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Purpose: Para-karate has been gaining popularity rapidly; however, scientific research on the subject remains limited. This study aims to examine the kata preferences at top-level para-karate events and explore the relationship between sport class (type of impairment) and kata selection. Methods: Data was collected from nine events—four World Para-Karate Championships (2016, 2018, 2021, 2023) and five European Para-Karate Championships (2018, 2019, 2021, 2022, 2023). A total of 906 katas were performed: 567 by males and 339 by females. Descriptive statistics and chi-square tests were used for analysis. Results: Top-level para-karate athletes utilized 62 katas (61%) from the official WKF list (102 katas). The most popular katas were Gojushiho Sho (19.9%), Unsu (11.5%), Kanku Sho (9.5%), Suparinpei (6.7%), and Jion (6.2%). A significant relationship was found between sport class and kata selection (p ≤ 0.05). The most popular kata for K30 was Unsu (15%), while K10 and K21 + K22 classes predominantly chose Gojushiho Sho (16.6% and 30.3%, respectively). Conclusions: Kata selection for para-karate athletes is influenced by the type of impairment. Intellectually impaired athletes and their coaches often select a single, challenging kata with a balanced fast-to-slow movement ratio, such as Gojushiho Sho, to optimize performance. Highlights: This work provides an insight into the preference of kata according to the sports class of competitors and their coaches in the monitored period of para-karate top-level competitions which does not differ of non-impaired competitors in recent years. [ABSTRACT FROM AUTHOR]

In wheelchair basketball, classes are based on competition observations. Since 2021, out-of-competition testing has been implemented; however, research remains limited. This study aimed to determine whether the quantified volume of action (VOA) can be an indicator for classification and examined the influence of a competitive wheelchair on VOA evaluation. This cross-sectional study included 47 wheelchair basketball players (21 able-bodied, 26 with physical impairments: class 1, n = 8; class 2, n = 5; class 3, n = 4; class 4, n = 9). Tests were performed in a wheelchair (wheelchair condition) and on a trainer bed (bed condition). Participants held a ball and rotated their trunks in various planes. Movements were recorded using four cameras, and position coordinates were extracted using the three-dimensional DLT method. Classes and sitting conditions were compared across five groups: classes 1, 2, 3, 4, and able-bodied. Comparisons between classes revealed significant differences in all planes, including wheelchair and bed conditions (p < 0.05). The VOA expanded in the wheelchair condition compared to the bed condition across multiple classes and planes (p < 0.05). Measuring the VOA outside the competition while sitting on a bed may effectively classify players by eliminating equipment influence. [ABSTRACT FROM AUTHOR]

This study aims to design and develop a virtual reality platform (VR-ISLS) tailored to support hearing and physically impaired students at the university library for navigating and utilizing library services. By employing an immersive virtual environment, the platform replicates the physical setting of the university's library to create a realistic experience that reduces anxiety and enhances familiarity. The platform integrates assistive technology functions, including sign language interpretation, customizable audio cues, vibration feedback, and various locomotion controls to meet the diverse needs of impaired students. The research methodology employs an iterative development process, incorporating feedback from library staff, disability support services, and students to ensure usability and accessibility. Evaluation of the platform using the System Usability Scale (SUS) and user feedback revealed a positive reception, with recommendations for further customization and enhanced assistive features to optimize the user experience. This study underscores the importance of inclusive design and continuous iteration in creating immersive virtual reality tools that provide significant benefits for persons with disabilities, enhancing both accessibility and learning experiences. [ABSTRACT FROM AUTHOR]

Abstract Purpose Para-karate has been gaining popularity rapidly; however, scientific research on the subject remains limited. This study aims to examine the kata preferences at top-level para-karate events and explore the relationship between sport class (type of impairment) and kata selection. Methods Data was collected from nine events—four World Para-Karate Championships (2016, 2018, 2021, 2023) and five European Para-Karate Championships (2018, 2019, 2021, 2022, 2023). A total of 906 katas were performed: 567 by males and 339 by females. Descriptive statistics and chi-square tests were used for analysis. Results Top-level para-karate athletes utilized 62 katas (61%) from the official WKF list (102 katas). The most popular katas were Gojushiho Sho (19.9%), Unsu (11.5%), Kanku Sho (9.5%), Suparinpei (6.7%), and Jion (6.2%). A significant relationship was found between sport class and kata selection (p ≤ 0.05). The most popular kata for K30 was Unsu (15%), while K10 and K21 + K22 classes predominantly chose Gojushiho Sho (16.6% and 30.3%, respectively). Conclusions Kata selection for para-karate athletes is influenced by the type of impairment. Intellectually impaired athletes and their coaches often select a single, challenging kata with a balanced fast-to-slow movement ratio, such as Gojushiho Sho, to optimize performance.

Purpose: The primary objective of this study was to measure and quantify the current level of physical activity among persons with disability in Qatar. The secondary objective was to assess and analyze the duration of sedentary behavior among individuals with disability in Qatar. Methods: This was a cross-sectional epidemiological study of persons with disability living in Qatar. The study period was from October 2020 to December 2021 Results: 96 persons with disabilities participated in this study. They included individuals with amputations, spinal cord injuries, cerebral palsy, and other developmental impairments. Of the respondents, 56% were male and 64% were Qataris. Of the respondents, 61.5%said that they felt psychologically and emotionally better when engaging in physical activity, and this difference was statistically significant. 71% of all those who reported feeling physically good after sport, 65% said that they enjoyed the social aspects of sports. This corroborates the beneficial effects of exercise, sports, and physical activity in persons with all types of disabilities. Conclusion: There was a definite impact on the emotional and physical well-being of those who participated in the physical activities. There was less participation in team activities and two-thirds preferred to exercise alone. However, their numbers were not statistically significant because of low enrollment in the study. [ABSTRACT FROM AUTHOR]

This study describes the 8-year course of physical and psychosocial impairment in middle-aged patients with borderline personality disorder (BPD) and other personality disorders (OPD). This study also compares BPD subgroups (recovered vs. nonrecovered) and explores predictors of physical impairment. Patients (N = 282) were assessed as part of the McLean Study of Adult Development. Physical and psychosocial impairments were assessed using the 36-Item Short-Form Health Survey. Patients with BPD reported significantly more impairment than OPD patients across all domains. Nonrecovered BPD patients reported significantly more impairment than their recovered counterparts. Three medical conditions (osteoarthritis, chronic fatigue syndrome, and obesity) and two symptomatic disorders (mood disorder and posttraumatic stress disorder) were significant multivariate predictors of physical impairment in BPD patients. These results suggest that BPD patients experience serious functioning impairment that persists over time and that physical functioning impairments reported by these patients are strongly related to certain physical and psychiatric health conditions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to: (1) test and explain the type of experience scuba diving is among people with physical impairments based on the experience-type framework; (2) assess and describe their personality based on the Big Five domains; and (3) identify if personality, years diving, and diving level predict experience-type. Methods: An explanatory sequential mixed methods design was employed. The quantitative phase used a cross-sectional survey (n = 103). The qualitative phase used follow-up interviews with 15 participants divided into 3 case study groups. Joint displays with meta-inferences integrated the data. Results: Quantitative and qualitative findings concurred on scuba being a transformative experience. 82.52% of survey participants reported scuba as a transformative experience, with no significant differences on experience impact based on impairment category (p = 0.56), impairment onset (p = 0.66), gender (p = 0.08), race/ethnicity (p = 0.51), or age (p = 0.07). Big Five personality domains, years diving, or diving level did not predict experience impact (R2 = 0.14, F(12,90) = 1.304, p = 0.2305). Data strand results differed on salient personality domains. Seven qualitative themes emerged, five on experience-type and two on personality. Conclusions: We recommend the exploration of scuba diving as a prospective rehabilitation intervention. IMPLICATIONS FOR REHABILITATION: Innovative rehabilitation interventions that provide positive experiences and long-term health benefits to people with physical impairments are needed. Participants reported that scuba diving had a positive transformative impact in their lives through positive emotions, peace/relaxation, personal growth, development of skills, social connections, physical and mental healing, and lasting behavioral changes. Reporting scuba diving as a transformative experience was not influenced by the scuba divers' personality domains, diving level, demographic characteristics, or the number of years they had been diving. Authors recommend the consideration and further exploration of scuba diving as a prospective physical and psychosocial rehabilitation intervention. [ABSTRACT FROM AUTHOR]

