Spatial Characteristics and Influencing Factors of Urban Resilience from the Perspective of Daily Activity:A Case Study of Nanjing,China

Based on the connotation of urban resilience and the main contradictions of China's urbanization,urban resilience is placed within the main daily activities contradictory scene of the urban man-land system to build a theoretical framework of urban activity resilience.Relying on geographic big data,this study identifies the spatial characteristics of activity resilience,reveals the impact of activity environment on activity resilience in Nanjing,and proposes countermeasures.The main conclusions are as follows.1)Activity resilience presents a composite spatial structure of circles and clusters,and most areas are resilient but at a low level.2)There are significantly positive and negative global autocorrelation between activity resilience and activity scale,and activity stability.Simultaneously,there also exists a local spatial autocorrelation with the opposite positive and negative trends.3)Activity environment has a significant effect on activity resilience,and the degree and direction of influence among different dimensions and regions are heterogeneous.4)For activity resilience,it is necessary to increase the matching degree between the scale and stability of activities,and reduce the excessive concentration and flow of activities.For the activity environment,it is necessary to improve the accessibility of the ecological environment,strengthen the high-quality supply of the infrastructure environment,optimize the balance of the location environment,and promote the inclusiveness of the social environment.

Effect of post-stroke sensory disorders on the recovery processes of motor function and activity of daily living A non-randomized synchronical controlled trial

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.

The Association between Activity of Daily Living and the Combination of Alzheimer’s Disease and Cataract in Elderly Requiring Nursing Care

Some clinical and epidemiological studies have suggested that Alzheimer’s Disease (AD) and cataract, may share common pathogenetic mechanisms, subsequently a positive association between the prevalence of AD and cataract, although other studies found no significant relationship between dementia and visual impairment including cataract in the elderly. Little is known about the association between Activity of Daily Living (ADL) and the combination of AD and cataract. To examine the association between ADL and the combination of AD and cataract, we performed a national survey in nursing care institutions in Japan, examining the decreased ADL in elderly with and without AD and cataract for 453 elderly aged 85.0 ± 8.13 years. The proportion, 43.5% of AD in subjects without cataract was significantly higher than that, 23.5% with cataract. Almost all ADL in AD with cataract was significantly lower than that without cataract, although all ADL in cataract patients receiving surgery in AD was significantly (all p < 0.002) higher than that in cataract patients without surgery in AD, as was confirmed by the multiple regression analysis incorporating into the relevant factors as independent variables. These results showed that ADL scores including cognitive functions decreased by cataract were increased by the surgery in the patients with AD. A significantly negative association between AD and cataract seen in our data, which was inconsistent with the previous result, might lead to the necessities of the clinical diagnosis for slight severity of cataract for patients with AD.

Patient Life Experience and Activity of Daily Living before and after Total Knee Arthroplasty

Background: As the population ageing, more patients suffer from joint disease. Joint replacement surgery performed in Taiwan is about 10,000 to 20,000 cases yearly. Aims: The purpose of this study is to realize Total Knee Arthroplasty (TKA) patients’ views about life experiences and difficulty in daily life before and after the surgery. Methods: In this study, in-depth interview with interview guideline was used to analyze patients’ experience by using a qualitative research method, and questionnaires were used to collect quantity data. Results: 1) A total of 20 participants were recruited. Average age was 75.15 (SD = 6.468). Eighteen of the participants were female and the other two were male. The majority of participants indicated that their home facilities were convenient or very convenient. 2) Motivations of the participants to undergo TKA were joint pain, limited joint range of motion, and weakness in legs. Participants’ expectations after surgery were no more pain and ease in walking, and able to manage daily life. 3) Depending on the time after surgery, joint pain and walking ability had improved to some extent. The joint range of motion increased, but kneeling remained difficult, and the participants’ mood and exercise capacity were improved. Conclusions: The finding can be as a reference for clinical practitioner to provide preoperative education for total knee arthroplasty patients.

