Limitations In Activities Of Daily Research Articles

Evaluating Biomechanical and Viscoelastic Properties of Masticatory Muscles in Temporomandibular Disorders: A Patient-Centric Approach Using MyotonPRO Measurements

The temporomandibular joint (TMJ) is essential for chewing and speaking functions, as well as for making facial expressions. However, this joint can be affected by disorders, known as temporomandibular disorders (TMDs), induced by complex causes that lead to limitations in daily activities. Building on the methodology and findings from our previous study on TMJ function, our research aims to apply the established criteria and norms to patients with TMDs. The primary goal is to evaluate the applicability and clinical relevance of these reference norms in predicting the severity and progression of TMJ disorders within a clinical population. Using non-invasive myotonic measurements, we evaluated 157 subjects, including both non-TMD-affected and TMD-affected individuals. To achieve optimal results, five primary parameters (frequency, stiffness, decrement, relaxation time, and creep) were analyzed using statistical–physical tools, providing quantitative functionality degrees across different previously examined clinical groups. The obtained results identified significant quantitative markers for early diagnosis and personalized treatment of TMJ disorders. This interdisciplinary approach leads to a deeper understanding of TMJ dysfunctions and makes a meaningful contribution to clinical practice, providing more precise tools for managing and treating this complex condition.

P0933 Symptoms improvement after VAAFT procedure in patients with perianal Crohn’s disease

Abstract Background Perianal fistulas may affect about 30% of patients with Crohn’s disease (CD). Management of perianal Crohn’s disease (pCD) is difficult due to the presence of complex and recurrent fistulae unlikely to heal spontaneously or after medical-surgical treatment. . Previous studies have shown how the use of Video-Assisted Anal Fistula Treatment (VAAFT) can lead to a benefit in terms of symptom control in patients with pCD. The aim of this study is to describe the outcome of VAAFT in terms of symptomatic improvement in patients affected by pCD. Methods A retrospective study was conducted in a single centre on CD patients with perianal fistulae undergoing VAAFT procedure from July 2021 to April 2024. According to the AGA classification, all perianal fistulae were "complex". The VAAFT procedures were performed with different technical aspect. Preoperatively and 8 weeks after the perianal surgery a questionnaire on symptoms was submitted to each patient. This questionnaire evaluated several items: pad usage per day and pain, discharge and daily activity limitation on a 0-6 point Likert scale. Results 25 patients underwent 37 VAAFT procedures. Ten patients had > 1 VAAFT. The median duration of pCD was 6 years. The majority of patients underwent previous anal fistula surgery and 13 patients were on biological therapy at the time the first VAAFT. 12 (48%) had multiple or secondary tracts; an additional 17 (68%) had an abscess and 3 (12%) horseshoe fistulae. Median values of pain score (5 vs 0, p<0.001), discharge score (5 vs 2, p<0.001), daily activity limitation score (4 vs 1, p<0.001) and pads usage per day (4 vs 1, p<0.001) significantly decrease after VAAFT procedure. Of these 25, 3 patients reach an improvement in symptoms after the second VAAFT procedure. No post-procedural complication were recorded. Conclusion VAAFT is a safe, repeatable and minimally invasive procedure that can provide a reduction of symptom burden in pCD patients, affecting their quality of life.

Access to context-specific lexical-semantic information during discourse tasks differentiates speakers with latent aphasia, mild cognitive impairment, and cognitively healthy adults

