Variety Of Functional Impairments Research Articles

Prevalence and clinical characteristics of low skeletal muscle index among adults visiting a health promotion center: Cross-sectional study.

Sarcopenia causes a variety of functional impairments and is associated with all-cause mortality, but once it occurs, it is difficult to treat and reverse. However, the prevalence of sarcopenia in healthy people has never been investigated due to the low awareness of sarcopenia in healthy people. This cross-sectional study was conducted in a single health promotion center from the January 1st 2020 to the December 31st 2021. Adults aged 18 years and older with an Inbody as part of their health checkup were included, and all data was collected from the EMR. Obesity was defined as a body mass index (BMI) of 23 (kg/m2) or more by Korean standards, and low skeletal muscle mass was defined as a skeletal muscle index (SMI) of <0.789 for men and <0.512 for women. 60.5% of the total participants (n = 5993) had low skeletal muscle mass. The low SMI group had lower BMI, waist circumference, and abdominal skinfold than the normal SMI group (low SMI group vs normal SMI: BMI; 25.47 ± 2.96 vs 22.98 ± 3.05, P < .001, waist circumference; 90.31 ± 8.80 cm vs 82.69 ± 9.71 cm, P < .001, abdominal skinfold; 18.78 ± 2.44 mm vs 15.99 ± 2.12 mm, P < .001). The body fat percentage was higher in the low SMI group than in the normal SMI group 25.30 ± 6.23% versus 29.82 ± 7.07%, P < .001. Triglyceride and uric acid levels were low in the low SMI group (TG; 147.69 ± 97.27 vs 115.86 ± 68.31, P < .001, uric acid level; 6.30 ± 1.38 vs 5.23 ± 1.30, P < .001) and high-density lipid (HDL) was high (HDL; 53.17 ± 11.41 vs 59.89 ± 14.72, P < .001). The odds ratio of low SMI prevalence for age, sex, BMI, fat body percent, and triglycerides relative to normal SMI was 1.05 (P = .031), 0.14 (P < .001), 0.12 (P < .001), 2.05 (P < .001), and 0.99 (P = .003), respectively. Of those who visited the Health Promotion Center, more than 60% had low SMI identified through Inbody. Low BMI and high body fat percentage increase the risk of low SMI. Compared to normal and low SMI based on obesity, Sex, height, BW, abdominal skinfold, and waist circumflex showed significant P values in both groups. The factors related to low SMI were TG, HDL, and uric acid levels.

Short-Term Mild Hypoxia Modulates Na,K-ATPase to Maintain Membrane Electrogenesis in Rat Skeletal Muscle.

The Na,K-ATPase plays an important role in adaptation to hypoxia. Prolonged hypoxia results in loss of skeletal muscle mass, structure, and performance. However, hypoxic preconditioning is known to protect against a variety of functional impairments. In this study, we tested the possibility of mild hypoxia to modulate the Na,K-ATPase and to improve skeletal muscle electrogenesis. The rats were subjected to simulated high-altitude (3000 m above sea level) hypobaric hypoxia (HH) for 3 h using a hypobaric chamber. Isolated diaphragm and soleus muscles were tested. In the diaphragm muscle, HH increased the α2 Na,K-ATPase isozyme electrogenic activity and stably hyperpolarized the extrajunctional membrane for 24 h. These changes were accompanied by a steady increase in the production of thiobarbituric acid reactive substances as well as a decrease in the serum level of endogenous ouabain, a specific ligand of the Na,K-ATPase. HH also increased the α2 Na,K-ATPase membrane abundance without changing its total protein content; the plasma membrane lipid-ordered phase did not change. In the soleus muscle, HH protected against disuse (hindlimb suspension) induced sarcolemmal depolarization. Considering that the Na,K-ATPase is critical for maintaining skeletal muscle electrogenesis and performance, these findings may have implications for countermeasures in disuse-induced pathology and hypoxic therapy.

Caregiver dissatisfaction with their child\u2019s participation in home activities after pediatric critical illness

