Статті в журналах: "Limb disability"

1

Heavey, Emily. "The multiple meanings of ‘disability’ in interviews with amputees." Communication and Medicine 10, no. 2 (March 11, 2014): 129–39. http://dx.doi.org/10.1558/cam.v10i2.129.

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The link between having a lower-limb amputation and being disabled might seem self-evident. Indeed, the medical model of disability would suggest that lower-limb amputation causes disability, and that all lower-limb amputees are disabled people. Conversely, social models of disability would argue that limb loss does not determine disability, but that disabilities are rather caused by social structures and prejudices, while the interactional model suggests that there are both individual and social causes of disability. This paper draws on interviews with nine lower-limb amputees to address amputees’ own accounts of disability, in order to determine how (if at all) they make links between being an amputee and being disabled. The analysis shows that participants draw on various models of disability, as well as their own lived experiences, to construct subjective and diverse definitions of disability. Three interlinking definitions of disability recurred across the data: disability as a measure of personal (in)abilities; disability as a stigmatizing mask; and disability as an official status. Overall, disability was constructed as a complex, context-dependent label, which could not be reduced to any singular concept.

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2

Straube, Sebastian, and Fiona Blyth. "Lower limb pain and locomotor disability." Pain 153, no. 5 (May 2012): 937–38. http://dx.doi.org/10.1016/j.pain.2012.02.036.

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Rodríguez-Romero, Beatriz, Coral Pérez-Valiño, Beatriz Ageitos-Alonso, and Sonia Pértega-Díaz. "Prevalence and Associated Factors for Musculoskeletal Pain and Disability Among Spanish Music Conservatory Students." Medical Problems of Performing Artists 31, no. 4 (December 1, 2016): 193–200. http://dx.doi.org/10.21091/mppa.2016.4035.

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OBJECTIVES: To assess the prevalence of and factors associated with musculoskeletal pain (MSP) and neck and upper limb disability among music conservatory students. METHODS: An observational study in two Spanish conservatories, investigating a total of 206 students, administered the Nordic Musculoskeletal Questionnaire, visual analog scale for pain intensity, Neck Disability Index, DASH, and SF-36. Demographic and lifestyle characteristics and musical performance variables were recorded. Regression models were performed to identify variables associated with MSP for the four most affected anatomical regions and with neck and upper limb disability. RESULTS: The locations with the highest prevalence of MSP were the neck, upper back, shoulders, and lower back. Mild disability affected 47% of participants in the neck and 31% in the upper limbs. Mental health (SF-36) was below the average for the general population (45.5±10.2). Women were more likely to suffer neck pain (odds ratio [OR] 1.1–5.2), lower back pain (OR 1.7–8.7), and neck disability (B 0.6–7.8). The risk for shoulder pain was higher in those who played for more hours (OR 1.7-24.7) and lower among those who performed physical activity (OR 0.23–1.00). Disability in the neck (B –0.3) and upper limbs (B –0.4) was associated with poorer mental health (SF-36). CONCLUSION: MSP is highly prevalent in music students. Neck and upper limb disability were slight to moderate and both were associated with poorer mental health. The main factors associated with MSP were being female, hours spent practicing, and physical activity. Physical and psychological factors should be taken into account in the prevention of MSP in student-musicians.

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Delcourt, Candice, Shoichiro Sato, Shihong Zhang, Else Charlotte Sandset, Danni Zheng, Xiaoying Chen, Maree L. Hackett, et al. "Intracerebral hemorrhage location and outcome among INTERACT2 participants." Neurology 88, no. 15 (February 24, 2017): 1408–14. http://dx.doi.org/10.1212/wnl.0000000000003771.

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Objective:To clarify associations between intracerebral hemorrhage (ICH) location and clinical outcomes among participants of the main phase Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).Methods:Associations between ICH sites and poor outcomes (death [6] or major disability [3–5] of modified Rankin Scale) and European Quality of Life Scale (EQ-5D) utility scores at 90 days were assessed in logistic regression models.Results:Of 2,066 patients included in the analyses, associations were identified between ICH sites and poor outcomes: involvement of posterior limb of internal capsule increased risks of death or major disability (odds ratio [OR] 2.10) and disability (OR 1.81); thalamic involvement increased risks of death or major disability (OR 2.24) and death (OR 1.97). Involvement of the posterior limb of the internal capsule, thalamus, and infratentorial sites were each associated with poor EQ-5D utility score (≤0.7 [median]; OR 1.87, 2.14, and 2.81, respectively). Posterior limb of internal capsule involvement was strongly associated with low scores across all health-related quality of life domains. ICH encompassing the thalamus and posterior limb of internal capsule were associated with death or major disability, major disability, and poor EQ-5D utility score (OR 1.72, 2.26, and 1.71, respectively).Conclusion:Poor clinical outcomes are related to ICH affecting the posterior limb of internal capsule, thalamus, and infratentorial sites. The highest association with death or major disability and poor EQ-5D utility score was seen in ICH encompassing the thalamus and posterior limb of internal capsule.ClinicalTrials.gov registration:NCT00716079.

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Ashtaputre, Arya Shirish, Ayman Shaad Gondekar, and Govinda Varadharajulu. "The Study of Prevalence of Low Back Pain and Its Correlation with Functional Disability in Patients with Lower Limb Amputation." Journal of Evolution of Medical and Dental Sciences 10, no. 30 (July 26, 2021): 2233–38. http://dx.doi.org/10.14260/jemds/2021/457.

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BACKGROUND Low back pain (LBP) is a very common and disabling condition experienced by individuals during their lifetime. However, the causes of low back pain may vary and include musculoskeletal impairments, biomechanical abnormalities, gait deviations, primary medical causes, and deleterious or excessive activity.1 The different levels at which amputation is done in the lower limb are hip disarticulation, transfemoral amputation (above knee), knee disarticulation, transtibial amputation (below knee), ankle disarticulation and transmetatarsal amputation. Lower limb amputation (LLA) is known to cause LBP and may result in functional disability in lower limb amputees. Different parameters such as level of amputation, use of prosthesis etc. affect low back pain in amputees. The purpose of this study was to find out the prevalence of low back pain and its correlation with functional disability in patients with lower limb amputation. METHODS This is a community based observational study. 41 participants were included in the study. Data was collected using a questionnaire including the demographic information of each participant, pain assessment and revised Oswestry low back pain disability (RODQ) questionnaire to assess functional disability. RESULTS The study revealed that the prevalence of the reported back pain in the studied sample was 60.9 %. In 60 % of the patients, the Oswestry disability index depicted moderate disability. CONCLUSIONS The study concludes that low back pain is a significant problem in lower limb amputees. Several factors such as level of amputation, age, time since amputation put the lower limb amputees at a risk of developing back pain. Back pain intensity is important to assess the back pain related functional disability. KEY WORDS Amputation, Low Back Pain, Disability, Prosthesis

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Dymecka, Joanna, and Mariola Bidzan. "Biomedical Variables and Adaptation to Disease and Health-Related Quality of Life in Polish Patients with MS." International Journal of Environmental Research and Public Health 15, no. 12 (November 28, 2018): 2678. http://dx.doi.org/10.3390/ijerph15122678.

