Long-term Physical Disability Research Articles

The Effect of Long-Term Physical Disability and Aging on Extracellular Matrix Biogenesis in Human Skeletal Muscle

Physical inactivity and aging cause significant impairments in the functionality and mechanical properties of skeletal muscles, as well as remodeling of the extracellular matrix (ECM). We aimed to study the effect of long-term inactivity and age on the biogenesis of ECM in skeletal muscle. For quantitative mass spectrometry-based proteomic analysis and RNA sequencing, biopsy samples were taken from m. vastus lateralis in 15 young healthy volunteers, 8 young and 37 elderly patients with long-term primary osteoarthritis of the knee/hip joint – which is a model for studying the effects of inactivity on muscles. We detected 1022 mRNAs and 101 ECM and associated proteins (matrisome). An increase in the expression of two dozen highly abundant matrisome proteins, specific to elderly and young patients (in relation to young healthy people), was detected; however, changes in the expression of mRNA encoding matrisome regulators (enzymatic regulators and secreted proteins) were similar. Comparison with previous proteomic and transcriptomic data showed that the changes in the matrisome that we described differed markedly from the changes caused by aerobic physical training in young healthy people, in particular, in the expression of the dominant ECM proteins and, especially, in the expression of mRNA of ECM enzymatic regulators and secreted proteins. Comparison of the changes in the expression profiles of these regulatory genes may be useful for identifying pharmacological targets for the prevention of adverse changes/activation of ECM biogenesis under various pathological conditions/physical training.

A cross-sectional study to assess the pattern of work-related musculoskeletal disorder among class-IV workers of tertiary care centres in central India

Background: Musculoskeletal disorders (MSDs) are typically characterized by persistent pain and limitations in mobility and dexterity. They are highly prevalent and are the leading cause of severe long-term pain and physical disability. Providing stress-management training, encouraging regular breaks, and offering physical therapy and other treatments can alleviate the physical symptoms of work-related MSDs (WMSDs). Objectives were to assess the prevalence and patterns of WMSDs among class-IV workers and to identify the key factors contributing to WMSDs. Methods: The study was conducted at the Hamidia Hospital and Gandhi Medical College Bhopal. 350 class IV workers were selected using random sampling, and data were collected by direct interview. Results: Among all housekeeping staff, 82% showed symptoms of MSDs. Pain was predominantly reported in the lower back (49.3%), followed by the lower leg (32.9%). Among the 350 participants, 72 experienced mental stress manifested as difficulty falling asleep, restlessness, and anxiety. Gutkha, followed by smoking, was the most common substance abused by Class IV workers, which correlated with musculoskeletal pain. Participants with a BMI<18.5 and 25-29.99 reported more MSD pain compared to those with a normal BMI (18.5-24.99). Additionally, workers who did not exercise or exercised only 1-2 times a month experienced higher levels of pain. Conclusions: Class IV workers face physically demanding tasks, so regular breaks should be advised. Promoting literacy can aid in the prevention and early detection of MSDs. Basic interventions and counselling are essential to prevent chronic pain, mental stress, and the development of MSDs.

Long-term Air Pollution and Physical Disability in Older U.S. Adults: A Multi-State Modeling Evaluation from the EPOCH Study

Long-term Air Pollution and Physical Disability in Older U.S. Adults: A Multi-State Modeling Evaluation from the EPOCH Study

Health navigation for people experiencing newly acquired long-term physical disability: A realist-informed integrative review

Health navigation for people experiencing newly acquired long-term physical disability: A realist-informed integrative review

Advances and Challenges in Spinal Cord Injury Treatments.

