Implementation and effects of Movement-oriented Restorative Care in a nursing home - a quasi-experimental study

Background: The prevalence of dementia is expected to increase rapidly, and institutionalization is a common consequence of the disease. Dependence in activities of daily living (ADL) is a predictor for institutionalization and a determinant for the quality of life (QoL). A promising method to increase functional independence in nursing homes is a restorative care or function focused care (FFC) approach. Movement-oriented restorative care (MRC) is derived from the concept of FFC and restorative care and focuses on the integration of physical activity in the daily lives of nursing home residents with dementia using a multidisciplinary approach. The objective of this study was to assess the effectiveness of MRC in preservation of ADL independence and QoL in nursing home residents with dementia. Methods: In this quasi-experimental 12-month study, the effects of MRC were compared to care as usual in 61 nursing home residents with moderate to severe dementia. The outcome measures were ADL independence and QoL. These outcomes were measured five times (i.e. at baseline, and after 3, 6, 9, and 12 months). Additionally, data was collected regarding the degree of implementation, and the barriers to the implementation process. The effect of the intervention was analyzed using linear mixed model analyses. Results: There was no significant overall intervention effect on ADL independence and QoL. A significant group-by-time interaction was found for the QoL subscale positive self-image: after a 12 month intervention period, the MRC group scored significantly better than the control group on positive self-image. Regarding the other subscales and the total score of the QoL, as well as ADL, no significant group-by-time interactions were found. Conclusions: MRC did not demonstrate significant improvements in ADL or QoL. After a 12-month intervention period, residents who received MRC showed higher scores on positive self-image compared to the control group. This study contributes to the limited research regarding the effect of MRC on resident outcomes. Further large-scale studies are recommended. Trial registration: The trial was retrospectively registered in http://clinicaltrials.gov on February 2, 2017: NCT03001232

Functional and morphological lumbar multifidus characteristics in subgroups with low back pain in primary care

Background: Since the contribution of the lumbar multifidus(LM) is not well understood in relation to nonspecific low back pain(LBP), this may limit physiotherapists in choosing the most appropriate treatment strategy. Objectives: This study aims to compare clinical characteristics, in terms of LM function and morphology, between subacute and chronic LBP patients from a large clinical practice cohort compared to healthy controls. Design: Multicenter case control study. Method: Subacute and chronic LBP patients and healthy controls between 18 and 65 years of age were included. Several clinical tests were performed: primary outcomes were the LM thickness from ultrasound measurements, trunk range of motion(ROM) from 3D kinematic tests, and median frequency and root mean square values of LM by electromyography measurements. The secondary outcomes Numeric Rating Scale for Pain(NRS) and the Oswestry Disability Index(ODI) were administered. Comparisons between groups were made with ANOVA, pvalues< 0.05, with Tukey’s HSD post-hoc test were considered significant. Results: A total of 161 participants were included, 50 healthy controls, 59 chronic LBP patients, and 52 subacute LBP patients. Trunk ROM and LM thickness were significantly larger in healthy controls compared to all LBP patients(p < 0.01). A lower LM thickness was found between subacute and chronic LBP patients although not significant(p = 0.11–0.97). All between-group comparisons showed no statistically significant differences in electromyography outcomes (p = 0.10–0.32). NRS showed no significant differences between LBP subgroups(p = 0.21). Chronic LBP patients showed a significant higher ODI score compared to subacute LBP patients(p = 0.03). Conclusions: Trunk ROM and LM thickness show differences between LBP patients and healthy controls

The delirium observation screening scale recognizes delirium early after cardiac surgery

Background: Ddelirium or acute confusion is a temporary mental disorder which occurs frequently among hospitalized elderly patients. Patients who undergo cardiac surgery have an increased risk of developing delirium. Prevention or early recognition of delirium is essential. The Delirium Observation Screening (DOS) scale was developed to facilitate early recognition of delirium by nurses' observations during routine clinical care. Aim: The aim of this study was to validate the DOS scale in accordance with the diagnosis of the psychiatrist, using the DSM-IV criteria as the gold standard. Methods: In this observational study, the DOS scale was used to assess whether 112 patients who underwent elective cardiac surgery had developed a postoperative delirium. The psychiatrist was consulted to confirm or refute the diagnosis delirium. Wilcoxon's Rank Sum Test was utilized to compare patients with and without delirium on duration of hospital stay. A Receiver Operating Characteristic Curve of the DOS scale was constructed with accompanying Area Under the Curve (AUC). Results: Based on the diagnosis of the psychiatrist, the incidence of delirium following cardiac surgery was 21.4% and the mean duration of delirium was two and a half days. The time to discharge was 11 days longer in patients with delirium. In 27 of the 112 patients a DOS score of > = 3 was found, that indicates delirium. The sensitivity and specificity of the DOS scale was 100% and 96.6% respectively. The AUC was 0.98. Conclusion: The DOS scale is a very good instrument to facilitate early recognition of delirium by nurses' observation of patients who undergo cardiac surgery. Early recognition will expedite good postoperative management such as implementation of appropriate interventions, and may decrease negative consequences caused by postoperative delirium

