Physical Component Summary Research Articles

Prosthesis and health-related factors of mobility in people with nontraumatic unilateral transtibial amputation.

Numerous factors can affect mobility of individuals with lower limb amputation, including prosthesis-dependent, physical and psychological determinants.Objective:This study aimed to investigate the prosthesis and health-related factors of mobility in people with nontraumatic unilateral transtibial amputation.Study Design:Cross-sectional observational study. Individuals with nontraumatic unilateral transtibial amputation who are using a prosthetic leg were included. All participants were asked to fill out the Prosthesis Evaluation Questionnaire, 12-Item Short-Form Health Survey (SF-12), Comprehensive Lower Limb Amputee Socket Survey, and 12-item Prosthetic Limb Users Survey of Mobility. The relationships between the variables of interest and mobility were investigated using correlation coefficient analyses. Multiple regression analysis was run to investigate the impact of a set of predictor variables on mobility. A total of 168 people with lower limb amputation were included. Mobility had a significant association with age, comorbidity, occupation, Prosthesis Evaluation Questionnaire score, physical and mental component scores of SF-12, subscales of the Comprehensive Lower Limb Amputee Socket Survey, educational status, amputation cause, time since amputation, time since using the prosthesis, and socket insert type. In the final model of multiple regression analysis, the Physical Component Summary score of SF-12 showed the strongest predictor of mobility (beta = 0.40, p < 0.001). Nonprosthetic factors play a significant role in mobility of people with nontraumatic unilateral transtibial amputation. Although some predictors, such as age and time since amputation, are immutable, clinicians may still enhance the mobility of this population through the utilization of health-related factors, such as improving their physical activity.

A comparative study of dynamic versus static rehabilitation protocols after acute Achilles tendon rupture repair with channel assisted minimally invasive repair technique

To explore the difference in effectiveness between a dynamic rehabilitation protocol and a traditional static rehabilitation protocol after the treatment of acute Achilles tendon rupture with channel assisted minimally invasive repair (CAMIR) technique through a prospective comparative trial, aiming to provide a reference for clinically selecting a feasible treatment regimen. Patients with acute Achilles tendon rupture admitted between June 2021 and June 2022 were included in the study, with 60 patients meeting the selection criteria. They were randomly divided into a dynamic rehabilitation group ( n=30) and a static rehabilitation group ( n=30) using a computer-generated random number method. There was no significant difference in baseline data such as gender, age, body mass index, smoking history, injured side, cause of injury, and disease duration between the two groups ( P>0.05). After Achilles tendon anastomosis by using CAMIR technique, the dynamic rehabilitation group implemented early partial weight-bearing training with the assistance of an Achilles heel boot and controlled ankle joint exercises for 6 weeks, while the static rehabilitation group maintained a non-weight-bearing status during this period. Complications in both groups were recorded. At 3 and 6 months after operation, the Achilles tendon total rupture score (ATRS) was used to evaluate the degree of functional limitation of the Achilles tendon in the affected limb, and the 12-Item Short Form Health Survey (SF-12 scale) was used to assess the patients' quality of life, including physical component summary (PCS) and mental component summary (MCS) scores. No sural nerve injury occurred during operation in both groups. All patients were followed up 12-18 months (mean, 14 months). The dynamic rehabilitation group had significantly higher ATRS scores at 3 and 6 months after operation compared to the static rehabilitation group ( P<0.05). At 3 months after operation, the dynamic rehabilitation group had significantly lower PCS, MCS, and SF-12 total scores compared to the static rehabilitation group ( P<0.05). At 6 months, all quality of life scores in the two groups were similar ( P>0.05). Two cases (6.6%) in the dynamic rehabilitation group and 5 cases (16.7%) in the static rehabilitation group developed complications, with no significant difference in incidence of complications ( P>0.05). For acute Achilles tendon rupture, the dynamic rehabilitation protocol after Achilles tendon anastomosis by using CAMIR technique can improve early functional recovery and maintains comparable safety and effectiveness compared to static rehabilitation.

Home Use Therapies for Pain, Disability, and Quality of Life in Military Service Members with a Musculoskeletal Injury: An Updated Systematic Review Meta-Analysis.

