Physical Function In Patients Research Articles

Working mode of oncology surgical pharmacy in China

Surgery plays an irreplaceable role in the prevention, diagnosis, staging, reconstruction, and rehabilitation in the overall management of cancer. Nevertheless, it is difficult for surgeons and nurses to take into account the details of medication management, considering the impact of surgery on the patient's physical function and the complexity of anti-tumor treatment with comorbidity. The pharmaceutical care services previously provided by pharmacists in oncology focus more on the internal medicine system, not widely the surgical field. At present, the pharmaceutical working mode in oncology surgery has not well been formed around China, and the whole process medication management needs to be improved. In 2015, the GuangDong Pharmaceutical Association came up with the concept of surgical pharmacist in China and subsequently created its position. In 2021, the GuangDong Pharmaceutical Association established a new discipline termed “surgical pharmacy”, which is the knowledge system of surgical pharmacists, and also tried to differentiate surgical pharmacy into diverse areas, such as oncology surgical pharmacy. This article introduced a working mode of surgical pharmacists in China that providing pharmaceutical care services in perioperative period around anti-tumor, anti-infection, anesthesia, anticoagulation, blood pressure, blood glucose, nutrition, and pain management, to improve quality of life for patients.

SIOG2023-1-OA-100 - Effect of geriatric intervention on physical function in patients operated for colorectal cancer

SIOG2023-1-OA-100 - Effect of geriatric intervention on physical function in patients operated for colorectal cancer

Single-facility study of the effectiveness of rehabilitation therapy using wearable hybrid assistive limb for patients with bleeding disorders: study protocol for a randomised controlled trial

IntroductionHaemophilic arthropathy, a serious complication of haemophilia, results from recurrent joint bleeding, causing progressive joint damage and severely impacting patient quality of life. Rehabilitation therapy (RT) effectively addresses declining physical...

Equipercentile equating of scores from common patient-reported outcome measures of physical function in patients with cancer

ObjectiveTo provide equipercentile equating of physical function (PF) scores from frequently used patient-reported outcome measures (PROMs) in cancer patients to facilitate data pooling and comparisons. Study Design and SettingAdult cancer patients from five European countries completed the European Organization for Research and Treatment of Cancer (EORTC) computer adaptive test (CAT) Core, EORTC Quality of Life Questionnaire Version 3.0 (QLQ-C30), Functional Assessment of Cancer Therapy - General (FACT-G), 36-item Short Form Health Survey (SF-36), and the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function 20a short form. The R package “equate” was used to establish conversion tables of PF scores on those measures with a bivariate rank correlation of at least 0.75. ResultsIn total, 953 patients with cancer (mean age 58.9 years, 54.7% men) participated. Bivariate rank correlations between PF scores from the EORTC CAT Core, EORTC QLQ-C30, SF-36, and PROMIS were all above 0.85, but below 0.69 for the FACT-G. Conversion tables were established for all measures but the FACT-G. These tables indicate which score from one PROM best matches the score from another PROM and provide standard errors of converted scores. ConclusionOur analysis indicates that linking of PF scores from both EORTC measures (CAT and QLQ-C30) with PROMIS and SF-36 is possible, whereas the physical domain of the FACT-G seems to be different. The established conversion tables may be used for comparing results or pooling data from clinical studies using different PROMs.

Impact of walk advice alone or in combination with supervised or home-based structured exercise on patient-reported physical function and generic and disease-specific health related quality of life in patients with intermittent claudication, a secondary analysis in a randomized clinical trial

