Journal articles on the topic '920403 Disability and Functional Capacity'
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Randolph, David Charles. "Functional capacity evaluation and disability management." Journal of Back and Musculoskeletal Rehabilitation 7, no. 3 (November 1, 1996): 181–86. http://dx.doi.org/10.3233/bmr-1996-7309.
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Pransky, Glenn. "Clinical Update: Functional Capacity Evaluations and Disability." Guides Newsletter 3, no. 2 (March 1, 1998): 4–5. http://dx.doi.org/10.1001/amaguidesnewsletters.1998.marapr02.
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Abstract According to the AMA Guides to the Evaluation of Permanent Impairment, a functional capacity evaluation (FCE) measures an individual's physical abilities via a set of activities in a structured setting and provides objective data about the relationship between an impairment and maximal ability to perform work activities. A key distinction between FCEs and self-reported activities of daily living is that the former involve direct observation by professional evaluators. Numerous devices can quantify the physical function of a specific part of the musculoskeletal system but do not address the performance of whole body tasks in the workplace, and these devices have not been shown to predict accurately the ability to perform all but the simplest job tasks. Information about reliability has been proposed as a way to identify magnification and malingering, but variability due to pain and poor comprehension of instructions may cause variations in assessments. Structured work capacity evaluations involve a set of activities but likely underestimate the individual's ability to do jobs that involve complex or varying activities. Job simulations involve direct observation of an individual performing actual job tasks, require a skilled and experienced evaluator, and raise questions about expense, time, objectivity and validity of results, and interpretation of results in terms of the ability to perform specific jobs. To understand the barriers to return to work, examiners must supplement FCEs with information regarding workplace environment, accommodations, and demotivators.
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Vasudevan, Sridhar V. "Role of functional capacity assessment in disability evaluation." Journal of Back and Musculoskeletal Rehabilitation 6, no. 3 (May 1, 1996): 237–48. http://dx.doi.org/10.3233/bmr-1996-6305.
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Taglietti, Marcelo, and Celeide Pinto Aguiar Peres. "Exercise capacity and pulmonary function in individuals with leprosy." Fisioterapia em Movimento 27, no. 1 (March 2014): 29–38. http://dx.doi.org/10.1590/0103-5150.027.001.ao03.
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Introduction In Brazil 23% of leprosy patients have some type of physical disability after discharge. The impact on the respiratory system and correlation with functional exercise capacity is still unknown. Objective To correlate the functional exercise capacity and pulmonary function in individuals with leprosy sequelae. Materials and methods We evaluated 20 subjects and 25 controls by sensory evaluation, muscle strength, graduate the grade of physical disability followed by pulmonary function tests with spirometry and manovacuometry, besides the functional exercise capacity through the six minute walking distance (6MWD). Results The majority (75%) of the subjects showed physical disability grade 1. The mean of the maximal inspiratory pressure were below than normal -71 ± 31 cmH20 and maximal expiratory pressure +89 ± 22 cmH20. Spirometric values presented measures within normal value. The functional exercise capacity found a reduced value with a distance of 404 ± 92m. Positive and statistically significant correlation between the inspiratory pressures with 6MWD (r = 0.49, p = 0.025) and, similarly, expiratory pressure (r = 0.53, p = 0.004). The same evidence is found in maximal respiratory pressures of individuals in grade 1 with significant correlations (r = 0.52, p = 0.036) and (r = 0.51, p = 0.042). Conclusion Individuals with leprosy sequelae had impaired respiratory muscle strength and functional exercise capacity. Maximal respiratory pressures are presented as an independent factor in the change in performance in the functional exercise capacity.
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White, L. J., S. C. McCoy, V. Castellano, G. Gutierrez, J. E. Stevens, G. A. Walter, and K. Vandenborne. "Resistance training improves strength and functional capacity in persons with multiple sclerosis." Multiple Sclerosis Journal 10, no. 6 (December 2004): 668–74. http://dx.doi.org/10.1191/1352458504ms1088oa.
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The purpose of this study was to evaluate the effect of an eight-week progressive resistance training programme on lower extremity strength, ambulatory function, fatigue and self-reported disability in multiple sclerosis (MS) patients (mean disability score 3.79-0.8). Eight MS subjects volunteered for twice weekly training sessions. During the first two weeks, subjects completed one set of 8 -10 reps at 50% of maximal voluntary contraction (MVC) of knee flexion, knee extension and plantarflexion exercises. In subsequent sessions, the subjects completed one set of 10 -15 repetitions at 70% of MVC. The resistance was increased by 2 -5% when subjects completed 15 repetitions in consecutive sessions. Isometric strength of the quadriceps, hamstring, plantarflexor and dorsiflexor muscle groups was assessed before and after the training programme using an isokinetic dynamometer. Magnetic resonance images of the thigh were acquired before and after the exercise programme as were walking speed (25-ft), number of steps in 3 min, and self-reported fatigue and disability. Knee extension (7.4%), plantarflexion (52%) and stepping performance (8.7%) increased significantly (PB-0.05). Self-reported fatigue decreased (PB-0.05) and disability tended to decrease (P -0.07) following the training programme. MS patients are capable of making positive adaptations to resistance training that are associated with improved ambulation and decreased fatigue.
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Kubal, Swati V., and Kshitija S. Ghole. "Correlation of Exercise Capacity with Functional Disability in Patients with Osteoarthritis of Knee." International Journal of Physiotherapy and Research 9, no. 4 (July 11, 2021): 3883–87. http://dx.doi.org/10.16965/ijpr.2021.136.
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Introduction: Osteoarthritis of knee is a progressive joint disease which produces pain, inflammation and destruction of joint which in turn leads to range of motion limitation and walking disabilities. Affection in physical functioning is determined not only by just activities involving lower limb capacity but also by the activities which require use of upper extremities. Hence in this study, 6MWD and no. of rings moved in 6 minutes were taken as an outcome measures for determining the exercise capacity. KOOS is a self-administered questionnaire which was used in its cross culturally adapted format for determining the functional disability in patients. Objectives: 1. To study correlation of exercise capacity with functional disability in patients with osteoarthritis of knee. 2. To study correlation of upper limb exercise capacity with lower limb exercise capacity in patients with osteoarthritis of knee. Methods: Cross sectional, observational study including 30 patients of either gender having unilateral osteoarthritis of knee conducted in a tertiary care hospital. Results: No. of rings moved in 6 minutes and global KOOS score showed no statistically significant correlation. 6MWD and global KOOS score showed no statistically significant correlation. 6 minute walk distance and 6 minute peg board ring test showed no statistically significant correlation. Conclusion: The study suggests that there is no correlation of exercise capacity with functional disability in patients with osteoarthritis of knee. Also, there is no correlation found between upper limb exercise capacity and lower limb exercise capacity in patients with osteoarthritis of knee. KEY WORDS: Knee osteoarthritis, Knee pain, squat depth, functional disability, cardiorespiratory endurance, Knee Injury and Osteoarthritis Outcome Score, Quality of life.
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Danielewicz, Ana Lúcia, Aline Rodrigues Barbosa, and Giovâni Firpo Del Duca. "Nutritional status, physical performance and functional capacity in an elderly population in southern Brazil." Revista da Associação Médica Brasileira 60, no. 3 (June 2014): 242–48. http://dx.doi.org/10.1590/1806-9282.60.03.0013.
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Objective: to investigate the association between nutritional status and functional limitation and disability in an elderly population in southern Brazil. Methods: epidemiological, cross-sectional household-based study carried out with 477 elderly of both sexes (60 to 100 years). Body mass index (BMI) served to assess the nutritional status: underweight (BMI < 22 kg/m2) and overweight (BMI > 27 kg/m2). The sum score (0-5) obtained in three tests: "chair stand" and "pick up a pen" (measured by time) and standing balance (four static measurements) assessed the functional limitation. The disability was evaluated by the difficulty in performing one or more self-reported tasks related to basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Crude and adjusted analyzes (3 models) were carried out using Poisson regression; prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. Results: crude analyzes showed a positive association between underweight and functional limitation (PR = 2.71, 95% CI = 1.63 to 4.51); overweight and disability in ADLs (PR = 2.20, CI 95% = 1.44 to 3.35); overweight and disability in IADLs (PR = 1.56, CI 95% = 1.20 to 2.03). The additional adjustments for gender, age, level of education, living arrangements, current work, cognitive function and number of morbidities reduced the strength of the associations, without changing the statistical strength. Conclusion: nutritional status is a factor that is independently and positively associated with functional limitation and disability. We recommend the use of this indicator to monitor the health of the elderly.