PurposeMild language impairments experienced by adults with neurogenic communication disorders are often difficult to detect due to the lack of sensitive traditional performance-based measures. This is problematic since many adults who have mild language deficits experience daily activity and participation limitations that are undetected and not managed. This study evaluates the potential for variables derived through core lexicon analysis to differentiate two clinical groups (latent aphasia, MCI) from each other, and from a cognitively healthy adult group, across three different discourse tasks (Aim 1). Innovatively, it also contrasts the sensitivity with which each task differentiates the groups based on this metric (Aim 2).MethodsTranscribed connected speech data from TalkBank were analyzed for three discourse tasks (i.e., Sandwich Procedure, Cat Rescue Picture Description, and Cinderella Story) from three participant groups [Mild Cognitive Impairment (MCI) n = 30, stroke-induced latent aphasia n = 29, and Cognitive Healthy Adults (CHA) n = 56]. Aim 1 used one-way ANOVAs (or non-parametric equivalents) to identify differences in lexical variables (total number of core lexical items; proportion of core lexical items out of all words produced; and rate of core lexical items produced per second) between participant groups. Aim 2 used linear discriminant analysis with cross validation to characterize the sensitivity of discourse task in identifying lexical variables differentiating the participant groups.ResultsUnivariate analysis revealed significant differences among the three participant groups. During the Cinderella task, the latent aphasia and MCI groups produced significantly fewer core lexical items than CHAs, while their proportion of core lexical items to total tokens was higher than CHAs. The latent aphasia group produced core lexical items more slowly than the MCI group for all three discourse tasks. Finally, individuals with latent aphasia produced significantly fewer core lexical items during the Sandwich task than either the MCI or CHA groups. Aim 2’s sensitivity analysis revealed that number of core lexical items produced during the Cinderella task best differentiated the MCI group from CHAs, number of core lexical items produced during Sandwich best differentiated latent aphasia from CHAs, and core lexical items per second during Cinderella best differentiated latent aphasia from MCI.ConclusionOur study suggests that the Cinderella story is more sensitive than a picture description task for demonstrating the subtle lexical-semantic changes in MCI and latent aphasia compared to CHAs. Core lexicon appears to be a sensitive discourse metric to identify linguistic differences between CHAs and individuals with mild cognitive and/or language deficits. These findings further support calls to provide speech/language and cognitive therapy to individuals with MCI and/or latent aphasia.

Physical and Sensory Long-Term Disabilities from Bothrops Snakebite Envenomings in Manaus, Western Brazilian Amazon.

Snakebites caused by Bothrops snakes are the most prevalent in the Amazon region, causing local and systemic complications. Local complications are mostly represented by necrosis, secondary bacterial infection and compartment syndrome. There are reports of long-term disabilities, but their burden is poorly investigated. This study aims to describe and estimate the frequency of physical and sensory long-term disabilities from Bothrops snakebites in the Manaus Region, in the western Brazilian Amazon region. Participants were >18-years individuals that accepted to return to the hospital 3-12 months (average follow-up time of 195 days) after the discharge for neuromusculoskeletal, chronic pain and sensory assessments. Assessment of disability was also performed using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Factors associated with summary disability using WHODAS 2.0 were identified. Fifty participants were enrolled. A frequency of 20% of the participants reported difficulty in moving the affected limb (20%), and 23.7% reported difficulty in walking. Limitations of daily activities were reported by 26% of the patients. Decreased strength of the affected limb was observed in 22% of the patients. Decreased range of joint motion was seen in 20% of the patients. Chronic pain was reported in 48% of the patients. Tactile sensibility was decreased in 30%, thermal sensibility in 14%, painful sensibility (hypoalgesia) in 12%, kinetic-postural sensibility (hypokinesthesia) in 4% and vibratory sensibility was decreased or abolished in 16% of the participants. Cognition and mobility domains were those with the highest frequencies of participants with any degree of disability, each with 57%. The summary WHODAS 2.0 disability rate was 59%. Age > 59 years (p = 0.02)] was associated with protection against disability. Difficulty in moving the limb (p = 0.05), pain at the affected limb (p < 0.01), limitations of daily activities (p < 0.01) and decreased thermal sensibility (p = 0.05) were significantly associated with disability. The present study consists of the first follow-up investigation involving Bothrops snakebite patients related to long-term disabilities. These findings represent important data on Bothrops snakebites causing clinically significant long-term neuromusculoskeletal and sensory disabilities, resulting in reduced quality of life of the patients.

Relationship between alcohol use and overactive bladder disease: a cross-sectional study of the NHANES 2005-2016.

