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Otolaryngology--head and Neck Surgery :... Apr 2024To investigate the relationship between hearing difficulty and measures of mobility for US adults.
OBJECTIVE
To investigate the relationship between hearing difficulty and measures of mobility for US adults.
STUDY DESIGN
Cross-sectional study.
SETTING
2021 National Health Interview Survey.
METHODS
The survey asked US adults about hearing difficulty and mobility measures, including difficulty walking 100 yards, difficulty climbing 12 steps, and injury from falling within the past 3 months. Multivariable logistic regressions examined the associations between hearing and mobility outcomes, controlling for visual difficulty, medical comorbidities, and various demographic characteristics (age [18-39, 40-64, 65+], race/ethnicity, sex, socioeconomic status).
RESULTS
The 2021 NHIS surveyed 29,467 adults, representing 253 million people in weighted responses (52% female; mean age 48.3, standard deviation = 18.6). Controlling for covariates, hearing difficulty was associated with increased odds of difficulty walking 100 yards (odds ratio, OR = 1.47, P < .001), difficulty climbing stairs (OR = 1.62, P < .001), and injury from falling in the past 3 months (OR = 1.51, P < .001). There was a significant interaction between age and hearing difficulty for injurious falls; stratifying by age revealed that younger adults (ages 18-39) with hearing difficulty were more likely to report recent harmful falls than their normal hearing peers; this increased risk was greater in magnitude than that observed comparing older adults with and without hearing difficulty.
CONCLUSION
The hearing difficulty is associated with worsened mobility for US adults and may be a stronger independent predictor of injury from falls for younger adults as compared to older adults. These findings can inform interventions to reduce the burden of declining mobility in adults with hearing difficulty.
Topics: Humans; Female; Aged; Middle Aged; Male; Cross-Sectional Studies; Mobility Limitation; Surveys and Questionnaires; Hearing Loss; Hearing
PubMed: 38037415
DOI: 10.1002/ohn.593 -
Prosthetics and Orthotics International Aug 2023People with a limb loss at the level of the hip or pelvis have the most difficulty returning to walking compared with those with a lower amputation. This is because...
People with a limb loss at the level of the hip or pelvis have the most difficulty returning to walking compared with those with a lower amputation. This is because their prosthesis must replace the hip, knee, and ankle joints. An adjustable hip-disarticulation/hemipelvectomy prosthesis simulator that allows able-bodied individuals to wear and assess a prosthesis can help researchers and manufacturers when designing new prosthetic components (ie, hip joints). SolidWorks computer-aided design software was used to design and simulate an adapter that can connect prosthetic components to an off-the-shelf hip abduction orthosis. The adapter was made of 1020 stainless steel and aluminium 6061-T3 with a yield strength of 276 MPa. To confirm that this adapter is strong and safe for ambulation, mechanical testing was performed using an INSTRON machine. The maximum loads generated in any activity were chosen according to the International Organization for Standardization 15032:2000 standard for hip disarticulation external prostheses. The designed adapter allowed frontal, lateral, or distal mounting of different prosthetic hip joints. Mechanical testing confirmed that the new adapter can withstand forces and moments experienced during ambulation. The hip disarticulation/hemipelvectomy prosthesis simulator is easy to use and adjustable based on each person's height and pelvic width. Furthermore, this simulator would assist rehabilitation practitioners in experiencing the use of hip-level prostheses and give them a better understanding of people using such technologies. The next step in this project is to evaluate able-bodied participant gait while using this hip simulator prosthesis with different hip joints.
Topics: Humans; Hip Prosthesis; Prosthesis Design; Walking; Gait; Arthroplasty, Replacement, Hip; Artificial Limbs; Biomechanical Phenomena
PubMed: 36723415
DOI: 10.1097/PXR.0000000000000208 -
Physical Therapy Jan 2024The objective of this study was to estimate the prevalence of cognitive impairment (including cognitive impairment no dementia [CIND] and dementia) among Medicare...
OBJECTIVE
The objective of this study was to estimate the prevalence of cognitive impairment (including cognitive impairment no dementia [CIND] and dementia) among Medicare fee-for-service beneficiaries who used outpatient physical therapy and to estimate the prevalence of cognitive impairment by measures that are relevant to rehabilitation practice.
METHODS
This cross-sectional analysis included 730 Medicare fee-for-service beneficiaries in the 2016 wave of the Health and Retirement Study with claims for outpatient physical therapy. Cognitive status, our primary variable of interest, was categorized as normal, CIND, or dementia using a validated approach, and population prevalence of cognitive impairment (CIND and dementia) was estimated by sociodemographic variables and Charlson comorbidity index score. Age-, gender- (man/woman), race-/ethnicity-adjusted population prevalence of CIND and dementia were also calculated for walking difficulty severity, presence of significant pain, self-reported fall history, moderate-vigorous physical activity (MVPA) ≤1×/week, and sleep disturbance frequency using multinomial logistic regression.
