractures representing a significant percentage of the trauma workload. Aim of the study: The study aimed to evaluate the effect of instructional guidelines for patients with pott’s fracture to improve physical activity and functional ability. Design: Quasi–experimental design was utilized. Setting: The study was accomplished in orthopedic Unit at Mansoura University Emergency & Accident Hospital then patients were followed up at orthopedic outpatient clinics. Subjects: Purposive sample of 52 patients at orthopedic department selected according to inclusion and exclusion criteria. Tools: Three tools were used. Assessment interview questionnaire sheet includes demographic and health relevant data, knowledge assessment sheet and Baird and Jackson Scoring System (BJSS). Results: Showed statistically significant improving of both physical activity and functional ability level after the application of instructional guidelines. Conclusion: The study concluded that there was an effective effect of instructional guidelines on improving physical activity and functional ability among pott`s fracture patients. Recommendation: It was recommended that Handout with instructional guidelines should be distributed and be available for every Pott`s fracture patient admitted to orthopedic department, which are supported by the presence of a nutritionist and exercise trainer.

Safe Exercise at Home Website: Keeping Older People Active during COVID-19

Background Physical distancing restrictions, including recommendations to ‘stay home’ during the COVID-19 pandemic has restricted exercise opportunities for older adults. Our group of academic and clinical physiotherapists and a communications expert identified the need to support safe exercise at home to minimise the impact of these restrictions. The project aimed to develop an online, publicly available resource to support older adults to exercise at home. We met virtually and: a) developed home exercise programs for people at three levels of functional ability; b) developed simple advice about exercising safely, exercise intensity, and staying motivated; and c) reviewed and selected online exercise programs and resources for consumers and health professionals to access. Examples of older adults keeping active during the pandemic were sourced to provide motivation. Website content was made available to download and print to increase accessibility. Modifications were made after consumer and international advisor feedback, the website was endorsed by the Australian Physiotherapy Association. Content is updated as restrictions are modified and in response to feedback received. Google Analytics was used to evaluate website usage. The website was launched on 5 May 2020, 35 days after the group’s initial meeting. In the first 9 weeks of website availability 20,608 users accessed the website, with 14.6% being returning users. There were 27,513 sessions and 74,927 page views. Most users were from Australia (80.74%), followed by Denmark (5.15%) and USA (3.85%) We present this example of the benefits of time-critical collaboration to facilitate rapid translation of evidence into practice.

Mobility with a lower limb prosthesis: experiences of users with high levels of functional ability

Purpose The Prosthetic Limb Users Survey of Mobility (PLUS-M) is a self-report item bank designed to measure the abilities with which people with lower limb amputation perform physical activities. Although PLUS-M includes items that span a range of mobility, additional items are needed to accurately measure mobility of highly active prosthesis users, such as athletes and service members with lower limb amputation. The aim of this study was to understand mobility in highly active lower limb prosthesis users to inform the development of new items for the PLUS-M item bank. Methods Focus groups were conducted with active, lower limb prosthesis users from across the USA. In-person and online focus groups were conducted by a trained facilitator using a semi-structured guide. Focus group transcripts were reviewed and coded by two researchers. Thematic analysis was used to identify important experiences across participants. Results Twenty-nine participants took part in four focus groups. Three resultant themes were identified: mobility after amputation, mobility characteristics, and healthcare providers and systems. Conclusions Identified themes inform clinician and researcher understanding of mobility in highly active lower limb prosthesis users. The results of this study will be used to inform development of high-activity items for the PLUS-M item bank. Implications for rehabilitation Participants described engagement in high-level activities as a learning process that included elements such as equipment challenges and modifications, pain and injury, and the need to trust the prosthetic limb. Participants with lower limb amputation who use prostheses identified mobility characteristics, such as postural changes, terrain, and obstacles, that influenced their ability to perform high-level activities. High-level mobility characteristics identified in these focus groups can be integrated into a revised version of the Prosthetic Limb Users Survey of Mobility to assess mobility in active adults and athletes with amputation. Rehabilitation professionals play an important role in facilitating access to specialized prosthetic components and training that can help patients achieve their mobility goals and potential.