Overactive bladder syndrome (OAB) is a prevalent urological condition which has a substantial impact on the life quality of affected individuals, resulting in restrictions in daily activities and work productivity. Alcohol is a diuretic, which means that it increases urine production and can potentially worsen urinary urgency and frequency. Several studies have investigated the association between alcohol consumption and OAB symptoms, but the results have been conflicting. This study aimed to investigate the relationship between alcohol consumption and OAB symptoms using a large, nationally representative sample. Data from the National Health and Nutrition Examination Survey 2005-2016 were obtained for analysis. The Overactive Bladder Symptom Scale (OBSS) was used to determine the presence of OAB in each participant. Multivariate logistic regression and ordinal logistic regression were used to analyze the association of alcohol use frequency and quantity with the onset and severity of OAB, respectively. A total of 7,805 samples (representing the 1,473,525,341 US population after weighting) were included in our analysis. Approximately 12.4% of this weighted sample self-reported having OAB. A greater proportion of nondrinkers, a higher proportion of females, higher blood pressure, older age, and lower income levels were observed in OAB patients compared to non-OAB patients. Univariate logistic regression revealed that the risk of OAB was significantly greater in the nondrinker group than in the 1-5 drinks/month (OR 0.64; 95% CI, 0.50-0.83), 5-10 drinks/month (OR 0.60; 95% CI, 0.43-0.82) and 10+ drinks/month groups (OR 0.41; 95% CI, 0.30-0.56) and the risk of OAB in the lowest quartile of alcohol consumption quantity was significantly higher than the second (OR 0.58; 95% CI, 0.47-0.70), third (OR 0.49; 95% CI, 0.39-0.62), and highest quartiles groups (OR 0.58; 95% CI, 0.45-0.75). The adjusted model revealed that only patients in the 10+ drinks/month group had a significantly lower risk of OAB than did those in the nondrinker group (OR = 0.64; 95% CI = 0.45-0.92), while the other two groups had similar risks. Furthermore, no significant association was found for the highest quartiles in the adjusted model; however, the second and third quartiles of alcohol consumption quantity group still exhibited obvious associations. These findings suggest that higher alcohol consumption, when appropriate, is associated with a lower risk of OAB compared to nondrinkers and the lowest quartile of alcohol consumption quantity group, even after adjusting for age, sex, race, and comorbidities. In conclusion, our findings revealed a significant association between alcohol consumption and the incidence of OAB in the study population. In terms of long-term effects, alcohol may not be a risk factor for OAB. These factors may represent intervention targets for lowering the risk and severity of OAB symptoms, but this needs to be confirmed in large clinical trials.

Association Between Running Characteristics and Lower Extremity Musculoskeletal Injuries in United States Military Academy Cadets.

Running-related overuse injuries are common among recreational runners; however, there is currently little prospective research investigating the role of running characteristics on overuse injury development. To investigate the relationship between running characteristics and lower extremity musculoskeletal injury (MSKI). Cohort study; Level of evidence, 2. The study included 827 incoming cadets of the class of 2020 at the United States Military Academy. Before cadet basic training, running spatiotemporal parameters (stride length, ground contact time, and cadence) were recorded for each participant, and foot-strike pattern was analyzed. Demographic data were recorded and analyzed as potential covariates. Lower extremity MSKIs sustained over the 9 weeks of cadet basic training were documented. Kaplan-Meier survival curves were estimated, with time to incident lower extremity MSKI as the primary outcome, by level of the independent predictor variables. Risk factors or potential covariates were carried forward into multivariate Cox proportional hazards regression models. Approximately 18.1% of participants incurred a lower extremity MSKI resulting in ≥3 days of activity limitation during cadet basic training. Univariate analysis indicated that participants with the shortest stride length (<133.0 cm) were 39% more likely to incur any lower extremity MSKI and 45% more likely to incur an overuse MSKI than those with the longest stride length (>158.5 cm), and that participants with the longest ground contact time (>0.42 seconds) were twice as likely to incur any MSKI than those with the shortest contact time (<0.28 seconds). After adjusting for sex, weekly distance running 3 months before cadet basic training, and history of injury, multivariate regression analysis indicated that participants with the longest contact times were significantly more likely to incur overuse lower extremity MSKI than those with the shortest contact times (hazard ratio, 2.15; 95% CI, 1.06-4.37). There was no significant difference in risk of MSKI associated with foot-strike pattern or cadence. Study participants running with the longest ground contact times were 2.15 times more likely to incur an overuse lower extremity MSKI during cadet basic training than those with the shortest contact times. Also, study participants with the shortest stride length were 45% more likely to incur an overuse MSKI than those with the longest stride length.