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Naila de Souza, Glenda, Cristina Pellegrino Baena, Jennifer Cristina Rabbers Vasconcelos, and Auristela Duarte de Lima Moser. "ASSOCIATION BETWEEN FUNCTIONAL CAPACITY AND HANDGRIP STRENGTH IN PEOPLE WITH DIABETES MELLITUS." Cogitare Enfermagem, no. 27 (September 28, 2022): 1–13. http://dx.doi.org/10.5380/ce.v27i0.87195.
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Objective: to investigate the association between handgrip strength and functional capacity in people with diabetes. Method: observational cross-sectional study with 168 participants seen at an outpatient clinic in Curitiba, Brazil, in 2019. Clinical, sociodemographic, and socioeconomic data were collected, and the following protocols were applied: World Health Organization Disability Assessment Schedule; Timed Up and Go; and dynamometry. For the analysis, multiple linear regression models were adjusted for the dependent variables related to functional capacity. Results: we observed mild disability, borderline functional mobility, and higher correlation between functional mobility scale and handgrip strength (r=-0.384; p < 0.01). Handgrip strength with other covariates explained less than 30% of the functional variability. Conclusion: these results contribute to the problem-solving of clinical practice in that they show that muscle strength and functional capacity should be considered in the evaluation of the patient in combination, making it clearer and more comprehensive.
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Cerón Lorente, Laura, María Carmen García Ríos, Santiago Navarro Ledesma, Rosa María Tapia Haro, Antonio Casas Barragán, María Correa-Rodríguez, and María Encarnación Aguilar Ferrándiz. "Functional Status and Body Mass Index in Postmenopausal Women with Fibromyalgia: A Case–control Study." International Journal of Environmental Research and Public Health 16, no. 22 (November 16, 2019): 4540. http://dx.doi.org/10.3390/ijerph16224540.
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Reduced functional capacity is a common characteristic of fibromyalgia (FMS). We aimed to investigate the relationship between functional status and body mass index (BMI) in a population with and without FMS. A pilot case–control study was performed in 34 women with FMS and 22 healthy controls which were classified according to their BMI. The main outcome measures were: Balance (MiniBestest, One Leg Stance Test), functional mobility (Timed up and Go), physical disability (Health Assessment Questionnaire Disability Index), spinal range of motion (Spinal Mouse), level of physical activity at work (Leisure Time Physical Activity Instrument), and home and leisure time (Physical Activity at Home and Work). Statistical differences were observed between overweight/obese healthy controls and women with FMS for several indicators of functional capacity. FMS patients reported worse dynamic (p = 0.001) and static balance (right: p = 0.002, left: p = 0.001), poorer functional mobility (p = 0.008), and higher levels of physical disability (p = 0.001). Functional status is altered in FMS women compared to the healthy control group, independently of nutritional status; therefore, BMI is unlikely to play a main role in functional capacity indicators in postmenopausal FMS women. Only dynamic balance seems to reduce the obesity status in this population.
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Matheson, Leonard N., Susan J. Isernhagen, and Dennis L. Hart. "Functional capacity evaluation as a facilitator of social security disability program reform." Work 10, no. 1 (1998): 77–84. http://dx.doi.org/10.3233/wor-1998-10112.
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Miller, Matthew J., Dawn M. Magnusson, Guy Lev, Thomas T. Fields, Paul F. Cook, Jennifer E. Stevens-Lapsley, and Cory L. Christiansen. "Relationships Among Perceived Functional Capacity, Self-Efficacy, and Disability After Dysvascular Amputation." PM&R 10, no. 10 (March 24, 2018): 1056–61. http://dx.doi.org/10.1016/j.pmrj.2018.03.014.
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Gross, Douglas P., and Michele C. Battié. "Factors Influencing Results of Functional Capacity Evaluations in Workers' Compensation Claimants With Low Back Pain." Physical Therapy 85, no. 4 (April 1, 2005): 315–22. http://dx.doi.org/10.1093/ptj/85.4.315.
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Abstract Background and Purpose. Physical and psychosocial factors are hypothesized to influence performance-based assessment. The purpose of this study was to evaluate the association between performance on the Isernhagen Work System Functional Capacity Evaluation (IWS-FCE) and various clinical and psychosocial factors. Subjects. The sample consisted of 170 workers' compensation claimants who were undergoing functional capacity evaluations (FCEs) for low back injuries. Methods. In this cross-sectional study, claimants completed a battery of work-related measures, including the IWS-FCE, the Pain Disability Index (PDI), a workplace organizational policies and practices scale, and a recovery expectations questionnaire. Functional capacity evaluation performance indicators were the number of tasks in which subjects did not meet work demands and weight lifted on the floor-to-waist lift. Analysis included multivariable regression. Results. Only the PDI, pain intensity, age, and sex independently contributed to floor-to-waist lift performance. The PDI, pain intensity, and duration of injury contributed to the number of failed tasks. Discussion and Conclusion. The results indicate that performance on FCEs is influenced by physical factors, perceptions of disability, and pain intensity. However, perceptions of workplace organizational policies and procedures were not associated with FCE results for workers' compensation claimants with chronic back pain disability. Functional capacity evaluations should be considered behavioral tests influenced by multiple factors, including physical ability, beliefs, and perceptions.
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Welch, Laura. "Clinical Update: Functional Capacity Evaluations—An Update." Guides Newsletter 4, no. 5 (September 1, 1999): 4–7. http://dx.doi.org/10.1001/amaguidesnewsletters.1999.sepoct02.
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Abstract Functional capacity evaluations (FCEs) have become an important component of disability evaluation during the past 10 years to assess an individual's ability to perform the essential or specific functions of a job, both preplacement and during rehabilitation. Evaluating both job performance and physical ability is a complex assessment, and some practitioners are not yet certain that an FCE can achieve these goals. An FCE is useful only if it predicts job performance, and factors that should be assessed include overall performance; consistency of performance across similar areas of the FCE; consistency between observed behaviors during the FCE and limitations or abilities reported by the worker; objective changes (eg, blood pressure and pulse) that are appropriate relative to performance; external factors (illness, lack of sleep, or medication); and a coefficient of variation that can be measured and assessed. FCEs can identify specific movement patterns or weaknesses; measure improvement during rehabilitation; identify a specific limitation that is amenable to accommodation; and identify a worker who appears to be providing a submaximal effort. FCEs are less reliable at predicting injury risk; they cannot tell us much about endurance over a time period longer than the time required for the FCE; and the FCE may measure simple muscular functions when the job requires more complex ones.
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Moran, Monica, and Jenny Strong. "Outcomes of a Rehabilitation Programme for Patients with Chronic Back Pain." British Journal of Occupational Therapy 58, no. 10 (October 1995): 435–38. http://dx.doi.org/10.1177/030802269505801010.
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In order to evaluate the effectiveness of a rehabilitation programme for patients with chronic back pain, data on the subjective outcomes of perceived pain intensity (as measured by the Visual Analogue Scale Horizontal) and perceived level of disability (as measured by the Oswestry Low Back Pain Disability Questionnaire), and the objective outcome of functional capacity (as measured by the West Standardised Evaluation), were collected on 51 subjects prior to entry into a back pain rehabilitation programme and at discharge. The results at discharge showed a significant reduction in the perceived level of disability and a significant Increase in the functional capacity. The perceived pain intensity did not change significantly. The discussion focuses on the importance of directing therapeutic interventions towards increasing physical function rather than concentrating on the reduction or elimination of pain.
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Harp, Mary Ann, Kevin K. McCully, Marina Moldavskiy, and Deborah Backus. "Skeletal muscle mitochondrial capacity in people with multiple sclerosis." Multiple Sclerosis Journal - Experimental, Translational and Clinical 2 (January 2016): 205521731667802. http://dx.doi.org/10.1177/2055217316678020.
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Background People with multiple sclerosis (MS) have functional disability and may have reduced muscle mitochondrial capacity. Objective The objective of this paper is to measure muscle mitochondrial capacity of leg muscles using near-infrared spectroscopy (NIRS) and compare to functional status. Materials and methods People with MS ( n = 16) and a control (CON) group ( n = 9) were evaluated for 25-ft walk time. Mitochondrial capacity of both gastrocnemius muscles were measured with NIRS as the rate of recovery of oxygen consumption in after exercise. Results Mitochondrial capacity was lower in the MS group compared to the CON group (rate constants: 1.13 ± 0.29 vs. 1.68 ± 0.37 min−1, p < 0.05). There was a tendency for people with MS who used assistive devices to have lower mitochondrial capacity in the weaker leg ( p = 0.07). Conclusion NIRS measurements of mitochondrial capacity suggest a 40% deficit in people with MS compared to CONs and this may contribute to walking disability.
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Platero, Jose Luis, María Cuerda-Ballester, Vanessa Ibáñez, David Sancho, María Mar Lopez-Rodríguez, Eraci Drehmer, and Jose Enrique de la Rubia Ortí. "The Impact of Coconut Oil and Epigallocatechin Gallate on the Levels of IL-6, Anxiety and Disability in Multiple Sclerosis Patients." Nutrients 12, no. 2 (January 23, 2020): 305. http://dx.doi.org/10.3390/nu12020305.