Spinal cord injury (SCI) is a debilitating condition that is associated with long-term physical and functional disability. Our understanding of the pathogenesis of SCI has evolved significantly over the past three decades. In parallel, significant advances have been made in optimizing the management of patients with SCI. Early surgical decompression, adequate bony decompression and expansile duraplasty are surgical strategies that may improve neurological and functional outcomes in patients with SCI. Furthermore, advances in the non-surgical management of SCI have been made, including optimization of hemodynamic management in the critical care setting. Several promising therapies have also been investigated in pre-clinical studies, with some being translated into clinical trials. Given the recent interest in advancing precision medicine, several investigations have been performed to delineate the role of imaging, cerebral spinal fluid (CSF) and serum biomarkers in predicting outcomes and curating individualized treatment plans for SCI patients. Finally, technological advancements in biomechanics and bioengineering have also found a role in SCI management in the form of neuromodulation and brain-computer interfaces.

Depression and Associated Factors Among Post-Stroke Patients in Tertiary Care Center

Introduction: Stroke is the leading cause of long-term physical and mental disability and causes major individual, social and financial burden. The relationship between depression and stroke is well established. There is substantial evidence that comorbid depression among stroke survivors is associated with a negative impact on recovery, especially on daily functioning, and it also decreases the quality of life. The aim of this study is to find the prevalence of depression and its associated factors among post-stroke patients.Method: A descriptive-prospective study was done among post-stroke patients attending the out-patient and inpatient departments of Internal Medicine at National Medical College from 1st June 2014 to 30 May 2015. Purposive sampling, a type of non-random sampling technique was utilized for the study. Informed consent was taken prior to study. Ethical approval was taken from Institutional Review Board. After proper instructions, self-designed pro-forma was used to collect data, following which, ICD-10 and HAM-D (Hamilton Depression Rating Scale) was applied. Data analysis was done using SPSS 20.Results: Out of 79 stroke patients, 62.02% had an ischemic stroke and 37.97% had a hemorrhagic stroke. Prevalence of depression using Hamilton Depression Rating Scale was 39.24%. Statistically significant association was seen between depression and sex, income and occupation among socio-demographic variables (p < 0.05). Association of depression with age, education, marital status, address, laterality of lesion, duration of illness and type of stroke was not statistically significant. Conclusion: Occurrence of depression in stroke survivors is common. Routine depression screening is recommended in stroke survivors for better management and early recovery.

Long-term physical disability in the sickest of the sick: Assessment of persons treated with Extracorporeal Membrane Oxygenation (ECMO) and early mobilization

Long-term physical disability in the sickest of the sick: Assessment of persons treated with Extracorporeal Membrane Oxygenation (ECMO) and early mobilization

Study of utilisation pattern and adverse reaction monitoring of drugs used for relief of musculoskeletal pain in a tertiary care teaching hospital in Eastern Odisha

Musculoskeletal conditions are the most common cause of long-term pain and physical disability. The burden of musculoskeletal conditions is not only in terms of global numbers but also in terms of physical and psychosocial disability. Pain arising from musculoskeletal conditions of the major joints like back, neck, shoulder, knee or multi-site involvement results in diminished quality of life. Evidence for the effectiveness and safety of the various drugs used to alleviate MSP is uncertain.The present study was an observational, cross-sectional study which included patients with complaints of musculoskeletal pain attending Regional Spine Injury Centre, S.C.B Medical College and Hospital. A total of 100 patients were included in the study. Demographic data of all the patients was collected and their level of significance in the causation of musculoskeletal pain was assessed. The prescription pattern of the drugs for musculoskeletal pain was analysed. All the patients taking the drugs were monitored for any adverse drug reaction and the same was documented.Low back ache (28%) was the most common type of musculoskeletal pain observed. Aceclofenac was the most common analgesic prescribed, followed by paracetamol and etoricoxib. Aceclofenac and paracetamol was the most common combination used. Pain abdomen was the most common ADR encountered.

The Relationship of Exercise, Psychosocial Factors, and Social Participation Among Adults Aging With Long-Term Physical Disability: A Cross-Sectional Study.

