Leisure-time physical activity and secondary conditions in women with physical disabilities

Purpose: To examine the relationship between secondary conditions and leisure-time physical activity participation (LTPA) in women with physical disabilities.

Method: A survey was conducted in a metropolitan urban USA area of women (n = 170) with physical disabilities including MS, CP, polio, arthritis, TBI, and CVA among others and aged 21 - 65 years. Outcome measures were LTPA, secondary conditions (numbers and severity), and functional status.

Results: Respondents experienced 11.99 ( ± 6.05) secondary conditions in the past year, self-rated their severity as 'moderate problems', and reported moderate levels of functional impairment. LTPA participation (excluding calisthenics/exercise) was reported to be 2.90 ( ± 5.12) times/week with 39.4% reporting no participation. After controlling for the interaction between severity of secondary conditions and functional status, the secondary conditions of physical deconditioning and isolation were significantly and inversely related to LTPA participation (r = - 0.164, p = 0.036; r = - 0.156, p = 0.045, respectively).

Conclusion: Reported secondary conditions of physical deconditioning and isolation are inversely related to the ability of moderately impaired women with physical disabilities to participate in LTPA when functional status was controlled and should be considered in efforts to increase involvement in this health promoting behaviour.     

Secondary conditions and women with physical disabilities: a descriptive study

OBJECTIVE: To examine secondary conditions and their relationship to life satisfaction in women with physical disabilities. DESIGN: Survey research. SETTING: Metropolitan Philadelphia. PARTICIPANTS: Women aged 18 to 65 years with self-reported functional limitations associated with neurologic, neuromuscular, brain, sensory, arthritic, spinal cord, orthopedic, or other chronic conditions. MAIN OUTCOME MEASURES: Secondary conditions, health status, functional status, and life satisfaction. RESULTS: In the past year, an average of 12 +/- 6.1 (SD) secondary conditions were experienced. Fatigue, mobility, physical deconditioning, spasticity, and joint pain were reported most frequently, followed by depression, chronic pain, access problems, weight problems, and isolation. In comparing women with multiple sclerosis (MS) and those with other disabling conditions, women with MS had higher secondary conditions problem index (SCPI) scores for bladder, bowel, and sexual dysfunction than women in the mixed disability group. Other secondary conditions with the highest SCPI scores remained similar. Self-reported emotional health status and SCPI scores were the only significant predictors of life satisfaction. CONCLUSION: Secondary conditions influence health status and quality of life for women with physical disabilities. Despite differences among disability groups in terms of the type of secondary conditions, common secondary conditions experienced by most women may be amenable to non-disability-specific health promotion programs.     

Narrative environments and the capacity of disability narratives to motivate leisure-time physical activity among individuals with spinal cord injury

Abstract

Purpose: Few individuals with spinal cord injury (SCI) engage in the recommended amount of leisure time physical activity (LTPA). Yet little is known about how, and why, active individuals engage in specific types of LTPA. This study explored how a unique narrative environment and disability narratives motivated individuals with SCI to engage in LTPA. Method: Fourteen individuals with SCI from a physical activity program participated in approximately hour-long interviews. Interviews were then subjected to a narrative analysis. Results: Individuals who used a restitution narrative (n?=?6) were motivated to engage in functional LTPA because of the desire to maintain the body and restore the past self. The individual who used the chaos narrative (n?=?1) preferred solitary LTPA as exposure to others with SCI was a constant reminder of the lost, pre-injury self. Individuals who used a quest narrative (n?=?7) explored LTPA options that fit with their interests; these individuals were open to new types of LTPA, such as sport and outdoor recreation. Conclusion: The plot of three disability narratives can all motivate the pursuit of LTPA; however, not all types of LTPA are seen as equal. LTPA interventions can be enhanced through the lessons learned from this unique type of environment.

• Implications for Rehabilitation

• Despite individuals’ views about their disability, they can still be motivated to engage in routine LTPA.

• Different theoretical determinants, such as health or social benefits, hold different relevance for LTPA among individuals with differing disability narratives.

• The environment provided by practitioners can therefore elicit some stories of SCI while stifling others. Open narrative environment will attract individuals to listen and maintain involvement in LTPA.