Eight of ten patients return to daily activities, work, and sports after total knee arthroplasty

BACKGROUND Besides return to work(RTW)and return to sports(RTS),patients also prefer to return to daily activities(RTA)such as walking,sleeping,grocery shopping,and domestic work following total knee arthroplasty(TKA).However,evidence on the timelines and probability of patients’RTA is sparse.AIM To assess the percentage of patients able to RTA,RTW,and RTS after TKA,as well as the timeframe and influencing factors of this return.METHODS A retrospective cohort study with prospectively collected data was conducted at a medium-sized Dutch orthopedic hospital.Assessments of RTA,RTW,and RTS were performed at 3 mo and/or 6 mo following TKA.Investigated factors en-compassed patient characteristics,surgical characteristics,and preoperative patient-reported outcomes.RESULTS TKA patients[n=2063;66 years old(interquartile range[IQR]:7 years);47%male;28 kg/m2(IQR:4 kg/m2)]showed RTA ranging from 28%for kneeling to 94%for grocery shopping,with 20 d(IQR:27 d)spent for putting on shoes to 74 d(IQR:57 d)for kneeling.RTW rates varied from 62%for medium-impact work to 87%for low-impact work,taking 33 d(IQR:29 d)to 78 d(IQR:55 d).RTS ranged from 48%for medium-impact sports to 90%for low-impact sports,occurring within 43 d(IQR:24 d)to 90 d(IQR:60 d).One or more of the investigated factors influenced the return to each of the 14 activities examined,with R²values ranging from 0.013 to 0.127.CONCLUSION Approximately 80%of patients can RTA,RTW,and RTS within 6 mo after TKA.Return is not consistently in-fluenced by predictive factors.Results help set realistic pre-and postoperative expectations.

Improvement of Activities of Daily Living (ADL) for Patients Treated in Skilled Nursing Facilities (SNFs)

Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after hospitalization, or it can determine the level of assistance required after discharge from a skilled nursing facility (SNF). We believe that comprehensive rehabilitation can improve a patient’s overall functioning during their short term stay in SNFs. The purpose of this study is to determine if an individual’s level of independence improved after admission to a skilled nursing facility and procurement of rehabilitation services. Methods: This study retrospectively reviewed 4612 nursing home patients in California who underwent rehabilitative services at skilled nursing facilities to determine how the patients responded to their environments, therapy interventions, and any other additional supportive measures. The records of patients who were admitted for short-term rehabilitation were reviewed in a blinded fashion, looking specifically at Section GG of the Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative staff provide objective data and measure patients’ levels of assistance that were required. Each activity is scored from 1, being completely dependent, to 6, being entirely independent, with varying levels of assistance with scores in between. The admission scores versus the discharge scores can be compared to determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of improvement in ADL performance on Section GG between the admission and discharge scores was identified, implying significant improvement in functional independence upon discharge. The average percent improvement for Managed Care patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The results support the benefits of rehabilitation services in skilled nursing facilities, and the data suggests that admission scores can be used as a predictive tool for functional outcomes.

Effect of action observation therapy on daily activities and motor recovery in stroke patients

Objective:To evaluate the effects of action observation therapy,which is based on mirror neuron theory,on upper limb function and activities of daily living in patients with stroke.Methods:Sixty-one patients with stroke were randomly divided into two groups;those in the control group received routine rehabilitation treatment and nursing,whereas those in the experimental group additionally received eight weeks of action observation therapy for 30 min,six times per week.Patients receiving action observation therapy watched videos depicting a model performing specific motor actions typically performed in daily life before enacting the same actions themselves.All patients were assessed using the FugleMeyer assessment,Barthel index and the modified Ashworth scale at baseline and at eight weeks,after treatment.Results:After the eight weeks of treatment,both groups of patients exhibited significant improvement in all the measurements(all p<0.05).Furthermore,the FugleMeyer assessment,Barthel index and modified Ashworth scale scores were significantly higher in the experimental group compared to the control group(all p<0.05).Conclusion:Action observation therapy significantly improves upper extremity motor function and performance of activities of daily living,and alleviates upper limb spasticity in patients with stroke.