This study investigated the relationships among exercise engagement, psychosocial factors, and social participation for adults aging with physical disabilities (AAwPD). A cross-sectional study within a community-based cohort study of participation among AAwPD was conducted. A comprehensive survey was administered online or via telephone. Participants were 474 individuals between the ages of 45-65, primarily living in the Midwestern United States, who reported living with a physical disability for at least 5years. Survey questions created based on prior consolidation of activity domains assessed exercise engagement. Psychosocial health and social participation were measured using the Patient Reported Outcomes Measurement Information System. Chi-square tests, t-tests, and a general linear model were used to examine differences between exercisers and non-exercisers. Participants who exercised reported less pain (P < .001), fatigue (P < .001), and depression (P < .001) and greater self-efficacy for management of chronic conditions (P = .002), satisfaction with participation in social roles and activities (P < .001), and ability to participate in social roles and activities (P < .001) compared with non-exercising participants. AAwPD who exercised reported fewer secondary conditions and greater social participation. Although causal relationships cannot be drawn, and the frequency, duration, and intensity of exercise were not examined, this study lays important groundwork for future research to determine the health and participation benefits of exercise for AAwPD. Future studies should also focus on the development of exercise interventions to support successful aging with disability.

Associated Factors of Suicidal Behavior Among Persons with Physical Disability: A Systematic Review.

Suicide is common among persons with physical disabilities as they face several physical, social, psychological, and economic problems. They are at risk for suicidal thoughts, behaviors, and death by suicide. We aimed to systematically review empirically published articles and identify the associated factors of suicidal ideation and suicide attempts in persons with physical disabilities. A systematic search was carried out on the literature published from January 1, 2000 to January 19, 2023 in PubMed, Cochrane, Web of Science, Google Scholar, Shodh Ganga, and so on. All the synonyms of keywords or MeSH terms for suicidal ideation, suicide attempt, and physical disability were used. Two hundred thirty-six articles were found, and after following inclusion and exclusion criteria, 12 remained. The associated factors of suicidal behavior were disability status (11/12 studies), burdensomeness (8/12 studies), felt stigma (4/12 studies), depressive symptoms (6/12 studies), loneliness (2/12 studies), lack of social and emotional connectedness (2/12 studies), long-term physical or mental disability (2/12 studies), congenital disability (1/12 studies), and aggression (1/12 studies). Timely, evidence-based, low-cost interventions can provide great assistance and address the specific needs of this vulnerable population as they have higher risk for suicidal behavior.

A Prevalence Survey on Attempted Suicides and Suicidal Deaths in a Selected Rural Area of Bangladesh

Introduction: Now-a-days suicide has become a significant public health problem all over the world. It is like a silent parasite of society. With a view to assess the community prevalence of attempted suicide and suicidal deaths a study was conducted among 181 respondents in Muradpur, Sadar, Dinajpur. Concerning National benefits, we have to grow awareness about the issue. Objectives: To assess the community prevalence, high risk groups, causes and process of attempted suicide and suicidal deaths in an area of Bangladesh. Method: This is a cross sectional type of descriptive study conducted in Muradpur, Sadar, Dinajpur from 21th October to 31th October, 2023.The sample size was 181 and convenience sampling technique was used for data collection. Results: This study showed that about 87.8% of the total respondents were literate and regarding occupation, maximum 45.9% female respondents were housewives and 18.8% were engaged in agriculture. Socio-economic status revealed that three-fourths of them were earning around 15,000 Taka monthly. About half of the totalrespondents thought that suicide is religiously prohibited and 34.8% thought that it is not good to commit suicide. In this area about three-fourths of people did not receive any health education regarding suicide prevention. Around 98.34% respondents avoided the thought of suicide and only 1.66% had somehow thought of committing suicide. The study found 16(8.8% of total respondents) cases of suicide, where 7 (3.9% of total respondents) were male and 9 (4.9% of total respondents) were female. Regarding age, maximum 8 (50%) people who committed suicide were more than 50 years old, one-fourths of them had a history of mental disorder and 6 (37.5%) people were attempted suicide previously. Majority of them committed suicide followed by family problem (37.5%) and long-term physical or mental disability (25%). Around 50% of total suicidal cases were conducted by hanging and 43.75% by poisoning. The study found that 50% of individuals who committed suicide were immediately transferred to hospital for treatment. Conclusion: The main reasons for suicide were illiteracy and family problems. Although, majority of the villagers thought that the real reason behind it is lack of religious knowledge. Family and social education will be beneficial for preventing suicide.