Revised definition of obesity in Asian Indians living in India.

The prevailing guidelines for obesity in Asian Indians, published in 2009, relied solely on body mass index (BMI) criteria. Recognizing the limitations of BMI in accurately diagnosing obesity and the emergence of new research revealing the association between generalized and abdominal adiposity in Asian Indians and early-onset co-morbid diseases, a comprehensive redefinition was needed. In a Delphi process focused on obesity in India, experts were invited via email to participate in five rounds. The survey questions were administered through Google Form to gather insights from the selected experts. In Stage 1 Obesity, individuals exhibit increased adiposity (BMI>23kg/m2) without discernible effects on organ functions or daily activities. Stage 2 Obesity denotes a more advanced state characterized by heightened adiposity (generalized and abdominal), impacting both physical and organ functions, resulting in functional limitations during day-to-day activities, and contributing to co-morbid diseases. The criteria for Stage 2 Obesity include a mandatory BMI exceeding 23kg/m2 and at least one of the following: excess waist circumference or waist-to-height ratio. Additionally, the presence of one or more symptoms indicative of limitations in daily activities or one or more obesity-related comorbid conditions/diseases are needed to support the stage 2 obesity. This refined framework seeks to enhance precision in identifying obesity and its associated health risks among Asian Indians living in India, and facilitation of rational management, and aligns with worldwide initiative of new definition of obesity.

Vision impairment and associated daily activity limitation: A systematic review and meta-analysis.

Vision impairment is a common disability that poses significant challenges to individuals' ability to perform activities essential for independent living, including activities of daily living (ADL) and instrumental activities of daily living (IADL). Despite extensive research, the extent and nature of these associations remain unclear, particularly across varying levels and types of vision impairment. This meta-analysis aims to estimate associations between vision impairment and difficulties with ADL and IADL. We conducted a systematic review of relevant literature from the inception of the databases to February 2024, using electronic database searches, including PubMed, MEDLINE (Ovid), EMBASE, Cochrane CENTRAL, and CDSR. The articles were screened for title and abstract and then for the full-text reports by two independent reviewers and study quality was appraised. Meta-analyses were performed using random effects models to calculate the pooled effect size, expressed as odds ratio (OR) with corresponding 95% confidence interval (CI) of each outcome. Forty-six studies involving 210,960 participants were included. A positive large correlation between vision impairment and difficulties with ADL (Correlation coefficient [r] = 0.55, 95% CI 0.37-0.68, p = 0.001) and IADL (r = 0.60, 95% CI 0.49-0.69, p = 0.001) was shown. We also found that vision impairment was associated with difficulties in ADL (OR = 1.77, 95% CI 1.56-2.01, p < 0.0001) and IADL (OR = 1.96, 95% CI 1.68-2.30, p < 0.0001). Subgroup analysis revealed that moderate to severe impairment resulted in difficulties in ADL (OR = 1.78, 95% CI 1.43-2.21, p = 0.02) and IADL (OR = 1.86, 95% CI 1.57-2.20, p = 0.0003). Further, there was a significant association between mild to moderate vision impairment and difficulties in IADL (OR = 1.38, 95% CI 1.23-1.55, p < 0.0001). Greater impact was observed in individuals with near vision impairment compared to those with distance vision impairment. Near vision impairment was significantly associated with higher difficulties in ADL (OR = 1.77, 95% CI 1.57-2.01, p < 0.0001) and IADL (OR = 1.79, 95% CI 1.32-2.42, p < 0.0001). In contrast, distance vision impairment showed lower but still significant associations with IADL (OR = 1.19, 95% CI 1.05-1.34, p = 0.005) and a nonsignificant association with ADL (OR = 1.12, 95% CI 0.90-1.40, p = 0.30). Meta-regression analysis indicated that for every one-year increase in age, ADL performance decreased by an average of 0.0147 units (p < 0.001), while IADL performance declined at a slower rate of 0.0047 units/year (p = 0.031). The present systematic review and meta-analysis using several statistical methods indicates that vision impairment including near vision impairment, is associated with difficulties in ADL and IADL. Thus, vision impairment remains an urgent and increasingly important public health priority. These findings highlight the need for targeted measures to raise public health awareness to provide rehabilitation and eye care examination strategies to reduce the risk of developing disabilities in adults and the elderly who have vision impairment.

