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Is recovery from ankle sprains negatively affected by obesity? / I.A. Bielska in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)
[article]
Titre : Is recovery from ankle sprains negatively affected by obesity? Type de document : texte imprimé Auteurs : I.A. Bielska ; R. Brison ; B. Brouwer ; et al. Année de publication : 2019 Article en page(s) : p. 8-13 Note générale : Doi : 10.1016/j.rehab.2018.08.006 Langues : Anglais (eng) Mots-clés : Body mass index BMI Ankle sprains Recovery Outcomes Résumé : Highlights
At 6 months, a sizeable proportion of participants with ankle sprains had not fully recovered.
Higher levels of incomplete recovery were observed among individuals with obesity.
This finding was statistically significant but not clinically meaningful on 2 foot and ankle outcome score subscales.
Abstract
Objective
Ankle sprains are common injuries that may lead to long-term morbidity. Individuals with obesity are at increased risk for ankle sprains; however, prognostic associations between body mass index (BMI) and recovery are less well understood. This study investigated whether BMI status affects recovery from ankle sprains.
Methods
We included individuals≥16 years old with grade 1 or 2 ankle sprains who sought emergency department treatment in Kingston, Ontario, Canada. Height in centimeters and weight in kilograms were measured at baseline by using a height rod and a standard medical column scale, respectively. BMI was calculated and categorized as non-overweight,<25.0kg/m2; overweight, 25.0–29.9kg/m2; and obese,≥30kg/m2. Recovery was assessed at 1, 3 and 6 months post-injury by the Foot and Ankle Outcome Score (FAOS). Continuous FAOS and binary recovery status were compared by BMI group at each assessment using a repeated measures linear mixed effects model and logistic regression, respectively.
Results
In total, 504 individuals were recruited and 6-month follow-up data were collected for 80%. We observed no significant differences in recovery at 1 and 3 months post-injury. At 6 months, between 53% and 66% of the participants were considered to have recovered according to the FAOS. The mean difference in unadjusted FAOS between participants classified as obese and non-overweight was −23.02 (95% confidence interval, −38.99 to −7.05) but decreased after adjusting for confounders. The odds ratio for recovery was 0.60 (0.37–0.97) before adjustment and 0.74 (0.43–1.29) after adjustment. Six-month recovery was significantly lower for participants with obesity than non-overweight participants on the FAOS Pain and Function in Daily Living subscales but were not clinically meaningful.
Conclusions
All BMI groups showed improvements from ankle sprain over time. However, at 6 months, a sizeable proportion of the participants had not fully recovered particularly among individuals classified as obese. The findings suggest that individuals with obesity may benefit from specialized interventions focused on symptom management and functional activity.Permalink : ./index.php?lvl=notice_display&id=82398
in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 8-13[article] Is recovery from ankle sprains negatively affected by obesity? [texte imprimé] / I.A. Bielska ; R. Brison ; B. Brouwer ; et al. . - 2019 . - p. 8-13.
Doi : 10.1016/j.rehab.2018.08.006
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 8-13
Mots-clés : Body mass index BMI Ankle sprains Recovery Outcomes Résumé : Highlights
At 6 months, a sizeable proportion of participants with ankle sprains had not fully recovered.
Higher levels of incomplete recovery were observed among individuals with obesity.
This finding was statistically significant but not clinically meaningful on 2 foot and ankle outcome score subscales.
Abstract
Objective
Ankle sprains are common injuries that may lead to long-term morbidity. Individuals with obesity are at increased risk for ankle sprains; however, prognostic associations between body mass index (BMI) and recovery are less well understood. This study investigated whether BMI status affects recovery from ankle sprains.
Methods
We included individuals≥16 years old with grade 1 or 2 ankle sprains who sought emergency department treatment in Kingston, Ontario, Canada. Height in centimeters and weight in kilograms were measured at baseline by using a height rod and a standard medical column scale, respectively. BMI was calculated and categorized as non-overweight,<25.0kg/m2; overweight, 25.0–29.9kg/m2; and obese,≥30kg/m2. Recovery was assessed at 1, 3 and 6 months post-injury by the Foot and Ankle Outcome Score (FAOS). Continuous FAOS and binary recovery status were compared by BMI group at each assessment using a repeated measures linear mixed effects model and logistic regression, respectively.