     

The relationship between the implementation and effectiveness of a nationwide physical activity telephone counseling service for adults with spinal cord injury

Purpose: Get in Motion (GIM) is an evidence-based telephone counseling service that promotes leisure-time physical activity (LTPA) among Canadian adults with spinal cord injury (SCI). The first phase of GIM sustained intentions for, and increased participation in, LTPA; however, it is unclear how GIM led to these outcomes. The purpose of this study was to explore the implementation correlates of change in LTPA intentions and behavior in the second phase of GIM.

Methods: The frequency, duration, and content of counseling sessions were tailored to meet clients’ (N?=?46; 50.0% male; 50.0% paraplegia; 51.46 (SD 12.36) years old) needs and preferences. Intervention dose and content were monitored using Counseling Session Checklists. Clients self-reported their intentions for and actual aerobic and strength-training LTPA participation at baseline, 2-, 4-, and 6-months, and their perceptions of service quality at 6-months.

Results: The second phase of GIM effectively sustained LTPA intentions and increased time spent on moderate-to-vigorous strength-training and total LTPA. Increases in clients’ moderate-to-vigorous aerobic LTPA were significantly positively related to intervention dose, intervention content (both informational and behavioral strategies), and clients’ perceptions of service credibility.

Conclusions: This study identified intervention dose and content as key implementation variables for an LTPA telephone counseling service for adults with SCI.

• Implications for Rehabilitation

• An evidence- and theory-based telephone counseling service can effectively sustain LTPA intentions and increase LTPA behavior among adults with SCI.

• The first two months of the service are a critical period for enhancing LTPA participation and for minimizing dropouts.

• The provision of both informational and behavioral strategies is important for increasing aerobic LTPA levels among adults with SCI.

     

Level of agreement between physical activity levels measured by ActiHeart and the International Physical Activity Questionnaire in persons with intellectual disability

Purpose: The purpose of this study was to determine the level of agreement between objective physical activity (PA) (ActiHeart^®) and subjective proxy-respondent International Physical Activity Questionnaire-short version (IPAQ-S) data in adults with intellectual disabilities (IDs).

Method: Fifty-eight participants wore ActiHeart^® monitors for seven consecutive days. Caregivers of each participant completed the IPAQ-S on behalf of the participant. Total PA, time spent in light, moderate, and vigorous activity as well as time spent being sedentary were assessed by the IPAQ-S and the ActiHeart^®. Results were compared by means of correlation analyses. The level of agreement was presented with Bland–Altman plots.

Results: Objective PA (ActiHeart^®) was higher (225.57?±?91.96?min/week) than IPAQ-S PA reported by care-givers (177.06?±?309.17?min/week). Weak significant correlations were observed between the ActiHeart^® and IPAQ-S instruments for sedentary behavior (r?=?0.31; p?=?0.04); no significant correlations for light (r=??0.04; p?=?0.8), moderate (r=??0.07; p?=?0.63), or vigorous PA (r=??0.2; p?=?0.18) were found. Limited agreement between objectively determine PA (ActiHeart^®) and IPAQ-S was found.

Conclusion: IPAQ-S is inaccurate when determining PA in persons with ID as it significantly underestimates the true levels of PA in this cohort.

• Implications for Rehabilitation

• Persons with intellectual disability (ID) report insufficient physical activity for health benefits.

• Physical activity is often determined by means of subjective proxy reporting.

• Objective physical activity measurements by means of combined heart rate and accelerometer are necessary to determine accurate levels of physical activity in persons with ID.

• Exercise interventions should be based on objective physical activity measurements.

     

Recreational participation and the development of social competence in preschool aged children with disabilities: a cross-sectional study

Abstract

Purpose: To explore the association between participation and social competence for preschool aged children with and without disabilities. Methods: The sample was drawn from the Longitudinal Study of Australian Children (n?=?4983) which included children aged 4–5 years reported to have hearing problems (n?=?164), vision problems (n?=?146) and other physical disabilities (n?=?114). Chi-square, correlation and logistic regression analyses were used to describe the participation and social competence of children with and without these conditions, as well as examine the association between these constructs. Results: Children with disabilities had similar levels of participation but lower social competence than children without these disabilities. Further analyses revealed a small negative correlation between the two variables (ranging from ?0.120 to ?0.300 for the three groups) and that children who have low participation are more likely to have abnormal levels of social competence than children with higher participation. Conclusions: The association between participation and social competence may not be as strong for this age group as anticipated in the literature, additional factors may be influential. Examination of the social competence scores identified two factors which may assist in explaining the variance in scores: (1) the experience of disability and (2) the quality of interactions.

