Interference of Upper Limb Tremor on Daily Life Activities in People with Multiple Sclerosis

SUMMARY

The interference of upper limb intention tremor on activities of daily living was described in 32 persons with multiple sclerosis. Ratings about their degree of impairment and disability (Functional Systems, Expanded Disability Status Scale, Functional Independence Measure) was obtained from the multidisciplinary rehabilitation team. The individuals were interviewed using a questionnaire, mainly based on the items of the FIM scale, about the interference of tremor during activities of daily life. Intention tremor is rarely an isolated symptom. It is extremely disabling and was reported to interfere the most with activities of daily life such as eating, drinking, grooming and dressing. A variety of aids and strategies to compensate for specific disabilities were reported reflecting the important counseling role of the occupational therapist in assisting persons to cope more effectively with tremor.     

The joint action of two mixed stimuli with a bivariate threshold

The general mathematical statistical theory of a mixture of two stimuli in quantal bioassay or other binary response is investigated assuming the existence of thresholds. Univariate thresholds have long been studied. Different serious attempts on bivariate threshold theory have emerged since the late 1940s. Some have been based on biologically established fact mixed with analysis, while others have been more heuristic. In this paper we investigate the properties of correlations of thresholds. Joint actions are then interpreted according to those correlations and deviations from independence. Isoboles are lines, curves, planes, or surfaces of constant probability. They are also investigated, and their properties are used in proofs of important theorems. It is proved that additivity or additivism of two stimuli is present if and only if the thresholds of the two stimuli are perfectly correlated. Furthermore, additivity requires univariate dose-response functions to be everywhere concave on the nonnegative real numbers (doses). Finally, threshold theory, itself, dictates cumulative distributions of marginal thresholds that are everywhere nondecreasing and concave on the nonnegative reals. That is, they cannot have points of inflection. Such popular distributions as the normal and logistic have points of inflection at their respective medians. This does not invalidate their usefulness. They are simply modeling phenomena other than those which are the subject of this paper, namely, threshold theory.     

Association of late effects of single,severe traumatic brain injury with Alzheimer’s disease using amyloid PET

Traumatic brain injury (TBI) is suggested to be a risk factor for the onset of Alzheimer’s disease (AD); however, the data remain controversial. This is the first report on cognitive decline in patients with TBI over 30 years post-injury. The medical significance/key learning points of this report are that (1) Functional Independence Measure (FIM) is useful in clinical settings, such as for higher brain dysfunction and dementia; (2) amyloid PET findings represent an essential biomarker for follow-up after TBI; and (3) cognitive decline can occur in patients with TBI more than 30 years post-injury.     

The prognostic value of sleep spindles in long-term outcome of West Syndrome

ObjectiveThere is a high risk for a profound developmental disorder in West Syndrome. However, a prognostic biomarker for neurodevelopmental outcome does not exist. Hypsarrhythmia disturbs normal EEG sleep patterns and hence sleep spindles, which are thought to be important for memory consolidation and learning. We postulated that the early recurrence of sleep spindles as well as an early resolution of hypsarrhythmic patterns after onset of West Syndrome lead to a favourable long-term outcome.Method448 sleep EEGs recorded during the first two years of life in 44 patients with newly diagnosed West Syndrome between 1980 and 1989 were reviewed retrospectively. Long-term outcome was assessed in 2015–2016 by the Functional Independence Measurement Score as an indicator for coping with everyday situations. EEG-data were correlated with long-term outcome by Fisher's Exact Probability Test or Kruskal–Wallis H test.ResultsThere were no statistically noticeable differences between time to cessation of hypsarrhythmia and long-term outcome. In a subgroup analysis of patients with cryptogenic etiology only (n = 13) recurrence of sleep spindles correlated with better long-term outcome (p = 0.038). In this subgroup 11/13 showed recurrence of sleep spindles in childhood, 10 of which had a good or intermediate outcome. Considering the whole patient cohort, recurrence of sleep spindles showed a statistically non-significant better long-term outcome.ConclusionRecurrence of sleep spindles and cessation of hypsarrhythmia cannot be used as a valid prognostic biomarker of neurodevelopmental outcome in non-cryptogenic West Syndrome.     

