Daily Life Of Patients Research Articles

Impact of binocular integrated visual field defects on healthy related quality of life in glaucoma.

To investigate the impact of different types of binocular integrated visual field defects on the quality of life in glaucoma.Ninety-six patients with primary glaucoma were divided into 5 groups with 25, 24, 11, 15, and 21 patients according to types of the binocular integrated visual field (BVF) defects. The criteria for BVF grouping included mild visual field defect in binocular eyes, mild visual field defect in 1 eye and moderate or advanced defect in the other, moderate and non-overlapping visual field defect in both eyes, overlapping and moderate visual field defect in binocular eyes, and severe defect in both eyes, respectively. The visual field (VF) evaluation was based on H-P-A visual field grading system. Visual acuity, visual field tests and Glaucoma Quality of Life-15 Questionnaire (GQL-15) were performed for enrolled patients, and binocular visual field results were integrated. The changes and correlations of the Visual field index values and quality of life scores were compared among the 5 groups. The main factors affecting the quality of life in glaucoma were analyzed by multiple regression analysis.The best binocular integrated visual field index (BVFI) and optimal quality of life were observed in group A. The BVFI of group B was better than that of group C or group D, but the peripheral vision glare and dark adaptation were worse. No significant difference was noted between group C and group D in terms of BVFI. However, the glare and dark adaptation in group C were better than that in group D. The BVFI was the lowest and the quality of life was the worst in group E. In all, BVFI and decibels (dB) values were negatively correlated with GQL-15 scores and positively correlated with patients’ quality of life.Binocular integrated visual field accurately reflects the visual function in glaucoma. Higher binocular integrated visual field indices represent a better quality of life for patients with glaucoma. Mild to moderate synchronous or complementary binocular VF defects had a slight effect on the quality of life, while severe and non-compensated VF loss significantly impacts on quality of life in glaucoma patients.

Dressing Oneself With Words: Key Points for Recovering Basic Activities of Daily Living in Patients With Severe Alzheimer's Disease.

Dressing Oneself With Words: Key Points for Recovering Basic Activities of Daily Living in Patients With Severe Alzheimer's Disease.

Prevalence of Fatigue and its Association with Pain Intensity, Psychological Status and Sleep Quality in Patients with Neck Pain

Introduction: Neck Pain (NP) is a major public health problem. Social and economic participation of many individuals gets negatively impacted due to NP. Fatigue and pain are common complaints in patients with this condition. Both can interfere with the daily life of patients by affecting the quality of sleep which can lead to psychological issues. But, the prevalence of fatigue and its association with pain, sleep quality and psychological factors have not been examined properly in patients complaining of NP. Aim: To examine the prevalence of fatigue and its association with pain intensity, depression, anxiety, and sleep disturbance in patients with NP. Materials and Methods: A cross-sectional study on 296 NP patients with a mean age of 30±7.2 years (181 males and 115 females) was conducted between March 2019 till November 2019. It was conducted at the Physiotherapy Department of the University and Amarjyoti College of Physiotherapy. The Multidimensional Fatigue Inventory (MFI), Hospital Anxiety and Depression, Pittsburgh Sleep Quality Index (PSQI) and Numeric Pain Rating Scale were used to evaluate fatigue, depression and anxiety, sleep quality and pain intensity, respectively. Spearman’s rank correlation coefficient and Mann-Whitney U test were used for analysis. Results: The point prevalence rate of severe fatigue in participants was 39.86%. Fatigue was significantly related with pain intensity, psychological factors, and sleep quality (p<0.05). We also observed a significant association between sleep quality and psychological factors in this sample (p<0.05). Conclusion: Fatigue was a prominent factor in patients with NP and it was associated with pain intensity, depression, anxiety, and sleep disturbance. Prevalence of fatigue was higher in chronic stage of NP than in the acute sage. Identifying these factors may help in prevention and management of NP and its co-morbidities.

Effect of Early Rehabilitation Treatment on Activities of Daily Living in Patients Receiving Conservative Treatment for Vertebral Compression Fracture.