• Implications for Rehabilitation

• Children with disabilities who participate in similar activities to their typically developing peers may not necessarily develop commensurate levels of social competence.

• As well as focusing on increasing the participation of children in activities other factors that may have a stronger influence on social competence should be considered, such as supporting (1) the social experience of disability and (2) the quality of interactions that children with disabilities experience.

     

Variations in leptin and insulin levels within one swimming season in non-obese female cold water swimmers

Aim: We examined whether cold water swimming for seven consecutive months changes basal leptin and insulin concentrations and insulin sensitivity in healthy non-obese women.

Materials and methods: Fourteen recreational female swimmers aged 45?±?8.7 years, regularly swimming outdoors during winter months were exposed to cold water at least twice a week. Fasting blood samples were collected in October, January and April. Serum leptin, insulin and glucose concentrations were tested and insulin sensitivity was calculated using updated model HOMA2.

Results: Repeated cold water baths significantly increased insulin sensitivity and decreased insulin and leptin concentrations (p?=?0.006, p?=?0.032, p?=?0.042, respectively). Leptin concentration positively correlated with body-mass index (BMI) and insulin level (r?=?0.412, r?=?0.868, respectively). Insulin level inversely correlated with insulin sensitivity and positively with glucose (r = ?0.893, r?=?0.166, respectively). No associations between leptin and insulin sensitivity were found.

Conclusion: Regular cold water swimming may stimulate metabolic changes suggesting that leptin and insulin participate in adaptive metabolic mechanisms triggered by repeated cold exposure accompanied by mild exercise in healthy non-obese women.     

A pilot study of a web-based physical activity motivational program for adults with physical disabilities

Purpose.?Develop, deliver, and assess the efficacy of a 4-week web-based leisure-time physical activity (LTPA) motivational program based on the Transtheoretical Model and tailored to inactive adults with physical disabilities.

Method.?This was a pilot-based study incorporating a true experimental design with one treatment and one control group. The intervention program was delivered on the web and was based on the constructs of the Transtheoretical Model. From the 151 individuals who completed the LTPA standardized questionnaire at baseline, 75 people participated in the 1-month post-test assessment.

Results.?The results of the analysis confirmed the pretest LTPA scores as the study covariate for the post-test assessment (F (1,72) = 16.06, p = 0.001, η² = 0.18). Based on the one-way ANCOVA, there were no statistically significant differences in LTPA scores between the treatment and control groups at post-test. However, the corresponding effect size and variance explained by the treatment approached a moderate level of significance (d = 0.34 and η² = 0.04).

Conclusions.?Although conclusive statements about program effectiveness cannot be secured, several ‘lessons learned’ from this project may be ‘key factors’ for program improvement. Given the pilot nature of the study and the limited resources for program development and monitoring, continued examination of such motivational materials and delivery mechanisms for people with physical disabilities appear warranted.     

Association between mental health and physical activity in patients with chronic heart failure

Abstract

Purpose: Poor mental health (MH) is common in chronic heart failure (CHF) patients. No studies have reported a relation between MH status and objectively measured physical activity (PA) in CHF patients. The study aim was to determine self-reported MH-related differences associated with PA and target values of PA for improved MH in CHF outpatients. Methods: We divided 243 CHF outpatients (mean age 57.1 years) into two groups according to MH assessed by Short Form-36 score: high-MH (≥68 points) group (n?=?148) and poor-MH (<68 points) group (n?=?95). Average step count (steps) and energy expenditure on PA (EE) (kcal) per day for 1 week of PA were assessed by an accelerometer and compared between groups. PA resulting in high MH was determined by the receiver-operating characteristic (ROC) analysis. Results: PA correlated positively with MH in all patients (steps: r?=?0.46, p?<?0.001; EE: r?=?0.43, p?<?0.001). After adjusting for patient characteristics, steps and EE were significantly lower in the poor-MH versus high-MH group (5020.1?±?280.7 versus 7174.1?±?221.5 steps, p?<?0.001; 133.9?±?10.8 versus 215.9?±?8.4?kcal, p?<?0.001). Cut-off values of 5590.8 steps and 141.1?kcal were determined as PA target values associated with improved MH. Conclusions: Poor MH status may reduce PA. Attaining PA target values may improve MH status of CHF outpatients.

• Implications for Rehabilitation

• Poor mental health may negatively affect physical exercise in CHF outpatients.

• In particular step counts and energy expenditure are lower in those with poor mental health.

