Self-reported Activity Limitations Research Articles

Contraception use among female youth with disabilities: Secondary analysis of a Canadian cross-sectional survey

BackgroundNon-use of contraception among sexually active youth is an important contributor to unintended pregnancy, but contraception use among disabled youth is poorly understood. ObjectiveTo compare contraception use in female youth with and without disabilities. MethodsWe used data from the 2013–2014 Canadian Community Health Survey on sexually active 15 to 24-year-old females with (n = 831) and without (n = 2,700) a self-reported functional or activity limitation, who reported that it was important to them to avoid getting pregnant. We used log binomial regression to derive adjusted prevalence ratios (aPR) for use of any vs. no contraception, and for oral contraception, injectable contraception, condoms, other contraception methods, and dual methods separately, comparing youth with and without disabilities. Adjusted analyses controlled for age, school enrollment, household income, marital status, race/ethnicity, immigrant status, and health region. ResultsThere were no differences in the use of any contraception (85.4% vs. 84.2%; aPR 1.03, 95% CI 0.998–1.06), oral contraception (aPR 0.98, 95% CI 0.92–1.05), condoms (aPR 1.00, 95% CI 0.92–1.09), or dual methods (aPR 1.02, 95% CI 0.91–1.15), comparing youth with and without disabilities. Those with disabilities were more likely to use injectable contraception (aPR 2.31, 95% CI 1.59–3.38) and other contraception methods (aPR 1.54, 95% CI 1.25–1.90). ConclusionYouth at risk of unintended pregnancy had similar overall use of contraception, regardless of disability status. Future studies should examine the reasons for higher uptake of injectable contraception in youth with disabilities, with possible implications for health care provider education on access to youth-controlled methods for this group.

Biopsychosocial factors associated with chronic low back pain-related activity limitations in Burundi.

BackgroundChronic low back pain (CLBP) is an increasing burden worldwide. The biopsychosocial factors associated with CLBP-related activity limitations have not yet been investigated in Burundi.ObjectiveThe aim of our study was to investigate the biopsychosocial factors that influence the CLBP-related activity limitations in a Burundian sample population.MethodWe carried out a cross-sectional study of 58 adults with nonspecific CLBP from Bujumbura city. Univariate and bivariate analyses were used to investigate the association between biopsychosocial factors and CLBP activity limitations. Sequential multiple regression analyses were subsequently used to predict CLBP activity limitations.ResultsFifty-eight individuals with a mean age of 41.3 ± 10.20, 58.6% of female gender, were recruited. The univariate and bivariate analyses demonstrated that educational level, gender, healthcare coverage, profession, height, pain intensity, depression and physical fitness were significantly associated with CLBP-related activity limitations (p range, < 0.001 to < 0.05). The multivariate regression analysis showed that the significant biopsychosocial factors accounted for 49% of the variance in self-reported activity limitations. Predictors of activity limitations were education level (β = −0.369; p = 0.001), abdominal muscle endurance (β = −0.339; p = 0.002) and depression (β = 0.289; p = 0.011).ConclusionsOur study provides evidence of biopsychosocial factor associations with CLBP-related activity limitations in Burundi. Evidence-based management and prevention of CLBP in Burundi should incorporate a biopsychosocial model.Clinical implicationsBiopsychosocial factors should be regularly evaluated in people with chronic low back pain and efforts to improve the burden of chronic low back pain in Burundi should take these factors into account.

An exploratory study on the application of screening of activity limitation and safety awareness (SALSA) scale for evaluation of activity limitation among elderly.

Aging poses a significant risk for activity and functional limitations. Problems among aged populations are interrelated, and these problems can lead to other disorders and finally leave a negative impact on the quality of life (QoL) This study used the screening of activity limitation and safety awareness (SALSA) scale to screen and measure activity limitations among the elderly. A community-based descriptive cross-sectional study was conducted among 928 elderly from the three districts of Tamil Nadu, India. The SALSA scale was administered via a door-to-door interview, and data analysis was carried out. Simple random sampling was used to obtain the study subjects in the selected study area. Chi-square tests and binary logistic regression were performed to find the association between selected risk factors. Among the 928 elderly, 53.7% of them were males, 84.9% were between the age of 60 and 69 years, and 31% were 70 years and above. The study found that 66.5% of the elderly have mild activity limitations, 15.7% of them had moderate limitations, 4.8% of them had severe limitations, around 3% of them had extreme limitations, and 10.3% of them had no significant limitations. The binary logistic regression found people of age 65 and above (OR = 3.80), female gender (OR = 2.90), with hypertension (OR = 1.95), vision problem (OR = 1.92), decreased sensation of the foot (OR = 3.41), as the significant independent risk factors for activity limitation among the elderly. The study found self-reported activity limitations among the elderly to be nearly 90%. The SALSA scale may be used as a handy tool to identify the activity limitation in community-based geriatric checkups.

