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Abstract Background The World Health Organization Disability Assessment Schedule 2.0 12-item survey (WHODAS-12) is a questionnaire developed by the WHO to measure functioning across health conditions, cultures, and settings. WHODAS-12 consists of a subset of the 36 items of WHODAS-2.0 36-item questionnaire. Little is known about the minimal important difference (MID) of WHODAS-12 in persons with chronic low back pain (LBP), which would be useful to determine whether rehabilitation improves functioning to an extent that is meaningful for people experiencing the condition. Our objective was to estimate an anchor-based MID for WHODAS-12 questionnaire in persons with chronic LBP. Methods We analyzed data from two cohort studies (identified in our previous systematic review) conducted in Europe that measured functioning using the WHODAS-36 in adults with chronic LBP. Eligible participants were adults with chronic LBP with scores on another measure as an anchor to indicate participants with small but important changes in functioning over time [Short-form-36 Physical Functioning (SF36-PF) or Oswestry Disability Index (ODI)] at baseline and follow-up (study 1: 3-months post-treatment; study 2: 1-month post-discharge from hospital). WHODAS-12 scores were constructed as sums of the 12 items (scored 0–4), with possible scores ranging from 0 to 48. We calculated the mean WHODAS-12 score in participants who achieved a small but meaningful improvement on SF36-PF or ODI at follow-up. A meaningful improvement was an MID of 4–16 on ODI or 5–16 on SF36-PF. Results Of 70 eligible participants in study 1 (mean age = 54.1 years, SD = 14.7; 69% female), 18 achieved a small meaningful improvement based on SF-36 PF. Corresponding mean WHODAS-12 change score was − 3.22/48 (95% CI -4.79 to -1.64). Of 89 eligible participants in study 2 (mean age = 65.5 years, SD = 11.5; 61% female), 50 achieved a small meaningful improvement based on ODI. Corresponding mean WHODAS-12 change score was − 5.99/48 (95% CI − 7.20 to -4.79). Conclusions Using an anchor-based approach, the MID of WHODAS-12 is estimated at -3.22 (95% CI -4.79 to -1.64) or -5.99 (95% CI − 7.20 to -4.79) in adults with chronic LBP. These MID values inform the utility of WHODAS-12 in measuring functioning to determine whether rehabilitation or other health services achieve a minimal difference that is meaningful to patients with chronic LBP.

Abstract Background Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, intestinal disorders, mood swings, and sleep disturbances. To the best of our knowledge, the questionnaire used for assessing problems and difficulties in the functioning of people with FM has not been translated and adapted in Poland so far. The aim of the study was to assess the psychometric properties of the Polish version of the Fibromyalgia Impact Questionnaire (FIQ-Pol). Material and method The study covered 150 people with FM living in Poland. The measurement reliability, internal structure, repeatability, and validity of the Polish version of the FIQ were examined. Results The scale score reliability of the entire tool for the research group was very good. The alpha Cronbach's test result for the whole scale was 0.84. The repeatability of the scale measured by the test–retest method using the interclass correlation coefficients (ICC) was very good and amounted to 0.96. Internal structure suggested by FIQ-Pol authors was confirmed (Confirmatory factor analysis). After introducing modification indices for the entire scale, satisfactory parameter values were obtained, i.e.: RMSEA (0.06), CFI (0.97) and TLI (0.96). Theoretical validity was assessed by correlating the results of the Polish version of the FIQ with the results of the Beck's Depression Inventory (BDI). Both the FIQ-Pol total score and its domains showed strong positive correlations with BDI. Conclusion The Polish FIQ is a reliable and valid tool to measure the functional disability and health status of Polish people with FM.

Abstract Rehabilitation is considered a key health strategy in the 21st century. The aim of rehabilitation is to optimize the functioning of patients. The International Classification of Functioning, Disability and Health (ICF) is a framework for describing and organizing information on functioning and disability. Current international efforts to implement ICF in rehabilitation practise include the implementation of ICF Core Sets and operationalize ICF tools for clinics. The aim of the study is to create simple, intuitive descriptions and an initial reference guide for the assessment of the ICF Rehabilitation Set in Polish practice. The development of the Polish version of ICF Rehabilitation Set involved the following steps: (1) identification of ICF Rehabilitation Set categories; (2) development simple, intuitive descriptions; (3) the drafting of the rating reference guide by a multidisciplinary panel following the process employed to develop the Japanese version. The Polish version of ICF Rehabilitation Set, the simple, intuitive descriptions for 29 categories and the rating reference guides were successfully developed. The Polish version of ICF Rehabilitation Set proposed by us is a reference framework for the harmonization of existing information on the functioning and disability of people participating in the rehabilitation process.

