Reference values and reliability for lumbopelvic strength and endurance in asymptomatic subjects

Background

Assessing the lumbopelvic region is useful for detecting many musculoskeletal dysfunctions and also performance deficits. Several clinical tests are used to assess this region, however, reference values and results related to method, reliability and error measurements of these tests have not been reported.

老年性骨质疏松患者骨折风险预测工具的范围综述

目的 综合分析老年性骨质疏松患者骨折风险预测工具,为研究人员开发或引入符合本国国情的预测工具提供参考。方法 采用范围综述方法,检索PubMed、Embase、Web of Science、中国知网、万方数据知识服务平台、维普中文科技期刊数据及中国生物医学文献数据库7个中英文数据库,由2名研究者独立筛选文献和提取数据,并进行偏倚风险及适用性评价。结果最后纳入18篇英文文献,包括12项预测工具开发研究及6项预测工具效能验证研究,共涉及12个老年性骨质疏松患者骨折风险预测工具,工具类型主要为风险预测模型及风险评估表。结论 老年性骨质疏松患者骨折风险预测工具种类繁多,预测性能良好但总体偏倚风险较高。相关研究人员一方面应对现有的预测工具进行验证及校准,另一方面应基于本土数据开发低偏倚风险、高临床适用性的风险预测工具,为老年性骨质疏松患者的精准健康管理提供参考。     

80岁以上长期卧床患者握力与营养状况的关系

目的探讨评估长期卧床的80岁以上老人营养状况的简便、有效的方法。方法采集22例卧床时间〉1年的80岁以上患者的空腹静脉血,检测白蛋白和血红蛋白水平,并采用JAMAR握力器分别测试其左、右手的握力。结果本组高龄老年人左、右手握力与白蛋白水平均呈正相关（r=0．439,r=0．424,P〈0．05）,与年龄和血红蛋白无相关性。结论长期卧床的高龄患者握力与其营养状态有显著相关性,可采用握力测试其营养状态。     

Neural gliding versus neural tensioning: Effects on heat and cold thresholds,pain thresholds and hand grip strength in asymptomatic individuals

IntroductionNeural mobilization can be performed in a way that facilitates movement through a stretching technique (tensioning) or in a way that maximizes the gliding of peripheral nerves in relation to adjacent structures (gliding). Evidence on how these techniques compare in terms of effects are scarce. The aim of this study is to compare the effects of neural gliding and neural tensioning targeting the median nerve on heat and cold temperature threshold, heat pain threshold, pressure pain thresholds and hand grip strength in asymptomatic participants.MethodsParticipants received 4 series of 10 repetitions of either neural gliding (n = 30) or neural tensioning (n = 30) and were assessed for heat and cold temperature threshold, heat pain threshold, pressure pain threshold, and hand grip strength at baseline, immediately after the intervention, and 30 min post-intervention.ResultsA significant main interaction between time and intervention was found for the PPT at the forearm (F(2,55) = 5.98; p = 0.004), favouring the tensioning neural mobilization. No significant differences were found for the other variables.ConclusionsFour series of 10 repetitions of neural tensioning targeting the median nerve in asymptomatic subjects seem to be enough to induce hypoalgesia and have no negative effects on A-delta and C mediated sensory function and on hand grip strength production.     

Cardiovascular risk assessment tools: A scoping review

ObjectivesThe objective of this review was to describe cardiovascular risk (CVR) assessment methods and to identify evidence-based practice recommendations when dealing with population at risk of developing cardiovascular diseases.Review methods and data sourcesA literature review following the Arksey and O'Malley scoping review methodology was conducted. By using appropriate key terms, literature searches were conducted in PubMed, SciELO, Cochrane Library, Dialnet, ENFISPO, Medigraphic, ScienceDirect, Cuiden, and Lilacs databases. A complementary search on websites related to the area of interest was conducted. Articles published in English or Spanish in peer-review journals between 2010 and 2017. Critical appraisal for methodological quality was conducted. Data was extracted using ad-hoc tables and qualitatively synthesized.ResultsAfter eliminating duplicates, 55 325 records remained, and 1432 records were selected for screening. Out of these, 88 full-text articles were selected for eligibility criteria, and finally, 67 studies were selected for this review, and 25 studies were selected for evidence synthesis. In total, 23 CVR assessment tools have been identified, pioneered by the Framingham study. Qualitative findings were grouped into four thematic areas: assessment tools and scores, CVR indicators, comparative models, and evidence-based recommendations.ConclusionsIt is necessary to adapt the instruments to the epidemiological reality of the population. The most appropriate way to estimate CVR is to choose the assessment tool that best suits individual conditions, accompanied by a comprehensive assessment of the patient. More research is required to determine a single, adequate, and reliable tool.     