ABSTRACTObjectives: Vertebral compression fractures are common among older people. Currently, knowledge of the effects of early rehabilitation treatment on the recovery of activities of daily living (ADL) in older patients who receive conservative treatment for these fractures is limited. Using the instrumental variable (IV) method, we examined the effects on ADL at discharge of a delay in initiating rehabilitation treatment.Methods:In this retrospective cohort study, data from the Japanese Diagnosis Procedure Combination database were analyzed. The subjects were patients with vertebral compression fracture who had undergone rehabilitation treatment during their hospitalization between 2014 and 2019 in one of the 29 acute-care hospitals in Yamagata Prefecture. We analyzed data from 1706 patients (mean age, 82.1 years). The independent variable was the number of days between hospital admission and the start of rehabilitation treatment, and the outcome was the Barthel index (BI) score at discharge. An IV method was applied, with adjustments for covariates, including demographics and functional status at admission.Results:Most patients started rehabilitation treatment within 3 days of hospital admission. Our IV method showed that the interval between hospital admission and the start of rehabilitation treatment was significantly associated with the BI score at discharge. The coefficient was −2.71 (95% confidence interval [CI]: −5.06 to −0.35).Conclusions:A delay in initiating rehabilitation treatment had a negative effect on ADL at discharge. This result emphasizes the importance of including early rehabilitation treatment in acute care, as recommended by several existing guidelines for the treatment of orthopedic diseases.

Identification of EEG Dynamics During Freezing of Gait and Voluntary Stopping in Patients With Parkinson’s Disease

Mobility is severely impacted in patients with Parkinson's disease (PD), who often experience involuntary stopping from the freezing of gait (FOG). Understanding the neurophysiological difference between "voluntary stopping" and "involuntary stopping" caused by FOG is vital for the detection of and potential intervention for FOG in the daily lives of patients. This study characterised the electroencephalographic (EEG) signature associated with FOG in contrast to voluntary stopping. The protocol consisted of a timed up-and-go (TUG) task and an additional TUG task with a voluntary stopping component, where participants reacted to verbal "stop" and "walk" instructions by voluntarily stopping or walking. Event-related spectral perturbation (ERSP) analysis was performed to study the dynamics of the EEG spectra induced by different walking phases, including normal walking, voluntary stopping and episodes of involuntary stopping (FOG), as well as the transition windows between normal walking and voluntary stopping or FOG. These results demonstrate for the first time that the EEG signal during the transition from walking to voluntary stopping is distinguishable from that during the transition to involuntary stopping caused by FOG. The EEG signature of voluntary stopping exhibits a significantly decreased power spectrum compared with that of FOG episodes, with distinctly different patterns in the delta and low-beta power in the central area. These findings suggest the possibility of a practical EEG-based tool that can accurately predict FOG episodes, excluding the potential confounding of voluntary stopping.

Assessment of the Effects of Early Ambulation on Activities of Daily Living in Patients Undergoing Abdominal Surgery

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Anxiety after subarachnoid hemorrhage: A systematic review and meta-analysis

• Anxiety is common in non-traumatic subarachnoid haemorrhage (SAH). • Anxiety seemed to run a chronic course and had negative impact on daily lives of patients with SAH. • Further research is needed to clarify patho-mechanisms and treatment post-SAH anxiety. Anxiety is a common and debilitating illness accompanying many neurological disorders including non-traumatic subarachnoid hemorrhage (SAH). The aim of this systematic review was to identify and critically appraise all published studies that have reported the frequency, severity, and time course of anxiety after SAH, the factors associated with its development and the impact of anxiety on patients’ quality of life. The PubMed EMBASE, PsycINFO and Ovid Nursing databases were searched for studies published in English that recruited at least 40 patients aged 18 or over who were diagnosed with anxiety after SAH. Twenty-nine studies covering 4,104 patients met the inclusion criteria. The frequency of anxiety ranged from 0% to 61.7%, with a weighted proportion of 31.2%. Anxiety remained prevalent several years after the index SAH. Anxiety after SAH was associated with education level, social support, and coping style. Comorbid cognitive impairment, fatigue, and depression also increased the risk of anxiety. Rupture of posterior circulation aneurysms may also be related to anxiety. Anxiety reduces the work capacity, participation in leisure and social activities, and quality of life of patients after SAH. Anxiety is common after SAH. Further research is needed to clarify its time course and identify the neurochemical factors and brain circuits associated with the development of post-SAH anxiety. Randomized controlled treatment trials targeting SAH-related anxiety are warranted.