Results
In total, 504 individuals were recruited and 6-month follow-up data were collected for 80%. We observed no significant differences in recovery at 1 and 3 months post-injury. At 6 months, between 53% and 66% of the participants were considered to have recovered according to the FAOS. The mean difference in unadjusted FAOS between participants classified as obese and non-overweight was −23.02 (95% confidence interval, −38.99 to −7.05) but decreased after adjusting for confounders. The odds ratio for recovery was 0.60 (0.37–0.97) before adjustment and 0.74 (0.43–1.29) after adjustment. Six-month recovery was significantly lower for participants with obesity than non-overweight participants on the FAOS Pain and Function in Daily Living subscales but were not clinically meaningful.
Conclusions
All BMI groups showed improvements from ankle sprain over time. However, at 6 months, a sizeable proportion of the participants had not fully recovered particularly among individuals classified as obese. The findings suggest that individuals with obesity may benefit from specialized interventions focused on symptom management and functional activity.Permalink : ./index.php?lvl=notice_display&id=82398 Exemplaires (1)
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Exclu du prêtMonoaminergic drugs for motor recovery after ischemic stroke in Annals of physical and rehabilitation medicine, Vol. 57, n°8 (Novembre 2014)
[article]
Titre : Monoaminergic drugs for motor recovery after ischemic stroke Titre original : Médicaments monoaminergiques dans la récupération motrice après accident vasculaire cérébral ischémique Type de document : texte imprimé Année de publication : 2014 Article en page(s) : p.509-519 Langues : Français (fre) Mots-clés : Stroke Recovery Fluoxetine Brain plasticity Monoaminergic drugs Ischémie cérébrale Récupération fonctionnelle Fluoxétine Plasticité cérébrale Médicaments monoaminergiques Résumé : Today, administering rTPA thrombolytic therapy within the first hours of a stroke is the only validated drug therapy for improving the spontaneous – and most of the time incomplete – recovery of neurological functions post-stroke. However in the past decade, thanks in part to the considerable advances of neuroimaging techniques, we have learned that spontaneous recovery of neurological functions was associated with a wide intracerebral reorganization of the damaged human brain. The question of whether lesioned-brain plasticity can be modulated by external factors like pharmacological agents is now addressed in the hope of improving recovery and reducing the chronic impairments of stroke patients. In this paper, we review the preclinical and clinical evidence for a direct action of SSRIs in promoting recovery in ischemic stroke patients.
La thrombolyse IV par le rTPA en urgence, est actuellement la seule thérapeutique médicamenteuse validée (bénéficiant d’une autorisation de mise sur le marché) capable d’améliorer la récupération fonctionnelle après un accident vasculaire cérébral ischémique. Toutefois, la dernière décennie nous a appris que la récupération fonctionnelle spontanée s’accompagnait d’une réorganisation intracérébrale constante et complexe du cerveau lésé. La modulation de cette plasticité cérébrale base rationnelle de la récupération fonctionnelle, par des facteurs externes tels que des médicaments, est maintenant largement d’actualité avec pour objectif d’améliorer la récupération et de réduire le handicap final. Cet article rassemble les arguments précliniques et cliniques qui soutiennent le rôle des inhibiteurs de la recapture de la sérotonine dans la récupération de la fonction motrice après accident vasculaire cérébral ischémique.Permalink : ./index.php?lvl=notice_display&id=34535
in Annals of physical and rehabilitation medicine > Vol. 57, n°8 (Novembre 2014) . - p.509-519[article] Monoaminergic drugs for motor recovery after ischemic stroke = Médicaments monoaminergiques dans la récupération motrice après accident vasculaire cérébral ischémique [texte imprimé] . - 2014 . - p.509-519.
Langues : Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 57, n°8 (Novembre 2014) . - p.509-519
Mots-clés : Stroke Recovery Fluoxetine Brain plasticity Monoaminergic drugs Ischémie cérébrale Récupération fonctionnelle Fluoxétine Plasticité cérébrale Médicaments monoaminergiques Résumé : Today, administering rTPA thrombolytic therapy within the first hours of a stroke is the only validated drug therapy for improving the spontaneous – and most of the time incomplete – recovery of neurological functions post-stroke. However in the past decade, thanks in part to the considerable advances of neuroimaging techniques, we have learned that spontaneous recovery of neurological functions was associated with a wide intracerebral reorganization of the damaged human brain. The question of whether lesioned-brain plasticity can be modulated by external factors like pharmacological agents is now addressed in the hope of improving recovery and reducing the chronic impairments of stroke patients. In this paper, we review the preclinical and clinical evidence for a direct action of SSRIs in promoting recovery in ischemic stroke patients.