Musculoskeletal (MSK) injury can negatively affect service members by compromising job performance and readiness. These injuries can impact the service member's physical health, functional abilities, and quality of life (QoL). Rehabilitation therapies for MSK injuries can reduce these impacts. One approach is home use rehabilitative therapy, usable during deployment and at home stations. The purpose of this updated systematic review with meta-analysis was to broaden our scope of pain/symptoms, disability, and QoL as outcome measures for nonpharmaceutical MSK therapies in a military population versus controls. An updated systematic literature search was conducted from inception to September 2022 using electronic databases. From 2790 retrievals, 22 reports were identified from 21 randomized or nonrandomized control trials. Interventions included exercise, electrotherapy, bracing, and other devices compared to a standard control treatment. Outcomes for MSK pain/symptoms, disability, and QoL were summarized as (1) standardized change from baseline for both intervention and control by time and (2) standardized mean differences (SMDs) in the time change between the intervention and control. Relative to baseline, pain improved during treatment and follow-up (P < .0001) with differences between intervention and control groups (P < .0001) but no significant interactions between group and time (P = .11). Overall, interventions showed modest (0.33 SMD, 95% CI, 0.11 to 0.54) improvement relative to controls across body regions and time. On average, disability exhibited an SMD of 0.12 (95% CI, -0.20 to 0.44) across all measures with substantial heterogeneity (I2 = 0.93). Time (P = .02) but not intervention (P = .87) was a significant moderator with no clear pattern of change over time and no time by group interaction (P = .84). Quality of life had an overall modest effect with an SMD of 0.10 (95% CI, -0.04 to 0.24) with no evidence supporting a difference between the intervention and control groups (P = .10) and no significant interaction between time and group (P = .41). The QoL measures were primarily derived using the Short Form Health Survey (SF12/36), which provide a mental and physical component summary score. For the mental component, there was either no change or a small decline during the study (P(time) = .80), with a difference between the intervention and control (P = .04) but no interaction between groups over time (P = .40). For the physical component scale, there was improvement during the study (P = .01), with the intervention showing better improvement than the control (P = .005), with no interaction between the time and treatment/control group (P = .80). The report considers responses by region and individual treatments. This analysis demonstrated modest improvement in pain and physical well-being with therapy, with low certainty across diverse military cohorts. The impact on overall health-related disability and QoL was limited, with little change in mental well-being. The substantial heterogeneity and low certainty across diverse military cohorts limit generalizability, suggesting that further research in homogeneous environments is important for guiding clinical decisions. The study's findings suggest that nonpharmacological home use interventions may offer modest improvements in pain relief, particularly early in treatment, and in strength and function, according to our previous report. These interventions could complement standard care, providing options that may benefit service members during deployment and at home.

Physical activity, and improvement in health-related quality of life among Australian middle-aged and older adults living with type 2 diabetes mellitus.

Physical inactivity is a major global public health concern and a recognized risk factor for type 2 diabetes mellitus (T2DM). However, the relationship between physical activity and health-related quality of life (HRQOL) in people with T2DM using longitudinal data remains underexplored. We aim to identify the improvement in HRQOL associated with physical activity in Australian middle-aged and older adults using population-based longitudinal data. Data for this study were drawn from waves 9, 13, 17, and 21 of the Household, Income and Labour Dynamics in Australia (HILDA) Survey. We constructed an unbalanced panel consisting of2,472 person-year observations from 1,270 unique individuals living with T2DM. We used a random effects Generalized Least Squares (GLS) model to examine the relationship between physical activity and HRQOL in people with T2DM. The regression results showed that physical activity is positively associated with physical component summary (PCS), mental components summary (MCS), and health state utility value (SF-6D). People with T2DM engaging in physical activity less than once or 1 or 2 times per week had a higher mean score for PCS (β = 4.28, 95%CI:3.38, 5.17), MCS (β = 2.36, 95%CI:1.38, 3.34), and SF-6D utility value (β = 0.04, 95%CI:0.03, 0.05) than their counterparts engaged in no physical activity. Similarly, engaging in physical activity three times daily per week had a further elevated mean score for PCS (β = 6.65, 95%CI: 5.72,7.60), MCS (β = 3.75, 95%CI:2.71, 4.79), and SF-6D utility value (β = 0.07, 95%CI: 0.06,0.08). Our results showed that physical activity is positively associated with improved HRQOL among people with T2DM. Public health initiatives should prioritize health education and community programs to promote physical activity across all demographics to enhance HRQOL in people living with T2DM.

Handgrip strength is independently associated with physical quality of life in patients undergoing maintenance hemodialysis: a cross-sectional study.