Background In recent years, physical impairment (PI) combined with cognitive impairment (CI) is a common comorbidity in the elderly. An early detection of PI combined with CI in the elderly and timely interventions may help to improve the quality of life of the elderly and reduce the burden on their families and society. However, relevant studies on the comorbidity of PI and CI in the elderly and its influencing factors have been rarely reported. Objective To observe the clinical characteristics of the comorbidity of PI and CI in the elderly and the influencing factors. Methods Elderly patients hospitalized in Peking University People's Hospital from September 2018 to November 2019 were selected. A total of eligible 244 subjects meeting the inclusion criteria were surveyed for the physical function and cognitive function using the Short Physical Performance Battery (SPPB) and the Mini-mental State Examination (MMSE), respectively. PI was diagnosed with lower than 10 points of the SPPB, and CI was diagnosed with lower than 27 points of the MMSE. Patients were divided into non-PI+non-CI, PI+non-CI, non-PI+CI, PI+CI. Social demographic, anthropometric, laboratory examination and other indicators of patients were collected, and Logistic regression analysis was used to explore the influencing factors for PI combined with CI in the elderly. Results Among the 244 patients, there were 102 (41.80%), 64 (26.23%), 26 (10.66%) and 52 (21.31%) cases of non-PI+non-CI, PI+non-CI, non-PI+CI and PI+CI, respectively. Multivariate binary Logistic regression analysis showed that compared with non-PI+non-CI cases, age (P

Background: All Abilities Touch Football provides individuals with intellectual and/or physical impairments the opportunity to participate in organised sport. However, the absence of a comprehensive framework to accommodate players with varying types and severities of impairments presents challenges for equitable participation and fairer competition. This study aimed to explore the broader challenges, opportunities and feasibility of implementing a classification framework for All Abilities Touch Football. Methods: A mixed methods approach was employed, combining online surveys of players (n ​= ​23), parents/carers (n ​= ​23), coaches (n ​= ​20) with semi-structured interviews from national level coaches (n ​= ​4) involved with All Abilities Touch Football across Australia. Survey data were analysed using counts and percentages, while thematic analysis was applied to interview data. Results: Survey and interview data revealed All Abilities Touch Football effectively promotes physical activity, social integration, and community engagement for individuals with disabilities. However, systemic challenges arise from managing the diverse abilities of players within the sport, with a lack of collaboration among stakeholders, inadequate educational initiatives, and limited resource allocation identified as major barriers to the sport's advancement. Conclusion: These findings offer valuable insights into the complexities of disability sport programs, highlighting the need for targeted strategies to advance All Abilities Touch Football. They also lay the groundwork for future initiatives aimed at developing a more inclusive and structured approach to the sport's growth.

Disability is part of the human experience, yet until recently, the lived experiences of individuals affected by physical impairment have been overlooked in bioarchaeological studies. Disability is a social construct; how we define disability is culturally specific, which makes identifying disability in archaeological contexts difficult. However, by defining disability as the inability to function within expected lifeways, it is possible to examine the effects of physical impairment on lived experiences and explore the construction of disability in historic contexts. Using a biocultural lens and robust cultural contextualization, this study examines the ability to function of three middle- to upper-class adult females from Grote Kerk, Alkmaar, the Netherlands (A.D. 1716-1830), with diagnoses of permanent, bilateral developmental dysplasia of the hip (DDH). DDH results from an abnormality in the hip joint's size, shape, or orientation and, when untreated, leads to loss of normal joint function and deteriorating quality of life. While DDH probably resulted in limited mobility and pain for all three individuals analyzed in the present study, there is little evidence to support disablement in the form of social restrictions. The findings add to the ongoing discussion of historic disability by examining the intersection of socioeconomic status, sex, and physical impairment in a post-medieval Dutch population and add data that can be used in estimating historic prevalence rates of DDH, which are variable across modern populations. [ABSTRACT FROM AUTHOR]

PurposeThe primary objective of this study was to measure and quantify the current level of physical activity among persons with disability in Qatar. The secondary objective was to assess and analyze the duration of sedentary behavior among individuals with disability in Qatar.MethodsThis was a cross-sectional epidemiological study of persons with disability living in Qatar. The study period was from October 2020 to December 2021Results96 persons with disabilities participated in this study. They included individuals with amputations, spinal cord injuries, cerebral palsy, and other developmental impairments. Of the respondents, 56% were male and 64% were Qataris. Of the respondents, 61.5%said that they felt psychologically and emotionally better when engaging in physical activity, and this difference was statistically significant. 71% of all those who reported feeling physically good after sport, 65% said that they enjoyed the social aspects of sports. This corroborates the beneficial effects of exercise, sports, and physical activity in persons with all types of disabilities.ConclusionThere was a definite impact on the emotional and physical well-being of those who participated in the physical activities. There was less participation in team activities and two-thirds preferred to exercise alone. However, their numbers were not statistically significant because of low enrollment in the study.

In wheelchair basketball, classes are based on competition observations. Since 2021, out-of-competition testing has been implemented; however, research remains limited. This study aimed to determine whether the quantified volume of action (VOA) can be an indicator for classification and examined the influence of a competitive wheelchair on VOA evaluation. This cross-sectional study included 47 wheelchair basketball players (21 able-bodied, 26 with physical impairments: class 1, n = 8; class 2, n = 5; class 3, n = 4; class 4, n = 9). Tests were performed in a wheelchair (wheelchair condition) and on a trainer bed (bed condition). Participants held a ball and rotated their trunks in various planes. Movements were recorded using four cameras, and position coordinates were extracted using the three-dimensional DLT method. Classes and sitting conditions were compared across five groups: classes 1, 2, 3, 4, and able-bodied. Comparisons between classes revealed significant differences in all planes, including wheelchair and bed conditions (p < 0.05). The VOA expanded in the wheelchair condition compared to the bed condition across multiple classes and planes (p < 0.05). Measuring the VOA outside the competition while sitting on a bed may effectively classify players by eliminating equipment influence.

