Functional Performance Measures Research Articles

Feasibility of Group Telerehabilitation for Older Adults: A Quality Improvement Project

A growing body of evidence suggests group rehabilitation may empower patients to achieve functional goals by leveraging social connectivity. From previous work, we adapted an in-person group for older Veterans to a telerehabilitation group called Fit for Life. The current quality improvement project aimed to evaluate the feasibility of implementing Fit for Life. Eligible Veterans lived in the community and were at risk for falls or hospitalization per functional performance measures. We used convergent parallel mixed methods approach in the evaluation. Eighteen Veterans ≥55 years old (all male, mean 77 years, 39% rural) received a referral to Fit for Life, two did not participate. We analyzed and integrated adaptations posed by clinicians and Veterans in real-time to enhance access to and participation in Fit for Life. Future work will explore clinical effectiveness, tools to identify patients most likely to benefit, and care delivery structures that integrate telerehabilitation groups for older Veterans.

Industry 4.0 Digital Technologies as Enablers of Sustainable Supply Chain Operations Performance

The objective of this paper is to find the best industry 4.0 digital technologies as enablers amongst the available alternatives based on sustainable supply chain operations performance. Numerous sustainability advantages are provided by these technologies, from the possibility of reducing energy consumption and waste generation to increased prospects for recycling and industrial symbiosis. Using twenty sustainable supply chain performance criteria, we identified ten industry 4.0 digital technologies and used the Multi-criteria Decision Making (TODIM) technique to rank the best of them in a hierarchical fashion. In order to assist newly emerging firms in identifying the best industry 4.0 practices, this study analyzes the dominance of industry 4.0 digital technologies based on the significance and dominance of sustainable supply chain operations performance measures. The results show that the most important Industry 4.0 digital technologies for a sustainable supply chain are IoT, Big Data Analytics, and Blockchain; hence, enterprises should prioritize these technologies more to reap their benefits.

Nano-scaled advanced materials for antimicrobial applications – mechanistic insight, functional performance measures, and potentials towards sustainability and circularity

About 13.7 million people died worldwide from infectious diseases in 2019 which accounts for one fifth of all annual deaths. Infectious diseases are caused by microbes (i.e. bacteria, fungi, viruses)...

STRATEGIC ENTREPRENEURSHIP AND OPERATIONAL PERFORMANCE OF NIGERIAN INDIGENOUS OIL AND GAS SERVICE COMPANIES IN SELECTED SOUTH-SOUTH STATES, NIGERIA

Objective: This study examined the relationship between strategic entrepreneurship and operational performance of Nigerian indigenous oil and gas service companies in selected South-South States, Nigeria. Theoretical Framework: The study adopted resource-based theory and Ansoff strategic success theory. Method: The study adopted survey research design at organisational unit of analysis used five-points Likert scale questionnaire for data collection. The population of the study was 1827 Nigerian indigenous oil and gas service compaines in selected South-South States, Nigeria with sample size of 328 determined by Taro Yamane’s formula and Bowley’s formula used for proportional allocation of firms. The reliability was determined by Cronbach’s Alpha and construct validity by Pearson’s r, factor analysis, Kaiser-Meyer-Olkin (KMO) and Bartlett’s Test of Sphericity. The data analysis were descriptive and inferential statistics in Microsoft Excel Software Package version 2016 and IBM Statistical Package for the Social Sciences (SPSS) version 29 software application tools respectively. Pearson Product Moment Correlation Coefficient (PPMCC) techniques was used to test the hypotheses. Results and Discussion: The results showed that strategic entrepreneurship had positive and significant relationship with operational performance of Nigerian indigenous oil and gas service companies in selected South-South States, Nigeria. Research Implications: The practical and theoretical implications of this research are in the domain fields of strategic studies, strategic management, entrepreneurial studies, strategic entrepreneurship, management sciences, management technology, innovation, operations and performance management. Originality/Value: The main contribution of this study is on developing a unique, innovative and simplified framework that systematically aided the empirical analysis of the relationship between strategic entrepreneurship dimensions and operational performance measures of Nigerian indigenous oil and gas service companies in selected South-South States, Nigeria.