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The aim of this research was to assess the level of adaptation to multiple sclerosis (Sclerosis multiplex; MS) and health-related quality of life (HRQoL) of the study population as well as to determine the relationship between biomedical factors related to the course of multiple sclerosis, adaptation to the disease, and HRQoL. Analysis of medical records, clinical and psychological interviews, the Extended Disability Status Scale (EDSS), Guy’s Neurological Disability Scale (GNDS), the Acceptance of Illness Scale (AIS), and the Multiple Sclerosis Impact Scale 29 (MSIS-29) were collected from 137 patients with MS. It was found that there was a relation between motor impairment, neurological disability, adaptation to illness, and HRQoL; it was also found that there were negative correlations between adaptation to illness and the severity of lower-limb disability, fatigue, mood disorders, other problems related to MS, and upper-limb disability. Of all the symptoms, lower-limb disability, fatigue, and mood disorders had the strongest relation with adaptation. All of the analysed symptoms were found to correlate with HRQoL. Of all the symptoms, HRQoL was most affected by lower- and upper-limb disability, fatigue, other MS problems, and mood disorders.

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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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Radhakrishnan, Seema, Friedbert Kohler, Christoph Gutenbrunner, Arun Jayaraman, Jianin Li, Karin Pieber, and Carolina Schiappacasse. "The use of the International Classification of Functioning, Disability and Health to classify the factors influencing mobility reported by persons with an amputation: An international study." Prosthetics and Orthotics International 41, no. 4 (July 2016): 412–19. http://dx.doi.org/10.1177/0309364616652016.

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Background: Amputation of lower limb results in limitations in mobility which are amenable to multiple rehabilitation interventions. The challenges faced by the persons with lower limb amputation vary internationally. The International Classification of Functioning, Disability and Health provides a common language to describe the function of persons with lower limb amputation across various countries. Objectives: This article reports the concepts in mobility important to persons with lower limb amputation across six countries using the International Classification of Functioning, Disability and Health. Study design: Qualitative study using focus groups and individual interviews. Methods: Focus groups and individual interviews of persons with lower limb amputation were organised across six countries to identify the issues faced by patients with an amputation during and after their amputation, subsequent rehabilitation and on an ongoing basis in their daily life. Meaningful concepts were extracted from the responses and linked to suitable second-level and where applicable third-level International Classification of Functioning, Disability and Health categories. International Classification of Functioning, Disability and Health categorical frequencies were analysed to represent the prevalence and spread of International Classification of Functioning, Disability and Health categories by location. Results: A total of 133 patients were interviewed. A large percentage (93%) of the identified concepts could be matched to International Classification of Functioning, Disability and Health categories for quantitative analysis. Conclusion: The important concepts in mobility were similar across different countries. The comprehensiveness of International Classification of Functioning, Disability and Health as a classification system for human function and its universality across the globe is demonstrated by the large proportion of the concepts contained in the interviews from across the study centres that could be matched to International Classification of Functioning, Disability and Health categories. Clinical relevance The activity and participation restrictions faced by a person with lower limb amputation vary internationally and are amenable to multiple rehabilitation interventions. The International Classification of Functioning, Disability and Health may provide a common language to report and quantify the various concepts important to the patient in their rehabilitation journey.

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Nogueira, Leandro Alberto Calazans, Felipe Resende Nóbrega, Kátia Nogueira Lopes, Luiz Claudio Santos Thuler, and Regina Maria Papais Alvarenga. "The effect of functional limitations and fatigue on the quality of life in people with multiple sclerosis." Arquivos de Neuro-Psiquiatria 67, no. 3b (September 2009): 812–17. http://dx.doi.org/10.1590/s0004-282x2009000500006.

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The purpose of this study was to determine the effect of functional limitations and fatigue on the quality of life (QoL) in people with multiple sclerosis (MS). A descriptive case series study at Lagoa Hospital - Rio de Janeiro, Brazil was carried. The main outcome measurements were demographic variables, QoL (SF-36 v.1), disability (EDSS), motor function of the upper limb (Box & Blocks test), Tone (Modified Ashworth Scale), gait (Hauser ambulatory index) and fatigue (Fatigue Severity Scale). Sixty one patients fulfilled the study criteria. The mean age of patients was 39 years and 74% of patients were female. The most of cases presented mild disability (EDSS<3.5). A decrease was found in all domains of QoL. It was found association between physical functioning and the variables of EDSS, fatigue, lower limb tone and gait. Gait, disability, hypertonia of the lower limbs and fatigue negatively affected QoL in people with MS.

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Hayward, Kathryn S., Ruth N. Barker, Amy H. Wiseman, and Sandra G. Brauer. "Dose and Content of Training Provided to Stroke Survivors with Severe Upper Limb Disability Undertaking Inpatient Rehabilitation: An Observational Study." Brain Impairment 14, no. 3 (November 28, 2013): 392–405. http://dx.doi.org/10.1017/brimp.2013.31.

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Background: To retrain upper limb function after stroke, a high dose of activity-related therapy is recommended. However, observational studies indicate that the dose undertaken is minimal. While it is speculated that those with severe disability will perform less therapy, this remains to be explored.Objective: Quantify the dose and content of upper limb therapy performed by stroke survivors with severe upper limb disability during routine inpatient rehabilitation.Methods: Therapy provided by physiotherapists and occupational therapists to 32 stroke survivors receiving inpatient rehabilitation over 20 weekdays was recorded. Dose of individual and group therapy was analysed by discipline and severity of upper and lower limb disability. Dose and content of individual therapy was also analysed by functional domain.Results: On average, 46 minutes of individual and 11 minutes of group upper limb therapy were provided per participant, per day. Occupational therapists provided a higher dose of both individual and group therapy compared to physiotherapists (p < 0.0005). Findings suggest that greater residual upper and lower limb movement can lead to provision of a higher dose of activity-related therapy. Within individual therapy, a higher dose (29 versus 17 minutes, p < 0.002) and greater number (1218 versus 549) of impairment- than activity-related interventions were administered.Conclusions: The dose of activity-related upper limb therapy provided to stroke survivors with severe disability was limited. There is a need to identify interventions and models of service delivery that can increase the intensity and appropriateness of therapy that stroke survivors with severe disability undertake during inpatient rehabilitation.

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Gibson, Richard B. "Elective Impairment Minus Elective Disability: The Social Model of Disability and Body Integrity Identity Disorder." Journal of Bioethical Inquiry 17, no. 1 (December 19, 2019): 145–55. http://dx.doi.org/10.1007/s11673-019-09959-5.

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AbstractIndividuals with body integrity identity disorder (BIID) seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be.

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Müller, Juliana dos Santos, Ila Rocha Falcão, Maria Carolina Barreto Moreira Couto, Wendel da Silva Viana, Ivone Batista Alves, Denise Nunes Viola, Courtney Georgette Woods, and Rita de Cássia Franco Rêgo. "Artisanal fisherwomen/shellfish gatherers: analyzing the impact of upper limb functioning and disability on health-related quality of life." Ciência & Saúde Coletiva 22, no. 11 (November 2017): 3635–44. http://dx.doi.org/10.1590/1413-812320172211.13392016.

