جستجوی مقالات مرتبط با کلیدواژه « disability » در نشریات گروه « پزشکی »

Chronic non-specific neck pain is one of the most common musculoskeletal disorders in modern society and is considered a cause of disability in many jobs, especially in office workers.

In this study, 36 female office worker with mean±SD age of 39.20±4.29 years, mean ± SD weight of 70.60±12.37 kg and mean±SD height of 163.15±6.23 cm were randomly divided into three groups: 1. Dynamic neuromuscular stability exercises 2. Stabilization Exercises and 3. Control group. Stabilization exercises with emphasis on the effect on deep neck muscles dynamic neuromuscular stability exercises with emphasis on the effect on cervical thoracic and lumbar pelvic chain coordination were performed for six weeks (3 sessions per week). Visual Analog Scale and disability questionnaire were used to measure the pain and disability of the subjects, respectively, and to measure muscle tolerance, two methods of assessing activation score and deep neck flexor muscle performance index were used by compression biofeedback device. Finally, data analysis was performed using SPSS software (version 22)at the significance level of P=0.05.

The one-way ANOVA test results showed a significant difference between the three groups in all variables (P<0.05). The Turkey post hoc test results showed no significant difference between the pain score and disability of the dynamic neuromuscular stability exercises and stabilization exercise groups (P>0.05). On the other hand, the results showed that after six weeks of training, there was no significant difference between muscle activation score and muscle performance index in the control and stabilization exercise groups (P>0.05).

Both training protocols had a significant effect on reducing pain and disability. However, dynamic neuromuscular stability and stabilization exercises substantially increased the tolerance of deep neck flexor muscles compared with the stabilization exercises group. It can also be a better approach to treat non-specific chronic neck pain.

There is conflicting evidence regarding the effects of exercise on shoulder impingement syndrome. Exercise therapy is one of the methods used to reduce pain and increase muscle strength in patients with shoulder impingement syndrome. There are several exercise therapy programs available in this area. The purpose of this study is to evaluate the effect of exercise therapy on pain and disability in patients with shoulder impingement syndrome.

This randomized clinical trial was conducted in 25 patients with impingement syndrome from the Dastgheib Yasaei Pain Clinic in Fasa. Patients were randomized to receive medication (n=13) or medication plus exercise therapy (n=12). The Oswestry Disability Index (ODI) and the Verbal Numeric Rating Scale were used to measure disability and pain intensity before and after the intervention. Patient satisfaction was measured using the Likert scale. Independent and paired t-test, Mann-Whitney U test, and chi-squared were performed at a significant level of P≤0.05. Analyses were performed with SPSS software (version 25.0).

There were no differences between groups in pre-intervention demographics (P>0.05), pain intensity (P=0.16), and ODI scores (0.93). Post-intervention pain and ODI scores were significantly higher in the medication group than in the medication-exercise group (P=0.06, P=0.03, respectively). There was a significant difference in pain and ODI scores at post-intervention compared to pre-intervention in both groups (P<0.001). The difference in pain intensity between pre- and post-intervention in both groups was also statistically significant (P=0.006). There was a significant difference in patient satisfaction between groups (P=0.03).

These results suggest that a regular exercise program, along with medication, may be effective in reducing pain and disability in patients with shoulder impingement syndrome.

Chronic non-specific low back pain (CNSLBP) is a common health issue caused by a mix of biological, psychological, and social factors. Cognitive functional therapy (CFT) is a comprehensive way to treat CNSLBP that focuses on changing negative thoughts and unhelpful habits through relaxation techniques. Since the evidence on the efficacy of CFT is still limited, it is essential to conduct clinical trials aimed at the effectiveness of CFT in the treatment of CNSLBP. This study aims to examine the effect of cognitive functional therapy on psychological variables in women with CNSLBP.

Thirty women with CNSLBP were recruited for the clinical trial. They were randomly divided into two experimental and control groups (15 patients in each group). Our experimental group will have 18 individualized CFT sessions, each lasting an hour, over two months. The control group received no intervention. Pain intensity, disability, and kinesiophobia were assessed via the visual analog scale, Oswestry, and Tampa scale, respectively. Two-way repeated measures analysis of variance (ANOVA) was used to compare results between groups.

