Mobility Scale Research Articles

Limited associations between passive range of motion and gross motor function in ambulant/semi-ambulant children and adolescents with cerebral palsy: A cross-sectional study

Background and aimCerebral palsy (CP) is the most common childhood motor disability, and the Cerebral Palsy Follow-Up Program (CPUP) in Nordic countries uses a traffic light system for passive range of motion (ROM) assessment to aid interpretation and guide decisions regarding interventions. However, the arbitrary chosen ROM threshold values and their potential clinical impact are uncertain. We investigated whether lower extremity ROM values were positively associated with gross motor function and whether gross motor function scores differ between the CPUP ROM thresholds. MethodsThis was a cross-sectional analysis of CPUP data for 841 ambulatory children and adolescents with CP, at a mean (SD) age of 9 (3). Regression analyses were employed to explore the relationship between gross motor capacity and performance (using the Gross Motor Function Measure (GMFM-66) and the Functional Mobility Scale (FMS) 5/50/500 m, respectively) and lower extremity ROM, measured with a goniometer. ROM was assessed both as continuous and categorical variables. ResultsWe found that two out of ten continuous ROM measures were positively associated with gross motor function. Limited differences in gross motor function between the ROM thresholds were seen for seven out of ten ROM measures. The CPUP traffic light thresholds primarily differentiated gross motor function between the red and green categories, predominantly for the subgroup of participants with bilateral spastic CP. ConclusionLimited associations between passive ROM and gross motor function in children and adolescents with CP were observed, indicating that there is more to consider than ROM when identifying whether interventions are needed.

Effects of acute phase intensive electrical muscle stimulation in COVID-19 patients requiring invasive mechanical ventilation: an observational case-control study

We investigated the effects of acute-phase intensive electrical muscle stimulation (EMS) on physical function in COVID-19 patients with respiratory failure requiring invasive mechanical ventilation (IMV) in the intensive care unit (ICU). Consecutive COVID-19 patients requiring IMV admitted to a university hospital ICU between January and April 2022 (EMS therapy group) or between March and September 2021 (age-matched historical control group) were included in this retrospective observational case–control study. EMS was applied to both upper and lower limb muscles for up to 2 weeks in the EMS therapy group. The study population consisted of 16 patients undergoing EMS therapy and 16 age-matched historical controls (median age, 71 years; 81.2% male). The mean period until initiation of EMS therapy after ICU admission was 3.2 ± 1.4 days. The EMS therapy group completed a mean of 6.2 ± 3.7 EMS sessions, and no adverse events occurred. There were no significant differences between the two groups in Medical Research Council sum score (51 vs. 53 points, respectively; P = 0.439) or ICU mobility scale at ICU discharge. Addition of upper and lower limb muscle EMS therapy to an early rehabilitation program did not result in improved physical function at ICU discharge in severe COVID-19 patients.

Are tactile function and body awareness of the foot related to motor outcomes in children with upper motor neuron lesions?

Somatosensory function can be reduced in children with Upper Motor Neuron (UMN) lesions. Therefore, we investigated relationships between somatosensory functions of the foot and motor outcomes in children with UMN lesions. In this cross-sectional study, we assessed the Tactile Threshold (TT) with monofilaments and body awareness with Tactile Localisation Tasks for spatial-related action (TLTaction) and structural-related perception (TLTperception) body representation at the foot sole. Furthermore, we assessed four motor outcomes: the Selective Control Assessment of the Lower Extremity (SCALE), the modified Timed Up and Go test (mTUG), the Gillette Functional Assessment Questionnaire (FAQ), and the Functional Mobility Scale (FMS). Spearman's correlations (ρ) were applied to assess relationships between the somatosensory function of the foot sole and the applied motor outcomes. Thirty-five children with UMN lesions, on average 11.7 ± 3.4 years old, participated. TLTperception correlated significantly with all lower limb motor outcomes (|ρ|=0.36-0.57; p < 0.05), but TLTaction (|ρ|=0.00-0.27; p = 0.15-0.97, and TT did not (|ρ|=0.01-0.83; p = 0.73-0.94). TLTperception correlated strongly with the Gross Motor Function Classification System (|ρ|=0.62; p = 0.001) in children with cerebral palsy (n = 24). Assessing structural body representation of the foot sole should be considered when addressing lower limb motor impairments, including gait, in children with upper motor neuron lesions. Our results suggest that the assessment of tactile function and spatial body representation may be less related to lower limb motor function.

