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Functional Performance (functional + performance)
Selected AbstractsAssociation Between Changes in Habitual Physical Activity and Changes in Bone Density, Muscle Strength, and Functional Performance in Elderly Men and WomenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2008Robin M. Daly PhD OBJECTIVES: To investigate the long-term effects of habitual physical activity on changes in musculoskeletal health, functional performance, and fracture risk in elderly men and women. DESIGN: Ten-year prospective population-based study. SETTING: Malmö-Sjöbo Prospective Study, Sweden. PARTICIPANTS: Participants were 152 men and 206 women aged 50, 60, 70, and 80 who were followed for 10 years. MEASUREMENTS: Distal radius bone mineral density (BMD) (single photon absorptiometry), upper limb muscle (grip) strength, balance, gait velocity, occupational and leisure-time activity, and fractures (interview-administered questionnaire) were reassessed after 10 years. Annual changes for all measures were compared between participants with varying habitual physical activity histories at baseline and follow-up: inactive,inactive (n=202), active,inactive (n=47), inactive,active (n=49), and active,active (n=60). Data for men and women were pooled, because there were no sex-by-activity group interactions. To detect possible differences in fracture incidence between the varying habitual activity groups, participants were classified into two activity groups based on their activity classification at baseline and follow-up: inactive:less active versus active:more active. RESULTS: The annual rate of bone loss was 0.6% per year less in individuals classified as active at both time points than in those classified as inactive at both time points (P<.01). Similar results were observed for balance, but there was no effect of varying habitual activity on changes in muscle strength or gait velocity. There were also no differences in fracture incidence between individuals categorized as active:more active and those categorized as inactive:less active during the follow-up (adjusted hazard ratio=0.90, 95% confidence interval (CI)=0.42,1.90). CONCLUSION: This study showed that elderly men and women who maintained a habitually active lifestyle over 10 years had lower bone loss and retained better balance than those who remained habitually inactive. [source] Contrasting Functional Performance of Juvenile Salmon Habitat in Recovering Wetlands of the Salmon River Estuary, Oregon, U.S.A.RESTORATION ECOLOGY, Issue 3 2002Ayesha Gray Abstract For an estuarine restoration project to be successful it must reverse anthropogenic effects and restore lost ecosystem functions. Restoration projects that aim to rehabilitate endangered species populations make project success even more important, because if misjudged damage to already weakened populations may result. Determining project success depends on our ability to assess the functional state or "performance" and the trajectory of ecosystem development. Mature system structure is often the desired "end point" of restoration and is assumed to provide maximum benefit for target species; however, few studies have measured linkages between structure and function and possible benefits available from early recovery stages. The Salmon River estuary, Oregon, U.S.A., offers a unique opportunity to simultaneously evaluate several estuarine restoration projects and the response of the marsh community while making comparisons with a concurring undiked portion of the estuary. Dikes installed in three locations in the estuary during the early 1960s were removed in 1978, 1987, and 1996, creating a "space-for-time substitution" chronosequence. Analysis of the marsh community responses enables us to use the development state of the three recovering marshes to determine a trajectory of estuarine recovery over 23 years and to make comparisons with a reference marsh. We assessed the rate and pattern of juvenile salmon habitat development in terms of fish density, available prey resources, and diet composition of wild juvenile Oncorhynchus tshawytscha (chinook salmon). Results from the outmigration of 1998 and 1999 show differences in fish densities, prey resources, and diet composition among the four sites. Peaks in chinook salmon densities were greatest in the reference site in 1998 and in the youngest (1996) site in 1999. The 1996 marsh had higher densities of chironomids (insects; average 864/m2) and lower densities of amphipods (crustaceans; average 8/m3) when compared with the other sites. Fauna differences were reflected in the diets of juvenile chinook with those occupying the 1978 and 1996 marshes based on insects (especially chironomids), whereas those from the 1987 and reference marshes were based on crustaceans (especially amphipods). Tracking the development of recovering emergent marsh ecosystems in the Salmon River estuary reveals significant fish and invertebrate response in the first 2 to 3 years after marsh restoration. This pulse of productivity in newly restored systems is part of the trajectory of development and indicates some level of early functionality and the efficacy of restoring estuarine marshes for juvenile salmon habitat. However, to truly know the benefits consumers experience in recovering systems requires further analysis that we will present in forthcoming publications. [source] Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplastyJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2005Ryan L. Mizner Abstract Purpose: Total knee arthroplasty (TKA) successfully reduces pain, but has not achieved comparable improvements in function. We hypothesized that quadriceps strength affects performance by altering loading and movement patterns during functional tasks. Methods: Fourteen subjects with isolated, unilateral TKA were tested three months after surgery. Quadriceps strength was assessed isometrically and kinematics, kinetics, and EMG were collected during level walking and sit-to-stand (STS). Function was assessed using the timed up and go test (TUG), stair climbing test (SCT), and the 6 min walk test (6MW). Results: Functional performance was significantly related to the