It remains unclear whether limitations in activities of daily living(ADL) increase the risk of stroke in older Chinese adults.This longitudinal study used data from the Chinese Longitudinal Healthy Longevity Survey to...It remains unclear whether limitations in activities of daily living(ADL) increase the risk of stroke in older Chinese adults.This longitudinal study used data from the Chinese Longitudinal Healthy Longevity Survey to investigate the effects of limitations in ADL on the incidence of stroke in older adults.Between 2002 and 2011,46,728 participants from 22 provinces in China were included in this study.Of participants,11,241 developed limitations in ADL at baseline.A 3-year follow-up was performed to determine the incidence of stroke.During the 3-year follow-up,929 participants(8.26%) and 2434 participants(6.86%) experienced stroke in the ADL limitations group and non-ADL limitations group,respectively.Logistic regression was used to analyze the effect of ADL limitations on the risk of stroke.The results showed that after adjusting for the confounding factors gender,age,weight,hypertension,diabetes,heart disease,natural teeth,hearing impairment,visual impairment,smoking,alcohol abuse,exercise,ethnicity,literacy,residential area,and poverty,the ADL limitations group had a 77% higher risk of developing stroke than the non-ADL limitations group.After propensity score matching,the ADL limitations group still had a 33% higher risk of developing stroke than the non-ADL limitations group(OR = 1.326,95% CI:1.174–1.497).These findings suggest that limitations in ADL are a stroke risk factor.展开更多
BACKGROUND： In the rehabilitation of stroke patients, clinicians usually concentrate on motor problems, such as spasm of limbs and restriction of joint motion, while sensory and perceptive problems are almost always ...BACKGROUND： In the rehabilitation of stroke patients, clinicians usually concentrate on motor problems, such as spasm of limbs and restriction of joint motion, while sensory and perceptive problems are almost always neglected, although they are just as important. One such area is the sensory disorder. OBJECTIVE： To evaluate the motor function and activities of daily living in stroke patients with and without sensory disorders after treatment of integrated western and Chinese medicine. DESIGN： A non-randomized synchronically controlled trial. SETTING： First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine. PARTICIPANTS： Totally 500 stroke inpatients were selected from the Department of Acupuncture and Massage, the First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine from January 2003 to December 2004. They all had suffered from stroke in the last 4 weeks and accompanied by sensory disorder of the ipsilateral limb to different severity. The patients were all accorded with the Diagnostic and Efficacy Evaluative Standards for Stroke （in trial） set by the Encephalopathy Emergency Assistant Group, the State Administration of Traditional Chinese Medicine in 1995, and they were diagnosed by imaging examination. The patients were stratified into sensory disorder group （n =220） and normal sense group （n =280）. Informed consent for the detected items and therapeutic program was obtained from the relatives of all the participants. The study was approved by the hospital ethical committee. METHODS： All the patients were treated with acupuncture of Xing Nao Kai Qiao for restoring consciousness and inducing resuscitation, assisted by traditional Chinese medicine and western medicine specific to corresponding symptoms. The therapeutic principles were restoring consciousness and inducing resuscitation, nourishing liver and kidney, and dredging meridian. In addition, the patients were given western medical treatments for decreasing intracranial pressure, thrombolysis, reducing blood viscosity, anticoagulation, anti-arteriosclerosis, ameliorating microcirculation, also administrated with activator for nerve cells. MAIN OUTCOME MEASURES： （1） The severity of motor function deficit was evaluated using clinical neurological deficit score for stroke patients set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995; （2） The activities of daily living was evaluated with Barthel Index, the higher the score, the better the independence, and the less the dependence. RESULTS： All the 500 stroke patients were involved in the final analysis of results. （1） The neurological deficit scores before treatment had no significant difference between the two groups （P 〉 0.05）, but the scores after treatment were significantly decreased as compared with those before treatment in both groups （t =6.59, 12.43, P 〈 0.01）. The neurological deficit score after treatment in the normal sense group was significantly lower than that in the sensory disorder group （t =1.63, P 〈 0.05）. （2） The scores of activities of daily living after treatment were significantly increased as compared with those before treatment in both groups （t =16.03, 25.10, P 〈 0.01）. The scores of activities of daily living in the normal sense group were higher than those in the sensory disorder group both before and after treatment （t =6.07, 14.26, P 〈 0.05）. CONCLUSION： Sensory disorders have obvious negative effects on the recovery of motor function and activities of daily living of stroke patients.展开更多