Unified Multi-Abstraction-Level Functional Testing and Performance Measurements for Industrial IoT in Spatially Distributed Narrow Band-Wireless Wide Area Networks.

Narrow Band-Wireless Wide Area Networking (NB-WWAN) technologies are becoming more popular across a wide range of application domains due to their ability to provide spatially distributed and reliable wireless connectivity in addition to offering low data rates, low bandwidth, long-range, and long battery life. For functional testing and performance assessments, the wide range of wireless technology alternatives within this category poses several difficulties. At the device level, it is necessary to address issues such as resource limitations, complex protocols, interoperability, and reliability, while at the network level, challenges include complex topologies and wireless channel/signal propagation problems. Testing the functionality and measuring the performance of spatially distributed NB-WWAN systems require a systematic approach to overcome these challenges. Furthermore, to provide a seamless test flow, it is also critical to test and compare the performance of wireless systems systematically and consistently across the different system development phases. To evaluate NB-WWAN technologies comprehensively across multiple abstraction levels-network simulators, emulated lab testbeds, and field test environments-we propose a unified multi-abstraction-level testing methodology. A detailed technical description of the prototype implementation and its evaluation is presented in this paper.

Psychometric properties of the Pediatric Evaluation of Disability Inventory - Patient Reported Outcome: A cognitively accessible measure of functional performance.

https://onlinelibrary.wiley.com/doi/10.1111/dmcn.16117

Psychometric properties of the Pediatric Evaluation of Disability Inventory - Patient Reported Outcome: A cognitively accessible measure of functional performance.

To evaluate the structural validity, internal reliability, and measurement invariance of the Pediatric Evaluation of Disability Inventory - Patient Reported Outcome (PEDI-PRO), a measure of functional performance of discrete tasks required to participate in everyday life situations important for adulthood. This was a cross-sectional study with 306 young people aged 14 to 22 years (mean 18 years 10 months, SD 2 years 5 months) with developmental disabilities (43.1% autism spectrum disorder only, 23.9% intellectual disability, 17.6% other disability, 11.4% both autism spectrum disorder and intellectual disability, 3.9% missing) completed the PEDI-PRO. Following COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) criteria, we conducted a confirmatory factor analysis, applied a Rasch rating-scale model, examined Cronbach's alpha, Rasch person reliability and separation coefficients, and differential item functioning (DIF). Structural validity was good for the daily activities and mobility domains, and acceptable for the social/cognitive domain. The 3-point Likert response scale functioned as intended. All domains demonstrated acceptable internal consistency on all criteria. One or two items in each domain demonstrated DIF, but the impact on all domain scores was less than 1.0 threshold. The cognitively accessible design and innovative conceptual measurement framework probably contributed to these promising findings. The PEDI-PRO addresses a gap in high-quality patient-reported outcome measures that assess priority outcomes for young people with developmental disabilities.

Functional Capacity, Functional Performance, and Symptoms in People With Heart Failure: An Integrative Review.

