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.

Daily physical activity and type 2 diabetes: A review

Physical activity improves glycemic control and reduces the risk of cardiovascular disease(CVD) and mortality in patients with type 2 diabetes(T2D). Moderate to vigorous physical activity is recommended to manage T2D; however, patients with T2D can be physically weak, making it difficult to engage in the recommended levels of physical activity. Daily physical activity includes various activities performed during both occupational and leisure time such as walking, gardening, and housework that type 2 diabetic patients should be able to perform without considerable physical burden. This review focuses on the association between daily physical activity and T2D. Walking was the most common form of daily physical activity, with numerous studies demonstrating its beneficial effects on reducing the risk of T2D, CVD, and mortality. Walking for at least 30 min per day was shown to reduce the risk of T2D by approximately 50%. Additionally, walking was associated with a reduction in mortality. In contrast, evidence was extremely limited regarding other daily physical activities such as gardening and housework in patients with T2D. Recent studies have suggested daily physical activity, including non-exercise activity thermogenesis, to be favorably associated with metabolic risks and mortality. However, well-designed longitudinal studies are warranted to elucidate its effects on overall health.

Effects of personalized exercise prescriptions and social media delivered through mobile health on cancer survivors’physical activity and quality of life

Purpose This study aimed to examine the effects of a multi-component mobile health intervention(wearable,apps,and social media)on cancer survivors’(CS')physical activity(PA),quality of life,and PA determinants compared to exercise prescription only,social media only,and attention control conditions.Methods A total of 126 CS(age=60.37±7.41 years,mean±SD)were recruited from the United States.The study duration was 6 months and participants were randomly placed into 4 groups.All participants received a Fitbit tracker and were instructed to install its companion app to monitor their daily PA.They(1)received previously established weekly personalized exercise prescriptions via email,(2)received weekly Facebook health education and interacted with one another,(3)received both Conditions 1 and 2,or(4)were part of the control condition,meaning they adopted usual care.CS PA daily steps,quality of life(i.e.,physical health and mental health),and PA determinants(e.g.,self-efficacy,social support)were measured at baseline,3 months,and 6 months.Results The final sample size included 123 CS.The results revealed only the multi-component condition had greater improvements in PA daily steps than the control condition post-intervention(95%confidence interval(95%CI):368–2951;p<0.05).Similarly,those in the multi-component condition had significantly greater increased physical health than the control condition(95%CI:–0.41 to–0.01;p<0.05)over time.In addition,the social media condition had significantly greater increased perceived social support than the control condition(95%CI:0.01–0.93;p<0.05).No other significant differences on outcomes were identified.Conclusion The study findings suggest that the implementation of a multi-component mobile health intervention had positive effects on CS PA steps and physical health.Also,offering social media intervention has the potential to improve CS perceived social support.

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.

Research on the Correlation between NSE Level and Activities of Daily Living in Parkinson’s Disease

Objective: To establish a prediction model of activities of daily living (ADL) as an auxiliary evaluation scheme of hospitalized Parkinson’s disease patients. Methods: The hospitalization data of Parkinson’s disease in patients in the Department of Neurology, Affiliated Brain Hospital of Guangzhou Medical University were collected. Firstly the NSE values and each BI item were analyzed by Pearson correlation analysis. Secondly, The NSE, Age, Body weight and Education level related to the total score of Barthel index were obtained by correlation analysis. At last, a multiple linear regression model was established with NSE, Age, Body weight and Education level as independent variables and BI as dependent variables. Results: A total of 95 patients with PD were enrolled in this study, including 53 males (55.8%) and 42 females (44.2%). The effects of the four independent variables incorporated in the model on the total score of Barthel index were statistically significant, as well as the regression model (F = 9.531, P Conclusion: The prediction model established in this research can effectively predict the activities of daily living of Parkinson’s patients and can be used as an auxiliary evaluation scheme of the hospitalized PD patients.

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.

Monitoring of Sleep Indicators, Physical Activity, Pain, and Fatigue in Patients with Systemic Lupus Erythematosus and Relations among These Variables: A Pilot Study

Background: Poor sleep, fatigue, and pain are major health problems in patients with systemic lupus erythematosus (SLE). However, only cross-sectional surveys on these health outcomes have been conducted, and the association between day-to-day fluctuations remains unknown. Objectives: We aimed to characterize daily fluctuations in sleep quality, physical activity, pain, and fatigue in patients with SLE. Method: Exploratory study with a cross-sectional design. Two rheumatology centers (a university hospital and a prefectural hospital) in Japan between September 2017 and May 2019. The sample size was set to 20. Demographic and clinical data were collected. Sleep and physical activity were measured with monitoring devices;pain and fatigue levels were recorded daily during the 4-week period. The Pittsburgh Sleep Quality Index, Short Form Health Survey-12, the Japanese version of the Lupus Patient Outcome, and SLE Disease Activity Index 2000 were collected at the start and end of the study. Descriptive statistics and coefficients of variation (CV) were tabulated to examine daily fluctuations. Pearson correlation coefficients were obtained for monitored variables. Results: The mean age was 43.7 ± 8.5 years, and the mean SLE duration was 16.0 ± 7.2 years. The mean moderate-to-vigorous physical activity (MVPA) duration was 7.8 ± 5.8 min/day, and the mean total sleep duration was 391.8 ± 65.3 min, with a mean sleep efficiency of 88.6% ± 6.1%. Daily fluctuations were high for leaving the bed frequency, MVPA duration, pain, and waking after sleep onset. Seventeen participants showed correlations between some of the variables, such as fatigue or longer MVPA duration and poorer sleep outcomes;longer sleep latency and increased frequency of leaving the bed;and higher physical activity and increased pain and fatigue. Conclusion: The quality of sleep and fatigue fluctuated daily, and correlations existed between these variables, as well as for pain and physical activity. The impact of MVPA duration on pain and fatigue is of concern as increased physical activity may worsen the quality of life patients with SLE. The monitoring of sleep and physical activity using the device seems feasible for SLE symptom management.