The purpose of this study was to initiate the development of an evidence-based sport classification system for powerchair football, a sport that serves athletes with physical impairments. Sport classification is designed to increase participation by minimizing the impact of impairment on competition outcome, and powerchair football lacks an evidence-based system of classification which is required of Paralympic sports. A number of approaches were used to build the theoretical model of sport performance (Step 2 of the International Paralympic Committee model). Key sport activities were identified through surveys of stakeholders and underlying determinants of those key activities were identified through game and database analyses. Current findings support drive control, ball control, communication, and adjustment to the ball as key activities in powerchair football with joint-specific strength and range of motion, sensory, and neurological variables identified as underlying determinants. [ABSTRACT FROM AUTHOR]

Summary: Aim: The aim of this study is to examine which interventions lead to clinically significant weight loss among people with physical disabilities. Methods: We systematically searched three electronic databases (PubMed, Scopus, and CENTRAL) including studies until May 2022 to find randomized controlled trials on behavioral interventions and weight‐related outcomes in people with physical disabilities. Pharmacological or surgical interventions were excluded. Study quality was evaluated using the Cochrane Risk of Bias Tool. Interventions were grouped as dietary, physical activity, education/coaching, or multi‐component. Mean weight changes, standard deviations, confidence intervals, and effect sizes were extracted or calculated for assessment of the intervention effect. Results: Sixty studies involving 6,511 participants were included in the qualitative synthesis. Most studies (n = 32) included multi‐component interventions, incorporating dietary and physical activity components. Limited evidence suggests that extensive dietary interventions or long‐term multi‐component interventions might lead to a clinically relevant weight reduction of at least 5% for older individuals (age > 50) with mild‐to‐moderate mobility impairments. Discussion: Due to the high heterogeneity of studies and low study quality, it can be assumed that the range of applicability of the findings is questionable. Further research should examine younger age groups (i.e., children, adolescents, and adults under 40 years) and compare different settings such as schools, clinics, nursing homes, and assisted living facilities. [ABSTRACT FROM AUTHOR]

This work shows the possibilities that observational analysis can offer to match analysis in Wheelchair Basketball, outlined in a study of the sequences that end in a shot, in the men's team considered to be the best in the world (USA), in the Tokyo Paralympic Games 2020. Data recording and coding the 527 sequences that end in a shot was carried out via the LINCE software, and inter-rater reliability guaranteed using Cohen's Kappa coefficient. Two diachronic behaviour analysis techniques – lag sequential analysis and T-pattern detection – were applied complementarily, thus allowing us to characterise effective and ineffective sequences. Effective behaviours are highlighted as being those which incorporate a final reception and shot by players with less functional limitation; or those in which the shot is made from the paint. Ineffective behaviours are those carried out by players with greater functional difficulty; or those which end in shots made from the offensive zone and external offensive zone. [ABSTRACT FROM AUTHOR]

Introduction: Multiple sclerosis (MS) is a disabling disease with unpredictable clinical manifestations. As clinical assessments may not fully capture the impact of MS on quality of life, they can be complemented by patient-reported outcome (PRO) measures to provide a more comprehensive picture of MS disease state and impact. The objectives of this study were to explore the experiences of people with relapsing–remitting MS, including symptoms and impacts on daily life, and to provide a conceptual model of MS outcomes. Methods: A literature review of studies that evaluated the experiences of people with MS was completed and combined with semi-structured concept elicitation interviews conducted with 14 people with relapsing–remitting MS in the USA. Results: The average age of the 14 participants was 43.9 (range 25–64) years, most were White (78.6%) and female (78.6%), and the mean duration since diagnosis was 6.6 (2–10) years. The most bothersome symptoms identified included fatigue (n = 9), cognitive dysfunction (n = 5), mobility/difficulty with walking (n = 3), and vision problems (n = 3). The most commonly reported impacts on daily life were balance problems/instability (n = 13), work life/productivity (n = 12), difficulty walking (n = 11), daily activities/household chores (n = 11), and leisure activities (n = 10). Conclusion: There was a high frequency of concepts associated with physical function, fatigue, and sensory-motor actions. A conceptual model was developed that captures the disease symptoms, impairments, and impacts identified in the interviews as well as known processes and symptoms identified in the literature search. This model underpins the appropriateness of PRO instruments, such as the PROMIS Fatigue (MS) 8a and PROMIS Physical Function (MS) 15a, which evaluate symptoms and impacts that matter most to people with MS. [ABSTRACT FROM AUTHOR]

Objective: While a substantial body of research describes the disabling impacts of migraine attacks, less research has described the impacts of migraine on physical functioning between migraine attacks. The objective of this study is to describe physical impairment during and between migraine attacks as a dimension of burden experienced by people living with chronic migraine. Methods: The physical impairment domain of the Migraine Physical Function Impact Diary was recorded in headache diaries from the Medication Overuse Treatment Strategy trial. Days with moderate to severe headache were used to approximate migraine attacks. Factor analysis and regression analysis were used to describe associations between migraine and physical impairment. Results: 77,662 headache diary entries from 720 participants were analyzed, including 25,414 days with moderate to severe headache, 19,149 days with mild headache, and 33,099 days with no headache. Mean physical impairment score was 41.5 (SD = 26.1) on days with moderate to severe headache, 12.8 (SD = 15.0) on days with mild headache, and 5.2 (SD = 13.1) on days with no headache. Physical impairment on days with mild headache and days with no headache was significantly associated with days since last moderate to severe headache, physical impairment with last moderate to severe headache, mild headache (compared to no headache), depression, hypersensitivities and cranial autonomic symptoms. Conclusions: Physical impairment occurs on migraine and non-migraine days. Study participants with frequent headaches, symptoms of depression, hypersensitivities and cranial autonomic symptoms experience physical impairment at a higher rate on days with no headache and days with mild headache. Clinical Trial Registration: ClinicalTrials.gov (NCT02764320) [ABSTRACT FROM AUTHOR]

Research has recently examined the role of impairment onset on athlete development in Paralympic sport; however, less is known on how impairment type can impact athlete sporting pathways. In this study, 187 Australian and Canadian Paralympic sport athletes completed a survey. Participants were divided into the following four groups: impaired muscle power (n = 79); ataxia, athetosis, and hypertonia (n = 44); limb deficiencies (n = 42); and other physical impairments (n = 22). Mechanisms of initiation into Paralympic sport varied between groups with some drawn to sport through friends and/or family (i.e., limb deficiencies and other physical impairments groups) while others through talent search programs (i.e., ataxia, athetosis, and hypertonia group) or health care professionals/rehabilitation centers (i.e., impaired muscle power group). Results revealed no significant differences between groups in the chronological age or absolute years for achieving milestones. However, considering the high variability within the sample, more research is necessary to better understand how athletes with different physical impairments navigate through their sporting careers. [ABSTRACT FROM AUTHOR]

This study aims to design and develop a virtual reality platform (VR-ISLS) tailored to support hearing and physically impaired students at the university library for navigating and utilizing library services. By employing an immersive virtual environment, the platform replicates the physical setting of the university’s library to create a realistic experience that reduces anxiety and enhances familiarity. The platform integrates assistive technology functions, including sign language interpretation, customizable audio cues, vibration feedback, and various locomotion controls to meet the diverse needs of impaired students. The research methodology employs an iterative development process, incorporating feedback from library staff, disability support services, and students to ensure usability and accessibility. Evaluation of the platform using the System Usability Scale (SUS) and user feedback revealed a positive reception, with recommendations for further customization and enhanced assistive features to optimize the user experience. This study underscores the importance of inclusive design and continuous iteration in creating immersive virtual reality tools that provide significant benefits for persons with disabilities, enhancing both accessibility and learning experiences.