Cancer-Related Activity Limitations Among Head and Neck Cancer Survivors.

To characterize self-reported cancer-related activity limitations among a broad population of head and neck (HNC) survivors and identify sociodemographic factors associated with these limitations. Cross-sectional analysis of data from the National Health Interview Survey. The study population included individuals who completed the National Health Interview Survey (NHIS) from 1997 to 2018 and self-reported a cancer diagnosis. Data regarding activity limitations, cancer history, mental health, and demographics were extracted from the NHIS. Poisson regression was used to evaluate associations between demographics and cancer-related limitations, and a descriptive analysis was performed to identify the most common types of cancer-related limitations experienced by HNC survivors. Individuals with HNC were more than twice as likely to report having a disability caused by cancer when compared to individuals with other cancers (24% vs. 11%, P < .001). Cancer-related disability was highest among HNC survivors who were Black (adjusted prevalence ratio (aPR)=1.57, 95% CI=1.13-2.18), were aged 50 to 64 (aPR=1.74, 95% CI=1.1-2.74), had high school or lower education (aPR=2.40, 95% CI=1.07-5.37), and had Medicaid insurance (aPR=2.58, 95% CI=1.62-4.10). Among HNC patients who reported a cancer-related limitation, the most common limitations included difficulty working (78%), going out (51%), and socializing (42%). Cancer-related activity limitations are more common among HNC survivors compared to survivors of other cancers, and disproportionately affect socioeconomically disadvantaged HNC survivors. Clinicians should be aware of the limitations experienced by HNC survivors to provide counseling and resources to help patients cope with these limitations. 3 Laryngoscope, 132:593-599, 2022.

Psychometric Validation of the World Health Organization Disability Assessment Schedule in a Sample of Community Dwelling Adults With Chronic Health Conditions and Disabilities

Chronic health conditions and disabilities interfere with major life activities, and these interferences are the result of complex interactions between health condition factors, psychological factors, personal factors, and socioenvironmental factors. The World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) framework is a biopsychosocial model that conceptualizes the experience of disability with attention to these interactions. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is an assessment tool developed to measure self-reported activity limitations and restrictions to participation experienced by individuals with disabilities independent of his or her medical diagnosis. In order to allow practitioners to effectively use this tool with individuals with various chronic illnesses and disabilities, the current study aimed to evaluate the measurement structure and psychometric properties of the WHODAS 2.0. A total of 945 adults with disabilities participated in the current study. Results support two-factor structure of this measurement tool with adequate reliability and construct validity. The WHODAS 2.0 is a valid, useful tool for rehabilitation counseling professionals to more effectively support adults with chronic health conditions and disabilities in achieving their psychosocial and employment success.

The Impact of Self-Efficacy on Activity Limitations in Patients With Hip Osteoarthritis: Results From a Cross-Sectional Study.

ObjectivePain and activity limitations are the main health complaints in osteoarthritis. We explored pathways between pain and activity limitations in a chain mediation model that involved self‐efficacy, physical activity behavior, and muscle function in patients with hip osteoarthritis not awaiting hip replacement.MethodsWe used cross‐sectional, baseline data from a randomized controlled trial on 152 patients with clinical hip osteoarthritis according to the American College of Rheumatology not awaiting hip replacement. The associations between pain, self‐efficacy, self‐reported physical activity, muscle function (leg extensor power), and activity limitations (performance‐based and self‐reported activity limitation outcomes) were modeled using structural equation models.ResultsThe effect of pain on performance‐based activity limitation was fully mediated by self‐efficacy, physical activity, and muscle function. Of the total effect of self‐efficacy on performance‐based activity limitation, the direct effect accounted for 63% (95% CI: 45%‐82%), whereas the indirect effect via physical activity constituted 16% (95% CI: 1%‐30%) and the indirect effect via muscle function constituted 21% (95% CI: 9%‐32%). In contrast, physical activity and muscle function had no effect on self‐reported activity limitations, whereas pain had a direct effect and an indirect effect mediated by self‐efficacy.ConclusionOur results suggest that self‐efficacy should be taken into consideration in prevention and treatment of activity limitations in patients with hip osteoarthritis not awaiting hip replacement. Coupling exercise with programs of self‐efficacy enhancement could potentially increase the positive effects of exercise.