RFID Systems in Healthcare Settings and Activity of Daily Living in Smart Homes: A Review

Elderly inhabitants have a strong influence to healthcare facilities globally in the last few years as a result of the high demand on the healthcare services and the gap between the services provided by caregivers and the increasing number of older people. Radio Frequency Identification (RFID) technologies have been increasingly adopted in smart homes and used widely for indoor localisation. These technologies have been benefiting to healthcare domain where they improve the quality of services delivering by healthcare providers. This article presents a comprehensive review on RFID systems and healthcare research works in smart homes. We also compare RFID-based solutions in healthcare and distinguish challenges of smart home technologies in indoor environment. We also discuss research challenges related to Activity in Daily Living (ADL) in smart homes for wellbeing.

Analysis of daily activity data from implanted cardiac defibrillators: The minimum clinically important difference and relationship to mortality/life expectancy

Background: Daily activity is a potentially important measure for assessing prognosis in individuals with chronic heart failure (CHF), and few studies have investigated the prognostic value of daily activity measurement. The present study sought to determine whether there is an association between daily activity and mortality/mean life expectancy as predicted by the Seattle Heart Failure Model (SHFM), and to provide an estimate of the anchor-based minimum clinically important difference (MCID) for daily activity measured by single-axis accelerometers in implanted cardiac defibrillators. Methods: This study utilized a retrospective chart review of 102 medical records of patients with CHF and Medtronic? implanted cardiac defibrillators (ICDs). Mean daily activity was calculated for a two week period prior to both a baseline and follow-up routine clinical visit. Clinical characteristics from the baseline clinic visit were used for calculating SHFM estimates of mean life expectancy, 1-year mortality, and 5-year mortality. A five-point global rating scale was scored based on documented clinician impression, patient self-report, and laboratory and cardiographic tests for determining the MCID. Results: There was a moderate correlation between baseline daily activity and each of the SHFM prognostic indicators: 1-year mortality (r = 0.36, p < 0.001, 5-year mortality (r = 0.40, p < 0.001), and life expectancy (r = 0.43, p < 0.001). The MCID for a decline in daily activity was approximately 0.5 hours and was approximately 1.0 hours for improvement in daily activity. Conclusions: Although previous re- search has established the short-term predictive value of ICD-measured daily activity for CHF-related clinical events, no prior study has examined the longer-term prognostic value of ICD-based daily activity. The results of the present study suggest that low daily activity, as recorded by ICDs in patients with CHF, should prompt a more formal evaluation of prognosis using the SHFM. Furthermore, changes of 0.5 to 1.0 hours of activity per day appear to be clinically mean- ingful.

The Effect of Early versus Traditional Hospital Discharge on Activities of Daily Living for Women Undergoing Elective Cesarean Section. An Observational Cohort Study

Background: Cesarean section is one of the most common surgeries performed worldwide and its consequences and complications represent a major public health concern. The policy of enhanced recovery after surgery has been implemented after cesarean section to optimize perioperative care. Enhanced recovery also aims to reduce the length of hospital stay, which might imply substantial healthcare savings. Rising hospital costs are one of the factors in early discharge. Patients & Methods: This was a prospective cohort study. 158 patients met the inclusion criteria of the study, 81 patients were discharged after 48 hours and 77 patients were discharged after 24 hours. All patients received the same postoperative care and instructions. All the study participants received a phone call 1, 3, and 5 days after discharge to objectively assess the activities of daily living through Katz index of independence in activities of daily living. All patients were offered a postpartum visit 1 week after discharge during which the wound was assessed by the Southampton wound assessment scale. Moreover, other maternal complications such as mastitis, puerperal sepsis, or pyelonephritis were assessed and cases who were readmitted were documented. Initiation of successful breastfeeding and neonatal readmission were reported as well. Results: 158 patients met the inclusion/exclusion criteria of the study. There was no significant difference between the two arms of the study regarding baseline characteristics. Katz index of independence showed that the resumption of activities of daily living after CS was similar in both arms of the study on days 1, 3 and 5 after discharge. Time till the passage of flatus and stool after the cesarean section was significantly shorter among the early discharge arm (9.31 VS 14.68, p value < 0.001 & 13.25 VS 24.82, p value < 0.001 respectively). Maternal readmission was not significantly higher among the early discharge arm and at the 1-week postpartum visit, objective wound assessment by Southampton wound scoring assessment was made and there was no significant difference between the two arms of the study. Initiation of successful breastfeeding, and neonatal readmission were similar in both groups. Conclusion: The policy of early discharge can be adopted in low-risk cases scheduled for elective uncomplicated CS provided that the mother and the neonate are in good general condition and proper instructions regarding red flag manifestations are given.