Background and objectiveThis study aimed to compare physical and cognitive functions between post-coronavirus disease 2019 (COVID-19) participants and healthy matched controls and investigate associations between physical and cognitive impairments with quality of life.MethodsTwenty-three post-COVID-19 participants and 23 age and sex-matched healthy people without a history of COVID-19 were included. Physical function was assessed using the Medical Research Council Sum Score (MRC-SS), 2 min Step Test, Modified Borg Scale, and Short Physical Performance Battery (SPPB) Test. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), and Stroop test, and the quality of life was evaluated using the Euro Quality of Life-5 Dimensions-3 Levels (EQ-5D-3l) questionnaire. Assessments were performed by a physical therapist in one session.ResultsMann-Whitney U test showed that in the post-COVID-19 group, compared to the control group, the number of steps in the 2 min Step Test (p

Abstract Post‐intensive care syndrome comprises physical, cognitive, and mental impairments in patients treated in an intensive care unit (ICU). It occurs either during the ICU stay or following ICU discharge and is related to the patients' long‐term prognosis. The same concept also applies to pediatric patients, and it can greatly affect the mental status of family members. In the 10 years since post‐intensive care syndrome was first proposed, research has greatly expanded. Here, we summarize the recent evidence on post‐intensive care syndrome regarding its pathophysiology, epidemiology, assessment, risk factors, prevention, and treatments. We highlight new topics, future directions, and strategies to overcome post‐intensive care syndrome among people treated in an ICU. Clinical and basic research are still needed to elucidate the mechanistic insights and to discover therapeutic targets and new interventions for post‐intensive care syndrome.

This study aimed to investigate the association between the optimum power load in the bench press (BP), shoulder press (SP), and prone bench pull (PBP) exercises and acceleration (ACC) and speed performances in 11 National Team wheelchair basketball (WB) players with similar levels of disability. All athletes were previously familiarized with the testing procedures that were performed on the same day during the competitive period of the season. First, athletes performed a wheelchair 20-m sprint assessment and, subsequently, a maximum power load test to determine the mean propulsive power (MPP) in the BP, SP, and PBP. A Pearson product–moment correlation was used to examine the relationships between sprint velocity (VEL), ACC, and the MPP in the three exercises. The significance level was set as p <.05. Large to very large significant associations were observed between VEL and ACC and the MPP in the BP, SP, and PBP exercises (r varying from.60 to.77; p <.05). The results reveal that WB players who produce more power in these three exercises are also able to accelerate faster and achieve higher speeds over short distances. Given the key importance of high and successive ACCs during wheelchair game-related maneuvers, it is recommended that coaches frequently assess the optimum power load in BP, SP, and PBP in WB players, even during their regular training sessions. [ABSTRACT FROM AUTHOR]

This study examined factors surrounding the development and advancement of campus intramural programming for college students with physical disabilities. Campus recreation staff from 164 universities completed a survey examining campus programming for students with and without physical disabilities, marketing, modifications, barriers, needs, and strategies for developing adapted and inclusive intramural sports programming. Weight training, cardiovascular training, and personal training were among the most reported programming designed to include students with physical disabilities. Wheelchair basketball is among the longest-running intramural programs with sitting volleyball, goalball, and beep baseball increasing in popularity. Environmental and equipment accessibility was a predominant strategy and accommodation to facilitate inclusive programming, with the primary reason for not including adapted or inclusive intramural programming attributed to lack of request or too few students with physical disabilities on campus. Additional results and discussion address best practices and recommendations to initiate and improve programming for students with physical disabilities. [ABSTRACT FROM AUTHOR]

ObjectivesTo examine the association of lifetime history of traumatic brain injury (TBI) with later-life physical impairment (PI) and functional impairment (FI) and to evaluate the impact of neurobehavioral symptoms that frequently co-occur with TBI on these relations.ParticipantsA total of 1148 respondents to the 2014 Wave of the Health and Retirement Study, a nationally representative survey of older community-dwelling adults, randomly selected to participate in a TBI exposure survey. They reported no prior TBI (n = 737) or prior TBI (n = 411).DesignCross-sectional survey study.Main measuresPhysical impairment (self-reported difficulty with ≥1 of 8 physical activities); FI (self-reported difficulty with ≥1 of 11 activities of daily living); self-reported current neurobehavioral symptoms (pain, sleep problems, depression, subjective memory impairment); The Ohio State University TBI Identification Method (OSU-TBI-ID)-short form.AnalysesStepwise logistic regression models ([1] unadjusted; [2] adjusted for demographics and medical comorbidities; [3] additionally adjusted for neurobehavioral symptoms) compared PI and FI between TBI groups.ResultsTraumatic brain injury-exposed (mean: 33.6 years postinjury) respondents were younger, less likely to be female, and reported more comorbidities and neurobehavioral symptoms. Although TBI was significantly associated with increased odds of PI and FI in unadjusted models and models adjusted for demographics/comorbidities (adjusted odds ratio, 95% confidence interval: PI 1.62, 1.21-2.17; FI 1.60, 1.20-2.14), this association was no longer statistically significant after further adjustment for neurobehavioral symptoms.ConclusionHistory of TBI is associated with substantial PI and FI among community-dwelling older adults. Further research is warranted to determine whether aggressive management of neurobehavioral symptoms in this population may mitigate long-term PI and FI in this population.

Purpose: Indonesia lacks policies and programmes that would reduce barriers towards improving the Quality of Life (QOL) of persons with disabilities. This cross-sectional study assessed the QOL of persons with physical disabilities in Indonesia and identified its predictors. Method: A total of 202 participants with physical disabilities completed the attitude subscale of Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0), and the World Health Organisation Quality of Life (WHOQOL-BREF) scale. The Rasch model converted the ordinal data to the interval logits scale. Multiple linear regression was used to analyse the QOL predictors. Results: Participants reported a mean WHOQOL-BREF score of 0.12+0.98 (or poor QOL). The participants perceived people's attitudes as impactful barriers (-1.68 ± 1.44). There was a significant difference in participants' mean WHODAS 2.0 scores with poor (-0.38 ± 1.06) and good QOL (-1.79 ± 0.77). The regression revealed the following significant QOL predictors: severe disability (B = -1.089), moderate disability (B= -0.697), employment (B = 0.544), attitude barrier (B = -0.096), and age (B = -0.015). Conclusion: Factors such as unemployment, perceptions of impactful attitudinal barriers, and ageing are associated with the poor QOL reported by persons with moderate to severe physical disabilities. It is necessary to ensure equal employment opportunities and remove stigma in society to promote QOL improvement for them. [ABSTRACT FROM AUTHOR]