Influence of falls, fall-related injuries, and fear of falling on social participation in people aging with long-term physical disability: a cross-sectional study

Purpose This study examined prevalence and relationships among falls, injuries, fear of falling, and social participation in people aging with long-term physical disability (PAwLTPD). Materials and methods A convenience sample of 474 PAwLTPD recruited from community agencies and social media as baseline of a longitudinal cohort study. Inclusion criteria: 45–65 years, self-reported physical disability for ≥5 years, and English-speaking. Self-report surveys of physical/mental health, falls in the past year, fear of falling, and Patient-Reported Outcomes Measurement Information System (PROMIS) ability and satisfaction with participation in social roles and activities measures were collected. Results Mean age 56.8 years; participants were mostly female (66.7%) and White (61.4%). Nearly 65% reported a fall; 56.6% of falls resulted in injury. Falls and fall-related injuries were associated with worse physical/mental health and presence of >5 health conditions. Seventy-five percent of participants reported fear of falling. Lower ability and satisfaction with participation were found in participants who fell and worried about falls. Conclusions PAwLTPD are at increased risk of falls, fall-related injuries, and fear of falling, which affects their ability to engage in social activities. Future research is needed to understand circumstances associated with falls and to develop effective interventions to address falls in PAwLTPD.

Aging with long-term physical disability: Cohort analysis of survey sample in the U.S.

Chronic health conditions, secondary conditions, and decreasing functional ability related to aging and/or changes in underlying impairment may influence participation for persons aging with long-term physical disability (AwD). To examine sample integrity and baseline findings through exploration of associations of sociodemographic, health, and disability factors with social participation for persons AwD. This is a longitudinal cohort study following persons AwD over three years, reporting baseline cohort study data. A convenience sample of 474 persons AwD aged 45-65 reporting physical disability of ≥5 years' duration was recruited through community organizations and social media. The cohort was majority female (66.7%) and single (62.0%), and over one-third (38.6%) was non-White. Pain, fatigue, depression, ability to participate in, and satisfaction with, social roles and activities were measured with the Patient Reported Outcomes Measurement Information System. Results were manually compared against AwD study samples identified through a focused literature review and national census data. Participants aged 55-60 and 61-65 had significantly lower rates of employment and marriage and higher rates of living alone than participants aged 45-54. Participants reported higher rates of fatigue, pain, and depression and lower ability to participate in, and satisfaction with, participation in, social roles and activities than the general population. Ability to participate and satisfaction with participation were highest among Black/African American participants. Participants reported higher rates of common AwD symptoms and lower ability to participate and satisfaction with participation than the general population, consistent with prior studies of AwD samples. This cohort reflects the AwD population and can be considered an AwD sample, comparable to those found in existing literature. The focus of future analyses will be to gain a greater understanding of chronic health conditions, incidence of falls, engagement in everyday life activities, and the impact of the environment.

Primates and disability: Behavioral flexibility and implications for resilience to environmental change.