• It may be that focused exercise training may impact positively both on mental health and physical well being.

     

Differences in participation based on self-esteem in power and manual wheelchair users on a university campus: a pilot study

Objectives: To examine the relationship of self-esteem and wheelchair type with participation of young adult manual and power wheelchair users with diverse physical disabilities. Design: Cross-sectional survey study. Setting: Large University Campus. Participants: A convenience sample of college students (N?=?39) with self-reported physical disabilities who are full time wheelchair users (>40 per week) and are two or more years post illness or injury. Interventions: Not applicable. Main outcome measures: The Rosenberg Self-Esteem Scale was used to measure self-esteem, and the Craig Handicap Assessment and Reporting Technique was used to measure participation. Results: Self-esteem correlated highly with cognitive independence (CI) (r?=?0.58), mobility (r?=?0.67) and social integration (SI) (r?=?0.52). Use of manual wheelchair was significantly related to higher levels of CI and mobility while longer use of any wheelchair (power or manual) was significantly associated with higher levels of mobility and SI. In addition higher self-esteem independently predicted a significant proportion of the variance in CI, mobility and SI, while type of wheelchair predicted a significant proportion of the variance in CI (p?Conclusions: High self-esteem was found to be the strongest predictor of participation in a population of young adults with mobility limitations. Better understanding of the factors influencing participation may help to facilitate new interventions to minimize the disparities between persons with disabilities and their able bodied peers.

• Implication for Rehabilitation

• A total of 46.8% of wheelchair users report the desire for increased community participant but face significant barriers.

• The type of wheelchair has been identified as having a large impact on participation.

• This study found self-esteem to be the strongest predictor of participation, which is notable because self-esteem is a characteristic that is potentially modifiable with treatment.

     

Functional factors that are important correlates to physical activity in people with multiple sclerosis: a pilot study

Purpose: Identify functional factors that are important correlates to physical activity levels among people with multiple sclerosis.

Methods: A total of eight functional tests were conducted and physical activity was objectively measured (Actigraph GT3X accelerometer) for one week in 34 people with multiple sclerosis. A corrected Akaike Information Criterion analysis was performed to identify the strongest correlates with moderate-to-vigorous physical activity, total activity and sedentary time.

Results: The multiple regression analysis converged on a model for moderate-to-vigorous physical activity (R²?=?0.31, F?=?6.97, p=?0.003) that included total strength of the less-affected leg (partial r?=?0.46, p?=?0.007) and average peg test performance (partial r?=??0.30, p?=?0.087). The model for total activity (R²?=?0.40, F?=?10.51, p?<?0.001) included five times sit-to-stand performance (partial r=??0.44, p?=?0.010) and total strength of the less-affected leg (partial r?=?0.31, p?=?0.077). The model for sedentary time (R²=0.22, F?=?9.23, p?=?0.005) only included total strength of the more affected leg (r=??0.47, p?=?0.005).

Conclusion: These results suggest that leg strength, manual dexterity and the ability to perform functional tasks may be important correlates with physical activity levels in people with multiple sclerosis. The findings of this pilot study can inform future investigations aiming to increase physical activity levels or develop improved rehabilitation protocols for people with multiple sclerosis.

• Implications for Rehabilitation

• Physical activity is an effective means of improving the symptoms associated with multiple sclerosis.

• Participation in physical activity by people with multiple sclerosis may be affected by functional factors such as leg strength, manual dexterity and the ability to rise from a seated position.

• Bilateral leg strength differences should be assessed and addressed in people with multiple sclerosis.

     

Functional outcome in patients with critical illness polyneuropathy

Purpose:?To evaluate the functional outcome of intensive care patients with critical illness polyneuropathy (CIP), 6 and 12 months after the onset.

Methods: Design:?A prospective observational cohort study and a cross-sectional study.

Setting:?University hospital in the Netherlands.

Patients:?Eight consecutive intensive care patients with CIP for the prospective study and eight patients diagnosed with CIP in the past 6 months for the cross-sectional study.

Main outcome measures:?Functional outcome regarding body functions and structure, activities, participation and perceived quality of life.

Results:?Nine patients (56%) died within one year. Functional outcome, participation and subjective health status in survivors varied widely at 6 and 12 months. After 12 months, physical functioning was improved in all patients. However activities related to mobility outdoors, autonomy, participation and quality of life were restricted in most patients.