Development, reliability, and validity of the mobility assessment scale in hospitalized patients (HMob)

BackgroundExisting mobility scales for hospitalized patients do not include assessment of tasks for the right and left side, ability to transfer from sitting to lying and from standing to sitting, ability to climbing steps and pick up an object from the floor in the same instrument. ObjectiveEvaluate the reliability and validity of the hospital mobility assessment scale (HMob) according to the Consensus-based standards for the selection of health measurement instruments (COSMIN). MethodsStudy conducted in three inpatient units (cardiology, neurology, and gastrohepatology) and one adult intensive care unit in a hospital. Patients of both sexes were included; age >18 years; collaborative and who obeyed commands, with different medical diagnoses and clinical release to leave their bed (provided by the doctor). Special populations such as those with burns and orthopedics were excluded. ResultsThe sample consisted of 130 patients; 20 from the pilot study and 110 to assess the clinimetric properties of the HMob. Cronbach alpha coefficient was 0.949. Relative intra- (A1-A2) and inter-rater (A1-B; A2-B) reliability was excellent (A1-A2: ICC = 0.982, p-value < 0.0001; A1-B: ICC = 0.993, p-value < 0.0001; A2-B: ICC = 0.986, p-value < 0.0001.) The convergent criterion validity of HMob in relation to the ICU Functional Status Score was 0.967 (p-value < 0.0001) and for Functional Independence measure (MIF) was 0.926 (p-value < 0.0001). ConclusionThe HMob scale showed excellent internal consistency, intra- and inter-rater reliability, and concurrent validity in the motor domain, which suggests that it can be used in daily practice to measure mobility in hospitalized patients.

Modifying the Mobility Scale for Acute Stroke (MSAS) for All Stroke Phases (MSAllS): Measurement Properties and Clinical Application

ObjectiveTo develop and examine the measurement properties and interpretability of the Mobility Scale for “All” Stroke Phases (MSAllS) as a potential single outcome measure to capture improvements in physical function throughout the stroke continuum. DesignRetrospective cross-sectional study. SettingInpatient rehabilitation unit. ParticipantsPeople after stroke at discharge from rehabilitation (N=309). InterventionNot applicable. Main Outcome Measure(s)We developed MSAllS by extending the highest MSAS level (walk 10 m independently) with 4 gait speed levels. To establish a clinical anchor, we extracted a 4-level discharge outcome. To assess the distributional properties and internal consistency of MSAllS, we evaluated its ceiling effects and calculated the Cronbach alpha, respectively. To assess structural validity, we performed a confirmatory factor analysis. To assess (i) its convergent validity with the FIM and (ii) its predictive validity with the clinical anchor, we used Spearman's rank correlations. To evaluate the clinical interpretability of MSAllS, we used an item-response theory-based method to estimate MSAllS thresholds associated with the clinical anchor. ResultsThe MSAllS had lower ceiling effects compared with MSAS (0% vs 25%). Internal consistency of MSAllS was excellent (α=0.94). Structural validity of MSAllS demonstrated a good fit (Comparative Fit Index=0.95; Tucker–Lewis Index=0.92; Root Means Square Error of Approximation=0.17). MSAllS demonstrated a moderate correlation (rho=0.66) with FIM score and with the clinical anchor (rho=0.75). MSAllS thresholds for increasing levels of the clinical anchor were 22 (20.8 to 23.6) – at least moderate assistance with walking/transfers, 28 (27.5 to 29.4) - at most supervision with walking, and 33 (32.5 to 33.4) - able to walk unassisted. ConclusionThe MSAllS showed adequate measurement properties and clinical interpretability. MSAllS has the potential to be a single universal measure to evaluate physical function after stroke but further evaluation of clinical interpretability is required.

