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OBJECTIVES To compare a modern ring fixator [Taylor Spatial Frame (TSF)] and reamed intramedullary nailing (IMN) for the treatment of closed tibial shaft fractures. DESIGN Randomized controlled trial. SETTING Two university hospitals. PATIENTS Patients between 18 and 70 years of age surgically treated for an acute tibial shaft fracture. INTERVENTION TSF (n = 31) versus a reamed intramedullary nail (n = 32). The patients were followed up for 2 years. MAIN OUTCOME MEASUREMENTS The physical component summary of Short Form 36 (SF-36) at 2 years was the primary outcome measure. Secondary outcomes included the other components of the SF-36, pain assessed by a visual analogue scale (VAS), complications, and resource consumption. RESULTS The mean age was 43 years (SD 14.0), and 42 (67%) were men. The physical component summary at 2 years was 52.4 (SD 6.3) in the TSF group and 53.3 (SD 8.0) in the IMN group (P = 0.35). There were modest differences in the other SF-36 scores during the follow-up period. Up to and including 12 months, the TSF group had less knee pain [at 12 months: VAS 0.5 (SD 1.2) vs. VAS 2.4 (SD 2.2; P < 0.001)], but this was not statistically significant at 24 months [VAS 0.7 (SD 1.4) vs. VAS 1.5 (SD 2.0; P = 0.11)]. Superficial skin infections were more frequent in the TSF group [22 (71%) vs. 4 (13%); P < 0.001]. The number of other complications was similar between the groups. CONCLUSIONS Both TSF and IMN provided good clinical results. TSF had more pin-track infections but less knee pain the first year. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Purpose Surgical management of ankle fractures has been extensively studied in literature but studies investigating validated clinical results are lacking and controversial. The purpose of this study was to evaluate functional and health-related quality of life (HRQL) outcomes after surgically treated ankle fractures and to detect some of their predictors. Methods Two hundred sixty-six skeletally mature patients who underwent surgery for an isolated ankle fracture from 2006 to 2017 were retrospectively identified from our hospital records and included in the study. All patients were evaluated at one, three, six and 12 months post-injury with clinical and radiographic examination. Outcome measures recorded at final two years minimum follow-up included patient-reported pain, patient satisfaction, functional (American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score) and quality of life (Short Form (SF) 36 score) status. Results Patient satisfaction score was 8.4 out of 10, Visual Analogue Scale mean score was 2.3, complication rate was 36.5% and mean AOFAS ankle-hindfoot score was 87.3. Mean SF36-physical summary score was 77.9 and SF36-mental summary score was 81.1. The injury demonstrated a significant effect on physical function, role-physical, bodily pain and social functioning SF-36 subdomains. Functional outcome was significantly related to occupation, syndesmotic lesion, number of fractured malleoli and delay to surgery. Main predictors of quality of life were age, occupation, cause of injury, syndesmotic lesion, number of fractured malleoli and waiting time to surgery. Conclusions Ankle fractures have a considerable impact on functional and quality of life status of patients. Occupation, presence of syndesmotic injury, Pott's classification and surgery delay must be considered as predictors of final outcome.

Background and Aim: Although forced expiratory volume in 1 second(FEV1) and FEV1 / forced vital capacity(FVC) ratio are objective parameters in treatment follow-up, many studies proved that these parameters have a limited ability to predict clinical outcomes. Therefore, small airways dysfunction, which is determined by maximal mid‐expiratory flow (MMEF), has recently come into prominence in the literature. The aim of this study was to compare dyspnea perception, the severity of fatigue, exercise capacity and HRQoL between COPD patients with high small airways dysfunction and relatively better. Methods: The study consisted of 96 patients with moderate COPD. Pulmonary Function Tests, the six-minute walk test distance (6MWD), the modified Medical Research Council Dyspnea Scale (mMRC), International Physical Activity Questionnaire -short form (IPAQ-SF), Fatigue Severity Scale (FSS), St. George’s Respiratory Questionnaire (SGRQ) and Short Form 36 (SF-36) questionnaire were evaluated in all patients. After calculating the average of MMEF % of patients, they were divided into two groups: Below the average (Group 1, n=54) and above the average (Group 2, n=42). Results: BMI, cigarette consumption, FEV1 %, FVC %, and FEV1 / FVC ratio not statistically different between the groups (p>0.05 for all). FSS and mMRC scores were significantly higher in Group 1, however, 6MWD and IPAQ-SF scores were significantly lower in Group 1 (p Conclusion: COPD patients with high small airways dysfunction have a higher perception of dyspnea and fatigue, as well as poor exercise capacity and HRQoL.