Conclusions:?The majority of survivors have persistent functional disabilities in activities, reduced quality of life and restrictions in autonomy and participation one year after the onset of CIP. Prolonged rehabilitation treatment is necessary for an increasing number of intensive care patients who develop CIP, in order to reduce handicaps and achieve optimal autonomy and social participation.     

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.

     

Examination of contraction-induced muscle pain as a behavioral correlate of physical activity in women with and without fibromyalgia

Abstract

Purpose: This study aimed to compare muscle pain intensity during a sustained isometric contraction in women with and without fibromyalgia (FM), and examine the association between muscle pain and self-reported levels of physical activity. Methods: Fourteen women with FM and 14 healthy women completed the study, where muscle pain ratings (MPRs) were obtained every 30?s during a 3?min isometric handgrip task at 25% maximal strength, and self-reported physical activity was quantified using the Baecke Physical Activity Questionnaire. Results: Women with FM were less physically active than healthy controls. During the isometric contraction, MPR progressively increased in both groups at a comparable rate, but women with FM generally reported a greater intensity of muscle pain than healthy controls. Among all women, average MPR scores were inversely associated with self-reported physical activity levels. Conclusions: Women with FM exhibit augmented muscle pain during isometric contractions and reduced physical activity than healthy controls. Furthermore, contraction-induced muscle pain is inversely associated with physical activity levels. These observations suggest that augmented muscle pain may serve as a behavioral correlate of reduced physical activity in women with FM.

• Implications for Rehabilitation

• Women with fibromyalgia experience a greater intensity of localized muscle pain in a contracting muscle compared to healthy women.

• The intensity of pain during muscle contraction is inversely associated with the amount of physical activity in women with and without fibromyalgia.

• Future studies should determine whether exercise adherence can be improved by considering the relationship between contraction-induced muscle pain and participation in routine physical activity.

     

Longitudinal changes in activity participation in the first year post-stroke and association with depressive symptoms

Abstract

Research question: 1. Does activity participation improve over time in the first year after stroke? 2. What is the association of depressive symptoms on retained activity participation 12-months post-stroke adjusting for neurological stroke severity and age? 3. Is an improvement in activity participation associated with a decrease in depressive symptoms between 3- and 12-months post-stroke?

Design: Longitudinal observational study of activity participation and depressive symptoms in ischemic stroke survivors.

Participants: A total of 100 stroke survivors with mild neurological stroke severity.

Methods: A total of 100 stroke survivors were recruited from five metropolitan hospitals and assessed at 3- and 12-months post-stroke using measures of activity participation (Activity Card Sort-Australia (ACS-Aus)) and depressive symptoms (Montgomery–Asberg Depression Rating Scale Structured Interview Guide (MADRS-SIGMA)).

Results: There was a significant association between time (pre-stroke to 3-months post-stroke) and current activity participation (?5.2 activities 95% CI ?6.8 to ?3.5, p?<?0.01) and time (pre-stroke to 12-months) and current activity participation (?2.1 activities 95% CI ?3.7 to ?0.5, p?=?0.01). At 12-months post-stroke, a one-point increase in depressive symptoms was associated with a median decrease of 0.3% (95% CI ?1.4% to ?0.1%, p?=?0.02) of retained overall activity participation, assuming similar neurological stroke severity and age. A decrease in depressive symptoms between 3- and 12-months post-stroke was associated with an improvement of 0.31 (95% CI ?0.5 to ?0.1, p?=?0.01) in current activity participation.

Conclusions: Activity participation improves during the first year of recovery post-stroke in stroke survivors with mild neurological stroke severity and is associated with depressive symptoms over time and at 12-months post-stroke.

• Implications for rehabilitation

• Improvements in participation occur in the first 3-months post-stroke and continue to a lesser degree in the first year after stroke.

• Depressive symptoms are associated with lower participation at 12-months.

• A multidimensional approach targeting depressive symptoms and increasing participation in the early months post-stroke and throughout the first-year after stroke is recommended to increase overall recovery following stroke.

• A focus on increasing leisure activity participation is recommended to improve depressive symptoms.

Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12610000987066.     

Using assistive technology for schoolwork: the experience of children with physical disabilities

Aim.?This study explored the experience of children with physical disabilities using assistive technology for participation with schoolwork to gain a greater understanding of their perspectives and subjective experiences.

Method.?A qualitative study involving thematic analysis of in-depth interviews of the child with a parent or significant adult. Purposeful sampling from a larger study recruited five children aged between 10 and 14 years, with differing physical disabilities who attended mainstream schools. All children used computer-based assistive technology.