Congenital malformations, conditions, injuries, and illness can lead to long-term physical impairment and disability in nonhuman primates. How individual primates change their behaviors flexibly to compensate for their disabilities can inform our understanding of their resilience and ability to adjust to environmental change. Here, we synthesize the literature on nonhuman primates and disability, addressing the questions: how does disability influence behavior in primates? What insights can we take from the literature to better understand and predict the capacity of primates to modify their behaviors in the face of human-induced environmental change? We conducted a systematic review of the literature on spontaneous physical impairment and disability in captive, free-ranging, and wild primates. We surveyed 2807 articles on Web of Science and Scopus and identified 114 studies that fit our predetermined inclusion criteria. Behavioral plasticity, maternal and conspecific care, and the potential for innovation of novel behaviors allow many primates with disabilities to compensate when faced with challenges that are outside the scope of usual circumstances. We also found that 60% of the publications connected primate physical impairment and disability to human activities, suggesting an entangled relationship among humans, the environment, and primate disability. Disability and physical impairments provide an opportunity to examine how primates modify their behavior when presented with challenging conditions, and their potential resilience to a changing environment.

Mechanisms associated with post-stroke depression and pharmacologic therapy.

Stroke is one of the most common cerebrovascular diseases, which is the cause of long-term mental illness and physical disability, Post-stroke depression (PSD) is the most common neuropsychiatric complication after stroke, and its mechanisms are characterized by complexity, plurality, and diversity, which seriously affects the quality of survival and prognosis of patients. Studies have focused on and recognized neurotransmitter-based mechanisms and selective serotonin-reuptake inhibitors (SSRIs) can be used to treat PSD. Neuroinflammation, neuroendocrinology, neurotrophic factors, and the site of the stroke lesion may affect neurotransmitters. Thus the mechanisms of PSD have been increasingly studied. Pharmacological treatment mainly includes SSRIs, noradrenergic and specific serotonergic antidepressant (NaSSA), anti-inflammatory drugs, vitamin D, ect, which have been confirmed to have better efficacy by clinical studies. Currently, there is an increasing number of studies related to the mechanisms of PSD. However, the mechanisms and pharmacologic treatment of PSD is still unclear. In the future, in-depth research on the mechanisms and treatment of PSD is needed to provide a reference for the prevention and treatment of clinical PSD.

The Potential Role of Mesenchymal Stem Cells Derived Exosomes on the Healing of Grade II Experimentally Induced Skeletal Muscle Injury in Adult Male Albino Rats. Histological Study

Abstract Background Musculoskeletal injuries are the most common cause of severe longterm pain and physical disability. However, there is still no efficient treatment that leads to prevention of muscle fibrosis. Cell-Free therapy using mesenchymal stem cells (MSCs) derived exosomes could provide a new promising therapy. Aim To study the potential role of MSCs-derived exosomes on the healing of experimentally induced grade II skeletal muscle injury in adult male albino rats. Materials and Methods Forty male albino Wister rats were used in this study. Five out of them were used for isolation of exosomes. The rest were randomly divided into three groups. Group I (Sham group), Group II (muscle injury group left for spontaneous healing), Group III (muscle injury treated with exosomes). Rats from each group were subdivided into two subgroups; subgroup “a and b” in which rats were sacrificed after ten days and twenty days, respectively. Muscle specimens were collected and prepared for proper histological techniques. Immuno-histochemical staining for detection of collagen type I and developmental myosin (MHCd) were also done. Morphometric study and statistical analysis were also performed. Results Granulation tissue and inflammatory cellular infiltration with significant increase in the mean area percentage of collagen fibers were noticed in subgroups of untreated muscle injury compared to the corresponding exosomes treated subgroups. This was confirmed by collagen type I immune histochemical reaction. Group III (treated with exosomes) showed better muscle regeneration and significant decrease in muscle fibrosis. Significant increase in immunohistochemical reaction of developmental myosin was noticed in exosomes treated subgroups compared to corresponding untreated muscle injury subgroups. Conclusions Exosomes enhance muscle regeneration after induced muscle injury. Exosomes also decreased muscle fibrosis and improve muscle healing.

Treat-to-Target in Pediatric Rheumatic Diseases.