Comparison of Self-Reported and Capacity-Based Measures of Mobility in Community-Dwelling Older Adults in Nigeria: The Mediating Role of Age, Cognitive Status, and Chronic Conditions.

Although the association between self-reported and capacity-based mobility outcomes is prominently researched, the pathways through which self-reported measures affect capacity-based measures remains poorly understood. Therefore, our study examines the association between self-reported and capacity-based mobility measures and explores which mobility determinants mediate the association in Nigerian community-dwelling older adults. This cross-sectional study included 169 older adults [mean age (SD) = 67.7 (7.0)]. Capacity-based mobility outcomes included the Short Physical Performance Battery (SPPB), the 6-Minute Walk Test (6MWT), and the 10-Meter Walk Test (10mWT), whereas the self-reported mobility outcomes included the Lower Extremity Functional scale (LEFS), the Life Space Questionnaire (LSQ), and the Mänty Preclinical Mobility scale (inability to walk 2 km, 0.5 km, or climb a flight of stairs). Spearman's correlations were conducted to examine the relationship between self-reported and capacity-based mobility measures, whereas structural equation modeling was used to determine the mediators. The correlation between SPPB and LEFS (rho = 0.284) and 0.5 km (rho = -0.251) were fair, whereas the correlation between SPPB and inability to walk 2 km (rho = -0.244) and inability to climb a flight of stairs (rho = -0.190) were poor. Similarly, correlations between 6MWT and the LEFS (rho = 0.286), inability to walk 2 km (rho = -0.269), and 0.5 km (rho = -0.303) were fair. The 6WMT was poorly correlated with inability to climb one flight of stairs (rho = -0.233). The LSQ was not correlated with SPPB or 10mWT. Age was the only significant mediator, whereas the number of chronic conditions and cognitive status were not. The correlation between self-reported and capacity-based mobility outcomes in older adults in Nigeria is lower than those in developed countries. Our analysis provides a foundation to explore mobility determinants that could be predictive mediators for mobility outcomes, making meaningful contributions to explaining mobility complexities.

Optimization of Postural Control, Balance, and Mobility in Children with Cerebral Palsy: A Randomized Comparative Analysis of Independent and Integrated Effects of Pilates and Plyometrics.

The paradigm of comprehensive treatment approaches for children with cerebral palsy has gained traction, prompting clinicians to deliberate between independent and integrated treatment delivery. However, this decision-making process is often hindered by the dearth of empirical evidence available to inform optimal therapeutic strategies. This study, therefore, sought to compare the effects of Pilates-based core strengthening (PsCS), plyometric-based muscle loading (PlyoML), and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP (age: 12-18 years) were randomized to PsCS (n = 27), PlyoML (n = 27), or a combined intervention (n = 27; equated for total sets/repetitions) group. The three interventions were applied twice/week over 12 successive weeks. Postural control (directional and overall limits of stability-LoS), balance, and mobility (Community Balance and Mobility Scale-CB&M; Functional Walking Test-FWT; Timed Up and Down Stair test-TUDS) were assessed pre- and post-intervention. The combined group exhibited greater increases in directional LoS compared to PsCS and PlyoML including the backward (p = 0.006 and 0.033, respectively), forward (p = 0.015 and 0.036, respectively), paretic (p = 0.017 and 0.018, respectively), and non-paretic directions (p = 0.006 and 0.004, respectively)], and this was also the case for overall LoS (p < 0.001 versus PsCS and PlyoML). In addition, the combined group displayed greater improvements compared to the PsCS and PlyoML groups regarding CB&M (p = 0.037 and p = 0.002, respectively), FWT (p = 0.012 and p = 0.038, respectively), and TUDS (p = 0.046 and p = 0.021, respectively). In conclusion, the combined PsCS and PlyoML exercise program promotes considerably greater improvements in postural control, balance, and mobility compared to unimodal training in children with ULCP.