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Background: Due to the inflammatory nature of multiple sclerosis (MS), interleukin 6 (IL-6) is high in blood levels, and it also increases the levels of anxiety related to functional disability. Epigallocatechin gallate (EGCG) decreases IL-6, which could be enhanced by the anti-inflammatory effect of high ketone bodies after administering coconut oil (both of which are an anxiolytic). Therefore, the aim of this study was to assess the impact of coconut oil and EGCG on the levels of IL-6, anxiety and functional disability in patients with MS. Methods: A pilot study was conducted for four months with 51 MS patients who were randomly divided into an intervention group and a control group. The intervention group received 800 mg of EGCG and 60 mL of coconut oil, and the control group was prescribed a placebo. Both groups followed the same isocaloric Mediterranean diet. State and trait anxiety were determined before and after the study by means of the State-Trait Anxiety Inventory (STAI). In addition, IL-6 in serum was measured using the ELISA technique and functional capacity was determined with the Expanded Disability Status Scale (EDSS) and the body mass index (BMI). Results: State anxiety and functional capacity decreased in the intervention group and IL-6 decreased in both groups. Conclusions: EGCG and coconut oil improve state anxiety and functional capacity. In addition, a decrease in IL-6 is observed in patients with MS, possibly due to the antioxidant capacity of the Mediterranean diet and its impact on improving BMI.
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Lante, K., G. Davis, R. Stancliffe, A. Bauman, S. Jan, and H. van der Ploeg. "Aerobic fitness, functional exercise capacity and muscle strength of adults with intellectual disability." Journal of Science and Medicine in Sport 15 (December 2012): S78—S79. http://dx.doi.org/10.1016/j.jsams.2012.11.189.
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Litwin, Howard, Amit Shrira, and Dov Shmotkin. "Self-Reported Functional Status Among the Old-Old." Journal of Aging and Health 24, no. 5 (March 15, 2012): 846–62. http://dx.doi.org/10.1177/0898264312436714.
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Objectives: To examine differences in functional status among two successive cohorts. Method: The study was a comparative analysis of Jewish respondents aged 75 to 94 from two nationwide random samples: the Cross-Sectional and Longitudinal Aging Study (1989-1992; N = 1,200) and the Survey of Health, Ageing, and Retirement in Europe (2005-2006; N = 379). Self-reported functional limitation and disability were compared by means of logistic regressions and MANCOVA, controlling for age, gender, origin, education, marital status, income, self-rated health, and home care receipt. Results: Reported functional limitation decreased in the later cohort (SHARE-Israel), but activities of daily living (ADL) and instrumental activities of daily living (IADL) disability increased. Receipt of home care moderated these effects. ADL and IADL disability increased among home care–receiving respondents in the later cohort whereas functional limitation decreased among respondents not in receipt of home care. Discussion: The findings suggest that different measures used to assess the disablement process capture different aspects and that contextual factors influence how older people rate their own functional capacity.
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Lien, Wei-Chih, Wei-Ming Wang, Hui-Min David Wang, Feng-Huei Lin, and Fen-Zhi Yao. "Environmental Barriers and Functional Outcomes in Patients with Schizophrenia in Taiwan: The Capacity-Performance Discrepancy." International Journal of Environmental Research and Public Health 19, no. 1 (December 28, 2021): 315. http://dx.doi.org/10.3390/ijerph19010315.
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Environmental factors are crucial determinants of disability in schizophrenic patients. Using data from the 2014–2018 Certification of Disability and Care Needs dataset, we identified 3882 adult patients (46.78% females; age, 51.01 ± 13.9 years) with schizophrenia. We found that patients with severe schizophrenia had lower capacity and performance than those with moderate schizophrenia. The chances of having an access barrier to environmental chapter 1 (e1) products and technology in moderate schizophrenic patients and in severe schizophrenic patients were 29.5% and 37.8%, respectively. Logistic regression analyses demonstrated that the performance score was related to accessibility barriers in the categories described in e1, with adequate fitness of models in category e110 for personal consumption, e115 for personal usage in daily living activities, and e120 for personal outdoor and indoor mobility and transportation. Furthermore, the capacity-performance discrepancy was higher in moderate schizophrenic patients with accessibility barriers in the e110, e115, and e120 categories than that in moderate schizophrenic patients without accessibility barriers. However, severe schizophrenic patients with category e120 accessibility barriers were prone to a lower discrepancy, with institutional care a potentially decreasing factor. In conclusion, providing an e1 barrier-free environment is necessary for patients with schizophrenia to decrease their disability.
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Benchehida, Aabdelkader, Adel Belkadi, Yassine Zenati, Otmane Benbernou, Lalia Cherara, and Mohamed Sebbane. "Implementation of An Adapted Physical Activity Therapy Protocol for Patients with Low Back Pain." GYMNASIUM 22, no. 1 (July 30, 2021): 83–96. http://dx.doi.org/10.29081/gsjesh.2021.22.1.06.
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This study set out to investigate the usefulness of an adapted physical activity protocol to improve pain and functional capacity through structured adapted exercises to muscular capacity on patients in a Functional Restoration program. Material and methods: 83 patients, aged between 19-63, who accepted to be included in this study and diagnosed as chronic low back pain. The patients were treated for a total of 12 weeks, 3 sessions per week. The level of pain severity of the participants was determined by Visual Pain Scale (VAS). Oswestry Disability Index for functional evaluation; Low Back Pain Disability Index (LBPDI). These assessments were performed at the beginning and end of the 12- week treatment program. In line with our study results, we anticipate that the planned physiotherapy and adapted physical activity (APA) protocol will reduce the health expenditures by finding a solution option for chronic low back pain commonly seen in societies.
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Klimenko, A., E. Zhilyaev, E. Mikheeva, N. Shostak, N. Babadaeva, A. Kondrashov, N. Demidova, and D. Khorolskii. "AB0672 Functional capacity and quality of life in patients with systemic sclerosis – data from Moscow register of patients with systemic sclerosis." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1464.1–1464. http://dx.doi.org/10.1136/annrheumdis-2022-eular.1957.
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BackgroundSystemic sclerosis (SSc) is a multisystem, connective tissue disease characterized by fibrosis of the skin and internal organ involvement, which can influence quality of life and functional capacity. SSc patients show some problems associated with reduced quality of life.ObjectivesSystemic sclerosis (SSc) is a multisystem, connective tissue disease characterized by fibrosis of the skin and internal organ involvement, which can influence quality of life and functional capacity. SSc patients show some problems associated with reduced quality of life.MethodsIn total, 51 patients with SSc were included: 50 women and 1 man (mean age: 63,2 ± 10,1 year, limited SSc 28/diffuse SSc 23, median duration since first non-Raynaud symptom: 10,1 years) who fulfilled the ACR/EULAR classification criteria (2013), filled in questionnaires assessing disability (HAQ, Health Assessment Questionnaire) and quality of life (SF-36, Medical outcomes study Short Form 36 - Physical Component Summary and Mental Component Summary).ResultsAverage HAQ in patients with limited and diffuse SSc was 0,66±0,58 and 0,9±0,59. Data analysis showed that 59% of the patients were in the mild to moderate HAQ disability category (0 ⩽ HAQ < 1), 39% in the moderate to severe disability category (1 ⩽ HAQ < 2), and 2% in the severe to very severe disability category (2 ⩽ HAQ ⩾ 3). The SF36 mean scores of the total group were 34,8±8,7 on the Mental Component Summary and 37,0±13,1 on the Physical Component Summary.ConclusionSsc and its complications decrease quality of life and functional capacity. Although validated in SSc, the HAQ disability index underestimates respiratory failure due to interstitial lung disease, gastrointestinal symptoms, cardiovascular complications and severity of Raynaud phenomenon. Alternative measures of functional impairment should be examined. Health-related quality of life, which was assessed by the SF-36 is reduced in both physical and mental domains. It should be taken into account by clinicians for further improvement of treatment and development rehabilitation program.References[1]Almeida C, Almeida I, Vasconcelos C. Quality of life in systemic sclerosis. Autoimmun Rev. 2015;14(12):1087-1096Disclosure of InterestsNone declared
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Ratzon, Navah Z., Yehuda Amit, Sharon Friedman, Shiri Zamir, and Debbie Rand. "Functional capacity evaluation: Does it change the determination of the degree of work disability?" Disability and Health Journal 8, no. 1 (January 2015): 80–85. http://dx.doi.org/10.1016/j.dhjo.2014.08.004.
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van der Meer, Suzan, Michiel F. Reneman, Jan Verhoeven, and Job van der Palen. "Relationship between self-reported disability and functional capacity in patients with Whiplash Associated Disorder." Journal of Occupational Rehabilitation 24, no. 3 (September 13, 2013): 419–24. http://dx.doi.org/10.1007/s10926-013-9473-6.
