Life Activity In Patients Research Articles

Associations between expiratory spirometry parameters and limitations in daily life activities in patients with schizophrenia

ObjectiveThis cross-sectional study considered whether variability in respiratory functioning could explain the variability in walking ability of individuals with schizophrenia taking into account variability in body mass index (BMI), lifestyle factors, psychiatric symptoms, antipsychotic medication use and muscular fitness. MethodEighty patients with schizophrenia and 40 age-, gender- and BMI-matched controls underwent a spirometry and the 6-min walk test (6MWT) and completed the International Physical Activity Questionnaire. Patients were additionally screened for psychiatric symptoms. ResultsCompared to health controls, patients with schizophrenia achieved a lower distance on the 6MWT (583.6±109.7 m versus 710.6±108.4 m, P<.001) and had a lower forced vital capacity (3.7±1.1 L versus 4.3±0.9 L, P<.001) and forced expiratory volume in 1 s (FEV1) (3.0±1.0 L versus 3.6±0.7 L, P<.001). In multiple regression analysis, 68.1% of the variance in walking distance was explained by FEV1, BMI, muscular fitness and total energy expenditure. ConclusionThe respiratory health of patients with schizophrenia should be of concern for clinicians. In addition, future research interventions should seek to investigate the impact of an impaired respiratory health upon individuals with schizophrenia.

AB0846-HPR Independence in daily life activities in patients with rheumatoid arthritis and correlation with personal causation, disease activity and functionality

BackgroundIndependence in daily life activities (DLA) is the capability to perform every procedure in adequate time and without any help. In rheumatoid arthritis (RA) patients functionality is reduced and usually...

The incidence of trismus and long-term impact on health-related quality of life in patients with head and neck cancer

Background. Trismus is a common symptom related to the treatment of head and neck (H&N) cancer. To date there are few prospective studies regarding the incidence of trismus and the patients’ experience of trismus in daily life activities. The aim of the study was to assess the incidence of trismus in H&N cancer patients and the impact on health-related quality of life (HRQL), by evaluating the patients before and after oncological treatment. Material and methods. We used the criteria for trismus of maximum interincisal opening (MIO) ≤ 35 mm and measured the patients at several occasions before and after treatment during one year. The patients answered the HRQL questionnaires EORTC QLQ C30, EORTC QLQ H&N 35, Gothenburg Trismus Questionnaire (GTQ) and the Hospital Anxiety and Depression Scale (HADS). Results. The incidence of trismus was 9% pre-treatment and 28% at the one-year follow-up post-treatment. The highest incidence, 38%, was found six months post-treatment. Patients with tumours of the tonsils were most prone to develop trismus. Patients with trismus reported greater HRQL impairments with regard to the GTQ domains; mouth opening (p < 0.001), jaw-related problems (p < 0.05), eating limitations (p < 0.05) and muscular tension (p < 0.001) six months post-treatment. EORTC QLQ H&N 35 scores indicated clinically significantly more problems with dry mouth, swallowing and pain for patients with trismus, 6–12 months post-treatment. Furthermore, all patients reported pain, anxiety and depression pre- and post-treatment. Conclusion. The incidence of trismus in patients with H&N cancer is non-negligible. Trismus severely impairs HRQL and negatively affects daily life activities in patients with H&N cancer. Further studies regarding symptomatic treatment of patients with trismus are highly warranted. The symptom-specific questionnaire GTQ is useful to identify the problems in this group of patients given it is responsive to showing change over time.

Life Quality of Patients in Hemodialysis Therapy in Sinop City MT

ABSTRACT: The Chronic Renal Failure (CRF) is characterized by irreversible loss of renal function. The treatment for these patients is the realization of dialysis therapy, which significantly affects the life quality. The present study aimed to identify the effect caused by hemodialysis in life activities of patients treated. It opted for the interviews as a methodological reference, the universe investigated corresponded to 56 patients. Results showed that the underlying diagnosis was the most frequent Hypertension in 44.65% of cases, those who reported constant vertigo was 76.78%, 87.50% patients did not perform because of the occupational therapy and 96.42% voice changes in diet and fluid intake. Complications from treatment affect the functional abilities, imposing limitations on daily activities which disrupt the individuals life. Therefore, it is extremely important that the nursing staff is able to intervene before these events, providing treatment for patients in the proper orientation, as well as an emotional preparation, so that the same is skilled to live with restriction imposed in the face of CRF.Keywords: Hemodialysis, life activities, nursing.