Health Literacy and Decisional Preferences in Hand Surgery

Patients increasingly prefer to be involved in health decisions. Shared decisions are associated with less decisional conflict and improved satisfaction. This study examines the relationship between health literacy and preferred decision-making role in patients seeking care for hand problems. We performed a cross-sectional study of 226 patients who were presenting to a hand service for the first time, who were older than 18 years, not pregnant, and fluent and literate in English. Patient demographic information, work status, and education level were collected from the patient. Diagnosis and insurance status were collected from the medical record. Pain interference, depression, and upper extremity function were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires administered with computerized adaptive testing. Health literacy and preferred decision-making role were assessed using the Newest Vital Sign Test and Control Preference Scale, respectively. Discordance between preferred and actual decision-making role was assessed using the Control Preference Scale statements with the words "I prefer" omitted. Bivariate and multivariable logistic regressions were used to assess for factors associated with preferred decision-making role and discordance. Seventy-eight percent of patients preferred an active or collaborative, rather than a passive, role in decision making. Sixty-one percent felt they had achieved their preferred role. Preferred role and achievement of that role were not associated with health literacy, age, race, insurance, work status, diagnosis, pain intensity, symptoms of depression, and magnitude of self-reported activity limitations. More years of education was associated with a more active preferred decision-making role but not with obtaining that preferred role. Most people want to participate in decisions about their care even if they have low health literacy. Hand specialists can seek strategies to help people understand and participate in care decisions.

Sleep disturbances and disability following work-related injury and illness: Examining longitudinal relationships across three follow-up waves.

Despite the high burden of sleep disturbances among the general population, there is limited information on prevalence and impact of poor sleep among injured workers. This study: (a) estimated the prevalence of sleep disturbance following work-related injury; and (b) examined the longitudinal association between sleep disturbances and disability/functioning, accounting for reciprocal relationships and mental illness. Longitudinal survey data were collected from workers' compensation claimants with a time-loss claim in Victoria, Australia (N=700). Surveys were conducted at baseline, 6 months and 12 months. Sleep disturbance was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire. Disability/functioning was based on self-reported activity limitations, participation restrictions and emotional functioning. Path models examined the association between disability/functioning and sleep. Mean sleep disturbance T-scores were 55.2 (SD 11.4) at 6 months, with 36.4% of the sample having a T-score of 60+. Longitudinal relationships were observed between disability (specifically, emotional functioning) and sleep disturbances across successive follow-up waves. For example, each unit increase in T2 emotional functioning (five-point scale) was associated with a 1.1 unit increase in T3 sleep disturbance (approximately 29-76 scale). Cross-lagged path models found evidence of a reciprocal relationship between disability and sleep, although adjustment for mental illness attenuated the estimates to the null. In conclusion, sleep disturbances are common among workers' compensation claimants with work injuries/illnesses. Given the links between some dimensions of disability, mental health and sleep disturbances, the findings have implications for the development of interventions that target the high prevalence of sleep problems among working populations.