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Sakulsriprasert, Prasert, Roongtiwa Vachalathiti, and Pathaimas Kingcha. "Responsiveness of pain, functional capacity tests, and disability level in individuals with chronic nonspecific low back pain." Hong Kong Physiotherapy Journal 40, no. 01 (December 6, 2019): 11–17. http://dx.doi.org/10.1142/s101370252050002x.
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Background: Clinical outcomes are very important in clinical assessment, and responsiveness is a component inside the outcome measures that needs to be investigated, particularly in chronic nonspecific low back pain (CNSLBP). Objective: This study aimed to investigate the responsiveness of pain, functional capacity tests, and disability in individuals with CNSLBP. Methods: Twenty subjects were assessed in pain using the following methods: visual analog scale (VAS) and numeric pain rating scale (NPRS), functional capacity tests: functional reach test (FRT), five-time sit-to-stand test (5 TSST), and two-minute step test (2 MST), and disability level: modified Oswestry Disability Questionnaire (MODQ), Thai version before and after 2-week intervention session. For interventions, the subjects received education, spinal manipulative therapy, and individual therapeutic exercise twice a week, for a total of two weeks. The statistics analyzed were change scores, effect size (ES), and standardized response mean (SRM). Results: The most responsive parameter for individuals with CNSLBP was pain as measured by numeric pain rating scale (NPRS) (ES [Formula: see text]0.986, SRM [Formula: see text]0.928) and five-time sit-to-stand test (5 TSST) (SRM [Formula: see text]0.846). Conclusion: This study found that NPRS pain and 5 TSST were responsive in individuals with CNSLBP at two weeks after the beginning of interventions.
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McGrath, Ryan, Sherri Stastny, Shanon Casperson, Lisa Jahns, James Roemmich, and Kyle J. Hackney. "Daily Protein Intake and Distribution of Daily Protein Consumed Decreases Odds for Functional Disability in Older Americans." Journal of Aging and Health 32, no. 9 (October 18, 2019): 1075–83. http://dx.doi.org/10.1177/0898264319881864.
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Objective: We sought to determine whether daily protein intake and protein distribution across eating occasions were associated with functional disability in a national sample of older Americans. Methods: Data from 8,070 adults aged ≥60 years from the 2007-2016 waves of the National Health and Nutrition Examination Survey were included. Protein intake and functional capacity was self-reported. A daily protein recommendation of ≥1.0 g/kg/day was utilized. The daily protein recommendation was then spread-out across four meals, whereby a ≥0.25 g/kg/meal threshold was used. Results: Those meeting the daily protein recommendation had 0.78 (95% confidence interval [CI] = [0.65, 0.93]) decreased odds for functional disability. Persons meeting the protein intake threshold per eating occasion for one, two, three, and four occasions had 0.60 (CI = [0.38, 0.95]), 0.48 (CI = [0.30, 0.77]), 0.47 (CI = [0.29, 0.77]), and 0.39 (CI = [0.20, 0.75]) decreased odds for functional disability, respectively. Discussion: Protein consumption seems to be important for preserving function in older Americans.
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Borysova, Inna, and Tetyana Potapova. "ASSESSMENT OF FUNCTIONAL ACTIVITY REDUCTION – AS A CRITERION FOR DETERMINING DISABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS." Wiadomości Lekarskie 75, no. 9 (2022): 2081–85. http://dx.doi.org/10.36740/wlek202209106.
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The aim: To analyze the assessment of the decrease in working capacity degree in patients with rheumatoid arthritis in accordance with modern diagnostic disease criteria and social approaches to disability definition in the world (the decline degree of vital activity). Materials and methods: We analyzed the dynamics of primary disability caused by musculoskeletal system and connective tissue diseases (the main disease - RA) in Ukraine in 2016-2020. We analyzed the data of medical and social cases of 433 patients with RA (referral for medical and social examination, Form 088/o). We studied the degree of reduction of their efficiency. Statistical processing was performed using descriptive and variational statistics methods. The results were calculated on a personal computer using the licensed programs STATISTICA 6.1 (StatoftInc., Serial № AGAR909E415822FA). Results: It is shown that in Ukraine in 2016-2020 the primary disability had a tendency to increase. The article defines the approaches to medical and social examination of patients with rheumatoid arthritis to determine the ability to work and signs of disability. The article emphasizes the importance of a thorough study of medical data, data on the functional state of the affected joints using functional tests, determining the state of the patient’s social activity according to the assessments of questionnaires based on the principles of evidence-based medicine. Conclusions: The problem of RA is a relevant in the world and in Ukraine. The dynamics of primary disability caused by musculoskeletal system and connective tissue diseases (the main disease - RA) in Ukraine in 2016-2020 shows a growth trend: from 5.8 to 7.1 per 10 thousand population. Carrying out medical and social examination of RA patients to determine the state of working capacity and signs of disability requires careful study of medical data, data on the functional state of the affected joints with functional tests and determining the state of social activity of the patient according to questionnaires. In patients with RA, the most important data for determining violations of vital signs and the presence of functional disability are: disease activity, its course, the presence of lesions of internal organs and the completeness and quality of treatment methods recommended from the standpoint of evidence-based medicine.
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Virtuoso Júnior, Jair Sindra, Cristiane Alves Martins, Liliane Beatriz Roza, Thais Reis Silva de Paulo, Maria da Conceição Lopes Ribeiro, and Sheilla Tribess. "Prevalence of disability and associated factors in the elderly." Texto & Contexto - Enfermagem 24, no. 2 (June 2015): 521–29. http://dx.doi.org/10.1590/0104-07072015001652014.
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The aim of this study was to estimate the prevalence and factors associated with functional disability in the elderly. The cross-sectional design was used with a sample of 624 individuals, between 60 and 96 years of age. In the assessment of the elderly interviews and physical performance tests were used. In the inferential data analysis, the Poisson regression was used, p≤0.05. The prevalence of disability was 17.6% for Basic Activities of Daily Living and 46.3% for Instrumental Activities of Daily Living. Functional disability for Basic Activities of Daily Living was associated with increasing age, alcohol consumption, depressive symptoms and frailty; the Instrumental Activities of Daily Living were associated with increasing age, illiteracy, multigenerational family arrangement, hospitalization and fragility. The variables that remained in the explanatory model for the decline of functional capacity should be emphasized in proposals for public policies to promote the health of the elderly.
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Chelimsky, Gisela, Pippa Simpson, Liyun Zhang, Doug Bierer, Steve Komas, Balaraman Kalyanaraman, and Thomas Chelimsky. "Impaired Mitochondrial Bioenergetics Function in Pediatric Chronic Overlapping Pain Conditions with Functional Gastrointestinal Disorders." Pain Research and Management 2021 (August 13, 2021): 1–7. http://dx.doi.org/10.1155/2021/6627864.
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Background. Fatigue is often the primary complaint of children with functional gastrointestinal disorders (FGDI) and other chronic overlapping pain disorders (COPC). The basis for this symptom remains unknown. We evaluated mitochondrial function in the white blood cells of these patients. Methods. This prospective Children’s Wisconsin IRB approved study recruited subjects aging 10–18 years from pediatric neurogastroenterology clinics and healthy comparison subjects (HC). Environmental and oxidative stressors can damage the mitochondrial respiratory chain. The known low-grade inflammation in COPC could, therefore, impact the respiratory chain and theoretically account for the disabling fatigue so often voiced by patients. Mitochondrial energy generation can be easily measured in peripheral mononuclear cells (PMC) as a general marker by the Seahorse XF96 Extracellular Flux Analyzer. We measured 5 parameters of oxygen consumption using this methodology: basal respiration (BR), ATP linked oxygen consumption (ATP-LC), maximal oxygen consumption rate (max R), spare respiratory capacity (SRC), and extracellular acidification rate (ECAR), which reflect non-electron chain energy generation through glycolysis. In health, we expect high ATP linked respiration, high reserve capacity, low proton leak, and low non-mitochondrial respiration. In disease, the proton leak typically increases, ATP demand increases, and there is decreased reserve capacity with increased non-mitochondrial respiration. Findings and clinical data were compared to healthy control subjects using a Mann–Whitney test for skewed variables, Fisher’s exact test for dichotomous variables, and regression tree for association with functional outcome (functional disability inventory, FDI). Results. 19 HC and 31 COPC showed no statistically significant difference in age. FGID, orthostatic intolerance, migraine, sleep disturbance, and chronic fatigue were present in the majority of COPC subjects. BR, ECAR, and ATP-LC rates were lower in the COPC group. The low BR and ATP-LC suggest that mitochondria are stressed with decreased ability to produce ATP. Tree analysis selected SRC as the best predictor of functional disability: patients with SRC >150 had a greater FDI (more disability) compared to patients with SRC <=150, p -value = 0.021. Conclusion. Subjects with COPC have reduced mitochondrial capacity to produce ATP. Predisposing genetic factors or reversible acquired changes may be responsible. A higher SRC best predicts disability. Since a higher SRC is typically associated with more mitochondrial reserve, the SRC may indicate an underutilized available energy supply related to inactivity, or a “brake” on mitochondrial function. Prospective longitudinal studies can likely discern whether these findings represent deconditioning, true mitochondrial dysfunction, or both.