Screening tests for migraine applied to the population of the Bauru campus of the University of São Paulo: a prevalence study

Introduction: Migraine is a prevalent neurological disorder marked by recurrent and severe headaches that significantly impacts individuals' quality of life. Objective: This study aims to apply migraine screening tools to the population of the Bauru campus of the University of São Paulo (USP) to estimate the prevalence of migraine and assess the impact of pain on daily life. Methods: A cross-sectional study involved 216 participants, comprising students, faculty, and staff, who completed online questionnaires, including the “ID Migraine,” “International Headache Society Migraine Diagnosis,” and “Migraine Screen Questionnaire.” The impact of migraine on daily activities was assessed using the “Headache Impact Test. The data were analyzed using the Shapiro-Wilk test, Student's t-test, Mann-Whitney test, and Pearson's correlation, adopting a 5% significance level. Results: Out of 216 respondents, 69 (31.94%) were diagnosed with migraine using the ID Migraine tool. The International Headache Society questionnaire identified 86 participants (39.81%) as having migraine, while the Migraine Screen Questionnaire indicated 94 participants (43.52%). A combined analysis identified 20.83% of participants (n=45) as having migraine across all questionnaires. A total of 113 participants (52.31%) tested positive for migraine in at least one questionnaire. Results also revealed a strong correlation between positive migraine diagnosis and significant limitations in daily activities, as assessed by the Headache Impact Test (p&lt;0.001). Conclusion: Using multiple migraine screening questionnaires enhances sensitivity and specificity in identifying individuals with migraine. The findings reveal a substantial population at the USP campus likely affected by migraines, emphasizing the need for further research and intervention strategies.

Medication Adherence and Health related Quality of life among Patients with Chronic Obstructive Pulmonary Disease in Pokhara

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable chronic disease. Patients have to consume medicine for longer duration which usually leads to non adherent to medicine in long term due to various socio-economic factors such as financial status, economical status of patients. This study focuses on nature of medicine adherence among COPD patients, factors affecting medicine adherence of the patients and influence of medicine adherence on Health related Quality Of Life.Methods: A descriptive analysis study was done among known case of COPD cases after obtaining approval from ethical review board of NHRC. A written consent was obtained from all the participants. Morrisky Medication adherence scale was used to access medication adherence among patient where as st. George ’s Respiratory Questionnaire for COPD was used to evaluate Health related Quality of life of the patients. Results: Among 350 cases analyzed, majority (n= 217; 63%) of the cases were poorly adherence to medicine. There was significant association between rural residence of patients, poor financial status, low education status, longer disease duration, lack of financial support, nuclear family type and poor adherent to medicine (p&lt; 0.05). There was also significant association between poor medicine adherent and poor Health related Quality of Life. (P &lt; 0.05).Conclusion: These patients experienced a severe impact on their symptoms, considerable limitations in daily activities, a higher burden of disease, and an overall reduction in their quality of life.