Two-way repeated measures ANOVA results showed that the experimental group compared to the control group in reducing pain (P=0.000, ηp2=0.787), disability (P=0.005, ηp2=0.457) and Kinesiophobia (P=0.000, ηp2=0.561) had a significant difference.

CFT reduced pain, disability, and kinesiophobia in patients with CNSLBP. Further evaluation of the efficacy of CFT in high-quality randomized clinical trials among patients with CNSLBP is recommended.

Fingolimod and interferons are used in the relapse form of multiple sclerosis (MS). The goal of this systematic review and meta‑analysis was to evaluate the efficacy of fingolimod versus interferon in patients with MS. The systematic search was done in PubMed, Scopus, Embase, Web of Science, and Google Scholar.

The references of included studies as well as conference abstracts were searched up to July 2021. The literature search revealed 8211 articles, and after deleting duplicates 5594 remained. For the meta‑analysis, four studies were included. The standardized mean difference (SMD) of the Expanded Disability Status Scale (EDSS) after treatment (interferon vs fingolimod) was −0.06 (95% CI: −0.28, 0.17) (I2 = 80.2%, P = 0.002).

The SMD of the annual relapse rate (ARR) after treatment (interferon – fingolimod) was −0.08 (95% CI: −0.53, 0.36) (I2 = 95.5%, P < 0.001). The SMD of the ARR after treatment and before treatment in the interferon group was − 1.45, (95% CI: −1.55, −1.36) (I2 = 0, P = 0.3). The SMD of ARR after treatment and before treatment in the fingolimod group was − 1.3, (95% CI: −1.94, −0.65) (I2 = 97.4%, P < 0.001).

The results of this systematic review show that efficacy of interferon and fingolimod in controlling relapse rate and disability is similar.

According to the World Health Organization (WHO), more than 1 billion people (approximately 15% of world population) live with disability. Also, about half of these people lack access to healthcare facilities. Therefore, providing timely healthcare services, especially rehabilitation, is of great significance for these people. The goal of the study was to determine the objectives and policies in the field of rehabilitation in middle- and high-income countries and compare them with Iran.

Based on available databases, a comprehensive review of documents, papers, and books was performed in the field of rehabilitation related to high- and middle-income countries. 

Due to a lack of coordinated services, inappropriate access, unplanned distribution, unclear service delivery levels, neglect of health promotion and prevention levels, lack of a transparent referral system, unclear insurance system, and weak financial resources, the need for a national program with a service integration approach is strongly felt. The review of the rehabilitation programs and documents in other countries help us to design a conceptual framework of the rehabilitation service model, which is based on three principles: Removing barriers and developing access to healthcare services and programs; strengthening and developing rehabilitation using technology, community-based support, and rehabilitation services; and promoting comparable international data collection on disability and supporting research on disability and related rehabilitation services.

Conclusion:

 The national rehabilitation program, with a service integration approach, provides a good platform for fair access to rehabilitation services for all people with disability. In this program, the health system is the most important reference to meet these needs. Therefore, it is suggested that this program pursue three main objectives Fair promotion of the healthcare services of rehabilitation for recipients, improving the response to the needs of rehabilitation service recipients, and reducing the financial and social risks of service recipients.

The death and fear of the COVID-19 pandemic has been a major concern in all countries. Estimating the burden of the disease is one of the indicators that estimates the severity of the damage caused by the disease. This study was performed to estimate the burden of years of life lost due to COVID-19 infection and premature death in North Khorasan.

In this study, all cases of definitive infection (PCR test positive) with COVID-19 from the beginning of the epidemic to April 2021 were included in the study. Disability-Adjusted Life -Years index (DALYs) was used to estimate the burden of the disease.

Since the beginning of the epidemic, 63697 definite cases of the disease have been identified (prevalence equal to 7%) and the total number of years of life lost due to disability and premature death was estimated at 24769 years. This number represents 28.7 years per 100,000 populations, which in women and men, this number was equal to 26.6 and 30.8, respectively.

According to the results of the study, COVID-19 has caused significant loss of years of life, which due to age and concomitant diseases, deaths are more common in the elderly.

Neck pain is one of the most common musculoskeletal disorders among office workers. This study aimed to investigate the impact of strengthening the neck muscles on pain prevalence and neck disability among office workers.