Economic and humanistic burden associated with noncommunicable diseases among adults with depression and anxiety in the United States

Aims: This study estimated the economic and humanistic burden associated with chronic non-communicable diseases (NCCDs) among adults with comorbid major depressive and/or any anxiety disorders (MDD and/or AAD).Materials and methods: A retrospective analysis was conducted using the Medical Expenditure Panel Survey data (2010–2015). The analytic cohort included adults (≥18 years) with MDD only (C1), AAD only (C2), or both (C3). The presence of either of 6 NCCDs (cardiovascular diseases [CVD], pulmonary disorders [PD], pain, high cholesterol, diabetes, and obesity) were assessed. Study outcomes included healthcare costs, activity limitations, and quality of life. Multivariate regressions were conducted in each of the 3 cohorts to evaluate the association between the presence of NCCDs and outcomes.Results: The analytic sample included 9,160,465 patients: C1 (4,391,738), C2 (3,648,436), C3 (1,120,292). Pain (59%) was the most common condition, followed by CVD (55%), high cholesterol (50%), obesity (42%), PD (17%), and diabetes (14%). Mean annual healthcare costs were the greatest for C3 ($14,317), followed by C1 ($10,490) and C2 ($7,906). For C1, CVD was associated with the highest increment in annual costs ($3,966) followed by pain ($3,617). For C2, diabetes was associated with the highest incremental annual costs ($4,281) followed by PD ($2,997). For C3, cost trends were similar to those seen in C2. NCCDs resulted in a significant decrease in physical quality of life across all cohorts. Pain was associated with a significantly higher likelihood of self-reported physical, social, cognitive, and activity limitations compared to those without pain.Conclusions: 60% of patients with MDD and/or AAD had at least one additional NCCD, which significantly increased the economic and humanistic burden. These findings are important for payers and clinicians in making treatment decisions. These results underscore the need for development of multi-pronged interventions which aim to improve quality of life and reduce activity limitations among patients with mental health disorders and NCCDs.

Racial/Ethnic Disparities in Physical Function Before and After Total Knee Arthroplasty Among Women in the United States

Although racial/ethnic differences in functional outcomes after total knee arthroplasty (TKA) exist, whether such differences are associated with differences in presurgical physical function (PF) has not been thoroughly investigated. To examine trajectories of PF by race/ethnicity before and after TKA among older women. This cohort study was conducted among the prospective Women's Health Initiative with linked Medicare claims data. A total of 10 325 community-dwelling women throughout the United States with Medicare fee-for-service underwent primary TKA between October 1, 1993, and December 31, 2014, and were followed up through March 31, 2017. Race/ethnicity comparisons between Hispanic or Latina women, non-Hispanic black or African American women, and non-Hispanic white women (hereafter referred to as Hispanic, black, and white women, respectively). Physical functioning scale scores and self-reported activity limitations with walking 1 block, walking several blocks, and climbing 1 flight of stairs were measured by the RAND 36-Item Health Survey during the decade before and after TKA, with a median of 9 PF measurements collected per participant over time. In total, 9528 white women (mean [SD] age at surgery, 74.6 [5.5] years), 622 black women (mean [SD] age at surgery, 73.1 [5.3] years), and 175 Hispanic women (mean [SD] age at surgery, 73.1 [5.2] years) underwent TKA. During the decade prior to TKA, black women had lower PF scores than white women (mean difference, -5.8 [95% CI, -8.0 to -3.6]) and higher odds of experiencing difficulty walking a single block (5 years before TKA: odds ratio, 1.86 [95% CI, 1.57-2.21]), walking multiple blocks (odds ratio, 2.14 [95% CI, 1.83-2.50]), and climbing 1 flight of stairs (odds ratio, 1.81 [95% CI, 1.55-2.12]). After TKA, black women continued to have lower PF scores throughout the decade (mean difference 1 year after TKA, -7.8 [95% CI, -10.8 to -4.9]). After adjusting for preoperative PF scores, PF scores after TKA were attenuated (mean difference 1 year after TKA, -3.0 [95% CI, -5.3 to -0.7]), with no statistically significant differences in long-term follow-up. Hispanic women had similar PF scores to white women during the pre-TKA and post-TKA periods. This study suggests that black women had significantly poorer PF than white women during the decades before and after TKA. Poorer PF after surgery was associated with poorer preoperative PF. Reducing disparities in post-TKA functional outcomes should target maintenance of function preoperatively in the early stages of arthritic disease and/or reduction of delays to receiving TKA once need arises.