La thrombolyse IV par le rTPA en urgence, est actuellement la seule thérapeutique médicamenteuse validée (bénéficiant d’une autorisation de mise sur le marché) capable d’améliorer la récupération fonctionnelle après un accident vasculaire cérébral ischémique. Toutefois, la dernière décennie nous a appris que la récupération fonctionnelle spontanée s’accompagnait d’une réorganisation intracérébrale constante et complexe du cerveau lésé. La modulation de cette plasticité cérébrale base rationnelle de la récupération fonctionnelle, par des facteurs externes tels que des médicaments, est maintenant largement d’actualité avec pour objectif d’améliorer la récupération et de réduire le handicap final. Cet article rassemble les arguments précliniques et cliniques qui soutiennent le rôle des inhibiteurs de la recapture de la sérotonine dans la récupération de la fonction motrice après accident vasculaire cérébral ischémique.Permalink : ./index.php?lvl=notice_display&id=34535 Exemplaires (1)
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Exclu du prêtA qualitative exploration of a community-based singing activity on the recovery process of people living with mental illness / Martin Lagacé in The British Journal of Occupational Therapy, Vol.79 N°3 (March 2016)
[article]
Titre : A qualitative exploration of a community-based singing activity on the recovery process of people living with mental illness Type de document : texte imprimé Auteurs : Martin Lagacé ; Catherine Briand ; Julie Desrosiers Année de publication : 2016 Article en page(s) : p.178-187 Langues : Anglais (eng) Mots-clés : Recovery mental health meaningful activity community-based service singing activity Résumé : Introduction This study first aims to qualitatively explore the benefits of a community-based singing activity taking place in Montreal, Canada. The second aim is to identify the activity’s essential components that potentially explain these benefits.
Method An exploratory evaluative design involving qualitative descriptive methods was used. Thirteen individuals with various mental illnesses, the voice teacher and the activity coordinator participated in a group interview.
Findings Four main benefits emerged from the participants’ interviews: (1) rediscovering identity and gaining self-confidence; (2) resuming and engaging in meaningful occupations and projects; (3) learning to collaborate with others and improving social skills; (4) improving physical condition and cognitive skills. The essential components of the activity were identified as: a normalizing environment and the absence of stigma; high expectations and support for participants; teacher-led stress relief exercises and activities; the use of singing as an activity to express emotions and stimulate cognitive functions.
Conclusion This community-based singing activity appears to have contributed to the recovery process of its participants. There is a clear role for occupational therapists to promote, facilitate and support such activities outside traditional mental health services, since the participants were looking for occupational participation opportunities in normalizing community contexts.Permalink : ./index.php?lvl=notice_display&id=42952
in The British Journal of Occupational Therapy > Vol.79 N°3 (March 2016) . - p.178-187[article] A qualitative exploration of a community-based singing activity on the recovery process of people living with mental illness [texte imprimé] / Martin Lagacé ; Catherine Briand ; Julie Desrosiers . - 2016 . - p.178-187.
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Vol.79 N°3 (March 2016) . - p.178-187
Mots-clés : Recovery mental health meaningful activity community-based service singing activity Résumé : Introduction This study first aims to qualitatively explore the benefits of a community-based singing activity taking place in Montreal, Canada. The second aim is to identify the activity’s essential components that potentially explain these benefits.
Method An exploratory evaluative design involving qualitative descriptive methods was used. Thirteen individuals with various mental illnesses, the voice teacher and the activity coordinator participated in a group interview.
Findings Four main benefits emerged from the participants’ interviews: (1) rediscovering identity and gaining self-confidence; (2) resuming and engaging in meaningful occupations and projects; (3) learning to collaborate with others and improving social skills; (4) improving physical condition and cognitive skills. The essential components of the activity were identified as: a normalizing environment and the absence of stigma; high expectations and support for participants; teacher-led stress relief exercises and activities; the use of singing as an activity to express emotions and stimulate cognitive functions.