Evaluation of Fatigue, Sleep Quality and Activities of Daily Living in Patients with Chronic Renal Failure

Introduction: Patients receiving hemodialysis treatment for chronic renal failure (CRF) develop various symptoms and experience lifestyle changes. CRF is a progressive disease characterized by irreversible loss of nephrons. Objective: The aim of the study was to evaluate fatigue, sleep quality and activities of daily living in patients with chronic renal failure. Method: This was a descriptive cross-sectional study. Sixty-seven CRF patients aged over 18 years who admitted to a private dialysis center for hemodialysis treatment were included. Sociodemographic information was recorded and the 'Visual Analog Scale for Fatigue' was used to evaluate fatigue, the 'Pittsburgh Sleep Quality Index' for assessment of sleep quality and the 'Katz Activities of Daily Living Scale' for evaluation of activities of daily living for all patients. All evaluations were conducted by the same investigator before hemodialysis session. Fatigue level assessment was repeated after hemodialysis session. The data obtained were analyzed using the SPSS 24.0 software package. Results: Thirty (44.8%) females and 37 (55.2%) males were enrolled in the study. The mean age of the study population was 55.8 ± 15.75 years. 74.6% of the patients had poor sleep quality. The mean fatigue score of the patients was 4.82 ± 2.02 before hemodialysis and 8.79±1.67 after hemodialysis, as assessed by VAS-F. All participants were independent in activities of daily living. The average of Katz ADL Scale was 16.80 ± 1.76. Discussion and Conclusion: In line with former studies, fatigue was the most common symptom in the study patients undergoing hemodialysis treatment for chronic kidney failure. Additionally, poor sleep quality and reduced performance in the activities of daily living in the study participants are noteworthy. Hemodialysis causes a number of symptoms that patients have to cope with in their daily lives. It is important to guide patients about individualized rehabilitation programs in the treatment of chronic renal failure.

Impact of gastrointestinal symptoms on quality of life in MEN2.

Besides medullary thyroid carcinoma and other endocrinopathies, people with Multiple Endocrine Neoplasia Type 2 (MEN2) are at risk of gastrointestinal (GI) symptoms. To investigate the impact of GI symptoms on the daily lives of patients with MEN2. An online survey was conducted among patients with MEN2 via the Association for Multiple Endocrine Neoplasia Disorders (AMEND). The survey incorporated two validated questionnaires for the assessment of GI symptoms (SAGIS, PAC-QoL). There were 91 respondents, MEN2A (n=57), MEN2B (n=34). People in the MEN2A group reported a high level of GI symptoms, the most prevalent being abdominal pain 85% (n=49), diarrhoea 85% (n=49) and constipation 75% (n=43) with one patient having a SAGIS score>10/12 in the constipation domain. People in the MEN2B group reported constipation in 79% (n=27) with one quarter of these scoring>10/12 in the constipation domain. Other GI symptoms included diarrhoea 62% (n=21), excessive gas and flatulence (79%), epigastric pain (59%) abdominal cramps (76%) and dysphagia (41%). The effect of constipation on quality of life was severe in all MEN2 patients as measured by PAC-QOL and all patients reported dissatisfaction of with their current treatment for constipation. There was a trend towards higher severity of GI symptoms in MEN2B. We report unmet needs of patients with MEN2 syndromes. The GI symptoms, especially constipation, had a severe impact on quality of life in people with MEN2. This suggests that there is room for improvement in the quality of care offered for these patients.

