Category: Research and Articles

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Prevalence of joint contractures and muscle weakness in people with multiple sclerosis

date: 2014;36(19):1588-93
author: Hoang PD1, Gandevia SC, Herbert RD.
publication: Disabil Rehabil.
pubmed_ID: 24236496

 

Abstract

OBJECTIVES:

To investigate the prevalence of joint contracture (limited passive range of joint motion) and muscle weakness in a population with multiple sclerosis (MS). A secondary aim was to establish normative data of functional tests of mobility and balance of people with MS who are still ambulant.

DESIGN:

Cross-sectional study.

SETTING:

People with MS living in metropolitan Sydney, Australia.

PARTICIPANTS:

330 people with MS living in metropolitan Sydney, Australia were randomly sampled on 23 July 2009 from the MS Australia register and invited to participate.

MAIN OUTCOME MEASURES:

Passive range of motion of large joints of the limbs and muscle strength. Tests of walking and balance were also conducted.

RESULTS:

156 people (109 females, 47 males; mean age 54.2 years; mean time since diagnosis 14.9 years) agreed to participate and were assessed. Fifty-six per cent (56%) of participants had contracture in at least one major joint of upper or lower limb. The most common site of contracture was the ankle (43.9%). Seventy per cent (70%) of participants had muscle weakness in one or more muscle groups. As muscle weakness, joint contractures were present at early stage of MS and the prevalence was associated with the progression of the disease.

CONCLUSIONS:

These data show that in addition to muscle weakness joint contractures are highly prevalent among people with MS, especially in the ankle joint. This implicates that prevention of contracture is crucial in providing rehabilitation to people with MS.

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The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke

date: 2008 Dec;39(12):3329-34
author: Sackley C1, Brittle N, Patel S, Ellins J, Scott M, Wright C, Dewey ME.
publication: Stroke
pubmed_ID:18787199

 

Abstract

BACKGROUND AND PURPOSE:

Complications after stroke have been shown to impede rehabilitation, lead to poor functional outcome, and increase cost of care. This inception cohort study sought to investigate the prevalence of immobility-related complications during the first year after severely disabling stroke in relation to functional independence and place of residence.

METHODS:

Over a 7-month period, 600 stroke survivors were identified in the hospital through the Nottingham Stroke Register. Those who had a Barthel Index score <or=10 3 months poststroke and did not have a primary diagnosis of dementia were eligible to participate in the study. Assessments of complications were carried out at 3, 6, and 12 months poststroke.

RESULTS:

Complications were recorded for 122 stroke survivors (mean age, 76 years; 57% male). Sixty-three (52%) had significant language impairment and of the remaining 59 who were able to complete an assessment of cognitive function, 10 (8%) were cognitively impaired. The numbers of reported complications over 12 months, in rank order, were falls, 89 (73%); contracture, 73 (60%); pain, 67 (55%); shoulder pain, 64 (52%); depression, 61 (50%); and pressure sores, 26 (22%). A negative correlation was found between Barthel Index score and the number of complications experienced (low scores on the Barthel Index correlate with a high number of complications). The highest relative percentages of complications were experienced by patients who were living in a nursing home at the time of their last completed assessment.

CONCLUSIONS:

Immobility-related complications are very common in the first year after a severely disabling stroke. Patients who are more functionally dependent in self-care are likely to experience a greater number of complications than those who are less dependent. Trials of techniques to limit and prevent complication are required.

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RESNA POSITION ON THE APPLICATION OF WHEELCHAIR STANDING DEVICES: 2013 CURRENT STATE OF THE LITERATURE

date: Dec. 23, 2013
author: Dicianno BE, Morgan A, Lieberman J, Rosen L
publication: Assit Technol.
pubmed_ID: 26910615

This article, approved by the Rehabilitation Engineering & Assistive Technology Society of North America Board of Directors on December 23, 2013, shares typical clinical applications and provides evidence from the literature supporting the use of wheelchair standers

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Standing and mortality in a prospective cohort of Canadian adults.

date: 2014;46(5):940-6
author:Katzmarzyk PT1.
publication:Med Sci Sports Exerc.

pubmed_ID:24152707

 

Abstract

PURPOSE:

Several studies have documented significant associations between sedentary behaviors such as sitting or television viewing and premature mortality. However, the associations between mortality and other low-energy-expenditure activities such as standing have not been explored. The purpose of this study was to examine the association between daily standing time and mortality among 16,586 Canadian adults 18-90 yr of age.

METHODS:

Information on self-reported time spent standing as well as several covariates including smoking, alcohol consumption, physical activity readiness, and moderate-to-vigorous physical activity was collected at baseline in the 1981 Canada Fitness Survey. Participants were followed for an average of 12.0 yr for the ascertainment of mortality status.

RESULTS:

There were 1785 deaths (743 from cardiovascular disease [CVD], 530 from cancer, and 512 from other causes) in the cohort. After adjusting for age, sex, and additional covariates, time spent standing was negatively related to mortality rates from all causes, CVD, and other causes. Across successively higher categories of daily standing, the multivariable-adjusted hazard ratios were 1.00, 0.79, 0.79, 0.73, and 0.67 for all-cause mortality (P for trend <0.0001); 1.00, 0.82, 0.84, 0.68, and 0.75 for CVD mortality (P for trend 0.02); and 1.00, 0.76, 0.63, 0.67, and 0.65 for other mortality (P for trend <0.001). There was no association between standing and cancer mortality. There was a significant interaction between physical activity and standing (P < 0.05), and the association between standing and mortality was significant only among the physically inactive (<7.5 MET·h·wk).

