ABSTRACT
AIM: The aim of this study was to analyze the effect of vitamin D deficiency on muscle strength and quality of life in postmenopausal women. METHODS: Self-sufficient, community-dwelling, postmenopausal women over 55 years old attending the Physical Medicine and Rehabilitation outpatient clinic were included in the study. 25-Hydroxyvitamin D levels below 20 ng/ml were accepted as indicative of vitamin D deficiency. A computerized isokinetic dynamometer (Cybex 770 Norm, Lumex Inc., Ronkonkoma, NY, USA) was used for testing knee extensor muscle strength. RESULTS: Forty-nine postmenopausal women with median age 64.3 years (interquartile range 59.0-69.5 years) were included in the study. Vitamin D deficiency was detected in 49% of the participants. There was no relation between vitamin D deficiency and knee muscle strength in both right and left legs. Vitamin D deficiency was found not to be associated with any of the domains of SF-36. CONCLUSIONS: Vitamin D deficiency is not related to decreased muscle strength and lowered quality of life in postmenopausal women. Other factors rather than vitamin D deficiency should be investigated for illuminating the causalities of these two common clinical conditions.
Subject(s)
Muscle Weakness , Postmenopause , Quality of Life , Vitamin D Deficiency , Female , Humans , Independent Living/psychology , Independent Living/statistics & numerical data , Middle Aged , Muscle Strength , Muscle Strength Dynamometer , Muscle Weakness/blood , Muscle Weakness/diagnosis , Muscle Weakness/epidemiology , Muscle Weakness/etiology , Postmenopause/physiology , Postmenopause/psychology , Prevalence , Statistics as Topic , Turkey/epidemiology , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/complications , Vitamin D Deficiency/epidemiologyABSTRACT
STUDY DESIGN: Retrospective review of medical notes. OBJECTIVE: To evaluate spinal cord injury (SCI) patients' compliance with bladder emptying method at long-term period after discharge and determine the frequency of urinary tract infections (UTIs). SETTING: Inpatient rehabilitation unit of tertiary research hospital. METHODS: Bladder management method of 164 new spinal cord injured patients were noted at discharge from rehabilitation center and follow-up. Patients were questioned whether they continued the initial bladder emtying method at follow-up, reasons for discontinuation and the history of treated UTIs. RESULTS: The most common bladder management method at discharge from inpatient rehabilitation center was clean intermittent catheterization (CIC) (63.4%). At follow-up 42% of the patients who used CIC changed their bladder emptying method. Rate of reverting to urethral indwelling catheter (IC) was 21.4%. Reasons for the patients who switched to IC application were recurrent UTIs, incontinence, nephrolithiasis, dependence on care givers and urethral strictures. For all patients, the frequency of treated UTI in 1 year was 38.8%. The number of UTIs were highest in patients using IC. CONCLUSION: Many factors, including urological complications, patient's preference, living environment, life-style and level of injury should be considered in deciding the method of bladder management in SCI patients. The CIC is a reliable and effective method in selected SCI patients. Despite changes in bladder emptying method, CIC was the most preferred method at long-term follow-up. Education of patients on catheterization technique and periodic follow-up is necessary to maintain patient compliance.
Subject(s)
Intermittent Urethral Catheterization/methods , Patient Compliance , Spinal Cord Injuries/complications , Urinary Bladder, Neurogenic , Adult , Aged , Female , Humans , Longitudinal Studies , Male , Middle Aged , Patient Discharge , Retrospective Studies , Severity of Illness Index , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/psychology , Urinary Bladder, Neurogenic/rehabilitation , Young AdultABSTRACT
STUDY DESIGN: Retrospective, 12-year case series. OBJECTIVE: To compare neurological and functional outcomes, and complications of patients with traumatic vs non-traumatic spinal cord injury (SCI) after in-patient rehabilitation. SETTING: In-patient rehabilitation unit of a tertiary research hospital. MATERIALS AND METHODS: The sample consisted of 165 newly injured patients with traumatic and non-traumatic spinal cord lesions whose medical records were retrospectively reviewed. Demographic characteristics, etiology, American Spinal Injury Association (ASIA) impairment scale, functional independence measurement (FIM) subgroup scores, length of stay and medical complications in both groups were compared. RESULTS: In all, 38 patients (23%) were non-traumatic and 127 patients (77%) were traumatic in etiology. Compared with patients with traumatic SCI (mean age 37.81±13.65 years), patients with non-traumatic SCI (mean age 53.97±14.48 years) were significantly older (P<0.05). Incomplete SCI was significantly higher in the non-traumatic group when compared with the traumatic group (P<0.001). In the non-traumatic group, admission motor FIM scores were significantly higher (28.29±16.04) than scores from the traumatic group (36.60±21.65; P=0.029); however, there was no significant difference in discharge motor FIM scores between the two groups (P=0.140). ASIA impairment scale scores were significantly higher in non-traumatic group both at admission and discharge (P=0.000 and P=0.000, respectively). The length of hospital stay was significantly shorter in the non-traumatic group (P=0.002). CONCLUSION: According to the results of this study, although patients with non-traumatic SCI had shorter length of stay and higher ASIA scores, there was no significant difference in functional outcomes between traumatic and non-traumatic SCI patients.