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Harvey, Philip D., and Martin Strassnig. "Predicting the severity of everyday functional disability in people with schizophrenia: cognitive deficits, functional capacity, symptoms, and health status." World Psychiatry 11, no. 2 (June 2012): 73–79. http://dx.doi.org/10.1016/j.wpsyc.2012.05.004.
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Izal, Maria, Almudena López-López, Ignacio Montorio, and José Luis González. "Discrepancy between Radiographic Damage and Functional Disability in Elderly People with Osteoarthritis: The Role of Pain Coping Strategies." Spanish journal of psychology 13, no. 2 (November 2010): 875–85. http://dx.doi.org/10.1017/s1138741600002523.
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The aim of this study is twofold. First, to assess the level of agreement between radiographic damage and functional disability in older people with osteoarthritis. And second, to assess the role of coping skills and sensory pain parameters as sources of disagreement between these variables. To achieve this objective we assess, in a sample of 104 older people with osteoarthritis, the following variables: functional capacity, radiographic damage, pain coping strategies, pain intensity, pain frequency and pain duration. The results show a non-linear relationship between radiographic damage and functional disability, modified by the levels of the two variables. There was maximum agreement between low levels of radiographic damage and of functional impairment, whilst agreement decreased for moderate and high levels of radiographic damage. Certain coping strategies may help to explain this disparity.
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Onan, D., and O. Ulger. "POS0028 THE EFFECTS OF TELEREHABILITATION WITH REMOTELY SPINAL STABILIZATION EXERCISES ON CLINICAL VARIABLES, FUNCTIONAL ACTIVITIES, EXERCISE ADHERENCE AND MUSCLE ARCHITECTURE OF NECK MUSCLES IN INDIVIDUALS WITH CHRONIC NECK PAIN." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 229.1–229. http://dx.doi.org/10.1136/annrheumdis-2022-eular.1931.
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BackgroundDoing a job with functional activity may aggravate chronic neck pain(CNP). Thickness, PCSA of the neck muscles can be improved with exercise. During the Covid-19 pandemic, people has caused an increase in home workload, the frequency of performing functional activities related to performance has increased. The distance between physiotherapists and the patient should be at least 2 meters in clinics due to the risk of transmission. As a result, the importance of telerehabilitation has increased.ObjectivesOur aim is to investigate the effect of remotely spinal stabilization exercises(SSE) with telerehabilitation on clinical variables, the functional activities, exercise adherence and muscle architecture patients with CNP.MethodsThe demographic characteristics were recorded. Pain intensity with Visual Analog Scale (VAS), disability level with Neck Disability Index (NDI), neck awareness with Fremantle Neck Awareness Questionnaire (FreNAQ), the functional capacity levels with neck function capacity evaluation test, the difficulty of functional activities with VAS were assessed. Muscle thickness of M. Sternocleideomastoideus, M. Upper Trapezius, PCSA of M. Longus Colli, M. Cervical Multifidus was evaluated in the resting with 3.5-10 MHz ultrasound. The exercise adherence with Exercise Adherence Rating Scale and exercise program satisfaction with VAS were evaluated. The telerehabilitation group (TG) used exercises videos and video conferences, control group (CG) did SSE in the clinic. To study the effects of the interventions, the outcome measures were compared time-by-group interaction effects, one the within-groups factor (time) and one the between-groups factor (group) by repeated-measures two-way ANOVA. The Mann Whitney-U test was performed to compare two groups for non-parametric data.ResultsTwenty-eight patients were randomly allocated to the TG and the CG. The VAS, NDI, FreNAQ, the functional capacity levels, muscle architecture showed similar changes over time in both groups. Results showed no significant time-by-group interaction effects of VAS, NDI, FreNAQ, the functional capacity levels, the difficulty of functional activities and muscle architecture (p>0.05); a significant effect for time in the VAS, NDI, FreNAQ, the functional capacity levels, the difficulty of functional activities and muscle architecture (p<0.001). There was no difference between the groups in terms of VAS, NDI, FreNAQ, the functional capacity levels, the difficulty of functional activities and muscle architecture. Results showed no significant effect for the group in the VAS, NDI, FreNAQ, the functional capacity levels, the difficulty of functional activities and muscle architecture (p>0.05). Both groups adapted well to the exercise program and were highly satisfied with the SSE (p<0.05).ConclusionThe VAS, NDI, difficulty of functional activities decreased; FreNAQ, functional capacity levels, architecture of neck muscles increased in both groups after 8 weeks SSE. It was determined that telerehabilitation with remotely SSE was beneficial as face-to-face SSE.References[1]Kashfi P, Karimi N, Peolsson A, Rahnama L. The effects of deep neck muscle-specific training versus general exercises on deep neck muscle thickness, pain and disability in patients with chronic non-specific neck pain:protocol for a randomized clinical trial (RCT).BMC Musculoskelet Disord. 2019;20(1):540. doi:10.1186/s12891-019-2880-x.[2]Amiri-Arimi S, Mohseni Bandpei MA, Rezasoltani A, Javanshir K, Biglarian A. Measurement of Cervical Multifidus and Longus Colli Muscle Dimensions in Patients With Cervical Radiculopathy and Healthy Controls Using Ultrasonography:A Reliability Study. PM R. 2019;11(3):236-242. doi:10.1016/j.pmrj.2018.07.014.[3]Lee, A. 2020. “COVID-19 and the Advancement of Digital Physical Therapist Practice and Telehealth”.Physical Therapy. pzaa079, doi:10.1093/ptj/pzaa079.Disclosure of InterestsNone declared
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Nogueira, Paula Sacha Frota, Marilia Braga Marques, Janaina Fonseca Victor Coutinho, Juliana Cunha Maia, Maria Josefina da Silva, and Escolástica Rejane Ferreira Moura. "Factors associated with the functional capacity of older adults with leprosy." Revista Brasileira de Enfermagem 70, no. 4 (August 2017): 711–18. http://dx.doi.org/10.1590/0034-7167-2017-0091.
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ABSTRACT Objective: to investigate the association between socio-demographic and clinical factors and the functional capacity of older adults with leprosy. Method: cross-sectional analytical study conducted in Fortaleza, Ceará, Brazil, with 77 older adult patients with leprosy in a referral service, through interview, medical records and application of the Katz Index and the Lawton and Brody Scale. Results: the mean age was 68.23 years, with prevalence of men, in stable union/married, with mean monthly family income of 2.04 minimum wages, positive bacillary index, clinical dimorphic form and grade zero disability. In the Lawton and Brody scale, independence (58.5%) was predominant and associated to the variables "living arrangement" and "educational attainment". Total independence (87.0%) was predominant in the Katz Index and statistically associated to the variable monthly family income. Conclusion: most of the participants were classified as independent in the instruments used. Furthermore, the instruments pointed to a greater number of associations with socio-demographic and clinical factors not related to leprosy.
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Carmeli, Eli, Joav Merrick, Shlomo Kessel, Yossef Masharawi, and Varda Carmeli. "Elderly Persons with Intellectual Disability: A Study of Clinical Characteristics, Functional Status, and Sensory Capacity." Scientific World JOURNAL 3 (2003): 298–307. http://dx.doi.org/10.1100/tsw.2003.24.
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Longer life expectancy is resulting in increasing numbers of elderly adults with intellectual disability (ID). There has been the question whether persons with ID demonstrate early signs of aging before the general population. The aim of this study was to determine if persons with ID (with and without Down syndrome) showed premature aging changes compared with a control group. Elderly persons (n = 24, average age of 61) from one residential care center in Israel and younger adults from another center (n = 37, average age of 45) were compared with elderly residents without ID in an independent living facility. The study considered demographic data, medical data, anthropometric measurements, body fat and body mass index, flexibility, and sensorimotor function tests. The results showed that the persons with ID had basically similar body composition to that of persons without ID, however, the functional performance of elderly adults with ID was more impaired. We postulate that the slower functioning responses may be explained by a less physically active lifestyle, that may accelerate the onset of disease and result in symptoms associated with aging that are detrimental to health. It is therefore important that persons with ID participate in physical activity and exercises in order to promote health and prevent disease.