新理疗技术在手外伤患者术后康复中应用的效果研究

目的 探讨多种新理疗技术在手外伤患者术后康复中应用的效果.方法 将手外伤术后患者150例随机分为观察组87例和对照组63例.对照组患者接受常规治疗及护理,观察组患者在此基础上接受氦氖激光治疗仪照射、醋疗、静电磁场疗法.比较2组患者术后康复的效果.结果 观察组疼痛、肿胀消退时间短于对照组,手功能康复程度优于对照组,2组比较,差异均有统计学意义.P<0.05.结论 手外伤术后患者结合应用新理疗技术能明显缩短康复时间,提高康复质量.     

Measurement properties of patient-reported hand function measures in rheumatoid arthritis: a systematic review protocol

Background: Patient-reported outcome measures (PROMs) are commonly used to evaluate hand function in people with rheumatoid arthritis (RA). A decision will always need to be made about which appropriate PROMs to use. The present review therefore aims to describe the available hand function PROMs for use in people with RA by appraising their methodological quality and psychometric properties using a contemporaneous method.

Methods/design: The proposed systematic review will include published studies written in English, which report evidence for psychometric properties and/or practical properties of hand function PROMs in RA. Four major databases (MEDLINE, Embase, PsycINFO, and CINAHL) will be searched from inception to May 2019. A three-staged search strategy will be applied: (1) electronic bibliographic databases for published studies, (2) ‘named measures’ searching approach, and (3) reference lists of studies with included PROMs. The proposed systematic review will be conducted in compliance with the consensus-based standards for the selection of health measurement instruments (COSMIN) guideline for systematic review of PROMs. Accordingly, the methodological quality of the included studies will be assessed against the updated COSMIN risk of bias checklist, and each study’s results will be assessed for their psychometric quality.

Conclusion: The proposed systematic review seeks to provide rigour, and transparent evaluation of PROMs used to evaluate hand function in the RA population. The findings will provide clarity for healthcare professionals and researchers on the appropriate PROMs for hand function assessment. It will also provide a summary of hand function PROM recommendations for RA.     

Relevant factors for arm choice in reaching movement: a scoping review

[Purpose] Arm choice is an unconscious action selection performed in daily life. Even if hemiparetic stroke patients can use their paretic arm, they compensate for their movements with their non-paretic arm, leading to decreased function of their paretic arm. Therefore, we need to encourage stroke patients to actively use their paretic arm. For this purpose, it is imperative to understand the process of selection of the left or right hand by patients. Here, we conducted a scoping review to summarize the findings of previous studies on factors and brain regions related to choice of arm. [Methods] We used PubMed/Medline, EBSCO, and the Cochrane Library to obtain research literature according to the PRISMA Extension for Scoping Reviews guidelines. [Results] Twenty-five of the 81 articles obtained from the search met the defined criteria. Cost, success, and dominance were investigated as relevant factors for arm choice. We also extracted articles examining the relationship between the posterior parietal and premotor cortex activity and arm choice. [Conclusion] From these results, we considered ways to facilitate the use of the paretic arm, such as the use of virtual reality systems or exoskeletal robots to modulate the reaching cost and success rates, or non-invasive brain stimulation methods to modulate brain activity.     