quadriceps strength of both legs, but was more strongly related to the uninvolved strength (involved rho = ,0.43 with TUG; ,0.65 with SCT; 0.64 with 6MW) (uninvolved rho = ,0.63 with TUG; ,0.68 with SCT; 0.77 with 6MW). During STS, subjects shifted weight away from the operated limb (p <0.01). Quadriceps muscle activity and the extension moments at the knee and hip were smaller in the involved compared to the uninvolved (p <0.05). The amount of asymmetry in knee excursion during weight acceptance in gait, the asymmetry in weight bearing from sit-to-stand, and the uninvolved hip extension moment during STS were related to the amount of asymmetry in quadriceps strength (rho > 0.56, p < 0.05). Conclusions: Quadriceps weakness in patients with TKA has a substantial impact on the movement patterns and performance of the knee during functionally important tasks. © 2005 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Improvement in quality of life for cancer patients treated with epoetin alfaEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2001S.E. Libretto PHD BSC MIBIOL CBIOL Anaemia is a common complication of cancer and cancer therapies, and fatigue is one of the most common symptoms of anaemia, disrupting functional performance and reducing overall quality of life. The positive effects of treating renal patients with recombinant human erythropoietin are well documented. This case report series details the specific effects of fatigue on individual patients with cancer and their way of life, and describes their significant improvement in lifestyle following the reversal of anaemia using recombinant human erythropoietin, epoetin alfa. [source] An open-label trial of Korean red ginseng as an adjuvant treatment for cognitive impairment in patients with Alzheimer's diseaseEUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2008J.-H. Heo Background and purpose:, Ginseng is one of the most popular herbs worldwide. Ginseng has various medical applications, and it seems to have significant effects as a cognition-enhancing drug. In this study, we examined the efficacy of Korean red ginseng (KRG) as an adjuvant therapy to conventional anti-dementia medications in patients with Alzheimer's disease. Methods:, The trial was designed as a 12-week randomized study. Sixty-one patients (24 males and 37 females) with Alzheimer's disease were randomly assigned to one of the following treatment groups: low-dose KRG (4.5 g/day, n = 15), high-dose KRG (9 g/day, n = 15) or control (n = 31). The Alzheimer's Disease Assessment Scale (ADAS), Korean version of the Mini-Mental Status Examination (K-MMSE) and Clinical Dementia Rating (CDR) scale were used to assess the change in cognitive and functional performance at the end of the 12-week study period. Results:, The patients in the high-dose KRG group showed significant improvement on the ADAS and CDR after 12 weeks of KRG therapy when compared with those in the control group (P = 0.032 and 0.006 respectively). The KRG treatment groups showed improvement from baseline MMSE when compared with the control group (1.42 vs. ,0.48), but this improvement was not statistically significant. Conclusions:, KRG showed good efficacy for the treatment of Alzheimer's disease; however, further studies with larger samples of patients and a longer efficacy trial should be conducted to confirm the efficacy of KRG. [source] ECOLOGICAL AND DEVELOPMENTAL CONTEXT OF NATURAL SELECTION: MATERNAL EFFECTS AND THERMALLY INDUCED PLASTICITY IN THE FROG BOMBINA ORIENTALISEVOLUTION, Issue 1 2006Robert H. Kaplan Abstract Variation in fitness generated by differences in functional performance can often be traced to morphological variation among individuals within natural populations. However, morphological variation itself is strongly influenced by environmental factors (e.g., temperature) and maternal effects (e.g., variation in egg size). Understanding the full ecological context of individual variation and natural selection therefore requires an integrated view of how the interaction between the environment and development structures differences in morphology, performance, and fitness. Here we use naturally occurring environmental and maternal variation in the frog Bombina orientalis in South Korea to show that ovum size, average temperature, and variance in temperature during the early developmental period affect body sizes, shapes, locomotor performance, and ultimately the probability of an individual surviving interspecific predation in predictable but nonadditive ways. Specifically, environmental variability can significantly change the relationship between maternal investment in offspring and offspring fitness so that increased maternal investment can actually negatively affect offspring over a broad range of environments. Integrating environmental variation and developmental processes into traditional approaches of studying phenotypic variation and natural selection is likely to provide a more complete picture of the ecological context of evolutionary change. [source] Salinity as a structuring factor for the composition and performance of bacterioplankton degrading riverine DOCFEMS MICROBIOLOGY ECOLOGY, Issue 2 2003Silke Langenheder Abstract The impact of salinity on the composition and functional performance (biomass production, growth efficiency and growth rates) of bacterial communities was investigated using batch cultures growing on dissolved organic carbon from a river draining into the Northern Baltic Sea. The cultures were adjusted to riverine or estuarine salinity levels and inoculated with bacteria from these two environments. Bacterial growth efficiencies differed in response to salinity and the origin of the inoculum. When salinity was adjusted to correspond to the salinity at the site where the inoculum was retrieved, growth efficiency was relatively high (11.5±2.6%). However, when bacteria were confronted with a shift in salinity, growth efficiency was lower (7.5±2.0%) and more of the utilized carbon was respired. In contrast, growth rates were higher when bacteria were exposed to a change in salinity. The composition of the bacterial communities developing in the batch cultures differed, as shown by 16S rDNA DGGE, depending