Relationships between take-off speed and performance in F-44 and F-46 paralympic discus throwers / Relações entre a velocidade de decolagem e desempenho em lançadores de disco paraolímpicos da classe F-44 e F-46 / Relaciones entre la velocidad de despegue y el rendimiento en los lanzadores de discos paralímpicos de las clases F-44 y F-46

ABSTRACT This study aimed to analyze discus throwing in Paralympic athletes from two functional classes (FCs). Seven athletes from two classes F-44 (N=4) and F-46 (N=3) performed three throws each during a regional competition and were evaluated through 3D kinemetry. The assessed athletes presented a similar throwing technique, with a preparation movement opposite to the throw preceding the shot. Class F-44 showed a weak correlation between take-off speed and range (r= 0.15; p>0.05). F-46 showed a strong correlation between take-off speed and range (r=0.77; p=0.014). We conclude that athletes from the assessed FCs present important differences in terms of performance.

RESUMO O presente estudo teve como objetivo a análise do lançamento de disco em atletas paralímpicos de duas classes funcionais (CFs). Sete atletas de duas classes F-44 (N=4) e F-46 (N=3) executaram 3 lançamentos cada durante uma competição regional, e foram avaliados por meio de cinemetria 3D. Os atletas avaliados apresentaram uma técnica de lançamento semelhante, com movimento de preparação em direção oposta ao lançamento que antecedia o arremate. Na classe F-44 houve uma fraca correlação entre a velocidade de decolagem e o alcance do disco (r= 0,15; p>0,05). Na F-46 houve forte correlação entre a velocidade de decolagem e o alcance (r= 0,77; p=0,014). Conclui-se que atletas das CFs avaliadas apresentam diferenças importantes em termos de desempenho.

RESUMEN El presente estudio tuvo como objetivo analizar el lanzamiento de disco en atletas paralímpicos de dos clases funcionales (FC). Siete atletas de dos clases F-44 (N = 4) y F-46 (N = 3) realizaron 3 lanzamientos cada uno durante una competencia regional, y fueron evaluados usando cinemetría 3D. Los deportistas evaluados presentaron una técnica de lanzamiento similar, con un movimiento de preparación en sentido contrario al lanzamiento que precedió al tiro. En la clase F-44 hubo una correlación débil entre la velocidad de despegue y el alcance del disco (r = 0,15; p> 0,05). En el F-46 hubo una fuerte correlación entre la velocidad de despegue y el alcance (r = 0,77; p = 0,014). Se concluye que los deportistas de los CF evaluados presentan importantes diferencias en cuanto a rendimiento.

Functional Communication Profiles in Children with Cerebral Palsy in Relation to Gross Motor Function and Manual and Intellectual Ability

PURPOSE: The aim of the present study was to investigate communication function using classification systems and its association with other functional profiles, including gross motor function, manual ability, intellectual functioning, and brain magnetic resonance imaging (MRI) characteristics in children with cerebral palsy (CP). MATERIALS AND METHODS: This study recruited 117 individuals with CP aged from 4 to 16 years. The Communication Function Classification System (CFCS), Viking Speech Scale (VSS), Speech Language Profile Groups (SLPG), Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and intellectual functioning were assessed in the children along with brain MRI categorization. RESULTS: Very strong relationships were noted among the VSS, CFCS, and SLPG, although these three communication systems provide complementary information, especially for children with mid-range communication impairment. These three communication classification systems were strongly related with the MACS, but moderately related with the GMFCS. Multiple logistic regression analysis indicated that manual ability and intellectual functioning were significantly related with VSS and CFCS function, whereas only intellectual functioning was significantly related with SLPG functioning in children with CP. Communication function in children with a periventricular white matter lesion (PVWL) varied widely. In the cases with a PVWL, poor functioning was more common on the SLPG, compared to the VSS and CFCS. CONCLUSION: Very strong relationships were noted among three communication classification systems that are closely related with intellectual ability. Compared to gross motor function, manual ability seemed more closely related with communication function in these children.

Functional Class and Targeted Therapy Are Related to the Survival in Patients with Pulmonary Arterial Hypertension

PURPOSE: Pulmonary arterial hypertension (PAH) is an orphan disease showing poor prognosis. The purpose of study was to evaluate clinical factors influencing outcomes in PAH. MATERIALS AND METHODS: Patients who were diagnosed with PAH at a single center were reviewed retrospectively. Forty patients (34.9+/-14.5 years, 80% of female) were enrolled. RESULTS: Causes were congenital heart disease in 24 (60%), connective tissue disease in 8 (20%) and idiopathic PAH in 6 (15%). Sixteen patients (40%) were WHO functional class III or IV at the time of diagnosis. Twenty seven patients (67.5%) received molecular targeted therapy. During follow-up (53.6+/-45.5 months), 10 patients (25%) died and 1-, 2-, and 8 year survival rates were 91.3%, 78.7%, and 66.8%, respectively. As expected, median survival of patients with functional class I or II were significantly longer than patients with III or IV (p=0.041). Interestingly, patients with molecular targeted therapy showed longer survival than conventional therapy (p=0.021). CONCLUSION: WHO functional class at the time of diagnosis was the strong predictor of survival, and molecular targeted therapy could significantly improve the survival. Therefore, early screening and intensive management would be crucial to improve the prognosis in the patient with PAH.