Abstract Background The assessment of disability in a population is an important part of public health management. In this article, we examine the psychometric properties and validation of the Polish version of the 12-item World Health Organization Disability Assessment Schedule 2.0. (12-item WHODAS 2.0). Methods A systematic random sample comprised 584 adult urban residents. The Polish version of the 12-item WHODAS 2.0 and the World Health Organization Quality of Life-BREF, Short Form (WHOQOL-BREF) questionnaire were used to assess disability and quality of life, respectively. Basic sociodemographic data and selected health-related data (e.g., pain and depressive moods) were also collected. Results Good scale score reliability for the entire tool was confirmed in the study population (Cronbach’s α = 0.90; Composite reliability = 0.95). In confirmatory factor analysis (CFA), satisfactory values of the fit indices were obtained (comparative fit index, CFI = 0.999; Tucker-Lewis Index, TLI = 0.999; root mean square error of approximation, RMSEA = 0.004; standardized root mean square residual, SRMR = 0.043, p = 0.454). Good consistency was noted over time (correlation coefficient = 0.88). The tool was found to have an appropriate level of validity. Conclusions We found that the 12-item WHODAS is short and easy to use, and it is suitable for use in the form of an interview during screening tests. This tool is appropriate for measuring the health status, functioning, and disability of an average population. It may be more relevant for studying populations with health problems. The 12-item WHODAS can be used to successfully obtain information about the general level of disability in a population.

Abstract Background The interest in physiotherapy programs for individuals in hospice is increasing. The aim of our study was to assess the impact of a multi-component, individualized physiotherapy program on the functional and emotional conditions and quality of life of patients receiving hospice services in the home. Methods The study included 60 patients (mean 66.3 years) receiving hospice services in the home. A model of a physiotherapy program was designed, including breathing, strengthening, transfer, gait, balance, functional, and ergonomic exercises, as well as an adaptation of the patient’s living environment to functional needs. The tests were performed before and after the intervention. The study used the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales, the World Health Organization Quality of Life - Bref (WHOQOL-BREF), the Visual Analogue Scale (VAS) pain scale, the Tinetti POMA Scale, and the Geriatric Depression Scale (GDS). To enable comparison of our results worldwide, a set of International Classification of Functioning, Disability and Health (ICF) categories was used. Results The average functional level of the ADL (mean 2.9) and the IADL (mean 11.9), as well as the WHOQOL-BREF (mean 46.4) of the patients before the intervention were low, whereas the intensity of pain (VAS mean 5.8), the risk of falling (Tinetti mean 8.2), and depression (GDS mean 16.7) were recorded as high. After the completion of the intervention program, a significant improvement was found in the ADL (mean 4.0), IADL (mean 13.9), WHOQOL-BREF (mean 52.6), VAS (mean 5.1), risk of falling (Tinetti mean 12.3), and GDS (mean 15.7) scores. Conclusions The physiotherapeutic intervention had a significant impact on improving the performance of ADL, as well as the emotional state and quality of life of patients receiving hospice services in the home. The results of our research provide evidence of the growing need for physiotherapy in individuals in hospice and for comprehensive assessment by means of ICF. Registered 02.12.2009 in the Research Registry ( https://www.researchregistry.com/why-register ) under the number research registry 5264.

Introduction and objective Cognitive functioning disorders are a common problem associated with the aging process. One of the non-pharmacological therapeutic methods used in attempts at improvement the cognitive functioning of the elderly is neurofeedback. The aim of the work was to conduct a review of the latest research on the effectiveness of the use of the neurofeedback method in cognitive training of older people. Brief description of the state of knowledge Based on a review of literature from 2013–2018 concerning the use of the neurofeedback method in the cognitive training of the elderly, 7 items qualified for the analysis. In the majority of them, the training included persons without diagnosed cognitive impairment. Positive influence on cognitive functions was dependent on the training protocol used; however, the most frequent changes were observed in the range of particular memory functions. In most studies, it was shown that the use of the neurofeedback method in cognitive training is associated with changes in the EEG record of older people. Conclusions The results of the conducted analysis indicate a potential of the neurofeedback method in the therapy of cognitive functions of the elderly. It was found that better therapeutic effects were achieved in patients whose cognitive state enabled fully active participation in the training. However, large discrepancies in the training protocols used, and the small number of publications meeting the inclusion criteria, suggest the need for further research, in particular regarding the observation of the long-term effects of the training procedures used.