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Abstract The aim is to analyze upper limb functioning and disability, and its association with health-related quality of life among artisanal fisherwomen from Bahia, Brazil. Cross-sectional epidemiological study was conducted with a sample of 209 fisherwomen. Structured questionnaires were used for socio-demographic and comorbidity information, as well as the instruments Disabilities of the Arm, Shoulder and Hand (DASH) and Short-Form Healthy Survey (SF-36) respectively, to evaluate the upper limbs and health-related quality of life. The results demonstrated that the presence of musculoskeletal disorders in the upper limbs directly affects the values of the DASH instrument and the SF-36v01 questionnaire scores, while also generating a negative correlation between the DASH and SF-36v01. The varying functioning abilities, pain and social aspects negatively affect upper limb function, and the daily activities and work of fisherwomen. The presence of chronic disease and the absence of intervention and rehabilitation for these professionals, that could produces, in a long-term, cases of disability.

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Sharrack, Basil, and Richard AC Hughes. "The Guy's Neurological Disability Scale (GNDS): a new disability measure for multiple sclerosis." Multiple Sclerosis Journal 5, no. 4 (August 1999): 223–33. http://dx.doi.org/10.1177/135245859900500406.

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A postal survey showed that the majority of 49 leading international neurologists involved with multiple sclerosis research felt that currently existing outcome measures for this illness were inadequate, and that there was a need for a new measure which should be patient orientated, multidimensional, and not biased towards any particular disability. The Guy's Neurological Disability Scale (GNDS) was subsequently devised as a simple and user-friendly clinical disability scale capable of embracing the whole range of disabilities which could be encountered in the course of multiple sclerosis. It has 12 separate categories which include cognition, mood, vision, speech, swallowing, upper limb function, lower limb function, bladder function, bowel function, sexual function, fatigue, and `others'. The GNDS was found to be acceptable to neurologists and patients, reliable, responsive, and valid as a measure of disability. The scale was also found to be valid when applied by non-neurologists, over the phone, or via a postal questionnaire.

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Jasim, Nizar Abdulateef. "Association of radiological osteoarthritis of the knee joint with locomotor disability." AL-Kindy College Medical Journal 15, no. 1 (September 12, 2019): 36–42. http://dx.doi.org/10.47723/kcmj.v15i1.76.

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Background: Knee osteoarthritis (KOA) is a common joint disorder leading to considerable pain and locomotor disability in lower limb function. Locomotor disability, which is difficulty in activities of daily living related to lower limb function, can be the consequence of KOA, so early diagnosis and management may improve quality of life. Objective: To assess the contribution of radiological osteoarthritis of the knees to disability in the activities of daily living related to lower limb function. Methods: One hundred twenty Iraqi KOA patients (104 females and 16 males) who were attending to Rheumatology Unit, Full history was taken and complete clinical examination was done for all patients. Wight-bearing X-rays of both knees (anteroposterior and lateral view) were taken for patients and were graded according to Kellgren and Lawrence scale. Results: The frequency of locomotor disability, was 62.50% for men and 72.11% for women (p=0.431). The frequency of radiological osteoarthritis of the knee was 50% for men and 40.37% for women (p=0.651). There was significant statistical differences between; locomotor disability, and increased age, morning stiffness, muscle wasting & BMI (p=0.000, p=0.003, p=0.002 and p=0.028 respectively). There was no statistical significant association between; KOA radiological grading, and gender, morning stiffness, BMI & lower limb locomotor functions disability (p=0.651, p=0.357 and p=0.972 respectively). Conclusion: Radiological osteoarthritis of the knee is only weak independent predictors of locomotor disability. Patient's age, pain of the knees, muscle wasting, morning stiffness and obesity seem to be the most important independent determinants of locomotor disability.

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Butowicz, Courtney M., Sheri P. Silfies, Jennifer Vendemia, Shawn Farrokhi, and Brad D. Hendershot. "Characterizing and Understanding the Low Back Pain Experience Among Persons with Lower Limb Loss." Pain Medicine 21, no. 5 (November 9, 2019): 1068–77. http://dx.doi.org/10.1093/pm/pnz293.

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Abstract Objective This study preliminarily characterizes and compares the impact of lower limb loss and development of chronic low back pain (cLBP) on psychosocial factors, as well as the relationship between these factors and low back pain–related functional disability. Design Cross-sectional study. Methods Participants were adults, active duty or retired military, with traumatic lower limb loss with and without chronic low back pain. Psychosocial factors and low back pain–related functional disability were measured using common clinical self-report questionnaires. The presence of psychosocial factors was compared between those with and without cLBP using multivariate analysis of covariance (P < 0.05), and correlations determined relationships between psychosocial factors and cLBP-related functional disability. Results There were no statistically significant differences among psychosocial factors between those with vs without cLBP (F(4, 13) = 0.81, P = 0.54, η2= 0.19). Employment status (ρ = 0.43, P = 0.02), anxiety (ρ = 0.45, P = 0.04), and kinesiophobia (ρ = 0.47, P = 0.04) were moderately associated with low back pain–related disability. Conclusions Psychological (i.e., anxiety) and social (i.e., employment status) factors may influence how persons with traumatic lower limb loss respond to self-reported measures of low back pain–related disability. The findings suggest that the Modified Oswestry Disability Index identifies cLBP-related functional disability in the context of lower limb loss. These results support the interdependence among biological, psychological, and social factors, which should be collectively considered during the development of rehabilitative strategies to treat secondary musculoskeletal conditions within this population.

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Aparicio, Pilar, Óscar Izquierdo, and Juan Castellanos. "Conservative Treatment of Distal Radius Fractures: A Prospective Descriptive Study." HAND 13, no. 4 (June 5, 2017): 448–54. http://dx.doi.org/10.1177/1558944717708025.

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Background: Disability of the upper limb is one of the consequences of distal radius fracture (DRF). The outcome of DRF treatment is based on objective clinical variables, as strength or range of movement (ROM); sometimes these variables do not correlate with the functional level of the patient. The principal objective of our study was to assess the repercussion of conservative treatment of DRF on upper limb disability. Methods: This is a retrospective review of prospectively collected data. We collected data of 61 nonconsecutive DRFs treated conservatively from July 2007 to August 2008. Results: Average Disabilities of the Arm, Shoulder and Hand (DASH) score before fracture was 20.8 points; average DASH score after the fracture was 42.6. There was a significant increase in the upper limb disability after 1 year of follow-up in the patients treated conservatively ( P < .001; size effect, 1.06). Average radial inclination, radial tilt, and radial length were 18.18°, 3.35°, and 5.76 mm, respectively. Average ROM for flexion-extension was 100.6° and for pronation-supination 144.0°. ROM for flexion-extension of the unaffected wrist was 128.2° and for pronation-supination 172.4°. We did not find any significant statistical correlation between the increase in disability and the decrease in the ROM ( P > .05). We did not find any significant statistical correlation between the increase in the disability and the worsening in the radiological parameters ( P > .05). Our results confirm the hypothesis that the conservative treatment of DRF produced an increase in the upper limb disability after 1 year of follow-up. Conclusions: Our study does not show a correlation between the increase in upper limb disability and the decrease in wrist ROM. Our study did not find a correlation between radiological measures and DASH scores.