Reference values for adult grip strength measured with a Jamar dynamometer: a descriptive meta-analysis

The purpose of this meta-analysis was to consolidate the results of studies presenting normative values for grip strength obtained with the Jamar dynamometer in accordance with the recommendations of the American Society of Hand Therapists. Relevant data from 12 sources (3317 subjects) were employed. Means and 95% confidence intervals are presented for the left and right sides of men and women in 12 age groups (20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75+ years). The consolidated grip strength reference values offer a better standard for comparison than provided by any single study alone. Limitations in the meta-analysis notwithstanding, the lower limit of the 95% confidence interval can serve as a reasonable threshold for establishing grip strength impairment among adults.     

Models of care for frail older persons who present to the emergency department: A scoping review of the literature

BackgroundPeople aged ≥65 years comprise approximately 20 % of all emergency department (ED) presentations. Frailty amongst this cohort is common yet can go undetected.ObjectiveTo summarise the evidence regarding models of care for frail older people in the ED.MethodsThe Joanna Briggs Institute scoping review framework was used. Literature searches were conducted in five electronic databases published from 2009 to 2022. Original research that met the criteria: frail older people aged ≥65 years, models of care and ED were included.ResultsA total of thirteen articles met the criteria for inclusion in this review. These comprised four studies of frailty care models and nine studies of care models using different assessment tools to identify frail older people. Care models were comprised of various specialist team members (e.g., geriatrician/ED physician and nurse). Processes underpinning these models included tools to support clinicians in the assessment of frail older adults, particularly around functional status, comorbidities, symptom distress, quality of life, cognition/delirium, and social aspects. Outcomes of care models for frail older people included: shorter ED length of stay, lower hospital admission rates, cost savings and increased patient satisfaction rates.ConclusionA variety of models, supported by a variety of assessment tools, exist to identify and guide care delivery for frail older people in the ED. Careful consideration of existing policies, guidelines and models is required before implementing new service models.     

Effects of therapeutic exercises in patients with lung cancer. A scoping review

IntroductionLung cancer is one of the most common malignancies worldwide and the leading cause of cancer-related death. Smoking is one of the main risk factors associated with this cancer. Treatment will depend on the form of cancer and its stage, existing many therapeutic possibilities. In this regard, therapeutic exercise plays an important role in lung cancer care, as well as the pulmonary rehabilitation and respiratory physical therapy.PurposeTo review the current scientific literature about the effects of therapeutic exercise in lung cancer.MethodA search was carried out in CINAHL, MEDLINE, PubMed, Scopus y Web of Science using de terms “Exercise Therapy” and “Lung Neoplasms”. 141 studies were obtained, but only 19 were selected by adjusting to the inclusion and exclusion criteria. 10 of them were randomized controlled trials with a Jadad score between 2 and 3.ResultsThese works performed a large variety of interventions based on therapeutic exercise, classified in preoperative, postoperative, during treatment, post treatment and combination. Most focused on aerobic exercise, muscle strength and respiratory exercises. Conclusion: therapeutic exercise seems to be positive and obtain significant improvements in patients with lung cancer, regardless the moment of intervention and the type of exercise performed.     

Clinimetric properties of the Duruoz hand index in patients with stroke

OBJECTIVE: To investigate the reliability, validity, and responsiveness of the Duruoz Hand Index (DHI) in assessing activity limitation related to hand function in patients with stroke. DESIGN: Prospective validation study. A consecutive sample of stroke patients was evaluated on 3 occasions: 2 baseline measurements with a 24-hour interval in between, and again 1 month later immediately after a 4-week inpatient rehabilitation program. SETTING: Three different inpatient rehabilitation centers. PARTICIPANTS: A consecutive sample of 56 patients with stroke (33 men, 23 women) with a mean age 62 years and a mean time since stroke 84 days. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Brunnstrom stages, Modified Ashworth Scale, sensory status, FIM instrument, and DHI. Test-retest reliability was tested using the intraclass correlation coefficient (ICC) and internal consistency was tested using the Cronbach alpha coefficient. Indexes of measurement error were calculated by standard error of measurement and minimal detectable change (MDC). Construct validity was assessed by association with the FIM instrument (Spearman rho correlation coefficient). Responsiveness was assessed by calculation of the effect size and paired t test. RESULTS: The test-retest reliability and internal consistency of the DHI were excellent, with an ICC of .99 (95% confidence interval, .93-.99) and alpha of .97. The MDC was 1.4 DHI points. The correlation between the DHI and the FIM self-care items was high (rho=-.73). The DHI significantly discriminated the patients with dominant side paresis versus nondominant side paresis (P<.01). The DHI score improved significantly after a 4-week inpatient rehabilitation program (P<.05). CONCLUSIONS: The DHI is a time and labor efficient, practical instrument that can be used to assess the hand-related activity level for clinical and research purposes in patients with stroke.     