Comparison of cerebral activation between motor execution and motor imagery of self-feeding activity

Motor imagery is defined as an act wherein an individual contemplates a mental action of motor execution without apparent action.Mental practice executed by repetitive motor imagery can improve motor performance without simultaneous sensory input or overt output.We aimed to investigate cerebral hemodynamics during motor imagery and motor execution of a self-feeding activity using chopsticks.This study included 21 healthy right-handed volunteers.The self-feeding activity task comprised either motor imagery or motor execution of eating sliced cucumber pickles with chopsticks to examine eight regions of interest:pre-supplementary motor area,supplementary motor area,bilateral prefrontal cortex,premotor area,and sensorimotor cortex.The mean oxyhemoglobin levels were detected using near-infrared spectroscopy to reflect cerebral activation.The mean oxyhemoglobin levels during motor execution were significantly higher in the left sensorimotor cortex than in the supplementary motor area and the left premotor area.Moreover,significantly higher oxyhemoglobin levels were detected in the supplementary motor area and the left premotor area during motor imagery,compared to motor execution.Supplementary motor area and premotor area had important roles in the motor imagery of self-feeding activity.Moreover,the activation levels of the supplementary motor area and the premotor area during motor execution and motor imagery are likely affected by intentional cognitive processes.Levels of cerebral activation differed in some areas during motor execution and motor imagery of a self-feeding activity.This study was approved by the Ethical Review Committee of Nagasaki University(approval No.18110801)on December 10,2018.

Relationship between activities of daily living and depression among older adults and the quality of life of family caregivers

Objective： The purposes of this study were to explore the associations of activities of daily living （ADL） and depression among older adults with family caregivers1 quality of life and provide evidence for improving family caregivers＇ quality of life.Methods： Older adults （n=395） and their family caregivers （n=395） were selected as participants. The ADL scale and Geriatric Depression Scale were used to assess ADL and depression among older adults, and the 36-Item Short Form Health Questionnaire （SF-36） was used to assess family caregivers1 quality of life. Descriptive statistics and multiple linear regression were used to analyze the data.Resslts： The older adults’ ADL and depression scores were 21 ±7 and 11 ±6, respectively. Approximately 69.9% of older adults had declining or severely impaired ADL, and 47.1% had mild or moderate-to-severe depression. Family caregivers＂ mean quality of life score was 529±100. There was a negative correlation of older adults＇ ADL and depression with caregivers＇ quality of life. The correlation coefficient between ADL and the SF-36 mental component summary score was stronger than it was with the SF-36 physical component summary score.Conclusions： The ADL and depression of older adults influenced family caregivers＇ quality of life. Psychological health deserves closer attention, especially that of caregivers of disabled older adults.

Factors associated with activities of daily living among the disabled elders with stroke

Objective:To determine the factors associated with activities of daily living(ADL)among the disabled elders post-stroke.Methods:A total of 158 patients were chosen from community health service stations in eighteen regions of Tianjin city by convenience sampling from March to November in 2013.The Barthel Index(BI)and the short-formmini-nutritional assessment(MNA-SF)were used to evaluate the ADL,the nutritional status respectively.Statistical analysis was performed using independent sample t-test,one-way ANOVA,Pearson correlation and multiple linear regression analysis.Barthel ADL index was the main outcome.Results:The mean score of ADL was 50.50±27.125.The multiple linear regression showed that the factors which had significant impact on ADL were stroke frequency,types of stroke,nutritional status,financial status,and age.Conclusions:Disabled elders with recurrent strokes,hemorrhagic stroke,dependent financial resources,older age,worse nutritional status and living with family had poorer strokerelated outcome.Healthcare providers can discover the high-risk groups of disability and implement individualized preventive interventions in accordance with the related factors.

Limitations in activities of daily living increase the risk of stroke in older Chinese adults:a population-based longitudinal study

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.

Botulinum toxin type A plus rehabilitative training for improving the motor function of the upper limbs and activities of daily life in patients with stroke and brain injury

BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.

Effect of Activities of Daily Living on Self-Care Agency in Individuals with Type 2 Diabetes