Association Between Sarcopenia and Its Components and Dependency in Activities of Daily Living in Patients on Hemodialysis

To investigate the association of sarcopenia and its components (muscle mass, muscle strength, and physical performance) with dependency in activities of daily living (ADLs) in maintaining patients on hemodialysis. This is a cross-sectional study. Sarcopenia was identified according to the Asian Working Group for Sarcopenia 2019 criteria. Basic ADLs (BADLs) and instrumental ADLs (IADLs) were assessed. Logistic regression was used to estimate the association of sarcopenia and its components with dependency. Area under the receiver-operating characteristic curve of gait speed corresponding with dependency was calculated. A total of 238 patients on hemodialysis were included. The proportion of enrolled male candidates was 67.6%, and the average age was 60.9years. In all, 49.2% (n=117) and 30.7% (n=73) of patients on dialysis were diagnosed with sarcopenia and severe sarcopenia, respectively. Dependency in BADLs was 21.0% (n=50), and dependency in IADLs was 41.2% (n=98). Severe sarcopenia was significantly associated with dependency in BADLs and IADLs after adjustment of clinical covariables (odds ratio [OR], 4.68 [95% confidence interval (CI): 2.11-10.40]; OR, 3.24 [95% CI: 1.61-6.53], respectively), whereas those effects for sarcopenia were not significant. With all three sarcopenia components in the analysis model, high gait speed remained strongly associated with low function dependency in BADLs and IADLs (per 0.1m/s increase of gait speed: OR, 0.52 [95% CI: 0.41-0.66]; and 0.46 [95% CI: 0.35-0.59], respectively). Area under the receiver-operating characteristic curve of gait speed corresponding with dependency in BADLs and IADLs was 0.827 (0.759, 0.896) and 0.878 (0.832, 0.925), respectively. Severe sarcopenia was closely related to dependency in ADL in patients on hemodialysis. Gait speed was the most important factor affecting dependency in sarcopenia and had good diagnostic accuracy for screening dependency in ADL.

The emotional and social burden of heart failure: integrating physicians\u2019, patients\u2019, and caregivers\u2019 perspectives through narrative medicine

BackgroundThe The Roadmap Using Story Telling project used a narrative medicine (NM) framework to assess the perspectives of people with heart failure (HF), their informal caregivers and HF specialists of the impact of HF on the daily life of patients and their carers.MethodsItalian HF specialists participated on a voluntary basis, completing their own narratives, and inviting patients and their caregivers to write anonymously about their experiences, all on a dedicated online platform. The narratives were analyzed according to standard NM methodology.Results82 narratives were collected from patients, 61 from caregivers, and 104 from HF specialists. Analysis of the three points of view revealed the extent of the burden of illness on the entire family, particularly that of the caregiver. The impact was mainly experienced as emotional and social limitations in patients’ and their caregivers’ daily lives. The analysis of all three points of view highlighted a strong difference between how HF is perceived by patients, caregivers, and HF specialists.ConclusionsThis NM project illustrates the complex issues of living with HF and gave insights to integrate three different perspectives into the HF pathway of care.

Effects of In-Hospital Physical Therapy on Activities of Daily Living in Patients with Hepatocellular Carcinoma.

Activities of daily living (ADL) are frequently impaired in patients with hepatocellular carcinoma (HCC). In this retrospective study, we aimed to investigate the effects of physical therapy on ADLs in patients with HCC during hospitalization for cancer treatment. Nineteen patients with HCC were enrolled. During hospitalization, patients performed a combination of resistance training, stretching, and aerobic exercise (20–60 min/day). ADLs were assessed using the functional independence measure (FIM). Changes in FIM were evaluated by before–after analysis. No significant difference was seen in Child–Pugh class before and after physical therapy. The bilateral knee extension strength and chair stand test were significantly increased after physical therapy compared with before physical therapy (p = 0.001 and p = 0.008, respectively). The total FIM score was significantly increased after physical therapy compared with that before physical therapy (p = 0.0156). Among the 18 indexes of FIM, the stairs index was significantly improved after physical therapy compared with that before physical therapy (5.9 vs. 6.4 points, p = 0.0241). We demonstrated that physical therapy improved muscle strength without worsening liver function. Furthermore, physical therapy improved FIM, especially in the stairs index, in patients with HCC. Thus, physical therapy may be beneficial in patients with HCC during cancer treatment.