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Borges, Larissa de Lima, Fernanda Pains Vieira dos Santos, Valéria Pagotto, and Ruth Losada de Menezes. "Functional disability in community-dwelling elderly: the role of cataracts and contextual factors." Fisioterapia em Movimento 27, no. 2 (June 2014): 189–200. http://dx.doi.org/10.1590/0103-5150.027.002.ao04.
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Introduction Cataract arises as a risk factor for functional disability in elderly Objective: To determine differences in functional capacity and contextual factors associated with it in elderly affected and not affected by cataract and association between disability and cataracts.Methods A transversal-type observational study was carried out with 100 community elderly, divided into two groups: elderly affected (n = 50) and not affected by cataracts (n = 50). It was evaluated: activities of daily living (ADL) – Katz Index –, instrumental activities of daily living (IADL) – Lawton scale – and mobility – Short Physical Performance Battery. Functional disability was detected when the elderly were dependent or semi-dependent for one or more IADL or ADL and/or when they presented any difficulty in mobility. Data analysis included absolute and relative frequencies, Chi-squared or Fisher’s exact tests (p < 0.05) and Poisson regression.Results No statistically significant associations were observed between IADL, ADL or mobility disability and cataracts. A statistically significant difference was observed between the disabled elderly affected and not affected by cataract according to contextual factors for ADL regarding age (p = 0.037) and comorbidity (p = 0.037), for mobility regarding the practice of physical activity (p = 0.013), and for IADL (p = 0.001), ADL (p = 0.001) and mobility (p = 0.013) regarding the self-reporting of eyesight problems.Conclusions Besides cataracts, physical inactivity, comorbidity and functional aging itself are contributing factors to the process of disability in elderly, so, the physiotherapy is essential both to prevent as to reverse this process.
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Maestas, Nicole. "Identifying Work Capacity and Promoting Work: A Strategy for Modernizing the SSDI Program." ANNALS of the American Academy of Political and Social Science 686, no. 1 (November 2019): 93–120. http://dx.doi.org/10.1177/0002716219882354.
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The Social Security Disability Insurance (SSDI) program, which provides income support to individuals who become unable to work because of a disability, has not been substantially reformed since the 1980s, despite sweeping changes in health, medical technology, and the functional requirements of jobs. I review how the SSDI program works, its history in terms of caseloads and reforms, and findings from the research evidence that offer lessons for the future. I then propose two interlocking reforms that would modernize the core functions of the program. The first is to improve SSDI’s process for determining whether an applicant has remaining capacity to work by replacing the outdated medical-vocational “grid” with a new system of individual work capacity measurement. Second, I propose the introduction of partial disability benefits, which would make use of the new system for measuring work capacity and allow beneficiaries to combine benefit receipt with work. Partial benefits could be paired with a generalized benefit offset to further encourage work by beneficiaries, and the Social Security Administration’s complex array of work-related rules could be eliminated.
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Feinberg, Steven D., Christopher R. Brigham, and Lee Ensalada. "Assessing Impairment and Disability in the Pain Patient." Guides Newsletter 21, no. 1 (January 1, 2016): 3–10. http://dx.doi.org/10.1001/amaguidesnewsletters.2016.janfeb01.
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Abstract Assessing impairment and/or disability in the pain patient often is difficult due to both administrative and clinical issues; in addition, the terms impairment and disability are misunderstood. Chronic pain complaints may be associated with significant disability, but typically the physician defines clinical issues, functional deficits, and, when requested, impairment; disability most often is an administrative determination. The biopsychosocial approach currently is viewed as most appropriate perspective for understanding, assessing, and treating chronic pain disorders and acknowledges a complex and dynamic interaction among biological, psychological, and social factors. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, discusses the assessment of pain and eligibility requirements for pain-related impairment (PRI). Some physicians feel that the AMA Guides’ approach to PRI does not adequately address the “disability” and functional loss caused by some chronic pain states, but the AMA Guides is limited, mostly, to describing measurable objective changes or impairment. The AMA Guides is not intended to be used for direct estimates of loss of work capacity (disability), and impairment percentages derived according to the AMA Guides criteria do not measure work disability. Impairment ratings in the AMA Guides already have accounted for impairment-associated pain, including that experienced in areas distant to the specific site of pathology.
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Nasrala Neto, Elias, Walkiria Shimoya Bittencourt, Mara Lilian Soares Nasrala, Andre Luiz Lopes de Oliveira, Ana Carolina Gaudencio de Souza, and Jéssica Fialho do Nascimento. "Correlations between low back pain and functional capacity among the elderly." Revista Brasileira de Geriatria e Gerontologia 19, no. 6 (December 2016): 987–94. http://dx.doi.org/10.1590/1981-22562016019.150227.
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Abstract Objective: To investigate the association between low back pain and functional capacity among non-institutionalized elderly persons. Method: A cross-sectional observational study of non-institutionalized elderly persons was performed. The Timed Up and Go (TUG) and Sitting-Rising Test (SRT) functional tests were used, together with the Roland Morris Disability Questionnaire (RMDQ). Result: A total of 99 elderly persons of both genders were included. Kendall’s Correlation analysis showed a significant correlation between the RMDQ and the SRT scores for the act of sitting (p=0.001) and the act of lifting (p=0.028). Despite the statistical significance, these two variables were weakly correlated (r=-239;r=-163). The results also identified a statistically significant correlation between the TUG and SRT tests for the act of sitting (r=-222; p=0.003) and the act of lifting (r=-206; p=0.006). Conclusion: It was observed that most of the non-institutionalized elderly persons had good functional capacity. It is also possible to affirm that there is an association between low back pain and functional capacity.
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Kato-Narita, Eliane Mayumi, Ricardo Nitrini, and Marcia Radanovic. "Assessment of balance in mild and moderate stages of Alzheimer's disease: implications on falls and functional capacity." Arquivos de Neuro-Psiquiatria 69, no. 2a (April 2011): 202–7. http://dx.doi.org/10.1590/s0004-282x2011000200012.
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OBJECTIVE: To analyze the correlation between balance, falls and loss of functional capacity in mild and moderate Alzheimer's disease(AD). METHOD: 40 subjects without cognitive impairment (control group) and 48 AD patients (25 mild, 23 moderate) were evaluated with the Berg Balance Scale (BBS) and the Disability Assessment for Dementia (DAD). Subjects answered a questionnaire about falls occurrence in the last twelve months. RESULTS: Moderate AD patients showed poorer balance (p=0.001) and functional capacity (p <0.0001) and it was observed a correlation between falls and balance (r= -0.613; p=0.045). CONCLUSION: There is a decline of balance related to AD which is a factor associated to the occurrence of falls, albeit not the most relevant one. The loss of functional capacity is associated with the disease's progress but not to a higher occurrence of falls. The balance impairment did not correlate with functional decline in AD patients.
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Shublaq, Marcia, Marco Orsini, and Marzia Puccioni-Sohler. "Implications of HAM/TSP functional incapacity in the quality of life." Arquivos de Neuro-Psiquiatria 69, no. 2a (April 2011): 208–11. http://dx.doi.org/10.1590/s0004-282x2011000200013.
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OBJECTIVE: To identify the functional status and quality of life of HAM/TSP patients. METHOD: We evaluated prospectively 30 HAM/TSP patients (20 females) seen in the Neuroinfection Clinic of the HUGG. The functional capacity was analyzed by the functional independence measure (FIM), the expanded disability status (EDSS) scale and the Osame's motor disability score (OMDS). The quality of life was assed by the Short-Form Health Survey 36 (SF-36)TM. RESULTS: All patients need assistance device. The FIM, OMDS and EDSS scores classified 70%, 67% and 67% of the patients as dependent, respectively. The lowest scores of the SF-36 survey were found in the domains related to the physical health (D1, D2), role-emotional functioning (D7) and social functioning (D6). CONCLUSION: Our data suggest that the HAM/TSP physical impairment has an impact in the emotional and social issues, considering the limitation in the daily activities.
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Smith, Natalie A., Marijka Batterham, Gregory E. Peoples, and Mark A. Shulman. "The clinical, functional and disability characteristics of patients with severe obesity presenting for non-bariatric surgery." Anaesthesia and Intensive Care 47, no. 6 (November 2019): 522–31. http://dx.doi.org/10.1177/0310057x19887976.
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The clinical and functional characteristics of patients with severe obesity who present for non-bariatric surgery have rarely been described. For this study, 293 such patients (mean body mass index 42 kg/m2) were investigated using their medical records, a 6-minute walk test, N-terminal pro B-type natriuretic peptide measurement, and the World Health Organization Disability Assessment Schedule 2.0 measure of disability. Cardiorespiratory disease and diabetes were common, with blood tests revealing a high probability of additional unexpected and undiagnosed renal and cardiac disease in a significant proportion of patients. One-third of patients had natriuretic peptide values that identify early left ventricular dysfunction in the community, with 16% above a value described as useful in predicting adverse outcomes for elective surgical patients. Only 10% of patients walked a distance within 10% of that predicted in six minutes, and 22% did not complete the test. Over one-third of patients (34%) had a clinically significant level of disability, with those unable to walk for six minutes describing higher levels of disability. Functional capacity as measured by the 6-minute walk test was significantly lower than would be expected from age, gender, and weight alone, and was related to age and degree of disability but not body mass index. We describe a severely obese population presenting for non-bariatric surgery who had significant levels of comorbid disease, functional impairment, and disability that were not apparent on routine preoperative assessment.