From joint to heart: Cardiovascular implications of rheumatoid arthritis

Rheumatoid arthritis is a commonly encountered autoimmune disease and a progressive chronic inflammatory condition that often leads to permanent joint damage. Systemic inflammation in rheumatoid arthritis is linked to various comorbid conditions such as interstitial lung disease, osteoporosis, metabolic syndrome, cardiovascular disease, infections, malignancies, cognitive dysfunction, depression, and fatigue, which can increase morbidity and mortality in rheumatoid arthritis patients. Approximately 36% of patients report worse health and limitations in daily activities, while nearly 30% require more assistance with personal care compared to individuals without rheumatoid arthritis. Epidemiological data from 1990 to 2017 show an incidence of rheumatoid arthritis of 246.6 per 100,000 people aged 33-54 years, with prevalence in women 2-3 times higher. In Southeast Asia, the incidence is 89 per 100,000 in individuals aged 13-22 years, while in Indonesia, it is estimated at around 5-7.5 per 100,000 population. Cardiovascular disease is the primary cause of mortality in rheumatoid arthritis patients, with myocardial infarction being the major contributor. The pathogenesis of rheumatoid arthritis is still complex and involves immunological processes that occur long before joint inflammation symptoms appear, including genetic modifications and environmental factors that lead to deimination and joint disturbances. Cardiovascular manifestations, particularly myocardial infarction, occur due to an atherosclerotic process triggered by rheumatoid antibody complexes. Given the higher cardiovascular risk in rheumatoid arthritis patients, early detection and awareness of these manifestations are crucial for better management.

Long-Term Determinants of Depression Mood: A 19-Year Follow Up of 2344 Middle-Aged and Older Adults.

Objectives: This study explores depression changes and influencing factors in middle-aged and older individuals, focusing on different cognitive function states. Methods: This cohort study uses panel data from seven waves of the nationally representative Taiwan Longitudinal Study on Aging (1996-2015) with 2344 participants aged 50 or above. Data analysis was conducted from 25 January 2023 to 4 May 2023. Results: Multivariate logistic regression analyzed three trajectories: maintained mood, progressive depression, and consistent depression. Protective factors for progressive depression included self-health perception, exercise, family satisfaction, and financial well being, while risk factors were chronic diseases, pain, substance use, and daily activity limitations. Cognitive function emerged as a significant protective factor, while pain exhibited the highest risk. In the cognitive dysfunction group, only social participation showed notable differences. Conclusion: Progressive and consistent depression in middle-aged and older people have aroused concern. In addition to necessary protection and risk factors, special attention should be paid to the risks posed by the level of pain. Addressing pain as a crucial risk factor is essential, particularly for middle-aged and older people with cognitive impairment and depression, necessitating targeted support.

The current situation and associated factors of preoperative frailty in elderly patients undergoing abdominal surgery

BackgroundThis study aimed to investigate the current preoperative frailty status of elderly patients undergoing abdominal surgery and identify its associated factors. The objective of this study was to provide clinicians with valuable insights for implementing frailty intervention strategies.MethodsA cross-sectional study was conducted with 375 elderly patients who underwent abdominal surgery at a tertiary hospital in Chengdu, Sichuan Province, between October 2021 and August 2022. The data were collected using various instruments, including a general information questionnaire, the FRAIL frailty assessment scale, the West China Mood Index, the Nutritional Risk Screening 2002, and the Barthel Index. Multivariate logistic regression analysis was conducted to investigate the factors influencing preoperative frailty in this patient population.ResultsAmong the 375 elderly patients who underwent abdominal surgery, 59 were identified as having preoperative frailty, resulting in a preoperative frailty rate of 15.7%. Multivariate analysis revealed that multiple chronic diseases, malnutrition risk, and limited ability to perform daily life activities were significant associated factors for preoperative frailty in these patients (P < 0.05).ConclusionClinical medical staff should prioritize the preoperative frailty assessment of elderly patients undergoing abdominal surgery, particularly those with multiple chronic diseases, malnutrition risk, and limited daily life activities.

Factors affecting pain experience after lower third molar germectomy in teenagers-a clinical study.