Psychometric Evaluation of the Persian Version of the Functional Mobility Scale: Assessing Validity and Reliability

Aim This study aimed to assess the content, concurrent validity, test-retest, and intra-rater reliability of the Persian version of the Functional Mobility Scale (FMS) for evaluating functional mobility in children and adolescents with cerebral palsy (CP). Methods Following international standards for measurement translation, we developed a Persian version of the FMS. A total of 160 participants took part in this study. Concurrent validity was assessed using Spearman’s coefficient to correlate with the Gross Motor Function Classification System (GMFCS). Test-retest (n = 30) and intra-rater (n = 30) reliability of the FMS were also examined by Cohen’s weighted kappa coefficient. Results Concurrent validity ranged from −0.912 to −0.941 for children and −0.912 to −0.936 for adolescents. Test-retest ranged from 0.902 to 1. Intra-rater ranged from 0.933 to 0.987. Conclusion The Persian version of the FMS demonstrates very strong validity and almost perfect reliability for assessing and classifying functional mobility in children and adolescents with CP. These findings suggest that this tool could be a useful addition to clinical practice and research for the Persian-speaking population.

Application of machine learning models on predicting the length of hospital stay in fragility fracture patients

BackgroundThe rate of geriatric hip fracture in Hong Kong is increasing steadily and associated mortality in fragility fracture is high. Moreover, fragility fracture patients increase the pressure on hospital bed demand. Hence, this study aims to develop a predictive model on the length of hospital stay (LOS) of geriatric fragility fracture patients using machine learning (ML) techniques.MethodsIn this study, we use the basic information, such as gender, age, residence type, etc., and medical parameters of patients, such as the modified functional ambulation classification score (MFAC), elderly mobility scale (EMS), modified Barthel index (MBI) etc, to predict whether the length of stay would exceed 21 days or not.ResultsOur results are promising despite the relatively small sample size of 8000 data. We develop various models with three approaches, namely (1) regularizing gradient boosting frameworks, (2) custom-built artificial neural network and (3) Google’s Wide & Deep Learning technique. Our best results resulted from our Wide & Deep model with an accuracy of 0.79, with a precision of 0.73, with an area under the receiver operating characteristic curve (AUC-ROC) of 0.84. Feature importance analysis indicates (1) the type of hospital the patient is admitted to, (2) the mental state of the patient and (3) the length of stay at the acute hospital all have a relatively strong impact on the length of stay at palliative care.ConclusionsApplying ML techniques to improve the quality and efficiency in the healthcare sector is becoming popular in Hong Kong and around the globe, but there has not yet been research related to fragility fracture. The integration of machine learning may be useful for health-care professionals to better identify fragility fracture patients at risk of prolonged hospital stays. These findings underline the usefulness of machine learning techniques in optimizing resource allocation by identifying high risk individuals and providing appropriate management to improve treatment outcome.

Effects of Vibration Therapy on the Physical Function of Critically Ill Adults Trial: A Randomized Controlled Trial.