Diabetes mellitus continues to be a global health problem with increasing importance across the world by affecting the activities of daily living and self-care ability of patients due to its incidence and troubles caused by it. The present study aims at determining the effect of activities of daily living of patients with type 2 diabetes mellitus on their self-care agency. Methods: The population of this descriptive study consisted of patients with type 2 diabetes mellitus who were being treated at the internal medicine clinic of a provincial state hospital between July 2014 and November 2015 and its sample consisted of 150 diabetic patients who volunteered to take part in the study and who were open to communication. A personal information form, the Activities of Daily Living (ADL) Scale, the Instrumental Activities of Daily Living (IADL) Scale and the Self-Care Ability Scale (CAS) were used as data collecting tools. The data were analyzed using descriptive statistics (numbers, percentages, mean, standard deviation, mean rank and frequencies), the Shapiro-Wilk, Kruskal-Wallis Variance Analysis, Mann-Whitney U test and Cronbach’s alpha formula and correlation analysis. Results: Approximately 97.3% of the patients with type 2 diabetes stated that they were independent in ADL and 75.3% of them in IADL. The patients’ mean self-care ability score was found to be 83.85 ± 17.87 ADL and IADL were found to be affected by age, marital status, education, duration of disease, willingness to receive further education, and presence of another disease besides diabetes. There was a significant correlation between the self-care agency score and marital status, education, duration of disease, willingness to receive further education, presence of another disease besides diabetes, regular checking of blood sugar and compliance with diet. A significant positive correlation was found between the patients’ activities of daily living and their self-care agency. Conclusion: The patients’ activities of daily living were found to affect their self-care agency. The personal and disease-related characteristics of patients should be identified so that their self-care behaviors can be increased.

Smart Devices Based Multisensory Approach for Complex Human Activity Recognition

Sensors based Human Activity Recognition(HAR)have numerous applications in eHeath,sports,fitness assessments,ambient assisted living(AAL),human-computer interaction and many more.The human physical activity can be monitored by using wearable sensors or external devices.The usage of external devices has disadvantages in terms of cost,hardware installation,storage,computational time and lighting conditions dependencies.Therefore,most of the researchers used smart devices like smart phones,smart bands and watches which contain various sensors like accelerometer,gyroscope,GPS etc.,and adequate processing capabilities.For the task of recognition,human activities can be broadly categorized as basic and complex human activities.Recognition of complex activities have received very less attention of researchers due to difficulty of problem by using either smart phones or smart watches.Other reasons include lack of sensor-based labeled dataset having several complex human daily life activities.Some of the researchers have worked on the smart phone’s inertial sensors to perform human activity recognition,whereas a few of them used both pocket and wrist positions.In this research,we have proposed a novel framework which is capable to recognize both basic and complex human activities using builtin-sensors of smart phone and smart watch.We have considered 25 physical activities,including 20 complex ones,using smart device’s built-in sensors.To the best of our knowledge,the existing literature consider only up to 15 activities of daily life.

Effect of six-month standardized tertiary rehabilitation program on the activities of daily living in stroke patients with hemiplegia

BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore the effects of standardized tertiary rehabilitation on the activities of daily living in stroke patients with hemiplegia within 6 months after attack. DESIGN： A clinical observation. SETTING： Department of Rehabilitation Medicine, Huashan Hospital of Fudan University. PARTICIPANTS： Eighty-two outpatients and inpatients with acute stroke were selected from the Department of Neurology, Shanghai Huashan Hosptial from January 1999 to June 2003, including 49 males and 33 females, 40 - 80 years of age, with a mean age of （65 ±11） years old. Inclusive criteria： According to the diagnostic standards for cerebrovascular diseases set by Fourth National Academic Meeting for Cerebrovascular Disease in 1995, the patients were diagnosed as new attack of cerebral infarction or cerebral hemorrhage, and confirmed by CT or MRI to be initial patients; They should be accorded with the following conditions, including within 1 week after stabilization of life signs, Glasgow coma score 〉 8 points, 40 - 80 years of age, with disturbance of limb function. Informed consents were obtained from all the patients or their relatives. Exclusive criteria： Patients were excluded due to active liver disease, liver and kidney malfunction, congestive heart failure, malignant tumor, history of dementia, failure in respiratory function, tetraplegia; cerebral infarction or cerebral hemorrhage for more than 3 weeks; unable to be followed up due to in other cities and provinces; psychiatric history; deafness and muteness. According to the will of the patients or their relatives, the patients who accepted the standardized rehabilitation program were enrolled as the treatment group （n =42）, and the others as the control group （n =40）. Approval was obtained from the ethical committee of the hospital. METHODS： All the patients were given routine therapies of internal medicine after admission. According to the conditions of Brunnstom recovery 6-phase evaluation, the patients in the treatment group were trained with the pre-designed comprehensive standardized rehabilitation program for corresponding period. At early period （within about 1 month after attack）, the patients received rehabilitative interventions in the Department of Emergency or Department of Neurology, once a day, 45 minutes for each time, 5 times a week; At middle period （about 1 - 3 months after attack）, the patients received rehabilitative interventions in the rehabilitation ward or center, once to twice a day, 30 - 45 minutes for each time, 4 - 5 days a week; At late period （about 3 - 6 months after attack）, the patients received rehabilitative intervention mainly assisted by rehabilitation physician in the community, relatives and volunteers, 3 - 4 times a week, and they were followed in the house or outpatient department once every two weeks. MAIN OUTCOME MEASURES： The patients were evaluated blindly by the same rehabilitation physician using scale of modified Barthel index at admission and 1, 3 and 6 months after attack respectively. RESULTS： Totally 82 patients with acute stroke were enrolled, and 3 cases in the treatment group missed, including 2 cases died at 1 month after admission, and 1 case refused the follow up l0 days later, all the others were involved in the analysis of results. The scores of modified Barthel index at corresponding time points after admission in the treatment group were all obviously higher than those in the control group （P 〈 0,01）, and the score differences were also obviously higher than those in the control group （P 〈 0,01）. The activities of daily living at admission and 1, 3 and 6 months after admission in the treatment group were 22,50%, 46.43%, 75,95% and 89,52% of that of normal people respectively, and those in the control group were 17.09%, 25,77%, 43,38% and 55,00% respectively, The activities of daily Diving at admission and 1, 3 and 6 months in the treatment group were 131.66%, 180.17%, 175.08% and 162.76% of those in the controlgroup. As compared with at admission, the percentage of the score difference to the total score at the ends of the 1^st, 3^rd and 6^th months were 23.93%, 53.45% and 67.02% in the treatment group, while 8.67%, 25.36% and 36.98% in the control group. CONCLUSION： Standardized tertiary rehabilitation can obviously promote the activities of daily living in stroke patients with hemiplegia.