Conclusion This community-based singing activity appears to have contributed to the recovery process of its participants. There is a clear role for occupational therapists to promote, facilitate and support such activities outside traditional mental health services, since the participants were looking for occupational participation opportunities in normalizing community contexts.Permalink : ./index.php?lvl=notice_display&id=42952 Exemplaires (1)
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Exclu du prêtFood skills group value, meaning, and use with inpatients in a mental health setting / Gina De Vos in The British Journal of Occupational Therapy, Vol. 82 Issue 6 (Juin 2019)
[article]
Titre : Food skills group value, meaning, and use with inpatients in a mental health setting Type de document : texte imprimé Auteurs : Gina De Vos ; Leanne L. Leclair Année de publication : 2019 Article en page(s) : p. 326-336 Note générale : doi.org/10.1177/0308022618823660 Langues : Anglais (eng) Mots-clés : Food skills group meal preparation recovery mental health inpatient meaningful occupation Résumé : Introduction
Occupational therapists use food skills groups to support mental health recovery and engagement in meaningful occupation. Research examining participants’ experiences in these mental health groups is sparse.
Method
Researchers used a convergent parallel mixed methods design. Following participation in an inpatient food skills group, 60 participants completed a questionnaire, and 20 also participated in a semi-structured interview. The questionnaire data was analysed using descriptive and correlational statistics. The interview data was analysed using thematic analysis. Triangulation was used to combine and interpret findings from the different methods to gain a more complete understanding of the participants’ experiences.
Findings
Participants strongly agreed/agreed that they enjoyed participating, felt having the opportunity to participate was important to their recovery, and after discharge would use the skills they had learnt. Age, sex, and level of education were associated with some of the questionnaire responses. Three main themes emerged from the interview data: importance of engaging/doing, connections with food, and being involved in a group process.
Conclusion
Individuals who participated in the food skills group valued having the opportunity to build skills and engage in meaningful activities with others while in hospital. They identified the food skills group as important to their recovery.Permalink : ./index.php?lvl=notice_display&id=84440
in The British Journal of Occupational Therapy > Vol. 82 Issue 6 (Juin 2019) . - p. 326-336[article] Food skills group value, meaning, and use with inpatients in a mental health setting [texte imprimé] / Gina De Vos ; Leanne L. Leclair . - 2019 . - p. 326-336.
doi.org/10.1177/0308022618823660
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Vol. 82 Issue 6 (Juin 2019) . - p. 326-336
Mots-clés : Food skills group meal preparation recovery mental health inpatient meaningful occupation Résumé : Introduction
Occupational therapists use food skills groups to support mental health recovery and engagement in meaningful occupation. Research examining participants’ experiences in these mental health groups is sparse.
Method
Researchers used a convergent parallel mixed methods design. Following participation in an inpatient food skills group, 60 participants completed a questionnaire, and 20 also participated in a semi-structured interview. The questionnaire data was analysed using descriptive and correlational statistics. The interview data was analysed using thematic analysis. Triangulation was used to combine and interpret findings from the different methods to gain a more complete understanding of the participants’ experiences.
Findings
Participants strongly agreed/agreed that they enjoyed participating, felt having the opportunity to participate was important to their recovery, and after discharge would use the skills they had learnt. Age, sex, and level of education were associated with some of the questionnaire responses. Three main themes emerged from the interview data: importance of engaging/doing, connections with food, and being involved in a group process.
Conclusion
Individuals who participated in the food skills group valued having the opportunity to build skills and engage in meaningful activities with others while in hospital. They identified the food skills group as important to their recovery.Permalink : ./index.php?lvl=notice_display&id=84440 Exemplaires (1)
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Exclu du prêtGABAergic drug use and global, cognitive, and motor functional outcomes after stroke / A.J.-P. Schwitzguébel in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)
[article]
Titre : GABAergic drug use and global, cognitive, and motor functional outcomes after stroke Type de document : texte imprimé Auteurs : A.J.-P. Schwitzguébel ; Charles Benaïm ; Stefano Carda ; [et al...] Année de publication : 2016 Article en page(s) : p. 320-325 Langues : Français (fre) Mots-clés : Recovery Rehabilitation Stroke GABA-A receptor agonists Benzodiazepines Minimal clinically important difference Functional independence measure Résumé : Background
In animal models and healthy volunteers, the use of GABA A receptor agonists (GABA-AGs) seem deleterious for functional recovery. The agents are widely used for subacute stroke, but their effect on functional recovery remains unclear.