Vibration therapy uses vibration to rehabilitate physical functions. Recently, it has been demonstrated to be safe for critically ill patients. However, its effects on physical functions are unclear. Randomized controlled trial. A single-center, ICU. Patients were randomly assigned to either vibration therapy coupled with protocolized mobilization or protocolized mobilization alone. We included patients who could sit at the edge of the bed or in a wheelchair during their ICU stay. The exclusion criteria were based on the early mobilization inhibition criteria. The primary outcome was the Functional Status Score for the ICU (FSS-ICU) at ICU discharge. Secondary outcomes were the Medical Research Council score, ICU-acquired weakness, delirium, ICU Mobility Scale (IMS), and ventilator- and ICU-free days. For safety assessment, vital signs were monitored during the intervention. Among 180 patients, 86 and 90 patients remained in the vibration therapy and control groups, respectively. The mean age was 69 ± 13 vs. 67 ± 16 years in the vibration therapy and control groups, and the Acute Physiology and Chronic Health Evaluation (APACHE) II score was 19 (14-25) vs. 18 (13-23). The total FSS-ICU at ICU discharge was 24 (18-27) and 21 (17-26) in the intervention and control groups, respectively ( p = 0.09), and the supine-to-sit ability significantly improved in the intervention group ( p < 0.01). The secondary outcomes were not significantly different. Vital signs remained stable during vibration therapy. In the predefined subgroup analysis, FSS-ICU improved in the population with a higher body mass index (≥ 23 kg/m 2 ), lower APACHE II scores (< 19), and higher IMS scores (≥ 6). Vibration therapy did not improve the total FSS-ICU. However, the supine-to-sit ability in the FSS-ICU improved without any adverse event.

Fear of Falling Avoidance Behavior, but Not Fall History, Is Associated with Balance and Dynamic Gait Performance in Community-Dwelling Older Adults: A Cross-Sectional Study

Purpose: The purpose of this study was to determine relationships among balance confidence, fear of falling (FoF) avoidance behaviour, and high-level balance performance in community-dwelling older adults. Method: Eighty-nine participants [76 ± 7 (mean ± standard deviation) years, 54 females] completed the Activities-specific Balance Confidence Scale, Fear of Falling Avoidance Behavior Questionnaire, Functional Gait Assessment (FGA), Community Balance and Mobility Scale (CB&amp;M), and falls experienced in the past 12 months for this cross-sectional study. Results: Outcome measure (OM) scores did not differ between people who reported a fall and those without a fall. Correlations between all OMs varied from 0.52 to 0.88. FoF avoidance behaviour, but not fall history, was associated with lower scores on all measures. There were no floor or ceiling effects for the performance-based OMs. Conclusion: FoF avoidance behaviour did not differ between community-dwelling older adults with and without a previous fall. Participants who reported FoF avoidance behaviour had poorer balance performance, suggesting clinicians should assess high-level balance performance in older adults who exhibit FoF activity avoidance. Patient-reported OMs may identify older adults who need an assessment of dynamic balance and gait. The CB&amp;M and FGA are appropriate to assess high-level balance in older adults.

Demonstration of water-lean 30 wt% MEA + 15 wt% MEG with rich solvent recycle for biogas upgrading

This study investigates the potential of a water-lean 30 wt% monoethanolamine (MEA) solvent for biogas upgrading. The solvent consists of 30 wt% MEA, 15 wt% monoethyleneglycol (MEG), and 55 wt% water at zero loading. The solvent is investigated using a mobile pilot scale amine scrubbing unit, with a capacity of 1 ton CO2 per day, with the option to utilize a rich solvent recycle (RSR) configuration. Without the RSR configuration, the water-lean solvent obtains a low rich loading of 0.46 mol/mol resulting in a specific reboiler duty (SRD) of 3.92 MJ per kg CO2, which is 6 % higher compared to aqueous 30 wt% MEA. Combining the RSR configuration with cooling enables a higher rich loading of 0.49 mol/mol and decreases the SRD to 3.48 MJ per kg CO2, which is 6% lower than for aqueous 30 wt% MEA. It is found that 30 wt% MEA + 15 wt% MEG only achieves lower SRD than aqueous 30 wt% MEA if similar rich loading can be achieved. By measuring emissions from the absorber and stripper columns, it was found that MEG and MEA form 2-methyl-dioxolane resulting in increased emissions when utilizing this water-lean solvent.

Photobiomodulation therapy (red/NIR LEDs) reduced the length of stay in intensive care unit and improved muscle function: A randomized, triple-blind, and sham-controlled trial.