BackgroundSupervised exercise is an integral part of the recommended first-line treatment for patients with intermittent claudication (IC). By reflecting the patients’ perspectives, patient-reported outcome measurements provide additional knowledge to the biomedical endpoints and are important outcomes to include when evaluating exercise interventions in patients with IC. We aimed to evaluate the one-year impact of three strategies: unsupervised Nordic pole walk advice (WA), WA + six months of home-based structured exercise (HSEP) or WA + six months of hospital-based supervised exercise (SEP) on health-related quality of life and patient-reported physical function in patients with IC.MethodsThis secondary exploratory analysis of a multi-center, randomized clinical trial compared three exercise strategies. The primary outcome of the secondary analysis was the one-year change in the 36-Item Short-Form (SF-36). Secondary outcomes were three- and six-months SF-36 changes alongside three, six- and 12-months changes in the disease-specific Vascular Quality of Life instrument (VascuQoL) and the Patient-Specific Functional Scale (PSFS). The Kruskal–Wallis test with Bonferroni-adjusted post-hoc tests were used for between-group comparisons. Effect size calculations were used to describe the size of observed treatment effects, and the clinical meaningfulness of observed changes in the VascuQoL summary score at one year was studied using established minimally important difference (MID) thresholds.ResultsA total of 166 patients with IC, mean age: 72.1 (SD 7.4) years, 41% women, were randomized. No significant between-group differences were observed over time for the SF-36 or the PSFS scores whereas some significant between-group differences were observed in the VascuQoL domain and summary scores over time, favoring SEP and/or HSEP over WA. The observed SF-36 and VascuQoL domain and summary score effect sizes were small to moderate, and many domain score effect sizes also remained unchanged over time. A significantly higher proportion of the patients in the SEP group reached the VascuQoL summary score MID of improvement in one year.ConclusionClinically important improvements were observed in SEP using the VascuQoL, while we did not observe any significant between-group differences using the SF-36. Whereas effect sizes for the observed changes over time were generally small, a significantly higher proportion of patients in SEP reached the VascuQoL MID of improvement.Trial registrationNCT02341716, January 19, 2015 (retrospectively registered).

The prevalence and characteristics of diffuse idiopathic skeletal hyperostosis in the community-living middle-aged and elderly population: The Yakumo study

BackgroundThe incidence of diffuse idiopathic skeletal hyperostosis (DISH) is increasing with the aging of the population. Asymptomatic DISH can decrease the spinal range of motion (ROM) and cause fractures. However, the prevalence or physical function of patients with DISH before experiencing fractures and other serious conditions is unclear. This study aimed to investigate the prevalence of DISH in the community residents on the basis of age and sex and characterize their physical function, ROM, and bone fragility. MethodsThe subjects were community volunteers who attended a health checkup in 2018 and 2019. Overall, 455 subjects (mean age, 64.2 ± 9.7 years; 177 men) were included for analysis. We performed whole-spine lateral radiography for detecting DISH according to the criteria reported by Resnick. We compared the age, sex, body mass index (BMI), results of muscle strength and walking tests, ROM measured by SpinalMouse®, and quantitative ultrasound (QUS) of calcaneus with and without DISH. ResultsDISH was detected in 83 (18.2%) cases. The DISH group was older (69.8 y.o. vs. 63.0 y.o.; p < 0.05) and comprised more men (prevalence: men, 27.7%; women, 12.2%; p < 0.001). BMI was high in the DISH group (24.8 vs. 23.3 kg/m2, p < 0.05). SpinalMouse measurements showed the DISH group had a significantly decreased ROM in the lumbar spine (43.2°, 57.2°, p < 0.05). The DISH group had a significantly lower T-score on the QUS measurement in the calcaneus (−2.0, −1.5, p < 0.05). There were, however, no significant differences between groups in both muscle strength test and walking test. ConclusionSubjects with DISH had decreased ROM in the lumbar spine and bone mineral density in calcaneal QUS. However, physical functions such as muscle strength and walking ability were similar among subjects with and without DISH without subjective symptoms.

PROMIS Scores for Chronic Plantar Fasciitis Before and After Gastrocnemius Recession