on the origin of the inoculum and salinity. Reverse and direct DNA,DNA hybridization revealed salinity optima in the growth of specific bacterial strains as well as broader phylogenetic groups. Strains belonging to the ,- and ,- Proteobacteria, Actinobacteria and ,- Proteobacteria other than the genus Pseudomonas showed higher relative abundance under freshwater conditions, whereas strains of the genus Pseudomonas and the Cytophaga,Flavobacterium,Bacteroides group were favored by estuarine conditions. Generally, our results demonstrate functional changes associated with changes in community composition. We suggest that even moderate changes in salinity affect bacterial community composition, which subsequently leads to altered growth characteristics. [source] Revolution and evolution: 30 years of ileoanal pouch surgeryINFLAMMATORY BOWEL DISEASES, Issue 2 2006Simon P Bach MD Abstract Ileal pouch-anal anastomosis (IPAA) has become the standard of care for the 25% of patients with ulcerative colitis who ultimately require colectomy. IPAA is favored by patients because it avoids the necessity for a long-term stoma. This review examines how 3 decades of experience with IPAA has molded current practice, highlighting 5- and 10-year follow-up of large series to determine durability and functional performance, in addition to causes of failure and the management of complications. [source] Generation, modeling, and analysis of CCII-based gyrators using the generalized symbolic framework for linear active circuitsINTERNATIONAL JOURNAL OF CIRCUIT THEORY AND APPLICATIONS, Issue 3 2008Ramy A. Saad Abstract In this paper, CCII-based gyrators are synthesized, modeled, and analyzed using the generalized symbolic framework for linear active circuits. The systematic synthesis method using admittance matrix expansion, included in the framework, is applied to generate optimized nullor,mirror descriptions for the gyrator. The resulting CCII-based circuit representations for the gyrators, obtained from mapping nullor,mirror pairs in the ideal realizations with equivalent second-generation current conveyors (CCIIs), can be classified into two topologies according to the type of the CCII terminals handling the gyrator input and output signals. In topology I, the gyrator input and output terminals are CCIIs Y,Z -terminals, whereas in topology II, the gyrator input and output terminals are CCIIs X -terminals. The parasitic components within the synthesized circuits, associated with the actual CCIIs, are modeled and included in their expanded admittance matrices. Exact non-ideal analysis for two circuits belonging to the two topologies, involving the reduction of their expanded admittance matrices to port admittance matrices, is then carried out to investigate the practical functional performance for these circuits at their ports. The non-ideal performance analysis based on the CCII actual parasitic elements indicates that, from a practical perspective, the CCII-based gyrator circuits belonging to topology I are more efficient and suitable for the gyrator applications than those belonging to topology II in terms of bandwidth and operation at high frequencies. SPICE simulations are included to demonstrate the analytical results for the comparison between the practical performances of the two circuit topologies. Copyright © 2007 John Wiley & Sons, Ltd. [source] Association Between Changes in Habitual Physical Activity and Changes in Bone Density, Muscle Strength, and Functional Performance in Elderly Men and WomenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2008Robin M. Daly PhD OBJECTIVES: To investigate the long-term effects of habitual physical activity on changes in musculoskeletal health, functional performance, and fracture risk in elderly men and women. DESIGN: Ten-year prospective population-based study. SETTING: Malmö-Sjöbo Prospective Study, Sweden. PARTICIPANTS: Participants were 152 men and 206 women aged 50, 60, 70, and 80 who were followed for 10 years. MEASUREMENTS: Distal radius bone mineral density (BMD) (single photon absorptiometry), upper limb muscle (grip) strength, balance, gait velocity, occupational and leisure-time activity, and fractures (interview-administered questionnaire) were reassessed after 10 years. Annual changes for all measures were compared between participants with varying habitual physical activity histories at baseline and follow-up: inactive,inactive (n=202), active,inactive (n=47), inactive,active (n=49), and active,active (n=60). Data for men and women were pooled, because there were no sex-by-activity group interactions. To detect possible differences in fracture incidence between the varying habitual activity groups, participants were classified into two activity groups based on their activity classification at baseline and follow-up: inactive:less active versus active:more active. RESULTS: The annual rate of bone loss was 0.6% per year less in individuals classified as active at both time points than in those classified as inactive at both time points (P<.01). Similar results were observed for balance, but there was no effect of varying habitual activity on changes in muscle strength or gait velocity. There were also no differences in fracture incidence between individuals categorized as active:more active and those categorized as inactive:less active during the follow-up (adjusted hazard ratio=0.90, 95% confidence interval (CI)=0.42,1.90). CONCLUSION: This study showed that elderly men and women who maintained a habitually active lifestyle over 10 years had lower bone loss and retained better balance than those who remained habitually inactive. [source] Efficacy and Feasibility of a Novel Tri-Modal Robust Exercise Prescription in a Retirement Community: A Randomized, Controlled TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2007Michael K. Baker BAppSc OBJECTIVES: To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults. DESIGN: Randomized, controlled trial. SETTING: Retirement village. PARTICIPANTS: Thirty-eight subjects (14 men and 24 women) aged 76.6 ± 6.1. INTERVENTION: A wait list control or 10 weeks of supervised exercise consisting of high-intensity (80% of one-repetition maximum (1RM)) progressive resistance training (PRT) 3 days per week, moderate-intensity (rating of perceived exertion 11 to 14/20) aerobic training 2 days per week, and progressive balance training 1 day per week. MEASUREMENTS: Blinded assessments of dynamic muscle strength (1RM), balance, 6-minute walk, gait velocity, chair stand, stair climb, depressive symptoms, self-efficacy, and habitual physical activity level. RESULTS: Higher baseline strength and psychological well-being were associated with better functional performance. Strength gains over 10 weeks averaged 39±31% in exercise, versus 21±24% in controls (P=.10), with greater improvements in hip flexion (P=.01), hip abduction (P=.02), and chest press (P=.04) in the exercise group. Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved. Stair climb power (12.3±15%, P=.002) and chair stand time (,7.1±15%, P=.006) improved significantly and similarly in both groups. Reduction in depressive symptoms was significantly related to compliance (attendance rate r=,0.568, P=.009, PRT progression in loading r=,0.587, P=.02, and total volume of aerobic training r=,0.541, P=.01), as well as improvements in muscle strength (r=,0.498, P=.002). CONCLUSION: Robust physical and psychological adaptations to exercise are linked, although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults. [source] Testosterone Supplementation Therapy for Older Men: Potential Benefits and RisksJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2003David A. Gruenewald MD Serum testosterone levels decline gradually and progressively with aging in men. Many manifestations associated with aging in men, including muscle atrophy and weakness, osteoporosis, reduced sexual functioning, and increased fat mass, are similar to changes associated with testosterone deficiency in young men. These similarities suggest that testosterone supplementation may prevent or reverse the effects of aging. A MEDLINE search was performed to identify studies of testosterone supplementation therapy in older men. A structured, qualitative review was performed of placebo-controlled trials that included men aged 60 and older and evaluated one or more physical, cognitive, affective, functional, or quality-of-life outcomes. Studies focusing on patients with severe systemic diseases and hormone deficiencies related to specific diseases were excluded. In healthy older men with low-normal to mildly decreased testosterone levels, testosterone supplementation increased lean body mass and decreased fat mass. Upper and lower body strength, functional performance, sexual functioning, and mood were improved or unchanged with testosterone replacement. Variable effects on cognitive function were reported, with improvements in some cognitive domains (e.g., spatial, working, and verbal memory). Testosterone supplementation improved exercise-induced coronary ischemia in men with coronary heart disease, whereas angina pectoris was improved or unchanged. In a few studies, men with low testosterone levels were more likely to experience improvements in lumbar bone mineral density, self-perceived functional status, libido, erectile function, and exercise-induced coronary ischemia with testosterone replacement than men with less marked testosterone deficiency. No major unfavorable effects on lipids were reported, but hematocrit and prostate specific antigen levels often increased. Based on these results, testosterone supplementation cannot be recommended at this time for older men with normal or low-normal testosterone levels and no clinical manifestations of hypogonadism. However, testosterone replacement may be warranted in older men with markedly decreased testosterone levels, regardless of symptoms, and in men with mildly decreased testosterone levels and symptoms or signs suggesting hypogonadism. The long-term safety and efficacy of testosterone supplementation remain uncertain. Establishment of evidence-based indications will depend on further demonstrations of favorable clinical outcomes and symptomatic, functional, and quality-of-life benefits in carefully performed, long-term, randomized, placebo-controlled clinical trials. J Am Geriatr Soc 51:101,115, 2003. [source] Weighted Stair Climbing in Mobility-Limited Older People: A Pilot StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2002MD Jonathan Bean MS OBJECTIVES: To evaluate weighted stair climbing exercise (SCE) as a means of increasing lower extremity muscle power in mobility-limited older people. DESIGN: Single-blinded, randomized controlled pilot study INTERVENTIONS: Subjects were randomized into one of two 12-week exercise programs. The intervention group (SCE) (n = 23) ascended and descended stairs, at a set pace, while wearing a weighted vest. The control group (WALK) (n = 22) participated in a standardized walking program. MEASUREMENTS: Primary and secondary outcomes included measures of muscle power and strength, submaximal aerobic capacity, and physical performance. RESULTS: SCE produced 17% improvement in double leg press peak power in comparison with WALK (P = .013) and significant improvement in stair climbing power from baseline (12%). Improvement in submaximal aerobic performance was equivalent for both groups. Although not statistically significant, effect size estimates suggest that SCE can potentially influence knee extension power and strength. Stair climb time was improved in both groups, whereas SCE produced significant improvements from baseline SPPB score in a subcohort of participants. CONCLUSIONS: These findings suggest that SCE may be a useful component of a home exercise program designed to enhance lower extremity muscle power, aerobic capacity, and functional performance. Further investigation is needed involving larger sample sizes and direct comparisons with other forms of resistance training. [source] Failure of the ammonia oxidation process in two pharmaceutical wastewater treatment plants is linked to shifts in the bacterial communitiesJOURNAL OF APPLIED MICROBIOLOGY, Issue 5 2005L. Wittebolle Abstract Aims:, To investigate whether two different wastewater treatment plants (WWTPs) , treating the same pharmaceutical influent , select for a different bacterial and/or ammonia oxidizing bacterial (AOB) community. Methods and Results:, Molecular fingerprinting demonstrated that each WWTP had its own total bacterial and AOB community structure, but Nitrosomonas eutropha and N. europea were dominant in both WWTP A and B. The DNA and RNA analysis of the AOB communities revealed different patterns; so the most abundant species may not necessarily be the most active ones. Nitritation failures, monitored by chemical parameter analysis, were reflected as AOB community shifts and visualized by denaturing gradient gel electrophoresis (DGGE)-based moving window analysis. Conclusions:, This research demonstrated the link between functional performance (nitritation parameters) and the presence and activity of a specific microbial ecology (AOB). Clustering and moving window analysis based on DGGE showed to be valuable to monitor community shifts in both WWTPs. Significance and Impact of the Study:, This study of specific community shifts together with functional parameter analysis has potential as a tool for relating functional instability (such as operational failures) to specific-bacterial community shifts. [source] Evaluating the efficacy of tele-cognitive rehabilitation for functional performance in three case studiesOCCUPATIONAL THERAPY INTERNATIONAL, Issue 1 2003Dr Sing-Fai Tam PhD Associate Professor Abstract Traumatic brain injury (TBI) is one of the main causes of long-term disability, and its rehabilitation is a challenge to the healthcare team. Tele-rehabilitation, through using advancements in networking and tailor-made software, has been developed and applied to the cognitive rehabilitation of persons with brain injury in the present study. Tele-cognitive rehabilitation uses customized online computer software as a treatment mode. The online treatment software is operated on an interactive tele-communication platform , for example, video conferencing with screen sharing. Through implementing the tele-cognitive rehabilitation activities, therapists can help clients to practise and thus improve their cognitive skills through using the treatment software successfully. Moreover, hypermedia programming techniques allow the therapist to adjust the software to meet the client's treatment needs, so that the treatment is appropriate to his/her functional levels and living environment. Also the software can customize immediate visual, auditory and personalized feedback to motivate the client and training can be set at the right pace for the client's needs. The present study aimed to evaluate the effectiveness and perceived efficacy of the newly developed customized tele-cognitive rehabilitation programme for three subjects with traumatic brain injury through using single-case and qualitative research design. The cognitive factors investigated in this pilot study were, respectively, Chinese word recognition, prospective memory and semantic memory. The subjects had undergone a recruitment process with stipulated screening criteria. A single case experimental design (ABA reversal/withdrawal design) consisted of a no-intervention baseline phase (A), an intervention phase (B) and a no-intervention withdrawal phase (A). There were six sessions in each phase, making a total of 18 sessions. Tele-cognitive rehabilitation software was tailor-made according to each subject's cognitive functional needs. To monitor the change in cognitive functions, variables were tapped by tailor-made assessment and qualitative questionnaires through interviews, and they were then used to explore subjects' opinions of the programme and to test the treatment efficacy of the tele-cognitive rehabilitation programme. Finally, the relationships among the three phases were analysed through visual analysis and trend line analysis by means of the split-middle method. The three persons with brain injury showed improving trends and levels of specific cognitive performance during the treatment phase. Qualitative findings were analysed and confirmed the efficacy of the treatment module. The tele-cognitive rehabilitation approach was well received by subjects. The authors suggest that further replication studies of this kind should be conducted in the future and that more subjects should be recruited to improve the generalizability of the results. Copyright © 2003 Whurr Publishers Ltd. [source] Occupational performance in older stroke wheelchair users living at homeOCCUPATIONAL THERAPY INTERNATIONAL, Issue 4 2001Dr Denise T Reid Professor, Faculty of Medicine Abstract This research aimed to identify problems in occupational performance experienced by survivors of stroke who used a wheelchair, both from their perspective and from the perspective of their caregivers. Sixteen stroke survivors over the age of 65 years who had used a prescribed wheelchair for at least one year, who lived in their own home, who were able to participate in a conversational interview and who had a caregiver willing to participate comprised the sample. The Canadian Occupational Performance Measure (COPM) was used to identify occupational performance problems and to measure stroke survivors' and caregivers' perceptions of performance. The Functional Autonomy Measurement System (SMAF) was also used to evaluate the functional performance of stroke survivors from the caregivers' perspective. The frequency and type of problems identified by the COPM were descriptively analysed and compared for both groups. The results of Mann-Whitney U tests showed no differences in the frequency of self-care, productivity and leisure problems reported between the two groups. Within-group comparisons using the Wilcoxon Signed Ranks Test showed that stroke survivors identified significantly more self-care problems than productivity-type problems (p=0.001), and more leisure problems than productivity problems (p=0.013). Caregivers identified significantly more self-care problems than productivity problems (p=0.001). The most common self-care problems reported by both stroke survivors and caregivers were dressing and bathing. Results suggest a high level of functional disability among the stroke survivors. There was a significant correlation between the score on the SMAF Instrumental Activities of Daily Living subscale and the frequency