智能握力系统在PICC患者功能锻炼中的应用

目的 探讨智能握力系统在PICC患者功能锻炼中的应用效果.方法 采用便利抽样法,选取2020年11月—2021年1月在苏州市某三级甲等医院门诊行PICC的100例肿瘤患者作为研究对象,采用随机数字表法分为试验组和对照组各50例.试验组采用以智能握力球为载体的智能握力系统进行功能锻炼,对照组采用传统握力球进行功能锻炼.比...     

Isometric hand grip strength correlated with isokinetic data of the shoulder stabilizers in individuals with chronic stroke

The purpose of this study was to examine the relationships between isometric hand grip (HG) strength and isokinetic strength data of the glenoumeral and scapulothoracic muscles in 12 individuals with chronic hemiparesis due to stroke. Measures of maximal grip strength were obtained on the HG dynamometer Jamar(?). Isokinetic measures of peak torque and work during shoulder rotations and scapular protraction-retraction movements were obtained with the isokinetic dynamometer at a speed of 60°/s. Pearson correlation coefficients between isometric HG and isokinetic strength data ranged between 0.60 and 0.82 for the peak torque and between 0.59 and 0.86 for the isokinetic work. The findings suggested that, in absence of isokinetic dynamometers, isometric HG strength measurements could be clinically used to monitor strength levels of the shoulder stabilizers and to guide load progressions during strengthening interventions for people with chronic hemiparesis.     

Exploring assessment policies for clinical practice: A scoping review of the literature

BackgroundAssessment of pre-registration nursing students in clinical practice is an essential process, ensuring students who graduate meet standards for practice and competently and safely care for patients under their care. However, such assessment remains challenging for individuals and organisations.AimWe aimed to investigate what is known about the application of clinical placement assessment policies guiding pre-registration nursing programmes.MethodsArskey and O’Malley’s five-stage method for scoping reviews was employed. Health and education databases were searched in July 2020 and December 2021. Identified papers were screened. The Joanna Briggs Institute’s critical appraisal tools were used to appraise the quality of the included articles. The Invitational Theory domains of people, processes, programmes, places, and policies were utilised to aid meaningful analysis of the findings.FindingsNineteen articles were appraised: eleven primary data studies, two that psychometrically tested a survey instrument, four discussion articles, and two literature reviews. Article quality varied widely. Three themes were identified: lack of processes around clinical practice, people and clinical practice, and policies and clinical practice.DiscussionAssessment within placement is complex and unique. Uncertainty permeates the literature around assessment of pre-registration students in clinical practice. There is a clear need to promote policies that highlight differences between theoretical and practice assessment, ensuring all stakeholders can access relevant governance processes that support patient safety.ConclusionMore empirical evidence is needed to develop policies and processes that reduce uncertainty and improve patient safety associated with student assessment within clinical placements.     

老年人尿失禁与衰弱的相关性分析

目的 探讨老年人尿失禁与衰弱的相关性.方法 回顾性分析473例住院老年患者的综合评估资料,尿失禁是采用症状诊断,衰弱是应用FRAIL量表筛查并测定躯体功能.应用多因素logistic回归探索尿失禁与衰弱的相关性.结果 身体强壮患者尿失禁的发生率是16.4％,衰弱前期患者尿失禁发生率为26.5％,而衰弱患者尿失禁的发生率...