Disability and self-reported adverse drug events among patients with chronic diseases

Very few studies have examined the association between self-reported adverse drug events (ADEs) and the presence of disability in patients with chronic diseases. The purpose of this study was to investigate the relationship between disability and self-reported ADEs in a population with chronic diseases in the community setting in Korea. Data were obtained from the Korean Health Panel from 2014 to 2016, from which 5382 adults aged ≥ 30 years who received any drug to treat a chronic disease were selected. The dependent variable was defined as a self-reported ADE related to a chronic-disease drug. Disability was measured by self-reported vision problems, hearing problems, cognitive impairment, chewing problems, and activity limitation. The data were analyzed using panel logistic regression. In 2016, 5.07% of participants self-reported an ADE related to a chronic-disease drug. The likelihood of a patient self-reporting an ADE depended on various sociodemographic factors, health status including disabilities, and polypharmacy. Specific risk factors for ADEs included age, vision problems, chewing problems, activity limitations, and polypharmacy. Subgroup analyses showed that the risk factors of hypertension, diabetes, and hyperlipidemia had slightly different effects on self-reporting of ADEs. Disabilities, such as vision problems, chewing problems, and activity limitation, were significantly related to self-reported ADEs in chronic-disease patients in the community setting.

Gender Differences in Disability and Economic Hardship in Older Europeans.

European women live longer, but they experience more old age-related disability than men. Disability is related to social factors, among which is poverty, through various pathways. While women's poverty has been pointed up as a challenge for Europe, our study investigates to what extent and in which countries a greater exposure to economic hardship is associated with older women's disability disadvantage. We used the 2014 EU-SILC data in 30 European countries for men and women aged 50-79years (N = [1179-17,474]). Disability was measured by self-reported activity limitation and economic hardship by difficulties in "making both ends meet" and "facing unexpected expenses". Country-specific nested logistic regressions measured the women's disability disadvantage and its association with economic hardship. We found that activity limitations and economic hardship varied substantially across Europe, being the lowest in Sweden and Norway. We found gender gaps in activity limitations in 23 countries, always to women's disadvantage. After adjusting for age, this disadvantage was significant in 19 countries. In 11 of these countries, women's excess disability is associated with excess economic hardship in women, especially in Iceland, France, Sweden, and Austria. Women's excess disability and social factors such as economic hardship are linked, even in protective countries. These situations of double disadvantage for women deserve attention when designing policies to reduce health inequalities and to promote healthy ageing.

Prevalence of self-reported disability, activity limitation and social participation in Sri Lanka

Introduction The World Health Organization estimates that 15% of the global population has a disability. Available evidence from Sri Lanka shows variable estimates of the magnitude of disability. Objectives Determine the prevalence of self-reported disability in the adult population aged ≥18 years, and associated risk factors in a nationally representative sample in Sri Lanka. Methods The Washington Group short questionnaire was used to identify persons with self-reported disability. Data were collected from responsible adults aged ≥18 years in the selected households. A four point-scale: “no difficulty”, “some difficulty”, “a lot of difficulty” and “cannot do at all” was used. Individuals screening positive for disability were administered an additional questionnaire on activity limitations, social participation and their health and financial concerns. Results Overall 41.5% (4131) [95% CI: 40.5-42.4] reported functional difficulty in at least one domain. The prevalence of disability, i.e. a lot of difficulty or cannot do at all was 3.8% (382) [95% CI: 3.5 – 4.2], while the prevalence of “some functional difficulty” was 37.6% (3749) [95% CI: 36.7-38.6]. The prevalence of disability increased with age and was higher among females, urban residents, and those with lower education and socio-economic status. Minor degrees of functional difficulties were more common among older people, females and people with lower education. Conclusions The prevalence of disability and varying degrees of functional difficulty is high among the adult population of Sri Lanka. Evidence shows that a strategic plan is required to address the magnitude of disability and functional limitations in Sri Lanka.

The Work Disability Functional Assessment Battery (WD-FAB): Development and validation review

Comprehensive, efficient assessment of work-related activity limitations is imperative to government disability programs and clinicians working with patients experiencing work limitations. This article describes the development and initial validation of a newly developed instrument: the Work Disability Functional Assessment Battery (WD-FAB). The WD-FAB characterises physical and mental function across 8 key dimensions related to work: Basic Mobility; Upper Body Function; Fine Motor Function; Community Mobility; Mood & Emotions; Resilience & Sociability; Self-Regulation; and Cognition & Communication. The WD-FAB draws upon a pool of over 300 items to generate scores for all 8 scales in under 15 minutes. WD-FAB scores allow direct comparisons between individuals with self-reported activity limitations and sex- and age-matched adults. Future research with the WD-FAB in both the US and Europe has potential implications for enhancing disability assessment methodologies within the context of disability determination and insurance medicine systems.