CONCLUSIONS:

The results suggest that standing may not be a hazardous form of behavior. Given that mortality rates declined at higher levels of standing, standing may be a healthier alternative to excessive periods of sitting.

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Sitting time and all-cause mortality risk in 222 497 Australian adults

date: 2012 Mar 26;172(6):494-500.
author: van der Ploeg HP1, Chey T, Korda RJ, Banks E, Bauman A.
publication:Arch Intern Med.
pubmed_ID:22450936

 

Abstract

BACKGROUND:

Prolonged sitting is considered detrimental to health, but evidence regarding the independent relationship of total sitting time with all-cause mortality is limited. This study aimed to determine the independent relationship of sitting time with all-cause mortality.

METHODS:

We linked prospective questionnaire data from 222 497 individuals 45 years or older from the 45 and Up Study to mortality data from the New South Wales Registry of Births, Deaths, and Marriages (Australia) from February 1, 2006, through December 31, 2010. Cox proportional hazards models examined all-cause mortality in relation to sitting time, adjusting for potential confounders that included sex, age, education, urban/rural residence, physical activity, body mass index, smoking status, self-rated health, and disability.

RESULTS:

During 621 695 person-years of follow-up (mean follow-up, 2.8 years), 5405 deaths were registered. All-cause mortality hazard ratios were 1.02 (95% CI, 0.95-1.09), 1.15 (1.06-1.25), and 1.40 (1.27-1.55) for 4 to less than 8, 8 to less than 11, and 11 or more h/d of sitting, respectively, compared with less than 4 h/d, adjusting for physical activity and other confounders. The population-attributable fraction for sitting was 6.9%. The association between sitting and all-cause mortality appeared consistent across the sexes, age groups, body mass index categories, and physical activity levels and across healthy participants compared with participants with preexisting cardiovascular disease or diabetes mellitus.

CONCLUSIONS:

Prolonged sitting is a risk factor for all-cause mortality, independent of physical activity. Public health programs should focus on reducing sitting time in addition to increasing physical activity levels.

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Standing time and all-cause mortality in a large cohort of Australian adults.

date: 2014 Dec;69:187-91.
author: van der Ploeg HP1, Chey T2, Ding D2, Chau JY2, Stamatakis E3, Bauman AE2
publication: Prev Med.
pubmed_ID:PMID:25456805

Outside_URL:https://www.ncbi.nlm.nih.gov/pubmed/25456805

Abstract

OBJECTIVE:

To determine the association between standing time and all-cause mortality.

METHODS:

Prospective questionnaire data from 221,240 individuals from the 45 and Up Study were linked to mortality data from the New South Wales Registry of Deaths (Australia) from February 1, 2006 to June 17, 2012. Hazard ratios for all-cause mortality according to standing time at baseline were estimated in 2013 using Cox regression modelling, adjusted for sex, age, education, urban/rural residence, physical activity, sitting time, body mass index, smoking status, self-rated health and disability.

RESULTS:

During 937,411 person years (mean follow-up=4.2 yr) 8009 deaths occurred. All-cause mortality hazard ratios were 0.90 (95% CI 0.85-0.95), 0.85 (95% CI 0.80-0.95), and 0.76 (95% CI 0.69-0.95) for standing 2-≤5h/d, 5-≤8h/d, or >8h/d respectively, compared to standing two or less hours per day. Further analyses revealed no significant interactions between standing and sex (p=0.93), the presence/absence of cardiovascular disease or diabetes (p=0.22), BMI (p=0.78), physical activity (p=0.16) and sitting time (p=0.22).

CONCLUSION:

This study showed a dose-response association between standing time and all-cause mortality in Australian adults aged 45 years and older. Increasing standing may hold promise for alleviating the health risks of prolonged sitting

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Effects of a standing table on work productivity and posture in an adult with developmental disabilities.

date:1997;9(1):13-20.
author: Nelson DL1, Schau EM1.
publication: Work
pubmed_ID: 24441921

 

Abstract

The standing table is an assistive device designed to encourage occupational performance of the upper extremities while helping the person compensate for limitations in standing posture. We conducted three single-subject studies of a standing table used by a 52-year-old man with spastic cerebral palsy and mental retardation. In the first study, positioning in the standing table resulted in no discernible difference in work output per hour in comparison to his customary seated posture. In the second study, positioning in the standing table resulted in an unexpectedly small increase in work output in comparison to his customary method of standing without special support at the work bench. In the third study, we demonstrated that the standing table dramatically improved the erectness of his posture as measured by an infrared motion detector in comparison to his customary method of standing. Because work productivity depends on multiple factors, improved posture and biomechanical stability do no always result in a proportionate improvement in work output. There remain multiple justifications of equipment such as the standing table in work settings for adults with developmental disabilities