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects

Patients suffering from homonymous hemianopia after infarction of the posterior cerebral artery (PCA) report different degrees of constraint in daily life, despite similar visual deficits. We assume this could be due to variable development of compensatory strategies such as altered visual scanning behavior. Scanning compensatory therapy (SCT) is studied as part of the visual training after infarction next to vision restoration therapy. SCT consists of learning to make larger eye movements into the blind field enlarging the visual field of search, which has been proven to be the most useful strategy1, not only in natural search tasks but also in mastering daily life activities2. Nevertheless, in clinical routine it is difficult to identify individual levels and training effects of compensatory behavior, since it requires measurement of eye movements in a head unrestrained condition. Studies demonstrated that unrestrained head movements alter the visual exploratory behavior compared to a head-restrained laboratory condition3. Martin et al.4 and Hayhoe et al.5 showed that behavior demonstrated in a laboratory setting cannot be assigned easily to a natural condition. Hence, our goal was to develop a study set-up which uncovers different compensatory oculomotor strategies quickly in a realistic testing situation: Patients are tested in the clinical environment in a driving simulator. SILAB software (Wuerzburg Institute for Traffic Sciences GmbH (WIVW)) was used to program driving scenarios of varying complexity and recording the driver's performance. The software was combined with a head mounted infrared video pupil tracker, recording head- and eye-movements (EyeSeeCam, University of Munich Hospital, Clinical Neurosciences).The positioning of the patient in the driving simulator and the positioning, adjustment and calibration of the camera is demonstrated. Typical performances of a patient with and without compensatory strategy and a healthy control are illustrated in this pilot study. Different oculomotor behaviors (frequency and amplitude of eye- and head-movements) are evaluated very quickly during the drive itself by dynamic overlay pictures indicating where the subjects gaze is located on the screen, and by analyzing the data. Compensatory gaze behavior in a patient leads to a driving performance comparable to a healthy control, while the performance of a patient without compensatory behavior is significantly worse. The data of eye- and head-movement-behavior as well as driving performance are discussed with respect to different oculomotor strategies and in a broader context with respect to possible training effects throughout the testing session and implications on rehabilitation potential.

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects

Patients suffering from homonymous hemianopia after infarction of the posterior cerebral artery (PCA) report different degrees of constraint in daily life, despite similar visual deficits. We assume this could be due to variable development of compensatory strategies such as altered visual scanning behavior. Scanning compensatory therapy (SCT) is studied as part of the visual training after infarction next to vision restoration therapy. SCT consists of learning to make larger eye movements into the blind field enlarging the visual field of search, which has been proven to be the most useful strategy1, not only in natural search tasks but also in mastering daily life activities2. Nevertheless, in clinical routine it is difficult to identify individual levels and training effects of compensatory behavior, since it requires measurement of eye movements in a head unrestrained condition. Studies demonstrated that unrestrained head movements alter the visual exploratory behavior compared to a head-restrained laboratory condition3. Martin et al.4 and Hayhoe et al.5 showed that behavior demonstrated in a laboratory setting cannot be assigned easily to a natural condition. Hence, our goal was to develop a study set-up which uncovers different compensatory oculomotor strategies quickly in a realistic testing situation: Patients are tested in the clinical environment in a driving simulator. SILAB software (Wuerzburg Institute for Traffic Sciences GmbH (WIVW)) was used to program driving scenarios of varying complexity and recording the driver's performance. The software was combined with a head mounted infrared video pupil tracker, recording head- and eye-movements (EyeSeeCam, University of Munich Hospital, Clinical Neurosciences). The positioning of the patient in the driving simulator and the positioning, adjustment and calibration of the camera is demonstrated. Typical performances of a patient with and without compensatory strategy and a healthy control are illustrated in this pilot study. Different oculomotor behaviors (frequency and amplitude of eye- and head-movements) are evaluated very quickly during the drive itself by dynamic overlay pictures indicating where the subjects gaze is located on the screen, and by analyzing the data. Compensatory gaze behavior in a patient leads to a driving performance comparable to a healthy control, while the performance of a patient without compensatory behavior is significantly worse. The data of eye- and head-movement-behavior as well as driving performance are discussed with respect to different oculomotor strategies and in a broader context with respect to possible training effects throughout the testing session and implications on rehabilitation potential.