Interventions to improve daily activity in individuals with COPD and CHF: A systematic review

Introduction: The purpose was to systematically review the literature regarding interventions to improve daily activity in individuals with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Methods: Articles found by searching CINAHL Plus Full-Text, PubMed, and PsycINFO databases were included in the review if the study examined the effect of exercise- and/or psychosocial-based interventions on daily activity in individuals with COPD or CHF. Article selection, data extraction, and evaluation of methodological rigor and quality were performed by two independent reviewers. Nine articles for COPD and seven articles for CHF met the inclusion criteria and were used in this review. Results: Only four of nine studies in COPD and two of seven studies in CHF resulted in improvement in daily activity, and of those, all but one study included a psychosocial-based intervention. Improvements in daily activity did not occur concurrently with changes in other outcomes such as exercise performance, quality of life, functional status, or anxiety/depression in COPD or CHF. Conclusions: Exercise-based interventions serve a limited, if any, role in improving daily activity in individuals with COPD and CHF. Disrupting the cycle of inactivity and deconditioning requires more than just addressing the deconditioning aspect of this cycle. Psychosocial-based interventions are a promising, but under-investigated, intervention.

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.

Health-related quality of life and the ability to perform activities of daily living: a cross-sectional study on 1079 war veterans with ankle-foot disorders

Background:The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime.This nationwide study aimed to assess health-related quality of life and the ability to perform activities of daily living in veterans with ankle-foot injuries due to the Iran-Iraq war.Methods:A total of 1079 veterans with ankle-foot injuries were enrolled in a cross-sectional study from 2014 to 2016.Demographic characteristics,including age,gender,marital status,disability percent,educational level,employment and additional injuries,were collected.The ability to perform daily activities was assessed using the Barthel activities of daily living(ADL)and Lawton instrumental activities of daily living(IADL)Indexes.Physical and mental health-related quality of life(HRQOL)data were measured via the SF-36 subscales.The data were compared with those of bilateral lower limb amputees(BLLAs)and of the general Iranian population.Statistical analyses,including Pearson’s correlation coefficient,one-sample t-test and analysis of variance(ANOVA),were performed using SPSS16.0.A multiple linear regression model was used to determine the contribution of independent variables to the Physical Component Summary(PCS)and Mental Component Summary(MCS).Results:The highest and lowest scores were observed for mental health(48.93±20.69)and bodily pain(28.16±21.74),respectively.The mean scores of veterans with ankle-foot injuries on the SF-36 were significantly lower on all eight measures than those of the general Iranian male population and of the bilateral lower limb amputees(P<0.001).The mean scores of ADLs and IADLs were 83.9±16.3 and 5.3±2.0,respectively.The higher dependency in ADLs(P<0.001)and IADLs(P<0.001),the higher disability rate(P<0.001)and additional injury(P<0.001)were significant determinants of the PCS.ADL(P<0.001)and IADL(P<0.001)limitations,additional injury(P<0.001),history of hospitalization in the year preceding the study(P=0.007)and employment(P=0.001)were reported as determinants of the MCS.Conclusion:The results strongly suggest that veterans with ankle-foot injuries suffer from critically poor healthrelated quality of life.The main predicting factors of HRQOL were the disability to perform ADLs/IADLs,suffering two or more injuries,a history of hospitalization in the year preceding the study and unemployment.

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.

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.

Daily Activities and Sleep Durations of Patients with Ischemic Heart Disease Who Were Discharged to Their Homes after Elective Percutaneous Coronary Intervention

The purpose of this study was to examine the relationship between daily activities and sleep durations for patients following elective percutaneous coronary intervention (ePCI) and diagnosed with ischemic heart disease (IHD) after discharge to their homes. The actigraph data were used to collect data from twenty five patients. The duration of night-time sleep (minutes from the start to end of night-time) and actual night-time sleep duration (total sleep duration excluding wake-up durations of night-time) on the seventh day after discharge were divided into three groups;less than 360, 360 to 480, and more than 480 minutes (short, optimal and long respectively). Subsequently, among the three groups of patients, the data were analyzed by Kruskal Wallis H-test with multiple comparison procedures using the Scheffé-test in order to compare differences in daytime activity items at seven days after discharge from the hospital. Total daytime nap duration (p p p p < 0.05). However, the duration of night-time sleep and daytime activity did not significantly differ. If actual night-time sleep duration is improved from 360 to 480 minutes, daytime nap could potentially be decreased. Determining objective sleep conditions for patients and treating sleep disorders may improve overall patient health, facilitating appropriate sleep and wake rhythms.

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.

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.