We aimed to identify the association between Health-related quality of life (HRQoL) and muscle strength in patients undergoing maintenance hemodialysis (MHD). In this cross-sectional study from March 2021 to December 2021, 110 MHD patients with a mean age of 63.9 ± 13.0 years and a median dialysis vintage of 25.5 (12.0-52.3) months, were enrolled at a hemodialysis center in Guangzhou city, China. HRQoL was assessed using the Short Form 36 Health Survey (SF-36) and converted into the Physical Component Summary (PCS) and the Mental Component Summary (MCS). The groups were assigned according to the mean score of PCS and MCS, and those with higher PCS/MCS scores (high-PCS/MCS) were compared with those with lower PCS/MCS scores (low-PCS/MCS). Independent factors were evaluated using multivariate analysis. Muscle strength was estimated by handgrip strength (HGS). The mean HGS was 23.7 ± 9.60 kg in men and 14.3 ± 5.30 kg in women. Compared to the high-PCS group, the low-PCS group had older age, higher levels of creatinine, total cholesterol, high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6), and had lower HGS (all p < 0.05). After adjusting for confounding factors in different models, the five-model multivariate binary logistic regression analyses revealed that HGS was the only independent factor in PCS domain, but not in MCS. HGS may be an independent factor of poor HRQoL in MHD patients, particularly in relation to physical health. The management of muscle strength may improve the HRQoL in MHD patients. The study was registered at https://www.chictr.org.cn/ as ChiCTR2100053790.

Sleep quality and risk of obstructive sleep apnea among breast cancer survivors with and without lymphedema.

Breast cancer survivors (BCSs) tend to have sleep disturbances such as obstructive sleep apnea (OSA). However, limited evidence exists on the role of breast cancer-related lymphedema (BCRL) in sleep disturbances and OSA. Therefore, this study aimed to investigate the quality of sleep (QoS) and OSA risk among women with and without BCRL. The quality of life (QoL) was evaluated using the SF-12 and EORTC-QLQ C-30 questionnaires, while their sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The STOP-bang questionnaire (SBQ) was utilized to quantify OSA risk. Sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Also, neck and waist circumference and the excessive volume in the affected limb were measured using a tape measure. The statistical analyses were performed using the SPSS 21.0 software. Seventy-one women with BCRL and 84 BCS without lymphedema were included. The comparison of PSQI, SBQ, ESS, SF-12, and EORTC QLQ-C30 questionnaires exhibited no significant difference between these two groups. The overnight snoring and average neck circumference were significantly higher in the BCRL group than in the control. The BCRL stage significantly correlated with neck circumference and SBQ total score. Additionally, the mean volume difference indicated a significant correlation with the ESS total score and both physical and mental summary components of the SF-12 questionnaire. The prevalence of sleep disturbances among BCSs with and without BCRL is high. Women with advanced stages of BCRL might be at high risk for OSA. Therefore clinical evaluation of BMI, neck circumference, and, snoring overnight should be emphasized among this population.

Association between accelerometry and physical activity levels measured by questionnaires in patients on hemodialysis

Purpose This study aimed to evaluate association of accelerometry data with physical activity levels (PAL) measured by three questionnaires and to investigate their ability to discriminate physically inactive from active patients on hemodialysis. Materials and methods A cross-sectional study was conducted. PAL were assessed by accelerometry and questionnaires: Human Activity Profile (HAP), International Physical Activity Questionnaire (IPAQ), and 36-Item Short Form Health Survey (SF-36). Results This study included 105 patients (59.2 ± 12.5 years, 60.0% male). Accelerometer data were significantly correlated with all questionnaire scores. Adjusted activity score (AAS) of HAP presented moderate to strong correlation with daily step count (ρ = 0.552, p < 0.001) and time in moderate and vigorous physical activity (ρ = 0.642, p < 0.001). AAS was associated with daily step count (R2 = 0.29, p < 0.001) and time in moderate to vigorous physical activity (R2 = 0.24, p = 0.001). Cutoff values for AAS of HAP, IPAQ, and physical component summary of the SF-36 for discriminating physically inactive from active patients were 63, 1139 and 44 (threshold of 5000 steps/day), respectively, and 55, 773 and 38 (threshold of 4260 steps/day), respectively. Conclusions PAL scores on questionnaires were associated with accelerometer data, mainly the HAP. Furthermore, this study established cutoff points for questionnaire scores to discriminate physically inactive from active patients.

Quality of life and its related predictors among acute coronary syndrome patients with coronary stents in Ho Chi Minh City, 2022

The health-related quality of life (HRQOL) assessment after coronary stents insertion to issue a very crucial tool for evaluating outcomes. Therefore, we investigated the associations between healthy affect, resilience to improve their health status and the quality of life of patient is improving. A cross-sectional design involving patients with having acute coronary syndrome (ACS) after coronary stents insertion (CSI) and being treated in the hospital in Ho Chi Minh City. The patients (N =210) who came to Tam Duc Heart Hospital for pre- examination during treatment were asked to answer questionnaires which included SF-36 and resilience-25. The t-test and ANOVA was applied to identify the factors related to quality of life and resilience. Result showed the mean score of resilience is 70.2 ± 8.1. The score of physical components summary (PCS) was range from 32.37 to 61.6 and the mean score was 51.0 ± 8.7. For the mental component summary (MCS) was range from 39.6 to 60.0 with the mean score was 51.0±5.7. Factors including age, gender, marital status, working status, education, duration after stent treatment, experience of hospitalization for stent treatment, number of stents in patients and regularly take medication were associated with patients’ quality of life. The mean score of quality of life was significantly different between patients’ resilience level (p &lt; 0.05).