This interventional study was performed among 85 University office workers (female=50 and male=35). Participants were randomly divided into the two groups (exercise group=42 subjects and control group=43 subjects). The exercise intervention was performed for 12 weeks, five sessions per week, and each session lasted approximately 15 minutes in the experimental group. Evaluations were performed at baseline and after 12 weeks: demographic questionnaire, Nordic questionnaire for measuring neck pain prevalence, and Neck Disability Index (NDI) for measuring functional disability were applied. The neck pain prevalence and NDI were compared before and after the intervention using McNemar and paired t-tests.

47.05% and 40% of all participants reported neck pain during the last 12 months and the last seven days, respectively. The neck pain prevalence during the last seven days (P<0.05) and NDI (P<0.01) after exercise were significantly decreased comparing to the other group.

About half of the office workers suffer from neck pain, and exercise intervention can improve and reduce the prevalence of neck pain and NDI by strengthening neck muscles.

Smartphone is now an inevitable device for the populace, with its use growing progressively worldwide. There is lack of published literature focusing on the consequences of smartphone addiction on middle-aged and older adults in Nigeria. This study investigated the association between smartphone addiction, psychological status, insomnia and pain-related disability of the neck among staff of the College of Medicine, University of Lagos (CMUL).

This study involved the use of cross-sectional survey to investigate 271 (106 females, 165 males) staff of CMUL, Lagos, mean age (45.797±9.28 years) via purposive sampling technique in 2022. Four standard questionnaires were used for data collection; smart phone addiction scale (SAS), depression, anxiety and stress scale (DASS), neck pain disability index (NDI), and insomnia severity index (ISI).

The results revealed that 80 (29.5%) staff of college of medicine were addicted to smartphone use. Eleven (4.1%) staff of this college had severe depression, 16 (5.9%) had extremely severe anxiety while nine (3.3%) were severely stressed. Nine (3.3%) participants had clinical insomnia and five (1.8%) had moderate to severe problem with their neck. It was revealed that there was a significant association between smartphone addiction, pain-related disability of the neck (p=0.023), and insomnia (p=0.001). However, no significant association existed between depression (p=0.578), anxiety (p=0.060), stress (0.685), and smartphone addiction level of the participants

Smartphone addiction is predominant among staff of CMUL, and it is associated with neck pain-related disability and insomnia.

 There is evidence supporting the effectiveness of mirror therapy (MT) in improving pain and function in the upper limbs. However, there are limited studies that validate its effectiveness in enhancing function and reducing pain among individuals with chronic back pain.

 This study aimed to assess the effect of motor correction exercises with and without MT on pain intensity and disability in patients with chronic low back.

 This randomized clinical trial study was conducted on 72 participants with chronic back pain referring to physiotherapy centers affiliated with Jundishapur University of Medical Sciences, Ahvaz. Specific exercises using MT were performed in the intervention group (36 participants) and without it in the control group (36 participants) for 10 weeks. The condition of the patients before and after the intervention and 3 months after the intervention was evaluated using a chronic pain questionnaire, pain intensity, and Oswestry index. The data were analyzed using SPSS version 22, employing descriptive and inferential statistical methods. A significance level of P ≤ 0.05 was used.

 A significant difference was observed between the groups for the variables that showed pain intensity after treatment (P = 0.001) and the difference remained in the follow-up (P = 0.003) Chronic pain after treatment and the difference at follow-up [-0.41 (-3.45 to 2.47), P = 0.001] and disability remained after treatment [-2.6 (-5.6 to 0.5); P = 0.02] which indicates the effectiveness of MT.

 Based on the results, MT was effective in reducing the pain intensity and disability experienced by patients with chronic back pain. As a result, considering its affordability and ease of access, patients can perform the exercises independently after receiving proper instruction and guidance.