of caregiver assistance (r=0.747, p=0.001). Addressing the perspectives of both stroke survivors who are wheelchair users and their caregivers in identifying occupational performance problems at home is important for occupational therapists for planning home-based intervention. Copyright © 2001 Whurr Publishers Ltd. [source] The Effects of Pain and Depression on Physical Functioning in Elderly Residents of a Continuing Care Retirement CommunityPAIN MEDICINE, Issue 4 2000Jana M. Mossey PhD Objective., Explore the relationships between pain, depression, and functional disability in elderly persons. Design.,A cross-sectional, observational study of 228 independently living retirement community residents. Methods., Self-report measures of pain (adaptation of McGill Pain Questionnaire), depression (Geriatric Depression Scale [GDS]) and physical functioning (Physical performance difficulties, activities of daily living [ADL], independent activities of daily living [IADL], and 3-meter walking speed) were employed. Outcome Measures.,Physical functioning variables were dichotomized. Individuals in the lowest quartiles of functional performance and of walking speed were contrasted to all others; for ADL and IADL, those needing some help were compared with those independent in activities. Results., Pain and depression levels were strongly related to physical performance; depression levels were related to ADL and walking speed. In multivariate analyses, an interaction effect was observed where the effects of pain were a function of level of depression. Individuals reporting activity-limiting pain and slightly elevated depressive symptom levels, sub-threshold depression, or major depression were significantly more likely (AOR 7.8; 95% CI, 3.07,20.03) than non-depressed persons to be in the lowest quartile of self-reported physical performance. Conclusions., While both pain and depression level affect physical performance, depressive symptoms rather than pain appear the more influential factor. When seeing elderly patients, identifying, evaluating, and treating both pain complaints and depressive symptoms and disorders may reduce functional impairment. [source] The effectiveness of a pre-operative home-based physiotherapy programme for chronic anterior cruciate ligament deficiencyPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2006SL Keays Abstract Background and Purpose.,Little evidence supports the prescription of pre-operative rehabilitation in the treatment of chronic anterior cruciate ligament-deficient (ACLD) subjects. The aim of the present study was to assess the effectiveness of a specific six-week pre-operative exercise programme on ACLD knees.,Method.,A single, masked, controlled study was designed. This comprised two matched groups of 12 chronically ACLD patients awaiting reconstruction and a group of 12 matched uninjured control subjects. Only one ACLD group received a home-based exercise and educational programme. Assessment before and after the exercise intervention included: knee joint stability (clinical and KT1000 evaluation); muscle strength (Cybex II); standing balance and functional performance (agility, hop and subjective tests).,Results.,At the time of initial assessment there were no statistically significant differences in any measures for the two ACLD groups but both ACLD groups were significantly different from the uninjured control group as regards quadriceps strength and function. Measures taken after six weeks showed no significant improvement in the untreated ACLD group or in the uninjured control group The treated ACLD group showed significant improvement in the following measures: quadriceps strength measured at 60° and 120° per second (p < 0.001); single leg standing balance with eyes closed (p < 0.001); instrumented passive stability at 20,lb (89N) force (p = 0.003); agility and subjective performance (p < 0.001). The incidence of unstable episodes had decreased in the treated ACLD group, reducing further damage to the joint.,Conclusion.,This study leaves little doubt that pre-operative physiotherapy had a positive effect on motor function in ACLD subjects and should be prescribed routinely to maximize muscle stabilizing potential prior to reconstruction. Patients report improved stability and, in certain cases, may avoid surgery. The finding that exercise increased the passive stability of the joint was unexpected and requires further investigation. Copyright © 2006 John Wiley & Sons, Ltd. [source] Validity of the EK scale: a functional assessment of non-ambulatory individuals with Duchenne muscular dystrophy or spinal muscular atrophyPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2001Birgit Steffensen Abstract Background and Purpose The EK scale comprises ten categories (EK 1,10), each contributing to an overall picture of function in the non-ambulatory stage of Duchenne muscular dystrophy (DMD). The purpose of the present study was to investigate content and construct validity of the EK scale as a tool to discriminate between levels of functional ability in individuals with DMD or spinal muscular atrophy (SMA) who were non-ambulatory. Method Data from a sample of 56 subjects with DMD and 38 with SMA, who were non-ambulatory, were obtained from four separate studies. The relationship of functional ability by use of the EK scale and (1) muscle strength, (2) contractures, (3) forced vital capacity and (4) years of wheelchair dependency were assessed. All items of the EK scale were used except the one representing severe hypoventilation. Results Regression analyses showed that the EK sum was the most significant explanatory variable (p<0.05) of all variables measured to explain muscle strength in both DMD and SMA subjects. The individual categories of EK (1,10) all contributed as significant explanatory variables (p<0.05) to the other variables measured. Conclusions The categories and items of the EK scale were relevant and valid as means of discriminating between levels of functional performance in the population studied which was evidence of content and construct validity. Copyright © 2001 Whurr Publishers Ltd. [source] Product Technology Transfer in the Upstream Supply ChainTHE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 