Effects of Virtual Reality–Based Activities of Daily Living Rehabilitation Training in Older Adults With Cognitive Frailty and Activities of Daily Living Impairments: A Randomized Controlled Trial

ObjectivesCognitive frailty, which is notably prevalent in nursing homes, correlates with a range of adverse health outcomes; however, interventions targeting this population are scarce, particularly those addressing activities of daily living (ADLs). The objective of this study was to evaluate the effects of virtual reality–based ADL rehabilitation training on older adults with cognitive frailty and ADL impairments. DesignA 2-arm randomized controlled trial. Setting and ParticipantsOlder adults with cognitive frailty and mild ADL impairments in a nursing home. MethodsSixty-six eligible participants were equally randomized into intervention and control groups. The intervention involved 45-minute sessions conducted twice weekly for 12 weeks. Outcomes evaluated included ADL performance, cognition, frailty, depression, and quality of life. Assessments were performed at baseline, 6 weeks (T1), and 12 weeks (T2). ResultsThere was no statistically significant difference between the 2 groups at baseline. The mean age of the participants was 80.20 ± 9.14 years, and most were women (54.55%). Compared with the control group, the intervention group showed significant improvements in ADLs (T1: β = 6.33, T2: β = 12.79), basic ADLs (T1: β = 4.09, T2: β = 6.97), instrumental ADLs (T1: β = 2.24, T2: β = 4.12), cognition (T1: β = 3.67, T2: β = 4.42), frailty (T1: β = −0.76, T2: β = −1.27), and mental component summary of quality of life (T1: β = 8.49, T2: β = 16.44) at T1 and T2. By T2, significant improvements were observed in depression (T2: β = −2.06) and physical component summary of quality of life (T2: β = 8.52). Conclusions and ImplicationsFor older adults with cognitive frailty and mild ADL impairments residing in a nursing home, the virtual reality–based ADL rehabilitation program was safe and effective. Following the 12-week intervention, significant improvements were observed in ADL performance, cognition, frailty, depression, and quality of life.

Interventions for the management of long covid (post-covid condition): living systematic review

ObjectiveTo compare the effectiveness of interventions for the management of long covid (post-covid condition).DesignLiving systematic review.Data sourcesMedline, Embase, CINAHL, PsycInfo, Allied and Complementary Medicine Database, and Cochrane Central Register of...

Incidence and risk factors of Post-intensive care syndrome (PICS) in surgical ICU survivors: a prospective Chinese cohort study

BackgroundPost-intensive care syndrome (PICS) is a term coined by the Society of Critical Care Medicine to describe the psychological, cognitive, and physical dysfunction that ICU survivors may experience. Although surgical patients represent a substantial proportion of ICU survivors, studies describing PICS in this specific population remain limited. This study aims to determine the incidence and independent risk factors associated with PICS among surgical ICU survivors in a Chinese cohort.MethodsThe study was a prospective cohort study of critically ill surgical patients who were discharged from the ICU at the First Affiliated Hospital of Sun Yat-sen University between August 2021 and June 2022. Demographic characteristics, disease-related information, and ICU treatment were collected, and enrolled participants were followed up within six months after ICU discharge. The Chinese version of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and the Short Memory Questionnaire (SMQ) were used to assess PICS. The physical component summary (PCS) and the mental component summary (MCS) were averaged from the corresponding four-dimension scores in the SF-36. PICS diagnosis was determined based on the presence of at least one of the following: physiological dysfunction (defined as PCS reductions greater than 10), psychological dysfunction (defined as MCS reductions greater than 10), or cognitive dysfunction (defined as SMQ reductions and scores less than 40 at six months). PICS diagnosis was based on the presence of at least one of the following: physiological, psychological, or cognitive dysfunction.ResultsA total of 565 patients were screened in this study, and 83 were enrolled after applying the inclusion and exclusion criteria. Overall, 65 surgical ICU survivors developed PICS within six months, with an incidence rate of 78.3%. The prevalences were 55.4% and 27.7% at the end of 3 and 6 months after ICU discharge, respectively. Univariate analysis showed that there was a correlation between the occurrence of PICS and the total bilirubin and creatinine levels at ICU admission, APACHE II score, ICU length of stay, and the presence of dialysis (P < 0.05). ICU length of stay was identified as an independent risk factor for the occurrence of PICS in surgical ICU survivors after adjusting for confounders.ConclusionThe overall PICS incidence in surgical ICU survivors was 78.3%, with prevalence gradually decreasing over time to 27.7% within 6 months. For surgical survivors requiring ICU care, the longer the ICU stay, the more likely to develop PICS.Implications for clinical practiceThe findings offer valuable insights into the incidence and risk factors of PICS in surgical ICU survivors, which can help healthcare professionals identify surgical cases at high risk of developing PICS and tailor the treatment effectively.