This study explored the performance of the Sitting Volleyball serve by investigating the causal factors associated with ball velocity. Thirty-seven athletes underwent anthropometry and strength assessment and performed ten successful maximal effort serves. Ball velocity was measured using a sports radar gun. The hip, shoulder, elbow and wrist angles at the instant of ball impact as well as the height of ball impact were estimated through two-dimensional motion analysis. The causal relationships between variables were described through a linear Structural Equation Model and a Directed Acyclic Graph. Results showed that a smaller hip angle determines a greater shoulder angle, which in turn causes a greater elbow angle. A more open elbow angle together with a greater vertical reach allowed for a greater height of ball impact. Finally, increased height of ball impact along with greater abdominal strength are beneficial for higher ball velocity. These results underlined that the Sitting Volleyball serve is a multifactorial stroke involving anthropometric, technical and strength factors and suggest that athletes should improve their abdominal strength and master the technique necessary to perform the serve with the shoulder and the elbow joints fully extended in order to produce the greatest possible impact on the ball. [ABSTRACT FROM AUTHOR]

Glucocorticoids (GCs) are hormones released in response to stressors and can provide insight into an organism's physiological well‐being. Experiencing chronic challenges to homeostasis is associated with significant deviations from baseline fecal GCs (fGCs) in many species, providing a noninvasive biomarker for assessing stress. In the group of free‐ranging Japanese macaques (Macaca fuscata) at the Awajishima Monkey Center in Japan, ~17% have congenital limb malformations. We collected 646 fecal samples from 27 females over three consecutive birth seasons (May–August) and analyzed them using enzyme immunoassay to extract fGCs. We explored the relationship between fGC levels and individual (physical impairment and reproductive status), social (dominance rank and availability of kin for social support), and ecological variables (exposure to potential predators, rainfall, and wild fruit availability). A disabled infant was associated significantly with higher fGC in the mother; however, physical impairment in adult females was not significantly related to fGC levels. Females with higher dominance rank had significantly lower fGC levels than lower ranking females. Other factors did not relate significantly to fGC. These results suggest that providing care that meets the support needs of disabled infants poses a physiological challenge for mothers and suggests that physically impaired adults are able to effectively compensate for their disabilities with behavioral plasticity. Once an individual with congenital limb malformations survives infancy through their mother's care, physical impairment does not appear to influence fGC values, while social variables like dominance rank significantly influenced cortisol values in free‐ranging female Japanese macaques. Highlights: Free‐ranging macaque mothers of disabled infants had higher fecal glucocorticoid (fGC) values than others. Physical impairments in adult females were not associated with differences in fGC values. Dominance rank related to fGCs: higher rank females had lower fCGs than lower rank. [ABSTRACT FROM AUTHOR]

Background Although studies to date have broadly shown that cardiovascular disease (CVD) increases cognitive and physical impairment risk, there is still limited understanding of the magnitude of this risk among relevant CVD subtypes or age cohorts. Methods We analyzed longitudinal data from 16 679 U.S. Health and Retirement Study participants who were aged ≥65 years at study entry. Primary endpoints were physical impairment (activities of daily living impairment) or cognitive impairment (Langa–Weir Classification of dementia). We compared these endpoints among participants who developed incident CVD versus those who were CVD free, both in the short term (<2-year postdiagnosis) and long term (>5 years), controlling for sociodemographic and health characteristics. We then analyzed the effects by CVD subtype (atrial fibrillation, congestive heart failure, ischemic heart disease, and stroke) and age-at-diagnosis (65–74, 75–84, and ≥85). Results Over a median follow-up of 10 years, 8 750 participants (52%) developed incident CVD. Incident CVD was associated with significantly higher adjusted odds (aOR) of short-term and long-term physical and cognitive impairment. The oldest (≥85) age-at-diagnosis subgroup had the highest risk of short-term physical (aOR 3.01, 95% confidence interval [CI]: 2.40–3.77) and cognitive impairment (aOR 1.96, 95% CI: 1.55–2.48), as well as long-term impairment. All CVD subtypes were associated with higher odds of physical and cognitive impairment, with the highest risk for patients with incident stroke. Conclusions Incident CVD was associated with an increased risk of physical and cognitive impairment across CVD subtypes. Impairment risk after CVD was highest among the oldest patients (≥85 years) who should therefore remain a target for prevention efforts. [ABSTRACT FROM AUTHOR]

The present study presents a novel specific multi-joint isometric test to assess upper limb strength impairment for evidence-based classification in wheelchair sports. Sixteen wheelchair athletes participated in this study and were classified according to their type of physical impairment and health condition as follows: athletes with neurological impairment (ANI, n = 5) and athletes with impaired muscle power (IMP, n = 11). In addition, six non-disabled participants formed a control group (CG, n = 6). All the participants performed the isometric propulsion strength test (IPST), evaluating pushing and pulling actions, and two wheelchair performance tests. Excellent relative intra-session reliability scores were obtained for strength values for the ANI, IMP and CG groups (0.90 < ICC < 0.99) and absolute reproducibility showed acceptable scores of SEM (< 9.52%) for IPST pushing action. The ANI had significantly lower scores in strength and wheelchair performance than the IMP and the CG, while no differences were found between the IMP and the non-disabled participants. In addition, no correlations were found for wheelchair athletes between the isometric upper limb strength measure and wheelchair performance. Our findings suggest that the IPST is a valid test for strength measurement in upper limb impairment wheelchair athletes with different health conditions, which must be used in combination with a performance test to obtain a holistic assessment of this population. [ABSTRACT FROM AUTHOR]

It is challenging to discriminate the early presentation of Degenerative Cervical Myelopathy (DCM) as well as sensitively and accurately distinguishing between mild, moderate, and severe levels of impairment. As gait dysfunction is one of the cardinal symptoms of DCM, we hypothesized that spatiotemporal gait parameters, including the enhanced gait variability index (eGVI), could be used to sensitively discriminate between different severities of DCM. A total of 153 patients recently diagnosed with DCM were recruited and stratified on the basis of DCM severity grades, as measured using the modified Japanese Orthopedic Association (mJOA) scale. Demographic information and neurological status were collected. Gait assessments were performed using an 8 m walkway. Spearman rank correlation was used to identify relationships between gait parameters and mJOA values as well as the mJOA lower extremity (LE) subscore. Kruskal-Wallis H test was performed to evaluate differences between severity groups, as defined by mJOA classification. A significant and relatively strong correlation was found between the mJOA score and eGVI, as well as between the LE subscore of the mJOA and eGVI. Significant differences in the eGVI (X2(2, N = 153) = 55.04, p < 0.0001, ε2 = 0.36) were found between all groups of DCM severity, with a significant increase in the eGVI as DCM progressed from mild to moderate. The eGVI was the most discriminative gait parameter, which facilitated objective differentiation between varying severities of DCM. Quantitative gait assessments show promise as an accurate and objective tool to diagnose and classify DCM, as well as to potentially evaluate the impact of therapeutic interventions.