To assess changes in the quality of life in adult patients undergoing percutaneous device closure of atrial septal defect (ASD).We used a standard Medical Outcome Study Short Form 36 (SF-36) that includes psychological and physiological aspects to assess and analyze the quality of life of 73 adult patients who underwent percutaneous device closure of ASD.Of the 73 patients who were investigated in this study, 67 completed questionnaires successfully. The following findings were revealed after analyzing the preoperative results and postoperative results. In some dimensions ( "physical functioning," "vitality," "general health" ), the postoperative perception was better than the preoperative status. Some differences were found in the quality of life feedback between the case group and the control group. Among the different subgroups, older patients scored lower than younger patients on most dimensions, and men seemed to perform better on "role-physical" factors than women. Unmarried people performed worse on "role-physical" and "bodily pain" than married people. Among people with different academic degrees, those with higher degrees demonstrated better scores on multiple dimensions ( "role-physical," "mental health," "social functioning," and "general health" ) than those with lower degrees.After percutaneous device closure of ASD, most adult patients feel that the quality of life is improved compared with that during the preoperative status. With the change of patients' own conditions, their quality of life seems to change differently. In order to better help patients integrate into life, psychological and physical support is still needed.

Summary Background The OVAMA (Outcome Measures for Vascular Malformations) project determined quality of life (QoL) as a core outcome domain for patients with vascular malformations. In order to measure how current therapeutic strategies alter QoL in these patients, a patient‐reported outcome measurement (PROM) responsive to changes in QoL is required. Objectives To assess the responsiveness of two widely used generic QoL PROMs, the Medical Outcomes Study Short Form 36 (SF‐36) and Skindex‐29, in adult patients with vascular malformations. Methods In an international multicentre prospective study, treated and untreated patients completed the SF‐36 and Skindex‐29 at baseline and after a follow‐up period of 6–8 weeks. Global rating of change (GRC) scales assessing various QoL‐related outcome domains were additionally completed. Per subscale, responsiveness was assessed using two methods: by testing hypotheses on expected correlation strength between change scores of the questionnaires and the GRC scales, and by calculating the area under the receiver operating characteristics curve (AUC). The questionnaires were considered responsive if ≥ 75% of the hypotheses were confirmed or if the AUC was ≥ 0·7. Results Eighty‐nine participants were recruited in three centres in the Netherlands and the U.S.A., of whom 67 completed all baseline and follow‐up questionnaires. For all subscales of the SF‐36 and Skindex‐29, < 75% of the hypotheses were confirmed and the AUC was < 0·7. Conclusions Our findings suggest that the SF‐36 and Skindex‐29 seemed unresponsive to change in QoL. This suggests that alternative PROMs are needed to measure – and ultimately improve – QoL in patients with vascular malformations. What's already known about this topic? Quality of life is often impaired in patients with vascular malformations.Quality of life is considered a core outcome domain for evaluating treatment of vascular malformations.To measure the effect of treatment on quality of life, a patient‐reported outcome measure is required that is responsive to changes in quality of life. What does this study add? This is the first study assessing the responsiveness of quality‐of‐life measures in patients with vascular malformations.The results seem to indicate that the Medical Outcomes Study Short Form 36 (SF‐36) and Skindex‐29 are not responsive to changes in quality of life in patients with vascular malformations. What are the clinical implications of this work? Medical Outcomes Study Short Form 36 (SF‐36) and Skindex‐29 are not ideal to assess the effect on quality of life over time, of treatment strategies for peripheral vascular malformations., Plain language summary available online Respond to this article

Objectives: This study compares the responsiveness, or the ability to detect clinical change in a disease, between the generic Short Form-36 (SF-36) and musculoskeletal specific Short Musculoskeletal Functional Assessment (SMFA) patient-reported outcome measures (PROMs) in the orthopaedic trauma population. Stratified analysis was performed to compare whether responsiveness differs between patients with single or multiple orthopaedic injuries. Design: Prospective case series. Setting: Level 1 Trauma Center. Patients: A total of 659 patients with orthopaedic trauma injuries to the pelvis, acetabulum, or tibia were included for analysis. There were 485 patients with a single isolated injury and 174 patients with multiple orthopaedic injuries. Intervention: None. Main Outcome Measurements: Responsiveness was calculated through the standard response mean (SRM), the proportion meeting a minimal clinically important difference, and floor and ceiling effects. Results: Between baseline and 6 months the magnitude of the SRM for SF-36 was consistently greater than that of SMFA in patients with single (P