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Volpin, Gershon, George Petronius, Dory Hoerer, and Haim Stein. "Lower Limb Pain and Disability Following Strenuous Activity." Military Medicine 154, no. 6 (June 1, 1989): 294–97. http://dx.doi.org/10.1093/milmed/154.6.294.

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Fearnhead, L., C. J. Eales, and V. U. Fritz. "Arm function after stroke - can we make a difference?" South African Journal of Physiotherapy 55, no. 2 (May 31, 1999): 4–7. http://dx.doi.org/10.4102/sajp.v55i2.559.

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Impairment of upper limb function is a significant cause of functional disability after stroke. Based on a review of the literature this paper defines upper limb function and highlights some of the relevant recent developments in neuropathology. The effects of changes in sensation, muscle recruitment and tone are described. Reliable and valid outcome measures of upper limb impairment and disability are listed. The principles of rehabilitation are described in terms of timing of rehabilitation, sensory reeducation, motor control and functional use. Questions are raised regarding the need for counselling for the loss of fine discriminative hand function and for research into this behavioural aspect of upper limb rehabilitation.

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Chanda, Srei, and T. V. Sekher. "Perceived health versus perceived disability among individuals with lower limb amputation and its associating factors: evidence from an exploratory study in Mumbai and Kolkata, India." International Journal Of Community Medicine And Public Health 9, no. 5 (April 27, 2022): 2230. http://dx.doi.org/10.18203/2394-6040.ijcmph20221245.

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Background: Self-rated health (SRH) has been used to predict the perception of health in objective measures. Understanding the perception of disability goes beyond simple perception of health. Lower limb amputation and locomotors disability has been studied in various aspects, however, measurement of the extent of disability in a single term has hardly been done. This study aims to find the difference between perceived health (SRH) and perceived disability self-rated disability (SRD) and its association with demographic and socio-economic factors.Methods: A primary study has been conducted on 270 adult lower limb amputees in Mumbai and Kolkata following mixed methodology approach. Descriptive statistics, correlations and narration were used to measure the SRH and SRD among individuals with lower limb amputation.Results: The 63% of respondents have achieved good SRH, while only 43% have achieved good SRD. Prosthetics satisfaction, perceived support, perceived body shape, and level of education influence the SRH and SRD. Health components explain SRH, whereas, functional components explain SRD more.Conclusions: SRD can be better in analyzing the coping with the disability status, and promoting the role of health care and rehabilitation programs. It can be used not only for the population having disability, but in a larger population with functional restrictions that can be used to address the health care need.

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Gallagher, Pamela, Mary-Ann O’Donovan, Anne Doyle, and Deirdre Desmond. "Environmental barriers, activity limitations and participation restrictions experienced by people with major limb amputation." Prosthetics and Orthotics International 35, no. 3 (September 2011): 278–84. http://dx.doi.org/10.1177/0309364611407108.

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Background: Limited research is available that explores major limb amputation and the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). Objectives: To investigate the barriers, participation restriction and functioning levels experienced by people with a major limb amputation. Study design: Secondary data analysis. Method: Relevant data for 148 people with major limb amputation were extracted from the National Physical and Sensory Disability Database in Ireland. Results: The most common environmental barriers encountered were climate, physical environment and income. Participation restriction was most commonly experienced in sports/physical recreation, leisure/cultural activity and employment/job-seeking. For daily activities and functioning, the most common difficulties were with standing for long periods, walking long distances and the emotional effects of disability. Differences were found between people with an upper limb or lower limb prosthesis. Conclusion: This paper addresses the limited information available on environmental barriers, activity limitation and participation restriction of people with a major limb amputation. Greater understanding of the impact of amputation andprosthesis type on activity, participation and environmental barriers is important to facilitate improved management and planning at the individual, service and societal level. Clinical relevance Improved understanding of environmental barriers and challenges, activity limitations and participation restrictions experienced by individuals with major limb amputation is a critical step in informing evidence-based service delivery, intervention and policy in order to improve outcomes for this group.

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Varalta, Valentina, Elisa Evangelista, Anna Righetti, Giovanni Morone, Stefano Tamburin, Alessandro Picelli, Cristina Fonte, et al. "Effect of Upper Limb Motor Rehabilitation on Cognition in Parkinson’s Disease: An Observational Study." Brain Sciences 12, no. 12 (December 8, 2022): 1684. http://dx.doi.org/10.3390/brainsci12121684.

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Parkinson’s disease is characterized by motor and cognitive deficits that usually have an impact on quality of life and independence. To reduce impairment, various rehabilitation programs have been proposed, but their effects on both cognitive and motor aspects have not been systematically investigated. Furthermore, most intervention is focused on lower limb treatment rather than upper limbs. In the present study, we investigated the effect of 3-week upper limb vibratory stimulation training on cognitive functioning in 20 individuals with Parkinson’s disease. We analyzed cognitive (Montreal Cognitive Assessment, Trial Making Test, Digit Symbol, Digit Span Forward and Backward and Alertness) and motor performance (Unified Parkinson’s Disease Rating Scale—part III; Disability of the Arm, Shoulder and Hand Questionnaire) before treatment, at the end of treatment and one month post treatment. After rehabilitation, a statistically significant improvement was observed in terms of global cognitive status, attention, global motor functioning and disability. The results suggest an impact of upper limb motor rehabilitation on cognition in Parkinson’s disease. Future studies on neuromotor interventions should investigate their effects on cognitive functioning to improve understanding of cognitive motor interaction in Parkinson’s disease.

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Zhu, Tian Yang, Hui Min Wang, and Jun Liang Zhou. "Research on the design of travel aids for the elderly with partial disability of lower limbs." E3S Web of Conferences 275 (2021): 03037. http://dx.doi.org/10.1051/e3sconf/202127503037.

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As the population continues to age, the daily lives of those with disabled lower limbs have gradually become an unavoidable social welfare problem. Based on an investigation and analysis into the daily routines of the elderly with partial disability in their lower limbs, the product design experiment is proposed to solve any mobility difficulties in the elderly with partial disability in their lower limbs to provide practical help that can ensure their independence and social contact. Based on the literature research and market comparison, According to the assessment criteria for the Instrumental Activity of Daily Living Scale (IADL), the physiological functions and user behaviors of this elderly population were investigated, and the actual needs for outdoor walking were analyzed. The idea of focusing on auxiliary tools for the elderly with lower limb disability was proposed, and a tool to aid in short-distance travel was designed for this target group to improve their IADL travel index and optimize their mobility.

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Coghe, Giancarlo, Federica Corona, Giuseppina Pilloni, Micaela Porta, Jessica Frau, Lorena Lorefice, Giuseppe Fenu, Eleonora Cocco, and Massimiliano Pau. "Is There Any Relationship between Upper and Lower Limb Impairments in People with Multiple Sclerosis? A Kinematic Quantitative Analysis." Multiple Sclerosis International 2019 (October 9, 2019): 1–6. http://dx.doi.org/10.1155/2019/9149201.