Heart failure (HF) is a clinical syndrome that has a negative effect on functional status, a multidimensional concept characterizing one's ability to provide for the necessities of life. Symptoms might be associated with different aspects of functional status in HF. However, the terms functional capacity and performance have been misused interchangeably, and no previous review has focused on the extent to which symptoms contribute to functional capacity and performance among people with HF. The aim of this study was to comprehensively review and synthesize the existing literature on the relationship between symptoms, functional capacity, and functional performance in people with HF. We conducted an integrated review of observational studies in which authors examined the relationship between at least 1 symptom and at least 1 aspect of functional capacity or performance in people with HF 18 years or older. The Joanna Briggs Institute's critical appraisal tools were used to analyze the quality of studies. We included 23 studies with 7219 participants and an age range of 40 to 86 years. Fifteen symptom measures were used to measure dyspnea, fatigue, pain, insomnia symptoms, depressive symptoms, and anxiety symptoms. Three functional capacity measures were assessed in 9 studies, and 7 functional performance measures were assessed in 17 studies. As often measured with the Six-Minute Walk Test, functional capacity was inversely associated with pain/discomfort, insomnia symptoms, and psychological symptoms. Functional performance, often measured by the New York Heart Association functional class and Medical Outcome Scale Short Form 36, was associated with sleep difficulties, fatigue, depressive symptoms, and anxiety. Four studies combined functional capacity and performance measures to elicit functional status. Depressive symptoms, fatigue, pain, and insomnia symptoms are associated with decreased functional performance and capacity. Commonly, symptoms experienced in HF are associated with declining functional status. However, this finding depends on the measures or metrics used to assess symptoms, functional capacity, and performance. The observed dissimilarities in the relationship between symptoms and functional capacity and performance highlight the conceptual distinctions, suggesting that authors of future studies should judiciously select appropriate dimensions and measures of functional status based on the study's purposes, design, and available resource.

The effect of post-match fatigue on physical performance in adolescent soccer players.

Soccer involves many physically challenging actions and engaging in such activities can induce a decline in performance due to physical fatigue which predisposes players to develop injuries. The present study aimed to examine the impact of post-match fatigue on functional performance and Inter-Limb Asymmetry Index (LSI) in adolescent soccer players. Thirty-eight adolescent male soccer players (15-18 years) completed a battery of functional performance measures (Rate of Perceived Exertion (RPE) scale, 10 m sprint, agility T-test, and Single leg hop for distance (SLHD) test). The data collection started prior to a soccer match and consisted of two testing sessions; two hours before the match, while the subsequent testing session was performed within two hours immediately following the match. The study results revealed a significant effect of post-match fatigue on change of direction abilities and SLHD (moderate effect size). However, no significant differences were observed in the 10 m sprint test and LSI (P>0.05). Functional performance measures such as agility test and SLHD test can detect physical ability changes due to post-match fatigue in adolescent soccer players. The study findings offer insightful and practical information on the importance of employing field-based functional performance measures in monitoring players' recovery following a game.

Effectiveness of In-Home, Augmented Reality-Based Telerehabilitation After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

New digital technology-based rehabilitation may be a viable option for patients after anterior cruciate ligament reconstruction (ACLR), with advantages such as easy access to treatment and learning as well as cost-effectiveness. To investigate the effects of an augmented reality (AR)-based, telerehabilitation system in patients after ACLR compared with a brochure-based rehabilitation program in terms of patient-reported outcomes and functional performance measures. Randomized controlled trial; Level of evidence, 2. This was a multicenter, assessor-blinded study. Enrolled participants were allocated randomly to either the intervention group, who underwent AR-based telerehabilitation system, or to the control group, who underwent a brochure-based rehabilitation program with a self-log. Both groups performed the same postoperative rehabilitation exercise protocol. Subjective knee function was assessed using the International Knee Documentation Committee (IKDC) as the primary outcome; secondary outcomes were a numeric rating scale for pain, the EuroQol 5-Dimension 5-Level, isometric knee strength, range of motion, and the single-leg hop test. The intervention group also completed a satisfaction survey. Follow-up was conducted at 2, 6, 12, and 24 weeks postoperatively. A total of 28 patients were enrolled in each group; 1 patient in the control group was lost to follow-up. Patients in both groups demonstrated improvement on all outcomes over time. There were no significant between-group differences in the IKDC score from baseline to 12 weeks postoperatively. The intervention group saw a greater increase in the relative isometric strength of the quadriceps on the involved limb at 6, 12, and 24 weeks postoperatively (P < .05 for all). No significant group differences were observed in the remaining secondary outcomes. Study findings indicated that patients who underwent AR-based telerehabilitation in the early rehabilitation phase after ACLR demonstrated similar improvements as those who followed a brochure-based rehabilitation program and had a quicker recovery of knee extensor strength. NCT04513327 (ClinicalTrials.gov identifier).