Category: Ankle; Hindfoot Introduction/Purpose: There has been an established relationship between increased loading on the Achilles tendon and tension on the plantar fascia. This supports the idea that either tight gastrocnemius and soleus muscles or contractures of the Achilles tendon are risk factors for plantar fasciitis. Gastrocnemius recession has gained popularity as a viable surgical intervention for cases of chronic plantar fasciitis due to isolated gastrocnemius contracture. To our knowledge, this is the first study to investigate PROMIS scores in patients with plantar fasciitis before and after gastrocnemius recession. Methods: The Electronic Medical Record was queried for medical record numbers associated with Current Procedural Terminology code 27687 (gastrocnemius recession). Our study included all patients with a preoperative diagnosis of chronic plantar fasciitis with treatment via isolated gastrocnemius recession with one-year minimum follow-up. 40 patients were included in our study. Patient variables were collected via chart review. Preoperative and postoperative PROMIS scores were collected in the clinic. Results: Preoperative and postoperative PROMIS scores improved for physical function and pain interference from 39.27 and 62.78 to 44.54 and 56.5 (p=0.0005, p=0.0001) respectively, PROIMS Depression scores were not significantly different (p=0.6727). VAS scores significantly decreased from 7.05 to 1.71 (p &lt; 0.0001). Patients with preoperative peripheral neuropathy had significantly lower improvement in PROMIS physical function scores (p=0.0029). Tobacco use led to significantly lower improvement in in PROMIS depression (p=0.0202). Conclusion: Gastrocnemius recession is an effective option for patients with refractory pain in plantar fasciitis. Our PROMIS and VAS data confirm this procedure's utility and highlight its ability to significantly decrease pain and improve physical function in patients with chronic plantar fasciitis. We believe we have added to the literature by incorporating the, inherently superior, PROMIS scores. Based on the results of this study, the authors recommend gastrocnemius recession for patients who fail conservative management for plantar fasciitis.

A Comprehensive Exercise (COMEX) Intervention to Optimize Exercise Participation for Improving Patient-Centered Outcomes and Physical Functioning in Patients Receiving Hemodialysis: Development and Pilot Testing

To address the need for an intradialytic exercise program that is easily delivered in clinical setting, engaging and scalable, we developed a novel COMprehensive EXercise (COMEX) program based on input from patients receiving hemodialysis (HD), dialysis staff members and nephrologists. The objective of this study was to determine the feasibility, safety, and acceptance of COMEX during HD. Single-arm prospective pilot feasibility study. Seventeen patients receiving in-center HD. Three-month participation in the COMEX program, which included video-based dialysis chair exercises (aerobic and resistance) integrated with educational and motivational components. Data on recruitment, adherence, safety and acceptability were collected. Additional assessments were performed to evaluate changes in physical functioning, patient-reported symptoms, and objectively measured sleep and physical activity. We also examined the feasibility of obtaining skeletal muscle biopsies and blood samples to explore molecular mechanisms of muscle atrophy and to assess platelet mitochondrial function and adaptation to exercise during HD. Thirteen of the 17 (76%) participants completed the 3-month intervention. The mean participant age was 63.6±15.1 years. In total, 46% of participants were males, and 55% were White. The mean body mass index was 38.7±11.6kg/m2. There were no reported adverse effects, and the adherence rate to exercise sessions was high with 88% of the sessions completed. Patient satisfaction was high, as 100% of the patients would recommend the program to other dialysis patients. It was feasible to collect data on physical functioning, patient-reported symptoms, and objective sleep and physical activity and to obtain muscle biopsies and blood samples. Small sample size, lack of an onsite exercise professional, and technological issues with telemedicine behavioral motivation. The COMEX intradialytic exercise intervention is safe and acceptable to patients, and outcome measures were feasible to obtain. Future studies should consider including exercise professionals to facilitate progression through a personalized exercise protocol. This work is supported by pilot award from P30 DK079307 (PI, Jhamb). ClinicalTrials.gov, NCT03055299. We tested a new COMprehensive EXercise (COMEX) program to deliver exercise during dialysis. This 3-month program included video-based dialysis chair exercises (aerobic and resistance) integrated with educational and motivational components. Our study shows COMEX was feasible, had high satisfaction and adherence, and was safe. It was feasible to collect data on physical functioning, patient-reported symptoms, and objective sleep and physical activity and to obtain muscle biopsies and blood samples. Future studies should consider including exercise professionals to facilitate progression through a personalized exercise protocol.