Results.?All of the children recognised that assistive technology enabled them to participate and reduced the impact of their physical disability, allowing independent participation, and facilitated higher learning outcomes. Issues related to ease of use, social implications and assistive technology systems are discussed.     

The complex array of antecedents of depression in women with physical disabilities: Implications for clinicians

Purpose. This article discusses the complex interrelation of elements of the physical, psychological, social, and environmental life context of women with physical disabilities and the association of these elements with significant disparities in rates of depression and access to mental health care for this population.

Method. Literature and concept review.

Results. High rates of depression in women with physical disabilities are well documented in the literature. Many elements that are disproportionately common in the lives of women with physical disabilities, including socio-economic disadvantage, functional limitations, pain and other chronic health conditions, poor diet, physical inactivity, smoking, violence, low self-esteem, sexuality problems, chronic stress, environmental barriers, and barriers to health care, have also been linked with higher rates of depression and depressive symptomatology. Depression self-management interventions tailored for women with disabilities have been developed and proven effective.

Conclusions. Many women who must deal with the stresses surrounding an array of health problems may experience symptoms of depression without necessarily meeting the criteria for clinical depression. Psychologists, counselors, primary care physicians, specialists, and other medical and rehabilitation professionals are challenged to recognize the symptoms of depression in women with physical disabilities and assist them in obtaining appropriate psychological and pharmacological interventions.     

Degenerative lumbar spinal stenosis and physical functioning: an exploration of associations between self-reported measures and physical performance tests

Background: Degenerative spinal stenosis is a common lumbar condition in the elderly population. Clinical decision-making in the physiotherapy settings is based on assessments of the patients physical status. The purpose of this study was to examine how self-reported measures on symptoms and physical function relate to responses on physical performance tests.

Methods: A total of 103 patients with LSS completed a comprehensive questionnaire and physical performance tests (functional leg-strength and dynamic balance). Associations between the subscales Symptom Severity (SYMP) and Physical Function (FUNC) from the Spinal Stenosis Questionnaire, and the performance tests were examined. Univariate correlation and multivariable linear regression analyses were applied.

Results: The associations between SYMP or FUNC and the performance tests were moderate (?0.3?p?p?R²?=?0.31 and R²?=?0.38).

Conclusions: The present study indicates that both self-reported symptoms and walking limitation are associated with leg strength, while only symptoms are associated with balance. The results suggest that a combination of simple performance tests will add information needed to map the patients disability and guide interventions.

• Implications for Rehabilitation

• One-leg-standing, 30-s sit-to-stand and stair climb test are easy to use and applicable for examining physical function in patients with lumbar spinal stenosis (LSS).

• Simple performance tests add information needed to map the patients’ disability and guide interventions.

• Leg strength is a key factor for both symptoms and walking ability. Also, balance is of importance for the symptoms in LSS patients.

     

Disability and race: a comparative analysis of physical activity patterns and health status

Purpose: Minority groups, specifically African Americans (AAs), are more likely to be physically inactive than the general population. Although the aforementioned finding is well documented, there is a dearth of literature that examines levels of physical activity among AA adults with disabilities. The purpose of this article was to study the patterns of physical activity and health status among AA adults with disabilities in comparison with their White counterparts. Methods: Data from the Centers for Disease Control and Preventions 2007 Behavioral Risk Factor Surveillance System survey were used to conduct comparative analyses of physical activity patterns and health status among 7315 AAs and 82?482 Whites who self-reported a disability. Results: Significant differences (p < 0.05) were found between health status and physical activity patterns across racial groups. AAs with disabilities were less likely to engage in moderate and vigorous physical activity than their White counterparts. AAs were also less likely to engage in physical activity as health status declined in comparison with White respondents. Conclusion: When considering the health of minorities with disabilities, physical activity must be central to improving their health status. The authors of this study provide additional support for developing unique health programming for AAs with disabilities. Rehabilitation and health care professionals can gain insight into lifestyle patterns of minorities with disabilities, which can be useful in addressing health behaviors that may be counter to physical well-being.

Implications for Rehabilitation

• African Americans with disabilities tend to report poorer health status and engage in less moderate and vigorous physical activity, even as health status decline, than their White counterparts.

• The use of a multilayered approach incorporating culturally tailored programming would be useful in improving health and physical activity outcomes of African Americans with disabilities.