Free fasciocutaneous versus muscle flaps in lower extremity reconstruction: Implications for functionality and quality of life.

Free tissue transplantations are commonly used to treat complex lower extremity defects caused by trauma, vascular disease, or malignancy, particularly when vital structures are exposed. This study aimed to expand the knowledge on patient-reported outcomes by comparing fasciocutaneous and muscle flaps, with the goal of facilitating patient counseling. Additionally, patient-level risk factors associated with decreased functioning and health-related quality of life were identified. This retrospective, cross-sectional, multicenter study included patients who underwent microsurgical lower extremity reconstruction using free fasciocutaneous or muscle flaps between 2003 and 2021, with a minimum follow-up of 12 months. Data were collected from medical records, pain scores, Short-Form 36 (SF-36), and Lower Extremity Functional Scale (LEFS). Mean scores were compared between flap types and predictors of LEFS, SF-36 Mental Component Summary (MCS), and SF-36 Physical Component Summary (PCS) scores were determined using a backward stepwise regression model. Of the 206 patients eligible, 100 (49%) were included in the retrospective part. A total of 89 (43%) responded to the questionnaires, with 62 treated using a fasciocutaneous flap and 27 with a muscle flap. No significant differences in total LEFS, SF-36 PCS, or MCS scores were found between the two flap type. Pain was a significant predictor of decreased functional outcomes for both flap types, and was also linked to poorer mental health in patients treated with fasciocutaneous flaps. Other predictors of low patient-reported outcome scores included obesity, diabetes, poorer mental health, and a follow-up of less than two years. Patients treated with fasciocutaneous and muscle flaps experience comparable levels of functionality and quality of life after surgery. Flap selection should be based on defect characteristics, along with the surgeon's individual skills and preferences. A comprehensive approach that considers physical comorbidities, pain, and mental health is essential, as these factors significantly impact patient functionality and quality of life.

Prospective cohort study of basivertebral nerve ablation for chronic low back pain in a real-world setting: 12 months follow-up

BackgroundThe basivertebral nerve, which densely supplies the vertebral endplates, is a potential source of chronic low back pain transmission in patients with Modic changes. Basivertebral nerve ablation (BVNA), a minimally invasive procedure, aims to disrupt this pain signaling. ObjectivesIn this study, we investigated BVNA's effectiveness in treatment of vertebrogenic low back pain and we followed patients for 12 months to assess long-term effectiveness. Study designSingle group prospective cohort study (ClinicalTrials.gov NCT05692440). SettingSingle-center, community private practice. MethodsThirty-five patients were treated with the INTRACEPT® device (Boston Scientific, MA, USA). Thirty-one patients completed Oswestry Disability Index (ODI), Visual Analog Scale (VAS), SF-36 Physical Component Summary (PCS), and SF-36 Mental Component Summary (MCS) at baseline and follow-up visits up to 12 months. ResultsThe average age of the 31 patients was 73.0 ± 6.34 years and 71.0 % of the population was male (N=22)) at baseline. All four self-reported outcomes (ODI, VAS, SF-36 PCS, and MCS) showed statistically and clinically significant improvements from baseline through 12 months (all p < 0.001, with the exception of the SF-36 MCS at 1 month, p = 0.165). Overall, 67.7 % of patients demonstrated ODI improvements above the minimal clinically important difference (decrease of at least 15 points) and 77.4 % of patients demonstrated a decrease on the VAS above the minimal clinically important difference (≥2 cm reduction) at 12 months. LimitationsLimitations of the study include the lack of a control group and potentially unintentional bias in patient selection. ConclusionsBVNA demonstrates potential as an effective and minimally invasive treatment for chronic low back pain in a real-world patient cohort where substantial improvements were observed. These results align with those seen in previous randomized controlled trials (RCTs) and industry-funded studies of BVNA.