<span style="font-family:Verdana;">Bedridden patients remain in bed for various reasons, such as chronic illness, old age, and disability, and they cannot perform self-care activities completely or par...<span style="font-family:Verdana;">Bedridden patients remain in bed for various reasons, such as chronic illness, old age, and disability, and they cannot perform self-care activities completely or partially. The provision of care for bedridden patients is a major issue in the aging population. Effective rehabilitation is associated with several factors such as cooperation between the patient and the medical staff, selection of effective facilities, and the financial burden. The objective of this study was to evaluate the effect on the activities of daily living (ADL) of occlusion restoration using removable dentures in bedridden older people.</span><span> </span><span style="font-family:Verdana;">This case</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">control study comprised 32 bedridden older patients who were divided into two groups as follows: denture (n </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> 18) and no-denture (n </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> 14). No rehabilitation was provided to any of the patients. The patients were evaluated 3 months after placing the denture, and the ADLs were compared between the two groups. Of the 18 bedridden patients who received removable dentures, 55.6% demonstrated improvements in the ADLs, and the effects persisted for </span><span style="font-family:Verdana;">at least 3 months. No improvement in the ADL was observed in the no-denture</span><span style="font-family:Verdana;"> group.</span><span> </span><span style="font-family:Verdana;">The results of this study suggested that adequate occlusal support can improve the ADL of the elderly. Thus, it is important to take care of oral health early in life in order to maintain oral health, which could help prevent the decrease in the ADL during the later stages of life.</span>展开更多
目的:观察脑卒中后肩手综合征(Shoulder-Hand Syndrome,SHS)患者日常生活活动能力(Activity of Daily Living,ADL)评分与其血脂水平的相关性,分析探讨其内在联系。方法:回顾性分析2016年8月至2018年2月医院收治的脑卒中肩手综合征患者11...目的:观察脑卒中后肩手综合征(Shoulder-Hand Syndrome,SHS)患者日常生活活动能力(Activity of Daily Living,ADL)评分与其血脂水平的相关性,分析探讨其内在联系。方法:回顾性分析2016年8月至2018年2月医院收治的脑卒中肩手综合征患者116例,在上述患者接受规范降脂治疗6个月后检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和极低密度脂蛋白(VLDL)水平,将ADL评分与TG、TC、HDL、LDL及VLDL水平进行关联分析。并按病情、性别、年龄对等原则,设立SHS研究组和无SHS对照组。比较两组患者ADL评分与上述指标差异。结果:出院后6个月SHS研究组患者ADL评分显著低于无SHS对照组(P<0.05);SHS研究组TC、HDL、LDL水平与无SHS对照组比较,差异无统计学意义(P>0.05);两组TG和VLDL水平比较,差异有统计学意义(P<0.05);ADL评分用多元Logistic回归分析显示,常数项、TG及VLDL水平进入模型,表明ADL评分与TG、VLDL水平具有负相关性。结论:ADL评分低与脑卒中肩手综合征患者血脂水平控制不理想有密切关系,通过改善患者日常生活活动能力,有利于调节患者的血脂水平。展开更多
基金supported by a grant from the Clinical Research Project of Affiliated Hospital of Guangdong Medical University of China,Nos.LCYJ2018A00 (to ZL) and LCYJ2019C006 (to YSC)the Natural Science Foundation of Guangdong Province of China,No.2020A151501284 (to ZL)+1 种基金the Science and Technology Planning Project of Zhanjiang of China,No.2018A01021 (to ZL)a grant from the Characteristic Innovation Projects of Colleges and Universities in Guangdong Province of China,No.2019KTSCX045 (to ZL)。
文摘It remains unclear whether limitations in activities of daily living(ADL) increase the risk of stroke in older Chinese adults.This longitudinal study used data from the Chinese Longitudinal Healthy Longevity Survey to investigate the effects of limitations in ADL on the incidence of stroke in older adults.Between 2002 and 2011,46,728 participants from 22 provinces in China were included in this study.Of participants,11,241 developed limitations in ADL at baseline.A 3-year follow-up was performed to determine the incidence of stroke.During the 3-year follow-up,929 participants(8.26%) and 2434 participants(6.86%) experienced stroke in the ADL limitations group and non-ADL limitations group,respectively.Logistic regression was used to analyze the effect of ADL limitations on the risk of stroke.The results showed that after adjusting for the confounding factors gender,age,weight,hypertension,diabetes,heart disease,natural teeth,hearing impairment,visual impairment,smoking,alcohol abuse,exercise,ethnicity,literacy,residential area,and poverty,the ADL limitations group had a 77% higher risk of developing stroke than the non-ADL limitations group.After propensity score matching,the ADL limitations group still had a 33% higher risk of developing stroke than the non-ADL limitations group(OR = 1.326,95% CI:1.174–1.497).These findings suggest that limitations in ADL are a stroke risk factor.