Effectiveness of exercise on pain intensity and physical function in patients with knee and hip osteoarthritis: an umbrella and mapping review with meta-meta-analysis

Purpose The aim of this review was to provide a qualitative and quantitative overview of the effects of exercise on pain, physical function, and quality of life for patients with knee and hip osteoarthritis. Materials and methods This study was an umbrella and mapping review with meta-meta-analysis. Meta-analyses of randomized controlled trials were included. The methodological quality and risk of bias were evaluated using the Modified Quality Assessment Scale for Systematic Reviews and the Risk of Bias in Systematic Reviews tool. The quality of evidence was evaluated using the Physical Activity Guidelines Advisory Committee Grading Criteria. Results 41 meta-analyses were included, 43.9% of the studies had adequate methodological quality, and 56.1% of the studies had a low risk of bias. Moderate evidence was found that exercise decreases pain intensity (33 meta-analyses; SMD = −0.49; 95% CI −0.56 to −0.42), improves function (19 meta-analyses; SMD = −0.50; 95% CI −0.58 to −0.41), strength (6 meta-analyses; SMD = −0.57; 95% CI −0.70 to −0.44) and quality of life (SMD = −0.36; 95% CI −0.46 to −0.27) for patients with hip and knee osteoarthritis. Conclusion Exercise is an effective intervention to decrease pain intensity and improve function in patients with hip and knee osteoarthritis. (PROSPERO, CRD42020221987)

The effects of end-range interventions in the management of primary adhesive capsulitis of the shoulder: a systematic review and meta-analysis

Purpose To compare the effects of end-range manual therapy versus other conservative intervention on pain intensity, shoulder range of movement (ROM), and physical function in adhesive capsulitis (AC). Methods Two reviewers conducted a comprehensive search from inception to December 2022. PUBMED, Cochrane Library, CINAHL, EMBASE, and PEDro databases were searched. Clinical trials investigating the effects of end-range mobilisation techniques on pain, ROM, and physical function in patients with AC were included. Methodological quality was evaluated using the PEDro scale, and bias risk was assessed using the Cochrane Collaboration tool. GRADE was used to assess the certainty of the evidence. Data were presented using forest plots, and the random effects models were applied according to the Cochrane handbook. Results Ten randomised controlled trials were reviewed, involving 424 AC patients aged 20–70 years. Methodological quality of studies ranged from high to low. The end-range mobilisation showed improvements in pain intensity, shoulder abduction, internal rotation, and external rotation, and physical function compared to other conservative interventions in the short-and medium-terms. Certainty of the evidence was downgraded to very low. Conclusions Very low certainty evidence suggests that end-range mobilisation techniques improve pain intensity, shoulder ROM, and physical function in the short-and medium-term in AC.

Minimal Clinically Important Differences of Patient-Reported Outcomes Measurement Information System Physical Function in Patients With Tibial Shaft Fracture.

To calculate the minimal clinically important differences (MCIDs) of patient-reported outcomes measurement information system physical function (PROMIS PF) scores for patients with operatively treated tibial shaft fractures. Retrospective Cohort Study. A Level 1 trauma center. All operatively treated tibial shaft fractures identified by Current Procedural Terminology codes. Enrolled patients treated acutely with operative fixation of their tibia. MCIDs were calculated by distribution-based and anchor-based methods, calculated from PROMIS PF scores completed at least at two-time points postoperatively. MCIDs were calculated at different time points including overall, 7-12 weeks, 3-6 months, and 6-24 months. MCIDs were calculated for different subgroups including open fractures, closed fractures, any complications, and no complications. MCID for PROMIS PF scores was 5.7 in the distribution-based method and 7.84 (SD 18.65) in the anchor-based method. At 6-24 postoperatively, the months the distribution-based MCID was 5.95 from a postoperative baseline 27.83 (8.74) to 42.85 (9.61), P < 0.001. At 6-24 months, the anchor-based MCID was 10.62 with a score difference between the improvement group of 16.03 (10.73) and the no improvement group of 5.41 (15.75), P < 0.001. Patients with open fractures (distribution-based 6.22 and anchor-based 8.05) and any complications (distribution-based 5.71 and anchor-based 9.29) had similar or higher MCIDs depending on the methodology used than the overall cohort MCIDs. This study identified distribution-based MCID of 5.7 and anchor-based MCID of 7.84 calculated from PROMIS PF scores in operative tibial shaft fractures. Distribution-based methods yielded smaller MCIDs than anchor-based methods. These MCID scores provide a standard to compare clinical and investigational outcomes.

Impact of Vutrisiran on Quality of Life and Physical Function in Patients with Hereditary Transthyretin-Mediated Amyloidosis with Polyneuropathy.