Dietary patterns and risk of self-reported activity limitation in older adults from the Three-City Bordeaux Study.

Few studies have been interested in the relationship between dietary patterns and activity limitation in older adults yet. We analysed the association between dietary patterns and the risk of self-reported activity limitation - that is mobility restriction, limitation in instrumental activities in daily living (IADL) and in activities in daily living (ADL) - in community-dwellers aged 67+ years initially free of activity limitation in 2001-2002 and re-examined at least once over 10 years - that is 583 participants for mobility restriction, 1114 for IADL limitation and 1267 for ADL limitation. At baseline, five sex-specific dietary clusters were derived by hybrid clustering method from weekly frequency of intake of twenty food and beverage items. Self-reported mobility restriction, limitations in IADL and in ADL were assessed using the Rosow-Breslau, the Lawton-Brody and the Katz scales, respectively. Associations between dietary clusters and the risk of each activity limitation were assessed using Cox proportional hazard models. In models adjusted for socio-demographic and health-related covariates, compared with the 'Healthy' cluster the 'Biscuits and snacking' cluster was associated with a higher risk of mobility restriction (hazard ratio (HR)=3·0; 95 % CI 1·6, 5·8) and limitation in IADL (HR=2·1; 95 % CI 1·1, 4·2) in men and limitation in ADL in women (HR=2·3; 95 % CI 1·3, 4·0). In this French cohort of community-dwellers aged 67+ years, some unhealthy dietary patterns may increase the risk of activity limitation all along the disablement process in older adults.

High prevalence of widespread pain in women with early rheumatoid arthritis

Objectives: The aim of the study was to determine the prevalence of widespread pain (WP) in women with early rheumatoid arthritis (RA) and to compare physical function, activity limitations, health-related quality of life, mental distress, and disease activity between women with WP and non-widespread pain (NWP).Method: This cross-sectional study included 102 women with early RA. Participants were provided with self-reported questionnaires quantifying activity limitations, physical activity, pain intensity, health-related quality of life, and fatigue. Hand-grip force, muscle function test of the lower extremities, erythrocyte sedimentation rate, and number of tender and swollen joints were assessed.Results: One-third (35.9%) of the women fulfilled the American College of Rheumatology criteria for WP 20 months after disease onset. Women with RA + WP had significantly higher 28-joint Disease Activity Score (DAS28) (p = 0.004), number of tender joints (p = 0.001), pain intensity (p < 0.001), fatigue (p < 0.001), Health Assessment Questionnaire score (p < 0.001), and Hospital Anxiety and Depression Scale – Depression (p = 0.001). Furthermore, women with RA + WP showed significantly worse global health (p < 0.001) and physical health (36-item Short Form Health Survey – Physical Component Summary) (p < 0.001). The hand-grip force was found to be significantly reduced (p = 0.001), as was the muscle function of the lower extremities (p < 0.001), for women with RA + WP compared to women with RA + NWP. After adjustment for inflammatory joint disease, the significant differences between the groups remained.Conclusion: A significant group of women with early RA experience WP with a high DAS28 and increased pain intensity level. These women display severe muscle function deficiency in clinical examinations, and report general activity limitations and low psychological and physical health, despite an absence of or low objective signs of inflammation.

Physical activity levels of adults with various physical disabilities.