Are clinical hip muscle strength or functional task performance measures associated with hip cartilage defects in young adults with femoroacetabular impingement syndrome?

Are clinical hip muscle strength or functional task performance measures associated with hip cartilage defects in young adults with femoroacetabular impingement syndrome?

Associations Between Hydration Status and Executive Function in Middle-Aged and Older Adults: Findings from the Nationally Representative Health and Retirement Study

The purpose of the current study is to examine the association between hydration status and cognitive function in middle-aged and older adults, drawing from a large, nationally representative sample in the United States and using a comprehensive set of executive function performance measures. We utilized data from the Health and Retirement Study to conduct twelve, three-stage hierarchical regressions on hydration status and executive function performance of older adults. Cognitive performance scores on the Trail Making A, Symbol Digit Modalities, and Letter Cancellation tests significantly differed by hydration status, and these outcomes follow a curvilinear pattern, such that performance scores are lower for those who are hyper-hydrated or dehydrated relative to those who are euhydrated or near-dehydration. Our study’s findings are consistent with prior studies examining the impact of serum osmolarity on cognitive performance. Specifically, a curvilinear pattern was associated with speed of processing tests of executive function. Overall, hydration status is associated with curvilinear patterns of performance on executive function measures, specifically Trail Making A, Symbol Digit Modalities, and Letter Cancellation Tests.

The acute effects of coffee ingestion on postural control and physical function in older adults: A randomised crossover trial

Caffeine consumption can elicit improvements in aspects of physical function in older adults but also, negatively modify standing balance, potentially increasing fall risk. However, balance alterations and changes in physical function induced by commonly consumed caffeine vehicles such as coffee have not been investigated. Therefore, this study investigated coffee ingestion providing 3 mg·kg BW−1 caffeine on balance performance and physical function, in a group of older adults. In a randomised, crossover design, 22 older adults (Male n = 10, Age: 68 ± 6 years) completed bipedal standing balance and physical function assessments (Senior Fitness Test) under one of the following conditions: caffeinated coffee (COF), decaffeinated coffee (DEC), placebo (PLA) or a control (CON) (no fluid ingestion). Centre of pressure (COP) root mean square and power frequency were calculated to characterise postural performance and strategy, respectively. The complexity (i.e., regularity) of the COP signal was also determined by calculating sample entropy. Caffeinated coffee had limited effects on COP outcomes. Frequency of the COP in the anteroposterior direction was greater following COF compared to DEC (P = 0.047;g = 0.29) but there were no statistical differences between COF and PLA or CON (P > 0.05). Furthermore, there were no significant performance differences between any conditions in all tests of physical function (P > 0.05). This suggests that coffee has limited effects on balance performance or physical function but may influence both balance complexity and the strategy utilised to maintain upright stance. Overall, a strong cup of coffee does not significantly influence balance and measures of functional performance in healthy older adults.

Deep multimodal saliency parcellation of cerebellar pathways: Linking microstructure and individual function through explainable multitask learning.