Abstract Background Knowledge of the prevalence and socio-demographic characteristics of physical impairments is limited. This study aimed to determine the prevalence of physical impairments among adults in Denmark, both in total and according to nine common diagnostic subgroups, describe the socio-demographic and socio-economic profile, and compare the data with those of the general adult population. Methods This descriptive, cross-sectional, register-based study evaluated the general socio-demographic and socio-economic variables, including sex, age, geographical region, origin, educational level, occupation, marital status, and disability level, of adults with physical impairments extracted by diagnosis from the Danish National Patient Register and Statistics Denmark by 31 December 2018. These data were compared with those of the general adult population in Denmark extracted from Statistics Denmark by January 2019. Results In total, 606,857 adults with physical impairments were identified. Of the nine selected diagnoses, osteoarthritis (69.4%) was the most prevalent, followed by acquired brain injury (29.0%), rheumatoid arthritis (6.7%), multiple sclerosis (2.6%), spinal cord injury (1.5%), cerebral palsy (1.2%), amputation (0.7%), muscular dystrophy (0.5%), and poliomyelitis (

The present study presents a novel specific multi-joint isometric test to assess upper limb strength impairment for evidence-based classification in wheelchair sports. Sixteen wheelchair athletes participated in this study and were classified according to their type of physical impairment and health condition as follows: athletes with neurological impairment (ANI, n = 5) and athletes with impaired muscle power (IMP, n = 11). In addition, six non-disabled participants formed a control group (CG, n = 6). All the participants performed the isometric propulsion strength test (IPST), evaluating pushing and pulling actions, and two wheelchair performance tests. Excellent relative intra-session reliability scores were obtained for strength values for the ANI, IMP and CG groups (0.90 < ICC < 0.99) and absolute reproducibility showed acceptable scores of SEM (< 9.52%) for IPST pushing action. The ANI had significantly lower scores in strength and wheelchair performance than the IMP and the CG, while no differences were found between the IMP and the non-disabled participants. In addition, no correlations were found for wheelchair athletes between the isometric upper limb strength measure and wheelchair performance. Our findings suggest that the IPST is a valid test for strength measurement in upper limb impairment wheelchair athletes with different health conditions, which must be used in combination with a performance test to obtain a holistic assessment of this population.

Background: Adolescents and young adults (AYA) with a chronic somatic disease (CD) have a 3-fold higher risk of post-traumatic stress disorder (PTSD) than healthy controls. In addition, elevated post-traumatic stress symptoms (PTSS) have a negative impact on CD severity, treatment adherence, health problems and functional impairment. However, a more detailed understanding of this comorbidity is lacking. Methods: AYA with type 1 diabetes mellitus, juvenile idiopathic arthritis or cystic fibrosis (12–21 years of age) and elevated anxiety and/or depression symptoms, as well as their reference persons (≥ 18 years of age), completed online questionnaires in self- or observer report. The most stressful event related to the CD was reported descriptively. Questionnaires were used to assess PTSS, anxious and depressive symptoms, actual overall health, coping, personal growth and social support. Qualitative content analysis, linear regression models and correlations were used for mixed methods analysis. Results: According to the reports of n = 235 AYA (mean age 15.61; 73% girls) and n = 70 reference persons, four categories were identified as the most stressful events due to CD: (1) psychological burden (40% of AYA / 50% of reference persons); (2) CD self-management (32% / 43%); (3) social burden (30% / 27%); and (4) physical impairment (23% / 16%). 37% of AYA reported clinically relevant PTSS due to CD. The best predictors of PTSS severity were anxious-depressive symptoms, emotional coping, personal growth and current overall health (F(4, 224) = 59.404, R² = 0.515, p <.001). Of all categories, psychological (β = 0.216, p =.002) and social burden (β = 0.143, p =.031) showed significant association with the severity of PTSS (F(4, 230) = 4.489, R² = 0.072, p =.002). The more categories the most stressful event addressed, the higher was the PTSS symptom severity (r =.168, p =.010). Conclusions: Many AYA showed clinically relevant PTSS and reported experiencing stressful events in several areas of life through their CD. The association between the stressful event categories and other variables could help identify AYA with CD who need psychological interventions the most. Trial registration: : German Clinical Trials Register (DRKS): DRKS00016714, registered on 25/03/2019 and DRKS00017161, registered on 17/09/201. [ABSTRACT FROM AUTHOR]

Purpose: Research on students with physical disabilities in higher educational institutions (HEIs) often focuses on students' abilities rather than on environmental barriers. Architectural barriers are notably the major roadblock for students with physical disabilities. This study explored the architectural barriers faced by students with physical disabilities in India, and the environmental requirements for social participation and inclusion. Method: Using a qualitative approach, an instrumental embedded case study was employed to explore the need for Universal Design to promote the inclusion of students with physical disabilities in higher educational institutions. The study participants were 6 students with physical disabilities, between 22 and 30 years of age, and their teachers (n=5). Data was collected through semi-structured interviews and a participatory observational accessibility assessment. It was analysed using categorical aggregation followed by cross-case analysis through constant comparisons of similarities and differences of themes. Results: Two-thirds of the participants reportedly experienced barriers to participation in the built and social environments. Most barriers originated from the institute's built environment design and from activities conducted on the premises. Students using wheelchairs or walking frames experienced significantly more participation barriers than those using crutches or sticks. The areas that need the most improvement are the indoor spaces (such as corridors and classrooms) and opportunities for vertical movement. Conclusion: Failure to make adequate modifications in the built environment for students with physical disabilities results in restricted participation or exclusion from opportunities to participate in and out of the classroom. The study findings can have implications across future research, architectural design practices, higher educational institutes, and policies to promote inclusion, optimal participation, and social interaction of students with physical disabilities within higher educational institutions. [ABSTRACT FROM AUTHOR]

Cognitive function can be affected by cancer and/or its treatment, and older patients are at a particular risk. In a prospective observational study including patients ≥65 years referred for radiotherapy (RT), we aimed to investigate the association between patient- and cancer-related factors and cognitive function, as evaluated by the Montreal Cognitive Assessment (MoCA), and sought to identify groups with distinct MoCA trajectories. The MoCA was performed at baseline (T0), RT completion (T1), and 8 (T2) and 16 (T3) weeks later, with scores ranging between 0 and 30 and higher scores indicating better function. Linear regression and growth mixture models were estimated to assess associations and to identify groups with distinct MoCA trajectories, respectively. Among 298 patients with a mean age of 73.6 years (SD 6.3), the baseline mean MoCA score was 24.0 (SD 3.7). Compared to Norwegian norm data, 37.9% had cognitive impairment. Compromised cognition was independently associated with older age, lower education, and physical impairments. Four groups with distinct trajectories were identified: the very poor (6.4%), poor (8.1%), fair (37.9%), and good (47.7%) groups. The MoCA trajectories were mainly stable. We conclude that cognitive impairment was frequent but, for most patients, was not affected by RT. For older patients with cancer, and in particular for those with physical impairments, we recommend an assessment of cognitive function.