In our country, outcome measures are needed to evaluate the results of occupational therapy in amputees. This study aimed to cross-culturally adapt the Reintegration to Normal Living Index (RNLI) and to evaluate the reliability and validity of a Turkish version of the RNLI. The Turkish version of the RNLI was applied to 120 amputees. Cronbach’s alpha coefficient and the intraclass correlation coefficient (ICC) were used to determine internal consistency and test–retest reliability, respectively. Criterion validity was assessed using Short Form 36 (SF-36). The Turkish version of the RNLI presented reliable results in repeated assessments (ICC = .88), and the internal consistency of the RNLI was high (Cronbach’s α coefficient = .89). A statistically significant relationship was found between RNLI and SF-36 ( p < .05). The Turkish RNLI is a reliable and valid tool to evaluate the level of reintegration to normal living for amputees.

WOS: 000511872800013, PubMed: 31773391, Psoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-based case report forms: demographic, clinical and radiographic data; physical examination findings, including tender and swollen joint counts (TJC and SJC); nail and skin involvement; Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS 28-ESR); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); Psoriasis Area Severity Index (PASI); Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s); Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Health Assessment Questionnaire for the spondyloarthropathies (HAQ-s); Psoriatic arthritis quality of Life scale (PsAQoL); Short Form 36 (SF-36); Hospital Anxiety Depression Scale (HADS); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Fibromyalgia Rapid Screening Tool (FiRST) scores. The patients were divided into two groups, namely with and without enthesitis, based on the triple Likert-type physician-reported statement of 'active enthesitis', 'history of enthesitis' or 'none' in the case report forms. Patients with active enthesitis were compared to others in terms of these clinical parameters. A total of 1130 patients were enrolled in this observational study. Of these patients, 251 (22.2%) had active enthesitis according to the clinical assessment. TJC, HAQ-s, BASDAI, FiRST and PsAQoL were significantly higher whereas the SF-36 scores were lower in patients with enthesitis (p < 0.05). Chronic back pain, dactylitis, and tenosynovitis were more frequent in the enthesopathy group (59.4%/39%, 13.1%/6.5% and 24.7%/3.4%, respectively). Significant positive correlations between the MASES score and the TJC, HAQ, DAS 28-ESR, BASDAI, FiRST and PsAQoL scores, and a negative correlation with the SF-36 score were found. When linear regression analysis was performed, the SF-36 MCS and PCS scores decreased by - 9.740 and - 11.795 units, and the FiRST scores increased by 1.223 units in patients with enthesitis. Enthesitis is an important involvement of PsA with significant relations to quality of life determined with PsAQoL and SF-36 scores. Our study found higher frequency of dactylitis and chronic back pain, and worse quality of life determined with SF-36 and PsAQoL scores in patients with enthesitis.

Introduction: Analysis of quality of life (QOL) outcomes is an important aspect of lymphedema treatment since this disease can substantially impact QOL in affected individuals. There are a growing number of studies reporting patient-reported outcomes (PROMs) for patients with lymphedema. The purpose of this study was to conduct a systematic review of outcomes and utilization of PROMs following surgical treatment of lymphedema. Methods: A literature search of four databases was performed up to and including March, 2019. Studies included reported on QOL outcomes after physiologic procedures, defined as either lymphovenous bypass (LVB) or vascularized lymph node transplant (VLNT), to treat upper and/or lower extremity primary or secondary lymphedema. Results: In total, 850 studies were screened—of which, 32 studies were included in this review. Lymphovenous bypass was the surgical intervention in 16 studies, VLNT in 11 studies, and both in 5 studies. Of the 32 total studies, 16 used validated survey tools. The most commonly used PROM was the lymph quality of life measure for limb lymphedema (LYMQOL) (12 studies). In the remaining four studies, the upper limb lymphedema 27 scale (ULL27), the short form 36 questionnaire (SF-36), the lymphedema functioning, disability and health questionnaire (Lymph-ICF), and lymphedema life impact scale (LLIS) were each used once. QOL improvement following surgical treatment was noted in all studies. Conclusions: Physiologic surgical treatment of lymphedema results in improved QOL outcomes in most patients. The use of validated PROM tools is increasing but there is no current consensus on use. Future research to evaluate the psychometric properties of PROMs in lymphedema is needed to guide the development and use of lymphedema-specific tools.