Parcellation of human cerebellar pathways is essential for advancing our understanding of the human brain. Existing diffusion magnetic resonance imaging tractography parcellation methods have been successful in defining major cerebellar fibre tracts, while relying solely on fibre tract structure. However, each fibre tract may relay information related to multiple cognitive and motor functions of the cerebellum. Hence, it may be beneficial for parcellation to consider the potential importance of the fibre tracts for individual motor and cognitive functional performance measures. In this work, we propose a multimodal data-driven method for cerebellar pathway parcellation, which incorporates both measures of microstructure and connectivity, and measures of individual functional performance. Our method involves first training a multitask deep network to predict various cognitive and motor measures from a set of fibre tract structural features. The importance of each structural feature for predicting each functional measure is then computed, resulting in a set of structure-function saliency values that are clustered to parcellate cerebellar pathways. We refer to our method as Deep Multimodal Saliency Parcellation (DeepMSP), as it computes the saliency of structural measures for predicting cognitive and motor functional performance, with these saliencies being applied to the task of parcellation. Applying DeepMSP to a large-scale dataset from the Human Connectome Project Young Adult study (n = 1065), we found that it was feasible to identify multiple cerebellar pathway parcels with unique structure-function saliency patterns that were stable across training folds. We thoroughly experimented with all stages of the DeepMSP pipeline, including network selection, structure-function saliency representation, clustering algorithm, and cluster count. We found that a 1D convolutional neural network architecture and a transformer network architecture both performed comparably for the multitask prediction of endurance, strength, reading decoding, and vocabulary comprehension, with both architectures outperforming a fully connected network architecture. Quantitative experiments demonstrated that a proposed low-dimensional saliency representation with an explicit measure of motor versus cognitive category bias achieved the best parcellation results, while a parcel count of four was most successful according to standard cluster quality metrics. Our results suggested that motor and cognitive saliencies are distributed across the cerebellar white matter pathways. Inspection of the final k = 4 parcellation revealed that the highest-saliency parcel was most salient for the prediction of both motor and cognitive performance scores and included parts of the middle and superior cerebellar peduncles. Our proposed saliency-based parcellation framework, DeepMSP, enables multimodal, data-driven tractography parcellation. Through utilising both structural features and functional performance measures, this parcellation strategy may have the potential to enhance the study of structure-function relationships of the cerebellar pathways.

Factors impacting outcomes of cochlear implantation in children at two University centres in China: Multi-year analysis from the Paediatric Implanted Recipient Observational Study (P-IROS)

Objectives To identify factors affecting functional hearing performance and quality of life (QoL) outcomes in paediatric cochlear implantation (CI) recipients at two University centres in mainland China. Methods Two university centres in mainland China, part of the prospective longitudinal Paediatric Implanted Recipient Observational Study (P-IROS), contributed participant data. Participants were aged under 10 years at time of CI. Functional hearing performance and QoL measures were collected prior to device activation, and at 6-monthly intervals for 2 years post-implantation. Functional hearing endpoints including Categories of Auditory Performance-II (CAP-II) and QoL were evaluated and analysed using ordinal mixed-effects regression models. Results Data were from 288 children with a mean age at implant of 2.74 years. Overall follow-up at 1 year was 59% and 51% at 2 years. Younger age at implantation (p<0.001) and hearing aid use preimplantation (p=0.026) were associated with significant benefit. Bilateral device users (both CI and bimodal) achieved significantly better functional hearing performance on the CAP-II than unilateral CI users (p<0.001). Slower functional hearing improvements were observed in those with lower parental expectations compared to higher expectations (p<0.001). QoL improved over time but followed a different initial trajectory between centres. Conclusion All participants demonstrated significant improvements in auditory performance and QoL over time. Younger age at CI, and bilateral/bimodal device fitting contributed to earlier improvements. Other potential factors that could help inform families, professionals, and health authorities about choice of hearing device and educational supports required included aetiology of hearing loss and level of maternal education.

Variables of performance governance model development: evidence from the Italian public healthcare

PurposeThe performance governance model, based on the use of performance information to improve governance, is particularly complex, considering the inter-institutional relationships and community involvement that it requires. In order to contribute to the scientific debate on this model, the paper aims to highlight what are the challenges in developing three variables of performance governance (operational performance measurement tools, governance integration and citizen involvement) in the public health context.Design/methodology/approachBased on the previous literature, we identified three variables that characterize the performance governance model. We then explored them through the case study methodology applied to the Apulia Regional Health System.FindingsThe analysis allows us to conclude that the healthcare system under consideration is still far from applying the performance governance model, but it highlights some factors that are preparatory to the same. Moreover, starting from the empirical evidence, some considerations arise regarding managerial and policy making implications for the variables investigated.Originality/valueThe paper contributes to a growing body of critical literature on performance governance contextualizing the analysis in a particularly relevant area of the public sector, namely public health. Furthermore, the research also identifies some potential risks of the performance governance model (rigidity in performance measurement tool, organization-objective-responsibility relationship, participatory illusion).