Low vision: mobility and independence training for the early years child

It is generally acknowledged that a child's primary caregiver acts as a spring board to independence. By encouraging the child to explore their world, parents and guardians are instrumental in developing the child's sense of self-esteem, self-worth and sociability. Less fortunate, however, are the increasing numbers of young children born with a visual impairment. Lacking visual cues, the child with a visual impairment requires specialist training to develop mobility and independent living skills. The primary aim of this paper is to outline the advantages mobility training has for young children. It also seeks to explore issues pertinent to the availability and extent of this training.     

独立学院制药工程专业人才培养模式的探讨

根据独立学院制药工程本科专业的培养目标和要求,对制药工程专业人才培养模式、课程体系进行了探讨,并对培养模式、教学突出重点提出建议。     

The Need and Its Influence Factors for Community-based Rehabilitation Services for Disabled Persons in One District in Beijing

Purpose To explore the needs for basic community-based rehabilitation services for disabled persons in Xuanwu District, Beijing, China, and to identify factors which influence disabled persons to accept rehabilitation services. Method One hundred and eight disabled persons were selected by systematic sampling and simple random sampling to assess their needs for community-based rehabilitation services. Results Of the interviewees, 57A% needed the community-based rehabilitation services, but only 13.9% took advantage of it. The main factors influencing the interviewees to accept these services were cost （P〈0.05）, knowledge about rehabilitation medicine （P〈0.05）; and the belief in the therapeutic benefit of the community-based rehabilitation service （P〈0.05）. Conclusion A considerable gap exists between the supply of community-based rehabilitation services in Beijing and the needs for these services by disabled residents underscoring the need for improved availability, and for additional research.     

Applicability,validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions

Purpose: To verify the applicability, reproducibility and validity of the SCIM III patients with non-traumatic spinal cord injury.

Method: The cross-sectional study included 30 patients (66% females; 41.5?±?14.7 yo) with non-traumatic spinal cord injury of any etiology. Subjects were subjected by computerized gait analysis and answered the Brazilian versions of SCIM III (0–100 points) and FIM? (18–126 points) by two raters (A and B) at the same day and 1 week later (A).

Results: The intraclass correlation coefficient for the use of SCIM III indicated appropriated intra- and inter-evaluator reproducibility (ICC?=?0.9). Correlation between the SCIM III and the motor FIM? was appropriate (r?=?0.6; p?=?0.0). SCIM III subscales and FIM? domains correlated strongly for self-care (r?=?0.8; p?≤?0.001), moderately for transfers (r?=?0.6; p?=?0.0005) and locomotion (r?=?0.6; p?=?0.0006). SCIM III mobility subscale positively correlated with the cadence (r?=?0.8; p?≤?0.01), gait speed (r?=?0.7; p?≤?0.01) and step length (r?=?0.6; p?≤?0.01).

Conclusions: SCIM III is a reproducible functional assessment instrument and capable of evaluating the level of independence of the individual with non-traumatic spinal cord injury. The SCIM III is more sensitive than the MIF? for non-traumatic spastic paraplegic patients with higher levels of independence, particularly if they can walk independently. Linear gait parameters correlated with its mobility subscale.

• Implications for Rehabilitation

• Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions.

• There are not many studies focused on patients with non-traumatic spinal cord lesion.

• Disability varies in severity, but frequently contributes to limitations in the activities of daily living (ADL) and participation.

• We do not find in the literature studies that assess the functionality of these individuals as comprehensive as ours.

     

Recovery after hip fracture

OBJECTIVES: The aim was to monitor the inhospital progress of 170 patients sustaining proximal femoral fractures. The extent of delay in discharge was recorded and what effect this prolonged hospitalisation had on nosocomial infection rates. SETTING: A regional trauma centre. DESIGN: A prospective observational study. PATIENTS AND PARTICIPANTS: All consecutive patients sustaining proximal femoral fracture over 60 years of age. INTERVENTION: The same clinician monitored each patient throughout their inhospital stay. Factors recorded included nosocomial infection acquired and when, mobility scores, loss of independence, delay in discharge amongst others. MAIN OUTCOME: Delay in discharge, incidence of nosocomial infection and mobility scores. RESULTS: Nosocomial infection occurred in 58% of patients (99 patients) when discharge was delayed beyond 8 days (after surgery). Eighty-five per cent of patients (145 patients) achieved their maximum mobility score by the 8th, and 95% (162 patients) by the 10th postoperative day. CONCLUSIONS: Patients with proximal femoral fracture derive no benefit from acute hospital admission of more than 8 days and the majority acquire nosocomial infection after this.