Функциональное состояние центральной нервной системы и физиологические реакции на стресс у педагогов с признаками эмоционального выгорания (на примере преподавателей педагогического вуза)

Currently, the problem of stress in the workplace has become particularly relevant and is an important area of research in the field of medicine, psychology and related sciences. The teaching profession makes significant demands on the teacher’s personal and psychological qualities, which often leads to chronic stress. The research involved 82 teachers of Surgut State Pedagogical University; the mean age of the subjects was 44.12 ± 3.74 and 43.21 ± 2.51 years for women and men, respectively. To diagnose emotional burnout, we used the Maslach Burnout Inventory (MBI) (adapted by N.E. Vodopyanova). All the teachers were divided into two groups depending on the presence or absence of the symptoms of emotional burnout. The functional state of the central nervous system (CNS) was assessed using simple visual-motor reaction, i.e. we analysed the speed of sensorimotor reaction, the system’s functional level, reaction stability, the level of functional abilities, and attention stability (by Whipple’s accuracy index). Physiological response to stress was determined with the help of J. Greenberg’s questionnaire “Physiological Response to Stress”. The entire psychological and psychophysiological diagnostics was carried out using the NS-PsychoTest computer complex. The results of the study showed that the functional state of the CNS in female teachers without symptoms of emotional burnout is significantly lower than that in men of the same group. Male teachers having symptoms of emotional burnout demonstrate a statistically significant decrease in all indicators of the functional state of the CNS compared to the asymptomatic men. The obtained results indicate the need to implement preventive measures in higher education institutions aimed at minimizing the risk of burnout in teachers as well as setting timely diagnosis and, if necessary, selecting adequate treatment methods.

Medical Symptom Validity Test (MSVT) profiles in individuals being evaluated for Alzheimer’s disease

Objective:Our purpose was to determine whether Medical Symptom Validity Test (MSVT) profiles could differentiate performance invalidity from true impairment in patients with varying levels of memory impairment and functional ability being evaluated for Alzheimer’s disease (AD). Method: Seventy-three older adults (13 healthy controls, 25 mild cognitive impairment [MCI], 16 mild AD, 19 moderate AD) were evaluated with a neuropsychological battery including the MSVT and activities of daily living (ADL) measures. Using MSVT classification guidelines, examinees’ MSVT profiles were categorized as: 1) valid, 2) invalid, 3) weak memory, or 4) genuine memory impairment (GMIP). Results: Eighty-four percent of moderate AD examinees produced a GMIP. Among MCI and mild AD examinees, who had only modestly affected ADLs, a substantial proportion manifested a GMIP (40% and 62.5%, respectively). An invalid profile was uncommon across patient groups (12.5% in mild AD, 5.3% in moderate AD, and 0% in MCI). Conclusions: The MSVT functions reasonably well in a dementia sample to determine if an examinee has an invalid profile, although for mild AD examinees, the false positive rate is slightly above the recommended 10% cut-off. However, even individuals with MCI, mild AD and relative preservation of ADLs may manifest a GMIP, demonstrating that such profile is found across patients with lower and higher degrees of functional impairment. Given this finding, the usefulness of the GMIP in differentiating performance invalidity from true impairment in patients being evaluated for AD appears limited.

Leg Venous Properties in Children With Myelomeningocele.