To summarize the current evidence on the adoption of the treat-to-target (T2T) strategy in pediatric rheumatic diseases (PRD). The recent advances in the management of PRD have markedly increased the ability to achieve disease remission. Complete disease quiescence is regarded as the ideal therapeutic goal because its attainment leads to lesser long-term damage and physical disability, and to optimization of quality of life. Studies in adult rheumatic diseases have shown that patient outcomes are improved if complete suppression of the inflammatory process is aimed for by frequent adjustments of therapy according to quantitative indices. This approach, which underlies the T2T concept, has been applied in strategic trials in rheumatoid arthritis (RA). Furthermore, recommendations for the T2T have been issued for RA and other adult rheumatic diseases. There is currently a growing interest for the introduction of T2T in PRD, and recommendations for treating juvenile idiopathic arthritis (JIA) to target were promulgated. A similar initiative has been undertaken for childhood-onset systemic lupus erythematosus. Preliminary therapeutic studies have explored the T2T design in JIA. The T2T strategy is a modern therapeutic approach that holds the promise of improving the outcomes in patients with PRD.

Organizations’ Perspectives on Successful Aging with Long-Term Physical Disability

In recent decades, there has been considerable discussion surrounding what it means to age successfully, and what supports, services, and programs are needed to facilitate successful aging. Rehabilitation scholars advocate for models of successful aging that take into account the unique needs and priorities of those aging with long-term physical disability. The aim of this study is to explore how organizations that serve those with physical disability define successful aging for this population, and whether their understanding of successful aging is consistent with the needs and priorities identified by those aging with physical disability. To do so, we analyze qualitative data from a national online survey of disability organizations (N = 106 organizations). Organizations described the following domains of successful aging for those with physical disability: (a) autonomy and/or maximized independence; (b) living arrangement; (c) health and well-being; and (d) social connection and meaningful community engagement. Overall, organizations’ understandings of successful aging are consistent with the priorities identified by those aging with long-term physical disability. We discuss strategies that organizations can adopt to ensure that the programs and services that they offer facilitate these elements of successful aging.

Cognitive Processing Speed Predicts Disability Milestones in Multiple Sclerosis (P5-3.014)

Cognitive Processing Speed Predicts Disability Milestones in Multiple Sclerosis (P5-3.014)

RETURN TO SPORTS FOLLOWING LOWER LIMB MUSCULOSKELETAL TUMOUR SURGERY: A SYSTEMATIC REVIEW

Primary malignant bone and soft tissue tumours often occur in the lower extremities of active individuals including children, teenagers and young adults. Survivors routinely face long-term physical disability. Participation in sports is particularly important for active young people but the impact of sarcoma treatment is not widely recognised and clinicians may be unable to provide objective advice about returning to sports. We aimed to identify and summarise the current evidence for involvement in sports following treatment of lower limb primary malignant bone and soft tissue tumours.A comprehensive search strategy was used to identify relevant studies combining the main concepts of interest: (1) Bone/Soft Tissue Tumour, (2) Lower Limb, (3) Surgical Interventions and (4) Sports. Studies were selected according to eligibility criteria with the consensus of three authors. Customised data extraction and quality assessment tools were used.22 studies were selected, published between 1985 – 2020, and comprising 1005 patients. Fifteen studies with data on return to sports including 705 participants of which 412 (58.4%) returned to some form of sport at a mean follow-up period of 7.6 years. Four studies directly compared limb sparing and amputation; none of these were able to identify a difference in sports participation or ability.Return to sports is important for patients treated for musculoskeletal tumours, however, there is insufficient published research to provide good information and support for patients. Future prospective studies are needed to collect better pre and post-treatment data at multiple time intervals and validated clinical and patient sports participation outcomes such as type of sports participation, level and frequency and a validated sports specific outcome score, such as UCLA assessment. In particular, more comparison between limb sparing and amputation would be welcome.