Health-Related Quality of Life in Living Kidney Donors Participating in Kidney Exchange Programs

Abstract Kidney exchange programs (KEP) have revolutionized living donor kidney transplantation (LDKT) by enabling transplants for patients with HLA or ABO incompatible donors. However, the implications for donors participating in KEP, particularly regarding postoperative health-related quality of life (HRQoL), are not well elucidated. This study compares the HRQoL of donors participating in KEP with donors donating directly (non-KEP). The study included 724 donors, with 121 in the KEP group and 603 in the non-KEP group. Outcomes were assessed using the mental component summary (MCS), physical component summary (PCS), EQ-5D-3L, MVI-20 score, and self-rated pain level. We used a mixed-effects regression model to assess differences between KEP and non-KEP over time, accounting for repeated measures within subjects. There was a significant temporary decline in both the MCS and PCS post-donation; however, these outcomes returned to pre-donation levels after an interval of two month. Donors participating in the KEP had higher PCS and MCS 1-year post-donation. Comparable results were observed in the self-assessed HRQoL using the EQ-5D-3L instrument, as well as in the fatigue scores measured by the MVI-20. We found that participation in KEP does not adversely affect donors' short- or long-term mental and physical HRQoL outcomes and that LDKT donors have HRQoL of pre-donation levels soon after donation. These insights are reassuring, indicating that donors participating in KEP can expect HRQoL comparable to those who do not. This reinforces the viability of KEP as a safe option for expanding LDKT and findings can inform patient and donor education.

Cross-Cultural Adaptation and Validation of Foot and Ankle Ability Measure (FAAM) for Arabic-Speaking Patients.

The original English Foot and Ankle Ability Measure (FAAM) is widely adopted to track changes in foot and ankle function. The aim of this study is to translate it to an Arabic version of FAAM (FAAM-A), and then to assess the validity and reliability of the FAAM-A version. One hundred five consecutive Arabic-speaking participants with different foot and ankle pathologies completed the FAAM-A. Fifty-six males and 49 females with a mean age of 39.8 years; 78.1% respondents have completed high school or higher. Convergent and divergent validities were assessed using correlation coefficients between the FAAM-A subscales and the short form-36 (SF-36), physical function (PF), physical component summary (PCS), mental health (MH), and mental component summary (MCS). Cronbach's alpha was calculated to assess internal consistency. A subgroup of 20 participants filled the FAAM-A twice to test for test-retest reliability, using intraclass correlation coefficients (ICCs) and minimal detectable changes (MDCs). The average FAAM-A was 55.32 and 43.23 for the activity of daily life (ADL) and Sports subscales, respectively. FAAM-A ADL subscale had a moderate correlation with the PF, 0.565; PCS, 0.546; and MCS, 0.447; and a low correlation with MH, 0.34. The sports subscale had a moderate correlation with the PF (0.529), PCS (0.513), and a low correlation with MCS (0. 395) and MH (0. 297). Cronbach's alpha was 0.97 and 0.95 for ADL and sports subscales, respectively. Intraclass correlation coefficient was 0.99 for both subscales. Minimal detectable change at a 95% confidence level was 6.81 and 8.19 for the ADL and sports subscales, respectively. The FAAM-A is proven to be valid and reliable instrument for assessing foot and ankle disability. It is an effective tool for clinical assessment and research within Arabic-speaking populations. Level II, Prospective cohort study.

Associations of anaemia and iron deficiency with health-related quality of life in patients with chronic kidney disease stage G3b-5 in Japan: sub analysis of the Reach-J CKD cohort study

BackgroundIron deficiency is a major contributor to anaemia in chronic kidney diseases. The association of anaemia and iron deficiency with health-related quality of life in Japanese patients with non-dialysis chronic kidney disease has not been examined. In this study, we evaluated anaemia and iron deficiency in patients with chronic kidney disease G3b-5 and examined their associations with health-related quality of life.MethodsThis nationwide cohort study included 2,249 patients with advanced chronic kidney disease receiving nephrologist care from 31 representative facilities throughout Japan; they were randomly selected through stratification by region and facility size and aligned with the Chronic Kidney Disease Outcomes and Practice Patterns Study. Using baseline patient data, we assessed the association of anaemia and iron deficiency with health-related quality of life, employing the 36-item Kidney Disease Quality of Life Questionnaire.ResultsThe mean mental and physical component summary scores for all patients were 49 and 47, respectively. Patients with haemoglobin levels < 10 g/dL had worse three kidney disease subscale, mental component summary, physical component summary, and subdomain scores than those with haemoglobin levels > 12 g/dL. Patients with absolute iron deficiency (TSAT < 20% and ferritin < 100 ng/mL) had worse three kidney disease subscale and mental component summary scores than those with functional iron deficiency (TSAT < 20% and ferritin ≥ 100 ng/mL).ConclusionsJapanese patients with chronic kidney disease G3b-5 with anaemia or absolute iron deficiency had worse health-related quality of life. Our results provide clinical evidence of renal anaemia in Japan and will be useful for international comparisons.

