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Cancer Treatment Reviews Dec 2017People with cancer frequently report limitation in Activities of Daily Living (ADLs); essential activities required to live independently within society. Although... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
People with cancer frequently report limitation in Activities of Daily Living (ADLs); essential activities required to live independently within society. Although several studies have assessed ADL related disability, variability in assessment, setting, and population means evidence is difficult to interpret. We aimed to determine the prevalence of ADL related disability, overall and by setting, and the most commonly affected ADLs in people living with cancer.
METHODS
We searched twelve databases to June 2016 for observational studies assessing ADL disability in adults with cancer. Data on study design, population, ADL instruments and disability (difficulty with or requiring assistance in ≥1 activity) were extracted, summarised, and pooled to estimate disability prevalence with 95% confidence intervals (95% CI) overall and by setting.
RESULTS
Forty-three studies comprising 19,246 patients were included. Overall, 36.7% (95% CI 29.8-44.3, 18 studies) and 54.6% (95% CI 46.5-62.3, 15 studies) of patients respectively reported disability relating to basic and instrumental ADLs. Disability was marginally more prevalent in inpatient compared to outpatient settings. The Katz Index (18 studies) and Lawton IADL Scale (11 studies) were the most commonly used instruments. Across the activities studied, the most frequently affected basic ADLs were personal hygiene, walking and transfers, and instrumental ADLs were housework, shopping and transportation.
CONCLUSIONS
About one-third and half of adults with cancer respectively have difficulty or require assistance to perform basic and instrumental ADLs. These findings highlight the need for rehabilitation focused on functional independence, and underscore the importance of professionals skilled in occupational assessment and therapy within cancer services.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Disability Evaluation; Disabled Persons; Humans; Middle Aged; Neoplasms
PubMed: 29125982
DOI: 10.1016/j.ctrv.2017.10.006 -
Journal of Aging and Physical Activity Apr 2015Mobility is critical in maintaining independence in older adults. This study aims to systematically review the scientific literature to identify measures of mobility... (Review)
Review
Mobility is critical in maintaining independence in older adults. This study aims to systematically review the scientific literature to identify measures of mobility limitation for community-dwelling older adults. A systematic search of PubMed, CINAHL, and psycINFO, using the search terms "mobility limitation", "mobility disability", and "mobility difficulty" yielded 1,847 articles from 1990 to 2012; a final selection of 103 articles was used for the present manuscript. Tools to measure mobility were found to be either self-report or performance-based instruments. Commonly measured constructs of mobility included walking, climbing stairs, and lower extremity function. There was heterogeneity in ways of defining and measuring mobility limitation in older adults living in the community. Given the lack of consistency in assessment tools for mobility, a clear understanding and standardization of instruments are required for comparison across studies and for better understanding indicators and outcomes of mobility limitation in community-dwelling older adults.
Topics: Aged; Disability Evaluation; Environment; Female; Geriatric Assessment; Humans; Independent Living; Male; Middle Aged; Mobility Limitation; Psychometrics; Self Report; Walking
PubMed: 24589525
DOI: 10.1123/japa.2013-0181 -
Journal of Clinical Neuroscience :... Jan 2023Understanding gait alterations immediately post-concussion can improve identification, management and prognosis of concussion. (Review)
Review
BACKGROUND
Understanding gait alterations immediately post-concussion can improve identification, management and prognosis of concussion.
OBJECTIVE
To identify and define gait characteristics immediately post-concussion.
METHOD
A review of electronic databases was conducted using terms gait alteration AND mTBI OR concussion. 172 reports were identified. After restricting to English and human studies, 158 remained. Reports were screened to include studies assessing quantifiable gait change post-concussion. 12 studies were included.
DISCUSSION
Multiple gait features are altered post-impact: stability, step length, walking speed and postural control. There is evidence that postural measures in gait initiation and termination may identify more subtle deficits. There is paucity of data evaluating the impact of concussion on gait function acutely and the authors identified no studies examining immediate changes.