BackgroundPediatric critical care is often accompanied by a variety of functional impairments. Preliminary evidence suggests children’s participation in home activities has a slow trajectory post-pediatric intensive care unit (PICU) discharge, however, additional and more granular knowledge on specific problematic activities is needed to inform patient-centric rehabilitative care. The objectives of this study are to identify common home activities in which caregivers’ report dissatisfaction and to determine predictors of caregivers’ dissatisfaction with their child’s participation in home activities post-PICU discharge.MethodsSecondary analyses of data from a prospective cohort study, the Wee-Cover study, using a subsample of caregivers (N = 170) of children 1–17 years, admitted to a PICU ≥48 h with data on our primary outcome measure from at least one time point. Data were gathered at enrollment and at 3 and 6 months post-PICU discharge. Caregivers reported on their dissatisfaction with their child’s participation in home activities via the Participation and Environment Measure. Common activities were identified by plotting caregiver dissatisfaction for each activity pre-and post-PICU, reporting activities in which ≥50% of caregivers reported dissatisfaction with post-PICU, and assessing for significantly different dissatisfaction levels between time-points for each activity. Predictors of caregiver dissatisfaction were assessed using Poisson generalized estimated equation models.ResultsThere was variability in reported dissatisfaction across all activities; ≥50% of caregivers reported dissatisfaction with five activities, including getting clean, personal care management, and mealtime for younger children and household chores and homework for school-aged children and youth. Four activities had significantly higher caregiver dissatisfaction post-PICU: sleep (children < 5 years), homework, indoor play and games, and computer/video games (children ≥5 years). Home environmental support and the interaction of having participation-focused strategies with receiving PICU-based rehabilitation services were negatively associated with caregiver dissatisfaction. Increased caregiver stress and functional performance were associated with increased dissatisfaction.ConclusionsIndividualized PICU-based rehabilitation services to determine family priorities and develop participation-focused strategies, specifically those increasing environmental supports within the home, may ease the family’s transition home post-PICU.Trial registrationClinicalTrials.gov Identifier NCT02148081 05/28/2014.

Rehabilitation therapies in Rett syndrome across the lifespan: A scoping review of human and animal studies.

To perform a scoping review of the evidence for therapeutic interventions to manage functional impairments associated with Rett syndrome (RTT) throughout the lifespan. MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, Scopus and Index to Chiropractic Literature were searched systematically up to December 2019. Two investigators independently reviewed all search results and extracted those that met the inclusion criteria. Human and animal model studies pertaining to therapies that increase functional ability or treat RTT-associated symptoms in all age groups were included. Relevant studies were grouped into intervention categories and rated using the Oxford Centre of Evidence Based Medicine Levels of Evidence. Demographics of participants, interventions, and outcomes were summarized. Ninety-one articles representing 88 studies met the inclusion criteria, of which 80 were human clinical studies and eight were studies using animal models. Study designs were primarily case series and only six studies involved participants above the age of 40. A small number of rigorously studied rehabilitation interventions have been published. Published studies aim to address a wide variety of functional impairments. Research regarding implementation of therapies for older patients with RTT is lacking and requires further exploration.

Minimizing Disability from Graft-Versus-Host Disease

Graft-versus-host disease (GVHD) is a complication of hematopoietic stem cell transplantation which can result in significant disability. Any organ system may be affected, and as a result, a wide variety of functional impairments may occur. Rehabiliation services can improve patient outcomes and quality of life, but an understanding of the underlying disease process is necessary. There have been few studies published recently regarding the management of functional impairments in GVHD patients. The National Institutes of Health Consensus Development Project on Criteria in Chronic Graft-versus-Host Disease is an ongoing project begun in 2005 and most recently updated in 2014; however, these data have not yet been used to assess the management of disability in this population. The treatment of functional impairments from GVHD remains largely annectdotal and based around experiences from similar diseases; however, rehabilitation interventions should still be considered for patients with significant disease burden.

Sleep, Agitation, and Irritation: Proxies for Functional Impairment Among Service Members Seeking Mental Health Treatment

ABSTRACTSymptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) have a negative effect on occupational, social, and marital/intimate partner functioning. Other problem emotions or behaviors, such as sleep troubles, irritation, or agitation, could also have a similar relationship to a variety of functional impairments. The current study sought to (a) replicate findings supporting a relationship between symptoms of psychopathology and a variety of functional impairments; (b) examine the relationship between sleep disturbances, agitation, and irritation on the same functional impairments; and (c) examine the differences in the strength of the relationships described in (a) and (b). Military providers completed a survey indicating clinical perceptions of the variables of interest for one service member from their clinical caseload. Higher levels of depression, anxiety, and PTSD symptomatology were related to all domains of functional impairment, as were reported levels of sleep disturbances, agitation, and irritation. Few differences were found in the strength of the correlations established for depression/anxiety/PTSD and sleep problems/irritation/agitation. Given the potential hesitation of service members to report symptoms of psychopathology, reports of sleep problems, irritation, and agitation may present unique clinical benefits by providing an additional health touch point for education on behavioral health and available services.

Elective bilateral above the knee amputation in T4-complete spinal cord injury: a case report

This case study outlines an individual with a T4 complete level injury with Ashworth scale grade 4 spasticity of the lower extremities. To discuss a treatment option for this individual with spinal cord injury (SCI) who had a variety of functional impairments, disabilities, and medical complications based on his level of injury. The department of physical medicine and rehabilitation at Kaiser Permanente in San Diego, California. The patient's lower extremity spasticity contributed to pressure ulcers of his hips and feet as well as comfort and functional issues with his instrumental activities of daily living (ADLs). After failing medical therapies to control spasticity, and much discussion, bilateral above the knee amputations were performed. The patient had resolution of his SCI medical complications and a marked improvement in his quality of life. This case study discusses a treatment option for a SCI-complete patient whose lower extremities had become detrimental to his function and general well being.