scholarly journals Distal Radial Fractures in the Superelderly: Does Malunion Affect Functional Outcome?

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
N. D. Clement ◽  
A. D. Duckworth ◽  
C. M. Court-Brown ◽  
M. M. McQueen
Keyword(s):  
Activities Of Daily Living ◽  
Functional Outcome ◽  
Grip Strength ◽  
Normal Level ◽  
Daily Living ◽  
Wrist Pain ◽  
Distal Radial Fracture ◽  
Distal Radial Fractures ◽  
Dorsal Angulation ◽  
Level Function

Purpose. The management of unstable distal radial fractures in the superelderly (≥80 years old) remains controversial. The aim of this study was to compare the functional outcome of super-elderly patients with and without malunion after a distal radial fracture. Methods. We identified 51 superelderly patients living independently with displaced fractures from a prospective database of 4024 patients with distal radial fractures. Activities of daily living, presence of wrist pain, whether the wrist had returned to its normal level function, grip strength and ROM were recorded. The dorsal angulation was measured radiographically. Results. There were 17 (33.3%) patients defined to have a malunion. The outcomes of the independent patients with and without malunion were compared at a mean follow-up of 15 months. No difference was observed in activities of daily living P=0.28, wrist pain P=0.14, whether the wrist had returned to its normal level function P=0.25, grip strength P=0.31, or ROM P=0.41. An increasing degree of dorsal angulation correlated with diminished ROM (P=0.038), but did not correlate with activities of daily living (P=0.10). Conclusions. Malunion of the distal radius does not influence the functional outcome of independent superelderly patients.

Inflammation, Functional Status, and Weight Loss During Recovery From Cardiac Surgery in Older Adults

2013 ◽  
Vol 16 (3) ◽  
pp. 344-352 ◽  
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Eileen M. Sullivan-Marx ◽  
Charlene Compher
Keyword(s):  
Weight Loss ◽  
Cardiac Surgery ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Grip Strength ◽  
Daily Living ◽  
Community Dwelling ◽  
Chair Stand ◽  
Prospective Longitudinal ◽  
Over Time

Objective: To determine the nutritional, inflammatory, and functional aspects of unintentional weight loss after cardiac surgery that warrant further investigation. Research Methods and Procedures: Twenty community-dwelling adults > 65 years old undergoing cardiac surgery (coronary artery bypass graft [CABG] or CABG + valve) were recruited for this prospective longitudinal (preoperative and 4–6 weeks postdischarge) pilot study. Anthropometrics (weight, standing height, and mid-arm and calf circumference), nutritional status (Mini-Nutritional Assessment™ [MNA]), appetite, physical performance (timed chair stand), muscle strength (hand grip) and functional status (basic and instrumental activities of daily living), and inflammatory markers (plasma leptin, ghrelin, interleukin [IL]-6, high-sensitivity[hs] C-reactive protein, and serum albumin and prealbumin) were measured. Results: Participants who completed the study ( n = 11 males, n = 3 females) had a mean age 70.21 ± 4.02 years. Of these, 12 lost 3.66 ± 1.44 kg over the study period. Weight, BMI, activities of daily living, and leptin decreased over time ( p < .05). IL-6 increased over time ( p < .05). Ghrelin, hs-CRP, and timed chair stand increased over time in those who underwent combined procedures ( p < .05). Grip strength decreased in those who developed complications ( p = .004). Complications, readmission status, and lowered grip strength were found in those with low preoperative MNA scores ( p < .05). Conclusion: After cardiac surgery, postdischarge weight loss occurs during a continued inflammatory response accompanied by decreased physical functioning and may not be a positive outcome. The impacts of weight loss, functional impairment, and inflammation during recovery on disability and frailty warrant further study.

scholarly journals Rheumatoid arthritis: hand function, activities of daily living, grip strength and essential assistive devices.

Curationis ◽  
2003 ◽  
Vol 26 (3) ◽  
Author(s):  
I Shipham
Keyword(s):  
Rheumatoid Arthritis ◽  
Activities Of Daily Living ◽  
Grip Strength ◽  
Daily Living ◽  
Hand Function ◽  
Assistive Devices ◽  
Hand Dexterity

Persons with rheumatoid arthritis use assistive devices to enable them, in spite of impaired hand dexterity and grip strength, to manage Activities of Daily Living (ADL).

scholarly journals Streamlining the KOOS Activities of Daily Living Subscale Using Machine Learning

