Activity of Daily Living

To evaluate the impact of a Mindfulness Based Stress Reduction (MBSR) program in patients with chronic bothersome tinnitus on the (1) severity of symptoms of tinnitus and (2) functional connectivity in neural attention networks. Open-label interventional pilot study. Outpatient academic medical center. A total of 13 adult participants with a median age of 55 years, suffering from bothersome tinnitus. An 8-week MBSR program was conducted by a trained MBSR instructor. The primary outcome measure was the difference in patient-reported tinnitus symptoms using the Tinnitus Handicap Index (THI) and Tinnitus Functional Index (TFI) between pre-intervention, post-MBSR, and 4-week post-MBSR assessments. Secondary outcomes included change in measurements of depression, anxiety, mindfulness, and cognitive abilities. Functional connectivity magnetic resonance imaging (MRI) was performed at pre- and post-MBSR intervention time points to serve as a neuroimaging biomarker of critical cortical netwo...

Patients with bone metastases may experience pain, fatigue, and decreased mobility. Multiple medications for analgesia are often required, each with attendant side effects. Although palliative-intent radiotherapy (RT) is effective in decreasing pain, additional supportive care interventions may be overlooked. Our objective was to describe the feasibility of multidisciplinary assessment of patients with symptomatic bone metastases attending a dedicated outpatient palliative RT clinic. Consecutive patients referred for RT for painful bone metastases were screened for symptoms and needs relevant to their medications, nutritional intake, activities of daily living, and psychosocial and spiritual concerns from January 1 to December 31, 2007. Consultations by appropriate team members and resulting recommendations were collected prospectively. Patients who received RT were contacted by telephone 4 weeks later to assess symptom outcomes. A total of 106 clinic visits by 82 individual patients occurred. As determined by screening form responses, the clinical Pharmacist, Occupational Therapist, Registered Dietician and Social Worker were consulted to provide assessments and recommendations within the time constraints presented by 1-day palliative RT delivery. In addition to pain relief, significant improvements in tiredness, depression, anxiety, drowsiness and overall well-being were reported at 4 weeks. Systematic screening of this population revealed previously unmet needs, addressed in the form of custom verbal and written recommendations. Multidisciplinary assessment is associated with a high number of recommendations and decreased symptom distress. Our findings lend strong support to the routine assessment by multiple supportive care professionals for patients with advanced cancer being considered for palliative RT.

Low back pain and sciatica is a common clinical condition. It is a most common orthopaedic complaint in the Kaski region of Nepal. The reason for its increased incidence may be hilly terrain, difficult working and living environment of the region. The initial treatment of Low back pain is conservative. Epidural steroid injection is being slowly established as are liable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of on-going study of the use of epidural steroid in the management of low back pain cases coming to the orthopaedic department of Manipal Teaching Hospital. Prospective clinical trial was carried out on the patients reporting with low back pain and sciatica not responding to other modes of conservative treatment. Pre and post injection evaluation was done clinically. The level of pain, improvement in physical signs and ability to do activities of daily living were noted. Fifty two patients were observed for the aver...

We describe the treatment of two patients with peripheral vestibular dysfunction using a novel, staged exercise program. Response to treatment was documented. The first patient, a 62-year-old woman with unilateral vestibular dysfunction (UVD) and a 6-month history of disequilibrium following herpes zoster oticus resulting in damage to the right inner ear, was treated with an 8-week course of vestibular physical therapy. During the 8 weeks, the patient attended weekly physical therapy sessions and was trained to perform vestibular adaptation exercises on a daily basis at home. The second patient, a 53-year-old woman with progressive disequilibrium secondary to profound bilateral vestibular hypofunction (BVH), was treated with a 16-week course of vestibular physical therapy. During the first 8 weeks, the patient attended weekly physical therapy sessions and was trained to perform vestibular adaptation and substitution exercises on a daily basis at home. During the second 8 weeks, the ...

Inhibidores de la colinesterasa y memantina en la ... Chara Kani1, Katerina Papanikolaou2, Artemios Pehlivanidis3, Stefanos Bonovas1 y Zeta Papadopoulou-Daifoti1 1Departamento de Farmacología. Facultad de Medicina. Universidad de Atenas. Grecia. 2Departamento de ...

The physical properties of water provide a unique environment for facilitating movement, particularly if the constraints imposed by gravity preclude carrying out the activities of daily living within reasonable limits of convenience. Consequently, aquatic exercises have been used extensively as a rehabilitative and recreational medium for persons with permanent physical disabilities. Although programs have been designed specifically for swimmers with

Difficulty in transferring, the ability to rise in and out of a bed and chair, is a common problem in older adults, particularly those residing in skilled nursing facilities. Focusing on one aspect of transferring, rising from supine to sitting position, we devised a set of bed mobility tasks to test key arm, leg, and trunk movements that likely contribute to successful rising from bed. Healthy young controls (YC, n=22, mean age 23), and older adults (aged 60 and over) either residing independently in congregate housing (CH, n=29, mean age 84) or undergoing rehabilitation in a skilled nursing facility (SNF, mean age 77) were assessed in the time to rise from supine to sitting and in the ability or inability to perform 16 other bed mobility tasks. Trunk function-related tasks, specifically those requiring trunk elevation and trunk balance, were most difficult for the SNF, followed by CH, and then YC. Tasks focusing on trunk flexion strength (sit up arms crossed, bilateral heel raise)...

This paper describes how we recognize activities of daily living (ADLs) with our designed sensor device, which is equipped with heterogeneous sensors such as a camera, a microphone, and an accelerometer and attached to a user’s wrist. Specifically, capturing a space around the user’s hand by employing the camera on the wrist mounted device enables us to recognize ADLs that involve the manual use of objects such as making tea or coffee and watering plant. Existing wearable sensor devices equipped only with a microphone and an accelerometer cannot recognize these ADLs without object embedded sensors. We also propose an ADL recognition method that takes privacy issues into account because the camera and microphone can capture aspects of a user’s private life. We confirmed experimentally that the incorporation of a camera could significantly improve the accuracy of ADL recognition.

From a University of California—Los Angeles, School of Nursing, b Cedars-Sinai Medical Center, and c University of California—Los Angeles, Schools of Public Health and Medicine. ... Objective: The purpose of this study was to evaluate gender differences in quality of life ...