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 ho...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.展开更多
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 cata...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.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
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...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.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
Background:Stroke is the leading cause of mortality.This study aimed to investigate the association between stroke,comorbidities,and activity of daily living(ADL)among older adults in the United States.Methods:Partici...Background:Stroke is the leading cause of mortality.This study aimed to investigate the association between stroke,comorbidities,and activity of daily living(ADL)among older adults in the United States.Methods:Participants were 1165 older adults aged 60 and older from two waves(2016 and 2018)of the Health and Retirement Study who had a stroke.Descriptive statistics were used to describe demographic information and comorbidities.Logistic regressions and multiple regression analyses were used to determine associations between stroke,comorbidities,and ADL.Results:The mean age was 75.32±9.5 years,and 55.6%were female.An adjusted analysis shows that older stroke adults living with diabetes as comorbidity are significantly associated with difficulty in dressing,walking,bedding,and toileting.Moreover,depression was significantly associated with difficulty in dressing,walking,bathing,eating,and bedding.At the same time,heart conditions and hypertension as comorbidity were rarely associated with difficulty in ADL.After adjusting for age and sex,heart condition and depression are significantly associated with seeing a doctor for stroke(odds ratio[OR]:0.66;95%confidence interval[CI]:0.49-0.91;p=0.01)and stroke therapy(OR:0.46;95%CI:0.25-0.84;p=0.01).Finally,stroke problem(unstandardizedβ[B]=0.58,p=0.017)and stroke therapy(B=1.42,p<0.001)significantly predict a lower level of independence.Conclusion:This study could benefit healthcare professionals in developing further interventions to improve older stroke adults'lives,especially those with a high level of dependence.展开更多
The present study aims at verifying whether participation in a physical activity programme has positive effects on the daily life autonomy and vitality of elderly people living in residential care facilities by the me...The present study aims at verifying whether participation in a physical activity programme has positive effects on the daily life autonomy and vitality of elderly people living in residential care facilities by the mediation of their physical well- being. Fifty-one institutionalised individuals took part in the study. The control group included 11 people (84.26, ± 7.4 years), whereas the experimental group was made up of 40 people (85 ± 6.6 years). The experimental group was involved in a physical activity programme twice a week. The 36-Item Short Form Health Survey Questionnaire, the Activities of Daily Living Scale, and the Tinetti Test were administered to the participants. The linear regression method as well as Sobel’s formula were used for the analysis. The results show that participation in a physical activity programme has positive effects on autonomy in bathing and on the participants’ sense of vitality due to the mediation of physical functioning. These results confirm the importance of physical activity for the elderly populations living in residential care facilities.展开更多
文摘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.
文摘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.
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.
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。
基金National Institute on Aging,Grant/Award Number:NIA U01AG009740。
文摘Background:Stroke is the leading cause of mortality.This study aimed to investigate the association between stroke,comorbidities,and activity of daily living(ADL)among older adults in the United States.Methods:Participants were 1165 older adults aged 60 and older from two waves(2016 and 2018)of the Health and Retirement Study who had a stroke.Descriptive statistics were used to describe demographic information and comorbidities.Logistic regressions and multiple regression analyses were used to determine associations between stroke,comorbidities,and ADL.Results:The mean age was 75.32±9.5 years,and 55.6%were female.An adjusted analysis shows that older stroke adults living with diabetes as comorbidity are significantly associated with difficulty in dressing,walking,bedding,and toileting.Moreover,depression was significantly associated with difficulty in dressing,walking,bathing,eating,and bedding.At the same time,heart conditions and hypertension as comorbidity were rarely associated with difficulty in ADL.After adjusting for age and sex,heart condition and depression are significantly associated with seeing a doctor for stroke(odds ratio[OR]:0.66;95%confidence interval[CI]:0.49-0.91;p=0.01)and stroke therapy(OR:0.46;95%CI:0.25-0.84;p=0.01).Finally,stroke problem(unstandardizedβ[B]=0.58,p=0.017)and stroke therapy(B=1.42,p<0.001)significantly predict a lower level of independence.Conclusion:This study could benefit healthcare professionals in developing further interventions to improve older stroke adults'lives,especially those with a high level of dependence.
文摘The present study aims at verifying whether participation in a physical activity programme has positive effects on the daily life autonomy and vitality of elderly people living in residential care facilities by the mediation of their physical well- being. Fifty-one institutionalised individuals took part in the study. The control group included 11 people (84.26, ± 7.4 years), whereas the experimental group was made up of 40 people (85 ± 6.6 years). The experimental group was involved in a physical activity programme twice a week. The 36-Item Short Form Health Survey Questionnaire, the Activities of Daily Living Scale, and the Tinetti Test were administered to the participants. The linear regression method as well as Sobel’s formula were used for the analysis. The results show that participation in a physical activity programme has positive effects on autonomy in bathing and on the participants’ sense of vitality due to the mediation of physical functioning. These results confirm the importance of physical activity for the elderly populations living in residential care facilities.