This study aimed to investigate the correlation between subjective pain threshold (SPT), daily pain recovery (PR) during the first postoperative week, and patient/surgical characteristics, while evaluating changes in SPT across multiple surgeries. Additionally, it assessed how perceived quality of life correlates with SPT and PR in adolescents undergoing lower third molar germectomy. A prospective clinical study was conducted at the Paediatric Surgery Unit, Sapienza University of Rome, involving 51 patients aged 10-16years undergoing lower third molar germectomy. SPT and daily PR were measured using the Visual Analogue Scale (VAS) during the first postoperative week, and quality of life was evaluated using the SF-12 questionnaire at 1-week follow-up. A total of 87 germectomies were performed, with 36 patients undergoing a second surgery. The mean age was 13.86 ± 1.81years. Mean VAS scores increased from 4.2 ± 1.5 for Intervention 1 to 4.8 ± 1.6 for Intervention 2. Longer operative times were associated with higher PR scores on postoperative day 3. Higher PR scores correlated with greater limitations in daily activities and emotional well-being, while lower PR scores were linked to better self-perceived health. SPT and PR are influenced by surgical duration and self-health perception. Shorter procedures and positive self-health perception contribute to faster recovery and improved postoperative quality of life in young patients.

Occupational Therapy Interventions and Their Impact on Work Performance and Activities of Daily Living in Persons with Multiple Sclerosis

Background. Multiple sclerosis (MS) is a chronic neurological disease that affects the central nervous system, leading to various physical, cognitive, and emotional challenges that significantly impact daily activities and work performance. Occupational therapy (OT) plays an important role in managing MS by providing interventions designed to improve functional performance, promote independence, and enhance overall well-being. Aim. To evaluate the impact of OT interventions on work performance and activities of daily living in individuals with MS. Methods. A total of 776 participants diagnosed with MS were included in this study. Data were collected through structured questions extracted from the MS Quality of Life-54 questionnaire. The study assessed the relationships between the type of MS, work performance, daily activities, and the effectiveness of OT interventions. Statistical analyses included Chi-Square tests, correlation analysis, calculations of standard deviation and variance, Box Plots, and ANOVA tests. Results. The study found that 65% of participants reported reduced working hours, 78% performed fewer activities than desired, and 66% experienced limitations in work tasks or daily activities due to MS. Emotional problems also impacted work performance and daily activities. The ANOVA test revealed significant differences in reduced working hours, fewer activities, and the impact of emotional problems among different types of MS. Specifically, the relapsing-remitting type of MS showed the highest impact on work performance and daily activities. Conclusions. OT plays a crucial role in addressing the functional and emotional challenges associated with MS. The interventions are particularly beneficial in improving work performance and daily activities, especially for individuals with the relapsing-remitting type of MS. Individualized OT strategies should be tailored to address the specific needs of individuals with different types of MS. Keywords: occupational therapy; multiple sclerosis; daily activities; work performance.

A case of apraxia of eyelid opening associated with benign essential blepharospasm in Bhutan

Apraxia of eyelid opening (AEO) is a non-paralytic motor abnormality characterized by difficulty in eyelid opening bilaterally. This is due to the inability of voluntary opening of the eyes in the absence of visible contraction of the orbicularis oculi despite sustained willful frontalis contraction. We present you a case of a 60-year-old woman with AEO associated with benign essential blepharospasm who suffered marked limitation in daily activities due to functional blindness. She was treated with botulinum toxin type A injections following which she had adequate eyelid opening in both eyes during 1 week follow up. It is essential for physicians and patients to be aware of this condition for proper diagnosis and treatment.

Living with Pyoderma Gangrenosum: A Qualitative Study.

Pyoderma gangrenosum is a rare, autoinflammatory disorder characterized by rapidly progressive painful ulcers that are challenging to diagnose and treat. This qualitative study aimed to explore the experiences of patients living with pyoderma gangrenosum. Using an inductive qualitative approach, semi-structured interviews were completed with a purposive sample of 21 patients with pyoderma gangrenosum recruited from a public dermatology outpatient clinic in Melbourne, Australia. A reflexive thematic analysis was performed, yielding 5 themes: pain, physical challenges, social functioning and relationships, mental health, and treatment. The impact of pyoderma gangrenosum on quality of life was multifaceted and varied throughout disease progression, remission, and recurrence. Experiences of delayed diagnosis and misdiagnosis were common, causing distress and resulting in unnecessary treatments including surgery. Severe pain disrupted sleep and limited daily activities, eroding patients' sense of self-control and perpetuating depressed mood and anxiety. Management should include early specialist referral, providing information sheets for managing pain and wound care, and communicating disease expectations. In conclusion, this study has deepened understanding and given personal perspectives on what it is like to live with a condition poorly understood by many health professionals. Increased efforts should be made to increase clinician awareness regarding pyoderma gangrenosum to facilitate early diagnosis.