Abstract Background The extension of the life span has led to an increase in the number of older people and an increase in the prevalence of disability in people over 60 years of age. The aim of this study was to assess the prevalence of ADL and IADL disability and to analyze its determinants among people aged 60 and older living in southeastern Poland. Methods This cross-sectional study was carried out among a randomly selected, representative population of people aged 60 and older living in southeastern Poland. Disability was assessed using the Katz Index of Independence in Basic Activities of Daily Living and Instrumental Activities of Daily Living. Logistic regression models were used to identify the factors related to ADLs and IADLs. For the variables that were included in the above models, their clustered influence on the increase in the odds ratio for the occurrence of an ADL or IADL limitation was also examined. Results The research results show that 35.75% of the participants reported at least one problem with IADLs. At least one problem with ADLs was reported by 17.13% of the participants. The most significant modifiable factors influencing the occurrence of disability were the presence of barriers in the participant’s environment, poor relations with relatives, a lack of social contacts, multimorbidity and pain. A multiple increase in the odds ratio of disability was found with the presence of pairs of analyzed factors. The highest odds ratio of at least one ADL limitation was observed for the combination of barriers in the participant’s environment with multimorbidity (OR 74.07). With regard to IADL disability, the highest odds ratio was observed for the combination of pain on the VAS scale ≥3 points with older age (OR 19.47). Conclusions The study showed a high prevalence of ADL and IADL disability in older people living in southeastern Poland. It also indicated the extent to which modifiable factors influenced the occurrence of disability and the extent to which the risk of disability increased with the presence of pairs of factors, especially those that included environmental barriers in the participant’s environment.

Background The increasing number of people receiving benefits due to incapacity for work is a heavy burden for the state budget. In order to reduce the scale of this phenomenon, the Social Insurance Institution (ZUS) carries out a rehabilitation program as part of disability pension prevention. Material and Methods The study was based on the analysis of medical documentation of 607 patients rehabilitated at the Saint Queen Jadwiga’s Regional Clinical Hospital No. 2 in Rzeszow, as part of the ZUS prevention of disability pension program in 2011−2013. Medical documentation included the medical history and results of the Functional Test recommended by ZUS. Two years after the completion of rehabilitation, a telephone check was conducted among 118 rehabilitated patients to assess their occupational status. Results The analysis of the Functional Test documentation showed that in all groups of wykorzystująpatients included in the rehabilitation program, as well as those among whom the control was carried out, the majority were people with post-exercise pain, full physical fitness, slight mobility limitation, full efficiency in everyday activities, correct strength of muscles and moving abilities, as well as normal psychosocial efficiency. The vast majority of them received a recommendation regarding work in a properly-adjusted position. It was shown that in the 2-year observation period, the percentage of professionally active people increased from 56% to 61.02%. Conclusions The most important factors determining the return to work include psychosocial efficiency and the level of pain. Med Pr. 2019;70(4):459–73

Background In Poland average life expectancy extends, while the number of the elderly who are active in the labor market decreases. Material and Methods The study population consisted of 429 people aged 50–70 years old living in the community of south-eastern Poland. The respondents were divided into 2 study groups: group I – late middle age (50–60 years old) and group II – early old age (61–70 years old). With the use of questionnaires they were given, we obtained their socio-demographic data, assessed their cognitive and emotional state, as their physical activity levels. We used the Tinetti test to assess their gait and balance. Results We did not find statistically significant difference in cognitive functioning between the studied groups (p = 0.109). Moreover, there was no significant relationship between belonging to an age group and suffering from depression (p = 0.06) as well as no major differences were observed in the general level of physical activity in relation to age (p = 0.112). Our study found that most of our subjects, regardless of gender, declared their willingness to continue professional work after reaching retirement age. Conclusions The results of own research did not show significant differences in psychophysical state between people in late middle age and at the beginning of old age. Most of the researched participants declared their willingness to continue professional work. Due to changing demographic conditions, it is becoming an important issue to maintain the highest possible level of professional activity of older people in the labor market in Poland. Med Pr 2018;69(4):375–381

Introduction There is a growing number of older people in Poland. This phenomenon results in the need to assess their problems related with functioning in everyday life. This is the first study conducted in Polish society which evaluates the prevalence of disability and limitations in functioning by means of WHODAS 2.0 questionnaire. Objective Evaluation of the health, functioning and disability of people aged 60–70 years living in south-eastern Poland. Material and Methods The researched material was a randomly- selected sample of 1,000 inhabitants of south-eastern Poland. The study was conducted by use of direct interviews applying the WHODAS 2.0. For the purpose of statistical analysis, measures of descriptive statistics and non-parametric tests of significance were used. Results Limitations in functioning were reported by 67.00% of participants aged 60–70 years, including 46.20% with a mild disability, 14.50% – moderate, 6.30% – significant and extremely large disability. The highest level of disability occurred in areas related to participation in social life (mean = 20.77), performing activities of daily living (mean = 17.42) and mobility (mean = 17.23). A significantly higher level of disability (p