PCN338 Healthcare Resource Utilization in Japanese Patients Newly Diagnosed with Multiple Myeloma or with Other Malignancies

For patients with multiple myeloma (MM), many factors can influence healthcare resource utilization (HCRU). This Japan-based study aimed to investigate the effect of disease burden on HCRU in patients with newly diagnosed MM (NDMM), and in patients newly diagnosed with other malignancies, using an administrative claims database. A retrospective analysis was conducted using health insurance data from a JMDC claims database. Data were extracted for patients aged ≥20 years with NDMM (ICD-10-CM: C90.0), newly diagnosed hematologic malignancies excluding MM (ICD-10-CM: C81–96 excluding C90.0), and newly diagnosed solid tumors (ICD-10-CM: C00–80) between January 2006 and October 2016. Hospitalizations, home medical care, and sick leave absence were evaluated for a 3-year follow-up period after index date. Return to work (RTW) rates were investigated. 230 patients with NDMM, 1,975 patients with newly diagnosed hematologic malignancies excluding MM, and 29,011 patients with newly diagnosed solid tumors were included in this analysis. Mean duration of inpatient care was similar for patients with NDMM and for other hematologic malignancies (77 and 86 days, respectively), and was shorter for patients with solid tumors (35 days). Mean duration of home medical care and sick leave in patients with NDMM (145 and 227 days, respectively) was longer compared with other hematologic malignancies (78 and 179 days) and solid tumors (92 and 122 days). RTW rates were comparable between patients with NDMM and patients with other hematologic malignancies (79.6% and 79.3%, respectively), and higher for those with solid tumors (87.3%). These data suggest there is a considerable burden on HCRU for patients with NDMM, as compared with patients with solid tumors or other hematological malignancies. This study provides insights into the effects of NDMM on the professional and daily lives of patients.

P011 Physical Activity Levels in Daily Life of Patients with Moderate-to-Severe Crohn's Disease Before and After Infliximab-Induced Remission.

BACKGROUND: Although the role of physical activity (PA) in inflammatory bowel disease (IBD) patients is not well defined, several studies about its effect on disease’s etiology and activity have addressed this issue. In addition, Crohn’s disease (CD) patients seem to have a lower level of PA and this behavior is associated with disease activity. This study evaluated a cohort of patients with moderately-to-severely active CD submitted to anti-TNF therapy in order to compare the exercise capacity and physical activity in daily life before and after anti-TNF-therapy induced remission. It is hypothesized that CD patients who achieved anti-TNF-therapy-induced remission present significant improvement in the previous levels of exercise capacity and PA in daily life. METHODS: In this prospective longitudinal study conducted between March 2015 and June 2018, 44 adult outpatients with active CD were evaluated at two different moments: before infliximab (IFX) administration and 24 weeks after infliximab therapy. We included patients with CD, aged ≥ 18 years and under 65 years, with a 3-month history of active disease, defined as a Harvey-Bradshaw index (HBI) score of 8 or higher and a serum level of C-reactive protein of more than 5.0 mg per liter, with indication for anti-tumor necrosis factor alpha therapy, i.e. refractory disease unresponsive to conventional therapies or steroid-dependent and those presenting with aggressive disease or features of poor prognosis prediction, such as extensive bowel disease, complex fistulizing disease, or severe endoscopic lesion as defined by the presence of deep and extensive ulcers. Eligible patients received induction therapy consisting of intravenous injections of 5 mg/Kg of IFX at weeks 0, 2, and 6 followed by maintenance infusion (5 mg/Kg) at weeks 14 and 22. Participants were followed until week 24. Patients were evaluated for PA in daily life using accelerometer, exercise capacity, peripheral muscle strength, anthropometry, and body composition. The primary endpoint was an increase in the total number of steps/day in daily life at week 24 in CD patients achieving IFX-induced remission. Secondary endpoints included improvement in the shuttle walking test (SWT), the handgrip strength (HS), active time, and inactive time. RESULTS: Thirty-eight (86.4%) patients achieved infliximab-induced remission at the end of 24 weeks and presented a significant increment from baseline in number of steps taken of 1092 (7440 ± 2980 vs. 6348 ± 3177, respectively; P = 0.006). The inactive time was significantly reduced when compared to baseline period (454.2 ± 106.3 vs. 427.9 ± 97.8, respectively; P = 0.033). There was no difference in the distance walked before and after IFX therapy. CONCLUSION: Infliximab-induced remission followed by maintenance therapy has shown to be effective for increasing PA levels in daily life as shows by increase in the number of steps taken per day as well as by reduced inactive time on patients with moderately-to-severely active CD. Given the important role of PA for patients with CD, anti-TNF therapy may be useful therapeutic strategy along with targeted PA recommendations for increasing PA levels. Furthermore, strategies of treatment associated with an exercise program must be considered for this population.