Comparação entre variáveis psicossociais e de desempenho funcional em um grupo de pacientes com lombalgia crônica / Comparison of psycho-social and functional performance variables in a group of chronic low back pain patients

JUSTIFICATIVA E OBJETIVOS: A dor lombar é um dos principais problemas do aparelho musculoesquelético e gera alto custo para o sistema de saúde. Independente da etiologia, os portadores de dor lombar crônica tendem a reduzir sua rotina de atividades físicas, o que compromete o condicionamento físico e o estado de humor. Portanto, estabelecer a relação entre as variáveis envolvidas na etiologia da lombalgia prejudiciais ao desempenho entre os seus portadores se faz necessário. O objetivo deste estudo foi comparar a distância percorrida no teste de caminhada de seis minutos (TC6) e as variáveis psicossociais: percepção de humor e nível de incapacidade entre portadores de dor lombar crônica e sujeitos saudáveis. MÉTODO: Estudo observacional transversal cuja amostra foi composta por voluntários de ambos os sexos, sedentários, com idade entre 30 e 58 anos, dividida em grupo controle (GC) e grupo lombar (GL). Os voluntários responderam a uma bateria de questionários: a saber, o Índice de Incapacidade de Oswestry e a Escala de Humor de Brunel para determinação do nível de incapacidade e da percepção de humor, respectivamente. Em seguida, realizaram o TC6. RESULTADOS: O GL (25,44 ± 14,3%) apresentou níveis de incapacidade significativamente maiores que o GC (1,25 ± 2,1%). Também se observou que o GL apresentou níveis de tensão, fadiga e confusão mental significativamente mais alto que o GC. CONCLUSÃO: Portadores de dor lombar crônica não apresentaram diferença, em relação aos seus pares livres de dor, no desempenho do TC6, no estado de humor de depressão, de raiva e de vigor. Contudo, apresentaram maiores níveis de incapacidade e piores índices no estado de humor de fadiga, de tensão e de confusão mental.

BACKGROUND AND OBJECTIVES: Low back pain is a major musculoskeletal system problem and generates high costs for the health system. Regardless of etiology, chronic low back pain patients tend to decrease their physical activities routine, thus impairing fitness and mood. So, it is necessary to establish the relationship among variables involved in the etiology of low back pain, which are noxious for patients' performance. This study aimed at comparing the distance covered during a six-minute walking test (6MWT) and the following psycho-social variables: mood perception and level of disability between chronic low back pain and healthy individuals. METHOD: This was an observational transversal study with volunteers of both genders, sedentary, aged between 30 and 58 years, who were divided in control group (CG) and low back pain group (LG). Volunteers answered a battery of questionnaires, as follows: Oswestry Disability Index and Brunel Mood Scale to determine the level of disability and mood perception, respectively. Then, volunteers made 6MWT. RESULTS: LG (25.44 ± 14.3%) had significantly higher levels of disability as compared to CG (1.25 ± 2.1%). It was also observed that LG had significantly higher levels of stress, fatigue and mental confusion as compared to CG. CONCLUSION: Low back pain patients were no different from their pain-free peers in the 6MWT performance, in depression, anger and vigor mood state. However, they presented higher levels of disability and poorer indices of fatigue, stress and mental confusion mood states.

Long-term outcome after pneumonectomy at Siriraj Hospital.

