Measured and predicted resting energy expenditure in wheelchair rugby athletes

Objective: Report measured resting energy expenditure (REE) in wheelchair rugby athletes and evaluate agreement between REE and the prediction models of Chun, Cunningham, Harris-Benedict, Mifflin, Nightingale and Gorgey, and Owen.

Design: Cohort-based validation study.

Setting. Paralympic team training camp.

Participants: Fourteen internationally competitive athletes who play wheelchair rugby, 13 of whom had cervical spinal cord injuries (SCI).

Outcome Measures: A portable metabolic analyzer was used to measure REE following an overnight fast and dual-energy X-ray absorptiometry (DXA) was used to assess lean body mass for the prediction equations.

Results: REE in the current sample was 1735?±?257?kcal?×?day^?1 ranging from 1324 to 2068?kcal?×?day^{?1 Bhambhani Y. Physiology of wheelchair racing in athletes with spinal cord injury. Sports Med 2002;32(1):23–51.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]}. Bland–Altman analyses revealed negative mean bias but similar limits of agreement between measured REE and scores predicted by Chun, Cunningham, Mifflin, Nightingale and Gorgey, and Owen models in elite athletes who play wheelchair rugby.

Conclusion: Prediction models regressed on persons with and without SCI under-predicted REE of competitive wheelchair rugby athletes. This outcome may be explained by the higher REE/fat-free mass (FFM) ratio of current athletes compared to less active samples. Findings from the current study will help practitioners to determine nutrient intake needs on training days of varied intensity.     

Can muscle weakness and disability influence the relationship between pain catastrophizing and pain worsening in patients with knee osteoarthritis? A cross-sectional study

ObjectiveTo verify if the relationship between pain catastrophizing and pain worsening would be mediated by muscle weakness and disability in patients with symptomatic knee osteoarthritis.MethodsThis was a cross-sectional study in a hospital out-patient setting. Convenience sampling was used with a total of 50 participants with symptomatic knee osteoarthritis. Pain and the activities of daily livings (ADL) were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale. Pain catastrophizing was assessed using the Coping Strategy Questionnaire (CSQ) subscale. Muscle strength of knee extension and 30-s chair stand test (30CST) were also assessed. Path analysis was performed to test the hypothetical model. Goodness of fit of models were assessed by using statistical parameters such as the chi-square value, goodness of fit index (GFI), adjusted goodness of fit index (AGFI), comparative fit index (CFI), and root mean square error of approximation (RMSEA).ResultsThe chi-square values were not significant (chi-square = 0.283, p = 0.594), and the indices of goodness of fit were high, implying a valid model (GFI = 1.000; AGFI = 0.997; CFI = 1.000; RMSEA = 0.000). Pain was influenced significantly by muscle strength and ADL; muscle strength was influenced significantly by ADL via 30CST; ADL was influenced by pain catastrophizing.ConclusionThe relationship between pain catastrophizing with pain worsening are mediated by muscle weakness and disability.     

Careful assistance? Personal assistance within the family as hybridization of modern welfare policy and traditional family care

The aim of this article is to examine how different ideological perspectives on Swedish disability policy, are reflected in the experiences of disabled people and their families personal assistants. Personal assistance provided within the family can be seen as a hybridization between publicly regulated and paid work performed in the private family sphere, and thus conflicting norms and practices may coexist. In Sweden, family members of the assistant user can be employed as paid personal assistants. Many users combine personal assistance from family members with non-family assistance. Approximately 20–25% of the employed personal assistants are relatives of the assistance users. The empirical data consists of qualitative interviews with seventeen adult users and twenty-three family members employed as PAs with different types of family ties; parent-child relationships, sibling relationships and partner relationships. The findings show that family assistance could entail advantages such as personalised services, to combine instrumental and emotional assistance as well as achieving a power-balance between the parties. But there were also disadvantages, such as unwanted or enforced dependency, with a risk for both parties to be ‘locked up’ in the family. In an overall analysis, we distinguished three broad approaches towards family assistance, family as a substitute, family as a supplement and family first.     

187例精神疾病患者劳动能力鉴定分析

目的：探讨精神疾病患者劳动能力鉴定状况及与其相关问题。方法：分析1998至2002年共187例精神疾病患者的劳动能力鉴定资料，并进行不同年代、不同诊断、不同级别的组问比较。结果：除1998年外，其余各年度基本资料相似；诊断以精神分裂症为主，精神发育迟滞为次；前者的平均年龄最大、病期最短、累计病休时间最长、残疾级别最低，后者反之。结论：劳动能力鉴定应按有关标准执行，但目前仍存在一些有待进一步完善的问题。