基金the National Key Basic Study Development Planning of China (973 Program),No.2006CB504504
文摘BACKGROUND： In the rehabilitation of stroke patients, clinicians usually concentrate on motor problems, such as spasm of limbs and restriction of joint motion, while sensory and perceptive problems are almost always neglected, although they are just as important. One such area is the sensory disorder. OBJECTIVE： To evaluate the motor function and activities of daily living in stroke patients with and without sensory disorders after treatment of integrated western and Chinese medicine. DESIGN： A non-randomized synchronically controlled trial. SETTING： First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine. PARTICIPANTS： Totally 500 stroke inpatients were selected from the Department of Acupuncture and Massage, the First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine from January 2003 to December 2004. They all had suffered from stroke in the last 4 weeks and accompanied by sensory disorder of the ipsilateral limb to different severity. The patients were all accorded with the Diagnostic and Efficacy Evaluative Standards for Stroke （in trial） set by the Encephalopathy Emergency Assistant Group, the State Administration of Traditional Chinese Medicine in 1995, and they were diagnosed by imaging examination. The patients were stratified into sensory disorder group （n =220） and normal sense group （n =280）. Informed consent for the detected items and therapeutic program was obtained from the relatives of all the participants. The study was approved by the hospital ethical committee. METHODS： All the patients were treated with acupuncture of Xing Nao Kai Qiao for restoring consciousness and inducing resuscitation, assisted by traditional Chinese medicine and western medicine specific to corresponding symptoms. The therapeutic principles were restoring consciousness and inducing resuscitation, nourishing liver and kidney, and dredging meridian. In addition, the patients were given western medical treatments for decreasing intracranial pressure, thrombolysis, reducing blood viscosity, anticoagulation, anti-arteriosclerosis, ameliorating microcirculation, also administrated with activator for nerve cells. MAIN OUTCOME MEASURES： （1） The severity of motor function deficit was evaluated using clinical neurological deficit score for stroke patients set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995; （2） The activities of daily living was evaluated with Barthel Index, the higher the score, the better the independence, and the less the dependence. RESULTS： All the 500 stroke patients were involved in the final analysis of results. （1） The neurological deficit scores before treatment had no significant difference between the two groups （P 〉 0.05）, but the scores after treatment were significantly decreased as compared with those before treatment in both groups （t =6.59, 12.43, P 〈 0.01）. The neurological deficit score after treatment in the normal sense group was significantly lower than that in the sensory disorder group （t =1.63, P 〈 0.05）. （2） The scores of activities of daily living after treatment were significantly increased as compared with those before treatment in both groups （t =16.03, 25.10, P 〈 0.01）. The scores of activities of daily living in the normal sense group were higher than those in the sensory disorder group both before and after treatment （t =6.07, 14.26, P 〈 0.05）. CONCLUSION： Sensory disorders have obvious negative effects on the recovery of motor function and activities of daily living of stroke patients.
文摘<span style="font-family:Verdana;">Bedridden patients remain in bed for various reasons, such as chronic illness, old age, and disability, and they cannot perform self-care activities completely or partially. The provision of care for bedridden patients is a major issue in the aging population. Effective rehabilitation is associated with several factors such as cooperation between the patient and the medical staff, selection of effective facilities, and the financial burden. The objective of this study was to evaluate the effect on the activities of daily living (ADL) of occlusion restoration using removable dentures in bedridden older people.</span><span> </span><span style="font-family:Verdana;">This case</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">control study comprised 32 bedridden older patients who were divided into two groups as follows: denture (n </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> 18) and no-denture (n </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> 14). No rehabilitation was provided to any of the patients. The patients were evaluated 3 months after placing the denture, and the ADLs were compared between the two groups. Of the 18 bedridden patients who received removable dentures, 55.6% demonstrated improvements in the ADLs, and the effects persisted for </span><span style="font-family:Verdana;">at least 3 months. No improvement in the ADL was observed in the no-denture</span><span style="font-family:Verdana;"> group.</span><span> </span><span style="font-family:Verdana;">The results of this study suggested that adequate occlusal support can improve the ADL of the elderly. Thus, it is important to take care of oral health early in life in order to maintain oral health, which could help prevent the decrease in the ADL during the later stages of life.</span>
文摘目的:观察脑卒中后肩手综合征(Shoulder-Hand Syndrome,SHS)患者日常生活活动能力(Activity of Daily Living,ADL)评分与其血脂水平的相关性,分析探讨其内在联系。方法:回顾性分析2016年8月至2018年2月医院收治的脑卒中肩手综合征患者116例,在上述患者接受规范降脂治疗6个月后检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和极低密度脂蛋白(VLDL)水平,将ADL评分与TG、TC、HDL、LDL及VLDL水平进行关联分析。并按病情、性别、年龄对等原则,设立SHS研究组和无SHS对照组。比较两组患者ADL评分与上述指标差异。结果:出院后6个月SHS研究组患者ADL评分显著低于无SHS对照组(P<0.05);SHS研究组TC、HDL、LDL水平与无SHS对照组比较,差异无统计学意义(P>0.05);两组TG和VLDL水平比较,差异有统计学意义(P<0.05);ADL评分用多元Logistic回归分析显示,常数项、TG及VLDL水平进入模型,表明ADL评分与TG、VLDL水平具有负相关性。结论:ADL评分低与脑卒中肩手综合征患者血脂水平控制不理想有密切关系,通过改善患者日常生活活动能力,有利于调节患者的血脂水平。
