Activities Of Daily Living Pain Research Articles

Pain in Hemodialysis Patients: Prevalence, Intensity, Location, and Functional Interference in Daily Activities.

Although pain is a frequent complaint of patients with chronic kidney disease who undergo hemodialysis, few studies have assessed the functional interference of pain in activities of daily living (ADLs). Hence, the aim of this study was to evaluate the prevalence, location, intensity, and functional interference of pain in ADLs of chronic kidney disease patients undergoing hemodialysis and to estimate the association of specific pain sites with severe functional interference by pain in ADLs. This cross-sectional study included patients with chronic kidney disease undergoing hemodialysis. The prevalence, intensity, and functional interference of pain in ADLs were assessed using the brief pain inventory. Poisson regression was used to calculate the prevalence ratio. A total of 65 patients participated in the study. The overall prevalence of pain was 89.23%; the prevalence of headache was 18.46% and that of pain in the trunk was 55.38%, upper limbs was 35.38%, and lower limbs was 60.00%. The prevalence of moderate and severe pain at the time of hemodialysis was 13.85% and 21.54%, respectively. A high prevalence of severe functional interference of pain in general activity (61.54%), mobility (56.92%), and disposition (55.38%) was observed. Pain is a frequent complaint in patients undergoing hemodialysis, mainly musculoskeletal and intradialytic, and it interferes with ADLs and incapacitates the patient. Pain was highly prevalent in the upper and lower limbs and the trunk. Furthermore, a higher prevalence of severe pain at the time of hemodialysis and functional interference of pain, mainly in general activity, mobility, and disposition, were observed.

Lumbar stiffness as a collateral outcome of spinal arthrodesis: a preliminary clinical study

Background contextAlthough spinal arthrodesis can improve function by correcting deformity and reducing pain, it also by intention reduces spinal mobility. Increased spinal stiffness may have the potential to impair function and ability to perform activities of daily living (ADLs), independent of pain levels. PurposeTo evaluate the ability to discriminate spinal stiffness from pain in ADLs after lumbar spine arthrodesis using two outcome instruments. Study designCross-sectional study. Patient sampleConsecutive cohort of lumbar spine fusion patients from a single surgeon's practice. Outcome measuresOswestry Disability Index (ODI), Lumbar Stiffness Disability Index (LSDI), radiographs. MethodsWe developed the LSDI questionnaire to assess the impact of spinal stiffness on ability to perform different ADLs. The LSDI and ODI were administered to 93 patients who underwent lumbar arthrodesis extending from one to five or more motion segments at a minimum follow-up of 1 year. Comparisons of mean LSDI and ODI scores between patients were made using generalized linear regression. A Pearson correlation coefficient (r) was computed to determine the relationship between the LSDI and ODI scores. ResultsThe sample included 61 women and 32 men, with mean age at surgery of 55.0 years (standard deviation [SD], 13.1) and mean time since surgery of 3.4 years (SD, 1.8). The mean LSDI score was 29.6 (SD, 19.2), and the mean ODI score was 39.7 (SD, 19.1). Comparing one-level and five-level arthrodesis, the LSDI scores were significantly different (p=.05), whereas the ODI scores were not significantly different (p=.36). Comparisons between other levels of arthrodesis did not show significant differences for either the LSDI or the ODI. Within the entire study group, LSDI and ODI scores were positively correlated (r=0.69, p<.001). ConclusionsDifficulty in performing certain ADLs increases for patients with multilevel lumbar fusions as opposed to one-level arthrodesis. The LSDI distinguishes functional difficulties with ADLs accruing because of spinal stiffness, which appear to be independent of the functional limitations resulting from low back pain as measured by ODI.