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Background. In people with multiple sclerosis (pwMS), disability is generally assessed on the basis of ambulation abilities, whereas upper limb motor dysfunctions are less frequently considered. Nevertheless, they can severely affect the quality of life of pwMS. To date, it remains mostly unknown whether a relationship exists between upper and lower limb impairments. Aim. To investigate the existence of a relationship between upper and lower limb impairments in pwMS based on two fundamental motor tasks, namely walking and hand-to-mouth (HTM) movement. Methods. Twenty-eight pwMS with Expanded Disability Status Scale (EDSS) scores in the range of 1–6, and 21 healthy controls (HC) underwent a kinematic analysis of gait and HTM movement performed with a motion capture system. The spatiotemporal parameters for the two tasks were calculated and correlated using Spearman’s rank correlation coefficients. Results. The pwMS performed worse than HC on both tasks. Small to large correlations were found between the total HTM movement duration and most of the gait parameters (rho, 0.35–0.68; p<0.05). Conclusions. Both upper and lower limb motor abilities in pwMS worsen as disability increases. Nevertheless, their relationship is only moderate. This finding emphasizes the need for specific tests to quantify disability considering the overall motor function in pwMS.

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Argiropoulos, D. "PECULIARITIES OF INTERACTION TEACHER WITH PERSONS WITH THE ACQUIRED DISABILITY." Zhytomyr Ivan Franko state university journal. Рedagogical sciences, no. 4(107) (December 30, 2021): 51–59. http://dx.doi.org/10.35433/pedagogy.4(107).2021.51-59.

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The aim of this essay is mainly focused on how the acquired disability can induce the affected people to reconstruct a new identity. To do so, self- emotional supports such as resilience are paramount for the acceptance of the new self that will eventually lead the way to independence. The body is considered zero point of every look, of every perception, which faces the world. It is a here that cannot become a there, in its characteristic as a cognitive geometrical around which the world and the intersubjective dimension unveil to consciousness. But, to the phenomenological reflection, we will add that it is not enough to affirm that man is an incarnate consciousness since he is at the same time a self-conscious body. It is a matter that, after acquiring life, has become aware of its existence. The body represents the manifestation of man in the world, as a 'limen' – a border, a passage between two worlds, the internal and external world. Thanks to his being a body in communication with the world, man acts and creates culture. Surprising that, due to the amputation of a limb, the ‘patient’ continued to perceive the missing limb as still present, as an integral part of his body, precisely the so-called phantom limb. The phantom limb syndrome plays an important role in understanding the reason for existing sensations after the amputation, making patients sense and believe that they can still walk or stand on the missing limb. This phenomenon “shows how the sense of possession of a limb depends on the cerebral representation of the same; how the awareness and experience of one's own body constitute the anchor on which the sense of self develops.

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Chae, John, Guang Yang, Byung Kyu Park, and Ihab Labatia. "Muscle Weakness and Cocontraction in Upper Limb Hemiparesis: Relationship to Motor Impairment and Physical Disability." Neurorehabilitation and Neural Repair 16, no. 3 (September 2002): 241–48. http://dx.doi.org/10.1177/154596830201600303.

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The purpose of this article is to describe the relationship between poststroke upper limb muscle weakness and cocontraction, and clinical measures of upper limb motor impairment and physical disability. Electromyographic (EMG) activity of the paretic and nonparetic wrist flexors and extensors of 26 chronic stroke survivors were recorded during isometric wrist flexion and extension. The root mean square (RMS) of the EMG signal was used as a measure of strength of contraction. A ratio of RMS of antagonist and agonist muscles was used as a measure of cocontraction. Upper limb motor impairment and physical disability were assessed with the Fugl-Meyer motor assessment (FMA) and the arm motor ability test (AMAT), respectively. The strength of muscle contraction was significantly stronger in the nonparetic limb (P < 0.001). The degree of cocontraction was significantly greater in the paretic limb (P < 0.001). The strength of muscle contraction in the paretic limb correlated significantly with FMA (r = 0.62 to 0.87,P ≤ 0.001) and AMAT (r = 0.66 to 0.80, P ≤ 0.001) scores. Similarly, the degree of cocontraction correlated significantly with FMA (r = -0.70 to -0.64, P ≤ 0.001) and AMAT (r = -0.72 to -0.62, P ≤ 0.001) scores. Muscle weakness and degree of cocontraction correlate significantly with motor impairment and physical disability in upper limb hemiplegia. This relationship may provide insights toward development of specific interventions. However, additional studies are needed to demonstrate a cause and effect relationship.

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Tokarski, Tomasz, and Danuta Roman-Liu. "Influence of disability type on upper-limb motor skills." International Journal of Occupational Safety and Ergonomics 22, no. 4 (July 11, 2016): 463–72. http://dx.doi.org/10.1080/10803548.2016.1182398.

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Sue See, Kirsten, and Julia Treleaven. "Identifying upper limb disability in patients with persistent whiplash." Manual Therapy 20, no. 3 (June 2015): 487–93. http://dx.doi.org/10.1016/j.math.2014.12.001.

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Celletti, Claudia, Marco Castori, Paola Grammatico, and Filippo Camerota. "Evaluation of lower limb disability in joint hypermobility syndrome." Rheumatology International 32, no. 8 (July 27, 2011): 2577–81. http://dx.doi.org/10.1007/s00296-011-2044-2.

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Śliwiński, Maciej, Piotr Wąż, Wojciech Zaręba, and Rita Hansdorfer-Korzon. "Motor Control Evaluation as a Significant Component in Upper Limb Function Assessment in Female Breast Cancer Patients after Mastectomy." Healthcare 9, no. 8 (July 31, 2021): 973. http://dx.doi.org/10.3390/healthcare9080973.

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Breast cancer is the most prevalent malignancy among women. Conservative and operative treatment methods are associated with a risk of side effects pertaining to the shoulder complex. The surgery complications including chronic pain, upper limb and chest lymphedema, range of motion limitations, and motor control deficiencies may lead to upper limb function impairment and affect the quality of life negatively. Twenty-three women were examined in the tested group and twenty-two women in the control group. The motor control was assessed with dissociation tests as defined by Comerford and Mottram. In order to assess patient-perceived upper limb disability, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used. The test of glenohumeral (GH) abduction control in frontal plane and in scapular plane and medial rotation control outcomes were found to be statistically significant. It pertains to both: Comparison between groups and analysis within the tested group—body sides comparison. The DASH questionnaire results analysis indicates that there was a higher degree of subjectively perceived disability of upper limb in the tested group. Surgical interventions in the breast cancer treatment and other medical procedures affect the level of motor control and perceived disability of upper limb negatively in this group of patients. Movement faults are statistically more prevalent in the tested group. Movement faults are more prevalent on the operated side in the tested group.

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Roberts, Derek J., Sudhir K. Nagpal, Alan J. Forster, Timothy Brandys, Christine Murphy, Alison Jennings, Shira A. Strauss, Evgeniya Vishnyakova, Julie Lawson, and Daniel I. McIsaac. "Disability, pain, and wound-specific concerns self-reported by adults at risk of limb loss: A cross-sectional study using the World Health Organization Disability Assessment Schedule 2.0." PLOS ONE 16, no. 6 (June 15, 2021): e0253288. http://dx.doi.org/10.1371/journal.pone.0253288.