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Amorim, Diane Nogueira Paranhos, Clarrissa Marrreiros Lages da Silveira, Vicente Paulo Alves, Vicente de Paula Faleiros, and Karla Helena Coelho Vilaça. "Association between religiosity and functional capacity in older adults: a systematic review." Revista Brasileira de Geriatria e Gerontologia 20, no. 5 (October 2017): 722–30. http://dx.doi.org/10.1590/1981-22562017020.170088.
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Abstract Objective: To verify the association between religiosity and functional capacity in the elderly. Method: a systematic review of literature in the SciELO, Lilacs, MEDLINE/PubMed and the portal of CAPES Journals databases was performed. The descriptors were selected through the list of Descriptors in Health Sciences (Decs) and Medical Subject Headings (Mesh). Original articles in Portuguese and English, published between 2007 and 2017, with a sample composed of elderly persons aged 60 years or more were included. Systematic or integrative reviews, case studies, scale validation studies, dissertations and theses and studies on religious social support were excluded, as well as articles that included elderly persons and adults in the sample. Result: 280 articles were identified, of which six were included in this review. Religiosity was associated with improved functional capacity and coping with disability and the delay of functional decline in the elderly. Different aspects of religiosity were associated with functional capacity, such as participation in religious activities, religious leadership role performance and religious beliefs and traditions. In three articles the positive association between religiosity and functional capacity was linked only to public religious activities and not to intrinsic religious practices. Conclusion: religiosity is significantly and positively associated with the functional capacity of the elderly. The association between intrinsic religiosity and functional capacity is still unclear.
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O'Shea, Tom. "A civic republican analysis of mental capacity law." Legal Studies 38, no. 1 (March 2018): 147–63. http://dx.doi.org/10.1017/lst.2017.7.
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AbstractThis paper draws upon the civic republican tradition to offer new conceptual resources for the normative assessment of mental capacity law. The republican conception of liberty as non-domination is used to identify ways in which such laws generate arbitrary power that can underpin relationships of servility and insecurity. It also shows how non-domination provides a basis for critiquing legal tests of decision making that rely upon ‘diagnostic’ rather than ‘functional’ criteria. In response, two main civic republican strategies are recommended for securing freedom in the context of the legal regulation of psychological disability: self-authorisation techniques and participatory shaping of power. The result is a series of proposals for the reform of decisional capacity law, including a transition towards purely functional assessment of decisional capacity, surer legal footing for advanced care planning, and greater control over the design and administration of decision making capacity laws by those with psychological disabilities.
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Notaro, Larissa Stefany Tavares, Manuella Moraes Monteiro Barbosa Barros, Taís Siqueira Vasconcelos, Mayara Cristina Macêdo de Menezes, Daniella Araújo de Oliveira, and Débora Wanderley. "Assessment of balance and functional capacity in fibromyalgia patients with and without migraine." Headache Medicine 13, no. 2 (June 30, 2022): 124–32. http://dx.doi.org/10.48208/headachemed.2022.8.
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ObjectiveTo evaluate the balance and functional capacity of fibromyalgia patients’ with and without migraine.MethodsObservational study with 60 women, between 20 and 60 years old (47±9 years), who were allocated into the following groups: 1. fibromyalgia and migraine (n=49); 2. only fibromyalgia (n=11). The following were used: Migraine Disability Assessment Test (MIDAS) to analyze the impact of migraine on quality of life; Revised Fibromyalgia Impact Questionnaire (FIQ-R) to assess the impact of fibromyalgia; six-minute walk test (6MWT)to assess functional capacity and Berg Balance Scale (BBE) for balance analysis.ResultsThere was no difference between groups 1 and 2 regarding functional capacity (TC6M: 308.7 m ±107.33 vs. 298.8 m ±153.54; p=0.55) and balance (BBE: 48± 14 vs. 47±16; p=0.68) as well as the impact on quality of life (FIQ: 78.8±14.77 vs. 74.4±13.99; p=0.28 and MIDAS: 31 ±24).ConclusionsOur study showed that there was no difference in functional capacity, balance and quality of life in fibromyalgia patients compared to patients with fibromyalgia associated with migraine.
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Loginova, E. Yu, T. V. Korotaeva, Yu L. Korsakova, E. E. Gubar, P. O. Tremaskina, E. A. Vasilenko, I. N. Kushnir, et al. "The clinical status and working capacity in patients included in the All-Russian Psoriatic Arthritis Registry." Modern Rheumatology Journal 14, no. 3 (September 21, 2020): 19–26. http://dx.doi.org/10.14412/1996-7012-2020-3-19-26.
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Objective: to study the clinical characteristics of PsA and working capacity in patients included in the All-Russian PsA Registry.Patients and methods. The investigation enrolled 614 patients aged 19–84 years with psoriasis from 39 subjects the Russian Federation, who were followed up in the All-Russian PsA Registry. On the basis of the assessment of demographic data, the spectrum of comorbidities, the degree of activity of the underlying disease according to Disease Activity Index for PsA (DAPSA) and Disease Activity in 28 joints (DAS28), clinical, functional, and social indicators were analyzed in the patients. The investigators studied information on the patients employment, working capacity, and disability, by assessing the group of the latter. The health status and the presence and severity of functional impairment in the patients were analyzed using the Health Assessment Questionnaire (HAQ), while their working efficiency was estimated according to the Workers Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP questionnaire), by calculating the following parameters: absenteeism, presenteeism, an overall decrease in labor productivity, and impairment in daily functional activity.Results and discussion. The analysis of the All-Russian PsA Registry showed that most of them were of working age (30 to 59 years); 48.4% had concomitant diseases. Data on DAPSA changes were obtained in 349 patients, who were recorded to have mainly moderate (34.7%) or high (42.7%) disease activity, multiple dactylitides and enthesitides, and limited joint function. The registry reflects information on the social status of 521 patients: employed (61.2%) and unemployed (22.1%) persons, pensioners (15.2%), and students (1.5%). More than one third (37.1%) of patients with PsA had disability, mainly of Group III. The changes in the HAQ disability index were assessed in 326 patients; mild, moderate, and severe functional impairments were observed in 36, 26.4, and 3.7%, respectively. Absenteeism was detected in less than one third of patients with PsA, presenteeism was found in about half; there was an overall decrease in labor productivity in more than 60% and daily activity impairment in 68.8%. Statistically significant direct moderate correlations were established between the indicators of PsA activity (DAPSA and DAS28) and the level of productivity impairment in the patients; this was mostly related to an overall decline in labor productivity and to a decrease in daily activity.Conclusion. The data obtained from real clinical practice suggest that half of the PsA patients had high disease activity and a third had severe functional impairment, which led to a lower quality of life and to disability. The overall decrease in labor productivity and daily activity, which was detected in more than half of the patients, was associated with high PsA activity. The follow-up in the All-Russian PsA Registry, regular anti-inflammatory therapy with disease-modifying antirheumatic drugs and biological agents can improve the clinical and functional status and, consequently, working capacity in patients with PsA.
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Kieseier, Bernd C., and Carlo Pozzilli. "Assessing walking disability in multiple sclerosis." Multiple Sclerosis Journal 18, no. 7 (April 24, 2012): 914–24. http://dx.doi.org/10.1177/1352458512444498.
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Most patients with multiple sclerosis (MS) eventually experience walking disability. The objective of this review was to evaluate the clinical utility of measures specific for walking in MS. Walking assessments had high reliability and were correlated with related measures, including the 12-item multiple sclerosis walking scale (MSWS-12). Shorter timed walking tests (Timed 25-foot Walk (T25FW), 10-metre Timed Walk, 30-metre Timed Walk) measure overall walking disability and are best suited for clinical settings, whereas longer timed or distance tests (100-metre Timed Walk, 6-minute Walk Test, 2-minute Walk Test) are better for the assessment of walking fatigability, distance limitations and functional capacity. The MSWS-12 measures different, but related, aspects of walking than the objective tests. The T25FW is the best characterised objective measure of walking disability and can be used across a wide range of walking disabilities. Additional work is needed to fully characterise the other objective walking assessments in MS.
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Dai, Mingliang, Pamela Roberto, Sarah Tom, Emma Gentry, and Bruce Stuart. "Quantifying the Cost of Disability Transitions in Medicare." Journal of Aging and Health 29, no. 5 (April 28, 2016): 788–804. http://dx.doi.org/10.1177/0898264316645547.