Objective: The purpose of this study is to identify predictors of long term survival following pneumonectomy and compare New York Heart Association (NYHA) functional classification and ECOG performance status before and after surgery at Siriraj Hospital. Methods: All fifty three patients having a pneumonectomy between 1998 and 2009 were retrospectively studied. We compared each patient’s status before and after surgery. The parameters of survival were tested by univariate analysis, the Kaplan-Meier method, and differences in survival were determined by log-rank analysis. Results: There were 35 males (66%) and 18 females (34%) with a mean age (standard deviation) of 51±17 years (range 0.7-82 years). The majority of patients were lung cancer (77%) and destroyed lungs from infectious (12%) diseases. The mean follow-up time was 33 months, median 22 months, standard deviation 24 months, ranging between 0 and 131 months. Post-operative complication occurred in 11% of patients (bronchopleural fistula, bleeding, cardiac herniation and recurrent laryngeal nerve injury). Hospital mortality occurred in 7.5% (4 deaths). Late death occurred in 52.8% (28 deaths) including metastasis 30% (16 patients), pneumonia 19% (10 patients), and miscellaneous causes 3.7% (2 patients). Using univariate analysis, non lung cancer (P = 0.035) and the slow growing lung cancer (P = 0.007) were independent predictors of long term survival. The decrease in NYHA functional classification and ECOG performance status after surgery was not significant. Conclusion: Long-term survival after pneumonectomy for lung cancer occurred in 20% and non lung cancer in 60% of patients. Non lung cancer and the slow growing lung cancer were independent predictors of long term survival. Decreases in NYHA functional classification and ECOG performance status after pneumonectomy were not significant.

Neurological Prognosis of Spinal Cord Injured Patients Using ASIA2000 Scale / 中国康复理论与实践

@#ObjectiveTo investigate the application of ASIA2000 classification in prognosis of spinal cord injury patients' neurological function. MethodsConsecutive observation was done to the 42 patients using ASIA2000 classification 1 month, 3 months and 12 months after injury respectively. ResultsTo the incomplete SCI patients, motor score, pin prick score and light touch score were significantly improved 3 months after injury compared with that in 1 month after injury (P<0.05), but no significant improvement was observed in the complete ones, nor did in all the patients between 3 months and 12 months after injury. ConclusionThe Standard Neurological Classification is more sensitive than Standard Impairment Classification in ASIA2000. Individuals within 3 months after injury got better neurological recovery than those more than 3 months after injury. Incomplete injuried individuals may get better neurological prognosis than complete ones.

The Functional Prognosis of Ambulation in Each Type of Cerebral Palsy

OBJECTIVE: This study is to investigate the prognosis of functional ambulation in each type of cerebral palsy (CP). METHOD: Medical records of 385 patients were retrospectively reviewed that visited outpatients department and were diagnosed as CP. Various information was surveyed including CP type, gestational age at birth, birth weight and associated problems such as mental retardation and seizure and gross motor functional status such as ambulational status and Gross Motor Functional Classification System (GMFCS). All of them were compared between each type. The influences of seizure and mental retardation on gross motor function were also investigated. RESULTS: Functional ambulation was achieved in 58.2% in overall. Inspecting in each type, 93.7% of spastic hemiplegia, 67.6% of spastic diplegia, 12.2% of spastic quadriplegia, 78.7% of dyskinetic type can ambulate functionally. Birth weight or gestational age had no independent influences on ambulation within each type. Seizure influenced negatively on ambulation of diplegic CPs with significance and mental retardation in diplegic CPs and quadriplegic CPs than any other type. CONCLUSION: Over the half of CP patients achieved functional ambulation. Hemiplegia and diplegia had good prognosis among all types. Seizure and mental retardation negatively affected ambulation function of CP patients, especially in diplegic CPs and quadriplegic CPs.

Sport-related Characteristics of Spinal Cord Injured Shooting Players and Functional Classification

OBJECTIVE: To categorize the spinal cord injury level and American Spinal Injury Association (ASIA) impairment scale into functional classification of shooting and to give information about shooting sport for the disabled to medical staffs, and to remind importance of sports activities for rehabilitation. METHOD: Seventy nine spinal cord injured players were classified into each functional classes by two international classifier. During the classification process, demographic data such as age, sex, duration, injury type and questions including attitude toward disabled shooting or benefits or difficulties from shooting were collected by interview. RESULTS: Functional classes of players were closely related to injury level and ASIA impairment scale. Average duration of shooting experience of men (8.01 years) was significantly different from that of women (5.29 years)(p<0.05). Self-motivated (39.3%) and disabled friends (21.5%) were leading motive providers followed by medical staff (20.2%), other shooting player or coach (12.7%), family (6.3%). Promoting self confidence (32.5%) was number one benefit from shooting and followed by making friends (22.1%), increasing independence (18.3%), and increasing in social participation (12.7%). CONCLUSION: We report the functional classification result of spinal cord inured player and we found that sports activities promote social activities and help to develop self confidence.

Reimbursement for the Long-Term Care

Reimbursement system for long-term care have to be based on the several principles: reimbursing cost of the care provision, maintaining quality, containing unnecessary cost, and minimizing administrative cost. Although it is difficult to adopt single system to satisfy all stakeholders, first of all characteristics of long-term care should be considered in developing the system. Among them, prepayment system based on the functional classification of the subjects would be given the highest priority, because resource utilization of the elderly people who need long-term care would be dependent on the functional status rather than diseases or specific problems.