Photobiomodulation therapy (PBMT) has been widely used to improve strength, fatigue resistance and increase muscle mass in healthy individuals. These effects could help critically ill patients admitted to intensive care units (ICUs) who show reduced mobility and muscle strength. ICU-acquired weakness lessens overall health and increases the patient's length of stay in the ICU. This study evaluated the effects of PBMT using low intensity light-emitting diodes (LEDs) on the mobility and muscle strength (functional capacity) and length of stay of patients admitted to hospital ICU. This randomized, triple-blind, sham-controlled trial was conducted in a hospital ICU. Sixty patients were randomly assigned to two equal groups: (a) PBMT and (b) Sham. PBMT was applied daily to patients until their discharge from the ICU, using a flexible neoprene array of 264 LEDs (120 at 635 nm, 1.2 mW each; 144 at 880 nm, 15 mW each) for 90s (207.36 Joules) at each site. Ten sites were located bilaterally on the thighs, legs, arms, and forearms ventrally and dorsally, 15 min totaling 2,073.6Joules per session. Outcomes were length of stay (in h) until discharge from the ICU, muscle strength by the Medical Research Council (MRC) score and handgrip dynamometry (HGD), patient mobility by Intensive Care Unit Mobility Scale (IMS) and the Simplified Acute Physiology Score 3 (SAPS 3) for predicting mortality of patients admitted to the ICU. PBMT reduced the average length of stay in the ICU by ~30% (p = 0.028); increased mobility (IMS: 255% vs. 110% p = 0.007), increased muscle strength (MRC: 12% vs. -9% p = 0.001) and HGD (34% vs. -13% p < 0.001), and the SAPS3 score was similar (p > 0.05). The results suggest that daily PBMT can reduce the length of stay of ICU patients and increase muscle strength and mobility.

Effectiveness of Sensing and Feedback Alerting Smart Cane System: An Assisted Device for Geriatric Population to Prevent Falling

Background: The main cause of injury-related death among the elderly is falling. The smart cane is a type ofassistive tool. A smart cane’s electronic sensors provide feedback and alert users to potential hazards, assistingusers in keeping their balance while moving around.Purpose: To evaluate the effectiveness of a smart cane system for the elderly population that integrates feedbackalerts and sensors to reduce falls.Materials and Methods: A Randomized Controlled Trial was done in elderly resort with 30 sample allocated intotwo group using lottery method .group-A receives conventional training using cane with quadripod base , whilethe group-B receives smart cane training using quadripod base .modified two-point gait pattern is employed for2 months of training. The outcome measure used for physical measure is Elderly Mobility Scale (EMS) and forpsychological is Activities-Specific Balance Confidence Scale (ABC,s).Results: According to the statistical analysis of the elderly mobility scale outcome measure, there were substantial changesin mobility and a decreased risk of falling .Based on the ABCs scale, when comparing the pre-test and post-test values, theexperimental group’s confidence in daily living is superior to the control group.Conclusion: According to the study’s findings, a smart assistive cane can help the elderly population both physically andpsychologically. During the gait training, the user of the smart assistive gadget did not encounter any unfavorable therapyrelatedconsequences.

The validity and reliability of the Turkish version of the functional mobility scale in patients with cerebral palsy.

Objectives: The aim of this study was to investigate the validity and reliability of the Turkish version of the Functional Mobility Scale (FMS) in patients with cerebral palsy. Patients and methods: The validity and reliability study was conducted with 100 cerebral palsy patients (66 males, 34 females; mean age: 6.4±2.7 years; range, 2 to 18 years) between July 2015 and July 2018. The translation of the FMS was performed according to international standards. For test-retest reliability, 54 patients were reevaluated one week after the initial test with the Turkish version of the FMS, and Cohen's weighted kappa values were analyzed. The validity of the scale was assessed by correlating the FMS with the Gross Motor Function Classification System and the Gillette Functional Assessment Questionnaire Walking Scale. Twenty patients were evaluated by two researchers for interobserver reliability. Results: The kappa coefficients for test-retest reliability were 0.90 for FMS 5 m, 0.92 for FMS 50 m, and 0.91 for FMS 500 m. An evaluation of the validity revealed a significant correlation between FMS and the Gross Motor Function Classification System for all distances (r=-0.95, r=-0.96, and r=-0.92 for 5, 50, and 500 m, respectively; p <0.001), as well as the Gillette Functional Assessment Questionnaire Walking Scale (r=-0.95, r=-0.94, and r=-0.91 for 5, 50, and 500 meters, respectively; p <0.001). The kappa coefficients related to interobserver reliability were 0.73 for 5 m, 0.69 for FMS 50 m, and 0.81 for FMS 500 m. Conclusion: The Turkish version of the FMS can be considered a valid and reliable instrument for the assessment of cerebral palsy patients.