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Objective: To investigate the impact of disability transitions on annual Medicare Part A and B cost. Method: We analyzed 6,385 community-dwelling beneficiaries who were continuously enrolled in fee-for-service Medicare Part A and B from 2008 to 2009. We estimated adjusted effects of disability transitions on Medicare cost using a generalized linear model. Results: Transitions to more severe disability states were associated with significantly higher average annual Medicare cost ranging from US$2,639 to US$5,405. Lower spending levels were observed for beneficiaries with improvements in functioning. Beneficiaries who transitioned from severe to moderate activities of daily living (ADLs) disability cost significantly less (−US$6,045) than those who remained severely disabled. Discussion: Interventions aimed at preventing disability progression and efforts to restore functional capacity are promising strategies for containing costs and generating savings for Medicare. Future research is needed to assess the longer term impact of disability in association with the progression of chronic conditions.
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Jovanovic, Jelena, Miodrag Stojanovic, Vladimir Jovanovic, Aleksandar Dimic, Sladjana Bozilov, Bojana Stamenkovic, and Sasa Milenkovic. "Influence of disease activity on functional capacity in patients with rheumatoid arthritis." Vojnosanitetski pregled 72, no. 1 (2015): 21–25. http://dx.doi.org/10.2298/vsp1501021j.
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Background/Aim. Progressive erosive changes in cartilage and bone in rheumatoid arthritis (RA) ultimately lead to joint deformities and disability which may be early, severe and permanent. Consequently, there is the reduction of functional ability and changes in the quality of life. The aim of this study was to estimate the impact of disease activity on functional status of patients with RA. Methods. A prospective investigation included 74 patients with RA who were treated in the Rheumatology Clinic of the ?Niska Banja? Institute. Assessment of functional status (capacity) was measured by the Health Assessment Questionnaire (HAQ) with the values from 0 to 3 that patients fill out on their own. The patients were then divided into three groups: the group I with the HAQ values from 0.125 to 1.000, the group II with the values from 1.125 to 2.000 and the group III with the values from 2.125 to 3.000. Disease activity was measured by Disease Activity Score (DAS28). The assessment also included sedimentation rate (SE) influence, IgM rheumatoid factor (RF) and C-reactive protein (CRP) positivity, age, and disease duration. Results. The patients with the most severe functional damage estimated by the HAQ - the group III, had the highest values of DAS28 SE (7.4 ? 0.8) compared to the group II (6.5 ? 1.2) and the group I (3.4 ? 1.2). The group III also showed the highest values of DAS28 CRP (7.1 ? 0.8) compared to the group II (6.7 ? 0.8) and the group I (3.6 ? 0.4). Compared with the patients with small and moderate functional damage, the patients in the group III had positive IgM RF and CRP as well as higher SE values more frequently and the difference was statistically significant. In the univariate logistic model, the tested parameters of DAS28 SE, DAS 28 CRP, SE, RF and CRP represent significant predictors of functional disability. The most significant factors that increase the odds of patient having the most severe functional damage include DAS28 SE which increases the odds by 5.5 times (OR = 5.450, 95% CI = 3.211-7.690, p = 0.001), DAS28 CRP by 5.1 times (OR = 5.111, 95% CI = 2.123-10.636, p < 0.01), and the presence of increased CRP (OR = 5.219, 95% CI = 1.305-18.231, p = 0.019) by 5.2 times. Conclusion. Functional status evaluated by the HAQ is a standard for assessment of RA due to its convenience and good correlation with parameters of disease activity. The most significant factors that increase the odds that the patient has the greatest functional damage are DAS28 SE, DAS28 CRP and the presence of CRP.
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Aldemir, Mustafa, Sadık Volkan Emren, Çınar Balçık, Ersel Onrat, and Merve Gürsoy. "Primary pulmonary arterial hypertension with preserved right ventricular function leads to lower extremity venous insufficiency." Vascular 26, no. 2 (August 23, 2017): 183–88. http://dx.doi.org/10.1177/1708538117723201.
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Objectives Pulmonary hypertension with heart failure is related to venous insufficiency. However, there is no clear data whether pulmonary arterial hypertension with preserved right ventricular function cause venous insufficiency. In this study, we aim to investigate the relation between pulmonary arterial pressure with venous insufficiency in pulmonary arterial hypertension patients with preserved right ventricular function. Methods Between January 2012 and October 2014, 38 patients with a diagnosis of pulmonary arterial hypertension and 47 control group patients were included. Venous disability score and venous segmental disease score of both groups were calculated in order to measure venous insufficiency. The relationship between venous disability score and venous segmental disease scores and mean pulmonary arterial pressure and World Heart Organization functional capacity was examined. Results Total venous segmental disease score (5 ± 3.9 vs. 2 ± 1.8 p < 0.001), right venous segmental disease score (2.6 ± 2.2 vs. 1 ± 0.9 p < 0.001), left venous segmental disease score (2.4 ± 2.2 vs. 1 ± 0.9 p < 0.001), and venous disability scores (2.2 ±1 vs. 1.6 ± 0.7 p < 0.001) of patients with pulmonary arterial hypertension were higher than the control group. While the total venous segmental disease score was highly related to mean pulmonary arterial pressure (r = 0.829, p < 0.001), the venous disability score was only weakly related (r = 0.343, p = 0.037). Total venous segmental disease score (r = 0.606, p < 0.001) and venous disability scores (r = 0.601, p < 0.001) were moderately related with World Health Organization functional capacity intensity. Conclusions The degree of venous insufficiency increase in accordance with the mean pulmonary arterial pressure even in patients with preserved right ventricular function.
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Knobler, Robert L., Charles N. Brooks, Leon H. Ensalada, James B. Talmage, and Christopher R. Brigham. "Letter to the Editor: The Continuing Challenge of Evaluating RSD Impairment and Disability." Guides Newsletter 3, no. 5 (September 1, 1998): 8–10. http://dx.doi.org/10.1001/amaguidesnewsletters.1998.sepoct05.
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Abstract The author of the two-part article about evaluating reflex sympathetic dystrophy (RSD) responds to criticisms that a percentage impairment score may not adequately reflect the disability of an individual with RSD. The author highlights the importance of recognizing the difference between impairment and disability in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides): impairment is the loss, loss of use, or derangement of any body part, system, or function; disability is a decrease in or the loss or absence of the capacity to meet personal, social, or occupational demands or to meet statutory or regulatory requirements because of an impairment. The disparity between impairment and disability can be encountered in diverse clinical scenarios. For example, a person's ability to resume occupational activities following a major cardiac event depends on medical, social, and psychological factors, but nonmedical factors appear to present the greatest impediment and many persons do not resume work despite significant improvements in functional capacity. A key requirement according to the AMA Guides is objective documentation, and the author agrees that when physicians consider the disability evaluation of people, more issues than those relating to the percentage loss of function should be considered. More study of the relationships among impairment, disability, and quality of life in patients with RSD are required.
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Donato, Michael Di, Ross Iles, Tyler Lane, and Alex Collie. "O4B.3 The impact of income support systems on healthcare quality and functional capacity in workers with LBP: a realist review." Occupational and Environmental Medicine 76, Suppl 1 (April 2019): A34.3—A35. http://dx.doi.org/10.1136/oem-2019-epi.93.
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BackgroundLow back pain (LBP) is a leading cause of work disability. While absent from work, workers with LBP may receive income support from a system such as workers’ compensation or social security. Current evidence suggests that income support systems can influence recovery from LBP, but provides little evidence as to why and how these effects occur. This study examines how and in what contexts income support systems impact the healthcare quality and functional capacity of people with work disability and LBP.MethodsWe performed a realist review, a type of literature review that seeks to explain how social interventions and phenomena in certain contexts generate outcomes, rather than simply whether or not they do. Five initial theories about the mechanisms of the relationship were developed, tested, and refined by acquiring and synthesising academic literature from purposive and iterative electronic database searching. This process was supplemented by grey literature searching for policy documents and legislative summaries, and semi-structured interviews with experts in income support, healthcare, and LBP.ResultsIncome support systems influence healthcare quality through healthcare funding restrictions, healthcare provider administrative burden, and allowing an employer to select healthcare providers. Income support systems influence worker functional capacity through the level of participation and share of income support funding required of employers, and through certain administrative procedures. These mechanisms are often exclusively context-dependent, and generate differing and unintended outcomes depending on features of the healthcare and income support system, as well as other contextual factors such as socioeconomic status and labour force composition.ConclusionIncome support systems impact the healthcare quality and functional capacity of people with work disability and LBP through context-dependent financial control, regulatory, and administrative mechanisms. Future policy design and research efforts should consider how income support systems may indirectly influence workers with LBP via the workplace.