Amac: Fibromiyalji sendromu (FMS) yaygin agri ile karakterize sik gorulen bir hastaliktir. Obezite de sik gorulen, adipoz dokuda asiri yag birikimi ile karakterize kompleks bir hastaliktir. Obez bireylerde normal kisilere gore daha fazla kas iskelet sistemi agrilari oldugu bilinmektedir. Biz de bu calismamizda obezite ile fibromyalji klinik ve laboratuar parametreleri arasindaki iliskiyi degerlendirmeyi amacladik. Gerec ve Yontemler: Calismaya 50 FMS hastasi ve 35 saglikli kontrol grubu alindi. FMS hastalari VKI’lerine gore obez (VKI≥30) ve non-obez (VKI

The Kidney Disease Quality of Life Short Form 36 (KDQOL-36) is a self-reported measure of health for patients with chronic kidney disease. Our goal was to develop an Arabic version of KDQOL-36 that is linguistically and conceptually equivalent to the original English version. We translated KDQOL-36 into formal Arabic language using forward and backward translation. To assess conceptual equivalence, we administered the Arabic and English versions simultaneously to a group of 10 bilingual patients. To assess test–re-test reliability, we administered the instrument twice to a group of 10 hemodialysis (HD) patients. To assess internal reliability, convergent validity, and discriminate validity, we administered the instrument to 62 HD patients and 82 kidney transplant patients asking them to simultaneously fill the Depression, Anxiety and Stress Scale (DASS-21). The intraclass correlation coefficient (ICC) between the Arabic and English versions indicated excellent conceptual equivalence. The ICC between test and re-test scores revealed good reliability in the burden of kidney disease subscale and excellent reliability in the remaining four subscales. The translated version of KDQOL-36 had a Cronbach’s alpha of 0.81, indicating good internal reliability. We found significant negative correlations between the five subscales of the instrument and DASS-21, indicating good convergent validity. Kidney transplant recipients had significantly better scores than HD patients in the five subscales of the instrument, indicating excellent discriminate validity. The current Arabic version of KDQOL-36 has excellent conceptual equivalence with the original English version. It is a reliable and valid instrument for Arab kidney disease patients.

INTRODUCTION: This study was investigate the impact of level of functional independence and ages on the quality of life of the mothers in children with Down Syndrome. MATERIALS and METHODS: Thirtyseven Down syndrome children (7.9±3.5 years) were included in this study. Functional independent level of children were evaluated by using Functional Independence Measure, mothers quality of life were evaluated by using Sort Form-36. Down syndrome children were classified according their Functional Independence Measure total score into two groups; need observation (36-90 scores) (n=19), and independent (91-126 scores) (n=18) groups. RESULTS: Functional Independence Measure total scores of children in need obsevation group and children in independent group were 73.7±15.4, 106.7±11.6, respectively. Sort Form -36 Physical, Sort Form -36 Mental and Sort Form -36 Total scores of children in need obsevation group were 53.1±25.1, 49.6 ± 14.9 and 102.7±37.4 and children in independent group scores were 68.3±21.6, 62.1±13,9 and 130.5±33.7, respectively. When we compared Sort Form -36 Mental and Sort Form -36 Total scores of the groups were significant in favor of independent group (p0,05). In addition, it was found no relationships between the quality of life of mothers and children age in the all groups (p>0,05). CONCLUSIONS: The results of our study suggested that functional dependence level of Down syndrome children effects on mothers’ quality of life and affected domain of quality of life was mental health. It was seen that the age of Down syndrome children did?t has effect on quality of life of mothers. © 2020, Galenos Yayincilik,. All rights reserved.