Age Related Changes in Physical Activity and Incidence of Non-Communicable Diseases in a Sample of Kuwaiti Adults

The incidence of major chronic Non Communicable Diseases (NCD) medically diagnosed or treated, was studies in a cross section of Kuwait adult population as well as their daily levels of physical activity (PA) as recalled by the International Physical Activity Questionnaire, IPAQ. A group of 1957 subjects 17 - 65 years of age, representative of the Kuwait population was selected using last year high school students and their relatives as well as government workers in each Kuwait governorate. Descriptive statistics, frequency tables, chi square and Fisher tests were used. ANOVA or Mann Whitney and Kruskal-Wallis tests were used for comparisons. The percentage of subjects in the low categorical PA level (from IPAQ) is high (29.4%) even at a young age (17 - 24), similar in prevalence to overweight/obesity (30%). At age 45, obesity increases to 40% with little change in % subjects of low PA. Weighted average categorical PA was 1280 MET.min/week reflecting that the majority (40%) of subjects belonged to the moderate PA category. A high proportion (38%) of subjects in the 17 - 24 age category contributed to the observed level of PA activity. Incidence of overweight and obesity increased from 30 to more than 55% from the second to the sixth decade of life. Hyperlipidemias increased in incidence from 8% to 45% of the sample from the third to the sixth decades of age. Hypertension and diabetes increased from the 4th to the 6th decades of life to affect from 14% to 40% and from 10% to 36% of the studied population, respectively. Incidence of Heart Disease increased from 9% to 15% of the sample population, between the 5th and 6th decades of life. The data indicate a sequence of events, initiated by overweight and obesity as early as in the 2d decade of life, followed by hyperlipidemia in the 3d decade, diabetes and hypertension in the 4th, and heart disease in the 5th decade of life. Changes in incidence of low energy expenditure (low PA) were not associated with the observed changes in prevalence of obesity/overweight with age which are likely due to increments in energy intake in groups with insufficient PA. Changes in low PA incidence with age did not correlate with those in NCD. Interventions to minimize overweight and hyperlipidemia should be started in the second and third decades of life respectively. Increases in PA may potentiate the responses to these treatments.