2020 ◽  
Vol 8 (3) ◽  
pp. 232596712091044 ◽  
Author(s):  
Ashim Gupta ◽  
Ajish S.R. Potty ◽  
Deepak Ganta ◽  
R. Justin Mistovich ◽  
Sreeram Penna ◽  
...  
Keyword(s):  
Machine Learning ◽  
Activities Of Daily Living ◽  
Functional Outcome ◽  
Acl Reconstruction ◽  
Daily Living ◽  
High Accuracy ◽  
Quality Data ◽  
Specific Patient ◽  
Patient Reported ◽  
Essential Questions

Background: Functional outcome scores provide valuable data, yet they can be burdensome to patients and require significant resources to administer. The Knee injury and Osteoarthritis Outcome Score (KOOS) is a knee-specific patient-reported outcome measure (PROM) and is validated for anterior cruciate ligament (ACL) reconstruction outcomes. The KOOS requires 42 questions in 5 subscales. We utilized a machine learning (ML) algorithm to determine whether the number of questions and the resultant burden to complete the survey can be lowered in a subset (activities of daily living; ADL) of KOOS, yet still provide identical data. Hypothesis: Fewer questions than the 17 currently provided are actually needed to predict KOOS ADL subscale scores with high accuracy. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Pre- and postoperative patient-reported KOOS ADL scores were obtained from the Surgical Outcome System (SOS) data registry for patients who had ACL reconstruction. Categorical Boosting (CatBoost) ML models were built to analyze each question and its value in predicting the patient’s actual functional outcome (ie, KOOS ADL score). A streamlined set of minimal essential questions were then identified. Results: The SOS registry contained 6185 patients who underwent ACL reconstruction. A total of 2525 patients between the age of 16 and 50 years had completed KOOS ADL scores presurgically and 3 months postoperatively. The data set consisted of 51.84% male patients and 48.16% female patients, with a mean age of 29 years. The CatBoost model predicted KOOS ADL scores with high accuracy when only 6 questions were asked ( R2 = 0.95), similar to when all 17 questions of the subscale were asked ( R2 = 0.99). Conclusion: ML algorithms successfully identified the essential questions in the KOOS ADL questionnaire. Only 35% (6/17) of KOOS ADL questions (descending stairs, ascending stairs, standing, walking on flat surface, putting on socks/stockings, and getting on/off toilet) are needed to predict KOOS ADL scores with high accuracy after ACL reconstruction. ML can be utilized successfully to streamline the burden of patient data collection. This, in turn, can potentially lead to improved patient reporting, increased compliance, and increased utilization of PROMs while still providing quality data.

scholarly journals Associations Between Fine Motor Performance in Activities of Daily Living and Cognitive Ability in a Nondemented Sample of Older Adults: Implications for Geriatric Physical Rehabilitation

2016 ◽  
Vol 29 (7) ◽  
pp. 1144-1159 ◽  
Author(s):  
Elizabeth B. Fauth ◽  
Sydney Y. Schaefer ◽  
Steven H. Zarit ◽  
Marie Ernsth-Bravell ◽  
Boo Johansson
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Cognitive Ability ◽  
Grip Strength ◽  
Daily Living ◽  
Ordinary Least Squares ◽  
Physical Rehabilitation ◽  
Fine Motor ◽  
Physical Ability

Objective: Fine motor ability (FMA) is essential in certain activities of daily living (ADL) and is considered mostly as a component of physical function. We hypothesize that cognitive ability explains significant variance in ADL-related FMA, above and beyond what is explained by physical ability (grip strength). Method: Origins of Variance in the Old Old Study (OCTO)-Twin participants ( n = 218), aged 80+ (dementia, stroke, Parkinson’s disease excluded) were assessed on depressive symptoms (Center for Epidemiologic Studies–Depression Scale [CES-D]), a cognitive battery, grip strength, and FMA. Results: In a series of ordinary least squares regression models, FMA was not associated with gender or depressive symptoms, but was associated with age (marginally; β = −.164, p = .051), grip strength (β = −.381, p < .01), and one cognitive measure, perceptual speed (β = −.249, p < .01). Discussion: In nondemented older adults, cognitive speed predicts ADL-related FMA after controlling for age and physical ability. Physical rehabilitation of FMA in ADL tasks should consider the importance of cognitive ability, even in nondemented older adults.