The last decades of research have consistently found strong associations between divorce and adverse health outcomes among adults. However, limitations of a majority of this research include (a) lack of “real-time” research, i.e., research employing data collected very shortly after juridical divorce where little or no separation periods have been effectuated, (b) research employing thoroughly validated and population-normed measures against which study results can be compared, and (c) research including a comprehensive array of previously researched sociodemographic- and divorce-related variables. The current cross-sectional study, including 1,856 recently divorced Danes, was designed to bridge these important gaps in the literature. Mental and physical health were measured using the Short Form 36 (SF-36)-2. Analyses included correlational analyses, t-test comparisons, and hierarchical multiple regression analyses. The study found that the health-related quality of life of Danish divorcees was significantly worse than the comparative background population immediately following divorce. Across gender, higher levels of divorce conflict were found to predict worse mental health, and worse physical health for women, even when controlling for other socio-demographic variables and divorce characteristics. Among men, lower age and higher income predicted better physical health, while more children, more previous divorces, participant divorce initiation, new partner status, and lower levels of divorce conflict predicted better mental health. Among women, higher income, fewer previous divorces, new partner status, and lower levels of divorce conflict predicted better physical health while higher income, participant divorce initiation, new partner status, and lower levels of divorce conflict predicted better mental health. The findings underscore the relevance of providing assistance to divorcees who experience higher levels of divorce conflict immediately following divorce, in seeking to reduce potential long-term negative health effects of divorce.

[Extract] Good Morning and Welcome. As you will see from today's presentations by our esteemed international panel of endocrine surgeons, an interest in surgeon job satisfaction and quality of life (QoL) has recently proliferated worldwide. The IAES has a diverse global membership, yet health-related QoL among endocrine surgeons had not been examined. Therefore, to set the stage for today’s symposium, in 2019 we conducted a multi-institutional, IRB-approved, anonymous English language survey of IAES members that aimed to examine how practice-related and geographic factors may contribute to QoL and musculoskeletal pain. The survey had two parts: the short form 36 (SF-36), which is a widely used and extensively validated health-related QoL assessment tool [1], and an original demographic and practice-related pain questionnaire for endocrine surgeons.

Objective This study aims to figure out the effects of dance therapy on patients with chronic venous insufficiency disease. Methods Forty subjects with chronic venous insufficiency were recruited to either the control group or the dance therapy group. As the severity of chronic venous insufficiency was defined with the Venous Clinical Severity Scores (VCSS), patients in control group received only medical treatment. Twenty patients with chronic venous insufficiency in dance therapy group received three times a week, for five weeks, totally 15 sessions of dance therapy in addition to medical treatment. Results There was no significant difference in pre- and post-treatment results of Rivermead Index, VCSS parameters constipation complaint, assistive breath muscle activity, lower limb circumference, strength and range of motion between groups (p > 0.05). The remarkable result of this study was obtaining that the post-treatment quality of life scale's bodily pain score was significantly higher in the dance therapy group than the control group (p < 0.05). Conclusions It was concluded that dance therapy has positive effects on quality of life. There were no barriers to chronic venous insufficiency patients in this form of gentle exercise, showing that it is to meliorate the cardiovascular, physical and psychological benefits of an activity that is enhancing of the self-esteem in addition to the quality of life. Treatment of chronic venous insufficiency should consist of methods that support the patient mentally, physically and psychologically, in addition to the medical treatment. Dance therapy might be a potential exercise intervention for improvements in chronic venous insufficiency patients, so clinicians focusing on them could recommend this form of gentle exercise in addition to the medical treatment. C1 [Dogru-Huzmeli, Esra; Gokcek, Ozden; Cam, Yagmur] Hatay Mustafa Kemal Univ, Hlth Sci Fac, Physiotherapy & Rehabil Dept, Antakya, Turkey. [Fansa, Iyad; Lale, Cem] Hatay Mustafa Kemal Univ, Tayfur Ata Sokmen Med Fac, Dept Cardiovasc Surg, Antakya, Turkey. [Oznur-Karabicak, Gul] Adnan Menderes Univ, Hlth Sci Fac, Dept Physiotherapy & Rehabil, Aydin, Turkey. [Cetisli-Korkmaz, Nilufer] Pamukkale Univ, Sch Phys Therapy & Rehabil, Antakya, Turkey.