Activating EGFR Signaling Attenuates Osteoarthritis Development Following Loading Injury in Mice.

Posttraumatic osteoarthritis (PTOA) results in joint pain, loss of joint function, and impaired quality of daily life in patients with limited treatment options. We previously demonstrated that epidermal growth factor receptor (EGFR) signaling is essential for maintaining chondroprogenitors during articular cartilage development and homeostasis. Here, we used a nonsurgical, loading-induced PTOA mouse model to investigate the protective action of EGFR signaling. A single bout of cyclic tibial loading at a peak force of 6N injured cartilage at the posterior aspect of lateral femoral condyle. Similar loading at a peak force of 9 N ruptured the anterior cruciate ligament, causing additional cartilage damage at the medial compartment and ectopic cartilage formation in meniscus and synovium. Constitutively overexpression of an EGFR ligand, heparin binding EGF-like growth factor (HBEGF), in chondrocytes significantly reduced cartilage injury length, synovitis, and pain after 6N loading and mitigated medial side cartilage damage and ectopic cartilage formation after 9N loading. Mechanistically, overactivation of EGFR signaling protected chondrocytes from loading-induced apoptosis and loss of proliferative ability and lubricant synthesis. Overexpressing HBEGF in adult cartilage starting right before 6N loading had similar beneficial effects. In contrast, inactivating EGFR in adult cartilage led to accelerated PTOA progression with elevated cartilage Mankin score and synovitis score and increased ectopic cartilage formation. As a therapeutic approach, we constructed a nanoparticle conjugated with the EGFR ligand TGFα. Intra-articular injections of this nanoconstruct once every 3 weeks for 12 weeks partially mitigated PTOA symptoms in cartilage and synovium after 6N loading. Our findings demonstrate the anabolic actions of EGFR signaling in maintaining articular cartilage during PTOA development and shed light on developing a novel nanomedicine for PTOA. © 2022 American Society for Bone and Mineral Research (ASBMR).

Reliability and Validity of Longshi Scale in Assessing the Activities of Daily Living of Patients with Spinal Cord Injury

Reliability and Validity of Longshi Scale in Assessing the Activities of Daily Living of Patients with Spinal Cord Injury

Effect of the Virtual Reality Cognitive Rehabilitation Program on Cognition Ability and Activities of Daily Living in Patients with Mild Cognitive Impairment

Effect of the Virtual Reality Cognitive Rehabilitation Program on Cognition Ability and Activities of Daily Living in Patients with Mild Cognitive Impairment

Clinical characteristics and health-related quality of life of patients with recurrent pericarditis in the United States: findings from a patient survey