6 2003Mohan V. Tatikonda This article addresses the transfer of new product technologies from outside the firm for integration into a new product system as part of a product development effort. Product technology transfer is a key activity in the complex process of new product development and is the fundamental link in the technology supply chain. Product technology transfer too often is dealt with in an ad-hoc fashion. Purposeful management of the product technology transfer process leads to more effective transfers in terms of timeliness, cost, functional performance, and competence building. Better management of product technology transfer gives firms access to a greater variety of new technology options, improves a firm's ability to offer significantly differentiated products, deepens the firm's competitive competencies, and positively influences sustained product development success. The central objective of this article is to gain insight into product technology transfer so that companies can manage this process more successfully and so that researchers can investigate this critical activity further. This article describes the technology supply chain as a unique form of a supply chain that poses a set of managerial challenges and requirements distinguishing it from the more traditional component supply chain. Because a single product technology transfer project is the fundamental piece in the technology supply chain, understanding this piece well is key to leveraging the extended technology supply chain and to improving overall product development performance. This article integrates literatures on new product development, supply chain management, and technology management and builds on organizational theory to present a conceptual model of determinants of product technology transfer success. The core proposition is that product technology transfer effectiveness is greatest when companies carefully match (or "fit") the type of technology to be transferred (the "technology uncertainty") with the type of relationship between the technology supplier and recipient (the "interorganizational interaction"). A quite detailed framework characterizing technology uncertainty along the dimensions of technology novelty, complexity, and tacitness is presented to help in assessing the challenges associated with transferring a particular product technology. This article also considers detailed elements characterizing the interorganizational interactions between the technology source and recipient firms. This helps firms consider the appropriate means to facilitate the interfirm process of technology transfer. Overall, this article provides practical insight into characterizing technologies and into improving the product technology transfer process. This article also provides a strong theoretical foundation to aid future research on product technology transfer in the technology supply chain. [source] How integrating industrial design in the product development process impacts on company performanceTHE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 1 2001Gerda Gemser There is a growing belief that investing in industrial design is beneficial to company performance. This article sheds more light on how and when integrating industrial design in the product development process can enhance a company's competitive position. The basic premise is that the impact of industrial design on company performance is not unconditional, but dependent on industry evolution and design strategy. We opted to define industrial design in a general way, namely as the activity that transforms a set of product requirements into a configuration of materials, elements and components. This activity can have an impact on a product's appearance, user friendliness, ease of manufacture, efficient use of materials, functional performance, and so on. The empirical data incorporated in this study stems from two Dutch manufacturing industries, namely home furniture and precision instruments. Home furniture and precision instruments were selected because the strategy of integrating industrial design in the product development process is rather mature in the first-named industry and emerging in the second. We collected data from firms investing considerably in industrial design (n = 23) and firms investing little to nothing in industrial design (n = 24), using a semistructured questionnaire that was administrated during face-to-face sessions with senior managers. Two out of the three research hypotheses were supported. It was found that the extent to which firms integrate industrial design in new product development projects has a significant and positive influence on company performance (Hla), in particular when the strategy of investing in industrial design is relatively new for the industry involved (Hlb). There was no systematic pattern indicating that design innovation is more important in industries where the use of design is mature than in industries where the use of design is emerging (H2). Instead, we found that design innovation has significant positive performance effects in both types of industries. One important managerial inference from our study is that new product development managers should consider the changing nature of competition during industry evolution while developing strategies that encompass the use of industrial design in new product development. Another important managerial inference is that, besides being innovative in the field of products, being innovative with respect to design and design strategy can help to enhance competitiveness regardless of industry evolution. [source] Experimental Evaluation of the V-Point Heparin-Bonding System Applied to a Dense-Membrane Artificial Lung During 24-Hour Extracorporeal Circulation in BeaglesARTIFICIAL ORGANS, Issue 8 2001Masafumi Tashiro Abstract: Heparin was covalently bonded to a hollow-fiber dense-membrane artificial lung and circuit using a silane coupling agent and polyethyleneimine as a spacer. This study investigated whether the novel artificial lung could sustain prolonged extracorporeal lung assist (ECLA) by venoarterial bypass in beagles using minimal anticoagulants. We maintained