CONCLUSION
Acutely post-concussion, various gait alterations are seen and correlate with degree of deficit and prognosis. Slowed gait, instability and postural control are several features. Dynamic gait and postural assessments identify more subtle gait alterations. Given the absence in literature, high quality prospective studies examining immediate gait alterations post-concussion would contribute to improved assessment, management and prognostication. Given difficulty in participant recruitment, technological and standardised gait assessments should be used to assess force of impact and immediate gait alteration.
Topics: Humans; Prospective Studies; Brain Concussion; Gait; Prognosis; Postural Balance; Post-Concussion Syndrome
PubMed: 36462967
DOI: 10.1016/j.jocn.2022.11.005 -
Manual Therapy Aug 2016In adolescent athletes, low back pain has a 1-year prevalence of 57% and causes include spondylolysis and spondylolisthesis. An accurate diagnosis enables healing,... (Comparative Study)
Comparative Study Review
BACKGROUND
In adolescent athletes, low back pain has a 1-year prevalence of 57% and causes include spondylolysis and spondylolisthesis. An accurate diagnosis enables healing, prevention of progression and return to sport.
OBJECTIVE
To evaluate the diagnostic utility of patient history and physical examination data to identify spondylolysis and/or spondylolisthesis in athletes.
DESIGN
Systematic review was undertaken according to published guidelines, and reported in line with PRISMA.
METHOD
Key databases were searched up to 13/11/15.
INCLUSION CRITERIA
athletic population with LBP, patient history and/or physical examination accuracy data for spondylolysis and/or spondylolisthesis, any study design including raw data. Two reviewers independently assessed risk of bias (ROB) using QUADAS-2. A data extraction sheet was pre-designed. Pooling of data and investigation for heterogeneity enabled a qualitative synthesis of data across studies.
RESULTS
Of the eight included studies, two were assessed as low ROB, one of which also had no concerns regarding applicability. Age (<20 years) demonstrated 81% sensitivity and 44% specificity and gender (male) 73% sensitivity and 57% specificity for spondylolysis. Difficulty falling asleep, waking up because of pain, pain worse with sitting and walking all have sensitivity >75% for spondylolisthesis. Step-deformity palpation demonstrated 60-88% sensitivity and 87-100% specificity for spondylolisthesis. The one-legged hyperextension test was not supported for spondylolysis (sensitivity 50-73%, specificity 0-87%).
CONCLUSION
No recommendations can be made utilising patient history data. Based on one low ROB study, step deformity palpation may be useful in diagnosing spondylolisthesis. No physical tests demonstrated diagnostic utility for spondylolysis. Further research is required.
Topics: Adolescent; Age Factors; Athletes; Athletic Injuries; Female; Humans; Low Back Pain; Lumbar Vertebrae; Male; Medical History Taking; Physical Examination; Sex Factors; Spondylolisthesis; Spondylolysis
PubMed: 27317501
DOI: 10.1016/j.math.2016.03.011 -
Disability and Rehabilitation Sep 2022To identify the short-term effects of robotic-assisted gait training (RAGT) on walking distance, gait speed and functionality of cerebral palsy (CP) patients, and to... (Meta-Analysis)
Meta-Analysis
Clinical effects of assisted robotic gait training in walking distance, speed, and functionality are maintained over the long term in individuals with cerebral palsy: a systematic review and meta-analysis.
PURPOSE
To identify the short-term effects of robotic-assisted gait training (RAGT) on walking distance, gait speed and functionality of cerebral palsy (CP) patients, and to verify if the effects of RAGT are maintained in the long term.
METHODS
A systematic literature review was performed in PubMed, PEDro, CINAHL, and LILACS databases. Studies were included considering: (1) population (CP individuals); (2) study design (experimental studies); (3) type of intervention (RAGT); (4) outcome (gait parameters and function); and (5) period (short and long term).