6 Impact of Physical Deconditioning on Daily Life Activities in Patients with Left Ventricular Assist Device

6 Impact of Physical Deconditioning on Daily Life Activities in Patients with Left Ventricular Assist Device

Effect of levothyroxine replacement on exercise performance in subclinical hypothyroidism

Although muscle metabolism and exercise capacity seem to be affected in patients with subclinical hypothyroidism, there is little evidence indicating improvement of the exercise tolerance due to levothyroxine (L-T(4)) replacement. The aim of the present study was to verify possible cardiopulmonary changes during exercise in patients with subclinical hypothyroidism on L-T(4) replacement with a normal serum TSH for six months. Twenty-three patients with subclinical hypothyroidism were randomized into treated (no.=11) and untreated (no.=12) patients. A cardiopulmonary test was performed with a treadmill, using the modified Balke protocol. Heart rate, oxygen uptake, minute ventilation and other cardiopulmonary parameters were assessed at the 5th minute of exercise. FT4 levels increased while TSH normalized after hormone replacement. Oxygen uptake decreased significantly after hormone replacement (24.1+/-6.3 vs 17.1+/-4.2 ml x kg x min(-1); p=0.03).Minute ventilation also showed an enhanced performance in treated patients (28.0+/-8.1 vs 23.5+/-5.6 l x min(-1); p=0.03), as did the heart rate (128+/-17 vs 121+/-17 bpm; p=0.03). There were no changes in the untreated group. The results demonstrate that submaximal cardiopulmonary exercise performance improved after six months of TSH normalization and this improvement can help enhance the ability to carry out daily life activities in patients with subclinical hypothyroidism.

Rehabilitation of limb apraxia improves daily life activities in patients with stroke

We randomly assigned 33 patients with left hemisphere stroke, limb apraxia, and aphasia to an apraxia or a control (aphasia) treatment group. Before and after each treatment, patients underwent a comprehensive neuropsychological testing battery and a caregiver evaluation of patient's activities of daily life (ADL) independence. Apraxia severity was related with ADL independence. Control (aphasia) treatment improved patients' language and intelligence performance. Apraxia treatment specifically improved praxic function and ADL.

Évaluation fonctionnelle de la douleur chronique chez le patient blessé médullaire

Objectives. – To evaluate pain and its impact on daily life activities in patients with spinal cord injuries. Methods. – Patients with chronic pain associated with spinal cord injuries were mailed 2 questionnaires: the multidimensional pain inventory for spinal cord injury, which includes a visual numeric scale for pain; and the quality of life questionnaire SF-36. Results. – Twenty-two of the 28 patients (women 9, men 19) who were mailed the questionnaires responded. The location of pain was, in decreasing order: lower limbs, upper limbs, trunk. The clinical type of pain was usually neuropathic, and the mean pain intensity was 7.2 ± 2.16. Eleven patients experienced sleep disturbances. In 17 patients, daily activities were limited because of pain (not counting 2 patients who were unable to answer because of hospitalization). Among 6 working patients (of 22), 5 experienced limitations in their job because of pain. SF-36 scores, which reflect psychological and physical health, were well below those of the general population. Discussion–conclusion. – Despite the small size of our population and lack of a French-language validation of the questionnaire, these preliminary results point out the important interference of chronic pain in functional autonomy and quality of life in patients with spinal cord injuries.

Functional cognitive assessment scale (FUCAS): a new scale to assess executive cognitive function in daily life activities in patients with dementia and mild cognitive impairment

Several tests have been developed to examine performance of demented patients in daily life activities. However, most of them are based either on the subjective evaluation of performance by the patient him/herself, or on the reports of relatives. Functional Cognitive Assessment Scale (FUCAS) is a new reliable (alpha > 0.89 - 0.92) cognitive-behavioral scale that assesses executive function in daily life activities directly in patients with dementia. This study aimed at testing FUCAS' internal consistency of items, criterion-related validity, interrater reliability, discriminative ability, and effect of age, sex, and education on FUCAS scores. Criterion-related validity was supported by significant correlations between FUCAS, CAMCOG, MMSE, and FRSSD. The interrater reliability of FUCAS' total score for two raters was r 0.997 and we found no significant effect of age, sex, or education on FUCAS' total performance. Discriminant analysis has identified that FUCAS was able to sufficiently discriminate the patients with MCI from those with moderate-severe dementia. FUCAS is a useful and reliable diagnostic tool for MCI. Cognitive-behavioral assessment such as that provided by FUCAS can provide objective information that can serve to enhance the quality of clinical decision-making.