Hereditary transthyretin (ATTRv; v for variant) amyloidosis, also known as hATTR amyloidosis, is a progressive and fatal disease associated with rapid deterioration of physical function and patients' quality of life (QOL). Vutrisiran, a subcutaneously administered RNA interference (RNAi) therapeutic that reduces hepatic production of transthyretin, was assessed in patients with ATTRv amyloidosis with polyneuropathy in the pivotal HELIOS-A study. The phase 3 open-label HELIOS-A study investigated the efficacy and safety of vutrisiran in patients with ATTRv amyloidosis with polyneuropathy, compared with an external placebo group from the APOLLO study of the RNAi therapeutic patisiran. Measures of QOL and physical function were assessed. At month 18, vutrisiran improved Norfolk Quality of Life-Diabetic Neuropathy (Norfolk QOL-DN) total score (least squares mean difference [LSMD] in change from baseline [CFB]: -21.0; p=1.84×10-10) and Norfolk QOL-DN domain scores, compared with external placebo. This benefit relative to external placebo was evident across all baseline polyneuropathy disability (PND) scores and most pronounced in patients with baseline PND scores I-II. Compared with external placebo, vutrisiran also demonstrated benefit in EuroQoL-Visual Analog Scale (EQ-VAS) score (LSMD in CFB: 13.7; nominal p=2.21×10-7), 10-m walk test (LSMD in CFB: 0.239m/s; p=1.21×10-7), Rasch-built Overall Disability Score (LSMD in CFB: 8.4; p=3.54×10-15), and modified body mass index (mBMI) (LSMD in CFB: 140.7; p=4.16×10-15) at month 18. Overall, Norfolk QOL-DN, EQ-VAS, and mBMI improved from pretreatment baseline with vutrisiran, whereas all measures worsened from baseline in the external placebo group. At month 18, Karnofsky Performance Status was stable/improved from baseline in 58.2/13.1% with vutrisiran versus 34.7/8.1% with external placebo. Vutrisiran treatment provided significant clinical benefits in multiple measures of QOL and physical function in patients with ATTRv amyloidosis with polyneuropathy. Benefits were most pronounced in patients with earlier-stage disease, highlighting the importance of early diagnosis and treatment. ClinicalTrials.gov: NCT03759379.

Body Composition, Physical Function and Exercise Capacity in Chronic Obstructive Pulmonary Disease

Current literature yields unequivocal results regarding the effect of body composition on physical function in patients with chronic obstructive pulmonary disease and disproportionately includes a majority of males. The purpose of this study was to determine whether specific body composition measures are significantly associated with physical function and exercise capacity in patients with chronic obstructive pulmonary disease with equal representation of males and females. Independent variables included sex, total body mass, total body lean and fat mass, appendicular total mass, and appendicular lean and fat mass. Dependent variables included peak oxygen consumption, 6-minute walk distance and self-reported physical function. Patients (n = 170) with dual-energy X-ray absorptiometry data, 6-minute walk distance, and self-reported physical function were used for these analyses. A sub-set of 145 of these patients with peak oxygen consumption data were also analysed. Hierarchical multiple regression analysis was used to determine if sex and body composition measures correlated with physical function and exercise capacity and if they explained additional variance after controlling for disease severity. After controlling for disease severity, appendicular lean mass, total body fat mass, and sex explained an additional 16.5% of the variance in peak oxygen consumption (p < 0.001). Appendicular lean mass explained an additional 8.9% of the variance in 6-minute walk distance (p < 0.001) and an additional 2.5% of the variance in self-reported physical function (p = 0.057). Body composition measures may further predict exercise capacity, 6-minute walk distance, and self-reported physical function in patients with chronic obstructive pulmonary disease.

Predictive Value of Malnutrition, Identified via Different Nutritional Screening or Assessment Tools, for Functional Outcomes in Patients with Stroke: A Systematic Review and Meta-Analysis.