RESULTS
This systematic review included seven articles in meta-analysis. Only walking distance, thru six minutes walking test, increased statistically after RAGT. However, RAGT demonstrated large clinical effects differences (minimal clinically important difference - MCID) in gait speed and Gross Motor Function Measure score (dimensions D and E), for CP population. After RAGT intervention, differences in short term (comparison 1) were maintained in long term (comparison 2) for all outcomes. Gait speed results were not significant.
CONCLUSIONS
Evidence from the present study demonstrated that RAGT can be an important intervention to improve gait parameters and functionality, in children with CP, that are maintained over long-term.Implications for RehabilitationRobotic-assisted gait training (RAGT) is a beneficial treatment for children with cerebral palsy (CP).RAGT improvements in walking distance are maintained over the long-term in children with CP.RAGT demonstrated large clinical effect differences in gait speed and functionality in CP population.
Topics: Cerebral Palsy; Child; Exercise Therapy; Gait; Humans; Robotic Surgical Procedures; Robotics; Walking
PubMed: 34232847
DOI: 10.1080/09638288.2021.1942242 -
Zeitschrift Fur Gerontologie Und... Dec 2022Life-space mobility (LSM), as the extent of mobility within one's environment, is a key for successful aging and has become a relevant concept in gerontology and... (Review)
Review
BACKGROUND
Life-space mobility (LSM), as the extent of mobility within one's environment, is a key for successful aging and has become a relevant concept in gerontology and geriatric research. Adequate assessment instruments are needed to identify older persons with LSM restrictions, and to initiate, adapt or evaluate intervention strategies.
OBJECTIVE
To systematically identify, describe and analyze the psychometric properties of LSM questionnaires, with a special focus on their availability in the German language.
METHODS
A systematic literature search was conducted in PubMed, PsycINFO, Cochrane Library, CINAHL, and Web of Science. Studies that examined at least one psychometric property of LSM questionnaires published up to August 2021 were included and evaluated based on the consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines.
RESULTS
This study included 37 validation studies describing 13 different LSM questionnaires. Methodological quality and comprehensiveness of validations were heterogeneous. Based on comprehensive and high-quality results, four LSM questionnaires stood out: the University of Alabama at Birmingham life-space assessment (UAB-LSA), life-space assessment in persons with cognitive impairment (LSA-CI), interview-based and proxy-based versions of the life-space assessment in institutionalized settings (LSA-IS), all of them available in the German language.
CONCLUSION
This systematic review provides a concise overview of available LSM questionnaires and their psychometric properties to facilitate the selection for use in clinical practice and research. The UAB-LSA and LSA-CI for community settings and the interview-based or proxy-based LSA-IS for institutional settings were found to be the most appropriate LSM questionnaires.
Topics: Humans; Aged; Aged, 80 and over
PubMed: 35244765
DOI: 10.1007/s00391-022-02035-5 -
Systematic Reviews Sep 2023We investigated whether an impediment to progress in understanding the environmental factors that cause falls may be the difficulty in comparing results across studies...
We investigated whether an impediment to progress in understanding the environmental factors that cause falls may be the difficulty in comparing results across studies because walking surfaces are poorly defined and underspecified. We conducted a systematic review of 384 studies from 370 articles that tested how different surfaces influenced human walking and falling. For each study, we report which categories of surfaces were used (indoor, outdoor, treadmill, virtual reality and qualitative), the nature of each surface (stairs, slopes, slippery, compliant, rough or default) and how information about each surface was measured. We found that minimal information was provided for many surfaces, making it impossible to meaningfully compare results for different types of surfaces across studies. We conclude that most published studies of walking and falling provide insufficient data to describe the surfaces that they used and we provide recommendations about how to improve the reporting of walking surfaces.