Abstract Background In recent years, there has been a significant change in the demographics of developed countries, including an increase in the number of older people. This aging population and the associated need for medical care and assistance places great strain on health care systems worldwide. In older populations, improved knowledge and understanding of the relationship between moderate exercise and health might result in greater motivation to engage in such activity; thus improving the overall health of this population. The aim of the proposed project is to assess the degree of improvement in functional performance through physical training with verbal stimulation, as well as the possibility of changing habitual ways of spending free time, in older people under institutional care. Methods Study participants aged 65–85 years, who are living a sedentary lifestyle in care homes in Southeast Poland, will be invited to participate in this randomized controlled trial. Those who meet the eligibility criteria and are enrolled in the study will be assigned at random to one of four parallel groups: (1) basic exercises combined with verbal stimulation, (2) basic exercises without verbal stimulation, (3) functional exercise training with verbal stimulation, and (4) functional exercise training without verbal stimulation. Participants will engage in 30-min workouts, twice per week, for 12 weeks. Tests will be done: (1) before exercises, (2) after 12 weeks of exercises, (3) 12 weeks after the end of the exercises, and (4) 24 weeks after the exercises. Primary outcome measures will include the Short Physical Performance Battery (SPPB). Secondary outcomes will include the Physical Activity Scale for the Elderly (PASE), the Timed Up and Go (TUG) test, the 10-Meter Walk test (10MWT), the Back Scratch (BS) test, the Chair Sit and Reach (CSR) test, the Grip Strength (GS), and the Berg Balance Scale (BBS). Other outcomes will include results regarding postural stability from the stabilometric platform and quality of life (SF-36). Discussion Our study will help to determine the effectiveness of the training programs, particularly in relation to participants’ motivation to exercise. Trial registration The Sri Lanka Clinical Trials Registry, ID: SLCTR/2016/004 . Registered on 12 February 2016.

Introduction Since the beginning of the 20th century, the aging of the European population has been observed, and the potential long-term social and economic problems have been flagged. Objective The aim of the study was assessment of the level of disability and multidimensional analysis of determining factors among the elderly living in rural areas. Material and Methods The study was conducted in a population of 973 people aged 60–80 living in south-eastern Poland. The research tool used in the study was the WHO Disability Assessment Schedule – WHODAS 2.0. Results As many as 28.26% of the study group had at least a moderate level of disability; severe disability was observed in 11.51 % of the participants, and extreme disability was experienced by 0.21%. The highest average level of disability in the study group was found in performing activities of daily living (mean = 28.94; SD = 30.04), participation in everyday life (mean = 28.40; SD = 23.29) and mobility (mean = 26.04; SD = 27.57). Statistically significant relationships were observed between age, gender, education level, physical activity and number of chronic diseases. Conclusions An increase in the level of education and popularization of physical activity may be helpful in reducing the prevalence of disability among the elderly inhabitants of rural areas. Increasing access to health care, aimed at rapid diagnosis of chronic diseases, treatment and rehabilitation, seems to be a reasonable action preventing the disability in rural areas.

Multiple sclerosis (MS) is one of the most common causes of neurological progressive disease and can lead to loss of mobility, walk impairment, and balance disturbance. Among several rehabilitative approaches proposed, exergaming and virtual reality (VR) have been studied in the recent years. Active video game therapy could reduce the boredom of the rehabilitation process, increasing patient motivation, providing direct feedback, and enabling dual-task training. Aim of this systematic review was to assess the efficacy of exergaming and VR for balance recovery in patients with MS. PubMed, Scopus, and Web of Science were systematically searched from the inception until May 14, 2021 to identify randomized controlled trials (RCTs) presenting: patients with MS as participants, exergaming and VR as intervention, conventional rehabilitation as comparator, and balance assessment [Berg Balance Scale (BBS)] as outcome measure. We also performed a meta-analysis of the mean difference in the BBS via the random-effects method. Out of 93 records, this systematic review included and analyzed 7 RCTs, involving a total of 209 patients affected by MS, of which 97 patients performed exergaming or VR and 112 patients underwent conventional rehabilitation. The meta-analysis reported a significant overall ES of 4.25 (p < 0.0001), showing in the subgroup analysis a non-significant ES of 1.85 (p = 0.39) for the VR and a significant ES of 4.49 (p < 0.0001) for the exergames in terms of the BBS improvement. Taken together, these findings suggested that balance rehabilitation using exergames appears to be more effective than conventional rehabilitation in patients affected by MS.