Malnutrition affects more than half of patients with stroke. Although malnutrition leads to more deaths, a longer hospital stay, and higher costs, there is still a lack of consensus regarding the impact of malnutrition on physical functional outcomes in patients with stroke, and there are large differences in the diagnostic effects of nutritional screening or assessment tools for malnutrition. This study aimed to explore the impact of malnutrition in patients with stroke and assess the significance of current nutritional screening and assessment tools for these patients. Six databases were systematically searched until October 2022. Cohort studies meeting the eligibility criteria were included. Pooled effects were calculated using random-effects models. Twenty-six studies with 21,115 participants were included. The pooled effects of malnutrition on poor functional outcome, FIM points, and dysphagia were OR = 2.72 (95% CI = 1.84-4.06), WMD = -19.42(95% CI = -32.87--5.96), and OR = 2.80 (95% CI = 1.67-4.67), respectively. Malnutrition adversely affects the recovery of physical and swallowing functions in patients with stroke. Nutritional assessments consistently predict the outcomes of physical function in patients with stroke.

The Impact of Self-acupressure on the Pain, Joint Stiffness, and Physical Functioning of Patients With Knee Osteoarthritis

Background: People with knee osteoarthritis have a low quality of life due to joint pain and stiffness, severely limiting their daily activities. This study aims to investigate the impact of self-acupressure on the pain, joint stiffness, and physical functioning of patients with knee osteoarthritis. Methods: This randomized clinical trial was conducted on 78 patients aged 50 to 70 with knee osteoarthritis, referred to Imam Khomeini Hospital and private orthopedic clinics in Ahvaz City, Iran, in 2018. The patients were recruited based on the inclusion criteria and then randomly assigned to three groups: self-acupressure (n=26), sham (n=26), and control (n=26). Patients in the intervention group applied daily self-acupressure to 5 specific points around their knees for 8 consecutive weeks. The sham group applied pressure on the points different from those used by the intervention group. The control group received no intervention. The study data were collected using the Western Ontario and McMaster osteoarthritis index (WOMAC), visual analog scale (VAS), and a checklist for daily recordings of pain medication. The obtained data were analyzed using the chi-square test and analysis of variance in SPSS software, version 20. The significance level was set at P&lt;0.05. Results: The comparison of changes within the group showed that the intensity of pain in the intervention group decreased over time (P&lt;0.0001). Also, the joint stiffness, physical functioning, and total WOMAC score significantly decreased in the intervention group (P&lt;0.0001). The frequency of analgesic use was also reduced in the intervention group over time (P=0.026). Conclusion: According to the results, self-acupressure effectively reduces the intensity of pain and joint stiffness and improves the physical performance of older adults with knee osteoarthritis. Overall, this easy and affordable intervention is recommended for this group.

OR03-03-23 Nutrition Risk and Physical Function of Patients With Acute Myeloid Leukemia or Myelodysplastic Syndrome Before Allogeneic Hematopoietic Cell Transplantation

OR03-03-23 Nutrition Risk and Physical Function of Patients With Acute Myeloid Leukemia or Myelodysplastic Syndrome Before Allogeneic Hematopoietic Cell Transplantation

EFFECT OF AYURVEDIC TREATMENT ON PHYSICAL AND RADIOLOGICAL PARAMETERS IN KNEE OSTEOARTHRITIS: A CASE REPORT

Osteoarthritis (OA) is a degenerative joint disease that affects millions of people worldwide, and conventional treatment options have limitations and side effects. Ayurveda, an ancient system of medicine originating in India, offers a holistic approach to health and wellness and has been used to treat various ailments, including OA. This case study evaluated the effect of Ayurvedic treatment in a single patient with bilateral knee OA. The patient underwent Ayurvedic treatment, which included internal herbal remedies and external therapies, for four months. The patient reported a significant reduction in pain and stiffness in both knees, and the radiographic findings showed a reduction in joint space narrowing and osteophyte formation. These findings suggest that Ayurvedic treatment may be effective in reducing pain and improving physical function in patients with OA. Further research with larger sample sizes and longer follow-up periods is needed to confirm these findings. Ayurveda may provide a safe and cost-effective adjunct therapy for OA patients seeking alternative treatments.