Generic vs. Disease-Specific Patient Reported Outcome (PRO) Instruments for Assessing HRQoL Burden Among Patients Diagnosed with Alopecia Areata: Evidence from TARGET-DERM AA

Introduction Alopecia areata (AA) is a chronic, autoimmune disease characterized by patchy hair loss. Compared to other disease areas, recent work has signaled a potential shortcoming, that generic quality of life (QOL) questionnaires are not sufficiently sensitive to the impact of AA disease severity. This cross-sectional analysis investigates the Short-Form 36, the dermatology life quality index (DLQI), and the Alopecia Areata Patient Priority Outcomes (AAPPO) for similar shortcomings. Methods Patients of all ages enrolled from December 2021 to June 2024 in TARGET-DERM AA (data collection on-going) in the United States and Canada were grouped by Severity of Alopecia Tool (SALT) score (1-20, 21-49, or 50-100). At enrollment, patients completed the AAPPO and DLQI questionnaire as well as the RAND MOS Short-Form 36. The SF-36 has 8 subdomain scores (vitality, physical function, bodily pain, general health, physical role function, emotional role function, social role function, mental health) along with the physical component summaries (PCS), mental component summaries (MCS), and the SF-6D utility index score. The Kruskal-Wallis test compared differences in mean scores across SALT subgroups defined by severity. Results Of the 141 AA patients, 61.7% were female; 95.0% adults, and 67.4% Non-Hispanic White. When comparing the SALT 1-20 and the &gt;50 subgroups, significant differences in SF-36 derived mean scores were only observed in the PCS and the physical function score (p&lt;0.05). None of the other scores (MCS, SF-6D, or other SF-36 subdomains) showed any differences. Mean DLQI scores were similar across subgroups (p&gt;.05) Notably, the hair loss and activity limitation domains of the AAPPO demonstrated significant differences between the patient subgroups (p&lt;.0001 and p&lt;.05, respectively) Discussion In this real-world cohort, generic QoL instruments, namely the SF-36 and DLQI, did not capture differences in the underlying health-related QoL burden of AA patients with different AA severity. Such differences were clear when HRQoL was measured for AA patients with mild hair loss AAPPO.

Impact of Enhanced Recovery After Surgery (ERAS) Protocols on Outcomes Up to Two Years After Adult Structural Spine Disorder Surgery

Study Design. Retrospective cohort study of prospectively enrolled database Objective. We analyze the recovery pattern of Adult Structural Spine Disorder (ASD) patients who underwent corrective surgery with Enhanced Recovery After Surgery protocol (ERAS+), including physical and psychological prehabilitation components, compared to non-ERAS protocol (ERAS-) up to 2-years after surgery. Summary of Background Data. Spine surgery for ASD is often highly invasive, which can contribute to prolonged recovery. The trajectory of recovery may be accelerated by the application of enhanced recovery principles. Methods. Inclusion criteria were operative patients with ASD&gt;18yrs with complete baseline, 90 days perioperative, and 2-year postoperative data. We assessed differences in baseline demographics, surgical details, baseline Health-Related Quality of Life (HRQL), and surgical outcomes between ERAS+ and ERAS- patients. Outcomes included adverse events, reoperations, and radiographic parameters such as sacral slope (SS), pelvic tilt (PT), pelvic incidence-lumbar lordosis (PI-LL) mismatch, sagittal vertical axis (SVA), lumbar lordosis (LL), T2–T12 kyphosis, and maximum Cobb angle. Additionally, HRQL measures included the PCS, ODI, NDI, EQ-5D, SRS-22r total and domain scores, NRS-Back, and NRS-Leg. We used multivariable logistic regression and ANCOVA to adjust for confounding. Results. 471 patients with ASD met inclusion criteria, with 59 designated ERAS+. Those individuals ERAS+ were older (64.1±13.0 vs. 58.0±16.0;P=0.005), had a higher CCI, (2.4±1.8 vs. 1.4±1.6;P&lt;0.001), and exhibited a higher modified ASD frailty index (8.2±5.4 vs. 6.3±4.9;P=0.019). Adjusted analysis demonstrated the ERAS+ cohort demonstrated lower likelihood of overall reoperations (OR:0.3; 95%CI:0.13-0.89), and a lower likelihood of overall adverse events (OR:0.4;CI95%:0.19-0.93). ERAS+ was more likely to achieve the MCID in the SRS-22r Total scores at 6 months(OR:3.1;CI95%:1.2-8.4), self-image domain at 6 months (OR:9.0;CI95%:1.6-50.0), in the pain domain at 6 months (OR:3.5;CI95%:1.01-11.9) and 1 year postoperatively (OR:2.6;CI95%:1.03-6.7), and in the SF-36’s physical component summary scores (PCS) at 1 year (OR:2.1;CI95%:1.05-4.2). No other statistically significant differences in HRQL were observed at the remaining time points (P&gt;0.05). Conclusion. Our work is the first to evaluate HRQL metrics and complication over two-years following ASD correction with ERAS. Despite presenting with more severe baseline frailty and higher comorbidity profiles, patients with ASD who underwent corrective surgery with an ERAS protocol experienced fewer short-term adverse events, and improved HRQL. We believe ERAS following ASD surgery leads to faster functional recovery, reduced postoperative deconditioning, and improved quality of life.