Questionnaire for the Evaluation of Daily Life Activity in Patients with Wrist Pathology

The questionnaire for the evaluation of daily life activity in patients with wrist pathology is presented. This questionnaire has been elaborated taking into account social and cultural peculiarities of Russians life and includes 33 questions reflecting the possibilities of carrying out of personal every day activities (hygiene, dressing, putting on shoes, cooking, eating etc.). The functional activity of patients with various wrist pathology ( bone fractures, traumatic wrist and fingers avulsion, multicomponent wrist injuries, tendon injuries, Dupuytren's contracture) was assessed by that questionnaire. Analysis of data obtained showed the conformity of questionnaire to modern requirements of psychometry - high validity, sensitivity and reliability. This questionnaire should be used for the evaluation of rehabilitation efficacy of patients with wrist pathology.

MULTIDISCIPLINARY PAIN ABSTRACTS: 19 . Neurology (19)

The objective of this study was to analyze the efficacy of BTX‐A treatment and its effect on daily life activities in patients suffering from myofascial pain syndrome (MPS). An open‐label interventional prospective trial was conducted in 77 patients diagnosed of refractory MPS (defined as the presence of muscle spasm with pain on mobilization or stretching, plus the existence of trigger points with associated referred pain), resistant to both conservative management and to physical therapy. The BTX‐A dosages for the different muscles were chosen according to a standardized protocol. Electromyographic guidance was used to localize the motor end plate prior to injection in superficial muscles. Fluoroscopic guidance was employed to evidence intramyofascial spread of the contrast solution within deep muscles. The assessment of treatment efficacy was based on a pain visual analogue scale (VAS) applied before enrollment and upon completion of the study. The Lattinen test to establish a relationship between pain intensity and its corresponding impact on daily living was also utilized. The Hospital Anxiety and Depression (HAD) scale was used to assess psychologic stress before treatment and at the end of the study. The Oswestry Questionnaire was used to evaluate each patient's ability to carry out daily life activities according to their degree of physical impairment and disability scores. The global analysis revealed a positive correlation between the VAS score prior to treatment and after treatment. This correlation was maintained when analyzing independently for superficial or deep muscles. The correlation coefficients for HAD scores and the Lattinen test values showed a significant association between pre‐treatment and post‐treatment findings. No adverse events were recorded for 83.1% of the cases. The results of this study are consistent with other studies showing the efficacy of BTX‐A for treating pain in MPS. The evaluation of the psychologic dimension of this disorder and its associated disability can provide valuable information for the adequate management of these patients and for assessing treatment outcome.

The cognitive management of daily life activities in patients with mild to moderate Alzheimer's disease in a day care centre: A case report

The day care centre appears to be a structure especially well suited for the management of mild to moderate Alzheimer patients. It constitutes a place in which performance in everyday life activities can be explored, and optimisation strategies can be installed before they are used at home. Another objective of the day care centre might also be to provide caregivers with support and ease the burden that the daily care of a demented patient represents. Finally, it may also help to alleviate the patient's loneliness. In this perspective, we describe the general organisation of the recently-created day care centre at the University Hospital of Liège. We also present the assessment and intervention programme which was conducted in this day care centre in order to reduce the generalised apathy and depressed mood observed in a 70-year-old Alzheimer patient (AM). This programme aimed at restoring a leisure activity (knitting) at home by proposing several adaptations designed to minimise the impact of AM's cognitive deficits on knitting activity. While an aggravation of her memory deficits was observed, the intervention significantly decreased AM's apathy and depressed mood as well as her husband's burden.

Questionnaire Survey on Asthma Management of Japanese Allergists I. Diagnosis patient education and management

A questionnaire on asthma management was sent to 586 physicians, consisting of specialists authorized by the Japanese Society of Allergology and councillors of the Society, who were treating patients with bronchial asthma. Of the total of 306 (52%) respondents in November 1993, 241 replied to questions relating to adult asthma and 129 to questions relating to childhood asthma (including duplicate replies). Responses to the questionnaire on the diagnosis, patient education and management of asthma indicated that a reduced number of patients with severe asthma were seen in 1993 in both Pediatric and Internal Medicine Departments compared with 5 years before, despite the increase in total number of asthma patients in Japan. Specifiic IgE radioallergosorbent test (RAST) measurements were frequently performed instead of skin testing for diagnosis, and eosinophil count and bronchodilator response served as an adjunct to the diagnosis. Patients were frequently asked detailed questions about aspirin-induced asthma, which accounted for 8.8, 2.2 and 1.5% of patients with asthma in the adult, schoolchildren (6–16 years) and infant (≤ 5 years) groups, respectively. In achieving ‘control of asthma’, first priority was given to coping with the symptoms in children aged 5 years or less and to enabling routine daily life activities in patients 6 years of age or older. Usefulness of peak flow measurements was widely recognized and a detailed plan for allergen avoidance (house dust) was often given to patients.