To compare the effect of using custom-made orthosis on improving extension lag and reducing disability in acute and chronic mallet fingers. We recruited 51 patients with acute or chronic Doyle type-1 mallet fingers, who were provided with a custom-made thermoplastic anti-mallet finger orthosis to wear full-time for 6 weeks and an additional 2 weeks at nighttime. The primary outcome, extension lag, was assessed at enrollment as well as six- and twelve-week followups. Secondary outcomes included disability and satisfaction, which were evaluated using the Disability of the Arm, Shoulder, and Hand questionnaire at enrollment and 12 weeks, and a satisfaction scale at 12 weeks follow-up. Data analysis was conducted using univariate analysis of variance (ANOVA), one-way repeated measure mixed model analysis of covariance (ANCOVA), and independent sample t-test. A total of 43 participants, 25 acute and 18 chronic mallet fingers, completed the 12-week evaluation. The study found no significant difference between the two groups in terms of improvement in extension lag at either follow-up time point (P=0.21). Disability improved in both the acute and chronic groups at follow-up (P<0.05). Additionally, both groups expressed satisfaction with the treatment outcome, and no statistically significant difference was observed (t=0.173, P=0.51). We could not identify any clinically significant difference between the two groups in regard to extension lag, disability, or satisfaction at follow-up. Notably, 96% of the patients in the acute group and 88% of the patients in the chronic group demonstrated good to excellent outcomes.  Orthotic intervention with custom-made thermoplastic material in acute and chronic mallet fingers improved extension lag and disability, and both groups were satisfied with the treatment outcomes. The findings of our study indicated that patients with chronic mallet fingers benefited from orthotic interventions in the same way that patients with acute mallet fingers did. Level of evidence: II

Nowadays, one of the purposes of ergonomics is to identify the risk factors of musculoskeletal disorders and provide solutions to reduce them. The aim of this study was to investigate the effect of using Kinesio tape and doing exercise during working hours for 8 weeks on the reduction of risk and pain and improvement of hand function during daily activities.

This clinical trial study was carried out on 40 female workers employed in the manufacturing industry. The subjects were divided into three groups, including exercise-taping, exercise, and control, and performed an 8-week rehabilitation program twice a week. To assess the upper limb function, the cognitive demand of the assigned task, and hand strength, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, Borg Scale, and a dynamometer were used, respectively.

The results of this study indicated a decrease in upper limb disability and increased grip strength in the tape plus exercise group compared to the control group (P<0.05). However, no significant change in the Borg scale was found in any of the three groups (P>0.05).

It can be concluded that attending at least 2 or 3 exercise sessions per week and using Kinesio tape can be effective in reducing pain in the upper limb.

Coronary surgery can have various outcomes, such as fear of death, cardiac anxiety, and pain disability. This study aimed to evaluate the effects of interventions based on patient expectations on different outcomes of coronary surgery, including expectations, cardiac anxiety, and pain-induced disability.

This randomized clinical trial evaluated 60 coronary surgery candidates. Patients meeting the inclusion criteria were randomly assigned to control and intervention groups. The patients were contacted 1 to 2 weeks before coronary surgery to complete the Cardiac Surgery Patient Expectations Questionnaire (C-SPEQ). Based on the analysis of expectations, the intervention group underwent interventions to optimize expectations, whereas the control group received only routine care. The Cardiac Anxiety Questionnaire (CAQ) and the Pain Disability Index (PDI) were completed on the day of hospitalization. Three months later, the participants recompleted all 3 questionnaires. The data were analyzed with descriptive and analytical statistics in SPSS 16.0.

There were no significant differences between the control and intervention groups in baseline variables, paininduced disability (P=0.353), and cardiac anxiety (P=0.479). After the intervention, no significant differences were observed between the groups concerning expectations (P=0.554) and pain-induced disability (P=0.557) when the confounding variables were adjusted. Nevertheless, cardiac anxiety decreased significantly (P=0.027).

Our interventions improved expectations and mitigated anxiety among coronary surgery patients. Actualization and optimization of patient expectations should be considered in the care of coronary surgery candidates.

 Incomprehensive studies have examined the therapeutic and side effects of curcumin on the treatment of debilitating diseases, such as Rheumatoid Arthritis (RA). This study aimed to explore the anti-inflammatory effects of curcumin on RA.

 This double-blind clinical trial was carried out on 64 RA patients with an erythrocyte sedimentation rate (ESR)-Disease Activity Score (DAS)-28>2.6. The patients were then randomly divided into two groups of intervention and control. In addition to the routine treatment, the intervention group was treated with 80-mg/day capsules of curcumin (nano-micelles). Further, the patients were followed up for three months, and clinical-laboratory examinations were recorded in this study.

 There was no significant difference between the intervention and control groups regarding the trends of the disease activity indicators, including DAS-28, disability index, physician assessment, and the number of tender joints (P>0.05). Further, a significant difference was found between the two groups in terms of pain score changes and the number of swollen joints. Additionally, the curcumin-treated subjects obtained lower mean pain and fewer swollen joints, compared to those in the control group (P<0.05).