Topics: Humans; Accidental Falls; Virtual Reality; Walking
PubMed: 37660050
DOI: 10.1186/s13643-023-02315-0 -
Journal of the Peripheral Nervous... Dec 2016Symptoms of Charcot-Marie-Tooth (CMT) disease typically arise in childhood or adolescence with gait difficulty most common. A systematic review was conducted to... (Review)
Review
Symptoms of Charcot-Marie-Tooth (CMT) disease typically arise in childhood or adolescence with gait difficulty most common. A systematic review was conducted to synthesise, review, and characterise gait in paediatric CMT. Health-related electronic databases were reviewed with search terms related to CMT and gait. Of 454 articles, 10 articles describing seven studies met eligibility criteria; samples ranged from 1 to 81, included mixed CMT sub-types and had a participant mean age of 13 years. Assessments included a variety of methods to examine only barefoot gait. Heterogeneity of gait patterns was noted. Children and adolescents with CMT walked slower, most likely due to shorter stride length. Common kinematic and kinetic abnormalities included significant foot drop during swing, reduced calf muscle power, and proximal compensatory mechanisms in the lower limb. Little data were found to inform typical functional gait characteristics or change over time. Of note, barefoot assessment does not reflect function in everyday life where footwear is commonly worn. With limited existing literature, future studies of gait in paediatric CMT need to evaluate the influence of diagnostic sub-types and disease progression; the effect of factors such as footwear and the environment; and to explore changes in gait and function throughout childhood and adolescence.
Topics: Adolescent; Biomechanical Phenomena; Charcot-Marie-Tooth Disease; Child; Databases, Factual; Gait Disorders, Neurologic; Humans
PubMed: 27513454
DOI: 10.1111/jns.12183 -
Journal of Clinical Medicine Dec 2023This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in... (Review)
Review
This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in relieving pain and increasing mandibular mobility. Randomized controlled trials were included with no limitation on report publication dates. Final searches were performed on 15 October 2023, using engines provided by the US National Library, Bielefeld University, and Elsevier Publishing House. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Articular pain and mandible abduction values and their mean differences were summarized in tables and graphs. Eight studies on a total of 252 patients evaluating intra-articular administration of articaine, bupivacaine, lidocaine, and mepivacaine were included in the systematic review. None of the eligible studies presented a high risk of bias in any of the assessed domains. An analgesic effect of intra-articular bupivacaine was observed for up to 24 h. In the long-term follow-up, there were no statistically significant changes in quantified pain compared to both the baseline value and the placebo group, regardless of the anesthetic used (articaine, bupivacaine, and lidocaine). There is no scientific evidence on the effect of intra-articular administration of local anesthesia on the range of motion of the mandible. Therefore, in the current state of knowledge, the administration of local anesthetics into the temporomandibular joint cavities can only be considered as a short-term pain relief measure.
PubMed: 38202113
DOI: 10.3390/jcm13010106 -
Japan Journal of Nursing Science : JJNS Apr 2020The integrated evidence on diabetes self-care behaviors in people with a disability is not commensurate with the growing number of people with both diabetes and a... (Review)
Review
AIM
The integrated evidence on diabetes self-care behaviors in people with a disability is not commensurate with the growing number of people with both diabetes and a disability. This study aims to identify factors influencing self-care behaviors in adults with diabetes and a disability based on a thorough review of the current evidence.
METHODS
This review followed the Cochrane guidelines for systematic review research and complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. To find eligible articles, five electronic databases-PubMed, Embase, CINAHL, Psych-articles, and the Cochrane Library-were searched, from the beginning of the chronological period covered by each database to June 2017. Four researchers independently conducted study selections, extracted data, and assessed the data quality.
RESULTS
Twenty studies were reviewed to identify barriers to and facilitators of diabetes self-care behaviors. For people with developmental disabilities, the most prominent facilitator of self-care behaviors was the support they received for the behaviors. For people with visual impairments, that facilitator was the use of helpful assistive devices that take advantage of another sense. The main barriers to self-care behaviors were mobility limitation for people with physical disabilities and lack of accessibility for people with visual impairments.
CONCLUSIONS
This review has identified barriers to and facilitators of diabetes self-care behaviors by type of disability. Healthcare services need to be tailored to these facilitators and barriers, and differentiated by type of disability.
Topics: Adult; Diabetes Mellitus; Disabled Persons; Humans; Self Care
PubMed: 31691458
DOI: 10.1111/jjns.12289