RESULTS
Among Medicare beneficiaries with outpatient physical therapist claims, the prevalence of any cognitive impairment was 20.3% (CIND:15.2%, dementia:5.1%). Cognitive impairment was more prevalent among those who were older, Black, had lower education attainment, or higher Charlson comorbidity index scores. The adjusted population prevalence of cognitive impairment among those who reported difficulty walking across the room was 29.8%, difficulty walking 1 block was 25.9%, difficulty walking several blocks was 20.8%, and no difficulty walking was 16.3%. Additionally, prevalence of cognitive impairment among those with MVPA ≤1×/week was 27.1% and MVPA >1×/week was 14.1%. Cognitive impairment prevalence did not vary by significant pain, self-reported fall history, or sleep disturbance.
CONCLUSION
One in 5 older adults who use outpatient physical therapist services have cognitive impairment. Furthermore, cognitive impairment is more common in older physical therapist patients who report worse physical function and less physical activity.
IMPACT
Physical therapists should consider cognitive screening for vulnerable older adults to inform tailoring of clinical practice toward a patient's ability to remember and process rehabilitation recommendations.
Topics: Male; Female; Humans; Aged; United States; Dementia; Cross-Sectional Studies; Prevalence; Outpatients; Mobility Limitation; Medicare; Cognitive Dysfunction; Physical Therapy Modalities; Pain
PubMed: 37615482
DOI: 10.1093/ptj/pzad115 -
Cureus Mar 2024Cerebral palsy (CP) manifests as atypical muscle tone, posture, and movement, and is classified into four main types: extrapyramidal (dyskinetic), spastic quadriplegia,...
Cerebral palsy (CP) manifests as atypical muscle tone, posture, and movement, and is classified into four main types: extrapyramidal (dyskinetic), spastic quadriplegia, spastic hemiplegia, and spastic diplegia. Patients with CP might move awkwardly because of this since it indicates that their muscles are tense. We report the case of a 13-year-old child who complained of soreness in his right calf muscle and trouble walking over the previous two years. His condition is recognized as spastic diplegic CP. This report aims to understand the impact of neurophysiotherapy procedures in the context of CP. Physical therapy employs various therapeutic techniques to help patients become more independent in carrying out their everyday tasks and enhance their quality of life, including stretching, proprioceptive neuromuscular facilitation, limb strengthening exercises, and gait training. Early rehabilitation aids in treating various motor functions, such as balance, posture, oral motor functioning, fine motor skills, gross motor skills, muscle control, muscle tone, reflexes, and body movement. It also helps children with CP reach their full potential for physical independence and fitness and enhances the quality of life for both the child and the family. Pediatric rehabilitation yields significant benefits in alleviating walking difficulty and calf muscle pain in individuals with spastic diplegic CP and clubfoot deformity.
PubMed: 38586773
DOI: 10.7759/cureus.55697 -
Neuroscience Sep 2023Age modifies walking balance and neuromuscular control. Cognitive and postural constraints can increase walking balance difficulty and magnify age-related differences....
Age modifies walking balance and neuromuscular control. Cognitive and postural constraints can increase walking balance difficulty and magnify age-related differences. However, how such challenges affect neuromuscular control remains unknown. We determined the effects of age, cognitive task, and arm position on neuromuscular control of walking balance. Young (YA) and older adults (OA) walked on a 6-cm wide beam with and without arm crossing and a cognitive task. Walking balance was quantified by the distance walked on the beam. We also computed step speed, margin of stability, and cognitive errors. Neuromuscular control was determined through muscle synergies extracted from 13 right leg and trunk muscles. We analyzed neuromuscular complexity by the number of synergies and the variance accounted for by the first synergy, coactivity by the number of significantly active muscles in each synergy, and efficiency by the sum of the activation of each significantly active muscle in each synergy. OA vs. YA walked a 14% shorter distance, made 12 times more cognitive errors, and showed less complex and efficient neuromuscular control. Cognitive task reduced walking balance mainly in OA. Decreases in step speed and margin of stability, along with increased muscle synergy coactivity and reduced efficiency were observed in both age groups. Arm-crossing also reduced walking balance mostly in OA, but step speed decreased mainly in YA, in whom the margin of stability increased. Arm-crossing reduced the complexity of synergies. Age, cognitive task, and arm position affect differently muscle synergy recruitment but have similar effects on walking balance.