Introduction: The vascular properties of individuals with myelomeningocele (MMC) are an underestimated problem, as evidenced by the lack of relevant research. Therefore, this study was conducted to assess the venous properties of the leg in children with MMC. This study compared the duration of retrograde flow (RF) of the distal and proximal sites of the great saphenous vein (GSV) in children with MMC and typically developing (TD) children. Additionally, the impact of MMC clinical features, such as the anatomical level of the spinal cord defect, muscle strength of the lower limbs, and level of gross motor functional abilities on the of GSV sufficiency were assessed.Methods: Thirty ambulant children between 7 and 12 years with MMC and an age- and sex-matched sample of thirty children with typical development (TD) were included in the study. All participants underwent a complete physical examination that included gross motor assessment, manual muscle testing, and duplex ultrasound examination of the GSV reflux. The duration of retrograde flow (RT) in the GSV was evaluated at four sites: P1: proximal thigh; P2: medial thigh; P3: upper leg; and P4: lower leg. The measurements were performed in two body positions: horizontal position (HP) and vertical position (VP).Results: Children with MMC showed increased duration of RT of both the proximal and peripheral sites of GSV, as compared with the TD peers. The prevalence of GSV reflux in peripheral segments was significantly higher than in the proximal segments. The severity of MMC (expressed by higher level of the spinal cord defect), deficit of thigh and leg muscle strength, and lower functional independence negatively influenced the GSV sufficiency in patients with MMC. Gravity directly influenced GSV reflux occurrence and reflux hemodynamic parameters in MMC.Conclusion: These findings may help better understand aspects concerning the risk of developing venous insufficiency in children with MMC and determine better screening, prevention, and treatment algorithms for venous insufficiency in patients with SB.

IMPROVING THE TRAINING PROCESS OF 16–17-YEAR-OLD BIATHLETES BY MEANS OF HYPOXIC-HYPERCAPNIC EXPOSURES AND CONTROL OF CHANGES IN THE PREMORBID CONDITION OF THE CARDIOVASCULAR SYSTEM IN THE BASIC STAGE OF SPORTS PREPARATION

Aim. The article deals with theoretical and experimental substantiation of the effectiveness of basic and ergogenic (hypoxic-hypercapnic exposures) aids in the preparation of 16–17-year-old biathletes. Materials and methods. The study involved two groups of 16–17-year-old biathletes. All athletes underwent an in-depth medical examination at the beginning of the experiment. Throughout the study, their functional status was assessed by the premorbid index of the cardio-vascular system obtained with the CardioSoft diagnostic system (USA). Results. Hypoxic-hypercapnic exposures in sports training along with the general training program aimed at deve­loping local-regional muscle endurance is a promising approach that can ensure a high level of functional abilities in athletes and improve their sports results. Conclusion. The results of the study contribute to the improvement of the training system for 16-17-year-old biathletes at the basic stage of sports preparation. The study proves that the innovative method proposed is effective for controlling the premorbid state of the cardiovascular system in athletes.

Neuromotor Characteristics Of Older Men With Sarcopenia

Skeletal muscle mass increases over the first three decades of life, declines steadily through middle age, and more rapidly in older age. Sarcopenia describes a condition of significant loss of muscle mass in conjunction with reduced strength and function. While the changes in mass, strength and function across the lifespan are well-documented, little is known of the underlying neuromotor changes. PURPOSE: To examine the neuromotor mechanisms that underpin changes in muscles mass and function in older men with sarcopenia. METHODS: Twenty four older men (74.4 ±5.0yrs) were recruited for testing. Muscle and fat mass were determined by DXA (Norland XR-800, USA). Functional performance was assessed via isometric knee extension strength, timed-up-and-go (TUG), 5-times sit-to-stand (5TSTS), self-selected gait speed, and hand grip strength. Neuromotor function was assessed using electrical stimulation of the tibial nerve (Digitimer DS7AH, UK) and recording of EMG activity and torque during a graded plantar flexion contraction protocol. Measures included Level of Voluntary Activation (LoVA; 20%, 40%, 60% 80%, and 100% of MVC), resting and superimposed twitch (SIT), ankle torque, and EMG activity of the plantar and dorsi flexor muscles. RESULTS: Six older men were classified as sarcopenic based on DXA-derived measures of appendicular lean mass and height (<7.25kg/m2). Differences in LoVA and SIT were observed between older men and sarcopenic men at the 60% (LoVA: OM=85.5 ±5.5% SM=77.3 ±11.7%, p<0.05; SIT: OM=2.0 ±1.0% SM=3.6 ±2.8%, p<0.05) and 80% (LoVA: OM=95.8 ±2.4% SM=92.4 ±3.3%, p<0.05; SIT: OM=0.5 ±0.3% SM=1.2 ±0.8%, p<0.05) contraction intensities. Significant differences in knee extension strength were observed between older men and sarcopenic men (OM=512.2 ±125.2N SM=328.6 ±74.4N, p=0.03), however no other differences in functional performance measures were observed. CONCLUSIONS: These preliminary findings suggest that there are underlying neuromotor changes in men with sarcopenia, particularly during submaximal muscle contractions. Interestingly, men with sarcopenia were still able to maintain a similar level of functional ability compared to older healthy men. Future work will examine neuromotor characteristics in response to fatigue.