Abstract Introduction The study aimed to assess the emotional state, the occurrence of symptoms of depression, anxiety, and stress, as well as the quality of life of adults living in Poland during the first weeks of the COVID-19 pandemic. Method The study was conducted on a group of 700 people aged 18 and over living in Poland. An anonymous online questionnaire was used in this cross-sectional study. The psychological impact of COVID-19 was measured using the Revised Event Impact Scale (IES-R) and the Depression, Anxiety, and Stress Scale (DASS - 21). The quality of life was assessed using the WHOQOL-BREF. Results In Poland, a high average level of post-traumatic stress was found as a result of the COVID-19 pandemic, with at least the minimum level occurring in all surveyed people. There was also a high incidence of depression (48.00%), anxiety (39.29%), and stress (54.86) in the first phase of the pandemic. The average level of quality of life in Poland was the lowest for the physical domain and amounted to 49.56 (SD = 11.71). The standard of living in the psychological domain was 60.26 (SD = 13.14). Conclusions The pandemic is having a significant impact on human mental health. The very high average levels of post-traumatic stress, stress, anxiety, and depression as well as low quality of life make it necessary to consider interventions that will favor the use of more adaptive defense mechanisms and build mental resilience during an infectious disease pandemic and its long-term consequences.

Abstract Handgrip strength (HGS) is used as a biomarker for the state of health of older people, but the number of research publications containing the normative values of HGS in older adult populations is limited. The aim of the study was to define reference values and factors associated with HGS in older adults living in southeastern Poland. A cross-sectional study including 405 participants aged 65 and older was conducted. Handgrip strength for the dominant hand was assessed by the average of three trials using a JAMAR dynamometer. The sample was categorized into the following age groups: 65–69 years, 70–74 years, 75–79 years, 80–84 years, 85 and over. The average HGS was 19.98 kg (16.91 kg for women and 26.19 kg for men). There was a decrease in handgrip strength across the age range in both sexes. The average handgrip strength of the older people was 17.97 kg (14.47 kg for women and 25.66 kg for men) for those aged 80–85 and 16.68 kg (13.51 kg for women and 21.77 kg for men) in the group over 85 years old. In both sexes, marital status was an independent factor associated with reduced handgrip strength. In conclusion, this study described, for the first time, handgrip strength values for the southeastern Polish population aged ≥ 65 years according to age and gender.

Objectives The aim of this work was to assess the work ability, health status, disability and quality of life of working people of pre-retirement and retirement age, as well as to analyze factors affecting the ability to perform work in older age. Material and Methods A cross-sectional pilot study was conducted in the Podkarpackie and Świętokrzyskie voivodeships, Poland, in randomly selected workplaces of intellectual nature. It was carried out by means of direct interviews in the workplace of the surveyed people, using the Work Ability Index , a questionnaire based on the WHO Disability Assessment Schedule 2.0 , the WHO Quality of Life-BREF questionnaire , the Geriatric Depression Scale , and the Visual Analogue Scale (VAS). The criteria for inclusion were: age 55–75 years and informed consent to participate in the study. Overall, 201 complete questionnaires were included in the analysis. Demographic data is presented using descriptive statistics measurements. The logistic regression model was used to identify factors related to work ability. Results The vast majority (69.66%) of employees performing intellectual work had moderate or poor work ability. The average level of general disability in the studied group was mild (20.65), and the quality of life was quite good (64.73). A significant problem among the surveyed people was a quite high average level of pain (VAS = 3.99), the occurrence of depression (73.63%), as well as musculoskeletal (64.18%) and cardiovascular diseases (52.24%). The most important factor contributing to a better work ability was the adaptation of the workplace to functional and healthrelated needs (OR = 7.79). Psychological well-being (OR = 1.12), cognitive performance (OR = 0.97) and a smaller number of chronic diseases (OR = 0.58) were also important factors. Conclusions Preparation of elderly people for professional activity should be conducted in 2 different ways, i.e., by means of education and implementation of an active, healthy lifestyle, and increasing control over one’s own health and factors determining it, as well as by the proper organization of working space, and quick access to treatment and rehabilitation, especially in the case of musculoskeletal and cardiovascular diseases. Int J Occup Med Environ Health. 2021;34(1):69–85