Topics: Arm; Postural Balance; Walking; Muscle, Skeletal; Cognition; Gait
PubMed: 37437799
DOI: 10.1016/j.neuroscience.2023.07.010 -
Physical Therapy Jan 2024The aims of this scoping review are to examine the available literature regarding dual tasking in children with cerebral palsy (CP) and to identify and categorize both... (Review)
Review
OBJECTIVE
The aims of this scoping review are to examine the available literature regarding dual tasking in children with cerebral palsy (CP) and to identify and categorize both the motor and cognitive tasks and outcome measures used primarily through the International Classification of Functioning, Disability, and Health model.
METHODS
Five electronic databases were searched. Studies were included if they: (1) were published in English; (2) included at least 1 group of children or adolescents with a diagnosis of CP; (3) assessed dual tasking as part of the study; (4) reported the method for performing the dual task; and (5) reported the outcome measures utilized.
RESULTS
Twenty-three studies with 439 children with CP were included. All studies utilized motor activities as the primary task, including walking, balance, and a functional transition. Motor secondary tasks occurred in 10 studies, cognitive secondary tasks in 12 studies, and 1 study used both. Forty-one outcome measures over 23 studies assessed the body structure and function domain, 7 measures over 6 studies assessed activity limitations, and 2 outcomes over 2 studies assessed participation.
CONCLUSION
The 23 included studies demonstrated heterogeneity in the age and function of participants, secondary tasks, and outcome measures. Future studies on dual tasking in children with CP should consider the difficulty of the primary motor or cognitive task and compare secondary tasks to establish this contribution to motor performance. Studies should incorporate activity and participation measures to assess meaningful functional outcomes.
IMPACT
Children with CP experience challenges when exposed to dual task situations. This scoping review highlights the importance of considering multiple factors when designing dual tasking studies involving children with CP to facilitate results translation, improved participation, and enhanced function. Similarly, studies should utilize activity and participation outcomes to assess quality of life.
Topics: Child; Adolescent; Humans; Cerebral Palsy; Quality of Life; Walking; Disabled Persons; Outcome Assessment, Health Care
PubMed: 37941469
DOI: 10.1093/ptj/pzad151 -
Nanomaterials (Basel, Switzerland) Oct 2023Two-dimensional (2D) transitional metal dichalcogenides (TMDs) have garnered remarkable attention in electronics, optoelectronics, and hydrogen precipitation catalysis... (Review)
Review
Two-dimensional (2D) transitional metal dichalcogenides (TMDs) have garnered remarkable attention in electronics, optoelectronics, and hydrogen precipitation catalysis due to their exceptional physicochemical properties. Their utilisation in optoelectronic devices is especially notable for overcoming graphene's zero-band gap limitation. Moreover, TMDs offer advantages such as direct band gap transitions, high carrier mobility, and efficient switching ratios. Achieving precise adjustments to the electronic properties and band gap of 2D semiconductor materials is crucial for enhancing their capabilities. Researchers have explored the creation of 2D alloy phases through heteroatom doping, a strategy employed to fine-tune the band structure of these materials. Current research on 2D alloy materials encompasses diverse aspects like synthesis methods, catalytic reactions, energy band modulation, high-voltage phase transitions, and potential applications in electronics and optoelectronics. This paper comprehensively analyses 2D TMD alloy materials, covering their growth, preparation, optoelectronic properties, and various applications including hydrogen evolution reaction catalysis, field-effect transistors, lithium-sulphur battery catalysts, and lasers. The growth process and characterisation techniques are introduced, followed by a summary of the optoelectronic properties of these materials.
PubMed: 37947689
DOI: 10.3390/nano13212843 -
Disability and Rehabilitation.... Oct 2023The overall aim of this systematic review was to identify and synthesise the best available evidence on effectiveness, resource use and costs involved in wheelchair...
OBJECTIVE
The overall aim of this systematic review was to identify and synthesise the best available evidence on effectiveness, resource use and costs involved in wheelchair interventions of adults with mobility limitations.
METHODOLOGY
This systematic review was undertaken in accordance with the Centre for Reviews and Dissemination Guidelines. The protocol for this systematic review was registered with PROSPERO International Prospective Register of Systematic reviews. The following PICOS eligibility criteria were considered: (P) Population was individuals with mobility limitations that live in their community (e.g., non-institutionalized), with aged 18 or older; (I) Intervention was mobility assistive technologies (MAT), such as manual and powered wheelchairs; (C) Comparators (Not Applied); (O) Outcome, the primary outcome of interest, was established as the cost-effectiveness of wheelchair interventions. Direct and indirect costs per unit of effect were expressed in terms of clinical outcome units, quality-adjusted life years gained, utility scores, quality of life measures and incremental cost-effectiveness ratios to inform the economic outcomes. (S) Study design was considered as a health economic evaluation (i.e., including cost-effectiveness analysis, cost-utility analysis and cost benefit analysis as well as partial economic evaluations). The Consolidated Health Economic Evaluation Reporting Standards - CHEERS, checklist was used for summarising and interpreting the results of economic evaluations.