This study examined the physical activity (PA) levels of people with specific disabilities, using health care registration data. Data of 321,656 adults (83%) from the Dutch Public Health Monitor 2012 were used to assess adherence to the World Health Organization (WHO) PA guidelines (%) and the time (min/week) spent on moderate-to-vigorous-intensity and vigorous-intensity PA. Specific physical and sensory (i.e. vision and hearing) disabilities were identified by means of two health claims registries that include reimbursement of functional aids and long-term care. Generalized estimated equations were used to determine the association of PA with disabilities, adjusted for confounders (model 1) and additionally for self-reported activity limitations (model 2). Adults with disabilities had lower levels of WHO PA guidelines adherence (range: −49.8% to −11.9%, p < 0.01) and of moderate-to-vigorous-intensity PA (range: −691 to −200 min/week, p < 0.01) than adults without physical and sensory disabilities. Adults with physical disabilities had the lowest levels. The difference in levels of vigorous-intensity PA between adults with and without physical and sensory disabilities ranged from −12 to 8 min/week Only adults receiving long-term care due to physical disabilities had significantly lower vigorous-intensity PA levels (−12 min/week, p < 0.01). After adjustment for self-reported activity limitations, the difference in PA levels between adults with and without physical and sensory disabilities attenuated, especially among those with physical disabilities, but PA levels were still lower for adults with physical disabilities (−34.5% to −9.8% and −466 to −172 min/week, p < 0.01, respectively). Regardless of self-reported activity limitations, adults with objectively measured disabilities, especially those with physical disabilities, had lower PA levels compared to adults without physical and sensory disabilities.

Poverty and disability in low- and middle-income countries: A systematic review.

IntroductionDisability and poverty are believed to operate in a cycle, with each reinforcing the other. While agreement on the existence of a link is strong, robust empirical evidence substantiating and describing this potential association is lacking. Consequently, a systematic review was undertaken to explore the relationship between disability and economic poverty, with a focus on the situation in low and middle income countries (LMICs).MethodsTen electronic databases were searched to retrieve studies of any epidemiological design, published between 1990-March 2016 with data comparing the level of poverty between people with and without disabilities in LMICs (World Bank classifications). Poverty was defined using economic measures (e.g. assets, income), while disability included both broad assessments (e.g. self-reported functional or activity limitations) and specific impairments/disorders. Data extracted included: measures of association between disability and poverty, population characteristics and study characteristics. Proportions of studies finding positive, negative, null or mixed associations between poverty and disability were then disaggregated by population and study characteristics.ResultsFrom the 15,500 records retrieved and screened, 150 studies were included in the final sample. Almost half of included studies were conducted in China, India or Brazil (n = 70, 47%). Most studies were cross-sectional in design (n = 124, 83%), focussed on specific impairment types (n = 115, 77%) and used income as the measure for economic poverty (n = 82, 55%). 122 studies (81%) found evidence of a positive association between disability and a poverty marker. This relationship persisted when results were disaggregated by gender, measure of poverty used and impairment types. By country income group at the time of data collection, the proportion of country-level analyses with a positive association increased with the rising income level, with 59% of low-income, 67% of lower-middle and 72% of upper-middle income countries finding a positive relationship. By age group, the proportion of studies reporting a positive association between disability and poverty was lowest for older adults and highest for working-age adults (69% vs. 86%).ConclusionsThere is strong evidence for a link between disability and poverty in LMICs and an urgent need for further research and programmatic/policy action to break the cycle.

The longitudinal relation between self-reported physical activity and presenteeism.

This study evaluates the longitudinal relation between self-reported physical activity and health related work limitations (also known as presenteeism) among employees from a public university system. A retrospective longitudinal study design was used to examine research aims. Data were from self-reported health assessments collected from employees at a large University System in Texas during the 2013-2015 plan years (n=6515).Work limitations were measured using the self-report 8-item work limitations questionnaire. Latent growth curve models were used to test whether: 1) baseline physical activity was associated with baseline work limitations; 2) changes in physical activity were related to changes in work limitations; and 3) baseline physical activity predicted changes in work limitations. Models were adjusted for demographic and health-related variables. The final adjusted growth curve model demonstrated excellent fit. Results revealed baseline physical activity was inversely associated with baseline work limitations (β=-0.12, p<0.001). In addition, changes in physical activity were related to changes in work limitations (β=-0.33, p=0.02). However, no relation was found between baseline physical activity and changes in work limitations (β=-0.06, p=0.42). Results provide evidence that increasing physical activity among employees leads to decreases in health-related work limitations. Therefore, promoting physical activity among employee populations can help prevent and reduce presenteeism.

Predictors for future activity limitation in women with chronic low back pain consulting primary care: a 2-year prospective longitudinal cohort study

ObjectivesTo assess if body function, activity, participation, health-related quality of life and lifestyle behavioural factors can predict activity limitation in women with chronic low back pain (CLBP) in primary healthcare...