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Introduction There has been limited study of patient-reported outcomes (PROs) in patients at risk of limb loss. Our primary objective was to estimate the prevalence of disability in this patient population using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Materials and methods We recruited patients referred to a limb-preservation clinic. Patients self-reported their disability status using the 12-domain WHODAS 2.0. Severity of disability in each domain was scored from 1 = none to 5 = extreme and the total normalized to a 100-point scale (total score ≥25 = clinically significant disability). We also asked patients about wound-specific concerns and wound-related discomfort or distress. Results We included 162 patients. Reasons for clinic referral included arterial-insufficient (37.4%), postoperative (25.9%), and mixed etiology (10.8%) wounds. The mean WHODAS 2.0 disability score was 35.0 (standard deviation = 16.0). One-hundred-and-nineteen (73.5%) patients had clinically significant disability. Patients reported they had the greatest difficulty walking a long distance (mean score = 4.2), standing for long periods of time (mean score = 3.6), taking care of household responsibilities (mean score = 2.7), and dealing with the emotional impact of their health problems (mean score = 2.5). In the two-weeks prior to presentation, 87 (52.7%) patients expressed concern over their wound(s) and 90 (55.6%) suffered a moderate amount or great deal of wound-related discomfort or distress. In adjusted ordinary least squares regression models, although WHODAS 2.0 disability scores varied with changes in wound volume (p = 0.03) and total revised photographic wound assessment tool scores (p<0.001), the largest decrease in disability severity was seen in patients with less wound-specific concerns and wound-related discomfort and distress. Discussion The majority of people at risk of limb loss report suffering a substantial burden of disability, pain, and wound-specific concerns. Research is needed to further evaluate the WHODAS 2.0 in a multicenter fashion among these patients and determine whether care and interventions may improve their PROs.

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Rounis, Elisabeth, and Ferdinand Binkofski. "Limb Apraxias: The Influence of Higher Order Perceptual and Semantic Deficits in Motor Recovery After Stroke." Stroke 54, no. 1 (January 2023): 30–43. http://dx.doi.org/10.1161/strokeaha.122.037948.

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Stroke is a leading cause of disability worldwide. Limb apraxia is a group of higher order motor disorders associated with greater disability and dependence after stroke. Original neuropsychology studies distinguished separate brain pathways involved in perception and action, known as the dual stream hypothesis. This framework has allowed a better understanding of the deficits identified in Limb Apraxia. In this review, we propose a hierarchical organization of this disorder, in which a distinction can be made between several visuomotor pathways that lead to purposeful actions. Based on this, executive apraxias (such as limb kinetic apraxia) cause deficits in executing fine motor hand skills, and intermediate apraxias (such as optic ataxia and tactile apraxia) cause deficits in reaching to grasp and manipulating objects in space. These disorders usually affect the contralesional limb. A further set of disorders collectively known as limb apraxias include deficits in gesture imitation, pantomime, gesture recognition, and object use. These deficits are due to deficits in integrating perceptual and semantic information to generate complex movements. Limb apraxias are usually caused by left-hemisphere lesions in right-handed stroke patients, affecting both limbs. The anterior- to posterior-axis of brain areas are disrupted depending on the increasing involvement of perceptual and semantic processes with each condition. Lower-level executive apraxias are linked to lesions in the frontal lobe and the basal ganglia, while intermediate apraxias are linked to lesions in dorso-dorsal subdivisions of the dorsal fronto-parietal networks. Limb apraxias can be caused by lesions in both dorsal and ventral subdivisions including the ventro-dorsal stream and a third visuomotor pathway, involved in body schema and social cognition. Rehabilitation of these disorders with behavioral therapies has aimed to either restore perceptuo-semantic deficits or compensate to overcome these deficits. Further studies are required to better stratify patients, using modern neurophysiology and neuroimaging techniques, to provide targeted and personalized therapies for these disorders in the future.

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Gomes, André Luiz Salcedo, Francisco Falleiros de Mello, Jorge Cocicov Neto, Marcelo Causin Benedeti, Luis Felipe Miras Modolo, and Marcelo Riberto. "Can the positions of the spastic upper limb in stroke survivors help muscle choice for botulinum toxin injections?" Arquivos de Neuro-Psiquiatria 77, no. 8 (August 2019): 568–73. http://dx.doi.org/10.1590/0004-282x20190087.

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ABSTRACT Motor impairments in stroke survivors are prevalent and contribute to dependence in daily activities, pain and overall disability, which can further upper-limb disability. Treatment with botulinum toxin A (BoNT-A) is indicated for focal spasticity and requires knowledge of biomechanics and anatomy to best select muscles to be injected in the limb. Objective: We aimed to describe the frequency of posture patterns in a Brazilian sample of stroke survivors and correlate them with recommendations of muscle selection for treatment with BoNT-A. Methods: Fifty stroke patients with spastic upper limbs scheduled for neuromuscular block were photographed and physically examined, to be classified by three independent evaluators according to Hefter's classification. Muscles that were injected with BoNT-A by their routine doctors were retrieved from medical charts. Results: Pattern III and IV were the most common (64.7%, 21.6%). We further subclassified pattern III according to the rotation of the shoulder, which effectively interfered in muscle choice. The muscles most frequently treated were shoulder adductors and internal rotators, elbow flexors and extensors, in forearm, the pronator teres and finger and wrist flexors, and, in the hand the adductor pollicis. Conclusion: Frequencies of upper-limb postures differed from previous reports. Other clinical features, besides spasticity, interfered with muscle choice for BoNT-A injection, which only partially followed the recommendations in the literature.

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Abbott, David L. "Trauma, Disability and the "Wounded Healer"." Music and Medicine 10, no. 3 (July 29, 2018): 152. http://dx.doi.org/10.47513/mmd.v10i3.616.

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A medical memoir addressing the author’s history of trauma, limb loss, use of music as a resource, and how these experiences shaped his pursuit of education and career in music therapy. The significant influence of Jung’s “wounded healer” concept (particularly as elucidated by Kirmayer) on the development of the author’s identity as a clinician with a history of trauma is discussed. The importance of addressing the needs of wounded clinicians, and the risks and benefits of disclosure, are explored.

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Moise (Constantinovici), Mariana-Isabela, and Adriana Sarah Nica. "Clinical and functional evaluation in patients with upper limb disability following traumatic peripheral nerve injury. Part II." Romanian Medical Journal 62, no. 4 (December 31, 2015): 367–70. http://dx.doi.org/10.37897/rmj.2015.4.7.

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Background. Current studies regarding the consequences of upper limb traumatic peripheral nerve injuries adresses both sensory-motor dysfunction and functioning, disability and pain issues. Aims. This article presents an overview of the biomedical literature regarding the available assessment methodologies and outcome measures used in research and clinical practice for the evaluation of upper limb function in the therapeutic management of posttraumatic upper limb peripheral nerve injuries and disability and their impact on patient’s functioning, health and quality of life. Design. Systematic review of the international biomedical literature. Methods. We used PubMedCentral database searches (PMC) of the last 10 years published literature. There were excluded scientific abstracts and articles that did not match to our search criteria, such as studies on brachial plexus injury, diabetic neuropathy, upper limb neurologic impairment due to Stroke, TBI or SCI, etc. Results and discussion. We selected 20 studies from the identified articles. We presented an overview of the main assessment methodologies and functional parameters investigated in these studies.