Analisis Rantai Pasok Jamur Tiram di UMKM Sidimpuan Hiratake Mushroom Dalam Memenuhi Permintaan

Oyster mushrooms, Pleurotus ostreatus, are a type of edible wood mushroom. MSME Sidimpuan Hiratake Mushroom have customer, a family restauran. In order to meet consumer demand with quality and quantity requirements, MSME had issues such as inability to fulfill demand due to insufficient production capacity, and occurrence of returns, where both of these continue to increase. Purpose of this study is to explain the process of supply chain, to find out the actual performance, and to provide some suggestions for improvements to the performance of supply chain. The process flows analyzed in this supply chain are product, information and financial. The product produced by partner farmers is fresh oyster mushrooms, the products that will be sent to restaurant are oyster mushrooms that have been weighed, cleaned and packaged. This research method is qualitative and quantitative. The results of analysis with food supply chain network show that the process flow in the supply chain has been going well. The operational performance measurement results were measured using several supply chain operation reference metrics, that the operational performance of the supply chain cannot be said to be perfect overall. To measure marketing performance, the farmer's share value obtained by partner farmers is 58.3% and the marketing margin for MSME is Rp.5.000. The results of 5 why's analysis, inability to fulfill restaurant's demand was caused due to several things including variations in the growth process as well as limited resources of farmers. Returns are caused by differences in quality control standards and qualifications between restaurant and MSME.

Do ankle braces affect functional performance? A randomised double-blinded cross-over trial

ObjectivesTo compare the effects of the KISS ankle brace, Aircast ankle brace, and no brace condition, on functional performance measures and perceptions of stability, confidence and reassurance in people with and without chronic ankle instability. DesignRandomised double-blinded cross-over trial. MethodA total of 42 participants (21 uninjured and 21 with chronic ankle instability) were recruited from the general population and completed a series of functional performance tests, including side hop (seconds), Star excursion balance test reach distance, triple hop for distance (centimetres), modified T-agility test (seconds), standing and maximum vertical jump reach (centimetres), while wearing two ankle brace conditions and no brace (control). Results were recorded and analysed by a blinded investigator. ResultsThere was no significant difference between conditions for average time on the side hop test (F(2,122) ​= ​0.04, P ​= ​0.96); best reach distance on SEBT in anterior (F (2,122) ​= ​0.04, P ​= ​0.96), postero-medial (F(2,122) ​= ​0.08, P ​= ​0.93) and postero-lateral (F(2,122) ​= ​0.08, P ​= ​0.92) directions; best distance performed on the triple hop (F(2,122) ​= ​0.03, P ​= ​0.97); best standing vertical jump performance (F(2,110) ​= ​0.04, P ​= ​0.97); best maximum vertical jump performance (F(2,110) ​= ​0.01, P ​= ​0.99); or best time for the modified T-agility run (F(2,122) ​= ​1.61, P ​= ​0.21). ConclusionsPractitioners can be assured that functional and balance performances will not be impacted by wearing an ankle brace.

Assessment of non-communicable disease risk factors, functional performance, and health-related quality of life in adults: a comparative analysis in low-resourced urban and rural areas of South Africa