The incidence of ulnocarpal complaints after distal radial fracture in relation to the fracture of the ulnar styloid

2012 ◽  
Vol 38 (7) ◽  
pp. 710-717 ◽  
Author(s):  
S. Krämer ◽  
H. Meyer ◽  
P. F. O’Loughlin ◽  
B. Vaske ◽  
C. Krettek ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Grip Strength ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Ulnar Styloid ◽  
Distal Radial Fractures ◽  
Pain Scores ◽  
Ulnar Styloid Fracture ◽  
Loss Of Motion

Two hundred distal radial fractures, with a mean follow up of 20 months (range 6–49), were divided into three groups according to the presence and healing status of an ulnar styloid fracture. The patients underwent both clinical and radiological examination and completed two different questionnaires. One hundred and one, of 200 distal radial fractures, were associated with an ulnar styloid fracture. Forty-six of these developed an ulnar styloid nonunion. The authors encountered significantly higher pain scores (ulnar sided pain p = 0.012), a higher rate of DRUJ instability ( p = 0.032), a greater loss of motion and grip strength ( p = 0.001), and a poorer clinical outcome in cases with an ulnar styloid fracture, but no differences were apparent when those with healed ulnar styloid fractures or ulnar styloid nonunions were compared ( p > 0.05). The investigators propose that the incidence of ulnocarpal complaints following distal radial fracture depends on the presence but not the healing status of an ulnar styloid fracture.

An 18-month prospective cohort study of functional outcome of delirium in elderly patients: activities of daily living

2006 ◽  
Vol 18 (4) ◽  
pp. 681-700 ◽  
Author(s):  
Stephen Vida ◽  
Guillaume Galbaud du Fort ◽  
Ritsuko Kakuma ◽  
Louise Arsenault ◽  
Robert W. Platt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cohort Study ◽  
Elderly Patients ◽  
Activities Of Daily Living ◽  
Functional Outcome ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Daily Living ◽  
Medical Problems

Objectives: To examine delirium, chronic medical problems and sociodemographic factors as predictors of activities of daily living (ADL), basic ADL (BADL) and instrumental ADL (IADL).Methods: A prospective cohort study of four groups of elderly patients examined in the emergency department (ED): those with delirium, dementia, neither, and both. All were aged 66 years or older and living at home. Delirium was assessed with the Confusion Assessment Method and dementia with the Informant Questionnaire on Cognitive Decline in the Elderly. Demographic variables and chronic medical problems were ascertained with questionnaires. Outcome was ADL at 6, 12 and 18 months, measured with the ADL subscale of the Older Americans Resources and Services instrument.Results: Univariate analyses suggested significantly poorer ADL, particularly IADL, at 18 months in the delirium versus the non-delirium group, in the absence of dementia only. Statistically significant independent predictors of poorer ADL at 18 months in the non-dementia groups were poorer initial ADL, stroke, Parkinson's disease, hypertension and female sex. Independent predictors of poorer BADL at 18 months in the non-dementia groups were poorer initial BADL, Parkinson's disease, stroke, cancer, colds/sinusitis/laryngitis, female sex and hypertension. Independent predictors of poorer IADL at 18 months in the non-dementia groups were poorer initial IADL, stroke, never-married status, colds/sinusitis/laryngitis, arthritis and hypertension, with Parkinson's disease showing a non-significant but numerically large regression coefficient.Conclusion: Rather than finding delirium to be a predictor of poorer functional outcome among survivors, we found an interaction between delirium and dementia and several plausible confounders, primarily chronic medical problems, although we cannot rule out the effect of misclassification or survivor bias.

The Association Between Handgrip Strength and Diabetes on Activities of Daily Living Disability in Older Mexican Americans

2017 ◽  
Vol 30 (8) ◽  
pp. 1305-1318 ◽  
Author(s):  
Ryan P. McGrath ◽  
Brenda M. Vincent ◽  
Soham Al Snih ◽  
Kyriakos S. Markides ◽  
Brad P. Dieter ◽  
...  
Keyword(s):  
Body Weight ◽  
Confidence Interval ◽  
Activities Of Daily Living ◽  
Grip Strength ◽  
Muscle Weakness ◽  
Mexican Americans ◽  
Daily Living ◽  
Handgrip Strength ◽  
Joint Effects ◽  
Adl Disability

Objective: The aim of this study is to determine the independent and joint effects of muscle weakness and diabetes on incident activities of daily living (ADL) disability in older Mexican Americans. Method: A subsample of 2,270 Mexican Americans aged at least 65 years at baseline were followed for 19 years. Handgrip strength was normalized to body weight (normalized grip strength [NGS]). Weakness was defined as NGS ≤0.46 in males and ≤0.30 in females. Diabetes and ADL disability were self-reported. Results: Compared with participants that were not weak and did not have diabetes, those that had diabetes only, were weak only, and were both weak and had diabetes experienced a 1.94 (95% confidence interval [CI] = [1.89, 1.98]), 1.17 (CI = [1.16, 1.19]), and 2.12 (CI = [2.08, 2.16]) higher rate for ADL disability, respectively. Discussion: Muscle weakness and diabetes were independently and jointly associated with higher rates for ADL disability in older Mexican Americans.

Sign in / Sign up

Export Citation Format

Share Document