Effect of a Planned Health Teaching on Improving Knowledge and Competence of Home Care Practice of Post Stroke Patient Among Caregivers' Achievement

Background: Stroke is one of the major healthcare challenges, being one of the leading causes of death, disability, and dependency in the activity of daily living worldwide Homecare of stroke patients is having a great role in the patient recovery. Patient family caregivers and relatives can play an important role in the care of patients. But how to continue proper care of the patient at home after discharge, they don't know what to do and don't have practice as well. In this view, the researcher believes that it might be a great help for caregivers and the patients to teach theirs about stroke and home care of stroke patients. Objective: The study aims to evaluate the effectiveness of a planned health teaching on the caregiver's knowledge and competence of home care of stroke patients. Therefore, improve the patients' functional ability. Methods: The two group pre and post-test, quasi-experimental design was conducted among 50 caregivers of stroke patients, assigned to 25 caregivers as a control group and 25 caregivers as an experimental group. The study was done in the university hospital at El Fayoum city from 1st March 2019 to 31st August 2019. Four tools were used for data collection after reviewing relevant data as the following; a structured interviewing questionnaire, caregiver's knowledge questionnaire regarding stroke, caregiver's practices regarding bed position, Position Change and Transfer, and Range of Motion Exercises, and patient function ability assessment according to Barthel index. Results: revealed that there was a poor score level of knowledge and competence of home care practices before the intervention. However, there was an improvement of score level in the control and experimental group post-intervention, but the higher score was observed in the experimental group. The mean score level of patient functional ability in the experimental group improved than the control group through follow up. Highly statistical significance was found between control and experimental group post-intervention related to knowledge and practices. A positive significant correlation between caregiver's practices and patients function ability in the experimental group was found. Conclusion: planned health teaching is important after patients discharge to increase the caregiver's knowledge and competence of home care practices of post-stroke patients; resulting in improved patient functional ability.

Self-care performance in children with cerebral palsy: a longitudinal study.

To investigate self-care developmental trajectories in children with cerebral palsy (CP) across all functional ability levels, according to Manual Ability Classification System (MACS) levels. This was a prospective longitudinal population-based study of 71 children aged from 2years 6months to 12years, with CP (47 [66%] males, 24 [34%] females). Pediatric Evaluation of Disability Inventory (PEDI) measures were taken at 2years 6months, 3, 4, and 5years, and the PEDI - Computer Adaptive Test (PEDI-CAT) between 8 and 12years. At 8 to 12years, children were classified in MACS levels I (21; 30%), II (22; 31%), III (16; 23%), IV (6; 8%), and V (6; 8%). Longitudinal analysis of the PEDI Functional Skills Scale self-care and PEDI-CAT daily activities domains used the published linking equation, and multilevel mixed-effects regression modelling with interaction between age and MACS. Between 5 and 12years of age, children classified in MACS levels I to III continued to show progress in self-care development (PEDI-CAT scaled scores estimated change per year: I, 0.72; II, 0.49; III, 0.48). Children classified in MACS level IV showed an upward non-significant trend between 5 and 8 to 12years (estimated change 0.42; 95% confidence interval [CI] -0.04 to 0.88). Children in MACS level V showed a decline in self-care (estimated change: -0.65; 95% CI -1.16 to -0.14). Self-care development attained by 8 to 12years of age was related to the severity of manual ability impairment. Application of the linking equation from PEDI to PEDI-CAT is somewhat uncertain at the extreme lower end of the scale. Our study supports recommendations for items to be added to the PEDI-CAT to address floor effect.