DergiPark: 762681 tmsj Aims: This study aims to investigate the main effects of physical exercise on lower back pain with the Short Form-36 Health Survey and Oswestry Disability Index scores. Methods: University students between 18-25 years old who suffer from low back pain were enrolled in the study. Short Form-36 Health Survey and Oswestry Disability Index were used as the reference scales of lower back pain and quality of life, respectively. There are some questions in the questionnaire to scale the average comfort of the place they sleep and sit during the day, which is the result of the Personal Comfort Score. The Mann-Whitney U test was used for non-normal distributed variables. Correlation and Linear Regression were used to analyze data. SPSS 25.0 was used for all statistical analysis. Results: A total of 139 university students (94 females, 45 males) were included in the study. The median age was 20 years (IQR=2) for female students and 20 years (IQR=1) for male students. Oswestry Disability Index scores of fe- male students were higher, while Short Form-36 scores were lower than the male students. Male students' physical functioning scores were higher than female students. Each one-unit increase in Personal Comfort Score is associated with an increase in the rate between the energy/fatigue (3.34 units). Body Mass Index considerably affected the pain and Oswestry Disability Score, an increase in one unit of baseline BMI upsurged the Short Form-36 pain score to 0.13, and Oswestry disability score to 0.55. Conc- lusion: In our study, Body Mass Index is found to be associated with Oswestry Disability Index and Short Form-36 score, which are used for the severity of low back pain and defining the life quality and of patients. PCS had a positive correlation between energy/fatigue. In addition, There was a positive correlation between physical exercise and general health score.

Objective Microprocessor-controlled knees are generally prescribed and reimbursed for active amputees. Recent studies suggested that this technology could be useful for amputees with moderate activity level. We compared the efficiency of a microprocessor-controlled knee (MPK, Kenevo, Otto Bock) and non-MPKs (NMPKs) in these indications. Methods A multi-centric randomized crossover trial was conducted in 16 hospitals from 3 European countries. Participants were randomized to an MPK-NMPK sequence, testing the MPK for 3 months and the NMPK for 1 month, or to an NMPK-MPK sequence, testing the NMPK for 1 month and the MPK for 3 months. Dynamic balance, the main criteria, was assessed with the Timed-Up and Go test (TUG), functional mobility with the Locomotor Capability Index (LCI-5), quality of life with the Medical Outcomes Study Short Form 36 v2 (SF-36v2) and satisfaction with the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0. The occurrence of falls was monitored during the last month of trial. Analysis was by intent-to-treat and per-protocol (PP). Results We recruited 35 individuals with transfemoral amputation or knee disarticulation (27 males; mean age 65.6 years [SD 10.1]). On PP analysis, dynamic balance and functional mobility were improved with the MPK, as shown by a reduced median TUG time (from 21.4 s [Q1–Q3 19.3–26.6] to 17.9 s [15.4–22.7], P = 0.001) and higher mean global LCI-5 (from 40.4 [SD 7.6] to 42.8 [6.2], P = 0.02). Median global satisfaction score increased (from 3.9 [Q1–Q3 3.8–4.4] to 4.7 [4.1–4.9], P = 0.001) and quality of life was improved for the mental component summary of the SF-36v2 (median score from 53.3 [Q1–Q3 47.8–60.7] to 60.2 [51.6–62.6], P = 0.03) and physical component summary but not significantly (mean score from 44.1 [SD 6.3] to 46.3 [7.0], P = 0.08). Monitoring of adverse events including falls revealed no differences between both assessed devices. Conclusion This study enhances the level of evidence to argue equal opportunity for all individuals with transfemoral amputation or knee disarticulation, regardless of their mobility grade, to be provided with appropriate prostheses.

This study investigated the validity of the Canadian Occupational Performance Measure (COPM) when included as one of the scales used by therapists with older adults on an inpatient sub-acute rehabilitation setting. Quantitative data from 36 participants in a sub-acute rehabilitation setting was obtained via the COPM, the Functional Independence Measure (FIM) and the Short Form 36 Health Survey (SF-36) using a pre-post methodology. Pearson's r correlations and linear regression analyses were computed. The COPM Performance admission score was significantly correlated with the FIM Total and FIM Physical admission scores (p