Bone fractures are the most common type of injuries preserved in the dinosaur fossil record. Poor healing of deep lesions could lead to infection and misalignment of the fracture parts, causing the animals to limp and jeopardising their survival. A wide variety of fossilised fractures have been identified in dinosaur remains, and the type of bone response can provide information about their resilience and ability to survive even major traumatic events. Here we describe a pathological ulna of the lambeosaurine dinosaur Amurosaurus riabinini, from the Udurchukan Formation (Maastrichtian, Upper Cretaceous) of Blagoveshchensk (Amur Region, Russia). Its distal region is hypertrophied and swollen, and the distal articular surface is engulfed within a large overgrowth of newly formed bone. CT-scanning identifies an oblique fracture resulting from an impact, implying that the swollen portion corresponds to callus formation. The bone was still healing prior to the moment of death, although the misalignment of the fracture parts appears to have resulted in a malunion of the two fragments. During locomotion, the wrist would have suffered from a continuous weight-bearing pressure that placed stress upon the fracture site and probably caused the animal to limp and perhaps walk on three limbs. [ABSTRACT FROM AUTHOR]

Background Leucine is suggested to play a central role in age-related physical decline, but the effect of dietary leucine intake on physical functioning is uncertain. We examined the prospective association between dietary leucine intake and impaired lower-extremity function (ILEF) and frailty in older adults. Methods We used data from 2 956 adults aged ≥60 and older from the Seniors-ENRICA cohort. At baseline (2008–2010) and in 2012, dietary information was obtained with a validated computerized face-to-face diet history, from which energy-adjusted cumulative leucine intake per body weight was calculated. Participants were followed up through 2017 to assess incident ILEF, ascertained with the Short Physical Performance Battery, and incident frailty, according to the Fried phenotype criteria. Statistical analysis was performed with Cox models adjusted for the main potential confounders. Results During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared with participants in the lowest tertile of leucine intake (35.5–89.0 mg/kg/d), those in the highest tertile (107.4–372.5 mg/kg/d) had a lower risk of ILEF (fully adjusted hazard ratio [95% confidence interval]: 0.70 [0.53–0.93], p trend:.01) and of frailty (0.63 [0.41–0.96], p trend:.03]. A higher consumption of important sources of leucine in this population, including unprocessed beef, oily and white fish, and bread, were also associated with a lower risk of incident ILEF and frailty. Conclusions Higher leucine intake was associated with reduced risk of ILEF and frailty. Dietary leucine, obtained from foods rich in high-quality protein, could be a key nutrient to prevent age-related physical function decline in older adults. [ABSTRACT FROM AUTHOR]

Frailty is a geriatric syndrome that leads to increased risk of hospitalization, disability, and death. The effect of plant-based diets defined by the quality of their plant foods is unclear. Our objective is to study the association between two plant-based diet indices and the occurrence of frailty among community-dwelling older adults in Spain. We analyzed data from 1880 individuals aged ≥ 60 years from the Spanish Seniors ENRICA-1 cohort. We used a validated diet history to build two indices: (a) the healthful Plant-based Diet Index (hPDI) where healthy plant foods received positive scores, whereas less-healthy plant foods and animal foods received reverse scores; and (b) the unhealthful Plant-based Diet Index (uPDI), with positive scores to less-healthy plant foods and reverse scores to animal and healthy plant foods. Incident frailty was defined with the Fried phenotype. Study associations were summarized with odds ratios (OR) and 95% confidence intervals (CI) obtained from multivariable logistic models. After 3.3 years of follow-up, 136 incident frailty cases were ascertained. Comparing the highest vs. the lowest tertile of adherence, the OR [95% CI] for frailty was 0.43 (0.25–0.74; p-trend =.003) for the hPDI, and 2.89 (1.73–4.84; p-trend <.001) for the uPDI. Higher consumption of healthy plant foods was inversely associated with frailty (0.39 [0.23–0.66; p-trend < 0.001]); higher consumption of unhealthy plant foods was associated with higher frailty risk (2.40 [1.23–4.71; p-trend =.01]). In older adults, the hPDI was associated with lower risk of frailty, while the opposite was found for the uPDI. [ABSTRACT FROM AUTHOR]

Objectives Previous research focused on the individual risk factors of mortality, while little is known about how family environment could influence mortality in later life. This study aims to examine mortality risks in different family types and what family type may increase mortality risk for older adults with medical comorbidities or functional impairment. Methods Data were derived from the Population Study of Chinese Elderly (PINE) in Chicago. The baseline interview was conducted from 2011 to 2013. The outcome was 6-year all-cause mortality. Family typology included tight-knit, unobligated-ambivalent, commanding-conflicted, and detached types. Cox proportional hazards models were used. Results The study sample consisted of 3,019 older adults and 372 participants passed away during 6 years follow-up. Older adults in the detached type had higher risks of mortality than those in the tight-knit type (hazard ratio: 1.45 [95% confidence interval, 1.02–2.07]). Regarding the interaction effect between family typology and functional impairment, older adults with higher levels of physical impairment (1.29 [1.07–1.56]) and cognitive impairment (1.07 [1.01–1.14]) nested in the commanding-conflicted type had higher mortality risks than their counterparts nested in the tight-knit type. Discussion In this longitudinal cohort study with a 6-year follow-up, older adults nested in the detached family type had higher 6-year mortality risks than those nested in the tight-knit family type. Living in the commanding-conflicted family increased the 6-year mortality risks for older adults with physical impairment or cognitive impairment compared with their counterparts residing in the tight-knit family type. [ABSTRACT FROM AUTHOR]

Objectives: To examine risk and protective factors predicting physical functioning and physical and psychological health-related quality of life (HRQOL) among sexual and gender minority (SGM) older adults with cognitive impairment. Methods: This study analyzed longitudinal data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study with a sub-sample of 855 SGM older adults who reported difficulties in cognitive performance. Results: Physical functioning and HRQOL linearly declined over time, and the decline of physical functioning was steeper for those with low levels of physical and outdoor leisure activities. The overall levels of physical functioning and HRQOL over time were associated with physical and outdoor leisure activities, optimal sleep, and sufficient food intake. HRQOL was negatively associated with lifetime discrimination and victimization, identity stigma, and smaller social network. Discussion: These findings can be used to develop interventions to improve physical functioning and HRQOL of SGM older adults living with cognitive impairment. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the association of global cognitive with chronic conditions, physical impairment, olfactory function, socio-demographics and other factors among older adults in the urban community, West Jakarta., Materials and Methods: The cross-sectional study involved 334 older adults aged 60 years and older who resided in urban community Jakarta, Indonesia. Trained interviewers visited and evaluated the respondents in the sub-district office. Cognitive function is examined using Montreal Cognitive Assessment-Indonesian Version (MoCA-INA). Respondents were clinically examined using a standardized protocol, which included medical history, general physical examination, cognitive assessment, and blood test for diabetes., Results: Global cognitive impairment was significantly associated with being female (adjusted odd ratio [AOR]: 1.99, 95% CI: 1.14-3.50) and low education (AOR: 4.79, 95% CI: 2.80-8.18). Moreover diabetes, impaired balance, and olfactory dysfunction have AOR:3.23 (95% CI: 1.39-7.51), 2.55% (95% CI: 1.07-6.07), and 2.26 (95% CI: 1.32-3.85) respectively., Conclusion: This paper highlights that cognitively impaired and diabetic as well as low education subject in urban community, West Jakarta, Indonesia. Global cognitive impairment was associated with being female, having obtained low levels of education, having diabetes, impaired balance and olfactory dysfunction.