Abstract Background Recurrent pericarditis (RP) is characterized by recurrence of symptoms of pericarditis after the original episode has ceased for 4–6 weeks. Though RP is associated with significant morbidity, there is little information regarding the impact of RP on patients' health-related quality of life (HRQOL). Purpose To describe clinical characteristics of and HRQOL burden in patients with RP in the United States. Methods An IRB-approved web-based survey was conducted among patients ≥18 years old with RP who experienced ≥1 recurrence during the prior 12 months. Respondents were recruited from the RHAPSODY clinical trial recruitment database. Patients who met the survey inclusion criteria were asked to provide information on their demographic/clinical characteristics, treatments for RP, and to complete an 11-point pericarditis pain numerical rating scale, the Patient Global Impression of Pericarditis Severity scale, the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Global Health and Sleep Disturbance scales, and questions about the impact of RP on daily life. Results Of the 83 respondents with RP included in the study, 25% responded while experiencing a recurrence. Most respondents were Caucasian (76%) and 55% were female, with mean (standard deviation [SD]) age of 49.3 (13.7) years. Patients frequently reported history of hypertension (39%), anxiety (37%), and depression (34%); 16% and 15% of patients reported having pre-existing autoimmune disease and diabetes, respectively. About half (49%) of patients reported ≥3 recurrences in the prior year, and 40% visited the ER and 25% were hospitalized for their most recent recurrence. Among patients not actively experiencing a recurrence, 37% reported that the duration of their prior episode lasted ≥8 days. Medications most frequently used for RP and pain in the prior year included non-steroidal anti-inflammatory drugs (82%), colchicine (63%), and corticosteroids (29%). Commonly reported symptoms included chest pain (93%), shortness of breath (66%), weakness/fatigue (64%), and heart palpitations (52%). Two-thirds of patients rated the severity of symptoms during the most recent RP episode as moderately severe to very severe, and 48% reported “quite a bit” or “very much” fear of pericarditis recurrence. The mean (SD) value for worst pericarditis pain (0–10 scale) during the recent recurrence was 6.1 (2.3), with 48% reporting severe pain (≥7 on the scale). Patients had substantially worse mean [SD] T scores for PROMIS physical health (37.6 [8.6]), mental health (42.8 [9.9]), and sleep disturbance (60.6 [8.3]) than the general population (50 [10]). Conclusions RP is a burden on the daily lives of patients, resulting in severe pain and impaired quality-of-life including poor physical and mental health, sleep disturbance, and fear of recurrence. This study demonstrates the unmet need for therapies that can rapidly resolve symptoms and prevent recurrences. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Kiniksa Pharmaceuticals Corp.

Impact of Body Mass Index on Activities of Daily Living in Patients with Idiopathic Interstitial Pneumonias.

In patients with idiopathic interstitial pneumonias, undernutrition has a profound effect on prognosis. However, whether body mass index affects the ability to perform activities of daily living as measured by the Barthel index in patients with idiopathic interstitial pneumonias remains unknown. Therefore, we examined the impact of body mass index on the activities of daily living in inpatients with idiopathic interstitial pneumonia. We used a database constructed by the Japan Medical Data Center. Data were extracted from 2774 inpatients from participating hospitals with a diagnosis of idiopathic interstitial pneumonia. Multiple regression analysis adjusted for confounding factors was performed to determine whether body mass index classification would be independently related to change in Barthel index during hospitalization. Underweight, normal weight, overweight, and obesity numbered 473 (19%), 1037 (41), 795 (31%), and 235 (9%), respectively. Multivariable analysis showed that being underweight was independently associated with a change in Barthel index during hospitalization of −2.95 (95% confidence interval −4.82 to −1.07) points lower than being normal weight. Approximately 20% of the patients with idiopathic interstitial pneumonias were underweight. Those who were underweight had decreased independence in activities of daily living during hospitalization.

Effect of Task-Oriented Bilateral Movements on Arm Global Synkinesis and Activities of Daily Living in Patients with Stroke

Background: Stroke patients exhibit arm global synkinesis (GS), involuntary movement due to muscle weakness and irregular muscle tension. But currently there are few studies examined the effects of GS on activates of daily living in stroke patients. Objectives: To investigate the effects the effects of task-oriented bilateral movements, which promote brain plasticity and are based on neurological theory, using the unaffected arm and the affected arm. Design: Quasi-randomized trial. Methods: Twenty stroke patients were randomly assigned to experimental group I (n=10) and experimental group II (n=10). Before the intervention, arm GS was measured using surface electromyography, and the Motor Activity Log evaluated the quantitative and qualitative uses of the affected arm in daily life. The same items were measured four weeks later. Results: The changes in the GS of the arm of experimental group I showed statistically significant differences only in bending motions (P<.05). Both groups showed statistically significant differences in the amount of use (AOU) and the quality of movement (QOM) scores (P<.01). Comparing the groups, statistically significant differences in GS appeared during bending motions (P<.05), and in the AOU (P<.01) and the QOM scores (P<.05). Conclusion: The intervention in GS reduced the abnormal muscle tension of the affected side by increasing the use of the ipsilateral motor pathway, indicating its effectiveness in improving upper limb functions with smooth contraction and relaxation of the muscles.