To examine patient-reported outcomes (PROs) in patients with different rheumatoid arthritis (RA) disease activity levels and identify residual symptoms.Post hoc analyses of overall and Japanese data from two randomized controlled trials including RA patients with previous inadequate responses to methotrexate (NCT01710358) or no/minimal previous disease-modifying antirheumatic drug treatment (NCT01711359) (sponsor: Eli Lilly and Company). Week 24 assessments were disease activity (Simplified Disease Activity Index, Disease Activity Score/Disease Activity Score 28 joints-erythrocyte sedimentation rate) and PROs (pain visual analog scale [VAS], morning joint stiffness [MJS], Health Assessment Questionnaire-Disability Index, Functional Assessment of Chronic Illness Therapy-Fatigue, and Medical Outcomes Study Short Form 36 Health Survey Physical and Mental Component Scores).Patients achieving remission/low disease activity (LDA) at Week 24 had larger/significant improvements from baseline in pain, MJS, disability, fatigue, and physical and emotional quality of life versus patients with high/moderate disease activity. Some patients achieving remission and LDA, reported residual pain (pain VAS10 mm): 20.8-39.3% and 48.7-70.0% (overall study populations), 16.0-34.5% and 47.1-62.0% (Japanese patients). Residual MJS and fatigue were also reported.Remission/LDA were associated with improvements in PROs in overall and Japanese patient populations; however, some patients achieving remission had residual symptoms, including pain.

Qigong is a gentle exercise that promotes health and well-being. This study evaluated the acute physiological and psychological effects of one session of qigong exercise in older practitioners. A total of 45 participants (mean age, 65.14 years) were recruited. Meridian electrical conductance, State-Trait Anxiety Inventory (STAI), heart rate variability (HRV), and Short Form 36 (SF-36) were evaluated and compared before and after one session of qigong exercise. The results revealed that the electrical conductance of all meridians, except spleen and bladder meridians, increased significantly (p<0.05). Compared with baseline values, upper to lower body ratio and sympathetic/vagal index were significantly improved and closer to 1 (p=0.011 and p=0.007, resp.). STAI-S and STAI-T scores decreased significantly (p<0.001 and p=0.001, resp.). The RR interval of HRV decreased significantly (p=0.035), a significant positive correlation was observed between kidney meridian electrical conductance and SF-36 physical scores (r=0.74, p=0.018), and a positive correlation was observed between pericardium meridian electrical conductance and SF-36 mental scores (r=0.50, p=0.06). In conclusion, one session of qigong exercise increased meridian electrical conductance, reduced anxiety, and improved body and autonomic nervous system balance. These findings provide scientific evidence for acute physiological and psychological effects of qigong exercise in older practitioners.

Background Body-altering surgery may affect perceptions of one's self. For those with abdominal stoma surgeries, altered perceptions amplified by peristomal skin condition can increase health burdens. Objectives To assess health utility and health-related quality of life in an adult US ostomy sample in the presence of three levels of peristomal skin condition: intact, moderately compromised, and severely compromised. Methods The short form 36 health survey version 2, a generic health survey incorporating the six-dimensional health state short form preference-based utility index, was chosen to assess the sample. Analysis of covariance adjusted for age and time from surgery was used. Results The six-dimensional health state short form utilities for those with intact skin and physical component summary (PCS) levels indicating no physical limitations varied significantly from those with severely compromised skin and indicating the greatest degree of physical limitation (0.833 vs. 0.527). Peristomal skin condition decreases were associated with health utility decreases across all levels of the PCS. Because peristomal skin conditions are intermittent, the analysis presents quality-adjusted life-days (QALDs) per month. Ostomates with intact skin and PCS levels indicating no physical limitations demonstrated significant differences from those with severe skin condition and indicating the greatest degree of physical limitations (26.5 d/mo vs. 15.8 d/mo). As peristomal skin condition worsened, QALDs decreased across all levels of the PCS. A minimally important expected value of health was estimated to be an increase of 2.18 QALDs/mo. Conclusions Successful treatment from a clinical perspective is more than the elimination of conditions—it is also a return of quality time to an individual.

Kabwe is a mining town in Zambia that has been ranked among "the ten most polluted places in the world" with previous findings of serious lead (Pb) pollution. In this study, we aim to examine the impact of childhood Pb poisoning on the health-related quality of life (HRQoL) of mothers in Kabwe. The HRQoL was assessed using the Short-Form 36 survey for 404 mothers coming from residences in 40 randomly selected standard enumeration areas (SEAs). Blood lead levels (BLLs) of the household members including the mothers themselves were measured. We found a significant positive correlation between the BLLs of the mothers and their children (R = 0.6385, p 0.0001), while the BLLs of preschool-aged and school-aged children were significantly higher than those of their mothers and fathers. Using the data sets containing the BLLs of the household members, the age of the mothers, the household income, and the household SEA, we performed stepwise multiple linear regression analyses. The results showed significant negative associations between the representative BLL of household children and the BLL of preschool-aged children with the vitality and mental health scores of their mothers. Additionally, the BLL of school-aged children was only significantly associated with the mental health score of their mothers. By contrast, there was a significant negative association between the BLLs of the mothers with the social role functioning score. This suggests that elevated BLLs in children have a negative impact on the mental health conditions of their mothers regardless of the mothers' BLL.