Knee pain and its influence on quality of life and physical function in Jazan adult population: A cross sectional study

BackgroundKnee pain is primarily caused by knee osteoarthritis (OA). As a result, the quality of life and physical function of patients are affected. This study aimed to evaluate prevalence of knee pain and its influence on quality of life and physical function in the adult population of Jazan region of Saudi Arabia. MethodsA cross-sectional study among 480 above 40 years adults who had knee pain and diagnosed with knee OA was conducted. A questionnaire containing the Arabic validated versions of the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) and the health-related quality of life (FS-12) was used. Data analysis included descriptive statistics, correlation and regression analysis. ResultsIKDC mean score was 40.05 with SD 9.75. Pain was present in 77.8%; 12.4% indicated continuous pain and 6.5% indicated worst pain intensity. Physical function was normal in 14%, 48% could perform light activities without pain, and 11% are unable to perform any activity. Results show a statistically significant relationship between pain intensity and sex, age, and BMI and, between age and knee function. Regression analysis showed significant association with sex and age. Pain is four times more common in females. Mean HRQoL score was 39.46 with subscale: MCS (39.41) and PCS (39.50) scores. ConclusionsLow IKDC scores were reported among the adult population with OA. The majority suffered from pain in different degrees and intensities. Physical function was also impaired and the quality of life is affected. Better pain management is recommended for OA patients.

Physical Functioning in Patients with a Recent Fracture: The “Can Do, Do Do” Framework Applied to Explore Physical Capacity, Physical Activity and Fall Risk Factors

Physical capacity (PC) and physical activity (PA) are associated physical performance measures, and combined, PC and PA are used to categorize physical performance in the “can do, do do” framework. We aimed to explore physical performance of patients attending the fracture liaison service (FLS). In this cross-sectional study, PC was measured by 6-min-walking-test (can’t do/can do) and PA by accelerometer (don’t do/do do). Following quadrants were defined based on predefined cut-off scores for poor performance: (1) “can’t do, don’t do”; (2) “can do, don’t do”; (3) “can’t do, do do”; (4) “can do, do do”. Odds ratios (OR) were calculated and fall and fracture risk factors were assessed between quadrants. Physical performance of 400 fracture patients was assessed (mean age 64; female 70.8%). Patients performed as follows: 8.3% “can’t do, don’t do”; 3.0% “can do, don’t do”; 19.3% “can’t do, do do”; 69.5% “can do, do do”. For the “can’t do” group the OR for low PA was 9.76 (95% CI: 4.82–19.80). Both the “can’t do, don’t do” and “can’t do, do do” group differed significantly compared to the “can do, do do” group on several fall and fracture risk factors and had lower physical performance. The “can do, do do” framework is able to identify fracture patients with an impaired physical performance. Of all FLS patients 20% “can’t do, but “do do” while having a high prevalence of fall risk factors compared to persons that “can do, do do”, which may indicate this group is prone to fall.

Investigating the Effects of Retro Walking on Pain, Physical Function, and Flexibility in Chronic Non-specific Low Back Pain

Objectives: Chronic non-specific low back pain (CNSLBP) is described as pain whose pathoanatomical cause cannot be determined. The current study aims to evaluate the impact of retro-walking on pain, flexibility, and physical functions in patients with CNSLBP. Methods: A randomized controlled trial was conducted in the Physical Therapy Department of District Head Quarter Hospital Nankana Sahib, Punjab, Pakistan from September 2021 to March 2022. The trial was conducted on 36 patients, randomly divided into 2 groups of 18 patients. Conventional treatment and retro-walking were given to the experimental group and the conventional treatment alone was provided to the control group for 1 month with 3 sessions per week. The outcome variables were pain, the flexibility of hamstrings and lumbar region, and physical function assessed by numeric pain rating scale, sit and reach test, modified Schober test, and modified Oswestry disability index, respectively. The data were assessed at pre-treatment after the sixth and twelfth sessions. Results: This study showed a significant difference in the numeric pain rating scale, sit-and-reach test, and modified Oswestry disability index with a P&lt;0.05 in both groups after intervention. However, in the group comparison, these variables showed better results in the retro-walking group compared to others with a P&lt;0.001 after both the sixth and twelfth sessions. Discussion: The current study suggested that when added up to conventional treatment, retro-walking was more beneficial in reducing pain and enhancing the flexibility and physical function in patients with CNSLBP when compared to conventional treatment alone; therefore, it should be added to the treatment protocol for chronic non-specific pain in the lower back.