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Moise (Constantinovici), Mariana-Isabela, and Adriana Sarah Nica. "Clinical and functional evaluation in patients with upper limb disability following traumatic peripheral nerve injury. Part I." Romanian Medical Journal 62, no. 3 (September 30, 2015): 243–48. http://dx.doi.org/10.37897/rmj.2015.3.5.

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Background. Current studies regarding the consequences of upper limb traumatic peripheral nerve injuries adresses both sensory-motor dysfunction and functioning, disability and pain issues. Aims. This article presents an overview of the biomedical literature regarding the available assessment methodologies and outcome measures used in research and clinical practice for the evaluation of upper limb function in the therapeutic management of posttraumatic upper limb peripheral nerve injuries and disability and their impact on patient’s functioning, health and quality of life. Design. Systematic review of the international biomedical literature. Methods. We used PubMedCentral database searches (PMC) of the last 10 years published literature. There were excluded scientific abstracts and articles that did not match to our search criteria, such as studies on brachial plexus injury, diabetic neuropathy, upper limb neurologic impairment due to Stroke, TBI or SCI, etc. Results and discussion. We selected 20 studies from the identified articles. We presented an overview of the main assessment methodologies and functional parameteres investigated in these studies.

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Facchetti, D., R. Mai, A. Micheli, N. Marcianó, R. Capra, R. Gasparotti, and M. Poloni. "Motor Evoked Potentials and Disability in Secondary Progressive Multiple Sclerosis." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 24, no. 04 (November 1997): 332–37. http://dx.doi.org/10.1017/s0317167100033011.

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ABSTRACT:Background:To investigate the mechanisms underlying disability in multiple sclerosis (MS), 40 patients with the relapsing-remitting form of the disease and 13 patients with secondary progressive MS underwent multimodal evoked potential (EP), motor evoked potential (MEP), and spinal motor conduction time evaluation. Clinical disability was evaluated by the expanded disability status scale (EDSS) and functional system scales. In secondary progressive MS patients, magnetic resonance imaging (MRI) was used to obtain a semiquantitative estimate of the total lesion load of the brain.Results:Spinal motor conduction time was significantly longer in secondary progressive MS patients than controls (p < 0.001) and relapsing-remitting MS patients (p < 0.05), but did not differ between relapsing-remitting patients and controls. Spinal motor conduction times also correlated directly with EDSS scores (p < 0.001) and pyramidal functional system scores (p < 0.001). Brain lesion load (4960.3 ± 3719.0 mm2) and the total number of lesions (67.7 ± 37.0) in secondary progressive MS did not correlate with disability scores. For the following EPs, the frequencies of abnormalities were significantly higher in secondary progressive MS patients than relapsing-remitting patients: visual evoked potentials (p < 0.05), somatosensory evoked potentials and upper limb motor evoked potentials (p < 0.01), and brainstem auditory evoked potentials, lower limb somatosensory evoked potentials and lower limb motor evoked potentials (p < 0.001).Conclusions:These findings suggest that disability in secondary progressive MS patients is mainly due to progressive involvement of corticospinal tract in the spinal cord.

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Yazdani, Mahdi, Ahmad Chitsaz, Vahid Zolaktaf, Mohammad Saadatnia, Majid Ghasemi, Fatemeh Nazari, Abbas Chitsaz, Katsuhiko Suzuki, and Hadi Nobari. "Can Early Neuromuscular Rehabilitation Protocol Improve Disability after a Hemiparetic Stroke? A Pilot Study." Brain Sciences 12, no. 7 (June 22, 2022): 816. http://dx.doi.org/10.3390/brainsci12070816.

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Background: The impairment of limb function and disability are among the most important consequences of stroke. To date, however, little research has been done on the early rehabilitation trial (ERT) after stroke in these patients. The purpose of this study was to evaluate the impact of ERT neuromuscular protocol on motor function soon after hemiparetic stroke. The sample included twelve hemiparetic patients (54.3 ± 15.4 years old) with ischemic stroke (n = 7 control, n = 5 intervention patients). ERT was started as early as possible after stroke and included passive range of motion exercises, resistance training, assisted standing up, and active exercises of the healthy side of the body, in addition to encouraging voluntary contraction of affected limbs as much as possible. The rehabilitation was progressive and took 3 months, 6 days per week, 2–3 hours per session. Fugle-Meyer Assessment (FMA), Box and Blocks test (BBT) and Timed up and go (TUG) assessments were conducted. There was a significantly greater improvement in the intervention group compared to control: FMA lower limbs (p = 0.001), total motor function (p = 0.002), but no significant difference in FMA upper limb between groups (p = 0.51). The analysis of data related to BBT showed no significant differences between the experimental and control groups (p = 0.3). However, TUG test showed significant differences between the experimental and control groups (p = 0.004). The most important finding of this study was to spend enough time in training sessions and provide adequate rest time for each person. Our results showed that ERT was associated with improved motor function but not with the upper limbs. This provides a basis for a definitive trial.

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Poveda-García, Ana, Carmen Moret-Tatay, and Miguel Gómez-Martínez. "The Association between Mental Motor Imagery and Real Movement in Stroke." Healthcare 9, no. 11 (November 17, 2021): 1568. http://dx.doi.org/10.3390/healthcare9111568.

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Background: Stroke is the main cause of disability in adults; the most common and long-term sequela is upper-limb hemiparesis. Many studies support the idea that mental motor imagery, which is related to the visualization of movement patterns, activates the same areas of the cortex as if the movement occurred. Objectives: This study aims to examine the capacity to elaborate mental motor images, as well as its relationship to loss of movement in the upper limbs after a stroke. Method: An observational study, in a sample of 39 adults who suffered a stroke, was carried out. The upper limb movement and functionality, cognitive disorders, the ability to visualize mental images, and activities of daily living were examined. Results: The results depicted a statistically significant correlation between the ability to visualize upper limb mental motor images with movement, functionality, and strength. In addition, a correlation between visual–spatial skills and mental visualization of motor ability and upper limb movement was found. Conclusions: These results suggest that the rehabilitation approach focused on the improvement of mental motor imagery could be of interest for the upper limb rehabilitation of movement and functionality.

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Bayartai, Munkh-Erdene, Hannu Luomajoki, Roberta De Micheli, Gabriella Tringali, Nicoletta Marazzi, and Alessandro Sartorio. "Changes in the Oswestry Disability Index after a 3-Week In-Patient Multidisciplinary Body Weight Reduction Program in Adults with Obesity." Journal of Clinical Medicine 11, no. 11 (June 2, 2022): 3175. http://dx.doi.org/10.3390/jcm11113175.