 The present study revealed that curcumin had no significant therapeutic effects on reducing the activity of RA; however, no significant side effects were observed on the patients, and it also showed its analgesic effect well.

  People with disabilities have experienced heightened social risks in the context of the pandemic, resulting in higher rates of infection and mortality. They have also borne elevated burdens associated with public health measures. The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) obliges its 184 state parties to eliminate discrimination and ensure equality and inclusion for persons with disabilities, including protection and safety in situations of emergency. It remains unclear to what extent national COVID-19 policies have aligned with these commitments under the UNCRPD. Our objective in this exploratory study was to assess alignment between the UNCRPD indicators and COVID-19 policies from 14 countries with the goal of informing policy development that is inclusive of persons with disabilities and responsive to rights under the UNCRPD.

  We identified COVID-19 policy documents from 14 purposively selected countries. Country selection considered diversity based on geographic regions and national income levels, with restriction to those countries that had ratified the UNCRPD and had English or French as an official language. We used a computational text mining approach and developed a complex multilevel dictionary or categorization model based on the UNCRPD Bridging the Gap indicators proposed by the Office of the High Commissioner on Human Rights (OHCHR). This dictionary was used to assess the extent to which indicators across the entirety of the UNCRPD were represented in the selected policies. We analyzed frequency of associations with UNCRPD, as well as conducting ‘key word in context’ analyses to identify themes.

  We identified 764 COVID-19 national policy documents from the period of January 2020 to June 2021. When analyzed in relation to the Articles of the UNCRPD, the most frequently identified were Articles 11 (risk and humanitarian emergencies), 23 (home and family), 24 (education), and 19 (community living). Six countries produced 27 policies that were specifically focused on disability. Common themes within these documents included continuation of services, intersectionality and equity, and disability considerations in regulations and public health measures.

  Analyzing country policies in light of the UNCRPD offers important insights about how these policies do and do not align with states’ commitments. As new policies are developed and existing ones revised, more comprehensive approaches to addressing the rights of persons with disabilities are urgently needed.

There is limited information on the status of international classification of functioning, disability, and health (ICF) framework in subjects with chronic stroke with varying duration of rehabilitation care. Accordingly, this study investigates whether the duration of rehabilitation care affects the status of ICF in subjects with chronic stroke.

This was an observational cross-section study on 58 individuals with chronic stroke. The number of subjects who received rehabilitation care for less than 3 months and more than 3 months were 22 (group A) and 36 (group B), respectively. The ICF components of impairment of body functions and structure were assessed using the clock drawing test, the Beck depression inventory, and the Fugl-Meyer assessment of motor recovery after stroke. The activity limitation and participation using timed up and go test, the community integration questionnaire, and environmental factors were assessed by the Craig Hospital inventory of environmental factors.

The Fugl-Meyer assessment and the policy components of the Craig hospital inventory of environmental factors showed a significant difference between the groups. Longer duration of rehabilitation care only showed a positive effect on the Fugl-Meyer assessment scores. No other components of ICF showed any difference between the groups.

The duration of rehabilitation impacts the impairments of body functions and body structures of ICF components. The study findings are limited and further studies are required before generalizing the results.

The unanticipated lockdown following the COVID-19 outbreak significantly impacted the field of rehabilitation, compelling the professionals to switch to tele-mode to continue providing their service without interruption. This article aims to highlight the steps taken to overcome the various challenges that were encountered in this period and to strengthen the opportunities in telerehabilitation services at a tertiary care center in Kerala, India. An average of 1000 clients were served monthly through telerehabilitation in various units at the selected institute during the COVID-19 pandemic. The telerehabilitation services included assessments, intervention, and counseling for clients of all ages with various types of disabilities. A high literacy rate and better access to technology among the general population in Kerala, India were identified as advantages for the rapid implementation of telerehabilitation as a viable form of service delivery.

Providing optimal rehabilitation services for people with disabilities has always been recognized as a major concern of health systems in all countries. Stewardship is one of the biggest challenges to provide rehabilitation services to people with disabilities in Iran. We advocate the Ministry of Health & Medical Education (MoHME) to take the lead as a steward of rehabilitation services in Iran, while the dedicated sections in the MoHME need to be determined, with a clear list of responsibilities and affiliations.