RESULTS
Sixteen studies were included, two were identified as full health economic evaluations and 14 were considered partial health economic evaluations.
CONCLUSION
Only two full health economic analyses of wheelchair interventions have been conducted and both focussed on powered wheelchair provision. There are important gaps in current knowledge regarding wheelchair health economic methods and available outcome measures, which there is a great need for further research.Implication for RehabilitationSystematic reviews of health economic evaluation studies are useful for synthesising economic evidence about health interventions and provide insight in new research development.Organisations involved in the provision of wheelchairs should apply cost-effectiveness outcome measures to help raise the standard of provision, to support evidence-based practice, and to improve resource utilisation.
Topics: Humans; Cost-Benefit Analysis; Mobility Limitation; Quality of Life; Wheelchairs
PubMed: 34753399
DOI: 10.1080/17483107.2021.1993360 -
IBRO Neuroscience Reports Jun 2024Spinal cord injury (SCI) is a devastating mechanical trauma. Although locomotion of model animals that mimic contusion SCI was actively examined, locomotion after...
Spinal cord injury (SCI) is a devastating mechanical trauma. Although locomotion of model animals that mimic contusion SCI was actively examined, locomotion after penetrating SCI caused by sharp objects was not extensively studied. Severity of walking difficulty after partial transection of the spinal cord including penetrating SCI likely depends on the regions affected. Therefore, we compared beam walking and overground walking between mice after penetrating SCI at inner spinal cord region and mice with the injury at the outer region. Mice with the both penetrating SCIs did not display changes in beam walking. When appearance and movements of hindlimbs during overground walking was rated using Basso Mouse Scale for locomotion (BMS), however, mice with inner penetrating SCI showed low score shortly after the SCI. However, the score became high at later time points, as seen in contusion SCI mice. By contrast, BMS score did not decrease shortly after the outer penetrating SCI. However, the score became low 3 weeks after the SCI. As quantitative values during overground walking, movement duration in an open field were shorter at 1 day after the two penetrating SCIs. However, slower moving speed and fewer number of movement at 1 day were specific to mice with inner and outer penetrating SCIs, respectively. Moreover, BMS score was correlated with walking distance in open field only in mice with inner penetrating SCI. Thus, inner and outer penetrating SCI cause difficulty in overground walking with different severity and progress.
PubMed: 38415183
DOI: 10.1016/j.ibneur.2024.02.005 -
Indian Journal of Pathology &... Apr 2024Phosphaturic mesenchymal tumors (PMTs) are rare mesenchymal tumors, associated with long-standing, non-specific but often debilitating symptoms in the affected patients.... (Review)
Review
BACKGROUND
Phosphaturic mesenchymal tumors (PMTs) are rare mesenchymal tumors, associated with long-standing, non-specific but often debilitating symptoms in the affected patients. These tumors display characteristic histopathological features and in case, identified timely, can be a boon for patients, given an excision is completely curative.
AIMS
To evaluate the clinical and histopathological features of 10 PMTs, diagnosed at our institution, along with clinical outcomes in those patients.
MATERIALS AND METHODS
This was a retrospective study, wherein 10 PMTs, diagnosed from January 2013 to July 2022, were included.
RESULTS
The average age at the time of diagnosis was 40 years with an M:F ratio of 4:1. Clinical features included lumps, weakness, bone pain, difficulty in moving and walking, and pathologic fractures. The biochemical analysis showed normal serum calcium levels (average = 9.5 mg/dL), with low serum phosphorus (average = 2.2 mg/dL) and raised serum fibroblast growth factor 23 (FGF23) levels, in all the cases, wherever available. On histopathology, all tumors showed cells arranged in a hemangiopericytomatous pattern, including oval to short spindle forms. Multinucleate giant cells were present in nine tumors, and characteristic "grungy calcifications" was observed in eight tumors. Prominent pseudo cystic spaces were seen in eight tumors. A significant number of mitotic figures and tumor necrosis were not seen in any tumor. In five cases where follow-up was available, there was complete resolution of symptoms post-resection with no recurrence or metastasis. All those patients were free of disease until the last follow-up.
CONCLUSION
This constitutes the first largest comprehensive study on these rare tumors from our country. PMTs can be diagnosed based on certain histopathological features and correlation with clinicoradiological and biochemical findings. These are invariably benign neoplasms. Patients are relieved of their debilitating symptoms after adequate surgical tumor resection. Therefore, their correct and timely diagnosis is crucial.
Topics: Adult; Female; Humans; Male; Middle Aged; Young Adult; Fibroblast Growth Factor-23; Fibroblast Growth Factors; Hypophosphatemia; Mesenchymoma; Phosphorus; Retrospective Studies; Treatment Outcome
PubMed: 38394416
DOI: 10.4103/ijpm.ijpm_295_23