Impact of lateral ankle sprains on physical function, range of motion, isometric strength and balance in professional soccer players

ObjectiveLateral ankle sprains (LASs) are prevalent in soccer and can affect long-term performance, injury recurrence and risk for chronic ankle instability. This case–control study examined functional impairments associated with LAS...

A Heat Sensitivity Scale for People with Parkinson's Disease.

People living with Parkinson's disease (PD) commonly experience heat sensitivity-worsening symptoms and restricted daily activities in heat. This study aimed to develop a scale of heat sensitivity for people with PD. Through a search of the scientific literature and online forums, we developed 41 items relating to experiences of heat for people with PD to assess heat sensitivity. A panel of experts was then consulted to review the scale items critically. After two rounds of review, the scale was refined to 36 items with an overall scale content validity index of 0.89. Via an online survey, 247 people with PD responded to the items. The items were examined with exploratory factor analysis to determine the underlying factors therein. After several iterations, a simple structure was achieved with 29 items loading uniquely onto one of four factors: daily activities, sweating and exercise, heat-related illness, and symptoms and medications. The model had acceptable to excellent fit statistics (root mean square error of approximation = 0.073 [90% confidence interval 0.067-0.081], root mean square of the residuals = 0.03, comparative fit index = 0.93, and Tucker-Lewis index = 0.91), and each factor showed high reliability (Cronbach's α ≥0.89). Factor and total scale scores were significantly higher among those reporting sensitivity to heat and poor health status. This new heat sensitivity scale for people living with PD can enable health professionals and clients to assess the severity and impact of heat sensitivity.

COMPLEX PHYSICAL THERAPY OF PATIENTS WITH ADHESIVE CAPSULITIS

Adhesive capsulitis is predominantly an idiopathic condition and is more common in patients with metabolic disorders. PS contracture can be of varying degrees of severity, depending on the pathology of the PS with which we are dealing. This condition greatly aff ects work capacity and quality of life due to the presence of pain, discomfort and limitation of daily life activities. Prolonged pain syndrome can provoke sleep disorders and depression. Disruption of normal sleep, pain and depression form a pathological closed circle and contribute to the maintenance of the pathological process in the locus morbi.The development of a comprehensive program of physical therapy for patients with adhesive capsulitis with the use of modern means of recovery, which will reduce the risk of the disease re-emerging, and will also contribute to the faster recovery of the functional capacity of the musculoskeletal system of the patients.The objective of the study. The develop and practically substantiate a comprehensive program of therapy for patients with adhesive capsulitis using physical therapy.Materials and Research Methods. The study is based on a comprehensive therapeutic approach for 36 patients diagnosed with adhesive capsulitis in the acute phase of the condition. The assessed parameters included X-ray and computed tomography results, evaluation of range of motion in the shoulder joint, joint- muscle apparatus, and analysis of pain intensity indicators.Conclusions. To improve the condition of patients and optimize the process of treatment and rehabilitation of patients with adhesive capsulitis of the shoulder joint in the acute period, it is advisable to use with the diff erentiation of means of therapeutic intervention according to the diagnosis of the international classifi cation of functioning, optimization of physiotherapeutic means and special means of physical therapy allowed to shorten the terms of treatment and recovery of patients with adhesive capsulitis. It was determined that the best combination of means of therapeutic intervention for patients with adhesive capsulitis is the use of a complex of ideomotor exercises to create the patient’s idea of correct movement; correct positioning of the limb during sleep, everyday and professional activity; passive exercises to increase the volume of painless movements (bending, external rotation); restorationof the pattern of typical motor actions and optimization of physiotherapeutic means due to the use of shock wave and TENS therapy signifi cantly improved the eff ectiveness of their recovery in the short-term and long-term stages of the acute period of rehabilitation.