Self-esteem mediates the relationship between physical activity and smartphone addiction of Chinese college students: a cross-sectional study.

Smartphone addiction, as a key topic in the current field of behavioral addictions and public health, has brought many negative impacts on the physical, psychological, interpersonal communication, and even academic performance among contemporary college students. Therefore, the purpose of this study is to offer ideas for solving smartphone addiction among college students through investigating the potential mediating effect of self-esteem in the relationship between physical activity and smartphone addiction. By the quota sampling, a cross-sectional study was conducted to investigate 650 college students from 10 colleges in Guangzhou Higher Mega Center, and several self-reported instruments including physical activity rating scale-3 (PARS-3), mobile phone addiction tendency scale (MPATS), self-esteem scale (SES) were used to collect the related data needed for the present study. The descriptive analysis, correlation analysis, hierarchical regression analysis, and mediating effect analysis in this study were performed in turn. The results showed that physical activity (r = -0.124, p < 0.01) and self-esteem (r = -0.360, p < 0.01) were all negatively correlated with smartphone addiction, and both could also significantly and negatively predict smartphone addiction. There was a positive correlation between physical activity and self-esteem (r = 0.084, p < 0.05), and self-esteem could be significantly predicted by physical activity. And more important, the relationship between physical activity and smartphone addiction could be partially mediated by self-esteem, and the indirect effect value was -0.346 (95% Boot CI = -0.695; -0.023), along with the mediating effect accounted for 24% of the total effect between physical activity and smartphone addiction. The current study shows that physical activity could not only directly reduce smartphone addiction, but also decrease smartphone addiction by indirectly improving self-esteem, which is important in practice for solving this troublesome issue and then gradually developing a healthy behavior in daily life for college students in China, and even across the world in near future.

Peer victimization and non-suicidal self-injury among high school students: the mediating role of social anxiety, mobile phone addiction, and sex differences

BackgroundPeer victimization (PV) is one of the major causes of non-suicidal self-injury. Non-suicidal self-injury (NSSI), peer victimization, social anxiety, and mobile phone addiction are significantly related; however, the interaction mechanism and effect of sex differences remain to be determined.ObjectiveHerein, we investigated the relationship between peer victimization and NSSI among Chinese high school students. We also explored the chain mediating roles of social anxiety and mobile phone addiction and the regulatory role of sex. The findings of this study provide insights for theoretical interventions based on internal mechanisms.MethodA self-reported survey of 14,666 high school students from Sichuan County was conducted using a peer victimization scale, NSSI scale, social anxiety scale, and mobile phone addiction scale. A self-administered questionnaire was used to capture sociodemographic information.ResultsPeer victimization, social anxiety, and mobile phone addiction were positively correlated with NSSI. Peer victimization had significant direct predictive effects on NSSI (95% CI: 0.341, 0.385) and significant indirect predictive effects on NSSI through social anxiety (95% CI: 0.008, 0.019) or mobile phone addiction (95% CI: 0.036, 0.053). Peer victimization had significant indirect predictive effects on NSSI through social anxiety as well as mobile phone addiction (95% CI: 0.009, 0.014). The first stage (predicting the effect of peer victimization on NSSI) and the third stage (predicting the effect of mobile phone addiction on NSSI) were both moderated by sex.ConclusionsPeer victimization could directly predict NSSI and indirectly predict NSSI through social anxiety and mobile phone addiction. Thus, social anxiety and mobile phone addiction exhibited chain mediating effects between peer victimization and NSSI in high school students; moreover, sex might be involved in the regulation of the mediation process.