Development of a brief observation method for measuring joint protective behaviors: Reliability

Ergonomic measures (joint protection, energy conservation and the use of devices) are part of basic treatment in rheumatoid arthritis (RA). It is of increasing importance that Health Care is based on evidence. Therefore, attention should be paid to the assessment of ergonomic performance in clinical practice and in studies on the effects of formal patient education. We describe a first step in developing a practical test for joint protection performance. The inter- and intraobserver reliability of this test was high in a preliminary study among 15 RA patients. The presented test is reliable and easy to perform. There is a need to determine the validity of the test

Corrigendum to “Reliability and validity of the Microgate Gyko for measuring range of motion o the low back” [Muscoskel. Sci. Pract. 45 (2020) 102091] (Musculoskeletal Science and Practice (2020) 45, (S2468781219302814), (10.1016/j.msksp.2019.102091))

The authors regret to inform that de-anonymisation of the study has failed in the publication. Section 2.2 of the methods section should be corrected with the following text. Line 1: Subjects were recruited based on convenience sampling from networks at Saxion University of Applied Sciences in the Eastern part of The Netherlands. Line 4 of section 2.2 should be corrected to: the study was part of regular education of Saxion University of Applied Sciences. The authors would like to apologise for any inconvenience caused

Study Uses Paced Deep Breathing to Measure Dutch Workers’ HRV

The researchers who conducted a recently published study using a short breathing protocol to measure heart rate variability (HRV) in a large group of Dutch workers say it&rsquo;s the first of its kind. "This is the first study," the researchers explained, "to explore a 1-minute paced deep-breathing HRV protocol as an objective screening measure for multiple future health issues in a working population." The study,&nbsp;Exploring a 1-Minute&nbsp;Paced&nbsp;Deep-Breathing&nbsp;Measurement of Heart Rate Variability as Part of a Workers&rsquo; Health Assessment, explored associations between a compressed measure of HRV and health-related parameters. It&nbsp;was intended to be a first step to studying the value of using HRV measures in a workers&rsquo; health assessment (WHA).&nbsp;(HRV,&nbsp;a&nbsp;measure of the consecutive differences in time between heartbeats.

Functional and morphological lumbar multifidus characteristics in subgroups with low back pain in primary care

CC-BY 4.0 Background: Since the contribution of the lumbar multifidus(LM) is not well understood in relation to nonspecific low back pain(LBP), this may limit physiotherapists in choosing the most appropriate treatment strategy.Objectives: This study aims to compare clinical characteristics, in terms of LM function and morphology, between subacute and chronic LBP patients from a large clinical practice cohort compared to healthy controls.Design: Multicenter case control study.Method: Subacute and chronic LBP patients and healthy controls between 18 and 65 years of age were included.Several clinical tests were performed: primary outcomes were the LM thickness from ultrasound measurements, trunk range of motion(ROM) from 3D kinematic tests, and median frequency and root mean square values of LM by electromyography measurements. The secondary outcomes Numeric Rating Scale for Pain(NRS) and the Oswestry Disability Index(ODI) were administered. Comparisons between groups were made with ANOVA, pvalues&lt; 0.05, with Tukey&rsquo;s HSD post-hoc test were considered significant.Results: A total of 161 participants were included, 50 healthy controls, 59 chronic LBP patients, and 52 subacute LBP patients. Trunk ROM and LM thickness were significantly larger in healthy controls compared to all LBP patients(p &lt; 0.01). A lower LM thickness was found between subacute and chronic LBP patients although not significant(p = 0.11&ndash;0.97). All between-group comparisons showed no statistically significant differences in electromyography outcomes (p = 0.10&ndash;0.32). NRS showed no significant differences between LBP subgroups(p = 0.21). Chronic LBP patients showed a significant higher ODI score compared to subacute LBP patients(p = 0.03).Conclusions: Trunk ROM and LM thickness show differences between LBP patients and healthy controls