Objectives
We aimed to evaluate the association between GABA-AG use and functional recovery after stroke.
Methods
We retrospectively recruited 434 survivors of subacute stroke admitted for inpatient rehabilitation between 2000 and 2013 in our institution (107 with and 327 without GABA-AG use). We used multivariate regression to assess the association of GABA-AG use and successful functional recovery, defined as reaching, between admission and discharge, the minimal clinically important difference (MCID) of 22 points on the global Functional Independence Measure (FIM). Secondary analyses were the associations of GABA-AG with cognitive and motor FIM MCID and constant GABA-AG exposure (24h/24 GABA-AG) with global, cognitive and motor FIM MCID. A new estimation of the MCID was performed with the standard error of measurement.
Results
Reaching the global FIM MCID was associated with GABA-AG use (adjusted odds ratio [aOR] 0.54 [95% CI 0.31–0.91], P=0.02) as well as 24h/24 GABA-AG use (aOR 0.25 [0.08–0.83]; P=0.02). Furthermore, GABA-AG and 24h/24 GABA-AG use was inversely but not always significantly associated with reaching the cognitive FIM MCID (aOR 0.56, P=0.07; aOR 0.26, P=0.06, respectively) and motor FIM MCID (aOR 0.51, P=0.07; aOR 0.13, P=0.01, respectively). The estimated MCID was 19 for global FIM, 4 for cognitive FIM, and 16 for motor FIM.
Conclusions
GABA-AG use is associated with not reaching successful functional recovery during stroke rehabilitation. Randomised trials are needed to formally establish the potential deleterious effect of GABA-AG use on functional recovery.Permalink : ./index.php?lvl=notice_display&id=47166
in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 320-325[article] GABAergic drug use and global, cognitive, and motor functional outcomes after stroke [texte imprimé] / A.J.-P. Schwitzguébel ; Charles Benaïm ; Stefano Carda ; [et al...] . - 2016 . - p. 320-325.
Langues : Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 320-325
Mots-clés : Recovery Rehabilitation Stroke GABA-A receptor agonists Benzodiazepines Minimal clinically important difference Functional independence measure Résumé : Background
In animal models and healthy volunteers, the use of GABA A receptor agonists (GABA-AGs) seem deleterious for functional recovery. The agents are widely used for subacute stroke, but their effect on functional recovery remains unclear.
Objectives
We aimed to evaluate the association between GABA-AG use and functional recovery after stroke.
Methods
We retrospectively recruited 434 survivors of subacute stroke admitted for inpatient rehabilitation between 2000 and 2013 in our institution (107 with and 327 without GABA-AG use). We used multivariate regression to assess the association of GABA-AG use and successful functional recovery, defined as reaching, between admission and discharge, the minimal clinically important difference (MCID) of 22 points on the global Functional Independence Measure (FIM). Secondary analyses were the associations of GABA-AG with cognitive and motor FIM MCID and constant GABA-AG exposure (24h/24 GABA-AG) with global, cognitive and motor FIM MCID. A new estimation of the MCID was performed with the standard error of measurement.
Results
Reaching the global FIM MCID was associated with GABA-AG use (adjusted odds ratio [aOR] 0.54 [95% CI 0.31–0.91], P=0.02) as well as 24h/24 GABA-AG use (aOR 0.25 [0.08–0.83]; P=0.02). Furthermore, GABA-AG and 24h/24 GABA-AG use was inversely but not always significantly associated with reaching the cognitive FIM MCID (aOR 0.56, P=0.07; aOR 0.26, P=0.06, respectively) and motor FIM MCID (aOR 0.51, P=0.07; aOR 0.13, P=0.01, respectively). The estimated MCID was 19 for global FIM, 4 for cognitive FIM, and 16 for motor FIM.
Conclusions
GABA-AG use is associated with not reaching successful functional recovery during stroke rehabilitation. Randomised trials are needed to formally establish the potential deleterious effect of GABA-AG use on functional recovery.Permalink : ./index.php?lvl=notice_display&id=47166 Exemplaires (1)
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Exclu du prêtA Photovoice study of user experiences of an occupational therapy department within an acute inpatient mental health setting / Mary Birken in The British Journal of Occupational Therapy, Vol. 82 Issue 9 (Septembre 2019)
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