Comparing the effectiveness of five traditional Chinese exercises in improving balance function in older adults: a systematic review and Bayesian network meta-analysis.

Despite numerous studies affirming the potential of traditional Chinese exercises (TCEs) in enhancing balance in older adults, systematic integration is lacking. This study evaluated the effectiveness of five TCEs-Baduanjin, Liuzijue, Tai Chi, Wuqinxi, and Yijinjing-in improving balance among older adults using network meta-analysis. This meta-analysis was registered in PROSPERO with the registration number CRD42023481450. Related articles indexed by Web of Science, Cochrane, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases before October 2023 were searched. Randomized controlled trials (RCTs) involving TCEs interventions to improve balance function conducted in older adults who aged ≥60 years were included. Two researchers used Review Manager to assess the quality of the studies, and analyzed the data using Stata and R. In total, 46 RCTs and 3,333 older adults were included. The aforementioned TCEs had positive effects on improving balance in older adults. Tai Chi revealed significant intervention effects in performing the Single-Leg Stand with eyes Closed (SLSC), 6-Min Walk Test (6MWT), and Short Form 36-Item Physical Component Summary (SF-36PCS). Liuzijue significantly improved performance in the Timed Up and Go Test (TUGT), 6MWT, SF-36PCS, and Berg Balance Scale (BBS). Baduanjin, Wuqinxi, and Yijinjing showed noteworthy intervention effects on the BBS. Tai Chi ranked highest in the SLSC, 6MWT, and SF-36PCS in the surface under the cumulative ranking, while Liuzijue and Yijinjing ranked highest in the TUGT and BBS, respectively. Tai Chi, Liuzijue, and Yijinjing improved the static, dynamic, and overall balance outcomes, respectively. Older adults can make a reasonable choice among these TCEs based on their needs.

Abstract 4143239: Extracorporeal Shockwave Therapy Improves Physical Outcomes and Quality of Life In Patients With Symptomatic Peripheral Arterial Disease: Results from a Meta-analysis of Randomized Controlled Trials

Introduction: Extracorporeal shockwave therapy (ESWT) is a non-invasive procedure that may be useful to treat symptomatic peripheral arterial disease (PAD). Trials comparing ESWT with control groups have shown promising results. Methods: PubMed, Cochrane, EMBASE, and Google Scholar were searched for randomized controlled trials reporting the efficacy of extracorporeal shockwave therapy versus control in patients with symptomatic PAD. Data from eligible studies was analyzed using the Review Manager 5.4 software. Mean difference (MD) and 95% Confidence intervals (CI) were calculated for continuous outcomes. Inverse variance method and a random effects model were used for pooled estimates. A p-value &lt; 0.05 (Z-test) was considered significant. Results: 5 randomized controlled trials with 264 patients were included in our analysis. A significant increase in the mean walking distance (MD: 54.13, 95% CI 9.34 to 98.92, p=0.02), pain-free walking distance (MD: 54.13, 95% CI 14.19, 57.88, p= 0.001), SF-36 physical component summary (MD: 11.97, 95% CI 0.26 to 23.69, p=0.05), EQ-5D-3L index score (MD; 0.08, 95% CI: 0.00 to 0.15, p=0.05) and VascuQoL index ((MD: 0.48, 95% CI 0.03 to 0.92, p= 0.04) was seen with ESWT. A slightly higher ankle brachial pressure index was seen in the control group (MD: -0.01, 95% CI: -0.02 to -0.00, p=0.04). There was no difference in SF-36 physical functioning domain score (MD: 18.58, 95% CI: -0.29 to 37.45, p=0.05) and SF-36 bodily pain score (MD: 9.17, 95% CI: -2.885 to 21.19, p=0.13). Conclusions: There was significant improvement in walking distances, exertional symptoms, and quality of life with ESWT. However, ESWT did not translate to an increase in post-treatment ankle-brachial index which was slightly higher in the control group. There is a need for larger randomized controlled trials to substantiate the efficacy of ESWT in treating symptomatic PAD.