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The aim of this study was to examine the short-term changes in disability after an inpatient, multidisciplinary body weight reduction program (BWRP) in adults with obesity. A total of 160 individuals (males: 52, females: 108, BMI > 35 kg/m2) hospitalized for a 3-week multidisciplinary BWRP were recruited into the study. Body composition, lower limb muscle power, fatigue severity, and disability were measured at the beginning and end of the intervention by means of bioimpedance analysis, a stair climbing test (SCT), the Fatigue Severity Scale (FSS), and the Oswestry disability index (ODI), respectively. At the end of the 3-week BWRP, an average body weight reduction of 5.0 kg (CI 95% −5.3; −4.6, p < 0.001) was determined, as well as an improvement in all parameters measured. Clinically meaningful reductions in disability were observed in the moderate disability (Δ = −11.8% CI 95% −14.3; −9.3, p < 0.001) and severe disability (Δ = −15.9% CI 95% −19.6; −12.2, p < 0.001) groups. Reductions in disability were explained only by improvements in the SCT (Δ = −2.7 CI 95% −4.1; −1.4, p < 0.001) and the FSS (Δ = −0.3% CI 95% −0.4; −0.1, p < 0.001). These findings demonstrate the importance of incorporating approaches into a BWRP that increase lower limb muscle power and decrease fatigue severity and thus reduce disability in adults with obesity.

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Campos Júnior, Walter, Roberta Murasaki Cardoso, Ronald Fidelis, Erasmo Simão da Silva, and Rodrigo Ramos. "A familial case of cleidocranial dysostosis presenting upper limb ischemia." Sao Paulo Medical Journal 123, no. 6 (December 2005): 292–94. http://dx.doi.org/10.1590/s1516-31802005000600009.

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CONTEXT: Upper limb ischemia is not as common as lower limb ischemia but may cause severe impairment or disability if it is misdiagnosed. CASE REPORT: A case of a woman with cleidocranial dysostosis resulting in upper right limb ischemia is presented. This uncommon condition is an exceedingly rare cause of vascular compression that gives rise to thrombosis of the axillary-subclavian arteries. Only two cases have previously been reported.

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SHIBAHARA, Miyuki. "Support for Infants with Lower Limb Disability Living at Home:." Rigakuryoho Kagaku 25, no. 5 (2010): 693–97. http://dx.doi.org/10.1589/rika.25.693.

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Muir, Keith W., and Jennifer J. Majersik. "Connecting Upper Limb Functional Stroke Recovery to Global Disability Measures." Neurology 96, no. 14 (February 15, 2021): 643–44. http://dx.doi.org/10.1212/wnl.0000000000011671.

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MACKENZIE, ELLEN J., MICHAEL J. BOSSE, ANDREW N. POLLAK, LAWRENCE X. WEBB, MARC F. SWIONTKOWSKI, JAMES F. KELLAM, DOUGLAS G. SMITH, et al. "LONG-TERM PERSISTENCE OF DISABILITY FOLLOWING SEVERE LOWER-LIMB TRAUMA." Journal of Bone and Joint Surgery-American Volume 87, no. 8 (August 2005): 1801–9. http://dx.doi.org/10.2106/00004623-200508000-00020.

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Huang, Piao-Piao Liu &. Haiqiao. "Ergonomic Design of Shoes for People with Lower Limb Disability." Journal of Fiber Bioengineering and Informatics 13, no. 4 (June 2020): 195–209. http://dx.doi.org/10.3993/jfbim00357.

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Altschuler, S. ""Ain't One Limb Enough?" Historicizing Disability in the American Novel." American Literature 86, no. 2 (January 1, 2014): 245–74. http://dx.doi.org/10.1215/00029831-2646991.

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Brugger, Peter, Markus Christen, Lena Jellestad, and Jürgen Hänggi. "Limb amputation and other disability desires as a medical condition." Lancet Psychiatry 3, no. 12 (December 2016): 1176–86. http://dx.doi.org/10.1016/s2215-0366(16)30265-6.

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Carty, Christopher P., Ian C. Dickinson, Mark C. Watts, Ross W. Crawford, and Peter Steadman. "Impairment and disability following limb salvage procedures for bone sarcoma." Knee 16, no. 5 (October 2009): 405–8. http://dx.doi.org/10.1016/j.knee.2009.02.006.

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Rivera, J. C., G. P. Glebus, and M. S. Cho. "Disability following combat-sustained nerve injury of the upper limb." Bone & Joint Journal 96-B, no. 2 (February 2014): 254–58. http://dx.doi.org/10.1302/0301-620x.96b2.31798.

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49

Yoshimoto, Kenji, Yusuke Okuma, Takashi Nakamura, Tomoki Mita, Atsuko Mitsumoto, Nobuya Yamasaki, Yoshiko Tobimatsu, and Masami Akai. "Limb fitting for quadruple amputees: Report of two cases of symmetrical peripheral gangrene caused by pneumococcal purpura fulminans." Prosthetics and Orthotics International 37, no. 6 (April 4, 2013): 489–94. http://dx.doi.org/10.1177/0309364613481797.

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Background: We report our experiences of prosthetic fitting in quadruple amputees. Two patients underwent quadruple amputation after suffering from disseminated intravascular coagulation in conjunction with pneumococcemia with purpura fulminans. Case Description and Methods: The first patient, a 52-year-old man, underwent bilateral transradial, left transtibial, and right transfemoral amputation, and the second patient, a 62-year-old man, underwent bilateral transradial and bilateral transfemoral amputation, both for symmetrical peripheral gangrene subsequent to septic shock. Findings and Outcomes: The amputations were accompanied by skin damage due to ischemic tissue changes both on the stumps and on the nose and/or lips. The combination of the intensive prosthetic rehabilitation program and supportive medical care led to completely independent functioning, including driving a car, with the use of four prosthetic limbs and a wheelchair in both cases. Conclusion: Early initiation of a multidisciplinary approach can properly address impairments and minimize future disability. Clinical relevance We have reported our experience of limb fitting in two patients who had undergone quadruple amputation after suffering peripheral gangrene. Appropriate limb fitting that provides support in daily activities can address impairments and minimize disability.

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Bennetto, L., J. Burrow, H. Sakai, J. Cobby, NP Robertson, and N. Scolding. "The relationship between relapse, impairment and disability in multiple sclerosis." Multiple Sclerosis Journal 17, no. 10 (October 2011): 1218–24. http://dx.doi.org/10.1177/1352458511407368.

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Objective: To describe the spatial relationship between relapse and disability in multiple sclerosis (MS). Methods: 141 relapse onset MS patients were studied. For each patient an examination was performed and a relapse history obtained. Multivariate logistic regression examined whether there was an association between localizing clinical signs and a history of relevant relapse in order to explore the spatial relationship between relapse and subsequent disability. Results: The presence of impaired vision or sensation was independently associated with a history of one or more anatomically related relapses. The presence of weakness or cerebellar ataxia in a limb was not associated with a single relevant relapse but was associated with multiple relevant relapses. A history of multiple episodes of weakness or ataxia in the same limb was uncommon. Conclusions: Our data suggest that motor pathways are relatively resistant to chronic impairment from acute relapse, whereas afferent pathways are more susceptible. This, in combination with prominent usage of the Expanded Disability Status Scale, which is dependent on mobility and motor function at higher scores, may explain the paradox between natural history studies that suggest relapses are irrelevant to long-term disability and shorter studies at lower disability levels suggesting relapses are responsible for disability accumulation.

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