IntroductionThe importance of patient-reported outcome measures (PROMs) for rheumatoid arthritis (RA) clinical studies has been recognised for many years. The current study aims to describe the RA PROMs used over the past 20 years, and their performance metrics, to underpin appropriate tool selection.MethodsThe study included a systematic search for PROMs that have been in use over the period 2000–2019, with detailed documentation of their psychometric properties, and a user-friendly presentation of the extensive evidence base.Results125 PROMs were identified with psychometric evidence available. The domains of pain, fatigue, emotional functions, mobility, physical functioning and work dominated, with self-efficacy and coping as personal factors. Domains such as stiffness and sleep were poorly served. The most frequently used PROMs included the Health Assessment Questionnaire Disability Index (HAQ), the Short Form 36 (SF-36), the EuroQoL and the Modified HAQ which, between them, appeared in more than 3500 papers. Strong psychometric evidence was found for the HAQ, and the SF-36 Physical Functioning and Vitality (fatigue) domains. Otherwise, all domains except stiffness, sleep, education and health utility, had at least one PROM with moderate level of psychometric evidence.ConclusionThere is a broad range of PROMs for measuring RA outcomes, but the quality of psychometric evidence varies widely. This work identifies gaps in key RA domains according to the biopsychosocial model.

Background and purpose The aim of our study was to describe, by a case-control and cross-sectional design, the correlation between clinical impairment and age in Charcot-Marie-Tooth type 1A (CMT1A) patients. Methods Seventy CMT1A patients and 70 sex- and age-matched healthy controls were enrolled. Motor performance was assessed through the 10-m walk test, the 6-min walk test and the 9-hole peg test of the dominant and non-dominant side, and muscle strength was measured by using the Medical Research Council score. In the CMT1A group, disability and quality of life were evaluated using the Charcot-Marie-Tooth Neuropathy Score (CMTNS) and the Short Form 36 (SF-36) questionnaire. Cross-sectional relationships between age and all clinical measures were analyzed and differences in the slopes between cases and controls were calculated. The occurrence of a structural change in the age-related progression of clinical measures was explored. Results The deterioration of motor performance correlated with age in both groups with a greater slope in CMT1A patients than controls. The deterioration of CMTNS and SF-36 correlated with age in the CMT1A group. The deterioration of all clinical measures with the exception of the SF-36 questionnaire showed a structural change at the 50th year of age. The rate of deterioration was no different between patients and controls until 50 years of age, whereupon it became significantly greater in CMT1A patients. Conclusion Our study supports that the disease progression in CMT1A patients is an age-related process and the 50th year of age represents a critical moment after which the clinical decline becomes faster.

International audience; Objectives: Patient's and physician's perspective can differ in rheumatoid arthritis (RA). The aim was to define the concept of patient-reported flares.Methods: Post-hoc analysis of a randomized controlled trial of a step-down strategy in RA patients treated with anti-TNF, in DAS28-remission for >= 6 months, randomized to either "spacing" or "maintaining" anti-TNF. The occurrence of patient-reported flares (PRF) was evaluated every 3 months for 18 months by: "Over the last 3 months, did you experience symptoms suggestive of disease exacerbation?". Visits with and without PRF were compared, using a linear mixed effects model, in terms of symptoms, disability based on the Health Assessment Questionnaire, quality of life based on Short Form 36 Health Survey and DAS28 based relapses (DBR), defined as an increase of DAS28 > 0.6 and an absolute value of DAS28 > 2.6. The agreement between PRF and DBR was measured by the kappa coefficient on repeated data.Results: In all, 137 patients were analyzed: mean age 55 +/- 11 years, females 78%, mean RA duration 9.5 +/- 8.0 years. Over the 18 months, PRF concerned 27.2% of the 940 available visits. DBR and PRF were observed in 24% and 16% of 940 visits for 137 patients respectively. All the items were associated with PRF with standardized effect size between -0.58 (SF36 PCS) and 0.87 (DAS28). The agreement between PRF and DBR was moderate (kappa = 0.44).Conclusion: The concept of flare refers to more than just RA disease activity.