ECLA for 24 h in 3 groups of minimal systemic heparinization, heparinization with the new anticoagulant nafamostat mesilate, and without any systemic anticoagulant. The results were assessed from the functional performance of the artificial lung and by macroscopic and microscopic examination after the experiments. Artificial lung function, hemodynamics, hemogram, and platelet aggregation activity were well maintained in all groups. There was no plasma leakage from the artificial lung. Although several clots were observed in stagnant areas of the artificial lungs and circuits, there was no clot formation inside the artificial lung in any group. This highly biocompatible, heparin-bonded dense-membrane artificial lung performed well and safely during prolonged ECLA with blood clotting times less than 120 s. [source] Linking ecological function to species composition in ecological restoration: Seed removal by ants in recreated woodlandAUSTRAL ECOLOGY, Issue 7 2009BORIS LOMOV Abstract Evaluations of ecological restoration typically focus on associating measures of structural properties of ecosystems (e.g. species diversity) with time since restoration efforts commenced. Such studies often conclude a failure to achieve restoration goals without examining functional performance of the organism assemblages in question. We compared diversity and composition of ant assemblages and the rates of seed removal by ants in pastures, 4- to 10-year old revegetated areas and remnants of Cumberland Plain Woodland, and an endangered ecological community in Sydney, Australia. Ant assemblages of forest remnant sites had significantly higher species richness, significantly different species composition and a more complex functional group structure in comparison with ant assemblages of pasture and revegetated sites, which did not differ significantly. However, the rates of seed removal by ants in revegetated sites were similar to those in forest remnants, with the rates in pasture sites being significantly lower. Approximately, one-third of all ant species were observed to remove seeds. Forest remnant sites had significantly different assemblages of seed removing ant species from those in pasture and revegetated sites. These results demonstrate that similar ant assemblages of unrestored and restored areas can function differently, depending on habitat context. Evaluation of restoration success by quantifying ecosystem structure and function offers more insights into ecosystem recovery than reliance on structural data alone. [source] A randomized clinical trial of energy conservation for patients with cancer-related fatigueCANCER, Issue 6 2004Andrea M. Barsevick D.N.Sc. Abstract BACKGROUND The efficacy of energy conservation and activity management (ECAM) for fatigue reduction and maintenance of functional performance has never been evaluated in adults with cancer who are undergoing treatment. METHODS A randomized clinical trial compared an ECAM intervention with a control intervention focused on nutrition. Individuals initiating chemotherapy, radiotherapy, or concurrent therapy for cancer were randomized to receive either the semistructured ECAM intervention (n = 200) or the control intervention (n = 196). Participants in each group participated in 3 telephone sessions with an oncology nurse during the first 5 weeks of treatment. Data on fatigue and limitation of functioning were obtained before cancer treatment and at two follow-up points that coincided with times of high fatigue for each type of treatment. The outcomes of interest included perception of fatigue and functional performance. RESULTS A repeated-measures analysis of covariance using the type of cancer treatment as a covariate revealed a significant study group,by-time interaction indicating that the ECAM group experienced a greater decrease in fatigue over time compared with the control group (F2,544 = 4.5; P = 0.01). The intervention was not associated with changes in overall functional performance. CONCLUSIONS Individuals who received the ECAM intervention derived a modest but significant benefit from it. To achieve a more robust clinical benefit from the intervention, it may be necessary to manage other key symptoms in addition to fatigue. Research is needed to examine symptom clusters or combinations associated with negative outcomes as well as combination strategies for symptom management. Cancer 2004. © 2004 American Cancer Society. [source] Anosognosia for memory impairment in Alzheimer's diseaseACTA NEUROPSYCHIATRICA, Issue 4 2010Georgina Stewart Stewart G, McGeown WJ, Shanks MF, Venneri A. Anosognosia for memory impairment in Alzheimer's disease. Objective: To investigate whether patients with Alzheimer's disease (AD) were able to alter their awareness of memory deficits after exposure to a memory task. Methods: Thirty normal older adults and 23 mild AD patients participated in the study. Anosognosia was assessed using discrepancies between self- and informant-evaluations of cognitive and functional performance. Participants estimated their performance on the Verbal Paired Associates task at different points in time (before, immediately after the task and after a 1-h delay). Results: AD patients were generally less able to judge their memory abilities than healthy older adults, and tended to overestimate their task performance beforehand. Their prediction accuracy increased immediately after the task, but after a 1-h delay, they again misjudged their abilities at pretesting accuracy levels. Self-carer discrepancy scores of awareness of deficits in memory and other areas correlated significantly with memory tests but not with other neuropsychological tasks in the assessment, and larger discrepancy scores were associated with poorer performance. Conclusion: AD patients can monitor their task performance online, but are unable to maintain awareness of their deficits over time. Loss of awareness of memory deficits (or of any other deficits) in early stage AD may indicate damage to a system which updates a personal knowledge base with recent information. Failure to retain this information impedes abstraction from episodic to semantic memory. 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