Congenital malformations, conditions, injuries, and illness can lead to long-term physical impairment and disability in nonhuman primates. How individual primates change their behaviors flexibly to compensate for their disabilities can inform our understanding of their resilience and ability to adjust to environmental change. Here, we synthesize the literature on nonhuman primates and disability, addressing the questions: how does disability influence behavior in primates? What insights can we take from the literature to better understand and predict the capacity of primates to modify their behaviors in the face of human-induced environmental change? We conducted a systematic review of the literature on spontaneous physical impairment and disability in captive, free-ranging, and wild primates. We surveyed 2807 articles on Web of Science and Scopus and identified 114 studies that fit our predetermined inclusion criteria. Behavioral plasticity, maternal and conspecific care, and the potential for innovation of novel behaviors allow many primates with disabilities to compensate when faced with challenges that are outside the scope of usual circumstances. We also found that 60% of the publications connected primate physical impairment and disability to human activities, suggesting an entangled relationship among humans, the environment, and primate disability. Disability and physical impairments provide an opportunity to examine how primates modify their behavior when presented with challenging conditions, and their potential resilience to a changing environment., (© 2023 The Authors. American Journal of Primatology published by Wiley Periodicals LLC.)

Abstract Background Diabetes and hypertension are common in older adults and represent established risk factors for frailty. Frailty is a multidimensional condition due to reserve loss and susceptibility to stressors with a high risk of death, hospitalizations, functional and cognitive impairment. Comorbidities such as diabetes and hypertension play a key role in increasing the risk of mortality, hospitalization, and disability. Moreover, frail patients with diabetes and hypertension are known to have an increased risk of cognitive and physical impairment. Nevertheless, no study assessed the correlation between physical and cognitive impairment in frail older adults with diabetes and hypertension. Methods We evaluated consecutive frail older patients with diabetes and hypertension who presented at ASL (local health unit of the Italian Ministry of Health) Avellino, Italy, from March 2021 to October 2021. The inclusion criteria were: a previous diagnosis of diabetes and hypertension with no evidence of secondary causes; age > 65 years; a frailty status; Montreal Cognitive Assessment (MoCA) score

Background: Knowledge of the prevalence and socio-demographic characteristics of physical impairments is limited. This study aimed to determine the prevalence of physical impairments among adults in Denmark, both in total and according to nine common diagnostic subgroups, describe the socio-demographic and socio-economic profile, and compare the data with those of the general adult population. Methods: This descriptive, cross-sectional, register-based study evaluated the general socio-demographic and socio-economic variables, including sex, age, geographical region, origin, educational level, occupation, marital status, and disability level, of adults with physical impairments extracted by diagnosis from the Danish National Patient Register and Statistics Denmark by 31 December 2018. These data were compared with those of the general adult population in Denmark extracted from Statistics Denmark by January 2019. Results: In total, 606,857 adults with physical impairments were identified. Of the nine selected diagnoses, osteoarthritis (69.4%) was the most prevalent, followed by acquired brain injury (29.0%), rheumatoid arthritis (6.7%), multiple sclerosis (2.6%), spinal cord injury (1.5%), cerebral palsy (1.2%), amputation (0.7%), muscular dystrophy (0.5%), and poliomyelitis (< 0.1%). There were large variations in the socio-demographic and socio-economic profile between the nine diagnostic subgroups. The adults with physical impairments were more often women, were older, were less often immigrants and employed adults, had a lower educational level, and were more commonly married than the general adult population. Only the geographical region did not differ. Conclusion: The nine subgroups with diagnoses related to the musculoskeletal system represent 13% of the adult Danish population. The socio-demographic and socio-economic profile varied largely between the nine diagnostic subgroups, and almost all variables differed significantly between adults with physical impairments and the general adult population in Denmark. These findings reveal patterns and trends on socio-demographic and socio-economic variables essential for future planning at a societal level, including the healthcare and social sectors. [ABSTRACT FROM AUTHOR]

Optimal energy and protein delivery goals for critically ill patients remain unknown. The purpose of this systematic review and meta-analysis was to compare the impact of energy and protein delivery during the first 4 to 10 days of an ICU stay on physical impairments. We performed a systematic literature search of MEDLINE, CENTRAL, and ICHUSHI to identify randomized controlled trials (RCTs) that compared energy delivery at a cut-off of 20 kcal/kg/day or 70% of estimated energy expenditure or protein delivery at 1 g/kg/day achieved within 4 to 10 days after admission to the ICU. The primary outcome was activities of daily living (ADL). Secondary outcomes were physical functions, changes in muscle mass, quality of life, mortality, length of hospital stay, and adverse events. Fifteen RCTs on energy delivery and 14 on protein were included in the analysis. No significant differences were observed in any of the outcomes included for energy delivery. However, regarding protein delivery, there was a slight improvement in ADL (odds ratio 21.55, 95% confidence interval (CI) −1.30 to 44.40, p = 0.06) and significantly attenuated muscle loss (mean difference 0.47, 95% CI 0.24 to 0.71, p < 0.0001). Limited numbers of RCTs were available to analyze the effects of physical impairments. In contrast to energy delivery, protein delivery ≥1 g/kg/day achieved within 4 to 10 days after admission to the ICU significantly attenuated muscle loss and slightly improved ADL in critically ill patients. Further RCTs are needed to investigate their effects on physical impairments. [ABSTRACT FROM AUTHOR]

Background: Zinc could be a target nutrient in the prevention of physical impairment and frailty in older adults due to its anti-inflammatory/antioxidant properties. However, prospective studies evaluating this inquiry are scarce. Thus, we aimed to assess the association between zinc intake and impaired lower-extremity function (ILEF) and frailty among community-dwelling older adults.Methods: We examined 2 963 adults aged ≥60 and older from the Seniors-ENRICA cohort. At baseline (2008-2010) and subsequent follow-up (2012), zinc intake (mg/d) was estimated with a validated computerized face-to-face diet history and adjusted for total energy intake. From 2012 to 2017, the occurrence of ILEF was ascertained with the Short Physical Performance Battery, and of frailty according to the Fried phenotype criteria. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders, including lifestyle, comorbidity, and dietary factors.Results: During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared with participants in the lowest tertile of zinc intake (3.99-8.36 mg/d), those in the highest tertile (9.51-21.2 mg/d) had a lower risk of ILEF (fully adjusted hazard ratio [95% confidence interval]: 0.75 [0.58-0.97]; p for trend: .03] and of frailty (0.63 [0.44-0.92]; p for trend: .02). No differences in the association were seen by strata of sociodemographic and lifestyle factors.Conclusions: Higher zinc intake was prospectively associated with a lower risk of ILEF and frailty among older adults, suggesting that adequate zinc intake, which can be achieved through a healthy diet, may help preserve physical function and reduce the progression to frailty. [ABSTRACT FROM AUTHOR]