BackgroundGlobally, disparities between non-communicable disease (NCD) risk factors, functional performance, and health-related quality of life (HRQoL) exist in people living in rural and low-resourced urban settings. Evidence of these health differences determined with objective NCD risk factors and functional performance measurements in South Africa, is scarce. Therefore, the study aimed to determine the differences in NCD risk factors, functional performance and HRQoL between rural and low-resourced urban areas.MethodsThe study recruited 311 adults (35–80 years) presenting with at least one NCD risk factor from low-resourced urban- (n = 183) and rural (n = 128) communities. Objective measurements of physical activity (PA) by means of combined heart rate and accelerometery, body composition employing skinfolds, peripheral lipid and glucose concentrations, blood pressure, functional performance indicators (handgrip, single leg stand, sit-to-stand, timed-up-and-go speed, predicted peak VO2 max); and HRQoL were measured according to standard procedures. Independent t-tests, Mann-Whitney U, and chi-square tests were performed to determine differences between the variables of low-resourced urban and rural settings.ResultsThe participants from the low-resourced urban setting were significantly older than the rural residents (59.1 ± 10.7 years vs. 52.8 ± 11.3 years; p = 0.001). NCD risk factors were significantly more prevalent in the low-resourced urban participants compared to rural participants, in particular for elevated systolic (85.8% vs. 62.5%; p = 0.001), and diastolic blood pressure (88.5% vs. 65.6%; p = 0.001), physical inactivity (95.9% vs. 87.7%; p = 0.026), increased cholesterol concentrations (22.1% vs. 8.7%; p = 0.002), and increased waist circumference (61.9% vs. 49.2%; p = 0.027). Low-resourced urban residents presented with a higher average body fat percentage (27.69% ± 7.65% vs. 12.23% ± 4.67%; p < 0.001), and lower moderate to vigorous PA levels (37.19 ± 49.55 [95% CI = 29.12–45.27] vs. 62.92 ± 60.43 min/week [95% CI = 47.95–77.90]; p = 0.003) compared to rural residents. Rural residents showed significantly better functional performance, including peak VO2 (23.99 ± 9.89 vs. 16.95 ± 7.64 ml/min/kg; p = 0.001) and single leg stand (right leg: 44.96 ± 18.47 vs. 20.87 ± 19.18 s; p = 0.001) as well as higher HRQoL for the physical (51.06 ± 8.14% vs. 45.62 ± 11.13%; p < 0.001) and mental (54.75 ± 8.24% vs. 48.91 ± 12.27%; p < 0.001) component scores compared to participants from the low-resourced urban areas.ConclusionNCD risk factors, functional performance, and HRQoL significantly differ in rural communities compared to low-resourced urban communities in South Africa. Urban areas’ most prevalent risk factors were elevated blood pressure, physical inactivity, and increased waist circumference. Participants from rural areas demonstrated significantly better functional performance, such as fitness and balance. HRQoL was better in rural settings than in urban settings. Future intervention programmes should be tailored for specific settings.

An immersive virtual reality shopping task detects declines in instrumental activities of daily living in individuals with Parkinson's disease

IntroductionDeclines in instrumental activities of daily living (IADLs) have been proposed as a prodromal marker of Parkinson's disease (PD). The Cleveland Clinic Virtual Reality Shopping (CC-VRS) platform combines an omnidirectional treadmill with a virtual reality headset to create a virtual grocery store that a user physically walks through and completes a shopping task. The primary aim of this project was to determine the known-group validity of the CC-VRS platform in discriminating IADL performance and to characterize specific motor and cognitive declines responsible for PD-related IADL impairments. MethodsSixteen individuals with PD and 15 healthy adults completed traditional motor, cognitive, and IADL assessments and the CC-VRS task. Group differences were evaluated using Welch's t-test. ResultsThere were no between-group differences in traditional performance measures of motor, cognitive, or IADL function. Regarding CC-VRS performance, participants in the PD group completed the task significantly slower than controls (690 vs. 523 sec, respectively). Participants with PD spent 25 % more time walking and turning and were stopped 46 % longer than controls. Average gait speed when viewing the shopping list, a measure of dual-task performance, was significantly slower in the PD group compared to controls (0.26 vs. 0.17 m/s, respectively). ConclusionUnlike traditional performance measures of motor, cognitive, and IADL function, the CC-VRS discriminated participants with PD from healthy older adults. For the PD group, motor and dual-task declines contributed to diminished CC-VRS performance. Identifying underlying contributors to IADL declines supports using ecological assessments, such as the CC-VRS, for the routine clinical evaluation of IADLs.