The spatial mobility network and influencing factors of the higher education population in China

Abstract The scale and frequency of talent mobility in the world have increased sharply, and the competition for talent has intensified in various regions. This paper mainly studies the spatial mobility characteristics and influencing factors of China’s highly educated talents. It found that China’s higher education population mobility network has prominent uneven characteristics, the central and eastern regions of China, especially the eastern coastal regions, are the hotspots of the network. The higher education population flows frequently in large cities and regional central areas. The hierarchical structure follows a “north-south division,” which is dominated by Beijing and Shanghai, respectively. Geographical distance has a specific hindering effect in this context. Furthermore, the similarity of culture, institutions, customs, and dialect facilitates the mobility of the higher education population. Cities with high economic levels, centralized educational resources, sound infrastructure, and aesthetically appealing environments are also likely to attract more talents.

Mobility level and factors affecting mobility status in hospitalized patients admitted in single-occupancy patient rooms

BackgroundAlthough stimulating patients’ mobility is considered a component of fundamental nursing care, approximately 35% of hospitalized patients experience functional decline during or after hospital admission. The aim of this study is to assess mobility level and to identify factors affecting mobility status in hospitalized patients admitted in single-occupancy patient rooms (SPRs) on general wards.MethodsMobility level was quantified with the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) and EQ-5D-3L. GENEActiv accelerometer data over 24 h were collected in a subset of patients. Data were analyzed using generalized ordinal logistic regression analysis. The STROBE reporting checklist was applied.ResultsWearing pajamas during daytime, having pain, admission in an isolation room, and wearing three or more medical equipment were negatively associated with mobilization level. More than half of patients (58.9%) who were able to mobilize according to the EQ-5D-3L did not achieve the highest possible level of mobility according to the JH-HLM. The subset of patients that wore an accelerometer spent most of the day in sedentary behavior (median 88.1%, IQR 85.9–93.6). The median total daily step count was 1326 (range 22-5362).ConclusionWe found that the majority of participating hospitalized patients staying in single-occupancy patient rooms were able to mobilize. It appeared, however, that most of the patients who are physically capable of walking, do not reach the highest possible level of mobility according to the JH-HLM scale. Nurses should take their responsibility to ensure that patients achieve the highest possible level of mobility.

Factors associated with voice-related quality of life among patients with temporomandibular disorders.

Research would be important for obtaining a better understanding of voice complaints among patients with temporomandibular disorders (TMD). The identification of predictors of voice disorders associated with TMD pain was made according to Diagnostic Criteria for TMD (DC/TMD) Axis I. Functional limitations were measured using the Jaw Functional Limitation Scales for mastication (JFLS-M), jaw mobility (JFLS-JM), and verbal and emotional expression (JFLS-VEE). Patients also completed the Hospital Anxiety and Depression Scale (HADS). The primary outcome was social-emotional and physical functioning as indicated by scores on the Voice-Related Quality of Life (V-RQOL) questionnaire. Multiple linear regression was used to model the relationship between the domains on the V-RQOL questionnaire and scores on the HADS and JFLS after adjusting for age, gender, DC/TMD diagnosis, pain intensity, and time since pain onset. The HADS-D (B=-1.15; 95% CI, -1.718 to -0.587; p<.001) and JFLS-VEE (B=-0.22; 95% CI, -0.40 to -0.06; p=.008) were significant predictors of scores on the V-RQOL questionnaire. Higher scores on depression measures and limitations in verbal and emotional expression could exacerbate voice problems among TMD pain patients. Future research should promote multidisciplinary treatments for TMD pain-related voice disorders.