Negative Association of Domestic Activity and Active Commuting with Metabolic Syndrome in a Chinese Population Aged 35-64 Years

Objective To understand the associations of physical activity domains with metabolic syndrome among a middle-aged Chinese population. Methods In all, 3326 professional adults aged 35-64 years from Beijing and Zhejiang province were recruited with a cluster random sampling method. The Global Physical Activity Questionnaire was modified, and the recommended Asia-Pacific cut-offs of waist circumstance were introduced into the criteria for metabolic syndrome from the Adult Treatment Panel III. A binary logistic regression model was applied to examine the association of all physical activity domains with the risk of the syndrome. Results Participants who engaged in domestic activity for 〉1176 MET-min/week had a 41.6% less chance of having metabolic syndrome [odds ratio （OR）, 0.584; 95% confidence interval （CI）, 0.480-0.710] than those without this activity. In adjusted models, adults who actively commuted for 〉33 MET-rain/week but 〈52g MET-min/week had a 25% less chance of having the syndrome （OR, 0.750; 95% CI, 0.582-0.966） than those who did not. No interaction was detected between the two domains of activity and the syndrome. Conclusion This study highlighted the independently negative association of traffic and house activity with the prevalence of the syndrome in this sample with a generally low level of moderate activity.

Activities of daily living and lesion position among multiple sclerosis patients by Bayes network

Magnetic resonance imaging is a highly sensitive approach for diagnosis of multiple sclerosis, and T2-weighted images can reveal lesions in the cerebral white matter, gray matter, and spinal cord. However, the lesions have a poor correlation with measurable clinical disability. In this study, we performed a large-scale epidemiological survey of 238 patients with multiple sclerosis in eleven districts by network member hospitals in Shanghai, China within 1 year. The involved patients were scanned for position and size of lesions by MRI. Results showed that lesions in the cerebrum, spina cord, or supratentorial position had an impact on the activities of daily living in multiple sclerosis patients, as assessed by the Bayes network. On the other hand, brainstem lesions were very unlikely to influence the activities of daily living, and were not associated with the position of lesion, patient＇s gender, and patient＇s living place.

Relationship between fall risks and activities of daily living in older individuals

Objective:To investigate the relationship between fall risks and maintaining activities of daily living in individuals aged 65 and over.Methods:This study is cross-sectional.It was conducted with 233 individuals who were aged 65 and over in Family Health Centers located in the eastern part of Turkey between February and June 2018.Results:The mean older individuals’DENN Fall Risks Assessment Scale score was 11.73±7.13,and 62.2%of the participants were in the high-risk group.Barthel Index of Activities of Daily Living(ADL)mean score was 68.03±25.36,and 45.1%of the participants were in the moderately dependent group.There was a statistically significant,negative correlationship between Barthel Index of ADL score and age and DENN Fall Risks Assessment Scale score.In addition,there was a statistically significant,positive relationship between the DENN Fall Risks Assessment Scale score and age(p<0.01).Conclusions:This study found that level of dependency and fall risks increased with the increase in age.Effective global and multidisciplinary interventions are needed to decrease older individuals’dependency levels and fall risks today when the number of older individuals is increasing.

Validation and Translation of the Greek Version of the “DCDDaily-Q-GR” Questionnaire

The origin of Developmental Coordination Disorder (DCD) has not been clarified yet. DCD is considered as a movement disorder that may strongly affect child’s Activities of Daily Living (ADL). Reliable evaluation tools for young DCD are importantly useful. This study aimed to translate and validate the Developmental Coordination Disorder Daily Questionnaire (DCDDaily-Q) into Greek. The current validation study reports on the translation, cultural adaptation and validation of the Greek. The total sample consisted of 191 children (age 5 - 8 years) and their parents who completed the questionnaire as a reference group. The participants were randomly divided into two groups. The first group (100 parents) completed only the DCDDaily-Q. The second group consisted of 91 parents who completed the DCDDaily-Q, while their children were additionally evaluated with the Movement Assessment Battery for Children 2 (MABC-2). Then two groups were created that included (25) children with DCD and a control group 30 children with typical developmental. The results were analyzed was performed using IBM SPSS statistics 24.0 (a = 0.05). The internal consistency of the Greek version of the DCDDaily-Q was assessed (Cronbach’s α = 0.86). High test-retest reliability for all items and good diagnostic performance for identifying children with DCD were achieved with a sensitivity of 0.76 and a specificity of 0.67. The Greek version of DCDDaily-Q was proved to be a reliable and valid screening tool for ADL assessment in 5 to 8 year old children with DCD;offering an easy to use and economical tool in the Greek healthcare system.